code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
APR-DRG,001-1,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,15769.98,17346.98,8
APR-DRG,001-2,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,15769.98,17346.98,8
APR-DRG,001-3,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,21907.45,24098.2,8
APR-DRG,001-4,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,51845.23,57029.75,8
APR-DRG,002-1,HEART AND/OR LUNG TRANSPLANT,,,65151.96,71667.16,8
APR-DRG,002-2,HEART AND/OR LUNG TRANSPLANT,,,65151.96,71667.16,8
APR-DRG,002-3,HEART AND/OR LUNG TRANSPLANT,,,65151.96,71667.16,8
APR-DRG,002-4,HEART AND/OR LUNG TRANSPLANT,,,146986.24,161684.86,8
APR-DRG,004-1,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,23371.26,25708.39,8
APR-DRG,004-2,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,23371.26,25708.39,8
APR-DRG,004-3,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,44760.58,49236.64,8
APR-DRG,004-4,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,59071.23,64978.35,8
APR-DRG,005-1,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,18157.57,19973.33,8
APR-DRG,005-2,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,18157.57,19973.33,8
APR-DRG,005-3,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,30180.67,33198.74,8
APR-DRG,005-4,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,41702.05,45872.26,8
APR-DRG,006-1,PANCREAS TRANSPLANT,,,15478.81,17026.69,8
APR-DRG,006-2,PANCREAS TRANSPLANT,,,15478.81,17026.69,8
APR-DRG,006-3,PANCREAS TRANSPLANT,,,15478.81,17026.69,8
APR-DRG,006-4,PANCREAS TRANSPLANT,,,15478.81,17026.69,8
APR-DRG,007-1,ALLOGENEIC BONE MARROW TRANSPLANT,,,49088.82,53997.7,8
APR-DRG,007-2,ALLOGENEIC BONE MARROW TRANSPLANT,,,49088.82,53997.7,8
APR-DRG,007-3,ALLOGENEIC BONE MARROW TRANSPLANT,,,61321.95,67454.15,8
APR-DRG,007-4,ALLOGENEIC BONE MARROW TRANSPLANT,,,125645.7,138210.27,8
APR-DRG,008-1,AUTOLOGOUS BONE MARROW TRANSPLANT,,,22447.98,24692.78,8
APR-DRG,008-2,AUTOLOGOUS BONE MARROW TRANSPLANT,,,22447.98,24692.78,8
APR-DRG,008-3,AUTOLOGOUS BONE MARROW TRANSPLANT,,,36964.69,40661.16,8
APR-DRG,008-4,AUTOLOGOUS BONE MARROW TRANSPLANT,,,49211.26,54132.39,8
APR-DRG,009-1,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,26673.68,29341.05,8
APR-DRG,009-2,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,26673.68,29341.05,8
APR-DRG,009-3,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,26673.68,29341.05,8
APR-DRG,009-4,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,65047.44,71552.18,8
APR-DRG,011-1,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,36613.79,40275.17,8
APR-DRG,011-2,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,36613.79,40275.17,8
APR-DRG,011-3,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,36613.79,40275.17,8
APR-DRG,011-4,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,36613.79,40275.17,8
APR-DRG,020-1,OPEN CRANIOTOMY FOR TRAUMA,,,8224.44,9046.88,8
APR-DRG,020-2,OPEN CRANIOTOMY FOR TRAUMA,,,11068.45,12175.3,8
APR-DRG,020-3,OPEN CRANIOTOMY FOR TRAUMA,,,15525.1,17077.61,8
APR-DRG,020-4,OPEN CRANIOTOMY FOR TRAUMA,,,25675.24,28242.76,8
APR-DRG,021-1,OPEN CRANIOTOMY EXCEPT TRAUMA,,,9304.5,10234.95,8
APR-DRG,021-2,OPEN CRANIOTOMY EXCEPT TRAUMA,,,12109.69,13320.66,8
APR-DRG,021-3,OPEN CRANIOTOMY EXCEPT TRAUMA,,,19197.33,21117.06,8
APR-DRG,021-4,OPEN CRANIOTOMY EXCEPT TRAUMA,,,30431.02,33474.12,8
APR-DRG,022-1,VENTRICULAR SHUNT PROCEDURES,,,7052.29,7757.52,8
APR-DRG,022-2,VENTRICULAR SHUNT PROCEDURES,,,8258.78,9084.66,8
APR-DRG,022-3,VENTRICULAR SHUNT PROCEDURES,,,12633.3,13896.63,8
APR-DRG,022-4,VENTRICULAR SHUNT PROCEDURES,,,37153.82,40869.2,8
APR-DRG,023-1,SPINAL PROCEDURES,,,7583.86,8342.25,8
APR-DRG,023-2,SPINAL PROCEDURES,,,11957.39,13153.13,8
APR-DRG,023-3,SPINAL PROCEDURES,,,17739.48,19513.43,8
APR-DRG,023-4,SPINAL PROCEDURES,,,26558.71,29214.58,8
APR-DRG,024-1,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,4219.23,4641.15,8
APR-DRG,024-2,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,5228.12,5750.93,8
APR-DRG,024-3,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,9265.18,10191.7,8
APR-DRG,024-4,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,18342.73,20177.0,8
APR-DRG,026-1,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,5807.97,6388.77,8
APR-DRG,026-2,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,7070.7,7777.77,8
APR-DRG,026-3,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,11080.89,12188.98,8
APR-DRG,026-4,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,27115.66,29827.23,8
APR-DRG,027-1,OTHER OPEN CRANIOTOMY,,,8234.89,9058.38,8
APR-DRG,027-2,OTHER OPEN CRANIOTOMY,,,10071.5,11078.65,8
APR-DRG,027-3,OTHER OPEN CRANIOTOMY,,,13990.6,15389.66,8
APR-DRG,027-4,OTHER OPEN CRANIOTOMY,,,25117.79,27629.57,8
APR-DRG,029-1,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,9852.5,10837.75,8
APR-DRG,029-2,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,11661.74,12827.91,8
APR-DRG,029-3,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,14265.85,15692.44,8
APR-DRG,029-4,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,24441.87,26886.06,8
APR-DRG,030-1,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,10869.85,11956.84,8
APR-DRG,030-2,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,12377.47,13615.22,8
APR-DRG,030-3,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,16896.83,18586.51,8
APR-DRG,030-4,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,25146.16,27660.78,8
APR-DRG,040-1,SPINAL DISORDERS AND INJURIES,,,3918.1,4309.91,8
APR-DRG,040-2,SPINAL DISORDERS AND INJURIES,,,8208.51,9029.36,8
APR-DRG,040-3,SPINAL DISORDERS AND INJURIES,,,15974.54,17571.99,8
APR-DRG,040-4,SPINAL DISORDERS AND INJURIES,,,15974.54,17571.99,8
APR-DRG,041-1,NERVOUS SYSTEM MALIGNANCY,,,3218.3,3540.13,8
APR-DRG,041-2,NERVOUS SYSTEM MALIGNANCY,,,3732.95,4106.25,8
APR-DRG,041-3,NERVOUS SYSTEM MALIGNANCY,,,5837.34,6421.07,8
APR-DRG,041-4,NERVOUS SYSTEM MALIGNANCY,,,8725.15,9597.67,8
APR-DRG,042-1,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,4929.48,5422.43,8
APR-DRG,042-2,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,5025.54,5528.09,8
APR-DRG,042-3,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,7788.92,8567.81,8
APR-DRG,042-4,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,16016.35,17617.99,8
APR-DRG,043-1,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,3702.09,4072.3,8
APR-DRG,043-2,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,6018.01,6619.81,8
APR-DRG,043-3,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,11473.1,12620.41,8
APR-DRG,043-4,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,21977.63,24175.39,8
APR-DRG,044-1,INTRACRANIAL HEMORRHAGE,,,2887.81,3176.59,8
APR-DRG,044-2,INTRACRANIAL HEMORRHAGE,,,5023.55,5525.91,8
APR-DRG,044-3,INTRACRANIAL HEMORRHAGE,,,7419.11,8161.02,8
APR-DRG,044-4,INTRACRANIAL HEMORRHAGE,,,11430.79,12573.87,8
APR-DRG,045-1,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,2465.24,2711.76,8
APR-DRG,045-2,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,3975.34,4372.87,8
APR-DRG,045-3,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,6140.45,6754.5,8
APR-DRG,045-4,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,11028.63,12131.49,8
APR-DRG,046-1,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,3034.64,3338.1,8
APR-DRG,046-2,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,3228.25,3551.08,8
APR-DRG,046-3,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,3938.51,4332.36,8
APR-DRG,046-4,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,3938.51,4332.36,8
APR-DRG,047-1,TRANSIENT ISCHEMIA,,,1990.9,2189.99,8
APR-DRG,047-2,TRANSIENT ISCHEMIA,,,2560.8,2816.88,8
APR-DRG,047-3,TRANSIENT ISCHEMIA,,,4843.87,5328.26,8
APR-DRG,047-4,TRANSIENT ISCHEMIA,,,4843.87,5328.26,8
APR-DRG,048-1,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,2545.87,2800.46,8
APR-DRG,048-2,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,3382.05,3720.26,8
APR-DRG,048-3,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,4978.26,5476.09,8
APR-DRG,048-4,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,10612.03,11673.23,8
APR-DRG,049-1,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,3960.91,4357.0,8
APR-DRG,049-2,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,7669.97,8436.97,8
APR-DRG,049-3,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,9434.91,10378.4,8
APR-DRG,049-4,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,18917.11,20808.82,8
APR-DRG,050-1,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,2999.3,3299.23,8
APR-DRG,050-2,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,6160.36,6776.4,8
APR-DRG,050-3,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,11136.14,12249.75,8
APR-DRG,050-4,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,24434.41,26877.85,8
APR-DRG,051-1,VIRAL MENINGITIS,,,2393.07,2632.38,8
APR-DRG,051-2,VIRAL MENINGITIS,,,3274.54,3601.99,8
APR-DRG,051-3,VIRAL MENINGITIS,,,6376.38,7014.02,8
APR-DRG,051-4,VIRAL MENINGITIS,,,6376.38,7014.02,8
APR-DRG,052-1,ALTERATION IN CONSCIOUSNESS,,,2292.03,2521.23,8
APR-DRG,052-2,ALTERATION IN CONSCIOUSNESS,,,3075.45,3383.0,8
APR-DRG,052-3,ALTERATION IN CONSCIOUSNESS,,,4963.83,5460.21,8
APR-DRG,052-4,ALTERATION IN CONSCIOUSNESS,,,10939.54,12033.49,8
APR-DRG,053-1,SEIZURE,,,2443.83,2688.21,8
APR-DRG,053-2,SEIZURE,,,3060.02,3366.02,8
APR-DRG,053-3,SEIZURE,,,4265.02,4691.52,8
APR-DRG,053-4,SEIZURE,,,8697.28,9567.01,8
APR-DRG,054-1,MIGRAINE AND OTHER HEADACHES,,,2622.52,2884.77,8
APR-DRG,054-2,MIGRAINE AND OTHER HEADACHES,,,3408.43,3749.27,8
APR-DRG,054-3,MIGRAINE AND OTHER HEADACHES,,,3722.0,4094.2,8
APR-DRG,054-4,MIGRAINE AND OTHER HEADACHES,,,4510.89,4961.98,8
APR-DRG,055-1,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,2156.15,2371.77,8
APR-DRG,055-2,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,3216.8,3538.48,8
APR-DRG,055-3,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,5756.21,6331.83,8
APR-DRG,055-4,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,9783.32,10761.65,8
APR-DRG,058-1,OTHER DISORDERS OF NERVOUS SYSTEM,,,4123.66,4536.03,8
APR-DRG,058-2,OTHER DISORDERS OF NERVOUS SYSTEM,,,6085.7,6694.27,8
APR-DRG,058-3,OTHER DISORDERS OF NERVOUS SYSTEM,,,9005.87,9906.46,8
APR-DRG,058-4,OTHER DISORDERS OF NERVOUS SYSTEM,,,15318.04,16849.84,8
APR-DRG,059-1,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,6446.56,7091.22,8
APR-DRG,059-2,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,6446.56,7091.22,8
APR-DRG,059-3,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,7496.76,8246.44,8
APR-DRG,059-4,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,9479.7,10427.67,8
APR-DRG,073-1,ORBIT AND EYE PROCEDURES,,,4531.8,4984.98,8
APR-DRG,073-2,ORBIT AND EYE PROCEDURES,,,5815.44,6396.98,8
APR-DRG,073-3,ORBIT AND EYE PROCEDURES,,,9983.9,10982.29,8
APR-DRG,073-4,ORBIT AND EYE PROCEDURES,,,19688.08,21656.89,8
APR-DRG,082-1,EYE INFECTIONS AND OTHER EYE DISORDERS,,,2779.8,3057.78,8
APR-DRG,082-2,EYE INFECTIONS AND OTHER EYE DISORDERS,,,3457.21,3802.93,8
APR-DRG,082-3,EYE INFECTIONS AND OTHER EYE DISORDERS,,,4824.46,5306.91,8
APR-DRG,082-4,EYE INFECTIONS AND OTHER EYE DISORDERS,,,8623.12,9485.43,8
APR-DRG,089-1,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,9064.6,9971.06,8
APR-DRG,089-2,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,10682.71,11750.98,8
APR-DRG,089-3,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,18035.13,19838.64,8
APR-DRG,089-4,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,25494.57,28044.03,8
APR-DRG,091-1,OTHER MAJOR HEAD AND NECK PROCEDURES,,,5902.54,6492.79,8
APR-DRG,091-2,OTHER MAJOR HEAD AND NECK PROCEDURES,,,12111.68,13322.85,8
APR-DRG,091-3,OTHER MAJOR HEAD AND NECK PROCEDURES,,,17435.37,19178.91,8
APR-DRG,091-4,OTHER MAJOR HEAD AND NECK PROCEDURES,,,33003.28,36303.61,8
APR-DRG,092-1,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,5365.99,5902.59,8
APR-DRG,092-2,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,6283.3,6911.63,8
APR-DRG,092-3,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,11621.42,12783.56,8
APR-DRG,092-4,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,16684.8,18353.28,8
APR-DRG,095-1,CLEFT LIP AND PALATE REPAIR,,,4771.7,5248.87,8
APR-DRG,095-2,CLEFT LIP AND PALATE REPAIR,,,6217.1,6838.81,8
APR-DRG,095-3,CLEFT LIP AND PALATE REPAIR,,,6919.89,7611.88,8
APR-DRG,095-4,CLEFT LIP AND PALATE REPAIR,,,6919.89,7611.88,8
APR-DRG,097-1,TONSIL AND ADENOID PROCEDURES,,,3435.8,3779.38,8
APR-DRG,097-2,TONSIL AND ADENOID PROCEDURES,,,4516.87,4968.56,8
APR-DRG,097-3,TONSIL AND ADENOID PROCEDURES,,,10123.26,11135.59,8
APR-DRG,097-4,TONSIL AND ADENOID PROCEDURES,,,10123.26,11135.59,8
APR-DRG,098-1,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,3704.58,4075.04,8
APR-DRG,098-2,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,5783.09,6361.4,8
APR-DRG,098-3,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,9677.8,10645.58,8
APR-DRG,098-4,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,17828.58,19611.44,8
APR-DRG,110-1,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,2995.81,3295.39,8
APR-DRG,110-2,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,4072.9,4480.19,8
APR-DRG,110-3,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,6233.03,6856.33,8
APR-DRG,110-4,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,10025.71,11028.28,8
APR-DRG,111-1,VERTIGO AND OTHER LABYRINTH DISORDERS,,,2445.83,2690.41,8
APR-DRG,111-2,VERTIGO AND OTHER LABYRINTH DISORDERS,,,2545.37,2799.91,8
APR-DRG,111-3,VERTIGO AND OTHER LABYRINTH DISORDERS,,,3298.93,3628.82,8
APR-DRG,111-4,VERTIGO AND OTHER LABYRINTH DISORDERS,,,3298.93,3628.82,8
APR-DRG,113-1,INFECTIONS OF UPPER RESPIRATORY TRACT,,,1999.86,2199.85,8
APR-DRG,113-2,INFECTIONS OF UPPER RESPIRATORY TRACT,,,2692.2,2961.42,8
APR-DRG,113-3,INFECTIONS OF UPPER RESPIRATORY TRACT,,,3857.88,4243.67,8
APR-DRG,113-4,INFECTIONS OF UPPER RESPIRATORY TRACT,,,8586.78,9445.46,8
APR-DRG,114-1,DENTAL DISEASES AND DISORDERS,,,2456.28,2701.91,8
APR-DRG,114-2,DENTAL DISEASES AND DISORDERS,,,4529.31,4982.24,8
APR-DRG,114-3,DENTAL DISEASES AND DISORDERS,,,4529.31,4982.24,8
APR-DRG,114-4,DENTAL DISEASES AND DISORDERS,,,4529.31,4982.24,8
APR-DRG,115-1,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,2646.41,2911.05,8
APR-DRG,115-2,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,3395.99,3735.59,8
APR-DRG,115-3,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,5088.26,5597.09,8
APR-DRG,115-4,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,14463.44,15909.78,8
APR-DRG,120-1,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,8240.36,9064.4,8
APR-DRG,120-2,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,10152.63,11167.89,8
APR-DRG,120-3,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,14847.19,16331.91,8
APR-DRG,120-4,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,30258.31,33284.14,8
APR-DRG,121-1,OTHER RESPIRATORY AND CHEST PROCEDURES,,,6721.3,7393.43,8
APR-DRG,121-2,OTHER RESPIRATORY AND CHEST PROCEDURES,,,8244.35,9068.79,8
APR-DRG,121-3,OTHER RESPIRATORY AND CHEST PROCEDURES,,,13139.99,14453.99,8
APR-DRG,121-4,OTHER RESPIRATORY AND CHEST PROCEDURES,,,22041.84,24246.02,8
APR-DRG,130-1,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,15580.84,17138.92,8
APR-DRG,130-2,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,15580.84,17138.92,8
APR-DRG,130-3,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,20231.6,22254.76,8
APR-DRG,130-4,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,26537.31,29191.04,8
APR-DRG,131-1,CYSTIC FIBROSIS - PULMONARY DISEASE,,,11685.13,12853.64,8
APR-DRG,131-2,CYSTIC FIBROSIS - PULMONARY DISEASE,,,11685.13,12853.64,8
APR-DRG,131-3,CYSTIC FIBROSIS - PULMONARY DISEASE,,,15464.87,17011.36,8
APR-DRG,131-4,CYSTIC FIBROSIS - PULMONARY DISEASE,,,16990.4,18689.44,8
APR-DRG,132-1,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,3330.78,3663.86,8
APR-DRG,132-2,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,4544.24,4998.66,8
APR-DRG,132-3,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,12376.47,13614.12,8
APR-DRG,132-4,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,22708.79,24979.67,8
APR-DRG,133-1,RESPIRATORY FAILURE,,,3500.51,3850.56,8
APR-DRG,133-2,RESPIRATORY FAILURE,,,3611.0,3972.1,8
APR-DRG,133-3,RESPIRATORY FAILURE,,,5461.06,6007.17,8
APR-DRG,133-4,RESPIRATORY FAILURE,,,8725.65,9598.22,8
APR-DRG,134-1,PULMONARY EMBOLISM,,,2176.56,2394.22,8
APR-DRG,134-2,PULMONARY EMBOLISM,,,2876.36,3164.0,8
APR-DRG,134-3,PULMONARY EMBOLISM,,,4690.57,5159.63,8
APR-DRG,134-4,PULMONARY EMBOLISM,,,7818.29,8600.12,8
APR-DRG,135-1,MAJOR CHEST AND RESPIRATORY TRAUMA,,,2251.21,2476.33,8
APR-DRG,135-2,MAJOR CHEST AND RESPIRATORY TRAUMA,,,2648.4,2913.24,8
APR-DRG,135-3,MAJOR CHEST AND RESPIRATORY TRAUMA,,,4287.91,4716.7,8
APR-DRG,135-4,MAJOR CHEST AND RESPIRATORY TRAUMA,,,6387.33,7026.06,8
APR-DRG,136-1,RESPIRATORY MALIGNANCY,,,3606.52,3967.17,8
APR-DRG,136-2,RESPIRATORY MALIGNANCY,,,3718.51,4090.36,8
APR-DRG,136-3,RESPIRATORY MALIGNANCY,,,5422.23,5964.45,8
APR-DRG,136-4,RESPIRATORY MALIGNANCY,,,8654.47,9519.92,8
APR-DRG,137-1,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,2872.88,3160.17,8
APR-DRG,137-2,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,3765.8,4142.38,8
APR-DRG,137-3,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,4231.17,4654.29,8
APR-DRG,137-4,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,6850.21,7535.23,8
APR-DRG,138-1,BRONCHIOLITIS AND RSV PNEUMONIA,,,2462.25,2708.48,8
APR-DRG,138-2,BRONCHIOLITIS AND RSV PNEUMONIA,,,3206.35,3526.99,8
APR-DRG,138-3,BRONCHIOLITIS AND RSV PNEUMONIA,,,5223.64,5746.0,8
APR-DRG,138-4,BRONCHIOLITIS AND RSV PNEUMONIA,,,10649.36,11714.3,8
APR-DRG,139-1,OTHER PNEUMONIA,,,2180.04,2398.04,8
APR-DRG,139-2,OTHER PNEUMONIA,,,2746.95,3021.65,8
APR-DRG,139-3,OTHER PNEUMONIA,,,3758.83,4134.71,8
APR-DRG,139-4,OTHER PNEUMONIA,,,6214.61,6836.07,8
APR-DRG,140-1,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,2471.21,2718.33,8
APR-DRG,140-2,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,2832.56,3115.82,8
APR-DRG,140-3,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,3322.32,3654.55,8
APR-DRG,140-4,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,4868.76,5355.64,8
APR-DRG,141-1,ASTHMA,,,2308.95,2539.85,8
APR-DRG,141-2,ASTHMA,,,2846.99,3131.69,8
APR-DRG,141-3,ASTHMA,,,3605.53,3966.08,8
APR-DRG,141-4,ASTHMA,,,5243.05,5767.36,8
APR-DRG,142-1,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,2677.77,2945.55,8
APR-DRG,142-2,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,3609.51,3970.46,8
APR-DRG,142-3,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,4481.53,4929.68,8
APR-DRG,142-4,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,7055.77,7761.35,8
APR-DRG,143-1,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,2593.15,2852.47,8
APR-DRG,143-2,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,3405.94,3746.53,8
APR-DRG,143-3,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4915.05,5406.56,8
APR-DRG,143-4,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,8245.34,9069.87,8
APR-DRG,144-1,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,2401.03,2641.13,8
APR-DRG,144-2,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,3650.82,4015.9,8
APR-DRG,144-3,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4827.45,5310.2,8
APR-DRG,144-4,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,7484.32,8232.75,8
APR-DRG,145-1,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,2182.53,2400.78,8
APR-DRG,145-2,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,2682.25,2950.48,8
APR-DRG,145-3,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,4260.54,4686.59,8
APR-DRG,145-4,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,7807.84,8588.62,8
APR-DRG,160-1,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,18064.5,19870.95,8
APR-DRG,160-2,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,20500.37,22550.41,8
APR-DRG,160-3,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,29725.25,32697.78,8
APR-DRG,160-4,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,72507.87,79758.66,8
APR-DRG,161-1,IMPLANTABLE HEART ASSIST SYSTEMS,,,129344.31,142278.74,8
APR-DRG,161-2,IMPLANTABLE HEART ASSIST SYSTEMS,,,129344.31,142278.74,8
APR-DRG,161-3,IMPLANTABLE HEART ASSIST SYSTEMS,,,129344.31,142278.74,8
APR-DRG,161-4,IMPLANTABLE HEART ASSIST SYSTEMS,,,167127.26,183839.99,8
APR-DRG,162-1,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,15402.16,16942.38,8
APR-DRG,162-2,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,21515.24,23666.76,8
APR-DRG,162-3,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,27693.53,30462.88,8
APR-DRG,162-4,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,38204.03,42024.43,8
APR-DRG,163-1,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,15960.11,17556.12,8
APR-DRG,163-2,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,17593.65,19353.02,8
APR-DRG,163-3,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,22902.41,25192.65,8
APR-DRG,163-4,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,38640.04,42504.04,8
APR-DRG,165-1,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,16737.56,18411.32,8
APR-DRG,165-2,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,16737.56,18411.32,8
APR-DRG,165-3,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,19807.54,21788.29,8
APR-DRG,165-4,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,27645.25,30409.78,8
APR-DRG,166-1,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,13491.38,14840.52,8
APR-DRG,166-2,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,14309.65,15740.62,8
APR-DRG,166-3,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,17358.22,19094.04,8
APR-DRG,166-4,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,25476.65,28024.32,8
APR-DRG,167-1,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,11674.18,12841.6,8
APR-DRG,167-2,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,12690.54,13959.59,8
APR-DRG,167-3,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,19425.78,21368.36,8
APR-DRG,167-4,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,30485.77,33534.35,8
APR-DRG,169-1,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,10236.75,11260.43,8
APR-DRG,169-2,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,10715.06,11786.57,8
APR-DRG,169-3,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,16589.73,18248.7,8
APR-DRG,169-4,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,25075.48,27583.03,8
APR-DRG,170-1,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,11508.44,12659.28,8
APR-DRG,170-2,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,11508.44,12659.28,8
APR-DRG,170-3,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,11508.44,12659.28,8
APR-DRG,170-4,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,11508.44,12659.28,8
APR-DRG,171-1,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,7206.58,7927.24,8
APR-DRG,171-2,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,8616.64,9478.3,8
APR-DRG,171-3,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,10561.26,11617.39,8
APR-DRG,171-4,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,19645.28,21609.81,8
APR-DRG,174-1,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,6009.05,6609.96,8
APR-DRG,174-2,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,6681.98,7350.18,8
APR-DRG,174-3,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,8190.09,9009.1,8
APR-DRG,174-4,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,12579.55,13837.51,8
APR-DRG,175-1,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,6752.16,7427.38,8
APR-DRG,175-2,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,8133.35,8946.69,8
APR-DRG,175-3,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,10716.06,11787.67,8
APR-DRG,175-4,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,17748.94,19523.83,8
APR-DRG,176-1,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,7678.43,8446.27,8
APR-DRG,176-2,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,7678.43,8446.27,8
APR-DRG,176-3,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,17445.33,19189.86,8
APR-DRG,176-4,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,22603.27,24863.6,8
APR-DRG,177-1,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,5263.96,5790.36,8
APR-DRG,177-2,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,5263.96,5790.36,8
APR-DRG,177-3,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,8594.74,9454.21,8
APR-DRG,177-4,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,15347.41,16882.15,8
APR-DRG,178-1,EXTERNAL HEART ASSIST DEVICES,,,26504.95,29155.45,8
APR-DRG,178-2,EXTERNAL HEART ASSIST DEVICES,,,26504.95,29155.45,8
APR-DRG,178-3,EXTERNAL HEART ASSIST DEVICES,,,26504.95,29155.45,8
APR-DRG,178-4,EXTERNAL HEART ASSIST DEVICES,,,44680.45,49148.5,8
APR-DRG,179-1,DEFIBRILLATOR IMPLANTS,,,18862.85,20749.14,8
APR-DRG,179-2,DEFIBRILLATOR IMPLANTS,,,19729.89,21702.88,8
APR-DRG,179-3,DEFIBRILLATOR IMPLANTS,,,22558.97,24814.87,8
APR-DRG,179-4,DEFIBRILLATOR IMPLANTS,,,30686.86,33755.55,8
APR-DRG,180-1,OTHER CIRCULATORY SYSTEM PROCEDURES,,,5046.95,5551.65,8
APR-DRG,180-2,OTHER CIRCULATORY SYSTEM PROCEDURES,,,6159.37,6775.31,8
APR-DRG,180-3,OTHER CIRCULATORY SYSTEM PROCEDURES,,,9067.09,9973.8,8
APR-DRG,180-4,OTHER CIRCULATORY SYSTEM PROCEDURES,,,17104.38,18814.82,8
APR-DRG,181-1,LOWER EXTREMITY VASCULAR PROCEDURES,,,6650.13,7315.14,8
APR-DRG,181-2,LOWER EXTREMITY VASCULAR PROCEDURES,,,9530.97,10484.07,8
APR-DRG,181-3,LOWER EXTREMITY VASCULAR PROCEDURES,,,14709.32,16180.25,8
APR-DRG,181-4,LOWER EXTREMITY VASCULAR PROCEDURES,,,24326.9,26759.59,8
APR-DRG,182-1,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,8132.85,8946.14,8
APR-DRG,182-2,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,9069.08,9975.99,8
APR-DRG,182-3,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,11468.12,12614.93,8
APR-DRG,182-4,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,23886.41,26275.05,8
APR-DRG,183-1,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,27524.3,30276.73,8
APR-DRG,183-2,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,28320.16,31152.18,8
APR-DRG,183-3,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,31540.95,34695.05,8
APR-DRG,183-4,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,44847.19,49331.91,8
APR-DRG,190-1,ACUTE MYOCARDIAL INFARCTION,,,2624.01,2886.41,8
APR-DRG,190-2,ACUTE MYOCARDIAL INFARCTION,,,3257.12,3582.83,8
APR-DRG,190-3,ACUTE MYOCARDIAL INFARCTION,,,4232.17,4655.39,8
APR-DRG,190-4,ACUTE MYOCARDIAL INFARCTION,,,6790.48,7469.53,8
APR-DRG,191-1,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,3139.66,3453.63,8
APR-DRG,191-2,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,3783.22,4161.54,8
APR-DRG,191-3,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,5076.81,5584.49,8
APR-DRG,191-4,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,7545.04,8299.54,8
APR-DRG,192-1,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,3575.67,3933.24,8
APR-DRG,192-2,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,4668.67,5135.54,8
APR-DRG,192-3,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,7372.33,8109.56,8
APR-DRG,192-4,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,12618.37,13880.21,8
APR-DRG,193-1,ACUTE AND SUBACUTE ENDOCARDITIS,,,3747.88,4122.67,8
APR-DRG,193-2,ACUTE AND SUBACUTE ENDOCARDITIS,,,3815.07,4196.58,8
APR-DRG,193-3,ACUTE AND SUBACUTE ENDOCARDITIS,,,5283.86,5812.25,8
APR-DRG,193-4,ACUTE AND SUBACUTE ENDOCARDITIS,,,8450.4,9295.44,8
APR-DRG,194-1,HEART FAILURE,,,2379.63,2617.59,8
APR-DRG,194-2,HEART FAILURE,,,3107.8,3418.58,8
APR-DRG,194-3,HEART FAILURE,,,4450.17,4895.19,8
APR-DRG,194-4,HEART FAILURE,,,7926.3,8718.93,8
APR-DRG,196-1,CARDIAC ARREST AND SHOCK,,,2955.0,3250.5,8
APR-DRG,196-2,CARDIAC ARREST AND SHOCK,,,2955.0,3250.5,8
APR-DRG,196-3,CARDIAC ARREST AND SHOCK,,,4016.65,4418.32,8
APR-DRG,196-4,CARDIAC ARREST AND SHOCK,,,9017.81,9919.59,8
APR-DRG,197-1,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,2480.17,2728.19,8
APR-DRG,197-2,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,2970.43,3267.47,8
APR-DRG,197-3,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,3922.58,4314.84,8
APR-DRG,197-4,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,8713.2,9584.52,8
APR-DRG,198-1,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,1891.36,2080.5,8
APR-DRG,198-2,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,2353.25,2588.58,8
APR-DRG,198-3,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,3494.54,3843.99,8
APR-DRG,198-4,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,7130.93,7844.02,8
APR-DRG,199-1,HYPERTENSION,,,2050.13,2255.14,8
APR-DRG,199-2,HYPERTENSION,,,2685.73,2954.3,8
APR-DRG,199-3,HYPERTENSION,,,3825.03,4207.53,8
APR-DRG,199-4,HYPERTENSION,,,6427.64,7070.4,8
APR-DRG,200-1,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,2010.81,2211.89,8
APR-DRG,200-2,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,3722.99,4095.29,8
APR-DRG,200-3,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,7327.53,8060.28,8
APR-DRG,200-4,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,32198.45,35418.3,8
APR-DRG,201-1,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,2084.97,2293.47,8
APR-DRG,201-2,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,2554.33,2809.76,8
APR-DRG,201-3,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,3934.03,4327.43,8
APR-DRG,201-4,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,7638.11,8401.92,8
APR-DRG,203-1,CHEST PAIN,,,1842.58,2026.84,8
APR-DRG,203-2,CHEST PAIN,,,2389.58,2628.54,8
APR-DRG,203-3,CHEST PAIN,,,3613.0,3974.3,8
APR-DRG,203-4,CHEST PAIN,,,4259.54,4685.49,8
APR-DRG,204-1,SYNCOPE AND COLLAPSE,,,2167.1,2383.81,8
APR-DRG,204-2,SYNCOPE AND COLLAPSE,,,2851.97,3137.17,8
APR-DRG,204-3,SYNCOPE AND COLLAPSE,,,4044.52,4448.97,8
APR-DRG,204-4,SYNCOPE AND COLLAPSE,,,5106.18,5616.8,8
APR-DRG,205-1,CARDIOMYOPATHY,,,1809.73,1990.7,8
APR-DRG,205-2,CARDIOMYOPATHY,,,6065.79,6672.37,8
APR-DRG,205-3,CARDIOMYOPATHY,,,6065.79,6672.37,8
APR-DRG,205-4,CARDIOMYOPATHY,,,6065.79,6672.37,8
APR-DRG,206-1,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,3629.92,3992.91,8
APR-DRG,206-2,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,3629.92,3992.91,8
APR-DRG,206-3,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,5294.32,5823.75,8
APR-DRG,206-4,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,10591.63,11650.79,8
APR-DRG,207-1,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,2291.03,2520.13,8
APR-DRG,207-2,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,3078.44,3386.28,8
APR-DRG,207-3,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,4648.77,5113.65,8
APR-DRG,207-4,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,12509.37,13760.31,8
APR-DRG,220-1,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,6441.58,7085.74,8
APR-DRG,220-2,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,8450.9,9295.99,8
APR-DRG,220-3,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,14131.96,15545.16,8
APR-DRG,220-4,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,28374.91,31212.4,8
APR-DRG,222-1,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,3873.8,4261.18,8
APR-DRG,222-2,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,6282.31,6910.54,8
APR-DRG,222-3,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,8617.64,9479.4,8
APR-DRG,222-4,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,17568.26,19325.09,8
APR-DRG,223-1,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,4508.41,4959.25,8
APR-DRG,223-2,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,6987.09,7685.8,8
APR-DRG,223-3,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,10592.12,11651.33,8
APR-DRG,223-4,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,18942.49,20836.74,8
APR-DRG,224-1,PERITONEAL ADHESIOLYSIS,,,5420.74,5962.81,8
APR-DRG,224-2,PERITONEAL ADHESIOLYSIS,,,6748.18,7423.0,8
APR-DRG,224-3,PERITONEAL ADHESIOLYSIS,,,10607.55,11668.31,8
APR-DRG,224-4,PERITONEAL ADHESIOLYSIS,,,20489.42,22538.36,8
APR-DRG,226-1,ANAL AND PERINEAL PROCEDURES,,,3689.15,4058.07,8
APR-DRG,226-2,ANAL AND PERINEAL PROCEDURES,,,4326.24,4758.86,8
APR-DRG,226-3,ANAL AND PERINEAL PROCEDURES,,,8673.39,9540.73,8
APR-DRG,226-4,ANAL AND PERINEAL PROCEDURES,,,8673.39,9540.73,8
APR-DRG,227-1,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,5096.22,5605.84,8
APR-DRG,227-2,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,6434.11,7077.52,8
APR-DRG,227-3,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,8986.95,9885.65,8
APR-DRG,227-4,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,18445.26,20289.79,8
APR-DRG,228-1,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,3388.02,3726.82,8
APR-DRG,228-2,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,4646.77,5111.45,8
APR-DRG,228-3,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,7164.78,7881.26,8
APR-DRG,228-4,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,14496.79,15946.47,8
APR-DRG,229-1,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,4441.71,4885.88,8
APR-DRG,229-2,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,6193.71,6813.08,8
APR-DRG,229-3,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,10046.61,11051.27,8
APR-DRG,229-4,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,23167.2,25483.92,8
APR-DRG,230-1,MAJOR SMALL BOWEL PROCEDURES,,,5919.96,6511.96,8
APR-DRG,230-2,MAJOR SMALL BOWEL PROCEDURES,,,8127.38,8940.12,8
APR-DRG,230-3,MAJOR SMALL BOWEL PROCEDURES,,,12993.16,14292.48,8
APR-DRG,230-4,MAJOR SMALL BOWEL PROCEDURES,,,25746.42,28321.06,8
APR-DRG,231-1,MAJOR LARGE BOWEL PROCEDURES,,,6662.07,7328.28,8
APR-DRG,231-2,MAJOR LARGE BOWEL PROCEDURES,,,8189.6,9008.56,8
APR-DRG,231-3,MAJOR LARGE BOWEL PROCEDURES,,,10874.83,11962.31,8
APR-DRG,231-4,MAJOR LARGE BOWEL PROCEDURES,,,18143.64,19958.0,8
APR-DRG,233-1,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,5722.36,6294.6,8
APR-DRG,233-2,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,6818.85,7500.74,8
APR-DRG,233-3,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,10677.23,11744.95,8
APR-DRG,233-4,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,10677.23,11744.95,8
APR-DRG,234-1,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,3306.4,3637.04,8
APR-DRG,234-2,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,4466.6,4913.26,8
APR-DRG,234-3,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,8333.44,9166.78,8
APR-DRG,234-4,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,8333.44,9166.78,8
APR-DRG,240-1,DIGESTIVE MALIGNANCY,,,3322.32,3654.55,8
APR-DRG,240-2,DIGESTIVE MALIGNANCY,,,4156.51,4572.16,8
APR-DRG,240-3,DIGESTIVE MALIGNANCY,,,5777.61,6355.37,8
APR-DRG,240-4,DIGESTIVE MALIGNANCY,,,10379.59,11417.55,8
APR-DRG,241-1,PEPTIC ULCER AND GASTRITIS,,,2673.78,2941.16,8
APR-DRG,241-2,PEPTIC ULCER AND GASTRITIS,,,3272.55,3599.81,8
APR-DRG,241-3,PEPTIC ULCER AND GASTRITIS,,,4726.91,5199.6,8
APR-DRG,241-4,PEPTIC ULCER AND GASTRITIS,,,9506.58,10457.24,8
APR-DRG,242-1,MAJOR ESOPHAGEAL DISORDERS,,,2393.56,2632.92,8
APR-DRG,242-2,MAJOR ESOPHAGEAL DISORDERS,,,3083.41,3391.75,8
APR-DRG,242-3,MAJOR ESOPHAGEAL DISORDERS,,,4478.04,4925.84,8
APR-DRG,242-4,MAJOR ESOPHAGEAL DISORDERS,,,13200.21,14520.23,8
APR-DRG,243-1,OTHER ESOPHAGEAL DISORDERS,,,3076.45,3384.1,8
APR-DRG,243-2,OTHER ESOPHAGEAL DISORDERS,,,3617.97,3979.77,8
APR-DRG,243-3,OTHER ESOPHAGEAL DISORDERS,,,5522.28,6074.51,8
APR-DRG,243-4,OTHER ESOPHAGEAL DISORDERS,,,8889.4,9778.34,8
APR-DRG,244-1,DIVERTICULITIS AND DIVERTICULOSIS,,,2290.53,2519.58,8
APR-DRG,244-2,DIVERTICULITIS AND DIVERTICULOSIS,,,2806.18,3086.8,8
APR-DRG,244-3,DIVERTICULITIS AND DIVERTICULOSIS,,,4276.96,4704.66,8
APR-DRG,244-4,DIVERTICULITIS AND DIVERTICULOSIS,,,7092.6,7801.86,8
APR-DRG,245-1,INFLAMMATORY BOWEL DISEASE,,,2715.59,2987.15,8
APR-DRG,245-2,INFLAMMATORY BOWEL DISEASE,,,3659.28,4025.21,8
APR-DRG,245-3,INFLAMMATORY BOWEL DISEASE,,,5486.44,6035.08,8
APR-DRG,245-4,INFLAMMATORY BOWEL DISEASE,,,9158.17,10073.99,8
APR-DRG,246-1,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,2651.88,2917.07,8
APR-DRG,246-2,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,3474.13,3821.54,8
APR-DRG,246-3,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,9934.13,10927.54,8
APR-DRG,246-4,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,9934.13,10927.54,8
APR-DRG,247-1,INTESTINAL OBSTRUCTION,,,2235.29,2458.82,8
APR-DRG,247-2,INTESTINAL OBSTRUCTION,,,3198.89,3518.78,8
APR-DRG,247-3,INTESTINAL OBSTRUCTION,,,4922.52,5414.77,8
APR-DRG,247-4,INTESTINAL OBSTRUCTION,,,10145.16,11159.68,8
APR-DRG,248-1,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,2730.53,3003.58,8
APR-DRG,248-2,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,3497.52,3847.27,8
APR-DRG,248-3,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,5401.83,5942.01,8
APR-DRG,248-4,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,18324.31,20156.74,8
APR-DRG,249-1,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,2505.05,2755.56,8
APR-DRG,249-2,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,3044.59,3349.05,8
APR-DRG,249-3,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,4657.72,5123.49,8
APR-DRG,249-4,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,9176.09,10093.7,8
APR-DRG,251-1,ABDOMINAL PAIN,,,2380.62,2618.68,8
APR-DRG,251-2,ABDOMINAL PAIN,,,2999.8,3299.78,8
APR-DRG,251-3,ABDOMINAL PAIN,,,4310.31,4741.34,8
APR-DRG,251-4,ABDOMINAL PAIN,,,4310.31,4741.34,8
APR-DRG,252-1,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,3346.71,3681.38,8
APR-DRG,252-2,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,3970.36,4367.4,8
APR-DRG,252-3,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,5890.59,6479.65,8
APR-DRG,252-4,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,9798.25,10778.08,8
APR-DRG,253-1,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,2505.55,2756.11,8
APR-DRG,253-2,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,3072.96,3380.26,8
APR-DRG,253-3,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,4706.5,5177.15,8
APR-DRG,253-4,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,8939.67,9833.64,8
APR-DRG,254-1,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,2910.2,3201.22,8
APR-DRG,254-2,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,3587.61,3946.37,8
APR-DRG,254-3,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,5636.75,6200.43,8
APR-DRG,254-4,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,14456.97,15902.67,8
APR-DRG,260-1,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,7942.72,8736.99,8
APR-DRG,260-2,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,10135.21,11148.73,8
APR-DRG,260-3,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,12826.92,14109.61,8
APR-DRG,260-4,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,25376.61,27914.27,8
APR-DRG,261-1,MAJOR BILIARY TRACT PROCEDURES,,,5984.66,6583.13,8
APR-DRG,261-2,MAJOR BILIARY TRACT PROCEDURES,,,9241.79,10165.97,8
APR-DRG,261-3,MAJOR BILIARY TRACT PROCEDURES,,,18216.8,20038.48,8
APR-DRG,261-4,MAJOR BILIARY TRACT PROCEDURES,,,18670.73,20537.8,8
APR-DRG,263-1,CHOLECYSTECTOMY,,,4107.74,4518.51,8
APR-DRG,263-2,CHOLECYSTECTOMY,,,5315.22,5846.74,8
APR-DRG,263-3,CHOLECYSTECTOMY,,,6602.84,7263.12,8
APR-DRG,263-4,CHOLECYSTECTOMY,,,12543.21,13797.53,8
APR-DRG,264-1,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,6570.99,7228.09,8
APR-DRG,264-2,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,6570.99,7228.09,8
APR-DRG,264-3,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,9744.49,10718.94,8
APR-DRG,264-4,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,23359.82,25695.8,8
APR-DRG,279-1,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,2100.4,2310.44,8
APR-DRG,279-2,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,3162.55,3478.81,8
APR-DRG,279-3,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,5263.96,5790.36,8
APR-DRG,279-4,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,10661.31,11727.44,8
APR-DRG,280-1,ALCOHOLIC LIVER DISEASE,,,2243.25,2467.58,8
APR-DRG,280-2,ALCOHOLIC LIVER DISEASE,,,2975.9,3273.49,8
APR-DRG,280-3,ALCOHOLIC LIVER DISEASE,,,4569.63,5026.59,8
APR-DRG,280-4,ALCOHOLIC LIVER DISEASE,,,10995.28,12094.81,8
APR-DRG,281-1,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,2918.67,3210.54,8
APR-DRG,281-2,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,3704.08,4074.49,8
APR-DRG,281-3,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,4903.6,5393.96,8
APR-DRG,281-4,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,7124.96,7837.46,8
APR-DRG,282-1,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,2289.04,2517.94,8
APR-DRG,282-2,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,2949.53,3244.48,8
APR-DRG,282-3,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,4687.59,5156.35,8
APR-DRG,282-4,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,11550.75,12705.83,8
APR-DRG,283-1,OTHER DISORDERS OF THE LIVER,,,2041.67,2245.84,8
APR-DRG,283-2,OTHER DISORDERS OF THE LIVER,,,2692.2,2961.42,8
APR-DRG,283-3,OTHER DISORDERS OF THE LIVER,,,4375.02,4812.52,8
APR-DRG,283-4,OTHER DISORDERS OF THE LIVER,,,10459.23,11505.15,8
APR-DRG,284-1,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,2560.3,2816.33,8
APR-DRG,284-2,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,3466.17,3812.79,8
APR-DRG,284-3,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,5024.05,5526.46,8
APR-DRG,284-4,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,11492.01,12641.21,8
APR-DRG,299-1,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,16089.52,17698.47,8
APR-DRG,299-2,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,19343.16,21277.48,8
APR-DRG,299-3,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,26300.39,28930.43,8
APR-DRG,299-4,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,33633.9,36997.29,8
APR-DRG,300-1,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,13380.39,14718.43,8
APR-DRG,300-2,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,17172.07,18889.28,8
APR-DRG,300-3,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,23695.28,26064.81,8
APR-DRG,300-4,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,38810.76,42691.84,8
APR-DRG,303-1,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,22333.01,24566.31,8
APR-DRG,303-2,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,27854.29,30639.72,8
APR-DRG,303-3,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,40476.15,44523.77,8
APR-DRG,303-4,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,53965.55,59362.11,8
APR-DRG,304-1,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,13636.72,15000.39,8
APR-DRG,304-2,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,16251.28,17876.41,8
APR-DRG,304-3,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,23181.63,25499.79,8
APR-DRG,304-4,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,31970.49,35167.54,8
APR-DRG,305-1,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,5217.17,5738.89,8
APR-DRG,305-2,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,6562.53,7218.78,8
APR-DRG,305-3,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,9327.4,10260.14,8
APR-DRG,305-4,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,15292.66,16821.93,8
APR-DRG,308-1,HIP AND FEMUR FRACTURE REPAIR,,,5966.25,6562.88,8
APR-DRG,308-2,HIP AND FEMUR FRACTURE REPAIR,,,7563.45,8319.8,8
APR-DRG,308-3,HIP AND FEMUR FRACTURE REPAIR,,,10197.43,11217.17,8
APR-DRG,308-4,HIP AND FEMUR FRACTURE REPAIR,,,16156.21,17771.83,8
APR-DRG,309-1,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,6732.25,7405.48,8
APR-DRG,309-2,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,8853.07,9738.38,8
APR-DRG,309-3,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,11895.67,13085.24,8
APR-DRG,309-4,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,18442.77,20287.05,8
APR-DRG,310-1,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,4815.01,5296.51,8
APR-DRG,310-2,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,7778.97,8556.87,8
APR-DRG,310-3,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,10164.58,11181.04,8
APR-DRG,310-4,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,16900.81,18590.89,8
APR-DRG,312-1,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,6573.97,7231.37,8
APR-DRG,312-2,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,9095.96,10005.56,8
APR-DRG,312-3,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,14384.31,15822.74,8
APR-DRG,312-4,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,29141.41,32055.55,8
APR-DRG,313-1,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,6046.88,6651.57,8
APR-DRG,313-2,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,7265.81,7992.39,8
APR-DRG,313-3,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,10791.71,11870.88,8
APR-DRG,313-4,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,16289.6,17918.56,8
APR-DRG,314-1,FOOT AND TOE PROCEDURES,,,5380.42,5918.46,8
APR-DRG,314-2,FOOT AND TOE PROCEDURES,,,5392.37,5931.61,8
APR-DRG,314-3,FOOT AND TOE PROCEDURES,,,6697.91,7367.7,8
APR-DRG,314-4,FOOT AND TOE PROCEDURES,,,11030.62,12133.68,8
APR-DRG,315-1,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,3697.11,4066.82,8
APR-DRG,315-2,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,6677.5,7345.25,8
APR-DRG,315-3,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,9399.07,10338.98,8
APR-DRG,315-4,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,15678.4,17246.24,8
APR-DRG,316-1,HAND AND WRIST PROCEDURES,,,3584.13,3942.54,8
APR-DRG,316-2,HAND AND WRIST PROCEDURES,,,4545.24,4999.76,8
APR-DRG,316-3,HAND AND WRIST PROCEDURES,,,7332.51,8065.76,8
APR-DRG,316-4,HAND AND WRIST PROCEDURES,,,11036.59,12140.25,8
APR-DRG,317-1,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,4073.39,4480.73,8
APR-DRG,317-2,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,5378.43,5916.27,8
APR-DRG,317-3,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,8113.44,8924.78,8
APR-DRG,317-4,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,16393.63,18032.99,8
APR-DRG,320-1,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,5052.42,5557.66,8
APR-DRG,320-2,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,6678.5,7346.35,8
APR-DRG,320-3,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,9177.09,10094.8,8
APR-DRG,320-4,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,16056.17,17661.79,8
APR-DRG,321-1,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,8492.21,9341.43,8
APR-DRG,321-2,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,10695.65,11765.22,8
APR-DRG,321-3,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,15184.65,16703.12,8
APR-DRG,321-4,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,24159.17,26575.09,8
APR-DRG,322-1,SHOULDER AND ELBOW JOINT REPLACEMENT,,,7641.6,8405.76,8
APR-DRG,322-2,SHOULDER AND ELBOW JOINT REPLACEMENT,,,8097.02,8906.72,8
APR-DRG,322-3,SHOULDER AND ELBOW JOINT REPLACEMENT,,,11953.9,13149.29,8
APR-DRG,322-4,SHOULDER AND ELBOW JOINT REPLACEMENT,,,11953.9,13149.29,8
APR-DRG,323-1,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,7789.42,8568.36,8
APR-DRG,323-2,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,9126.32,10038.95,8
APR-DRG,323-3,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,12205.75,13426.33,8
APR-DRG,323-4,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,19670.66,21637.73,8
APR-DRG,324-1,ELECTIVE HIP JOINT REPLACEMENT,,,6612.8,7274.08,8
APR-DRG,324-2,ELECTIVE HIP JOINT REPLACEMENT,,,7323.05,8055.36,8
APR-DRG,324-3,ELECTIVE HIP JOINT REPLACEMENT,,,9863.45,10849.8,8
APR-DRG,324-4,ELECTIVE HIP JOINT REPLACEMENT,,,14406.21,15846.83,8
APR-DRG,325-1,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,10340.27,11374.3,8
APR-DRG,325-2,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,11084.38,12192.82,8
APR-DRG,325-3,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,16043.73,17648.1,8
APR-DRG,325-4,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,21515.74,23667.31,8
APR-DRG,326-1,ELECTIVE KNEE JOINT REPLACEMENT,,,6406.74,7047.41,8
APR-DRG,326-2,ELECTIVE KNEE JOINT REPLACEMENT,,,7391.74,8130.91,8
APR-DRG,326-3,ELECTIVE KNEE JOINT REPLACEMENT,,,10990.8,12089.88,8
APR-DRG,326-4,ELECTIVE KNEE JOINT REPLACEMENT,,,14079.7,15487.67,8
APR-DRG,340-1,FRACTURE OF FEMUR,,,1856.02,2041.62,8
APR-DRG,340-2,FRACTURE OF FEMUR,,,2689.71,2958.68,8
APR-DRG,340-3,FRACTURE OF FEMUR,,,5212.69,5733.96,8
APR-DRG,340-4,FRACTURE OF FEMUR,,,5212.69,5733.96,8
APR-DRG,341-1,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,2449.31,2694.24,8
APR-DRG,341-2,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,2677.27,2945.0,8
APR-DRG,341-3,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,3261.6,3587.76,8
APR-DRG,341-4,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,5672.09,6239.3,8
APR-DRG,342-1,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,2156.15,2371.77,8
APR-DRG,342-2,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,2745.46,3020.01,8
APR-DRG,342-3,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,4242.12,4666.33,8
APR-DRG,342-4,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,5134.05,5647.46,8
APR-DRG,343-1,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,4404.88,4845.37,8
APR-DRG,343-2,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,4419.81,4861.79,8
APR-DRG,343-3,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,6167.83,6784.61,8
APR-DRG,343-4,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,9829.61,10812.57,8
APR-DRG,344-1,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,3429.83,3772.81,8
APR-DRG,344-2,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,3900.68,4290.75,8
APR-DRG,344-3,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,5426.21,5968.83,8
APR-DRG,344-4,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,7512.69,8263.96,8
APR-DRG,346-1,CONNECTIVE TISSUE DISORDERS,,,4154.02,4569.42,8
APR-DRG,346-2,CONNECTIVE TISSUE DISORDERS,,,5236.58,5760.24,8
APR-DRG,346-3,CONNECTIVE TISSUE DISORDERS,,,8428.5,9271.35,8
APR-DRG,346-4,CONNECTIVE TISSUE DISORDERS,,,16945.11,18639.62,8
APR-DRG,347-1,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,2688.22,2957.04,8
APR-DRG,347-2,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,3164.05,3480.46,8
APR-DRG,347-3,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,4323.25,4755.58,8
APR-DRG,347-4,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,8092.04,8901.24,8
APR-DRG,349-1,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,2333.84,2567.22,8
APR-DRG,349-2,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,3413.41,3754.75,8
APR-DRG,349-3,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,5008.12,5508.93,8
APR-DRG,349-4,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,8964.06,9860.47,8
APR-DRG,351-1,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,2595.64,2855.2,8
APR-DRG,351-2,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,2936.09,3229.7,8
APR-DRG,351-3,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,5136.54,5650.19,8
APR-DRG,351-4,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,12542.72,13796.99,8
APR-DRG,361-1,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,6681.48,7349.63,8
APR-DRG,361-2,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,8425.52,9268.07,8
APR-DRG,361-3,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,18087.89,19896.68,8
APR-DRG,361-4,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,18087.89,19896.68,8
APR-DRG,362-1,MASTECTOMY PROCEDURES,,,6347.51,6982.26,8
APR-DRG,362-2,MASTECTOMY PROCEDURES,,,8765.47,9642.02,8
APR-DRG,362-3,MASTECTOMY PROCEDURES,,,12357.56,13593.32,8
APR-DRG,362-4,MASTECTOMY PROCEDURES,,,12357.56,13593.32,8
APR-DRG,363-1,BREAST PROCEDURES EXCEPT MASTECTOMY,,,3436.8,3780.48,8
APR-DRG,363-2,BREAST PROCEDURES EXCEPT MASTECTOMY,,,7787.93,8566.72,8
APR-DRG,363-3,BREAST PROCEDURES EXCEPT MASTECTOMY,,,12470.05,13717.06,8
APR-DRG,363-4,BREAST PROCEDURES EXCEPT MASTECTOMY,,,12470.05,13717.06,8
APR-DRG,364-1,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,3151.6,3466.76,8
APR-DRG,364-2,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,4173.44,4590.78,8
APR-DRG,364-3,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,6838.76,7522.64,8
APR-DRG,364-4,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,14600.32,16060.35,8
APR-DRG,380-1,SKIN ULCERS,,,2423.93,2666.32,8
APR-DRG,380-2,SKIN ULCERS,,,3186.94,3505.63,8
APR-DRG,380-3,SKIN ULCERS,,,5188.8,5707.68,8
APR-DRG,380-4,SKIN ULCERS,,,8036.3,8839.93,8
APR-DRG,381-1,MAJOR SKIN DISORDERS,,,2968.94,3265.83,8
APR-DRG,381-2,MAJOR SKIN DISORDERS,,,3756.84,4132.52,8
APR-DRG,381-3,MAJOR SKIN DISORDERS,,,8906.32,9796.95,8
APR-DRG,381-4,MAJOR SKIN DISORDERS,,,8906.32,9796.95,8
APR-DRG,382-1,MALIGNANT BREAST DISORDERS,,,3490.06,3839.07,8
APR-DRG,382-2,MALIGNANT BREAST DISORDERS,,,3490.06,3839.07,8
APR-DRG,382-3,MALIGNANT BREAST DISORDERS,,,4623.38,5085.72,8
APR-DRG,382-4,MALIGNANT BREAST DISORDERS,,,8616.15,9477.77,8
APR-DRG,383-1,CELLULITIS AND OTHER SKIN INFECTIONS,,,2272.12,2499.33,8
APR-DRG,383-2,CELLULITIS AND OTHER SKIN INFECTIONS,,,2958.48,3254.33,8
APR-DRG,383-3,CELLULITIS AND OTHER SKIN INFECTIONS,,,4338.18,4772.0,8
APR-DRG,383-4,CELLULITIS AND OTHER SKIN INFECTIONS,,,7761.05,8537.16,8
APR-DRG,384-1,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,2120.81,2332.89,8
APR-DRG,384-2,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,2880.34,3168.37,8
APR-DRG,384-3,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,5110.66,5621.73,8
APR-DRG,384-4,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,6539.13,7193.04,8
APR-DRG,385-1,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,2554.83,2810.31,8
APR-DRG,385-2,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,3209.84,3530.82,8
APR-DRG,385-3,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,4894.14,5383.55,8
APR-DRG,385-4,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,11446.22,12590.84,8
APR-DRG,401-1,ADRENAL PROCEDURES,,,6941.3,7635.43,8
APR-DRG,401-2,ADRENAL PROCEDURES,,,6941.3,7635.43,8
APR-DRG,401-3,ADRENAL PROCEDURES,,,6941.3,7635.43,8
APR-DRG,401-4,ADRENAL PROCEDURES,,,6941.3,7635.43,8
APR-DRG,403-1,PROCEDURES FOR OBESITY,,,5764.17,6340.59,8
APR-DRG,403-2,PROCEDURES FOR OBESITY,,,6378.37,7016.21,8
APR-DRG,403-3,PROCEDURES FOR OBESITY,,,9052.65,9957.92,8
APR-DRG,403-4,PROCEDURES FOR OBESITY,,,17942.06,19736.27,8
APR-DRG,404-1,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,4963.83,5460.21,8
APR-DRG,404-2,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,6352.98,6988.28,8
APR-DRG,404-3,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,10924.6,12017.06,8
APR-DRG,404-4,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,10924.6,12017.06,8
APR-DRG,405-1,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,5824.89,6407.38,8
APR-DRG,405-2,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,6133.98,6747.38,8
APR-DRG,405-3,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,10592.62,11651.88,8
APR-DRG,405-4,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,23994.42,26393.86,8
APR-DRG,420-1,DIABETES,,,2432.88,2676.17,8
APR-DRG,420-2,DIABETES,,,2596.14,2855.75,8
APR-DRG,420-3,DIABETES,,,3843.44,4227.78,8
APR-DRG,420-4,DIABETES,,,7236.45,7960.1,8
APR-DRG,421-1,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,3278.03,3605.83,8
APR-DRG,421-2,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,5097.22,5606.94,8
APR-DRG,421-3,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,8000.46,8800.51,8
APR-DRG,421-4,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,15559.94,17115.93,8
APR-DRG,422-1,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,2217.37,2439.11,8
APR-DRG,422-2,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,2870.88,3157.97,8
APR-DRG,422-3,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,4016.65,4418.32,8
APR-DRG,422-4,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,7739.15,8513.07,8
APR-DRG,423-1,INBORN ERRORS OF METABOLISM,,,3978.82,4376.7,8
APR-DRG,423-2,INBORN ERRORS OF METABOLISM,,,4322.75,4755.03,8
APR-DRG,423-3,INBORN ERRORS OF METABOLISM,,,9018.31,9920.14,8
APR-DRG,423-4,INBORN ERRORS OF METABOLISM,,,9018.31,9920.14,8
APR-DRG,424-1,OTHER ENDOCRINE DISORDERS,,,2790.25,3069.28,8
APR-DRG,424-2,OTHER ENDOCRINE DISORDERS,,,3476.62,3824.28,8
APR-DRG,424-3,OTHER ENDOCRINE DISORDERS,,,6081.72,6689.89,8
APR-DRG,424-4,OTHER ENDOCRINE DISORDERS,,,9459.79,10405.77,8
APR-DRG,425-1,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,1936.15,2129.77,8
APR-DRG,425-2,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,2648.4,2913.24,8
APR-DRG,425-3,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,3990.77,4389.85,8
APR-DRG,425-4,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,6779.04,7456.94,8
APR-DRG,426-1,NON-HYPOVOLEMIC SODIUM DISORDERS,,,2152.66,2367.93,8
APR-DRG,426-2,NON-HYPOVOLEMIC SODIUM DISORDERS,,,2870.39,3157.43,8
APR-DRG,426-3,NON-HYPOVOLEMIC SODIUM DISORDERS,,,4649.26,5114.19,8
APR-DRG,426-4,NON-HYPOVOLEMIC SODIUM DISORDERS,,,8400.13,9240.14,8
APR-DRG,427-1,THYROID DISORDERS,,,2278.09,2505.9,8
APR-DRG,427-2,THYROID DISORDERS,,,2869.89,3156.88,8
APR-DRG,427-3,THYROID DISORDERS,,,5285.86,5814.45,8
APR-DRG,427-4,THYROID DISORDERS,,,6679.49,7347.44,8
APR-DRG,428-1,GENETIC DISORDERS,,,3181.47,3499.62,8
APR-DRG,428-2,GENETIC DISORDERS,,,4948.4,5443.24,8
APR-DRG,428-3,GENETIC DISORDERS,,,13622.78,14985.06,8
APR-DRG,428-4,GENETIC DISORDERS,,,23103.98,25414.38,8
APR-DRG,440-1,KIDNEY TRANSPLANT,,,10438.33,11482.16,8
APR-DRG,440-2,KIDNEY TRANSPLANT,,,10438.33,11482.16,8
APR-DRG,440-3,KIDNEY TRANSPLANT,,,19023.12,20925.43,8
APR-DRG,440-4,KIDNEY TRANSPLANT,,,19023.12,20925.43,8
APR-DRG,441-1,MAJOR BLADDER PROCEDURES,,,10240.23,11264.25,8
APR-DRG,441-2,MAJOR BLADDER PROCEDURES,,,10240.23,11264.25,8
APR-DRG,441-3,MAJOR BLADDER PROCEDURES,,,13757.17,15132.89,8
APR-DRG,441-4,MAJOR BLADDER PROCEDURES,,,21194.7,23314.17,8
APR-DRG,442-1,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,6147.92,6762.71,8
APR-DRG,442-2,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,7053.28,7758.61,8
APR-DRG,442-3,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,10958.45,12054.3,8
APR-DRG,442-4,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,16812.72,18493.99,8
APR-DRG,443-1,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,5262.46,5788.71,8
APR-DRG,443-2,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,5839.83,6423.81,8
APR-DRG,443-3,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,11546.27,12700.9,8
APR-DRG,443-4,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,11546.27,12700.9,8
APR-DRG,444-1,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,6221.08,6843.19,8
APR-DRG,444-2,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,6221.08,6843.19,8
APR-DRG,444-3,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,9302.51,10232.76,8
APR-DRG,444-4,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,16325.94,17958.53,8
APR-DRG,445-1,OTHER BLADDER PROCEDURES,,,4284.43,4712.87,8
APR-DRG,445-2,OTHER BLADDER PROCEDURES,,,7611.73,8372.9,8
APR-DRG,445-3,OTHER BLADDER PROCEDURES,,,9269.66,10196.63,8
APR-DRG,445-4,OTHER BLADDER PROCEDURES,,,9269.66,10196.63,8
APR-DRG,446-1,URETHRAL AND TRANSURETHRAL PROCEDURES,,,3110.79,3421.87,8
APR-DRG,446-2,URETHRAL AND TRANSURETHRAL PROCEDURES,,,3965.88,4362.47,8
APR-DRG,446-3,URETHRAL AND TRANSURETHRAL PROCEDURES,,,7356.9,8092.59,8
APR-DRG,446-4,URETHRAL AND TRANSURETHRAL PROCEDURES,,,11582.1,12740.31,8
APR-DRG,447-1,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,6360.95,6997.05,8
APR-DRG,447-2,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,6360.95,6997.05,8
APR-DRG,447-3,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,8617.64,9479.4,8
APR-DRG,447-4,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,23130.86,25443.95,8
APR-DRG,448-1,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,6421.67,7063.84,8
APR-DRG,448-2,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,8961.57,9857.73,8
APR-DRG,448-3,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,10835.01,11918.51,8
APR-DRG,448-4,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,21920.39,24112.43,8
APR-DRG,461-1,KIDNEY AND URINARY TRACT MALIGNANCY,,,4379.49,4817.44,8
APR-DRG,461-2,KIDNEY AND URINARY TRACT MALIGNANCY,,,4379.49,4817.44,8
APR-DRG,461-3,KIDNEY AND URINARY TRACT MALIGNANCY,,,6239.5,6863.45,8
APR-DRG,461-4,KIDNEY AND URINARY TRACT MALIGNANCY,,,6239.5,6863.45,8
APR-DRG,462-1,NEPHRITIS AND NEPHROSIS,,,2705.14,2975.65,8
APR-DRG,462-2,NEPHRITIS AND NEPHROSIS,,,4263.52,4689.87,8
APR-DRG,462-3,NEPHRITIS AND NEPHROSIS,,,8641.03,9505.13,8
APR-DRG,462-4,NEPHRITIS AND NEPHROSIS,,,8641.03,9505.13,8
APR-DRG,463-1,KIDNEY AND URINARY TRACT INFECTIONS,,,2266.15,2492.77,8
APR-DRG,463-2,KIDNEY AND URINARY TRACT INFECTIONS,,,2894.28,3183.71,8
APR-DRG,463-3,KIDNEY AND URINARY TRACT INFECTIONS,,,4246.6,4671.26,8
APR-DRG,463-4,KIDNEY AND URINARY TRACT INFECTIONS,,,6784.01,7462.41,8
APR-DRG,465-1,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,2358.72,2594.59,8
APR-DRG,465-2,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,2832.06,3115.27,8
APR-DRG,465-3,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,4581.07,5039.18,8
APR-DRG,465-4,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,9546.9,10501.59,8
APR-DRG,466-1,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,2270.13,2497.14,8
APR-DRG,466-2,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,3041.6,3345.76,8
APR-DRG,466-3,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,4399.4,4839.34,8
APR-DRG,466-4,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,6778.04,7455.84,8
APR-DRG,468-1,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,2638.94,2902.83,8
APR-DRG,468-2,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,3384.54,3722.99,8
APR-DRG,468-3,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,4645.28,5109.81,8
APR-DRG,468-4,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,12556.15,13811.77,8
APR-DRG,469-1,ACUTE KIDNEY INJURY,,,2080.0,2288.0,8
APR-DRG,469-2,ACUTE KIDNEY INJURY,,,2819.62,3101.58,8
APR-DRG,469-3,ACUTE KIDNEY INJURY,,,4933.47,5426.82,8
APR-DRG,469-4,ACUTE KIDNEY INJURY,,,9531.47,10484.62,8
APR-DRG,470-1,CHRONIC KIDNEY DISEASE,,,3174.5,3491.95,8
APR-DRG,470-2,CHRONIC KIDNEY DISEASE,,,3174.5,3491.95,8
APR-DRG,470-3,CHRONIC KIDNEY DISEASE,,,5506.35,6056.99,8
APR-DRG,470-4,CHRONIC KIDNEY DISEASE,,,9376.67,10314.34,8
APR-DRG,482-1,TRANSURETHRAL PROSTATECTOMY,,,3606.03,3966.63,8
APR-DRG,482-2,TRANSURETHRAL PROSTATECTOMY,,,4432.25,4875.48,8
APR-DRG,482-3,TRANSURETHRAL PROSTATECTOMY,,,7355.9,8091.49,8
APR-DRG,482-4,TRANSURETHRAL PROSTATECTOMY,,,7355.9,8091.49,8
APR-DRG,483-1,"PENIS, TESTES AND SCROTAL PROCEDURES",,,3657.79,4023.57,8
APR-DRG,483-2,"PENIS, TESTES AND SCROTAL PROCEDURES",,,5489.43,6038.37,8
APR-DRG,483-3,"PENIS, TESTES AND SCROTAL PROCEDURES",,,10151.14,11166.25,8
APR-DRG,483-4,"PENIS, TESTES AND SCROTAL PROCEDURES",,,10151.14,11166.25,8
APR-DRG,484-1,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,5692.0,6261.2,8
APR-DRG,484-2,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,5692.0,6261.2,8
APR-DRG,484-3,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,7565.45,8322.0,8
APR-DRG,484-4,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,7565.45,8322.0,8
APR-DRG,485-1,PROSTATECTOMY PROCEDURES,,,6215.11,6836.62,8
APR-DRG,485-2,PROSTATECTOMY PROCEDURES,,,7154.32,7869.75,8
APR-DRG,485-3,PROSTATECTOMY PROCEDURES,,,11450.2,12595.22,8
APR-DRG,485-4,PROSTATECTOMY PROCEDURES,,,18883.26,20771.59,8
APR-DRG,500-1,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,4064.43,4470.87,8
APR-DRG,500-2,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,4064.43,4470.87,8
APR-DRG,500-3,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,4830.93,5314.02,8
APR-DRG,500-4,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,4830.93,5314.02,8
APR-DRG,501-1,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,2134.75,2348.23,8
APR-DRG,501-2,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,3089.88,3398.87,8
APR-DRG,501-3,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,4741.84,5216.02,8
APR-DRG,501-4,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,7567.44,8324.18,8
APR-DRG,511-1,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,5846.3,6430.93,8
APR-DRG,511-2,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,7199.12,7919.03,8
APR-DRG,511-3,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,10808.14,11888.95,8
APR-DRG,511-4,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,10808.14,11888.95,8
APR-DRG,513-1,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,3880.27,4268.3,8
APR-DRG,513-2,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,4615.92,5077.51,8
APR-DRG,513-3,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,7300.16,8030.18,8
APR-DRG,513-4,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,9106.91,10017.6,8
APR-DRG,514-1,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,3269.07,3595.98,8
APR-DRG,514-2,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,4880.71,5368.78,8
APR-DRG,514-3,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,4880.71,5368.78,8
APR-DRG,514-4,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,4880.71,5368.78,8
APR-DRG,517-1,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,3132.69,3445.96,8
APR-DRG,517-2,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,3448.75,3793.63,8
APR-DRG,517-3,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,6710.35,7381.39,8
APR-DRG,517-4,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,6710.35,7381.39,8
APR-DRG,518-1,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,3287.48,3616.23,8
APR-DRG,518-2,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,4765.73,5242.3,8
APR-DRG,518-3,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,8621.62,9483.78,8
APR-DRG,518-4,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,8621.62,9483.78,8
APR-DRG,519-1,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,3869.32,4256.25,8
APR-DRG,519-2,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,4873.24,5360.56,8
APR-DRG,519-3,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,10907.18,11997.9,8
APR-DRG,519-4,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,10907.18,11997.9,8
APR-DRG,530-1,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,2811.65,3092.82,8
APR-DRG,530-2,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,3395.49,3735.04,8
APR-DRG,530-3,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,5056.4,5562.04,8
APR-DRG,530-4,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,9737.03,10710.73,8
APR-DRG,531-1,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,2219.36,2441.3,8
APR-DRG,531-2,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,2771.84,3049.02,8
APR-DRG,531-3,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,5307.76,5838.54,8
APR-DRG,531-4,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,5307.76,5838.54,8
APR-DRG,532-1,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,2238.27,2462.1,8
APR-DRG,532-2,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,2625.5,2888.05,8
APR-DRG,532-3,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,3379.06,3716.97,8
APR-DRG,532-4,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,3379.06,3716.97,8
APR-DRG,539-1,CESAREAN SECTION WITH STERILIZATION,,,3586.62,3945.28,8
APR-DRG,539-2,CESAREAN SECTION WITH STERILIZATION,,,4006.7,4407.37,8
APR-DRG,539-3,CESAREAN SECTION WITH STERILIZATION,,,5656.16,6221.78,8
APR-DRG,539-4,CESAREAN SECTION WITH STERILIZATION,,,10035.66,11039.23,8
APR-DRG,540-1,CESAREAN SECTION WITHOUT STERILIZATION,,,3363.63,3699.99,8
APR-DRG,540-2,CESAREAN SECTION WITHOUT STERILIZATION,,,4098.78,4508.66,8
APR-DRG,540-3,CESAREAN SECTION WITHOUT STERILIZATION,,,4932.47,5425.72,8
APR-DRG,540-4,CESAREAN SECTION WITHOUT STERILIZATION,,,8698.27,9568.1,8
APR-DRG,541-1,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,3583.13,3941.44,8
APR-DRG,541-2,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,3889.23,4278.15,8
APR-DRG,541-3,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,4513.88,4965.27,8
APR-DRG,541-4,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,5784.58,6363.04,8
APR-DRG,542-1,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,2932.6,3225.86,8
APR-DRG,542-2,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,3319.83,3651.81,8
APR-DRG,542-3,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,4416.33,4857.96,8
APR-DRG,542-4,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,10868.86,11955.75,8
APR-DRG,543-1,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,1880.41,2068.45,8
APR-DRG,543-2,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2497.59,2747.35,8
APR-DRG,543-3,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,3238.21,3562.03,8
APR-DRG,543-4,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,6061.81,6667.99,8
APR-DRG,547-1,ANTEPARTUM WITH O.R. PROCEDURE,,,3092.37,3401.61,8
APR-DRG,547-2,ANTEPARTUM WITH O.R. PROCEDURE,,,3893.71,4283.08,8
APR-DRG,547-3,ANTEPARTUM WITH O.R. PROCEDURE,,,6154.39,6769.83,8
APR-DRG,547-4,ANTEPARTUM WITH O.R. PROCEDURE,,,10533.39,11586.73,8
APR-DRG,548-1,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,2057.6,2263.36,8
APR-DRG,548-2,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,3454.22,3799.64,8
APR-DRG,548-3,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,6914.42,7605.86,8
APR-DRG,548-4,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,14267.84,15694.62,8
APR-DRG,560-1,VAGINAL DELIVERY,,,2644.92,2909.41,8
APR-DRG,560-2,VAGINAL DELIVERY,,,2928.12,3220.93,8
APR-DRG,560-3,VAGINAL DELIVERY,,,3546.3,3900.93,8
APR-DRG,560-4,VAGINAL DELIVERY,,,5237.58,5761.34,8
APR-DRG,561-1,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,1376.71,1514.38,8
APR-DRG,561-2,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,1981.45,2179.6,8
APR-DRG,561-3,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,2792.74,3072.01,8
APR-DRG,561-4,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,5354.54,5889.99,8
APR-DRG,564-1,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,1564.35,1720.79,8
APR-DRG,564-2,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2060.58,2266.64,8
APR-DRG,564-3,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,4170.95,4588.05,8
APR-DRG,564-4,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,4170.95,4588.05,8
APR-DRG,566-1,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,1590.73,1749.8,8
APR-DRG,566-2,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,2049.63,2254.59,8
APR-DRG,566-3,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,2543.88,2798.27,8
APR-DRG,566-4,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,6584.43,7242.87,8
APR-DRG,580-1,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,1776.88,1954.57,8
APR-DRG,580-2,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,1928.69,2121.56,8
APR-DRG,580-3,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,2920.66,3212.73,8
APR-DRG,580-4,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,2920.66,3212.73,8
APR-DRG,581-1,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,539.53,593.48,8
APR-DRG,581-2,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,778.94,856.83,8
APR-DRG,581-3,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,879.98,967.98,8
APR-DRG,581-4,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,1263.72,1390.09,8
APR-DRG,583-1,NEONATE WITH ECMO,,,188900.33,207790.36,8
APR-DRG,583-2,NEONATE WITH ECMO,,,188900.33,207790.36,8
APR-DRG,583-3,NEONATE WITH ECMO,,,198590.58,218449.64,8
APR-DRG,583-4,NEONATE WITH ECMO,,,198590.58,218449.64,8
APR-DRG,588-1,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,98644.01,108508.41,8
APR-DRG,588-2,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,98644.01,108508.41,8
APR-DRG,588-3,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,103704.4,114074.84,8
APR-DRG,588-4,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,205292.97,225822.27,8
APR-DRG,589-1,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,42662.66,46928.93,8
APR-DRG,589-2,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,42662.66,46928.93,8
APR-DRG,589-3,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,44850.67,49335.74,8
APR-DRG,589-4,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,44850.67,49335.74,8
APR-DRG,591-1,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,37087.62,40796.38,8
APR-DRG,591-2,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,37087.62,40796.38,8
APR-DRG,591-3,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,49160.99,54077.09,8
APR-DRG,591-4,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,88747.21,97621.93,8
APR-DRG,593-1,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,37842.18,41626.4,8
APR-DRG,593-2,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,37842.18,41626.4,8
APR-DRG,593-3,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,59817.32,65799.05,8
APR-DRG,593-4,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,95597.42,105157.16,8
APR-DRG,602-1,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,22664.49,24930.94,8
APR-DRG,602-2,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,38702.75,42573.03,8
APR-DRG,602-3,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,52897.92,58187.71,8
APR-DRG,602-4,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,65431.19,71974.31,8
APR-DRG,603-1,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,16399.1,18039.01,8
APR-DRG,603-2,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,22554.0,24809.4,8
APR-DRG,603-3,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,38085.07,41893.58,8
APR-DRG,603-4,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,38085.07,41893.58,8
APR-DRG,607-1,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,23617.64,25979.4,8
APR-DRG,607-2,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,31777.87,34955.66,8
APR-DRG,607-3,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,45473.83,50021.21,8
APR-DRG,607-4,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,64710.48,71181.53,8
APR-DRG,608-1,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,14969.63,16466.59,8
APR-DRG,608-2,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,20759.19,22835.11,8
APR-DRG,608-3,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,32045.15,35249.67,8
APR-DRG,608-4,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,32045.15,35249.67,8
APR-DRG,609-1,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,50902.54,55992.79,8
APR-DRG,609-2,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,50902.54,55992.79,8
APR-DRG,609-3,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,53514.11,58865.52,8
APR-DRG,609-4,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,131670.19,144837.21,8
APR-DRG,611-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,8668.91,9535.8,8
APR-DRG,611-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,20167.4,22184.14,8
APR-DRG,611-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,27419.28,30161.21,8
APR-DRG,611-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,50728.83,55801.71,8
APR-DRG,612-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,16563.85,18220.24,8
APR-DRG,612-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,24218.89,26640.78,8
APR-DRG,612-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,29540.09,32494.1,8
APR-DRG,612-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,47420.93,52163.02,8
APR-DRG,613-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,9369.71,10306.68,8
APR-DRG,613-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,15418.58,16960.44,8
APR-DRG,613-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,16209.97,17830.97,8
APR-DRG,613-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,16209.97,17830.97,8
APR-DRG,614-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,7569.92,8326.91,8
APR-DRG,614-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,11790.15,12969.17,8
APR-DRG,614-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,23866.5,26253.15,8
APR-DRG,614-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,23866.5,26253.15,8
APR-DRG,621-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,3614.99,3976.49,8
APR-DRG,621-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,10740.45,11814.5,8
APR-DRG,621-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,26124.19,28736.61,8
APR-DRG,621-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,49812.51,54793.76,8
APR-DRG,622-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,9590.7,10549.77,8
APR-DRG,622-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,15378.76,16916.64,8
APR-DRG,622-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,16167.66,17784.43,8
APR-DRG,622-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,31571.32,34728.45,8
APR-DRG,623-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,6985.1,7683.61,8
APR-DRG,623-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,10813.61,11894.97,8
APR-DRG,623-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,11368.58,12505.44,8
APR-DRG,623-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,11368.58,12505.44,8
APR-DRG,625-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,6356.96,6992.66,8
APR-DRG,625-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,9738.52,10712.37,8
APR-DRG,625-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,10237.74,11261.51,8
APR-DRG,625-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,10237.74,11261.51,8
APR-DRG,626-1,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1300.06,1430.07,8
APR-DRG,626-2,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1454.85,1600.34,8
APR-DRG,626-3,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,4831.93,5315.12,8
APR-DRG,626-4,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,4831.93,5315.12,8
APR-DRG,630-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,36984.1,40682.51,8
APR-DRG,630-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,36984.1,40682.51,8
APR-DRG,630-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,56443.73,62088.1,8
APR-DRG,630-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,127784.93,140563.42,8
APR-DRG,631-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,21938.31,24132.14,8
APR-DRG,631-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,21938.31,24132.14,8
APR-DRG,631-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,42807.01,47087.71,8
APR-DRG,631-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,112793.39,124072.73,8
APR-DRG,633-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,1498.65,1648.52,8
APR-DRG,633-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,6128.01,6740.81,8
APR-DRG,633-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,20041.47,22045.62,8
APR-DRG,633-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,55032.67,60535.94,8
APR-DRG,634-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,4012.17,4413.39,8
APR-DRG,634-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,8337.42,9171.16,8
APR-DRG,634-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,10485.11,11533.62,8
APR-DRG,634-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,31950.09,35145.1,8
APR-DRG,636-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,3676.21,4043.83,8
APR-DRG,636-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,4792.11,5271.32,8
APR-DRG,636-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,13127.05,14439.76,8
APR-DRG,636-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,13127.05,14439.76,8
APR-DRG,639-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,3779.24,4157.16,8
APR-DRG,639-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,7218.53,7940.38,8
APR-DRG,639-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,15744.59,17319.05,8
APR-DRG,639-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,15744.59,17319.05,8
APR-DRG,640-1,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1004.41,1104.85,8
APR-DRG,640-2,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1223.41,1345.75,8
APR-DRG,640-3,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,2333.34,2566.67,8
APR-DRG,640-4,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,2333.34,2566.67,8
APR-DRG,650-1,SPLENIC PROCEDURES,,,6292.26,6921.49,8
APR-DRG,650-2,SPLENIC PROCEDURES,,,7784.45,8562.9,8
APR-DRG,650-3,SPLENIC PROCEDURES,,,12406.34,13646.97,8
APR-DRG,650-4,SPLENIC PROCEDURES,,,12456.61,13702.27,8
APR-DRG,651-1,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,4181.9,4600.09,8
APR-DRG,651-2,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,6161.36,6777.5,8
APR-DRG,651-3,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,8670.4,9537.44,8
APR-DRG,651-4,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,8670.4,9537.44,8
APR-DRG,660-1,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,4021.63,4423.79,8
APR-DRG,660-2,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,4693.56,5162.92,8
APR-DRG,660-3,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,7121.47,7833.62,8
APR-DRG,660-4,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,30170.21,33187.23,8
APR-DRG,661-1,COAGULATION AND PLATELET DISORDERS,,,4330.22,4763.24,8
APR-DRG,661-2,COAGULATION AND PLATELET DISORDERS,,,5142.01,5656.21,8
APR-DRG,661-3,COAGULATION AND PLATELET DISORDERS,,,9475.72,10423.29,8
APR-DRG,661-4,COAGULATION AND PLATELET DISORDERS,,,18065.99,19872.59,8
APR-DRG,662-1,SICKLE CELL ANEMIA CRISIS,,,3598.06,3957.87,8
APR-DRG,662-2,SICKLE CELL ANEMIA CRISIS,,,4689.58,5158.54,8
APR-DRG,662-3,SICKLE CELL ANEMIA CRISIS,,,5900.55,6490.61,8
APR-DRG,662-4,SICKLE CELL ANEMIA CRISIS,,,9724.09,10696.5,8
APR-DRG,663-1,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,2564.28,2820.71,8
APR-DRG,663-2,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,3243.18,3567.5,8
APR-DRG,663-3,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,4800.07,5280.08,8
APR-DRG,663-4,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,8491.72,9340.89,8
APR-DRG,680-1,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,6550.58,7205.64,8
APR-DRG,680-2,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,8896.87,9786.56,8
APR-DRG,680-3,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,15346.91,16881.6,8
APR-DRG,680-4,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,26148.58,28763.44,8
APR-DRG,681-1,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,5029.53,5532.48,8
APR-DRG,681-2,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,8284.16,9112.58,8
APR-DRG,681-3,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,14651.58,16116.74,8
APR-DRG,681-4,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,39182.56,43100.82,8
APR-DRG,690-1,ACUTE LEUKEMIA,,,14107.07,15517.78,8
APR-DRG,690-2,ACUTE LEUKEMIA,,,14107.07,15517.78,8
APR-DRG,690-3,ACUTE LEUKEMIA,,,28199.22,31019.14,8
APR-DRG,690-4,ACUTE LEUKEMIA,,,44505.75,48956.33,8
APR-DRG,691-1,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,5061.38,5567.52,8
APR-DRG,691-2,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,6086.2,6694.82,8
APR-DRG,691-3,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,10560.77,11616.85,8
APR-DRG,691-4,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,18098.34,19908.17,8
APR-DRG,692-1,RADIOTHERAPY,,,6285.29,6913.82,8
APR-DRG,692-2,RADIOTHERAPY,,,6285.29,6913.82,8
APR-DRG,692-3,RADIOTHERAPY,,,6285.29,6913.82,8
APR-DRG,692-4,RADIOTHERAPY,,,14208.11,15628.92,8
APR-DRG,694-1,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,2991.83,3291.01,8
APR-DRG,694-2,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,3436.3,3779.93,8
APR-DRG,694-3,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,6601.85,7262.04,8
APR-DRG,694-4,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,11737.89,12911.68,8
APR-DRG,695-1,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,4916.54,5408.19,8
APR-DRG,695-2,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,4916.54,5408.19,8
APR-DRG,695-3,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,13541.16,14895.28,8
APR-DRG,695-4,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,38959.08,42854.99,8
APR-DRG,696-1,OTHER CHEMOTHERAPY,,,4451.17,4896.29,8
APR-DRG,696-2,OTHER CHEMOTHERAPY,,,5912.49,6503.74,8
APR-DRG,696-3,OTHER CHEMOTHERAPY,,,10269.1,11296.01,8
APR-DRG,696-4,OTHER CHEMOTHERAPY,,,20038.98,22042.88,8
APR-DRG,710-1,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,3627.43,3990.17,8
APR-DRG,710-2,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,5637.25,6200.98,8
APR-DRG,710-3,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,9652.41,10617.65,8
APR-DRG,710-4,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,22900.41,25190.45,8
APR-DRG,711-1,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,4949.39,5444.33,8
APR-DRG,711-2,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,6588.91,7247.8,8
APR-DRG,711-3,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,11361.11,12497.22,8
APR-DRG,711-4,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,22339.48,24573.43,8
APR-DRG,720-1,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,2437.86,2681.65,8
APR-DRG,720-2,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,3147.12,3461.83,8
APR-DRG,720-3,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,5002.15,5502.37,8
APR-DRG,720-4,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,10159.1,11175.01,8
APR-DRG,721-1,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,3162.55,3478.81,8
APR-DRG,721-2,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,3829.51,4212.46,8
APR-DRG,721-3,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,6310.68,6941.75,8
APR-DRG,721-4,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,12068.38,13275.22,8
APR-DRG,722-1,FEVER AND INFLAMMATORY CONDITIONS,,,2416.46,2658.11,8
APR-DRG,722-2,FEVER AND INFLAMMATORY CONDITIONS,,,3193.41,3512.75,8
APR-DRG,722-3,FEVER AND INFLAMMATORY CONDITIONS,,,4837.9,5321.69,8
APR-DRG,722-4,FEVER AND INFLAMMATORY CONDITIONS,,,7477.85,8225.64,8
APR-DRG,723-1,VIRAL ILLNESS,,,2608.08,2868.89,8
APR-DRG,723-2,VIRAL ILLNESS,,,3079.43,3387.37,8
APR-DRG,723-3,VIRAL ILLNESS,,,7873.04,8660.34,8
APR-DRG,723-4,VIRAL ILLNESS,,,7873.04,8660.34,8
APR-DRG,724-1,OTHER INFECTIOUS AND PARASITIC DISEASES,,,3435.31,3778.84,8
APR-DRG,724-2,OTHER INFECTIOUS AND PARASITIC DISEASES,,,4141.58,4555.74,8
APR-DRG,724-3,OTHER INFECTIOUS AND PARASITIC DISEASES,,,6873.6,7560.96,8
APR-DRG,724-4,OTHER INFECTIOUS AND PARASITIC DISEASES,,,10535.88,11589.47,8
APR-DRG,740-1,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,8935.19,9828.71,8
APR-DRG,740-2,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,13976.17,15373.79,8
APR-DRG,740-3,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,13976.17,15373.79,8
APR-DRG,740-4,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,13976.17,15373.79,8
APR-DRG,750-1,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,6280.31,6908.34,8
APR-DRG,750-2,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,6280.31,6908.34,8
APR-DRG,750-3,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,10179.51,11197.46,8
APR-DRG,750-4,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,23936.18,26329.8,8
APR-DRG,751-1,DEPRESSIVE DISORDERS,,,3600.55,3960.61,8
APR-DRG,751-2,DEPRESSIVE DISORDERS,,,4072.4,4479.64,8
APR-DRG,751-3,DEPRESSIVE DISORDERS,,,6648.63,7313.49,8
APR-DRG,751-4,DEPRESSIVE DISORDERS,,,17247.73,18972.5,8
APR-DRG,752-1,PERSONALITY DISORDERS,,,5242.06,5766.27,8
APR-DRG,752-2,PERSONALITY DISORDERS,,,5242.06,5766.27,8
APR-DRG,752-3,PERSONALITY DISORDERS,,,5242.06,5766.27,8
APR-DRG,752-4,PERSONALITY DISORDERS,,,5242.06,5766.27,8
APR-DRG,753-1,BIPOLAR DISORDERS,,,3915.61,4307.17,8
APR-DRG,753-2,BIPOLAR DISORDERS,,,4389.95,4828.95,8
APR-DRG,753-3,BIPOLAR DISORDERS,,,6541.12,7195.23,8
APR-DRG,753-4,BIPOLAR DISORDERS,,,17023.75,18726.13,8
APR-DRG,755-1,ADJUSTMENT DISORDERS,,,4190.86,4609.95,8
APR-DRG,755-2,ADJUSTMENT DISORDERS,,,5585.49,6144.04,8
APR-DRG,755-3,ADJUSTMENT DISORDERS,,,7735.67,8509.24,8
APR-DRG,755-4,ADJUSTMENT DISORDERS,,,7735.67,8509.24,8
APR-DRG,756-1,ACUTE ANXIETY AND STRESS SYNDROMES,,,4299.86,4729.85,8
APR-DRG,756-2,ACUTE ANXIETY AND STRESS SYNDROMES,,,4938.44,5432.28,8
APR-DRG,756-3,ACUTE ANXIETY AND STRESS SYNDROMES,,,5598.43,6158.27,8
APR-DRG,756-4,ACUTE ANXIETY AND STRESS SYNDROMES,,,7211.56,7932.72,8
APR-DRG,757-1,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,8412.58,9253.84,8
APR-DRG,757-2,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,10027.2,11029.92,8
APR-DRG,757-3,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,10027.2,11029.92,8
APR-DRG,757-4,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,10027.2,11029.92,8
APR-DRG,758-1,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,7747.12,8521.83,8
APR-DRG,758-2,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,11415.36,12556.9,8
APR-DRG,758-3,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,18329.29,20162.22,8
APR-DRG,758-4,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,18470.15,20317.17,8
APR-DRG,759-1,EATING DISORDERS,,,9865.44,10851.98,8
APR-DRG,759-2,EATING DISORDERS,,,9865.44,10851.98,8
APR-DRG,759-3,EATING DISORDERS,,,12043.99,13248.39,8
APR-DRG,759-4,EATING DISORDERS,,,12043.99,13248.39,8
APR-DRG,760-1,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,6733.74,7407.11,8
APR-DRG,760-2,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,7501.24,8251.36,8
APR-DRG,760-3,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,12362.04,13598.24,8
APR-DRG,760-4,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,12362.04,13598.24,8
APR-DRG,761-1,SCHIZOAFFECTIVE DISORDERS,,,7240.43,7964.47,8
APR-DRG,761-2,SCHIZOAFFECTIVE DISORDERS,,,6480.4,7128.44,8
APR-DRG,761-3,SCHIZOAFFECTIVE DISORDERS,,,10786.24,11864.86,8
APR-DRG,761-4,SCHIZOAFFECTIVE DISORDERS,,,12776.15,14053.77,8
APR-DRG,762-1,OBSESSIVE COMPULSIVE DISORDERS,,,8042.77,8847.05,8
APR-DRG,762-2,OBSESSIVE COMPULSIVE DISORDERS,,,7149.35,7864.29,8
APR-DRG,762-3,OBSESSIVE COMPULSIVE DISORDERS,,,12087.3,13296.03,8
APR-DRG,762-4,OBSESSIVE COMPULSIVE DISORDERS,,,12087.3,13296.03,8
APR-DRG,770-1,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,1948.6,2143.46,8
APR-DRG,770-2,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,2649.89,2914.88,8
APR-DRG,770-3,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,4600.49,5060.54,8
APR-DRG,770-4,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,9418.48,10360.33,8
APR-DRG,772-1,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,2378.13,2615.94,8
APR-DRG,772-2,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,2518.0,2769.8,8
APR-DRG,772-3,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,3551.77,3906.95,8
APR-DRG,772-4,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,3551.77,3906.95,8
APR-DRG,773-1,OPIOID ABUSE AND DEPENDENCE,,,2988.85,3287.74,8
APR-DRG,773-2,OPIOID ABUSE AND DEPENDENCE,,,3240.2,3564.22,8
APR-DRG,773-3,OPIOID ABUSE AND DEPENDENCE,,,5720.37,6292.41,8
APR-DRG,773-4,OPIOID ABUSE AND DEPENDENCE,,,11422.33,12564.56,8
APR-DRG,774-1,COCAINE ABUSE AND DEPENDENCE,,,3213.82,3535.2,8
APR-DRG,774-2,COCAINE ABUSE AND DEPENDENCE,,,3414.4,3755.84,8
APR-DRG,774-3,COCAINE ABUSE AND DEPENDENCE,,,5507.34,6058.07,8
APR-DRG,774-4,COCAINE ABUSE AND DEPENDENCE,,,10433.35,11476.69,8
APR-DRG,775-1,ALCOHOL ABUSE AND DEPENDENCE,,,3135.68,3449.25,8
APR-DRG,775-2,ALCOHOL ABUSE AND DEPENDENCE,,,4128.64,4541.5,8
APR-DRG,775-3,ALCOHOL ABUSE AND DEPENDENCE,,,6414.7,7056.17,8
APR-DRG,775-4,ALCOHOL ABUSE AND DEPENDENCE,,,13311.21,14642.33,8
APR-DRG,776-1,OTHER DRUG ABUSE AND DEPENDENCE,,,4309.81,4740.79,8
APR-DRG,776-2,OTHER DRUG ABUSE AND DEPENDENCE,,,4309.81,4740.79,8
APR-DRG,776-3,OTHER DRUG ABUSE AND DEPENDENCE,,,6387.33,7026.06,8
APR-DRG,776-4,OTHER DRUG ABUSE AND DEPENDENCE,,,6387.33,7026.06,8
APR-DRG,792-1,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,7213.05,7934.36,8
APR-DRG,792-2,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,8072.63,8879.89,8
APR-DRG,792-3,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,14384.8,15823.28,8
APR-DRG,792-4,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,35959.78,39555.76,8
APR-DRG,793-1,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,4843.38,5327.72,8
APR-DRG,793-2,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,6852.7,7537.97,8
APR-DRG,793-3,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,10273.08,11300.39,8
APR-DRG,793-4,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,17233.79,18957.17,8
APR-DRG,794-1,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,3793.67,4173.04,8
APR-DRG,794-2,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,5119.12,5631.03,8
APR-DRG,794-3,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,7902.9,8693.19,8
APR-DRG,794-4,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,15915.81,17507.39,8
APR-DRG,810-1,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,2395.06,2634.57,8
APR-DRG,810-2,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,3371.1,3708.21,8
APR-DRG,810-3,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,5337.12,5870.83,8
APR-DRG,810-4,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,10513.98,11565.38,8
APR-DRG,811-1,ALLERGIC REACTIONS,,,1905.29,2095.82,8
APR-DRG,811-2,ALLERGIC REACTIONS,,,2414.47,2655.92,8
APR-DRG,811-3,ALLERGIC REACTIONS,,,4159.0,4574.9,8
APR-DRG,811-4,ALLERGIC REACTIONS,,,7765.03,8541.53,8
APR-DRG,812-1,POISONING OF MEDICINAL AGENTS,,,1825.66,2008.23,8
APR-DRG,812-2,POISONING OF MEDICINAL AGENTS,,,2354.24,2589.66,8
APR-DRG,812-3,POISONING OF MEDICINAL AGENTS,,,3143.14,3457.45,8
APR-DRG,812-4,POISONING OF MEDICINAL AGENTS,,,5545.17,6099.69,8
APR-DRG,813-1,OTHER COMPLICATIONS OF TREATMENT,,,2888.3,3177.13,8
APR-DRG,813-2,OTHER COMPLICATIONS OF TREATMENT,,,3538.83,3892.71,8
APR-DRG,813-3,OTHER COMPLICATIONS OF TREATMENT,,,5070.84,5577.92,8
APR-DRG,813-4,OTHER COMPLICATIONS OF TREATMENT,,,8861.03,9747.13,8
APR-DRG,815-1,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,2659.35,2925.29,8
APR-DRG,815-2,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,4118.69,4530.56,8
APR-DRG,815-3,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,8187.11,9005.82,8
APR-DRG,815-4,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,18050.06,19855.07,8
APR-DRG,816-1,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,1895.34,2084.87,8
APR-DRG,816-2,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,2573.24,2830.56,8
APR-DRG,816-3,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,3061.51,3367.66,8
APR-DRG,816-4,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,5874.67,6462.14,8
APR-DRG,817-1,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,2229.31,2452.24,8
APR-DRG,817-2,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,3015.72,3317.29,8
APR-DRG,817-3,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,3915.61,4307.17,8
APR-DRG,817-4,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,6617.77,7279.55,8
APR-DRG,841-1,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,116955.39,128650.93,8
APR-DRG,841-2,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,116955.39,128650.93,8
APR-DRG,841-3,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,116955.39,128650.93,8
APR-DRG,841-4,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,116955.39,128650.93,8
APR-DRG,842-1,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,11292.92,12422.21,8
APR-DRG,842-2,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,14720.77,16192.85,8
APR-DRG,842-3,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,25660.81,28226.89,8
APR-DRG,842-4,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,48832.99,53716.29,8
APR-DRG,843-1,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,4482.52,4930.77,8
APR-DRG,843-2,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,4636.82,5100.5,8
APR-DRG,843-3,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,8887.41,9776.15,8
APR-DRG,843-4,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,8887.41,9776.15,8
APR-DRG,844-1,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,2665.82,2932.4,8
APR-DRG,844-2,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,4653.74,5119.11,8
APR-DRG,844-3,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,7059.26,7765.19,8
APR-DRG,844-4,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,7059.26,7765.19,8
APR-DRG,850-1,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,8781.39,9659.53,8
APR-DRG,850-2,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,11061.98,12168.18,8
APR-DRG,850-3,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,21865.64,24052.2,8
APR-DRG,850-4,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,55652.84,61218.12,8
APR-DRG,851-1,GENDER RELATED PROCEDURES,,,9901.28,10891.41,8
APR-DRG,851-2,GENDER RELATED PROCEDURES,,,12942.89,14237.18,8
APR-DRG,851-3,GENDER RELATED PROCEDURES,,,16882.89,18571.18,8
APR-DRG,851-4,GENDER RELATED PROCEDURES,,,53858.54,59244.39,8
APR-DRG,860-1,REHABILITATION,,,8225.43,9047.97,8
APR-DRG,860-2,REHABILITATION,,,10153.63,11168.99,8
APR-DRG,860-3,REHABILITATION,,,13158.4,14474.24,8
APR-DRG,860-4,REHABILITATION,,,15947.67,17542.44,8
APR-DRG,861-1,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,2819.62,3101.58,8
APR-DRG,861-2,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,3467.66,3814.43,8
APR-DRG,861-3,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,5608.38,6169.22,8
APR-DRG,861-4,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,6743.7,7418.07,8
APR-DRG,862-1,OTHER AFTERCARE AND CONVALESCENCE,,,6049.87,6654.86,8
APR-DRG,862-2,OTHER AFTERCARE AND CONVALESCENCE,,,7461.92,8208.11,8
APR-DRG,862-3,OTHER AFTERCARE AND CONVALESCENCE,,,10499.05,11548.96,8
APR-DRG,862-4,OTHER AFTERCARE AND CONVALESCENCE,,,20097.71,22107.48,8
APR-DRG,863-1,NEONATAL AFTERCARE,,,4651.75,5116.93,8
APR-DRG,863-2,NEONATAL AFTERCARE,,,18818.56,20700.42,8
APR-DRG,863-3,NEONATAL AFTERCARE,,,33767.79,37144.57,8
APR-DRG,863-4,NEONATAL AFTERCARE,,,44695.38,49164.92,8
APR-DRG,890-1,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,3604.53,3964.98,8
APR-DRG,890-2,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,3604.53,3964.98,8
APR-DRG,890-3,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,6390.81,7029.89,8
APR-DRG,890-4,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,11260.57,12386.63,8
APR-DRG,894-1,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,2419.94,2661.93,8
APR-DRG,894-2,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,3272.05,3599.26,8
APR-DRG,894-3,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,4479.04,4926.94,8
APR-DRG,894-4,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,4479.04,4926.94,8
APR-DRG,910-1,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,7479.34,8227.27,8
APR-DRG,910-2,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,7479.34,8227.27,8
APR-DRG,910-3,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,19266.01,21192.61,8
APR-DRG,910-4,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,31774.89,34952.38,8
APR-DRG,911-1,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,7420.61,8162.67,8
APR-DRG,911-2,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,7420.61,8162.67,8
APR-DRG,911-3,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,9721.6,10693.76,8
APR-DRG,911-4,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,27301.81,30031.99,8
APR-DRG,912-1,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,8330.95,9164.05,8
APR-DRG,912-2,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,8330.95,9164.05,8
APR-DRG,912-3,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,13532.2,14885.42,8
APR-DRG,912-4,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,24629.52,27092.47,8
APR-DRG,930-1,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,1881.9,2070.09,8
APR-DRG,930-2,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,3180.97,3499.07,8
APR-DRG,930-3,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,4987.72,5486.49,8
APR-DRG,930-4,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,15608.22,17169.04,8
APR-DRG,950-1,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,7211.06,7932.17,8
APR-DRG,950-2,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,9618.57,10580.43,8
APR-DRG,950-3,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,14789.95,16268.95,8
APR-DRG,950-4,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,34945.91,38440.5,8
APR-DRG,951-1,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,4589.04,5047.94,8
APR-DRG,951-2,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,5856.75,6442.43,8
APR-DRG,951-3,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,10682.71,11750.98,8
APR-DRG,951-4,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,22994.98,25294.48,8
APR-DRG,952-1,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,4595.51,5055.06,8
APR-DRG,952-2,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,5076.31,5583.94,8
APR-DRG,952-3,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,9283.6,10211.96,8
APR-DRG,952-4,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,21500.81,23650.89,8
CDM,0054TAK,CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES,118.0,76.7,0.01,486.52,32
CDM,0055TAK,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,730.0,474.5,0.01,820.62,32
CDM,0075TAK,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,3898.0,2533.7,1.1,3898.0,32
CDM,0076TAK,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,2228.0,1448.2,1.1,1791901.44,31
CDM,0101TAK,"EXTRACORP SHOCKWV TX,HI ENRG",180.0,117.0,1.1,1725.52,34
CDM,0184TAK,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,7239.0,4705.35,1.1,9730.56,34
CDM,0201TAK,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,12831.0,8340.15,1.1,12831.0,31
CDM,0232TAK,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,750.0,487.5,1.1,1039.24,32
CDM,0232TPRPAK,NJX PLATELET PLASMA,750.0,487.5,1.1,1039.24,32
CDM,0338TAK,TRANSCATH RENAL SYMP DENERV UNI,7571.0,4921.15,1.1,18417.4,31
CDM,0339TAK,TRANSCATH RENAL SYMP DENERV BILAT,8704.0,5657.6,1.1,29389.56,31
CDM,0362TAK,BEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME,293.0,190.45,1.1,294.52,31
CDM,0373TAK,ADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME,191.0,124.15,1.1,266.89,31
CDM,0437TAK,IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL,2128.0,1383.2,1.1,2128.0,32
CDM,0474TAK,INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR,5757.0,3742.05,1.1,5757.0,32
CDM,0483TAK,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,11627.0,7557.55,1.1,1791901.44,31
CDM,0484TAK,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,26564.0,17266.6,1.1,1791901.44,31
CDM,0515TAK,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,13216.0,8590.4,1.1,40246.53,31
CDM,0516TAK,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,13216.0,8590.4,1.1,18231.81,31
CDM,0517TAK,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,13216.0,8590.4,1.1,18231.81,31
CDM,0518TAK,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,2529.0,1643.85,1.1,6705.66,31
CDM,0519TAK,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,2529.0,1643.85,1.1,18231.81,31
CDM,0520TAK,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,2529.0,1643.85,1.1,18231.81,31
CDM,0521TAK,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,308.0,200.2,1.1,308.0,31
CDM,0522TAK,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,403.0,261.95,1.1,403.0,31
CDM,0523TAK,INTRAPROCEDURAL CORONARY FFP W/3D FUNCJL MAPPING,2593.0,1685.45,1.1,7735.57,32
CDM,0569TAK,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,11278.0,7330.7,1.1,11278.0,32
CDM,0570TAK,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,11278.0,7330.7,1.1,1791901.44,31
CDM,0571TAK,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,9806.0,6373.9,1.1,56172.03,31
CDM,0572TAK,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,2484.0,1614.6,1.1,14506.24,31
CDM,0573TAK,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,10278.0,6680.7,1.1,10278.0,31
CDM,0574TAK,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,2835.0,1842.75,1.1,6705.66,31
CDM,0575TAK,PROGRAMMING DEV EVAL ICDS W/SS ELTRD IN PERSON,299.0,194.35,1.1,299.0,31
CDM,0576TAK,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,402.0,261.3,1.1,402.0,32
CDM,0577TAK,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,2414.0,1569.1,1.1,2414.0,31
CDM,0578TAK,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D PHY/QHP,662.0,430.3,1.1,1791901.44,31
CDM,0580TAK,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,1407.0,914.55,1.1,6705.66,31
CDM,0583TAK,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,1949.0,1266.85,1.1,2603.78,43
CDM,0587TAK,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,3473.0,2257.45,1.1,11676.67,31
CDM,0588TAK,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,2800.0,1820.0,1.1,5809.66,31
CDM,0589TAK,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,351.0,228.15,1.1,351.0,31
CDM,0590TAK,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,654.0,425.1,1.1,654.0,31
CDM,0601TAK,IRE ABLATION 1+TUMORS PR ORGN W/FLUOR & US GDN OPN,13390.0,8703.5,1.1,17575.94,31
CDM,0620TAK,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,12104.0,7867.6,1.1,49281.79,31
CDM,0622TAK,TRABECULOSTOMY AB INTERNO LASER W/OPH ENDOSCOPE,3772.0,2451.8,1.1,1791901.44,31
CDM,0652TAK,EGD FLEXIBLE TRANSNASAL DX W/COLLJ SPEC BR/WA,1037.0,674.05,1.1,3248.9,25
CDM,0654TAK,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,1055.0,685.75,1.1,6539.01,26
CDM,0683TAK,PROGRAMMING DEVICE EVALUATION IN PERSON ISDSS,291.0,189.15,1.1,1791901.44,28
CDM,0684TAK,PERIPROCEDURAL DEVICE EVALUATION IN PERSON ISDSS,53.0,34.45,1.1,1791901.44,28
CDM,0685TAK,INTERROGATION DEVICE EVALUATION IN PERSON ISDSS,126.0,81.9,1.1,1791901.44,28
CDM,0695TAK,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM IMPLT,82.0,53.3,1.1,661.95,31
CDM,0696TAK,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM F/UP,82.0,53.3,1.1,661.95,31
CDM,0707TAK,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,966.0,627.9,1.1,5526.53,31
CDM,0710TAK,N-INVAS ARTL PLAQ ALYS DATA PRP QUAN REVIEW I&R,1016.0,660.4,1.1,1791901.44,28
CDM,0713TAK,N-INVAS ARTL PLAQ ALYS DATA REVIEW I&R,1016.0,660.4,1.1,1791901.44,28
CDM,0740TAK,REM AUTON ALG INSULIN DOSE 1ST SETUP& PT EDUCAJ,297.0,193.05,1.1,297.0,31
CDM,0741TAK,REM AUTON ALG NSLN DOS CAL SW DATA COLL TRANSMIS,465.0,302.25,1.1,465.0,31
CDM,0742TAK,AQMBF SPECT W/EXERCISE/RX STRESS & REST,585.0,380.25,1.1,585.0,25
CDM,0743TAK,BONE STRENGTH & FRACTURE RSK CNCRNT VRT FX ASSMT,96.0,62.4,1.1,1791901.44,30
CDM,0744TAK,INSERTION BIOPROSTHETIC VALVE OPEN FEMORAL VEIN,7136.0,4638.4,1.1,9382.91,31
CDM,0745TAK,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,12255.0,7965.75,1.1,1791901.44,31
CDM,0746TAK,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,12255.0,7965.75,1.1,1791901.44,31
CDM,0747TAK,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,12255.0,7965.75,1.1,1791901.44,31
CDM,0748TAK,NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS,997.0,648.05,1.1,1791901.44,31
CDM,0764TAK,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,298.0,193.7,1.1,1791901.44,31
CDM,0765TAK,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,298.0,193.7,1.1,1791901.44,31
CDM,0766TAK,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN 1ST NERVE,308.0,200.2,1.1,741.48,28
CDM,0767TAK,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN EA ADD NRV,308.0,200.2,1.1,741.48,28
CDM,0776TAK,THERAPEUTIC INDUCTION OF INTRA-BRAIN HYPOTHERMIA,1906.0,1238.9,1.1,1791901.44,28
CDM,0777TAK,R-T PRESSURE SENSING EPIDURAL GUIDANCE SYSTEM,993.0,645.45,1.1,993.0,31
CDM,0778TAK,SMMG CNCRNT APPL IMU SNR MEAS ROM POST GAIT MUSC,174.0,113.1,1.1,267.01,28
CDM,0779TAK,GI MYOELECTRICAL ACTIVITY STUDY STMCH-COLON I&R,69.0,44.85,1.1,1092.16,31
CDM,0780TAK,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,603.0,391.95,1.1,603.0,31
CDM,0781TAK,BRNCHSC RF DSTRJ PULM NRV BI MAINSTEM BRONCHI,1177.0,765.05,1.1,1791901.44,28
CDM,0782TAK,BRNCHSC RF DSTRJ PULM NRV UNI MAINSTEM BRONCHUS,1177.0,765.05,1.1,1791901.44,28
CDM,0783TAK,TC AURICULAR NSTIMJ SETUP CALIBRATION &PT EDUCAJ,174.0,113.1,1.1,741.48,31
CDM,0784TAK,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,3546.0,2304.9,1.1,23258.37,31
CDM,0785TAK,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,2574.0,1673.1,1.1,5809.66,31
CDM,0786TAK,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,2697.0,1753.05,1.1,23258.37,31
CDM,0787TAK,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,1047.0,680.55,1.1,5809.66,31
CDM,0788TAK,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,388.0,252.2,1.1,388.0,31
CDM,0789TAK,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,397.0,258.05,1.1,397.0,31
CDM,0795TAK,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,3867.0,2513.55,1.1,33268.48,24
CDM,0804TAK,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,246.0,159.9,1.1,246.0,24
CDM,0811TAK,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,84.0,54.6,1.1,225.79,30
CDM,0812TAK,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,84.0,54.6,1.1,84.0,28
CDM,0816TAK,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ,2856.0,1856.4,1.1,37350.66,30
CDM,0817TAK,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBF,2192.0,1424.8,1.1,37350.66,29
CDM,0818TAK,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS,2529.0,1643.85,1.1,5809.66,30
CDM,0819TAK,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL,2529.0,1643.85,1.1,5809.66,28
CDM,0820TAK,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,1722.0,1119.3,1.1,1791901.44,31
CDM,0821TAK,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,1722.0,1119.3,1.1,1722.0,31
CDM,0822TAK,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,1722.0,1119.3,1.1,1722.0,31
CDM,0823TAK,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,3867.0,2513.55,1.1,33268.48,24
CDM,0824TAK,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,1557.0,1012.05,1.1,5442.3,24
CDM,0825TAK,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,2603.0,1691.95,1.1,33268.48,24
CDM,0826TAK,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,472.0,306.8,1.1,472.0,24
CDM,0826TAK-26,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,323.0,209.95,1.1,323.0,24
CDM,0826TAK-TC,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,149.0,96.85,1.1,149.0,24
CDM,0857TAK,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,787.0,511.55,1.1,787.0,25
CDM,0857TAK-26,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,362.0,235.3,1.1,362.0,25
CDM,0857TAK-TC,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,425.0,276.25,1.1,425.0,27
CDM,0866TAK,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,1237.0,804.05,1.1,1237.0,30
CDM,0866TAK-26,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,270.0,175.5,1.1,303.3,30
CDM,0866TAK-TC,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,967.0,628.55,1.1,967.0,32
CDM,0894TAK,CANNULJ LVR ALGRFT PREPJ CONNJ NRMTHRMC PRFU DEV,6094.0,3961.1,1.1,6094.0,30
CDM,0895TAK,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV 1ST 4 HOURS,3924.0,2550.6,1.1,3924.0,24
CDM,0896TAK,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV EA ADDL HOUR,1666.0,1082.9,1.1,1666.0,24
CDM,0908TAK,OPEN IMPLTJ INT NEUROSTIMULATION SYS VAGUS NERVE,4180.0,2717.0,1.1,4180.0,28
CDM,0909TAK,REPLACEMENT INT NEUROSTIMULATION SYS VAGUS NERVE,5108.0,3320.2,1.1,5108.0,28
CDM,0910TAK,REMOVAL INT NEUROSTIMULATION SYS VAGUS NERVE,4226.0,2746.9,1.1,4226.0,28
CDM,0911TAK,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,163.0,105.95,1.1,163.0,28
CDM,0912TAK,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,363.0,235.95,1.1,363.0,28
CDM,0913TAK,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART,2708.0,1760.2,1.1,2708.0,29
CDM,0914TAK,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,2708.0,1760.2,1.1,2708.0,28
CDM,0915TAK,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,5227.0,3397.55,1.1,5227.0,28
CDM,0916TAK,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,2334.0,1517.1,1.1,2334.0,28
CDM,0917TAK,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,2460.0,1599.0,1.1,2460.0,28
CDM,0918TAK,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,2460.0,1599.0,1.1,2460.0,28
CDM,0919TAK,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,1436.0,933.4,1.1,1436.0,28
CDM,0920TAK,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,3675.0,2388.75,1.1,3675.0,28
CDM,0921TAK,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,3675.0,2388.75,1.1,3675.0,28
CDM,0922TAK,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,3675.0,2388.75,1.1,4461.08,28
CDM,0923TAK,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,2330.0,1514.5,1.1,2330.0,28
CDM,0924TAK,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2071.0,1346.15,1.1,2071.0,28
CDM,0925TAK,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,2926.0,1901.9,1.1,2926.0,28
CDM,0926TAK,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,872.0,566.8,1.1,872.0,28
CDM,0927TAK,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,390.0,253.5,1.1,390.0,28
CDM,0928TAK,REMOTE INTERROG DEV EVAL CCM-D SYS <90D PHYS/QHP,279.0,181.35,1.1,279.0,28
CDM,0930TAK,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,5227.0,3397.55,1.1,5227.0,28
CDM,0931TAK,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,5227.0,3397.55,1.1,5227.0,28
CDM,0933TAK,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,2786.0,1810.9,1.1,2786.0,28
CDM,0934TAK,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,325.0,211.25,1.1,325.0,28
CDM,0935TAK,CYSTO W/RNL PEL SYMPATHETIC DNRVTJ RF ABLTJ BI,3715.0,2414.75,1.1,3715.0,28
CDM,0936TAK,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,28.0,18.2,1.1,1858.16,29
CDM,0937TAK,XTRNL ECG REC>15D<30D REC SCAN ALYS RVW&INTERPJ,256.0,166.4,1.1,857.19,28
CDM,0940TAK,XTRNL ECG REC>15D<30D REVIEW&INTERPJ PHYS/QHP,256.0,166.4,1.1,5185.26,28
CDM,0941TAK,CYSTO FLX INSJ&XPNSJ PROSTATIC URTL SCAFFOLD,762.0,495.3,1.1,762.0,28
CDM,0942TAK,CYSTO FLX RMVL&RPLCMT PROSTATIC URTL SCAFFOLD,1306.0,848.9,1.1,3359.91,28
CDM,0943TAK,CYSTO FLX REMOVAL PROSTATIC URETHRAL SCAFFOLD,1306.0,848.9,1.1,2392.5,28
CDM,0944TAK,3D CONTOUR SIMULAJ TRGT LVR LES&MRGN MICRWV ABLT,93.0,60.45,1.1,801.19,28
CDM,0947TAK,MRGFUS STRTCTC BLD-BRN BARR DISRPJ MBUBB RSN8TR,7488.0,4867.2,1.1,7488.0,22
CDM,0950TAK,PR ABLTJ B9 PRST8 TISSUE TRANSRECTAL HIFU W/US GDN,7092.0,4609.8,1.1,7092.0,28
CDM,0988TAK,OPEN INSJ/RPLCMT INT NSTIMJ SYS PTN SUBQ&SUBF,2192.0,1424.8,1.1,2192.0,22
CDM,0989TAK,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBQ&SUBF,2529.0,1643.85,1.1,2529.0,22
CDM,0990TAK,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,387.0,251.55,1.1,387.0,22
CDM,0991TAK,CYSTO LO-NRG LITHOTRP&ACOUS ACTUATED MICROSPHERE,3200.0,2080.0,1.1,3200.0,22
CDM,0993TAK,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,1291.0,839.15,1.1,1291.0,22
CDM,0993TAK-26,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,316.0,205.4,1.1,316.0,22
CDM,0993TAK-TC,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,975.0,633.75,1.1,975.0,22
CDM,0997TAK,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,584.0,379.6,1.1,584.0,22
CDM,0998TAK,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,584.0,379.6,1.1,584.0,22
CDM,10004AK,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,320.0,208.0,1.1,320.0,53
CDM,10005AK,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,642.0,417.3,1.1,1200.64,53
CDM,10006AK,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,440.0,286.0,1.1,440.0,53
CDM,10007AK,FINE NEEDLE ASPIRATION BX W/FLUORO GDN 1ST LESION,724.0,470.6,1.1,1200.64,53
CDM,10008AK,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,472.0,306.8,1.1,475.4,53
CDM,10009AK,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,904.0,587.6,1.1,1422.85,53
CDM,10010AK,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,660.0,429.0,1.1,784.91,53
CDM,10011AK,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,1206.0,783.9,1.1,1537.59,31
CDM,10012AK,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,605.0,393.25,1.1,929.99,31
CDM,10021AK,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,453.0,294.45,1.1,680.96,53
CDM,10030AK,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,1100.0,715.0,1.1,2115.72,53
CDM,10035AK,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,680.0,442.0,1.1,1209.18,53
CDM,10036AK,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,340.0,221.0,1.1,998.28,53
CDM,10040AK,ACNE SURGERY,400.0,260.0,1.1,400.0,53
CDM,10040URVU1AK,ACNE SURGERY,151.0,98.15,1.1,383.79,53
CDM,10040URVUAK,ACNE SURGERY OF SKIN ABSCESS,151.0,98.15,1.1,383.79,53
CDM,10060AK,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,537.0,349.05,1.1,537.0,53
CDM,10060URVU1AK,"I & D ABSCESS, SINGLE",169.0,109.85,1.1,416.21,53
CDM,10060URVUAK,DRAINAGE OF SKIN ABSCESS,169.0,109.85,1.1,416.21,53
CDM,10061AK,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1078.0,700.7,1.1,1078.0,53
CDM,10061URVU1AK,"I & D, ABCESS COMPLEX MULTIP",302.0,196.3,1.1,710.76,53
CDM,10061URVUAK,DRAINAGE OF SKIN ABSCESS,302.0,196.3,1.1,710.76,53
CDM,10080AK,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,537.0,349.05,1.1,1200.64,53
CDM,10080URVUAK,DRAINAGE OF PILONIDAL CYST,253.0,164.45,1.1,1200.64,53
CDM,10081AK,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,1100.0,715.0,1.1,1200.64,53
CDM,10081URVU1AK,DRAIN PILONIDAL CYST COMPLIC,450.0,292.5,1.1,1200.64,53
CDM,10081URVUAK,DRAINAGE OF PILONIDAL CYST,450.0,292.5,1.1,1200.64,53
CDM,10120AK,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,537.0,349.05,1.1,680.96,53
CDM,10120URVU1AK,INCIS & REMOV FB SUBCUTANEOUS,209.0,135.85,1.1,680.96,53
CDM,10120URVUAK,REMOVE FOREIGN BODY,209.0,135.85,1.1,680.96,53
CDM,10121AK,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,1206.0,783.9,1.1,2768.64,53
CDM,10140AK,I&D HEMATOMA SEROMA/FLUID COLLECTION,695.0,451.75,1.1,2768.64,53
CDM,10140URVU1AK,"I & D HEMATOMA, SEROMA",234.0,152.1,1.1,2768.64,53
CDM,10140URVUAK,DRAINAGE OF HEMATOMA/FLUID,234.0,152.1,1.1,2768.64,53
CDM,10160AK,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,500.0,325.0,1.1,680.96,53
CDM,10160URVU1AK,"PUNC ASP; ABSCESS, HEMATO",187.0,121.55,1.1,680.96,53
CDM,10160URVUAK,PUNCTURE DRAINAGE OF LESION,187.0,121.55,1.1,680.96,53
CDM,10180AK,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,920.0,598.0,1.1,4850.94,53
CDM,10180URVU1AK,"I & D, COMP POSTOP INFECTION",379.0,246.35,1.1,4850.94,53
CDM,10180URVUAK,"COMPLEX DRAINAGE, WOUND",379.0,246.35,1.1,4850.94,53
CDM,11000AK,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,240.0,156.0,1.1,1071.62,53
CDM,11000URVU1AK,DEBRIDEMENT UP TO 10%,86.0,55.9,1.1,1071.62,53
CDM,11000URVUAK,DEBRIDE INFECTED SKIN,86.0,55.9,1.1,1071.62,53
CDM,11001AK,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,120.0,78.0,1.1,120.0,53
CDM,11004AK,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,4320.0,2808.0,1.1,4320.0,50
CDM,11004URVU1AK,DEBRIDE GENITALIA & PERINEUM,944.0,613.6,1.1,1941.29,50
CDM,11004URVUAK,DEBRIDE SKIN/SUBCU/MUSC/FASC EXT GENITAL,944.0,613.6,1.1,1941.29,50
CDM,11005AK,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,5696.0,3702.4,1.1,5696.0,50
CDM,11006AK,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,5240.0,3406.0,1.1,5240.0,50
CDM,11006URVUAK,"DEBRIDE SKIN/SUBC/MUSC/FAS ABD,EXT GEN,P",1151.0,748.15,1.1,2394.89,50
CDM,11008AK,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,2000.0,1300.0,1.1,2000.0,50
CDM,11008URVUAK,REMOVAL OF MESH,510.0,331.5,1.1,935.52,50
CDM,11010AK,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,1844.0,1198.6,1.1,1844.0,53
CDM,11010URVU1AK,DEBRIDE SKIN AT FX SITE,765.0,497.25,1.1,1508.5,53
CDM,11010URVUAK,"DEBRIDE SKIN, FX",765.0,497.25,1.1,1508.5,53
CDM,11011AK,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2174.0,1413.1,1.1,2174.0,53
CDM,11011URVU1AK,DEBRIDE SKIN MUSC AT FX SITE,887.0,576.55,1.1,1661.98,53
CDM,11011URVUAK,"DEBRIDE SKIN/MUSCLE, FX",887.0,576.55,1.1,1661.98,53
CDM,11012AK,DBRDMT FX&/DISLC SUBQ T/M/F BONE,3023.0,1964.95,1.1,4850.94,53
CDM,11012URVU1AK,DEB SKIN BONE AT FX SITE,1302.0,846.3,1.1,4850.94,53
CDM,11012URVUAK,"DEBRIDE SKIN/MUSCLE/BONE, FX",1302.0,846.3,1.1,4850.94,53
CDM,11042AK,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,444.0,288.6,1.1,680.96,53
CDM,11042URVU1AK,DEBRIDE SKIN AND SUBQ TISSU,182.0,118.3,1.1,680.96,53
CDM,11042URVUAK,DEBRIDE SKIN/TISSUE,182.0,118.3,1.1,680.96,53
CDM,11043AK,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1188.0,772.2,1.1,1188.0,53
CDM,11043URVU1AK,"DEBRI;CURRET,SKIN/SUBQ/MUS",410.0,266.5,1.1,1071.62,53
CDM,11043URVUAK,DEBRIDE TISSUE/MUSCLE,410.0,266.5,1.1,1071.62,53
CDM,11044AK,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,1804.0,1172.6,1.1,2768.64,53
CDM,11044URVU1AK,DEB BONE 20 SQ CM/<,561.0,364.65,1.1,2768.64,53
CDM,11044URVUAK,DEBRIDE TISSUE/MUSCLE/BONE,561.0,364.65,1.1,2768.64,53
CDM,11045AK,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,200.0,130.0,1.1,200.0,53
CDM,11046AK,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,412.0,267.8,1.1,412.0,53
CDM,11047AK,DEBRIDEMENT BONE EA ADDL 20 SQ CM/<,720.0,468.0,1.1,720.0,53
CDM,11055AK,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,154.0,100.1,1.1,342.27,53
CDM,11055URVU1AK,PARE BENIGN LES; SGL,76.0,49.4,1.1,342.27,53
CDM,11055URVUAK,TRIM SKIN LESION,76.0,49.4,1.1,342.27,53
CDM,11056AK,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,220.0,143.0,1.1,342.27,53
CDM,11056URVU1AK,TRIM SKIN LESIONS 2 TO 4,114.0,74.1,1.1,342.27,53
CDM,11056URVUAK,"TRIM SKIN LESIONS, 2 TO 4",114.0,74.1,1.1,342.27,53
CDM,11057AK,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,286.0,185.9,1.1,342.27,53
CDM,11057URVU1AK,TRIM SKIN LESIONS OVER 4,108.0,70.2,1.1,342.27,53
CDM,11057URVUAK,"TRIM SKIN LESIONS, OVER 4",108.0,70.2,1.1,342.27,53
CDM,11102AK,TANGENTIAL BIOPSY SKIN SINGLE LESION,290.0,188.5,1.1,342.27,53
CDM,11103AK,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,167.0,108.55,1.1,167.0,53
CDM,11104AK,PUNCH BIOPSY SKIN SINGLE LESION,365.0,237.25,1.1,680.96,53
CDM,11105AK,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,198.0,128.7,1.1,198.0,53
CDM,11106AK,INCISIONAL BIOSPY SKIN SINGLE LESION,404.0,262.6,1.1,1071.62,53
CDM,11107AK,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,216.0,140.4,1.1,236.37,53
CDM,11200AK,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,361.0,234.65,1.1,361.0,53
CDM,11200RVU3AK,SKIN TAG REMOVAL 1 - 15,250.0,162.5,1.1,342.27,53
CDM,11200URVU1AK,REM SKIN TAGS; <=15 LESIONS,130.0,84.5,1.1,342.27,53
CDM,11200URVUAK,REMOVAL OF SKIN TAGS,130.0,84.5,1.1,342.27,53
CDM,11201AK,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,128.0,83.2,1.1,128.0,53
CDM,11300AK,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,264.0,171.6,1.1,680.96,53
CDM,11300URVU1AK,SHAVE LES T/A/L; 0.5CM/<,111.0,72.15,1.1,680.96,53
CDM,11300URVUAK,SHAVE SKIN LESION,111.0,72.15,1.1,680.96,53
CDM,11301AK,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,396.0,257.4,1.1,402.94,53
CDM,11302AK,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,462.0,300.3,1.1,462.0,53
CDM,11302URVU1AK,SHAVE LES T/A/L; 1.1-2.0CM,181.0,117.65,1.1,453.78,53
CDM,11302URVUAK,SHAVE SKIN LESION,181.0,117.65,1.1,453.78,53
CDM,11303AK,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,550.0,357.5,1.1,680.96,53
CDM,11303URVU1AK,SHAVE LES T/A/L; > 2.0CM,215.0,139.75,1.1,680.96,53
CDM,11303URVUAK,SHAVE SKIN LESION,215.0,139.75,1.1,680.96,53
CDM,11305AK,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,352.0,228.8,1.1,352.0,53
CDM,11305URVU1AK,SHAVE LES S/N/H/F/G; 0.5CM/<,113.0,73.45,1.1,349.05,53
CDM,11305URVUAK,SHAVE SKIN LESION,113.0,73.45,1.1,349.05,53
CDM,11306AK,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,422.0,274.3,1.1,422.0,53
CDM,11306URVU1AK,SHAVE LES S/N/H/F/G; 0.6-1.0CM,157.0,102.05,1.1,406.74,53
CDM,11306URVUAK,SHAVE SKIN LESION,157.0,102.05,1.1,406.74,53
CDM,11307AK,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,528.0,343.2,1.1,528.0,53
CDM,11307URVUAK,SHAVE SKIN LESION,185.0,120.25,1.1,461.93,53
CDM,11308AK,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,642.0,417.3,1.1,680.96,53
CDM,11308URVUAK,SHAVE SKIN LESION,210.0,136.5,1.1,680.96,53
CDM,11310AK,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,352.0,228.8,1.1,384.8,53
CDM,11310URVUAK,SHAVE SKIN LESION,137.0,89.05,1.1,384.8,53
CDM,11311AK,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,484.0,314.6,1.1,484.0,53
CDM,11311URVUAK,SHAVE SKIN LESION,175.0,113.75,1.1,453.38,53
CDM,11312AK,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,572.0,371.8,1.1,680.96,53
CDM,11312URVUAK,SHAVE SKIN LESION,203.0,131.95,1.1,680.96,53
CDM,11313AK,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,739.0,480.35,1.1,739.0,53
CDM,11313URVUAK,SHAVE SKIN LESION,256.0,166.4,1.1,680.96,53
CDM,11400AK,"REM LESION TRUNK,ARM, LEG <0.5 CM",360.0,234.0,1.1,1200.64,53
CDM,11400URVUAK,REMOVAL OF SKIN LESION,180.0,117.0,1.1,1200.64,53
CDM,11401AK,"REM LESION TRUNK,ARM,LEG 0.6 -1.0CM",563.0,365.95,1.1,680.96,53
CDM,11401URVUAK,REMOVAL OF SKIN LESION,220.0,143.0,1.1,680.96,53
CDM,11402AK,"REM LESIO TRUNK,ARM,LEG 1.1 -2.0CM",638.0,414.7,1.1,1200.64,53
CDM,11402URVUAK,REMOVAL OF SKIN LESION,246.0,159.9,1.1,1200.64,53
CDM,11403AK,"REM LESIO TRUNK,ARM,LEG 2.1-3.0CM",810.0,526.5,1.1,1200.64,53
CDM,11403URVUAK,REMOVAL OF SKIN LESION,287.0,186.55,1.1,1200.64,53
CDM,11404AK,"REM LESIO TRUNK,ARM,LEG 3.0-4.0CM",928.0,603.2,1.1,2768.64,53
CDM,11404URVUAK,REMOVAL OF SKIN LESION,327.0,212.55,1.1,2768.64,53
CDM,11406AK,"REM LESION TRUNK,ARM,LEG > 4.0CM",1549.0,1006.85,1.1,2768.64,53
CDM,11406URVUAK,REMOVAL OF SKIN LESION,465.0,302.25,1.1,2768.64,53
CDM,11420AK,"REM LESION NEC,HAND,SCAL<0.5CM",453.0,294.45,1.1,2768.64,53
CDM,11420URVUAK,REMOVAL OF SKIN LESION,181.0,117.65,1.1,2768.64,53
CDM,11421AK,"REM LESION NEC,HND,SCAL 0.6-1.0CM",647.0,420.55,1.1,1200.64,53
CDM,11421URVUAK,REMOVAL OF SKIN LESION,234.0,152.1,1.1,1200.64,53
CDM,11422AK,"REM LESION NEC,HND,SCAL,FEET,GENITALIA 1.1-2.0CM",739.0,480.35,1.1,2768.64,53
CDM,11422URVUAK,REMOVAL OF SKIN LESION,272.0,176.8,1.1,2768.64,53
CDM,11423AK,"REM LESION NEC,HND,SCAL 2.1-3.0CM",906.0,588.9,1.1,2768.64,53
CDM,11423URVUAK,REMOVAL OF SKIN LESION,311.0,202.15,1.1,2768.64,53
CDM,11424AK,"REM LESION NEC,HND,SCAL 3.1-4.0CM",1091.0,709.15,1.1,2768.64,53
CDM,11424URVUAK,REMOVAL OF SKIN LESION,361.0,234.65,1.1,2768.64,53
CDM,11426AK,"REM LESION NECK,HAND,SCAL >4.0CM",1800.0,1170.0,1.1,4850.94,53
CDM,11426URVUAK,REMOVAL OF SKIN LESION,508.0,330.2,1.1,4850.94,53
CDM,11440AK,"REM LESION FACE,EAR,EYEL <5MM",462.0,300.3,1.1,1200.64,53
CDM,11440URVUAK,REMOVAL OF SKIN LESION,202.0,131.3,1.1,1200.64,53
CDM,11441AK,"REM LESION FACE,EAR,EYE 0.6-1CM",673.0,437.45,1.1,1200.64,53
CDM,11441URVUAK,REMOVAL OF SKIN LESION,256.0,166.4,1.1,1200.64,53
CDM,11442AK,"REM LESION FACE,EAR,EYE 1.1-2 CM",779.0,506.35,1.1,1200.64,53
CDM,11442URVUAK,REMOVAL OF SKIN LESION,290.0,188.5,1.1,1200.64,53
CDM,11443AK,"REM LESION FACE,EAR,EYE 2.1-3 CM",1030.0,669.5,1.1,2768.64,53
CDM,11443URVUAK,REMOVAL OF SKIN LESION,348.0,226.2,1.1,2768.64,53
CDM,11444AK,"REM LESION FACE,EAR,EYE 3.1-4 CM",1404.0,912.6,1.1,2768.64,53
CDM,11444URVUAK,REMOVAL OF SKIN LESION,436.0,283.4,1.1,2768.64,53
CDM,11446AK,"REM LESION FACE,EAR,EYE >4CM",2112.0,1372.8,1.1,4850.94,53
CDM,11446URVUAK,REMOVAL OF SKIN LESION,750.0,487.5,1.1,4850.94,53
CDM,11450AK,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,1288.0,837.2,1.1,4850.94,53
CDM,11450URVUAK,"REMOVAL, SWEAT GLAND LESION",585.0,380.25,1.1,4850.94,53
CDM,11451AK,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,1772.0,1151.8,1.1,4850.94,53
CDM,11451URVUAK,"REMOVAL, SWEAT GLAND LESION",950.0,617.5,1.1,4850.94,53
CDM,11462AK,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,1200.0,780.0,1.1,4850.94,53
CDM,11462URVUAK-29,"REMOVAL, SWEAT GLAND LESION",3040.0,1976.0,1.1,4850.94,53
CDM,11462URVUAK-30,"REMOVAL, SWEAT GLAND LESION",3040.0,1976.0,1.1,4850.94,53
CDM,11463AK,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,1772.0,1151.8,1.1,4850.94,53
CDM,11463URVUAK-31,"REMOVAL, SWEAT GLAND LESION",3709.0,2410.85,1.1,4850.94,53
CDM,11463URVUAK-32,"REMOVAL, SWEAT GLAND LESION",3709.0,2410.85,1.1,4850.94,53
CDM,11470AK,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,1496.0,972.4,1.1,4850.94,53
CDM,11471AK,EXCISION H/P/P/U COMPLEX REPAIR,1956.0,1271.4,1.1,4850.94,53
CDM,11600AK,MAL REM LESION 0.5 CM OR LESS,717.0,466.05,1.1,1200.64,53
CDM,11600URVUAK,REMOVAL OF SKIN LESION,285.0,185.25,1.1,1200.64,53
CDM,11601AK,"MAL LESION TRUNK,ARM,LEG 0.6-1.0CM",911.0,592.15,1.1,1200.64,53
CDM,11601URVUAK,REMOVAL OF SKIN LESION,344.0,223.6,1.1,1200.64,53
CDM,11602AK,"MAL LESION TRUNK,ARM,LEG 1.1-2.0 CM",999.0,649.35,1.1,999.0,53
CDM,11602URVUAK,REMOVAL OF SKIN LESION,378.0,245.7,1.1,811.59,53
CDM,11603AK,"MAL LESION TRUNK,ARM,LEG 2.1-3.0 CM",1241.0,806.65,1.1,1241.0,53
CDM,11603URVUAK,REMOVAL OF SKIN LESION,430.0,279.5,1.1,1200.64,53
CDM,11604AK,"MAL LESION TRUNK,ARM,LEG 3.1-4.0 CM",1395.0,906.75,1.1,1395.0,53
CDM,11604URVUAK,REMOVAL OF SKIN LESION,482.0,313.3,1.1,1200.64,53
CDM,11606AK,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,2209.0,1435.85,1.1,2768.64,53
CDM,11606URVUAK,REMOVAL OF SKIN LESION,677.0,440.05,1.1,2768.64,53
CDM,11620AK,"MAL LESION TRUNK,ARM,LEG<0.5CM",656.0,426.4,1.1,2768.64,53
CDM,11620URVUAK,REMOVAL OF SKIN LESION,296.0,192.4,1.1,2768.64,53
CDM,11621AK,"MAL LESION NECK,HAND,SCAL 0.6-1CM",832.0,540.8,1.1,1200.64,53
CDM,11621URVUAK,REMOVAL OF SKIN LESION,359.0,233.35,1.1,1200.64,53
CDM,11622AK,"MAL LESION NECK,HAND,SCAL 1.1-2CM",964.0,626.6,1.1,1200.64,53
CDM,11622URVUAK,REMOVAL OF SKIN LESION,409.0,265.85,1.1,1200.64,53
CDM,11623AK,"MAL LESION NECK,HAND,SCAL 2.1-3CM",1244.0,808.6,1.1,2768.64,53
CDM,11623URVUAK,REMOVAL OF SKIN LESION,483.0,313.95,1.1,2768.64,53
CDM,11624AK,"MAL LESION NECK,HAND,SCAL 3.1-4CM",1448.0,941.2,1.1,2768.64,53
CDM,11624URVUAK,REMOVAL OF SKIN LESION,600.0,390.0,1.1,2768.64,53
CDM,11626AK,EXC SKIN MALIG >4CM REMAINDR BODY,1844.0,1198.6,1.1,4850.94,53
CDM,11626URVUAK,REMOVAL OF SKIN LESION,725.0,471.25,1.1,4850.94,53
CDM,11640AK,"MAL LESION FACE,EAR,EYEL <5MM",668.0,434.2,1.1,1200.64,53
CDM,11640URVUAK,REMOVAL OF SKIN LESION,319.0,207.35,1.1,1200.64,53
CDM,11641AK,"MAL LESION FACE,EAR,EYEL 0.6-1CM",868.0,564.2,1.1,1200.64,53
CDM,11641URVUAK,REMOVAL OF SKIN LESION,389.0,252.85,1.1,1200.64,53
CDM,11642AK,"MAL LESION FACE,EAR,EYEL 1.1-2CM",1048.0,681.2,1.1,1200.64,53
CDM,11642URVUAK,REMOVAL OF SKIN LESION,451.0,293.15,1.1,1200.64,53
CDM,11643AK,"MAL LESION FACE,EAR,EYEL 2.1-3CM",1368.0,889.2,1.1,2768.64,53
CDM,11643URVUAK,REMOVAL OF SKIN LESION,535.0,347.75,1.1,2768.64,53
CDM,11644AK,"MAL LESION FACE,EAR,EYEL 3.1-4CM",1736.0,1128.4,1.1,2768.64,53
CDM,11644URVUAK,REMOVAL OF SKIN LESION,656.0,426.4,1.1,2768.64,53
CDM,11646AK,"MAL LESION FACE,EAR,EYEL >4.0CM",2504.0,1627.6,1.1,4850.94,53
CDM,11646URVUAK,REMOVAL OF SKIN LESION,844.0,548.6,1.1,4850.94,53
CDM,11719AK,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,75.0,48.75,1.1,103.94,47
CDM,11719URVUAK,TRIM NAIL(S),34.0,22.1,1.1,103.94,47
CDM,11720AK,"DEBRIDEMENT OF NAIL(S), 1-5",141.0,91.65,1.1,141.0,53
CDM,11721AK,"DEBRIDEMENT OF NAILS, 6 OR MORE",238.0,154.7,1.1,238.0,53
CDM,11730AK,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,462.0,300.3,1.1,462.0,53
CDM,11730URVUAK,REMOVAL OF NAIL PLATE,148.0,96.2,1.1,381.01,53
CDM,11732AK,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,152.0,98.8,1.1,152.0,53
CDM,11740AK,EVAC. SUBUNGUAL HEMATOMA,148.0,96.2,1.1,218.62,53
CDM,11740URVUAK,DRAIN BLOOD FROM UNDER NAIL,74.0,48.1,1.1,218.62,53
CDM,11750AK,EXCISION NAIL MATRIX PERMANENT REMOVAL,695.0,451.75,1.1,695.0,53
CDM,11750URVUAK,REMOVAL OF NAIL BED,340.0,221.0,1.1,680.96,53
CDM,11755AK,BIOPSY NAIL UNIT SEPARATE PROCEDURE,500.0,325.0,1.1,1200.64,53
CDM,11755URVUAK,"BIOPSY, NAIL UNIT",210.0,136.5,1.1,1200.64,53
CDM,11760AK,"REPAIR OF NAIL BED, SIMPLE",652.0,423.8,1.1,1071.62,53
CDM,11760URVUAK,REPAIR OF NAIL BED,364.0,236.6,1.1,1071.62,53
CDM,11762AK,RECONSTRUC OF NAIL BED W GRAFT,1176.0,764.4,1.1,3114.5,53
CDM,11765AK,WEDGE EXCISION SKIN NAIL FOLD,488.0,317.2,1.1,680.96,53
CDM,11765URVUAK,"EXCISION OF NAIL FOLD, TOE",237.0,154.05,1.1,680.96,53
CDM,11770AK,EXCISION PILONIDAL CYST/SINUS SIMPLE,1170.0,760.5,1.1,4850.94,53
CDM,11770URVUAK,REMOVAL OF PILONIDAL LESION,466.0,302.9,1.1,4850.94,53
CDM,11771AK,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,2680.0,1742.0,1.1,4850.94,53
CDM,11771URVUAK,REMOVAL OF PILONIDAL LESION,1250.0,812.5,1.1,4850.94,53
CDM,11772AK,EXCISION PILONIDAL CYST/SINUS COMPLICATED,3234.0,2102.1,1.1,4850.94,53
CDM,11772URVUAK,REMOVAL OF PILONIDAL LESION,1600.0,1040.0,1.1,4850.94,53
CDM,11900AK,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,229.0,148.85,1.1,342.27,53
CDM,11901AK,INJECTION INTRALESIONAL >7 LESIONS,352.0,228.8,1.1,352.0,53
CDM,11920AK,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,644.0,418.6,1.1,1071.62,53
CDM,11921AK,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,772.0,501.8,1.1,1071.62,53
CDM,11922AK,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,196.0,127.4,1.1,202.23,53
CDM,11950AK,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,336.0,218.4,1.1,342.27,53
CDM,11951AK,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,476.0,309.4,1.1,1071.62,53
CDM,11952AK,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,676.0,439.4,1.1,1071.62,53
CDM,11954AK,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,740.0,481.0,1.1,1071.62,53
CDM,11960AK,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,4596.0,2987.4,1.1,6125.06,50
CDM,11970AK,REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT,3296.0,2142.4,1.1,12214.27,50
CDM,11971AK,REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT,2808.0,1825.2,1.1,4850.94,51
CDM,11976AK,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,712.0,462.8,1.1,1200.64,53
CDM,11980AK,SUBCUTANEOUS HORMONE PELLET IMPLANT,440.0,286.0,1.1,680.96,53
CDM,11981AK,INSERT DRUG IMPLANT DEVICE,502.0,326.3,1.1,502.0,53
CDM,11982AK,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,590.0,383.5,1.1,680.96,53
CDM,11983AK,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,840.0,546.0,1.1,840.0,53
CDM,12000005,ACCOMMODATION SEMI PRIVATE,3675.0,2388.75,1212.75,7687.0,21
CDM,12000025,ACCOMMODATION SEMI PRIVATE,3675.0,2388.75,1212.75,7687.0,21
CDM,12000045,ACCOMMODATION ONCOLOGY,3675.0,2388.75,1212.75,7687.0,21
CDM,12000055,ACCOMMODATION ICU NON-CRITICAL,3675.0,2388.75,1212.75,7687.0,21
CDM,12000065,ACCOMMODATION PERINATAL,3675.0,2388.75,1212.75,7687.0,21
CDM,12000075,ACCOMMODATION PERINATAL W FETAL MON,3675.0,2388.75,1212.75,7687.0,21
CDM,12000085,ACCOMMODATION PERI MULTI W FETAL MON,3675.0,2388.75,1212.75,7687.0,21
CDM,12000105,ACCOMMODATION ORTHO,3675.0,2388.75,1212.75,7687.0,21
CDM,12000115,ACCOMMODATION EMU,3675.0,2388.75,1212.75,7687.0,21
CDM,12001AK,"SIMP REPAIR SCALP,NECK,TRK <2.5CM",370.0,240.5,1.1,370.0,53
CDM,12002AK,"SIMP REPAIR SCALP,NECK,TRK 2.6-7.5CM",502.0,326.3,1.1,502.0,53
CDM,12004AK,"SIMP REPAIR SCALP,NECK,TRK 7.6-12.5CM",634.0,412.1,1.1,634.0,53
CDM,12005AK,"SIMP REPAIR SCALP,NECK,TRK 12.6-20CM",867.0,563.55,1.1,867.0,53
CDM,12006AK,REPR SUPERF WND BODY 20.1-30,1052.0,683.8,1.1,1052.0,53
CDM,12007AK,REPR SUPERF WND BODY >30CM,1276.0,829.4,1.1,1276.0,53
CDM,12011AK,"SIMP REPAIR FACE,EAR,EYE <2.5CM",471.0,306.15,1.1,471.0,53
CDM,12013AK,"SIMP REPAIR FACE,EAR,EYE 2.6-5CM",537.0,349.05,1.1,537.0,53
CDM,12014AK,"SIMP REPAIR FACE,EAR,EYE 5.1-7.5CM",691.0,449.15,1.1,691.0,53
CDM,12015AK,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5CM",871.0,566.15,1.1,871.0,53
CDM,12016AK,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1179.0,766.35,1.1,1179.0,53
CDM,12017AK,SREP F/E/N/L/MM 20.1-30.0CM,1399.0,909.35,1.1,1399.0,50
CDM,12020AK,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1175.0,763.75,1.1,1175.0,53
CDM,12021AK,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,832.0,540.8,1.1,832.0,53
CDM,12031AK,"INT REPAIR SCALP,AXL,TRUNK <2.5CM",880.0,572.0,1.1,880.0,53
CDM,12031URVUAK,LAYER CLOSURE OF WOUND(S),352.0,228.8,1.1,870.74,53
CDM,12032AK,"INT REPAIR SCALP,AXL,TRUNK 2.6-7.5CM",1109.0,720.85,1.1,1109.0,53
CDM,12032URVUAK,LAYER CLOSURE OF WOUND(S),444.0,288.6,1.1,1006.01,53
CDM,12034AK,"INT REPAIR SCALP,AXL,TRUNK 7.6-12.5CM",1307.0,849.55,1.1,1307.0,53
CDM,12034URVUAK-33,LAYER CLOSURE OF WOUND(S),452.0,293.8,1.1,1110.84,53
CDM,12034URVUAK-34,LAYER CLOSURE OF WOUND(S),452.0,293.8,1.1,1050.2,53
CDM,12035AK,"INT REPAIR SCALP,AXL,TRUNK 12.6-20CM",1540.0,1001.0,1.1,1540.0,53
CDM,12035URVUAK,LAYER CLOSURE OF WOUND(S),549.0,356.85,1.1,1297.81,53
CDM,12036AK,"LAYR CLOS WND TRUNK,ARM,LEG 20.1-30",1861.0,1209.65,1.1,1861.0,53
CDM,12036URVUAK,LAYER CLOSURE OF WOUND(S),630.0,409.5,1.1,1445.54,53
CDM,12037AK,"LAYR CLOS WND TRUNK,ARM,LEG >30CM",2200.0,1430.0,1.1,3114.5,53
CDM,12037URVUAK-35,LAYER CLOSURE OF WOUND(S),3151.0,2048.15,1.1,3151.0,53
CDM,12037URVUAK-36,LAYER CLOSURE OF WOUND(S),3151.0,2048.15,1.1,3151.0,53
CDM,12041AK,INT REPAIR NECK/HANDS/FEET/XTRNL GENT <2.5CM,924.0,600.6,1.1,924.0,53
CDM,12041URVUAK,LAYER CLOSURE OF WOUND(S),371.0,241.15,1.1,875.17,53
CDM,12042AK,"INT REPAIR NECK,HANDS,FEET, GENIT, 2.6-7.5 CM",1228.0,798.2,1.1,1228.0,53
CDM,12042URVUAK,LAYER CLOSURE OF WOUND(S),428.0,278.2,1.1,1028.37,53
CDM,12044AK,"INT REPAIR SCALP,NEC,TRK 7.6-12.5CM",1404.0,912.6,1.1,1404.0,53
CDM,12044URVUAK,LAYER CLOSURE OF WOUND(S),509.0,330.85,1.1,1265.46,53
CDM,12045AK,"INT REPAIR SCALP,NEC,TRK 12.6-20CM",1650.0,1072.5,1.1,1650.0,53
CDM,12045URVUAK,LAYER CLOSURE OF WOUND(S),650.0,422.5,1.1,1383.14,53
CDM,12046URVUAK,LAYER CLOSURE OF WOUND(S),2840.0,1846.0,1.1,2840.0,53
CDM,12047AK,LAYR CLOS WND REST BODY >30CM,2178.0,1415.7,1.1,3114.5,53
CDM,12051AK,"INT REPAIR FACE,EAR,EYE <2.5CM",1025.0,666.25,1.1,1025.0,53
CDM,12051URVUAK,LAYER CLOSURE OF WOUND(S),393.0,255.45,1.1,941.23,53
CDM,12052AK,"INT REPAIR FACE,EAR,EYE 2.6-5CM",1263.0,820.95,1.1,1263.0,53
CDM,12053AK,"INT REPAIR FACE,EAR,EYE 5.1-7.5CM",1395.0,906.75,1.1,1395.0,53
CDM,12053URVUAK,LAYER CLOSURE OF WOUND(S),560.0,364.0,1.1,1210.24,53
CDM,12054AK,"INT REPAIR FAC,EAR,EYE 7.6-12.5CM",1540.0,1001.0,1.1,1540.0,53
CDM,12054URVUAK,LAYER CLOSURE OF WOUND(S),700.0,455.0,1.1,1283.21,53
CDM,12055AK,"INT REPAIR FAC,EAR,EYE 12.6-20CM",1980.0,1287.0,1.1,1980.0,53
CDM,12056AK,"LAYR CLOS WND FACE,FACIAL 20.1-30",2332.0,1515.8,1.1,2332.0,53
CDM,12200005,ACCOMMODATION OBSTETRICS,2590.0,1683.5,854.7,7687.0,21
CDM,12200015,ACCOMMODATION POST PARTUM,2529.0,1643.85,834.57,7687.0,21
CDM,12400005,ACCOMMODATION PSYCH,2811.0,1827.15,927.63,7687.0,22
CDM,12400015,ACCOMMODATION PSYCHIATRIC,2530.0,1644.5,834.9,7687.0,22
CDM,13100AK,REPR CMPL WND TRUNK 1.1-2.5CM,1200.0,780.0,1.1,1200.0,53
CDM,13101AK,REPR CMPL WND TRUNK 2.6-7.5CM,1400.0,910.0,1.1,1400.0,53
CDM,13102AK,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,496.0,322.4,1.1,496.0,53
CDM,13120AK,"REPR CMPL WND SCALP,EXTR 1.1-2.5",1292.0,839.8,1.1,1292.0,53
CDM,13121AK,"REPR CMPL WND SCALP,EXTR 2.6-7.5",1600.0,1040.0,1.1,1600.0,53
CDM,13122AK,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,576.0,374.4,1.1,576.0,53
CDM,13131AK,"REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",1492.0,969.8,1.1,1492.0,53
CDM,13132AK,"REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",2103.0,1366.95,1.1,2103.0,53
CDM,13133AK,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,964.0,626.6,1.1,964.0,53
CDM,13151AK,"REPR CMPL WND LID,NOS,EAR 1.1-2.5",1736.0,1128.4,1.1,1736.0,53
CDM,13152AK,"REPR CMPL WND LID,NOS,EAR 2.5-7.5",2136.0,1388.4,1.1,2136.0,53
CDM,13153AK,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,952.0,618.8,1.1,952.0,53
CDM,13160AK,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,4816.0,3130.4,1.1,4816.0,50
CDM,14000AK,TISSUE REARRAN TRUNK DEF <10SCM,2548.0,1656.2,1.1,3114.5,53
CDM,14000URVUAK,SKIN TISSUE REARRANGEMENT,1010.0,656.5,1.1,3114.5,53
CDM,14001AK,TISSUE REARRAN TRUNK  10.1-30SCM,3512.0,2282.8,1.1,3512.0,53
CDM,14001URVUAK,SKIN TISSUE REARRANGEMENT,1310.0,851.5,1.1,3114.5,53
CDM,14020AK,"TISSUE REARRA SCALP,EXTRE LT 10SCM",2888.0,1877.2,1.1,3114.5,53
CDM,14020URVUAK,SKIN TISSUE REARRANGEMENT,1067.0,693.55,1.1,3114.5,53
CDM,14021AK,"ADJ TISS XFER SCALP,EXTREM 10.1-30",3888.0,2527.2,1.1,3888.0,53
CDM,14021URVUAK,SKIN TISSUE REARRANGEMENT,1344.0,873.6,1.1,3114.5,53
CDM,14040AK,"TISSUE REARR MOUTH,FORE  <10SCM",3440.0,2236.0,1.1,3440.0,53
CDM,14040URVUAK,SKIN TISSUE REARRANGEMENT,1194.0,776.1,1.1,3114.5,53
CDM,14041AK,"TISSUE REARR MOUTH,FORE 10.1-30SCM",4332.0,2815.8,1.1,4332.0,53
CDM,14041URVUAK,SKIN TISSUE REARRANGEMENT,4361.0,2834.65,1.1,4361.0,53
CDM,14060AK,"TISSUE REARR LIP,EAR,EYE GT 10 SCM",4061.0,2639.65,1.1,4061.0,53
CDM,14060URVUAK,SKIN TISSUE REARRANGEMENT,1260.0,819.0,1.1,3114.5,53
CDM,14061AK,"TISSUE REARR LIP,EAR,EYE 10.1-30SCM",5051.0,3283.15,1.1,5051.0,53
CDM,14301AK,ATT/R ANY AREA DEFECT 30.1-60SQCM,5060.0,3289.0,1.1,6125.06,53
CDM,14301URVUAK,ADJA TSSU TRANSFER/REARR ANY 30.1CM/60.0,1810.0,1176.5,1.1,6125.06,53
CDM,14302AK,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,1641.0,1066.65,1.1,1641.0,50
CDM,14350AK,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,4420.0,2873.0,1.1,4420.0,50
CDM,14350URVUAK,SKIN TISSUE REARRANGEMENT,1500.0,975.0,1.1,3114.5,50
CDM,15002AK,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,1606.0,1043.9,1.1,3114.5,53
CDM,15003AK,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,320.0,208.0,1.1,320.0,53
CDM,15004AK,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,1832.0,1190.8,1.1,1832.0,53
CDM,15005AK,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,640.0,416.0,1.1,640.0,53
CDM,15011AK,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,929.0,603.85,1.1,929.0,29
CDM,15012AK,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,929.0,603.85,1.1,929.0,29
CDM,15013AK,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,1696.0,1102.4,1.1,1696.0,29
CDM,15014AK,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,1696.0,1102.4,1.1,1696.0,29
CDM,15015AK,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,697.0,453.05,1.1,1991.3,29
CDM,15016AK,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,697.0,453.05,1.1,697.0,29
CDM,15017AK,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,850.0,552.5,1.1,2294.28,29
CDM,15018AK,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,850.0,552.5,1.1,850.0,29
CDM,15050AK,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,2228.0,1448.2,1.1,2228.0,53
CDM,15100AK,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,3960.0,2574.0,1.1,3960.0,53
CDM,15101AK,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,688.0,447.2,1.1,688.0,53
CDM,15110AK,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,4827.0,3137.55,1.1,4827.0,53
CDM,15111AK,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,740.0,481.0,1.1,740.0,53
CDM,15115AK,EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100SQCM,4963.0,3225.95,1.1,4963.0,53
CDM,15116AK,EPIDRM A-GRFT F/N/HF/G ADDL 100 SQ CM/1% BA,1000.0,650.0,1.1,1000.0,53
CDM,15120AK,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,4060.0,2639.0,1.1,6125.06,53
CDM,15121AK,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,800.0,520.0,1.1,800.0,53
CDM,15200AK,FULL GRAFT PROC TRUNK <20 SQCM,3660.0,2379.0,1.1,3660.0,53
CDM,15201AK,FULL GRAFT PROC TRUNK ADD 20 SQCM,581.0,377.65,1.1,581.0,53
CDM,15220AK,"FULL THICKNESS GRAFT SCALP, ARMS LEGS 20 SQ CM OR LESS",3236.0,2103.4,1.1,3236.0,53
CDM,15221AK,"FULL GRAFT PROC SCALP,ARM ADD 20SQCM",476.0,309.4,1.1,476.0,53
CDM,15240AK,SKIN GRAFT HAND <20 SQ CM,4164.0,2706.6,1.1,4164.0,53
CDM,15241AK,SKIN GRAFT HAND ADD'L 20 SCM,818.0,531.7,1.1,818.0,53
CDM,15260AK,SKIN GRAFT NOSE <20 SQ CM,4656.0,3026.4,1.1,4656.0,53
CDM,15261AK,SKIN GRAFT NOSE ADD'L 20SCM,892.0,579.8,1.1,892.0,53
CDM,15271AK,APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM,660.0,429.0,1.1,3114.5,53
CDM,15272AK,APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM,145.0,94.25,1.1,145.0,53
CDM,15273AK,APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM,1400.0,910.0,1.1,6125.06,53
CDM,15274AK,APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM,320.0,208.0,1.1,320.0,53
CDM,15275AK,SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM,732.0,475.8,1.1,3114.5,53
CDM,15276AK,SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM,200.0,130.0,1.1,200.0,53
CDM,15277AK,SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM,1600.0,1040.0,1.1,3114.5,53
CDM,15278AK,SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM,400.0,260.0,1.1,400.0,53
CDM,15574AK,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,4280.0,2782.0,1.1,4280.0,53
CDM,15576AK,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,3748.0,2436.2,1.1,3748.0,53
CDM,15600AK,DELAY/SECTN FLAP TRUNK,804.0,522.6,1.1,6125.06,53
CDM,15620AK,"DELAY/SECTN FLAP FACE,GENIT,HAND,FT",1500.0,975.0,1.1,3114.5,53
CDM,15630AK,"DELAY/SECTN FLAP LID,NOS,EAR,LIP",1632.0,1060.8,1.1,3114.5,53
CDM,15730AK,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,5400.0,3510.0,1.1,6125.06,53
CDM,15731AK,FOREHEAD FLAP W/VASC PEDICLE,5752.0,3738.8,1.1,6125.06,53
CDM,15733AK,MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL,6272.0,4076.8,1.1,6272.0,50
CDM,15734AK,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,9200.0,5980.0,1.1,9200.0,50
CDM,15736AK,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,6816.0,4430.4,1.1,6816.0,50
CDM,15738AK,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,8378.0,5445.7,1.1,8378.0,50
CDM,15740AK,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,4720.0,3068.0,1.1,4720.0,53
CDM,15750AK,NEUROVASCULAR PEDICLE GRAFT,5184.0,3369.6,1.1,6125.06,50
CDM,15756AK,FREE MUSC FLAP W MICROVASC ANAST,14776.0,9604.4,1.1,14776.0,50
CDM,15758AK,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,14760.0,9594.0,1.1,14760.0,50
CDM,15769AK,GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC,2672.0,1736.8,1.1,6125.06,50
CDM,15769RVU1AK,FAT INJECTIONS FOR BUTTOCK AUGMENT (BBL) - MODERATE,1500.0,975.0,1.1,6125.06,50
CDM,15770AK,"GRAFT,DERMA-FAT-FASCIA",3942.0,2562.3,1.1,6125.06,50
CDM,15771AK,GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS,2961.0,1924.65,1.1,6125.06,52
CDM,15772AK,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC,1100.0,715.0,1.1,1100.0,52
CDM,15773AK,GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS,2732.0,1775.8,1.1,3114.5,52
CDM,15773RVU1AK,FAT INJECTION FACE/NECK INC REVOLVE - MODERATE,990.0,643.5,1.1,3114.5,52
CDM,15774AK,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC,964.0,626.6,1.1,964.0,52
CDM,15777AK,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,1460.0,949.0,1.1,1460.0,50
CDM,15778AK,IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA,2820.0,1833.0,1.1,2820.0,50
CDM,15781AK,DERMABRAS RX SKIN SGMENT FACE,2008.0,1305.2,1.1,2008.0,47
CDM,15786AK,ABRAS SINGLE LESION,832.0,540.8,1.1,832.0,53
CDM,15788AK,"CHEM PEEL, FACE, EPIDERM",836.0,543.4,1.1,1275.31,47
CDM,15789AK,"CHEM PEEL, FACE, DERMAL",1964.0,1276.6,1.1,1964.0,47
CDM,15792AK,"CHEM PEEL, NONFACIAL EPIDERM",744.0,483.6,1.1,1094.09,47
CDM,15819RVU4AK,CERVICOPLASTY   (REMOVAL EXCESS NECK SKIN),3000.0,1950.0,1.1,3114.5,24
CDM,15820AK,BLEPHAROPLASTY LOWER LID,2759.0,1793.35,1.1,3114.5,47
CDM,15822AK,BLEPHAROPLASTY UPPER EYELID,2033.0,1321.45,1.1,3114.5,47
CDM,15823AK,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,2996.0,1947.4,1.1,3114.5,53
CDM,15824AK,RHYTIDECTOMY FOREHEAD,4486.0,2915.9,1.1,4486.0,32
CDM,15825AK,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,5845.0,3799.25,1.1,6125.06,32
CDM,15828AK,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,1.1,8610.0,32
CDM,15829AK,RHYTIDECTOMY SMAS FLAP,9126.0,5931.9,1.1,9126.0,32
CDM,15830AK,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,6844.0,4448.6,1.1,11133.7,50
CDM,15832AK,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,5654.0,3675.1,1.1,5654.0,44
CDM,15834AK,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,4868.0,3164.2,1.1,4868.0,44
CDM,15835AK,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,5196.0,3377.4,1.1,5196.0,44
CDM,15836AK,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,4668.0,3034.2,1.1,4850.94,44
CDM,15838AK,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,3300.0,2145.0,1.1,4850.94,44
CDM,15839AK,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,4200.0,2730.0,1.1,4850.94,53
CDM,15847AK,"EXCISE EXCESS SKIN TISSUE,ABDOMEN, ADD-ON",5828.0,3788.2,1.1,5828.0,38
CDM,15847RVU1AK,ABDOMINOPLASTY ADD-ON  (INCL FLEUR DE LIS),1000.0,650.0,1.1,2068.22,38
CDM,15851AK,REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA,440.0,286.0,1.1,3114.5,53
CDM,15852AK,DRESSING CHANGE UNDER ANESTHESIA,344.0,223.6,1.1,1071.62,50
CDM,15853AK,REMOVAL SUTURES OR STAPLES NOT REQUIRING ANESTHESIA,364.0,236.6,1.1,364.0,50
CDM,15854AK,REMOVAL SUTURES & STAPLES NOT REQUIRING ANESTHESIA,337.0,219.05,1.1,337.0,22
CDM,15860AK,TEST FOR BLOOD FLOW IN GRAFT,780.0,507.0,1.1,780.0,50
CDM,15876AK,"SUCT ASSIS LIPECTOMY,HEAD/NECK",2456.0,1596.4,1.1,6125.06,35
CDM,15877AK,"SUCT ASSIS LIPECTOMY,TRUNK",4640.0,3016.0,1.1,6125.06,35
CDM,15878AK,"SUCT ASSIS LIPECTOMY,UP EXTREM",4777.0,3105.05,1.1,4777.0,35
CDM,15879AK,"SUCT ASSIS LIPECTOMY,LOW EXTREM",4640.0,3016.0,1.1,6125.06,35
CDM,15920AK,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,3316.0,2155.4,1.1,4850.94,50
CDM,15931AK,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,4028.0,2618.2,1.1,4850.94,50
CDM,15933AK,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,4708.0,3060.2,1.1,4850.94,50
CDM,15936AK,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,5264.0,3421.6,1.1,5264.0,50
CDM,15937AK,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,6056.0,3936.4,1.1,6056.0,50
CDM,15941AK,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,4964.0,3226.6,1.1,4964.0,50
CDM,15945AK,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,5500.0,3575.0,1.1,5500.0,50
CDM,15946AK,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,9648.0,6271.2,1.1,9648.0,50
CDM,15950AK,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,3212.0,2087.8,1.1,3212.0,50
CDM,15958AK,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,6700.0,4355.0,1.1,6700.0,50
CDM,16000AK,"INITIAL TX, FIRST DEGREE BURN, LOCAL TREATMENT",356.0,231.4,1.1,356.0,53
CDM,16020AK,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,312.0,202.8,1.1,342.27,53
CDM,16025AK,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,696.0,452.4,1.1,696.0,53
CDM,16030AK,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,832.0,540.8,1.1,832.0,53
CDM,16035AK,ESCHAROTOMY; INIT INC,1496.0,972.4,1.1,1496.0,50
CDM,16100005,ACCOMMODATION CARE AT HOME,2576.0,1674.4,850.08,2318.4,13
CDM,17000AK,"DESTRUCTION, 1ST LESION",268.0,174.2,1.1,342.27,53
CDM,17000URVUAK,DESTROY BENIGN/PREMAL LESION,122.0,79.3,1.1,342.27,53
CDM,17003AK,"DESTRUC BENIGN/PREMAL,2-14 LESIONS",18.0,11.7,1.1,21.76,53
CDM,17004AK,"DESTRUC BENIGN/PREMAL,>15 LESIONS",603.0,391.95,1.1,680.96,53
CDM,17100005,ACCOMMODATION NEWBORN - LEVEL I,2382.0,1548.3,786.06,7687.0,22
CDM,17106AK,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1624.0,1055.6,1.1,1624.0,53
CDM,17106URVUAK,DESTRUCTION OF SKIN LESIONS,330.0,214.5,1.1,1143.19,53
CDM,17107AK,"DESTR,CUTAN VASC LESION 10-50SCM",2108.0,1370.2,1.1,2108.0,53
CDM,17107URVUAK,DESTRUCTION OF SKIN LESIONS,656.0,426.4,1.1,1482.3,53
CDM,17108AK,DESTRUC CUT/VASC >50 SQ CM,3296.0,2142.4,1.1,3296.0,53
CDM,17108URVUAK,DESTRUCTION OF SKIN LESIONS,1050.0,682.5,1.1,3114.5,53
CDM,17110AK,DESTRUCTION BENIGN LESIONS UP TO 14,308.0,200.2,1.1,372.57,53
CDM,17110RVU3AK,KERATOSES DESTRUCTION UP TO 14,200.0,130.0,1.1,372.57,53
CDM,17110URVUAK,"DESTRUCT LESION, UP TO 14",158.0,102.7,1.1,372.57,53
CDM,17111AK,"DESTRUC FLAT WARTS, 15 OR MORE",427.0,277.55,1.1,436.77,53
CDM,17111RVU3AK,KERATOSES DESTRUCTION 15 OR MORE,250.0,162.5,1.1,436.77,53
CDM,17111URVUAK,"DESTRUCT LESION, 15 OR MORE",198.0,128.7,1.1,436.77,53
CDM,17200005,ACCOMMODATION NEWBORN - LEVEL II,3086.0,2005.9,1018.38,7687.0,22
CDM,17250AK,CHEM CAUTER GRANULAR TISSUE,220.0,143.0,1.1,342.27,53
CDM,17250URVUAK,"CHEMICAL CAUTERY, TISSUE",114.0,74.1,1.1,342.27,53
CDM,17260AK,"DESTR MALIG TRUNK,EXTREM <0.5 CM",422.0,274.3,1.1,422.0,53
CDM,17260URVUAK,DESTRUCTION OF SKIN LESIONS,157.0,102.05,1.1,342.27,53
CDM,17261AK,"DESTR MALIG TRUNK,EXTREM 0.6-1 CM",537.0,349.05,1.1,537.0,53
CDM,17261URVUAK,DESTRUCTION OF SKIN LESIONS,220.0,143.0,1.1,488.81,53
CDM,17262AK,"DESTR MALIG TRUNK,EXTREM 1.1-2 CM",717.0,466.05,1.1,717.0,53
CDM,17262URVUAK,DESTRUCTION OF SKIN LESIONS,291.0,189.15,1.1,592.33,53
CDM,17263AK,"DESTR MALIG TRUNK,EXTREM 2.1-3 CM",810.0,526.5,1.1,810.0,53
CDM,17263URVUAK,DESTRUCTION OF SKIN LESIONS,319.0,207.35,1.1,640.59,53
CDM,17264AK,"DESTR MALIG TRUNK,EXTREM 3.1-4 CM",876.0,569.4,1.1,876.0,53
CDM,17264URVUAK,DESTRUCTION OF SKIN LESIONS,343.0,222.95,1.1,686.1,53
CDM,17266AK,"DESTR MALIG TRUNK,EXTREM >4.0 CM",1052.0,683.8,1.1,1052.0,53
CDM,17266URVUAK,DESTRUCTION OF SKIN LESIONS,390.0,253.5,1.1,784.01,53
CDM,17270AK,"DESTR MALIG SCAL,NCK,HAND <0.5 CM",548.0,356.2,1.1,548.0,53
CDM,17270URVUAK,DESTRUCTION OF SKIN LESIONS,250.0,162.5,1.1,497.65,53
CDM,17271AK,"DESTR MALIG SCAL,NCK,HAND 0.6-1 CM",616.0,400.4,1.1,616.0,53
CDM,17271URVUAK,DESTRUCTION OF SKIN LESIONS,273.0,177.45,1.1,552.8,53
CDM,17272AK,"DESTR MALIG SCAL,NCK,HAND 1.1-2 CM",728.0,473.2,1.1,728.0,53
CDM,17272URVUAK,DESTRUCTION OF SKIN LESIONS,311.0,202.15,1.1,626.49,53
CDM,17273AK,"DESTR MALIG SCAL,NCK,HAND 2.1-3 CM",840.0,546.0,1.1,840.0,53
CDM,17273URVUAK,DESTRUCTION OF SKIN LESIONS,348.0,226.2,1.1,695.05,53
CDM,17274AK,"DESTR MALIG SCAL,NCK,HAND 3.1-4 CM",1056.0,686.4,1.1,1056.0,53
CDM,17274URVUAK,DESTRUCTION OF SKIN LESIONS,412.0,267.8,1.1,815.77,53
CDM,17276AK,"DESTR MALIG SCAL,NCK,HAND >4 CM",1300.0,845.0,1.1,1300.0,53
CDM,17276URVUAK,DESTRUCTION OF SKIN LESIONS,481.0,312.65,1.1,949.45,53
CDM,17280AK,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,488.0,317.2,1.1,488.0,53
CDM,17280URVUAK,DESTRUCTION OF SKIN LESIONS,234.0,152.1,1.1,463.17,53
CDM,17281AK,"DESTR MALIG FACE,NOSE,LIP 0.6-1 CM",708.0,460.2,1.1,708.0,53
CDM,17281URVUAK,DESTRUCTION OF SKIN LESIONS,297.0,193.05,1.1,680.96,53
CDM,17282AK,"DESTR MALIG FACE,NOSE,LIP 1.1-2 CM",836.0,543.4,1.1,836.0,53
CDM,17282URVUAK,DESTRUCTION OF SKIN LESIONS,322.0,209.3,1.1,684.26,53
CDM,17283AK,"DESTR MALIG FACE,NOSE,LIP 2.1-3 CM",1076.0,699.4,1.1,1076.0,53
CDM,17283URVUAK,DESTRUCTION OF SKIN LESIONS,411.0,267.15,1.1,809.86,53
CDM,17284AK,"DESTR MALIG FACE,NOSE,LIP 3.1-4 CM",1280.0,832.0,1.1,1280.0,53
CDM,17284URVUAK,DESTRUCTION OF SKIN LESIONS,471.0,306.15,1.1,1071.62,53
CDM,17286AK,"DESTR MALIG FACE,NOSE,LIP >4CM",1792.0,1164.8,1.1,1792.0,53
CDM,17286URVUAK,DESTRUCTION OF SKIN LESIONS,611.0,397.15,1.1,1184.05,53
CDM,17300005,ACCOMMODATION NEWBORN - LEVEL III,5217.0,3391.05,1721.61,7687.0,22
CDM,17340AK,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,308.0,200.2,1.1,308.0,53
CDM,17360AK,CHEMICAL EXFOLIATION ACNE,584.0,379.6,1.1,584.0,53
CDM,17999AGRVU1AK,"UNLIST PROC, SKIN, MUCOUS MEMBRANE & SUBCUT TISSUE COMP TO 15777",1205.0,783.25,0.01,1205.0,28
CDM,17999AGRVUAK,"UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSU",1252.0,813.8,0.01,1252.0,28
CDM,17999AK,UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,401.0,260.65,0.01,401.0,28
CDM,17999DAK,UNLISTED PROCEDURE SKIN COMP CPT 13131,1343.0,872.95,0.01,1343.0,28
CDM,17999RVU100AK,FAT PAD BIOPSY (COMP CODE 20200),584.0,379.6,0.01,584.0,28
CDM,17999RVU101AK,STERNOHYOID/OMOHYOID ROTNAL MSCLE FLAP RPR ESOPHAGL INJRY (COMP,9200.0,5980.0,0.01,9200.0,28
CDM,17999RVU12AK,"FACIAL RESURFACING, LASER (COMP CODE 17108)",3183.0,2068.95,0.01,3183.0,28
CDM,17999RVU5AK,"SUBDERMAL RADIOFREQUENCY, LOWER FACE & NECK SCULPTING (COMP 1578",4375.0,2843.75,0.01,4375.0,28
CDM,17999RVU6AK,"SUBDERMAL RADIOFREQUENCY, POSTERIOR ARMS, BOTH (COMP 15782)",3125.0,2031.25,0.01,3125.0,28
CDM,17999RVU75AK,MICRONEEDLING SMALL (COMP CODE 15781),250.0,162.5,0.01,342.27,28
CDM,17999RVU7AK,SUBDERMAL RADIOFREQUENCY ABDOMEN (5X8 AREA) OR UPPER BACK (COMP,1875.0,1218.75,0.01,1875.0,28
CDM,17999RVU8AK,"SUBDERMAL RADIOFREQUENCY, KNEES, BOTH (COMP 15780)",1250.0,812.5,0.01,1250.0,28
CDM,17999RVU90AK,UMBILICOPLASTY (COMPARABLE CODE 49591),2533.0,1646.45,0.01,2533.0,28
CDM,17999RVU92AK,CERVICOPLASTY (REMOVAL EXCESS NECK SKIN),990.0,643.5,0.01,990.0,28
CDM,17999RVU93AK,WOUND ELECTROCAUTERIZATION/CONTROL OF BLEEDING (COMP 20103),1923.0,1249.95,0.01,1923.0,28
CDM,17999RVU96AK,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 3 LARGE (COMP CODE 15780),2200.0,1430.0,0.01,2200.0,28
CDM,17999RVU97AK,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),2200.0,1430.0,0.01,2200.0,28
CDM,17999RVU98AK,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),2808.0,1825.2,0.01,2808.0,28
CDM,17999RVU99AK,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),2752.0,1788.8,0.01,2752.0,28
CDM,19000AK,PUNCTURE ASPIRATION CYST BREAST,336.0,218.4,1.1,1200.64,53
CDM,19000URVUAK,DRAINAGE OF BREAST LESION,208.0,135.2,1.1,1200.64,53
CDM,19001AK,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,168.0,109.2,1.1,168.0,53
CDM,19020AK,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,1532.0,995.8,1.1,2768.64,53
CDM,19020URVUAK,INCISION OF BREAST LESION,473.0,307.45,1.1,2768.64,53
CDM,19081AK,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,1448.0,941.2,1.1,2768.64,53
CDM,19081URVUAK,"BREAST BIOPSY NEEDLE LOCALIZATION, 1ST",320.0,208.0,1.1,2768.64,53
CDM,19082AK,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,726.0,471.9,1.1,1277.0,53
CDM,19083AK,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,1364.0,886.6,1.1,2768.64,53
CDM,19084AK,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,682.0,443.3,1.1,1257.66,53
CDM,19085AK,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,1602.0,1041.3,1.1,2768.64,53
CDM,19086AK,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,801.0,520.65,1.1,1957.74,53
CDM,19100AK,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,508.0,330.2,1.1,2768.64,53
CDM,19100URVUAK,BX BREAST PERCUT W/O IMAGE,197.0,128.05,1.1,2768.64,53
CDM,19101AK,BIOPSY BREAST OPEN INCISIONAL,1292.0,839.8,1.1,6508.54,53
CDM,19101URVUAK,"BIOPSY OF BREAST, OPEN",480.0,312.0,1.1,6508.54,53
CDM,19110AK,NIPPLE EXPLORATION,1776.0,1154.4,1.1,6508.54,53
CDM,19112AK,EXCISION LACTIFEROUS DUCT FISTULA,1524.0,990.6,1.1,6508.54,53
CDM,19120AK,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,2368.0,1539.2,1.1,6508.54,53
CDM,19120URVUAK,REMOVAL OF BREAST LESION,657.0,427.05,1.1,6508.54,53
CDM,19125AK,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,2944.0,1913.6,1.1,6508.54,53
CDM,19125URVUAK,"EXCISION, BREAST LESION",886.0,575.9,1.1,6508.54,53
CDM,19126AK,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,1172.0,761.8,1.1,1172.0,50
CDM,19281AK,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,800.0,520.0,1.1,2768.64,53
CDM,19282AK,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,440.0,286.0,1.1,563.06,53
CDM,19283AK,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,880.0,572.0,1.1,1200.64,53
CDM,19284AK,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,440.0,286.0,1.1,629.47,53
CDM,19285AK,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,748.0,486.2,1.1,1219.89,53
CDM,19286AK,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,374.0,243.1,1.1,995.06,53
CDM,19287AK,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,1020.0,663.0,1.1,2097.46,53
CDM,19288AK,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,512.0,332.8,1.1,1615.81,53
CDM,19294AK,PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY,1200.0,780.0,1.1,1200.0,50
CDM,19296AK,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,1452.0,943.8,1.1,16095.74,53
CDM,19297AK,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,688.0,447.2,1.1,688.0,50
CDM,19300AK,MASTECTOMY FOR GYNECOMASTIA,2124.0,1380.6,1.1,6508.54,53
CDM,19300URVUAK,REMOVAL OF BREAST TISSUE,786.0,510.9,1.1,6508.54,53
CDM,19301AK,"MASTECTOMY, PARTIAL",4052.0,2633.8,1.1,6508.54,50
CDM,19301URVUAK,PARTIAL MASTECTOMY,1205.0,783.25,1.1,6508.54,50
CDM,19302AK,"MASTECTOMY,PARTIAL,  WITH AXILLARY LYMPHADENECTOMY",5596.0,3637.4,1.1,11133.7,50
CDM,19302URVUAK,P-MASTECTOMY W/LN REMOVAL,1430.0,929.5,1.1,11133.7,50
CDM,19303AK,"MASTECTOMY, SIMPLE, COMPLETE",6000.0,3900.0,1.1,11133.7,50
CDM,19303URVUAK,"MASTECTOMY, SIMPLE, COMPLETE",1868.0,1214.2,1.1,11133.7,50
CDM,19305AK,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,6984.0,4539.6,1.1,6984.0,50
CDM,19305URVUAK,"MAST, RADICAL",2205.0,1433.25,1.1,3939.95,50
CDM,19306AK,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,7252.0,4713.8,1.1,7252.0,50
CDM,19307AK,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,7196.0,4677.4,1.1,11133.7,50
CDM,19307URVUAK,"MASTECTOMY, MOD RAD, INCL AX LYM NO",2219.0,1442.35,1.1,11133.7,50
CDM,19316AK,MASTOPEXY,4880.0,3172.0,1.1,11133.7,50
CDM,19318AK,REDUCTION OF LARGE BREAST,7053.0,4584.45,1.1,11133.7,50
CDM,19318RVU1AK,BREAST REDUCTION FEMALE - MODERATE,1820.0,1183.0,1.1,11133.7,50
CDM,19325AK,BREAST AUGMENTATION WITH IMPLANT,3573.0,2322.45,1.1,16095.74,50
CDM,19325RVU8AK,BREAST AUG (GEL) - MODERATE,2500.0,1625.0,1.1,16095.74,50
CDM,19328AK,REMOVAL OF BREAST IMPLANT,2976.0,1934.4,1.1,6508.54,50
CDM,19330AK,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,3600.0,2340.0,1.1,6508.54,50
CDM,19340AK,INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY,4192.0,2724.8,1.1,11133.7,50
CDM,19342AK,INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY,4611.0,2997.15,1.1,16095.74,50
CDM,19350AK,NIPPLE/AREOLA RECONSTRUCTION,4008.0,2605.2,1.1,6508.54,53
CDM,19355AK,CORRECT INVERTED NIPPLE(S),3408.0,2215.2,1.1,6508.54,53
CDM,19355RVU1AK,INVERTED NIPPPLE CORRECTION,1600.0,1040.0,1.1,6508.54,53
CDM,19357AK,BREAST RECONSTRUC W TISS EXPANDR,6530.0,4244.5,1.1,30087.68,50
CDM,19361AK,BREAST RECONSTRUC W LAT DORSI FLAP,9344.0,6073.6,1.1,9344.0,50
CDM,19364AK,BREAST RECONSTRUC W FREE FLAP,18735.0,12177.75,1.1,18735.0,50
CDM,19367AK,BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP,10720.0,6968.0,1.1,10720.0,50
CDM,19370AK,REVISION PERI-IMPLANT CAPSULE BREAST,4035.0,2622.75,1.1,6508.54,50
CDM,19371AK,PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE,4391.0,2854.15,1.1,6508.54,50
CDM,19380AK,REVISE BREAST RECONSTRUCTION,4915.0,3194.75,1.1,11133.7,50
CDM,19499RVU1AK,ENDOSCOPIC MASTECTOMY (COMP CODE 19303),6000.0,3900.0,0.01,6508.54,28
CDM,20000005,ACCOMMODATION ACUTE CARE,8166.0,5307.9,2694.78,7687.0,21
CDM,20000015,ACCOMMODATION OB LABOR AND DELIVERY,8166.0,5307.9,2694.78,7687.0,21
CDM,20000025,ACCOMMODATION SICU,8166.0,5307.9,2694.78,7687.0,21
CDM,20000035,ACCOMMODATION MICU,8166.0,5307.9,2694.78,7687.0,21
CDM,20000045,ACCOMMODATION CVVHD,8166.0,5307.9,2694.78,7687.0,21
CDM,20100AK,EXPLORATION PENETRATING WOUND SPX NECK,4152.0,2698.8,1.1,4152.0,50
CDM,20101AK,EXPLORATION PENETRATING WOUND SPX CHEST,1292.0,839.8,1.1,3114.5,53
CDM,20102AK,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,1592.0,1034.8,1.1,3114.5,53
CDM,20102URVUAK,"EXPLORE WOUND, ABDOMEN",535.0,347.75,1.1,3114.5,53
CDM,20103AK,EXPLORATION PENETRATING WOUND SPX EXTREMITY,2136.0,1388.4,1.1,2768.64,53
CDM,20103URVUAK,"EXPLORE WOUND, EXTREMITY",1056.0,686.4,1.1,2768.64,53
CDM,20200AK,BIOPSY MUSCLE SUPERFICIAL,584.0,379.6,1.1,2768.64,53
CDM,20205AK,DEEP MUSCLE BIOPSY,940.0,611.0,1.1,4850.94,53
CDM,20205URVUAK,DEEP MUSCLE BIOPSY,465.0,302.25,1.1,4850.94,53
CDM,20206AK,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,396.0,257.4,1.1,2768.64,53
CDM,20220AK,"BONE BIOPSY,TROCAR/NEEDLE SUPERF",660.0,429.0,1.1,2768.64,53
CDM,20225AK,"BONE BIOPSY,TROCAR/NEEDLE DEEP",980.0,637.0,1.1,2768.64,53
CDM,20240AK,BIOPSY BONE OPEN SUPERFICIAL,1148.0,746.2,1.1,4850.94,50
CDM,20245AK,BIOPSY BONE OPEN DEEP,2640.0,1716.0,1.1,4850.94,50
CDM,20500AK,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,512.0,332.8,1.1,2603.78,53
CDM,20520AK,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,760.0,494.0,1.1,2768.64,53
CDM,20520URVUAK,REMOVAL OF FOREIGN BODY,401.0,260.65,1.1,2768.64,53
CDM,20525AK,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1416.0,920.4,1.1,4850.94,53
CDM,20525URVUAK,REMOVAL OF FOREIGN BODY,790.0,513.5,1.1,4850.94,53
CDM,20526AK,INJECTION THERAPEUTIC CARPAL TUNNEL,414.0,269.1,1.1,505.34,53
CDM,20526URVUAK,INJECTION THERAPUTIC CARPAL TUNNEL,129.0,83.85,1.1,505.34,53
CDM,20527AK,INJECTION ENZYME PALMAR FASCIAL CORD,400.0,260.0,1.1,505.34,53
CDM,20550AK,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,330.0,214.5,1.1,505.34,53
CDM,20551AK,INJECTION SINGLE TENDON ORIGIN/INSERTION,330.0,214.5,1.1,505.34,53
CDM,20552AK,TRIGGER POINT INJECTION MULTI 1-2 MUSCLE GR,290.0,188.5,1.1,505.34,53
CDM,20552URVUAK,"TRIGGER POINT INJ,SINGLE OR MULT PT",96.0,62.4,1.1,505.34,53
CDM,20553AK,TRIGGER POINT INJECTION MULTI 3+ MUSCLE GRP,330.0,214.5,1.1,505.34,53
CDM,20553URVUAK,"TRIGGER POINT, SNGL/MULT, 3+ MUSCLES",103.0,66.95,1.1,505.34,53
CDM,20560AK,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,1.1,141.0,52
CDM,20561AK,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,211.0,137.15,1.1,211.0,52
CDM,20600005,ACCOMMODATION ICU - STEP DOWN,6125.0,3981.25,2021.25,7687.0,21
CDM,20600AK,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,290.0,188.5,1.1,505.34,53
CDM,20600URVUAK,"DRAIN/INJECT, JOINT/BURSA",96.0,62.4,1.1,505.34,53
CDM,20604AK,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,392.0,254.8,1.1,505.34,53
CDM,20605AK,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,299.0,194.35,1.1,505.34,53
CDM,20605URVUAK,"DRAIN/INJECT, JOINT/BURSA",111.0,72.15,1.1,505.34,53
CDM,20606AK,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,440.0,286.0,1.1,1180.93,53
CDM,20610AK,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,348.0,226.2,1.1,505.34,53
CDM,20610URVUAK,"DRAIN/INJECT, JOINT/BURSA",166.0,107.9,1.1,505.34,53
CDM,20611AK,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,484.0,314.6,1.1,505.34,53
CDM,20612AK,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,308.0,200.2,1.1,505.34,53
CDM,20612URVUAK,ASPIRATE/INJECT GANGLION CYST(S),100.0,65.0,1.1,505.34,53
CDM,20650AK,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,912.0,592.8,1.1,5526.53,53
CDM,20660AK,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,1600.0,1040.0,1.1,2743.55,50
CDM,20661AK,APPLICATION HALO CRANIAL INCLUDING REMOVAL,2104.0,1367.6,1.1,2104.0,50
CDM,20670AK,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,788.0,512.2,1.1,2768.64,53
CDM,20680AK,REMOVAL DEEP IMPLANT,2622.0,1704.3,1.1,4850.94,53
CDM,20690AK,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,3512.0,2282.8,1.1,12214.27,50
CDM,20692AK,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,6508.0,4230.2,1.1,22471.68,50
CDM,20693AK,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,2424.0,1575.6,1.1,12214.27,50
CDM,20694AK,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,1712.0,1112.8,1.1,2743.55,53
CDM,20696AK,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,7024.0,4565.6,1.1,31818.75,50
CDM,20700AK,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,600.0,390.0,1.1,600.0,50
CDM,20701AK,REMOVAL DEEP DRUG DELIVERY DEVICE,497.0,323.05,1.1,497.0,50
CDM,20702AK,MANUAL PREP&AMP;INSJ INTRAMEDULLARY DRUG DLVR DEVICE,1000.0,650.0,1.1,1000.0,50
CDM,20703AK,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,720.0,468.0,1.1,720.0,50
CDM,20704AK,MANUAL PREP&AMP;INSJ I-ARTIC DRUG DELIVERY DEVICE,1040.0,676.0,1.1,1040.0,50
CDM,20705AK,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,860.0,559.0,1.1,860.0,50
CDM,20800005,ACCOMMODATION ICU TRAUMA,10855.0,7055.75,3479.22,9769.5,21
CDM,20822AK,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,11730.0,7624.5,1.1,11730.0,50
CDM,20827AK,RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION,10992.0,7144.8,1.1,10992.0,50
CDM,20900005,ACCOMMODATION PERINATAL AC,6178.0,4015.7,2038.74,7687.0,21
CDM,20900015,ACCOMMODATION PERINATAL AC MULTI,8166.0,5307.9,2694.78,7687.0,21
CDM,20900AK,BONE GRAFT ANY DONOR AREA MINOR/SMALL,1200.0,780.0,1.1,12214.27,53
CDM,20902AK,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,1832.0,1190.8,1.1,12214.27,50
CDM,20910AK,CARTILAGE GRAFT COSTOCHONDRAL,2212.0,1437.8,1.1,2212.0,50
CDM,20912AK,CARTILAGE GRAFT NASAL SEPTUM,2616.0,1700.4,1.1,6125.06,50
CDM,20922AK,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,2772.0,1801.8,1.1,3114.5,53
CDM,20924AK,TENDON GRAFT FROM A DISTANCE,2672.0,1736.8,1.1,12214.27,50
CDM,20930AK,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,767.0,498.55,1.1,767.0,32
CDM,20931AK,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,724.0,470.6,1.1,724.0,50
CDM,20933AK,HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL,4776.0,3104.4,1.1,4776.0,50
CDM,20936AK,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,1089.0,707.85,1.1,1089.0,32
CDM,20937AK,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,1116.0,725.4,1.1,1116.0,50
CDM,20938AK,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,1208.0,785.2,1.1,1208.0,50
CDM,20939AK,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,464.0,301.6,1.1,464.0,50
CDM,20950AK,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,504.0,327.6,1.1,1200.64,53
CDM,20975AK,ELECTRICAL STIMULATION BONE HEALING INVASIVE,1040.0,676.0,1.1,1040.0,50
CDM,20982AK,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,2808.0,1825.2,1.1,22471.68,53
CDM,20983AK,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,2752.0,1788.8,1.1,16594.94,53
CDM,20999AGRVU1AK,"UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL",383.0,248.95,0.01,403.2,28
CDM,20999AGRVUAK,"UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL (COMPARISON",930.0,604.5,0.01,930.0,28
CDM,20999RVU16AK,"MARROW ASPIRATION, PROXIMAL TIBIA (COMP CODE 38222)",383.0,248.95,0.01,403.2,28
CDM,20999RVU19AK,UNLISTED PROC; REMOVED DISPLACED INGUINAL HERNIA MESH (COMP TO 2,1967.0,1278.55,0.01,1967.0,28
CDM,20999RVU20AK,REMOVAL OF CEMENT FROM THE DISTAL FEMUR AND PLACEMENT OF COMPLET,4290.0,2788.5,0.01,4290.0,28
CDM,20999RVU22AK,RFA MSK TUMOR (COMP CODE 20982),2808.0,1825.2,0.01,2808.0,28
CDM,20999RVU23AK,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),2808.0,1825.2,0.01,2808.0,28
CDM,20999RVU24AK,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),2752.0,1788.8,0.01,2752.0,28
CDM,20999RVU6AK,"EXTRACORPOREAL SHOCK WAVE, LOW INTENSITY",150.0,97.5,0.01,403.2,28
CDM,21000005,ACCOMMODATION POST PARTUM ACUTE CARE,8166.0,5307.9,2694.78,7687.0,21
CDM,21000015,ACCOMMODATION ICC CARE,8166.0,5307.9,2694.78,7687.0,21
CDM,21000025,ACCOMMODATION CVIC,8166.0,5307.9,2694.78,7687.0,21
CDM,21000035,ACCOMMODATION CVICU,8166.0,5307.9,2694.78,7687.0,21
CDM,21011AK,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,1196.0,777.4,1.1,2768.64,53
CDM,21011URVUAK,EXC TUMOR FACE/SCALP SUBQ <2CM,550.0,357.5,1.1,2768.64,53
CDM,21012AK,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,1780.0,1157.0,1.1,2768.64,50
CDM,21012URVUAK,EXC TUMOR FACE/SCALP SUBQ 2CM OR>,750.0,487.5,1.1,2768.64,50
CDM,21013AK,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,2168.0,1409.2,1.1,2768.64,53
CDM,21013URVUAK,EXC TUMOR FACE/SCALP SUBFASCIAL <2CM,853.0,554.45,1.1,2768.64,53
CDM,21014AK,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,2852.0,1853.8,1.1,4850.94,50
CDM,21025AK,EXCISION BONE MANDIBLE,4012.0,2607.8,1.1,9999.36,53
CDM,21026AK,EXCISION OF FACIAL BONE(S),2280.0,1482.0,1.1,9999.36,53
CDM,21029AK,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,3356.0,2181.4,1.1,5497.86,53
CDM,21031AK,EXCISION TORUS MANDIBULARIS,1320.0,858.0,1.1,5497.86,53
CDM,21032AK,EXCISION MAXILLARY TORUS PALATINUS,1336.0,868.4,1.1,5497.86,53
CDM,21040AK,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,1964.0,1276.6,1.1,5497.86,53
CDM,21048AK,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,5884.0,3824.6,1.1,9999.36,50
CDM,21049AK,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,7728.0,5023.2,1.1,9999.36,50
CDM,21076AK,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,5360.0,3484.0,1.1,5360.0,53
CDM,21077AK,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,13480.0,8762.0,1.1,13480.0,53
CDM,21079AK,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,8924.0,5800.6,1.1,8924.0,53
CDM,21080AK,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,10024.0,6515.6,1.1,10024.0,53
CDM,21081AK,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,9140.0,5941.0,1.1,9999.36,53
CDM,21082AK,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,8336.0,5418.4,1.1,8336.0,53
CDM,21083AK,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,7708.0,5010.2,1.1,7708.0,53
CDM,21084AK,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,8992.0,5844.8,1.1,8992.0,53
CDM,21085AK,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,3596.0,2337.4,1.1,3596.0,53
CDM,21086AK,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,9952.0,6468.8,1.1,9952.0,53
CDM,21087AK,IMPRESSION & PREPARATION NASAL PROSTHESIS,9952.0,6468.8,1.1,9999.36,53
CDM,21088AK,IMPRESSION & PREPARATION FACIAL PROSTHESIS,7736.0,5028.4,1.1,9976.48,32
CDM,21089AK,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,1040.0,676.0,0.01,1040.0,28
CDM,21110AK,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,2396.0,1557.4,1.1,2844.06,53
CDM,21141AK,"RECONST FACE,LEFORT I,1 PIECE",7828.0,5088.2,1.1,9999.36,50
CDM,21179AK,RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC,9060.0,5889.0,1.1,9060.0,50
CDM,21210AK,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,5144.0,3343.6,1.1,9999.36,53
CDM,21210RVU1AK,CHEECK IMPLANT W BONE GRAFT,2000.0,1300.0,1.1,9999.36,53
CDM,21215AK,GRAFT BONE MANDIBLE,4892.0,3179.8,1.1,13314.11,53
CDM,21235AK,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,3000.0,1950.0,1.1,9999.36,53
CDM,21243AK,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,9812.0,6377.8,1.1,31818.75,50
CDM,21248AK,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,5096.0,3312.4,1.1,9999.36,53
CDM,21270RVU1AK,CHEECK IMPLANT W/O BONE GRAFT,2000.0,1300.0,1.1,9999.36,53
CDM,21282RVU1AK,CANTHOPEXY,1538.0,999.7,1.1,5497.86,50
CDM,21299RVU5AK,"TRANS-OSTEAL PLATING FOR MANDIBLE RECONSTRUCTION, INTRAORAL, WIT",4904.0,3187.6,0.01,4904.0,28
CDM,21299RVU6AK,COMPLEX SCULPTING & CARVING OF CADAVERIC RIB EAR CARTILAGE FRAME,4022.0,2614.3,0.01,4022.0,28
CDM,21315AK,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,422.0,274.3,1.1,2603.78,53
CDM,21320AK,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,700.0,455.0,1.1,5497.86,53
CDM,21325AK,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,1672.0,1086.8,1.1,5497.86,50
CDM,21330AK,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,2316.0,1505.4,1.1,9999.36,50
CDM,21335AK,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,3608.0,2345.2,1.1,5497.86,50
CDM,21336AK,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,2708.0,1760.2,1.1,5526.53,50
CDM,21337AK,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,1356.0,881.4,1.1,5497.86,53
CDM,21343AK,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,5728.0,3723.2,1.1,5728.0,50
CDM,21344AK,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,8628.0,5608.2,1.1,8628.0,50
CDM,21346AK,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,4580.0,2977.0,1.1,9999.36,50
CDM,21347AK,OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN,5412.0,3517.8,1.1,9999.36,50
CDM,21356AK,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,1932.0,1255.8,1.1,9999.36,53
CDM,21360AK,OPEN TX DEPRESSED MALAR FRACTURE,2876.0,1869.4,1.1,9999.36,50
CDM,21365AK,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,6708.0,4360.2,1.1,9999.36,50
CDM,21385AK,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,3828.0,2488.2,1.1,9999.36,50
CDM,21386AK,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,3828.0,2488.2,1.1,9999.36,50
CDM,21387AK,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,4044.0,2628.6,1.1,9999.36,50
CDM,21390AK,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,4492.0,2919.8,1.1,9999.36,50
CDM,21400AK,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,600.0,390.0,1.1,939.01,53
CDM,21406AK,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,2968.0,1929.2,1.1,9999.36,50
CDM,21421AK,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,2408.0,1565.2,1.1,5497.86,53
CDM,21422AK,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,3492.0,2269.8,1.1,9999.36,50
CDM,21423AK,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,4340.0,2821.0,1.1,4340.0,50
CDM,21432AK,OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ,3528.0,2293.2,1.1,3528.0,50
CDM,21433AK,OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR,10516.0,6835.4,1.1,10516.0,50
CDM,21440AK,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,1376.0,894.4,1.1,5497.86,53
CDM,21450AK,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1484.0,964.6,1.1,1945.16,53
CDM,21451AK,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,2260.0,1469.0,1.1,2603.78,53
CDM,21453AK,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,2656.0,1726.4,1.1,9999.36,53
CDM,21461AK,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,3724.0,2420.6,1.1,9999.36,53
CDM,21462AK,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,4404.0,2862.6,1.1,9999.36,53
CDM,21470AK,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,7016.0,4560.4,1.1,9999.36,50
CDM,21480AK,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,268.0,174.2,1.1,465.46,53
CDM,21497AK,INTERDENTAL WIRING OTHER THAN FRACTURE,1856.0,1206.4,1.1,2603.78,53
CDM,21501AK,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,1592.0,1034.8,1.1,4850.94,53
CDM,21501URVUAK,DRAIN NECK/CHEST LESION,665.0,432.25,1.1,4850.94,53
CDM,21510AK,INCISION DEEP OPENING BONE CORTEX THORAX,2480.0,1612.0,1.1,2480.0,50
CDM,21550AK,BIOPSY SOFT TISSUE NECK/CHEST,844.0,548.6,1.1,2768.64,53
CDM,21550URVUAK,BIOPSY OF NECK/CHEST,538.0,349.7,1.1,2768.64,53
CDM,21552AK,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,2596.0,1687.4,1.1,4850.94,50
CDM,21552URVUAK,EXCISE TUMOR NECK SUBQ 3CM OR >,988.0,642.2,1.1,4850.94,50
CDM,21554AK,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,4452.0,2893.8,1.1,4850.94,50
CDM,21554URVUAK,REMOVE TUMOR NECK/CHEST 5CM OR >,1604.0,1042.6,1.1,4850.94,50
CDM,21555AK,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
CDM,21555URVUAK,"REMOVE LESION, NECK/CHEST",651.0,423.15,1.1,2768.64,53
CDM,21556AK,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,3064.0,1991.6,1.1,4850.94,50
CDM,21556URVUAK,"REMOVE LESION, NECK/CHEST",1074.0,698.1,1.1,4850.94,50
CDM,21557URVUAK,"REMOVE TUMOR, NECK/CHEST",2044.0,1328.6,1.1,4850.94,50
CDM,21558AK,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,8632.0,5610.8,1.1,8632.0,50
CDM,21558URVUAK,REMOVE TUMOR NECK/CHEST 5CM OR >,3242.0,2107.3,1.1,4850.94,50
CDM,21600AK,EXCISION RIB PARTIAL,2904.0,1887.6,1.1,12214.27,50
CDM,21601AK,EXCISION CHEST WALL TUMOR INCLUDING RIBS,7112.0,4622.8,1.1,7112.0,50
CDM,21602AK,EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC,8876.0,5769.4,1.1,8876.0,50
CDM,21603AK,EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC,10068.0,6544.2,1.1,10068.0,50
CDM,21615AK,EXCISION 1ST &/CERVICAL RIB,4180.0,2717.0,1.1,4180.0,50
CDM,21620AK,OSTECTOMY STERNUM PARTIAL,2912.0,1892.8,1.1,2912.0,50
CDM,21627AK,STERNAL DEBRIDEMENT,2920.0,1898.0,1.1,2920.0,50
CDM,21750AK,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,4560.0,2964.0,1.1,4560.0,50
CDM,21811AK,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,4316.0,2805.4,1.1,12214.27,50
CDM,21812AK,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,5200.0,3380.0,1.1,12214.27,50
CDM,21813AK,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,7044.0,4578.6,1.1,7044.0,50
CDM,21820AK,CLOSED TREATMENT STERNUM FRACTURE,544.0,353.6,1.1,544.0,53
CDM,21825AK,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,3104.0,2017.6,1.1,3104.0,50
CDM,21899AGRVU2AK,"UNLISTED PROCEDURE, NECK OR THORAX (COMPARISON CODE 49652)",4224.0,2745.6,0.01,4224.0,28
CDM,21899AGRVU3AK,"UNLISTED PROCEDURE, NECK OR THORAX (COMPARISON CODE 23044)",2505.0,1628.25,0.01,2505.0,28
CDM,21899AGRVUAK,"UNLISTED PROCEDURE, NECK OR THORAX (COMPARISON CODE 21740)",2250.0,1462.5,0.01,2250.0,28
CDM,21899AK,UNLISTED PROCEDURE NECK/THORAX,2318.0,1506.7,0.01,2318.0,28
CDM,21899RVU2AK,PLATYSMAL MYOTOMY FOR SYNKINESIS/TIGHTNESS FOR FACIAL NERVE SPAS,2494.0,1621.1,0.01,2494.0,28
CDM,21899RVU4AK,STERNAL NONUNION TAKEDOWN (COMP CODE 27470),6171.0,4011.15,0.01,6171.0,28
CDM,21920AK,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,844.0,548.6,1.1,2768.64,53
CDM,21925AK,BIOPSY SOFT TISSUE BACK/FLANK DEEP,1852.0,1203.8,1.1,2768.64,53
CDM,21930AK,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,1976.0,1284.4,1.1,2768.64,53
CDM,21930URVUAK,"REMOVE LESION, BACK OR FLANK",805.0,523.25,1.1,2768.64,53
CDM,21931AK,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,2752.0,1788.8,1.1,2768.64,50
CDM,21931URVUAK,EXCISE TUMOR BACK/FLANK 3CM OR >,1050.0,682.5,1.1,2768.64,50
CDM,21932AK,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,3928.0,2553.2,1.1,4850.94,50
CDM,21932URVUAK,EXCISE TUMOR BACK/FLANK < 5CM,1700.0,1105.0,1.1,4850.94,50
CDM,21933AK,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,4452.0,2893.8,1.1,4850.94,50
CDM,21933URVUAK,EXCISE TUMOR BACK\FLANK 5CM OR >,1622.0,1054.3,1.1,4850.94,50
CDM,21936AK,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,9020.0,5863.0,1.1,9020.0,50
CDM,22010AK,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,5100.0,3315.0,1.1,5100.0,50
CDM,22015AK,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,5056.0,3286.4,1.1,5056.0,50
CDM,22100AK,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,4400.0,2860.0,1.1,12214.27,50
CDM,22102AK,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,4432.0,2880.8,1.1,12214.27,50
CDM,22103AK,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,936.0,608.4,1.1,936.0,50
CDM,22114AK,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,5628.0,3658.2,1.1,5628.0,50
CDM,22207AK,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,14672.0,9536.8,1.1,14672.0,50
CDM,22210AK,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,10152.0,6598.8,1.1,10152.0,50
CDM,22212AK,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,8396.0,5457.4,1.1,8396.0,50
CDM,22214AK,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,8408.0,5465.2,1.1,8408.0,50
CDM,22216AK,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,2653.0,1724.45,1.1,2653.0,50
CDM,22220AK,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV,9176.0,5964.4,1.1,9176.0,50
CDM,22310AK,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1380.0,897.0,1.1,1380.0,53
CDM,22315AK,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,4044.0,2628.6,1.1,5526.53,53
CDM,22318AK,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,9088.0,5907.2,1.1,9088.0,50
CDM,22325AK,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,7948.0,5166.2,1.1,7948.0,50
CDM,22326AK,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,8336.0,5418.4,1.1,8336.0,50
CDM,22327AK,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,8308.0,5400.2,1.1,8308.0,50
CDM,22328AK,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,1840.0,1196.0,1.1,1840.0,50
CDM,22510AK,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,3160.0,2054.0,1.1,5964.48,53
CDM,22511AK,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,2932.0,1905.8,1.1,5927.09,53
CDM,22512AK,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,1600.0,1040.0,1.1,2408.68,53
CDM,22513AK,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,3460.0,2249.0,1.1,18675.2,53
CDM,22514AK,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,3196.0,2077.4,1.1,18576.58,53
CDM,22515AK,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,1760.0,1144.0,1.1,9588.76,53
CDM,22526AK,"PERC INTRADISC ELECTRO ANNULOPLASTY, SINGLE LEVEL",2340.0,1521.0,1.1,6472.18,42
CDM,22527AK,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,1212.0,787.8,1.1,5305.19,42
CDM,22533AK,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,9916.0,6445.4,1.1,9916.0,50
CDM,22534AK,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,2396.0,1557.4,1.1,2396.0,50
CDM,22551AK,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,11000.0,7150.0,1.1,22471.68,50
CDM,22552AK,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,2600.0,1690.0,1.1,2600.0,50
CDM,22554AK,ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2,7784.0,5059.6,1.1,22471.68,50
CDM,22556AK,ARTHRD ANT INTERBODY MIN DSC THORACIC,9880.0,6422.0,1.1,9880.0,50
CDM,22558AK,ARTHRD ANT INTERBODY MIN DSC LUMBAR,10353.0,6729.45,1.1,10353.0,50
CDM,22585AK,ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE,2429.0,1578.85,1.1,2429.0,50
CDM,22590AK,ARTHRODESIS POSTERIOR CRANIOCERVICAL,8704.0,5657.6,1.1,8704.0,50
CDM,22595AK,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,8256.0,5366.4,1.1,8256.0,50
CDM,22600AK,ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT,6960.0,4524.0,1.1,6960.0,50
CDM,22610AK,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC,7603.0,4941.95,1.1,7603.0,50
CDM,22612AK,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR,10353.0,6729.45,1.1,31818.75,50
CDM,22614AK,ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC,2829.0,1838.85,1.1,2829.0,50
CDM,22630AK,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR,9720.0,6318.0,1.1,31818.75,50
CDM,22632AK,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL,2297.0,1493.05,1.1,2297.0,50
CDM,22633AK,ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR,11792.0,7664.8,1.1,31818.75,50
CDM,22634AK,ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL,3502.0,2276.3,1.1,3502.0,50
CDM,22800AK,ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM,8580.0,5577.0,1.1,8580.0,50
CDM,22802AK,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM,14128.0,9183.2,1.1,14128.0,50
CDM,22830AK,EXPLORATION OF SPINAL FUSION,4937.0,3209.05,1.1,4937.0,50
CDM,22836AK,ANT THORACIC VRT BODY TETHERING <7 VRT SEGMENTS,14080.0,9152.0,1.1,14080.0,50
CDM,22837AK,ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS,15620.0,10153.0,1.1,15620.0,50
CDM,22838AK,REVJ RPLCMT/RMVL THORACIC VRT BODY TETHERING,15840.0,10296.0,1.1,15840.0,50
CDM,22840AK,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,5509.0,3580.85,1.1,5509.0,50
CDM,22842AK,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,5526.0,3591.9,1.1,5526.0,50
CDM,22843AK,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,5914.0,3844.1,1.1,5914.0,50
CDM,22844AK,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,7225.0,4696.25,1.1,7225.0,50
CDM,22845AK,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,5254.0,3415.1,1.1,5254.0,50
CDM,22846AK,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,5456.0,3546.4,1.1,5456.0,50
CDM,22848AK,PELVIC FIXATION OTHER THAN SACRUM,2636.0,1713.4,1.1,2636.0,50
CDM,22849AK,REINSERTION SPINAL FIXATION DEVICE,8435.0,5482.75,1.1,8435.0,50
CDM,22850AK,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,3928.0,2553.2,1.1,3928.0,50
CDM,22852AK,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,3748.0,2436.2,1.1,3748.0,50
CDM,22853AK,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD,1870.0,1215.5,1.1,1870.0,50
CDM,22854AK,INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD,2420.0,1573.0,1.1,2420.0,50
CDM,22855AK,REMOVAL ANTERIOR INSTRUMENTATION,6978.0,4535.7,1.1,6978.0,50
CDM,22856AK,TOTAL DISC ARTHRP ANT DSC 1 INTERSPACE CERVICAL,10582.0,6878.3,1.1,31818.75,50
CDM,22857AK,TOT DISC ARTHRP ANT DSC SINGLE INTERSPACE LUMBAR,10852.0,7053.8,1.1,10852.0,50
CDM,22858AK,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,3360.0,2184.0,1.1,3360.0,50
CDM,22859AK,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD,2420.0,1573.0,1.1,2420.0,50
CDM,22860AK,TOTAL DISC ARTHRP ANT SECOND INTERSPACE LUMBAR,2752.0,1788.8,1.1,2752.0,44
CDM,22899AK,UNLISTED SPINE SURGERY OR PROCEDURE,601.0,390.65,0.01,601.0,28
CDM,22899RVU7AK,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,2845.0,1849.25,0.01,2845.0,28
CDM,22900015,INTENDED PARENT DAILY,2091.0,1359.15,311.14,2091.0,38
CDM,22900AK,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,3328.0,2163.2,1.1,4850.94,50
CDM,22900URVUAK,REMOVE ABDOMINAL WALL LESION,1430.0,929.5,1.1,4850.94,50
CDM,22901AK,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,4044.0,2628.6,1.1,4850.94,50
CDM,22901URVUAK,EXCISE TUMOR ABDOML WALL 5CM OR >,1449.0,941.85,1.1,4850.94,50
CDM,22902AK,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,1768.0,1149.2,1.1,2768.64,53
CDM,22902URVUAK,EXCISE TUMOR ABD WALL <3CM,723.0,469.95,1.1,2768.64,53
CDM,22903AK,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,2556.0,1661.4,1.1,4850.94,50
CDM,22903URVUAK,EXCISE TUMOR ABD WALL 3CM OR >,955.0,620.75,1.1,4850.94,50
CDM,22904AK,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,6676.0,4339.4,1.1,6676.0,50
CDM,22905AK,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,8632.0,5610.8,1.1,8632.0,50
CDM,22999AK,ABDOMEN WALL SURG PROC UNLISTED,4052.0,2633.8,0.01,4052.0,28
CDM,22999RVU2AK,EXPLORATORY OF ABDOMEN (COMP CODE 20102),1592.0,1034.8,0.01,1592.0,28
CDM,22999RVUAK,REMOVAL OF MESH ABD WALL (COMP 20680),2457.0,1597.05,0.01,2457.0,28
CDM,23000015,EMERGENCY RESUSCITATION CHARGE,1474.0,958.1,219.33,1474.0,38
CDM,23000025,INTENSIVE NURSING CARE 1,887.0,576.55,131.99,887.0,38
CDM,23000035,INTENSIVE NURSING CARE 2,1747.0,1135.55,259.95,1747.0,38
CDM,23000045,INTENSIVE NURSING CARE 3,2625.0,1706.25,390.6,2625.0,38
CDM,23000055,PICC LINE INSERTION (IP),3982.0,2588.3,592.52,3982.0,38
CDM,23000065,IP FOOT & NAIL CARE/PER 15 MIN,108.0,70.2,16.07,108.0,38
CDM,23000075,ARCTIC SUN INITIAL (NORMAL),5740.0,3731.0,854.11,5740.0,38
CDM,23000085,ARCTIC SUN ADL DAILY,723.0,469.95,107.58,723.0,38
CDM,23000095,BALLOON PUMP DAILY,3735.0,2427.75,555.77,3735.0,38
CDM,23000AK,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,1792.0,1164.8,1.1,4850.94,53
CDM,23020AK,CAPSULAR CONTRACTURE RELEASE,3744.0,2433.6,1.1,5526.53,50
CDM,23030AK,I&D SHOULDER DEEP ABSCESS/HEMATOMA,1388.0,902.2,1.1,4850.94,53
CDM,23035AK,INCISION BONE CORTEX SHOULDER AREA,3664.0,2381.6,1.1,3664.0,50
CDM,23040AK,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,4290.0,2788.5,1.1,5526.53,50
CDM,23044AK,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,3036.0,1973.4,1.1,5526.53,50
CDM,23065AK,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,920.0,598.0,1.1,2768.64,53
CDM,23066AK,BIOPSY SOFT TISSUE SHOULDER DEEP,1720.0,1118.0,1.1,4850.94,53
CDM,23071AK,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,2364.0,1536.6,1.1,2768.64,50
CDM,23071URVUAK,EXCISE TUMOR SHOULDER AREA 3CM OR >,908.0,590.2,1.1,2768.64,50
CDM,23073AK,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,4052.0,2633.8,1.1,4850.94,50
CDM,23073URVUAK,EXCISE TUMOR SHOULDER AREA 5CM OR >,1505.0,978.25,1.1,4850.94,50
CDM,23075AK,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,1684.0,1094.6,1.1,2768.64,53
CDM,23075URVUAK,REMOVAL OF SHOULDER LESION,578.0,375.7,1.1,2768.64,53
CDM,23076AK,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,2964.0,1926.6,1.1,4850.94,50
CDM,23076URVUAK,REMOVAL OF SHOULDER LESION,1156.0,751.4,1.1,4850.94,50
CDM,23077AK,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,7064.0,4591.6,1.1,7064.0,50
CDM,23078AK,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,9020.0,5863.0,1.1,9020.0,50
CDM,23100005,BLUE LITES CARE/PER DAY,631.0,410.15,93.89,631.0,38
CDM,23100015,NEWBORN PULSE OX SCREENING,194.0,126.1,28.87,194.0,38
CDM,23100AK,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,2480.0,1612.0,1.1,5526.53,50
CDM,23105AK,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,3392.0,2204.8,1.1,12214.27,50
CDM,23106AK,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,2452.0,1593.8,1.1,5526.53,50
CDM,23120AK,CLAVICULECTOMY PARTIAL,3252.0,2113.8,1.1,5526.53,50
CDM,23130AK,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,3419.0,2222.35,1.1,5526.53,50
CDM,23140AK,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,2848.0,1851.2,1.1,5526.53,50
CDM,23146AK,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,3232.0,2100.8,1.1,12214.27,50
CDM,23150AK,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,3564.0,2316.6,1.1,5526.53,50
CDM,23182AK,PARTIAL EXCISION BONE SCAPULA,3444.0,2238.6,1.1,12214.27,50
CDM,23184AK,PARTIAL EXCISION BONE PROXIMAL HUMERUS,3960.0,2574.0,1.1,12214.27,50
CDM,23190AK,OSTECTOMY SCAPULA PARTIAL,2988.0,1942.2,1.1,5526.53,50
CDM,23195AK,RESECTION HUMERAL HEAD,4144.0,2693.6,1.1,12214.27,50
CDM,23210AK,RAD RESECT SCAPULA FOR TUMOR,10884.0,7074.6,1.1,10884.0,50
CDM,23330AK,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,760.0,494.0,1.1,2768.64,53
CDM,23333AK,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,2400.0,1560.0,1.1,4850.94,50
CDM,23334AK,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,6200.0,4030.0,1.1,6200.0,50
CDM,23335AK,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,7600.0,4940.0,1.1,7600.0,50
CDM,23350AK,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,400.0,260.0,1.1,541.7,53
CDM,23395AK,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,7416.0,4820.4,1.1,12214.27,50
CDM,23397AK,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,6704.0,4357.6,1.1,12214.27,50
CDM,23400AK,SCAPULOPEXY,5548.0,3606.2,1.1,12214.27,50
CDM,23405AK,TENOTOMY SHOULDER AREA 1 TENDON,3416.0,2220.4,1.1,12214.27,50
CDM,23406AK,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,4404.0,2862.6,1.1,12214.27,50
CDM,23410AK,OPEN REPAIR OF ROTATOR CUFF ACUTE,4556.0,2961.4,1.1,12214.27,50
CDM,23412AK,OPEN REPAIR OF ROTATOR CUFF CHRONIC,4772.0,3101.8,1.1,12214.27,50
CDM,23415AK,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,3692.0,2399.8,1.1,12214.27,50
CDM,23420AK,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,5416.0,3520.4,1.1,12214.27,50
CDM,23430AK,TENODESIS LONG TENDON BICEPS,4068.0,2644.2,1.1,12214.27,50
CDM,23440AK,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,4256.0,2766.4,1.1,12214.27,50
CDM,23450AK,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,5480.0,3562.0,1.1,12214.27,50
CDM,23455AK,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,5868.0,3814.2,1.1,12214.27,50
CDM,23460AK,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,6961.0,4524.65,1.1,12214.27,50
CDM,23462AK,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,6288.0,4087.2,1.1,12214.27,50
CDM,23465AK,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,6520.0,4238.0,1.1,12214.27,50
CDM,23466AK,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,6952.0,4518.8,1.1,12214.27,50
CDM,23470AK,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,7156.0,4651.4,1.1,22471.68,50
CDM,23472AK,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,9737.0,6329.05,1.1,31818.75,50
CDM,23473AK,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,10000.0,6500.0,1.1,22471.68,50
CDM,23474AK,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,10884.0,7074.6,1.1,10884.0,50
CDM,23480AK,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,4616.0,3000.4,1.1,12214.27,50
CDM,23485AK,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,5564.0,3616.6,1.1,22471.68,50
CDM,23500AK,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,972.0,631.8,1.1,972.0,53
CDM,23505AK,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,1532.0,995.8,1.1,2743.55,53
CDM,23515AK,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,3876.0,2519.4,1.1,12214.27,50
CDM,23520AK,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,916.0,595.4,1.1,2743.55,53
CDM,23525AK,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,1516.0,985.4,1.1,1516.0,53
CDM,23530AK,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,2992.0,1944.8,1.1,12214.27,50
CDM,23540AK,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,944.0,613.6,1.1,944.0,53
CDM,23545AK,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1372.0,891.8,1.1,1372.0,53
CDM,23550AK,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,3036.0,1973.4,1.1,12214.27,50
CDM,23552AK,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3528.0,2293.2,1.1,12214.27,50
CDM,23570AK,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,944.0,613.6,1.1,944.0,53
CDM,23585AK,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,5692.0,3699.8,1.1,12214.27,50
CDM,23600AK,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1200.0,780.0,1.1,1200.0,53
CDM,23605AK,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,2024.0,1315.6,1.1,2743.55,53
CDM,23615AK,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,4920.0,3198.0,1.1,22471.68,50
CDM,23616AK,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,7348.0,4776.2,1.1,31818.75,50
CDM,23620AK,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1020.0,663.0,1.1,1020.0,53
CDM,23625AK,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,1640.0,1066.0,1.1,2743.55,53
CDM,23630AK,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,4228.0,2748.2,1.1,12214.27,50
CDM,23650AK,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1553.0,1009.45,1.1,1553.0,53
CDM,23655AK,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,2094.0,1361.1,1.1,2743.55,50
CDM,23660AK,OPEN RX ACUTE SHLDR DISLOC,3064.0,1991.6,1.1,12214.27,50
CDM,23665AK,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,1864.0,1211.6,1.1,2743.55,53
CDM,23670AK,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,4912.0,3192.8,1.1,12214.27,50
CDM,23680AK,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,5260.0,3419.0,1.1,22471.68,50
CDM,23700AK,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,1028.0,668.2,1.1,2743.55,50
CDM,23800AK,ARTHRODESIS GLENOHUMERAL JOINT,5892.0,3829.8,1.1,12214.27,50
CDM,23900015,IP ENTERSTOMAL CARE/PER 15 MIN,90.0,58.5,13.39,90.0,38
CDM,23900AK,INTERTHORACOSCAPULAR AMPUTATION,8288.0,5387.2,1.1,8288.0,50
CDM,23920AK,DISARTICULATION SHOULDER,6492.0,4219.8,1.1,6492.0,50
CDM,23929AGRVUAK,"UNLISTED PROCEDURE, SHOULDER COMPARED TO CPT 23466",5214.0,3389.1,0.01,5214.0,28
CDM,23929RVU10AK,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),3460.0,2249.0,0.01,3460.0,28
CDM,23929RVU6AK,"UNLISTED PROC, OPEN POSTERIOR REMPLISSAGE PROC (COMP TO 23465)",1542.0,1002.3,0.01,1542.0,28
CDM,23929RVU8AK,UNLISTED PROC; OPEN TENODESIS OF SHORT HEAD OF THE BICEPS TENDON,1542.0,1002.3,0.01,1542.0,28
CDM,23929RVU9AK,UNLISTED PROC; OPEN REMPLISSATE PROC (COMP TO 23410),3801.0,2470.65,0.01,3801.0,28
CDM,23930AK,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,1196.0,777.4,1.1,4850.94,53
CDM,23931AK,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,736.0,478.4,1.1,2768.64,53
CDM,23935AK,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,2552.0,1658.8,1.1,5526.53,50
CDM,24000AK,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,2432.0,1580.8,1.1,5526.53,50
CDM,24006AK,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,4286.0,2785.9,1.1,5526.53,50
CDM,24065AK,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",852.0,553.8,1.1,2768.64,53
CDM,24065URVUAK,BIOPSY ARM/ELBOW SOFT TISSUE,397.0,258.05,1.1,2768.64,53
CDM,24066AK,"BX ARM/ELBOW SOFT TISSUE,DEEP",2140.0,1391.0,1.1,4850.94,53
CDM,24066URVUAK,BIOPSY ARM/ELBOW SOFT TISSUE,1004.0,652.6,1.1,4850.94,53
CDM,24071AK,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,2280.0,1482.0,1.1,4850.94,50
CDM,24071URVUAK,EXCISE TUMOR UPPR ARM/ELBOW 3CM OR >,881.0,572.65,1.1,4850.94,50
CDM,24073AK,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,4052.0,2633.8,1.1,4850.94,50
CDM,24073URVUAK,EXCISE TUMOR UPPR ARM/ELBOW 5CM OR >,1060.0,689.0,1.1,4850.94,50
CDM,24075AK,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,1866.0,1212.9,1.1,2768.64,53
CDM,24075URVUAK,REMOVE ARM/ELBOW LESION,673.0,437.45,1.1,2768.64,53
CDM,24076AK,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,3260.0,2119.0,1.1,4850.94,50
CDM,24076URVUAK,REMOVE ARM/ELBOW LESION,1094.0,711.1,1.1,4850.94,50
CDM,24101AK,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,2520.0,1638.0,1.1,5526.53,50
CDM,24102AK,ARTHROTOMY ELBOW W/SYNOVECTOMY,3304.0,2147.6,1.1,5526.53,50
CDM,24105AK,EXCISION OLECRANON BURSA,1512.0,982.8,1.1,5526.53,50
CDM,24110AK,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,3032.0,1970.8,1.1,5526.53,50
CDM,24116AK,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,4892.0,3179.8,1.1,12214.27,50
CDM,24120AK,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,2728.0,1773.2,1.1,5526.53,50
CDM,24130AK,EXCISION RADIAL HEAD,2568.0,1669.2,1.1,5526.53,50
CDM,24140AK,PARTIAL REMOVAL HUMERUS,3820.0,2483.0,1.1,5526.53,50
CDM,24147AK,PARTIAL REMOVAL OLECRANNON PROCESS,3136.0,2038.4,1.1,5526.53,50
CDM,24149AK,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,7137.0,4639.05,1.1,12214.27,50
CDM,24164AK,PROSTHESIS REMOVAL RADIAL HEAD,4000.0,2600.0,1.1,5526.53,50
CDM,24200AK,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,724.0,470.6,1.1,2768.64,53
CDM,24201AK,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,1880.0,1222.0,1.1,4850.94,53
CDM,24300AK,MANIPULATION ELBOW W/ANESTH,1616.0,1050.4,1.1,2743.55,50
CDM,24301AK,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,4152.0,2698.8,1.1,12214.27,50
CDM,24305AK,"ARM/ELBOW TENDON LENGTHEN,SINGLE,EA",3048.0,1981.2,1.1,5526.53,50
CDM,24310AK,"TENOTOMY,ELBOW-SHLDR,SINGL,EACH",2448.0,1591.2,1.1,5526.53,50
CDM,24320AK,"TENOPLASTY,ELB-SHLDR,MUSC XFER,SINGL",4344.0,2823.6,1.1,12214.27,50
CDM,24332AK,"TENOLYSIS, TRICEPS",3164.0,2056.6,1.1,5526.53,50
CDM,24341AK,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,3796.0,2467.4,1.1,12214.27,50
CDM,24342AK,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,4344.0,2823.6,1.1,12214.27,50
CDM,24343AK,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,5526.53,50
CDM,24344AK,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,6084.0,3954.6,1.1,12214.27,50
CDM,24345AK,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,12214.27,50
CDM,24357AK,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,2176.0,1414.4,1.1,5526.53,50
CDM,24358AK,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,2664.0,1731.6,1.1,5526.53,50
CDM,24359AK,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,3592.0,2334.8,1.1,5526.53,50
CDM,24360AK,"ARTHROPLASTY,ELBOW,W MEMBRANE",5575.0,3623.75,1.1,12214.27,50
CDM,24363AK,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,8800.0,5720.0,1.1,31818.75,50
CDM,24366AK,ARTHROPLASTY RADIAL HEAD W/IMPLANT,3744.0,2433.6,1.1,22471.68,50
CDM,24371AK,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,11000.0,7150.0,1.1,31818.75,50
CDM,24400AK,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,4985.0,3240.25,1.1,12214.27,50
CDM,24430AK,REPAIR NON/MALUNION HUMERUS W/O GRAFT,6100.0,3965.0,1.1,22471.68,50
CDM,24435AK,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,5996.0,3897.4,1.1,22471.68,50
CDM,24495AK,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,3364.0,2186.6,1.1,12214.27,50
CDM,24498AK,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,4912.0,3192.8,1.1,22471.68,50
CDM,24500AK,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1500.0,975.0,1.1,1500.0,53
CDM,24505AK,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,2156.0,1401.4,1.1,2743.55,53
CDM,24515AK,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,4848.0,3151.2,1.1,22471.68,50
CDM,24516AK,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,4876.0,3169.4,1.1,22471.68,50
CDM,24530AK,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1476.0,959.4,1.1,1476.0,53
CDM,24535AK,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,2844.0,1848.6,1.1,2844.0,53
CDM,24538AK,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,4299.0,2794.35,1.1,12214.27,50
CDM,24545AK,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,5260.0,3419.0,1.1,22471.68,50
CDM,24546AK,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,5964.0,3876.6,1.1,22471.68,50
CDM,24560AK,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1192.0,774.8,1.1,1192.0,53
CDM,24575AK,OPEN TX HUMERAL EPICONDYLAR FRACTURE,3884.0,2524.6,1.1,22471.68,50
CDM,24576AK,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1346.0,874.9,1.1,1346.0,53
CDM,24577AK,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,2644.0,1718.6,1.1,2743.55,53
CDM,24579AK,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,4576.0,2974.4,1.1,22471.68,50
CDM,24586AK,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,6312.0,4102.8,1.1,22471.68,50
CDM,24587AK,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,6316.0,4105.4,1.1,22471.68,50
CDM,24600AK,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1748.0,1136.2,1.1,1748.0,53
CDM,24605AK,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,2256.0,1466.4,1.1,2743.55,50
CDM,24615AK,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,3932.0,2555.8,1.1,12214.27,50
CDM,24620AK,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,2888.0,1877.2,1.1,2888.0,50
CDM,24635AK,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,3520.0,2288.0,1.1,12214.27,50
CDM,24640AK,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,550.0,357.5,1.1,550.0,53
CDM,24650AK,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1016.0,660.4,1.1,1016.0,53
CDM,24655AK,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,2033.0,1321.45,1.1,2743.55,53
CDM,24665AK,OPEN TX RADIAL HEAD/NECK FRACTURE,3344.0,2173.6,1.1,12214.27,50
CDM,24666AK,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,3944.0,2563.6,1.1,22471.68,50
CDM,24670AK,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1076.0,699.4,1.1,1076.0,53
CDM,24675AK,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,1964.0,1276.6,1.1,2743.55,53
CDM,24685AK,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,3348.0,2176.2,1.1,12214.27,50
CDM,24900AK,"AMPUTATN ARM,THRU HUMERUS,PRIM CLOS",4072.0,2646.8,1.1,4072.0,50
CDM,24920AK,AMPUTATE ARM-HUMER; OP CIRCULAR,4052.0,2633.8,1.1,4052.0,50
CDM,24925AK,"AMPUTATN ARM,THRU HUMER,SECOND CL",2920.0,1898.0,1.1,5526.53,50
CDM,24930AK,AMPUTATE ARM-HUMERUS RE-AMPUT,4332.0,2815.8,1.1,4332.0,50
CDM,24999RVU5AK,UPPER ARM COMPARTMENT DECOMPRESSON FASCIOTOMY/RELEASE WITH COMP,1621.0,1053.65,0.01,1621.0,28
CDM,25000070,NITRIC OXIDE PER HOUR,131.0,85.15,19.49,131.0,40
CDM,25000250,HUMIDIFIER 650ML,35.0,22.75,5.21,35.0,40
CDM,25000390,SODIUM CHLORIDE .9% IRRIG,6.24,4.06,0.93,6.24,40
CDM,25000665,LIDOCAINE 1% 20ML VIAL,8.36,5.43,1.24,8.36,40
CDM,25000895,SODIUM CL FLUSH 10ML,18.07,11.75,2.69,18.07,40
CDM,25000925,LIDOCAINE 2% 20ML VIAL,11.54,7.5,1.72,11.54,40
CDM,25000945,LIDOCAINE 0.5% 50ML VL,18.07,11.75,2.69,18.07,40
CDM,25000965,TETANUS TOXOID 0.5ML SYR,172.9,112.39,25.73,172.9,40
CDM,25000975,LIDOCAINE 1% W/EPI 20ML VIAL,11.62,7.55,1.73,11.62,40
CDM,25000985,LIDOCAINE 1% 5ML VIAL,13.08,8.5,1.95,13.08,40
CDM,25000AK,INCISION EXTENSOR TENDON SHEATH WRIST,1420.0,923.0,1.1,2743.55,50
CDM,25001005,LIDOCAINE 1% 10ML VL,9.9,6.44,1.47,9.9,40
CDM,25001015,LIDOCAINE JELLY 2% 5ML,29.7,19.31,4.42,29.7,40
CDM,25001025,LIDOCAINE HCI INJ 4% 5ML,27.54,17.9,4.1,27.54,40
CDM,25001045,EXPAREL 133MG/10ML,486.0,315.9,72.32,486.0,40
CDM,25001AK,INCISE FLX TENDN SHEATH WRST,1516.0,985.4,1.1,5526.53,50
CDM,25020AK,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,2424.0,1575.6,1.1,2743.55,50
CDM,25023AK,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,5532.0,3595.8,1.1,5532.0,50
CDM,25024AK,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,4316.0,2805.4,1.1,5526.53,50
CDM,25025AK,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,7176.0,4664.4,1.1,7176.0,50
CDM,25028AK,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,2156.0,1401.4,1.1,5526.53,50
CDM,25031AK,INCISION & DRAINAGE FOREARM&/WRIST BURSA,1704.0,1107.6,1.1,2743.55,50
CDM,25035AK,INCISION DEEP BONE CORTEX FOREARM&/WRIST,3060.0,1989.0,1.1,12214.27,50
CDM,25040AK,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,3000.0,1950.0,1.1,5526.53,50
CDM,25065AK,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,816.0,530.4,1.1,2768.64,53
CDM,25066AK,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,1708.0,1110.2,1.1,4850.94,50
CDM,25066URVU1AK,BIOPSY FOREARM SOFT TISSUES,999.0,649.35,1.1,4850.94,50
CDM,25071AK,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,2364.0,1536.6,1.1,2768.64,50
CDM,25071URVUAK,EXCISE TUMOR FOREARM\WRIST 3CM OR >,922.0,599.3,1.1,2768.64,50
CDM,25073AK,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,2852.0,1853.8,1.1,4850.94,50
CDM,25075AK,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
CDM,25075URVUAK,REMOVAL OF FOREARM LESION,682.0,443.3,1.1,2768.64,53
CDM,25076AK,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,2696.0,1752.4,1.1,2768.64,50
CDM,25076URVUAK,REMOVAL OF FOREARM LESION,1223.0,794.95,1.1,2768.64,50
CDM,25078AK,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,7076.0,4599.4,1.1,7076.0,50
CDM,25085AK,CAPSULOTOMY WRIST,2256.0,1466.4,1.1,5526.53,50
CDM,25101AK,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,1932.0,1255.8,1.1,5526.53,50
CDM,25105AK,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,2408.0,1565.2,1.1,5526.53,50
CDM,25107AK,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,3080.0,2002.0,1.1,5526.53,50
CDM,25109AK,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,2776.0,1804.4,1.1,5526.53,50
CDM,25110AK,"EXCIS TENDON SHEATH LESN,WRIST/FORE",1616.0,1050.4,1.1,2743.55,50
CDM,25111AK,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,1412.0,917.8,1.1,2743.55,50
CDM,25112AK,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,1868.0,1214.2,1.1,2743.55,50
CDM,25115AK,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,4036.0,2623.4,1.1,4036.0,50
CDM,25116AK,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,3024.0,1965.6,1.1,5526.53,50
CDM,25118AK,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,1804.0,1172.6,1.1,2743.55,50
CDM,25119AK,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,2484.0,1614.6,1.1,5526.53,50
CDM,25120AK,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,2508.0,1630.2,1.1,5526.53,50
CDM,25126AK,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,3096.0,2012.4,1.1,5526.53,50
CDM,25130AK,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,2172.0,1411.8,1.1,5526.53,50
CDM,25135AK,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,2832.0,1840.8,1.1,12214.27,50
CDM,25150AK,"PART REMOVAL BONE,ULNA",2952.0,1918.8,1.1,5526.53,50
CDM,25210AK,CARPECTOMY 1 BONE,2448.0,1591.2,1.1,5526.53,50
CDM,25215AK,CARPECTOMY ALL BONES PROXIMAL ROW,3256.0,2116.4,1.1,5526.53,50
CDM,25230AK,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,2148.0,1396.2,1.1,5526.53,50
CDM,25240AK,"EXCIS DISTAL ULNA,PART/COMPLETE",2124.0,1380.6,1.1,5526.53,50
CDM,25246AK,INJECTION FOR WRIST ARTHROGRAM,580.0,377.0,1.1,651.72,53
CDM,25248AK,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,2124.0,1380.6,1.1,2743.55,50
CDM,25251AK,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,3928.0,2553.2,1.1,5526.53,50
CDM,25259AK,MANIPULATE WRIST W/ANESTHES,1616.0,1050.4,1.1,2743.55,50
CDM,25260AK,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,3216.0,2090.4,1.1,5526.53,50
CDM,25263AK,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,3216.0,2090.4,1.1,12214.27,50
CDM,25270AK,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,2468.0,1604.2,1.1,5526.53,50
CDM,25272AK,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,2884.0,1874.6,1.1,5526.53,50
CDM,25274AK,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,3576.0,2324.4,1.1,5526.53,50
CDM,25275AK,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,3584.0,2329.6,1.1,5526.53,50
CDM,25280AK,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,2956.0,1921.4,1.1,5526.53,50
CDM,25290AK,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2172.0,1411.8,1.1,5526.53,50
CDM,25295AK,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2688.0,1747.2,1.1,5526.53,50
CDM,25300AK,TENODESIS WRIST FLEXORS FINGERS,3608.0,2345.2,1.1,5526.53,50
CDM,25301AK,TENODESIS WRIST EXTENSORS FINGERS,3436.0,2233.4,1.1,5526.53,50
CDM,25310AK,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,3960.0,2574.0,1.1,5526.53,50
CDM,25312AK,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,4321.0,2808.65,1.1,5526.53,50
CDM,25320AK,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,5100.0,3315.0,1.1,12214.27,50
CDM,25332AK,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,4696.0,3052.4,1.1,5526.53,50
CDM,25337AK,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,4692.0,3049.8,1.1,12214.27,50
CDM,25350AK,"OSTEOTOMY RADIUS,DISTAL THIRD",3636.0,2363.4,1.1,12214.27,50
CDM,25360AK,OSTEOTOMY ULNA,3496.0,2272.4,1.1,12214.27,50
CDM,25390AK,OSTEOPLASTY RADIUS/ULNA SHORTENING,4280.0,2782.0,1.1,12214.27,50
CDM,25400AK,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,4512.0,2932.8,1.1,12214.27,50
CDM,25405AK,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,6004.0,3902.6,1.1,12214.27,50
CDM,25415AK,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,5520.0,3588.0,1.1,12214.27,50
CDM,25420AK,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,6816.0,4430.4,1.1,12214.27,50
CDM,25430AK,VASC PEDICL INTO CARPAL BONE,3884.0,2524.6,1.1,5526.53,50
CDM,25440AK,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,4272.0,2776.8,1.1,12214.27,50
CDM,25446AK,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,6920.0,4498.0,1.1,31818.75,50
CDM,25447AK,ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION,4200.0,2730.0,1.1,5526.53,50
CDM,25448AK,ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION,5214.0,3389.1,1.1,5214.0,49
CDM,25500075,HO CONTRAST (350-399) PER ML,43.85,28.5,6.52,43.85,40
CDM,25500085,HO CONTRAST (400>) PER ML,69.71,45.31,10.37,69.71,40
CDM,25500095,LO CONTRAST (100-199) PER ML,8.25,5.36,1.23,8.25,43
CDM,25500AK,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1040.0,676.0,1.1,1040.0,53
CDM,25505AK,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,2180.0,1417.0,1.1,2743.55,53
CDM,25515AK,OPEN TREATMENT RADIAL SHAFT FRACTURE,3520.0,2288.0,1.1,12214.27,50
CDM,25520AK,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,2600.0,1690.0,1.1,2743.55,53
CDM,25525AK,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,4220.0,2743.0,1.1,12214.27,50
CDM,25526AK,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,5260.0,3419.0,1.1,12214.27,50
CDM,25530AK,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,896.0,582.4,1.1,902.04,53
CDM,25535AK,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,2144.0,1393.6,1.1,2144.0,53
CDM,25545AK,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,3176.0,2064.4,1.1,12214.27,50
CDM,25560AK,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1036.0,673.4,1.1,1036.0,53
CDM,25565AK,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,2340.0,1521.0,1.1,2743.55,53
CDM,25574AK,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,3520.0,2288.0,1.1,12214.27,50
CDM,25575AK,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,4916.0,3195.4,1.1,12214.27,50
CDM,25600AK,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1112.0,722.8,1.1,1154.06,53
CDM,25605AK,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,2500.0,1625.0,1.1,2743.55,53
CDM,25606AK,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,3324.0,2160.6,1.1,5526.53,50
CDM,25607AK,"OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR",4206.0,2733.9,1.1,12214.27,50
CDM,25608AK,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG",4871.0,3166.15,1.1,12214.27,50
CDM,25609AK,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG",6327.0,4112.55,1.1,12214.27,50
CDM,25622AK,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1116.0,725.4,1.1,1116.0,53
CDM,25624AK,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,1908.0,1240.2,1.1,2743.55,53
CDM,25628AK,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,3868.0,2514.2,1.1,12214.27,50
CDM,25630AK,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1333.0,866.45,1.1,1333.0,53
CDM,25635AK,CLTX CARPAL BONE FX W/MANJ EACH BONE,2028.0,1318.2,1.1,2743.55,53
CDM,25645AK,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,2968.0,1929.2,1.1,5526.53,50
CDM,25650AK,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1292.0,839.8,1.1,1292.0,53
CDM,25651AK,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,2328.0,1513.2,1.1,5526.53,50
CDM,25652AK,OPEN TREATMENT ULNAR STYLOID FRACTURE,3224.0,2095.6,1.1,12214.27,50
CDM,25660AK,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1992.0,1294.8,1.1,1992.0,50
CDM,25670AK,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,3236.0,2103.4,1.1,12214.27,50
CDM,25671AK,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,2584.0,1679.6,1.1,5526.53,50
CDM,25675AK,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1956.0,1271.4,1.1,1956.0,53
CDM,25676AK,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,3316.0,2155.4,1.1,12214.27,50
CDM,25685AK,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,4036.0,2623.4,1.1,12214.27,50
CDM,25690AK,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,2288.0,1487.2,1.1,2743.55,50
CDM,25695AK,OPEN TREATMENT LUNATE DISLOCATION,3404.0,2212.6,1.1,12214.27,50
CDM,25800040,F NACL .9 1000ML,5.0,3.25,0.74,8.86,51
CDM,25800580,"INFUSION, NORMAL SALINE 500ML",5.0,3.25,0.74,8.86,51
CDM,25800AK,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,4431.0,2880.15,1.1,12214.27,50
CDM,25810AK,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,4780.0,3107.0,1.1,22471.68,50
CDM,25820AK,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,3056.0,1986.4,1.1,12214.27,50
CDM,25825AK,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,3876.0,2519.4,1.1,12214.27,50
CDM,25830AK,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,4352.0,2828.8,1.1,12214.27,50
CDM,25900AK,AMPUTATION FOREARM THROUGH RADIUS & ULNA,3844.0,2498.6,1.1,3844.0,50
CDM,25920AK,DISARTICULATION THROUGH WRIST,3612.0,2347.8,1.1,3612.0,50
CDM,25999AGRVUAK,"UNLISTED PROCEDURE, FOREARM AND WRIST",2000.0,1300.0,0.01,2000.0,28
CDM,25999RVU1AK,DECOMPRESSION OF THE DISTAL RADIUS (COMP CODE 25035),3060.0,1989.0,0.01,3060.0,28
CDM,25999RVU2AK,RESURFACING OF THE CAPITATE (COMP CODE 25444),4911.0,3192.15,0.01,4911.0,28
CDM,26000010,IV HYDRATE INIT 31-60MIN,1454.0,945.1,55.38,1454.0,61
CDM,26000050,IV HYDRATE EA ADD HR,318.0,206.7,20.85,359.38,61
CDM,26000090,IV INF INIT UP TO 1 HR,1454.0,945.1,107.52,1454.0,61
CDM,26000130,IV INF SEQ EA ADD HR,318.0,206.7,34.57,359.38,61
CDM,26000170,IV INF SEQ UP TO 1HR,491.0,319.15,48.2,491.0,61
CDM,26000210,IV INF CONCUR THERAPY,762.0,495.3,32.83,762.0,46
CDM,26000250,INJ SQ/IM,491.0,319.15,17.51,491.0,61
CDM,26000265,FILL PORTABLE PUMP,1454.0,945.1,36.15,1454.0,61
CDM,26000290,INJ IVPUSH INIT DRUG,1454.0,945.1,36.15,1454.0,61
CDM,26000330,INJ IVPUSH SEQ NEW DRUG,318.0,206.7,25.72,318.0,61
CDM,26000335,"PROLONGED IV INF, REQ PUMP",1907.0,1239.55,201.23,1907.0,61
CDM,26000370,INJ IV PUSH SEQ SAME DRUG,488.0,317.2,36.15,488.0,46
CDM,26000380,IRRIG DRUG DELIVERY DEVICE,410.0,266.5,36.15,410.0,61
CDM,26000385,THERAPEUTIC IV INFUSION 1ST HR,1454.0,945.1,107.52,1454.0,61
CDM,26000395,THERAP IV INFUSION EA ADDL HR,318.0,206.7,34.57,359.38,61
CDM,26000515,INJECTION IV PUSH INIT,1454.0,945.1,36.15,1454.0,61
CDM,26000525,INJ IV PUSH SEQ NEW DRUG,318.0,206.7,25.72,318.0,61
CDM,26000545,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,318.0,206.7,30.96,3004.0,61
CDM,26000605,FILL IMP PUMP RESVOIR IV OR IA,1454.0,945.1,36.15,1454.0,61
CDM,26000665,THER/PROPH/DIAG INJ IA,1454.0,945.1,32.83,1454.0,61
CDM,26010AK,DRAIN FINGER ABSCESS SIMPLE,700.0,455.0,1.1,1134.89,53
CDM,26011AK,DRAIN FINGER ABSCESS COMPL,986.0,640.9,1.1,2768.64,53
CDM,26020AK,DRAIN HAND TENDON SHEATH,2736.0,1778.4,1.1,5526.53,50
CDM,26025AK,"DRAINAGE PALM BURSA,SINGLE",2032.0,1320.8,1.1,5526.53,50
CDM,26030AK,"DRAINAGE PALM BURSA,MULTIP/COMPLX",2500.0,1625.0,1.1,5526.53,50
CDM,26034AK,INCIS DEEP FINGR/HAND BONE LESN,2652.0,1723.8,1.1,2743.55,50
CDM,26035AK,"DECOMPRESS FINGERS/HAND,INJECT INJ",4548.0,2956.2,1.1,5526.53,50
CDM,26037AK,DECOMPRESS FASCIOTOMY FINGR/HAND,3028.0,1968.2,1.1,5526.53,50
CDM,26040AK,FASCIOTOMY PALMAR PERCUTANEOUS,1384.0,899.6,1.1,2743.55,50
CDM,26045AK,FASCIOTOMY PALMAR OPEN PARTIAL,2292.0,1489.8,1.1,5526.53,50
CDM,26055AK,INCISE FINGER TENDON SHEATH,1368.0,889.2,1.1,2743.55,53
CDM,26060AK,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,1164.0,756.6,1.1,2743.55,50
CDM,26070AK,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,1524.0,990.6,1.1,2743.55,50
CDM,26075AK,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,1564.0,1016.6,1.1,5526.53,50
CDM,26080AK,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,1788.0,1162.2,1.1,2743.55,50
CDM,26100AK,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,1516.0,985.4,1.1,5526.53,50
CDM,26110AK,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,1460.0,949.0,1.1,2743.55,50
CDM,26111AK,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,2168.0,1409.2,1.1,2768.64,50
CDM,26111URVUAK,EXCISION HAND LES SC 1.5 CM/>,930.0,604.5,1.1,2768.64,50
CDM,26113AK,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,2852.0,1853.8,1.1,2852.0,50
CDM,26115AK,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,1584.0,1029.6,1.1,2768.64,53
CDM,26115URVUAK,REMOVAL OF HAND LESION,799.0,519.35,1.1,2768.64,53
CDM,26116AK,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,2696.0,1752.4,1.1,2768.64,50
CDM,26116URVUAK,REMOVAL OF HAND LESION,1075.0,698.75,1.1,2768.64,50
CDM,26121AK,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,3092.0,2009.8,1.1,5526.53,50
CDM,26123AK,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,4352.0,2828.8,1.1,5526.53,50
CDM,26125AK,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,1840.0,1196.0,1.1,1840.0,50
CDM,26130AK,SYNOVECTOMY CARPOMETACARPAL JOINT,2236.0,1453.4,1.1,5526.53,50
CDM,26135AK,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,2852.0,1853.8,1.1,5526.53,50
CDM,26140AK,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,2536.0,1648.4,1.1,2743.55,50
CDM,26145AK,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,2596.0,1687.4,1.1,2743.55,50
CDM,26160AK,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,1571.0,1021.15,1.1,2743.55,53
CDM,26170AK,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,1964.0,1276.6,1.1,2743.55,50
CDM,26180AK,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,2140.0,1391.0,1.1,2743.55,50
CDM,26200AK,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,2260.0,1469.0,1.1,2743.55,50
CDM,26210AK,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,2128.0,1383.2,1.1,2743.55,50
CDM,26230AK,"PART REMV BONE,METACARPAL",2588.0,1682.2,1.1,5526.53,50
CDM,26235AK,"PART REMV BONE,PROX/MID PHALANX",2532.0,1645.8,1.1,2743.55,50
CDM,26236AK,"PART REMV BONE,DISTAL PHALANX",2184.0,1419.6,1.1,2743.55,50
CDM,26320AK,REMOVAL OF IMPLANT FROM HAND/FINGR,1640.0,1066.0,1.1,2768.64,50
CDM,26340AK,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,1120.0,728.0,1.1,2743.55,50
CDM,26341AK,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,364.0,236.6,1.1,403.2,53
CDM,26350AK,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,2484.0,1614.6,1.1,5526.53,50
CDM,26356AK,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,3824.0,2485.6,1.1,5526.53,50
CDM,26357AK,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,4400.0,2860.0,1.1,5526.53,50
CDM,26358AK,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,5040.0,3276.0,1.1,12214.27,50
CDM,26370AK,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,2912.0,1892.8,1.1,5526.53,50
CDM,26373AK,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,3364.0,2186.6,1.1,5526.53,50
CDM,26390AK,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,3772.0,2451.8,1.1,12214.27,50
CDM,26392AK,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,4200.0,2730.0,1.1,12214.27,50
CDM,26410AK,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,1908.0,1240.2,1.1,2743.55,50
CDM,26418AK,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,1788.0,1162.2,1.1,2743.55,50
CDM,26420AK,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,2776.0,1804.4,1.1,5526.53,50
CDM,26426AK,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,2528.0,1643.2,1.1,5526.53,50
CDM,26428AK,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,2960.0,1924.0,1.1,5526.53,50
CDM,26432AK,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,1664.0,1081.6,1.1,2743.55,50
CDM,26433AK,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,1880.0,1222.0,1.1,5526.53,50
CDM,26437AK,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,2396.0,1557.4,1.1,5526.53,50
CDM,26440AK,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,2064.0,1341.6,1.1,2743.55,50
CDM,26442AK,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,4290.0,2788.5,1.1,5526.53,50
CDM,26445AK,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,1780.0,1157.0,1.1,5526.53,50
CDM,26449AK,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,3436.0,2233.4,1.1,5526.53,50
CDM,26450AK,"TENOTOMY PALM FLEX,SINGLE,OPEN,EACH",1516.0,985.4,1.1,5526.53,50
CDM,26455AK,"TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH",1504.0,977.6,1.1,2743.55,50
CDM,26460AK,"TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH",1432.0,930.8,1.1,2743.55,50
CDM,26471AK,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,2360.0,1534.0,1.1,5526.53,50
CDM,26478AK,"TENDON LENGTHENING,FLEX,HAND/FINGR",2388.0,1552.2,1.1,5526.53,50
CDM,26480AK,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,3600.0,2340.0,1.1,5526.53,50
CDM,26483AK,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,3392.0,2204.8,1.1,5526.53,50
CDM,26485AK,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,3156.0,2051.4,1.1,5526.53,50
CDM,26489AK,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,3944.0,2563.6,1.1,5526.53,50
CDM,26490AK,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,3440.0,2236.0,1.1,5526.53,50
CDM,26492AK,OPPONENSPLASTY TDN TR W/GRF EA TDN,3936.0,2558.4,1.1,5526.53,50
CDM,26496AK,OPPONENSPLASTY OTHER METHODS,3912.0,2542.8,1.1,5526.53,50
CDM,26497AK,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,3904.0,2537.6,1.1,5526.53,50
CDM,26498AK,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,5684.0,3694.6,1.1,5684.0,50
CDM,26500AK,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,2452.0,1593.8,1.1,12214.27,50
CDM,26502AK,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,2924.0,1900.6,1.1,5526.53,50
CDM,26510AK,CROSS INTRINSIC TRANSFER EACH TENDON,2240.0,1456.0,1.1,5526.53,50
CDM,26516AK,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,2928.0,1903.2,1.1,5526.53,50
CDM,26520AK,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,2188.0,1422.2,1.1,5526.53,50
CDM,26525AK,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,2200.0,1430.0,1.1,2743.55,50
CDM,26531AK,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,3252.0,2113.8,1.1,12214.27,50
CDM,26535AK,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,2164.0,1406.6,1.1,5526.53,50
CDM,26536AK,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,2624.0,1705.6,1.1,12214.27,50
CDM,26540AK,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,2640.0,1716.0,1.1,5526.53,50
CDM,26541AK,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,3524.0,2290.6,1.1,5526.53,50
CDM,26542AK,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,2780.0,1807.0,1.1,5526.53,50
CDM,26545AK,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,2844.0,1848.6,1.1,5526.53,50
CDM,26546AK,RPR NON-UNION MTCRPL/PHALANX,4332.0,2815.8,1.1,12214.27,50
CDM,26548AK,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,3288.0,2137.2,1.1,5526.53,50
CDM,26561AK,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,4440.0,2886.0,1.1,5526.53,50
CDM,26562AK,REPAIR SYNDACTYLY EACH SPACE COMPLEX,6672.0,4336.8,1.1,6672.0,50
CDM,26565AK,OSTEOTOMY METACARPAL EACH,2764.0,1796.6,1.1,5526.53,50
CDM,26567AK,OSTEOTOMY PHALANX FINGER EACH,2796.0,1817.4,1.1,5526.53,50
CDM,26591AK,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,1487.0,966.55,1.1,5526.53,50
CDM,26593AK,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,2200.0,1430.0,1.1,5526.53,50
CDM,26600AK,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1144.0,743.6,1.1,1144.0,53
CDM,26605AK,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1333.0,866.45,1.1,1333.0,53
CDM,26607AK,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,2192.0,1424.8,1.1,5526.53,50
CDM,26608AK,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,2220.0,1443.0,1.1,5526.53,50
CDM,26615AK,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,2828.0,1838.2,1.1,5526.53,50
CDM,26641AK,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1652.0,1073.8,1.1,1652.0,53
CDM,26645AK,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,1832.0,1190.8,1.1,2743.55,53
CDM,26650AK,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,2140.0,1391.0,1.1,5526.53,50
CDM,26665AK,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,3176.0,2064.4,1.1,5526.53,50
CDM,26670AK,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1532.0,995.8,1.1,1532.0,53
CDM,26676AK,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,2296.0,1492.4,1.1,5526.53,50
CDM,26685AK,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,2828.0,1838.2,1.1,5526.53,50
CDM,26686AK,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,3268.0,2124.2,1.1,5526.53,50
CDM,26700AK,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1532.0,995.8,1.1,1532.0,53
CDM,26706AK,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,2124.0,1380.6,1.1,5526.53,50
CDM,26715AK,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,2812.0,1827.8,1.1,5526.53,50
CDM,26720AK,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,774.0,503.1,1.1,774.0,53
CDM,26725AK,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1531.0,995.15,1.1,1531.0,53
CDM,26727AK,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,2168.0,1409.2,1.1,5526.53,50
CDM,26735AK,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,2968.0,1929.2,1.1,5526.53,50
CDM,26740AK,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,828.0,538.2,1.1,828.0,53
CDM,26742AK,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,1596.0,1037.4,1.1,2743.55,53
CDM,26746AK,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,3920.0,2548.0,1.1,5526.53,50
CDM,26750AK,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,720.0,468.0,1.1,720.0,53
CDM,26755AK,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1292.0,839.8,1.1,1292.0,53
CDM,26756AK,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,1832.0,1190.8,1.1,5526.53,50
CDM,26765AK,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,2344.0,1523.6,1.1,5526.53,50
CDM,26770AK,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1260.0,819.0,1.1,1260.0,53
CDM,26775AK,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1560.0,1014.0,1.1,1560.0,53
CDM,26776AK,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,1996.0,1297.4,1.1,5526.53,50
CDM,26785AK,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,2640.0,1716.0,1.1,5526.53,50
CDM,26842AK,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,3396.0,2207.4,1.1,12214.27,50
CDM,26844AK,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,3592.0,2334.8,1.1,12214.27,50
CDM,26850AK,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,2856.0,1856.4,1.1,12214.27,50
CDM,26852AK,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,3484.0,2264.6,1.1,12214.27,50
CDM,26860AK,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,1952.0,1268.8,1.1,5526.53,50
CDM,26861AK,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,696.0,452.4,1.1,696.0,50
CDM,26862AK,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,3024.0,1965.6,1.1,5526.53,50
CDM,26863AK,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,1556.0,1011.4,1.1,1556.0,50
CDM,26910AK,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,3116.0,2025.4,1.1,5526.53,50
CDM,26951AK,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,2416.0,1570.4,1.1,5526.53,50
CDM,26952AK,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,2592.0,1684.8,1.1,5526.53,50
CDM,26989RVU1AK,UNLISTED PROC; TENODESIS RINGER FINGER TO SMALL FINGER (COMP TO,1947.0,1265.55,0.01,1947.0,28
CDM,26989RVU2AK,UNLISTED RADICAL TENOSYNOVECTOMY ECD TENDON (COMP CODE 26145),2758.25,1792.86,0.01,2758.25,28
CDM,26990AK,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,3180.0,2067.0,1.1,5526.53,50
CDM,26990URVUAK,DRAINAGE OF PELVIS LESION,1280.0,832.0,1.1,5526.53,50
CDM,26991AK,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,2824.0,1835.6,1.1,2824.0,53
CDM,26992AK,INCISION BONE CORTEX PELVIS&/HIP JOINT,5392.0,3504.8,1.1,5392.0,50
CDM,27000065,SLING PEDIATRIC MEDIUM,28.0,18.2,6.1,43.9,47
CDM,27000075,SPLINT,32.0,20.8,4.76,32.0,47
CDM,27000385,CAST SUP GAUNTLET PLASTER,25.0,16.25,5.45,80.24,47
CDM,27000AK,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,2296.0,1492.4,1.1,2743.55,50
CDM,27001285,ORTHOWEDGE SHOE EACH,46.0,29.9,6.84,46.0,47
CDM,27001455,SHORT LEG SPLINT FIBERGLASS,75.0,48.75,11.16,75.0,39
CDM,27001AK,TENOTOMY ADDUCTOR HIP OPEN,2856.0,1856.4,1.1,5526.53,50
CDM,27004880,W LENS MORGAN,105.0,68.25,15.62,105.0,39
CDM,27005545,ICEMAN (COLD THERAPY SYSTEM),174.0,113.1,25.89,184.68,47
CDM,27006AK,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,4044.0,2628.6,1.1,5526.53,50
CDM,27009135,OXYGEN SUBSEQUENT DAY-HOSP,331.0,215.15,49.25,331.0,39
CDM,27013635,SUPPLIES-SHORT LEG NON-WT BRNG,84.04,54.63,12.51,84.04,39
CDM,27013640,SUPPLIES-SHORT LEG WT BEARING,105.92,68.85,15.76,105.92,39
CDM,27014240,OXYGEN SUBSEQUENT DAY-HOSP,331.0,215.15,49.25,331.0,39
CDM,27015505,PCA INITIAL SETUP,479.51,311.68,71.35,479.51,39
CDM,27015715,TRNSCTNS MNTR-O2/CO2/DAY,210.0,136.5,31.25,210.0,39
CDM,27016225,ABDOMINAL BINDER,48.0,31.2,7.14,48.0,39
CDM,27017075,MARATHON MICROCATH,3036.0,1973.4,159.5,3036.0,47
CDM,27017485,"SHORT LEG SPLINT, FIBERGLASS",73.0,47.45,10.86,73.0,47
CDM,27019825,SPLINT ANKLE-LACER (ALL SIZES),71.0,46.15,10.56,71.0,39
CDM,27020575,MONITOR PAD EKG,111.0,72.15,16.52,111.0,39
CDM,27020585,"STAPLER, INSORB 20",252.0,163.8,37.5,252.0,39
CDM,27020595,"VISCERA RETAINER ""FISH""",80.0,52.0,11.9,80.0,39
CDM,27020605,BAKRI TAMPONADE BALLOON (COOK),1042.0,677.3,155.05,1042.0,39
CDM,27020615,"CLIP, FILSHIE",264.0,171.6,39.28,264.0,39
CDM,27020625,HEMOVAC DRAIN,29.0,18.85,4.32,29.0,39
CDM,27020635,J-VAC DRAIN,205.0,133.25,30.5,205.0,39
CDM,27020645,KIWI VACUUM,129.0,83.85,19.2,129.0,39
CDM,27020655,IUPC CATH,124.0,80.6,18.45,124.0,39
CDM,27020685,"ABD PILLOW SHOULDER, MED",248.0,161.2,36.9,248.0,39
CDM,27020695,"ABD PILLOW SHOULDER, LG",246.0,159.9,36.6,246.0,39
CDM,27020705,ABDUCTION PILLOW SMALL,277.0,180.05,41.22,277.0,39
CDM,27020715,ABDUCTION PILLOW MEDIUM,277.0,180.05,41.22,277.0,39
CDM,27020725,ABDUCTION PILLOW LARGE,277.0,180.05,41.22,277.0,39
CDM,27020735,AIR ACTIVATED CALL CORD,885.0,575.25,131.69,885.0,39
CDM,27020745,BED EXCEL CARE FRAME W AIR/TZ,631.0,410.15,93.89,631.0,39
CDM,27020765,BED VC P500 NSC AIR FRAME,329.0,213.85,48.96,329.0,39
CDM,27020775,BED CLINITRON RITE HITE,367.0,238.55,54.61,367.0,39
CDM,27020785,BED TOTALCARE BARIATRIC FOAM,487.0,316.55,72.47,487.0,39
CDM,27020795,BED TOTALCARE SPORT,621.0,403.65,92.4,621.0,39
CDM,27020805,CARD ART LINE SUPPLY TRAY,681.0,442.65,101.33,681.0,39
CDM,27020815,CARD ART MONITOR CART,252.0,163.8,37.5,252.0,39
CDM,27020825,BED EXCEL CARE W/AIR/SCALE,583.0,378.95,86.75,583.0,39
CDM,27020835,BED EXCEL CARE W/FOAM/SCALE,391.0,254.15,58.18,391.0,39
CDM,27020845,BED TOTALCARE BARIATRIC W/AIR,631.0,410.15,93.89,631.0,39
CDM,27020855,BED TOTALCARE BARI W/AIR&PULM,750.0,487.5,111.6,750.0,39
CDM,27020865,"CHAIR, AOC BARIATRIC ELECTRIC",211.0,137.15,31.4,211.0,39
CDM,27020875,CARDIOVASCULAR BRA XXXLG,180.0,117.0,26.78,180.0,39
CDM,27020885,CARD CATH OXIMETRIC OPTICATH,1205.0,783.25,179.3,1205.0,39
CDM,27020895,CARD CATH SWAN G 831,895.0,581.75,133.18,895.0,39
CDM,27020905,CART GU,185.0,120.25,27.53,185.0,39
CDM,27020915,CART GYN,537.0,349.05,79.91,537.0,39
CDM,27020925,CATH FEMORAL ARTERY/COOK,167.0,108.55,24.85,167.0,39
CDM,27020935,"CATH, MAC CV COMPANION 7 FR",91.0,59.15,13.54,91.0,39
CDM,27020945,DRSG INTERDRY AG 10X36,195.0,126.75,0.07,195.0,47
CDM,27020955,EENT CART,102.0,66.3,15.18,102.0,39
CDM,27020965,FEMOSTOP DEVICE,239.0,155.35,35.56,239.0,39
CDM,27021015,NASAL TUBE RETAIN SYS 10/12/18,488.0,317.2,72.61,488.0,39
CDM,27021025,MEDI-SHAVER 1 PATIENT USE,97.0,63.05,14.43,97.0,39
CDM,27021035,CUSHION BARIATRIC,134.0,87.1,19.94,134.0,39
CDM,27021045,BARIATRIC PREVALON BOOT,469.0,304.85,69.79,469.0,39
CDM,27021055,PREVALON BOOT,267.0,173.55,39.73,267.0,39
CDM,27021065,"PUMP, A-V IMPULSE",76.0,49.4,11.31,76.0,39
CDM,27021075,"PAD, A-V FOOT",333.0,216.45,49.55,333.0,39
CDM,27021085,SCD SLEEVES (PAIR),163.0,105.95,24.25,163.0,39
CDM,27021095,BED EXCEL W/P5 30 CLRT/SCALE,645.0,419.25,95.98,645.0,39
CDM,27021105,SUCTION MACHINE PORTABLE ASPIR,221.0,143.65,32.88,221.0,39
CDM,27021115,SUCTION OHIO WALL/GASTRIC-WOUN,221.0,143.65,32.88,221.0,39
CDM,27021125,TRAY ABD PARACENTESIS,102.0,66.3,15.18,102.0,39
CDM,27021135,TRAY BIOPSY PLEURAL,306.0,198.9,45.53,306.0,39
CDM,27021145,TRAY OPEN CHEST/CARDIAC ARREST,478.0,310.7,71.13,478.0,39
CDM,27021165,ER PLASTIC SUTURE TRAY,260.0,169.0,38.69,260.0,39
CDM,27021175,TRAY DISP ENDOTRACHEAL,504.0,327.6,75.0,504.0,39
CDM,27021195,TRAY MYELOGM/LUMBAR PUNCT DISP,181.0,117.65,26.93,181.0,39
CDM,27021215,TRAY PERICARDIALCENTESIS,156.0,101.4,23.21,156.0,39
CDM,27021225,TRAY PNEUMOTHORAX,410.0,266.5,61.01,410.0,39
CDM,27021235,TRAY MAHURKAR CATH,1079.0,701.35,160.56,1079.0,39
CDM,27021255,TRAY DISP THOR OPEN/CLOSED,428.0,278.2,63.69,428.0,39
CDM,27021265,TRAY THORACOTOMY,228.0,148.2,33.93,228.0,39
CDM,27021275,TRAY TRACHEOSTOMY,306.0,198.9,45.53,306.0,39
CDM,27021285,TRAY WOUND DEBRIDMENT,130.0,84.5,19.34,130.0,39
CDM,27021295,TUBE TRACH FENES 6,300.0,195.0,44.64,300.0,39
CDM,27021305,TUBE TRACH FENES 8,291.0,189.15,43.3,291.0,39
CDM,27021315,WOUND VAC UNIT,372.0,241.8,55.35,372.0,39
CDM,27021325,ABTHERA VAC UNIT,290.0,188.5,43.15,290.0,39
CDM,27021335,WOUND VAC (DISPOSABLE),3131.0,2035.15,465.89,3131.0,39
CDM,27021345,WOUND VAC (PREVENA),3143.0,2042.95,467.68,3143.0,39
CDM,27021355,WOUND VAC (PREV CUSTOM),3138.0,2039.7,466.93,3138.0,39
CDM,27021365,VEST STERNUM SUPPORT,886.0,575.9,131.84,886.0,39
CDM,27021375,"PLEURVAC, DRY (SINGLE)",164.0,106.6,24.4,164.0,39
CDM,27021385,BREAST PUMP,168.0,109.2,25.0,168.0,39
CDM,27021395,SURGI BRA MED,239.0,155.35,35.56,239.0,39
CDM,27021405,SURGI BRA LG,167.0,108.55,24.85,167.0,39
CDM,27021415,SURGI BRA XLG,171.0,111.15,25.44,171.0,39
CDM,27021425,SURGI BRA XXLG,189.0,122.85,28.12,189.0,39
CDM,27021435,SURGI BRA SUPER QUEEN,285.0,185.25,42.41,285.0,39
CDM,27021445,WAFFLE HEEL,134.0,87.1,19.94,134.0,39
CDM,27021455,BONE MARROW BIOPSY TRAY,189.0,122.85,28.12,189.0,39
CDM,27021465,WAFFLE MATTRESS,137.0,89.05,20.39,137.0,39
CDM,27021475,DEFIB PAD M3713A,106.0,68.9,15.77,106.0,39
CDM,27021485,DEFIB PAD M3716A,116.0,75.4,17.26,116.0,39
CDM,27021495,"KIT, CV QUAD LUMEN",397.0,258.05,59.07,397.0,39
CDM,27021505,BARRIER KIT W/PRS INJECT CATH,543.0,352.95,80.8,543.0,39
CDM,27021515,KIT FLEXISEAL FMS FECAL INCONT,1718.0,1116.7,255.64,1718.0,39
CDM,27021575,SANE SAEC KIT,31.0,20.15,4.61,31.0,39
CDM,27021805,BOVIE TOOL,204.0,132.6,30.36,204.0,39
CDM,27021915,BED COMPELLA BARIATRIC,768.0,499.2,114.28,768.0,39
CDM,27021925,BED COMPELLA W/AIR MATT W/CLRT,828.0,538.2,123.21,828.0,39
CDM,27022365,MAHURKAR  ELITE DIALYSIS CATHETER,542.0,352.3,80.65,542.0,39
CDM,27022475,IUP MONITOR SUPPLY,44.0,28.6,6.55,44.0,39
CDM,27022485,OXYGEN SUPPLY PER HOUR,36.1,23.47,5.37,36.1,39
CDM,27022495,VACUUM EXTRACTION SUPPLY,129.0,83.85,19.2,129.0,39
CDM,27022535,COMPRESSION STOCKING XLARGE,108.0,70.2,16.07,108.0,39
CDM,27023405,WOUND VAC (SNAP THPY SYSTEM),976.0,634.4,145.23,976.0,39
CDM,27023535,"CAST SUPPLIES, SHOULDER CAST, 11 YRS +, PLASTER",72.34,47.02,15.77,179.04,47
CDM,27023545,"CAST SUPPLIES, SHOULDER CAST, 11 YRS+, FIBERGLASS",250.5,162.83,28.98,619.84,47
CDM,27023555,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, PLASTER",26.68,17.34,5.82,66.01,47
CDM,27023565,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, FIBERGLASS",26.68,17.34,5.82,148.73,47
CDM,27023575,"CAST SUPPLIES, LONG ARM CAST, PEDS, PLASTER",13.34,8.67,2.91,32.99,47
CDM,27023585,"CAST SUPPLIES, LONG ARM CAST, PEDS, FIBERGLASS",30.0,19.5,6.54,74.33,47
CDM,27023595,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, PLASTER",17.82,11.58,3.88,44.1,47
CDM,27023605,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, FIBERGLASS",40.08,26.05,8.74,99.16,47
CDM,27023615,"CAST SUPPLIES, SHORT ARM CAST, PEDS, PLASTER",8.88,5.77,1.94,21.99,47
CDM,27023625,"CAST SUPPLIES, SHORT ARM CAST, PEDS, FIBERGLASS",20.08,13.05,4.38,49.7,47
CDM,27023635,"CAST SUPPLIES, GAUNTLET CAST, 11 YRS +, FIBERGLASS",54.66,35.53,11.92,135.3,47
CDM,27023645,"CAST SUPPLIES, GAUNTLET CAST, PEDS, PLASTER",16.24,10.56,3.54,40.18,47
CDM,27023655,"CAST SUPPLIES, GAUNTLET CAST, PEDS, FIBERGLASS",27.34,17.77,5.96,67.61,47
CDM,27023665,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, PLASTER",75.0,48.75,8.84,75.0,47
CDM,27023675,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, FIBERGLASS",29.88,19.42,6.51,73.89,47
CDM,27023685,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, PLASTER",9.4,6.11,2.05,23.19,47
CDM,27023695,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, FIBERGLASS",14.98,9.74,3.27,37.1,47
CDM,27023705,"CAST SUPPLIES, SHORT ARM SPLINT, 11 YRS +, PLASTER",13.88,9.02,3.03,34.34,47
CDM,27023715,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, PLASTER",6.98,4.54,1.52,17.23,47
CDM,27023725,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, FIBERGLASS",12.54,8.15,2.73,31.03,47
CDM,27024105,ARCTIC SUN GEL PAD SM/MED/LG,4227.0,2747.55,628.98,4227.0,39
CDM,27024115,ARCTIC SUN GEL PAD UNI,1055.0,685.75,156.98,1055.0,39
CDM,27024125,SYSTEM PREVENA PLUS 125MMHG NEG PRESS CAN 150ML NONSTERILE,4774.0,3103.1,710.37,4774.0,39
CDM,27024135,CONNECTOR PREVENA PLUS VAC,1217.0,791.05,181.09,1217.0,39
CDM,27024145,KIT PREVENA PEEL & PLACE VAC 20CM DRESSING PRESSURE INDICATOR IN,948.0,616.2,141.06,948.0,39
CDM,27024155,KIT PREVENA PEEL & PLACE PATCH STRIPS 13CM DRESSING PRESSURE IND,948.0,616.2,141.06,948.0,39
CDM,27024445,SYSTEM CAST 4IN APL TCC-EZ,214.0,139.1,31.84,214.0,39
CDM,27024465,BILI BLANKET,82.08,53.35,12.21,82.08,39
CDM,27024585,BILIRUBIN LIGHT 24 HOURS,53.0,34.45,7.89,53.0,39
CDM,27024665,HIGH FLOW OXYGEN DAILY,345.0,224.25,51.34,345.0,39
CDM,27024675,THORACENTESIS KIT,153.0,99.45,22.77,153.0,39
CDM,27024715,SEIZURE PADS,514.0,334.1,76.48,514.0,39
CDM,27025985,AMBU DISPOSABLE BRONCHOSCOPE,690.0,448.5,102.67,690.0,39
CDM,27025995,SYSTEM CRYO/CUFF IC UNIVERSAL COMPRESSION THERAPY COOLER,174.0,113.1,25.16,174.0,47
CDM,27025AK,FASCIOTOMY HIP/THIGH ANY TYPE,5156.0,3351.4,1.1,5156.0,50
CDM,27027AK,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,5216.0,3390.4,1.1,12214.27,50
CDM,27030AK,ARTHROTOMY HIP W/DRAINAGE,5460.0,3549.0,1.1,5460.0,50
CDM,27033AK,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,5644.0,3668.6,1.1,12214.27,50
CDM,27036AK,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,5752.0,3738.8,1.1,5752.0,50
CDM,27040AK,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,1168.0,759.2,1.1,2768.64,53
CDM,27041AK,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,4072.0,2646.8,1.1,4072.0,50
CDM,27043AK,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,2752.0,1788.8,1.1,4850.94,50
CDM,27045AK,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,4452.0,2893.8,1.1,4850.94,50
CDM,27047AK,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,2174.0,1413.1,1.1,4850.94,53
CDM,27048AK,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,3540.0,2301.0,1.1,4850.94,50
CDM,27052AK,ARTHROTOMY W/BIOPSY HIP JOINT,2968.0,1929.2,1.1,2968.0,50
CDM,27054AK,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,3684.0,2394.6,1.1,3684.0,50
CDM,27059AK,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,11740.0,7631.0,1.1,11740.0,50
CDM,27062AK,EXCISION TROCHANTERIC BURSA/CALCIFICATION,2300.0,1495.0,1.1,5526.53,50
CDM,27066AK,EXCISION BONE CYST/BENIGN TUMOR DEEP,4480.0,2912.0,1.1,5526.53,50
CDM,27076AK,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,16084.0,10454.6,1.1,16084.0,50
CDM,27080AK,COCCYGECTOMY PRIMARY,2756.0,1791.4,1.1,5526.53,50
CDM,27087AK,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,3532.0,2295.8,1.1,5526.53,50
CDM,27090AK,REMOVAL OF HIP PROSTHESIS,4676.0,3039.4,1.1,4676.0,50
CDM,27091AK,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,9740.0,6331.0,1.1,9740.0,50
CDM,27093AK,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,520.0,338.0,1.1,771.37,53
CDM,27096AK,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,651.0,423.15,1.1,651.0,53
CDM,27098AK,ADDUCTOR TRANSFER TO ISCHIUM,4101.0,2665.65,1.1,5526.53,50
CDM,27101155,YB HELMET PROT SOFT PREFAB,1194.0,776.1,46.46,1194.0,47
CDM,27122AK,ACETABULOPLASTY RESECTION FEMORAL HEAD,6436.0,4183.4,1.1,6436.0,50
CDM,27125AK,HEMIARTHROPLASTY HIP PARTIAL,6656.0,4326.4,1.1,6656.0,50
CDM,27130AK,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,8624.0,5605.6,1.1,22471.68,50
CDM,27132AK,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,11304.0,7347.6,1.1,11304.0,50
CDM,27134AK,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,13323.0,8659.95,1.1,13323.0,50
CDM,27137AK,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,9988.0,6492.2,1.1,9988.0,50
CDM,27138AK,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,10428.0,6778.2,1.1,10428.0,50
CDM,27161AK,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,7156.0,4651.4,1.1,7156.0,50
CDM,27165AK,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,8116.0,5275.4,1.1,8116.0,50
CDM,27187AK,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,5692.0,3699.8,1.1,5692.0,50
CDM,27197AK,CLSD TX PELVIC RING FX W/O MANIPULATION,673.0,437.45,1.1,673.0,50
CDM,27198AK,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,2090.0,1358.5,1.1,2090.0,50
CDM,27200AK,CLOSED TREATMENT COCCYGEAL FRACTURE,768.0,499.2,1.1,768.0,53
CDM,27201056,OCTARAY MAPPING CATHETER,12136.0,7888.4,159.5,12136.0,47
CDM,27201556,ARROWGUARD BLUE PLUS CATHETER,267.0,173.55,39.73,267.0,47
CDM,27201876,FETAL PILLOW,2488.0,1617.2,370.21,2488.0,39
CDM,27201886,PTS SIZING BALLOON CATHETER,593.0,385.45,88.24,593.0,39
CDM,27202656,WORLEY HEMOSTATIC SAFESHEATH 9FR X 40CM,630.0,409.5,93.74,630.0,47
CDM,27203020,W CATH BLLN HYPERFORM 7MMX150CM,6698.0,4353.7,159.5,6698.0,47
CDM,27203096,BOTOX CHEMODEVERVATION NEEDLE,95.38,62.0,14.19,95.38,39
CDM,27203106,STENT GRASPER,119.11,77.42,17.72,119.11,39
CDM,27203326,"OPTRELL, 36 ELECTRODE WITH D-F CURVE",12136.0,7888.4,159.5,12136.0,47
CDM,27203596,AMBU DISPOSABLE FLEXIBLE CYSTOSCOPE,250.0,162.5,37.2,250.0,39
CDM,27204136,HIS SHEATH,704.0,457.6,104.76,704.0,39
CDM,27204146,ADJUSTABLE SLITTER,56.0,36.4,8.33,56.0,39
CDM,27204166,STERILE INSTRUMENTS,306.0,198.9,45.53,306.0,39
CDM,27204386,TRAXI PANNICULUS RETRACTOR,120.0,78.0,17.86,120.0,39
CDM,27204396,TRAXI EXTENDER,80.0,52.0,11.9,80.0,39
CDM,27204696,ABBOTT LV SHEATH,424.0,275.6,63.09,424.0,47
CDM,27204706,ABBOTT SHEATH,154.0,100.1,22.92,184.68,47
CDM,27204716,ARROW BALLOON,104.0,67.6,15.48,104.0,39
CDM,27204726,BSX SAFE SHEATH,100.0,65.0,14.88,184.68,47
CDM,27204736,BSX EZ4 CONNECT,1000.0,650.0,148.8,1000.0,39
CDM,27204746,SORBX SHIELD,66.7,43.36,9.92,66.7,39
CDM,27204816,VERISIGHT PRO,6400.0,4160.0,159.5,6400.0,47
CDM,27204876,CENTURION VASECTOMY SET,108.0,70.2,13.46,108.0,47
CDM,27205266,FARADRIVE PFA,2600.0,1690.0,159.5,2600.0,47
CDM,27205276,FARAWAVE PFA W/CABLE,17300.0,11245.0,159.5,17300.0,47
CDM,27205390,W CATHETER MAMMOSITE,56.0,36.4,8.33,184.68,47
CDM,27206206,HRAM 10 CHANNEL CATH,520.0,338.0,77.38,520.0,39
CDM,27206216,ARM 4 CHANNEL CATH,145.0,94.25,21.58,145.0,39
CDM,27206326,AVEIR INTRODUCER 25F X 50CM,1200.0,780.0,159.5,1200.0,47
CDM,27206336,AVEIR DELIVERY SYSTEM CATHETER,3500.0,2275.0,159.5,3500.0,47
CDM,27206536,GEN 2 SMART TIP 190,700.0,455.0,104.16,700.0,47
CDM,27206626,AVEIR RETRIEVAL CATHETER 105CM,6000.0,3900.0,159.5,6000.0,47
CDM,27207256,AGILIS NXT STEERABLE INTRODUCER 13FR MEDIUM CURL,2600.0,1690.0,159.5,2600.0,47
CDM,27207386,VARIPULSE BI-DIRECTIONAL CATHETER,12346.0,8024.9,159.5,12346.0,47
CDM,27207506,PANNUS RETRACTOR CZ-PPR-XL,150.0,97.5,22.32,150.0,39
CDM,27207535,"SURGICEL,HEMOSTAT ABSORB 4X8",51.0,33.15,7.59,51.0,39
CDM,27207666,BSW NUVISION,6400.0,4160.0,159.5,6400.0,47
CDM,27207676,WORLEY VEIN SELECTOR STD CURVE,248.0,161.2,36.9,248.0,47
CDM,27207686,WORLEY LVI SYSTEM RENAL 5.5F,840.0,546.0,124.99,840.0,39
CDM,27207696,WORLEY ADVANCED CSG STANDARD,630.0,409.5,93.74,630.0,47
CDM,27207706,STRYKER MATS,123.0,79.95,18.3,123.0,39
CDM,27207716,VARIPULSE INTERFACE CABLE,1374.0,893.1,204.45,1374.0,39
CDM,27207726,CARDINAL PERIPHERAL VASCULAR PACK,150.0,97.5,22.32,150.0,39
CDM,27207736,CARDINAL PACK SURGICAL CUSTOM ANGIOGRAPHY,84.0,54.6,12.5,84.0,39
CDM,27207746,CATH ART 7.5FR THRMDIL,54.0,35.1,8.04,184.68,47
CDM,27207756,MULTIFLEX PENTALUMEN 7FR,96.0,62.4,14.28,96.0,39
CDM,27207766,KIT MAC ARROWG+ARD BLUE ARROW ADVANCER 9FR,272.0,176.8,40.47,272.0,47
CDM,27207776,SUPREME QUAD CRD-2 4FR,278.0,180.7,41.37,278.0,47
CDM,27207786,AMPLATZER SIZING BALLOON II 24MM X 70CM,682.0,443.3,101.48,682.0,39
CDM,27212600,W NDL BRACHYTHRPY,56.0,36.4,8.33,184.68,47
CDM,27213010,W NEEDLE CRYO SEEDNET ICEROD EA,4928.0,3203.2,159.5,4928.0,47
CDM,27214755,COIL PUSHER (401216),978.0,635.7,145.53,978.0,39
CDM,27214765,CONNECTING CABLE SET FOR GDC,475.0,308.75,70.68,475.0,39
CDM,27214785,INFLATION DEVICE,316.0,205.4,47.02,316.0,39
CDM,27215AK,OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD,4180.0,2717.0,1.1,4180.0,39
CDM,27216315,BILIARY DRAINAGE KIT,461.0,299.65,68.6,461.0,39
CDM,27216325,NEPHROSTOMY DRAINAGE KIT,240.0,156.0,35.71,240.0,39
CDM,27216AK,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,6292.0,4089.8,1.1,6292.0,39
CDM,27217AK,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,6446.0,4189.9,1.1,6446.0,39
CDM,27218AK,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,8372.0,5441.8,1.1,8372.0,39
CDM,27219120,W K-WIRE 2.5 MM,319.0,207.35,47.47,319.0,39
CDM,27220280,W CATH PICC DUAL LUMEN,1250.0,812.5,159.5,1250.0,47
CDM,27220890,W DEV RETRV 3MM ALGTR,12543.0,8152.95,159.5,12543.0,47
CDM,27220970,W CATH ANG 135CM CROSSBOSS,2166.0,1407.9,159.5,2166.0,47
CDM,27220AK,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,2420.0,1573.0,1.1,2420.0,53
CDM,27221300,W CATH GUID EP FINECROSS,900.0,585.0,133.92,900.0,47
CDM,27221910,W SYS INZONE DETACH HANDLE,936.0,608.4,139.28,936.0,39
CDM,27221975,MICROPUNCTURE INTRO SET,68.0,44.2,10.12,68.0,39
CDM,27222115,A-LINE ADD-ON KIT,215.0,139.75,31.99,215.0,39
CDM,27222415,AERONEB NEBULIZER,70.0,45.5,10.42,70.0,39
CDM,27222AK,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,5644.0,3668.6,1.1,5644.0,50
CDM,27223080,W CATH INF EXCELSIOR SL-10,4558.0,2962.7,159.5,4558.0,47
CDM,27223140,W CATH ATHER TURBO ELITE OTW,10537.0,6849.05,159.5,10537.0,47
CDM,27223560,W CATH EKOS SYS ENDOVASCULAR,13678.0,8890.7,159.5,13678.0,47
CDM,27223740,W CATH NEURON MAX SEL SIM,2588.0,1682.2,159.5,2588.0,47
CDM,27226AK,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,6228.0,4048.2,1.1,6228.0,50
CDM,27227AK,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,10164.0,6606.6,1.1,10164.0,50
CDM,27228675,PWR BONE MARROW BX NEEDLE102MM,258.0,167.7,38.39,258.0,47
CDM,27228AK,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,11732.0,7625.8,1.1,11732.0,50
CDM,27230305,CARTO NAVIS STAR CATHETER,7855.0,5105.75,159.5,7855.0,47
CDM,27230335,PICC CATHETER,459.0,298.35,68.3,459.0,47
CDM,27230455,THROMBECT/EMBOLECTMY CATH,629.0,408.85,93.6,629.0,47
CDM,27230545,GUIDE WIRE,2591.0,1684.15,159.5,2591.0,47
CDM,27230725,MIRAGE GUIDEWIRE .008,2107.0,1369.55,159.5,2107.0,47
CDM,27230755,GUIDE WIRE,145.0,94.25,21.58,184.68,47
CDM,27230775,GUIDE WIRE,2183.0,1418.95,159.5,2183.0,47
CDM,27230995,GUIDE WIRE,1236.0,803.4,159.5,1236.0,47
CDM,27230AK,CLTX FEM FX PROX END NCK W/O MANJ,2324.0,1510.6,1.1,2324.0,53
CDM,27231075,RENEGADE MICROCATHETER,1686.0,1095.9,159.5,1686.0,47
CDM,27231205,ECHELON 14 MICROCATH,3211.0,2087.15,159.5,3211.0,47
CDM,27232495,BRACHYTX SEED ADMIN SET,56.0,36.4,8.33,184.68,47
CDM,27232675,AQUACEL SURGICAL DRESSING,52.96,34.42,7.88,52.96,39
CDM,27232745,WATCHMAN ACCESS CAP 1-3 UNITS,3650.0,2372.5,543.12,3650.0,39
CDM,27232750,WATCHMAN ACCESS CAP EA ADD,3650.0,2372.5,543.12,3650.0,39
CDM,27232AK,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4688.0,3047.2,1.1,4688.0,50
CDM,27234425,REPERFUSION 3 MAX CATH & PENUMBRA HI-FLOW ASPIRATION TUBING,8820.0,5733.0,1312.42,8820.0,39
CDM,27235AK,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,5200.0,3380.0,1.1,12214.27,50
CDM,27236AK,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,7044.0,4578.6,1.1,7044.0,50
CDM,27238AK,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,2300.0,1495.0,1.1,2743.55,50
CDM,27240005,SCISSORS HOT SHEARS DA VINCI S/SI,1610.0,1046.5,239.57,1610.0,39
CDM,27240155,ESOPHAGEAL RETRACTOR,1442.0,937.3,214.57,1442.0,39
CDM,27240175,PATIENT PROGRAMMER NEUROSTIMULATOR C1787 (272),6935.0,4507.75,159.5,6935.0,47
CDM,27240375,ID INSTANT DETACHER,246.0,159.9,36.6,246.0,39
CDM,27240715,VORTX .018 DIAMOND 3MM X 3.3MM,1727.0,1122.55,256.98,1727.0,39
CDM,27243325,CATHETER SOFT-VU 4FR BERENSTEIN CURVE ANGLE 110CM ANGIOGRAPHIC N,68.0,44.2,10.12,68.0,39
CDM,27244205,FLOSEAL HEMOSTATIC MATRIX,271.38,176.4,40.38,271.38,39
CDM,27244375,KYPHOPLASTY KIT,18985.0,12340.25,2824.97,18985.0,39
CDM,27244465,NEEDLE GUIDE,219.0,142.35,32.59,219.0,39
CDM,27244805,SWAN GANZ,86.0,55.9,12.8,86.0,39
CDM,27244AK,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,7272.0,4726.8,1.1,7272.0,50
CDM,27245095,CODA BALLOON CATH,2090.0,1358.5,159.5,2090.0,47
CDM,27245275,FOLEY DRAINAGE CATH,27.0,17.55,4.02,184.68,47
CDM,27245515,SNARE,1727.0,1122.55,256.98,1727.0,39
CDM,27245525,"BALLOON CATH, RIVAL",607.0,394.55,90.32,607.0,39
CDM,27245535,"BALLOON CATH, ULTRAVERSE",1445.0,939.25,215.02,1445.0,39
CDM,27245545,"BALLOON CATH, STERLING",1503.0,976.95,223.65,1503.0,39
CDM,27245555,"BALLOON CATH, OCCLUSION",2399.0,1559.35,356.97,2399.0,39
CDM,27245565,"BALLOON CATH, CUTTING",3875.0,2518.75,576.6,3875.0,39
CDM,27245575,"BALLOON CATH, GATEWAY",3925.0,2551.25,584.04,3925.0,39
CDM,27245585,"BALLOON CATH, VIATRAC",1147.0,745.55,170.67,1147.0,39
CDM,27245595,"BALLOON CATH, MAVERICK",581.0,377.65,86.45,581.0,39
CDM,27245605,BALLOON DILATION CATH,1162.0,755.3,172.91,1162.0,39
CDM,27245615,"CATH, SKATER",179.0,116.35,26.64,179.0,39
CDM,27245625,"CATH, HEMODIALYSIS",906.0,588.9,134.81,906.0,39
CDM,27245635,"CATH, DIALYSIS",532.0,345.8,79.16,532.0,38
CDM,27245635_IP,"CATH, DIALYSIS",532.0,345.8,212.27,212.27,1
CDM,27245635_OP,"CATH, DIALYSIS",532.0,345.8,205.88,205.88,1
CDM,27245645,"CATH, TEMP DIALYSIS",436.0,283.4,64.88,436.0,39
CDM,27245655,ANGIOJET CATH 50CM,3690.0,2398.5,549.07,3690.0,39
CDM,27245665,ANGIOJET CATH 90CM,8540.0,5551.0,1270.75,8540.0,39
CDM,27245675,ANGIOJET CATH 120CM,9067.0,5893.55,1349.17,9067.0,39
CDM,27245685,"CATH, THROMBECTOMY",389.0,252.85,57.88,389.0,39
CDM,27245695,"CATH, ATLANTIS IVUS",3946.0,2564.9,587.16,3946.0,39
CDM,27245705,"FILTER, IVC RETRVL DEVICE",1133.0,736.45,168.59,1133.0,39
CDM,27245725,ABLATION PROBE 20/30,3698.0,2403.7,550.26,3698.0,39
CDM,27245755,"SHEATH, LONG",159.0,103.35,23.66,159.0,39
CDM,27245765,"SHEATH, ARROW",402.0,261.3,59.82,402.0,39
CDM,27245775,PROBE/NEEDLE CRYO,8441.0,5486.65,1256.02,8441.0,39
CDM,27245785,"REVASC DEV, SOLITAIRE",32550.0,21157.5,4843.44,32550.0,39
CDM,27245795,"REVASC DEV, CONC-TREVO",34673.0,22537.45,5159.34,34673.0,39
CDM,27245AK,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,7272.0,4726.8,1.1,7272.0,50
CDM,27246AK,CLTX GREATER TROCHANTERIC FX W/O MANJ,1932.0,1255.8,1.1,1932.0,53
CDM,27248AK,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,4312.0,2802.8,1.1,4312.0,50
CDM,27250125,DISPOSABLE BIOPSY FORCEP,92.0,59.8,13.69,92.0,39
CDM,27250135,PONSKY NON-BALLOON G-TUBE,290.0,188.5,43.15,290.0,39
CDM,27250145,GASTRIC LAVAGE KIT,843.0,547.95,125.44,843.0,39
CDM,27250155,ENDOCLIP,307.0,199.55,45.68,307.0,39
CDM,27250165,BIPOLAR ELECTROHEMO CATH,198.0,128.7,29.46,198.0,39
CDM,27250175,PLEURX DRAINAGE,108.0,70.2,16.07,108.0,39
CDM,27250185,STERILE CYTOLOGY BRUSH,145.0,94.25,21.58,145.0,39
CDM,27250195,BALLOON DILATORS B,1236.0,803.4,183.92,1236.0,39
CDM,27250205,DISP HOT BIOPSY FORCEPS,2183.0,1418.95,324.83,2183.0,39
CDM,27250215,TRI-FUNNEL REPLACE G-TUBE,2591.0,1684.15,385.54,2591.0,39
CDM,27250225,"GUIDE WIRE, COOK THSCF,TSCF",129.0,83.85,19.2,129.0,39
CDM,27250235,"GUIDE WIRE, SPARTACORE",438.0,284.7,65.17,438.0,39
CDM,27250245,"GUIDE WIRE, GLIDEWIRE",239.0,155.35,35.56,239.0,39
CDM,27250255,"GUIDE WIRE, BSC FATHOM",1796.0,1167.4,267.24,1796.0,39
CDM,27250265,"GUIDE WIRE, EXPEDION",1204.0,782.6,179.16,1204.0,39
CDM,27250275,"GUIDE WIRE, X-CELERATOR",1781.0,1157.65,265.01,1781.0,39
CDM,27250285,"GUIDE WIRE, TRANSEND 10X205",2183.0,1418.95,324.83,2183.0,39
CDM,27250295,"GUIDE WIRE, TARGET SYNCHRO",2495.0,1621.75,371.26,2495.0,39
CDM,27250305,"GUIDE WIRE, MAILMAN",343.0,222.95,51.04,343.0,39
CDM,27250315,HYDRAWIRE,1581.0,1027.65,235.25,1581.0,39
CDM,27250325,CYTOMAX II BILIARY BRUSH,792.0,514.8,117.85,792.0,39
CDM,27250335,CIRCUMFERENTIAL PROBE,3133.0,2036.45,466.19,3133.0,39
CDM,27250345,JAG WIRE - GUIDEWIR,2158.0,1402.7,321.11,2158.0,39
CDM,27250355,STRAIGHT FIRE PROBE,4766.0,3097.9,709.18,4766.0,39
CDM,27250365,SPOT-ENDOSCOPIC MARKER,3211.0,2087.15,477.8,3211.0,39
CDM,27250375,DISPOSABLE VARICES I CATH,5497.0,3573.05,817.95,5497.0,39
CDM,27250385,CRE DILATATION BALLOON,809.0,525.85,120.38,809.0,39
CDM,27250395,GUIDE WIRE,5254.0,3415.1,781.8,5254.0,39
CDM,27250405,"CATH, LUMAX 6.0-7.0",1172.0,761.8,174.39,1172.0,39
CDM,27250415,"GUIDE WIRE, LOW",92.0,59.8,13.69,92.0,39
CDM,27250425,"CATH, EXCEL 6CM TIP 2",3983.0,2588.95,592.67,3983.0,39
CDM,27250435,"CATH, NEUROFORM",5854.0,3805.1,871.08,5854.0,39
CDM,27250445,"GUIDE WIRE, MED",290.0,188.5,43.15,290.0,39
CDM,27250455,"GUIDE WIRE, HIGH",843.0,547.95,125.44,843.0,39
CDM,27250465,"GUIDE WIRE, EV3 NITREX",299.0,194.35,44.49,299.0,39
CDM,27250475,"GUIDE WIRE, RPC CONNORS-EX",213.0,138.45,31.69,213.0,39
CDM,27250485,"GUIDE WIRE, M-TECH (BENTSON)",70.0,45.5,10.42,70.0,39
CDM,27250495,"BALLOON CATH, HYPERFORM",159.0,103.35,23.66,159.0,39
CDM,27250505,ACCUSTICK SYSTEM,1049.0,681.85,156.09,1049.0,39
CDM,27250515,"CATH, DIAGNOSTIC",2508.0,1630.2,373.19,2508.0,39
CDM,27250525,"CATH, EKOS ENDOVASC SYSTEM",3037.0,1974.05,451.91,3037.0,39
CDM,27250535,"SPHERE, EMBOSPHERE 5ML SYR",125.0,81.25,18.6,125.0,39
CDM,27250545,"SPHERE, EMBOPARTICLES 2ML VL",686.0,445.9,102.08,686.0,39
CDM,27250555,KYPHO PAK EXPRESS,263.0,170.95,39.13,263.0,39
CDM,27250565,"BX NEEDLE, STRYKER",284.0,184.6,42.26,284.0,39
CDM,27250575,"VALVE, ROTATING HEMOSTATIC",106.0,68.9,15.77,106.0,39
CDM,27250585,"INJECTOR, EV3 CAD PREC 1ML",2926.0,1901.9,435.39,2926.0,39
CDM,27250595,"CATH, HNBRO 5.0-35-100",159.0,103.35,23.66,159.0,39
CDM,27250605,"CATH, SIDEWINDER 6FR",92.0,59.8,13.69,92.0,39
CDM,27250615,GDC ACCESSORY CONN CABLE,475.0,308.75,70.68,475.0,39
CDM,27250625,"CATH, MICRO",1581.0,1027.65,235.25,1581.0,39
CDM,27250635,INSTANT DETACHER,792.0,514.8,117.85,792.0,39
CDM,27250645,"CATH, NEURON DELIVERY",3618.0,2351.7,538.36,3618.0,39
CDM,27250655,"CATH, ENVOY MPD 6-100",1506.0,978.9,224.09,1506.0,39
CDM,27250665,ONYX 18/34 EMBOL,12644.0,8218.6,1881.43,12644.0,39
CDM,27250675,"CATH, PROWLER",3327.0,2162.55,495.06,3327.0,39
CDM,27250685,"INFLATION DEVICE, BLUE DIAMOND",68.0,44.2,10.12,68.0,39
CDM,27250695,"CATH, MARKSMAN MICRO",5149.0,3346.85,766.17,5149.0,39
CDM,27250705,"CATH, SHUTTLE SHEATH",438.0,284.7,65.17,438.0,39
CDM,27250715,"CATH, NAVIEN",4991.0,3244.15,742.66,4991.0,39
CDM,27250725,"CABLE, IZDC CONNECTING",240.0,156.0,35.71,240.0,39
CDM,27250735,CANISTER,1928.0,1253.2,286.89,1928.0,39
CDM,27250745,"TUBING, ASPIRATION",1928.0,1253.2,286.89,1928.0,39
CDM,27250755,"DRAIN, LUMBAR CATH/KIT",1489.0,967.85,221.56,1489.0,39
CDM,27250765,KIVA IMPLANT KIT,18992.0,12344.8,2826.01,18992.0,39
CDM,27250775,KIVA PILOT DEVICE,4204.0,2732.6,625.56,4204.0,39
CDM,27250785,"VALVE, BLEEDBACK CONTROL",127.0,82.55,18.9,127.0,39
CDM,27250795,PENUMBRA ACE 64 KIT,14009.0,9105.85,2084.54,14009.0,39
CDM,27250805,D-STAT PATCH,106.0,68.9,15.77,106.0,39
CDM,27250855,ASSURA DRAIN CONVX POUCH EACH,38.0,24.7,5.65,38.0,39
CDM,27250865,NEW IMAGE CONVX WAFER EACH,26.0,16.9,3.87,26.0,39
CDM,27250875,NEW IMAGE HO DRAIN POUCH EACH,25.0,16.25,3.72,25.0,39
CDM,27250885,PREMIER HO DRAIN POUCH EACH,49.0,31.85,7.29,49.0,39
CDM,27250895,SUR-FIT CONVX WAFER EACH,29.0,18.85,4.32,29.0,39
CDM,27250925,COOLED RF KIT (1 PROBE),3956.0,2571.4,13.46,3956.0,47
CDM,27250935,"KIT, PICC (SINGLE)",1148.0,746.2,170.82,1148.0,39
CDM,27250945,"KIT, PICC (DUAL)",1176.0,764.4,174.99,1176.0,39
CDM,27250975,DRSG MATRISTEM PER SQ CM,27.0,17.55,4.02,27.0,39
CDM,27250AK,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1681.0,1092.65,1.1,1681.0,50
CDM,27251015,SJM EP INTRODUCER,1109.0,720.85,165.02,1109.0,39
CDM,27251025,BSW LASSO CATH,5704.0,3707.6,159.5,5704.0,47
CDM,27251035,BSW CELSIUS ABLTN CATH,4130.0,2684.5,614.54,4130.0,39
CDM,27251045,BSW NAVISTAR CATH 8MM,12633.0,8211.45,1879.79,12633.0,39
CDM,27251055,BSW NAVISTAR CATH 4MM,10559.0,6863.35,1571.18,10559.0,39
CDM,27251065,BARD QUAD TIP CS CATH,1469.0,954.85,159.5,1469.0,47
CDM,27251075,BSC BLAZER II ABLTN 5MM,3457.0,2247.05,514.4,3457.0,39
CDM,27251085,SJM SUPREME QUAD CATH,608.0,395.2,90.47,608.0,46
CDM,27251085_IP,SJM SUPREME QUAD CATH,608.0,395.2,242.59,242.59,1
CDM,27251085_OP,SJM SUPREME QUAD CATH,608.0,395.2,235.3,235.3,1
CDM,27251095,SJM TRANS BRK NEEDLE,1346.0,874.9,200.28,1346.0,39
CDM,27251105,BSC BLAZER II ABLTN 8MM,6836.0,4443.4,1017.2,6836.0,39
CDM,27251115,SIEMENS ACCUNAVE 10F CATH,17394.0,11306.1,159.5,17394.0,47
CDM,27251115_IP,SIEMENS ACCUNAVE 10F CATH,17394.0,11306.1,11636.59,11636.59,1
CDM,27251115_OP,SIEMENS ACCUNAVE 10F CATH,17394.0,11306.1,11045.19,11045.19,1
CDM,27251125,BARD DECAP STEER DIAG CATH,2145.0,1394.25,159.5,2145.0,47
CDM,27251135,DERMABOND,141.0,91.65,20.98,141.0,39
CDM,27251145,DIAGNOSTIC GUIDEWIRE,150.0,97.5,22.32,184.68,47
CDM,27251155,TEMPORARY PACING ELECTRODE,929.0,603.85,138.24,929.0,39
CDM,27251165,SJM LWIRE DUO-DECA 7FR CTH,5676.0,3689.4,159.5,5676.0,47
CDM,27251175,BSW CELSIUS THERM CATH,7376.0,4794.4,1097.55,7376.0,39
CDM,27251185,BSW NAVISTAR THERM CATH,12199.0,7929.35,1815.21,12199.0,39
CDM,27251195,BSW COOL FLOW TUBING CATH,316.0,205.4,47.02,316.0,39
CDM,27251205,CRYO FREEZOR XTRA 1/3/5 CATH,8166.0,5307.9,1215.1,8166.0,39
CDM,27251215,CRYO COAX UMBILICAL TUBING,459.0,298.35,68.3,459.0,39
CDM,27251225,SJM NAV X PATCH,4753.0,3089.45,707.25,4753.0,39
CDM,27251235,SJM MULLINS EP INTRODUCER,647.0,420.55,96.27,647.0,39
CDM,27251245,SJM RAMP EP INTRODUCER,1056.0,686.4,157.13,1056.0,39
CDM,27251255,SJM SUPREME DECA CATH,2377.0,1545.05,159.5,2377.0,47
CDM,27251265,COOK AMPLATZ GUIDEWIRE,145.0,94.25,21.58,145.0,39
CDM,27251275,BSW QUAD DX CATH,1721.0,1118.65,159.5,1721.0,47
CDM,27251285,SPECTRANETICS LLD EZ,2905.0,1888.25,432.26,2905.0,39
CDM,27251295,BSW NAVISTAR RMT 4MM,13148.0,8546.2,1956.42,13148.0,39
CDM,27251305,BSW NAVISTAR THERM RMT,13509.0,8780.85,2010.14,13509.0,39
CDM,27251315,STEREOTAXIS QUIKCAS,7921.0,5148.65,1178.64,7921.0,39
CDM,27251325,COOK EVOLUTION SHEATH,7879.0,5121.35,1172.4,7879.0,39
CDM,27251335,COOK EXTRACTION SHORTIE,7879.0,5121.35,1172.4,7879.0,39
CDM,27251345,COOK EXTRACTION GUIDEWIRE,502.0,326.3,74.7,502.0,39
CDM,27251355,COOK FEMORAL SHEATH SET,5004.0,3252.6,744.6,5004.0,39
CDM,27251365,BSW CELSIUS RMT THERM CATH,11992.0,7794.8,1784.41,11992.0,39
CDM,27251375,BYRD WORK STATION FEMORAL,5793.0,3765.45,862.0,5793.0,39
CDM,27251385,SNARE 13-20MM,2564.0,1666.6,381.52,2564.0,39
CDM,27251395,FEMORAL SHEATH 12 FR,878.0,570.7,130.65,878.0,39
CDM,27251405,FEMORAL SHEATH 16 FR,2204.0,1432.6,327.96,2204.0,39
CDM,27251415,BSW C3 REFERENCE PATCH,1051.0,683.15,156.39,1051.0,39
CDM,27251425,AGILIS INTRO/SHEATH,4225.0,2746.25,628.68,4225.0,39
CDM,27251435,BSW (GM) CS CATHETER,3028.0,1968.2,159.5,3028.0,47
CDM,27251445,LASER SHEATH GLIDELIGHTS,15288.0,9937.2,2274.85,15288.0,39
CDM,27251455,BSW NAVISTAR THERM SF CATH,16635.0,10812.75,2475.29,16635.0,39
CDM,27251465,BSW MOBI SM CURVE CATH,3337.0,2169.05,496.55,3337.0,39
CDM,27251475,BSW LASSO ECO 2515 CATH,7842.0,5097.3,1166.89,7842.0,39
CDM,27251495,SHORTIE STEADY SHEATH,1189.0,772.85,176.92,1189.0,39
CDM,27251505,LONG EVOLUTION STEADY SHEATH,1319.0,857.35,196.27,1319.0,39
CDM,27251515,SJM IBI 6FR DECA BI-DIR CATH,2886.0,1875.9,159.5,2886.0,47
CDM,27251525,MDT ARCTIC FRONT ABL CATH,22138.0,14389.7,3294.13,22138.0,39
CDM,27251535,MDT FREEZOR MAX ABL CATH,10015.0,6509.75,1490.23,10015.0,39
CDM,27251545,MDT FLEXCATH STEER SHEATH,5272.0,3426.8,784.47,5272.0,39
CDM,27251555,MDT ACHIEVE MAPPING CATH,4216.0,2740.4,627.34,4216.0,39
CDM,27251565,BSW PENTARAY NAV,9466.0,6152.9,1408.54,9466.0,39
CDM,27251575,VISA SHEATH,1188.0,772.2,176.77,1188.0,39
CDM,27251585,"SEALER,AQUAMANTYS 9.5XL BIPOLR",2999.0,1949.35,446.25,2999.0,39
CDM,27251595,PHOTON/PLASMABLADE,885.0,575.25,131.69,885.0,39
CDM,27251605,BSC BLAZER ASYMMETRIC CURVE,5777.0,3755.05,859.62,5777.0,39
CDM,27251615,"RETRV DEVICE, TIGHTRAIL",8951.0,5818.15,1331.91,8951.0,39
CDM,27251625,BSW THERM SMART TOUCH CATH,17208.0,11185.2,2560.55,17208.0,39
CDM,27251635,V-LOOP,4750.0,3087.5,706.8,4750.0,39
CDM,27251645,SNARE GOOSENECK (ALL SIZES),1611.0,1047.15,239.72,1611.0,39
CDM,27251655,CORDIS BIOPSY FORCEP,1346.0,874.9,200.28,1346.0,39
CDM,27251665,BRIDGE BALLOON SHEATH,1399.0,909.35,208.17,1399.0,39
CDM,27251675,BRIDGE BALLOON CATH 90CM,4490.0,2918.5,159.5,4490.0,47
CDM,27251685,EXOFIN,62.0,40.3,9.23,62.0,39
CDM,27251695,BSW NAVISTAR THERM ST/SF CATH,18891.0,12279.15,2810.98,18891.0,39
CDM,27251705,TLA MED LAUNCH GUIDE CATH,237.0,154.05,35.27,237.0,39
CDM,27251715,IVT CUTTING BALLOON,2792.0,1814.8,415.45,2792.0,39
CDM,27251725,TLA ABBOTT/CORDIS BALLOON,265.0,172.25,39.43,265.0,39
CDM,27251735,TLA MED BALLOON,686.0,445.9,102.08,686.0,39
CDM,27251745,"WIRE, DOPPLER FLOW",3434.0,2232.1,510.98,3434.0,39
CDM,27251755,IVUS CATHETER,3631.0,2360.15,540.29,3631.0,39
CDM,27251765,GUARDWIRE PLUS CATHETER,8286.0,5385.9,1232.96,8286.0,39
CDM,27251775,ACS/GUIDANT GUIDEWIRE,459.0,298.35,68.3,459.0,39
CDM,27251785,BOSTON SCIENTIFIC GUIDEWIRE,343.0,222.95,51.04,343.0,39
CDM,27251795,MEDTRONIC GUIDEWIRE,396.0,257.4,58.92,396.0,39
CDM,27251805,ABBOTT GUIDEWIRE CONFI/MIRACLE,899.0,584.35,133.77,899.0,39
CDM,27251815,ABBOTT GUIDEWIRE PROWATER,459.0,298.35,68.3,459.0,39
CDM,27251825,FILTERWIRE EX,6248.0,4061.2,929.7,6248.0,39
CDM,27251835,MEDTRONIC EXPORT CATH,2109.0,1370.85,313.82,2109.0,39
CDM,27251845,DIAG CATH LOW,46.0,29.9,6.84,46.0,39
CDM,27251855,WIRE DIAGNOSTIC LOW,48.0,31.2,7.14,48.0,39
CDM,27251865,TEMPORARY PACING ELECTRODE,929.0,603.85,138.24,929.0,39
CDM,27251875,DIAGNOSTIC CATHETER KIT,131.0,85.15,19.49,131.0,39
CDM,27251885,OXIMETRIC OPTICATH,847.0,550.55,126.03,847.0,39
CDM,27251895,WIRE DIAGNOSTIC MED,313.0,203.45,46.57,313.0,39
CDM,27251905,IMPELLA CARDIAC ASSIST DEVICE,132025.0,85816.25,19645.32,132025.0,39
CDM,27251915,DIAG CATH MED,236.0,153.4,35.12,236.0,39
CDM,27251925,GUIDELINER CATHETER,2080.0,1352.0,309.5,2080.0,39
CDM,27251945,CANISTER VAC PREVENA,125.0,81.25,18.6,125.0,39
CDM,27251955,CANISTER VAC VIA,195.0,126.75,29.02,195.0,39
CDM,27251965,DRSG VAC VERAFLO MED,559.0,363.35,83.18,559.0,39
CDM,27251975,CASSETTE VAC VERALINK,268.0,174.2,39.88,268.0,39
CDM,27251985,"KIT, VENTRICULOSTOMY",1706.0,1108.9,253.85,1706.0,39
CDM,27251995,DRSG VAC BLACK SM,144.0,93.6,21.43,144.0,39
CDM,27252005,DRSG VAC BLACK MED,181.0,117.65,26.93,181.0,39
CDM,27252015,DRSG VAC BLACK LRG,218.0,141.7,32.44,218.0,39
CDM,27252025,CANISTER KIT VAC (WC APPRVL),197.0,128.05,29.31,197.0,39
CDM,27252035,DRSG VAC GRANUFOAM SILVER MED,366.0,237.9,54.46,366.0,39
CDM,27252045,DRSG VAC GRANUFOAM SILVER LRG,437.0,284.05,65.03,437.0,39
CDM,27252055,DRSG VAC WHTFOAM SM,65.0,42.25,9.67,65.0,39
CDM,27252065,CANISTER VAC ABTHERA,62.0,40.3,9.23,62.0,39
CDM,27252AK,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,4853.0,3154.45,1.1,4853.0,50
CDM,27253AK,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,5432.0,3530.8,1.1,5432.0,50
CDM,27254985,"SHEATH, SHORT",123.0,79.95,18.3,123.0,39
CDM,27254995,"CATH, ANGIOPLASTY DRUG-COATED",10030.0,6519.5,1492.46,10030.0,39
CDM,27255005,"FILTER, ACCUNET",8023.0,5214.95,1193.82,8023.0,39
CDM,27255015,"REVASC DEV, SOLITAIRE",34363.0,22335.95,5113.21,34363.0,39
CDM,27255025,BONE MARROW BX NEEDLE,327.0,212.55,48.66,327.0,39
CDM,27255035,LIBERATOR LOCKING STYLET,2764.0,1796.6,411.28,2764.0,39
CDM,27255045,"SLEEVE, MED STERILE 6177",59.0,38.35,8.78,59.0,39
CDM,27255055,SUPERCROSS/CARAVEL/CORSAIR/TURNPIKE MICRO-CATH,2067.0,1343.55,307.57,2067.0,39
CDM,27255065,ABLATION CATHETER,1210.0,786.5,180.05,1210.0,39
CDM,27255285,S DRVR NDL LRG SUTURE CT DVNC XI,1207.0,784.55,179.6,1207.0,39
CDM,27255295,S CAUTERY PERM HOOK DVNC XI,1006.0,653.9,149.69,1006.0,39
CDM,27255325,S APPL CLP LARGE DVNC XI,352.0,228.8,52.38,352.0,39
CDM,27255335,S SHEARS DA VINCI S/SI ENDOWRIST HARMONIC ACE 8MM CURVE SURGICAL,277.0,180.05,41.22,277.0,39
CDM,27255345,S SHR ESU HARM DVNC 8MM CRV,659.0,428.35,98.06,659.0,39
CDM,27255355,S FORCEPS MARYLAND BIPOLAR,1317.0,856.05,195.97,1317.0,39
CDM,27255365,S STPL EWRST STAPLER 45 DVNC XI,704.0,457.6,104.76,704.0,39
CDM,27255375,S FORCEPS DA VINCI S/SI ENDOWRIST DEBAKEY 8MM 30- D MED 54.6CM 1,931.0,605.15,138.53,931.0,39
CDM,27255385,S FORCEPS DA VINCI S/SI ENDOWRIST CADIERE 8MM LAP FINGERTIP CTRL,1006.0,653.9,149.69,1006.0,39
CDM,27255395,S HOOK DA VINCI S/SI ENDOWRIST 8MM 55.2CM 1.6CM LAPAROSCOPIC CAU,1006.0,653.9,149.69,1006.0,39
CDM,27255405,S ELECTRD DA VINCI S/SI ENDOWRIST 8MM MONOPOL CAUTERY SPATULA PE,1006.0,653.9,149.69,1006.0,39
CDM,27255415,S GRASPER DA VINCI S/SI ENDOWRIST 8MM 56.7CM LAP 2 FENESTRATE,1006.0,653.9,149.69,1006.0,39
CDM,27255425,S DRIVE DA VINCI S/SI ENDOWRIST 8MM 30- D LRG 54.4CM 49.3CM NDL,1107.0,719.55,164.72,1107.0,39
CDM,27255435,S FORCEPS PROGRASP DA VINCI S/SI ENDOWRIST 8MM 38- D 56.2CM 2.8C,1107.0,719.55,164.72,1107.0,39
CDM,27255445,S FORCEPS DA VINCI S/SI ENDOWRIST RESANO 8MM 30- D MED 54.5CM 1.,1107.0,719.55,164.72,1107.0,39
CDM,27255455,S DRIVER MEGA DA VINCI S/SI ENDOWRIST 8MM 30- D 54.7CM 1.3CM NEE,1107.0,719.55,164.72,1107.0,39
CDM,27255465,S DRVR NDL LRG 1X31.5CM DVNC XI,1107.0,719.55,164.72,1107.0,39
CDM,27255475,S FRCP PRGRSP 2.8X33.53 DVNC XI,1107.0,719.55,164.72,1107.0,39
CDM,27255485,S GRSP TIP-UP FENES DVNC XI,1107.0,719.55,164.72,1107.0,39
CDM,27255495,S DRIVER DA VINCI S/SI ENDOWRIST 5MM 30- D 55.1CM .9CM NEEDLE,1010.0,656.5,150.29,1010.0,39
CDM,27255505,S ELECTRD DA VINCI S/SI ENDOWRIST 5MM 56.7CM 1.3CM MONOPOL CAUTE,1122.0,729.3,166.95,1122.0,39
CDM,27255515,S DISSECTOR DA VINCI S/SI ENDOWRIST MARYLAND 5MM 30- D 56.1CM 2.,2163.0,1405.95,321.85,2163.0,39
CDM,27255525,S DRIVE SUTURECUT DA VINCI S/SI ENDOWRIST 8MM 30- D LRG 54.5CM 1,1207.0,784.55,179.6,1207.0,39
CDM,27255535,S DRIVE SUTURECUT ENDOWRIST 8MM 23- D MEG 49.7CM 1.4CM NEEDLE RO,1207.0,784.55,179.6,1207.0,39
CDM,27255545,S RETRACT ENDOWRIST DA VINCI S/SI GRAPTOR SML ENDOSCOPIC GRASP,1207.0,784.55,179.6,1207.0,39
CDM,27255555,S SCISSORS DA VINCI S/SI ENDOWRIST 5MM 30- D MED CURVE 55.6CM 1.,1509.0,980.85,224.54,1509.0,39
CDM,27255565,S FORCEPS DA VINCI S/SI ENDOWRIST MARYLAND 8MM 45 D 55.8CM 2CM L,1358.0,882.7,202.07,1358.0,39
CDM,27255575,S FORCEPS DA VINCI S/SI ENDOWRIST 8MM 45- D MED 55.9CM 2.1CM LAP,1358.0,882.7,202.07,1358.0,39
CDM,27255585,S FRCP MRYLND BPLR DVNC XI,1358.0,882.7,202.07,1358.0,39
CDM,27255595,S FRCP BPLR FENES DVNC XI,1358.0,882.7,202.07,1358.0,39
CDM,27255605,S FORCEPS DA VINCI S/SI ENDOWRIST PK 8MM 70- D 55.4CM 2CM LAP,1459.0,948.35,217.1,1459.0,39
CDM,27255615,S RETRACTOR DA VINCI S/SI ENDOWRIST 8MM 60- D 58.2CM 4.8CM LAP,1484.0,964.6,220.82,1484.0,39
CDM,27255625,S CAUTERY HOT SHEARS MCS DVNC XI,1610.0,1046.5,239.57,1610.0,39
CDM,27255635,S GRASP DA VINCI S/SI ENDOWRIST SCHERTEL 5MM 30- D 56.6CM 3.2CM,1081.0,702.65,160.85,1081.0,39
CDM,27257715,BAKRI BALLOON,1042.0,677.3,155.05,1042.0,39
CDM,27257AK,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,2152.0,1398.8,1.1,2743.55,50
CDM,27261065,"ACCUSTICK II W/RO MARK INTRO SYS, W/0.038 SS J-TIP & 0.018  NITI",461.0,299.65,68.6,461.0,47
CDM,27262060,"BALLOON CATH, MUSTANG",628.0,408.2,93.45,628.0,47
CDM,27262065,"CATH, LUMAX 8.0",1505.0,978.25,159.5,1505.0,47
CDM,27262075,"CATH, 5 MAX ACE",13045.0,8479.25,159.5,13045.0,47
CDM,27262085,"CATH, VELOCITY",5677.0,3690.05,159.5,5677.0,47
CDM,27262095,"BALLOON CATH, EV3-HYPERGLIDE",5419.0,3522.35,159.5,5419.0,47
CDM,27262105,"SPHERE, EMBOSPHERE 5ML SYR",1114.0,724.1,165.76,1114.0,39
CDM,27262375,PVA-100/200/300/500 EMBOL,3209.0,2085.85,477.5,3209.0,39
CDM,27262385,TRUFILL N-BCA EMBOL 1G VL,13664.0,8881.6,2033.2,13664.0,39
CDM,27262395,DIAGNOSTIC CATHETER KIT,141.0,91.65,20.98,141.0,39
CDM,27262525,DRSG VAC VERAFLO CLEANSE CHC,729.0,473.85,108.48,729.0,39
CDM,27262535,DRSG VAC ABTHERA W/TUBING,1944.0,1263.6,289.27,1944.0,39
CDM,27262545,PENUMBRA 4/5 MAX KIT,10748.0,6986.2,1599.3,10748.0,39
CDM,27262555,MICRA SHEATH,1365.0,887.25,203.11,1365.0,39
CDM,27265AK,CLTX POST HIP ARTHRP DISLC W/O ANES,2096.0,1362.4,1.1,2096.0,50
CDM,27266AK,CLTX POST HIP ARTHRP DISLC REQ ANES,3112.0,2022.8,1.1,3112.0,50
CDM,27267AK,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,2200.0,1430.0,1.1,5526.53,50
CDM,27268AK,CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ,2848.0,1851.2,1.1,2848.0,50
CDM,27269AK,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,7556.0,4911.4,1.1,7556.0,50
CDM,27275AK,MANIPULATION HIP JOINT W ANESTHESIA,928.0,603.2,1.1,2743.55,50
CDM,27278015,GUIDEWIRE C1769 54,195.0,126.75,29.02,195.0,47
CDM,27278AK,ARTHRD SI JT PRQ W/PLMT IARTIC IMPLT WO TFXJ DEV,3458.0,2247.7,1.1,37661.58,52
CDM,27280405,CIRCUMCISION SUPPLIES,37.8,24.57,5.62,37.8,39
CDM,27280745,ROTOBLATOR DEVICE,4326.0,2811.9,643.71,4326.0,39
CDM,27280755,MYOCARDIAL BIOPSY FORCEPS,3119.0,2027.35,464.11,3119.0,39
CDM,27280765,BOSTON SCIENTIFIC ROTO WIRE,830.0,539.5,123.5,830.0,39
CDM,27280775,SANE SAEC KIT,36.0,23.4,5.36,36.0,39
CDM,27280785,SANE DFSA KIT,12.0,7.8,1.79,12.0,39
CDM,27280795,STUDY FFR VERRATA PLS,12.0,7.8,1.79,12.0,39
CDM,27280875,GRSP LAPSCP BOWEL DVNC S/SI,1081.45,702.94,160.92,1081.45,39
CDM,27280885,SCIS LAPSCP 8MM DVNC EWRST,980.86,637.56,145.95,980.86,39
CDM,27280895,DISECT BPLR EWRST 8MM CRV CAUT,1358.1,882.77,202.09,1358.1,39
CDM,27280AK,ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ,8000.0,5200.0,1.1,8000.0,50
CDM,27281635,"KIT, BEDSIDE",2645.0,1719.25,393.58,2645.0,39
CDM,27282205,"KIT, PICC (DUAL W-3CG WIRE)",1502.0,976.3,223.5,1502.0,39
CDM,27282215,"KIT, MIDLINE",704.0,457.6,104.76,704.0,39
CDM,27282225,ACCUCATH INTRAVASC CATH,222.0,144.3,33.03,222.0,39
CDM,27282235,"KIT, US PRIV INSERT",77.0,50.05,11.46,77.0,39
CDM,27282255,DRSG VAC GRANUFOAM BLACK LRG,250.0,162.5,37.2,250.0,39
CDM,27282965,MICROPUNCTURE,51.0,33.15,7.59,51.0,39
CDM,27283205,BAIR HUGGER,36.0,23.4,5.36,36.0,39
CDM,27283215,CERVICAL RIPENING BALLOON,113.0,73.45,16.81,113.0,39
CDM,27283225,MONICA NOVII ELECTRODES,84.0,54.6,12.5,84.0,39
CDM,27283235,PELVIC EXAM TRAY,27.0,17.55,4.02,27.0,39
CDM,27283605,TOOL WRENCH TORQUE KIT,64.0,41.6,9.52,64.0,39
CDM,27283945,GUIDEWIRE C1769 185,690.0,448.5,102.67,690.0,47
CDM,27284105,"BALLOON CATH, EMERGE MR/OTW",582.0,378.3,86.6,582.0,39
CDM,27284205,"CATH, ATHERECTOMY DEVICE",11570.0,7520.5,1721.62,11570.0,39
CDM,27284785,"CATH, SOFIA 5F",6835.0,4442.75,1017.05,6835.0,39
CDM,27284795,"CATH, SOFIA 6F",10559.0,6863.35,1571.18,10559.0,39
CDM,27284805,"STENT, SYNERGY OTW",4100.0,2665.0,159.5,4100.0,46
CDM,27284805_IP,"STENT, SYNERGY OTW",4100.0,2665.0,2742.9,2742.9,1
CDM,27284805_OP,"STENT, SYNERGY OTW",4100.0,2665.0,2603.5,2603.5,1
CDM,27285825,"CATH, ANGIO MP 6FR",2062.0,1340.3,306.83,2062.0,39
CDM,27285835,EMBL PROTCT 4MM/5MM,3285.0,2135.25,488.81,3285.0,39
CDM,27285845,"CATH, DLV SYS 120CM",3595.0,2336.75,534.94,3595.0,39
CDM,27285855,"CATH, NEURON 6FR",456.0,296.4,67.85,456.0,39
CDM,27285865,"CATH, ANGIO DUO 16.5CM",2648.0,1721.2,394.02,2648.0,39
CDM,27287635,"GUIDE WIRE, VACS STD",108.0,70.2,16.07,108.0,39
CDM,27287645,"BALLOON CATH, OCC TRNSFRM",5103.0,3316.95,759.33,5103.0,39
CDM,27290135,THORACENTESIS TRAY,400.0,260.0,59.52,400.0,39
CDM,27290645,SNARE VASC 120CM,1004.0,652.6,149.4,1004.0,47
CDM,27290655,"REVAS DEV, CERENOVUS",20075.0,13048.75,2987.16,20075.0,39
CDM,27290665,WATER BIRTH SUPPLIES,620.0,403.0,92.26,620.0,39
CDM,27291385,ALEXIS O RETRACTOR,235.0,152.75,34.97,235.0,39
CDM,27293155,PTNS KIT,201.0,130.65,29.91,201.0,39
CDM,27293685,"FILTER, EMBOSHIELD NAV 6",5001.0,3250.65,744.15,5001.0,39
CDM,27293695,"GUIDE WIRE, BAREWIRE",438.0,284.7,65.17,438.0,39
CDM,27293745,CATH GUIDE STINGRAY 135CM,3042.0,1977.3,452.65,3042.0,39
CDM,27294205,CIRCA S-CATH,2190.0,1423.5,325.87,2190.0,39
CDM,27294225,"CATH, REACT 71",6753.0,4389.45,1004.85,6753.0,39
CDM,27294245,SUPPLY - MINI-BAL CATHETER,162.0,105.3,24.11,162.0,39
CDM,27294305,"CATH, SIMMONS 2/3 GLIDE",189.0,122.85,28.12,189.0,39
CDM,27294315,"CATH, MERIT MED LEGATO SIMMONS 2",142.0,92.3,21.13,142.0,39
CDM,27294405,"CATH, SINGLE PG 18G 10CM",245.0,159.25,36.46,245.0,39
CDM,27294415,"KIT, FULL PG 18G 10CM",398.0,258.7,59.22,398.0,39
CDM,27294445,"BAND, RADIAL REG/LG",91.0,59.15,13.54,91.0,39
CDM,27294455,"SHEATH, RADIAL 5/6FR",183.0,118.95,27.23,183.0,39
CDM,27294465,CAST SUPPLIES SHORT ARM SPLINT ADULT,81.0,52.65,12.05,81.0,39
CDM,27294525,TLA OSTIAL FLASH DUAL BALLOON,4380.0,2847.0,651.74,4380.0,39
CDM,27294725,CATH GUIDE SHEATHLESS EAUCATH CORONARY,507.0,329.55,75.44,507.0,39
CDM,27295015,CORONARY ASPIRATION CATH (MECH THROMB),7081.0,4602.65,159.5,7081.0,47
CDM,27295025,CANISTER (MECH THROMB),1332.0,865.8,198.2,1332.0,39
CDM,27295065,TABLO CARTRIDGE,120.0,78.0,17.86,120.0,39
CDM,27295715,EDWARDS SAPIEN 3 ULTRA 26 MM TRANSCATHER HEART VALVE,43875.0,28518.75,6528.6,43875.0,39
CDM,27295765,COOK CATH INDUCTION BALLOON,155.0,100.75,23.06,155.0,39
CDM,27295825,TISSUE RETENTION SYSTEM,219.0,142.35,32.59,219.0,39
CDM,27295AK,DISARTICULATION OF HIP,7864.0,5111.6,1.1,7864.0,50
CDM,27296365,INTRO SHTH 8.5FR 71CM GUID,1664.0,1081.6,159.5,1664.0,47
CDM,27297365,EVIVA STEREO DEVICE,657.0,427.05,13.46,657.0,47
CDM,27297375,STEREO BIOPSY TRAY,40.15,26.1,5.97,40.15,47
CDM,27297385,US BIOPSY TRAY,111.47,72.46,13.46,111.47,47
CDM,27297395,BARD MARQUEE US BIOPSY DEVICE,273.75,177.94,13.46,273.75,47
CDM,27297405,BARD MARQUEE US BIOPSY DEVICE W/GUIDE,189.8,123.37,13.46,189.8,47
CDM,27297415,JADA SYSTEM DEVICE,2987.5,1941.88,444.54,2987.5,39
CDM,27297675,"CATHETER, CORONARY IVL SHOCKWAVE",17155.0,11150.75,159.5,17155.0,47
CDM,27299195,IPAS DOUBLE VALVE ASPIRATOR W CANNULA SINGLE USE,74.0,48.1,11.01,74.0,39
CDM,27299245,ENSOETM ESOPHAGEAL COOLING DEVICE CATH,2830.0,1839.5,421.1,2830.0,39
CDM,27299315,BAYLIS VERSACROSS TRANS SEPTAL ACCESS KIT,3376.0,2194.4,502.35,3376.0,39
CDM,27299445,5GM ARISTA AH ABSORBABLE HEMOSTAT,163.84,106.5,24.38,163.84,39
CDM,27299605,EDWARDS ARTERIAL CATH TRUE WAVE 2 LUMEN,220.0,143.0,32.74,220.0,47
CDM,27299AGRVU1AK,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",914.0,594.1,0.01,914.0,28
CDM,27299AGRVU2AK,"UNLISTED PROC, PELVIS OR HIP JOINT COMPARED TO 29916",2250.0,1462.5,0.01,2250.0,28
CDM,27299AGRVUAK,"UNLISTED PROCEDURE, PELVIS OR HIP JOINT (COMPARISON CODE 22511)",2501.0,1625.65,0.01,2501.0,28
CDM,27299AK,PELVIS/HIP JOINT SURGERY UNLISTED,2318.0,1506.7,0.01,2318.0,28
CDM,27299RVU11AK,ABDUCTOR ANCHOR RECONSTRUCTION (COMP CODE 27100),4880.0,3172.0,0.01,4880.0,28
CDM,27299RVU12AK,OPEN PX TO RPR ABDUCTOR MUSCULATURE TO TUMOR PROSTHESIS (COMP CO,4101.0,2665.65,0.01,4101.0,28
CDM,27299RVU14AK,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),2639.0,1715.35,0.01,2639.0,28
CDM,27299RVU15AK,POSTERIOR CAPSULAR RECONSTRUCTION (COMP CODE 27100),4540.0,2951.0,0.01,4540.0,28
CDM,27299RVU3AK,GLUTEUS MEDIUS/MINIMUS REPAIR (COMP CODE 27385),2458.0,1597.7,0.01,2458.0,28
CDM,27299RVU8AK,UNLISTED PROC; CORE DECOMPRESSION OF FEMORAL HEAD (COMP TO 27235,4290.0,2788.5,0.01,4290.0,28
CDM,27299RVU9AK,UNLISTED PROC; OPEN TREATMENT TOTAL HIP REPLACEMENT DISLOCATION,2501.0,1625.65,0.01,2501.0,28
CDM,27300235,PLEURX CATH SYSTEM,2894.0,1881.1,430.63,2894.0,39
CDM,27300245,PLEURX DRAINAGE BOTTLE,282.0,183.3,41.96,282.0,39
CDM,27300265,HEARING AID RENTAL (MO),66.0,42.9,9.82,66.0,47
CDM,27301AK,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,2712.0,1762.8,1.1,4850.94,53
CDM,27303AK,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,3452.0,2243.8,1.1,3452.0,50
CDM,27305AK,"FASCIOTOMY,ILIOTIBIAL,OPEN",2472.0,1606.8,1.1,5526.53,50
CDM,27306AK,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,1896.0,1232.4,1.1,5526.53,50
CDM,27307AK,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,2424.0,1575.6,1.1,5526.53,50
CDM,27310AK,ARTHRT KNE W/EXPL DRG/RMVL FB,4000.0,2600.0,1.1,5526.53,50
CDM,27323AK,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,932.0,605.8,1.1,2768.64,53
CDM,27324AK,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,2016.0,1310.4,1.1,4850.94,50
CDM,27327AK,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
CDM,27328AK,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,3540.0,2301.0,1.1,4850.94,50
CDM,27329AK,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,6288.0,4087.2,1.1,6288.0,50
CDM,27330AK,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,2044.0,1328.6,1.1,5526.53,50
CDM,27331AK,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,2408.0,1565.2,1.1,5526.53,50
CDM,27334AK,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,3676.0,2389.4,1.1,5526.53,50
CDM,27335AK,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,4220.0,2743.0,1.1,12214.27,50
CDM,27337AK,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,2364.0,1536.6,1.1,4850.94,50
CDM,27337URVUAK,EXICSN TUMR SFT TSSUE THIGH OR KNEE >3CM,910.0,591.5,1.1,4850.94,50
CDM,27339AK,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,4452.0,2893.8,1.1,4850.94,50
CDM,27339URVUAK,"EXCISION TUMOR, THIGH, KNEE, 5 CM >",1641.0,1066.65,1.1,4850.94,50
CDM,27340AK,EXCISION PREPATELLAR BURSA,1728.0,1123.2,1.1,5526.53,50
CDM,27345AK,EXCISION SYNOVIAL CYST POPLITEAL SPACE,2436.0,1583.4,1.1,5526.53,50
CDM,27347AK,EXCISION LESION MENISCUS/CAPSULE KNEE,2692.0,1749.8,1.1,5526.53,50
CDM,27350AK,PATELLECTOMY/HEMIPATELLECTOMY,3464.0,2251.6,1.1,12214.27,50
CDM,27355AK,EXCISION/CURETTAGE CYST/TUMOR FEMUR,3200.0,2080.0,1.1,5526.53,50
CDM,27356AK,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,4036.0,2623.4,1.1,22471.68,50
CDM,27360AK,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,4584.0,2979.6,1.1,5526.53,50
CDM,27364AK,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,9796.0,6367.4,1.1,9796.0,50
CDM,27365AK,"RAD RESEC TUMOR,FEMUR OR KNEE",12884.0,8374.6,1.1,12884.0,50
CDM,27369AK,NJX PX CNTRST KNE ARTHG CONTRST ENHNCD CT/MRI KNE,308.0,200.2,1.1,608.77,53
CDM,27372AK,"REMV FOREIGN BODY,KNEE/THIGH,DEEP",2084.0,1354.6,1.1,4850.94,53
CDM,27372URVUAK,REMOVAL OF FOREIGN BODY,837.0,544.05,1.1,4850.94,53
CDM,27380AK,SUTURE INFRAPATELLAR TENDON PRIMARY,2980.0,1937.0,1.1,12214.27,50
CDM,27381AK,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,4304.0,2797.6,1.1,12214.27,50
CDM,27385AK,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,3049.0,1981.85,1.1,12214.27,50
CDM,27386AK,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,4452.0,2893.8,1.1,12214.27,50
CDM,27400045,"RUBBER PESSARY, ANY TYPE",109.0,70.85,8.84,116.79,48
CDM,27400050,W BRACE ACL T-ROM KO ADJ JNT,151.0,98.15,32.92,3384.52,46
CDM,27400050_IP,W BRACE ACL T-ROM KO ADJ JNT,151.0,98.15,60.25,60.25,1
CDM,27400050_OP,W BRACE ACL T-ROM KO ADJ JNT,151.0,98.15,58.44,58.44,1
CDM,27400055,"PESSARY, NON RUBBER",139.0,90.35,25.16,290.15,46
CDM,27400055_IP,"PESSARY, NON RUBBER",139.0,90.35,55.46,55.46,1
CDM,27400055_OP,"PESSARY, NON RUBBER",139.0,90.35,53.79,53.79,1
CDM,27400120,WHO PREFAB WRIST W/O JOINTS,92.0,59.8,20.06,327.85,46
CDM,27400120_IP,WHO PREFAB WRIST W/O JOINTS,92.0,59.8,36.71,36.71,1
CDM,27400120_OP,WHO PREFAB WRIST W/O JOINTS,92.0,59.8,35.6,35.6,1
CDM,27400145,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,75.92,4887.04,46
CDM,27400145_IP,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,138.95,138.95,1
CDM,27400145_OP,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,134.77,134.77,1
CDM,27400160,W KO W/ ADJ FLEX/EXT ROTAT CUS,1041.52,676.99,227.05,4116.07,46
CDM,27400160_IP,W KO W/ ADJ FLEX/EXT ROTAT CUS,1041.52,676.99,415.57,415.57,1
CDM,27400160_OP,W KO W/ ADJ FLEX/EXT ROTAT CUS,1041.52,676.99,403.07,403.07,1
CDM,27400185,SIO FLEX PELVISACRAL PREFAB,159.0,103.35,34.66,259.64,46
CDM,27400185_IP,SIO FLEX PELVISACRAL PREFAB,159.0,103.35,63.44,63.44,1
CDM,27400185_OP,SIO FLEX PELVISACRAL PREFAB,159.0,103.35,61.53,61.53,1
CDM,27400210,W ORTHOSIS ANK/FT STATIC,204.0,132.6,44.47,824.55,46
CDM,27400210_IP,W ORTHOSIS ANK/FT STATIC,204.0,132.6,81.4,81.4,1
CDM,27400210_OP,W ORTHOSIS ANK/FT STATIC,204.0,132.6,78.95,78.95,1
CDM,27400240,WHFO PREFAB W/O JOINTS,602.0,391.3,131.24,1118.18,46
CDM,27400240_IP,WHFO PREFAB W/O JOINTS,602.0,391.3,240.2,240.2,1
CDM,27400240_OP,WHFO PREFAB W/O JOINTS,602.0,391.3,232.97,232.97,1
CDM,27400250,W PREFAB WHFO WO JNTS,449.0,291.85,97.88,1118.18,46
CDM,27400250_IP,W PREFAB WHFO WO JNTS,449.0,291.85,179.15,179.15,1
CDM,27400250_OP,W PREFAB WHFO WO JNTS,449.0,291.85,173.76,173.76,1
CDM,27400360,W VALVE TRACH PASSY MUIR,333.0,216.45,46.46,591.25,46
CDM,27400360_IP,W VALVE TRACH PASSY MUIR,333.0,216.45,132.87,132.87,1
CDM,27400360_OP,W VALVE TRACH PASSY MUIR,333.0,216.45,128.87,128.87,1
CDM,27400450,W BRACE LSO SAG-CORONL PNL PRFB,249.0,161.85,54.28,6365.65,46
CDM,27400450_IP,W BRACE LSO SAG-CORONL PNL PRFB,249.0,161.85,99.35,99.35,1
CDM,27400450_OP,W BRACE LSO SAG-CORONL PNL PRFB,249.0,161.85,96.36,96.36,1
CDM,27400505,PREFAB ELASTIC KO W JNTS,175.0,113.75,38.15,505.85,46
CDM,27400505_IP,PREFAB ELASTIC KO W JNTS,175.0,113.75,69.83,69.83,1
CDM,27400505_OP,PREFAB ELASTIC KO W JNTS,175.0,113.75,67.73,67.73,1
CDM,27400510,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,119.46,2236.43,46
CDM,27400510_IP,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,218.65,218.65,1
CDM,27400510_OP,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,212.08,212.08,1
CDM,27400515,PLAYMAKER KNEE BRACE,167.28,108.73,36.47,698.29,46
CDM,27400515_IP,PLAYMAKER KNEE BRACE,167.28,108.73,66.74,66.74,1
CDM,27400515_OP,PLAYMAKER KNEE BRACE,167.28,108.73,64.74,64.74,1
CDM,27400525,PREFAB CANVAS KO IMMOBILIZER,85.0,55.25,18.53,282.87,46
CDM,27400525_IP,PREFAB CANVAS KO IMMOBILIZER,85.0,55.25,33.92,33.92,1
CDM,27400525_OP,PREFAB CANVAS KO IMMOBILIZER,85.0,55.25,32.9,32.9,1
CDM,27400565,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,194.67,4408.86,46
CDM,27400565_IP,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,356.31,356.31,1
CDM,27400565_OP,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,345.59,345.59,1
CDM,27400575,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,278.17,5749.09,46
CDM,27400575_IP,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,853.64,853.64,1
CDM,27400575_OP,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,810.26,810.26,1
CDM,27400595,AFO ANKLE GAUNTLET,119.0,77.35,25.16,366.75,46
CDM,27400595_IP,AFO ANKLE GAUNTLET,119.0,77.35,47.48,47.48,1
CDM,27400595_OP,AFO ANKLE GAUNTLET,119.0,77.35,46.05,46.05,1
CDM,27400615,AFO AIR CAST,182.0,118.3,39.68,552.55,46
CDM,27400615_IP,AFO AIR CAST,182.0,118.3,72.62,72.62,1
CDM,27400615_OP,AFO AIR CAST,182.0,118.3,70.43,70.43,1
CDM,27400635,"AFO,RIGID,ANTERIOR,CRB, PREFAB",3734.0,2427.1,814.01,4384.59,46
CDM,27400635_IP,"AFO,RIGID,ANTERIOR,CRB, PREFAB",3734.0,2427.1,2498.05,2498.05,1
CDM,27400635_OP,"AFO,RIGID,ANTERIOR,CRB, PREFAB",3734.0,2427.1,2371.09,2371.09,1
CDM,27400665,PREFAB SPIRAL AFO,3515.0,2284.75,766.27,4126.5,46
CDM,27400665_IP,PREFAB SPIRAL AFO,3515.0,2284.75,2351.54,2351.54,1
CDM,27400665_OP,PREFAB SPIRAL AFO,3515.0,2284.75,2232.03,2232.03,1
CDM,27400840,VAR/VAL KNEE CAP,101.0,65.65,22.02,494.82,46
CDM,27400840_IP,VAR/VAL KNEE CAP,101.0,65.65,40.3,40.3,1
CDM,27400840_OP,VAR/VAL KNEE CAP,101.0,65.65,39.09,39.09,1
CDM,27401235,"HEEL, PAD AND DEPRESSION SPUR",51.0,33.15,11.12,306.14,48
CDM,27401280,SO-PREFAB FIG OF 8 RESTRAINER,44.0,28.6,9.59,322.25,46
CDM,27401280_IP,SO-PREFAB FIG OF 8 RESTRAINER,44.0,28.6,17.56,17.56,1
CDM,27401280_OP,SO-PREFAB FIG OF 8 RESTRAINER,44.0,28.6,17.03,17.03,1
CDM,27401285,SO FIG 8 RESTR CANV WEBBING,39.0,25.35,8.5,462.07,46
CDM,27401285_IP,SO FIG 8 RESTR CANV WEBBING,39.0,25.35,15.56,15.56,1
CDM,27401285_OP,SO FIG 8 RESTR CANV WEBBING,39.0,25.35,15.09,15.09,1
CDM,27401300,EO W/O JOINTS CF,806.0,523.9,175.71,1291.3,46
CDM,27401300_IP,EO W/O JOINTS CF,806.0,523.9,321.59,321.59,1
CDM,27401300_OP,EO W/O JOINTS CF,806.0,523.9,311.92,311.92,1
CDM,27401315,EO PREFAB RIGID W/O JOINTS,180.0,117.0,39.24,480.78,46
CDM,27401315_IP,EO PREFAB RIGID W/O JOINTS,180.0,117.0,71.82,71.82,1
CDM,27401315_OP,EO PREFAB RIGID W/O JOINTS,180.0,117.0,69.66,69.66,1
CDM,27401320,EO CUSTOM W/WRIST,1151.0,748.15,250.92,3346.45,46
CDM,27401320_IP,EO CUSTOM W/WRIST,1151.0,748.15,459.25,459.25,1
CDM,27401320_OP,EO CUSTOM W/WRIST,1151.0,748.15,445.44,445.44,1
CDM,27401335,WHFO CUSTOM W/JOINTS,1119.0,727.35,243.94,2031.21,46
CDM,27401335_IP,WHFO CUSTOM W/JOINTS,1119.0,727.35,446.48,446.48,1
CDM,27401335_OP,WHFO CUSTOM W/JOINTS,1119.0,727.35,433.05,433.05,1
CDM,27401340,WHFO CUSTOM RIGID W/OUT JOINTS,553.0,359.45,72.46,1593.0,46
CDM,27401340_IP,WHFO CUSTOM RIGID W/OUT JOINTS,553.0,359.45,220.65,220.65,1
CDM,27401340_OP,WHFO CUSTOM RIGID W/OUT JOINTS,553.0,359.45,214.01,214.01,1
CDM,27401355,WHO CUSTOM W/NONTORSION JOINTS,1210.0,786.5,263.78,4434.64,46
CDM,27401355_IP,WHO CUSTOM W/NONTORSION JOINTS,1210.0,786.5,482.79,482.79,1
CDM,27401355_OP,WHO CUSTOM W/NONTORSION JOINTS,1210.0,786.5,468.27,468.27,1
CDM,27401360,WHO CUSTOM W/O JOINTS,726.0,471.9,158.27,2266.14,46
CDM,27401360_IP,WHO CUSTOM W/O JOINTS,726.0,471.9,289.67,289.67,1
CDM,27401360_OP,WHO CUSTOM W/O JOINTS,726.0,471.9,280.96,280.96,1
CDM,27401365,WHFO PREFAB FLEXION GLOVE,146.0,94.9,13.46,471.15,46
CDM,27401365_IP,WHFO PREFAB FLEXION GLOVE,146.0,94.9,58.25,58.25,1
CDM,27401365_OP,WHFO PREFAB FLEXION GLOVE,146.0,94.9,56.5,56.5,1
CDM,27401370,HFO CUSTOM W/O JOINTS,442.0,287.3,96.36,1211.05,46
CDM,27401370_IP,HFO CUSTOM W/O JOINTS,442.0,287.3,176.36,176.36,1
CDM,27401370_OP,HFO CUSTOM W/O JOINTS,442.0,287.3,171.05,171.05,1
CDM,27401375,PREFAB METACARPL FX ORTHOSIS,140.0,91.0,30.52,472.23,46
CDM,27401375_IP,PREFAB METACARPL FX ORTHOSIS,140.0,91.0,55.86,55.86,1
CDM,27401375_OP,PREFAB METACARPL FX ORTHOSIS,140.0,91.0,54.18,54.18,1
CDM,27401380,HO CUSTOM W/O FINGERS,353.0,229.45,76.95,1211.05,46
CDM,27401380_IP,HO CUSTOM W/O FINGERS,353.0,229.45,140.85,140.85,1
CDM,27401380_OP,HO CUSTOM W/O FINGERS,353.0,229.45,136.61,136.61,1
CDM,27401385,HFO CUSTOM W/JOINTS,587.0,381.55,72.46,1436.47,46
CDM,27401385_IP,HFO CUSTOM W/JOINTS,587.0,381.55,234.21,234.21,1
CDM,27401385_OP,HFO CUSTOM W/JOINTS,587.0,381.55,227.17,227.17,1
CDM,27401395,HFO PREFAB W/O JOINTS SOFT,105.0,68.25,22.89,431.97,46
CDM,27401395_IP,HFO PREFAB W/O JOINTS SOFT,105.0,68.25,41.9,41.9,1
CDM,27401395_OP,HFO PREFAB W/O JOINTS SOFT,105.0,68.25,40.64,40.64,1
CDM,27401400,FO PREFAB SPRING TENSION FINGER,105.0,68.25,22.89,293.75,46
CDM,27401400_IP,FO PREFAB SPRING TENSION FINGER,105.0,68.25,41.9,41.9,1
CDM,27401400_OP,FO PREFAB SPRING TENSION FINGER,105.0,68.25,40.64,40.64,1
CDM,27401405,FO PREFAB STATIC FINGER,63.0,40.95,13.73,156.53,46
CDM,27401405_IP,FO PREFAB STATIC FINGER,63.0,40.95,25.14,25.14,1
CDM,27401405_OP,FO PREFAB STATIC FINGER,63.0,40.95,24.38,24.38,1
CDM,27401410,HFO PREFAB HINGED W/ JOINTS,327.0,212.55,25.16,408.46,46
CDM,27401410_IP,HFO PREFAB HINGED W/ JOINTS,327.0,212.55,130.47,130.47,1
CDM,27401410_OP,HFO PREFAB HINGED W/ JOINTS,327.0,212.55,126.55,126.55,1
CDM,27401420,WHFO PREFAB W/ JOINTS,657.0,427.05,143.23,932.38,46
CDM,27401420_IP,WHFO PREFAB W/ JOINTS,657.0,427.05,262.14,262.14,1
CDM,27401420_OP,WHFO PREFAB W/ JOINTS,657.0,427.05,254.26,254.26,1
CDM,27401425,FO CUSTOM STATIC FINGER,244.0,158.6,53.19,954.13,46
CDM,27401425_IP,FO CUSTOM STATIC FINGER,244.0,158.6,97.36,97.36,1
CDM,27401425_OP,FO CUSTOM STATIC FINGER,244.0,158.6,94.43,94.43,1
CDM,27401430,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",348.0,226.2,75.86,987.84,46
CDM,27401430_IP,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",348.0,226.2,138.85,138.85,1
CDM,27401430_OP,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",348.0,226.2,134.68,134.68,1
CDM,27401435,QUADRANT SHOULDER BRACE,993.0,645.45,216.47,3566.59,46
CDM,27401435_IP,QUADRANT SHOULDER BRACE,993.0,645.45,396.21,396.21,1
CDM,27401435_OP,QUADRANT SHOULDER BRACE,993.0,645.45,384.29,384.29,1
CDM,27401485,ORTH DEV REPAIR/REPL MINOR P,105.0,68.25,13.46,105.0,46
CDM,27401485_IP,ORTH DEV REPAIR/REPL MINOR P,105.0,68.25,41.9,41.9,1
CDM,27401485_OP,ORTH DEV REPAIR/REPL MINOR P,105.0,68.25,40.64,40.64,1
CDM,27401495,PREFAB ANKLE AIRCAST,59.0,38.35,12.86,475.39,46
CDM,27401495_IP,PREFAB ANKLE AIRCAST,59.0,38.35,23.54,23.54,1
CDM,27401495_OP,PREFAB ANKLE AIRCAST,59.0,38.35,22.83,22.83,1
CDM,27401500,NON-PNEUMATIC WALKING SPLINT,125.0,81.25,27.25,779.09,46
CDM,27401500_IP,NON-PNEUMATIC WALKING SPLINT,125.0,81.25,49.88,49.88,1
CDM,27401500_OP,NON-PNEUMATIC WALKING SPLINT,125.0,81.25,48.38,48.38,1
CDM,27401510,STANDARD CROW,3520.0,2288.0,531.62,7243.42,46
CDM,27401510_IP,STANDARD CROW,3520.0,2288.0,2354.88,2354.88,1
CDM,27401510_OP,STANDARD CROW,3520.0,2288.0,2235.2,2235.2,1
CDM,27402725,PEDS TRACH TUBE,284.0,184.6,28.98,284.0,46
CDM,27402725_IP,PEDS TRACH TUBE,284.0,184.6,113.32,113.32,1
CDM,27402725_OP,PEDS TRACH TUBE,284.0,184.6,109.91,109.91,1
CDM,27403115,COLLAR ADULT - REG,22.0,14.3,4.8,129.98,46
CDM,27403115_IP,COLLAR ADULT - REG,22.0,14.3,8.78,8.78,1
CDM,27403115_OP,COLLAR ADULT - REG,22.0,14.3,8.51,8.51,1
CDM,27403185,LUMBOSACRAL SUPPORT,175.0,113.75,25.16,175.0,46
CDM,27403185_IP,LUMBOSACRAL SUPPORT,175.0,113.75,69.83,69.83,1
CDM,27403185_OP,LUMBOSACRAL SUPPORT,175.0,113.75,67.73,67.73,1
CDM,27403195,LSO BACK BRACE,655.0,425.75,142.79,2019.61,46
CDM,27403195_IP,LSO BACK BRACE,655.0,425.75,261.35,261.35,1
CDM,27403195_OP,LSO BACK BRACE,655.0,425.75,253.49,253.49,1
CDM,27403275,TRU PULL LITE,146.0,94.9,31.83,505.85,46
CDM,27403275_IP,TRU PULL LITE,146.0,94.9,58.25,58.25,1
CDM,27403275_OP,TRU PULL LITE,146.0,94.9,56.5,56.5,1
CDM,27403285,"LATERAL ""J"" BRACE",92.75,60.29,20.22,505.85,46
CDM,27403285_IP,"LATERAL ""J"" BRACE",92.75,60.29,37.01,37.01,1
CDM,27403285_OP,"LATERAL ""J"" BRACE",92.75,60.29,35.89,35.89,1
CDM,27403305,ECONOMY HINGED KNEE BRACE,69.0,44.85,15.04,698.29,46
CDM,27403305_IP,ECONOMY HINGED KNEE BRACE,69.0,44.85,27.53,27.53,1
CDM,27403305_OP,ECONOMY HINGED KNEE BRACE,69.0,44.85,26.7,26.7,1
CDM,27403325,PREFAB CANVAS KO IMMOBILIZER,134.0,87.1,25.16,282.87,46
CDM,27403325_IP,PREFAB CANVAS KO IMMOBILIZER,134.0,87.1,53.47,53.47,1
CDM,27403325_OP,PREFAB CANVAS KO IMMOBILIZER,134.0,87.1,51.86,51.86,1
CDM,27403355,THROM ADVANCE KNEE,589.0,382.85,128.4,3384.52,46
CDM,27403355_IP,THROM ADVANCE KNEE,589.0,382.85,235.01,235.01,1
CDM,27403355_OP,THROM ADVANCE KNEE,589.0,382.85,227.94,227.94,1
CDM,27403385,OA KNEE BRACE,1584.0,1029.6,345.31,4116.07,46
CDM,27403385_IP,OA KNEE BRACE,1584.0,1029.6,1059.7,1059.7,1
CDM,27403385_OP,OA KNEE BRACE,1584.0,1029.6,1005.84,1005.84,1
CDM,27403415,OTS BRACE - ACL/PCL,759.0,493.35,165.46,4116.07,46
CDM,27403415_IP,OTS BRACE - ACL/PCL,759.0,493.35,302.84,302.84,1
CDM,27403415_OP,OTS BRACE - ACL/PCL,759.0,493.35,293.73,293.73,1
CDM,27403425,CUSTOM ACL/PCL W/PNEUMATIC KNE,1059.0,688.35,230.86,5749.09,46
CDM,27403425_IP,CUSTOM ACL/PCL W/PNEUMATIC KNE,1059.0,688.35,422.54,422.54,1
CDM,27403425_OP,CUSTOM ACL/PCL W/PNEUMATIC KNE,1059.0,688.35,409.83,409.83,1
CDM,27403435,AIR SPORT/ANKLE BRACE,163.0,105.95,25.16,366.75,46
CDM,27403435_IP,AIR SPORT/ANKLE BRACE,163.0,105.95,65.04,65.04,1
CDM,27403435_OP,AIR SPORT/ANKLE BRACE,163.0,105.95,63.08,63.08,1
CDM,27403635,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,26.16,974.88,46
CDM,27403635_IP,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,47.88,47.88,1
CDM,27403635_OP,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,46.44,46.44,1
CDM,27403685,FELT HEEL LIFTS,137.0,89.05,25.16,362.44,46
CDM,27403685_IP,FELT HEEL LIFTS,137.0,89.05,54.66,54.66,1
CDM,27403685_OP,FELT HEEL LIFTS,137.0,89.05,53.02,53.02,1
CDM,27403725,ULTRA SLING,56.0,36.4,12.21,508.37,46
CDM,27403725_IP,ULTRA SLING,56.0,36.4,22.34,22.34,1
CDM,27403725_OP,ULTRA SLING,56.0,36.4,21.67,21.67,1
CDM,27403735,EO CUSTOM W/O WRIST,806.0,523.9,175.71,1291.3,46
CDM,27403735_IP,EO CUSTOM W/O WRIST,806.0,523.9,321.59,321.59,1
CDM,27403735_OP,EO CUSTOM W/O WRIST,806.0,523.9,311.92,311.92,1
CDM,27403765,ELBOW-DJ IROM BRACE,526.0,341.9,114.67,2236.43,46
CDM,27403765_IP,ELBOW-DJ IROM BRACE,526.0,341.9,209.87,209.87,1
CDM,27403765_OP,ELBOW-DJ IROM BRACE,526.0,341.9,203.56,203.56,1
CDM,27403825,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,58.21,1593.0,46
CDM,27403825_IP,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,106.53,106.53,1
CDM,27403825_OP,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,103.33,103.33,1
CDM,27403835,WRIST CUSTOM (OT),298.0,193.7,64.96,2266.14,46
CDM,27403835_IP,WRIST CUSTOM (OT),298.0,193.7,118.9,118.9,1
CDM,27403835_OP,WRIST CUSTOM (OT),298.0,193.7,115.33,115.33,1
CDM,27403845,WRIST SPLINT,107.0,69.55,23.33,327.85,46
CDM,27403845_IP,WRIST SPLINT,107.0,69.55,42.69,42.69,1
CDM,27403845_OP,WRIST SPLINT,107.0,69.55,41.41,41.41,1
CDM,27403855,FOREARM SPLINT,30.0,19.5,6.54,327.85,46
CDM,27403855_IP,FOREARM SPLINT,30.0,19.5,11.97,11.97,1
CDM,27403855_OP,FOREARM SPLINT,30.0,19.5,11.61,11.61,1
CDM,27403AK,ARTHROTOMY W/MENISCUS REPAIR KNEE,3448.0,2241.2,1.1,12214.27,50
CDM,27404025,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,11.77,431.97,46
CDM,27404025_IP,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,21.55,21.55,1
CDM,27404025_OP,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,20.9,20.9,1
CDM,27404255,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,49.49,1272.15,46
CDM,27404255_IP,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,90.57,90.57,1
CDM,27404255_OP,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,87.85,87.85,1
CDM,27404285,AIRCAST PNEUMATIC WALKER,414.0,269.1,72.46,1272.15,46
CDM,27404285_IP,AIRCAST PNEUMATIC WALKER,414.0,269.1,165.19,165.19,1
CDM,27404285_OP,AIRCAST PNEUMATIC WALKER,414.0,269.1,160.22,160.22,1
CDM,27404335,DORSIWEDGE NIGHT SPLINT,68.0,44.2,14.82,824.55,46
CDM,27404335_IP,DORSIWEDGE NIGHT SPLINT,68.0,44.2,27.13,27.13,1
CDM,27404335_OP,DORSIWEDGE NIGHT SPLINT,68.0,44.2,26.32,26.32,1
CDM,27404355,PTB CROW,3520.0,2288.0,531.62,7243.42,46
CDM,27404355_IP,PTB CROW,3520.0,2288.0,2354.88,2354.88,1
CDM,27404355_OP,PTB CROW,3520.0,2288.0,2235.2,2235.2,1
CDM,27405365,YB TLSO BACK BRACE,1766.0,1147.9,72.46,1766.0,46
CDM,27405365_IP,YB TLSO BACK BRACE,1766.0,1147.9,1181.45,1181.45,1
CDM,27405365_OP,YB TLSO BACK BRACE,1766.0,1147.9,1121.41,1121.41,1
CDM,27405375,YB TLSO 3 SHELL,3732.0,2425.8,531.62,6135.12,46
CDM,27405375_IP,YB TLSO 3 SHELL,3732.0,2425.8,2496.71,2496.71,1
CDM,27405375_OP,YB TLSO 3 SHELL,3732.0,2425.8,2369.82,2369.82,1
CDM,27405385,YB TLSO HYPEREXT,2059.0,1338.35,448.86,2059.0,46
CDM,27405385_IP,YB TLSO HYPEREXT,2059.0,1338.35,1377.47,1377.47,1
CDM,27405385_OP,YB TLSO HYPEREXT,2059.0,1338.35,1307.47,1307.47,1
CDM,27405395,YB TLSO 2 SHELL W/LINER,10459.0,6798.35,2280.06,10459.0,38
CDM,27405395_IP,YB TLSO 2 SHELL W/LINER,10459.0,6798.35,6997.07,6997.07,1
CDM,27405395_OP,YB TLSO 2 SHELL W/LINER,10459.0,6798.35,6641.47,6641.47,1
CDM,27405405,YB LSO CORSET,868.0,564.2,25.16,868.0,46
CDM,27405405_IP,YB LSO CORSET,868.0,564.2,346.33,346.33,1
CDM,27405405_OP,YB LSO CORSET,868.0,564.2,335.92,335.92,1
CDM,27405415,YB LSO AP CORSET W/APRON,1972.0,1281.8,72.46,1972.0,46
CDM,27405415_IP,YB LSO AP CORSET W/APRON,1972.0,1281.8,1319.27,1319.27,1
CDM,27405415_OP,YB LSO AP CORSET W/APRON,1972.0,1281.8,1252.22,1252.22,1
CDM,27405425,YB HO HIP JOINT,4791.0,3114.15,531.62,4791.0,46
CDM,27405425_IP,YB HO HIP JOINT,4791.0,3114.15,3205.18,3205.18,1
CDM,27405425_OP,YB HO HIP JOINT,4791.0,3114.15,3042.29,3042.29,1
CDM,27405435,YB KO KNEE W/PADS & JTS,1046.0,679.9,46.46,1046.0,46
CDM,27405435_IP,YB KO KNEE W/PADS & JTS,1046.0,679.9,417.35,417.35,1
CDM,27405435_OP,YB KO KNEE W/PADS & JTS,1046.0,679.9,404.8,404.8,1
CDM,27405445,YB KO KNEE BRACE IMMOB,528.0,343.2,25.16,528.0,46
CDM,27405445_IP,YB KO KNEE BRACE IMMOB,528.0,343.2,210.67,210.67,1
CDM,27405445_OP,YB KO KNEE BRACE IMMOB,528.0,343.2,204.34,204.34,1
CDM,27405455,YB KO KNEE ADJ JOINTS,3523.0,2289.95,264.38,3523.0,46
CDM,27405455_IP,YB KO KNEE ADJ JOINTS,3523.0,2289.95,2356.89,2356.89,1
CDM,27405455_OP,YB KO KNEE ADJ JOINTS,3523.0,2289.95,2237.11,2237.11,1
CDM,27405465,YB AFO SINGLE UPRIGHT,1502.0,976.3,278.93,1502.0,46
CDM,27405465_IP,YB AFO SINGLE UPRIGHT,1502.0,976.3,1004.84,1004.84,1
CDM,27405465_OP,YB AFO SINGLE UPRIGHT,1502.0,976.3,953.77,953.77,1
CDM,27405475,YB AFO PLASTIC,2490.0,1618.5,264.38,2490.0,46
CDM,27405475_IP,YB AFO PLASTIC,2490.0,1618.5,1665.81,1665.81,1
CDM,27405475_OP,YB AFO PLASTIC,2490.0,1618.5,1581.15,1581.15,1
CDM,27405485,YB AFO PLASTIC ANKLE JOINT,3543.0,2302.95,772.37,3543.0,46
CDM,27405485_IP,YB AFO PLASTIC ANKLE JOINT,3543.0,2302.95,2370.27,2370.27,1
CDM,27405485_OP,YB AFO PLASTIC ANKLE JOINT,3543.0,2302.95,2249.81,2249.81,1
CDM,27405495,YB ADTN BELOW KNEE,373.0,242.45,25.16,398.98,46
CDM,27405495_IP,YB ADTN BELOW KNEE,373.0,242.45,148.83,148.83,1
CDM,27405495_OP,YB ADTN BELOW KNEE,373.0,242.45,144.35,144.35,1
CDM,27405505,YB PLASTAZOTE MOLDED SHOE,397.0,258.05,25.16,397.0,46
CDM,27405505_IP,YB PLASTAZOTE MOLDED SHOE,397.0,258.05,158.4,158.4,1
CDM,27405505_OP,YB PLASTAZOTE MOLDED SHOE,397.0,258.05,153.64,153.64,1
CDM,27405515,YB EO DOUBLE UPRIGHT,4998.0,3248.7,531.62,4998.0,46
CDM,27405515_IP,YB EO DOUBLE UPRIGHT,4998.0,3248.7,3343.66,3343.66,1
CDM,27405515_OP,YB EO DOUBLE UPRIGHT,4998.0,3248.7,3173.73,3173.73,1
CDM,27405525,YB WALKING BOOT PNEUM,1105.0,718.25,72.46,1272.15,46
CDM,27405525_IP,YB WALKING BOOT PNEUM,1105.0,718.25,440.9,440.9,1
CDM,27405525_OP,YB WALKING BOOT PNEUM,1105.0,718.25,427.64,427.64,1
CDM,27405535,YB RIGID DRESSING BELOW KNEE,2422.0,1574.3,528.0,2422.0,46
CDM,27405535_IP,YB RIGID DRESSING BELOW KNEE,2422.0,1574.3,1620.32,1620.32,1
CDM,27405535_OP,YB RIGID DRESSING BELOW KNEE,2422.0,1574.3,1537.97,1537.97,1
CDM,27405545,YB PROS SHRINKER BELOW KNEE,237.0,154.05,25.16,237.0,46
CDM,27405545_IP,YB PROS SHRINKER BELOW KNEE,237.0,154.05,94.56,94.56,1
CDM,27405545_OP,YB PROS SHRINKER BELOW KNEE,237.0,154.05,91.72,91.72,1
CDM,27405555,YB PROS SHRINKER ABOVE KNEE,353.0,229.45,25.16,353.0,46
CDM,27405555_IP,YB PROS SHRINKER ABOVE KNEE,353.0,229.45,140.85,140.85,1
CDM,27405555_OP,YB PROS SHRINKER ABOVE KNEE,353.0,229.45,136.61,136.61,1
CDM,27405565,YB HALO JACKET VEST,13670.0,8885.5,2980.06,13670.0,38
CDM,27405565_IP,YB HALO JACKET VEST,13670.0,8885.5,9145.23,9145.23,1
CDM,27405565_OP,YB HALO JACKET VEST,13670.0,8885.5,8680.45,8680.45,1
CDM,27405575,YB ADTN HALO MRI COMP SYSTEM,5210.0,3386.5,531.62,5597.04,46
CDM,27405575_IP,YB ADTN HALO MRI COMP SYSTEM,5210.0,3386.5,3485.49,3485.49,1
CDM,27405575_OP,YB ADTN HALO MRI COMP SYSTEM,5210.0,3386.5,3308.35,3308.35,1
CDM,27405585,YB PROS SHEATH BELOW KNEE,92.0,59.8,8.84,92.0,46
CDM,27405585_IP,YB PROS SHEATH BELOW KNEE,92.0,59.8,36.71,36.71,1
CDM,27405585_OP,YB PROS SHEATH BELOW KNEE,92.0,59.8,35.6,35.6,1
CDM,27405595,YB PROS SOCK BELOW KNEE,36.0,23.4,7.85,36.0,46
CDM,27405595_IP,YB PROS SOCK BELOW KNEE,36.0,23.4,14.36,14.36,1
CDM,27405595_OP,YB PROS SOCK BELOW KNEE,36.0,23.4,13.93,13.93,1
CDM,27405605,YB UP EXTREM HUMERAL PREFAB,1803.0,1171.95,72.46,1803.0,46
CDM,27405605_IP,YB UP EXTREM HUMERAL PREFAB,1803.0,1171.95,1206.21,1206.21,1
CDM,27405605_OP,YB UP EXTREM HUMERAL PREFAB,1803.0,1171.95,1144.91,1144.91,1
CDM,27405615,YB ADTN UP EXT ORTHO SOCK,190.0,123.5,28.98,190.0,46
CDM,27405615_IP,YB ADTN UP EXT ORTHO SOCK,190.0,123.5,75.81,75.81,1
CDM,27405615_OP,YB ADTN UP EXT ORTHO SOCK,190.0,123.5,73.53,73.53,1
CDM,27405625,"YB PROS SOCK, MULTI BELOW KNEE",123.0,79.95,8.84,123.0,46
CDM,27405625_IP,"YB PROS SOCK, MULTI BELOW KNEE",123.0,79.95,49.08,49.08,1
CDM,27405625_OP,"YB PROS SOCK, MULTI BELOW KNEE",123.0,79.95,47.6,47.6,1
CDM,27405635,YB ADTN HALO LINER/INTERFACE,1097.0,713.05,239.15,1097.0,46
CDM,27405635_IP,YB ADTN HALO LINER/INTERFACE,1097.0,713.05,437.7,437.7,1
CDM,27405635_OP,YB ADTN HALO LINER/INTERFACE,1097.0,713.05,424.54,424.54,1
CDM,27405645,YB ADTN LW EXT PELVIC/HIP FLEX,1608.0,1045.2,72.46,1917.22,46
CDM,27405645_IP,YB ADTN LW EXT PELVIC/HIP FLEX,1608.0,1045.2,1075.75,1075.75,1
CDM,27405645_OP,YB ADTN LW EXT PELVIC/HIP FLEX,1608.0,1045.2,1021.08,1021.08,1
CDM,27405655,YB EO ADJ LOCK JT PREFAB,2368.0,1539.2,516.22,2368.0,46
CDM,27405655_IP,YB EO ADJ LOCK JT PREFAB,2368.0,1539.2,1584.19,1584.19,1
CDM,27405655_OP,YB EO ADJ LOCK JT PREFAB,2368.0,1539.2,1503.68,1503.68,1
CDM,27405665,YB LSO SAG-COR W/RIG POST FRM,2376.0,1544.4,264.38,2376.0,46
CDM,27405665_IP,YB LSO SAG-COR W/RIG POST FRM,2376.0,1544.4,1589.54,1589.54,1
CDM,27405665_OP,YB LSO SAG-COR W/RIG POST FRM,2376.0,1544.4,1508.76,1508.76,1
CDM,27405675,YB LO SAG RIGID PANEL (BOA),2420.0,1573.0,527.56,2420.0,46
CDM,27405675_IP,YB LO SAG RIGID PANEL (BOA),2420.0,1573.0,1618.98,1618.98,1
CDM,27405675_OP,YB LO SAG RIGID PANEL (BOA),2420.0,1573.0,1536.7,1536.7,1
CDM,27405685,YB CERV COLLAR W/THOR EXT,1498.0,973.7,72.46,1498.0,46
CDM,27405685_IP,YB CERV COLLAR W/THOR EXT,1498.0,973.7,1002.16,1002.16,1
CDM,27405685_OP,YB CERV COLLAR W/THOR EXT,1498.0,973.7,951.23,951.23,1
CDM,27405695,YB LSO SAG-COR RIG POST PREFAB,6638.0,4314.7,531.62,6638.0,46
CDM,27405695_IP,YB LSO SAG-COR RIG POST PREFAB,6638.0,4314.7,4440.82,4440.82,1
CDM,27405695_OP,YB LSO SAG-COR RIG POST PREFAB,6638.0,4314.7,4215.13,4215.13,1
CDM,27405705,YB AFO TIBIAL FRACT RIGID,6591.0,4284.15,1022.49,6591.0,46
CDM,27405705_IP,YB AFO TIBIAL FRACT RIGID,6591.0,4284.15,4409.38,4409.38,1
CDM,27405705_OP,YB AFO TIBIAL FRACT RIGID,6591.0,4284.15,4185.29,4185.29,1
CDM,27405715,YB TLSO 2 SHELL BOA DUAL,5351.0,3478.15,531.62,5351.0,46
CDM,27405715_IP,YB TLSO 2 SHELL BOA DUAL,5351.0,3478.15,3579.82,3579.82,1
CDM,27405715_OP,YB TLSO 2 SHELL BOA DUAL,5351.0,3478.15,3397.89,3397.89,1
CDM,27405725,YB CTLSO ANT/POST/LAT CONTROL,11722.0,7619.3,2555.4,11722.0,38
CDM,27405725_IP,YB CTLSO ANT/POST/LAT CONTROL,11722.0,7619.3,7842.02,7842.02,1
CDM,27405725_OP,YB CTLSO ANT/POST/LAT CONTROL,11722.0,7619.3,7443.47,7443.47,1
CDM,27405735,YB ADTN LOW EXTREM TIBIAL SOCK,232.0,150.8,28.98,232.0,46
CDM,27405735_IP,YB ADTN LOW EXTREM TIBIAL SOCK,232.0,150.8,92.57,92.57,1
CDM,27405735_OP,YB ADTN LOW EXTREM TIBIAL SOCK,232.0,150.8,89.78,89.78,1
CDM,27405745,YB HELMET SOFT PREFAB,1046.0,679.9,155.64,1046.0,39
CDM,27405755,YB CERVICAL COLLAR CHIN CUP,573.0,372.45,46.46,573.0,46
CDM,27405755_IP,YB CERVICAL COLLAR CHIN CUP,573.0,372.45,228.63,228.63,1
CDM,27405755_OP,YB CERVICAL COLLAR CHIN CUP,573.0,372.45,221.75,221.75,1
CDM,27405765,YB HELMET HARD PREFAB,1189.0,772.85,176.92,1189.0,39
CDM,27405775,YB BELOW KNEE SUSPSN SLEEVE,875.0,568.75,46.46,875.0,46
CDM,27405775_IP,YB BELOW KNEE SUSPSN SLEEVE,875.0,568.75,349.13,349.13,1
CDM,27405775_OP,YB BELOW KNEE SUSPSN SLEEVE,875.0,568.75,338.63,338.63,1
CDM,27405785,YB AFO STATIC/DYNAMIC PREFAB,2043.0,1327.95,46.46,2043.0,46
CDM,27405785_IP,YB AFO STATIC/DYNAMIC PREFAB,2043.0,1327.95,1366.77,1366.77,1
CDM,27405785_OP,YB AFO STATIC/DYNAMIC PREFAB,2043.0,1327.95,1297.31,1297.31,1
CDM,27405795,YB LO SAG RIGID AN/POS PREFAB,2732.0,1775.8,595.58,2732.0,46
CDM,27405795_IP,YB LO SAG RIGID AN/POS PREFAB,2732.0,1775.8,1827.71,1827.71,1
CDM,27405795_OP,YB LO SAG RIGID AN/POS PREFAB,2732.0,1775.8,1734.82,1734.82,1
CDM,27405805,YB LSO SAG-COR RIGD PNL PREFAB,7506.0,4878.9,531.62,7506.0,46
CDM,27405805_IP,YB LSO SAG-COR RIGD PNL PREFAB,7506.0,4878.9,5021.51,5021.51,1
CDM,27405805_OP,YB LSO SAG-COR RIGD PNL PREFAB,7506.0,4878.9,4766.31,4766.31,1
CDM,27405815,YB WALKING BOOT PNEUM/VACUUM,1202.0,781.3,72.46,1272.15,46
CDM,27405815_IP,YB WALKING BOOT PNEUM/VACUUM,1202.0,781.3,479.6,479.6,1
CDM,27405815_OP,YB WALKING BOOT PNEUM/VACUUM,1202.0,781.3,465.17,465.17,1
CDM,27405825,YB AFO STATIC/DYN PREFAB OTS,1023.0,664.95,46.46,1023.0,46
CDM,27405825_IP,YB AFO STATIC/DYN PREFAB OTS,1023.0,664.95,408.18,408.18,1
CDM,27405825_OP,YB AFO STATIC/DYN PREFAB OTS,1023.0,664.95,395.9,395.9,1
CDM,27405835,YB ORTHO DVC REPAIR PER 15 MIN,1986.0,1290.9,13.46,1986.0,46
CDM,27405835_IP,YB ORTHO DVC REPAIR PER 15 MIN,1986.0,1290.9,1328.63,1328.63,1
CDM,27405835_OP,YB ORTHO DVC REPAIR PER 15 MIN,1986.0,1290.9,1261.11,1261.11,1
CDM,27405845,YB AD LW EXT DORSI/PLNTR EA JT,771.0,501.15,25.16,771.0,46
CDM,27405845_IP,YB AD LW EXT DORSI/PLNTR EA JT,771.0,501.15,307.63,307.63,1
CDM,27405845_OP,YB AD LW EXT DORSI/PLNTR EA JT,771.0,501.15,298.38,298.38,1
CDM,27405855,YB LO SAG W/RIG PANEL POS L1-5,394.0,256.1,85.89,778.15,46
CDM,27405855_IP,YB LO SAG W/RIG PANEL POS L1-5,394.0,256.1,157.21,157.21,1
CDM,27405855_OP,YB LO SAG W/RIG PANEL POS L1-5,394.0,256.1,152.48,152.48,1
CDM,27405865,YB CERV M-POST COLLAR (SOMI),3236.0,2103.4,264.38,3236.0,46
CDM,27405865_IP,YB CERV M-POST COLLAR (SOMI),3236.0,2103.4,2164.88,2164.88,1
CDM,27405865_OP,YB CERV M-POST COLLAR (SOMI),3236.0,2103.4,2054.86,2054.86,1
CDM,27405875,YB CTLSO ANT/POST/LAT MOLDED,12114.0,7874.1,2640.85,12114.0,38
CDM,27405875_IP,YB CTLSO ANT/POST/LAT MOLDED,12114.0,7874.1,8104.27,8104.27,1
CDM,27405875_OP,YB CTLSO ANT/POST/LAT MOLDED,12114.0,7874.1,7692.39,7692.39,1
CDM,27405885,YB LSO SAG-COR RIGD PREFAB OTS,2138.0,1389.7,72.46,2138.0,46
CDM,27405885_IP,YB LSO SAG-COR RIGD PREFAB OTS,2138.0,1389.7,1430.32,1430.32,1
CDM,27405885_OP,YB LSO SAG-COR RIGD PREFAB OTS,2138.0,1389.7,1357.63,1357.63,1
CDM,27405895,POH LO SAG RIGID PANEL PREFAB,3301.0,2145.65,672.04,3301.0,46
CDM,27405895_IP,POH LO SAG RIGID PANEL PREFAB,3301.0,2145.65,2208.37,2208.37,1
CDM,27405895_OP,POH LO SAG RIGID PANEL PREFAB,3301.0,2145.65,2096.14,2096.14,1
CDM,27405905,BREAST BIOPSY UNI,4861.0,3159.65,0.01,4861.0,61
CDM,27405915,FINE NEEDLE ASP W/O IMG,1838.0,1194.7,0.01,3004.0,61
CDM,27405925,PUNC ASP ABS BRST UNI,2111.0,1372.15,0.01,3004.0,61
CDM,27405985,GENETIC COUNSELING 15 MIN,90.0,58.5,0.01,90.0,38
CDM,27405995,PLAYMAKER KNEE BRACE,836.0,543.4,182.25,3384.52,46
CDM,27405995_IP,PLAYMAKER KNEE BRACE,836.0,543.4,333.56,333.56,1
CDM,27405995_OP,PLAYMAKER KNEE BRACE,836.0,543.4,323.53,323.53,1
CDM,27405AK,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,3632.0,2360.8,1.1,12214.27,50
CDM,27406005,HUMERAL FRACT CUFF FIT & ADJ,462.0,300.3,72.46,1729.98,46
CDM,27406005_IP,HUMERAL FRACT CUFF FIT & ADJ,462.0,300.3,184.34,184.34,1
CDM,27406005_OP,HUMERAL FRACT CUFF FIT & ADJ,462.0,300.3,178.79,178.79,1
CDM,27406015,TROM KNEE BRACE,1097.0,713.05,239.15,3384.52,46
CDM,27406015_IP,TROM KNEE BRACE,1097.0,713.05,437.7,437.7,1
CDM,27406015_OP,TROM KNEE BRACE,1097.0,713.05,424.54,424.54,1
CDM,27406035,PROFORE COMPRESSION BANDAGE,78.0,50.7,17.0,485.42,46
CDM,27406035_IP,PROFORE COMPRESSION BANDAGE,78.0,50.7,31.12,31.12,1
CDM,27406035_OP,PROFORE COMPRESSION BANDAGE,78.0,50.7,30.19,30.19,1
CDM,27406045,COBAN II COMPRESSION BANDAGE,74.0,48.1,16.13,485.42,46
CDM,27406045_IP,COBAN II COMPRESSION BANDAGE,74.0,48.1,29.53,29.53,1
CDM,27406045_OP,COBAN II COMPRESSION BANDAGE,74.0,48.1,28.64,28.64,1
CDM,27406055,COBAN II LITE COMPRSSN BANDAGE,68.0,44.2,14.82,485.42,46
CDM,27406055_IP,COBAN II LITE COMPRSSN BANDAGE,68.0,44.2,27.13,27.13,1
CDM,27406055_OP,COBAN II LITE COMPRSSN BANDAGE,68.0,44.2,26.32,26.32,1
CDM,27406065,CERVICAL COLLAR MED.,3156.0,2051.4,46.46,3156.0,46
CDM,27406065_IP,CERVICAL COLLAR MED.,3156.0,2051.4,2111.36,2111.36,1
CDM,27406065_OP,CERVICAL COLLAR MED.,3156.0,2051.4,2004.06,2004.06,1
CDM,27406495,"YB CERV COLLAR M-POST,THOR EXT",3156.0,2051.4,264.38,3156.0,46
CDM,27406495_IP,"YB CERV COLLAR M-POST,THOR EXT",3156.0,2051.4,2111.36,2111.36,1
CDM,27406495_OP,"YB CERV COLLAR M-POST,THOR EXT",3156.0,2051.4,2004.06,2004.06,1
CDM,27406505,"COLLAR, ASPEN VISTA UNIVERSAL",195.0,126.75,42.51,525.92,46
CDM,27406505_IP,"COLLAR, ASPEN VISTA UNIVERSAL",195.0,126.75,77.81,77.81,1
CDM,27406505_OP,"COLLAR, ASPEN VISTA UNIVERSAL",195.0,126.75,75.47,75.47,1
CDM,27406615,FINGER ORTH STATIC FIT & ADJ,244.0,158.6,53.19,954.13,46
CDM,27406615_IP,FINGER ORTH STATIC FIT & ADJ,244.0,158.6,97.36,97.36,1
CDM,27406615_OP,FINGER ORTH STATIC FIT & ADJ,244.0,158.6,94.43,94.43,1
CDM,27406645,COFLEX TLC COMPRESSION BANDAGE,68.0,44.2,14.82,485.42,46
CDM,27406645_IP,COFLEX TLC COMPRESSION BANDAGE,68.0,44.2,27.13,27.13,1
CDM,27406645_OP,COFLEX TLC COMPRESSION BANDAGE,68.0,44.2,26.32,26.32,1
CDM,27406655,YB UP EXT FRAC ORTH HUM PREFAB,5360.0,3484.0,72.46,5360.0,46
CDM,27406655_IP,YB UP EXT FRAC ORTH HUM PREFAB,5360.0,3484.0,3585.84,3585.84,1
CDM,27406655_OP,YB UP EXT FRAC ORTH HUM PREFAB,5360.0,3484.0,3403.6,3403.6,1
CDM,27406665,YB AFO TIBIAL FRACT PLASTIC,4801.0,3120.65,1022.49,4801.0,46
CDM,27406665_IP,YB AFO TIBIAL FRACT PLASTIC,4801.0,3120.65,3211.87,3211.87,1
CDM,27406665_OP,YB AFO TIBIAL FRACT PLASTIC,4801.0,3120.65,3048.64,3048.64,1
CDM,27406675,YB TLSO SAG RIG POST FRAME,2297.0,1493.05,500.75,2297.0,46
CDM,27406675_IP,YB TLSO SAG RIG POST FRAME,2297.0,1493.05,1536.69,1536.69,1
CDM,27406675_OP,YB TLSO SAG RIG POST FRAME,2297.0,1493.05,1458.6,1458.6,1
CDM,27406685,THUMB SPICA,161.0,104.65,35.1,1118.18,46
CDM,27406685_IP,THUMB SPICA,161.0,104.65,64.24,64.24,1
CDM,27406685_OP,THUMB SPICA,161.0,104.65,62.31,62.31,1
CDM,27406695,CUSTOM FOOT ORTHOTIC,120.0,78.0,26.16,974.88,46
CDM,27406695_IP,CUSTOM FOOT ORTHOTIC,120.0,78.0,47.88,47.88,1
CDM,27406695_OP,CUSTOM FOOT ORTHOTIC,120.0,78.0,46.44,46.44,1
CDM,27406705,SPINOMED BRACE (BASIC),263.0,170.95,57.33,4887.04,46
CDM,27406705_IP,SPINOMED BRACE (BASIC),263.0,170.95,104.94,104.94,1
CDM,27406705_OP,SPINOMED BRACE (BASIC),263.0,170.95,101.78,101.78,1
CDM,27406715,SPINOMED BRACE (FULL),305.0,198.25,66.49,4887.04,46
CDM,27406715_IP,SPINOMED BRACE (FULL),305.0,198.25,121.7,121.7,1
CDM,27406715_OP,SPINOMED BRACE (FULL),305.0,198.25,118.04,118.04,1
CDM,27406735,YB KO ADJ KNEE JT RIGID PREFAB,4188.0,2722.2,264.38,4188.0,46
CDM,27406735_IP,YB KO ADJ KNEE JT RIGID PREFAB,4188.0,2722.2,2801.77,2801.77,1
CDM,27406735_OP,YB KO ADJ KNEE JT RIGID PREFAB,4188.0,2722.2,2659.38,2659.38,1
CDM,27406915,YB TLSO 4 SHELL,7931.0,5155.15,531.62,7931.0,46
CDM,27406915_IP,YB TLSO 4 SHELL,7931.0,5155.15,5305.84,5305.84,1
CDM,27406915_OP,YB TLSO 4 SHELL,7931.0,5155.15,5036.19,5036.19,1
CDM,27406965,UE PREFAB HUMERAL BRACE,438.0,284.7,72.46,1729.98,46
CDM,27406965_IP,UE PREFAB HUMERAL BRACE,438.0,284.7,174.76,174.76,1
CDM,27406965_OP,UE PREFAB HUMERAL BRACE,438.0,284.7,169.51,169.51,1
CDM,27407025,EO PREFAB ELASTIC W METAL JOINTS,548.0,356.2,46.46,638.51,46
CDM,27407025_IP,EO PREFAB ELASTIC W METAL JOINTS,548.0,356.2,218.65,218.65,1
CDM,27407025_OP,EO PREFAB ELASTIC W METAL JOINTS,548.0,356.2,212.08,212.08,1
CDM,27407035,"CUFFED TRACH TUBE 4,6,8 CUFF",198.0,128.7,28.98,268.04,46
CDM,27407035_IP,"CUFFED TRACH TUBE 4,6,8 CUFF",198.0,128.7,79.0,79.0,1
CDM,27407035_OP,"CUFFED TRACH TUBE 4,6,8 CUFF",198.0,128.7,76.63,76.63,1
CDM,27407045,"CUFFED TRACH TUBE DISTAL 5,6,7 CUFF",328.0,213.2,28.98,328.0,46
CDM,27407045_IP,"CUFFED TRACH TUBE DISTAL 5,6,7 CUFF",328.0,213.2,130.87,130.87,1
CDM,27407045_OP,"CUFFED TRACH TUBE DISTAL 5,6,7 CUFF",328.0,213.2,126.94,126.94,1
CDM,27407115,OA REACTION KNEE BRACE,135.0,87.75,29.43,313.9,46
CDM,27407115_IP,OA REACTION KNEE BRACE,135.0,87.75,53.87,53.87,1
CDM,27407115_OP,OA REACTION KNEE BRACE,135.0,87.75,52.25,52.25,1
CDM,27407285,YB ADTL SPINAL ORTHO HALO RING,219.0,142.35,13.46,219.0,46
CDM,27407285_IP,YB ADTL SPINAL ORTHO HALO RING,219.0,142.35,87.38,87.38,1
CDM,27407285_OP,YB ADTL SPINAL ORTHO HALO RING,219.0,142.35,84.75,84.75,1
CDM,27407525,YB TLSO FLEX TRNK SJ-SS PRE CAST,4161.0,2704.65,531.62,4887.04,46
CDM,27407525_IP,YB TLSO FLEX TRNK SJ-SS PRE CAST,4161.0,2704.65,2783.71,2783.71,1
CDM,27407525_OP,YB TLSO FLEX TRNK SJ-SS PRE CAST,4161.0,2704.65,2642.24,2642.24,1
CDM,27407535,"YB ADTN LOW EXTREM, LIMITED ANKLE MOTION EA JOINT",208.0,135.2,25.16,246.89,46
CDM,27407535_IP,"YB ADTN LOW EXTREM, LIMITED ANKLE MOTION EA JOINT",208.0,135.2,82.99,82.99,1
CDM,27407535_OP,"YB ADTN LOW EXTREM, LIMITED ANKLE MOTION EA JOINT",208.0,135.2,80.5,80.5,1
CDM,27407555,YB TLSO FLEX PROV TRUNK SUPP,4161.0,2704.65,531.62,4161.0,46
CDM,27407555_IP,YB TLSO FLEX PROV TRUNK SUPP,4161.0,2704.65,2783.71,2783.71,1
CDM,27407555_OP,YB TLSO FLEX PROV TRUNK SUPP,4161.0,2704.65,2642.24,2642.24,1
CDM,27407565,YB WHFO W/O JOINTS OFF THE SHELF,524.0,340.6,114.23,1118.18,46
CDM,27407565_IP,YB WHFO W/O JOINTS OFF THE SHELF,524.0,340.6,209.08,209.08,1
CDM,27407565_OP,YB WHFO W/O JOINTS OFF THE SHELF,524.0,340.6,202.79,202.79,1
CDM,27407585,YB AFO ANKLE GAUNTLET PREFAB INC FIT & ADJ,314.0,204.1,25.16,366.75,46
CDM,27407585_IP,YB AFO ANKLE GAUNTLET PREFAB INC FIT & ADJ,314.0,204.1,125.29,125.29,1
CDM,27407585_OP,YB AFO ANKLE GAUNTLET PREFAB INC FIT & ADJ,314.0,204.1,121.52,121.52,1
CDM,27407605,FO STATIC FINGER CUSTOM,25.0,16.25,5.45,954.13,46
CDM,27407605_IP,FO STATIC FINGER CUSTOM,25.0,16.25,9.98,9.98,1
CDM,27407605_OP,FO STATIC FINGER CUSTOM,25.0,16.25,9.68,9.68,1
CDM,27407615,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,57.99,987.84,46
CDM,27407615_IP,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,106.13,106.13,1
CDM,27407615_OP,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,102.94,102.94,1
CDM,27407625,YB CERVICAL FLEXIBLE NON-ADJ FOAM COLLAR,131.0,85.15,28.56,131.0,46
CDM,27407625_IP,YB CERVICAL FLEXIBLE NON-ADJ FOAM COLLAR,131.0,85.15,52.27,52.27,1
CDM,27407625_OP,YB CERVICAL FLEXIBLE NON-ADJ FOAM COLLAR,131.0,85.15,50.7,50.7,1
CDM,27407675,YB PROS SOCK ABOVE KNEE EACH,106.0,68.9,23.11,116.31,46
CDM,27407675_IP,YB PROS SOCK ABOVE KNEE EACH,106.0,68.9,42.29,42.29,1
CDM,27407675_OP,YB PROS SOCK ABOVE KNEE EACH,106.0,68.9,41.02,41.02,1
CDM,27407685,"YB ADTN LOW EXTREM ORTHO, FEM LENGTH SOCK, FRACT OR EQUAL, EACH",256.0,166.4,25.16,297.23,46
CDM,27407685_IP,"YB ADTN LOW EXTREM ORTHO, FEM LENGTH SOCK, FRACT OR EQUAL, EACH",256.0,166.4,102.14,102.14,1
CDM,27407685_OP,"YB ADTN LOW EXTREM ORTHO, FEM LENGTH SOCK, FRACT OR EQUAL, EACH",256.0,166.4,99.07,99.07,1
CDM,27407705,YB KNEE ORTHOSIS (BRACE) SINGLE UPRIGHT PRE-FAB,3077.0,2000.05,670.79,4408.86,46
CDM,27407705_IP,YB KNEE ORTHOSIS (BRACE) SINGLE UPRIGHT PRE-FAB,3077.0,2000.05,2058.51,2058.51,1
CDM,27407705_OP,YB KNEE ORTHOSIS (BRACE) SINGLE UPRIGHT PRE-FAB,3077.0,2000.05,1953.9,1953.9,1
CDM,27407715,"YB AFO POS SOLID ANKLE, PLASTIC, CUSTOM FAB",2606.0,1693.9,264.38,3045.83,46
CDM,27407715_IP,"YB AFO POS SOLID ANKLE, PLASTIC, CUSTOM FAB",2606.0,1693.9,1743.41,1743.41,1
CDM,27407715_OP,"YB AFO POS SOLID ANKLE, PLASTIC, CUSTOM FAB",2606.0,1693.9,1654.81,1654.81,1
CDM,27407755,YB SPINAL ORTHOSIS,155.0,100.75,13.46,155.0,46
CDM,27407755_IP,YB SPINAL ORTHOSIS,155.0,100.75,61.85,61.85,1
CDM,27407755_OP,YB SPINAL ORTHOSIS,155.0,100.75,59.99,59.99,1
CDM,27407765,"YB - CERVICAL, MULTIPLE POST COLLAR OCCIPITAL/MANIBULA, ADJUSTAB",1894.0,1231.1,412.89,2216.8,46
CDM,27407765_IP,"YB - CERVICAL, MULTIPLE POST COLLAR OCCIPITAL/MANIBULA, ADJUSTAB",1894.0,1231.1,1267.09,1267.09,1
CDM,27407765_OP,"YB - CERVICAL, MULTIPLE POST COLLAR OCCIPITAL/MANIBULA, ADJUSTAB",1894.0,1231.1,1202.69,1202.69,1
CDM,27408025,YB - SOFT INTERFACE PAD ON PLASTIC SECTION OF BRACE,154.5,100.43,25.16,398.98,46
CDM,27408025_IP,YB - SOFT INTERFACE PAD ON PLASTIC SECTION OF BRACE,154.5,100.43,61.65,61.65,1
CDM,27408025_OP,YB - SOFT INTERFACE PAD ON PLASTIC SECTION OF BRACE,154.5,100.43,59.79,59.79,1
CDM,27408055,TLSO BACK BRACE,240.0,156.0,46.46,492.46,46
CDM,27408055_IP,TLSO BACK BRACE,240.0,156.0,95.76,95.76,1
CDM,27408055_OP,TLSO BACK BRACE,240.0,156.0,92.88,92.88,1
CDM,27408065,ASPEN COLLAR,68.0,44.2,14.82,695.89,46
CDM,27408065_IP,ASPEN COLLAR,68.0,44.2,27.13,27.13,1
CDM,27408065_OP,ASPEN COLLAR,68.0,44.2,26.32,26.32,1
CDM,27408075,HUMERAL FX CUFF,51.0,33.15,11.12,1729.98,46
CDM,27408075_IP,HUMERAL FX CUFF,51.0,33.15,20.35,20.35,1
CDM,27408075_OP,HUMERAL FX CUFF,51.0,33.15,19.74,19.74,1
CDM,27408085,UNIV QUICK FIT SHOULDER IMMOBILIZER,55.0,35.75,11.99,508.37,46
CDM,27408085_IP,UNIV QUICK FIT SHOULDER IMMOBILIZER,55.0,35.75,21.95,21.95,1
CDM,27408085_OP,UNIV QUICK FIT SHOULDER IMMOBILIZER,55.0,35.75,21.29,21.29,1
CDM,27408095,ROM ELBOW,160.0,104.0,34.88,2236.43,46
CDM,27408095_IP,ROM ELBOW,160.0,104.0,63.84,63.84,1
CDM,27408095_OP,ROM ELBOW,160.0,104.0,61.92,61.92,1
CDM,27408105,HINGED KNEE BRACE,97.0,63.05,21.15,698.29,46
CDM,27408105_IP,HINGED KNEE BRACE,97.0,63.05,38.7,38.7,1
CDM,27408105_OP,HINGED KNEE BRACE,97.0,63.05,37.54,37.54,1
CDM,27408115,REACTION KNEE BRACE,95.0,61.75,20.71,505.85,46
CDM,27408115_IP,REACTION KNEE BRACE,95.0,61.75,37.91,37.91,1
CDM,27408115_OP,REACTION KNEE BRACE,95.0,61.75,36.77,36.77,1
CDM,27408125,ACL BRACE-OTS,159.0,103.35,34.66,4116.07,46
CDM,27408125_IP,ACL BRACE-OTS,159.0,103.35,63.44,63.44,1
CDM,27408125_OP,ACL BRACE-OTS,159.0,103.35,61.53,61.53,1
CDM,27408135,NIGHT SPLINT,59.0,38.35,12.86,824.55,46
CDM,27408135_IP,NIGHT SPLINT,59.0,38.35,23.54,23.54,1
CDM,27408135_OP,NIGHT SPLINT,59.0,38.35,22.83,22.83,1
CDM,27409765,"SEWHO, ABDUCTION POSITIONING, AIRPLANE DESIGN",1672.0,1086.8,364.5,3566.59,48
CDM,27409815,"KNEE ORTHOSIS (KO), SINGLE UPRIGHT CUSTOM FABRICATED",950.0,617.5,207.1,7482.67,48
CDM,27409AK,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,5484.0,3564.6,1.1,12214.27,50
CDM,27412AK,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,9896.0,6432.4,1.1,12214.27,50
CDM,27415AK,OSTEOCHONDRAL KNEE ALLOGRAFT,8000.0,5200.0,1.1,22471.68,50
CDM,27418AK,ANTERIOR TIBIAL TUBERCLEPLASTY,4640.0,3016.0,1.1,12214.27,50
CDM,27420AK,RCNSTJ DISLOCATING PATELLA,4104.0,2667.6,1.1,12214.27,50
CDM,27422AK,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,4084.0,2654.6,1.1,12214.27,50
CDM,27425AK,LATERAL RETINACULAR RELEASE OPEN,2156.0,1401.4,1.1,5526.53,50
CDM,27427AK,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,3916.0,2545.4,1.1,12214.27,50
CDM,27428AK,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,6232.0,4050.8,1.1,22471.68,50
CDM,27430AK,QUADRICEPSPLASTY,4064.0,2641.6,1.1,12214.27,50
CDM,27437AK,ARTHROPLASTY PATELLA W/O PROSTHESIS,3572.0,2321.8,1.1,12214.27,50
CDM,27438AK,ARTHROPLASTY PATELLA W/PROSTHESIS,4756.0,3091.4,1.1,22471.68,50
CDM,27442AK,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,4948.0,3216.2,1.1,22471.68,50
CDM,27446AK,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,6852.0,4453.8,1.1,22471.68,50
CDM,27447AK,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,7840.0,5096.0,1.1,22471.68,50
CDM,27448AK,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,4640.0,3016.0,1.1,4640.0,50
CDM,27450AK,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,5844.0,3798.6,1.1,5844.0,50
CDM,27458AK,OSTEOT FEMUR UNI INSJ XTRNL CTRLD IMED LNGTH DEV,11726.0,7621.9,1.1,11726.0,35
CDM,27470AK,RPR NON/MAL FEMUR DSTL H/N W/O GRF,6856.0,4456.4,1.1,6856.0,50
CDM,27472AK,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,8237.0,5354.05,1.1,8237.0,50
CDM,27486AK,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,8448.0,5491.2,1.1,8448.0,50
CDM,27487AK,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,10844.0,7048.6,1.1,10844.0,50
CDM,27488AK,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,7040.0,4576.0,1.1,7040.0,50
CDM,27495AK,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,6616.0,4300.4,1.1,6616.0,50
CDM,27496AK,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,2712.0,1762.8,1.1,5526.53,50
CDM,27498AK,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,3464.0,2251.6,1.1,3464.0,50
CDM,27499AK,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,3772.0,2451.8,1.1,12214.27,50
CDM,27500215,LEAD PACEMAKER TIER II,2868.0,1864.2,159.5,2868.0,46
CDM,27500215_IP,LEAD PACEMAKER TIER II,2868.0,1864.2,1918.69,1918.69,1
CDM,27500215_OP,LEAD PACEMAKER TIER II,2868.0,1864.2,1821.18,1821.18,1
CDM,27500230,LEAD ICD TIER I,13250.0,8612.5,159.5,13250.0,47
CDM,27500230_IP,LEAD ICD TIER I,13250.0,8612.5,8864.25,8864.25,1
CDM,27500230_OP,LEAD ICD TIER I,13250.0,8612.5,8413.75,8413.75,1
CDM,27500255,PACEMAKER SGL CHAMBER TIER III,17955.0,11670.75,159.5,17955.0,47
CDM,27500255_IP,PACEMAKER SGL CHAMBER TIER III,17955.0,11670.75,12011.9,12011.9,1
CDM,27500255_OP,PACEMAKER SGL CHAMBER TIER III,17955.0,11670.75,11401.43,11401.43,1
CDM,27500265,PACEMAKER DUAL CHMBR TIER III,20332.0,13215.8,159.5,20332.0,47
CDM,27500265_IP,PACEMAKER DUAL CHMBR TIER III,20332.0,13215.8,13602.11,13602.11,1
CDM,27500265_OP,PACEMAKER DUAL CHMBR TIER III,20332.0,13215.8,12910.82,12910.82,1
CDM,27500275,ICD  DUAL CHAMBER TIER II,71293.0,46340.45,159.5,71293.0,47
CDM,27500275_IP,ICD  DUAL CHAMBER TIER II,71293.0,46340.45,47695.02,47695.02,1
CDM,27500275_OP,ICD  DUAL CHAMBER TIER II,71293.0,46340.45,45271.06,45271.06,1
CDM,27500285,ICD SINGLE CHAMBER TIER III,56507.0,36729.55,159.5,56507.0,47
CDM,27500285_IP,ICD SINGLE CHAMBER TIER III,56507.0,36729.55,37803.18,37803.18,1
CDM,27500285_OP,ICD SINGLE CHAMBER TIER III,56507.0,36729.55,35881.95,35881.95,1
CDM,27500355,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,159.5,15938.0,47
CDM,27500355_IP,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,10662.52,10662.52,1
CDM,27500355_OP,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,10120.63,10120.63,1
CDM,27500365,ICD DUAL CHAMBER TIER I,47202.0,30681.3,159.5,47202.0,47
CDM,27500365_IP,ICD DUAL CHAMBER TIER I,47202.0,30681.3,31578.14,31578.14,1
CDM,27500365_OP,ICD DUAL CHAMBER TIER I,47202.0,30681.3,29973.27,29973.27,1
CDM,27500AK,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,2520.0,1638.0,1.1,2520.0,53
CDM,27501430,W PM MICRA LEADLESS,37590.0,24433.5,159.5,37590.0,47
CDM,27501430_IP,W PM MICRA LEADLESS,37590.0,24433.5,25147.71,25147.71,1
CDM,27501430_OP,W PM MICRA LEADLESS,37590.0,24433.5,23869.65,23869.65,1
CDM,27501515,AVEIR LEADLESS AR PACEMAKER,37950.0,24667.5,159.5,37950.0,49
CDM,27501525,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,159.5,61950.0,49
CDM,27501545,AVEIR LEADLESS VENTRICAL PACEMAKER,24000.0,15600.0,159.5,24000.0,49
CDM,27501595,MDT EPI/LEAD/TOOL 10626,5018.0,3261.7,746.68,5018.0,39
CDM,27501595_IP,MDT EPI/LEAD/TOOL 10626,5018.0,3261.7,3357.04,3357.04,1
CDM,27501595_OP,MDT EPI/LEAD/TOOL 10626,5018.0,3261.7,3186.43,3186.43,1
CDM,27501615,PPM SGL GEN TIER 1,8677.0,5640.05,159.5,8677.0,47
CDM,27501615_IP,PPM SGL GEN TIER 1,8677.0,5640.05,5804.91,5804.91,1
CDM,27501615_OP,PPM SGL GEN TIER 1,8677.0,5640.05,5509.9,5509.9,1
CDM,27501625,PPM SGL GEN TIER 2,13831.0,8990.15,159.5,13831.0,47
CDM,27501625_IP,PPM SGL GEN TIER 2,13831.0,8990.15,9252.94,9252.94,1
CDM,27501625_OP,PPM SGL GEN TIER 2,13831.0,8990.15,8782.69,8782.69,1
CDM,27501635,PPM DUAL GEN TIER 1,10250.0,6662.5,159.5,10250.0,47
CDM,27501635_IP,PPM DUAL GEN TIER 1,10250.0,6662.5,6857.25,6857.25,1
CDM,27501635_OP,PPM DUAL GEN TIER 1,10250.0,6662.5,6508.75,6508.75,1
CDM,27501645,PPM BI-V GEN TIER 1,24124.0,15680.6,159.5,24124.0,47
CDM,27501645_IP,PPM BI-V GEN TIER 1,24124.0,15680.6,16138.96,16138.96,1
CDM,27501645_OP,PPM BI-V GEN TIER 1,24124.0,15680.6,15318.74,15318.74,1
CDM,27501655,PPM BI-V GEN TIER 2,34881.0,22672.65,159.5,34881.0,47
CDM,27501655_IP,PPM BI-V GEN TIER 2,34881.0,22672.65,23335.39,23335.39,1
CDM,27501655_OP,PPM BI-V GEN TIER 2,34881.0,22672.65,22149.44,22149.44,1
CDM,27501665,LEAD ICD SHOCK TIER 2,16899.0,10984.35,159.5,16899.0,47
CDM,27501665_IP,LEAD ICD SHOCK TIER 2,16899.0,10984.35,11305.43,11305.43,1
CDM,27501665_OP,LEAD ICD SHOCK TIER 2,16899.0,10984.35,10730.87,10730.87,1
CDM,27501675,LEAD PPM PACING/EPICARD TIER 1,1637.0,1064.05,159.5,1637.0,46
CDM,27501675_IP,LEAD PPM PACING/EPICARD TIER 1,1637.0,1064.05,1095.15,1095.15,1
CDM,27501675_OP,LEAD PPM PACING/EPICARD TIER 1,1637.0,1064.05,1039.5,1039.5,1
CDM,27501685,LEAD PPM PACING/EPICARD TIER 3,5915.0,3844.75,159.5,5915.0,47
CDM,27501685_IP,LEAD PPM PACING/EPICARD TIER 3,5915.0,3844.75,3957.14,3957.14,1
CDM,27501685_OP,LEAD PPM PACING/EPICARD TIER 3,5915.0,3844.75,3756.03,3756.03,1
CDM,27501695,LEAD LV TRANSVENOUS TIER 1,5608.0,3645.2,159.5,5608.0,47
CDM,27501695_IP,LEAD LV TRANSVENOUS TIER 1,5608.0,3645.2,3751.75,3751.75,1
CDM,27501695_OP,LEAD LV TRANSVENOUS TIER 1,5608.0,3645.2,3561.08,3561.08,1
CDM,27501705,LEAD LV TRANSVENOUS TIER 2,7954.0,5170.1,159.5,7954.0,47
CDM,27501705_IP,LEAD LV TRANSVENOUS TIER 2,7954.0,5170.1,5321.23,5321.23,1
CDM,27501705_OP,LEAD LV TRANSVENOUS TIER 2,7954.0,5170.1,5050.79,5050.79,1
CDM,27501715,LEAD LV TRANSVENOUS TIER 3,10694.0,6951.1,159.5,10694.0,47
CDM,27501715_IP,LEAD LV TRANSVENOUS TIER 3,10694.0,6951.1,7154.29,7154.29,1
CDM,27501715_OP,LEAD LV TRANSVENOUS TIER 3,10694.0,6951.1,6790.69,6790.69,1
CDM,27501AK,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,2580.0,1677.0,1.1,2580.0,53
CDM,27502AK,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,4544.0,2953.6,1.1,4544.0,50
CDM,27503AK,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,4508.0,2930.2,1.1,4508.0,50
CDM,27504385,MICRA AV LEADLESS PACEMAKER,30938.0,20109.7,159.5,30938.0,47
CDM,27504385_IP,MICRA AV LEADLESS PACEMAKER,30938.0,20109.7,20697.52,20697.52,1
CDM,27504385_OP,MICRA AV LEADLESS PACEMAKER,30938.0,20109.7,19645.63,19645.63,1
CDM,27505545,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,159.5,17500.0,47
CDM,27505545_IP,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,11707.5,11707.5,1
CDM,27505545_OP,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,11112.5,11112.5,1
CDM,27506AK,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,7860.0,5109.0,1.1,7860.0,50
CDM,27507AK,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5792.0,3764.8,1.1,5792.0,50
CDM,27508AK,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,2480.0,1612.0,1.1,2480.0,53
CDM,27509AK,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,3256.0,2116.4,1.1,12214.27,50
CDM,27510AK,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,3920.0,2548.0,1.1,3920.0,50
CDM,27511AK,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,6648.0,4321.2,1.1,6648.0,50
CDM,27513AK,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,8470.0,5505.5,1.1,8470.0,50
CDM,27514AK,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,5840.0,3796.0,1.1,5840.0,50
CDM,27516AK,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,2236.0,1453.4,1.1,2236.0,53
CDM,27520AK,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1216.0,790.4,1.1,1216.0,53
CDM,27524AK,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,4148.0,2696.2,1.1,12214.27,50
CDM,27530AK,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1166.0,757.9,1.1,1166.0,53
CDM,27532AK,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,3322.0,2159.3,1.1,5526.53,53
CDM,27535AK,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,5364.0,3486.6,1.1,5364.0,50
CDM,27536AK,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,6956.0,4521.4,1.1,6956.0,50
CDM,27538AK,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,2036.0,1323.4,1.1,2036.0,53
CDM,27540AK,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,4520.0,2938.0,1.1,4520.0,50
CDM,27550AK,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,2392.0,1554.8,1.1,2392.0,53
CDM,27552AK,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,3272.0,2126.8,1.1,3272.0,50
CDM,27557AK,OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR,6996.0,4547.4,1.1,6996.0,50
CDM,27560AK,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1596.0,1037.4,1.1,1596.0,53
CDM,27562AK,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,2392.0,1554.8,1.1,2392.0,50
CDM,27570AK,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,716.0,465.4,1.1,2743.55,50
CDM,27580AK,ARTHRODESIS KNEE ANY TECHNIQUE,8440.0,5486.0,1.1,8440.0,50
CDM,27590AK,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,5927.0,3852.55,1.1,5927.0,50
CDM,27592AK,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,4392.0,2854.8,1.1,4392.0,50
CDM,27594AK,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,2916.0,1895.4,1.1,5526.53,50
CDM,27596AK,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,4516.0,2935.4,1.1,4516.0,50
CDM,27599AGRVU1AK,"UNLIST PROC, FEMUR OR KNEE COMPARED TO 29855",1645.0,1069.25,0.01,1645.0,28
CDM,27599AGRVU2AK,"UNLISTED PROCEDURE, FEMUR OR KNEE COMPARED TO CPT 27365",8356.0,5431.4,0.01,8356.0,28
CDM,27599AGRVUAK,"UNLIST PROC, FEMUR OR KNEE COMPARED TO 27509",1190.0,773.5,0.01,1190.0,28
CDM,27599RVU19AK,"UNLISTED PROC, POLYETHYLENE EXCHANGE FOR A PARTIAL KNEE REPLACEM",5864.0,3811.6,0.01,5864.0,28
CDM,27599RVU20AK,PERCUTANEOUS ULTRASOUND GUIDED TENOTOMY OF LEFT KNEE (COMP TO 24,1795.0,1166.75,0.01,1795.0,28
CDM,27599RVU21AK,"REPAIR OF GLUTEUS MEDIUS INSERTION, RIGHT HIP (COMP TO 27385)",2269.0,1474.85,0.01,2269.0,28
CDM,27599RVU22AK,TREATMENT OF OSSEOUS FEMORAL HEAD & NECK METATSTATIC DISEASE W/I,769.0,499.85,0.01,769.0,28
CDM,27599RVU23AK,STAGE 1 OSSEOINTEGRATION (COMP CODE 27495),7112.0,4622.8,0.01,7112.0,28
CDM,27599RVU24AK,MANIPULATION KNEE JOINT NOT UNDER GENERAL ANESTHESIA (COMP CODE,769.0,499.85,0.01,769.0,28
CDM,27599RVU25AK,"ARTHROPLASTY FEMORAL/FEMUR/PATELLA, KNEE (COMP CODE 27446)",7365.0,4787.25,0.01,7365.0,28
CDM,27599RVU26AK,"ALLOGRAFT STRUT, FEMUR (COMP CODE 27472)",8050.0,5232.5,0.01,8050.0,28
CDM,27599RVU27AK,OPEN REPAIR OF MEDIAL RETINACULUM (COMP CODE 27424),4096.0,2662.4,0.01,4096.0,28
CDM,27600AK,DECOMPRESS ANT/LAT LEG CMPART,2412.0,1567.8,1.1,5526.53,50
CDM,27601AK,DECOMPRESS POST LEG COMPARTMT,2420.0,1573.0,1.1,5526.53,50
CDM,27602AK,DECOMPRESS ANT/LAT+POST LEG CMPART,3128.0,2033.2,1.1,5526.53,50
CDM,27603AK,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,2092.0,1359.8,1.1,4850.94,53
CDM,27604AK,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,1836.0,1193.4,1.1,5526.53,53
CDM,27605AK,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,1168.0,759.2,1.1,2743.55,53
CDM,27606AK,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,1672.0,1086.8,1.1,5526.53,50
CDM,27607AK,INCISION LEG/ANKLE,3448.0,2241.2,1.1,5526.53,50
CDM,27610AK,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,3652.0,2373.8,1.1,5526.53,50
CDM,27612AK,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,3260.0,2119.0,1.1,5526.53,50
CDM,27613AK,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,888.0,577.2,1.1,2768.64,53
CDM,27614AK,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,2320.0,1508.0,1.1,4850.94,53
CDM,27616AK,RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5+CM,7852.0,5103.8,1.1,7852.0,50
CDM,27618AK,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
CDM,27619AK,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,2764.0,1796.6,1.1,4850.94,50
CDM,27620AK,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,2460.0,1599.0,1.1,5526.53,50
CDM,27625AK,ARTHROTOMY W/SYNOVECTOMY ANKLE,3396.0,2207.4,1.1,5526.53,50
CDM,27626AK,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,3640.0,2366.0,1.1,5526.53,50
CDM,27630AK,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,1976.0,1284.4,1.1,5526.53,53
CDM,27632AK,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM,2364.0,1536.6,1.1,4850.94,50
CDM,27634AK,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,4052.0,2633.8,1.1,4850.94,50
CDM,27635AK,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,3212.0,2087.8,1.1,5526.53,50
CDM,27638AK,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,4396.0,2857.4,1.1,12214.27,50
CDM,27640AK,PARTIAL EXCISION BONE TIBIA,4896.0,3182.4,1.1,5526.53,50
CDM,27641AK,PARTIAL EXCISION BONE FIBULA,3936.0,2558.4,1.1,5526.53,50
CDM,27646AK,"RAD RESEC TUMOR,FIBULA",9284.0,6034.6,1.1,9284.0,50
CDM,27650AK,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,3684.0,2394.6,1.1,12214.27,50
CDM,27652AK,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,4312.0,2802.8,1.1,12214.27,50
CDM,27654AK,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,4212.0,2737.8,1.1,12214.27,50
CDM,27658AK,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,2048.0,1331.2,1.1,5526.53,50
CDM,27659AK,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,2840.0,1846.0,1.1,12214.27,50
CDM,27664AK,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,1892.0,1229.8,1.1,12214.27,50
CDM,27665AK,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,2228.0,1448.2,1.1,12214.27,50
CDM,27675AK,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,2940.0,1911.0,1.1,5526.53,50
CDM,27676AK,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,3492.0,2269.8,1.1,12214.27,50
CDM,27680AK,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,2352.0,1528.8,1.1,5526.53,50
CDM,27681AK,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,2820.0,1833.0,1.1,5526.53,50
CDM,27685AK,"LENGTH/SHORT LEG/ANKL TENDON,SINGLE",2676.0,1739.4,1.1,5526.53,53
CDM,27687AK,GASTROCNEMIUS RECESSION,2564.0,1666.6,1.1,5526.53,50
CDM,27690AK,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,3668.0,2384.2,1.1,12214.27,50
CDM,27691AK,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,4196.0,2727.4,1.1,12214.27,50
CDM,27692AK,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,748.0,486.2,1.1,748.0,50
CDM,27695AK,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,2680.0,1742.0,1.1,12214.27,50
CDM,27696AK,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,3432.0,2230.8,1.1,12214.27,50
CDM,27698AK,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,3844.0,2498.6,1.1,12214.27,50
CDM,27704AK,REMOVAL OF ANKLE IMPLANT,3124.0,2030.6,1.1,5526.53,50
CDM,27705AK,OSTEOTOMY TIBIA,4344.0,2823.6,1.1,12214.27,50
CDM,27707AK,OSTEOTOMY FIBULA,1912.0,1242.8,1.1,5526.53,50
CDM,27709AK,OSTEOTOMY TIBIA & FIBULA,6992.0,4544.8,1.1,22471.68,50
CDM,27713AK,OSTEOT TIBIA UNI INSJ XTRNL CTRLD IMED LNGTH DEV,12320.0,8008.0,1.1,12320.0,35
CDM,27715AK,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,6200.0,4030.0,1.1,6200.0,50
CDM,27720AK,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,4944.0,3213.6,1.1,12214.27,50
CDM,27722AK,REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT,5478.0,3560.7,1.1,12214.27,50
CDM,27724AK,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,7724.0,5020.6,1.1,7724.0,50
CDM,27726AK,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,5736.0,3728.4,1.1,12214.27,50
CDM,27745AK,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,4196.0,2727.4,1.1,12214.27,50
CDM,27750AK,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1348.0,876.2,1.1,1348.0,53
CDM,27752AK,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,2508.0,1630.2,1.1,2743.55,53
CDM,27756AK,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,2980.0,1937.0,1.1,12214.27,50
CDM,27758AK,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5016.0,3260.4,1.1,22471.68,50
CDM,27759AK,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,5780.0,3757.0,1.1,22471.68,50
CDM,27760AK,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1284.0,834.6,1.1,1284.0,53
CDM,27762AK,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,2188.0,1422.2,1.1,2743.55,53
CDM,27766AK,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,3156.0,2051.4,1.1,12214.27,50
CDM,27767AK,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1056.0,686.4,1.1,1056.0,52
CDM,27768AK,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,2056.0,1336.4,1.1,2743.55,50
CDM,27769AK,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,4056.0,2636.4,1.1,12214.27,50
CDM,27780AK,CLTX PROX FIBULA/SHFT FX W/O MANJ,1132.0,735.8,1.1,1132.0,53
CDM,27781AK,CLTX PROX FIBULA/SHFT FX W/MANJ,1836.0,1193.4,1.1,2743.55,53
CDM,27784AK,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,3868.0,2514.2,1.1,12214.27,50
CDM,27786AK,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1208.0,785.2,1.1,1208.0,53
CDM,27788AK,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1856.0,1206.4,1.1,1856.0,53
CDM,27792AK,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,3500.0,2275.0,1.1,12214.27,50
CDM,27801045,BRACHYTX NON-STR HDR IR-192,543.0,352.95,153.56,980.75,61
CDM,27801045_IP,BRACHYTX NON-STR HDR IR-192,543.0,352.95,216.66,216.66,1
CDM,27801045_OP,BRACHYTX NON-STR HDR IR-192,543.0,352.95,210.14,210.14,1
CDM,27801085,"H980006 BRACHYTX,NON-STR,90 TH",79000.0,51350.0,10410.03,79000.0,62
CDM,27801085_IP,"H980006 BRACHYTX,NON-STR,90 TH",79000.0,51350.0,52851.0,52851.0,1
CDM,27801085_OP,"H980006 BRACHYTX,NON-STR,90 TH",79000.0,51350.0,50165.0,50165.0,1
CDM,27801115,"BRACHYTX, STRANDED, I-125",215.0,139.75,32.65,284.74,61
CDM,27801115_IP,"BRACHYTX, STRANDED, I-125",215.0,139.75,85.79,85.79,1
CDM,27801115_OP,"BRACHYTX, STRANDED, I-125",215.0,139.75,83.21,83.21,1
CDM,27802020,W DEVICE CLSURE VASC IMP/INSRT,1004.0,652.6,149.4,1004.0,46
CDM,27802020_IP,W DEVICE CLSURE VASC IMP/INSRT,1004.0,652.6,400.6,400.6,1
CDM,27802020_OP,W DEVICE CLSURE VASC IMP/INSRT,1004.0,652.6,388.55,388.55,1
CDM,27804860,W IMP LD NSTM TST,2525.0,1641.25,159.5,2525.0,46
CDM,27804860_IP,W IMP LD NSTM TST,2525.0,1641.25,1689.23,1689.23,1
CDM,27804860_OP,W IMP LD NSTM TST,2525.0,1641.25,1603.38,1603.38,1
CDM,27805100,W INJ BULK AGENT COLLAGEN IMP U,1765.0,1147.25,384.77,1765.0,46
CDM,27805100_IP,W INJ BULK AGENT COLLAGEN IMP U,1765.0,1147.25,1180.79,1180.79,1
CDM,27805100_OP,W INJ BULK AGENT COLLAGEN IMP U,1765.0,1147.25,1120.78,1120.78,1
CDM,27806430,W LOOP RECORDER REVEAL DX 9528,25586.0,16630.9,159.5,25586.0,47
CDM,27806430_IP,W LOOP RECORDER REVEAL DX 9528,25586.0,16630.9,17117.03,17117.03,1
CDM,27806430_OP,W LOOP RECORDER REVEAL DX 9528,25586.0,16630.9,16247.11,16247.11,1
CDM,27807985,TISSUE MARKER,911.0,592.15,135.56,911.0,46
CDM,27807985_IP,TISSUE MARKER,911.0,592.15,363.49,363.49,1
CDM,27807985_OP,TISSUE MARKER,911.0,592.15,352.56,352.56,1
CDM,27808AK,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1212.0,787.8,1.1,1212.0,53
CDM,27809010,W $ PORT INDWELLING IMP,1451.0,943.15,159.5,1451.0,46
CDM,27809010_IP,W $ PORT INDWELLING IMP,1451.0,943.15,970.72,970.72,1
CDM,27809010_OP,W $ PORT INDWELLING IMP,1451.0,943.15,921.39,921.39,1
CDM,27810AK,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,2128.0,1383.2,1.1,2743.55,53
CDM,27813290,W STENT LIFE FLEXSTAR SELF EXP,4481.0,2912.65,159.5,4481.0,46
CDM,27813290_IP,W STENT LIFE FLEXSTAR SELF EXP,4481.0,2912.65,2997.79,2997.79,1
CDM,27813290_OP,W STENT LIFE FLEXSTAR SELF EXP,4481.0,2912.65,2845.44,2845.44,1
CDM,27813330,W $ STENT NONCOR TEMP W/O DEL SYS,377.0,245.05,56.1,377.0,46
CDM,27813330_IP,W $ STENT NONCOR TEMP W/O DEL SYS,377.0,245.05,150.42,150.42,1
CDM,27813330_OP,W $ STENT NONCOR TEMP W/O DEL SYS,377.0,245.05,145.9,145.9,1
CDM,27813480,W STENT VIABAHN VBH061502,19871.0,12916.15,159.5,19871.0,47
CDM,27813480_IP,W STENT VIABAHN VBH061502,19871.0,12916.15,13293.7,13293.7,1
CDM,27813480_OP,W STENT VIABAHN VBH061502,19871.0,12916.15,12618.09,12618.09,1
CDM,27813890,W STNT NCOAT/COV,5536.0,3598.4,159.5,5536.0,47
CDM,27813890_IP,W STNT NCOAT/COV,5536.0,3598.4,3703.58,3703.58,1
CDM,27813890_OP,W STNT NCOAT/COV,5536.0,3598.4,3515.36,3515.36,1
CDM,27813900,W STNT NCOAT/COV2,3169.0,2059.85,159.5,3169.0,46
CDM,27813900_IP,W STNT NCOAT/COV2,3169.0,2059.85,2120.06,2120.06,1
CDM,27813900_OP,W STNT NCOAT/COV2,3169.0,2059.85,2012.32,2012.32,1
CDM,27813910,W STNT NCOAT/COV3,3294.0,2141.1,159.5,3294.0,46
CDM,27813910_IP,W STNT NCOAT/COV3,3294.0,2141.1,2203.69,2203.69,1
CDM,27813910_OP,W STNT NCOAT/COV3,3294.0,2141.1,2091.69,2091.69,1
CDM,27813940,W STNT PERCU SFT,609.0,395.85,90.62,609.0,46
CDM,27813940_IP,W STNT PERCU SFT,609.0,395.85,242.99,242.99,1
CDM,27813940_OP,W STNT PERCU SFT,609.0,395.85,235.68,235.68,1
CDM,27814AK,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,4248.0,2761.2,1.1,12214.27,50
CDM,27815280,W STENT 6MMX170MM LIFESTENT XL,5798.0,3768.7,159.5,5798.0,47
CDM,27815280_IP,W STENT 6MMX170MM LIFESTENT XL,5798.0,3768.7,3878.86,3878.86,1
CDM,27815280_OP,W STENT 6MMX170MM LIFESTENT XL,5798.0,3768.7,3681.73,3681.73,1
CDM,27816400,DEV CLSR 6FR EXOSEAL VASC,872.0,566.8,129.75,872.0,46
CDM,27816400_IP,DEV CLSR 6FR EXOSEAL VASC,872.0,566.8,347.93,347.93,1
CDM,27816400_OP,DEV CLSR 6FR EXOSEAL VASC,872.0,566.8,337.46,337.46,1
CDM,27816530,W STENT DRUG ELUTING PROMUS,5282.0,3433.3,159.5,5282.0,47
CDM,27816530_IP,W STENT DRUG ELUTING PROMUS,5282.0,3433.3,3533.66,3533.66,1
CDM,27816530_OP,W STENT DRUG ELUTING PROMUS,5282.0,3433.3,3354.07,3354.07,1
CDM,27816690,W STENT BIL HERCULNK ELITE,3962.0,2575.3,159.5,3962.0,46
CDM,27816690_IP,W STENT BIL HERCULNK ELITE,3962.0,2575.3,2650.58,2650.58,1
CDM,27816690_OP,W STENT BIL HERCULNK ELITE,3962.0,2575.3,2515.87,2515.87,1
CDM,27816AK,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1351.0,878.15,1.1,1351.0,53
CDM,27817060,"BRACHY SOURCE TX, STRANDED I-125",195.0,126.75,32.65,284.74,61
CDM,27817060_IP,"BRACHY SOURCE TX, STRANDED I-125",195.0,126.75,77.81,77.81,1
CDM,27817060_OP,"BRACHY SOURCE TX, STRANDED I-125",195.0,126.75,75.47,75.47,1
CDM,27817250,W ELECTRODE Q-TRAK,23739.0,15430.35,159.5,23739.0,47
CDM,27817250_IP,W ELECTRODE Q-TRAK,23739.0,15430.35,15881.39,15881.39,1
CDM,27817250_OP,W ELECTRODE Q-TRAK,23739.0,15430.35,15074.27,15074.27,1
CDM,27817650,W IMP TISSUE MARKER BREAST,442.0,287.3,65.77,442.0,46
CDM,27817650_IP,W IMP TISSUE MARKER BREAST,442.0,287.3,176.36,176.36,1
CDM,27817650_OP,W IMP TISSUE MARKER BREAST,442.0,287.3,171.05,171.05,1
CDM,27818055,MICRO VASCULAR PLUG MVP-5 US,8526.0,5541.9,159.5,8526.0,47
CDM,27818055_IP,MICRO VASCULAR PLUG MVP-5 US,8526.0,5541.9,5703.89,5703.89,1
CDM,27818055_OP,MICRO VASCULAR PLUG MVP-5 US,8526.0,5541.9,5414.01,5414.01,1
CDM,27818540,BRACHYTX NON-STR HDR IR-192,543.0,352.95,153.56,980.75,61
CDM,27818540_IP,BRACHYTX NON-STR HDR IR-192,543.0,352.95,216.66,216.66,1
CDM,27818540_OP,BRACHYTX NON-STR HDR IR-192,543.0,352.95,210.14,210.14,1
CDM,27818550,IVC FIILTER TIER I,4718.0,3066.7,159.5,4718.0,46
CDM,27818550_IP,IVC FIILTER TIER I,4718.0,3066.7,3156.34,3156.34,1
CDM,27818550_OP,IVC FIILTER TIER I,4718.0,3066.7,2995.93,2995.93,1
CDM,27818575,STENT CTD/COV W/DEL MAQUET,8803.0,5721.95,159.5,8803.0,47
CDM,27818575_IP,STENT CTD/COV W/DEL MAQUET,8803.0,5721.95,5889.21,5889.21,1
CDM,27818575_OP,STENT CTD/COV W/DEL MAQUET,8803.0,5721.95,5589.91,5589.91,1
CDM,27818680,WATCHMAN DEVICE CAP 1-3 UNITS,62050.0,40332.5,9233.04,62050.0,39
CDM,27818680_IP,WATCHMAN DEVICE CAP 1-3 UNITS,62050.0,40332.5,41511.45,41511.45,1
CDM,27818680_OP,WATCHMAN DEVICE CAP 1-3 UNITS,62050.0,40332.5,39401.75,39401.75,1
CDM,27818685,WATCHMAN DEVICE CAP EA ADD,62050.0,40332.5,9233.04,62050.0,39
CDM,27818685_IP,WATCHMAN DEVICE CAP EA ADD,62050.0,40332.5,41511.45,41511.45,1
CDM,27818685_OP,WATCHMAN DEVICE CAP EA ADD,62050.0,40332.5,39401.75,39401.75,1
CDM,27818700,ANGIOSEAL,685.0,445.25,101.93,685.0,46
CDM,27818700_IP,ANGIOSEAL,685.0,445.25,273.32,273.32,1
CDM,27818700_OP,ANGIOSEAL,685.0,445.25,265.1,265.1,1
CDM,27818715,DRUG ELUTING STENT,7393.0,4805.45,159.5,7393.0,47
CDM,27818715_IP,DRUG ELUTING STENT,7393.0,4805.45,4945.92,4945.92,1
CDM,27818715_OP,DRUG ELUTING STENT,7393.0,4805.45,4694.56,4694.56,1
CDM,27818AK,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,2504.0,1627.6,1.1,2743.55,53
CDM,27820935,LEAD NEUROSTIMULATOR C1778 (278),14965.0,9727.25,159.5,14965.0,47
CDM,27820935_IP,LEAD NEUROSTIMULATOR C1778 (278),14965.0,9727.25,10011.59,10011.59,1
CDM,27820935_OP,LEAD NEUROSTIMULATOR C1778 (278),14965.0,9727.25,9502.78,9502.78,1
CDM,27821315,RX ACCULINK CAROTID STENT,10797.0,7018.05,159.5,10797.0,47
CDM,27821315_IP,RX ACCULINK CAROTID STENT,10797.0,7018.05,7223.19,7223.19,1
CDM,27821315_OP,RX ACCULINK CAROTID STENT,10797.0,7018.05,6856.1,6856.1,1
CDM,27822AK,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,4484.0,2914.6,1.1,12214.27,50
CDM,27823AK,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,5264.0,3421.6,1.1,12214.27,50
CDM,27824AK,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1324.0,860.6,1.1,1324.0,53
CDM,27825AK,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,2676.0,1739.4,1.1,2743.55,53
CDM,27826AK,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,4440.0,2886.0,1.1,12214.27,50
CDM,27827AK,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,5916.0,3845.4,1.1,22471.68,50
CDM,27828AK,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,7372.0,4791.8,1.1,22471.68,50
CDM,27829AK,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,3520.0,2288.0,1.1,12214.27,50
CDM,27830AK,CLTX PROX TIBFIB JT DISLC W/O ANES,1584.0,1029.6,1.1,1584.0,53
CDM,27832645,CARDIOMEMS SENSOR/DELIV SYSTEM,63875.0,41518.75,159.5,63875.0,47
CDM,27832645_IP,CARDIOMEMS SENSOR/DELIV SYSTEM,63875.0,41518.75,42732.38,42732.38,1
CDM,27832645_OP,CARDIOMEMS SENSOR/DELIV SYSTEM,63875.0,41518.75,40560.63,40560.63,1
CDM,27832835,EMBOLIZATION COILS,1816.0,1180.4,270.22,1816.0,38
CDM,27832835_IP,EMBOLIZATION COILS,1816.0,1180.4,1214.9,1214.9,1
CDM,27832835_OP,EMBOLIZATION COILS,1816.0,1180.4,1153.16,1153.16,1
CDM,27832875,TRUFILL LIQUID EMBOLIC,13531.0,8795.15,2013.41,13531.0,39
CDM,27832875_IP,TRUFILL LIQUID EMBOLIC,13531.0,8795.15,9052.24,9052.24,1
CDM,27832875_OP,TRUFILL LIQUID EMBOLIC,13531.0,8795.15,8592.19,8592.19,1
CDM,27832AK,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,4475.0,2908.75,1.1,12214.27,50
CDM,27840015,GEL MARKER,825.0,536.25,122.76,825.0,46
CDM,27840015_IP,GEL MARKER,825.0,536.25,80.2,80.2,1
CDM,27840015_OP,GEL MARKER,825.0,536.25,77.79,77.79,1
CDM,27840025,"STENT, GRAFTMASTER",12624.0,8205.6,159.5,12624.0,47
CDM,27840025_IP,"STENT, GRAFTMASTER",12624.0,8205.6,8445.46,8445.46,1
CDM,27840025_OP,"STENT, GRAFTMASTER",12624.0,8205.6,8016.24,8016.24,1
CDM,27840035,"STENT, VIATORR",20557.0,13362.05,159.5,20557.0,47
CDM,27840035_IP,"STENT, VIATORR",20557.0,13362.05,13752.63,13752.63,1
CDM,27840035_OP,"STENT, VIATORR",20557.0,13362.05,13053.7,13053.7,1
CDM,27840045,"STENT, WALLFLEX",15808.0,10275.2,159.5,15808.0,47
CDM,27840045_IP,"STENT, WALLFLEX",15808.0,10275.2,10575.55,10575.55,1
CDM,27840045_OP,"STENT, WALLFLEX",15808.0,10275.2,10038.08,10038.08,1
CDM,27840055,"STENT, WALLSTENT W DEL SYS",5486.0,3565.9,159.5,5486.0,47
CDM,27840055_IP,"STENT, WALLSTENT W DEL SYS",5486.0,3565.9,3670.13,3670.13,1
CDM,27840055_OP,"STENT, WALLSTENT W DEL SYS",5486.0,3565.9,3483.61,3483.61,1
CDM,27840065,"STENT, ENTERPRISE",26275.0,17078.75,159.5,26275.0,47
CDM,27840065_IP,"STENT, ENTERPRISE",26275.0,17078.75,17577.98,17577.98,1
CDM,27840065_OP,"STENT, ENTERPRISE",26275.0,17078.75,16684.63,16684.63,1
CDM,27840075,"STENT, ACCULINK",10610.0,6896.5,159.5,10610.0,47
CDM,27840075_IP,"STENT, ACCULINK",10610.0,6896.5,7098.09,7098.09,1
CDM,27840075_OP,"STENT, ACCULINK",10610.0,6896.5,6737.35,6737.35,1
CDM,27840085,"STENT, OMNILINK OTW",3618.0,2351.7,159.5,3618.0,46
CDM,27840085_IP,"STENT, OMNILINK OTW",3618.0,2351.7,2420.44,2420.44,1
CDM,27840085_OP,"STENT, OMNILINK OTW",3618.0,2351.7,2297.43,2297.43,1
CDM,27840095,"STENT, NEUROFORM",28663.0,18630.95,159.5,28663.0,47
CDM,27840095_IP,"STENT, NEUROFORM",28663.0,18630.95,19175.55,19175.55,1
CDM,27840095_OP,"STENT, NEUROFORM",28663.0,18630.95,18201.01,18201.01,1
CDM,27840105,"COIL, CONCERTO HELIX",3300.0,2145.0,491.04,3300.0,38
CDM,27840105_IP,"COIL, CONCERTO HELIX",3300.0,2145.0,2207.7,2207.7,1
CDM,27840105_OP,"COIL, CONCERTO HELIX",3300.0,2145.0,2095.5,2095.5,1
CDM,27840115,"SPHERE, CONTOUR EMBOSPHERE",1302.0,846.3,193.74,1302.0,38
CDM,27840115_IP,"SPHERE, CONTOUR EMBOSPHERE",1302.0,846.3,871.04,871.04,1
CDM,27840115_OP,"SPHERE, CONTOUR EMBOSPHERE",1302.0,846.3,826.77,826.77,1
CDM,27840125,"CATH, TENCKHOFF",2208.0,1435.2,328.55,2208.0,38
CDM,27840125_IP,"CATH, TENCKHOFF",2208.0,1435.2,1477.15,1477.15,1
CDM,27840125_OP,"CATH, TENCKHOFF",2208.0,1435.2,1402.08,1402.08,1
CDM,27840135,SPINAL CEMENT SYSTEM,4220.0,2743.0,627.94,4220.0,38
CDM,27840135_IP,SPINAL CEMENT SYSTEM,4220.0,2743.0,2823.18,2823.18,1
CDM,27840135_OP,SPINAL CEMENT SYSTEM,4220.0,2743.0,2679.7,2679.7,1
CDM,27840145,LC BEAD EMBOLIZATION DEVICE,10230.0,6649.5,1522.22,10230.0,39
CDM,27840145_IP,LC BEAD EMBOLIZATION DEVICE,10230.0,6649.5,6843.87,6843.87,1
CDM,27840145_OP,LC BEAD EMBOLIZATION DEVICE,10230.0,6649.5,6496.05,6496.05,1
CDM,27840155,KYPHO BONE CEMENT,924.0,600.6,137.49,924.0,38
CDM,27840155_IP,KYPHO BONE CEMENT,924.0,600.6,368.68,368.68,1
CDM,27840155_OP,KYPHO BONE CEMENT,924.0,600.6,357.59,357.59,1
CDM,27840165,"COIL, EMBOLIZATION",489.0,317.85,72.76,489.0,38
CDM,27840165_IP,"COIL, EMBOLIZATION",489.0,317.85,195.11,195.11,1
CDM,27840165_OP,"COIL, EMBOLIZATION",489.0,317.85,189.24,189.24,1
CDM,27840175,"COIL, GDC 18 2-DIAM",2878.0,1870.7,428.25,2878.0,38
CDM,27840175_IP,"COIL, GDC 18 2-DIAM",2878.0,1870.7,1925.38,1925.38,1
CDM,27840175_OP,"COIL, GDC 18 2-DIAM",2878.0,1870.7,1827.53,1827.53,1
CDM,27840185,"COIL, GDC 18 3D SHAPE",4225.0,2746.25,628.68,4225.0,38
CDM,27840185_IP,"COIL, GDC 18 3D SHAPE",4225.0,2746.25,2826.53,2826.53,1
CDM,27840185_OP,"COIL, GDC 18 3D SHAPE",4225.0,2746.25,2682.88,2682.88,1
CDM,27840195,"COIL, GDC 10 2-DIAM",2113.0,1373.45,314.41,2113.0,38
CDM,27840195_IP,"COIL, GDC 10 2-DIAM",2113.0,1373.45,1413.6,1413.6,1
CDM,27840195_OP,"COIL, GDC 10 2-DIAM",2113.0,1373.45,1341.76,1341.76,1
CDM,27840205,"COIL, GDC 10 ULTRASOFT",3169.0,2059.85,471.55,3169.0,38
CDM,27840205_IP,"COIL, GDC 10 ULTRASOFT",3169.0,2059.85,2120.06,2120.06,1
CDM,27840205_OP,"COIL, GDC 10 ULTRASOFT",3169.0,2059.85,2012.32,2012.32,1
CDM,27840215,"COIL, GDC 10 SOFT SR/2D SR",3169.0,2059.85,471.55,3169.0,38
CDM,27840215_IP,"COIL, GDC 10 SOFT SR/2D SR",3169.0,2059.85,2120.06,2120.06,1
CDM,27840215_OP,"COIL, GDC 10 SOFT SR/2D SR",3169.0,2059.85,2012.32,2012.32,1
CDM,27840225,"COIL, GDC 10 3D SHAPE",3962.0,2575.3,589.55,3962.0,38
CDM,27840225_IP,"COIL, GDC 10 3D SHAPE",3962.0,2575.3,2650.58,2650.58,1
CDM,27840225_OP,"COIL, GDC 10 3D SHAPE",3962.0,2575.3,2515.87,2515.87,1
CDM,27840235,"COIL, 360 STAND/SOFT/ULTRA",5635.0,3662.75,838.49,5635.0,39
CDM,27840235_IP,"COIL, 360 STAND/SOFT/ULTRA",5635.0,3662.75,3769.82,3769.82,1
CDM,27840235_OP,"COIL, 360 STAND/SOFT/ULTRA",5635.0,3662.75,3578.23,3578.23,1
CDM,27840245,"COIL, 360 HELICAL ULTRA",5635.0,3662.75,838.49,5635.0,39
CDM,27840245_IP,"COIL, 360 HELICAL ULTRA",5635.0,3662.75,3769.82,3769.82,1
CDM,27840245_OP,"COIL, 360 HELICAL ULTRA",5635.0,3662.75,3578.23,3578.23,1
CDM,27840255,"COIL, HELIX",2878.0,1870.7,428.25,2878.0,38
CDM,27840255_IP,"COIL, HELIX",2878.0,1870.7,1925.38,1925.38,1
CDM,27840255_OP,"COIL, HELIX",2878.0,1870.7,1827.53,1827.53,1
CDM,27840265,"COIL, AXIUM 3D",3962.0,2575.3,589.55,3962.0,38
CDM,27840265_IP,"COIL, AXIUM 3D",3962.0,2575.3,2650.58,2650.58,1
CDM,27840265_OP,"COIL, AXIUM 3D",3962.0,2575.3,2515.87,2515.87,1
CDM,27840275,"STENT SYSTEM, WINGSPAN",23675.0,15388.75,3522.84,23675.0,39
CDM,27840275_IP,"STENT SYSTEM, WINGSPAN",23675.0,15388.75,15838.58,15838.58,1
CDM,27840275_OP,"STENT SYSTEM, WINGSPAN",23675.0,15388.75,15033.63,15033.63,1
CDM,27840285,PIPELINE EMBOLIZATION DEVICE,68131.0,44285.15,10137.89,68131.0,39
CDM,27840285_IP,PIPELINE EMBOLIZATION DEVICE,68131.0,44285.15,45579.64,45579.64,1
CDM,27840285_OP,PIPELINE EMBOLIZATION DEVICE,68131.0,44285.15,43263.19,43263.19,1
CDM,27840295,"COIL, VORT X DIAMOND",404.0,262.6,60.12,404.0,38
CDM,27840295_IP,"COIL, VORT X DIAMOND",404.0,262.6,161.2,161.2,1
CDM,27840295_OP,"COIL, VORT X DIAMOND",404.0,262.6,156.35,156.35,1
CDM,27840305,SPINAL CEMENT SYSTEM 11CC,4225.0,2746.25,628.68,4225.0,38
CDM,27840305_IP,SPINAL CEMENT SYSTEM 11CC,4225.0,2746.25,2826.53,2826.53,1
CDM,27840305_OP,SPINAL CEMENT SYSTEM 11CC,4225.0,2746.25,2682.88,2682.88,1
CDM,27840315,SPINAL CEMENT SYSTEM 5CC,3169.0,2059.85,471.55,3169.0,38
CDM,27840315_IP,SPINAL CEMENT SYSTEM 5CC,3169.0,2059.85,2120.06,2120.06,1
CDM,27840315_OP,SPINAL CEMENT SYSTEM 5CC,3169.0,2059.85,2012.32,2012.32,1
CDM,27840325,"COIL, GDC 18 2-DIAM SOFT",5254.0,3415.1,781.8,5254.0,39
CDM,27840325_IP,"COIL, GDC 18 2-DIAM SOFT",5254.0,3415.1,3514.93,3514.93,1
CDM,27840325_OP,"COIL, GDC 18 2-DIAM SOFT",5254.0,3415.1,3336.29,3336.29,1
CDM,27840335,"COIL, 360 TARGET SOFT",14364.0,9336.6,2137.36,14364.0,39
CDM,27840335_IP,"COIL, 360 TARGET SOFT",14364.0,9336.6,9609.52,9609.52,1
CDM,27840335_OP,"COIL, 360 TARGET SOFT",14364.0,9336.6,9121.14,9121.14,1
CDM,27840445,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,159.5,5275.0,47
CDM,27840445_IP,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,3528.98,3528.98,1
CDM,27840445_OP,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,3349.63,3349.63,1
CDM,27840475,TYRX ENVELOPE,6839.0,4445.35,1017.64,6839.0,39
CDM,27840485,ICD SGL GEN TIER 1,37780.0,24557.0,159.5,37780.0,47
CDM,27840485_IP,ICD SGL GEN TIER 1,37780.0,24557.0,25274.82,25274.82,1
CDM,27840485_OP,ICD SGL GEN TIER 1,37780.0,24557.0,23990.3,23990.3,1
CDM,27840495,ICD SGL GEN TIER 2,46738.0,30379.7,159.5,46738.0,47
CDM,27840495_IP,ICD SGL GEN TIER 2,46738.0,30379.7,31267.72,31267.72,1
CDM,27840495_OP,ICD SGL GEN TIER 2,46738.0,30379.7,29678.63,29678.63,1
CDM,27840505,ICD SGL GEN TIER 4,51000.0,33150.0,159.5,51000.0,47
CDM,27840505_IP,ICD SGL GEN TIER 4,51000.0,33150.0,60060.81,60060.81,1
CDM,27840505_OP,ICD SGL GEN TIER 4,51000.0,33150.0,57008.4,57008.4,1
CDM,27840515,ICD BI-V GEN TIER 1,61524.0,39990.6,159.5,61524.0,47
CDM,27840515_IP,ICD BI-V GEN TIER 1,61524.0,39990.6,41159.56,41159.56,1
CDM,27840515_OP,ICD BI-V GEN TIER 1,61524.0,39990.6,39067.74,39067.74,1
CDM,27840525,ICD BI-V GEN TIER 2,80249.0,52161.85,159.5,80249.0,47
CDM,27840525_IP,ICD BI-V GEN TIER 2,80249.0,52161.85,53686.58,53686.58,1
CDM,27840525_OP,ICD BI-V GEN TIER 2,80249.0,52161.85,50958.12,50958.12,1
CDM,27840535,ICD BI-V GEN TIER 3,88721.0,57668.65,159.5,88721.0,47
CDM,27840535_IP,ICD BI-V GEN TIER 3,88721.0,57668.65,59354.35,59354.35,1
CDM,27840535_OP,ICD BI-V GEN TIER 3,88721.0,57668.65,56337.84,56337.84,1
CDM,27840545,ICD BI-V GEN TIER 4,98755.0,64190.75,159.5,98755.0,47
CDM,27840545_IP,ICD BI-V GEN TIER 4,98755.0,64190.75,66067.1,66067.1,1
CDM,27840545_OP,ICD BI-V GEN TIER 4,98755.0,64190.75,62709.43,62709.43,1
CDM,27840555,"BALLOON, INTRA AORTIC",4877.0,3170.05,159.5,4877.0,47
CDM,27840555_IP,"BALLOON, INTRA AORTIC",4877.0,3170.05,3262.71,3262.71,1
CDM,27840555_OP,"BALLOON, INTRA AORTIC",4877.0,3170.05,3096.9,3096.9,1
CDM,27840565,JOMED STENT,12656.0,8226.4,159.5,12656.0,47
CDM,27840565_IP,JOMED STENT,12656.0,8226.4,8466.86,8466.86,1
CDM,27840565_OP,JOMED STENT,12656.0,8226.4,8036.56,8036.56,1
CDM,27840575,MEDTRONIC STENT DRUG ELUTING,7117.0,4626.05,159.5,7117.0,47
CDM,27840575_IP,MEDTRONIC STENT DRUG ELUTING,7117.0,4626.05,4761.27,4761.27,1
CDM,27840575_OP,MEDTRONIC STENT DRUG ELUTING,7117.0,4626.05,4519.3,4519.3,1
CDM,27840585,"CATHETER, VENTRIC EVD",1297.0,843.05,192.99,1297.0,38
CDM,27840585_IP,"CATHETER, VENTRIC EVD",1297.0,843.05,867.69,867.69,1
CDM,27840585_OP,"CATHETER, VENTRIC EVD",1297.0,843.05,823.6,823.6,1
CDM,27840595,"CATHETER, VENTRIC BACTISEAL",3205.0,2083.25,476.9,3205.0,38
CDM,27840595_IP,"CATHETER, VENTRIC BACTISEAL",3205.0,2083.25,2144.15,2144.15,1
CDM,27840595_OP,"CATHETER, VENTRIC BACTISEAL",3205.0,2083.25,2035.18,2035.18,1
CDM,27840605,EXACTA DRAINAGE SYSTEM,979.0,636.35,145.68,979.0,38
CDM,27840605_IP,EXACTA DRAINAGE SYSTEM,979.0,636.35,390.62,390.62,1
CDM,27840605_OP,EXACTA DRAINAGE SYSTEM,979.0,636.35,378.87,378.87,1
CDM,27840615,"KIT, INTRACRANIAL MONITOR",4528.0,2943.2,673.77,4528.0,38
CDM,27840615_IP,"KIT, INTRACRANIAL MONITOR",4528.0,2943.2,3029.23,3029.23,1
CDM,27840615_OP,"KIT, INTRACRANIAL MONITOR",4528.0,2943.2,2875.28,2875.28,1
CDM,27840AK,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1908.0,1240.2,1.1,1908.0,50
CDM,27842AK,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,2584.0,1679.6,1.1,2743.55,50
CDM,27846AK,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,4112.0,2672.8,1.1,12214.27,50
CDM,27848AK,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,4672.0,3036.8,1.1,12214.27,50
CDM,27852315,LUNG TRACT SEALANT,1663.0,1080.95,159.5,1663.0,46
CDM,27852315_IP,LUNG TRACT SEALANT,1663.0,1080.95,1112.55,1112.55,1
CDM,27852315_OP,LUNG TRACT SEALANT,1663.0,1080.95,1056.01,1056.01,1
CDM,27852325,"IUD, LYLETTA",2103.0,1366.95,312.93,2103.0,38
CDM,27852325_IP,"IUD, LYLETTA",2103.0,1366.95,1406.91,1406.91,1
CDM,27852325_OP,"IUD, LYLETTA",2103.0,1366.95,1335.41,1335.41,1
CDM,27852395,"IUD, PARAGARD",2043.0,1327.95,304.0,2043.0,38
CDM,27852395_IP,"IUD, PARAGARD",2043.0,1327.95,1366.77,1366.77,1
CDM,27852395_OP,"IUD, PARAGARD",2043.0,1327.95,1297.31,1297.31,1
CDM,27852405,"COIL, AXIUM PRIME HEL STD/SOFT",5810.0,3776.5,864.53,5810.0,39
CDM,27852405_IP,"COIL, AXIUM PRIME HEL STD/SOFT",5810.0,3776.5,3886.89,3886.89,1
CDM,27852405_OP,"COIL, AXIUM PRIME HEL STD/SOFT",5810.0,3776.5,3689.35,3689.35,1
CDM,27852415,"COIL, AXIUM PRIME 3D",6338.0,4119.7,943.09,6338.0,39
CDM,27852415_IP,"COIL, AXIUM PRIME 3D",6338.0,4119.7,4240.12,4240.12,1
CDM,27852415_OP,"COIL, AXIUM PRIME 3D",6338.0,4119.7,4024.63,4024.63,1
CDM,27852425,"COIL, AXIUM PRIME ES HELICAL",7605.0,4943.25,1131.62,7605.0,39
CDM,27852425_IP,"COIL, AXIUM PRIME ES HELICAL",7605.0,4943.25,5087.75,5087.75,1
CDM,27852425_OP,"COIL, AXIUM PRIME ES HELICAL",7605.0,4943.25,4829.18,4829.18,1
CDM,27852435,"COIL, AXIUM PRIME ES 3D",8424.0,5475.6,1253.49,8424.0,39
CDM,27852435_IP,"COIL, AXIUM PRIME ES 3D",8424.0,5475.6,5635.66,5635.66,1
CDM,27852435_OP,"COIL, AXIUM PRIME ES 3D",8424.0,5475.6,5349.24,5349.24,1
CDM,27860AK,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,956.0,621.4,1.1,5526.53,50
CDM,27870AK,ARTHRODESIS ANKLE OPEN,6164.0,4006.6,1.1,22471.68,50
CDM,27871AK,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,3816.0,2480.4,1.1,22471.68,50
CDM,27874035,ASPIRA CATHETER,3018.0,1961.7,449.08,3018.0,38
CDM,27874035_IP,ASPIRA CATHETER,3018.0,1961.7,2019.04,2019.04,1
CDM,27874035_OP,ASPIRA CATHETER,3018.0,1961.7,1916.43,1916.43,1
CDM,27874145,ABBOTT BM STENT,2515.0,1634.75,159.5,2515.0,46
CDM,27874145_IP,ABBOTT BM STENT,2515.0,1634.75,1682.54,1682.54,1
CDM,27874145_OP,ABBOTT BM STENT,2515.0,1634.75,1597.03,1597.03,1
CDM,27874445,FILTER IVC ANGEL,11903.0,7736.95,159.5,11903.0,47
CDM,27874445_IP,FILTER IVC ANGEL,11903.0,7736.95,7963.11,7963.11,1
CDM,27874445_OP,FILTER IVC ANGEL,11903.0,7736.95,7558.41,7558.41,1
CDM,27875275,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,264.38,14965.0,47
CDM,27875275_IP,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,10011.59,10011.59,1
CDM,27875275_OP,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,9502.78,9502.78,1
CDM,27875335,"STENT, VASC 8/6MM 6FR",6935.0,4507.75,159.5,6935.0,47
CDM,27875335_IP,"STENT, VASC 8/6MM 6FR",6935.0,4507.75,4639.52,4639.52,1
CDM,27875335_OP,"STENT, VASC 8/6MM 6FR",6935.0,4507.75,4403.73,4403.73,1
CDM,27875355,"COIL, EMBL TRGT",5515.0,3584.75,820.63,5515.0,39
CDM,27875355_IP,"COIL, EMBL TRGT",5515.0,3584.75,3689.54,3689.54,1
CDM,27875355_OP,"COIL, EMBL TRGT",5515.0,3584.75,3502.03,3502.03,1
CDM,27877575,"STENT, XACT (ALL SIZES)",6023.0,3914.95,159.5,6023.0,47
CDM,27877575_IP,"STENT, XACT (ALL SIZES)",6023.0,3914.95,4029.39,4029.39,1
CDM,27877575_OP,"STENT, XACT (ALL SIZES)",6023.0,3914.95,3824.61,3824.61,1
CDM,27877745,SURPASS FLOWDIVERTER <40MM,45990.0,29893.5,159.5,45990.0,47
CDM,27877745_IP,SURPASS FLOWDIVERTER <40MM,45990.0,29893.5,30767.31,30767.31,1
CDM,27877745_OP,SURPASS FLOWDIVERTER <40MM,45990.0,29893.5,29203.65,29203.65,1
CDM,27877755,SURPASS FLOWDIVERTER >40MM,50370.0,32740.5,159.5,50370.0,47
CDM,27877755_IP,SURPASS FLOWDIVERTER >40MM,50370.0,32740.5,33697.53,33697.53,1
CDM,27877755_OP,SURPASS FLOWDIVERTER >40MM,50370.0,32740.5,31984.95,31984.95,1
CDM,27877915,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.48,348.8,47
CDM,27877915_IP,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,4.91,4.91,1
CDM,27877915_OP,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,4.76,4.76,1
CDM,27877925,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.56,1012.39,55
CDM,27877925_IP,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,6.44,6.44,1
CDM,27877925_OP,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,6.24,6.24,1
CDM,27877945,SENTINEL CEREBRAL PROTECTION DEVICE,14600.0,9490.0,159.5,14600.0,47
CDM,27877945_IP,SENTINEL CEREBRAL PROTECTION DEVICE,14600.0,9490.0,9767.4,9767.4,1
CDM,27877945_OP,SENTINEL CEREBRAL PROTECTION DEVICE,14600.0,9490.0,9271.0,9271.0,1
CDM,27877995,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,117.73,2450.0,47
CDM,27877995_IP,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,1639.05,1639.05,1
CDM,27877995_OP,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,1555.75,1555.75,1
CDM,27878035,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",83950.0,54567.5,159.5,83950.0,47
CDM,27878035_IP,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",83950.0,54567.5,56162.55,56162.55,1
CDM,27878035_OP,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",83950.0,54567.5,53308.25,53308.25,1
CDM,27878065,"PROBE, IMAGE-GUIDED, ROBOTIC, WATERJET ABLATION",11863.0,7710.95,159.5,11863.0,47
CDM,27878065_IP,"PROBE, IMAGE-GUIDED, ROBOTIC, WATERJET ABLATION",11863.0,7710.95,7936.35,7936.35,1
CDM,27878065_OP,"PROBE, IMAGE-GUIDED, ROBOTIC, WATERJET ABLATION",11863.0,7710.95,7533.01,7533.01,1
CDM,27878235,ABBOTT XIENCE STENT DRUG ELUTING,2920.0,1898.0,159.5,2920.0,46
CDM,27878235_IP,ABBOTT XIENCE STENT DRUG ELUTING,2920.0,1898.0,1953.48,1953.48,1
CDM,27878235_OP,ABBOTT XIENCE STENT DRUG ELUTING,2920.0,1898.0,1854.2,1854.2,1
CDM,27878595,SAVI SCOUT REFLECTOT,1460.0,949.0,159.5,1460.0,46
CDM,27878595_IP,SAVI SCOUT REFLECTOT,1460.0,949.0,976.74,976.74,1
CDM,27878595_OP,SAVI SCOUT REFLECTOT,1460.0,949.0,927.1,927.1,1
CDM,27878775,BARD US BIOPSY CLIP,200.75,130.49,29.87,200.75,46
CDM,27878775_IP,BARD US BIOPSY CLIP,200.75,130.49,80.1,80.1,1
CDM,27878775_OP,BARD US BIOPSY CLIP,200.75,130.49,77.69,77.69,1
CDM,27878785,HYDROMARK US BIOPSY CLIP,248.2,161.33,36.93,248.2,46
CDM,27878785_IP,HYDROMARK US BIOPSY CLIP,248.2,161.33,99.03,99.03,1
CDM,27878785_OP,HYDROMARK US BIOPSY CLIP,248.2,161.33,96.05,96.05,1
CDM,27878795,HOLOGIC STEREO BIOPSY CLIP,164.25,106.76,24.44,184.68,46
CDM,27878795_IP,HOLOGIC STEREO BIOPSY CLIP,164.25,106.76,65.54,65.54,1
CDM,27878795_OP,HOLOGIC STEREO BIOPSY CLIP,164.25,106.76,63.56,63.56,1
CDM,27878805,NEEDLE LOC WIRE,60.23,39.15,8.96,184.68,46
CDM,27878805_IP,NEEDLE LOC WIRE,60.23,39.15,24.03,24.03,1
CDM,27878805_OP,NEEDLE LOC WIRE,60.23,39.15,23.31,23.31,1
CDM,27878825,GORE CARDIOFORM SEPTAL OCCLUDER,15822.0,10284.3,2354.31,15822.0,39
CDM,27878825_IP,GORE CARDIOFORM SEPTAL OCCLUDER,15822.0,10284.3,10584.92,10584.92,1
CDM,27878825_OP,GORE CARDIOFORM SEPTAL OCCLUDER,15822.0,10284.3,10046.97,10046.97,1
CDM,27879645,CANGAROO POUCH ENVELOPE 975,2500.0,1625.0,372.0,2500.0,38
CDM,27879645_IP,CANGAROO POUCH ENVELOPE 975,2500.0,1625.0,1672.5,1672.5,1
CDM,27879645_OP,CANGAROO POUCH ENVELOPE 975,2500.0,1625.0,1587.5,1587.5,1
CDM,27880065,KERECIS 16 MM,1825.0,1186.25,117.73,1825.0,47
CDM,27880065_IP,KERECIS 16 MM,1825.0,1186.25,1220.93,1220.93,1
CDM,27880065_OP,KERECIS 16 MM,1825.0,1186.25,1158.88,1158.88,1
CDM,27880075,KERECIS 1.75 X 1.75,1938.0,1259.7,117.73,1938.0,47
CDM,27880075_IP,KERECIS 1.75 X 1.75,1938.0,1259.7,1296.52,1296.52,1
CDM,27880075_OP,KERECIS 1.75 X 1.75,1938.0,1259.7,1230.63,1230.63,1
CDM,27880085,KERECIS 3 X 3.5 CM,2668.0,1734.2,117.73,2668.0,47
CDM,27880085_IP,KERECIS 3 X 3.5 CM,2668.0,1734.2,1784.89,1784.89,1
CDM,27880085_OP,KERECIS 3 X 3.5 CM,2668.0,1734.2,1694.18,1694.18,1
CDM,27880AK,AMPUTATION LOW LEG THRU TIB/FIB,6148.0,3996.2,1.1,6148.0,50
CDM,27880URVUAK,AMPUTATION OF LOWER LEG,2038.0,1324.7,1.1,3077.91,50
CDM,27881AK,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,5388.0,3502.2,1.1,5388.0,50
CDM,27882015,AGENT DRUG COATED BALLOON,16950.0,11017.5,159.5,16950.0,47
CDM,27882015_IP,AGENT BALLOON CATHETER-DRUG-COATED,16950.0,11017.5,11339.55,11339.55,1
CDM,27882015_OP,AGENT BALLOON CATHETER-DRUG-COATED,16950.0,11017.5,10763.25,10763.25,1
CDM,27882215,TUMARK BIOPSY MARKER,165.0,107.25,24.55,184.68,48
CDM,27882295,TRUMPET TUBE,84.0,54.6,12.5,84.0,48
CDM,27882325,RICHARDS T TUBE,64.0,41.6,9.52,64.0,48
CDM,27882465,AZUR CX PERIPHERAL COIL SYSTEM 2MM X 2CM,3927.0,2552.55,584.34,3927.0,40
CDM,27882475,ELUVIA DRUG-ELUTING STENT 7MM X 150MM X 130CM,10497.0,6823.05,159.5,10497.0,49
CDM,27882AK,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,3916.0,2545.4,1.1,3916.0,50
CDM,27884AK,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,3504.0,2277.6,1.1,5526.53,50
CDM,27886AK,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,4008.0,2605.2,1.1,4008.0,50
CDM,27888AK,AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV,4148.0,2696.2,1.1,4148.0,50
CDM,27892AK,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,3176.0,2064.4,1.1,5526.53,50
CDM,27893AK,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,3160.0,2054.0,1.1,12214.27,50
CDM,27894AK,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,5068.0,3294.2,1.1,5526.53,50
CDM,27899AGRVUAK,"UNLISTED PROCEDURE, LEG OR ANKLE COMPARED TO 27860",789.0,512.85,0.01,789.0,28
CDM,27899RVU3AK,"EXCISION OF ACCESSORY SOLEUS MUSCLE, LEG OR ANKLE AREA (COMP COD",2972.0,1931.8,0.01,2972.0,28
CDM,27899RVU5AK,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),451.0,293.15,0.01,451.0,28
CDM,27899RVU6AK,REPAIR/SUTURE MUSCLE LOWER LEG (COMP CODE 27658),1844.0,1198.6,0.01,1844.0,28
CDM,28001AK,INCIS/DRAINAGE BURSA OF FOOT,800.0,520.0,1.1,2768.64,53
CDM,28002AK,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,1116.0,725.4,1.1,2743.55,53
CDM,28003AK,I&D BELOW FASCIA FOOT MULTIPLE AREAS,2112.0,1372.8,1.1,5526.53,53
CDM,28005AK,INCISION BONE CORTEX FOOT,3776.0,2454.4,1.1,5526.53,50
CDM,28008AK,FASCIOTOMY FOOT&/TOE,1836.0,1193.4,1.1,5526.53,53
CDM,28010AK,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,1188.0,772.2,1.1,2743.55,53
CDM,28020AK,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,2060.0,1339.0,1.1,5526.53,53
CDM,28022AK,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,1924.0,1250.6,1.1,5526.53,53
CDM,28024AK,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,1808.0,1175.2,1.1,2743.55,53
CDM,28035AK,RELEASE TARSAL TUNNEL,2092.0,1359.8,1.1,3297.28,53
CDM,28039AK,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,2168.0,1409.2,1.1,4850.94,53
CDM,28041AK,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,2852.0,1853.8,1.1,4850.94,50
CDM,28043AK,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,1584.0,1029.6,1.1,2768.64,53
CDM,28045AK,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,2180.0,1417.0,1.1,4850.94,53
CDM,28046AK,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,4952.0,3218.8,1.1,4952.0,50
CDM,28052AK,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,1624.0,1055.6,1.1,5526.53,53
CDM,28054AK,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,1428.0,928.2,1.1,5526.53,53
CDM,28060AK,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,2160.0,1404.0,1.1,5526.53,53
CDM,28062AK,FASCIECTOMY PLANTAR FASCIA RADICAL SPX,2676.0,1739.4,1.1,5526.53,53
CDM,28070AK,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,2096.0,1362.4,1.1,12214.27,53
CDM,28072AK,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,1888.0,1227.2,1.1,5526.53,53
CDM,28080AK,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,1944.0,1263.6,1.1,2743.55,53
CDM,28086AK,"SYNOVECTOMY FLEX TENDN SHEATH,FOOT",1968.0,1279.2,1.1,5526.53,53
CDM,28090AK,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,1820.0,1183.0,1.1,2743.55,53
CDM,28092AK,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,1512.0,982.8,1.1,2743.55,53
CDM,28100AK,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,2332.0,1515.8,1.1,5526.53,53
CDM,28102AK,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,3168.0,2059.2,1.1,12214.27,50
CDM,28103AK,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,2668.0,1734.2,1.1,12214.27,50
CDM,28104AK,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,2104.0,1367.6,1.1,5526.53,53
CDM,28107AK,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,2292.0,1489.8,1.1,12214.27,53
CDM,28108AK,EXC/CURTG CST/B9 TUM PHALANGES FOOT,1720.0,1118.0,1.1,2743.55,53
CDM,28110AK,OSTECTOMY PRTL 5TH METAR HEAD SPX,1688.0,1097.2,1.1,5526.53,53
CDM,28111AK,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,2060.0,1339.0,1.1,5526.53,53
CDM,28112AK,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,1852.0,1203.8,1.1,5526.53,53
CDM,28113AK,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,2444.0,1588.6,1.1,5526.53,53
CDM,28116AK,OSTECTOMY TARSAL COALITION,3656.0,2376.4,1.1,5526.53,53
CDM,28118AK,OSTECTOMY CALCANEUS,2452.0,1593.8,1.1,5526.53,53
CDM,28119AK,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,2224.0,1445.6,1.1,5526.53,53
CDM,28120AK,PARTIAL EXCISION BONE TALUS/CALCANEUS,2924.0,1900.6,1.1,5526.53,53
CDM,28122AK,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,2704.0,1757.6,1.1,5526.53,53
CDM,28124AK,PARTICAL EXCISION BONE PHALANX TOE,2000.0,1300.0,1.1,5526.53,53
CDM,28126AK,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,1456.0,946.4,1.1,5526.53,53
CDM,28130AK,TALECTOMY ASTRAGALECTOMY,3800.0,2470.0,1.1,12214.27,50
CDM,28140AK,METATARSECTOMY,2856.0,1856.4,1.1,5526.53,53
CDM,28153AK,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,1520.0,988.0,1.1,5526.53,53
CDM,28160AK,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,1552.0,1008.8,1.1,5526.53,53
CDM,28190AK,"REMV FOOT FOREIGN BODY,SUBCUTANEOUS",884.0,574.6,1.1,1200.64,53
CDM,28192AK,"REMV FOOT FOREIGN BODY,DEEP",1912.0,1242.8,1.1,2768.64,53
CDM,28193AK,"REMV FOOT FOREIGN BODY,COMPLEX",2360.0,1534.0,1.1,2768.64,53
CDM,28200AK,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,1896.0,1232.4,1.1,5526.53,53
CDM,28202AK,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,2828.0,1838.2,1.1,12214.27,53
CDM,28208AK,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,1804.0,1172.6,1.1,5526.53,53
CDM,28210AK,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,2608.0,1695.2,1.1,12214.27,53
CDM,28220AK,TENOLYSIS FLEXOR FOOT SINGLE TENDON,1868.0,1214.2,1.1,2743.55,53
CDM,28222AK,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,2304.0,1497.6,1.1,5526.53,53
CDM,28225AK,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,1512.0,982.8,1.1,5526.53,53
CDM,28230AK,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,1744.0,1133.6,1.1,2743.55,53
CDM,28232AK,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,1404.0,912.6,1.1,2743.55,53
CDM,28234AK,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,1416.0,920.4,1.1,2743.55,53
CDM,28238AK,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,3184.0,2069.6,1.1,12214.27,53
CDM,28240AK,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,1792.0,1164.8,1.1,5526.53,53
CDM,28260AK,"CAPSULOTOMY MIDFOOT JT,MED RELEASE",3276.0,2129.4,1.1,5526.53,53
CDM,28262AK,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,7572.0,4921.8,1.1,12214.27,53
CDM,28270AK,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,1972.0,1281.8,1.1,5526.53,53
CDM,28285AK,CORRECTION HAMMERTOE,2473.0,1607.45,1.1,5526.53,53
CDM,28288AK,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,2408.0,1565.2,1.1,5526.53,53
CDM,28289AK,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT,2760.0,1794.0,1.1,5526.53,53
CDM,28292AK,CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE,2976.0,1934.4,1.1,5526.53,53
CDM,28296AK,CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT,3300.0,2145.0,1.1,5526.53,53
CDM,28297AK,CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS,3716.0,2415.4,1.1,12214.27,53
CDM,28298AK,CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT,3100.0,2015.0,1.1,12214.27,53
CDM,28299AK,CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY,3716.0,2415.4,1.1,12214.27,53
CDM,28300AK,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,3892.0,2529.8,1.1,12214.27,50
CDM,28302AK,OSTEOTOMY TALUS,3896.0,2532.4,1.1,12214.27,50
CDM,28304AK,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,4140.0,2691.0,1.1,12214.27,53
CDM,28305AK,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,4308.0,2800.2,1.1,12214.27,50
CDM,28306AK,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,2400.0,1560.0,1.1,12214.27,53
CDM,28308AK,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,2192.0,1424.8,1.1,5526.53,53
CDM,28309AK,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,5664.0,3681.6,1.1,12214.27,50
CDM,28310AK,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,2228.0,1448.2,1.1,12214.27,53
CDM,28312AK,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,1876.0,1219.4,1.1,5526.53,53
CDM,28313AK,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,2266.0,1472.9,1.1,5526.53,53
CDM,28315AK,SESAMOIDECTOMY FIRST TOE SPX,2000.0,1300.0,1.1,5526.53,53
CDM,28320AK,REPAIR NONUNION/MALUNION TARSAL BONES,3748.0,2436.2,1.1,22471.68,50
CDM,28322AK,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,3412.0,2217.8,1.1,12214.27,53
CDM,28400AK,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,924.0,600.6,1.1,924.0,53
CDM,28405AK,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1896.0,1232.4,1.1,1896.0,53
CDM,28406AK,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,2624.0,1705.6,1.1,12214.27,50
CDM,28415AK,OPEN TREATMENT CALCANEAL FRACTURE,6476.0,4209.4,1.1,12214.27,50
CDM,28420AK,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,7008.0,4555.2,1.1,22471.68,50
CDM,28430AK,CLOSED TX TALUS FRACTURE W/O MANIPULATION,888.0,577.2,1.1,888.0,53
CDM,28435AK,CLOSED TX TALUS FRACTURE W/MANIPULATION,1416.0,920.4,1.1,2743.55,53
CDM,28436AK,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,1960.0,1274.0,1.1,12214.27,50
CDM,28445AK,OPEN TREATMENT TALUS FRACTURE,6304.0,4097.6,1.1,12214.27,50
CDM,28446AK,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,7084.0,4604.6,1.1,12214.27,50
CDM,28450AK,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,893.0,580.45,1.1,893.0,53
CDM,28455AK,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,1426.0,926.9,1.1,2743.55,53
CDM,28456AK,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,1144.0,743.6,1.1,12214.27,50
CDM,28465AK,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,3520.0,2288.0,1.1,12214.27,50
CDM,28470AK,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,893.0,580.45,1.1,893.0,53
CDM,28475AK,CLTX METAR FX W/MANJ,1204.0,782.6,1.1,1204.0,53
CDM,28476AK,PRQ SKEL FIXJ METAR FX W/MANJ,1440.0,936.0,1.1,5526.53,50
CDM,28485AK,OPEN TREATMENT METATARSAL FRACTURE EACH,2976.0,1934.4,1.1,12214.27,50
CDM,28490AK,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,468.0,304.2,1.1,475.3,53
CDM,28495AK,CLTX FX GRT TOE PHLX/PHLG W/MANJ,672.0,436.8,1.1,672.0,53
CDM,28496AK,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,992.0,644.8,1.1,5526.53,53
CDM,28505AK,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,2976.0,1934.4,1.1,5526.53,53
CDM,28510AK,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,468.0,304.2,1.1,468.0,53
CDM,28515AK,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,624.0,405.6,1.1,624.0,53
CDM,28525AK,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,2248.0,1461.2,1.1,5526.53,53
CDM,28530AK,CLOSED TREATMENT SESAMOID FRACTURE,444.0,288.6,1.1,444.0,53
CDM,28540AK,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,876.0,569.4,1.1,876.0,53
CDM,28545AK,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,1040.0,676.0,1.1,5526.53,53
CDM,28546AK,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,1360.0,884.0,1.1,2743.55,53
CDM,28555AK,OPEN TREATMENT TARSAL BONE DISLOCATION,3860.0,2509.0,1.1,12214.27,53
CDM,28570AK,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,704.0,457.6,1.1,793.17,53
CDM,28575AK,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,1396.0,907.4,1.1,5526.53,53
CDM,28576AK,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,1840.0,1196.0,1.1,12214.27,50
CDM,28585AK,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,4452.0,2893.8,1.1,12214.27,53
CDM,28600AK,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,808.0,525.2,1.1,808.0,53
CDM,28605AK,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,1156.0,751.4,1.1,1156.96,53
CDM,28606AK,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,2036.0,1323.4,1.1,5526.53,50
CDM,28615AK,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,4280.0,2782.0,1.1,12214.27,50
CDM,28630AK,CLTX METATARSOPHLNGL JT DISLC W/O ANES,700.0,455.0,1.1,700.0,53
CDM,28635AK,CLTX METATARSOPHLNGL JT DISLC REQ ANES,784.0,509.6,1.1,2743.55,53
CDM,28636AK,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,1108.0,720.2,1.1,5526.53,53
CDM,28645AK,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,2976.0,1934.4,1.1,5526.53,53
CDM,28660AK,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,512.0,332.8,1.1,512.0,53
CDM,28665AK,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,788.0,512.2,1.1,788.0,53
CDM,28675AK,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,2248.0,1461.2,1.1,5526.53,53
CDM,28715AK,ARTHRODESIS TRIPLE,5368.0,3489.2,1.1,22471.68,50
CDM,28725AK,ARTHRODESIS SUBTALAR,4488.0,2917.2,1.1,22471.68,50
CDM,28730AK,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,4280.0,2782.0,1.1,22471.68,50
CDM,28735AK,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,4892.0,3179.8,1.1,22471.68,50
CDM,28737AK,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,4412.0,2867.8,1.1,22471.68,50
CDM,28740AK,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,3716.0,2415.4,1.1,12214.27,53
CDM,28750AK,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,3428.0,2228.2,1.1,12214.27,53
CDM,28755AK,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,1952.0,1268.8,1.1,12214.27,53
CDM,28760AK,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,3656.0,2376.4,1.1,12214.27,53
CDM,28800AK,"AMPUTATION FOOT,MIDTARSAL-CHOPART",3516.0,2285.4,1.1,3516.0,50
CDM,28805AK,"AMPUTATION FOOT,TRANSMETATARSAL",5084.0,3304.6,1.1,5526.53,50
CDM,28810AK,"AMPUTATION METATARSAL+TOE,SINGLE",2656.0,1726.4,1.1,5526.53,50
CDM,28820AK,AMPUTATION TOE METATARSOPHALANGEAL JOINT,1544.0,1003.6,1.1,5526.53,53
CDM,28825AK,AMPUTATION TOE INTERPHALANGEAL JOINT,1500.0,975.0,1.1,5526.53,53
CDM,28890AK,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,1380.0,897.0,1.1,2743.55,53
CDM,28899AGRVU1AK,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 25447)",2180.0,1417.0,0.01,2180.0,28
CDM,28899AGRVU2AK,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 20680)",950.0,617.5,0.01,950.0,28
CDM,28899AGRVU3AK,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 28302)",2080.0,1352.0,0.01,2080.0,28
CDM,28899AGRVU4AK,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 29891)",1970.0,1280.5,0.01,1970.0,28
CDM,28899AGRVU5AK,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 28100)",1924.0,1250.6,0.01,1924.0,28
CDM,28899AGRVU6AK,"UNLISTED PROCEDURE, FOOT OR TOES",916.0,595.4,0.01,916.0,28
CDM,28899AGRVUAK,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 27415)",3680.0,2392.0,0.01,3680.0,28
CDM,28899AK,FOOT/TOES SURGERY PROC UNLISTED,3790.0,2463.5,0.01,3790.0,28
CDM,28899RVU12AK,TALUS DECOMPRESSION W/DRILLING (COMP CODE 28005),916.0,595.4,0.01,916.0,28
CDM,28899RVU15AK,"UNLISTED PROC, HALLUX INTERPHALANGEAL ARTHROPLASTY W/PERCUTANEOU",1100.0,715.0,0.01,1100.0,28
CDM,28899RVU17AK,INTERPOSITIONAL ARTHROPLASTY AT 2ND METATARSOPHALANGEAL JOINT (C,2270.0,1475.5,0.01,2270.0,28
CDM,28899RVU19AK,COMPLETE REMOVAL OF TARSAL BONE (COMP CODE 28130),4085.0,2655.25,0.01,4085.0,28
CDM,28899RVU21AK,SUBTALAR JOINT?ARTHROEREISIS (COMP CODE 28725),4040.0,2626.0,0.01,4040.0,28
CDM,28899RVU22AK,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),330.0,214.5,0.01,403.2,28
CDM,28899RVU6AK,REPAIR LIGAMENT FOOT (COMP CODE 27695),2413.0,1568.45,0.01,2413.0,28
CDM,28899RVU9AK,UNLISTED PLANTAR PLATE REPAIR 2ND METATARSOPHALANGEAL JOINT OF L,1700.0,1105.0,0.01,1700.0,28
CDM,29000110,SPACER BAG/RESERVOIR,48.0,31.2,7.14,48.0,46
CDM,29000345,DELUXE HOME TRACTION KIT,631.0,410.15,137.56,631.0,46
CDM,29065AK,APPLICATION CAST SHOULDER HAND LONG ARM,348.0,226.2,1.1,458.75,53
CDM,29075AK,APPLICATION CAST ELBOW FINGER SHORT ARM,308.0,200.2,1.1,458.75,53
CDM,29085AK,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,348.0,226.2,1.1,348.0,53
CDM,29105AK,APPLICATION LONG ARM SPLINT SHOULDER HAND,320.0,208.0,1.1,320.0,53
CDM,29125AK,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,220.0,143.0,1.1,220.48,53
CDM,29126AK,"APPLY FOREARM SPLINT,DYNAMIC",299.0,194.35,1.1,299.0,53
CDM,29130AK,APPLICATION FINGER SPLINT STATIC,220.0,143.0,1.1,220.0,53
CDM,29131AK,"APPLY FINGER SPLINT,DYNAMIC",242.0,157.3,1.1,242.0,53
CDM,29240AK,STRAPPING SHOULDER,172.0,111.8,1.1,218.62,53
CDM,29260AK,STRAPPING ELBOW OR WRIST,172.0,111.8,1.1,172.0,53
CDM,29280AK,STRAPPING HAND OR FINGER,172.0,111.8,1.1,172.0,53
CDM,29345AK,APPLICATION LONG LEG CAST THIGH-TOE,560.0,364.0,1.1,560.0,53
CDM,29405AK,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,320.0,208.0,1.1,458.75,53
CDM,29425AK,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,320.0,208.0,1.1,458.75,53
CDM,29445AK,APPLICATION RIGID TOTAL CONTACT LEG CAST,712.0,462.8,1.1,712.0,53
CDM,29450AK,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,915.0,594.75,1.1,915.0,53
CDM,29505AK,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,304.0,197.6,1.1,304.0,53
CDM,29515AK,APPLICATION SHORT LEG SPLINT CALF FOOT,321.0,208.65,1.1,321.0,53
CDM,29530AK,STRAPPING KNEE,172.0,111.8,1.1,218.62,53
CDM,29540AK,STRAPPING ANKLE &/FOOT,172.0,111.8,1.1,268.8,53
CDM,29580AK,STRAPPING UNNA BOOT,242.0,157.3,1.1,268.8,53
CDM,29581AK,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,264.0,171.6,1.1,291.48,53
CDM,29584AK,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FINGER,140.0,91.0,1.1,268.8,53
CDM,29700AK,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,228.0,148.2,1.1,458.75,53
CDM,29740AK,WEDGING CAST EXCEPT CLUBFOOT CASTS,448.0,291.2,1.1,458.75,53
CDM,29805AK,DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX,2412.0,1567.8,1.1,5526.53,50
CDM,29806AK,SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY,6056.0,3936.4,1.1,12214.27,50
CDM,29807AK,SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION,5868.0,3814.2,1.1,12214.27,50
CDM,29819AK,SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB,3116.0,2025.4,1.1,5526.53,50
CDM,29820AK,SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY,2884.0,1874.6,1.1,12214.27,50
CDM,29821AK,SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY,3156.0,2051.4,1.1,5526.53,50
CDM,29822AK,SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2,3093.0,2010.45,1.1,5526.53,50
CDM,29823AK,SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+,3511.0,2282.15,1.1,5526.53,50
CDM,29824AK,SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC,3592.0,2334.8,1.1,5526.53,50
CDM,29825AK,SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS,3116.0,2025.4,1.1,5526.53,50
CDM,29826AK,SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS,1320.0,858.0,1.1,1320.0,50
CDM,29827AK,SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR,6236.0,4053.4,1.1,12214.27,50
CDM,29828AK,SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS,5790.0,3763.5,1.1,12214.27,50
CDM,29834AK,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,2568.0,1669.2,1.1,5526.53,50
CDM,29835AK,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,2648.0,1721.2,1.1,5526.53,50
CDM,29838AK,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,3152.0,2048.8,1.1,5526.53,50
CDM,29840AK,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,2272.0,1476.8,1.1,5526.53,50
CDM,29843AK,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,2460.0,1599.0,1.1,5526.53,50
CDM,29844AK,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,2604.0,1692.6,1.1,5526.53,50
CDM,29845AK,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,3076.0,1999.4,1.1,5526.53,50
CDM,29846AK,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,2756.0,1791.4,1.1,5526.53,50
CDM,29847AK,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,2888.0,1877.2,1.1,12214.27,50
CDM,29848AK,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,2556.0,1661.4,1.1,2743.55,50
CDM,29850AK,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,3308.0,2150.2,1.1,3308.0,50
CDM,29851AK,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,5304.0,3447.6,1.1,5304.0,50
CDM,29855AK,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,4304.0,2797.6,1.1,12214.27,50
CDM,29856AK,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,5712.0,3712.8,1.1,22471.68,50
CDM,29866AK,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,5868.0,3814.2,1.1,12214.27,50
CDM,29868AK,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,10040.0,6526.0,1.1,12214.27,50
CDM,29870AK,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,2284.0,1484.6,1.1,5526.53,53
CDM,29871AK,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,2944.0,1913.6,1.1,5526.53,50
CDM,29873AK,ARTHRS KNEE W LAT RELEASE,2746.0,1784.9,1.1,5526.53,50
CDM,29874AK,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,3164.0,2056.6,1.1,5526.53,50
CDM,29875AK,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,2838.0,1844.7,1.1,5526.53,50
CDM,29876AK,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,3548.0,2306.2,1.1,5526.53,50
CDM,29877AK,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,3652.0,2373.8,1.1,5526.53,50
CDM,29879AK,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,3596.0,2337.4,1.1,5526.53,50
CDM,29880AK,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,3252.0,2113.8,1.1,5526.53,50
CDM,29881AK,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,3093.0,2010.45,1.1,5526.53,50
CDM,29882AK,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,4224.0,2745.6,1.1,5526.53,50
CDM,29883AK,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,4708.0,3060.2,1.1,5526.53,50
CDM,29884AK,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,3312.0,2152.8,1.1,5526.53,50
CDM,29885AK,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,4084.0,2654.6,1.1,12214.27,50
CDM,29886AK,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,3736.0,2428.4,1.1,5526.53,50
CDM,29887AK,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,4064.0,2641.6,1.1,12214.27,50
CDM,29888AK,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6292.0,4089.8,1.1,12214.27,50
CDM,29889AK,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6964.0,4526.6,1.1,22471.68,50
CDM,29891AK,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,3868.0,2514.2,1.1,5526.53,50
CDM,29892AK,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,4108.0,2670.2,1.1,12214.27,50
CDM,29893AK,ENDOSCOPIC PLANTAR FASCIOTOMY,2528.0,1643.2,1.1,5526.53,53
CDM,29894AK,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,2940.0,1911.0,1.1,5526.53,50
CDM,29895AK,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,2852.0,1853.8,1.1,5526.53,50
CDM,29897AK,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,2928.0,1903.2,1.1,5526.53,50
CDM,29898AK,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,3736.0,2428.4,1.1,5526.53,50
CDM,29906AK,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,3860.0,2509.0,1.1,5526.53,50
CDM,29999AGRVU10AK,"UNLISTED PROCEDURE, ARTHROSCOPY COMPARED TO 27635",2650.0,1722.5,0.01,2650.0,28
CDM,29999AGRVU11AK,"UNLISTED PROCEDURE, ARTHROSCOPY COMPARED TO 29855 X 3",4935.0,3207.75,0.01,4935.0,28
CDM,29999AGRVU1AK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 25390)",1650.0,1072.5,0.01,1650.0,28
CDM,29999AGRVU2AK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 29877)",1350.0,877.5,0.01,1350.0,28
CDM,29999AGRVU3AK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 29806)",4934.0,3207.1,0.01,4934.0,28
CDM,29999AGRVU4AK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 29827)",5095.0,3311.75,0.01,5095.0,28
CDM,29999AGRVU5AK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 23450)",4481.0,2912.65,0.01,4481.0,28
CDM,29999AGRVU6AK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 23465)",5379.0,3496.35,0.01,5379.0,28
CDM,29999AGRVU7AK,"UNLISTED PROCEDURE, ARTHROSCOPY",1645.0,1069.25,0.01,1645.0,28
CDM,29999AGRVU8AK,"UNLISTED PROCEDURE, ARTHROSCOPY",4712.0,3062.8,0.01,4712.0,28
CDM,29999AGRVU9AK,"UNLIST PROC, ARTHROSCOPY COMPARED TO 23420",2319.0,1507.35,0.01,2319.0,28
CDM,29999AGRVUAK,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 27347)",1410.0,916.5,0.01,1410.0,28
CDM,29999AK,UNLISTED PROCEDURE ARTHROSCOPY,1391.0,904.15,0.01,1391.0,28
CDM,29999RVU17AK,UNLISTED ARTHROSCOPIC I&D OF HEMATOMA (COMPARED TO 10140),521.0,338.65,0.01,521.0,28
CDM,29999RVU24AK,"UNLISTED PROC, ARTHROSCOPIC AIDED INTERNAL FIXATION OF LAT BIL F",3290.0,2138.5,0.01,3290.0,28
CDM,29999RVU28AK,"UNLISTED PROC, ARTHROSCOPIC ULNAR WAFER PROC (REMOVING APPROX 2M",1752.0,1138.8,0.01,1752.0,28
CDM,29999RVU29AK,"UNLISTED PROC; ARTHROSCOPIC REPAIR GREATER TUBEROSITY FRACTURE,",3477.0,2260.05,0.01,3477.0,28
CDM,29999RVU2AK,ARTHROSCOPY KNEE SUBCHONDROPLAST,1350.0,877.5,0.01,1350.0,28
CDM,29999RVU30AK,UNLISTED PROC; RIGHT SHOULDER ARTHROSCOPIC SUPERIOR CAPSULE RECO,10141.0,6591.65,0.01,10141.0,28
CDM,29999RVU31AK,ARTHROSCOPIC REPAIR GREATER TUBEROSITY FRACTURE (COMP TO 29827),5145.0,3344.25,0.01,5145.0,28
CDM,29999RVU32AK,ARTHROSCOPIC REPAIR AND THERMAL CAPSULORRAPHY SCAPHOLUNATE LIGAM,4629.0,3008.85,0.01,4629.0,28
CDM,29999RVU33AK,LEFT HIP CORE DECOMPRESSION WITH INTRAOSSEOUS BIOPLASTY (COMP TO,4893.0,3180.45,0.01,4893.0,28
CDM,29999RVU34AK,ENDOSCOPIC GASTROCNEMIUS RECESSION (COMP CODE 27687),1089.0,707.85,0.01,1089.0,28
CDM,29999RVU37AK,TENOTOMY OF HIP FLEXORS (COMP CODE 27005),4330.0,2814.5,0.01,4330.0,28
CDM,29999RVU38AK,ARTHROSCOPY SHOULDER - BALLOON SPACER IMPLANTATION (COMP CODE 29,3432.0,2230.8,0.01,3432.0,28
CDM,29999RVU39AK,ARTHROSCOPIC REMOVAL OF IMPLANT (COMP CODE 20680),2622.0,1704.3,0.01,2622.0,28
CDM,29999RVU40AK,ARTHROSCOPIC TENOTOMY (COMP CODE 23405),3416.0,2220.4,0.01,3416.0,28
CDM,29999RVU41AK,ARTHROSCOPIC AC JOINT RECONSTRUCTION (COMP CODE 23462),6288.0,4087.2,0.01,6288.0,28
CDM,29999RVU42AK,ENDOSCOPIC ILIOPSOAS TENDON RELEASE (COMP CODE 29862),4468.0,2904.2,0.01,4468.0,28
CDM,29999RVU43AK,ARTHROSCOPIC EXCISION OF MENISCAL CYST OF THE KNEE (COMP CODE 29,2838.0,1844.7,0.01,2838.0,28
CDM,29999RVU44AK,ARTHROSCOPICALLY AIDED CARPAL DECOMPRESSION/BONE DRILLING (COMP,3060.0,1989.0,0.01,3060.0,28
CDM,29999RVU45AK,ARTHROSCOPIC CORACOPLASTY SHOULDER (COMP CODE 23182),3444.0,2238.6,0.01,3444.0,28
CDM,29999RVU46AK,ARTHROSCOPIC BONE EXCISION WITH GRAFTING (COMP CODE 27360),4584.0,2979.6,0.01,4584.0,28
CDM,29999RVU8AK,ARTHROSCOPIC REMPLISSAGE REPAIR (COMP CODE 29827),5613.0,3648.45,0.01,5613.0,28
CDM,30000055,COLL CAP BLOOD SPECIMEN,48.0,31.2,2.09,48.0,46
CDM,30000065,COLL BLOOD OFF PICC VENOUS,741.0,481.65,28.36,741.0,61
CDM,30000075,%AMITRIPTYLINE,742.0,482.3,27.64,742.0,60
CDM,30000085,CARBAMAZEPINE FREE,91.0,59.15,0.95,91.0,60
CDM,30000095,%DESIPRAMINE PL,164.0,106.6,27.64,468.91,60
CDM,30000105,%IMIPRAMINE PL,147.0,95.55,27.64,468.91,60
CDM,30000125,TOPIRAMATE,82.0,53.3,0.95,82.0,60
CDM,30000135,VANCOMYCIN,93.0,60.45,0.95,93.0,60
CDM,30000145,%ACTH STIMULATION PANEL,225.0,146.25,0.95,225.0,60
CDM,30000150,*GLIADIN ANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30000180,PHENYTOIN FREE,95.0,61.75,0.95,95.0,60
CDM,30000235,PREGNANCY TEST URINE (POINT OF CARE LAB),59.0,38.35,0.95,59.0,60
CDM,30000255,HEMOCULT FECES SCREEN (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
CDM,30000265,OCCULT BLOOD FECES 1-3 TEST,29.0,18.85,0.95,29.0,60
CDM,30000295,BLOOD GAS W CALC O2 SATUR (POINT OF CARE LAB),180.0,117.0,0.95,180.0,60
CDM,30000335,HCG TEST QUAL,52.0,33.8,0.95,52.0,60
CDM,30000340,"ALPHA-1-ANTITRYPSIN,STOOL",93.0,60.45,0.95,93.0,60
CDM,30000345,COAG TIME ACTIVATED (POINT OF CARE LAB),30.0,19.5,0.95,32.77,60
CDM,30000365,FIBRINOLYSINS SCREEN I&R,107.0,69.55,0.95,107.0,60
CDM,30000390,AMIKACIN ASSAY,104.0,67.6,0.95,104.0,60
CDM,30000425,RBC ANTIB ELUTION,1182.0,768.3,0.95,1182.0,61
CDM,30000435,AGT DIR MONOSPECIF C3,37.0,24.05,0.95,165.35,61
CDM,30000445,ANTIBODY TITER,36.0,23.4,0.95,477.52,61
CDM,30000465,SPECIAL ANTIGEN SCREEN,44.0,28.6,0.95,1004.67,61
CDM,30000470,STRONGYLOIDES IGG AB,90.0,58.5,0.95,90.0,60
CDM,30000475,RBC ANTIGEN TYPING,26.0,16.9,0.95,1004.67,61
CDM,30000485,INCUBATION CROSSMATCH,1182.0,768.3,0.95,1182.0,61
CDM,30000495,ELECTRONIC CROSSMATCH,1182.0,768.3,0.95,1182.0,61
CDM,30000520,ASPERGILLUS AB,104.0,67.6,0.95,105.93,60
CDM,30000535,PREWARM MODIFICATION,169.0,109.85,0.95,169.0,61
CDM,30000545,R E S ABSORP TEST,1182.0,768.3,0.95,1182.0,61
CDM,30000555,TRIPLE ABSORPTION X3,410.0,266.5,0.95,410.0,61
CDM,30000565,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,1182.0,768.3,0.95,1182.0,61
CDM,30000580,TREPONEMA PALLIDUM,91.0,59.15,0.95,91.0,60
CDM,30000595,KRUGER'S TEST,29.0,18.85,0.95,29.0,60
CDM,30000605,SMEAR WET MOUNT,40.0,26.0,0.95,40.0,60
CDM,30000625,STREP A ASSAY W/OPTIC,114.0,74.1,0.95,114.0,60
CDM,30000635,BILIRUBIN TOTAL TRANSCUT (POINT OF CARE LAB),35.0,22.75,0.95,35.0,60
CDM,30000640,ACTH,266.0,172.9,0.95,266.0,60
CDM,30000715,CRYOPRESERVATION SPERM,540.0,351.0,0.95,540.0,61
CDM,30000725,SPERM WASH FOR INSEMINATI,268.0,174.2,0.95,397.39,61
CDM,30000735,SPERM WASH SECOND INSEM,500.0,325.0,0.95,500.0,61
CDM,30000820,COLL/STORE AUTOLOGOUS BLOOD,1182.0,768.3,0.95,1182.0,61
CDM,30000825,SPERM COUNT/MOTILITY SEMEN,59.0,38.35,0.95,60.05,60
CDM,30000830,COMPATIBILITY TEST ANTIGLOB,1182.0,768.3,0.95,1182.0,61
CDM,30000835,CASA,205.0,133.25,0.95,205.0,60
CDM,30000840,COMPATIBILITY TEST SPIN,1182.0,768.3,0.95,1182.0,61
CDM,30000845,SEMEN ANAL POST VASEC,191.0,124.15,0.95,191.0,60
CDM,30000860,COOMBS TEST DIR EA ANTISERUM,37.0,24.05,0.95,165.35,61
CDM,30000865,ANTI SPERM AB TYPING,210.0,136.5,0.95,210.0,60
CDM,30000875,EVAL SPERM HAMSTER TEST,135.0,87.75,0.95,135.0,60
CDM,30000905,CITRIC ACID URINE,192.0,124.8,0.95,192.0,60
CDM,30000925,STORAGE/YEAR OOCYTE(S),500.0,325.0,0.95,655.34,61
CDM,30000945,THAW CRYOPRESERVE SPERM/SEMEN,250.0,162.5,0.95,250.0,61
CDM,30000950,*CREATINE KINASE ISOENZYME,92.0,59.8,0.95,92.0,60
CDM,30000970,*CREATININE BLOOD,35.0,22.75,0.95,35.0,60
CDM,30000995,SPECIMEN ACQUISITION KIT- DD WAIT LIST,49.0,31.85,2.09,49.0,46
CDM,30000AK,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,592.0,384.8,1.1,886.21,53
CDM,30001005,STAT/AFTER-HOURS REQUEST,144.0,93.6,8.52,144.0,46
CDM,30001075,MATERNAL 8PC DRUG SCREEN,429.0,278.85,0.95,429.0,60
CDM,30001115,ITRACONAZOLE,129.0,83.85,0.95,129.0,60
CDM,30001120,*DIPHTHERIA ABMA,105.0,68.25,0.95,105.0,60
CDM,30001165,CANNABANOIDS,742.0,482.3,27.64,742.0,60
CDM,30001170,EBV EBNA,106.0,68.9,0.95,106.0,60
CDM,30001175,GM1 ANTIBODY PANEL X2,80.0,52.0,0.95,80.0,60
CDM,30001185,"CV2 AB IGG CBA-IFA SCREEN, SERUM",119.0,77.35,0.95,119.0,60
CDM,30001300,ESTRIOL,167.0,108.55,0.95,167.0,60
CDM,30001310,ESTROGENS TOTAL,150.0,97.5,0.95,150.0,60
CDM,30001375,I STAT BUN DETERMINATION (POINT OF CARE LAB),27.0,17.55,0.95,27.0,60
CDM,30001430,G6PD QUANT,67.0,43.55,0.95,67.0,60
CDM,30001450,GAMMAGLOBULIN ASSAY IGE,114.0,74.1,0.95,114.0,60
CDM,30001455,CBC W/DIFF,54.0,35.1,0.95,54.0,60
CDM,30001480,GLUCOSE BLD BY MONIT DEV (POINT OF CARE LAB),23.0,14.95,0.95,23.0,60
CDM,30001485,CULTURE FOR BLOOD,71.0,46.15,0.95,71.0,60
CDM,30001490,GLUCAGON,99.0,64.35,0.95,110.02,60
CDM,30001500,GLUCOSE QUANT,27.0,17.55,0.95,27.0,60
CDM,30001515,CULTURE FOR STOOL PANEL,65.0,42.25,0.95,65.0,60
CDM,30001530,GONADOTROPIN LH,128.0,83.2,0.95,128.0,60
CDM,30001575,FSH SERUM,128.0,83.2,0.95,128.0,60
CDM,30001595,HEMATOCRIT,16.0,10.4,0.95,16.0,60
CDM,30001615,IGA,64.0,41.6,0.95,64.0,60
CDM,30001625,IRON TEST,45.0,29.25,0.95,45.0,60
CDM,30001635,LDH,42.0,27.3,0.95,42.0,60
CDM,30001655,LIPOPROTEIN,146.0,94.9,0.95,146.0,60
CDM,30001665,MAGNESIUM,46.0,29.9,0.95,46.0,60
CDM,30001685,MRSA,46.0,29.9,0.95,46.0,60
CDM,30001715,PLATELETS,31.0,20.15,0.95,31.0,60
CDM,30001745,PROTHROMBIN TIME AND INR (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
CDM,30001750,"IMMUNOASSAY, FECAL OCCULT BLOOD",110.0,71.5,0.95,110.0,60
CDM,30001800,HIV ANTIBODY,61.0,39.65,0.95,61.0,60
CDM,30001820,HIV1 HIV2 SNGL ASSAY AB,95.0,61.75,0.95,95.0,60
CDM,30001825,T4,47.0,30.55,0.95,47.0,60
CDM,30001830,HIV-2 AB,93.0,60.45,0.95,93.0,60
CDM,30001845,TSH,116.0,75.4,0.95,116.0,60
CDM,30001855,URINALYSIS (POINT OF CARE LAB),16.0,10.4,0.95,17.31,60
CDM,30001885,PARATHYROID HORMONE INTACT,285.0,185.25,0.95,285.0,60
CDM,30001940,B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB),271.0,176.15,0.95,271.0,60
CDM,30001950,*INFLUENZA A,114.0,74.1,0.95,114.0,60
CDM,30001965,ALDOLASE,67.0,43.55,0.95,67.0,60
CDM,30001975,CELL COUNT/DIFF BODY FLD,39.0,25.35,0.95,42.4,60
CDM,30001980,IRRADIATION BLOOD PRODUCT,271.0,176.15,0.95,271.0,61
CDM,30002030,*LAC (LD)(LDH) ASSAY ENZYME,88.0,57.2,0.95,88.0,60
CDM,30002040,LACTATE(LACTIC ACID),80.0,52.0,0.95,80.0,60
CDM,30002045,VITAMIN A LEVEL,80.0,52.0,0.95,89.35,60
CDM,30002065,HEMOGLOBIN,16.0,10.4,0.95,16.0,60
CDM,30002250,MICROALBUMIN UR SEMI QNT (POINT OF CARE LAB),43.0,27.95,0.95,43.0,60
CDM,30002285,"METHADONE QNT, UR",742.0,482.3,27.64,742.0,60
CDM,30002415,%UQNTPP COCAINE,742.0,482.3,27.64,742.0,60
CDM,30002425,%UQNTPP BUPRENORPHINE,742.0,482.3,27.64,742.0,60
CDM,30002515,GQ1B AUTOANTIBODY,119.0,77.35,0.95,119.0,60
CDM,30002530,OCCLT BLD GST (POINT OF CARE LAB),37.0,24.05,0.95,37.0,60
CDM,30002535,STORAGE EMBRYO EA YR,700.0,455.0,0.95,700.0,61
CDM,30002575,SPECIMEN ACQUISITION-KIT - DAILY TESTING,59.0,38.35,2.09,59.0,46
CDM,30002595,%UQNTPP TRAMADOL,742.0,482.3,27.64,742.0,60
CDM,30002620,PH BODY FLUID EXCEPT BLD (POINT OF CARE),25.0,16.25,0.95,27.56,60
CDM,30002625,%IOHWC CULTURE,59.0,38.35,0.95,59.0,60
CDM,30002645,%UQNTPP FENTANYL,742.0,482.3,27.64,742.0,60
CDM,30002655,%SENNRO SENSRY NEU IMMX6,119.0,77.35,0.95,119.0,60
CDM,30002660,POOLING BLOOD PLT OR OTHER BLD PRD,1182.0,768.3,0.95,1182.0,61
CDM,30002665,SENMOT IMMUNOASSAY X11,119.0,77.35,0.95,119.0,60
CDM,30002675,RECOMBX MA TA AUTOAB,119.0,77.35,0.95,119.0,60
CDM,30002715,"5-FLUCYTOSINE, S",129.0,83.85,0.95,129.0,60
CDM,30002725,DTT TREATMENT,410.0,266.5,0.95,410.0,61
CDM,30002741,PRETREAT RBC AB ID DENSITYSEP,1182.0,768.3,0.95,1182.0,61
CDM,30002750,PRETREAT RBC AB ID DRUG,410.0,266.5,0.95,410.0,61
CDM,30002760,PRETREAT SERUM AB ID ABSORP,410.0,266.5,0.95,410.0,61
CDM,30002770,PRETREAT SERUM AB ID INCUBATE,1182.0,768.3,0.95,1182.0,61
CDM,30002780,*PRIMIDONE ASSAY,114.0,74.1,0.95,127.78,60
CDM,30002950,RBC AB ID EA PANL,2482.0,1613.3,0.95,2482.0,61
CDM,30002970,*RBC AB SCREEN EA SERUM,67.0,43.55,0.95,168.05,61
CDM,30003020,*CHLAMYDIA IGM,87.0,56.55,0.95,87.0,60
CDM,30003090,RSV IA W DIR OBSERV,90.0,58.5,0.95,90.0,60
CDM,30003150,SODIUM BLOOD (POINT OF CARE LAB),33.0,21.45,0.95,33.0,60
CDM,30003220,SERUM PROCESSING AND STORAGE,59.0,38.35,2.09,59.0,46
CDM,30003240,SYPHILIS TEST QUANT,30.0,19.5,0.95,31.66,60
CDM,30003260,SYPHILIS TEST QUAL,29.0,18.85,0.95,29.0,60
CDM,30003280,T3 FREE,117.0,76.05,0.95,117.0,60
CDM,30003340,THAW FFP EA UNIT,1182.0,768.3,0.95,1182.0,61
CDM,30003370,THYROGLOBULIN,111.0,72.15,0.95,111.0,60
CDM,30003380,THRYOGLOB ANTIBODY,110.0,71.5,0.95,110.0,60
CDM,30003430,TSH,116.0,75.4,0.95,116.0,60
CDM,30003440,UA NON-AUTO W/O MICRO (POINT OF CARE LAB),24.0,15.6,0.95,24.0,60
CDM,30003450,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),16.0,10.4,0.95,17.31,60
CDM,30003460,VALPROIC ACID ASSAY,93.0,60.45,0.95,93.0,60
CDM,30003500,ROUTINE VENIPUNCTURE,63.0,40.95,2.09,63.0,60
CDM,30003540,VIT B-12,104.0,67.6,0.95,104.0,60
CDM,30003580,VITAMIN E,98.0,63.7,0.95,102.87,60
CDM,30003630,CALCITONIN,185.0,120.25,0.95,185.0,60
CDM,30003720,TETANUS AB,102.0,66.3,0.95,102.0,60
CDM,30007770,RBC AG NOT AB,26.0,16.9,0.95,1004.67,61
CDM,30007790,CHLORIDE,32.0,20.8,0.95,32.0,60
CDM,30007800,ABO BLOOD TYPING,21.0,13.65,0.95,372.91,61
CDM,30007810,*BLOOD TYPING RH(D),21.0,13.65,0.95,104.69,61
CDM,30007830,CELL COUNT FLUID DIFF COUNT,39.0,25.35,0.95,42.4,60
CDM,30007960,VDRL/RPR QUAN,30.0,19.5,0.95,31.66,60
CDM,30007990,RBC AB ELUTION EA ELUTION,1182.0,768.3,0.95,1182.0,61
CDM,30008000,RBC AB ID EA PANL,2482.0,1613.3,0.95,2482.0,61
CDM,30008010,LIPOPROTEIN (A),99.0,64.35,0.95,99.0,60
CDM,30008040,EXAM SYNOVIAL FLUID CRYSTALS,51.0,33.15,0.95,51.0,60
CDM,30008130,ARSENIC ASSAY,131.0,85.15,0.95,131.0,60
CDM,30008200,LUTEINING HORMONE,128.0,83.2,0.95,128.0,60
CDM,30008220,HERPES IGM,99.0,64.35,0.95,99.0,60
CDM,30008240,HIV I AB,61.0,39.65,0.95,61.0,60
CDM,30008250,HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB),95.0,61.75,0.95,95.0,60
CDM,30008420,*RICKETTSIA AB,134.0,87.1,0.95,134.0,60
CDM,30008480,VDRL/RPR QUAL,29.0,18.85,0.95,29.0,60
CDM,30008490,VDRL-CSF QUAL,29.0,18.85,0.95,29.0,60
CDM,30008530,VENIPUNCTURE,63.0,40.95,2.09,63.0,60
CDM,30008770,*SODIUM BLOOD,33.0,21.45,0.95,33.0,60
CDM,30008780,*POTASSIUM SERUM,33.0,21.45,0.95,33.0,60
CDM,30008790,*CALCIUM IONIZED,94.0,61.1,0.95,94.0,60
CDM,30008800,*CHLORIDE,32.0,20.8,0.95,32.0,60
CDM,30008850,*BLOOD TYPING RH(D),21.0,13.65,0.95,104.69,61
CDM,30008900,COOMBS; DIRECT,37.0,24.05,0.95,165.35,61
CDM,30008930,COOMBS TEST INDIRECT TITER,36.0,23.4,0.95,477.52,61
CDM,30008940,COMPATIBILITY TEST INCUBATE,1182.0,768.3,0.95,1182.0,61
CDM,30008985,RETRO AN SPERM COUNT,135.0,87.75,0.95,135.0,60
CDM,30009105,AB ID ENZYMES,1182.0,768.3,0.95,1182.0,61
CDM,30009115,"CRC AB ID, EACH CELL",39.0,25.35,0.95,477.52,61
CDM,30009270,AB ID RULE OUT,2482.0,1613.3,0.95,2482.0,61
CDM,30009295,CRC AB ID PANEL,2482.0,1613.3,0.95,2482.0,61
CDM,30009300,"CROSSMATCH, ANTIGLOBULIN",1182.0,768.3,0.95,1182.0,61
CDM,30009305,CSF COUNT BILL (NO DIFF),33.0,21.45,0.95,33.0,60
CDM,30009345,HERPES SIMPLEX IGM ABS,99.0,64.35,0.95,99.0,60
CDM,30009355,COOMBS TEST INDIRECT QUAL,39.0,25.35,0.95,477.52,61
CDM,30009365,VENIPUNCTURE (ACC),63.0,40.95,2.09,63.0,60
CDM,30009375,AB ABSORPTION,410.0,266.5,0.95,410.0,61
CDM,30009415,OB PANEL,330.0,214.5,0.95,381.89,60
CDM,30009425,PRETREATMENT W/ENZYME,1182.0,768.3,0.95,1182.0,61
CDM,30009455,LAB VENOUS-PH,76.0,49.4,0.95,89.32,60
CDM,30009465,CJD NEURO CSF QUAL,3733.0,2426.45,75.0,3733.0,60
CDM,30009495,GIST PDGFRA GENE,2274.0,1478.1,0.95,2274.0,60
CDM,30020165,BLOOD DRAW VENOUS ACCESS DEV,741.0,481.65,28.36,741.0,61
CDM,30020215,PAT BLOOD TYPING RH(D),21.0,13.65,0.95,104.69,61
CDM,30020255,WHIVF BLD TYPE RHD,21.0,13.65,0.95,104.69,61
CDM,30020265,WHIVF BLD BYPE ABO,21.0,13.65,0.95,372.91,61
CDM,30020275,WHIVF RBC AB ACRN,67.0,43.55,0.95,168.05,61
CDM,30020295,WKD D AG TYPING,21.0,13.65,0.95,104.69,61
CDM,30020485,"CHYLOSCREEN, BF ELECTROPHORESIS, REFLEX",424.0,275.6,0.95,424.0,60
CDM,30020505,GENOMIC SEQUENCING AHUS1,6121.0,3978.65,0.95,10033.71,60
CDM,30020555,ABSENCE/PRESENCE SPERM (POC) (POINT OF CARE LAB),45.0,29.25,6.5,45.0,60
CDM,30020565,RED CELL GENOTYPING,4968.0,3229.2,137.41,4968.0,60
CDM,30020595,FLT3 ITD MRD ASSAY,2811.0,1827.15,75.0,2811.0,60
CDM,30020605,CHITOTRIOSIDASE,288.0,187.2,0.95,1005.62,46
CDM,30020615,"SEQUENCING, INFLUENZA PLUS",202.0,131.3,0.95,202.0,60
CDM,30020635,URINE COLLECTION ONLY,25.0,16.25,3.72,25.0,38
CDM,30100010,COMPRE META PANL,73.0,47.45,0.95,73.0,60
CDM,30100015,BMP I STAT ANALYZER,95.0,61.75,0.95,95.0,60
CDM,30100020,LIPID-LIPO PANEL 1,92.0,59.8,0.95,92.0,60
CDM,30100025,BASIC METABOLIC PANEL,58.0,37.7,0.95,58.0,60
CDM,30100030,RENAL FUNC PANL,60.0,39.0,0.95,60.0,60
CDM,30100035,ELECTROLYTE PANEL,48.0,31.2,0.95,48.0,60
CDM,30100040,HEP FUNC PANL,56.0,36.4,0.95,56.0,60
CDM,30100055,DESIPRAMINE PLASMA,153.0,99.45,27.64,468.91,60
CDM,30100065,DOXEPIN/NORDOXEPIN,742.0,482.3,27.64,742.0,60
CDM,30100070,COLUMN CHROM QUANT,157.0,102.05,27.64,468.91,60
CDM,30100085,LIDOCAINE PLASMA,101.0,65.65,0.95,101.0,60
CDM,30100095,NORTRIPTYLINE PLASMA,742.0,482.3,27.64,742.0,60
CDM,30100105,PHENYTOIN FREE PLASMA,95.0,61.75,0.95,95.0,60
CDM,30100115,%FREE PRIMIDONE PLASMA,114.0,74.1,0.95,127.78,60
CDM,30100135,ACTH STIM W/2 TIME PTS,225.0,146.25,0.95,225.0,60
CDM,30100205,BCR/ABL QUANT BLOOD TEST,1131.0,735.15,0.95,1262.54,60
CDM,30100215,P190PCR BLOOD,999.0,649.35,0.95,1115.21,60
CDM,30100270,CARBAZEPINE TEGRETOL,101.0,65.65,0.95,101.0,60
CDM,30100290,DIGOXIN ASSAY,92.0,59.8,0.95,92.0,60
CDM,30100310,GENTAMICIN ASSAY,113.0,73.45,0.95,113.0,60
CDM,30100315,PTGENEO TEST,453.0,294.45,0.95,453.0,60
CDM,30100325,FACT V LEIDEN TEST,506.0,328.9,0.95,506.0,60
CDM,30100330,PHENOBARBITAL ASSAY,106.0,68.9,0.95,106.0,60
CDM,30100335,%FRAX FMR 1 TEST,394.0,256.1,0.95,930.61,60
CDM,30100345,HEMDNA TEST,451.0,293.15,0.95,503.27,60
CDM,30100350,PHENYTOIN-DILANTIN,91.0,59.15,0.95,91.0,60
CDM,30100355,ALPHA THALASSEMIA TEST,706.0,458.9,0.95,1397.77,60
CDM,30100370,ANALGESICS NON-OPIOID 1 OR 2,742.0,482.3,27.64,742.0,60
CDM,30100390,THEOPHYLLINE ASSAY,98.0,63.7,0.95,98.0,60
CDM,30100395,RECIPIENT TYPING FOR ENGRAFTMENT MONITORING,1608.0,1045.2,0.95,1608.0,60
CDM,30100400,TOBRAMYCIN ASSAY,111.0,72.15,0.95,111.0,60
CDM,30100405,POST-TX FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,0.95,1431.0,60
CDM,30100420,VANCOMYCIN ASSAY,93.0,60.45,0.95,93.0,60
CDM,30100425,JAK2 TEST,632.0,410.8,0.95,632.0,60
CDM,30100435,KRAS GENE,1333.0,866.45,0.95,1333.0,60
CDM,30100445,MTHFR BY PCR TEST,451.0,293.15,0.95,451.0,60
CDM,30100485,APLPCR RTPCR TEST,1430.0,929.5,0.95,1596.35,60
CDM,30100495,TCBMD II TEST,1442.0,937.3,0.95,1442.0,60
CDM,30100515,T GAMMA TEST,1390.0,903.5,0.95,1390.0,60
CDM,30100560,FE ASSAY,45.0,29.25,0.95,45.0,60
CDM,30100580,ACETONE/KETONE SERUM QUAL,31.0,20.15,0.95,31.0,60
CDM,30100590,ALBUMIN SERUM ASSAY,34.0,22.1,0.95,34.0,60
CDM,30100600,ALBUMIN URINE/OTHER QUANT,54.0,35.1,0.95,54.0,60
CDM,30100605,ACYLCARN PRO1 QT PLASMA,116.0,75.4,0.95,129.85,60
CDM,30100615,ACTH,266.0,172.9,0.95,266.0,60
CDM,30100620,*MICROALBUMIN URINE QUANT,40.0,26.0,0.95,40.0,60
CDM,30100630,ALDOSTERONE ASSAY,281.0,182.65,0.95,281.0,60
CDM,30100640,ALKA PHOSPHTA,36.0,23.4,0.95,36.0,60
CDM,30100645,ETHANOL PLASMA,742.0,482.3,27.64,742.0,60
CDM,30100650,ALPHA-FETOPROTEIN SERUM,116.0,75.4,0.95,116.0,60
CDM,30100660,ALT/SGPT,37.0,24.05,0.95,37.0,60
CDM,30100665,ALDOSTERONE,281.0,182.65,0.95,281.0,60
CDM,30100675,%SERPINA1 A1A,93.0,60.45,0.95,93.0,60
CDM,30100695,AMINO ACID>=6 QUANT EA,116.0,75.4,0.95,129.85,60
CDM,30100710,AMMONIA,101.0,65.65,0.95,101.0,60
CDM,30100715,%UQNTPP AMPHET,742.0,482.3,27.64,742.0,60
CDM,30100725,ANDROSTENEDIONE,202.0,131.3,0.95,202.0,60
CDM,30100735,ANGIOTENSIN CONV ENZYM,101.0,65.65,0.95,101.0,60
CDM,30100745,APOLIPOPROTEIN A1+B X2,146.0,94.9,0.95,146.0,60
CDM,30100755,PENTOBARBITAL,742.0,482.3,27.64,742.0,60
CDM,30100765,BETA 2 MICROGLOBULIN BLD,112.0,72.8,0.95,112.0,60
CDM,30100770,CA URINE QUANT TIMED,42.0,27.3,0.95,42.0,60
CDM,30100775,BIOTINIDASE ASSAY EA,116.0,75.4,0.95,116.0,60
CDM,30100785,%FGSTRO GSTRC OCCULT BLD,37.0,24.05,0.95,37.0,60
CDM,30100790,AST/SGOT,36.0,23.4,0.95,36.0,60
CDM,30100795,ASSAY IONIZED CA,94.0,61.1,0.95,94.0,60
CDM,30100800,ATOMIC ABSORP SPECTROSCOPY EA,110.0,71.5,0.95,110.0,60
CDM,30100805,CALCULI (STONE) ANALYSIS,89.0,57.85,0.95,89.0,60
CDM,30100810,BARBITURATES,742.0,482.3,27.64,742.0,60
CDM,30100815,CARBOXYHEMOGLOBIN,85.0,55.25,0.95,85.0,60
CDM,30100825,CARNITINE FR & TOT PLASMA,116.0,75.4,0.95,129.85,60
CDM,30100830,BETA 2 MICROGLOBULIN ASSAY,112.0,72.8,0.95,112.0,60
CDM,30100835,CAROTENE,64.0,41.6,0.95,64.0,60
CDM,30100845,CATECHOLAMINE FRACT PL,174.0,113.1,0.95,174.0,60
CDM,30100850,BILIRUBIN TOTAL,35.0,22.75,0.95,35.0,60
CDM,30100855,CERULOPLASMIN LEVEL,74.0,48.1,0.95,74.0,60
CDM,30100860,BILIRUBIN DIR,35.0,22.75,0.95,35.0,60
CDM,30100865,CHEMILUMINESCENT ASSAY,97.0,63.05,0.95,104.92,60
CDM,30100870,OCCULT BLOOD FECES COLORECT,30.0,19.5,0.95,30.0,60
CDM,30100875,ASSAY BLOOD CHLORIDE,32.0,20.8,0.95,32.0,60
CDM,30100880,OCCULT BLOOD FECES 1-3 TEST,29.0,18.85,0.95,29.0,60
CDM,30100885,AMIODARONE,166.0,107.9,0.95,166.0,60
CDM,30100895,CHROMIUM BLOOD,140.0,91.0,0.95,142.17,60
CDM,30100925,CROSS-LINK N-TELOPEPTIDES,129.0,83.85,0.95,129.0,60
CDM,30100935,COPPER BLOOD,86.0,55.9,0.95,95.56,60
CDM,30100940,CALCIUM,36.0,23.4,0.95,36.0,60
CDM,30100945,COPPER URINE,86.0,55.9,0.95,95.56,60
CDM,30100960,PSEUDOCHOLINESTERASE TOTAL,54.0,35.1,0.95,54.0,60
CDM,30100970,CARNITINE TOTAL & FREE QUANT,116.0,75.4,0.95,129.85,60
CDM,30100975,CRYOGLOBULIN QL,45.0,29.25,0.95,49.8,60
CDM,30100980,CO2 BLOOD ASSAY,34.0,22.1,0.95,34.0,60
CDM,30100985,DHEA-S,153.0,99.45,0.95,153.0,60
CDM,30100990,CEA AG,131.0,85.15,0.95,131.0,60
CDM,30100AK,"BIOPSY,INTRANASAL",376.0,244.4,1.1,2603.78,53
CDM,30101005,VIT D 1 25 DIHYDROXY,266.0,172.9,0.95,266.0,60
CDM,30101015,ISOELECTRIC FOCUSING HB,424.0,275.6,0.95,424.0,60
CDM,30101020,*CATECHOLAMINE FRACT ASSAY,174.0,113.1,0.95,174.0,60
CDM,30101025,ERYTHROPOIETIN,130.0,84.5,0.95,130.0,60
CDM,30101035,ESTRADIOL-17B,193.0,125.45,0.95,193.0,60
CDM,30101045,%QUAD4 MARKERS  ESTRIOL,167.0,108.55,0.95,167.0,60
CDM,30101050,CL URINE ASSAY,40.0,26.0,0.95,40.0,60
CDM,30101055,FECAL FAT QUALITATIVE,35.0,22.75,0.95,35.0,60
CDM,30101065,FETAL FIBRONECTIN,444.0,288.6,0.95,444.0,60
CDM,30101070,CL OTHER SOURCE ASSAY,35.0,22.75,0.95,37.65,60
CDM,30101075,FOLIC ACID RBC TEST,122.0,79.3,0.95,122.0,60
CDM,30101080,CHOLESTEROL BLOOD TOTAL,30.0,19.5,0.95,30.0,60
CDM,30101085,%IGG SUBCLASSES X4,55.0,35.75,0.95,55.0,60
CDM,30101095,BLOOD GAS VENOUS (POINT OF CARE LAB),180.0,117.0,0.95,180.0,60
CDM,30101105,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),67.0,43.55,0.95,67.0,60
CDM,30101125,GASTRIN,122.0,79.3,0.95,122.0,60
CDM,30101135,GLUC BLOOD QUANT ASSAY,27.0,17.55,0.95,27.0,60
CDM,30101155,G6PD SCREEN,42.0,27.3,0.95,42.0,60
CDM,30101165,GLUC BLOOD TEST BY DVC (POINT OF CARE LAB),23.0,14.95,0.95,23.0,60
CDM,30101175,GROWTH HORMONE HUMAN,115.0,74.75,0.95,115.0,60
CDM,30101185,HAPTOGLOBIN QUANT,87.0,56.55,0.95,87.0,60
CDM,30101195,H.PYLORI BREATH TEST,465.0,302.25,0.95,465.0,60
CDM,30101205,HEMOGLOBIN FRACT AND QUANT,89.0,57.85,0.95,89.0,60
CDM,30101215,HEMOGLOBIN A2 ASCAA,125.0,81.25,0.95,125.0,60
CDM,30101225,METHEMOGLOBIN QUANT,57.0,37.05,0.95,57.0,60
CDM,30101235,HEMOGLOBIN SERUM (POINT OF CARE LAB),50.0,32.5,0.95,51.56,60
CDM,30101265,HEMOSIDERIN URINE,33.0,21.45,0.95,33.0,60
CDM,30101295,%ANCA C+P EIA X2,80.0,52.0,0.95,80.0,60
CDM,30101305,%FLT3 ITD TEST,1142.0,742.3,0.95,1142.0,60
CDM,30101315,INSULIN FREE,89.0,57.85,0.95,99.71,60
CDM,30101325,ASSAY LACTIC ACID,80.0,52.0,0.95,80.0,60
CDM,30101335,%OSHA LEAD,84.0,54.6,0.95,84.0,60
CDM,30101350,COLLAGEN CROSS LINKS,129.0,83.85,0.95,129.0,60
CDM,30101355,LP (A),99.0,64.35,0.95,99.0,60
CDM,30101365,MANGANESE BLOOD,184.0,119.6,0.95,184.0,60
CDM,30101375,ATMS MASS SPEC QUAL,166.0,107.9,0.95,166.0,60
CDM,30101380,"COPPER, FREE, SERUM OR PLASMA",86.0,55.9,0.95,95.56,60
CDM,30101385,METANEPHRINES URINE,117.0,76.05,0.95,130.46,60
CDM,30101395,%UQNTPP METHADONE,742.0,482.3,27.64,742.0,60
CDM,30101400,CORTISOL TOTAL,112.0,72.8,0.95,112.0,60
CDM,30101415,MYOGLOBIN BLOOD,89.0,57.85,0.95,89.0,60
CDM,30101425,KAPPA & LAMBDA SERUM X2,94.0,61.1,0.95,94.0,60
CDM,30101435,NICOTINE/COTININE,742.0,482.3,27.64,742.0,60
CDM,30101455,PRADER-WILLI METH,352.0,228.8,0.95,352.0,60
CDM,30101465,OLIGOCLONAL BAND TEST,189.0,122.85,0.95,189.0,60
CDM,30101475,METHYLMALONIC ACID BL,146.0,94.9,0.95,146.0,60
CDM,30101480,*CREATINE KINASE TOTAL ASSAY,45.0,29.25,0.95,45.0,60
CDM,30101495,OXALATE URINE,100.0,65.0,0.95,100.0,60
CDM,30101500,*CREATINE KINASE MB FRACT,80.0,52.0,0.95,80.0,60
CDM,30101510,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,0.95,36.0,60
CDM,30101515,PROSTATIC ACID PHOS,753.0,489.45,0.95,753.0,60
CDM,30101525,PORPHOBILINOGEN UR SCN,40.0,26.0,0.95,40.0,60
CDM,30101555,POTASSIUM,33.0,21.45,0.95,33.0,60
CDM,30101565,PROGESTERONE,144.0,93.6,0.95,144.0,60
CDM,30101575,PROCALCITONIN,188.0,122.2,0.95,188.0,60
CDM,30101585,PROLACTIN,134.0,87.1,0.95,134.0,60
CDM,30101590,CREATININE CLEARANCE TEST,65.0,42.25,0.95,65.0,60
CDM,30101600,*DRUG SCREEN QUAL SNGL,742.0,482.3,27.64,742.0,60
CDM,30101605,PSA FREE,127.0,82.55,0.95,127.0,60
CDM,30101625,INNER EAR 68KD ANTIBODY,118.0,76.7,0.95,118.0,60
CDM,30101645,ALDOLASE,67.0,43.55,0.95,67.0,60
CDM,30101655,ALPHA-1 ANTITRYPSIN TOTAL,93.0,60.45,0.95,93.0,60
CDM,30101670,FERRITIN ASSAY,94.0,61.1,0.95,94.0,60
CDM,30101675,%SEQ2 ALPHA FETOPROTEIN,116.0,75.4,0.95,116.0,60
CDM,30101680,FOLIC ACID SERUM ASSAY,101.0,65.65,0.95,101.0,60
CDM,30101685,RENIN PLASMA,152.0,98.8,0.95,152.0,60
CDM,30101690,GAMMAGLOBULIN ASSAY,64.0,41.6,0.95,64.0,60
CDM,30101705,SODIUM FLUID,34.0,22.1,0.95,34.0,60
CDM,30101715,AMINOLEVULINIC ACID (ALA) URINE,114.0,74.1,0.95,114.0,60
CDM,30101725,TESTOSTERONE FREE,176.0,114.4,0.95,176.0,60
CDM,30101745,THYROGLOBULIN,111.0,72.15,0.95,111.0,60
CDM,30101760,BLD GAS PH/PO2/PCO2 W SAT (POINT OF CARE LAB),544.0,353.6,0.95,544.0,60
CDM,30101765,VIT E ALPHA-TOCO TEST,98.0,63.7,0.95,102.87,60
CDM,30101770,GLUCOSE BF,27.0,17.55,0.95,27.0,60
CDM,30101775,ASSAY OF ASCORBIC ACID,68.0,44.2,0.95,68.0,60
CDM,30101785,%T4TFI T4 UPTAKE,45.0,29.25,0.95,45.0,60
CDM,30101795,TROPONIN T,86.0,55.9,0.95,86.0,60
CDM,30101805,"TYROSINE, PLASMA, EA",73.0,47.45,0.95,73.0,60
CDM,30101815,UREA CLEARANCE 24 HR UR,185.0,120.25,0.95,185.0,60
CDM,30101820,GTT 3SPEC,89.0,57.85,0.95,89.0,60
CDM,30101830,GTT EA ADD SPEC BEYOND 3,27.0,17.55,0.95,27.0,60
CDM,30101840,GGT ASSAY,50.0,32.5,0.95,50.0,60
CDM,30101845,VIT A (RETINAL) TEST,80.0,52.0,0.95,89.35,60
CDM,30101850,GLYCATED PROTEIN,116.0,75.4,0.95,116.0,60
CDM,30101865,C-PEPTIDE SERUM,144.0,93.6,0.95,144.0,60
CDM,30101870,GONADOTROPIN FSH,128.0,83.2,0.95,128.0,60
CDM,30101875,HCG QUANT SERUM,104.0,67.6,0.95,104.0,60
CDM,30101900,HGB ELECPHRSIS FRACT/QUANT,89.0,57.85,0.95,89.0,60
CDM,30101915,DRUG TEST PRSMV CHEM ANLYZR,429.0,278.85,0.95,429.0,60
CDM,30101935,%PCA3 INTERP REPORT PC,32.0,20.8,0.95,35.18,60
CDM,30101965,%NMRLIP CHOLESTEROL,92.0,59.8,0.95,92.0,60
CDM,30101970,HGB A1C GLYCOSYLATED,67.0,43.55,0.95,67.0,60
CDM,30101975,ETHOSUXIMIDE ZARONTIN,113.0,73.45,0.95,113.0,60
CDM,30101980,HISTAMINE,204.0,132.6,0.95,204.0,60
CDM,30101985,HALOPERIDOL,99.0,64.35,0.95,99.0,60
CDM,30101995,QUINIDINE,101.0,65.65,0.95,101.0,60
CDM,30102000,HOMOCYSTEINE ASSAY,124.0,80.6,0.95,124.0,60
CDM,30102005,DEHYDROEPIANDROSTERONE,174.0,113.1,0.95,174.0,60
CDM,30102020,IMMUNOASSY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30102025,11-DEOXYCORTISOL,202.0,131.3,0.95,202.0,60
CDM,30102045,DIHYDROTESTOSTERONE,742.0,482.3,27.64,742.0,60
CDM,30102065,ELECTROPHORESIS NON-SPEC,424.0,275.6,0.95,424.0,60
CDM,30102095,ESTRIOL SERUM,167.0,108.55,0.95,167.0,60
CDM,30102100,*IMMUNOASSAY NONINF QUANT RIA,127.0,82.55,0.95,127.0,60
CDM,30102105,ESTRONE SERUM,172.0,111.8,0.95,172.0,60
CDM,30102115,ETHYLENE GLYCOL,103.0,66.95,0.95,103.0,60
CDM,30102125,FECAL FAT QUANT FECES,117.0,76.05,0.95,117.0,60
CDM,30102135,FATTY ACIDS NONESTERIFIED,130.0,84.5,0.95,130.0,60
CDM,30102155,FLUORIDE SERUM,128.0,83.2,0.95,183.29,60
CDM,30102195,%NEO GIPO4 URIDYL TRANS,81.0,52.65,0.95,81.0,60
CDM,30102230,IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,0.95,119.0,60
CDM,30102245,GLUCOSE 6 PHOS DEHYD QT,67.0,43.55,0.95,67.0,60
CDM,30102285,F(FETAL) QUAL,55.0,35.75,0.95,55.0,60
CDM,30102295,HEMOGLOBIN PLASMA,50.0,32.5,0.95,51.56,60
CDM,30102345,5 HIAA URINE,89.0,57.85,0.95,99.26,60
CDM,30102355,%NEO 17 OH PROGESTERONE,187.0,121.55,0.95,187.0,60
CDM,30102375,%U17K 17KETOSTEROIDS 24UR,88.0,57.2,0.95,88.0,60
CDM,30102395,LACTATE (LACTIC ACID),80.0,52.0,0.95,80.0,60
CDM,30102400,FE BINDING CAPACITY,60.0,39.0,0.95,60.0,60
CDM,30102405,%LDISO LD ISOENZYMES,88.0,57.2,0.95,88.0,60
CDM,30102410,LAC (LD)(LDH),42.0,27.3,0.95,42.0,60
CDM,30102415,"LACTOFERRIN, FECAL",136.0,88.4,0.95,136.0,60
CDM,30102425,HUMAN PLACENTAL LACTOGEN,140.0,91.0,0.95,140.0,60
CDM,30102430,LEAD ASSAY,84.0,54.6,0.95,84.0,60
CDM,30102450,LIPASE ASSAY,48.0,31.2,0.95,48.0,60
CDM,30102455,HDL CHOL SUBFRACTIONS,234.0,152.1,0.95,234.0,60
CDM,30102480,*LIPOPROTEIN MR SPECTROSCOPY,236.0,153.4,0.95,236.0,60
CDM,30102490,HDL CHOLESTEROL DIR ASSAY,57.0,37.05,0.95,57.0,60
CDM,30102500,LDL CHOLESTE,72.0,46.8,0.95,72.0,60
CDM,30102510,MAG ASSAY,46.0,29.9,0.95,46.0,60
CDM,30102515,MYELIN BASIC PROTEIN,119.0,77.35,0.95,119.0,60
CDM,30102525,MYELOPEROXIDASE (MPO),351.0,228.15,0.95,351.0,60
CDM,30102535,NICKEL SERUM,169.0,109.85,0.95,169.0,60
CDM,30102545,NICOTINE AND METAB UR,742.0,482.3,27.64,742.0,60
CDM,30102555,NUCLEOTIDASE-5,77.0,50.05,0.95,77.0,60
CDM,30102565,ORGANIC ACIDS QUANT EA,163.0,105.95,0.95,163.0,60
CDM,30102575,%UORA ORG ACIDS UR QNT,163.0,105.95,0.95,163.0,60
CDM,30102585,"OXYCODONE CONF/QT, URINE",742.0,482.3,27.64,742.0,60
CDM,30102595,OSTEOCALCIN,206.0,133.9,0.95,206.0,60
CDM,30102600,MERCURY QUANT ASSAY,112.0,72.8,0.95,112.0,60
CDM,30102605,HER-2/NEU SERUM,444.0,288.6,0.95,444.0,60
CDM,30102615,"%SSAT24 PH, UR",25.0,16.25,0.95,27.56,60
CDM,30102620,METANEPHRINES ASSAY,117.0,76.05,0.95,130.46,60
CDM,30102635,%NEO PHENYLALANINE,38.0,24.7,0.95,39.14,60
CDM,30102645,ACID PHOSPHATASE TOTL,53.0,34.45,0.95,53.0,60
CDM,30102655,PROSTATIC ACID PHOS,67.0,43.55,0.95,67.0,60
CDM,30102660,MYOGLOBIN ASSAY,89.0,57.85,0.95,89.0,60
CDM,30102665,%STCATH PHOSPOROUS,33.0,21.45,0.95,33.0,60
CDM,30102680,NATRIURETIC PEPTIDE ASSAY,271.0,176.15,0.95,271.0,60
CDM,30102685,PORPHYRINS URINE,101.0,65.65,0.95,113.27,60
CDM,30102695,PORPHYRINS STOOL,270.0,175.5,0.95,270.0,60
CDM,30102715,PREGNENOLONE SERUM,143.0,92.95,0.95,143.0,60
CDM,30102725,HYDROXYPREGNENELONE-17,157.0,102.05,0.95,157.0,60
CDM,30102755,"PROTEIN TOTAL, OTHER SOURCE",28.0,18.2,0.95,28.0,60
CDM,30102765,PAPP-A,104.0,67.6,0.95,115.95,60
CDM,30102785,PROINSULIN SERUM,184.0,119.6,0.95,184.0,60
CDM,30102795,VITAMIN B6 PLASMA,194.0,126.1,0.95,194.0,60
CDM,30102815,PYRUVATE KINASE,65.0,42.25,0.95,65.0,60
CDM,30102825,SELENIUM BLOOD,176.0,114.4,0.95,176.0,60
CDM,30102855,SOMATOSTATIN,126.0,81.9,0.95,140.77,60
CDM,30102865,%CDG SUGAR CHROMATOGR,269.0,174.85,0.95,269.0,60
CDM,30102885,SUGARS MULT QL EA,38.0,24.7,0.95,38.0,60
CDM,30102905,THYROXINE BIND GLOBULIN,102.0,66.3,0.95,102.0,60
CDM,30102915,%NEO TSH,116.0,75.4,0.95,116.0,60
CDM,30102925,CORTICOSTEROID-BINDING GLOGULIN,124.0,80.6,0.95,124.0,60
CDM,30102965,T3 DIAL FREE,117.0,76.05,0.95,117.0,60
CDM,30102975,REVERSE T3,109.0,70.85,0.95,109.0,60
CDM,30103005,VIP,244.0,158.6,0.95,272.08,60
CDM,30103015,"COPEPTIN PROAVP, PLASMA",234.0,152.1,0.95,234.0,60
CDM,30103025,VITAMIN K,95.0,61.75,0.95,104.38,60
CDM,30103055,C1 ESTERASE INHIBITOR,83.0,53.95,0.95,83.0,60
CDM,30103065,%CEPHAL FLOUR AB X3,83.0,53.95,0.95,83.0,60
CDM,30103095,CANNABINOIDS CONF UR,742.0,482.3,27.64,742.0,60
CDM,30103155,SEX-HORMONE BIND GLOBULIN,150.0,97.5,0.95,150.0,60
CDM,30103165,INSULIN LIK GR FAC 1,147.0,95.55,0.95,147.0,60
CDM,30103175,AMPHETAMINE CONF URINE,742.0,482.3,27.64,742.0,60
CDM,30103185,COCAINE CONFIRM UR,742.0,482.3,27.64,742.0,60
CDM,30103195,%SERPINA1 GENE ANALYSIS,301.0,195.65,0.95,301.0,60
CDM,30103215,"TRAMADOL & METAB, QUANT",742.0,482.3,27.64,742.0,60
CDM,30103300,ORGANIC ACID SNGL QUANT,146.0,94.9,0.95,146.0,60
CDM,30103315,DRGTOF TAPENTADOL AND MET,170.0,110.5,27.64,468.91,60
CDM,30103340,OSMOLALITY BLOOD ASSAY,46.0,29.9,0.95,46.0,60
CDM,30103360,OSMOLALITY URINE ASSAY,47.0,30.55,0.95,47.0,60
CDM,30103380,PARATHYROID HORMONE ASSAY,285.0,185.25,0.95,285.0,60
CDM,30103435,11 DEOXYCORTICOSTERONE,214.0,139.1,0.95,214.0,60
CDM,30103455,%IGA12 IGA SUBCLASS 1&2,55.0,35.75,0.95,55.0,60
CDM,30103460,PHOSPHOROUS ASSAY,33.0,21.45,0.95,33.0,60
CDM,30103480,PHOSPHOROUS URINE ASSAY,40.0,26.0,0.95,40.0,60
CDM,30103515,THYROGLOB AB INTERFERENCE,111.0,72.15,0.95,111.0,60
CDM,30103525,URIC ACID BODY FLUID,35.0,22.75,0.95,35.0,60
CDM,30103540,K URINE ASSAY,33.0,21.45,0.95,33.0,60
CDM,30103545,EVEROLIMUS,95.0,61.75,0.95,95.0,60
CDM,30103555,GABAPENTIN,150.0,97.5,0.95,150.0,60
CDM,30103565,MYCOPHENOLIC ACID,125.0,81.25,0.95,125.0,60
CDM,30103575,OXCARBAZEPINE,91.0,59.15,0.95,91.0,60
CDM,30103580,PREALBUMIN ASSAY,101.0,65.65,0.95,101.0,60
CDM,30103585,ZONISAMIDE,91.0,59.15,0.95,91.0,60
CDM,30103595,CRMSNP TEST,4500.0,2925.0,0.95,4753.45,60
CDM,30103605,MGMT TEST,860.0,559.0,0.95,860.0,60
CDM,30103630,PROTEIN TOTAL SERUM ASSAY,25.0,16.25,0.95,25.0,60
CDM,30103635,INSULIN ASSAY,79.0,51.35,0.95,79.0,60
CDM,30103640,*PROTEIN TOTAL URINE ASSAY,25.0,16.25,0.95,25.0,60
CDM,30103645,PHENYLALANINE (PKU) EA,38.0,24.7,0.95,39.14,60
CDM,30103655,CAFFEINE,266.0,172.9,0.95,266.0,60
CDM,30103690,PROTEIN TOTAL OTHER ASSAY,28.0,18.2,0.95,28.0,60
CDM,30103710,PROTEIN ELECPHRSIS SERUM,74.0,48.1,0.95,74.0,60
CDM,30103750,WESTERN BLOT BLOOD OR BODY FL,118.0,76.7,0.95,118.0,60
CDM,30103820,PROTOPORPHYRIN RBC QUANT,99.0,64.35,0.95,110.47,60
CDM,30103825,%HLAA29 TEST,513.0,333.45,0.95,513.0,60
CDM,30103850,NONENDOCRINE RECEPTOR ASSAY,35.0,22.75,0.95,37.65,60
CDM,30103860,VIT B-2 ASSAY,140.0,91.0,0.95,140.0,60
CDM,30103885,AFP AMNIOTIC FLUID,117.0,76.05,0.95,129.17,60
CDM,30103890,NA URINE ASSAY,35.0,22.75,0.95,35.0,60
CDM,30103895,%NEO AMINO ACIDS X3,96.0,62.4,0.95,96.0,60
CDM,30103905,ANGIOTENSIN II,142.0,92.3,0.95,158.03,60
CDM,30103945,CRYOFIBRINOGEN,98.0,63.7,0.95,98.0,60
CDM,30103955,CYANIDE BLOOD,134.0,87.1,0.95,134.0,60
CDM,30103975,PIVKA II,444.0,288.6,0.95,444.0,60
CDM,30104030,TESTOSTERONE TOTAL ASSAY,178.0,115.7,0.95,178.0,60
CDM,30104060,VIT B-1 ASSAY,146.0,94.9,0.95,146.0,60
CDM,30104080,THYROXINE TOTAL ASSAY,47.0,30.55,0.95,47.0,60
CDM,30104090,THYROXINE FREE ASSAY,62.0,40.3,0.95,62.0,60
CDM,30104125,ISOPROPANOL,742.0,482.3,27.64,742.0,60
CDM,30104130,TRIGLYCERIDES ASSAY,40.0,26.0,0.95,40.0,60
CDM,30104145,"AMPHETAMINE CONF, UR",742.0,482.3,27.64,742.0,60
CDM,30104150,TRIIODOTHYRONINE TOTAL(TT-3),98.0,63.7,0.95,98.0,60
CDM,30104160,TRIIODOTHYRONINE FREE(FT-3),117.0,76.05,0.95,117.0,60
CDM,30104175,VALPROIC ACID-DEPAKENE,93.0,60.45,0.95,93.0,60
CDM,30104180,BUN,27.0,17.55,0.95,27.0,60
CDM,30104185,VALPROIC ACID FREE,93.0,60.45,0.95,93.0,60
CDM,30104195,LAMOTRIGINE,86.0,55.9,24.32,468.91,60
CDM,30104200,UREA NITROGEN URINE ASSAY,38.0,24.7,0.95,38.0,60
CDM,30104205,LEVETIRACETAM/KEPPRA,91.0,59.15,0.95,91.0,60
CDM,30104215,THERAPEUTIC DRUG LEVEL,129.0,83.85,0.95,129.0,60
CDM,30104220,URIC ACID BLOOD ASSAY,31.0,20.15,0.95,31.0,60
CDM,30104230,URIC ACID OTHER SOURCE ASSAY,35.0,22.75,0.95,35.0,60
CDM,30104235,17-OH PROGESTERONE,187.0,121.55,0.95,187.0,60
CDM,30104250,VOLATILES ASSAY,118.0,76.7,0.95,118.0,60
CDM,30104255,%PORPHYRIN SCREEN,92.0,59.8,0.95,92.0,60
CDM,30104265,PSA DIAGNOSTIC,127.0,82.55,0.95,127.0,60
CDM,30104275,PROTEIN ELECTRO.FLUID QT,123.0,79.95,0.95,123.0,60
CDM,30104285,ZINC PROTOPORPHYRINS,99.0,64.35,0.95,110.47,60
CDM,30104295,PYRUVIC ACID CSF,100.0,65.0,0.95,100.0,60
CDM,30104305,SPECIFIC GRAVITY BDY FLD,23.0,14.95,0.95,23.0,60
CDM,30104315,THIOCYANATE,80.0,52.0,0.95,80.0,60
CDM,30104325,%TRAB THYROID STIM IMMUN,351.0,228.15,0.95,351.0,60
CDM,30104335,VMA URINE,107.0,69.55,0.95,119.32,60
CDM,30104345,ZINC BLOOD,79.0,51.35,0.95,87.67,60
CDM,30104355,HCG QUAL FLUID/URINE,59.0,38.35,0.95,59.0,60
CDM,30104365,PSA SCREENING,127.0,82.55,0.95,127.0,60
CDM,30104385,BRWK ACETAMINOPHEN BL,742.0,482.3,27.64,742.0,60
CDM,30104395,ASSAY NONENDOCRINE RECEPTOR,252.0,163.8,0.95,252.0,60
CDM,30104405,CALR EXON 9 MUTATION,839.0,545.35,0.95,839.0,60
CDM,30104415,KIT D816V MUT DETECT,862.0,560.3,0.95,862.0,60
CDM,30104505,%A1APHE A1A PHENOTYPE,100.0,65.0,0.95,100.0,60
CDM,30104515,%2ND TRI AFP,116.0,75.4,0.95,116.0,60
CDM,30104525,AMYLASE,45.0,29.25,0.95,45.0,60
CDM,30104545,CRYOGLOBULIN QL,45.0,29.25,0.95,49.8,60
CDM,30104555,GLUCOSE SCRN POST DOSE,33.0,21.45,0.95,33.0,60
CDM,30104565,%LIVFIB GGT,50.0,32.5,0.95,50.0,60
CDM,30104575,%CELCMP TRANSGLUT IGA,80.0,52.0,0.95,80.0,60
CDM,30104595,%1ST TRI PAPP-A,104.0,67.6,0.95,115.95,60
CDM,30104605,%1ST TRI HCG QUANT,104.0,67.6,0.95,104.0,60
CDM,30104615,%UQNTPP HEROIN METABOLITE,742.0,482.3,27.64,742.0,60
CDM,30104625,CREATININE UR/FLUID,36.0,23.4,0.95,36.0,60
CDM,30104635,VITAMIN B12 BLOOD,104.0,67.6,0.95,104.0,60
CDM,30104645,PSA FREE,127.0,82.55,0.95,127.0,60
CDM,30104685,JAK2 TEST,632.0,410.8,0.95,632.0,60
CDM,30104705,%CFA VERY LONG CHAIN,136.0,88.4,0.95,139.04,60
CDM,30104715,%CELCMP HLADQ2 TEST,853.0,554.45,0.95,853.0,60
CDM,30104745,%CELCMP GAMMALOBULIN,64.0,41.6,0.95,64.0,60
CDM,30104815,GBL MYL NGS 5-50 GENE,5241.0,3406.65,0.95,5241.0,60
CDM,30104825,%A1APHE A1A TOTAL,93.0,60.45,0.95,93.0,60
CDM,30104885,"SULFONYLUREA HYPOGLY, SER",309.0,200.85,27.64,468.91,60
CDM,30104905,MPL MUTATION ANLYS BLD,1278.0,830.7,0.95,1988.72,60
CDM,30104915,POTASSIUM (POINT OF CARE LAB),33.0,21.45,0.95,33.0,60
CDM,30104925,%NGSCOL BRAF,1210.0,786.5,0.95,1210.0,60
CDM,30104935,"%NGSCOL KRAS 12,13",1333.0,866.45,0.95,1333.0,60
CDM,30104945,%KRASGN KRAS EXON2,1333.0,866.45,0.95,1333.0,60
CDM,30104975,%NGSCOL KRAS 61,1333.0,866.45,0.95,1333.0,60
CDM,30104995,CFNGS 139 VAR,3841.0,2496.65,0.95,4289.05,60
CDM,30105115,%BCRQL BCR/ABL1 MAJ BRKPT,1131.0,735.15,0.95,1262.54,60
CDM,30105125,%PHI PROST SPEC AG TOT,127.0,82.55,0.95,127.0,60
CDM,30105225,%CELCMP HLADQ8 TEST,853.0,554.45,0.95,853.0,60
CDM,30105255,RESP VIRUS 3-5 TARGETS,984.0,639.6,0.95,984.0,60
CDM,30105265,%LIVFIB APOLIPOPROTEIN,146.0,94.9,0.95,146.0,60
CDM,30105275,%LIVFIB BILIRUBIN,35.0,22.75,0.95,35.0,60
CDM,30105285,%LIVFIB HAPTOGLOBIN QNT,87.0,56.55,0.95,87.0,60
CDM,30105295,%LIVFIB NEPHELOMETRY,94.0,61.1,0.95,94.0,60
CDM,30105305,%LIVFIB ALANINE AMINO,37.0,24.05,0.95,37.0,60
CDM,30105315,TROPONIN I,86.0,55.9,0.95,86.0,60
CDM,30105325,%BCRQL BCR/ABL1 MIN BRKPT,999.0,649.35,0.95,1115.21,60
CDM,30105335,%BCRQL BCR/ABL1 OTH BRKPT,1481.0,962.65,0.95,1481.0,60
CDM,30105345,NT PRO BNP,271.0,176.15,0.95,271.0,60
CDM,30105365,MYELOID NGS 5-50 GENE,5241.0,3406.65,0.95,5241.0,60
CDM,30105375,ADMARK PHOS TAU CSF X3,119.0,77.35,0.95,119.0,60
CDM,30105385,MATRIX METALLOPRO-9 MMP-9,119.0,77.35,0.95,119.0,60
CDM,30105425,PAIN PANEL QNT UR,1015.0,659.75,59.88,1015.0,60
CDM,30105435,"HLA-A-B,CW,DR,DQ,DRB345-RSSOP-Q9 VERIF",2791.0,1814.15,0.95,2791.0,60
CDM,30105485,%FLT3 TKD TEST,573.0,372.45,0.95,573.0,60
CDM,30105765,CLOTTING TEST,30.0,19.5,0.95,30.0,60
CDM,30105800,IMMUNOASSAY NONINF QUANT RIA,127.0,82.55,0.95,127.0,60
CDM,30105805,MUSK ANTIBODY,127.0,82.55,0.95,127.0,60
CDM,30105815,MUSCLE MODULATING AB,127.0,82.55,0.95,127.0,60
CDM,30105820,CYSTATIN C,128.0,83.2,0.95,128.0,60
CDM,30105825,GANGLIONIC NACHR ANTIBOD,127.0,82.55,0.95,127.0,60
CDM,30105835,PROCOL TYPEL N TARMINAL,127.0,82.55,0.95,127.0,60
CDM,30105845,VOLTAGE-GATED CAL IGG AB,127.0,82.55,0.95,127.0,60
CDM,30105855,GANGLIONIC ACHR AUTOAB,127.0,82.55,0.95,127.0,60
CDM,30105860,IMMUNOASSAY,127.0,82.55,0.95,127.0,60
CDM,30105865,MELANOCYTE STIM HORMONE ALP,127.0,82.55,0.95,127.0,60
CDM,30105875,PANCREASTATIN,127.0,82.55,0.95,127.0,60
CDM,30105880,"PORPHOBILINOGEN, QN, RANDOM UR",58.0,37.7,0.95,58.09,60
CDM,30105885,NEURO VG K CHAN ABS MOD,127.0,82.55,0.95,127.0,60
CDM,30105890,PANC ELASTASE FECAL QUAL/SEMI,80.0,52.0,0.95,88.84,60
CDM,30105895,MELATONIN,119.0,77.35,0.95,119.0,60
CDM,30105900,PARATHYROID HORMONE ASSAY,285.0,185.25,0.95,285.0,60
CDM,30105905,%MYGRAV ACHR ABX2,127.0,82.55,0.95,127.0,60
CDM,30105915,%CEPHAL IA/RIA,127.0,82.55,0.95,127.0,60
CDM,30105920,*PROLACTIN ASSAY,134.0,87.1,0.95,134.0,60
CDM,30105925,IGF-II INSULIN LIKE GR,127.0,82.55,0.95,127.0,60
CDM,30105935,VOLTAGE-GATED KCHANNEL AB,127.0,82.55,0.95,127.0,60
CDM,30105945,%LAMBRT IA;QNT RIA X4 MOD,127.0,82.55,0.95,127.0,60
CDM,30105965,PANCREATIC POLYPE,127.0,82.55,0.95,127.0,60
CDM,30105975,ACETYLCHOL REC MOD,127.0,82.55,0.95,127.0,60
CDM,30105980,K URINE ASSAY,33.0,21.45,0.95,33.0,60
CDM,30105985,IGFBP-3 INSULIN,97.0,63.05,0.95,104.92,60
CDM,30105995,%PARNEO AB BIND X2 MOD,127.0,82.55,0.95,127.0,60
CDM,30106005,IGF BINDING PROTEIN 2,127.0,82.55,0.95,127.0,60
CDM,30106015,TRYPSINOGEN,119.0,77.35,0.95,119.0,60
CDM,30106035,GALACTOSE-1-PHOSPHATE,80.0,52.0,0.95,80.0,60
CDM,30106045,VASC ENDO GROWTH FACT,119.0,77.35,0.95,119.0,60
CDM,30106085,VITAMIN B1 PLASMA,146.0,94.9,0.95,146.0,60
CDM,30106095,KINASE TEST,2070.0,1345.5,0.95,2070.0,60
CDM,30106115,MPL TEST,1278.0,830.7,0.95,1988.72,60
CDM,30106125,CEBPA MUT ANALYSIS,1669.0,1084.85,0.95,1669.0,60
CDM,30106135,JAKNON TEST,1278.0,830.7,0.95,1988.72,60
CDM,30106145,%NGSLUNG KRAS 61,1333.0,866.45,0.95,1333.0,60
CDM,30106185,GBM ANTIBODY,118.0,76.7,0.95,118.0,60
CDM,30106225,"CHYMOTRYPSIN, STOOL",56.0,36.4,0.95,56.0,60
CDM,30106245,PBG DEAMINASE,56.0,36.4,0.95,56.0,60
CDM,30106265,PORPHYRINS PLASMA,56.0,36.4,0.95,56.0,60
CDM,30106275,PHOSPHOLIPIDS,56.0,36.4,0.95,56.0,60
CDM,30106295,PORPHYRINS SERUM TOTAL,56.0,36.4,0.95,56.0,60
CDM,30106365,%BRAFGN BRAF GENE AN,1210.0,786.5,0.95,1210.0,60
CDM,30106375,PURINE&PYRIMIDINE,166.0,107.9,0.95,166.0,60
CDM,30106385,THIOPURINE METHYLT TPMT,153.0,99.45,0.95,153.0,60
CDM,30106395,BILE ACIDS FRACTIONATED,166.0,107.9,0.95,166.0,60
CDM,30106405,N-METHYLHISTAMINE UR,166.0,107.9,0.95,166.0,60
CDM,30106415,IODINE TOTAL URINE,152.0,98.8,0.95,152.0,60
CDM,30106425,PLTHY MASS SPEC QUANT,166.0,107.9,0.95,166.0,60
CDM,30106435,SILVER UR QUANT,166.0,107.9,0.95,166.0,60
CDM,30106455,IODIDE SERUM,152.0,98.8,0.95,152.0,60
CDM,30106485,SEROTONIN SERUM,214.0,139.1,0.95,214.0,60
CDM,30106495,SEROTONIN WHOLE BLOOD,214.0,139.1,0.95,214.0,60
CDM,30106535,PLASMIN ACT INHIBITOR AG,119.0,77.35,0.95,119.0,60
CDM,30106545,"PAN.ELASTASE, FECAL",119.0,77.35,0.95,119.0,60
CDM,30106555,ADIPONECTIN,119.0,77.35,0.95,119.0,60
CDM,30106565,ANTI-IGA ANTIBODY,119.0,77.35,0.95,119.0,60
CDM,30106585,INTERLEUKIN 2 RECEPTOR,119.0,77.35,0.95,119.0,60
CDM,30106595,INTERLEUKIN 2,119.0,77.35,0.95,119.0,60
CDM,30106615,ANTI MULLERIAN HORMONE,119.0,77.35,0.95,119.0,60
CDM,30106625,%MYGRAV STRIATIONAL AB,119.0,77.35,0.95,119.0,60
CDM,30106635,INTERLEUKIN 6,119.0,77.35,0.95,119.0,60
CDM,30106645,INTERLEUKIN 5,119.0,77.35,0.95,119.0,60
CDM,30106655,ALPHA SUBUNIT,97.0,63.05,0.95,104.92,60
CDM,30106665,LEPTIN,119.0,77.35,0.95,119.0,60
CDM,30106685,ANTI IGE,119.0,77.35,0.95,119.0,60
CDM,30106695,NEURON SPECIFIC ENO CSF,119.0,77.35,0.95,119.0,60
CDM,30106705,%IBDSER SACCH CEREV X2,85.0,55.25,0.95,85.0,60
CDM,30106715,MANNOSE BINDING PROTEIN,119.0,77.35,0.95,119.0,60
CDM,30106725,COLLAGEN TYPE II AB,119.0,77.35,0.95,119.0,60
CDM,30106735,%LAMBRT IMMUNASSY QNT;NOS,119.0,77.35,0.95,119.0,60
CDM,30106740,*THYROXINE TOTAL ASSAY,47.0,30.55,0.95,47.0,60
CDM,30106745,TUMOR NECROSIS SERUM,119.0,77.35,0.95,119.0,60
CDM,30106755,INHIBIN B,119.0,77.35,0.95,119.0,60
CDM,30106765,GLOM BASE MEM AB IGG,80.0,52.0,0.95,80.0,60
CDM,30106785,%INHAB IMMUNO QT,119.0,77.35,0.95,119.0,60
CDM,30106795,%PARNEO STRIATIONAL AB,119.0,77.35,0.95,119.0,60
CDM,30106815,RIBOSOMAL P PROTEIN IGG,119.0,77.35,0.95,119.0,60
CDM,30106820,LITHIUM ASSAY,46.0,29.9,0.95,46.0,60
CDM,30106825,IBDSGI ELISA X6,119.0,77.35,0.95,119.0,60
CDM,30106845,GANGLIOSIDE ABS MAYO X6,119.0,77.35,0.95,119.0,60
CDM,30106980,TOTAL BILIRUBIN,35.0,22.75,0.95,35.0,60
CDM,30107000,CORTISOL FREE,115.0,74.75,0.95,115.0,60
CDM,30107015,%PANCPL PRSS1,1896.0,1232.4,0.95,1896.0,60
CDM,30107030,MANGANESE,184.0,119.6,0.95,184.0,60
CDM,30107040,VITAMIN NOS,118.0,76.7,0.95,118.0,60
CDM,30107165,MYD88 L265P MUTATION,2070.0,1345.5,0.95,2070.0,46
CDM,30107170,PHENOBARBITAL FREE (UNBOUND),106.0,68.9,0.95,106.0,60
CDM,30107190,DRUG QUANT NOS ASSAY,129.0,83.85,0.95,129.0,60
CDM,30107210,ACETAZOLAMIDE,129.0,83.85,0.95,129.0,60
CDM,30107230,DRUG SCREEN QUANT CLOZAPINE,139.0,90.35,0.95,139.0,60
CDM,30107265,IBDSGI ATG16L1 TEST,146.0,94.9,0.95,837.52,46
CDM,30107275,IBDSGI STAT3 TEST,146.0,94.9,0.95,837.52,46
CDM,30107285,IBDSGI NKX23 TEST,146.0,94.9,0.95,837.52,46
CDM,30107295,IBDSGI UNLISTED MOL PATH,144.0,93.6,0.95,837.52,46
CDM,30107330,*ALKA PHOSPHTAS ASSAY,36.0,23.4,0.95,36.0,60
CDM,30107360,*AMYLASE ASSAY,45.0,29.25,0.95,45.0,60
CDM,30107365,PAIGEN TEST,441.0,286.65,0.95,1608.07,60
CDM,30107380,ARSENIC,131.0,85.15,0.95,131.0,60
CDM,30107415,MPLDNA TEST,1278.0,830.7,0.95,1988.72,60
CDM,30107425,YCMICR TEST,1278.0,830.7,0.95,1988.72,60
CDM,30107550,CHROM QUANT,742.0,482.3,27.64,742.0,60
CDM,30107600,ANTIDEPRESSANT TRICYCLIC 1/2,116.0,75.4,27.64,468.91,60
CDM,30107685,COENZYME Q10,166.0,107.9,0.95,166.0,60
CDM,30107705,FLUCONAZOLE SERUM,129.0,83.85,0.95,129.0,60
CDM,30107710,CORTISOL TOTAL,112.0,72.8,0.95,112.0,60
CDM,30107735,"KAPPA FREE, URINE",94.0,61.1,0.95,94.0,60
CDM,30107745,"LAMBDA FREE, URINE",94.0,61.1,0.95,94.0,60
CDM,30107750,*CREATINE KINASE TOTAL ASSAY,45.0,29.25,0.95,45.0,60
CDM,30107760,CREATININE OTHER SOURCE,36.0,23.4,0.95,36.0,60
CDM,30107765,%NGSCOL NRAS,2041.0,1326.65,0.95,2041.0,60
CDM,30107770,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,0.95,36.0,60
CDM,30107780,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,0.95,36.0,60
CDM,30107790,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,0.95,36.0,60
CDM,30107795,%FSII IMMUNO QUANT,119.0,77.35,0.95,119.0,60
CDM,30107805,BENZODIAZEPINES CONF UR,742.0,482.3,27.64,742.0,60
CDM,30107825,LEFLUNOMIDE METABOLITE,129.0,83.85,0.95,129.0,60
CDM,30107845,%FSII CHEMILUMINESCENT,97.0,63.05,0.95,104.92,60
CDM,30107875,"GLUCOSE RANDOM, UR",27.0,17.55,0.95,27.0,60
CDM,30107880,GLUC BODY FLUID NOT BLOOD,27.0,17.55,0.95,27.0,60
CDM,30107885,"CARBOHYDRATE, UR",38.0,24.7,0.95,38.0,60
CDM,30107895,"BENZO, QUANT, UR",742.0,482.3,27.64,742.0,60
CDM,30107900,HGB ELECPHRSIS FRACT/QUANT,89.0,57.85,0.95,89.0,60
CDM,30107915,FLECAINIDE BLOOD,129.0,83.85,0.95,129.0,60
CDM,30107920,HGB CHROMO FRACT/QUANT,125.0,81.25,0.95,125.0,60
CDM,30107925,DEXAMETHASONE SERUM,129.0,83.85,0.95,129.0,60
CDM,30107935,SULFONAMIDES,129.0,83.85,0.95,129.0,60
CDM,30107945,VORICONAZOLE,129.0,83.85,0.95,129.0,60
CDM,30107955,POSACONAZOLE,129.0,83.85,0.95,129.0,60
CDM,30107970,*IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30108035,DIGITOXIN,129.0,83.85,0.95,129.0,60
CDM,30108040,IMMUNOASSY NONINF QUANT RIA,127.0,82.55,0.95,127.0,60
CDM,30108050,IMMUNOASSY NONINF QUANT RIA,127.0,82.55,0.95,127.0,60
CDM,30108140,*IMMUNOASSAY QUANT NOS,119.0,77.35,0.95,119.0,60
CDM,30108145,FREE CORTISOL URINE LCM,115.0,74.75,0.95,115.0,60
CDM,30108155,FREE CORTISOL UR LCM X3,115.0,74.75,0.95,115.0,60
CDM,30108275,ALPHA GALACTOS SERUM,153.0,99.45,0.95,153.0,60
CDM,30108305,FATTY ACIDS FREE,130.0,84.5,0.95,130.0,60
CDM,30108315,LONG CHAIN FATTY ACIDS,136.0,88.4,0.95,139.04,60
CDM,30108325,HBSCN1 REFLEX,89.0,57.85,0.95,89.0,60
CDM,30108335,TYSABRI ANTIBODIES,80.0,52.0,0.95,80.0,60
CDM,30108345,IMMUNOASSAY (MYOSPL),80.0,52.0,0.95,80.0,60
CDM,30108355,MAG ANTIBODY IGM,80.0,52.0,0.95,80.0,60
CDM,30108365,%CEPHAL IA QNTNOS NONABX4,119.0,77.35,0.95,119.0,60
CDM,30108375,RNA POLYMER III IGG,80.0,52.0,0.95,80.0,60
CDM,30108385,U3 RNP AB,124.0,80.6,0.95,124.0,60
CDM,30108395,IMMUNOASSAY NONANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30108405,GANGLIOSIDE ABS X2,80.0,52.0,0.95,80.0,60
CDM,30108415,GANGLIOSIDE ABS X6,80.0,52.0,0.95,80.0,60
CDM,30108455,HU AUTOANTIBODY,119.0,77.35,0.95,119.0,60
CDM,30108465,NEOSEN NEURO PARANEO X3,119.0,77.35,0.95,119.0,60
CDM,30108495,%NGSMEL KIT,2274.0,1478.1,0.95,2274.0,60
CDM,30108505,%NGSMEL NRAS,2041.0,1326.65,0.95,2041.0,60
CDM,30108555,"14.3.3 ETA PROTEIN, SER",119.0,77.35,0.95,119.0,60
CDM,30108565,ETHYL GLUC UR SCRN,429.0,278.85,0.95,429.0,60
CDM,30108685,METHYLMALONIC ACID URINE,146.0,94.9,0.95,146.0,60
CDM,30108710,*PROTEIN TOTAL URINE ASSAY,25.0,16.25,0.95,25.0,60
CDM,30108725,RI AUTOANTIBODY,119.0,77.35,0.95,119.0,60
CDM,30108735,CRMP-5 WB BAND ID,202.0,131.3,0.95,202.0,60
CDM,30108740,*PROTEIN ELECPHRSIS OTHER,123.0,79.95,0.95,123.0,60
CDM,30108745,%CEPHAL ISLET CELL AB,163.0,105.95,0.95,163.0,60
CDM,30108755,YO AUTOANTIBODY,119.0,77.35,0.95,119.0,60
CDM,30108765,CRMP 5 IGG WEST BLOT CSF,202.0,131.3,0.95,202.0,60
CDM,30108775,%CJD WESTERN BLOT,202.0,131.3,0.95,202.0,60
CDM,30108785,%SEQ1 HCG,104.0,67.6,0.95,104.0,60
CDM,30108795,%SEQ2 HCG QUANT,104.0,67.6,0.95,104.0,60
CDM,30108800,NONENDOCRINE RECEPTOR ASSAY,252.0,163.8,0.95,252.0,60
CDM,30108805,BETA HCG QUANT SERUM,104.0,67.6,0.95,104.0,60
CDM,30108825,B27PCR TEST,513.0,333.45,0.95,513.0,60
CDM,30108895,HOMOCYSTINE UR QNT,159.0,103.35,0.95,159.0,60
CDM,30108930,OXYCODONE,742.0,482.3,27.64,742.0,60
CDM,30108960,MAGNESIUM RBC,46.0,29.9,0.95,46.0,60
CDM,30108965,RETINOL BINDING PROTEIN,94.0,61.1,0.95,94.0,60
CDM,30108975,PROLACTIN MACROADENOMA,134.0,87.1,0.95,134.0,60
CDM,30108985,FECAL WT 24HR WET WEIGHT,20.0,13.0,0.95,1005.62,46
CDM,30109015,MATRNL TEST,1608.0,1045.2,0.95,1608.0,60
CDM,30109025,POST-TX NO-T-CELL FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,0.95,1431.0,60
CDM,30109055,T GAMMA TEST,1390.0,903.5,0.95,1390.0,60
CDM,30109065,HLADQ8 TEST,853.0,554.45,0.95,853.0,60
CDM,30109075,HLADQ2 TEST,853.0,554.45,0.95,853.0,60
CDM,30109095,BLOOD GAS ARTERIAL (POINT OF CARE LAB),180.0,117.0,0.95,180.0,60
CDM,30109215,ALPHA 1 ANTRY STOOL,93.0,60.45,0.95,93.0,60
CDM,30109235,%PHA1A TOTAL,93.0,60.45,0.95,93.0,60
CDM,30109255,ARSENIC URINE,131.0,85.15,0.95,131.0,60
CDM,30109275,CARBOHYDRATE DEF TRANSFER,125.0,81.25,0.95,139.04,60
CDM,30109295,CATECHOLAMINE FRAC UR,174.0,113.1,0.95,174.0,60
CDM,30109315,IBDSGI CHEMILUM X4,97.0,63.05,0.95,104.92,60
CDM,30109325,"COPPER, TISSUE",86.0,55.9,0.95,95.56,60
CDM,30109335,"CREATINE, URINE",32.0,20.8,0.95,35.18,60
CDM,30109340,T3/T4 UPTAKE,45.0,29.25,0.95,45.0,60
CDM,30109345,SULFONYLUREA HYPO URINE,240.0,156.0,27.64,468.91,60
CDM,30109350,*TESTOSTERONE TOTAL ASSAY,178.0,115.7,0.95,178.0,60
CDM,30109380,CAR AUTOANTIBODY,119.0,77.35,0.95,119.0,60
CDM,30109390,*CRYSTAL EXAM FLUID/TIS,64.0,41.6,0.95,64.0,60
CDM,30109410,AMYLASE,45.0,29.25,0.95,45.0,60
CDM,30109415,%UCAT24 CREATININE,36.0,23.4,0.95,36.0,60
CDM,30109460,QUANT SERUM ACETONES/KETONES,56.0,36.4,0.95,56.0,60
CDM,30109465,CHYLOMICRON SCREEN,424.0,275.6,0.95,424.0,60
CDM,30109470,ASSAY FOR CALPROTECTIN FECAL,135.0,87.75,0.95,151.13,60
CDM,30109475,%SEQ2 ESTRIOL,167.0,108.55,0.95,167.0,60
CDM,30109495,GLYCOPROTEINS,116.0,75.4,0.95,116.0,60
CDM,30109505,TITANIUM SER/PLAS,152.0,98.8,0.95,152.0,60
CDM,30109525,NMRLIPO PARTICLE QT,236.0,153.4,0.95,236.0,60
CDM,30109535,%STCATH MAGNESIUM,46.0,29.9,0.95,46.0,60
CDM,30109545,MANGANESE URINE,184.0,119.6,0.95,184.0,60
CDM,30109565,MERCURY URINE,112.0,72.8,0.95,112.0,60
CDM,30109575,%UTXM3 MERCURY,112.0,72.8,0.95,112.0,60
CDM,30109585,MYOGLOBIN URINE,89.0,57.85,0.95,89.0,60
CDM,30109595,ALK-P BONE SPECIFIC,102.0,66.3,0.95,102.0,60
CDM,30109600,PTH RELATED PEPTIDE,97.0,63.05,0.95,104.92,60
CDM,30109615,%NCDG SUGAR CHROMATOGR,269.0,174.85,0.95,269.0,60
CDM,30109620,DRGTOF BENZODIAZEPINES1-12,742.0,482.3,27.64,742.0,60
CDM,30109635,THYROGLOBULIN FLUID,111.0,72.15,0.95,111.0,60
CDM,30109640,ALUM ASSAY,176.0,114.4,0.95,176.0,60
CDM,30109645,VITAMIN B5,118.0,76.7,0.95,118.0,60
CDM,30109655,VITAMIN B7 (BIOTIN),118.0,76.7,0.95,118.0,60
CDM,30109665,PROPYLENE GLYCOL,118.0,76.7,0.95,118.0,60
CDM,30109675,TOLUENE BLOOD,118.0,76.7,0.95,118.0,60
CDM,30109695,COMPLEMENT FACTOR B,83.0,53.95,0.95,83.0,60
CDM,30109705,%ABLQUL BCR/ABL1 MAJ,1131.0,735.15,0.95,1262.54,60
CDM,30109715,%ABLQUL BCR/ABL1 MIN,999.0,649.35,0.95,1115.21,60
CDM,30109725,%ABLQUL BCR/ABL1 OTH,1481.0,962.65,0.95,1481.0,60
CDM,30109745,LP-PLA2 ACTIVITY,320.0,208.0,0.95,320.0,60
CDM,30109750,*ALBUMIN SERUM ASSAY,34.0,22.1,0.95,34.0,60
CDM,30109755,DRGTOF FENTANYL AND METABOLITE,170.0,110.5,27.64,468.91,60
CDM,30109775,GROWTH DIFF FACTOR 15,119.0,77.35,0.95,119.0,60
CDM,30109785,PROCAINAMIDE/NAPA,116.0,75.4,0.95,116.0,60
CDM,30109795,%NGSMEL BRAF,1210.0,786.5,0.95,1210.0,60
CDM,30109860,"TOXIC METAL, QUANT EA",152.0,98.8,0.95,152.0,60
CDM,30109875,NARCOLEPSY ASSOC AG,753.0,489.45,0.95,753.0,60
CDM,30109885,HLADR TEST,843.0,547.95,0.95,843.0,60
CDM,30109890,"PH BODY FLUID, NES",25.0,16.25,0.95,27.56,60
CDM,30109970,CREATININE BLOOD ASSAY,35.0,22.75,0.95,35.0,60
CDM,30110005,MYD88 L265P MUT ANLYS,599.0,389.35,0.95,837.52,46
CDM,30110045,TRIMETHYLAMINE N-OXIDE,166.0,107.9,0.95,166.0,60
CDM,30110065,ESTRADIOL TANDEM MASS SP,193.0,125.45,0.95,193.0,60
CDM,30110075,"IMGLB IGG, A, M X3",64.0,41.6,0.95,64.0,60
CDM,30110085,"IMMUNOGLOB D QT, SERUM",64.0,41.6,0.95,64.0,60
CDM,30110115,%NEUR 5-HIAA,89.0,57.85,0.95,99.26,60
CDM,30110135,ANTI-C1Q AB IGG,80.0,52.0,0.95,80.0,60
CDM,30110155,ANTI-HMGCR AUTO AB,80.0,52.0,0.95,80.0,60
CDM,30110165,LIPOPROTEIN ELECTROPHOR,78.0,50.7,0.95,78.0,60
CDM,30110190,ALPHA-FETOPROTEIN L3,444.0,288.6,0.95,444.0,60
CDM,30110195,PARA AB WB CSF,202.0,131.3,0.95,202.0,60
CDM,30110205,%OSHA ZPP,99.0,64.35,0.95,110.47,60
CDM,30110210,IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30110215,"ADENOSINE DEAMINASE, PF",56.0,36.4,0.95,56.0,60
CDM,30110225,"ADENOSINE DEAMINASE, RBC",56.0,36.4,0.95,56.0,60
CDM,30110235,"ADENOSINE DEAMINASE, SER",56.0,36.4,0.95,56.0,60
CDM,30110240,*SEX HORMONE BINDING GLOBULIN,150.0,97.5,0.95,150.0,60
CDM,30110245,GLYCOMARK,80.0,52.0,0.95,80.0,60
CDM,30110255,UCPEP C PEPTIDE URINE,144.0,93.6,0.95,144.0,60
CDM,30110265,"OXYCODONE SCRN, UR",429.0,278.85,0.95,429.0,60
CDM,30110275,TRAZODONE,742.0,482.3,27.64,742.0,60
CDM,30110380,BLOOD GAS,544.0,353.6,0.95,544.0,60
CDM,30110390,THYROID STIMULATING HORMONE (TSH),116.0,75.4,0.95,116.0,60
CDM,30110400,*FE ASSAY,45.0,29.25,0.95,45.0,60
CDM,30110410,*FE BINDING CAPACITY,60.0,39.0,0.95,60.0,60
CDM,30110420,*GAMMAGLOBULIN IGG SUBCLASS EA,55.0,35.75,0.95,55.0,60
CDM,30110440,*GAMMAGLOBULIN ASSAY IGE,114.0,74.1,0.95,114.0,60
CDM,30110470,VITAMIN D 25 HYDROXY,204.0,132.6,0.95,204.0,60
CDM,30110690,*CFTR GENE FULL SEQUENCE,3443.0,2237.95,0.95,3443.0,60
CDM,30110710,*UNLISTED MOLECULAR PATHOLOGY,1124.0,730.6,0.95,1124.0,46
CDM,30110750,CFTR GENE COM VARIANTS,3841.0,2496.65,0.95,4289.05,60
CDM,30110820,MOPATH PROCEDURE LEVEL 1,441.0,286.65,0.95,1608.07,60
CDM,30110990,IMMUNOASSY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30111040,ALKA PHOSPHTAS ISOENZYME,102.0,66.3,0.95,102.0,60
CDM,30111070,LAC (LD)(LDH),42.0,27.3,0.95,42.0,60
CDM,30111100,*CITRATE ASSAY,192.0,124.8,0.95,192.0,60
CDM,30111110,*OXALATE ASSAY,100.0,65.0,0.95,100.0,60
CDM,30111120,*NA URINE ASSAY,35.0,22.75,0.95,35.0,60
CDM,30111140,LEAD UR 24HR,84.0,54.6,0.95,84.0,60
CDM,30111150,MERCURY QUANT,112.0,72.8,0.95,112.0,60
CDM,30111160,"CADMIUM, WHOLE BLOOD",163.0,105.95,0.95,163.0,60
CDM,30111170,AMINO ACID SINGL QUANT,159.0,103.35,0.95,159.0,60
CDM,30111270,"HLA-A,B,CW,DR,DQ,DRB345-RSSOP",2775.0,1803.75,0.95,2775.0,60
CDM,30111350,TACROLIMUS ASSAY,95.0,61.75,0.95,95.0,60
CDM,30111360,SIROLIMUS ASSAY,95.0,61.75,0.95,95.0,60
CDM,30111370,CYCLOSPORINE ASSAY,125.0,81.25,0.95,125.0,60
CDM,30111380,HEPATITIS ACUTE PANEL,329.0,213.85,0.95,329.0,60
CDM,30111530,PROTEIN E-PHORESIS/URINE/CSF,123.0,79.95,0.95,123.0,60
CDM,30111620,PROINSULIN,184.0,119.6,0.95,184.0,60
CDM,30111630,TRANSFERRIN,88.0,57.2,0.95,88.0,60
CDM,30111660,IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30111680,IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30111690,IGH VARI REGIONAL MUTATION,2032.0,1320.8,0.95,2032.0,60
CDM,30111720,*LIPID PANEL,92.0,59.8,0.95,92.0,60
CDM,30111730,*TSI ASSAY,351.0,228.15,0.95,351.0,60
CDM,30111740,*IMMUNOASSAY QUANT NOS,119.0,77.35,0.95,119.0,60
CDM,30111760,*IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,60
CDM,30111780,IMMUNOASSAY QUANT NOS,119.0,77.35,0.95,119.0,60
CDM,30111910,LDL CHOLESTEROL DIR ASSAY,72.0,46.8,0.95,72.0,60
CDM,30111930,SODIUM,33.0,21.45,0.95,33.0,60
CDM,30111950,*GLUCOSE QUANT,27.0,17.55,0.95,27.0,60
CDM,30112070,UNLISTED CHEMISTRY TEST,268.0,174.2,0.95,1005.62,46
CDM,30112080,*ALPHA-1-ANTITRYPSIN; TOTAL,93.0,60.45,0.95,93.0,60
CDM,30112090,*ALPHA-1-ANTITRYPSIN PHENOTYPE,100.0,65.0,0.95,100.0,60
CDM,30112100,*HEAVY METAL; QUAN,152.0,98.8,0.95,152.0,60
CDM,30112120,UREA NITROGEN; QUAN,27.0,17.55,0.95,27.0,60
CDM,30112170,COPPER,86.0,55.9,0.95,95.56,60
CDM,30112190,VALPROIC ACID FREE,93.0,60.45,0.95,93.0,60
CDM,30112450,METHADONE,742.0,482.3,27.64,742.0,60
CDM,30112460,OPIATES 1 OR MORE,742.0,482.3,27.64,742.0,60
CDM,30112570,PHENCYCLIDINE (PCP),187.0,121.55,27.64,468.91,60
CDM,30112680,SERPINA1 GENE,301.0,195.65,0.95,301.0,60
CDM,30112710,ESTROGENS; FRACTIONATED,223.0,144.95,0.95,223.0,60
CDM,30112740,MAGNESIUM,46.0,29.9,0.95,46.0,60
CDM,30113150,BLOOD GAS O2 SATUR ONLY,67.0,43.55,0.95,67.0,60
CDM,30113320,HGB; PLASMA,50.0,32.5,0.95,51.56,60
CDM,30113435,%AJPWO G6PC,404.0,262.6,0.95,404.0,60
CDM,30113450,DRUG TEST PRSMV CHEM ANLYZR,429.0,278.85,0.95,429.0,60
CDM,30113475,CALCITONIN FNA LYMPH ND,185.0,120.25,0.95,185.0,60
CDM,30113495,OMEGACHECK,166.0,107.9,0.95,166.0,60
CDM,30113505,"GFR, RENAL FUNCTION",166.0,107.9,0.95,166.0,60
CDM,30113510,CHOLESTEROL FLUID,30.0,19.5,0.95,30.0,60
CDM,30113525,BENZODIAZEPINES1-12,742.0,482.3,27.64,742.0,60
CDM,30113615,AMPCQ METHYLENDIOXY%,742.0,482.3,27.64,742.0,60
CDM,30113695,TARGETED B-ALL FUS ANLYS,5241.0,3406.65,0.95,5241.0,60
CDM,30113725,"DRUG SCRN, BLD",429.0,278.85,0.95,429.0,60
CDM,30113795,DRUG ANALYSIS UR,429.0,278.85,0.95,429.0,60
CDM,30113835,DRUGS OF ABUSE 9A SCRN UR,429.0,278.85,0.95,429.0,60
CDM,30113895,%NGSLUNG EGFR,2240.0,1456.0,0.95,2240.0,60
CDM,30113935,TCRB TEST,1442.0,937.3,0.95,1442.0,60
CDM,30114005,GLUCOSE BLOOD REAGENT STRIP (POINT OF CARE LAB),35.0,22.75,0.95,35.0,60
CDM,30114025,KIT D816V MUTATION PCR,862.0,560.3,0.95,862.0,60
CDM,30114035,MLH1 PROMOTER HYPERMETH,1327.0,862.55,0.95,1327.0,60
CDM,30114055,TTR GENE FULL ANALYSIS,1896.0,1232.4,0.95,1896.0,60
CDM,30114065,VWF2A SEQ 9 EXON REFLEX,2079.0,1351.35,0.95,2079.0,60
CDM,30114175,%CSFPE PROTEIN TOTAL CSF,28.0,18.2,0.95,28.0,60
CDM,30114185,%CSFPE PROT ELEC SCF QT,123.0,79.95,0.95,123.0,60
CDM,30114195,%FSII NEPHELOMETRY EA,94.0,61.1,0.95,94.0,60
CDM,30114205,TESTOSTERONE FR AD MALE,176.0,114.4,0.95,176.0,60
CDM,30114215,GALECTIN-3 SERUM,305.0,198.25,0.95,305.0,60
CDM,30114265,%GMAPS CARNITINE,116.0,75.4,0.95,129.85,60
CDM,30114405,%GMAPS CATECHOLAMINES,201.0,130.65,0.95,201.0,60
CDM,30114445,%GMAPS ORGANIC ACIDS QL,114.0,74.1,0.95,126.71,60
CDM,30114455,%GMAPS PHENYLKETONES,27.0,17.55,0.95,27.0,60
CDM,30114465,%GMAPS VIT B-6,194.0,126.1,0.95,194.0,60
CDM,30114475,%GMAPS PYRUVATE,100.0,65.0,0.95,100.0,60
CDM,30114485,%GMAPS VITAMIN B-2,140.0,91.0,0.95,140.0,60
CDM,30114495,%GMAPS SEROTONIN,214.0,139.1,0.95,214.0,60
CDM,30114505,%GMAPS SUGARS QL,38.0,24.7,0.95,38.0,60
CDM,30114515,%GMAPS URIC ACID BLD,31.0,20.15,0.95,31.0,60
CDM,30114535,%PSEUDOCHOL PHENOTYPE,85.0,55.25,0.95,85.0,60
CDM,30114545,%PHI PROST SPEC AG FREE,127.0,82.55,0.95,127.0,60
CDM,30114555,THYROXIN FREE,62.0,40.3,0.95,62.0,60
CDM,30114595,PARA AB WB BND ID,202.0,131.3,0.95,202.0,60
CDM,30114705,%UQNTPP CANNABINOID NAT,742.0,482.3,27.64,742.0,60
CDM,30114715,%UQNTPP OPIATE,742.0,482.3,27.64,742.0,60
CDM,30114725,%UQNTPP OPIOIDS 5+,742.0,482.3,27.64,742.0,60
CDM,30114735,%UQNTPP OXYCODONE,742.0,482.3,27.64,742.0,60
CDM,30114785,"PH, BLOOD (POINT OF CARE LAB)",76.0,49.4,0.95,89.32,60
CDM,30114805,"DRUG SCREEN,PRESUMPTIVE SCREEN",118.0,76.7,0.95,118.0,60
CDM,30114865,AUTOMATED DIFFERENTIAL,45.0,29.25,0.95,45.0,60
CDM,30114875,SCHISTOCYT SCAN,24.0,15.6,0.95,24.0,60
CDM,30114915,OBSTETRIC PANEL,330.0,214.5,0.95,381.89,60
CDM,30114955,"DRUG SCREEN,PRESUMPTIVE MEDTOX",118.0,76.7,0.95,118.0,60
CDM,30114965,ACETYLCHOLINE RECEPTOR MOD AB,80.0,52.0,0.95,80.0,60
CDM,30114975,S. CEREVISIAE IGA AND IGG,119.0,77.35,0.95,119.0,60
CDM,30114985,"BARBITURATES, BLOOD",104.0,67.6,27.64,468.91,60
CDM,30114995,"BENZODIAZEPINE, BLOOD",104.0,67.6,27.64,468.91,60
CDM,30115005,"UR DRUG SCRN, MULTI (PT ENCTR)",429.0,278.85,0.95,429.0,60
CDM,30115025,PSA (SEND OUT),127.0,82.55,0.95,127.0,60
CDM,30115035,PTH RELATED PEPTIDE,97.0,63.05,0.95,104.92,60
CDM,30115045,PREMATURE RUPTURE MEMBRANES,677.0,440.05,0.95,677.0,60
CDM,30115055,PSA SCREEN,127.0,82.55,0.95,127.0,60
CDM,30115075,PROSTATIC SPECIFIC AG,127.0,82.55,0.95,127.0,60
CDM,30115285,ANTI AT1R AB DETERMINATION,80.0,52.0,0.95,80.0,60
CDM,30115315,%GMAPS VIT B-1,146.0,94.9,0.95,146.0,60
CDM,30115325,%GMAPS VIT E,98.0,63.7,0.95,102.87,60
CDM,30115335,%GMAPS TYROSINE,73.0,47.45,0.95,73.0,60
CDM,30115345,%GMAPS UREA NITROGEN,35.0,22.75,0.95,35.0,60
CDM,30115365,%GMAPS VIT A,80.0,52.0,0.95,89.35,60
CDM,30115375,"NITROGEN, TOTAL, FECES",761.0,494.65,0.95,1005.62,46
CDM,30115415,LIPID ASSOC SIALIC ACID,93.0,60.45,0.95,103.46,60
CDM,30115425,CHROMIUM URINE,140.0,91.0,0.95,142.17,60
CDM,30115445,NEOPTERIN BLD/CSF,119.0,77.35,0.95,119.0,60
CDM,30115455,QUETIAPINE,129.0,83.85,0.95,129.0,60
CDM,30115505,%F2 MS/MS QUANTITATIVE,166.0,107.9,0.95,166.0,60
CDM,30115515,%F2 CREATININE,36.0,23.4,0.95,36.0,60
CDM,30115555,METHYL ETHYL KETONE URIN,118.0,76.7,0.95,118.0,60
CDM,30115565,XIIIVL TEST,441.0,286.65,0.95,1608.07,60
CDM,30115595,FLUVOXAMINE,742.0,482.3,27.64,742.0,60
CDM,30115625,%GMAPS OXALATE,100.0,65.0,0.95,100.0,60
CDM,30115645,HYPEROXALURIA,166.0,107.9,0.95,166.0,60
CDM,30115655,SILICON SERUM,174.0,113.1,0.95,174.0,60
CDM,30115865,DRUG TEST PRSMV INSTRMNT (POINT OF CARE LAB),118.0,76.7,0.95,118.0,60
CDM,30115AK,"EXCISION NOSE POLYP(S),EXTENSIVE",1776.0,1154.4,1.1,5497.86,50
CDM,30116055,METHOTREXATE,129.0,83.85,0.95,129.0,60
CDM,30116060,TRILEPTAL,129.0,83.85,0.95,129.0,60
CDM,30116065,ASSAY OF ACETAMINOPHEN,429.0,278.85,0.95,429.0,60
CDM,30116070,"SALICYLATE, S",429.0,278.85,0.95,429.0,60
CDM,30116080,IMIPRAMINE,157.0,102.05,27.64,468.91,60
CDM,30116085,NORTRIPTYLINE,118.0,76.7,27.64,468.91,60
CDM,30116090,"ALDOSTERONE, URINE",281.0,182.65,0.95,281.0,60
CDM,30116095,"ALPHA-1 ANTITRYPSIN, TOTAL",93.0,60.45,0.95,93.0,60
CDM,30116100,ALPHA FETO TUMOR MARKER,116.0,75.4,0.95,116.0,60
CDM,30116105,"CREATININE, URINE RANDOM",36.0,23.4,0.95,36.0,60
CDM,30116120,TTG IGG/IGA,80.0,52.0,0.95,80.0,60
CDM,30116125,"QUAD-HCG,QUANT",104.0,67.6,0.95,104.0,60
CDM,30116130,LIPID,92.0,59.8,0.95,92.0,60
CDM,30116135,OCC.HEALTH/ BLOOD SUGAR,27.0,17.55,0.95,27.0,60
CDM,30116140,QUICK CHECK GLUCOMETER B/S,23.0,14.95,0.95,23.0,60
CDM,30116295,T3 UPTAKE,45.0,29.25,0.95,45.0,60
CDM,30116365,ALCOHOL,429.0,278.85,0.95,429.0,60
CDM,30116395,"SALICYLATE, S",429.0,278.85,0.95,429.0,60
CDM,30116475,URINE OPIATE,429.0,278.85,0.95,429.0,60
CDM,30116485,"VOLATILES, QUAL (SEND OUT)",78.0,50.7,22.06,468.91,60
CDM,30116685,AUTOMATED DIFFERENTIAL,45.0,29.25,0.95,45.0,60
CDM,30116765,IGG SUBCLASS PANEL,64.0,41.6,0.95,64.0,60
CDM,30116775,IG-M,64.0,41.6,0.95,64.0,60
CDM,30116815,HISTONE ANTIBODIES,80.0,52.0,0.95,80.0,60
CDM,30116825,MYOSITIS ANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30116835,PARIETAL AB,80.0,52.0,0.95,80.0,60
CDM,30117175,%HA1AT SERPINA1 GENE ANLY,301.0,195.65,0.95,301.0,60
CDM,30117225,TOX 8 (BUP) PANEL (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117235,TOX CUP SCREEN 14 (IN-HOUSE),87.0,56.55,0.95,87.0,60
CDM,30117245,AMPHETAMINE CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117255,THC CONFIRM (GS/MS) (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117265,PHENCYCLID CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117275,CLONAZEPAM METAB (SEND OUT),78.0,50.7,22.06,468.91,60
CDM,30117285,FENTANYL CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117295,TRAMADOL SCREEN (SEND OUT),429.0,278.85,0.95,429.0,60
CDM,30117305,"ALCOHOL, ETHYL, QUAL(IN-HOUSE)",87.0,56.55,0.95,87.0,60
CDM,30117325,SYNTH STIM SCREEN (SEND OUT),78.0,50.7,22.06,468.91,60
CDM,30117335,SYNTH CANNABIN SCREEN (SD OUT),78.0,50.7,22.06,468.91,60
CDM,30117345,OXYCODONE SCREEN (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117355,LSD SCREEN (SEND OUT),429.0,278.85,0.95,429.0,60
CDM,30117365,TRICYCLIC ANTIDEPRESS CONFIRM,742.0,482.3,27.64,742.0,60
CDM,30117385,CHSER,140.0,91.0,0.95,142.17,60
CDM,30117415,"OSMOLALITY, BODY FLUID",46.0,29.9,0.95,46.0,60
CDM,30117425,"OSMOLALITY, STOOL",75.0,48.75,0.95,1005.62,46
CDM,30117435,"POTASSIUM, BODY FLUID",56.0,36.4,0.95,1005.62,46
CDM,30117445,"POTASSIUM, STOOL",62.0,40.3,0.95,1005.62,46
CDM,30117465,DRGTOF METHYLENEDIOXYAMPHETAMINE,173.0,112.45,27.64,468.91,60
CDM,30117505,"OCCULT BLOOD, SGL DIGTL EXAM",30.0,19.5,0.95,32.77,60
CDM,30117525,FTTESM TESTOSTERONE,178.0,115.7,0.95,178.0,60
CDM,30117535,FTTESM TESTO FR AD MALE,176.0,114.4,0.95,176.0,60
CDM,30117545,SMN1 SMN2 SCRN DIAG,945.0,614.25,0.95,2297.92,60
CDM,30117555,HUMOR1 ASSAY GAMMAG X3,64.0,41.6,0.95,64.0,60
CDM,30117565,HUMOR1 IGG SUBCLASSES X4,55.0,35.75,0.95,55.0,60
CDM,30117575,UR QUANT ALC (SEND OUT),78.0,50.7,22.06,468.91,60
CDM,30117585,UR QUANT BUP (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30117635,HEMOQUANT FECAL,270.0,175.5,0.95,270.0,60
CDM,30117645,GENERAL HEALTH PANEL,497.0,323.05,0.95,497.0,46
CDM,30117685,%UTXM3 ARSENIC,131.0,85.15,0.95,131.0,60
CDM,30117695,%UTXM3 LEAD,84.0,54.6,0.95,84.0,60
CDM,30117715,%UTXM4 LEAD,84.0,54.6,0.95,84.0,60
CDM,30117725,%UTXM4 CADMIUM,163.0,105.95,0.95,163.0,60
CDM,30117765,"FATTY ACID PROFILE,SER PL",157.0,102.05,27.64,468.91,60
CDM,30117825,HLA B5701,1172.0,761.8,0.95,1172.0,60
CDM,30117845,RFLX IMBLOT PARNEO AIDYSA,202.0,131.3,0.95,202.0,60
CDM,30117855,"HLA-A,B,CW,DR,DQ,DP-NGS-BMT",2384.0,1549.6,0.95,2384.0,60
CDM,30117905,HBA1 HBA2 DEL/DUP,1397.0,908.05,0.95,1397.0,60
CDM,30117AK,"EXCIS INTRANASAL LESN,INTERN APPRCH",1564.0,1016.6,1.1,5497.86,53
CDM,30118075,%PANCPL SPINK1,1896.0,1232.4,0.95,1896.0,60
CDM,30118085,%PANCPL MOPATH LVL 6,2079.0,1351.35,0.95,2079.0,60
CDM,30118115,%IDHI12 GENE ANALYSIS IDH1,1333.0,866.45,0.95,1333.0,60
CDM,30118125,%IDHI12 GENE ANALYSIS IDH2,2041.0,1326.65,0.95,2041.0,60
CDM,30118135,TPMT GENOTYPE ASSAY,1206.0,783.9,0.95,1206.0,60
CDM,30118145,FLOW SCRN TUBE 1ST MKR,2482.0,1613.3,0.95,2482.0,61
CDM,30118155,LNG550 LUNG CANCER GENE PNL,2409.0,1565.85,0.95,2450.12,60
CDM,30118235,THIOPURINE METAB LC-MS/MS,129.0,83.85,0.95,129.0,60
CDM,30118255,"ALCOHOL CONF, UR",742.0,482.3,27.64,742.0,60
CDM,30118275,17-HYDROXYPROG QNT TIMED X2,187.0,121.55,0.95,187.0,60
CDM,30118285,GLUTATHIONE TOTAL,107.0,69.55,0.95,107.0,60
CDM,30118305,MNGS PATHOGEN DX,7250.0,4712.5,0.95,7250.0,46
CDM,30118335,RISPERIDONE AND METAB,742.0,482.3,27.64,742.0,60
CDM,30118345,PREGABALIN,742.0,482.3,27.64,742.0,60
CDM,30118355,HSP-70 AB,80.0,52.0,0.95,80.0,60
CDM,30118365,DIGOXIN FREE,92.0,59.8,0.95,92.0,60
CDM,30118435,BARBITURATES CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30118445,CHLORIDE UR 24HR,40.0,26.0,0.95,40.0,60
CDM,30118485,MYELOPROLIF NEOPL PNL BM,830.0,539.5,0.95,837.52,46
CDM,30118495,MYELOPROLIF NEOPL PNL BLD,896.0,582.4,0.95,896.0,46
CDM,30118515,DRUG TESTS PRESUMPTIVE,429.0,278.85,0.95,429.0,60
CDM,30118525,"UREA NITROGEN, U 24HR",38.0,24.7,0.95,38.0,60
CDM,30118545,AMINOLEV ACID DEHYD,153.0,99.45,0.95,153.0,60
CDM,30118565,HNMNGS HN NGS SEQ PANEL BM,1616.0,1050.4,0.95,11963.94,60
CDM,30118585,NORFENTANYL (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30118595,TOX PROFILE 56 PANEL (SEND OUT),742.0,482.3,27.64,742.0,60
CDM,30118605,BLOOD GLUCOSE,27.0,17.55,0.95,27.0,60
CDM,30118615,HCG QUAL URI,52.0,33.8,0.95,52.0,60
CDM,30118655,OXIDIZED LDL,119.0,77.35,0.95,119.0,60
CDM,30118675,ADANEU THEARP DRG QNT,129.0,83.85,0.95,129.0,60
CDM,30118685,ADANEU CHEMILUMINESCENT,97.0,63.05,0.95,104.92,60
CDM,30118695,IFXNEU THEARP DRG QNT,129.0,83.85,0.95,129.0,60
CDM,30118705,IFXNEU CHEMILUMINESCENT,97.0,63.05,0.95,104.92,60
CDM,30118715,"FAT, FECAL QUAL",35.0,22.75,0.95,35.0,60
CDM,30118725,"BACLOFEN (BACLOF), SKELETAL MUSCLE RELAXANT 1 OR 2",21.0,13.65,5.94,468.91,60
CDM,30118745,PROD OF CONCEPTION + SNP,4500.0,2925.0,0.95,4753.45,60
CDM,30118755,BRUCELLA AB TOTAL,62.0,40.3,0.95,68.79,60
CDM,30118765,MARIJUANA METAB UMB CRD QUAL,742.0,482.3,27.64,742.0,60
CDM,30118795,"NITROGEN, URINE 24 HR",119.0,77.35,0.95,119.0,60
CDM,30118805,ACYLGLYCINES QNT UR,166.0,107.9,0.95,166.0,60
CDM,30118865,RIBPRO IMMUNO NON AB,80.0,52.0,0.95,80.0,60
CDM,30118945,METHYLPHENIDATE QNT,742.0,482.3,27.64,742.0,60
CDM,30118985,DRGTOF DRG SCRN BARBITURATES,238.0,154.7,27.64,468.91,60
CDM,30119005,DRGTOF DRG SCRN BUPRENORPHINE,238.0,154.7,27.64,468.91,60
CDM,30119025,DRGTOF DRG SCRN COCAINE,238.0,154.7,27.64,468.91,60
CDM,30119035,DRGTOF DRG SCRN METHADONE,238.0,154.7,27.64,468.91,60
CDM,30119065,DRGTOF PHENCYCLIDINE,238.0,154.7,27.64,468.91,60
CDM,30119085,CSPNL BCKDHB GENE,655.0,425.75,0.95,655.0,60
CDM,30119105,CSPNL CFTR GENE COM VARS,3841.0,2496.65,0.95,4289.05,60
CDM,30119115,CSPNL FANCC GENE,253.0,164.45,0.95,253.0,60
CDM,30119125,CSPNL FMR1 GENE DETECTION,394.0,256.1,0.95,930.61,60
CDM,30119135,CSPNL G6PC GENE,404.0,262.6,0.95,404.0,60
CDM,30119145,CSPNL GBA GENE,326.0,211.9,0.95,326.0,60
CDM,30119155,CSPNL HEXA GENE,355.0,230.75,0.95,355.0,60
CDM,30119165,CSPNL IKBKAP GENE,271.0,176.15,0.95,271.0,60
CDM,30119175,CSPNL MCOLN1 GENE,271.0,176.15,0.95,271.0,60
CDM,30119185,CSPNL SMPD1 GENE COMMON VARS,324.0,210.6,0.95,324.0,60
CDM,30119195,CSPNL MOPATH PROC LVL 1,441.0,286.65,0.95,1608.07,60
CDM,30119205,CSPNL MOPATH PROC LVL 2,945.0,614.25,0.95,2297.92,60
CDM,30119215,CSPNL UNLISTED MOPATH,72.0,46.8,0.95,837.52,46
CDM,30119365,LPMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,0.95,5241.0,60
CDM,30119405,MYMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,0.95,5241.0,60
CDM,30119425,5FUDPD DPYD GENE COMMON VARS,1206.0,783.9,0.95,1206.0,60
CDM,30119475,ACTIM*ACTIM PROM,677.0,440.05,0.95,677.0,60
CDM,30119485,CF PATHOGENIC VARIANT,3841.0,2496.65,0.95,4289.05,60
CDM,30119495,DIHYDROTESTOSTERONE,202.0,131.3,0.95,202.0,60
CDM,30119525,DERMATOMYOSITIS PANEL X6,80.0,52.0,0.95,80.0,60
CDM,30119575,PHOSPHATIDYLETHANOL,742.0,482.3,27.64,742.0,60
CDM,30119605,VITAMIN B WHOLE BLOOD,146.0,94.9,0.95,146.0,60
CDM,30119615,TRYPSINOGEN,127.0,82.55,0.95,127.0,60
CDM,30119665,KAPPA/LAMDA FR LT CH UR,94.0,61.1,0.95,94.0,60
CDM,30119675,CYTOKINE PANEL,119.0,77.35,0.95,119.0,60
CDM,30119815,ZINC WHOL BLOOD,79.0,51.35,0.95,87.67,60
CDM,30119825,AIDYSA RIA NONAB,127.0,82.55,0.95,127.0,60
CDM,30119835,AIDYSA IMMUNO QNT NOS NONAB,119.0,77.35,0.95,119.0,60
CDM,30119865,BTSTFC TESTOSTERONE FR,176.0,114.4,0.95,176.0,60
CDM,30120265,ADALIMUMAB ACT NEUT AB,266.0,172.9,0.95,266.0,60
CDM,30120275,INFLIXIMAB/BIOSIMILAR ACT NEUT AB,266.0,172.9,0.95,266.0,60
CDM,30120285,POSACONAZOLE,187.0,121.55,0.95,187.0,60
CDM,30120295,LACOSAMIDE,187.0,121.55,0.95,187.0,60
CDM,30120305,VORICONAZOLE,187.0,121.55,0.95,187.0,60
CDM,30120315,BETA HCG QNT TUMOR MKR,106.0,68.9,0.95,106.0,60
CDM,30120335,FENTANYL URINE,742.0,482.3,27.64,742.0,60
CDM,30120345,BUPRENOR & METAB QNT UR,742.0,482.3,27.64,742.0,60
CDM,30120365,SOLUBLE TRANSFERRINE RECEPTOR,252.0,163.8,0.95,252.0,60
CDM,30120375,D2D3 25-OH VITAMIN,204.0,132.6,0.95,204.0,60
CDM,30120385,OPISEC OPIATES 1 OR MORE,742.0,482.3,27.64,742.0,60
CDM,30120395,DRGTOF OPISEC DRG SCRN OXYCODONE,742.0,482.3,27.64,742.0,60
CDM,30120405,DRGTOF ORLOPI OPIATES 1 OR MORE,246.0,159.9,27.64,468.91,60
CDM,30120415,TESTOSTERONE TOTAL ASSAY,178.0,115.7,0.95,178.0,60
CDM,30120435,OPIATE CONFIRMATION UR,742.0,482.3,27.64,742.0,60
CDM,30120445,HYDROXYLASE-21 AB,80.0,52.0,0.95,80.0,60
CDM,30120455,UFLCKL IMMUNO QNT NOS NAB,119.0,77.35,0.95,119.0,60
CDM,30120465,UFLCKL PROTEIN UR,25.0,16.25,0.95,25.0,60
CDM,30120475,HVIIVF ANTI MULLERIAN,266.0,172.9,0.95,266.0,60
CDM,30120485,ASSAY OF GLYCATED PROTEIN,116.0,75.4,0.95,116.0,60
CDM,30120495,CYSTATIN C WITH GFR,128.0,83.2,0.95,128.0,60
CDM,30120535,"METHYLONE CONF, UR",146.0,94.9,27.64,468.91,60
CDM,30120545,CPEPSP INSULIN SUPPRESSION PANEL,1143.0,742.95,0.95,1143.0,60
CDM,30120555,UC5DC ACYLCARNITINES QUANT,116.0,75.4,0.95,129.85,60
CDM,30120565,UCYS24 AMINO ACIDS QUANT 2-5,135.0,87.75,0.95,135.0,60
CDM,30120575,CPALMT ENZYME CELL ACTIVITY,153.0,99.45,0.95,153.0,60
CDM,30120585,FAOSCM ENZYME CELL ACTIVITY X4,153.0,99.45,0.95,153.0,60
CDM,30120595,FAOACM ENZYME CELL ACTIVITY X8,153.0,99.45,0.95,153.0,60
CDM,30120605,CPALMT ENZYME CELL ACTIVITY RA X2,304.0,197.6,0.95,304.0,60
CDM,30120615,17-HYDROXYPROGESTERONE UR,187.0,121.55,0.95,187.0,60
CDM,30120625,GBMGP IMMUNOASSAY NONANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30120635,ACESTR IMMUNOASSAY NONANTIBODY X2,80.0,52.0,0.95,80.0,60
CDM,30120645,ACETYLCHOL REC MOD,80.0,52.0,0.95,80.0,60
CDM,30120655,ACESTR RIA NONANTIBODY,127.0,82.55,0.95,127.0,60
CDM,30120665,STFRTP ASSAY OF FECES PORPHYRINS,270.0,175.5,0.95,270.0,60
CDM,30120675,CPALMT ASSAY OF PROTEIN OTHER,28.0,18.2,0.95,28.0,60
CDM,30120685,FAOSCM ASSAY OF PROTEIN OTHER,28.0,18.2,0.95,28.0,60
CDM,30120695,FAOACM ASSAY OF PROTEIN OTHER,28.0,18.2,0.95,28.0,60
CDM,30120705,HUWB WESTERN BLOT TEST,118.0,76.7,0.95,118.0,60
CDM,30120715,FAOSCM SPECTROPHOTOMETRY X4,56.0,36.4,0.95,56.0,60
CDM,30120725,FAOACM SPECTROPHOTOMETRY X8,56.0,36.4,0.95,56.0,60
CDM,30120735,USO4 ASSAY OF URINE SULFATE,38.0,24.7,0.95,38.0,60
CDM,30120745,UMHISR COL CHROMOTOGRAPHY,166.0,107.9,0.95,166.0,60
CDM,30120755,UMHISR UR CREATININE,36.0,23.4,0.95,36.0,60
CDM,30120765,DIGITOXIN,742.0,482.3,27.64,742.0,60
CDM,30120875,AT1R-ANTIBODY-REFERENCE SAMPLE,80.0,52.0,0.95,80.0,60
CDM,30120895,PROT WB IMMUNO (MYOSPL),202.0,131.3,0.95,202.0,60
CDM,30120935,FLECAINIDE,129.0,83.85,0.95,129.0,60
CDM,30120955,ACETAMINOPHEN BL TEST,129.0,83.85,0.95,129.0,60
CDM,30120965,SALICYLATE,129.0,83.85,0.95,129.0,60
CDM,30120975,AMIODARONE,129.0,83.85,0.95,129.0,60
CDM,30120985,CARBAMAZEPINE-10-11-EPOXI,129.0,83.85,0.95,129.0,60
CDM,30120995,FELBAMATE,129.0,83.85,0.95,129.0,60
CDM,30120AK,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,2156.0,1401.4,1.1,5497.86,53
CDM,30121015,METHOTREXATE,266.0,172.9,0.95,266.0,60
CDM,30121025,ITRACONAZOLE,187.0,121.55,0.95,187.0,60
CDM,30121055,ETHANOL PLASMA,119.0,77.35,0.95,119.0,60
CDM,30121065,MCROHN SAA CHEMILUM,97.0,63.05,0.95,104.92,60
CDM,30121075,ANSADA MEAS SER ADA,266.0,172.9,0.95,266.0,60
CDM,30121085,ANSADA MEAS AB ATI,166.0,107.9,0.95,166.0,60
CDM,30121095,ANSIFX MEAS SER ADA,266.0,172.9,0.95,266.0,60
CDM,30121105,ANSIFX MEAS AB ATI,166.0,107.9,0.95,166.0,60
CDM,30121115,ANSVDZ MEAS SER VDZ,266.0,172.9,0.95,266.0,60
CDM,30121125,ANSVDZ MEAS AB ATI,166.0,107.9,0.95,166.0,60
CDM,30121135,ANSUST MEAS SER UST,129.0,83.85,0.95,129.0,60
CDM,30121145,ANSUST MEAS AB ATI,166.0,107.9,0.95,166.0,60
CDM,30121155,ANTI IGE,80.0,52.0,0.95,80.0,60
CDM,30121205,"FILM ARRAY, MENINGITIS/ENCEPHALITIS",2876.0,1869.4,0.95,2876.0,60
CDM,30121215,ALLOGEN AUTOANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30121235,BETA HCG QUANT TUMOR MARKER,104.0,67.6,0.95,104.0,60
CDM,30121305,ETHAMBUTOL,742.0,482.3,27.64,742.0,60
CDM,30121325,"DRUG PAN9, SER/PLA W/ RFLX TO CONF",429.0,278.85,0.95,429.0,60
CDM,30121335,RFLX AMPHETAMINES,742.0,482.3,27.64,742.0,60
CDM,30121345,RFLX BARBITUATES,742.0,482.3,27.64,742.0,60
CDM,30121355,RFLX BENZODIAZIPINE,742.0,482.3,27.64,742.0,60
CDM,30121365,RFLX THC METABOLITE,742.0,482.3,27.64,742.0,60
CDM,30121375,RFLX COCAINE,742.0,482.3,27.64,742.0,60
CDM,30121385,RFLX METHADONE,742.0,482.3,27.64,742.0,60
CDM,30121395,RFLX OPIATES,742.0,482.3,27.64,742.0,60
CDM,30121405,RFLX BUPRENORPHINE,742.0,482.3,27.64,742.0,60
CDM,30121415,RFLX PHENCYCLIDINE,742.0,482.3,27.64,742.0,60
CDM,30121435,IMMUNOGL LT CHNS FR EA,119.0,77.35,0.95,119.0,60
CDM,30121445,ELASTASE PANCREATIC FECAL,158.0,102.7,0.95,158.0,60
CDM,30121645,MECDRG AMPHETAMINES 5 OR MORE,1015.0,659.75,59.88,1015.0,60
CDM,30121655,MECDRG DRUG SCRN BENZODIAZ 13 OR MORE,1015.0,659.75,59.88,1015.0,60
CDM,30121665,MECDRG OPIOIDS AND OPIATE ANALOGS 5 OR MORE,1015.0,659.75,59.88,1015.0,60
CDM,30121675,DTOFMP GABAPENTIN,1015.0,659.75,59.88,1015.0,60
CDM,30121755,BTSTFC ASSAY OF SEX HORMONE GLOBUL,150.0,97.5,0.95,150.0,60
CDM,30121765,ROM RUPTURE OF FETAL MEMBRANES,677.0,440.05,0.95,677.0,60
CDM,30121845,PLASMA THYMIDINE DETERMINATION,166.0,107.9,0.95,166.0,60
CDM,30121855,"PRIMARY MEMBRANOUS NEPHROPATHY DIAG CASCADE, SER",119.0,77.35,0.95,119.0,60
CDM,30121865,DUPNL DPYD GENE COMMON VARIANTS,1206.0,783.9,0.95,1206.0,60
CDM,30121875,DUPNL UGT1A1 GENE COMMON VARIANTS,1615.0,1049.75,0.95,1615.0,60
CDM,30121985,"PHOSPHOLIPASE A2 RECEPTOR AB, ELISA, SERUM",119.0,77.35,0.95,119.0,60
CDM,30121995,TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH,40.0,26.0,0.95,40.0,60
CDM,30122005,"RBC FOLATE (REFLAB ONLY, REQUIRES HCT WITHIN 24 HRS)",122.0,79.3,0.95,122.0,60
CDM,30122035,"LH, PEDIATRIC",128.0,83.2,0.95,128.0,60
CDM,30122045,CLOZAPINE,139.0,90.35,0.95,139.0,60
CDM,30122055,CAHSP ASSAY OF ANDROSTENEDIONE,202.0,131.3,0.95,202.0,60
CDM,30122065,CAHSP DEOXYCORTISOL,202.0,131.3,0.95,202.0,60
CDM,30122075,CAHSP TOTAL CORTISOL,112.0,72.8,0.95,112.0,60
CDM,30122085,CAHSP DEHYDROEPIANDROSTERONE,174.0,113.1,0.95,174.0,60
CDM,30122095,CAHSP ASSAY OF 17-HYDROXYPREGNENO,157.0,102.05,0.95,157.0,60
CDM,30122105,CAHSP ASSAY OF PROGESTERONE,144.0,93.6,0.95,144.0,60
CDM,30122115,CAHSP ASY HYDROXYPROGESTERONE 17-D,187.0,121.55,0.95,187.0,60
CDM,30122125,CAHSP ASSAY OF TOTAL TESTOSTERONE,178.0,115.7,0.95,178.0,60
CDM,30122135,CAHSP DESOXYCORTICOSTERONE,214.0,139.1,0.95,214.0,60
CDM,30122145,"15AGTL - 1,5 ANHYDROGLUCITOL",80.0,52.0,0.95,80.0,60
CDM,30122155,"BENZO, SER PL, QNT RFLX",742.0,482.3,27.64,742.0,60
CDM,30122165,"COCAINE METABOLITE, SER OR PL, QNT RFLX",742.0,482.3,27.64,742.0,60
CDM,30122175,"PCP SER OR PL, QNT RFLX",742.0,482.3,27.64,742.0,60
CDM,30122185,DRG SCRN 9 PANEL SER OR PL,429.0,278.85,0.95,429.0,60
CDM,30122195,"IOHEXOL GLOMERULAR FILTRATION RATE (GFR), PLASMA",166.0,107.9,0.95,166.0,60
CDM,30122205,"PREGABALIN, URINE",32.0,20.8,0.95,32.0,46
CDM,30122215,"INFLIXIMAB, SERUM",266.0,172.9,0.95,266.0,60
CDM,30122225,"ADALIMUMAB, SERUM",119.0,77.35,0.95,119.0,60
CDM,30122235,CANNABINOIDS NATURAL,53.0,34.45,0.95,53.0,46
CDM,30122245,"AMMONIUM, 24 HOUR, URINE",101.0,65.65,0.95,101.0,60
CDM,30122255,"AMMONIUM, RANDOM, URINE",101.0,65.65,0.95,101.0,60
CDM,30122265,ASPARAGINASE ENZYME ACTIVITY,153.0,99.45,0.95,153.0,60
CDM,30122275,"MITRAGYNINE (KRATOM), URINE",429.0,278.85,0.95,429.0,60
CDM,30122285,KRATOM (MITRAGYNINE) CONFIRMATION,334.0,217.1,0.95,334.0,46
CDM,30122295,ASSAY OF ANTI-MULLERIAN HORMONE,266.0,172.9,0.95,266.0,60
CDM,30122305,"ZINC, URINE QUANTITATIVE",79.0,51.35,0.95,87.67,60
CDM,30122315,NEUROFILAMENT LIGHT (NFL),119.0,77.35,0.95,119.0,60
CDM,30122325,ORGANIC ACID SNGL QUANT-LABCORP,146.0,94.9,0.95,146.0,60
CDM,30122335,"CREATININE, UR (LABCORP PORPHOBILINOGEN, QN, RANDOM UR)",36.0,23.4,0.95,36.0,60
CDM,30122345,UA DIP URINE HCG (POINT OF CARE LAB),52.0,33.8,0.95,52.0,60
CDM,30122365,"ACYLCARNITINES, QUANTIT, P-MAYO",116.0,75.4,0.95,129.85,60
CDM,30122375,"5-HIAA, PLASMA - LABCORP",89.0,57.85,0.95,99.26,60
CDM,30122385,"HYDROXYCHLOROQUINE, BLOOD",129.0,83.85,0.95,129.0,60
CDM,30122395,"CARNITINE, P",116.0,75.4,0.95,129.85,60
CDM,30122405,VENLAFAXINE SERUM/PLASMA - ARUP,36.0,23.4,0.95,36.0,46
CDM,30122415,IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,0.95,119.0,60
CDM,30122425,ADIPONECTIN,127.0,82.55,0.95,127.0,60
CDM,30122435,BLOOD GAS MIXED WO O2 SAT,180.0,117.0,0.95,180.0,60
CDM,30122445,"VEDOLIZUMAB QN, S",266.0,172.9,0.95,266.0,60
CDM,30122455,"VEDOLIZUMAB AB, S",97.0,63.05,0.95,104.92,60
CDM,30122465,"USTEKINUMAB QN, S",129.0,83.85,0.95,129.0,60
CDM,30122475,"USTEKINUMAB AB, S",119.0,77.35,0.95,119.0,60
CDM,30122485,ASSAY OF LACTIC ACID,80.0,52.0,0.95,80.0,60
CDM,30122495,"NEURONAL AB (TR/DNER) IGG, SER",202.0,131.3,0.95,202.0,60
CDM,30122505,"NEURONAL NUCLEAR AB (HU) IGG, IB, SERUM",202.0,131.3,0.95,202.0,60
CDM,30122525,"NEURONAL AB (TR/DNER) IGG, CSF",202.0,131.3,0.95,202.0,60
CDM,30122535,MPS ELECTROPHORESIS,424.0,275.6,0.95,424.0,60
CDM,30122545,MUCOPOLYSACCHARIDES MG/MMOL CRT,197.0,128.05,0.95,197.0,60
CDM,30122555,ATLANTIC RESPIRATORY PANEL IGE TOTAL,114.0,74.1,0.95,114.0,60
CDM,30122565,"BULLOUS PEMPHIGOID, BP180 AND BP230, IGG ANTIBODIES",80.0,52.0,0.95,80.0,60
CDM,30122575,CHRONIC VIRAL HEPATITIS NEPHELOMETRY (ARUP),94.0,61.1,0.95,94.0,60
CDM,30122585,"ASPARTATE AMINOTRANSFERASE, FIBROMETER",36.0,23.4,0.95,36.0,60
CDM,30122595,"ALANINE AMINOTRANSFERASE, FIBROMETER",37.0,24.05,0.95,37.0,60
CDM,30122605,"UREA NITROGEN, SERUM, FIBROMETER",27.0,17.55,0.95,27.0,60
CDM,30122615,"GAMMA GLUTAMYL TRANSFERASE, FIBROMETER",50.0,32.5,0.95,50.0,60
CDM,30122625,SENMOT IMMUNOASSAY (ARUP),80.0,52.0,0.95,80.0,60
CDM,30122635,SENNRO IMMUNOASSAY (ARUP),80.0,52.0,0.95,80.0,60
CDM,30122645,INHIBIN B,119.0,77.35,0.95,119.0,60
CDM,30122655,GAUCHER GBA ACTIVITY LEUKOCYTES,153.0,99.45,0.95,153.0,60
CDM,30122665,VITAMIN B3 (NIACIN AND METABOLITES),118.0,76.7,0.95,118.0,60
CDM,30122675,7ALPHAC4,166.0,107.9,0.95,166.0,60
CDM,30122685,PHI PROST SPEC AG TOT,127.0,82.55,0.95,127.0,60
CDM,30122695,ADIPONECTIN,119.0,77.35,0.95,119.0,60
CDM,30122705,DRGTOF OPIATE CONFIRMATION,742.0,482.3,27.64,742.0,60
CDM,30122715,DRGTOF TRAMADOL,742.0,482.3,27.64,742.0,60
CDM,30122725,OPIOIDS AND OPIATE ANALOGS (DRGTOF),742.0,482.3,27.64,742.0,60
CDM,30122735,DRGTOF GABAPENTIN,742.0,482.3,27.64,742.0,60
CDM,30122745,DRGTOF AMPHETAMINES,742.0,482.3,27.64,742.0,60
CDM,30122755,DRGTOF ZOLPIDEM,742.0,482.3,27.64,742.0,60
CDM,30122765,OPIATE CONFIRMATION (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122775,TRAMADOL (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122785,OPIOIDS AND OPIATE ANALOGS (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122795,GABAPENTIN (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122805,AMPHETAMINES (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122815,METHYLPHENIDATE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122825,ALKALOID DRUGS (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122835,ZOLPIDEM (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30122845,LORAZEPAM,742.0,482.3,27.64,742.0,60
CDM,30122865,"SYNTHETIC GLUCOCORTICOID SCREEN, URINE",129.0,83.85,0.95,129.0,60
CDM,30122875,CORTISOL,112.0,72.8,0.95,112.0,60
CDM,30122885,"IMMUNOASSAY, LACTOFERRIN, FECAL, QUALITATIVE",136.0,88.4,0.95,136.0,60
CDM,30122895,ARIPIPRAZOLE AND METABOLITE,85.0,55.25,24.04,468.91,60
CDM,30122905,"ANTI-SP100 AND ANTI-GP210 ANTIBODIES, IGG",80.0,52.0,0.95,80.0,60
CDM,30122915,HEX4 GLC4,166.0,107.9,0.95,166.0,60
CDM,30122925,HEX4 CREATININE,36.0,23.4,0.95,36.0,60
CDM,30122935,OXYSTEROLS,166.0,107.9,0.95,166.0,60
CDM,30122945,RUFINAMIDE,187.0,121.55,0.95,187.0,60
CDM,30122955,PREGABALIN,68.0,44.2,19.23,468.91,60
CDM,30122965,ETHOSUXIMIDE LEVEL,113.0,73.45,0.95,113.0,60
CDM,30122975,BRIVARACETAM - QUANTITATIVE ASSAY DRUG,129.0,83.85,0.95,129.0,60
CDM,30122985,PERAMPANEL - QUANTITATIVE ASSAY DRUG,129.0,83.85,0.95,129.0,60
CDM,30122995,DRGTOF OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,468.91,60
CDM,30123005,DRGTOF PROPOXYPHENE,53.0,34.45,14.99,468.91,60
CDM,30123015,DTOFMP BENZODIAZEPINES,53.0,34.45,14.99,468.91,60
CDM,30123025,DTOFMP BUPRENORPHINE,53.0,34.45,14.99,468.91,60
CDM,30123035,DTOFMP COCAINE METABOLITE,53.0,34.45,14.99,468.91,60
CDM,30123045,DTOFMP HYDROCODONE,53.0,34.45,14.99,468.91,60
CDM,30123055,DTOFMP HEROIN METABOLITE,53.0,34.45,14.99,468.91,60
CDM,30123065,DTOFMP OXYCODONE AND METABOLITE,53.0,34.45,14.99,468.91,60
CDM,30123075,DTOFMP OPIOIDS,53.0,34.45,14.99,468.91,60
CDM,30123085,DTOFMP OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,468.91,60
CDM,30123095,DTOFMP MDMA,53.0,34.45,14.99,468.91,60
CDM,30123105,DTOFMP AMPHETAMINES,53.0,34.45,14.99,468.91,60
CDM,30123115,DTOFMP BARBITURATES,53.0,34.45,14.99,468.91,60
CDM,30123125,DTOFMP TAPENTADOL,53.0,34.45,14.99,468.91,60
CDM,30123135,DTOFMP METHADONE,53.0,34.45,14.99,468.91,60
CDM,30123145,DTOFMP PHENCYCLIDINE,53.0,34.45,14.99,468.91,60
CDM,30123155,DTOFMP SEDATIVE HYPNOTICS,53.0,34.45,14.99,468.91,60
CDM,30123165,DTOFMP PROPOXYPHENE,53.0,34.45,14.99,468.91,60
CDM,30123175,DTOFMP MARIJUANA METABOLITE,53.0,34.45,14.99,468.91,60
CDM,30123185,BILE ACIDS TOTAL,118.0,76.7,0.95,118.0,60
CDM,30123195,"PHENOLPHTHALEIN, STOOL",53.0,34.45,14.99,468.91,60
CDM,30123205,MELATONIN,295.0,191.75,27.64,468.91,60
CDM,30123215,MLPTHY CRMP-5 WB,202.0,131.3,0.95,202.0,60
CDM,30123225,"MA2/TA ANTIBODY, IGG SERUM",202.0,131.3,0.95,202.0,60
CDM,30123235,"MA2/TA ANTIBODY, IGG CSF",202.0,131.3,0.95,202.0,60
CDM,30123275,INTERLEUKIN 4,119.0,77.35,0.95,119.0,60
CDM,30123285,CREATININE SERUM (TRPHOS),35.0,22.75,0.95,35.0,60
CDM,30123295,CREATININE URINE (TRPHOS),36.0,23.4,0.95,36.0,60
CDM,30123305,"INORGANIC PHOSPHATE, SERUM (TRPHOS)",33.0,21.45,0.95,33.0,60
CDM,30123315,"INORGANIC PHOSPHATE, URINE (TRPHOS)",40.0,26.0,0.95,40.0,60
CDM,30123325,BETA-AMYLOID; 1-42 (ABETA 42),121.0,78.65,0.95,528.29,55
CDM,30123335,"DIURETIC SURVEY, URINE",739.0,480.35,27.64,739.0,60
CDM,30123345,"SULFONYLUREA HYPOGLYCEMIA PANEL, QUANTITATIVE, URINE",739.0,480.35,27.64,739.0,60
CDM,30123355,HUMAN ANTI-MOUSE AB (HAMA),119.0,77.35,0.95,119.0,60
CDM,30123365,AMPHETAMINES CONF URINE,739.0,480.35,27.64,739.0,60
CDM,30123375,METHYLENEDIOXYAMPHETAMINES CONF URINE,739.0,480.35,27.64,739.0,60
CDM,30123385,PCP CONFIRM URINE,739.0,480.35,27.64,739.0,60
CDM,30123395,FENTANYL URINE,739.0,480.35,27.64,739.0,60
CDM,30123405,"TRAMADOL & METAB, QUANT",739.0,480.35,27.64,739.0,60
CDM,30123415,CANNABINOIDS CONF UR,739.0,480.35,27.64,739.0,60
CDM,30123425,UQNTOX AMPHETAMINES,78.0,50.7,22.06,468.91,60
CDM,30123435,UQNTOX BUPRENORPHINE,78.0,50.7,22.06,468.91,60
CDM,30123445,UQNTOX CANNABINOIDS NATURAL,78.0,50.7,22.06,468.91,60
CDM,30123455,UQNTOX COCCAINE,78.0,50.7,22.06,468.91,60
CDM,30123465,UQNTOX FENTANYL,78.0,50.7,22.06,468.91,60
CDM,30123475,UQNTOX HEROINE METABOLITE,78.0,50.7,22.06,468.91,60
CDM,30123485,UQNTOX METHADONE,78.0,50.7,22.06,468.91,60
CDM,30123495,UQNTOX METHYLENEDIOXYAMPHETAMINES,78.0,50.7,22.06,468.91,60
CDM,30123505,UQNTOX OPIATES,78.0,50.7,22.06,468.91,60
CDM,30123515,UQNTOX OPIOIDS 5+,78.0,50.7,22.06,468.91,60
CDM,30123525,UQNTOX OXYCODONE,78.0,50.7,22.06,468.91,60
CDM,30123535,UQNTOX TRAMADOL,78.0,50.7,22.06,468.91,60
CDM,30123545,UQNTOX PHENCYCLIDINE,78.0,50.7,22.06,468.91,60
CDM,30123555,LYMRFX SERUM ALBUMIN,34.0,22.1,0.95,34.0,60
CDM,30123565,LYMRFX CSF ALBUMIN,54.0,35.1,0.95,54.0,60
CDM,30123575,LYMRFX IGG QUANT,64.0,41.6,0.95,64.0,60
CDM,30123585,3-METHYLGLUTACONIC ACID,146.0,94.9,0.95,146.0,60
CDM,30123595,ALPRAZOLAM,739.0,480.35,27.64,739.0,60
CDM,30123605,DERMATOMYOSITIS PANEL,80.0,52.0,0.95,80.0,60
CDM,30123615,IMMUNOBLOT (POLMYO),202.0,131.3,0.95,202.0,60
CDM,30123625,DTOFMP FENTANYL,53.0,34.45,14.99,468.91,60
CDM,30123635,ANTIBODY IMMUNOASSAY (POLMYO),80.0,52.0,0.95,80.0,60
CDM,30123645,"PT AB, IGG",80.0,52.0,0.95,80.0,60
CDM,30123655,DISACCHARIDASE IN TISSUE,153.0,99.45,0.95,153.0,60
CDM,30123665,OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL),72.0,46.8,0.95,72.0,60
CDM,30123675,"TESTOSTERONE, TOTAL, SERUM",178.0,115.7,0.95,178.0,60
CDM,30123685,"TESTOSTERONE, FREE, SERUM",176.0,114.4,0.95,176.0,60
CDM,30123695,ENHANCED LIVER FIBROSIS (ELF) SCORE,1216.0,790.4,0.95,1216.0,60
CDM,30123705,"CXCL9 QUANTITATION, SERUM",119.0,77.35,0.95,119.0,60
CDM,30123715,GLUCOSE QUANT (POINT OF CARE LAB),27.0,17.55,0.95,27.0,60
CDM,30123725,BMP I STAT ANALYZER (POINT OF CARE LAB),95.0,61.75,0.95,95.0,60
CDM,30123735,LIPID-LIPO PANEL 1 (POINT OF CARE LAB),92.0,59.8,0.95,92.0,60
CDM,30123745,ASSAY IONIZED CA (POINT OF CARE LAB),94.0,61.1,0.95,94.0,60
CDM,30123755,BILIRUBIN TOTAL (BACK OFFICE),35.0,22.75,0.95,35.0,60
CDM,30123765,OCCULT BLOOD FECES 1-3 TEST (POINT OF CARE LAB),29.0,18.85,0.95,29.0,60
CDM,30123775,ASSAY LACTIC ACID (POINT OF CARE LAB),80.0,52.0,0.95,80.0,60
CDM,30123785,HGB A1C GLYCOSYLATED (POINT OF CARE LAB),67.0,43.55,0.95,67.0,60
CDM,30123795,"PH BODY FLUID, NES (POINT OF CARE LAB)",25.0,16.25,0.95,27.56,60
CDM,30123805,BLOOD GAS (POINT OF CARE LAB),544.0,353.6,0.95,544.0,60
CDM,30123815,HCG TEST QUAL (POINT OF CARE LAB),52.0,33.8,0.95,52.0,60
CDM,30123835,"DRUG TEST, DEFINITVE, PER DAY?1-7?DRUG CLASSES",742.0,482.3,27.64,742.0,60
CDM,30123845,"DRUG TEST, DEFINITVE, PER DAY?8-14?DRUG CLASSES",1015.0,659.75,59.88,1015.0,60
CDM,30123855,"DRUG TEST, DEFINITVE, PER DAY?15-21 DRUG CLASSES",1288.0,837.2,59.88,1288.0,60
CDM,30123865,"DRUG TEST, DEFINITVE, PER DAY?22 OR MORE DRUG CLASSES",1600.0,1040.0,59.88,1600.0,60
CDM,30123875,URDRG GABAPENTIN,68.0,44.2,19.23,468.91,60
CDM,30123885,URDRG PREGABALIN,68.0,44.2,19.23,468.91,60
CDM,30123895,URDRG BENZODIAZEPINES,68.0,44.2,19.23,468.91,60
CDM,30123905,URDRG BUPRENORPHINE,68.0,44.2,19.23,468.91,60
CDM,30123915,URDRG CANNABINOIDS,68.0,44.2,19.23,468.91,60
CDM,30123925,URDRG FENTANYL,68.0,44.2,19.23,468.91,60
CDM,30123935,URDRG 6-MONOACETYLMORPHINE,68.0,44.2,19.23,468.91,60
CDM,30123945,URDRG KETAMINE AND NORKETAMINE,68.0,44.2,19.23,468.91,60
CDM,30123955,URDRG METHADONE,68.0,44.2,19.23,468.91,60
CDM,30123965,URDRG OPIATES,68.0,44.2,19.23,468.91,60
CDM,30123975,URDRG SKELETAL MUSCLE RELAXANTS,68.0,44.2,19.23,468.91,60
CDM,30123985,URDRG COCAINE,68.0,44.2,19.23,468.91,60
CDM,30123995,URDRG OPIOIDS,68.0,44.2,19.23,468.91,60
CDM,30124005,URDRG OXYCODONE,68.0,44.2,19.23,468.91,60
CDM,30124015,URDRG DRUGS NOT OTHERWISE SPECIFIED,68.0,44.2,19.23,468.91,60
CDM,30124025,URDRG ZOLPIDEM,68.0,44.2,19.23,468.91,60
CDM,30124035,URDRG TRAMADOL,68.0,44.2,19.23,468.91,60
CDM,30124045,"CENOBAMATE (XCOPRI), PLASMA",129.0,83.85,0.95,129.0,60
CDM,30124055,URDRG AMPHETAMINES,68.0,44.2,19.23,468.91,60
CDM,30124065,URDRG METHYLENEDIOXYAMPHETAMINES,68.0,44.2,19.23,468.91,60
CDM,30124625,BENZODIAZEPINES1-12 (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124635,CARBOXY-THC (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124645,DRG BUPRENORPHINE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124655,DRG COCAINE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124665,ORLOPI OPIATES 1 OR MORE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124675,OPISEC OXYCODONE (MEDDRG),64.4,41.86,18.21,468.91,60
CDM,30124685,FENTANYL AND METABOLITE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124695,METHYLEEDIOXAMPHETAMINE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124705,BARBITURATES (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124715,TAPENTADOL AND MET (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124725,METHADONE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124735,PHENCYCLIDINE (MECDRG),64.4,41.86,18.21,468.91,60
CDM,30124755,LEAD CONCENTRATION,84.0,54.6,0.95,84.0,60
CDM,30124765,CHLORIDE (POINT OF CARE LAB),32.0,20.8,0.95,32.0,60
CDM,30124775,CREATININE BLOOD (POINT OF CARE LAB),35.0,22.75,0.95,35.0,60
CDM,30124785,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),67.0,43.55,0.95,67.0,60
CDM,30124795,CARBOXYHEMOGLOBIN (POINT OF CARE LAB),85.0,55.25,0.95,85.0,60
CDM,30124805,METHEMOGLOBIN QUANT (POINT OF CARE LAB),57.0,37.05,0.95,57.0,60
CDM,30124835,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,0.95,104.92,60
CDM,30124845,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,0.95,104.92,60
CDM,30124855,PHOSPHOLIPASE A2 RECEPTOR IGG ANTIBODY ELISA,119.0,77.35,0.95,119.0,60
CDM,30124865,GLUC NON GEST TOLERANCE,33.0,21.45,0.95,33.0,60
CDM,30124875,"GLUC, FASTING",27.0,17.55,0.95,27.0,60
CDM,30124885,NEUROFILAMENT LIGHT (NFL),119.0,77.35,0.95,476.29,55
CDM,30124905,"DIPHENHYDRAMINE, SERUM/PLASMA",32.0,20.8,9.05,468.91,60
CDM,30124915,"METOPROLOL, SER/PL",32.0,20.8,9.05,468.91,60
CDM,30124925,RAPID URINE DRUG SCREEN 10-PANEL - MEDTOX,65.0,42.25,9.67,65.0,38
CDM,30124935,RAPID URINE DRUG SCREEN 5-PANEL - MEDTOX,65.0,42.25,9.67,65.0,38
CDM,30124955,URINE DRUG SCREEN 10-PANEL - MEDTOX,50.0,32.5,7.44,50.0,38
CDM,30125015,URINE DRUG SCREEN 12-PANEL - MEDTOX,95.0,61.75,14.14,95.0,38
CDM,30125025,URINE DRUG SCREEN 4-PANEL (NO THC) - MEDTOX,50.0,32.5,7.44,50.0,38
CDM,30125035,URINE DRUG SCREEN 5-PANEL - MEDTOX,50.0,32.5,7.44,50.0,38
CDM,30125055,URINE DRUG SCREEN 9-PANEL (NO THC) - MEDTOX,50.0,32.5,7.44,50.0,38
CDM,30125065,URINE DRUG SCREEN DOT - MEDTOX,50.0,32.5,7.44,50.0,38
CDM,30125085,URINE DRUG SCREEN CRL WS66 - CRL,95.0,61.75,14.14,95.0,38
CDM,30125105,HAIR DRUG SCREEN 5-PANEL - OMEGA,105.0,68.25,15.62,105.0,38
CDM,30125175,BREATH ALCOHOL TEST - CCAW / WW,30.0,19.5,4.46,30.0,38
CDM,30125205,PTH RELATED PEPTIDE,166.0,107.9,0.95,166.0,60
CDM,30125215,"URDRG STIMULANTS, SYNTHETIC",68.0,44.2,19.23,468.91,60
CDM,30125225,URDRG ALKALOIDS NOS,68.0,44.2,19.23,468.91,60
CDM,30125235,URDRG ASSAY FOR PHENCYCLIDINE,68.0,44.2,19.23,468.91,60
CDM,30125245,"URDRG DRUG SCREENING, TAPENTADOL",68.0,44.2,19.23,468.91,60
CDM,30130AK,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,1527.0,992.55,1.1,5497.86,50
CDM,30140AK,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,1320.0,858.0,1.1,5497.86,53
CDM,30200005,ANTI PLATELET FACT 4 X2,127.0,82.55,0.95,127.0,60
CDM,30200015,*%ANA,77.0,50.05,0.95,77.0,60
CDM,30200020,*ALLERGEN IGG QUANT/SEMI EA,54.0,35.1,0.95,54.0,60
CDM,30200025,ANTI-STREPTOLYSIN O,50.0,32.5,0.95,50.0,60
CDM,30200030,ALLERGEN IGE QUANT/SEMI EA,36.0,23.4,0.95,36.0,60
CDM,30200035,BETA2 GLYCOPROT IGG/MX2,176.0,114.4,0.95,176.0,60
CDM,30200045,CARDIOLIPIN AB SCREEN,176.0,114.4,0.95,176.0,60
CDM,30200070,AB ID LEUKO AB,104.0,67.6,0.95,104.0,60
CDM,30200075,COLD AGGLUTININS,56.0,36.4,0.95,56.0,60
CDM,30200085,C3 COMPLEMENT B1C/B1A,83.0,53.95,0.95,83.0,60
CDM,30200090,*PLATELET AB SCREEN,127.0,82.55,0.95,127.0,60
CDM,30200105,COMPLEMENT DEFICIENCY,140.0,91.0,0.95,140.0,60
CDM,30200115,CYCLIC CITRU PEPT ANTI IG,89.0,57.85,0.95,89.0,60
CDM,30200125,DNA ANTIBODY,95.0,61.75,0.95,95.0,60
CDM,30200135,ENA ANY METHOD,124.0,80.6,0.95,124.0,60
CDM,30200140,ANTINUCLEAR AB(ANA),83.0,53.95,0.95,83.0,60
CDM,30200145,FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
CDM,30200150,ANTINUCLEAR AB(ANA) TITER,77.0,50.05,0.95,77.0,60
CDM,30200155,HEPATITIS B SUR AB QUANT,103.0,66.95,0.95,103.0,60
CDM,30200170,*ANTISTREPTOLYSIN 0 TITER,50.0,32.5,0.95,50.0,60
CDM,30200175,%IMMUNOFIXATION,154.0,100.1,0.95,154.0,60
CDM,30200180,C-REACTIVE PROTEIN,36.0,23.4,0.95,36.0,60
CDM,30200185,"MONOCLONAL PROTEIN,FLUID",203.0,131.95,0.95,203.0,60
CDM,30200190,C-REACTIVE PROTEIN HIGH SENSE,89.0,57.85,0.95,89.0,60
CDM,30200195,%QUAD4 MARKERS INHIBIN,108.0,70.2,0.95,108.0,60
CDM,30200200,*BETA 2 GLYCOPROTEIN I AB EA,176.0,114.4,0.95,176.0,60
CDM,30200205,INSULIN ANTIBODY,148.0,96.2,0.95,148.0,60
CDM,30200215,GAD65 ANTIBODY,163.0,105.95,0.95,163.0,60
CDM,30200225,%RETROVIR LYMPH TRANSF,338.0,219.7,0.95,358.7,60
CDM,30200230,*PHOSPHOLIPID AB,111.0,72.15,0.95,111.0,60
CDM,30200235,B CELLS TOTAL COUNT,260.0,169.0,0.95,260.0,60
CDM,30200245,%PNH CELL AG,185.0,120.25,0.95,185.0,60
CDM,30200255,NK CELLS TOTAL COUNT,260.0,169.0,0.95,260.0,60
CDM,30200260,"COMPLEMENT AG, EA",83.0,53.95,0.95,83.0,60
CDM,30200265,T CELLS TOTAL COUNT,260.0,169.0,0.95,260.0,60
CDM,30200285,T CELL ABSOLUTE COUNT/RATIO,324.0,210.6,0.95,324.0,60
CDM,30200295,%CD4ABS ABSOLUTE COUNT,185.0,120.25,0.95,185.0,60
CDM,30200310,COMPLEMENT/FUNC ACTIVITY EA,83.0,53.95,0.95,83.0,60
CDM,30200325,THYROID PEROXIDASE AB,100.0,65.0,0.95,100.0,60
CDM,30200340,COMPLEMENT TOTAL(CH50),140.0,91.0,0.95,140.0,60
CDM,30200355,CRYPTOCOCCAL ANTIGEN,80.0,52.0,0.95,80.0,60
CDM,30200365,TB GOLD PLUS,428.0,278.2,0.95,428.0,60
CDM,30200375,TEST SKIN CANDIDA,169.0,109.85,0.95,169.0,61
CDM,30200385,"SKIN TEST, UNLISTED ANTIGEN EA",169.0,109.85,0.95,169.0,61
CDM,30200390,*DEOXYRIBONUCLEASE AB,91.0,59.15,0.95,91.0,60
CDM,30200395,TUBERCULOSIS INTRADERMAL (POINT OF CARE LAB),169.0,109.85,0.95,169.0,61
CDM,30200415,ASPERGILLUS ID,104.0,67.6,0.95,105.93,60
CDM,30200420,EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
CDM,30200425,BLASTOMYCES ID,89.0,57.85,0.95,99.37,60
CDM,30200435,LYME WESTERN BLOT,107.0,69.55,0.95,107.0,60
CDM,30200445,LYME IGG & IGM SERUM,118.0,76.7,0.95,118.0,60
CDM,30200455,COCCIDIOIDES ID,79.0,51.35,0.95,88.34,60
CDM,30200465,CMV IGG ANTIBODY,99.0,64.35,0.95,99.0,60
CDM,30200475,CMV IGM EIA AB,116.0,75.4,0.95,116.0,60
CDM,30200485,EBV-EA IFA,91.0,59.15,0.95,91.0,60
CDM,30200495,EBV-NA IFA,106.0,68.9,0.95,106.0,60
CDM,30200505,EBV-VCA IFA IGG,125.0,81.25,0.95,125.0,60
CDM,30200515,H PYLORI AB,116.0,75.4,0.95,116.0,60
CDM,30200525,%IDM ANTI HTLV I,63.0,40.95,0.95,63.0,60
CDM,30200540,FAB SCREEN E,83.0,53.95,0.95,83.0,60
CDM,30200545,HIV  CONFIRMATION,134.0,87.1,0.95,134.0,60
CDM,30200575,HISTO ID,95.0,61.75,0.95,96.24,60
CDM,30200605,INFLUENZA A+B CF X2,93.0,60.45,0.95,93.0,60
CDM,30200615,LEGIONELLA ANTIBODY,106.0,68.9,0.95,106.0,60
CDM,30200625,MUMPS IGG ANTIBODY,90.0,58.5,0.95,90.0,60
CDM,30200635,MYCOPLASMA IGM AB,91.0,59.15,0.95,91.0,60
CDM,30200645,PARVO B19 AB IGG & IGMX2,104.0,67.6,0.95,104.0,60
CDM,30200655,%IDM CHAGAS,85.0,55.25,0.95,90.01,60
CDM,30200665,RUBELLA IGG SEMI-QUANT,99.0,64.35,0.95,99.0,60
CDM,30200675,MEASLES-RUBEOLA IGG AB,89.0,57.85,0.95,89.0,60
CDM,30200685,TOXOPLAS IGG,99.0,64.35,0.95,99.0,60
CDM,30200695,TOXOPLASMOSIS IGM AB,99.0,64.35,0.95,99.0,60
CDM,30200705,SYPHILIS T PALLIDUM IGG,91.0,59.15,0.95,91.0,60
CDM,30200710,IMMUNOASSY TUMOR CA 15-3,144.0,93.6,0.95,144.0,60
CDM,30200715,VARICELLA ZOSTER IGG AB,89.0,57.85,0.95,89.0,60
CDM,30200725,%CNILE WEST NILE VRS IGM,116.0,75.4,0.95,116.0,60
CDM,30200730,IMMUNOASSY TUMOR CA 19-9,144.0,93.6,0.95,144.0,60
CDM,30200735,%CNILE WEST NILE VRS IGG,99.0,64.35,0.95,110.69,60
CDM,30200740,IMMUNOASSY TUMOR CA 125,144.0,93.6,0.95,144.0,60
CDM,30200750,HTEROPHIL AB SCREEN,36.0,23.4,0.95,36.0,60
CDM,30200755,THYROGLOBULIN AB,110.0,71.5,0.95,110.0,60
CDM,30200795,HLA B27 FLOW,178.0,115.7,0.95,178.0,60
CDM,30200815,"HLA-DR,DQ,DR51,52,53 -TYPING DECEASED DONOR",732.0,475.8,0.95,732.0,60
CDM,30200820,IMMUNODIFFUSION NOS,97.0,63.05,0.95,97.0,60
CDM,30200870,*IMMUNOFIX ELECPHRSIS SERUM,154.0,100.1,0.95,154.0,60
CDM,30200885,*%HEP HBSAG,71.0,46.15,0.95,71.0,60
CDM,30200890,*IMMUNOFIX ELECPHRSIS OTHER,203.0,131.95,0.95,203.0,60
CDM,30200895,HEPATITIS HBSAG CONF,71.0,46.15,0.95,71.0,60
CDM,30200905,AG DETECT NOS IA MULT,83.0,53.95,0.95,83.0,60
CDM,30200920,INHIBIN A,108.0,70.2,0.95,108.0,60
CDM,30200935,TH/TO ANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30200945,HUMAN ANTI-MOUSE AB (HAMA),119.0,77.35,0.95,119.0,60
CDM,30200950,INT FAC AB,104.0,67.6,0.95,104.0,60
CDM,30200955,%IBDSGI C REAC PROTEIN,36.0,23.4,0.95,36.0,60
CDM,30200960,ISLET CELL AB,163.0,105.95,0.95,163.0,60
CDM,30200965,HE4,144.0,93.6,0.95,144.0,60
CDM,30201010,*B CELL TOTAL COUNT,260.0,169.0,0.95,260.0,60
CDM,30201015,RHEUMATOID FACTOR QUANT,39.0,25.35,0.95,39.0,60
CDM,30201020,*NATURAL KILLER TOTAL COUNT,260.0,169.0,0.95,260.0,60
CDM,30201030,*T CELL TOTAL COUNT,260.0,169.0,0.95,260.0,60
CDM,30201035,ADENOVIRUS ANTIBODY,89.0,57.85,0.95,89.0,60
CDM,30201045,ASPERGILLUS QUAL OR SEMI-QUANT,104.0,67.6,0.95,105.93,60
CDM,30201050,*T CELL ABSOLUTE COUNT W RATIO,324.0,210.6,0.95,324.0,60
CDM,30201055,STREPTO.PNEUM.X14,89.0,57.85,0.95,89.0,60
CDM,30201065,%FABCSF BLASTOMYCES,89.0,57.85,0.95,99.37,60
CDM,30201070,MICROSOMAL ANTIBODIES EA,100.0,65.0,0.95,100.0,60
CDM,30201075,LYME IGG/IGM IB CSF X2,107.0,69.55,0.95,107.0,60
CDM,30201085,BORELIA BURGDORFERI LYME,118.0,76.7,0.95,118.0,60
CDM,30201095,CAMPY JEJUNI AB IGG,91.0,59.15,0.95,91.0,60
CDM,30201105,CANDIDA IMMUNE COMPLEX,83.0,53.95,0.95,92.43,60
CDM,30201115,%FABCSF COCCIDIODE IGG/M ABS,79.0,51.35,0.95,88.34,60
CDM,30201135,%TORCH AB CMV IGG,99.0,64.35,0.95,99.0,60
CDM,30201145,%TORCHM AB CMV IGM,116.0,75.4,0.95,116.0,60
CDM,30201165,EHRLICHIA,70.0,45.5,0.95,78.37,60
CDM,30201170,RHEUMATOID FACTOR TEST QUANT,39.0,25.35,0.95,39.0,60
CDM,30201175,GIARDIA LAMBLIA IG/GAM X3,102.0,66.3,0.95,103.03,60
CDM,30201195,HAEMOPHILUS INFLU B IGG,103.0,66.95,0.95,103.0,60
CDM,30201205,HEPATITIS DELTA AB,118.0,76.7,0.95,118.0,60
CDM,30201225,HEPATITIS BE ANTIBODY,80.0,52.0,0.95,80.0,60
CDM,30201240,BARTONELLA,70.0,45.5,0.95,78.37,60
CDM,30201245,LEGIONELLA IGM ABS,106.0,68.9,0.95,106.0,60
CDM,30201250,*BRUCELLA AB,62.0,40.3,0.95,68.79,60
CDM,30201255,LEISHMANIASIS,85.0,55.25,0.95,85.0,60
CDM,30201260,CHLAMYDIA,82.0,53.3,0.95,82.0,60
CDM,30201265,LEPTOSPIRA ANTIBODY,112.0,72.8,0.95,112.0,60
CDM,30201285,MUMPS VIRUS AB IGM,90.0,58.5,0.95,90.0,60
CDM,30201295,MYCOPLASMA AB,91.0,59.15,0.95,91.0,60
CDM,30201335,ENTAMOEBA HISTO IGG,85.0,55.25,0.95,90.01,60
CDM,30201355,RUBELLA IGM IFA,99.0,64.35,0.95,99.0,60
CDM,30201360,*FUNGI AB NOS,85.0,55.25,0.95,85.0,60
CDM,30201365,MEASLES-RUBEOLA IGM AB,89.0,57.85,0.95,89.0,60
CDM,30201375,%TORCH AB TOXOPLS IGG,99.0,64.35,0.95,99.0,60
CDM,30201385,%TORCHM AB TOXOPLS IGM,99.0,64.35,0.95,99.0,60
CDM,30201395,TRICHINELLA IGG AB,87.0,56.55,0.95,87.0,60
CDM,30201405,VARICELLA ZOSTER IGM,89.0,57.85,0.95,89.0,60
CDM,30201410,*AB; HSV II,134.0,87.1,0.95,134.0,60
CDM,30201425,%ARBOVIRUS W NILE AB IGG,99.0,64.35,0.95,110.69,60
CDM,30201460,*LYMPH CHORIOMENINGITIS AB,89.0,57.85,0.95,89.0,60
CDM,30201465,"PT AB, IGG & IGM X2",326.0,211.9,0.95,326.0,46
CDM,30201485,HISTOPLASMA CAPSULA AG,91.0,59.15,0.95,92.38,60
CDM,30201495,NORWALK-LIKE VIRUS AG,83.0,53.95,0.95,83.0,60
CDM,30201515,"IMMUNOASSAY, CAD TITER",111.0,72.15,0.95,111.0,60
CDM,30201525,HIV 1&2 ANTIGEN/ANTIBODY,166.0,107.9,0.95,166.0,60
CDM,30201545,%HSVG12 IGG 2,134.0,87.1,0.95,134.0,60
CDM,30201555,%HSVG12 IGG 1,91.0,59.15,0.95,91.0,60
CDM,30201575,%HEXP HIV 1&2 AG/AB,166.0,107.9,0.95,166.0,60
CDM,30201585,PHOSPHOLIP A2-R AB IGG,83.0,53.95,0.95,83.0,60
CDM,30201605,%ABPA2 IGG TOTAL,54.0,35.1,0.95,54.0,60
CDM,30201615,DNA AB DOUBLE STRANDED,95.0,61.75,0.95,95.0,60
CDM,30201625,SS DNA ANTIBODY IGG,84.0,54.6,0.95,84.0,60
CDM,30201635,BABESIA MICROTI G+M X2,85.0,55.25,0.95,90.01,60
CDM,30201655,%TORC AB RUBELLA IGM,99.0,64.35,0.95,99.0,60
CDM,30201665,%CJD IMMUNO QT,144.0,93.6,0.95,144.0,60
CDM,30201675,N MENINGITIIDIS IGG X4,103.0,66.95,0.95,103.0,60
CDM,30201680,HLA TYPING A/B/C MULT AG,400.0,260.0,0.95,409.49,60
CDM,30201685,TETANUS TOXOID IGG,103.0,66.95,0.95,103.0,60
CDM,30201695,%HUMOR DIPHTHERIA TOX AB,103.0,66.95,0.95,103.0,60
CDM,30201705,DIPHTHERIA TOXOID IGG,103.0,66.95,0.95,103.0,60
CDM,30201715,%HUMOR TETANUS TOX AB,103.0,66.95,0.95,103.0,60
CDM,30201725,STREP PNEUMO ABS X14,103.0,66.95,0.95,103.0,60
CDM,30201735,PNEUMO ABS SEROTYPES X23,106.0,68.9,0.95,377.12,55
CDM,30201775,%RHEUMA IMMUNO X2,80.0,52.0,0.95,80.0,60
CDM,30201785,PLATELET AB DETECTION,127.0,82.55,0.95,127.0,60
CDM,30201805,ISLET CELL ANTIBODY,163.0,105.95,0.95,163.0,60
CDM,30201815,GAD65 ANTIBODY,163.0,105.95,0.95,163.0,60
CDM,30201835,%CANDA ALBICAN AB X3,83.0,53.95,0.95,92.43,60
CDM,30201865,C1Q BINDING ASSAY,168.0,109.2,0.95,168.0,60
CDM,30201965,%TORCHM HSV 1/2 IGM,99.0,64.35,0.95,99.0,60
CDM,30201985,WEST NILE VIRUS IGM,116.0,75.4,0.95,116.0,60
CDM,30202005,ALLERGEN IGG EACH,54.0,35.1,0.95,54.0,60
CDM,30202015,ALLERGEN IGE EACH,36.0,23.4,0.95,36.0,60
CDM,30202025,COMPLEMENT C2,83.0,53.95,0.95,83.0,60
CDM,30202035,COMPLEMENT COMP4A,83.0,53.95,0.95,83.0,60
CDM,30202045,COMPLEMENT COMP3A,83.0,53.95,0.95,83.0,60
CDM,30202055,COMPLEMENT FUNCT ACT C8,83.0,53.95,0.95,83.0,60
CDM,30202075,PM - 1 ANTIBODY,124.0,80.6,0.95,124.0,60
CDM,30202085,ENA (MYOSPL),124.0,80.6,0.95,124.0,60
CDM,30202095,RETICULIN IGA IGG ABS,83.0,53.95,0.95,83.0,60
CDM,30202105,%IBDSER NEUTROPH SP ABS,83.0,53.95,0.95,83.0,60
CDM,30202115,NMDA IGG,83.0,53.95,0.95,83.0,60
CDM,30202120,*IMMUNODIF QUAL EA AB/AG,83.0,53.95,0.95,83.0,60
CDM,30202125,EPIDERMAL ABS & REFLEXX2,83.0,53.95,0.95,83.0,60
CDM,30202135,NMO AQUAPORIN4 IGG CSF,83.0,53.95,0.95,83.0,60
CDM,30202145,NMO AQUAPORIN4 IGG,83.0,53.95,0.95,83.0,60
CDM,30202165,SKELETAL MUSCLE AB SCREEN,83.0,53.95,0.95,83.0,60
CDM,30202175,ADRENAL ANTIBODY,83.0,53.95,0.95,83.0,60
CDM,30202185,ENDOMYSTAL AB IGG,83.0,53.95,0.95,104.69,60
CDM,30202195,PARANEOPLAST ABS CSF X9,83.0,53.95,0.95,83.0,60
CDM,30202205,NMDAG TITER,83.0,53.95,0.95,104.69,60
CDM,30202215,BM2 ABS TITER,83.0,53.95,0.95,104.69,60
CDM,30202225,%PARNEO FLUORESCENT X9,83.0,53.95,0.95,83.0,60
CDM,30202235,INTERCELL SUB AB TITER,83.0,53.95,0.95,104.69,60
CDM,30202245,S-100B PROTEIN,144.0,93.6,0.95,144.0,60
CDM,30202255,AFP CSF TUMOR MARKER,144.0,93.6,0.95,144.0,60
CDM,30202265,%HUMOR PNEUMO IGG X14,103.0,66.95,0.95,103.0,60
CDM,30202270,*LYME WESTERN BLOT,107.0,69.55,0.95,107.0,60
CDM,30202275,%ABPA2 ASPERG QUAL OUCHT,83.0,53.95,0.95,83.0,60
CDM,30202285,INHIBIN A,108.0,70.2,0.95,108.0,60
CDM,30202295,NABFERON AB,937.0,609.05,0.95,937.0,60
CDM,30202335,IMMUNE FUN ASSY ATP,937.0,609.05,0.95,937.0,60
CDM,30202345,LPT TO BERYLLIUM,338.0,219.7,0.95,358.7,60
CDM,30202355,LYMPH TRANS TEST,338.0,219.7,0.95,358.7,60
CDM,30202385,LISTERIA ANTIBODY,89.0,57.85,0.95,89.0,60
CDM,30202395,PERTUSSIS/PARAPERT GAM X3,91.0,59.15,0.95,91.0,60
CDM,30202405,B PERTUSSIS AB IGA IB,91.0,59.15,0.95,91.0,60
CDM,30202415,B PERTUSSIS AB IGG IB,91.0,59.15,0.95,91.0,60
CDM,30202425,B PERTUSSIS AB IGM IB,91.0,59.15,0.95,91.0,60
CDM,30202435,BRUCELLA CONFIRM,62.0,40.3,0.95,68.79,60
CDM,30202445,%CIGIM ABS X3,82.0,53.3,0.95,82.0,60
CDM,30202455,CHLAMYDIA AB PANEL X3,82.0,53.3,0.95,82.0,60
CDM,30202465,%CIGIM IGM ABS X3,87.0,56.55,0.95,87.0,60
CDM,30202475,CHLAMYDIA IGM PANEL X3,87.0,56.55,0.95,87.0,60
CDM,30202485,COCCIDIODES IGG/M ABS X2,79.0,51.35,0.95,88.34,60
CDM,30202495,COXIELLA IGG IGM IGA X6,84.0,54.6,0.95,84.0,60
CDM,30202505,COXIELLA BURNETII IGG X2,84.0,54.6,0.95,84.0,60
CDM,30202515,CMV IGG AVIDITY,99.0,64.35,0.95,99.0,60
CDM,30202520,*CANDIDA AB,83.0,53.95,0.95,92.43,60
CDM,30202525,%IDM CMV,99.0,64.35,0.95,99.0,60
CDM,30202535,COXSACKIE A ABS,90.0,58.5,0.95,100.33,60
CDM,30202545,ECHOVIRUS ANTIBODIES X5,90.0,58.5,0.95,100.33,60
CDM,30202555,POLIOVIRUS ANTIBODIES X3,90.0,58.5,0.95,100.33,60
CDM,30202565,EHRLICHIA CHAF IGG/IGMX2,70.0,45.5,0.95,78.37,60
CDM,30202575,"A PHAGO AB, IGG/IGM X2",70.0,45.5,0.95,78.37,60
CDM,30202580,DIPTHERIA TETANUS AB,103.0,66.95,0.95,103.0,60
CDM,30202585,STRONGYLOIDES IGG ABS,90.0,58.5,0.95,90.0,60
CDM,30202595,FILARIASIS ABS IGG4,90.0,58.5,0.95,90.0,60
CDM,30202605,SCHISTOSOMA IGG AB,90.0,58.5,0.95,90.0,60
CDM,30202615,TOXOCARA ANTIBODIES,90.0,58.5,0.95,90.0,60
CDM,30202635,%CSFTOX TOXOPLAS IGG,99.0,64.35,0.95,99.0,60
CDM,30202645,%CSFTOX TOXOPLAS IGM,99.0,64.35,0.95,99.0,60
CDM,30202655,"VZV IGG AB, CSF",89.0,57.85,0.95,89.0,60
CDM,30202665,HERPES VIRUS 6 IGG AB,89.0,57.85,0.95,89.0,60
CDM,30202670,ANTINUCLEAR,83.0,53.95,0.95,83.0,60
CDM,30202675,DENGUE VIRUS IGM AB,89.0,57.85,0.95,89.0,60
CDM,30202685,DENGUE FEVER ABS IGG/M X2,89.0,57.85,0.95,89.0,60
CDM,30202695,HV6 HUMAN IGG/IGM ABSX2,89.0,57.85,0.95,89.0,60
CDM,30202705,HERPESVIRUS 6 IGM AB,89.0,57.85,0.95,89.0,60
CDM,30202715,HERPESVIRUS-7 IGG/M X2,89.0,57.85,0.95,89.0,60
CDM,30202725,DENGUE VIRUS IGG AB,89.0,57.85,0.95,89.0,60
CDM,30202735,HATAVIRUS IGG & IGM,89.0,57.85,0.95,89.0,60
CDM,30202745,PARAINFLU 123ABS IGG/MX3,89.0,57.85,0.95,89.0,60
CDM,30202755,HEPATITIS E IGG/IGM ABX2,89.0,57.85,0.95,89.0,60
CDM,30202765,HTLV I/II ANTIBODY EIA,89.0,57.85,0.95,89.0,60
CDM,30202775,HEPATITIS E IGM,89.0,57.85,0.95,89.0,60
CDM,30202785,HEPATITIS E IGG,89.0,57.85,0.95,89.0,60
CDM,30202795,CHIKUNGUNYA AB W/ REFLEX,89.0,57.85,0.95,89.0,60
CDM,30202805,CHIKUNGUNYA IGM TITER,89.0,57.85,0.95,89.0,60
CDM,30202815,CHIKUNGUNYA IGG TITER,89.0,57.85,0.95,89.0,60
CDM,30202885,"HLA-A,B,CW - TYPING DECEASED DONOR",400.0,260.0,0.95,409.49,60
CDM,30202895,"HLA-A,B TYPING VERIFICATION",400.0,260.0,0.95,409.49,60
CDM,30202905,XM T & B FLOW AUTO,755.0,490.75,0.95,755.0,60
CDM,30202915,XM T & B FLOW ALLO,755.0,490.75,0.95,755.0,60
CDM,30202925,XM POST-TX DSA MONITORING  CLASS I,2234.0,1452.1,0.95,2234.0,60
CDM,30202935,AB ID & VPRA -CLASS I C1Q,2234.0,1452.1,0.95,2234.0,60
CDM,30202945,XM POST-TX DSA MONITORING  CLASS II,2248.0,1461.2,0.95,2248.0,60
CDM,30202955,AB ID & VPRA-CLAS II LUMINEX-C1Q,2248.0,1461.2,0.95,2248.0,60
CDM,30202965,MYELIN ANTIBODY IGG,83.0,53.95,0.95,83.0,60
CDM,30202975,NMO/AQP4 FACS TITER,83.0,53.95,0.95,104.69,60
CDM,30203025,%FANA ANA AB,83.0,53.95,0.95,83.0,60
CDM,30203035,"COMPLEMENT C7, FUNC",83.0,53.95,0.95,83.0,60
CDM,30203075,PLA2R AB IGG TITER,83.0,53.95,0.95,104.69,60
CDM,30203085,IMMUNOFIX ELEC GEL,154.0,100.1,0.95,154.0,60
CDM,30203095,"LYME REFLEX PNL, CSF",118.0,76.7,0.95,118.0,60
CDM,30203115,"CANDIDA ABS IGA,G,M X3",83.0,53.95,0.95,92.43,60
CDM,30203125,HIV2 AB CONF SERUM,134.0,87.1,0.95,134.0,60
CDM,30203155,HERPESVIR 6 AB IGM TITER,89.0,57.85,0.95,89.0,60
CDM,30204005,BIRD FANCIERS PRECIPITIN,83.0,53.95,0.95,83.0,60
CDM,30204015,LYME DISEASE AB RFLX,107.0,69.55,0.95,107.0,60
CDM,30204025,LRP4 AB TEST,83.0,53.95,0.95,83.0,60
CDM,30204035,TRYPANOSOMA CRUZI AB IGG,85.0,55.25,0.95,90.01,60
CDM,30204045,TRYPANOSOMA CRUZI AB IGM,85.0,55.25,0.95,90.01,60
CDM,30204065,%PNUTCP ALLG SPEC IGE,36.0,23.4,0.95,36.0,60
CDM,30204105,%PHI IMMUNO TUMOR AG,144.0,93.6,0.95,144.0,60
CDM,30204115,LEGIONELLA PNEUMOPHILA AB,106.0,68.9,0.95,106.0,60
CDM,30204135,HIV 1&2 ANTIBODY SCREEN,95.0,61.75,0.95,95.0,60
CDM,30204145,POLIOVIRUS ABS NEUTRAL X2,90.0,58.5,0.95,100.33,60
CDM,30204155,NEUTROPHIL SPECIFIC ABS,83.0,53.95,0.95,83.0,60
CDM,30204445,TEICHOIC ACID ANTIBODIES,97.0,63.05,0.95,97.0,60
CDM,30204455,COXSACKIE A DIFF AB X6,90.0,58.5,0.95,100.33,60
CDM,30204475,HETEROPHILE AB TITER,45.0,29.25,0.95,45.0,60
CDM,30204485,"COMPLEMENT C3, SER",83.0,53.95,0.95,83.0,60
CDM,30204495,"COMPLEMENT C4, SER",83.0,53.95,0.95,83.0,60
CDM,30204525,ANCA TITER,83.0,53.95,0.95,104.69,60
CDM,30204535,STRIATED MUSCLE TITER,83.0,53.95,0.95,104.69,60
CDM,30204545,AMPA RECEPTOR AB CBA,83.0,53.95,0.95,83.0,60
CDM,30204555,C2 COMPLEMENT AG,83.0,53.95,0.95,83.0,60
CDM,30204595,CASPR2 IGG REFLEX,83.0,53.95,0.95,83.0,60
CDM,30204605,LGI1 IGG,83.0,53.95,0.95,83.0,60
CDM,30204615,%HIVIFA HSV 1 IGM,91.0,59.15,0.95,91.0,60
CDM,30204635,HSV 2 IGM TITER REFLEX,134.0,87.1,0.95,134.0,60
CDM,30204645,%HSVIFA HSV 2 IGM,91.0,59.15,0.95,91.0,60
CDM,30204655,DNA CRITHIDIA ANTIBODY,83.0,53.95,0.95,83.0,60
CDM,30204665,SMOOTH MUSCLE AB SCR,83.0,53.95,0.95,83.0,60
CDM,30204685,PHOEV - CARDIOLIPIN,176.0,114.4,0.95,176.0,60
CDM,30204695,MITOCHONDR AB,83.0,53.95,0.95,83.0,60
CDM,30204715,"TEICHOIC ACID, QUAL",83.0,53.95,0.95,83.0,60
CDM,30204775,"GALAC-ALPHA 1,3-GALAC IGE",124.0,80.6,0.95,124.0,60
CDM,30204785,ZIKA VIRUS IGM,116.0,75.4,0.95,116.0,60
CDM,30204795,ALLG SPEC IGE RECOMB EA,124.0,80.6,0.95,124.0,60
CDM,30204805,NMOA4 AQUAPORIN4 IGG,83.0,53.95,0.95,83.0,60
CDM,30204815,%PNUTCP ALLG IGE RECOMBX5,124.0,80.6,0.95,124.0,60
CDM,30204835,ANCA TITER BILL,83.0,53.95,0.95,104.69,60
CDM,30204845,AQUAPORIN4 REC AB IGG CSF,83.0,53.95,0.95,83.0,60
CDM,30204855,SEROTONIN RELEASE LMWH,127.0,82.55,0.95,127.0,60
CDM,30204865,"A FUMIGATUS AB, IGG",104.0,67.6,0.95,105.93,60
CDM,30204885,ALLG SPEC IGE IN HOUSE,124.0,80.6,0.95,124.0,60
CDM,30204915,ASPERGILLUS ID,104.0,67.6,0.95,105.93,60
CDM,30204925,BLASOMYCES DERMATITIDIS AB,89.0,57.85,0.95,99.37,60
CDM,30204945,FUNCF ASPERGILLUS ID,104.0,67.6,0.95,105.93,60
CDM,30204955,FUNCF BLASOMYCES DERMATITIDIS AB,89.0,57.85,0.95,99.37,60
CDM,30204965,FUNCF COCCIDOIDES AB,79.0,51.35,0.95,88.34,60
CDM,30204975,FUNCF HISTOPLASMA AB X2,95.0,61.75,0.95,96.24,60
CDM,30204985,"HISTOPLASMA AB, CF X2",95.0,61.75,0.95,96.24,60
CDM,30205015,SC5B-9 LEVEL MAC COMPLEX,83.0,53.95,0.95,83.0,60
CDM,30205045,MITOCHONDRIAL ANTIBODY EACH,176.0,114.4,0.95,176.0,60
CDM,30205055,TISSUE TRANSGLUTAMINASE EA,80.0,52.0,0.95,80.0,60
CDM,30205065,GLIADIN ANTIBODY EACH,83.0,53.95,0.95,83.0,60
CDM,30205075,ANTINEUT CYT AB SCR EA,83.0,53.95,0.95,83.0,60
CDM,30205085,ACTIN SMOOTH MUSCLE AB EA,83.0,53.95,0.95,83.0,60
CDM,30205095,CDS1SE AQ4 AB FL CYT EA,260.0,169.0,0.95,260.0,60
CDM,30205105,CDS1SE MOG-IGG1 AB FL EA,260.0,169.0,0.95,260.0,60
CDM,30205115,"MOG AB IGG CBA-IFA SCREEN, SERUM",260.0,169.0,0.95,260.0,60
CDM,30205125,"MOG FACS TITNER, SERUM RFLX",260.0,169.0,0.95,260.0,60
CDM,30205155,VOLTAGE-GATED NA CH AB EA,83.0,53.95,0.95,83.0,60
CDM,30205175,NMOIFA AQ-4 AB EA,83.0,53.95,0.95,83.0,60
CDM,30205185,IBDSER ANTINEUT CYT AB SCR EA,83.0,53.95,0.95,83.0,60
CDM,30205205,"THSD7A AB, S",83.0,53.95,0.95,83.0,60
CDM,30205215,"PLA2R, IMMUNOFLUORESCENCE, S (REFLEX ONLY)",83.0,53.95,0.95,83.0,60
CDM,30209960,TB TEST CELL IMMUNITY MEAS,428.0,278.2,0.95,428.0,60
CDM,30210010,CHLAMYDIA IGM,87.0,56.55,0.95,87.0,60
CDM,30210020,BORDETELLA QUAL OR SEMI-QUANT,91.0,59.15,0.95,91.0,60
CDM,30210050,*ALLERG SP IGE;QT OR QUAL,36.0,23.4,0.95,36.0,60
CDM,30210070,*ALLERGEN IGE QUANT/SEMI,36.0,23.4,0.95,36.0,60
CDM,30210140,*AB ID PLT AB,127.0,82.55,0.95,127.0,60
CDM,30210150,*AB ID PLT AB,127.0,82.55,0.95,127.0,60
CDM,30210190,*AB ID PLT IG ASSAY,86.0,55.9,0.95,95.9,60
CDM,30210200,ANTINUCLEAR AB(ANA) TITER,77.0,50.05,0.95,77.0,60
CDM,30210210,COMPLEMENT AG EA,83.0,53.95,0.95,83.0,60
CDM,30210270,*EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
CDM,30210290,EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
CDM,30210300,EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
CDM,30210310,EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
CDM,30210340,EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
CDM,30210400,FAB SCREEN EA AB,83.0,53.95,0.95,83.0,60
CDM,30210500,*FAB TITER EA AB,83.0,53.95,0.95,104.69,60
CDM,30210530,FAB TITER EA AB,83.0,53.95,0.95,104.69,60
CDM,30210550,IMMUNOASSY TUMOR CA 15-3,144.0,93.6,0.95,144.0,60
CDM,30210560,HETRPHL AB SCRN,36.0,23.4,0.95,36.0,60
CDM,30210570,IMMUNOASSY TUMOR AG QUANT,144.0,93.6,0.95,144.0,60
CDM,30210670,ISLET CELL AB,163.0,105.95,0.95,163.0,60
CDM,30210750,*PARTCL AGGLUT SCREEN EA,80.0,52.0,0.95,80.0,60
CDM,30210820,FUNGI AB NOS,85.0,55.25,0.95,85.0,60
CDM,30210830,*FUNGI AB NOS,85.0,55.25,0.95,85.0,60
CDM,30210850,HISTOPLASMA,95.0,61.75,0.95,96.24,60
CDM,30210860,*HISTOPLASMA AB,95.0,61.75,0.95,96.24,60
CDM,30210890,*AB; SALMONELLA,91.0,59.15,0.95,91.0,60
CDM,30210960,*VIRUS AB NOS,117.0,76.05,0.95,117.0,60
CDM,30210AK,DISPLACEMENT THERAPY PROETZ TYPE,452.0,293.8,1.1,2603.78,53
CDM,30211090,*ENTEROVIRUS AB,90.0,58.5,0.95,100.33,60
CDM,30211100,*ENTEROVIRUS AB,90.0,58.5,0.95,100.33,60
CDM,30211170,*PHOSPHOLIPID AB,111.0,72.15,0.95,111.0,60
CDM,30211180,*BARTONELLA AB,70.0,45.5,0.95,78.37,60
CDM,30211190,*Q FEVER (COXIELLA) AB,84.0,54.6,0.95,84.0,60
CDM,30211230,*AB ID PLT IG ASSAY,86.0,55.9,0.95,95.9,60
CDM,30211280,FRANCISELLA TULARENSIS AB,98.0,63.7,0.95,98.0,60
CDM,30211320,HIV AB CONFIRM/WESTERN BLOT,134.0,87.1,0.95,134.0,60
CDM,30211340,HERPES SIMPLEX TYPE I,91.0,59.15,0.95,91.0,60
CDM,30211420,*H PYLORI AB,116.0,75.4,0.95,116.0,60
CDM,30211470,*CHLAMYDIA AB,82.0,53.3,0.95,82.0,60
CDM,30211560,AB PRA FLOW,443.0,287.95,0.95,443.0,60
CDM,30211570,AB ID & VPRA -CLASS I LUMINEX,2234.0,1452.1,0.95,2234.0,60
CDM,30211580,AB ID & VPRA -CLASS II LUMINEX,2248.0,1461.2,0.95,2248.0,60
CDM,30211620,XM T & B FLOW ALLO- ADD SERUM SAMPLE,252.0,163.8,0.95,252.0,60
CDM,30211680,*HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,60
CDM,30211690,*HEP B SURFACE AB,74.0,48.1,0.95,74.0,60
CDM,30211700,*HEP C AB,98.0,63.7,0.95,98.0,60
CDM,30211710,"HEP A, HEP A AB IGM",78.0,50.7,0.95,78.0,60
CDM,30211720,HEP B CORE IGM AB,81.0,52.65,0.95,81.0,60
CDM,30211730,HEP A AB TOTAL,85.0,55.25,0.95,85.0,60
CDM,30211800,*IMMUNODIFFUSION QUAL EA AB/AG,83.0,53.95,0.95,83.0,60
CDM,30211820,ASPERGILLUS AB,104.0,67.6,0.95,105.93,60
CDM,30211880,*WEST NILE VIRUS AB,99.0,64.35,0.95,110.69,60
CDM,30211980,*HERPES SIMPLEX TYPE 2 AB,134.0,87.1,0.95,134.0,60
CDM,30212380,DNA CRITHIDIA ANTIBODY,89.0,57.85,0.95,89.0,60
CDM,30212385,ENDOMYSIAL IGA,83.0,53.95,0.95,83.0,60
CDM,30212390,AB; VIRUS NES,89.0,57.85,0.95,89.0,60
CDM,30212395,EBV CAPSID AG IGM,125.0,81.25,0.95,125.0,60
CDM,30212405,GABA-B RECEPTOR AB CBA,83.0,53.95,0.95,83.0,60
CDM,30212415,CHROMOGRANIN A,144.0,93.6,0.95,144.0,60
CDM,30212435,EBV IGG AB,106.0,68.9,0.95,106.0,60
CDM,30212445,PARIETAL CELL AB SCR,83.0,53.95,0.95,83.0,60
CDM,30212455,HUMOR1 IMMUNASSY INF AG1 X6,103.0,66.95,0.95,103.0,60
CDM,30212465,HUMOR1 IMMUNASSY INF AG2 X6,103.0,66.95,0.95,103.0,60
CDM,30212475,HUMOR1 IMMUNASSY INF AG X4,103.0,66.95,0.95,103.0,60
CDM,30212485,CHROMOGRANIN A,144.0,93.6,0.95,144.0,60
CDM,30212495,ALGN FOOD PANEL IGG X19,54.0,35.1,0.95,54.0,60
CDM,30212505,"ALLERGEN, MILK IGE X4",36.0,23.4,0.95,36.0,60
CDM,30212515,"ALLERGEN, EGG IGE X2",36.0,23.4,0.95,36.0,60
CDM,30212525,"NERUON SPEC ENOLASE, SER",119.0,77.35,0.95,119.0,60
CDM,30212535,NEUROMYELITIS OPT AQP4IGG,83.0,53.95,0.95,104.69,60
CDM,30212545,MOG-IGG1 FACS,83.0,53.95,0.95,83.0,60
CDM,30212555,"MOG FACS TITER, S REF",83.0,53.95,0.95,104.69,60
CDM,30212575,B BURGDO AB IGG IGM X2,107.0,69.55,0.95,107.0,60
CDM,30212635,ANTI NEUT CY AB,83.0,53.95,0.95,83.0,60
CDM,30212675,ASPERGILLUS AB IMDIFF,104.0,67.6,0.95,105.93,60
CDM,30212685,NEUTROPHIL OX BURST BLD,937.0,609.05,0.95,937.0,60
CDM,30212695,CHIKUNGUNYA AB IGG IGM X2,89.0,57.85,0.95,89.0,60
CDM,30212765,ADRENAL AB TITER RFLX,83.0,53.95,0.95,104.69,60
CDM,30212775,CJD IMASSAY IA AB QNT,103.0,66.95,0.95,103.0,60
CDM,30212785,COMPLEMENT AH50 FUNC,83.0,53.95,0.95,83.0,60
CDM,30212825,ALGN ORRIS ROOT IGE,36.0,23.4,0.95,36.0,60
CDM,30212835,ALGN CHAETOMIUM GLOB IGE,36.0,23.4,0.95,36.0,60
CDM,30212915,IDM HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,60
CDM,30212925,IDM HEP C AB,98.0,63.7,0.95,98.0,60
CDM,30212955,BPHENO MONONUCLEAR AG,185.0,120.25,0.95,185.0,60
CDM,30213015,AIDYSA FLUOR AB SCRN,83.0,53.95,0.95,83.0,60
CDM,30213025,AIDYSA ISLET CELL AB,163.0,105.95,0.95,163.0,60
CDM,30213135,WHIIVF SYPHILIS TEST,29.0,18.85,0.95,29.0,60
CDM,30213145,WHIIVF HEP C AB,98.0,63.7,0.95,98.0,60
CDM,30213155,WHIIVF HEP B CORE AB TOTA,83.0,53.95,0.95,83.0,60
CDM,30213165,WHIIVF2 RUBELLA IGG SEMI-QUANT,99.0,64.35,0.95,99.0,60
CDM,30213175,WHIIVF2 RUBELLA IGM IFA,99.0,64.35,0.95,99.0,60
CDM,30213185,WHIIVF2 CMV IGG AB,99.0,64.35,0.95,99.0,60
CDM,30213195,WHIIVF2 CMV IGM EIA AB,116.0,75.4,0.95,116.0,60
CDM,30213205,C5COMF COMPLEMENT/FUNCTION ACTIVITY,83.0,53.95,0.95,83.0,60
CDM,30213215,GBMGP FLUORESCENT ANTIBODY SCREEN,83.0,53.95,0.95,83.0,60
CDM,30213225,HUANT FLUORESCENT ANTIBODY SCREEN,83.0,53.95,0.95,83.0,60
CDM,30213235,ACESTR FLUORESCENT ANTIBODY SCREEN,83.0,53.95,0.95,83.0,60
CDM,30213245,GABTTR FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
CDM,30213255,AMPIFC FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
CDM,30213265,NANNTR FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
CDM,30213275,HUTIT FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
CDM,30213325,"HLA-A,B TYPING",400.0,260.0,0.95,409.49,60
CDM,30213335,"HLA-DR,DQ,DRW TYPING",732.0,475.8,0.95,732.0,60
CDM,30213345,XM T&B FLOW ALLO DECEASED DONOR,755.0,490.75,0.95,755.0,60
CDM,30213355,AB PRA FLOW REPEAT,443.0,287.95,0.95,443.0,60
CDM,30213365,AB ID & VPRA -CLASS I LUMINEX REPEAT,2234.0,1452.1,0.95,2234.0,60
CDM,30213375,AB ID DILUTION - CLASS I LUMINEX,2234.0,1452.1,0.95,2234.0,60
CDM,30213385,AB ID CLASS I PHENO BEADS,2234.0,1452.1,0.95,2234.0,60
CDM,30213395,AB ID & VPRA -CLASS II LUMINEX REPEAT,2248.0,1461.2,0.95,2248.0,60
CDM,30213405,AB ID DILUTION - CLASS II LUMINEX,2248.0,1461.2,0.95,2248.0,60
CDM,30213415,AB ID CLASS II PHENO BEADS,2248.0,1461.2,0.95,2248.0,60
CDM,30213435,"ALGN FOOD, ALPHA-GAL IGE",124.0,80.6,0.95,124.0,60
CDM,30213455,AB ID CLASS I PHENO BEADS REPEAT,2234.0,1452.1,0.95,2234.0,60
CDM,30213465,AB ID CLASS II PHENO BEADS REPEAT,2248.0,1461.2,0.95,2248.0,60
CDM,30213495,ENCSER FLUORESCENT AB SCRN,83.0,53.95,0.95,83.0,60
CDM,30213505,ENCSER ISLET CELL AB,163.0,105.95,0.95,163.0,60
CDM,30213515,ENCCSF FLUORESCENT AB X21,83.0,53.95,0.95,83.0,60
CDM,30213525,ENCCSF ISLET CELL AB,163.0,105.95,0.95,163.0,60
CDM,30213615,%PARNEO VOLTAGE-GTD CA CHNL ANTB EA,83.0,53.95,0.95,83.0,60
CDM,30213625,ASPERGILLUS FUMIGATUS ANTIBODY IGG,103.0,66.95,0.95,103.0,60
CDM,30213635,WHIIVF SYPHILIS,91.0,59.15,0.95,91.0,60
CDM,30213955,HUMORAL IMMUNITY PANELS 1/2,103.0,66.95,0.95,103.0,60
CDM,30213995,ZINC TRANSPORTER 8 ANTIBODY,163.0,105.95,0.95,163.0,60
CDM,30214005,C3 NEPHRITIC FACTOR,83.0,53.95,0.95,83.0,60
CDM,30214015,COMPLEMENT FACTOR H,83.0,53.95,0.95,83.0,60
CDM,30214025,COMPLEMENT FACTOR I,83.0,53.95,0.95,83.0,60
CDM,30214035,"ALLERGEN, SESAME SEED RSES I 1 COMPONENT",124.0,80.6,0.95,124.0,60
CDM,30214045,"ALLERGEN, WHEAT, RTRI A OMEGA-5-GLIADIN COMPONENT",124.0,80.6,0.95,124.0,60
CDM,30214055,"ALLERGEN, SESAME SEED WITH COMPONENT REFLEX",36.0,23.4,0.95,36.0,60
CDM,30214065,"ALLERGEN, WHEAT WITH COMPONENT REFLEX",36.0,23.4,0.95,36.0,60
CDM,30214075,"QUANTIFERON-TB GOLD PLUS, BLOOD",428.0,278.2,0.95,428.0,60
CDM,30214085,"ALLERGEN, PAPER WASP COMPONENT IGE",124.0,80.6,0.95,124.0,60
CDM,30214095,"ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS",36.0,23.4,0.95,36.0,60
CDM,30214105,"ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE",36.0,23.4,0.95,36.0,60
CDM,30214115,"ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT",36.0,23.4,0.95,36.0,60
CDM,30214125,"ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS",36.0,23.4,0.95,36.0,60
CDM,30214135,"ALLERGEN, YELLOW JACKET (COMMON WASP) COMPONENTS IGE",124.0,80.6,0.95,124.0,60
CDM,30214145,ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,83.0,53.95,0.95,83.0,60
CDM,30214155,ACETYLCHOLINE RECEPTOR (ACHR) BINDING ANTIBODY,127.0,82.55,0.95,127.0,60
CDM,30214165,ACETYLCHOLINE RECEPTOR (ACHR) BLOCKING ANTIBODY,127.0,82.55,0.95,127.0,60
CDM,30214175,"MUSCLE-SPECIFIC KINASE (MUSK) AUTOANTIBODY, SERUM",127.0,82.55,0.95,127.0,60
CDM,30214185,ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,127.0,82.55,0.95,127.0,60
CDM,30214195,ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,127.0,82.55,0.95,127.0,60
CDM,30214205,B CELL TOTAL-ARUP,260.0,169.0,0.95,260.0,60
CDM,30214215,BPHENO MONONUCLEAR AG - ARUP,185.0,120.25,0.95,185.0,60
CDM,30214225,PLATELET ANTIBODIES,127.0,82.55,0.95,127.0,60
CDM,30214235,PLATELET ANTIBODIES,127.0,82.55,0.95,127.0,60
CDM,30214245,BAL FCM MARKERS,185.0,120.25,0.95,185.0,60
CDM,30214265,"B CELLS, TOTAL COUNT",260.0,169.0,0.95,260.0,60
CDM,30214275,"CD20 MONONUCLEAR CELL ANTIGEN, QUANT",185.0,120.25,0.95,185.0,60
CDM,30214285,F324-IGE HOP (FOOD),36.0,23.4,0.95,36.0,60
CDM,30214295,LUPINE SEED (LUPINUS ALBUS) IGE,36.0,23.4,0.95,36.0,60
CDM,30214305,CHEESE MOZZARELLA IGE,36.0,23.4,0.95,36.0,60
CDM,30214315,CHEESE PARMESAN IGE,36.0,23.4,0.95,36.0,60
CDM,30214325,CHEESE SWISS IGE,36.0,23.4,0.95,36.0,60
CDM,30214335,"ALLERGEN, FOOD, ASPARAGUS IGE",36.0,23.4,0.95,36.0,60
CDM,30214345,"ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE",36.0,23.4,0.95,36.0,60
CDM,30214355,"ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA",36.0,23.4,0.95,36.0,60
CDM,30214365,"PDE10A AB IFA TITER, S",83.0,53.95,0.95,104.69,60
CDM,30214375,"TRIM46 AB CBA, S",83.0,53.95,0.95,83.0,60
CDM,30214385,"TRIM46 AB IFA TITER, S",83.0,53.95,0.95,104.69,60
CDM,30214395,"PDE10A AB IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214405,"TRIM46 AB CBA, CSF",83.0,53.95,0.95,83.0,60
CDM,30214415,"TRIM46 AB IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214425,GLUTAMIC ACID DECARBOXYLASE ANTIBODY,163.0,105.95,0.95,163.0,60
CDM,30214435,"MOG AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,0.95,83.0,60
CDM,30214445,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,0.95,83.0,60
CDM,30214455,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, SERUM",83.0,53.95,0.95,83.0,60
CDM,30214465,GLUTAMIC ACID DECARBOXYLASE ANTIBODY CSF,163.0,105.95,0.95,163.0,60
CDM,30214475,"NMO/AQP4 AB IGG CBA-IFA SCREEN, CSF",83.0,53.95,0.95,83.0,60
CDM,30214485,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, CSF",83.0,53.95,0.95,83.0,60
CDM,30214495,"REFLEX MGLUR1 AB IGG CBA-IFA TITER, SERUM",83.0,53.95,0.95,104.69,60
CDM,30214505,"GABA-A RECE$TOR IGG CBA-IFA TITER, SERUM",83.0,53.95,0.95,104.69,60
CDM,30214515,"NEURONAL NUCLEAR AB (ANNA) IFA TITER, IGG",83.0,53.95,0.95,104.69,60
CDM,30214525,"PURKINJE CELL ANTIBODY, TITER",83.0,53.95,0.95,104.69,60
CDM,30214535,"MOG AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
CDM,30214545,"LGI1 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
CDM,30214555,"GABA-BR AB IGG CBA-IFA TITER, SER",83.0,53.95,0.95,104.69,60
CDM,30214565,"DPPX AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
CDM,30214575,"CASPR2 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
CDM,30214585,"NEURONAL NUCLEAR ANTIBODY (ANNA) IFA TITER, IGG, CSF",83.0,53.95,0.95,104.69,60
CDM,30214595,"PURKINJE CELL ANTIBODY, TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214605,"GABA-BR AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214615,"CASPR2 AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214625,"LGI1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214635,"DPPX AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214645,"GABA-AR AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214655,"MGLUR1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30214665,"NEURONAL NUCLEAR AB (HU) IGG, IB, CSF",202.0,131.3,0.95,202.0,60
CDM,30214675,"ALLERGEN, FOOD, APRICOT",36.0,23.4,0.95,36.0,60
CDM,30214685,"ALLERGEN, INSECT, MOSQUITO, IGE",36.0,23.4,0.95,36.0,60
CDM,30214695,"ALLERGEN, FOOD, NUTMEG IGE",36.0,23.4,0.95,36.0,60
CDM,30214705,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,0.95,83.0,60
CDM,30214715,"MOG AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,0.95,83.0,60
CDM,30214725,"ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE",36.0,23.4,0.95,36.0,60
CDM,30214735,"ALLERGEN, FOOD, SUMMER SQUASH IGE",36.0,23.4,0.95,36.0,60
CDM,30214745,"ALLERGEN, FOOD, SPINACH",36.0,23.4,0.95,36.0,60
CDM,30214755,"ALLERGEN, FOOD, TEA IGE",36.0,23.4,0.95,36.0,60
CDM,30214765,"ALLERGEN, FOOD, TURMERIC IGE",36.0,23.4,0.95,36.0,60
CDM,30214775,"ALLERGEN, FOOD, BLACK OLIVE IGE",36.0,23.4,0.95,36.0,60
CDM,30214785,"ALLERGEN, FOOD, CAULIFLOWER IGE",36.0,23.4,0.95,36.0,60
CDM,30214795,"ALLERGEN, FOOD, GOAT MILK IGE",36.0,23.4,0.95,36.0,60
CDM,30214805,"N. MENINGITIDIS A, C, W-135 AND Y IGG",91.0,59.15,0.95,91.0,60
CDM,30214815,"ALLERGEN, FOOD, GINGER IGE",36.0,23.4,0.95,36.0,60
CDM,30214825,"ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN",36.0,23.4,0.95,36.0,60
CDM,30214835,"ALLERGEN, FOOD, LAMB",36.0,23.4,0.95,36.0,60
CDM,30214845,"ALLERGEN, FOOD, NAVY BEAN IGE",36.0,23.4,0.95,36.0,60
CDM,30214855,"ALLERGEN, FOOD, ANCHOVY IGE",36.0,23.4,0.95,36.0,60
CDM,30214865,"ALLERGEN, FOOD, ANNATTO SEED IGE",36.0,23.4,0.95,36.0,60
CDM,30214875,"ALLERGEN, FOOD, EGGPLANT",36.0,23.4,0.95,36.0,60
CDM,30214885,"ALLERGEN, INSECT, FIRE ANT, IMPORTED",36.0,23.4,0.95,36.0,60
CDM,30214895,"ALLERGEN, FOOD, SARDINE IGE",36.0,23.4,0.95,36.0,60
CDM,30214905,"ALLERGEN, INSECT, BUMBLE BEE VENOM IGE",36.0,23.4,0.95,36.0,60
CDM,30214915,"ALLERGEN, FOOD, CAROB GUM IGE",36.0,23.4,0.95,36.0,60
CDM,30214925,"ALLERGEN, TREE, PALM/QUEEN TREE IGE",36.0,23.4,0.95,36.0,60
CDM,30214935,"HOPS, IGE ALLERGEN",36.0,23.4,0.95,36.0,60
CDM,30214945,"ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE",36.0,23.4,0.95,36.0,60
CDM,30214955,PLATELET SURFACE GLYCOPROTEIN EXPRESSION,127.0,82.55,0.95,127.0,60
CDM,30214965,HYPERSENSITIVITY PNEUMO IGE QUANT,36.0,23.4,0.95,36.0,60
CDM,30214975,HYPERSENSITIVITY PNEUMO IGE QUAL,55.0,35.75,0.95,55.0,60
CDM,30214985,HYPERSENSITIVITY PNEUMO IA QUAL,104.0,67.6,0.95,105.93,60
CDM,30214995,HYPERSENSITIVITY PNEUMO ID QUAL,83.0,53.95,0.95,83.0,60
CDM,30215005,%ABPA IMMDIFF QUAL,104.0,67.6,0.95,105.93,60
CDM,30215015,"CV2 ANTIBODY TITER, IGG",83.0,53.95,0.95,104.69,60
CDM,30215025,SENMOT FLUORESCENT ANTIBODY (ARUP),83.0,53.95,0.95,83.0,60
CDM,30215035,SENNRO FLUORESCENT AB (ARUP),83.0,53.95,0.95,83.0,60
CDM,30215045,SPSDEV GAD65 AB,163.0,105.95,0.95,163.0,60
CDM,30215055,SPSDEV FLUORESCENT AB SCREEN,83.0,53.95,0.95,83.0,60
CDM,30215065,SPSDEV GLYCINE RECEPTOR ALPHA1 IGG,252.0,163.8,14.4,252.0,60
CDM,30215075,MLPTHY GAD65 AB,163.0,105.95,0.95,163.0,60
CDM,30215085,MLPTHY FLUORESCENT AB SCREEN,83.0,53.95,0.95,83.0,60
CDM,30215095,MLPTHY NMO/AQP4 FACS,260.0,169.0,0.95,260.0,60
CDM,30215105,MLPTHY MOG FACS,260.0,169.0,0.95,260.0,60
CDM,30215115,LYME IGG CSF,118.0,76.7,0.95,118.0,60
CDM,30215125,LYMRFX BORRELIA ANTIBODY,118.0,76.7,0.95,118.0,60
CDM,30215135,SEMIQUANTITATIVE ANA (DERMYO),77.0,50.05,0.95,77.0,60
CDM,30215145,SEMIQUANTITATIVE ANA (MYOSPL),77.0,50.05,0.95,77.0,60
CDM,30215155,ANA (POLMYO),77.0,50.05,0.95,77.0,60
CDM,30215165,IMMUNOASSAY ENA (POLMYO),124.0,80.6,0.95,124.0,60
CDM,30215175,LYMPHOCYTE ANTIGEN PROLIFERATION,338.0,219.7,0.95,358.7,60
CDM,30215185,COMPLEMENT C9 FUNCTIONAL,83.0,53.95,0.95,83.0,60
CDM,30215195,FLOW CD107A CELL FUNCTION,937.0,609.05,0.95,937.0,60
CDM,30215205,PSTAT5 CELL FUNCTION,937.0,609.05,0.95,937.0,60
CDM,30215215,"LYMPHOCYTE SUBSET 2, CD4 PCT. AND ABSL",185.0,120.25,0.95,185.0,60
CDM,30215225,"PCCA/ANNA BY IFA, SERUM",83.0,53.95,0.95,83.0,60
CDM,30215235,"AMPA RECEPTOR AB IGG TITER, CSF",83.0,53.95,0.95,104.69,60
CDM,30215245,"AMPA RECEPTOR AB IGG TITER, SERUM - REFLEX",83.0,53.95,0.95,104.69,60
CDM,30215255,H PYLORI AB (BACK OFFICE),116.0,75.4,0.95,116.0,60
CDM,30215265,HTEROPHIL AB SCREEN (POINT OF CARE LAB),36.0,23.4,0.95,36.0,60
CDM,30215275,"ALLERGEN, BROMELAIN IGE",124.0,80.6,0.95,124.0,60
CDM,30215285,"SEND-OUT PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODY, IGG BY IMMU",83.0,53.95,0.95,83.0,60
CDM,30215295,"PHOSPHOLIPASE RECEPTOR A2 ANTIBODY, IGG TITER",83.0,53.95,0.95,104.69,60
CDM,30215305,TB SKIN TEST,30.0,19.5,4.46,30.0,38
CDM,30215355,TB SKIN TESTING (2-STEP) (RETURN TO CLINIC FOR READING WITHIN 48,60.0,39.0,8.93,60.0,38
CDM,30215365,ALLG SPEC IGE RECOMB EA,124.0,80.6,0.95,124.0,60
CDM,30220AK,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,636.0,413.4,1.1,2603.78,53
CDM,30300AK,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,480.0,312.0,1.1,694.46,53
CDM,30400AK,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,4778.0,3105.7,1.1,9999.36,50
CDM,30410AK,RHINP PRIM COMPLETE XTRNL PARTS,5600.0,3640.0,1.1,9999.36,50
CDM,30420AK,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,6760.0,4394.0,1.1,9999.36,50
CDM,30430AK,RHINOPLASTY SECONDARY MINOR REVISION,3296.0,2142.4,1.1,9999.36,50
CDM,30435AK,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,5601.0,3640.65,1.1,9999.36,50
CDM,30465AK,NASAL VESTIBUL STENOS REPAIR,4944.0,3213.6,1.1,9999.36,50
CDM,30468AK,RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT,1120.0,728.0,1.1,9999.36,52
CDM,30469AK,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,976.0,634.4,1.1,9999.36,52
CDM,30500020,WBC COUNT MANUAL DIFF,26.0,16.9,0.95,26.0,60
CDM,30500025,BUFFY COAT SEZARY CELL,35.0,22.75,0.95,35.0,60
CDM,30500030,*BLOOD COUNT HCT,16.0,10.4,0.95,16.0,60
CDM,30500040,*BLOOD COUNT HGB,16.0,10.4,0.95,16.0,60
CDM,30500050,CBC AUTO W AUTO DIFF,54.0,35.1,0.95,54.0,60
CDM,30500060,CBC AUTO WO DIFF,45.0,29.25,0.95,45.0,60
CDM,30500065,COAG FACT ASSAY 5,122.0,79.3,0.95,122.0,60
CDM,30500070,MANUAL CELL COUNT EA,30.0,19.5,0.95,30.0,60
CDM,30500075,COAG FACT ASSAY 8,124.0,80.6,0.95,124.0,60
CDM,30500085,VON WILLEBRAND ANTIGEN,158.0,102.7,0.95,158.0,60
CDM,30500090,LEUKO (WBC) COUNT AUTO,18.0,11.7,0.95,18.0,60
CDM,30500095,COAG FACT ASSAY 9,131.0,85.15,0.95,131.0,60
CDM,30500100,COAG FACT ASSAY 10,124.0,80.6,0.95,124.0,60
CDM,30500105,COAG FACT ASSAY 11,124.0,80.6,0.95,124.0,60
CDM,30500110,PLT COUNT AUTO,31.0,20.15,0.95,31.0,60
CDM,30500115,COAG FACTOR ASSAY 13,113.0,73.45,0.95,113.0,60
CDM,30500125,ANTITHROMBIN 3,82.0,53.3,0.95,82.0,60
CDM,30500135,PROTEIN C FUNCTIONAL,95.0,61.75,0.95,95.0,60
CDM,30500145,PROTEIN S FREE,106.0,68.9,0.95,106.0,60
CDM,30500155,APC RESISTANCE,106.0,68.9,0.95,106.0,60
CDM,30500160,FACTOR VIII TEST 1 STAGE,124.0,80.6,0.95,124.0,60
CDM,30500165,%AD13IN FACTR INHIB TEST,89.0,57.85,0.95,99.1,60
CDM,30500180,FACTOR VIII TEST VW FACTOR,158.0,102.7,0.95,158.0,60
CDM,30500185,EUGLOBULIN LYSIS TIME,58.0,37.7,0.95,58.82,60
CDM,30500195,DEGRADATION PRODUCTS,48.0,31.2,0.95,53.05,60
CDM,30500205,COAGULOPATHY INTERPRET,107.0,69.55,0.95,107.0,60
CDM,30500220,FACTOR VIII TEST VW MULT,158.0,102.7,0.95,176.68,60
CDM,30500225,%AD13AC COAG/FIBFUNC ACT,213.0,138.45,0.95,213.0,60
CDM,30500235,ALPHA 2 ANTIPLASMIN,53.0,34.45,0.95,58.82,60
CDM,30500245,PLASMINOGEN FUNCTIONAL,45.0,29.25,0.95,46.35,60
CDM,30500255,HEINZ BODY STAIN,29.0,18.85,0.95,29.0,60
CDM,30500265,KLEIHAUER BETKE ST,53.0,34.45,0.95,59.61,60
CDM,30500285,IRON STAIN MISC,47.0,30.55,0.95,115.77,60
CDM,30500290,ANTITHROMBIN III AG ASSAY,75.0,48.75,0.95,75.0,60
CDM,30500300,PROTEIN C AG,83.0,53.95,0.95,87.58,60
CDM,30500310,PROTEIN C ACTIVITY,95.0,61.75,0.95,95.0,60
CDM,30500315,PLATELET NEUTRALIZATION,124.0,80.6,0.95,124.0,60
CDM,30500325,DILUTE RVVT X2,66.0,42.9,0.95,66.0,60
CDM,30500335,REPTILASE R TIME,68.0,44.2,0.95,68.0,60
CDM,30500345,VISCOSITY BLOOD,81.0,52.65,0.95,81.0,60
CDM,30500380,ACTIVATED COAGULATION,30.0,19.5,0.95,32.77,60
CDM,30500400,D-DIMER QUANT,70.0,45.5,0.95,70.0,60
CDM,30500405,PREKALLIKREIN FLETCHER,131.0,85.15,0.95,131.0,60
CDM,30500410,FIBRINOGEN,67.0,43.55,0.95,67.0,60
CDM,30500420,FIBRIN AG,100.0,65.0,0.95,100.0,60
CDM,30500450,FIBRIN PLASMINOGEN ACTIVATOR,119.0,77.35,0.95,119.0,60
CDM,30500455,RETICULOCYTE HEMOGLOBIN,38.0,24.7,0.95,38.0,60
CDM,30500475,COAG FACT ASSAY 2,90.0,58.5,0.95,90.0,60
CDM,30500485,VWF MULTIMER,158.0,102.7,0.95,176.68,60
CDM,30500495,COAG FACT ASSAY 12,134.0,87.1,0.95,134.0,60
CDM,30500505,PROTEIN C IMMUNO,83.0,53.95,0.95,87.58,60
CDM,30500515,PROTEIN S TOTAL,80.0,52.0,0.95,89.35,60
CDM,30500525,COAG FACT ASSAY 7,124.0,80.6,0.95,124.0,60
CDM,30500535,CLOT FACTOR VIII VW RISTOCTN,158.0,102.7,0.95,158.0,60
CDM,30500540,WBC ALKA PHOSPHTAS W COUNT,59.0,38.35,0.95,66.27,60
CDM,30500550,MURAMIDASE,129.0,83.85,0.95,129.0,60
CDM,30500565,CLOTTING TEST (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
CDM,30500575,SED RATE WESTERGREN,29.0,18.85,0.95,29.0,60
CDM,30500580,*PRO TIME,30.0,19.5,0.95,30.0,60
CDM,30500585,D-DIMER (POINT OF CARE LAB),70.0,45.5,0.95,70.0,60
CDM,30500590,*PRO TIME TEST PLASMA FRACT EA,27.0,17.55,0.95,30.36,60
CDM,30500605,OCCULT BLD IA SCRN,110.0,71.5,0.95,110.0,60
CDM,30500615,OSMOTIC FRAG ERYTHRO,52.0,33.8,0.95,52.0,60
CDM,30500630,SEDIMENTATION RATE AUTO,19.0,12.35,0.95,19.0,60
CDM,30500640,RBC SICKLING REDUC,38.0,24.7,0.95,38.0,60
CDM,30500655,%VWD2N FACTOR ANTIGEN,158.0,102.7,0.95,158.0,60
CDM,30500670,*PTT PLASMA/WHOLE BLOOD,41.0,26.65,0.95,41.0,60
CDM,30500690,*PTT PLASMA FRACT EA,45.0,29.25,0.95,45.0,60
CDM,30500740,HGB FETAL ROS,65.0,42.25,0.95,90.26,60
CDM,30500760,BLOOD TYPE AN,44.0,28.6,0.95,1004.67,61
CDM,30500780,*BLOOD PLT AGGREGATION EA,172.0,111.8,0.95,172.0,60
CDM,30500860,*PTT PLASMA/WHOLE BLOOD,41.0,26.65,0.95,41.0,60
CDM,30500900,*LEUKO (WBC) COUNT AUTO,18.0,11.7,0.95,18.0,60
CDM,30500970,*PRO TIME,30.0,19.5,0.95,30.0,60
CDM,30501060,RETICULOCYTE COUNT AUTO,28.0,18.2,0.95,28.0,60
CDM,30501100,THROMBIN TIME,40.0,26.0,0.95,40.0,60
CDM,30501110,ANTIXA,90.0,58.5,0.95,90.0,60
CDM,30501120,*CLOTTING FUNCT ACTIVITY,213.0,138.45,0.95,213.0,60
CDM,30501210,*FIBRINOLYSINS SCREEN I&R,107.0,69.55,0.95,107.0,60
CDM,30501220,PRO TIME (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
CDM,30501340,HEPARIN ASSAY,90.0,58.5,0.95,90.0,60
CDM,30501360,BLOOD COUNT SPUN MICRO HCT,48.0,31.2,0.95,48.0,60
CDM,30501420,PLATELET NEUTRALIZATION,124.0,80.6,0.95,124.0,60
CDM,30501440,RUSSELL VIPER VENOM TIME DILUT,66.0,42.9,0.95,66.0,60
CDM,30501480,BLOOD COUNT HGB,16.0,10.4,0.95,16.0,60
CDM,30501510,BLOOD TYPE ANTIGEN DONOR EA,44.0,28.6,0.95,1004.67,61
CDM,30501655,IMMATURE PLATELET FRACT,247.0,160.55,0.95,247.0,60
CDM,30501685,AUTOMATED RBC COUNT,21.0,13.65,0.95,21.0,60
CDM,30501755,CSPNL AUTO RBC COUNT,21.0,13.65,0.95,21.0,60
CDM,30501795,VISCOSITY SERUM,81.0,52.65,0.95,81.0,60
CDM,30501845,MANUAL HEME - PRO TIME,30.0,19.5,0.95,30.0,60
CDM,30501855,MANUAL HEME - PTT PLASMA/WHOLE BLOOD,41.0,26.65,0.95,41.0,60
CDM,30501885,HEXAGOAL PHASE PHOSPHOLIPID NEUTRALIZATION,124.0,80.6,0.95,124.0,60
CDM,30501895,LUPUS ANTICOAG INTERP PANEL,124.0,80.6,0.95,124.0,60
CDM,30501925,ACTIVATED COAGULATION,30.0,19.5,0.95,32.77,60
CDM,30501935,*BLOOD PLT AGGREGATION EA,172.0,111.8,0.95,172.0,60
CDM,30501945,FIBRINOGEN,67.0,43.55,0.95,67.0,60
CDM,30501955,COAGULATION/FIBRINOLYSIS,163.0,105.95,0.95,163.0,46
CDM,30501965,"SMEAR, PARASITEMIA CELL COUNT",30.0,19.5,0.95,30.0,60
CDM,30501975,MANUAL HEME- FIBRINOGEN,67.0,43.55,0.95,67.0,60
CDM,30501985,MANUAL HEME - FIBRINOGEN,67.0,43.55,0.95,67.0,60
CDM,30501995,HEMATOCRIT (POINT OF CARE LAB),16.0,10.4,0.95,16.0,60
CDM,30502005,BLOOD COUNT HCT (POINT OF CARE LAB),16.0,10.4,0.95,16.0,60
CDM,30502015,BLOOD COUNT HGB (POINT OF CARE LAB),16.0,10.4,0.95,16.0,60
CDM,30502025,PRO TIME (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
CDM,30502035,"CARBOHYDRATE, UR",80.0,52.0,0.95,80.0,60
CDM,30520AK,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,2804.0,1822.6,1.1,5497.86,50
CDM,30560AK,LYSIS INTRANASAL SYNECHIA,524.0,340.6,1.1,1065.47,53
CDM,30580AK,REPAIR FISTULA OROMAXILLARY,2752.0,1788.8,1.1,9999.36,53
CDM,30600005,"CULTURE, BACTERIAL, STOOL, EACH PLATE",65.0,42.25,0.95,65.0,60
CDM,30600010,"PROCESSING, AFB CONCENTRATION",46.0,29.9,0.95,46.0,60
CDM,30600015,"CULTURE, BACTERIAL, AEROBIC, QUANTITATIVE",68.0,44.2,0.95,68.0,60
CDM,30600025,"CULTURE, BACTERIAL, ANAEROBIC, QUANTITATIVE",67.0,43.55,0.95,67.0,60
CDM,30600030,"CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC",71.0,46.15,0.95,71.0,60
CDM,30600035,"IDENTIFICATION, ANAEROBIC ISOLATE",56.0,36.4,0.95,62.24,60
CDM,30600050,"CULTURE, BACTERIAL, STOOL, SALMONELLA SHIGELLA",65.0,42.25,0.95,65.0,60
CDM,30600055,CULT FUNGI SKIN HAIR NAIL,53.0,34.45,0.95,59.38,60
CDM,30600065,"CULTURE, FUNGAL ISOLATION",58.0,37.7,0.95,58.0,60
CDM,30600075,"CULTURE, FUNGAL ISOLATION, BLOOD",141.0,91.65,0.95,141.0,60
CDM,30600085,"IDENTIFICATION, YEAST",71.0,46.15,0.95,71.0,60
CDM,30600095,"IDENTIFICATION, MOLD",71.0,46.15,0.95,71.0,60
CDM,30600100,"CULTURE, BACTERIAL, AEROBIC",59.0,38.35,0.95,59.0,60
CDM,30600105,"CULTURE, MYCOPLASMA",106.0,68.9,0.95,106.0,60
CDM,30600115,"CULTURE, ACID FAST",75.0,48.75,0.95,75.0,60
CDM,30600155,MICRO ID BY PNA FISH,138.0,89.7,0.95,138.0,60
CDM,30600160,"CULTURE, BACTERIAL, ANAEROBIC",65.0,42.25,0.95,65.0,60
CDM,30600175,ID BY PYROSEQUENCING,53.0,34.45,0.95,53.0,60
CDM,30600180,"IDENTIFICATION, AEROBIC ISOLATE",56.0,36.4,0.95,62.24,60
CDM,30600185,"MACROSCOPIC EXAM, ARTHROPOD",29.0,18.85,0.95,39.45,60
CDM,30600195,"MACROSCOPIC EXAM, PARASITE",30.0,19.5,0.95,32.88,60
CDM,30600205,PINWORM PREP PERIANAL,29.0,18.85,0.95,29.0,60
CDM,30600215,"PROCESSING, TISSUE HOMOGENIZATION",41.0,26.65,0.95,45.32,60
CDM,30600225,"CONCENTRATION AND ID, OVA AND PARASITE",61.0,39.65,0.95,61.0,60
CDM,30600235,SENSITIVITY - DISK PER PLATE,52.0,33.8,0.95,53.16,60
CDM,30600240,"CULTURE, PRESUMPTIVE SCREENING",46.0,29.9,0.95,46.0,60
CDM,30600245,"SUSCEPTIBILITY, ENZYME DETECTION, PER ENZYME",33.0,21.45,0.95,33.0,60
CDM,30600260,CULT/COLONY COUNT QUANT URINE,56.0,36.4,0.95,56.0,60
CDM,30600265,"SMEAR, FUNGAL FLUORESCENT",37.0,24.05,0.95,37.0,60
CDM,30600275,KOH EXAM (POINT OF CARE LAB),29.0,18.85,0.95,29.0,60
CDM,30600285,ENTEROVIRUS CULTURE,180.0,117.0,0.95,180.0,60
CDM,30600295,VIRUS CULTURE W/STAIN,139.0,90.35,0.95,155.51,60
CDM,30600300,*CULT FUNGI PRES ID BLOOD,141.0,91.65,0.95,141.0,60
CDM,30600305,HERPES SIMPLEX CULTURE,234.0,152.1,0.95,234.0,60
CDM,30600315,*%DFA ADENO,100.0,65.0,0.95,100.0,60
CDM,30600340,CULT MYCOPLASMA ANY SOURCE,106.0,68.9,0.95,106.0,60
CDM,30600360,*CULT TUBERCLE PRES ID,75.0,48.75,0.95,75.0,60
CDM,30600365,VARICELLA ZOSTER DFA,93.0,60.45,0.95,93.0,60
CDM,30600385,HERPES SIMPLEX DFA,83.0,53.95,0.95,83.0,60
CDM,30600395,HEPATITIS BE ANTIGEN,80.0,52.0,0.95,80.0,60
CDM,30600415,"IMMUNOASSAY, ROTAVIRUS",83.0,53.95,0.95,83.0,60
CDM,30600425,%STOOL SHIGA LIKE TOX X2,83.0,53.95,0.95,83.0,60
CDM,30600445,%VAGONA CANDIDA,138.0,89.7,0.95,138.0,60
CDM,30600455,CHLAMYDIA TRACH AMPLIFY,242.0,157.3,0.95,242.0,60
CDM,30600465,"AMPLIFICATION, CLOSTRIDIUM DIFFICILE",257.0,167.05,0.95,257.0,60
CDM,30600475,"QUANTIFICATION, CYTOMEGALOVIRUS",296.0,192.4,0.95,296.0,60
CDM,30600480,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL",60.0,39.0,0.95,60.0,60
CDM,30600485,ENTEROVIRUS PCR,242.0,157.3,0.95,242.0,60
CDM,30600490,"SMEAR, GRAM STAIN",29.0,18.85,0.95,29.0,60
CDM,30600495,%VAGDNA GARDNERELLA,138.0,89.7,0.95,138.0,60
CDM,30600500,*SMEAR FLUORESCENT/ACID STAIN,37.0,24.05,0.95,37.0,60
CDM,30600505,%IDM HBVNAT,242.0,157.3,0.95,242.0,60
CDM,30600515,"QUANTIFICATION, HEPATITIS B VIRUS",296.0,192.4,0.95,296.0,60
CDM,30600525,HEPATITIS C AMPLIFIED PROBE,242.0,157.3,0.95,270.23,60
CDM,30600530,SMEAR SPECIAL STAIN,41.0,26.65,0.95,58.34,60
CDM,30600535,"QUANTIFICATION, HEPATITIS C VIRUS",296.0,192.4,0.95,296.0,60
CDM,30600545,"AMPLIFIED PROBE, HERPES SIMPLEX VIRUS",242.0,157.3,0.95,270.23,60
CDM,30600565,"QUANTIFICATION, HIV-1",587.0,381.55,0.95,587.0,60
CDM,30600570,SMEAR WET MOUNT,40.0,26.0,0.95,40.0,60
CDM,30600575,LEGIONELLA PNEUM PCR,242.0,157.3,0.95,242.0,60
CDM,30600580,TISSUE CULTURE,180.0,117.0,0.95,180.0,60
CDM,30600595,ID MTB COMPLEX VS NTM,333.0,216.45,0.95,333.0,60
CDM,30600625,GC AMPLIFICATION,242.0,157.3,0.95,242.0,60
CDM,30600645,"AMPLIFICATION, STAPHYLOCOCCUS AUREUS",242.0,157.3,0.95,242.0,60
CDM,30600655,"AMPLIFICATION, METHICILLIN RESISTANCE",242.0,157.3,0.95,242.0,60
CDM,30600675,"AMPLIFICATION, STREPTOCOCCUS, GROUP B",242.0,157.3,0.95,242.0,60
CDM,30600685,%VAGDNA TRICHOMONAS,138.0,89.7,0.95,138.0,60
CDM,30600695,BORDETELLA PERTUSSIS,242.0,157.3,0.95,242.0,60
CDM,30600705,"QUANTIFICATION, EPSTEIN-BARR VIRUS",296.0,192.4,0.95,309.32,60
CDM,30600715,INFLUENZA OIA (POINT OF CARE LAB),114.0,74.1,0.95,114.0,60
CDM,30600735,"GENOTYPE, HEPATITIS C VIRUS",1776.0,1154.4,0.95,1776.0,60
CDM,30600755,%CANDA PART AGG,80.0,52.0,0.95,80.0,60
CDM,30600775,SUSCEPTIBILITY AGAR DIL,33.0,21.45,0.95,33.0,60
CDM,30600810,"IMMUNOASSAY, CLOSTRIDIUM DIFFICILE TOXIN",83.0,53.95,0.95,83.0,60
CDM,30600820,"IMMUNOASSAY, CRYPTOSPORIDIUM",95.0,61.75,0.95,95.0,60
CDM,30600825,BORDETELLA PERTUSS DFA X2,83.0,53.95,0.95,83.0,60
CDM,30600830,GIARDIA AG EIA,83.0,53.95,0.95,83.0,60
CDM,30600835,HPV DNA 16 18 PCR,242.0,157.3,0.95,242.0,60
CDM,30600840,"IMMUNOASSAY, H. PYLORI",99.0,64.35,0.95,99.0,60
CDM,30600845,%ROTAD ADENOV 40-41,83.0,53.95,0.95,83.0,60
CDM,30600855,ENTAMOEBA HISTOLYT AG,83.0,53.95,0.95,83.0,60
CDM,30600860,HEP B SURFACE AG NEUTRAL,71.0,46.15,0.95,71.0,60
CDM,30600865,HPV DNA PROBE REFLEX,242.0,157.3,0.95,242.0,60
CDM,30600875,TRICHOMONAS VAG AMP,242.0,157.3,0.95,242.0,60
CDM,30600910,*INFECT AGENT NOS EIA MULT,83.0,53.95,0.95,83.0,60
CDM,30600915,HHV-6 PCR,242.0,157.3,0.95,242.0,60
CDM,30600935,LIMULUS AMEBOCYTE LT,111.0,72.15,0.95,111.0,60
CDM,30600945,CYTSEQ NFCT AGT GNTYP ALYS CMV,1776.0,1154.4,0.95,1776.0,60
CDM,30600955,HEPATITIS B GENOTYPING,1776.0,1154.4,0.95,1776.0,60
CDM,30600965,HISTOPLASMA ANTIGEN UR,91.0,59.15,0.95,92.38,60
CDM,30600975,%E18RP CHLAMYDIA PNEU AMP,242.0,157.3,0.95,789.1,60
CDM,30600980,LYME DISEASE DNA AMPL PROBE,242.0,157.3,0.95,247.11,60
CDM,30600985,"IMMUNOASSAY, GIARDIA",83.0,53.95,0.95,83.0,60
CDM,30600995,%E18RP MYCOPLAS PNEU AMP,242.0,157.3,0.95,242.0,60
CDM,30601000,CHLAMYDIA PNEUM DNA AMPL PROB,242.0,157.3,0.95,789.1,60
CDM,30601005,RVP BY PCR,2876.0,1869.4,0.95,2876.0,60
CDM,30601020,CMV DNA AMPL PROB,242.0,157.3,0.95,242.0,60
CDM,30601030,CMV DNA QUANT,296.0,192.4,0.95,296.0,60
CDM,30601045,HISTOPLASMA ANTIGEN SERUM,91.0,59.15,0.95,92.38,60
CDM,30601105,TRICHOMONAS ANTIGEN,106.0,68.9,0.95,106.0,60
CDM,30601125,CHIKUNGUNYA BY PCR,242.0,157.3,0.95,242.0,60
CDM,30601150,HIV-2 DNA AMPL PROBE,242.0,157.3,0.95,270.23,60
CDM,30601180,MYCOPLASMA PNEUM DNA AMPL,242.0,157.3,0.95,242.0,60
CDM,30601200,HPV HIGH-RISK TYPES,242.0,157.3,0.95,242.0,60
CDM,30601205,TISSUE EXAM KOH,29.0,18.85,0.95,29.0,60
CDM,30601210,INFECT AGENT NOS AMPL PROBE,242.0,157.3,0.95,242.0,60
CDM,30601215,"AMPLIFICATION, STREPTOCOCCUS, GROUP A",242.0,157.3,0.95,242.0,60
CDM,30601245,INFLUENZA RAPID PCR,984.0,639.6,0.95,984.0,60
CDM,30601255,STREP SCREEN,116.0,75.4,0.95,116.0,60
CDM,30601285,"IDENTIFICATION, NUCLEIC ACID SEQUENCING",796.0,517.4,0.95,796.0,60
CDM,30601295,"IDENTIFICATION, MYCOBACTERIAL",101.0,65.65,0.95,101.0,60
CDM,30601360,EBV BY PCR QUANT CSF,296.0,192.4,0.95,309.32,60
CDM,30601365,FLUPCR RAPID PCR FLU,661.0,429.65,0.95,661.0,60
CDM,30601385,%IOHWC GRAM STAIN,29.0,18.85,0.95,29.0,60
CDM,30601395,ENTEROVIRUS BY PCR,242.0,157.3,0.95,242.0,60
CDM,30601415,"IDENTIFICATION, URINE, PRESUMPTIVE",56.0,36.4,0.95,56.0,60
CDM,30601425,"CULTURE,  BACTERIAL, URINE, QUANTITATIVE",56.0,36.4,0.95,56.0,60
CDM,30601430,STREP ASSAY (POINT OF CARE LAB),114.0,74.1,0.95,114.0,60
CDM,30601440,"IMMUNOASSAY, CAD",111.0,72.15,0.95,111.0,60
CDM,30601445,INFLUENZA RSV DETECT,984.0,639.6,0.95,984.0,60
CDM,30601465,STAPH AUREUS AMPLIFICATION,242.0,157.3,0.95,242.0,60
CDM,30601470,%HIVGEN HIV GENOTYPING,1776.0,1154.4,0.95,1776.0,60
CDM,30601475,%IDM W NILE RNA PCR,242.0,157.3,0.95,242.0,60
CDM,30601495,P JIROVECI PCR,242.0,157.3,0.95,242.0,60
CDM,30601535,"IMMUNOASSAY, PAN-MALARIAL",111.0,72.15,0.95,111.0,60
CDM,30601545,"IMMUNOASSAY, MALARIA P. FALCIPARUM",111.0,72.15,0.95,111.0,60
CDM,30601555,"IMMUNOASSAY, STREP PNEUMONIAE ANTIGEN",111.0,72.15,0.95,111.0,60
CDM,30601565,FUNGI ASSAY FOR B-D GLUC,83.0,53.95,0.95,83.0,60
CDM,30601575,BLASTOMYCES ANTIGEN,83.0,53.95,0.95,83.0,60
CDM,30601625,CMV PCR M4,242.0,157.3,0.95,242.0,60
CDM,30601635,HSV PCR OCULAR FLD,242.0,157.3,0.95,270.23,60
CDM,30601655,HPV DNA HI RISK ANL RECT,242.0,157.3,0.95,242.0,60
CDM,30601665,MTBAM1 AMPLIFICATION,242.0,157.3,0.95,242.0,60
CDM,30601675,%MTBAM1 PROBE PCR,242.0,157.3,0.95,242.0,60
CDM,30601685,HTLV I/II DNA PCR X2,242.0,157.3,0.95,242.0,60
CDM,30601705,TOXOPLASMA PCR,242.0,157.3,0.95,242.0,60
CDM,30601710,ASPERGILLUS GALACT SERUM,83.0,53.95,0.95,92.38,60
CDM,30601715,JC VIRUS DNA PCR,242.0,157.3,0.95,242.0,60
CDM,30601720,*CULT CHLAMYDIA ANY SOURCE,135.0,87.75,0.95,135.0,60
CDM,30601725,VARICELLA ZOSTER PCR,242.0,157.3,0.95,242.0,60
CDM,30601730,*CULT TYPE IF EA ANTISERUM,38.0,24.7,0.95,38.0,60
CDM,30601735,WHIPPLE DNA WHOLE BLD,242.0,157.3,0.95,242.0,60
CDM,30601745,PARVO B19 PLASMA PCR,242.0,157.3,0.95,242.0,60
CDM,30601755,EPSTEIN BARR VIRUS PCR,242.0,157.3,0.95,242.0,60
CDM,30601765,BK VIRUS QUAL URINE,242.0,157.3,0.95,242.0,60
CDM,30601770,CULTURE ANTIGEN DFA,135.0,87.75,0.95,135.0,60
CDM,30601775,WEST NILE VIRUS PCR PLS,242.0,157.3,0.95,242.0,60
CDM,30601780,*CONC FOR INFECTIOUS AGENT,46.0,29.9,0.95,46.0,60
CDM,30601785,M HOMINTS PCR,242.0,157.3,0.95,242.0,60
CDM,30601795,HEP D VIRUS PCR,242.0,157.3,0.95,242.0,60
CDM,30601825,HUMAN METAPNEUM RT-PCR,242.0,157.3,0.95,242.0,60
CDM,30601835,NOROVIR 1 & 2 DETECT X2,242.0,157.3,0.95,242.0,60
CDM,30601845,JC VIRUS BY PCR,242.0,157.3,0.95,242.0,60
CDM,30601865,UNIVERSAL FUNGAL PCR,484.0,314.6,0.95,484.0,60
CDM,30601885,%CHROMO CULT AMNIOTIC,1037.0,674.05,0.95,1037.0,60
CDM,30601890,CULT SCREEN ONLY,46.0,29.9,0.95,46.0,60
CDM,30601895,MOLD SUSCEPT 2 DRUG X2,46.0,29.9,0.95,51.09,60
CDM,30601905,AZOLE PANEL X4,46.0,29.9,0.95,51.09,60
CDM,30601935,"CULTURE, FUNGAL ISOLATION, HAIR, SKIN, NAIL",53.0,34.45,0.95,59.38,60
CDM,30601945,"ASPER GALACTOMAN, BAL",83.0,53.95,0.95,92.38,60
CDM,30601985,%AFBPCR MYCOBACT PROBE,333.0,216.45,0.95,333.0,60
CDM,30602005,BK VIRUS QUANT URINE,296.0,192.4,0.95,309.32,60
CDM,30602015,HERPESVIRUS 7 PCR QUANT,296.0,192.4,0.95,309.32,60
CDM,30602025,ADENOVIRUS PCR QUANT,296.0,192.4,0.95,309.32,60
CDM,30602105,RT-QULC ANALYSIS CSF,242.0,157.3,0.95,242.0,60
CDM,30602140,INFECT AGENT NOS EIA MULT,83.0,53.95,0.95,83.0,60
CDM,30602150,*INFECT AGENT NOS EIA MULT,83.0,53.95,0.95,83.0,60
CDM,30602180,INFECT AGENT NOS QUANT,296.0,192.4,0.95,309.32,60
CDM,30602280,*VIRUS INOCULATION SHELL VIAL,135.0,87.75,0.95,135.0,60
CDM,30602375,RSV EIA,96.0,62.4,0.95,96.0,60
CDM,30602380,*HERPES SIMPLEX DNA AMPL PROBE,242.0,157.3,0.95,270.23,60
CDM,30602430,*INFECT AGENT NOS AMPL PROBE,242.0,157.3,0.95,242.0,60
CDM,30602490,INFECT AGENT NOS AMPL PROBE,242.0,157.3,0.95,242.0,60
CDM,30602580,"SMEAR, BLOOD PARASITE",41.0,26.65,0.95,58.34,60
CDM,30602620,CULT MYCOPLASMA ANY SOURCE,106.0,68.9,0.95,106.0,60
CDM,30605800,ASPERGILLUS AG EIA,83.0,53.95,0.95,92.38,60
CDM,30605870,*NEISSERIA GONORR DNA AMPL,242.0,157.3,0.95,242.0,60
CDM,30605880,HHV-6A HHV-6B QT PCR,288.0,187.2,0.95,321.49,60
CDM,30605900,GENOSURE INTEGRASE,888.0,577.2,0.95,888.0,60
CDM,30606050,*DNA/RNA;MULTI ORG-AMP PR,484.0,314.6,0.95,484.0,60
CDM,30606070,MYCOBACTERIA TB AMPLIFIED PROBE,288.0,187.2,0.95,288.0,60
CDM,30606120,*HEP B SURFACE AG EIA,71.0,46.15,0.95,71.0,60
CDM,30606150,CULT TYPE IF EA ANTISERUM,38.0,24.7,0.95,38.0,60
CDM,30606190,*CONCENTRATION FOR INFECT AGNT,46.0,29.9,0.95,46.0,60
CDM,30606270,BACTERIAL CULTURE OTHR SOURCE,59.0,38.35,0.95,59.0,60
CDM,30606280,BACTERIAL CULTURE OTHR SOURCE,59.0,38.35,0.95,59.0,60
CDM,30606300,"PROCESSING, FLUID CONCENTRATION",46.0,29.9,0.95,46.0,60
CDM,30606320,*SMEAR GRAM STAIN,29.0,18.85,0.95,29.0,60
CDM,30606340,TRICHOMONAS VAGINALIS AMPLIF,242.0,157.3,0.95,242.0,60
CDM,30606390,*BACTERIAL CULTURE-OTHR SOURCE,59.0,38.35,0.95,59.0,60
CDM,30606450,HPV LOW-RISK TYPES,242.0,157.3,0.95,242.0,60
CDM,30606560,SMEAR - INFECTIOUS WET MOUNT,40.0,26.0,0.95,40.0,60
CDM,30606685,UREAPLASMA SPECIES BY PCR,242.0,157.3,0.95,242.0,60
CDM,30606695,%HIVGEN PHENOTYPE,899.0,584.35,0.95,899.0,60
CDM,30606705,HIV I/II POST EXP AG SRN,111.0,72.15,0.95,111.0,60
CDM,30606735,"GIARDIA ANTIGEN, STOOL",83.0,53.95,0.95,83.0,60
CDM,30606745,"QUANTIFICATION, BK VIRUS",296.0,192.4,0.95,309.32,60
CDM,30606755,INFLUENZA A&B MOLECULAR (POINT OF CARE LAB),661.0,429.65,0.95,661.0,60
CDM,30606765,RAPID BACTERIAL VAGINOSIS,84.0,54.6,0.95,84.0,60
CDM,30606775,RAPID INFLUENZA AG TRGR,97.0,63.05,0.95,97.0,60
CDM,30606805,LEGIONELLA CULTURE,46.0,29.9,0.95,46.0,60
CDM,30606825,CRYPTOCOCCUS NEOFORMANS ANTGN,93.0,60.45,0.95,93.0,60
CDM,30606845,"BK VIRUS QUANT PCR, PLASMA",296.0,192.4,0.95,309.32,60
CDM,30606855,ADENOVIRUS PCR,242.0,157.3,0.95,242.0,60
CDM,30606895,RSV ANTIGEN,96.0,62.4,0.95,96.0,60
CDM,30606925,"AMPLIFICATION, MYCOBACTERIA TUBERCULOSIS",288.0,187.2,0.95,288.0,60
CDM,30606955,%HIVPHS PHENO EA ADD X12,180.0,117.0,0.95,180.0,60
CDM,30606965,%HIVPHS PHENO 1-10 DRUGS,3372.0,2191.8,0.95,3372.0,60
CDM,30606995,CARBAPENEM RESISTANCE GENE PCR,242.0,157.3,0.95,242.0,60
CDM,30607000,VRE SCREEN,46.0,29.9,0.95,46.0,60
CDM,30607005,RAPID INFLUENZA AG TRGR,97.0,63.05,0.95,97.0,60
CDM,30607010,"RAPID INFLUENZA AG, PER AG",97.0,63.05,0.95,97.0,60
CDM,30607020,TYPING BY IMMUNOLOGIC METHOD,36.0,23.4,0.95,36.0,60
CDM,30607025,PARASITE STAIN,124.0,80.6,0.95,124.0,60
CDM,30607055,H. PYLORI QUALITATIVE,99.0,64.35,0.95,99.0,60
CDM,30607060,RAPID BACTERIAL VAGINOSIS,84.0,54.6,0.95,84.0,60
CDM,30607085,CHLAMYDIATRACH AMP OCULAR,242.0,157.3,0.95,242.0,60
CDM,30607105,%CTNGAO CHLAMYDIA OCULAR,242.0,157.3,0.95,242.0,60
CDM,30607145,STOOL GASTROINT PNL PCR,2876.0,1869.4,0.95,2876.0,60
CDM,30607185,HIV GENO (INTEGRASE),888.0,577.2,0.95,888.0,60
CDM,30607205,EHRLICHIA/ANAPLASMA PCR,242.0,157.3,0.95,242.0,60
CDM,30607225,NFCT AGENT DETECTION GI,885.0,575.25,0.95,885.0,60
CDM,30607235,JC VIRUS QUANT PCR,296.0,192.4,0.95,309.32,60
CDM,30607245,RSV RAPID PCR,484.0,314.6,0.95,484.0,60
CDM,30607255,ZIKA VIRUS RT-PCR,354.0,230.1,0.95,354.0,60
CDM,30607275,HERPES TYPING,38.0,24.7,0.95,38.0,60
CDM,30607285,BK VIRUS PCR QUAL BLD,242.0,157.3,0.95,242.0,60
CDM,30607295,MOLD SUSCEPT 3 DRUGS X3,46.0,29.9,0.95,51.09,60
CDM,30607305,MUMPS VIRUS BY PCR,242.0,157.3,0.95,242.0,60
CDM,30607325,GPC BLD CULT ID VERIGENE,138.0,89.7,0.95,138.0,60
CDM,30607335,%HSVCUL VIR INNOC TISSUE,180.0,117.0,0.95,180.0,60
CDM,30607345,%HSVCUL VIR INNOC TIS ADD,139.0,90.35,0.95,155.51,60
CDM,30607355,HSV PCR MISC SPEC,242.0,157.3,0.95,270.23,60
CDM,30607365,HCV NS5A DRG RES SEQ,1776.0,1154.4,0.95,1776.0,60
CDM,30607425,"BACTERIAL PCR, DIRECT SPEC",484.0,314.6,0.95,484.0,60
CDM,30607435,ENTEROVIRUS PCR PLASMA,242.0,157.3,0.95,242.0,60
CDM,30607445,CULTURE TYPE IMMUNOLOGIC,36.0,23.4,0.95,36.0,60
CDM,30607455,E COLI AGGL,36.0,23.4,0.95,36.0,60
CDM,30607495,URMPCR DETECT AGENT NOS DNA AMP,242.0,157.3,0.95,242.0,60
CDM,30607535,ROTAD ADENOV 40-41,83.0,53.95,0.95,83.0,60
CDM,30607545,%ROTAD ROTAVIRUS,83.0,53.95,0.95,83.0,60
CDM,30607585,IN HOUSE CULT ANTIGEN DFA,135.0,87.75,0.95,135.0,60
CDM,30607615,HBV DRUG RESISTANCE SEQ,1776.0,1154.4,0.95,1776.0,60
CDM,30607625,IDM HIV-1 DNA BY PCR,242.0,157.3,0.95,242.0,60
CDM,30607645,NY BK VIRUS QNT PCR BLD,296.0,192.4,0.95,309.32,60
CDM,30607695,CYTOMEGALOVIRUS,135.0,87.75,0.95,135.0,60
CDM,30607705,MYCOPLASMA GENITALIUM PCR,242.0,157.3,0.95,242.0,60
CDM,30607715,URMPCR MYCOPLAS GENITALIUM AMP,242.0,157.3,0.95,242.0,60
CDM,30607725,"AMPLIFIED PROBE, VARICELLA ZOSTER VIRUS",242.0,157.3,0.95,242.0,60
CDM,30607735,HSV DNA AMP PROBE X2,242.0,157.3,0.95,270.23,60
CDM,30607745,WHIIVF HIV 1&2 AG/AB,166.0,107.9,0.95,166.0,60
CDM,30607755,WHIIVF *%HEP HBSAG,71.0,46.15,0.95,71.0,60
CDM,30607765,WHIIVF CHLAMYDIA TRACH AM,242.0,157.3,0.95,242.0,60
CDM,30607775,WHIIVF GC AMP,242.0,157.3,0.95,242.0,60
CDM,30607785,COVID19 SENDOUT,354.0,230.1,13.21,354.0,61
CDM,30607795,COVID19 INHOUSE,354.0,230.1,13.21,354.0,61
CDM,30607805,RPRAPD CHLAMYDIA PNEU AMP,242.0,157.3,0.95,789.1,60
CDM,30607815,RPRAPD M.PNEUM AMP PRB,242.0,157.3,0.95,242.0,60
CDM,30607825,RPRAPD INFLUENZA RAPID PCR,984.0,639.6,0.95,984.0,60
CDM,30607835,RPRAPD INFECT AGENT NOS AMP,242.0,157.3,0.95,242.0,60
CDM,30607845,COVID19 INHOUSE,354.0,230.1,0.95,354.0,61
CDM,30607855,COVID19 SENDOUT,354.0,230.1,0.95,354.0,61
CDM,30607865,AG DETECT NOS IA MULT,83.0,53.95,0.95,83.0,60
CDM,30607885,HPVSFX HPV HIGH-RISK TYPE,242.0,157.3,0.95,242.0,60
CDM,30607935,COVID19 SENDOUT,248.0,161.2,13.21,248.0,61
CDM,30607945,COVID19 INHOUSE,248.0,161.2,13.21,248.0,61
CDM,30607955,"FILM ARRAY, RESPIRATORY 22 TARGETS",2876.0,1869.4,87.06,2876.0,60
CDM,30608005,SARSCOV2 & INF A&B AMP PRB,984.0,639.6,0.95,984.0,61
CDM,30608045,BCID DNA/RNA AMP PROBE,242.0,157.3,0.95,242.0,60
CDM,30608065,CNS DNA AMP PROBE TYPE 12-25,2876.0,1869.4,0.95,2876.0,60
CDM,30608075,HIVNGS PHENOTYPE INFECT AGENT DRUG,899.0,584.35,0.95,899.0,60
CDM,30608085,HIVNGS GENOTYPE DNA HIV REVERSE T,1776.0,1154.4,0.95,1776.0,60
CDM,30608095,HIVNGS GENOTYPE DNA/RNA HIV,888.0,577.2,0.95,888.0,60
CDM,30608105,CANDIDA DNA AMP PROBE,242.0,157.3,0.95,242.0,60
CDM,30608115,"SUSCEPTIBILITY, AGAR DILUTION, PER AGENT",33.0,21.45,0.95,33.0,60
CDM,30608125,"SUSCEPTIBILITY, DISK METHOD, PER PLATE",52.0,33.8,0.95,53.16,60
CDM,30608135,CYTOMEGALOVIRUS CMV,242.0,157.3,0.95,242.0,60
CDM,30608145,"IDENTIFICATION, BLOOD PATHOGEN PANEL",1505.0,978.25,0.95,1505.0,60
CDM,30608155,BACTERIAL VAGINOSIS AMPLIFICATION,984.0,639.6,0.95,984.0,60
CDM,30608195,HSVCUL GENETIC VIRUS ISOLATION HSV,234.0,152.1,0.95,234.0,60
CDM,30608205,PCRHSV HSV DNA AMP PROBE X2,242.0,157.3,0.95,270.23,60
CDM,30608225,MONKEYPOX VIRUS QUAL PCR,242.0,157.3,0.95,242.0,60
CDM,30608235,MONKEYPOX VIRUS QUAL PCR,354.0,230.1,0.95,354.0,60
CDM,30608275,"AMPLIFICATION, ORTHOPOX VIRUS",354.0,230.1,0.95,354.0,60
CDM,30608335,"EPSTEIN-BARR VIRUS BY QUALITATIVE PCR, CSF",242.0,157.3,0.95,242.0,60
CDM,30608345,AMBCAN AMPHOTERICIN B/CANDIN SUSCEPTIBILITY PANEL X4,46.0,29.9,0.95,51.09,60
CDM,30608355,CYTSEQ PHENOTYPE INFECT AGENT DRUG,899.0,584.35,0.95,899.0,60
CDM,30608365,"CYTOMEGALOVIRUS (CMV) PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
CDM,30608375,"PARVOVIRUS B19 PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
CDM,30608385,"TOXOPLASMA GONDII, PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
CDM,30608395,"AMPLIFICATION, EXPEDITED, COVID, FLU A/B, RSV",925.0,601.25,0.95,925.0,61
CDM,30608405,"COVID & INFLUENZA A/B & RSV NAAT, ROUTINE",984.0,639.6,0.95,984.0,61
CDM,30608415,HPV SCREEN BY TMA (ARUP),242.0,157.3,0.95,242.0,60
CDM,30608425,HEPATITIS DELTA VIRUS BY QUANTITATIVE PCR,296.0,192.4,0.95,296.0,60
CDM,30608435,HPV GENOTYPE BY TMA (ARUP REFLEX),280.0,182.0,0.95,280.0,60
CDM,30608455,POTASSIUM HYDROXIDE (KOH) PREPS (POC) (POINT OF CARE LAB),40.0,26.0,0.95,40.0,60
CDM,30608465,"HISTOPLASMA GALACTOMANNAN EIA, BAL",91.0,59.15,0.95,92.38,60
CDM,30608475,"HISTOPLASMA GALACTOMANNAN EIA, CSF",91.0,59.15,0.95,92.38,60
CDM,30608485,OIL TEST (SCABIES) (POC) (POINT OF CARE LAB),153.0,99.45,0.95,153.0,60
CDM,30608495,"ACANTHAMOEBA SPECIES DETECTION, PCR",242.0,157.3,0.95,242.0,60
CDM,30608505,MUCORALES BY PCR,242.0,157.3,0.95,242.0,60
CDM,30608515,HHV8 BY QUANTITATIVE PCR,296.0,192.4,0.95,309.32,60
CDM,30608555,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL VITEK",60.0,39.0,0.95,60.0,60
CDM,30608565,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL PHOENIX",60.0,39.0,0.95,60.0,60
CDM,30608575,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL SENSITITRE",60.0,39.0,0.95,60.0,60
CDM,30608585,"PROCESSING, CYTOSPIN",46.0,29.9,0.95,46.0,60
CDM,30608595,"AMPLIFICATION, RIFAMPIN RESISTANCE",242.0,157.3,0.95,242.0,60
CDM,30608605,"IDENTIFICATION, OTHER METHODS",53.0,34.45,0.95,53.0,60
CDM,30608615,"SMEAR, ACID FAST FLUORESCENT",37.0,24.05,0.95,37.0,60
CDM,30608625,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL AFB",60.0,39.0,0.95,60.0,60
CDM,30608635,PROCESSING AFB REDIGESTION,46.0,29.9,0.95,46.0,60
CDM,30608645,"AMPLIFICATION, RIFAMPIN RESISTANCE",242.0,157.3,0.95,242.0,60
CDM,30608665,HIV-1 RNA,242.0,157.3,0.95,242.0,60
CDM,30608675,HIV-2 RNA,242.0,157.3,0.95,270.23,60
CDM,30608685,COVID-19 MOLECULAR (POINT OF CARE LAB),354.0,230.1,0.95,354.0,61
CDM,30608695,COVID-19 MOLECULAR (POC) & INFLUENZA A&B MOLECULAR (POC),984.0,639.6,0.95,984.0,61
CDM,30608705,RSV RAPID PCR (POINT OF CARE LAB),484.0,314.6,0.95,484.0,60
CDM,30608715,IADNA HPV SEP RPRT HI-RSK TYP&HI-RSK POOLD RSLTS,484.0,314.6,0.95,484.0,60
CDM,30608725,"AMPLIFIED PROBE, PNEUMOCYSTIS JIROVECII",242.0,157.3,0.95,242.0,60
CDM,30608735,"AMPLIFICATION, MYCOBACTERIUM TUBERCULOSIS",530.0,344.5,0.95,530.0,60
CDM,30608745,MTB RIF RES,530.0,344.5,0.95,530.0,60
CDM,30608755,STREP PNEUMO ABS X14,106.0,68.9,0.95,377.12,55
CDM,30608775,"SEQUENCING, INFLUENZA",661.0,429.65,0.95,661.0,60
CDM,30608785,RSV IA W DIR OBSERV (POINT OF CARE LAB),90.0,58.5,0.95,90.0,60
CDM,30608795,"IDENTIFICATION, AEROBIC ISOLATE (POINT OF CARE LAB)",56.0,36.4,0.95,62.24,60
CDM,30608805,PINWORM PREP PERIANAL (POINT OF CARE LAB),29.0,18.85,0.95,29.0,60
CDM,30608815,MEASLES VIRUS QUAL NAAT,242.0,157.3,0.95,242.0,60
CDM,30608835,GROUP A STREP PCR (POINT OF CARE LAB),242.0,157.3,0.95,242.0,60
CDM,30608845,FLUPCR RAPID PCR FLU (POINT OF CARE LAB),661.0,429.65,0.95,661.0,60
CDM,30608855,COVID19 INHOUSE (POINT OF CARE LAB),354.0,230.1,0.95,354.0,61
CDM,30608865,PLASMODIUM SP DIFF PCR X5,242.0,157.3,0.95,242.0,60
CDM,30608875,"GASTROINTESTINAL PANEL, 5 VIRAL TARGETS",885.0,575.25,0.95,885.0,60
CDM,30608915,"SUSCEPTIBILITY, CARBAPENAMASE ENZYME DETECTION, PER ISOLATE",260.0,169.0,0.95,260.0,46
CDM,30608925,"AMPLIFIED PROBE, GC/CT",484.0,314.6,0.95,484.0,55
CDM,30608945,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",484.0,314.6,0.95,484.0,55
CDM,30608955,"ENTEROVIRUS, REAL-TIME PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
CDM,30608965,"AMPLIFICATION, STREPTOCOCCUS, GROUP B WITH LIM BROTH",242.0,157.3,0.95,242.0,60
CDM,30630AK,REPAIR NASAL SEPTAL PERFORATIONS,2916.0,1895.4,1.1,5497.86,50
CDM,30700005,URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB),28.0,18.2,0.95,28.0,60
CDM,30700010,URINALYSIS AUTO W SCPE,22.0,14.3,0.95,22.0,60
CDM,30700015,N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB),24.0,15.6,0.95,24.0,60
CDM,30700020,URINALYSIS AUTO WO SCPE,16.0,10.4,0.95,17.31,60
CDM,30700025,"URINANALYSIS, QUAL OR SEMI-QUANT",15.0,9.75,0.95,15.0,60
CDM,30700030,PREGNANCY TEST URINE (POINT OF CARE LAB),59.0,38.35,0.95,59.0,60
CDM,30700035,URINALYSIS MICROSCOP ONLY,21.0,13.65,0.95,21.0,60
CDM,30700045,VOL MEASURE TIMED UR OUT,25.0,16.25,0.95,25.0,60
CDM,30700055,URINALYSIS WITH MICRO (POINT OF CARE LAB),22.0,14.3,0.95,22.0,60
CDM,30700065,URINALYSIS ONLY,16.0,10.4,0.95,17.31,60
CDM,30700075,HCG URINE (POINT OF CARE LAB),59.0,38.35,0.95,59.0,60
CDM,30700095,"REDUCING SUBSTANCE, URINE",11.0,7.15,0.95,11.0,46
CDM,30700195,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),16.0,10.4,0.95,17.31,60
CDM,30700205,URINALYSIS MICROSCOP ONLY (POINT OF CARE LAB),21.0,13.65,0.95,21.0,60
CDM,30801AK,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,456.0,296.4,1.1,2603.78,53
CDM,30802AK,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,832.0,540.8,1.1,2603.78,53
CDM,30808765,"PROCESSING, THICK SMEAR PREPARATION",46.0,29.9,0.95,46.0,60
CDM,30900025,LAMELLAR BODY COUNT,133.0,86.45,0.95,133.0,60
CDM,30900045,CELL COUNT & DIFF,39.0,25.35,0.95,42.4,60
CDM,30900055,EXAM SYNOVIAL FLUID CRYSTALS,51.0,33.15,0.95,51.0,60
CDM,30900065,EOSINOPHIL SMEAR MISC,40.0,26.0,0.95,40.0,60
CDM,30900375,HIV-1/2 AG/AB COMBO,111.0,72.15,0.95,111.0,60
CDM,30901AK,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,440.0,286.0,1.1,521.9,53
CDM,30903AK,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,678.0,440.7,1.1,814.94,53
CDM,30905AK,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,867.0,563.55,1.1,1162.67,53
CDM,30906AK,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1078.0,700.7,1.1,1236.48,53
CDM,30930AK,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,524.0,340.6,1.1,5497.86,50
CDM,30999AK,UNLISTED PROCEDURE NOSE,1179.0,766.35,0.01,1179.0,28
CDM,30999RVU4AK,CRYOABLATION OF NASAL NERVE,1076.0,699.4,0.01,1076.0,28
CDM,30999RVU6AK,UNLISTED PROC; NASAL SURG PROC (COMP TO 30465),4079.0,2651.35,0.01,4079.0,28
CDM,30999RVU7AK,UNLISTED PROC; CRYOABLATION THPY INTRANASAL NERVE(S) MULTIPLE (C,2152.0,1398.8,0.01,2152.0,28
CDM,31000025,BONE MARROW ROUTINE,5637.0,3664.05,0.95,5637.0,61
CDM,31000045,%CHROMO BLD TISSUE CULT,804.0,522.6,0.95,804.0,60
CDM,31000055,CHROM TISSUE CULT PROCESS,971.0,631.15,0.95,1083.61,60
CDM,31000075,CHROM LEUK BLD CULT PROC,992.0,644.8,0.95,992.0,60
CDM,31000085,%CHROMO SOL TUMOR CULTURE,1018.0,661.7,0.95,1026.15,60
CDM,31000100,SPEC STN GRP II,126.0,81.9,0.95,372.91,61
CDM,31000105,%CHROMO POC KARY 15-20,866.0,562.9,0.95,866.0,60
CDM,31000115,%UROFISH MOLE GEN DNA X4,148.0,96.2,0.95,164.91,60
CDM,31000140,CISH EA PROBE,673.0,437.45,0.95,673.0,61
CDM,31000160,PAP SMR THN PRP,140.0,91.0,0.95,140.0,60
CDM,31000170,SURG PATH GROSS MICRO LVL IV,369.0,239.85,0.95,369.0,61
CDM,31000175,%AHTBX PATH LVL V,2482.0,1613.3,0.95,2482.0,61
CDM,31000180,SPEC STN GRP I,207.0,134.55,0.95,207.0,61
CDM,31000185,"SPECIAL STAIN GRP I EA, SEMEN",207.0,134.55,0.95,207.0,61
CDM,31000195,"SPECIAL STAIN GRP II EA, SEMEN",126.0,81.9,0.95,372.91,61
CDM,31000210,HISTOCHEMICAL STAIN,184.0,119.6,0.95,184.0,46
CDM,31000215,DIRECT IMMUNOFLUOR-EACH,1182.0,768.3,0.95,1182.0,61
CDM,31000265,ATMS MICRODISECTION,519.0,337.35,0.95,519.0,46
CDM,31000275,%MSI3 MICRO DELETION X3,519.0,337.35,0.95,519.0,46
CDM,31000285,PARATHYROID GLAND CRYOPRESERVA,335.0,217.75,0.95,335.0,61
CDM,31000300,SURGERY PATH GROSS MICRO LEVEL 4,369.0,239.85,0.95,369.0,61
CDM,31000320,*IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,0.95,1182.0,61
CDM,31000325,"LABCORP CMBP CHROMOSOME ANALYSIS, CHORIONIC VILLUS",1037.0,674.05,0.95,1037.0,60
CDM,31000360,*MICRODISECTION MANUAL,519.0,337.35,0.95,519.0,46
CDM,31000385,%FSHPCM ANALY 25-99,292.0,189.8,0.95,292.0,60
CDM,31000395,%CHROMO HEM KAROTYPES,866.0,562.9,0.95,866.0,60
CDM,31000415,%CVC CHROMOSOME ANALYSIS,1301.0,845.65,0.95,1301.0,60
CDM,31000450,CYTP URINE 3-5 PROBES CMPTR,1182.0,768.3,0.95,1182.0,61
CDM,31000465,"CHROMOSOME ANAL, KAROTYPE EA",231.0,150.15,0.95,231.0,60
CDM,31000470,IMMUNO H/C EA ADDTL AB STAIN,247.0,160.55,0.95,247.0,46
CDM,31000580,M/PHMTRC ALYS ISHQUANT/SEMIQ,1182.0,768.3,0.95,1182.0,61
CDM,31000620,INSITU HYBRIDIZATION DUAL,1182.0,768.3,0.95,1182.0,61
CDM,31000670,IMMUNOFLUOR ADDTL,249.0,161.85,0.95,249.0,46
CDM,31000735,MISC SENDOUT CPT 81240,438.0,284.7,0.95,438.0,60
CDM,31000855,CISH EA PROBE MOD,673.0,437.45,0.95,673.0,61
CDM,31000865,CISH KAPPA,673.0,437.45,0.95,673.0,61
CDM,31000875,CISH LAMDA,673.0,437.45,0.95,673.0,61
CDM,31000895,CISH EACH PROBE,673.0,437.45,0.95,673.0,61
CDM,31000905,CISH FOR EPSTEIN BARR,673.0,437.45,0.95,673.0,61
CDM,31000915,CISH EACH PROBE,673.0,437.45,0.95,673.0,61
CDM,31000AK,LAVAGE CANNULATION MAXILLARY SINUS,480.0,312.0,1.1,614.61,53
CDM,31001035,ISIGHT DNA PROBE,148.0,96.2,0.95,164.91,60
CDM,31001105,APLFSH PROBE X2,148.0,96.2,0.95,164.91,60
CDM,31001115,FISH FOR BCR/ABL 1 PROBE X2,148.0,96.2,0.95,164.91,60
CDM,31001125,%CLLFSH PROBE X7,148.0,96.2,0.95,164.91,60
CDM,31001135,%FAMLPN PROBE,148.0,96.2,0.95,164.91,60
CDM,31001165,%FSHPCM DNA PROBE,148.0,96.2,0.95,164.91,60
CDM,31001215,%FSHMDS PROBE X6,148.0,96.2,0.95,164.91,60
CDM,31001275,FHT410 100-300,353.0,229.45,0.95,353.0,60
CDM,31001295,%IBDSGI IFA FIRST,1182.0,768.3,0.95,1182.0,61
CDM,31001325,%IBDSGI IFA ADDTL,249.0,161.85,0.95,249.0,46
CDM,31001365,%ENTERO AB ADDTL X2,249.0,161.85,0.95,249.0,46
CDM,31001495,FISH FOR CHOP GENE,1182.0,768.3,0.95,1182.0,61
CDM,31001555,%APLFSH ANALY 100-300,353.0,229.45,0.95,353.0,60
CDM,31001565,%BCRFSH ANALY 100-300,353.0,229.45,0.95,353.0,60
CDM,31001575,%CLLFSH ANALY 100-300 X3,353.0,229.45,0.95,353.0,60
CDM,31001585,%FAMLPN ANALY 100-300,353.0,229.45,0.95,353.0,60
CDM,31001665,%FSHMDS ANALY 100-300 X3,353.0,229.45,0.95,353.0,60
CDM,31001685,%FSHPCM ANALY 100-300,353.0,229.45,0.95,353.0,60
CDM,31001715,FISH ALK NSCLC,1182.0,768.3,0.95,1182.0,61
CDM,31001725,FISH FOR AGG B CL LYM,1182.0,768.3,0.95,1182.0,61
CDM,31001735,ALK FISH LUNG NSCLC,1182.0,768.3,0.95,1182.0,61
CDM,31001935,%CHRMDS CULT PROC,992.0,644.8,0.95,992.0,60
CDM,31001975,SEQUENTIAL SCR 2,1059.0,688.35,0.95,1059.0,60
CDM,31001995,HLA-B*57:01,1172.0,761.8,0.95,1172.0,60
CDM,31002035,QUAD SCREEN 2014,1059.0,688.35,0.95,1059.0,60
CDM,31002195,%HIVPHS PHENOTYPE,899.0,584.35,0.95,899.0,60
CDM,31002205,%HIVPHS GENOTYPE,1776.0,1154.4,0.95,1776.0,60
CDM,31002230,CYTO BRONCH BR CONC TECH,369.0,239.85,0.95,369.0,61
CDM,31002235,FNA CONCENTRATION,369.0,239.85,0.95,369.0,61
CDM,31002255,HLA-B*57:01,1172.0,761.8,0.95,1172.0,60
CDM,31002265,PLASMINOGEN ACTIVATOR INHIB 1,441.0,286.65,0.95,1608.07,60
CDM,31002285,SEQUENTIAL SCR 2,1059.0,688.35,0.95,1059.0,60
CDM,31002295,BCR P210 (CML),1131.0,735.15,0.95,1262.54,60
CDM,31002305,BCR P190 (ALL),999.0,649.35,0.95,1115.21,60
CDM,31002315,FACTOR V LEIDEN MUTATION,506.0,328.9,0.95,506.0,60
CDM,31002325,HEREDITARY HEMOCHROM,451.0,293.15,0.95,503.27,60
CDM,31002335,JAK2 MUTATION,632.0,410.8,0.95,632.0,60
CDM,31002345,MTHFR 1298 & MTHFR 677,451.0,293.15,0.95,451.0,60
CDM,31002365,MOLECULAR PATH PROC,218.0,141.7,0.95,837.52,46
CDM,31002375,LIVER FIBROSIS (FIBROSURE),710.0,461.5,0.95,710.0,46
CDM,31002435,"B. PERTUSSIS IGG, BLOT",189.0,122.85,0.95,605.33,38
CDM,31002455,FERN TEST (POINT OF CARE LAB),67.0,43.55,0.95,67.0,60
CDM,31002605,FAMILAL MEDITER FEVER SEQ,1896.0,1232.4,0.95,1896.0,60
CDM,31002735,MYD88 L265P MUT ANLS,1210.0,786.5,0.95,1210.0,60
CDM,31002755,SMA CARRIER SCRN DIAG,945.0,614.25,0.95,945.0,60
CDM,31002775,LIVER FIBRO AND ACTI,498.0,323.7,0.95,498.0,60
CDM,31002805,BTK GENE ANALYISIS,1210.0,786.5,0.95,1210.0,60
CDM,31002815,PLCG2 GENE ANALYSIS,2010.0,1306.5,0.95,2010.0,60
CDM,31002905,CYTOCHROME P450 2C19,2010.0,1306.5,0.95,2010.0,60
CDM,31002915,CYTOCHROME P450 2D6,3111.0,2022.15,0.95,3111.0,60
CDM,31002945,GIST BRAF GENE,1210.0,786.5,0.95,1210.0,60
CDM,31002955,GIST KIT GENE,2274.0,1478.1,0.95,2274.0,60
CDM,31002965,GIST NGS GIST,189.0,122.85,0.95,837.52,46
CDM,31002975,SHOX DNA DIAGNOSTIC,161.0,104.65,0.95,837.52,46
CDM,31003025,CSPNL SMN1 GENE DOS/DEL,945.0,614.25,0.95,945.0,60
CDM,31003035,MATERNIT21 PLUS,5237.0,3404.05,0.95,5237.0,60
CDM,31003095,PGPAIN CYP2D6 GENE COM VAR,3111.0,2022.15,0.95,3111.0,60
CDM,31003135,PD-L1 22C3 IHC WITH TPS,1182.0,768.3,0.95,1182.0,61
CDM,31003225,HNCPPB NGS,1616.0,1050.4,0.95,11963.94,60
CDM,31003245,HLA-B51,879.0,571.35,0.95,879.0,60
CDM,31003295,FISH RENAL CELL CARCINOMA PNL,1182.0,768.3,0.95,1182.0,61
CDM,31003335,RETTFG MECP2 GENE FULL SEQ,3642.0,2367.3,0.95,3642.0,60
CDM,31003345,RETTFG MECP2 GENE DUP/DELET VARIANT,1035.0,672.75,0.95,1035.0,60
CDM,31003355,CIFAB AB IGG FIRST,1182.0,768.3,0.95,1182.0,61
CDM,31003365,CIFAB AB IGG ADDTL,249.0,161.85,0.95,249.0,46
CDM,31003375,HLA-B58,513.0,333.45,0.95,513.0,60
CDM,31003405,CHIMERISM/ENGRAFTMENT ANALY W/COMP TO BASLINE,1431.0,930.15,0.95,1431.0,60
CDM,31003415,STR GENOTYPING,1608.0,1045.2,0.95,1608.0,60
CDM,31003425,"HLA-A,B,C,DR,DQ,DRB345_RT-PCR",2775.0,1803.75,0.95,2775.0,60
CDM,31003435,SOLID ORGAN NGS FEE,2775.0,1803.75,0.95,2775.0,60
CDM,31003565,HEAD AND NECK NGS,1737.0,1129.05,0.95,2450.12,60
CDM,31003575,SARCOMA FUSION NGS,1737.0,1129.05,0.95,11963.94,60
CDM,31003635,MPL MUTATION ANSYS BLD,1037.0,674.05,0.95,1037.0,60
CDM,31003655,JAKNON EX 12-16 SEQ BLD,1278.0,830.7,0.95,1278.0,60
CDM,31003705,NTRK NGS,3359.0,2183.35,0.95,3359.0,60
CDM,31003725,190PCR BONE MARROW TEST,999.0,649.35,0.95,1115.21,60
CDM,31003745,TCBMDM GENE REARRANGE AMP,1442.0,937.3,0.95,1442.0,60
CDM,31003755,TCBMDM GENE REARRANGE ANAL,1390.0,903.5,0.95,1390.0,60
CDM,31003765,TCBMDO GENE REARRANGE AMP,1442.0,937.3,0.95,1442.0,60
CDM,31003775,TCBMDO GENE REARRANGE ANAL,1390.0,903.5,0.95,1390.0,60
CDM,31003805,BCBMDO LGH REARR HCL,1366.0,887.9,0.95,1524.53,60
CDM,31003815,BCBMDO LGK REARR KLCL,1192.0,774.8,0.95,1192.0,60
CDM,31003875,TCRBO GENE REARRANGE AMP,1442.0,937.3,0.95,1442.0,60
CDM,31003905,MYD88 L265P MUT ANLS BM,1210.0,786.5,0.95,1210.0,60
CDM,31003915,MYD88 L265P MUT ANLS OTH,1210.0,786.5,0.95,1210.0,60
CDM,31004005,1P19Q FISH FOR 1P/19Q,1182.0,768.3,0.95,1182.0,61
CDM,31004015,POCHF PROD CONCEPT+SNP,4500.0,2925.0,0.95,4753.45,60
CDM,31004025,MTHRF 2 VARIANTS,451.0,293.15,0.95,451.0,60
CDM,31004115,IDH1 COMMON VARIANTS,1333.0,866.45,0.95,1333.0,60
CDM,31004125,IDH2 COMMON VARIANTS,2041.0,1326.65,0.95,2041.0,60
CDM,31004145,LUNG CANCER HOTSPOT CYTO,1992.0,1294.8,0.95,2450.12,60
CDM,31004325,CVCYTO CHROMOSOME COUNT ADDITIONAL,186.0,120.9,0.95,186.0,60
CDM,31004375,"CXCR4 MUTATION ANALYSIS, SOMATIC",891.0,579.15,0.95,891.0,46
CDM,31004395,HFMNGS HN FUSION NGS PNL BLD,1616.0,1050.4,0.95,11963.94,60
CDM,31004415,HDPNGS ACUTE LEUK NGS PNL BLD,3000.0,1950.0,0.95,11963.94,60
CDM,31004425,HDMNGS ACUTE LEUK NGS PNL BM,3000.0,1950.0,0.95,11963.94,60
CDM,31004435,HDONGS ACUTE LEUK NGS PNL OTHER,3000.0,1950.0,0.95,11963.94,60
CDM,31004445,MYNGSM MYELOID PANEL NGS BM,1616.0,1050.4,0.95,11963.94,60
CDM,31004455,MYNGSP MYELOID PANEL NGS P BLD,1616.0,1050.4,0.95,11963.94,60
CDM,31004525,KIT D816V MUT DETECT BLD,862.0,560.3,0.95,862.0,60
CDM,31004535,KIT D816V MUT DETECT BM,862.0,560.3,0.95,862.0,60
CDM,31004605,BMFUNG CHIMERISM ANAL W/CELL SELECT,1799.0,1169.35,0.95,1799.0,60
CDM,31004615,BCRPB BCR/ABL1 GENE MAJOR BP,1131.0,735.15,0.95,1262.54,60
CDM,31004625,BCRPB BCR/ABL1 GENE MINOR BP,999.0,649.35,0.95,1115.21,60
CDM,31004635,BCRBM BCR/ABL1 GENE MAJOR BP,1131.0,735.15,0.95,1262.54,60
CDM,31004645,BCRBM BCR/ABL1 GENE MINOR BP,999.0,649.35,0.95,1115.21,60
CDM,31004675,TISSUE DNA FP FOR MOLAR PREG - IHC SENDOUT,1608.0,1045.2,0.95,1608.0,60
CDM,31004685,CILIARY MOTILITY - EM DIAG,5637.0,3664.05,0.95,5637.0,61
CDM,31004695,"TOPPB TGT ONC NGS, PER BLD",4400.0,2860.0,0.95,11963.94,60
CDM,31004705,"TOPBM TGT ONC NGS, BM",4400.0,2860.0,0.95,11963.94,60
CDM,31004715,"TOPTO TGT ONC NGS, OTH",4400.0,2860.0,0.95,11963.94,60
CDM,31004725,"TOPCY TGT ONC NGS, CYTO",4400.0,2860.0,0.95,11963.94,60
CDM,31004735,NMP1 MUTATION DETECTION BY RT-PCR,1701.0,1105.65,0.95,1701.0,60
CDM,31004745,"PRENATAL SNP MICROARRAY, AMNIOTIC FLUID, CVS",4500.0,2925.0,0.95,4753.45,60
CDM,31004755,UBA1 MUTATION TESTING FOR VEXAS SYNDROME,1278.0,830.7,0.95,1988.72,60
CDM,31004775,PRENATAL QUAD SCREEN,1059.0,688.35,0.95,1059.0,60
CDM,31004785,NARCOLEPSY GENOTYPING (HLADQB1* 06:02),853.0,554.45,0.95,853.0,60
CDM,31004795,HPA-1 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004805,HPA-2 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004815,HPA-3 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004825,HPA-4 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004835,HPA-5 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004845,HPA-6 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004855,HPA-9 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004865,HPA-15 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004875,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2490.0,1618.5,0.95,2490.0,46
CDM,31004885,HPA-1 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004895,HPA-2 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004905,HPA-3 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004915,HPA-4 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004925,HPA-5 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004935,HPA-6 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004945,HPA-9 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004955,HPA-15 GENOTYPING,843.0,547.95,0.95,843.0,60
CDM,31004965,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2964.0,1926.6,0.95,2964.0,46
CDM,31004975,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2964.0,1926.6,0.95,2964.0,46
CDM,31004985,"MORPHOMETRIC ANALYSIS, IN SITU HYBRID (HER2FGAST)",1182.0,768.3,0.95,1182.0,61
CDM,31004995,EGFR GENETIC ANALYSIS,2240.0,1456.0,0.95,2240.0,60
CDM,31005005,EXOME SEQUENCING AHUS1,11950.0,7767.5,0.95,19587.48,60
CDM,31005015,KRAS GENETIC ANALYSIS,1333.0,866.45,0.95,1333.0,60
CDM,31005025,KRAS ADDITIONAL VARIANTS,1333.0,866.45,0.95,1333.0,60
CDM,31005035,ONKOSIGHT ADVANCED CHRONIC LYMPHOID NGS PANEL,5241.0,3406.65,0.95,5241.0,60
CDM,31005045,NPM1 GENE ANALYSIS PB,1701.0,1105.65,0.95,1701.0,60
CDM,31005055,NPM1 GENE ANALYSIS BM,1701.0,1105.65,0.95,1701.0,60
CDM,31005065,NPM1 GENE ANALYSIS OTHER,1701.0,1105.65,0.95,1701.0,60
CDM,31005075,MICROSATELLITE INSTABILITY DET (MSIID),2405.0,1563.25,0.95,2405.0,60
CDM,31005085,%PEMGUS IFL ADDTL,249.0,161.85,0.95,249.0,46
CDM,31005095,"LIVER FIBROSIS, CHRONIC VIRAL HEPATITIS (ARUP)",106.0,68.9,0.95,106.0,46
CDM,31005105,POLE DROPLET DIGITAL PCR,378.0,245.7,0.95,837.52,46
CDM,31005115,PARD UNLISTED MOL PATH,1278.0,830.7,0.95,1988.72,60
CDM,31005125,IDH1&2-COMMON VARIANTS,1160.0,754.0,0.95,1160.0,46
CDM,31005135,TARGETED ONCOLOGY PANEL - FINE NEEDLE ASPIRATE,4400.0,2860.0,0.95,11963.94,60
CDM,31005145,IDH1 HOTSPOT VARIANT BM,1333.0,866.45,0.95,1333.0,60
CDM,31005155,IHD2 HOTSPOT VARIANT BM,2041.0,1326.65,0.95,2041.0,60
CDM,31005165,IDH1 HOTSPOT VARIANT PB,1333.0,866.45,0.95,1333.0,60
CDM,31005175,IDH2 HOTSPOT VARIANT PB,2041.0,1326.65,0.95,2041.0,60
CDM,31005185,"HISTIOCYTIC NEOPLASMS, NGS",5241.0,3406.65,0.95,5241.0,60
CDM,31005195,"T-CELL LYMPHOMA, NGS",5241.0,3406.65,0.95,5241.0,60
CDM,31005205,"B-CELL LYMPHOMA, NGS",5241.0,3406.65,0.95,5241.0,60
CDM,31005215,"ACUTE LEUKEMIA RAPID NGS PANEL, BLOOD",4922.0,3199.3,0.95,11963.94,60
CDM,31005225,"ACUTE LEUKEMIA RAPID NGS PANEL, BONE MARROW",4922.0,3199.3,0.95,11963.94,60
CDM,31005275,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",121.0,78.65,0.95,528.29,55
CDM,31005285,"TAU, TOTAL (TTAU)",121.0,78.65,0.95,528.29,55
CDM,31005295,RUNX1-RUNX1T1,945.0,614.25,0.95,2297.92,60
CDM,31005305,CBFB-MYH11 INV(16),945.0,614.25,0.95,2297.92,60
CDM,31005315,MICROBIAL CELL-FREE DNA BY NGS,14671.0,9536.15,75.0,14671.0,60
CDM,31005325,UBA1 MUT DET BY DDPCR BLOOD,1278.0,830.7,0.95,1988.72,60
CDM,31005335,UBA1 MUT DET BY DDPCR BONE MARROW,1278.0,830.7,0.95,1988.72,60
CDM,31005345,UBA1 MUT DET BY DDPCR OTHER,1278.0,830.7,0.95,1988.72,60
CDM,31005355,DNA FINGERPRNT TEST-NGS-GENOTYPING,4128.0,2683.2,0.95,4128.0,46
CDM,31005365,DNA FINGERPRNT TEST-NGS-FOLLOW UP,4128.0,2683.2,0.95,4128.0,46
CDM,31005485,TARGETED ONCOLOGY PANEL LOW PURITY,4400.0,2860.0,0.95,11963.94,60
CDM,31005495,FLT3 TKDM BONE MARROW,573.0,372.45,0.95,573.0,60
CDM,31005505,"ISH, QUANT/SEMI QUANT, MULTIPLEX PROBE STAIN",1182.0,768.3,0.95,1182.0,61
CDM,31005515,INTESTINAL TRANSPLANT REJECTION RISK EVALUATION (PLEXIMMUNE),4421.0,2873.65,0.95,4421.0,60
CDM,31005525,CYTOGENOMIC SNP MICROARRAY - FETAL,4500.0,2925.0,0.95,4753.45,60
CDM,31005535,FETAL CELL CONTAMINATION (FCC),1608.0,1045.2,0.95,1608.0,60
CDM,31005545,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",121.0,78.65,0.95,528.29,55
CDM,31005565,BRAF V600E/D AND V600K/R MUTATION DETECTION CIRCULATING TUMOR DN,1335.0,867.75,0.95,1335.0,60
CDM,31005575,"MICROARRAY ANALYSIS, SNP, FORMALIN FIXED PARAFFIN EMBEDDED TISSU",1335.0,867.75,0.95,4753.45,60
CDM,31005585,"MICROARRAY ANALYSIS, POC FFPE",1335.0,867.75,0.95,4753.45,60
CDM,31005595,CALR GENE ANALYSIS,839.0,545.35,0.95,839.0,60
CDM,31005605,"JAK2 GENE ANALYSIS, VAL617PHE VARIANT",632.0,410.8,0.95,632.0,60
CDM,31005615,MPL GENE ANALYSIS,1278.0,830.7,0.95,1278.0,60
CDM,31005625,"JAK2 GENE ANALYSIS, EXONS 12 AND 13",1278.0,830.7,0.95,1278.0,60
CDM,31005635,"STR ANALYSIS FOR MOL PREG, BLD",1608.0,1045.2,0.95,1608.0,60
CDM,31005645,"STR ANALYSIS FOR MOL PREG, OTHER",1608.0,1045.2,0.95,1608.0,60
CDM,31005655,MICORARRAY SNP FFPET,8004.0,5202.6,0.95,8004.0,60
CDM,31005665,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, BLOOD",1608.0,1045.2,0.95,1608.0,60
CDM,31005675,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",1608.0,1045.2,0.95,1608.0,60
CDM,31005685,BCR-ABL1 KINASE MUT DET SANGER BLD,2070.0,1345.5,0.95,2070.0,60
CDM,31005695,BCR-ABL1 KINASE MUT DET BY SANGER SEQ BM,2070.0,1345.5,0.95,2070.0,60
CDM,31005705,SERPINA1 TARG MUT BY SANGER SEQ,301.0,195.65,0.95,301.0,60
CDM,31005715,UGT1A1 TARG MUT DET BY SANGER,1615.0,1049.75,0.95,1615.0,60
CDM,31005725,UBA1 TARG MUT DET BY SANGER OTHER,1278.0,830.7,0.95,1988.72,60
CDM,31005735,UGTA1 TARG MUT DET BY SANGER BLD,1278.0,830.7,0.95,1988.72,60
CDM,31005745,UBA1 TARG MUT DET BY SANGER BM,1278.0,830.7,0.95,1988.72,60
CDM,31005755,POLE TARG MUT DET BY SANGER,378.0,245.7,0.95,837.52,46
CDM,31005765,ONC PAN-TUMOR DNA&RNA NEXT-GENERATION SEQUENCING-CARIS,58339.0,37920.35,533.45,58339.0,55
CDM,31005775,HFE TARGETED MUT BY SANGER SEQ,451.0,293.15,0.95,503.27,60
CDM,31005785,"TP53 SOMATIC MUT, PROGNOSTIC",2274.0,1478.1,0.95,2274.0,60
CDM,31005798,FULL GENE SEQUENCE ANALYSIS OF THE TP53 (TUMOR PROTEIN 53) GENE,4429.0,2878.85,0.95,4429.0,60
CDM,31005805,MATERNAL CELL CONTAMINATION,1608.0,1045.2,0.95,1608.0,60
CDM,31005815,ADDITIONAL CELLS COUNTED,186.0,120.9,0.95,186.0,60
CDM,31005825,INTER FISH ANALYSIS 25-99 CELLS,292.0,189.8,0.95,292.0,60
CDM,31005835,SANGER SEQ DNA BLD,1278.0,830.7,0.95,1988.72,60
CDM,31005845,SANGER SQ DNA BONE MARROW,1278.0,830.7,0.95,1988.72,60
CDM,31005855,SANGER SEQ DNA OTHER,1278.0,830.7,0.95,1988.72,60
CDM,31005865,SANGER SEQ RNA BLD,1278.0,830.7,0.95,1988.72,60
CDM,31005875,SANGER SEQ RNA BONE MARROW,1278.0,830.7,0.95,1988.72,60
CDM,31075AK,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,3804.0,2472.6,1.1,9999.36,50
CDM,31085AK,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,6256.0,4066.4,1.1,9999.36,50
CDM,31100010,CYTPATH NONGYN SMEAR INTERP,271.0,176.15,0.95,271.0,61
CDM,31100015,CYTOLOGY FLUID TP,369.0,239.85,0.95,369.0,61
CDM,31100035,CYTO IMAGER GYN TP DIAG,184.0,119.6,0.95,184.0,60
CDM,31100045,CYTO SECOND PASS ADEQ,147.0,95.55,0.95,147.0,46
CDM,31100050,CYTPATH SACCOMENNO SMEAR,271.0,176.15,0.95,271.0,61
CDM,31100075,ADDITIONAL MARKERS,149.0,96.85,0.95,149.0,46
CDM,31100110,CYTPATH SMEAR OTHER,169.0,109.85,0.95,169.0,61
CDM,31100155,CYTOLOGY GYN SC THIN PREP,140.0,91.0,0.95,140.0,60
CDM,31100170,CYTPATH FNA IMMEDIATE EVAL,259.0,168.35,0.95,477.52,61
CDM,31100175,CYTO IMAGER GYN TP SCREEN,184.0,119.6,0.95,184.0,60
CDM,31100180,CYTPATH FNA I&R,369.0,239.85,0.95,369.0,61
CDM,31100200,"FLOW CYTOMETRY TC, 1ST MARKER",2482.0,1613.3,0.95,2482.0,61
CDM,31100310,TISS CULT BONE MARROW,992.0,644.8,0.95,992.0,60
CDM,31100370,CHROMO ANALYSIS 15-20CELL BAND,866.0,562.9,0.95,866.0,60
CDM,31100420,CYTOGEN DNA PROBE EA,148.0,96.2,0.95,164.91,60
CDM,31100440,CYTOGEN INTERPHASE 100-300,353.0,229.45,0.95,353.0,60
CDM,31100480,MOL CYTOGEN I&R,229.0,148.85,0.95,229.0,46
CDM,31100500,CHROMO ANALYSIS 15-20CELL BAND,866.0,562.9,0.95,866.0,60
CDM,31100530,CHROMO COUNT ADD,186.0,120.9,0.95,186.0,60
CDM,31100600,*FLOW CYTOMETRY TC 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31100610,"FLOW CYTO, EA ADD MARKER",149.0,96.85,0.95,149.0,46
CDM,31100670,FLOW EA ADD MARK 10,149.0,96.85,0.95,149.0,46
CDM,31100750,CHRMSM ANAL 2 KARYO BAND,866.0,562.9,0.95,866.0,60
CDM,31100760,"FLOW CYTO, 1ST MARKER",2482.0,1613.3,0.95,2482.0,61
CDM,31100810,*TIS CULT LYMPHOCYTE,804.0,522.6,0.95,804.0,60
CDM,31100950,CYTPATH NONGYN SMEAR INTERP,271.0,176.15,0.95,271.0,61
CDM,31101100,CYTP FNA EVAL EA ADDL,147.0,95.55,0.95,147.0,46
CDM,31101215,BILIARY TRACT MALIG,369.0,239.85,0.95,369.0,61
CDM,31101315,%ISIGHT MOL CY 100 - 300,353.0,229.45,0.95,353.0,60
CDM,31101355,CYTOLOGY FLUID,271.0,176.15,0.95,271.0,61
CDM,31101365,%PLAFLW FLOW 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101375,%NKFUNC FIRST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101385,%PLAFLW FLW ADD MARKER X5,149.0,96.85,0.95,149.0,46
CDM,31101405,%NKFUNC ADDTL MARKERS X2,149.0,96.85,0.95,149.0,46
CDM,31101415,RBCB3 PROTEIN RED,2482.0,1613.3,0.95,2482.0,61
CDM,31101425,%CVID FLW EA ADD MARK X2,149.0,96.85,0.95,149.0,46
CDM,31101475,%PNH BY FCM 1ST MARK X2,2482.0,1613.3,0.95,2482.0,61
CDM,31101485,%PNH BY FCM ADD MARK X7,149.0,96.85,0.95,149.0,46
CDM,31101525,%CHROMO AMNIOTIC FL,1301.0,845.65,0.95,1301.0,60
CDM,31101595,%CVID FLOW FIRST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101645,INDIVIDUAL FCM MARKER X1,2482.0,1613.3,0.95,2482.0,61
CDM,31101665,%NUCLEAR TDT BY FCM 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101675,%ACLUK2 1ST MARK,2482.0,1613.3,0.95,2482.0,61
CDM,31101685,%MYELOMA 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101695,%T CELL VBETA 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101715,%PNH PANEL 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101755,%LGLYM 1ST MRK,2482.0,1613.3,0.95,2482.0,61
CDM,31101765,%RLLLIP 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31101815,%DGEORG DNA PROBEX2,148.0,96.2,0.95,164.91,60
CDM,31101865,"PAP, THIN PREP RESCREEN",159.0,103.35,0.95,159.0,60
CDM,31102505,PDGFAM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31102515,PDGFAM BM PROBE X2,148.0,96.2,0.95,164.91,60
CDM,31102525,PDGFAM BM 100-300,353.0,229.45,0.95,353.0,60
CDM,31102735,FAMLPN TISSUE CULT BLOOD,992.0,644.8,0.95,992.0,60
CDM,31102785,FSBLLM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31102795,FSBLLM BM PROBE X12,148.0,96.2,0.95,164.91,60
CDM,31102805,FSBLLM BM 100-300,353.0,229.45,0.95,353.0,60
CDM,31102825,FABCBM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31102835,FABCBM BM PROBE X8,148.0,96.2,0.95,164.91,60
CDM,31102875,MPNFSM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31102885,MPNFSM BM PROBE X9,148.0,96.2,0.95,164.91,60
CDM,31102895,MPNFSM BM 100-300 X4,353.0,229.45,0.95,353.0,60
CDM,31102975,APLFSH TISSUE CULT BLOOD,992.0,644.8,0.95,992.0,60
CDM,31102985,APLFBM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31102995,APLFBM BM PROBE X2,148.0,96.2,0.95,164.91,60
CDM,31103005,APLFBM BM 100-300,353.0,229.45,0.95,353.0,60
CDM,31103025,FSMDSM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31103035,FSMDSM BM PROBE X6,148.0,96.2,0.95,164.91,60
CDM,31103045,FSMDSM BM 100-300 X3,353.0,229.45,0.95,353.0,60
CDM,31103055,CVCYTO CHROMOSOME KARYOTYPE,231.0,150.15,0.95,231.0,60
CDM,31103065,FABCBM BM 100-300 X4,353.0,229.45,0.95,353.0,60
CDM,31103085,CHRBLD CHROMO STDY ADD,238.0,154.7,0.95,238.0,60
CDM,31103105,CHROM BM CULT PROC,992.0,644.8,0.95,992.0,60
CDM,31103115,CHRBMH CHROM ANLY 20-25,998.0,648.7,0.95,998.0,60
CDM,31103185,CELL PROCESSING AND STORAGE,90.0,58.5,0.95,90.0,60
CDM,31103195,POCHF CHROM TIS CUL PROC,971.0,631.15,0.95,1083.61,60
CDM,31103205,POCHF CHR ANLS KARY 15-20,866.0,562.9,0.95,866.0,60
CDM,31103215,CLLFSH TISSUE CULT BLD,992.0,644.8,0.95,992.0,60
CDM,31103285,CHRMDS CHROM ANLY 20-25,998.0,648.7,0.95,998.0,60
CDM,31103525,CLLFSM TISSUE CULT BLD,992.0,644.8,0.95,992.0,60
CDM,31103535,CLLFSM PROBE X7,148.0,96.2,0.95,164.91,60
CDM,31103545,CLLFSM ANALY 100-300 X3,353.0,229.45,0.95,353.0,60
CDM,31103555,PAP SMEAR,98.0,63.7,12.13,98.0,61
CDM,31103565,DDIT3 PROBE X2,148.0,96.2,0.95,164.91,60
CDM,31103575,DDIT3 ANALY 100-300,353.0,229.45,0.95,353.0,60
CDM,31103585,PAP AND REFLEX HPV SCREEN- ARUP,140.0,91.0,0.95,140.0,60
CDM,31103595,PAP WITH REFLEX HPV SCREEN-ARUP,140.0,91.0,0.95,140.0,60
CDM,31103605,ALPS FLOW CYTOMETRY,2482.0,1613.3,0.95,2482.0,61
CDM,31103615,ALPS FLOW MARKERS,149.0,96.85,0.95,149.0,46
CDM,31103625,ALPS FLOW INTERP,1947.0,1265.55,0.95,1947.0,46
CDM,31103635,TELOMERE LENGTH MEASUREMENT,369.0,239.85,0.95,369.0,61
CDM,31103645,MAML2 FISH DNA PROBES,148.0,96.2,0.95,164.91,60
CDM,31103655,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31103665,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31103675,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31103685,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31103695,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31103705,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31103715,FISH MAYO GREATER THAN 100 CELLS (IF APPROPRIATE),353.0,229.45,0.95,353.0,60
CDM,31103725,"RET GENE REARRANGEMENTS, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31103735,"I(12P), GERM CELL TUMOR, FISH, TS",148.0,96.2,0.95,164.91,60
CDM,31103745,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-I(12P), GERM CELL",148.0,96.2,0.95,164.91,60
CDM,31103755,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,0.95,164.91,60
CDM,31103765,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,0.95,164.91,60
CDM,31103775,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,0.95,164.91,60
CDM,31103785,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-I(12P), GERM CELL",292.0,189.8,0.95,292.0,60
CDM,31103795,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-I(12P), GERM CELL TUMO",292.0,189.8,0.95,292.0,60
CDM,31103805,"PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
CDM,31103815,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PDGFB (22Q13), FI",148.0,96.2,0.95,164.91,60
CDM,31103825,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
CDM,31103835,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
CDM,31103845,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
CDM,31103855,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FIS",292.0,189.8,0.95,292.0,60
CDM,31103865,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FISH, T",292.0,189.8,0.95,292.0,60
CDM,31103875,"PLASMA CELL PROLIFERATIVE DISORDER, FISH",148.0,96.2,0.95,164.91,60
CDM,31103885,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PLASMA CELL PROLI,148.0,96.2,0.95,164.91,60
CDM,31103895,SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,0.95,164.91,60
CDM,31103905,SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,0.95,164.91,60
CDM,31103915,SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,0.95,164.91,60
CDM,31103925,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIF,292.0,189.8,0.95,292.0,60
CDM,31103935,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFERAT,292.0,189.8,0.95,292.0,60
CDM,31103945,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFE,353.0,229.45,0.95,353.0,60
CDM,31103955,"PRKACA, REARRANGEMENT, FISH",148.0,96.2,0.95,164.91,60
CDM,31103965,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PRKACA, REARRANGE",148.0,96.2,0.95,164.91,60
CDM,31103975,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,0.95,164.91,60
CDM,31103985,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,0.95,164.91,60
CDM,31103995,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,0.95,164.91,60
CDM,31104005,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEM",292.0,189.8,0.95,292.0,60
CDM,31104015,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEMENT,",292.0,189.8,0.95,292.0,60
CDM,31104025,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PRKACA, REARRANGEME",353.0,229.45,0.95,353.0,60
CDM,31104035,"JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
CDM,31104045,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FI",148.0,96.2,0.95,164.91,60
CDM,31104055,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
CDM,31104065,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
CDM,31104075,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
CDM,31104085,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FIS",292.0,189.8,0.95,292.0,60
CDM,31104095,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",292.0,189.8,0.95,292.0,60
CDM,31104105,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",353.0,229.45,0.95,353.0,60
CDM,31104115,"NR4A3, REARRANGEMENT, FISH",148.0,96.2,0.95,164.91,60
CDM,31104125,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-NR4A3, REARRANGEM",148.0,96.2,0.95,164.91,60
CDM,31104135,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,0.95,164.91,60
CDM,31104145,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,0.95,164.91,60
CDM,31104155,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,0.95,164.91,60
CDM,31104165,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEME",292.0,189.8,0.95,292.0,60
CDM,31104175,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMENT,",292.0,189.8,0.95,292.0,60
CDM,31104185,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMEN",353.0,229.45,0.95,353.0,60
CDM,31104195,"T-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA, FISH",148.0,96.2,0.95,164.91,60
CDM,31104205,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104215,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104225,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104235,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104245,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31104255,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31104265,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE),353.0,229.45,0.95,353.0,60
CDM,31104275,"ALK, (2P23), IMT, FISH",148.0,96.2,0.95,164.91,60
CDM,31104285,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104295,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104305,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104315,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104325,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31104335,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31104345,"FUS (16P11.2), FISH",148.0,96.2,0.95,164.91,60
CDM,31104355,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104365,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104375,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104385,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,60
CDM,31104395,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31104405,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,60
CDM,31104415,FISH 3Q26 BLD PROBE,148.0,96.2,0.95,164.91,60
CDM,31104425,FISH 3Q26 BLD ANALYSIS,353.0,229.45,0.95,353.0,60
CDM,31104435,FISH3Q36 TISSUE CULT BLOOD,992.0,644.8,0.95,992.0,60
CDM,31104445,FISH 3Q36 BM PROBE,148.0,96.2,0.95,164.91,60
CDM,31104455,FISH 3Q26 BM ANALYSIS,353.0,229.45,0.95,353.0,60
CDM,31104465,FISH 3Q26 TISSUE CULT BM,992.0,644.8,0.95,992.0,60
CDM,31104475,T-CELL ALL FISH 10 PROBE SETS,148.0,96.2,0.95,164.91,60
CDM,31104485,TALLAF FISH 100-300 CELLS,353.0,229.45,0.95,353.0,60
CDM,31104495,T-CELL ALL FISH ADDITIONAL PROBE SET,148.0,96.2,0.95,164.91,60
CDM,31104505,T-CELL ALL FISH 100-300 CELLS ADDITIONAL PROBE SET,353.0,229.45,0.95,353.0,60
CDM,31104515,FLOW TH17,2482.0,1613.3,0.95,2482.0,61
CDM,31104525,FLOW TH17 ADDITIONAL,149.0,96.85,0.95,149.0,46
CDM,31104535,FLOW CD107A,2482.0,1613.3,0.95,2482.0,61
CDM,31104545,FLOW CD107A ADDITIONAL,149.0,96.85,0.95,149.0,46
CDM,31104555,CD52EX FIRST MARKER,2482.0,1613.3,0.95,2482.0,61
CDM,31104565,CD52EX ADDITIONAL MARKERS,149.0,96.85,0.95,149.0,46
CDM,31104575,"KIRFLW FLOW CYTOMETRY; FIRST CELL SURFACE, CYTOPLASMIC OR NUCLEA",2482.0,1613.3,0.95,2482.0,61
CDM,31104585,"KIRFLW FLOW CYTOMETRY; ADDITIONAL CELL SURFACE, CYTOPLASMIC OR N",149.0,96.85,0.95,149.0,46
CDM,31104595,FLOW PERFORIN/GRANZYME B,2482.0,1613.3,0.95,2482.0,61
CDM,31104605,FLOW PERFORIN/GRANZYME B ADDITIONAL,149.0,96.85,0.95,149.0,46
CDM,31104615,FLOW SAP (XLP1) AND XIAP (XLP2),2482.0,1613.3,0.95,2482.0,61
CDM,31104625,FLOW SAP (XLP1) AND XIAP (XLP2) ADDITIONAL,149.0,96.85,0.95,149.0,46
CDM,31104635,FLOW PSTAT5,2482.0,1613.3,0.95,2482.0,61
CDM,31104645,FLOW PSTAT5 ADDITIONAL,149.0,96.85,0.95,149.0,46
CDM,31104765,PAP WITH REFLEX HPV SCREEN-ARUP,184.0,119.6,0.95,184.0,60
CDM,31104775,CHROMOSOME ANALYSIS AMNIOTIC FLUID,1198.0,778.7,0.95,1198.0,60
CDM,31104785,AMNIOTIC FLUID FETAL CELL CULTURE,1037.0,674.05,0.95,1037.0,60
CDM,31104795,REFLEX AMNIOTIC FLUID CULTURE,1037.0,674.05,0.95,1037.0,60
CDM,31104805,"REFLEX COUNT 5, 1 KARYOTYPE",1824.0,1185.6,0.95,1824.0,60
CDM,31104815,CVS FETAL CELL CULTURE,1037.0,674.05,0.95,1037.0,60
CDM,31104825,CHROMOSOME ANALYSIS CVS,1301.0,845.65,0.95,1301.0,60
CDM,31104835,"REFLEX COUNT 5, 1 KARYOTYPE",1824.0,1185.6,0.95,1824.0,60
CDM,31104845,REFLEX AMNIOTIC FLUID CULTURE PROCESSING FEE,1037.0,674.05,0.95,1037.0,60
CDM,31104855,CHROMOSOME FISH PRENATAL,148.0,96.2,0.95,164.91,60
CDM,31104865,CHROMOSOME ANALYSIS AMNIOTIC FLUID,353.0,229.45,0.95,353.0,60
CDM,31104875,MOLECULAR CYTOGENETIC TEST,148.0,96.2,0.95,164.91,60
CDM,31104885,INTERPHASE IN SITU HYBRIDIZATION,353.0,229.45,0.95,353.0,60
CDM,31104895,SEND OUT ROS1 BY FISH,1182.0,768.3,0.95,1182.0,61
CDM,31104905,"SEND OUT ALK GENE REARRANGEMENTS BY FISH, LUNG",1182.0,768.3,0.95,1182.0,61
CDM,31104915,CHROMOSOME AMNIOTIC FLUID,1037.0,674.05,0.95,1037.0,60
CDM,31104925,"CHROMOSOME ANALYSIS 6-12 COLONIES, 1 KARYOTYPE",1198.0,778.7,0.95,1198.0,60
CDM,31104935,CHROMOSOME ANALYSIS ADDITIONAL KARYOTYPE,231.0,150.15,0.95,231.0,60
CDM,31104945,"18, XY AMNIO ANEUPLOID FISH",148.0,96.2,0.95,164.91,60
CDM,31104955,"13, 21 AMNIO ANEUPLOID FISH",148.0,96.2,0.95,164.91,60
CDM,31200005,FISH FOR BLADDER CANCER W/URINARY CYTO,1182.0,768.3,0.95,1182.0,61
CDM,31200010,SURG PATH GROSS ONLY LVL I,169.0,109.85,0.95,169.0,61
CDM,31200015,PATH TOUCH PREP INIT,169.0,109.85,0.95,169.0,61
CDM,31200020,SURG PATH GROSS MICRO LVL II,271.0,176.15,0.95,271.0,61
CDM,31200025,SPECIAL STAIN ON FS,184.0,119.6,0.95,184.0,46
CDM,31200030,SURG PATH GROSS MICRO LVL III,369.0,239.85,0.95,369.0,61
CDM,31200050,TISSUE EXAM BY PATH LVL V,2482.0,1613.3,0.95,2482.0,61
CDM,31200060,TISSUE EXAM BY PATH LVL VI,5637.0,3664.05,0.95,5637.0,61
CDM,31200065,IMMUNOHISTOCHEM QT,1182.0,768.3,0.95,1182.0,61
CDM,31200080,DECALCIFICATION PROC,106.0,68.9,0.95,106.0,46
CDM,31200105,"GLOM BASE AB, IGG IFA",83.0,53.95,0.95,83.0,60
CDM,31200130,HISTOCHEMISTRY FOR ENZYME,5637.0,3664.05,0.95,5637.0,61
CDM,31200145,IHC EA ADDTL AB/BLOCK,247.0,160.55,0.95,247.0,46
CDM,31200160,CONSULT SLIDE PREP ELSEWHERE,271.0,176.15,0.95,271.0,61
CDM,31200165,IHC EA MULTIPLEX AB,2482.0,1613.3,0.95,2482.0,61
CDM,31200170,CONSULT SLIDE W PREP,369.0,239.85,0.95,369.0,61
CDM,31200175,CISH ADDTL,935.0,607.75,0.95,935.0,46
CDM,31200190,PATH CONSULT OR 1ST BLOCK,1182.0,768.3,0.95,1182.0,61
CDM,31200200,PATH CONSULT OR ADD TIS BLOCK,183.0,118.95,0.95,183.0,46
CDM,31200205,SP BIOPSY PROSTATE,369.0,239.85,0.95,369.0,61
CDM,31200210,PATH CONSULT CYTO EXAM INIT,5637.0,3664.05,0.95,5637.0,61
CDM,31200230,IMMUNOHISTOCHEM EA AB,1182.0,768.3,0.95,1182.0,61
CDM,31200235,IHC /SPC EA ADD AB STN,247.0,160.55,0.95,247.0,46
CDM,31200245,"SMEAR, PARASITE SPECIAL STAIN",41.0,26.65,0.95,58.34,60
CDM,31200255,"SMEAR, TRICHROME STAIN",124.0,80.6,0.95,124.0,60
CDM,31200275,IMMUNOHISTOCHEM EA AB,1182.0,768.3,0.95,1182.0,61
CDM,31200285,PATH TOUCH PREP EA ADD,183.0,118.95,0.95,183.0,46
CDM,31200290,ELECTRON MICRO DX,5637.0,3664.05,0.95,5637.0,61
CDM,31200325,DECALCIFICATION MOD,106.0,68.9,0.95,106.0,46
CDM,31200335,PATH TOUCH PREP INIT,5637.0,3664.05,0.95,5637.0,61
CDM,31200350,SPEC STN GRP II,126.0,81.9,0.95,372.91,61
CDM,31200365,FISH HER-2,1182.0,768.3,0.95,1182.0,61
CDM,31200375,FISH FOR BCL2,1182.0,768.3,0.95,1182.0,61
CDM,31200400,*IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,0.95,1182.0,61
CDM,31200590,SURG PATH GROSS MICRO LVL V MOD,2482.0,1613.3,0.95,2482.0,61
CDM,31200600,SURG PATH GROSS MICRO LVL VI MOD,5637.0,3664.05,0.95,5637.0,61
CDM,31200615,FISH FOR ANGIO MYC AMP,1182.0,768.3,0.95,1182.0,61
CDM,31200635,FISH SYT GENE(18Q11),1182.0,768.3,0.95,1182.0,61
CDM,31200655,FISH FOR EGFR,1182.0,768.3,0.95,1182.0,61
CDM,31200665,FISH FOR 19Q,1182.0,768.3,0.95,1182.0,61
CDM,31200685,FISH FOR MDM2,1182.0,768.3,0.95,1182.0,61
CDM,31200705,FISH FOR RET PRFN,1182.0,768.3,0.95,1182.0,61
CDM,31200715,FISH FOR ROS1 PRFN,1182.0,768.3,0.95,1182.0,61
CDM,31200795,FISH CUTANE MELANOMA,1182.0,768.3,0.95,1182.0,61
CDM,31200915,ER PARAFFIN BLOCK,1182.0,768.3,0.95,1182.0,61
CDM,31200925,PR PARAFFIN BLOCK,1182.0,768.3,0.95,1182.0,61
CDM,31200935,RETRVL/SELECT SPCM MOLEC TEST,169.0,109.85,0.95,169.0,61
CDM,31200945,"HER-2 MORPH ANLYS MULTI, MAN",1182.0,768.3,0.95,1182.0,61
CDM,31200975,BTM FISH REFLEX 1,1182.0,768.3,0.95,1182.0,61
CDM,31201035,FISH FOR RET CYTO BLOCK,1182.0,768.3,0.95,1182.0,61
CDM,31201045,FISH FOR ROS1 CYTO BLOCK,1182.0,768.3,0.95,1182.0,61
CDM,31201075,QFEVER AB IGG IGM PH I&II,84.0,54.6,0.95,84.0,60
CDM,31201115,QFEVER ABS IGG PH2 RFLX,2482.0,1613.3,0.95,2482.0,61
CDM,31201205,"MYCN (N-MYC), FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201215,"MDM2, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201225,"PD-L1 (SP142) SEMIQUANT IHC, MANUAL",1182.0,768.3,0.95,1182.0,61
CDM,31201235,"PD-L1 (SP263) SEMIQUANT IHC, MANUAL",1182.0,768.3,0.95,1182.0,61
CDM,31201245,"PD-L1 (28-8), SEMIQUANT IHC, MANUAL",1182.0,768.3,0.95,1182.0,61
CDM,31201255,"HER2 AMPLIFICATION, MISCELLANEOUS TUMOR, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201265,"SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201275,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201285,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201295,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201305,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201315,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201325,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201335,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201345,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201355,"T-CELL LYMPHOMA, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201365,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201375,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201385,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201395,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201405,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201415,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201425,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201435,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201445,"B-CELL LYMPHOMA, FISH, TISSUE",1182.0,768.3,0.95,1182.0,61
CDM,31201455,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, FISH",1182.0,768.3,0.95,1182.0,61
CDM,31201465,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201475,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201485,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201495,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201505,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
CDM,31201665,SPEC STN GRP II,126.0,81.9,0.95,372.91,61
CDM,31231AK,"NASAL ENDOS,DIAG,UNI/ BILATERAL",484.0,314.6,1.1,623.0,53
CDM,31237AK,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,1144.0,743.6,1.1,2897.66,53
CDM,31238AK,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,1206.0,783.9,1.1,2897.66,53
CDM,31239AK,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,3978.0,2585.7,1.1,6393.86,50
CDM,31240AK,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,1148.0,746.2,1.1,2897.66,50
CDM,31241AK,NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY,3520.0,2288.0,1.1,3520.0,50
CDM,31242AK,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,1188.0,772.2,1.1,9999.36,52
CDM,31243AK,NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV,1188.0,772.2,1.1,9999.36,52
CDM,31253AK,NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL,3960.0,2574.0,1.1,11685.63,50
CDM,31254AK,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,1879.0,1221.35,1.1,11685.63,53
CDM,31255AK,NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY,2530.0,1644.5,1.1,11685.63,50
CDM,31256AK,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,1368.0,889.2,1.1,6393.86,50
CDM,31257AK,NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY,3520.0,2288.0,1.1,11685.63,50
CDM,31259AK,NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL,3731.0,2425.15,1.1,11685.63,50
CDM,31267AK,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,2059.0,1338.35,1.1,11685.63,50
CDM,31276AK,NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS,2970.0,1930.5,1.1,11685.63,50
CDM,31287AK,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,1540.0,1001.0,1.1,11685.63,50
CDM,31288AK,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,1640.0,1066.0,1.1,11685.63,50
CDM,31291AK,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,7824.0,5085.6,1.1,7824.0,50
CDM,31295AK,NSL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,1080.0,702.0,1.1,11685.63,53
CDM,31296AK,NSL/SINUS NDSC SURG W/DILAT FRONTAL SINUS,1364.0,886.6,1.1,11685.63,53
CDM,31297AK,NSL/SINUS NDSC SURG W/DILAT SPHENOID SINUS,976.0,634.4,1.1,11685.63,53
CDM,31298AK,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,1800.0,1170.0,1.1,11685.63,53
CDM,31299RVU4AK,MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION (COMP 31225),9613.0,6248.45,0.01,9613.0,28
CDM,31300AK,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,6364.0,4136.6,1.1,6364.0,50
CDM,31500AK,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1200.0,780.0,1.1,1200.0,50
CDM,31502AK,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,260.0,169.0,1.1,417.54,50
CDM,31505AK,"LARYNGOSCOPY,INDIRECT,DIAGNOSTIC",244.0,158.6,1.1,338.69,53
CDM,31520AK,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,1024.0,665.6,1.1,1024.0,50
CDM,31525AK,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,1052.0,683.8,1.1,2897.66,53
CDM,31526AK,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,1028.0,668.2,1.1,2897.66,50
CDM,31530AK,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,1352.0,878.8,1.1,2897.66,50
CDM,31531AK,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,1432.0,930.8,1.1,6393.86,50
CDM,31535AK,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,1264.0,821.6,1.1,6393.86,50
CDM,31536AK,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,1420.0,923.0,1.1,6393.86,50
CDM,31541AK,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,1808.0,1175.2,1.1,6393.86,50
CDM,31552AK,LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >,8200.0,5330.0,1.1,9999.36,50
CDM,31560AK,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,2398.0,1558.7,1.1,11685.63,50
CDM,31573AK,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,972.0,631.8,1.1,2897.66,53
CDM,31574AK,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,972.0,631.8,1.1,3098.02,53
CDM,31575AK,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,414.0,269.1,1.1,428.61,53
CDM,31579AK,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,827.0,537.55,1.1,827.0,53
CDM,31579AK-52,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,827.0,537.55,1.1,827.0,22
CDM,31591AK,LARYNGOPLASTY MEDIALIZATION UNLIATERAL,5424.0,3525.6,1.1,9999.36,50
CDM,31599RVU15AK,UNLISTED ENDOSCOPIC LARYNGOPLASTY WITH PLACEMENT OF POSTERIOR CR,7741.0,5031.65,0.01,7741.0,28
CDM,31600AK,"TRACHEOSTOMY, PLANNED",2446.0,1589.9,1.1,5497.86,50
CDM,31600URVUAK,INCISION OF WINDPIPE,823.0,534.95,1.1,5497.86,50
CDM,31603AK,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,2400.0,1560.0,1.1,2603.78,50
CDM,31605AK,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,2580.0,1677.0,1.1,2580.0,50
CDM,31610AK,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,4800.0,3120.0,1.1,9999.36,50
CDM,31613AK,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,1884.0,1224.6,1.1,5497.86,50
CDM,31615AK,TRACHEOBRNCHSC THRU EST TRACHS INC,810.0,526.5,1.1,939.01,53
CDM,31622AK,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,1113.0,723.45,1.1,2897.66,53
CDM,31623AK,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,1157.0,752.05,1.1,2897.66,53
CDM,31624AK,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,1157.0,752.05,1.1,2897.66,53
CDM,31625AK,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,1368.0,889.2,1.1,2897.66,53
CDM,31627AK,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,800.0,520.0,1.1,3502.07,53
CDM,31628AK,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,1562.0,1015.3,1.1,6393.86,53
CDM,31629AK,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,1650.0,1072.5,1.1,6393.86,53
CDM,31630AK,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,1524.0,990.6,1.1,6393.86,50
CDM,31631AK,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,1744.0,1133.6,1.1,11685.63,50
CDM,31632AK,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,412.0,267.8,1.1,412.0,53
CDM,31633AK,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,528.0,343.2,1.1,528.0,53
CDM,31635AK,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,1505.0,978.25,1.1,2897.66,53
CDM,31636AK,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,1720.0,1118.0,1.1,11685.63,50
CDM,31637AK,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,632.0,410.8,1.1,632.0,50
CDM,31638AK,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,1952.0,1268.8,1.1,11685.63,50
CDM,31640AK,BRONCHOSCOPY W/EXCISION TUMOR,1972.0,1281.8,1.1,6393.86,50
CDM,31645AK,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,1267.0,823.55,1.1,2897.66,53
CDM,31646AK,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1223.0,794.95,1.1,1223.0,50
CDM,31652AK,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,1962.0,1275.3,1.1,6393.86,53
CDM,31653AK,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,2182.0,1418.3,1.1,6393.86,53
CDM,31725AK,CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX,684.0,444.6,1.1,684.0,50
CDM,31730AK,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,1140.0,741.0,1.1,3480.34,53
CDM,31785AK,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,6607.0,4294.55,1.1,9999.36,50
CDM,31800AK,SUTURE TRACHEAL WOUND/INJURY CERVICAL,3272.0,2126.8,1.1,3272.0,50
CDM,31825AK,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,2828.0,1838.2,1.1,5497.86,53
CDM,31830AK,REVISE TRACHEOSTOMY SCAR,1848.0,1201.2,1.1,5497.86,53
CDM,31899AGRVUAK,"UNLIST PROC, TRACHEA, BRONCHI COMPARED TO 31613",1554.0,1010.1,0.01,1554.0,28
CDM,31899RVU2AK,UNLISTED PROC; TRACHEOSTOMY TUBE EXCHANGE FOLLOWING ESTABLISHED,215.0,139.75,0.01,338.69,28
CDM,32000010,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,5451.0,3543.15,0.87,5451.0,61
CDM,32000020,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,0.87,608.0,61
CDM,32000030,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000040,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000075,ORTHOPANTOGRAM,608.0,395.2,0.87,608.0,61
CDM,32000080,RADEX FACIAL BONES < 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000085,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000090,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000095,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000100,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000115,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000120,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000130,RADEX SINUSES PARANASAL <3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000140,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000160,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000170,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000190,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,608.0,395.2,0.87,608.0,61
CDM,32000200,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,608.0,395.2,0.87,608.0,61
CDM,32000215,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32000225,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,10719.0,6967.35,0.87,10719.0,61
CDM,32000250,RADEX RIBS UNILATERAL 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000260,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000270,RADEX RIBS BILATERAL 3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000280,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000290,RADEX STERNUM MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000300,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000320,RADEX SPINE 1 VIEW SPECIFY LEVEL,608.0,395.2,0.87,608.0,61
CDM,32000330,RADEX SPINE CERVICAL 2 OR 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000340,RADEX SPINE CERVICAL 4 OR 5 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000350,RADEX SPINE CERVICAL 6 OR MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000370,RADEX SPINE THORACIC 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000380,RADEX SPINE THORACIC 3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000385,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,734.0,477.1,0.87,734.0,61
CDM,32000390,RADEX SPINE THORACIC MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000400,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000420,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000430,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000440,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,734.0,477.1,0.87,734.0,61
CDM,32000450,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000455,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,0.87,266.0,46
CDM,32000460,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000470,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000480,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000490,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000500,MYELOGRAPHY CERVICAL RS&I,5451.0,3543.15,0.87,5451.0,61
CDM,32000510,MYELOGRAPHY THORACIC RS&I,5451.0,3543.15,0.87,5451.0,61
CDM,32000530,MYELOGRAPY LUMBOSACRAL RS&I,5451.0,3543.15,0.87,5451.0,61
CDM,32000535,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000550,MYELOGRAPY 2/MORE REGIONS RS&I,5451.0,3543.15,0.87,5451.0,61
CDM,32000570,DISKOGRAPY CERVICAL/THORACIC RS&I,13474.0,8758.1,0.87,13474.0,61
CDM,32000575,DXA BONE DENSITY STUDY AXIAL SKELETON,734.0,477.1,0.87,734.0,53
CDM,32000590,DISKOGRAPY LUMBAR RS&I,13474.0,8758.1,0.87,13474.0,61
CDM,32000600,RADEX CLAVICLE COMPLETE,608.0,395.2,0.87,608.0,61
CDM,32000610,RADEX SCAPULA COMPLETE,734.0,477.1,0.87,734.0,61
CDM,32000620,RADEX SHOULDER 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32000630,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000640,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,608.0,395.2,0.87,608.0,61
CDM,32000650,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000660,RADEX ELBOW 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000665,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,0.87,608.0,61
CDM,32000670,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000675,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,0.87,734.0,61
CDM,32000680,RADEX FOREARM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000685,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,734.0,477.1,0.87,734.0,61
CDM,32000690,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000695,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,734.0,477.1,0.87,734.0,61
CDM,32000700,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000710,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000715,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32000720,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000725,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000730,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000735,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000755,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000765,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000775,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32000785,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000790,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000800,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000810,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32000820,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,608.0,395.2,0.87,608.0,61
CDM,32000830,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000840,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000850,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000860,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000870,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000880,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000890,RADEX TOE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32000920,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,734.0,477.1,0.87,734.0,61
CDM,32000930,PERITONEOGRAM RS&I,3783.0,2458.95,0.87,3783.0,61
CDM,32000940,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32000950,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32000960,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32001010,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32001020,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32001030,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32001040,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32001050,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1101.0,715.65,0.87,1101.0,46
CDM,32001060,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,214.0,139.1,0.87,214.0,46
CDM,32001110,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,927.0,602.55,0.87,927.0,46
CDM,32001120,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,632.0,410.8,0.87,632.0,46
CDM,32001140,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,894.0,581.1,0.87,894.0,46
CDM,32001160,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1228.0,798.2,0.87,1228.0,61
CDM,32001170,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1228.0,798.2,0.87,1228.0,61
CDM,32001180,UROGRAPHY RETROGRADE WITH/WO KUB,2464.0,1601.6,0.87,2464.0,61
CDM,32001190,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2464.0,1601.6,0.87,2464.0,61
CDM,32001200,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32001210,URETHROCYSTOGRAPHY RETROGRADE RS&I,1668.0,1084.2,0.87,1668.0,61
CDM,32001220,URETHROCYSTOGRAPHY VOIDING RS&I,1668.0,1084.2,0.87,1668.0,61
CDM,32001270,DILATION URETERS/URETHRA RS&I,14135.0,9187.75,0.87,14135.0,61
CDM,32001280,HYSTEROSALPINGOGRAPHY RS&I,1668.0,1084.2,0.87,1668.0,61
CDM,32001320,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,0.87,37299.0,61
CDM,32001330,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001350,SPLENOPORTOGRAPY RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001360,VENOGRAPHY EXTREMITY UNILATERAL RS&I,10719.0,6967.35,0.87,10719.0,61
CDM,32001390,VENOGRAPHY EXTREMITY BILATERAL RS&I,10719.0,6967.35,0.87,10719.0,61
CDM,32001420,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001450,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001460,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001470,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001490,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001510,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001540,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001550,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,21718.0,14116.7,0.87,21718.0,61
CDM,32001560,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001570,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32001580,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,37299.0,24244.35,0.87,37299.0,61
CDM,32001590,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,0.87,3113.0,46
CDM,32001620,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,720.0,468.0,0.87,720.0,46
CDM,32001630,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,419.0,272.35,0.87,419.0,46
CDM,32001800,TRANSCATHETER BIOPSY RS&I,3670.0,2385.5,0.87,3670.0,46
CDM,32001850,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1051.0,683.15,0.87,1051.0,46
CDM,32001860,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,0.87,2127.0,46
CDM,32001910,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1668.0,1084.2,0.87,1668.0,61
CDM,32001950,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,608.0,395.2,0.87,608.0,61
CDM,32001960,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3783.0,2458.95,0.87,3783.0,61
CDM,32001980,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3783.0,2458.95,0.87,3783.0,61
CDM,32002030,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,823.0,534.95,0.87,823.0,46
CDM,32002050,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,838.0,544.7,0.87,838.0,46
CDM,32002070,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,996.0,647.4,0.87,996.0,46
CDM,32002110,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,1668.0,1084.2,0.87,1668.0,61
CDM,32002120,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,1668.0,1084.2,0.87,1668.0,61
CDM,32002140,BONE AGE STUDIES,734.0,477.1,0.87,734.0,61
CDM,32002150,BONE LENGTH STUDIES,734.0,477.1,0.87,734.0,61
CDM,32002160,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,734.0,477.1,0.87,734.0,61
CDM,32002170,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,734.0,477.1,0.87,734.0,61
CDM,32002180,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,734.0,477.1,0.87,734.0,61
CDM,32002190,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,734.0,477.1,0.87,734.0,53
CDM,32002210,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,0.87,2127.0,46
CDM,32002240,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,608.0,395.2,0.87,608.0,53
CDM,32002260,XR DEXA WHOLE BODY COMPOSITION,734.0,477.1,0.87,734.0,61
CDM,32002270,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32002300,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,608.0,395.2,0.87,608.0,53
CDM,32002370,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32002420,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32002430,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32002440,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32002525,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.87,863.0,46
CDM,32002545,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,0.87,436.0,46
CDM,32002705,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,757.0,492.05,0.87,757.0,46
CDM,32002715,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,11180.0,7267.0,280.55,11180.0,61
CDM,32002725,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,2550.0,1657.5,140.47,3004.0,46
CDM,32002735,BRONCHOGRAPHY,398.0,258.7,0.87,409.57,61
CDM,32002745,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1228.0,798.2,0.87,1228.0,61
CDM,32002755,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,0.87,436.0,46
CDM,32002775,BRONCHOGRAPHY,1162.0,755.3,0.87,1162.0,61
CDM,32002785,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,2037.0,1324.05,0.01,3004.0,61
CDM,32002815,RADEX ELBOW 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002825,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002835,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32002845,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002855,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002865,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002875,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002885,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002895,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002905,RADEX FOREARM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002915,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32002925,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002935,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32002945,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002955,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002965,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002975,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32002985,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32002995,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003005,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003015,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003025,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003035,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003045,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003055,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003065,RADEX ELBOW 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003075,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003085,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003095,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003105,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003115,RADEX FOREARM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003125,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003135,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003145,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003155,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003165,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003175,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003185,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003195,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003205,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003215,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003225,RADEX CLAVICLE COMPLETE,608.0,395.2,0.87,608.0,61
CDM,32003235,RADEX SCAPULA COMPLETE,734.0,477.1,0.87,734.0,61
CDM,32003245,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,0.87,608.0,61
CDM,32003255,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003265,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003275,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003285,RADEX ELBOW 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003295,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003305,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003315,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003325,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003335,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003345,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003355,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003365,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003375,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003385,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003395,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003405,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003415,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003425,RADEX CLAVICLE COMPLETE,608.0,395.2,0.87,608.0,61
CDM,32003435,RADEX SCAPULA COMPLETE,734.0,477.1,0.87,734.0,61
CDM,32003445,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003455,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003465,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003475,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003485,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003495,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003505,RADEX FOREARM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003515,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003525,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003535,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003545,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003555,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003565,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003575,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003585,RADEX CLAVICLE COMPLETE,608.0,395.2,0.87,608.0,61
CDM,32003595,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003605,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003615,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003625,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003635,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003645,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003655,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003665,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003675,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003685,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003695,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003705,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003715,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003725,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003735,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003745,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003755,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003765,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003775,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003785,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003795,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003805,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003815,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,0.87,608.0,61
CDM,32003825,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003835,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003845,RADEX ELBOW 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003855,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003865,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003875,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003885,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003895,RADEX FOREARM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003905,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003915,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003925,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003935,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003945,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32003955,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003965,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003975,RADEX SHOULDER 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32003985,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32003995,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004005,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004015,RADEX CLAVICLE COMPLETE,608.0,395.2,0.87,608.0,61
CDM,32004025,RADEX SCAPULA COMPLETE,734.0,477.1,0.87,734.0,61
CDM,32004035,RADEX SCAPULA COMPLETE,734.0,477.1,0.87,734.0,61
CDM,32004045,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004055,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004065,RADEX HAND 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32004075,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004085,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004095,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004105,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004115,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,734.0,61
CDM,32004125,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004135,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004145,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004155,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004455,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004465,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32004625,RADIOLOGIC EXAM ABDOMEN 1 VIEW,608.0,395.2,0.87,608.0,61
CDM,32004635,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32004645,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,734.0,477.1,0.87,734.0,61
CDM,32004895,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1228.0,798.2,0.87,1228.0,61
CDM,32004905,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,795.0,516.75,0.87,795.0,46
CDM,32004925,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,10719.0,6967.35,0.87,10719.0,61
CDM,32004955,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,309.0,200.85,0.87,309.0,38
CDM,32004975,TBS TECHNICAL CALCULATION ONLY,608.0,395.2,0.87,608.0,53
CDM,32005005,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILAT RS&I,4266.0,2772.9,0.87,4266.0,61
CDM,32005085,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,425.0,276.25,77.56,530.3,61
CDM,32005115,CT ABDOMEN W/O SCREENING,734.0,477.1,0.87,734.0,61
CDM,32005125,3D RENDERING LIVER (DONOR) S&I,1436.0,933.4,0.87,1436.0,61
CDM,32005135,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE,2773.0,1802.45,0.87,2773.0,61
CDM,32005145,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP",21718.0,14116.7,0.87,21718.0,61
CDM,32005155,UNLISTED DXA BODY COMPOSITION STUDY,734.0,477.1,0.87,734.0,61
CDM,32005165,LYMPHANGIOGRAPHY OF FACE & NECK,10719.0,6967.35,0.87,10719.0,61
CDM,32005175,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),19680.0,12792.0,0.87,19680.0,61
CDM,32005185,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),3872.0,2516.8,0.87,3872.0,61
CDM,32005195,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),33929.0,22053.85,0.87,33929.0,61
CDM,32005205,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),33929.0,22053.85,0.87,33929.0,61
CDM,32005215,VENOGRAM AZYGOS VEIN (COMP COMP CODE 75705),33929.0,22053.85,0.87,33929.0,61
CDM,32005225,VENOGRAM GASTRIC VEIN (COMP CODE 75891),19680.0,12792.0,0.87,19680.0,61
CDM,32005235,VENOGRAM GONADAL VEIN (COMP CODE 75831),19680.0,12792.0,0.87,19680.0,61
CDM,32005245,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),19680.0,12792.0,0.87,19680.0,61
CDM,32005255,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),21718.0,14116.7,0.87,21718.0,61
CDM,32005265,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),21718.0,14116.7,0.87,21718.0,61
CDM,32005275,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,0.87,37299.0,61
CDM,32005285,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",21718.0,14116.7,0.87,21718.0,61
CDM,32005295,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),21718.0,14116.7,0.87,21718.0,61
CDM,32005305,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),37299.0,24244.35,0.87,37299.0,61
CDM,32005315,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,0.87,37299.0,61
CDM,32005325,VENOGRAM SPLENIC VEIN (COMP CODE 75891),21718.0,14116.7,0.87,21718.0,61
CDM,32005335,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),37299.0,24244.35,0.87,37299.0,61
CDM,32005345,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4182.0,2718.3,0.87,4182.0,61
CDM,32005355,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),21718.0,14116.7,0.87,21718.0,61
CDM,32005365,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),10719.0,6967.35,0.87,10719.0,61
CDM,32005375,VENOGRAM CARDINAL VARIX (COMP CODE 75891),21718.0,14116.7,0.87,21718.0,61
CDM,32005385,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3783.0,2458.95,0.87,3783.0,61
CDM,32005395,COR ANGIO W/ FLOW RESRV,27869.0,18114.85,1546.13,27869.0,46
CDM,32035AK,"THORACOSTOMY,RIB RESECT,EMPYEMA",4516.0,2935.4,1.1,4516.0,50
CDM,32036AK,"THORACOSTOMY,OPEN DRAIN/EMPYEMA",4920.0,3198.0,1.1,4920.0,50
CDM,32096AK,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,5500.0,3575.0,1.1,5500.0,50
CDM,32097AK,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,5500.0,3575.0,1.1,5500.0,50
CDM,32098AK,THORACOTOMY W/BIOPSY OF PLEURA,5164.0,3356.6,1.1,5164.0,50
CDM,32100AK,THORACOTOMY WITH EXPLORATION,5500.0,3575.0,1.1,5500.0,50
CDM,32110AK,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10112.0,6572.8,1.1,10112.0,50
CDM,32120AK,"THORACOTOMY,POSTOP COMPLICATNS",5756.0,3741.4,1.1,5756.0,50
CDM,32124AK,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,6180.0,4017.0,1.1,6180.0,50
CDM,32140AK,"THORACOTOMY,CYST REMOVAL",6664.0,4331.6,1.1,6664.0,50
CDM,32141AK,THORACOTOMY W/RESECTION BULLAE,10872.0,7066.8,1.1,10872.0,50
CDM,32160AK,THORACOTOMY W/CARDIAC MASSAGE,5240.0,3406.0,1.1,5240.0,50
CDM,32200010,RADEX SHOULDER ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32200015,RADEX ELBOW ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32200020,RADEX ELBOW ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32200025,RADEX WRIST ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32200035,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32200040,RADEX HIP ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
CDM,32220AK,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,10660.0,6929.0,1.1,10660.0,50
CDM,32225AK,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,6700.0,4355.0,1.1,6700.0,50
CDM,32300020,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37299.0,24244.35,0.87,37299.0,61
CDM,32300025,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300030,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300050,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300200,ANGIOGRAPHY SPINAL SELECTIVE RS&I,37299.0,24244.35,0.87,37299.0,61
CDM,32300210,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300230,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300320,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,0.87,37299.0,61
CDM,32300330,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300340,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300350,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,21718.0,14116.7,0.87,21718.0,61
CDM,32300370,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4182.0,2718.3,0.87,4182.0,46
CDM,32300400,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,0.87,21718.0,61
CDM,32300445,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,0.87,3113.0,46
CDM,32300475,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,18098.0,11763.7,584.96,18098.0,61
CDM,32300495,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,18098.0,11763.7,426.06,18098.0,61
CDM,32300515,"SIM ANGRM W/ PRSR-GEN CATH (ONE-WAY VALVE, INTERMIT OCCLUDING) I",30915.0,20094.75,2003.13,32356.61,55
CDM,32310AK,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,6112.0,3972.8,1.1,6112.0,50
CDM,32320AK,DECORTICATION & PARIETAL PLEURECTOMY,10900.0,7085.0,1.1,10900.0,50
CDM,32400080,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,0.87,608.0,61
CDM,32400090,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32400105,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,0.87,608.0,61
CDM,32400115,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32400125,RADIOLOGIC EXAM CHEST 3 VIEWS,608.0,395.2,0.87,608.0,61
CDM,32400130,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,0.87,734.0,61
CDM,32400135,RADIOLOGIC EXAM CHEST 4+ VIEWS,734.0,477.1,0.87,734.0,61
CDM,32400185,"X-RAY, CHEST, 2 VIEWS",105.0,68.25,15.62,105.0,38
CDM,32400AK,BIOPSY PLEURA PERCUTANEOUS NEEDLE,704.0,457.6,1.1,2768.64,53
CDM,32408AK,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,1399.0,909.35,1.1,2806.95,52
CDM,32440AK,REMOVAL OF LUNG PNEUMONECTOMY,10912.0,7092.8,1.1,10912.0,50
CDM,32480AK,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,10328.0,6713.2,1.1,10328.0,50
CDM,32482AK,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,10976.0,7134.4,1.1,10976.0,50
CDM,32484AK,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,10152.0,6598.8,1.1,10152.0,50
CDM,32486AK,RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY,17152.0,11148.8,1.1,17152.0,50
CDM,32501AK,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,1872.0,1216.8,1.1,1872.0,50
CDM,32505AK,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,6300.0,4095.0,1.1,6300.0,50
CDM,32506AK,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,1.1,1200.0,50
CDM,32550AK,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,1568.0,1019.2,1.1,5906.43,53
CDM,32551AK,TUBE THORACOSTOMY INCLUDES WATER SEAL,1216.0,790.4,1.1,2734.59,50
CDM,32551URVUAK,INSERTION OF CHEST TUBE,351.0,228.15,1.1,2734.59,50
CDM,32552AK,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,1012.0,657.8,1.1,1073.41,53
CDM,32554AK,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,801.0,520.65,1.1,1073.41,53
CDM,32555AK,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,999.0,649.35,1.1,1073.41,53
CDM,32556AK,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,1100.0,715.0,1.1,3248.9,53
CDM,32557AK,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,1373.0,892.45,1.1,2734.59,53
CDM,32560AK,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,616.0,400.4,1.1,1073.41,53
CDM,32561AK,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,556.0,361.4,1.1,1073.41,53
CDM,32562AK,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,496.0,322.4,1.1,1073.41,53
CDM,32601AK,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,2200.0,1430.0,1.1,9852.42,50
CDM,32606AK,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,3356.0,2181.4,1.1,9852.42,50
CDM,32607AK,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,2200.0,1430.0,1.1,17575.94,50
CDM,32608AK,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,2736.0,1778.4,1.1,17575.94,50
CDM,32609AK,THORACOSCOPY WITH BIOPSYIES OF PLEURA,1832.0,1190.8,1.1,9852.42,50
CDM,32650AK,THORACOSCOPY SURG W PLEURODESIS,4332.0,2815.8,1.1,4332.0,50
CDM,32651AK,THORACOSCOPY SURG PART PULM DECORT,7512.0,4882.8,1.1,7512.0,50
CDM,32652AK,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,11652.0,7573.8,1.1,11652.0,50
CDM,32653AK,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,7268.0,4724.2,1.1,7268.0,50
CDM,32654AK,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,8208.0,5335.2,1.1,8208.0,50
CDM,32655AK,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,6468.0,4204.2,1.1,6468.0,50
CDM,32656AK,THORACOSCOPY SURG PART PLEURECTOMY,5304.0,3447.6,1.1,5304.0,50
CDM,32661AK,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,5332.0,3465.8,1.1,5332.0,50
CDM,32662AK,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,5996.0,3897.4,1.1,5996.0,50
CDM,32663AK,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,9856.0,6406.4,1.1,9856.0,50
CDM,32664AK,THORACOSCOPY W/THORACIC SYMPATHECTOMY,6283.0,4083.95,1.1,6283.0,50
CDM,32666AK,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,5800.0,3770.0,1.1,5800.0,50
CDM,32668AK,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,1200.0,780.0,1.1,1200.0,50
CDM,32669AK,THORACOSCOPY W/SEGMENTECTOMY,9412.0,6117.8,1.1,9412.0,50
CDM,32674AK,THORCOSCPY W/MEDIASTINL &REGIONL LYMPHADENECTOMY,1648.0,1071.2,1.1,1648.0,50
CDM,32815AK,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,20012.0,13007.8,1.1,20012.0,50
CDM,32900015,MEDICAL PHYSICS DOSE EVAL RADIATION EXPOS W/RPRT,3661.0,2379.65,0.87,3661.0,61
CDM,32900AK,RESECTION RIBS EXTRAPLEURAL ALL STAGES,9524.0,6190.6,1.1,9524.0,50
CDM,32994AK,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,3612.0,2347.8,1.1,17575.94,53
CDM,32997AK,TOTAL LUNG LAVAGE (UNILATERAL),2924.0,1900.6,1.1,2924.0,50
CDM,32999AK,UNLISTED PROCEDURE LUNGS & PLEURA,274.0,178.1,0.01,1073.41,28
CDM,32999RVU2AK,UNLISTED PROC; VIDEO ASSISTED THORACIC SURGERY FOR CONTROL OF PE,8342.0,5422.3,0.01,8342.0,28
CDM,32999RVU3AK,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),628.0,408.2,0.01,1073.41,28
CDM,32999RVU4AK,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),1562.0,1015.3,0.01,1562.0,28
CDM,33016AK,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,1760.0,1144.0,1.1,2734.59,50
CDM,33017AK,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,2033.0,1321.45,1.1,2033.0,50
CDM,33018AK,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,2160.0,1404.0,1.1,2160.0,50
CDM,33019AK,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,1888.0,1227.2,1.1,1888.0,50
CDM,33020AK,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,5724.0,3720.6,1.1,5724.0,50
CDM,33025AK,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,5808.0,3775.2,1.1,5808.0,50
CDM,33030AK,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,14400.0,9360.0,1.1,14400.0,50
CDM,33050AK,RESECTION PERICARDIAL CYST/TUMOR,6788.0,4412.2,1.1,6788.0,50
CDM,33100015,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,2289.0,1487.85,36.15,2289.0,61
CDM,33100020,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,2289.0,1487.85,132.83,2289.0,61
CDM,33100025,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,491.0,319.15,36.15,491.0,61
CDM,33100030,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2289.0,1487.85,36.15,2289.0,61
CDM,33100035,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,1454.0,945.1,36.15,1454.0,61
CDM,33100040,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,491.0,319.15,36.15,491.0,61
CDM,33100050,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,36.15,491.0,61
CDM,33100060,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,491.0,319.15,36.15,491.0,61
CDM,33100070,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,2289.0,1487.85,36.15,2289.0,61
CDM,33120AK,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,15380.0,9997.0,1.1,15380.0,50
CDM,33202AK,"INSERT EPICARDIAL ELECTRODE, OPEN",5808.0,3775.2,1.1,5808.0,50
CDM,33206AK,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,3142.0,2042.3,1.1,18231.81,50
CDM,33207AK,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,3120.0,2028.0,1.1,18231.81,50
CDM,33208AK,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,3408.0,2215.2,1.1,18231.81,50
CDM,33210AK,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,1342.0,872.3,1.1,14506.24,50
CDM,33211AK,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,1256.0,816.4,1.1,14506.24,50
CDM,33213AK,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,2112.0,1372.8,1.1,18231.81,50
CDM,33214AK,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,3036.0,1973.4,1.1,18231.81,50
CDM,33215AK,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,1968.0,1279.2,1.1,5442.3,50
CDM,33216AK,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,2248.0,1461.2,1.1,14506.24,50
CDM,33217AK,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,2236.0,1453.4,1.1,14506.24,50
CDM,33218AK,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,2328.0,1513.2,1.1,6705.66,50
CDM,33220AK,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,2360.0,1534.0,1.1,6705.66,50
CDM,33221AK,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,2220.0,1443.0,1.1,33268.48,50
CDM,33222AK,RELOCATION OF SKIN POCKET FOR PACEMAKER,1940.0,1261.0,1.1,3114.5,50
CDM,33223AK,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,2520.0,1638.0,1.1,3114.5,50
CDM,33224AK,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,3616.0,2350.4,1.1,18231.81,50
CDM,33225AK,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,3332.0,2165.8,1.1,3332.0,50
CDM,33226AK,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,3472.0,2256.8,1.1,5442.3,50
CDM,33227AK,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,2100.0,1365.0,1.1,14506.24,50
CDM,33228AK,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,2208.0,1435.2,1.1,18231.81,50
CDM,33229AK,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,2316.0,1505.4,1.1,33268.48,50
CDM,33233AK,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,1256.0,816.4,1.1,14506.24,50
CDM,33234AK,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,3064.0,1991.6,1.1,6705.66,50
CDM,33235AK,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,3960.0,2574.0,1.1,6705.66,50
CDM,33241AK,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,1216.0,790.4,1.1,6705.66,50
CDM,33243AK,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,9428.0,6128.2,1.1,9428.0,50
CDM,33244AK,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,5496.0,3572.4,1.1,6705.66,50
CDM,33249AK,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,6565.0,4267.25,1.1,56172.03,50
CDM,33254AK,ABLATION & RECONSTRUCTION ATRIA LIMITED,9484.0,6164.6,1.1,9484.0,50
CDM,33256AK,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,13960.0,9074.0,1.1,13960.0,50
CDM,33257AK,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,3852.0,2503.8,1.1,3852.0,50
CDM,33259AK,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,5656.0,3676.4,1.1,5656.0,50
CDM,33262AK,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEAD,2324.0,1510.6,1.1,40246.53,50
CDM,33263AK,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEAD,2432.0,1580.8,1.1,40246.53,50
CDM,33264AK,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEAD,2540.0,1651.0,1.1,56172.03,50
CDM,33265AK,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,9484.0,6164.6,1.1,9484.0,50
CDM,33267AK,EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD,7400.0,4810.0,1.1,7400.0,50
CDM,33268AK,EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD,1000.0,650.0,1.1,1000.0,50
CDM,33269AK,EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH,5724.0,3720.6,1.1,5724.0,50
CDM,33270AK,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,4004.0,2602.6,1.1,56172.03,50
CDM,33272AK,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,2385.0,1550.25,1.1,6705.66,50
CDM,33273AK,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,2600.0,1690.0,1.1,6705.66,50
CDM,33274AK,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,3432.0,2230.8,1.1,33268.48,50
CDM,33275AK,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,3436.0,2233.4,1.1,5442.3,50
CDM,33285AK,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,673.0,437.45,1.1,14506.24,53
CDM,33286AK,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,600.0,390.0,1.1,1200.64,53
CDM,33289AK,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,2400.0,1560.0,1.1,49624.06,50
CDM,33300010,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,916.0,595.4,0.87,916.0,61
CDM,33300030,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,0.87,2526.0,61
CDM,33300040,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,9441.0,6136.65,0.87,9441.0,61
CDM,33300050,BASIC RADIATION DOSIMETRY CALCULATION,916.0,595.4,0.87,916.0,61
CDM,33300060,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,9441.0,6136.65,0.87,9441.0,61
CDM,33300085,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,2526.0,1641.9,0.87,2526.0,61
CDM,33300100,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2526.0,1641.9,0.87,2526.0,61
CDM,33300105,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,52747.0,34285.55,0.87,52747.0,61
CDM,33300110,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,916.0,595.4,0.87,916.0,61
CDM,33300120,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,916.0,595.4,0.87,916.0,61
CDM,33300130,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,916.0,595.4,0.87,916.0,61
CDM,33300140,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,2526.0,1641.9,0.87,2526.0,61
CDM,33300150,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,916.0,595.4,0.87,916.0,61
CDM,33300160,SPEC MEDICAL RADJ PHYSICS CONSLTJ,916.0,595.4,0.87,916.0,61
CDM,33300170,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,52747.0,34285.55,0.87,52747.0,61
CDM,33300180,STEREOTACTIC BODY RADIATION DELIVERY,12116.0,7875.4,0.87,12116.0,61
CDM,33300230,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,0.87,3388.0,61
CDM,33300270,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,4855.0,3155.75,0.87,4855.0,61
CDM,33300295,STEREOTACTIC BODY RADIATION DELIVERY,12116.0,7875.4,0.87,12116.0,61
CDM,33300310,THERAPEUTIC RADIOLOGY PORT IMAGES(S),483.0,313.95,0.87,483.0,46
CDM,33300335,RESPIRATORY MOTION MANAGEMENT SIMULATION,2981.0,1937.65,0.87,2981.0,46
CDM,33300345,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,2526.0,1641.9,0.87,2526.0,61
CDM,33300350,SPECIAL TREATMENT PROCEDURE,3991.0,2594.15,0.87,3991.0,61
CDM,33300355,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,2526.0,1641.9,0.87,2526.0,61
CDM,33300365,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,61
CDM,33300375,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,61
CDM,33300385,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,61
CDM,33300390,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,2526.0,1641.9,0.87,2526.0,61
CDM,33300400,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,61
CDM,33300410,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,61
CDM,33300415,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,392.0,254.8,0.87,392.0,46
CDM,33300420,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,61
CDM,33300425,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,0.87,897.0,61
CDM,33300435,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,0.87,3388.0,61
CDM,33300445,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,4787.0,3111.55,0.87,4787.0,61
CDM,33300455,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,4787.0,3111.55,0.87,4787.0,61
CDM,33300470,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,0.87,897.0,61
CDM,33300495,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,2526.0,1641.9,0.87,2526.0,61
CDM,33300505,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,916.0,595.4,0.87,916.0,61
CDM,33300515,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,0.87,2526.0,61
CDM,33300525,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,0.87,2526.0,61
CDM,33300555,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,1815.0,1179.75,0.87,1815.0,61
CDM,33300625,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1135.0,737.75,0.87,1135.0,46
CDM,33300635,"ROM RAD THERAPY ANAL, TC",67428.0,43828.2,10033.29,67428.0,38
CDM,33300645,"ROM RAD THERAPY BLADDER, TC",54154.0,35200.1,8058.12,54154.0,38
CDM,33300655,"ROM RAD THER BONE METS, TC",24248.0,15761.2,3608.1,24248.0,38
CDM,33300665,"ROM RAD THER BRAIN METS, TC",38984.0,25339.6,5800.82,38984.0,38
CDM,33300675,"ROM RAD THERAPY BREAST, TC",39712.0,25812.8,5909.15,39712.0,38
CDM,33300685,"ROM RAD THERAPY CERVICAL, TC",54252.0,35263.8,8072.7,54252.0,38
CDM,33300695,"ROM RAD THERAPY CNS, TC",59412.0,38617.8,8840.51,59412.0,38
CDM,33300705,"ROM RAD THER COLORECTAL, TC",48679.0,31641.35,7243.44,48679.0,38
CDM,33300715,"ROM RAD THER HEAD/NECK, TC",70144.0,45593.6,10437.43,70144.0,38
CDM,33300725,"ROM RAD THERAPY LUNG, TC",48030.0,31219.5,7146.86,48030.0,38
CDM,33300735,"ROM RAD THERAPY LYMPHOMA, TC",31717.0,20616.05,4719.49,31717.0,38
CDM,33300745,"ROM RAD THERAPY PANCREAS, TC",54386.0,35350.9,8092.64,54386.0,38
CDM,33300755,"ROM RAD THERAPY PROSTATE, TC",81221.0,52793.65,12085.68,81221.0,38
CDM,33300765,"ROM RAD THERAPY GI, TC",58634.0,38112.1,8724.74,58634.0,38
CDM,33300775,"ROM RAD THERAPY UTERUS, TC",56879.0,36971.35,8463.6,56879.0,38
CDM,33300AK,REPAIR CARDIAC WOUND W/O BYPASS,17988.0,11692.2,1.1,17988.0,50
CDM,33310AK,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,8136.0,5288.4,1.1,8136.0,50
CDM,33315AK,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,14000.0,9100.0,1.1,14000.0,50
CDM,33320AK,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,7416.0,4820.4,1.1,7416.0,50
CDM,33322AK,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,9768.0,6349.2,1.1,9768.0,50
CDM,33335AK,INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS,13564.0,8816.6,1.1,13564.0,50
CDM,33340AK,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,6160.0,4004.0,1.1,6160.0,50
CDM,33361AK,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,9887.0,6426.55,1.1,9887.0,50
CDM,33362AK,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,9816.0,6380.4,1.1,9816.0,50
CDM,33363AK,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,10188.0,6622.2,1.1,10188.0,50
CDM,33364AK,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,10388.0,6752.2,1.1,10388.0,50
CDM,33365AK,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,10636.0,6913.4,1.1,10636.0,50
CDM,33366AK,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,12914.0,8394.1,1.1,12914.0,50
CDM,33367AK,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,4752.0,3088.8,1.1,4752.0,50
CDM,33368AK,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,5756.0,3741.4,1.1,5756.0,50
CDM,33369AK,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,7600.0,4940.0,1.1,7600.0,50
CDM,33370AK,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,1000.0,650.0,1.1,1000.0,50
CDM,33405AK,RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT,18181.0,11817.65,1.1,18181.0,50
CDM,33411AK,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,24828.0,16138.2,1.1,24828.0,50
CDM,33415AK,RESECTION/INCISION SUBVALVULAR TISSUE,14908.0,9690.2,1.1,14908.0,50
CDM,33416AK,VENTRICULOMYOTOMY-MYECTOMY,14624.0,9505.6,1.1,14624.0,50
CDM,33425AK,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,19984.0,12989.6,1.1,19984.0,50
CDM,33426AK,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,17312.0,11252.8,1.1,17312.0,50
CDM,33427AK,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,17932.0,11655.8,1.1,17932.0,50
CDM,33430AK,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,20372.0,13241.8,1.1,20372.0,50
CDM,33440AK,RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE,25600.0,16640.0,1.1,25600.0,50
CDM,33463AK,VALVULOPLAS TRICUS NO RING INSERT,22832.0,14840.8,1.1,22832.0,50
CDM,33464AK,VALVULOPLAS TRICUS W RING INSERT,17848.0,11601.2,1.1,17848.0,50
CDM,33465AK,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,20288.0,13187.2,1.1,20288.0,50
CDM,33500000,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,220.33,2289.0,61
CDM,33500005,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,2289.0,1487.85,32.9,2289.0,61
CDM,33500010,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,491.0,319.15,46.32,491.0,61
CDM,33500020,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,491.0,319.15,65.76,491.0,61
CDM,33500030,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2289.0,1487.85,222.38,2289.0,61
CDM,33500045,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,2289.0,1487.85,220.33,2289.0,61
CDM,33500055,CONCURRENT CHEMO INFUSION UNLISTED,761.0,494.65,42.63,761.0,61
CDM,33500065,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2289.0,1487.85,226.66,2289.0,61
CDM,33500115,CHEMO EXTEND IV INFUS W/PUMP,2289.0,1487.85,306.47,2289.0,61
CDM,33500195,CHEMOTHERAPY ADMIN INTRA-ARTERIAL  INFUSION TECHNIQUE >8 HR PRTB,2289.0,1487.85,294.34,2289.0,61
CDM,33507AK,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,12560.0,8164.0,1.1,12560.0,50
CDM,33508AK,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,124.0,80.6,1.1,124.0,50
CDM,33509AK,ENDOSCOPIC HARVEST UXTR ARTERY 1 SEGMENT CAB PX,1336.0,868.4,1.1,1336.0,50
CDM,33510AK,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,13992.0,9094.8,1.1,13992.0,50
CDM,33511AK,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,15380.0,9997.0,1.1,15380.0,50
CDM,33512AK,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,17592.0,11434.8,1.1,17592.0,50
CDM,33513AK,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,18148.0,11796.2,1.1,18148.0,50
CDM,33517AK,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,1588.0,1032.2,1.1,1588.0,50
CDM,33518AK,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,3489.0,2267.85,1.1,3489.0,50
CDM,33519AK,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,4616.0,3000.4,1.1,4616.0,50
CDM,33521AK,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,5540.0,3601.0,1.1,5540.0,50
CDM,33522AK,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,6222.0,4044.3,1.1,6222.0,50
CDM,33530AK,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,4052.0,2633.8,1.1,4052.0,50
CDM,33533AK,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,14850.0,9652.5,1.1,14850.0,50
CDM,33534AK,"CABG, ARTERIAL, TWO",17547.0,11405.55,1.1,17547.0,50
CDM,33535AK,"CABG, ARTERIAL, THREE",19690.0,12798.5,1.1,19690.0,50
CDM,33536AK,"CABG, ARTERIAL, FOUR+",21309.0,13850.85,1.1,21309.0,50
CDM,33548AK,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,21656.0,14076.4,1.1,21656.0,50
CDM,33572AK,CORONARY ENDARTERCOMY OPEN ANY METHOD,1776.0,1154.4,1.1,1776.0,50
CDM,33612AK,RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ,14628.0,9508.2,1.1,14628.0,50
CDM,33641AK,REPR ASD W BYPASS,11832.0,7690.8,1.1,11832.0,50
CDM,33745AK,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,8000.0,5200.0,1.1,8000.0,50
CDM,33746AK,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3200.0,2080.0,1.1,3200.0,50
CDM,33840AK,EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS,8536.0,5548.4,1.1,8536.0,50
CDM,33858AK,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,25360.0,16484.0,1.1,25360.0,50
CDM,33859AK,AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ,18052.0,11733.8,1.1,18052.0,50
CDM,33863AK,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,23516.0,15285.4,1.1,23516.0,50
CDM,33864AK,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,24032.0,15620.8,1.1,24032.0,50
CDM,33866AK,AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS,7810.0,5076.5,1.1,7810.0,50
CDM,33871AK,TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA,24352.0,15828.8,1.1,24352.0,50
CDM,33880AK,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,13832.0,8990.8,1.1,13832.0,50
CDM,33881AK,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,11832.0,7690.8,1.1,11832.0,50
CDM,33882AK,EVASC RPR TA DPLMNT BRNCHD NDGFT MULTIPIECE SYS,15400.0,10010.0,1.1,15400.0,35
CDM,33886AK,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,7236.0,4703.4,1.1,7236.0,50
CDM,33894AK,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,8039.0,5225.35,1.1,8039.0,50
CDM,33895AK,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,6398.0,4158.7,1.1,6398.0,50
CDM,33897AK,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,4324.0,2810.6,1.1,4324.0,50
CDM,33900AK,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,4412.0,2867.8,1.1,18783.74,50
CDM,33901AK,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,5800.0,3770.0,1.1,18783.74,50
CDM,33902AK,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,5600.0,3640.0,1.1,29938.94,50
CDM,33903AK,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,6600.0,4290.0,1.1,18783.74,50
CDM,33904AK,PERQ P-ART REVSC ST EA ADDL VSL/SEP LES NM/ABNL,2212.0,1437.8,1.1,2212.0,50
CDM,33927AK,IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY,19600.0,12740.0,1.1,19600.0,50
CDM,33928AK,REMOVAL & RPLCMT TOTAL RPLCMT HEART SYS,20031.0,13020.15,1.1,1791901.44,31
CDM,33929AK,REMOVAL TOTAL RPLCMT HEART SYS FOR HEART TRNSPL,27438.0,17834.7,1.1,1791901.44,31
CDM,33946AK,ECMO/ECLS INITIATION VENO-VENOUS,2640.0,1716.0,1.1,2640.0,50
CDM,33947AK,ECMO/ECLS INITIATION VENO-ARTERIAL,2917.0,1896.05,1.1,2917.0,50
CDM,33948AK,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,2081.0,1352.65,1.1,2081.0,50
CDM,33949AK,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1840.0,1196.0,1.1,1840.0,50
CDM,33952AK,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,3260.0,2119.0,1.1,3260.0,50
CDM,33958AK,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,1404.0,912.6,1.1,1404.0,50
CDM,33966AK,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,1800.0,1170.0,1.1,1800.0,50
CDM,33967AK,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,1936.0,1258.4,1.1,1936.0,50
CDM,33968AK,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,256.0,166.4,1.1,256.0,50
CDM,33970AK,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,2696.0,1752.4,1.1,2696.0,50
CDM,33974AK,RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA,6012.0,3907.8,1.1,6012.0,50
CDM,33990AK,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,2970.0,1930.5,1.1,2970.0,50
CDM,33992AK,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,1420.0,923.0,1.1,1420.0,50
CDM,33993AK,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,1240.0,806.0,1.1,1240.0,50
CDM,33995AK,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,2700.0,1755.0,1.1,2700.0,50
CDM,33997AK,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,1200.0,780.0,1.1,1200.0,50
CDM,33999AGRVU1AK,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33800)",2210.0,1436.5,0.01,2210.0,28
CDM,33999AGRVU2AK,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33320)",3160.0,2054.0,0.01,3160.0,28
CDM,33999AGRVU3AK,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33330)",4250.0,2762.5,0.01,4250.0,28
CDM,33999AGRVUAK,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33310)",2450.0,1592.5,0.01,2450.0,28
CDM,33999AK,UNLISTED CARDIAC SURG PROCEDURE,2776.0,1804.4,0.01,2776.0,28
CDM,33999RVU12AK,EXTRACTION/REMOVAL OF INTRA AORTIC /INTRACARDIAC MASS (COMP CODE,3953.0,2569.45,0.01,3953.0,28
CDM,34000105,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,0.87,9008.0,61
CDM,34000125,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,0.87,1546.0,61
CDM,34100000,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,2773.0,1802.45,0.87,2773.0,61
CDM,34100005,THYROID IMAGING WITH VASCULAR FLOW,2773.0,1802.45,0.87,2773.0,61
CDM,34100025,THYROID CARCINOMA METASTASES UPTAKE,883.0,573.95,0.87,883.0,46
CDM,34100035,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,3714.0,2414.1,0.87,3714.0,61
CDM,34100050,THYROID CARCINOMA METASTASES IMG WHOLE BODY,3714.0,2414.1,0.87,3714.0,61
CDM,34100060,PARATHYROID PLANAR IMAGING,2773.0,1802.45,0.87,2773.0,61
CDM,34100070,ADRENAL IMAGING CORTEX &/MEDULLA,9008.0,5855.2,0.87,9008.0,61
CDM,34100080,BONE MARROW IMAGING LIMITED AREA,2773.0,1802.45,0.87,2773.0,61
CDM,34100100,BONE MARROW IMAGING WHOLE BODY,2773.0,1802.45,0.87,2773.0,61
CDM,34100130,LYMPHATICS & LYMPH NODES IMAGING,3714.0,2414.1,0.87,3714.0,61
CDM,34100170,LIVER & SPLEEN IMAGING STATIC ONLY,2773.0,1802.45,0.87,2773.0,61
CDM,34100220,GASTROESOPHAGEAL REFLUX STUDY,2773.0,1802.45,0.87,2773.0,61
CDM,34100230,GASTRIC EMPTYING IMAGING STUDY,2773.0,1802.45,0.87,2773.0,61
CDM,34100235,BONE &/JOINT IMAGING LIMITED AREA,2773.0,1802.45,0.87,2773.0,61
CDM,34100245,PULMONARY PERFUSION IMAGING PARTICULATE,2773.0,1802.45,0.87,2773.0,61
CDM,34100250,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,2773.0,1802.45,0.87,2773.0,61
CDM,34100255,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,3714.0,2414.1,0.87,3714.0,61
CDM,34100260,INTESTINE IMAGING,2773.0,1802.45,0.87,2773.0,61
CDM,34100270,PERITONEAL-VENOUS SHUNT PATENCY TEST,2773.0,1802.45,0.87,2773.0,61
CDM,34100275,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,2773.0,1802.45,0.87,2773.0,61
CDM,34100290,BONE &/JOINT IMAGING WHOLE BODY,2773.0,1802.45,0.87,2773.0,61
CDM,34100300,BONE &/JOINT IMAGING 3 PHASE STUDY,2773.0,1802.45,0.87,2773.0,61
CDM,34100320,CARDIAC SHUNT DETECTION,2773.0,1802.45,0.87,2773.0,61
CDM,34100340,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,9008.0,5855.2,0.87,9008.0,61
CDM,34100350,MYOCARDIAL SPECT MULTIPLE STUDIES,9008.0,5855.2,0.87,9008.0,61
CDM,34100400,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,2773.0,1802.45,0.87,2773.0,61
CDM,34100410,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,2773.0,1802.45,0.87,2773.0,61
CDM,34100510,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,3714.0,2414.1,0.87,3714.0,61
CDM,34100530,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,3714.0,2414.1,0.87,3714.0,61
CDM,34100540,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,3714.0,2414.1,0.87,3714.0,61
CDM,34100560,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,9008.0,5855.2,0.87,9008.0,61
CDM,34100570,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,3714.0,2414.1,0.87,3714.0,61
CDM,34100580,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,3714.0,2414.1,0.87,3714.0,61
CDM,34100610,TESTICULAR IMAGING WITH VASCULAR FLOW,2773.0,1802.45,0.87,2773.0,61
CDM,34100640,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,2773.0,1802.45,0.87,2773.0,61
CDM,34100660,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9008.0,5855.2,0.87,9008.0,61
CDM,34100670,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,0.87,9008.0,61
CDM,34100680,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,9008.0,5855.2,0.87,9008.0,61
CDM,34100730,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,2773.0,1802.45,0.87,2773.0,61
CDM,34100740,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,3714.0,2414.1,0.87,3714.0,61
CDM,34100750,PULMONARY VENTILATION IMAGING,2773.0,1802.45,0.87,2773.0,61
CDM,34100760,PULMONARY VENTILATION & PERFUSION IMAGING,3714.0,2414.1,0.87,3714.0,61
CDM,34100770,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,2773.0,1802.45,0.87,2773.0,61
CDM,34100780,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2773.0,1802.45,0.87,2773.0,61
CDM,34100790,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,2773.0,1802.45,0.87,2773.0,61
CDM,34100875,BONE &/JOINT IMAGING MULTIPLE AREAS,2773.0,1802.45,0.87,2773.0,61
CDM,34100885,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,1607.0,1044.55,55.22,3004.0,61
CDM,34100895,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10064.0,6541.6,0.87,10064.0,53
CDM,34100905,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10064.0,6541.6,0.87,10064.0,53
CDM,34100915,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,15528.0,10093.2,0.87,15528.0,53
CDM,34100935,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,13458.0,8747.7,0.87,13924.42,53
CDM,34100945,AQMBF PET REST AND PHARMACOLOGIC STRESS,3209.0,2085.85,0.87,3209.0,38
CDM,34100955,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9008.0,5855.2,0.87,9008.0,61
CDM,34100965,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9008.0,5855.2,0.87,9008.0,61
CDM,34100975,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10064.0,6541.6,0.87,10064.0,61
CDM,34100985,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,410.0,266.5,0.87,410.0,46
CDM,34101035,VCAR MUGA GATING IMAGING,1439.0,935.35,54.37,1439.0,61
CDM,34101055,MRI FUSION TO PET (COMP CODE 76376),656.0,426.4,0.87,1909.17,61
CDM,34101AK,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,4372.0,2841.8,1.1,9382.91,50
CDM,34111AK,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,4372.0,2841.8,1.1,9382.91,50
CDM,34151AK,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,10608.0,6895.2,1.1,10608.0,50
CDM,34200010,RP THERAPY ORAL ADMINISTRATION,1546.0,1004.9,0.87,1546.0,61
CDM,34200015,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,0.87,4787.0,61
CDM,34200025,SUPERVISION HANDLING LOADING RADIATION SOURCE,961.0,624.65,0.87,961.0,46
CDM,34200030,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,0.87,1546.0,61
CDM,34200055,INSERTION VAGINAL RADIATION DEVICE,1399.0,909.35,162.64,4001.0,61
CDM,34200060,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,0.87,1546.0,61
CDM,34201AK,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,7792.0,5064.8,1.1,9382.91,50
CDM,34203AK,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,7144.0,4643.6,1.1,9382.91,50
CDM,34300005,TC99M TETROFOSMIN/PER DOSE,62.0,40.3,0.01,339.38,44
CDM,34300020,TC99M SESTAMIBI PER DOSE,66.0,42.9,0.01,968.75,44
CDM,34300030,TC99M MEDRONATE<30MCI,56.0,36.4,0.01,127.26,44
CDM,34300050,TC99 PERTECHNET,34.0,22.1,0.01,119.02,44
CDM,34300060,I-123 SODIUM CAP 200 UCI,210.0,136.5,0.01,239.94,44
CDM,34300070,TC99M EXAMETAZIME<25MCI,3128.0,2033.2,0.01,3128.0,59
CDM,34300075,TC99M PYROPHOSPHATE<25MCI,118.0,76.7,0.01,119.02,44
CDM,34300080,I131 DX CAPSL /MCI,180.0,117.0,0.01,203.07,44
CDM,34300090,TC99M MEBROFENIN<15MCI,62.0,40.3,0.01,243.94,44
CDM,34300100,TC99M PENTETATE<25MCI,240.0,156.0,0.01,240.0,44
CDM,34300110,TC99M MAA<10MCI,1092.0,709.8,0.01,1092.0,44
CDM,34300120,TC99M SULFUR COLLOID =< 20MCI,200.0,130.0,0.01,1615.51,44
CDM,34300140,IN111 OXYQUINOLINE 0.5MCI,5030.0,3269.5,0.01,5030.0,59
CDM,34300150,IN111 DTPA.5MCI,4518.0,2936.7,0.01,4518.0,59
CDM,34300155,IN111 AUTO WBC DIAG/PER DOSE,4928.0,3203.2,0.01,4928.0,59
CDM,34300160,F18 FDG DOSE,250.0,162.5,0.01,897.82,44
CDM,34300180,TC99M BICISATE<25MCI,3766.0,2447.9,0.01,3766.0,59
CDM,34300190,TC99 RBC DOSE,350.0,227.5,0.01,350.0,44
CDM,34300200,TC99M MERTIATIDE<15MCI,568.0,369.2,0.01,1651.69,44
CDM,34300210,IND111 PENTETREOTIDE DOSE,10558.0,6862.7,0.01,10558.0,59
CDM,34300220,I-123 MIBG DOSE UP TO 15MCI,8816.0,5730.4,102.79,8816.0,61
CDM,34300270,TC99M FILTERED SULFR COLLOID,200.0,130.0,0.01,1615.51,44
CDM,34300300,TC99M AERO<75MCI,240.0,156.0,0.01,240.0,44
CDM,34300310,IOFLUPANE I-123 UP TO 5 MCI,4537.0,2949.05,0.01,4537.0,59
CDM,34300340,I-123 CAP PER 1 MCI,210.0,136.5,0.01,331.04,44
CDM,34300350,TC99 TILMANOCEPT DIAG 0.5MCI,1190.0,773.5,0.01,1190.0,44
CDM,34300455,PET SCAN ISOTP UP TO 45MCI,250.0,162.5,0.01,897.82,44
CDM,34300465,"GALLIUM GA 67, PER MCI",2626.0,1706.9,0.01,2626.0,44
CDM,34300475,"IN-111 PENTETATE, PER 0.5 MCI",4518.0,2936.7,0.01,4518.0,59
CDM,34300485,"XENON XE 133, PER 10 MCI",460.0,299.0,0.01,557.75,44
CDM,34300495,NETSPOT (GA-68 DOTATATE),152.0,98.8,0.01,152.0,59
CDM,34300605,"IODINE I-131 SODIUM IODID SOLUTION, DIAG, PER MCI",180.0,117.0,0.01,180.0,44
CDM,34300615,TC99M DISOFENIN UP TO 15MCI,202.0,131.3,0.01,202.0,44
CDM,34300625,HEPTOLITE,825.0,536.25,0.01,825.0,44
CDM,34300665,NON-HEU TC-99M ADD-ON/DOSE,11.0,7.15,3.11,119.02,55
CDM,34300705,"COPPER CU-64, DOTATATE, DIAGNOSTIC, 1 MILLICURIE",2081.0,1352.65,0.01,2081.0,59
CDM,34300735,F-18 PSMA PYLARIFY,745.0,484.25,0.01,1026.51,59
CDM,34300755,GENERIC IOFLUPANE1-123 UP TO 5 MCI,4537.0,2949.05,0.01,4537.0,59
CDM,34300785,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,1534.0,997.1,0.01,1534.0,59
CDM,34300805,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1329.0,863.85,102.79,1988.53,61
CDM,34300815,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,0.01,8400.0,59
CDM,34400010,I131 THERA CAPSL /MCI,180.0,117.0,2.17,310.51,61
CDM,34400040,RADIUM 223 DICHLORIDE PER UCI,338.0,219.7,95.59,5961.96,61
CDM,34400095,"LUTETIUM LU 177 DOTATATE, TX",671.0,436.15,2.17,17165.41,61
CDM,34400115,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",512.0,332.8,144.79,17165.41,61
CDM,34502AK,RECONSTRUCTION VENA CAVA ANY METHOD,11228.0,7298.2,1.1,11228.0,50
CDM,34701AK,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,9484.0,6164.6,1.1,9484.0,50
CDM,34702AK,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,14400.0,9360.0,1.1,14400.0,50
CDM,34703AK,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,10608.0,6895.2,1.1,10608.0,50
CDM,34704AK,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,18000.0,11700.0,1.1,18000.0,50
CDM,34705AK,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,11832.0,7690.8,1.1,11832.0,50
CDM,34706AK,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,18000.0,11700.0,1.1,18000.0,50
CDM,34707AK,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,8912.0,5792.8,1.1,8912.0,50
CDM,34708AK,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,14600.0,9490.0,1.1,14600.0,50
CDM,34709AK,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,2600.0,1690.0,1.1,2600.0,50
CDM,34710AK,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,6000.0,3900.0,1.1,6000.0,50
CDM,34711AK,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,2400.0,1560.0,1.1,2400.0,50
CDM,34712AK,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,4800.0,3120.0,1.1,4800.0,50
CDM,34713AK,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,1000.0,650.0,1.1,1000.0,50
CDM,34714AK,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,2100.0,1365.0,1.1,2100.0,50
CDM,34715AK,OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI,2400.0,1560.0,1.1,2400.0,50
CDM,34716AK,OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ,2876.0,1869.4,1.1,2876.0,50
CDM,34717AK,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,3960.0,2574.0,1.1,3960.0,50
CDM,34718AK,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,10560.0,6864.0,1.1,10560.0,50
CDM,34812AK,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,1652.0,1073.8,1.1,1652.0,50
CDM,34831AK,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,15192.0,9874.8,1.1,15192.0,50
CDM,34833AK,OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP,3264.0,2121.6,1.1,3264.0,50
CDM,34834AK,OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI,1166.0,757.9,1.1,1166.0,50
CDM,34839AK,PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT,3486.0,2265.9,1.1,1791901.44,31
CDM,34846AK,VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS,8117.0,5276.05,1.1,8157.79,38
CDM,35000015,CT HRT W/O DYE W/CA TEST,608.0,395.2,0.87,608.0,61
CDM,35000110,CT GUIDANCE STEREOTACTIC LOCALIZATION,1527.0,992.55,0.87,1527.0,46
CDM,35000115,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,0.87,566.0,46
CDM,35000120,CT GUIDANCE NEEDLE PLACEMENT,2193.0,1425.45,0.87,2193.0,46
CDM,35000125,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1436.0,46
CDM,35000130,CT GUIDANCE &MONITORING VISC TISS ABLATION,2593.0,1685.45,0.87,2593.0,46
CDM,35000165,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,0.87,2127.0,46
CDM,35000185,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35000205,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35000265,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,47892.0,31129.8,773.07,47892.0,61
CDM,35000295,CT CARDIAC SCREENING,150.0,97.5,22.32,150.0,38
CDM,35000315,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,25651.0,16673.15,780.86,29793.81,61
CDM,35000325,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,3237.0,2104.05,162.75,3237.0,61
CDM,35000335,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,7453.0,4844.45,334.5,7453.0,61
CDM,35000365,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,143.14,7453.0,61
CDM,35000375,ABLTJ 1/> LVR TUM PRQ RF,26838.0,17444.7,1265.58,26838.0,61
CDM,35000385,BIOPSY PANCREA PERCUTANEOUS NEEDLE,7453.0,4844.45,366.62,7453.0,61
CDM,35000395,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,180.94,4313.0,61
CDM,35000400,CT LIMITED/LOCALIZED FOLLOW UP STUDY,608.0,395.2,0.87,608.0,61
CDM,35000410,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,2464.0,1601.6,0.87,2464.0,61
CDM,35000420,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,2464.0,1601.6,0.87,2464.0,61
CDM,35000430,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35000440,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35000450,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35000460,CT CERVICAL SPINE W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35000470,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,2464.0,1601.6,0.87,2464.0,61
CDM,35000480,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35000510,CT CALCIUM SCORING,65.0,42.25,0.87,409.57,61
CDM,35000535,CT ANGIOGRAPHY LOWER EXTREMITY,1228.0,798.2,0.87,1228.0,61
CDM,35000565,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35000575,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35000585,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35000595,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,7453.0,4844.45,334.03,7453.0,61
CDM,35000605,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,7453.0,4844.45,353.68,7453.0,61
CDM,35000615,BIOPSY LIVER NEEDLE PERCUTANEOUS,7453.0,4844.45,148.97,7453.0,61
CDM,35000625,RENAL BIOPSY PRQ TROCAR/NEEDLE,7453.0,4844.45,215.08,7453.0,61
CDM,35000655,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,734.0,477.1,0.87,734.0,61
CDM,35000705,LOW DOSE WHOLE BODY CT,10064.0,6541.6,0.87,10064.0,61
CDM,35000785,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7020.0,4563.0,0.87,7020.0,61
CDM,35000815,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6558.0,4262.7,0.87,6558.0,55
CDM,35000825,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,975.0,633.75,145.8,975.0,55
CDM,35001AK,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8324.0,5410.6,1.1,8324.0,50
CDM,35011AK,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,7432.0,4830.8,1.1,9382.91,50
CDM,35021AK,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,8868.0,5764.2,1.1,8868.0,50
CDM,35045AK,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,7204.0,4682.6,1.1,9382.91,50
CDM,35081AK,DIR RPR ANEURYSM ABDOMINAL AORTA,13412.0,8717.8,1.1,13412.0,50
CDM,35082AK,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,16836.0,10943.4,1.1,16836.0,50
CDM,35091AK,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,14140.0,9191.0,1.1,14140.0,50
CDM,35092AK,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,20388.0,13252.2,1.1,20388.0,50
CDM,35100010,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35100020,CT HEAD/BRAIN W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35100030,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35100040,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,734.0,477.1,0.87,734.0,61
CDM,35100050,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1228.0,798.2,0.87,1228.0,61
CDM,35100060,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1228.0,798.2,0.87,1228.0,61
CDM,35100070,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35100080,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35100090,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35100100,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35102AK,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,14612.0,9497.8,1.1,14612.0,50
CDM,35103AK,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,17448.0,11341.2,1.1,17448.0,50
CDM,35111AK,DIR RPR ANEURYSM SPLENIC ARTERY,10512.0,6832.8,1.1,10512.0,50
CDM,35121AK,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,12608.0,8195.2,1.1,12608.0,50
CDM,35131AK,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,10560.0,6864.0,1.1,10560.0,50
CDM,35141AK,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,8364.0,5436.6,1.1,8364.0,50
CDM,35142AK,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,10064.0,6541.6,1.1,10064.0,50
CDM,35151AK,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,9488.0,6167.2,1.1,9488.0,50
CDM,35190AK,RPR/TRAUMATIC AV FISTULA EXTREMITIES,5368.0,3489.2,1.1,9382.91,50
CDM,35200010,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,734.0,477.1,0.87,734.0,61
CDM,35200020,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35200025,CT CERVICAL SPINE W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200030,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1228.0,798.2,0.87,1228.0,61
CDM,35200040,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35200050,CT CERVICAL SPINE W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,35200060,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200070,CT THORACIC SPINE W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200080,CT THORACIC SPINE W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200090,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200100,CT LUMBAR SPINE W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200110,CT LUMBAR SPINE W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,35200120,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200130,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35200140,CT PELVIS W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200150,CT PELVIS W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200160,CT PELVIS W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200170,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200180,CT UPPER EXTREMITY W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,35200190,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200200,CT ANGIOGRAPHY UPPER EXTREMITY,1228.0,798.2,0.87,1228.0,61
CDM,35200210,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200220,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200230,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1228.0,798.2,0.87,1228.0,61
CDM,35200240,CT ANGIOGRAPHY LOWER EXTREMITY,1228.0,798.2,0.87,1228.0,61
CDM,35200250,CT ABDOMEN W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
CDM,35200260,CT ABDOMEN W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200270,CT ABDOMEN W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
CDM,35200280,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,35200290,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1228.0,798.2,0.87,1228.0,61
CDM,35200300,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,35200310,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,35200320,CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE,2464.0,1601.6,0.87,2464.0,61
CDM,35200330,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,2464.0,1601.6,0.87,2464.0,61
CDM,35200345,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,734.0,477.1,0.87,734.0,61
CDM,35200365,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,2459.0,1598.35,0.87,2459.0,55
CDM,35200375,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1228.0,798.2,0.87,1228.0,46
CDM,35200385,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1236.0,803.4,0.87,1236.0,55
CDM,35201AK,REPAIR BLOOD VESSEL DIRECT NECK,6772.0,4401.8,1.1,9382.91,50
CDM,35206AK,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,5536.0,3598.4,1.1,5536.0,50
CDM,35207AK,REPAIR BLOOD VESSEL DIRECT HAND FINGER,4376.0,2844.4,1.1,5442.3,50
CDM,35211AK,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS,9832.0,6390.8,1.1,9832.0,50
CDM,35221AK,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,10648.0,6921.2,1.1,10648.0,50
CDM,35226AK,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,6120.0,3978.0,1.1,6120.0,50
CDM,35236AK,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,7208.0,4685.2,1.1,9382.91,50
CDM,35256AK,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,7624.0,4955.6,1.1,9382.91,50
CDM,35261AK,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,7584.0,4929.6,1.1,7584.0,50
CDM,35281AK,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,12024.0,7815.6,1.1,12024.0,50
CDM,35286AK,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,6876.0,4469.4,1.1,9382.91,50
CDM,35301AK,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,8464.0,5501.6,1.1,8464.0,50
CDM,35302AK,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,8540.0,5551.0,1.1,8540.0,50
CDM,35303AK,TEAEC W/GRAFT POPLITEAL ARTERY,9440.0,6136.0,1.1,9440.0,50
CDM,35351AK,TEAEC W/WO PATCH GRAFT ILIAC,9844.0,6398.6,1.1,9844.0,50
CDM,35355AK,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,7944.0,5163.6,1.1,7944.0,50
CDM,35371AK,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,6124.0,3980.6,1.1,6124.0,50
CDM,35372AK,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,7432.0,4830.8,1.1,7432.0,50
CDM,35390AK,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,1276.0,829.4,1.1,1276.0,50
CDM,35500AK,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,2576.0,1674.4,1.1,2576.0,50
CDM,35522AK,BYPASS W/VEIN AXILLARY-BRACHIAL,9260.0,6019.0,1.1,9260.0,50
CDM,35556AK,BYPASS W/VEIN FEMORAL-POPLITEAL,10700.0,6955.0,1.1,10700.0,50
CDM,35558AK,BYPASS W/VEIN FEMORAL-FEMORAL,9252.0,6013.8,1.1,9252.0,50
CDM,35566AK,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,12940.0,8411.0,1.1,12940.0,50
CDM,35571AK,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,11229.0,7298.85,1.1,11229.0,50
CDM,35583AK,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,11100.0,7215.0,1.1,11100.0,50
CDM,35585AK,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,12940.0,8411.0,1.1,12940.0,50
CDM,35587AK,IN-SITU VEIN BYP POP-TIBL PRONEAL,10484.0,6814.6,1.1,10484.0,50
CDM,35600AK,OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB,1580.0,1027.0,1.1,1580.0,50
CDM,35601AK,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,10836.0,7043.4,1.1,10836.0,50
CDM,35602AK,BPG OTH/THN VEIN CAROTID-CONTRALATERAL CAROTID,10353.0,6729.45,1.1,10353.0,35
CDM,35606AK,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,8984.0,5839.6,1.1,8984.0,50
CDM,35621AK,BYP OTH/THN VEIN AXILLARY-FEMORAL,8412.0,5467.8,1.1,8412.0,50
CDM,35638AK,"BYPASS GRAFT OTHR,AORTOBI-ILIAC",13440.0,8736.0,1.1,13440.0,50
CDM,35646AK,BYP OTH/THN VEIN AORTOBIFEMORAL,13192.0,8574.8,1.1,13192.0,50
CDM,35647AK,BYP OTH/THN VEIN AORTOFEMORAL,11892.0,7729.8,1.1,11892.0,50
CDM,35654AK,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,10512.0,6832.8,1.1,10512.0,50
CDM,35656AK,BYP OTH/THN VEIN FEMORAL-POPLITEAL,8188.0,5322.2,1.1,8188.0,50
CDM,35661AK,BYP OTH/THN VEIN FEMORAL-FEMORAL,8140.0,5291.0,1.1,8140.0,50
CDM,35663AK,BYP OTH/THN VEIN ILIOILIAC,9572.0,6221.8,1.1,9572.0,50
CDM,35665AK,BYP OTH/THN VEIN ILIOFEMORAL,8940.0,5811.0,1.1,8940.0,50
CDM,35666AK,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,9464.0,6151.6,1.1,9464.0,50
CDM,35671AK,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,8308.0,5400.2,1.1,8308.0,50
CDM,35681AK,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,640.0,416.0,1.1,640.0,50
CDM,35682AK,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,2876.0,1869.4,1.1,2876.0,50
CDM,35685AK,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,1616.0,1050.4,1.1,1616.0,50
CDM,35697AK,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,1200.0,780.0,1.1,1200.0,50
CDM,35700AK,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,1232.0,800.8,1.1,1232.0,50
CDM,35701AK,EXPLORATION N/FLWD SURG NECK ARTERY,3300.0,2145.0,1.1,3300.0,50
CDM,35702AK,EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY,2848.0,1851.2,1.1,2848.0,50
CDM,35703AK,EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY,3000.0,1950.0,1.1,3000.0,50
CDM,35800AK,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,4800.0,3120.0,1.1,4800.0,50
CDM,35820AK,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,14756.0,9591.4,1.1,14756.0,50
CDM,35840AK,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,8300.0,5395.0,1.1,8300.0,50
CDM,35860AK,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,6100.0,3965.0,1.1,6100.0,50
CDM,35875AK,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,4288.0,2787.2,1.1,9382.91,50
CDM,35876AK,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,7128.0,4633.2,1.1,9382.91,50
CDM,35881AK,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,7740.0,5031.0,1.1,9382.91,50
CDM,35883AK,REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF,9260.0,6019.0,1.1,9382.91,50
CDM,35900040,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,608.0,395.2,0.87,608.0,61
CDM,35900050,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1436.0,46
CDM,35900060,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,0.87,566.0,46
CDM,35900070,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1436.0,46
CDM,35900330,CT CALCIUM SCORING - SELF PAY,608.0,395.2,0.87,608.0,61
CDM,35903AK,"EXCISION, INFEC GRAFT, EXTREMITY",3812.0,2477.8,1.1,5442.3,50
CDM,35907AK,"EXCISION, INFEC GRAFT, ABDOMEN",14908.0,9690.2,1.1,14908.0,50
CDM,36000015,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,9213.0,5988.45,75.0,9213.0,46
CDM,36000180,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,110.66,8932.0,61
CDM,36000260,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,7638.0,4964.7,283.94,7638.0,46
CDM,36000265,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2111.0,1372.15,232.37,4001.0,61
CDM,36000270,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,283.94,4525.0,46
CDM,36000280,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,4013.0,2608.45,283.94,4013.0,46
CDM,36000285,I&D HEMATOMA SEROMA/FLUID COLLECTION,4861.0,3159.65,194.37,4861.0,61
CDM,36000290,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,848.0,551.2,82.69,4001.0,46
CDM,36000295,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,133.98,3398.0,61
CDM,36000300,INTRODUCTION CATHETER AORTA,3075.0,1998.75,230.67,4001.0,46
CDM,36000305,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1199.0,779.35,101.57,4001.0,61
CDM,36000320,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,5469.0,3554.85,283.94,5469.0,46
CDM,36000340,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,7505.0,4878.25,283.94,7505.0,46
CDM,36000350,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,8125.0,5281.25,283.94,8125.0,46
CDM,36000410,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,144.79,18098.0,61
CDM,36000420,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,990.0,643.5,87.13,4001.0,46
CDM,36000430,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,26152.0,16998.8,543.69,29295.35,61
CDM,36000440,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,26791.0,17414.15,592.27,26791.0,61
CDM,36000450,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,30717.0,19966.05,595.85,30717.0,61
CDM,36000460,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,20926.0,13601.9,639.93,20926.0,61
CDM,36000465,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,7453.0,4844.45,96.66,7453.0,61
CDM,36000475,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,148.97,7453.0,61
CDM,36000480,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,27759.0,18043.35,773.46,29295.35,61
CDM,36000485,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,221.13,7453.0,61
CDM,36000495,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,6814.0,4429.1,149.28,6814.0,61
CDM,36000500,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,20926.0,13601.9,639.93,20926.0,61
CDM,36000510,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,47587.0,30931.55,369.72,47587.0,61
CDM,36000520,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,56044.0,36428.6,1471.35,87978.22,61
CDM,36000535,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,62.0,3398.0,61
CDM,36000540,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,20926.0,13601.9,342.84,20926.0,61
CDM,36000545,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,60.84,3398.0,61
CDM,36000550,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,29510.0,19181.5,831.86,29510.0,61
CDM,36000555,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,62.63,3398.0,61
CDM,36000560,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,25647.0,16670.55,836.97,29295.35,61
CDM,36000565,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,75.85,3398.0,61
CDM,36000575,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1358.0,882.7,69.17,3398.0,61
CDM,36000580,INS PM PLS GEN W/EXIST SINGLE LEAD,22737.0,14779.05,520.99,23194.66,61
CDM,36000600,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,18098.0,11763.7,500.64,18098.0,61
CDM,36000605,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,59187.0,38471.55,620.59,59187.0,61
CDM,36000625,BIOPSY SOFT TISSUE NECK/THORAX,7453.0,4844.45,254.42,7453.0,61
CDM,36000630,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,20926.0,13601.9,639.93,20926.0,61
CDM,36000640,RELOCATION OF SKIN POCKET FOR PACEMAKER,10518.0,6836.7,547.22,10518.0,61
CDM,36000650,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,10518.0,6836.7,639.93,10518.0,61
CDM,36000660,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,16614.0,10799.1,751.82,16614.0,46
CDM,36000670,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,18098.0,11763.7,795.93,18098.0,61
CDM,36000680,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,50000.0,32500.0,580.46,62345.36,61
CDM,36000700,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,20926.0,13601.9,623.67,20926.0,61
CDM,36000730,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,180.64,3398.0,46
CDM,36000740,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,3601.0,2340.65,262.43,3601.0,46
CDM,36000750,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,3904.0,2537.6,283.94,3904.0,46
CDM,36000770,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,265.98,47587.0,61
CDM,36000775,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,761.0,494.65,65.08,3398.0,46
CDM,36000785,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,65.08,3398.0,46
CDM,36000795,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,65.08,3398.0,46
CDM,36000815,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,728.0,473.2,65.08,3398.0,46
CDM,36000830,PERFUSION EA ADD 30 MIN,1134.0,737.1,168.74,1134.0,38
CDM,36000840,SURGERY LEVEL 6 EA ADD 30 MIN,6381.0,4147.65,949.49,6381.0,38
CDM,36000845,INJECTION ANKLE ARTHROGRAPHY,651.0,423.15,65.08,3398.0,46
CDM,36000860,SURGERY LEVEL 2 1ST 30 MIN,4184.0,2719.6,622.58,4184.0,38
CDM,36000870,SURGERY LEVEL 4 1ST 30 MIN,5786.0,3760.9,860.96,5786.0,38
CDM,36000880,SURGERY LEVEL 5 1ST 30 MIN,5971.0,3881.15,888.48,5971.0,38
CDM,36000890,SURGERY LEVEL 6 1ST 30 MIN,6381.0,4147.65,949.49,6381.0,38
CDM,36000900,SURGERY LEVEL 1 EA ADD 30 MIN,3387.0,2201.55,503.99,3387.0,38
CDM,36000910,SURGERY LEVEL 2 EA ADD 30 MIN,3885.0,2525.25,578.09,3885.0,38
CDM,36000920,SURGERY LEVEL 3 EA ADD 30 MIN,4734.0,3077.1,704.42,4734.0,38
CDM,36000930,SURGERY LEVEL 4 EA ADD 30 MIN,5786.0,3760.9,860.96,5786.0,38
CDM,36000985,BIOPSY PLEURA PERCUTANEOUS NEEDLE,7453.0,4844.45,145.1,7453.0,61
CDM,36000990,SURGERY LEVEL 5 EA ADD 30 MIN,5971.0,3881.15,888.48,5971.0,38
CDM,36000AK,INTRODUCTION NEEDLE/INTRACATHETER VEIN,72.0,46.8,1.1,99.38,42
CDM,36001000,PERFUSION INIT HOUR,9861.0,6409.65,1467.32,9861.0,38
CDM,36001025,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,16234.0,10552.1,344.64,16234.0,61
CDM,36001045,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,258.94,3728.0,61
CDM,36001050,SURGERY LEVEL 1 1ST 30 MIN,3394.0,2206.1,505.03,3394.0,38
CDM,36001065,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,188.5,3728.0,61
CDM,36001080,SURGERY LEVEL 3 1ST 30 MIN,4734.0,3077.1,704.42,4734.0,38
CDM,36001085,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,7146.0,4644.9,257.53,7146.0,61
CDM,36001145,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,26893.0,17480.45,732.0,29295.35,61
CDM,36001155,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,27759.0,18043.35,773.46,29295.35,61
CDM,36001165,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,25647.0,16670.55,836.97,29295.35,61
CDM,36001175,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,265.98,47587.0,61
CDM,36001200,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,64.38,3398.0,61
CDM,36001215,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,25785.0,16760.25,771.64,29295.35,61
CDM,36001225,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,18098.0,11763.7,500.64,18098.0,61
CDM,36001235,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,30717.0,19966.05,595.85,30717.0,61
CDM,36001245,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,26791.0,17414.15,592.27,26791.0,61
CDM,36001255,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,20926.0,13601.9,623.67,20926.0,61
CDM,36001260,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,62.63,3398.0,61
CDM,36001265,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,20926.0,13601.9,612.52,20926.0,61
CDM,36001275,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,45037.0,29274.05,573.82,53987.6,61
CDM,36001280,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,65.08,3398.0,46
CDM,36001285,RELOCATION OF SKIN POCKET FOR PACEMAKER,10518.0,6836.7,547.22,10518.0,61
CDM,36001290,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1928.0,1253.2,141.82,3398.0,46
CDM,36001295,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,10518.0,6836.7,639.93,10518.0,61
CDM,36001300,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,221.13,7453.0,61
CDM,36001305,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,29510.0,19181.5,831.86,29510.0,61
CDM,36001310,INJECTION ANKLE ARTHROGRAPHY,651.0,423.15,65.08,3398.0,46
CDM,36001315,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,16614.0,10799.1,751.82,16614.0,46
CDM,36001330,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,65.08,3398.0,46
CDM,36001335,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,21495.0,13971.75,545.02,23194.66,61
CDM,36001340,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,728.0,473.2,65.08,3398.0,46
CDM,36001345,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,26736.0,17378.4,570.43,29295.35,61
CDM,36001355,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,42964.0,27926.6,598.58,53987.6,61
CDM,36001380,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,761.0,494.65,65.08,3398.0,46
CDM,36001385,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,47587.0,30931.55,369.72,47587.0,61
CDM,36001395,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,20926.0,13601.9,639.93,20926.0,61
CDM,36001405,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,20926.0,13601.9,639.93,20926.0,61
CDM,36001410,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,4313.0,2803.45,33.17,9496.0,61
CDM,36001425,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,20926.0,13601.9,342.84,20926.0,61
CDM,36001430,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1119.0,727.35,174.83,3398.0,61
CDM,36001435,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,20926.0,13601.9,639.93,20926.0,61
CDM,36001445,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,56044.0,36428.6,1471.35,87978.22,61
CDM,36001450,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,107.4,4778.0,61
CDM,36001455,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,42062.0,27340.3,598.47,62345.36,61
CDM,36001465,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,40488.0,26317.2,622.46,62345.36,61
CDM,36001475,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,52725.0,34271.25,648.56,87978.22,61
CDM,36001605,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3138.0,2039.7,423.16,18167.0,46
CDM,36001620,BIOPSY LIVER NEEDLE PERCUTANEOUS,7453.0,4844.45,148.97,7453.0,61
CDM,36001625,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,7901.0,5135.65,589.05,62681.75,46
CDM,36001645,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,4456.0,2896.4,307.62,9496.0,46
CDM,36001780,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,14478.0,9410.7,364.46,14478.0,61
CDM,36001825,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,28.36,3398.0,46
CDM,36001845,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2206.0,1433.9,80.02,3398.0,46
CDM,36001855,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,180.64,3398.0,46
CDM,36001865,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,3601.0,2340.65,262.43,3601.0,46
CDM,36001875,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,3904.0,2537.6,283.94,3904.0,46
CDM,36001895,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2775.0,1803.75,255.0,3398.0,46
CDM,36001905,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,3225.0,2096.25,283.94,3398.0,46
CDM,36001925,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,3657.0,2377.05,147.18,3657.0,46
CDM,36001965,INTRODUCTION CATHETER AORTA,3075.0,1998.75,230.67,4001.0,46
CDM,36001970,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,143.14,7453.0,61
CDM,36001975,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,7505.0,4878.25,283.94,7505.0,46
CDM,36001985,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,7638.0,4964.7,283.94,7638.0,46
CDM,36001995,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,8125.0,5281.25,283.94,8125.0,46
CDM,36002005,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,990.0,643.5,87.13,4001.0,46
CDM,36002015,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,18098.0,11763.7,330.09,18098.0,61
CDM,36002025,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,18098.0,11763.7,467.53,18098.0,61
CDM,36002035,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,31083.0,20203.95,535.94,31083.0,61
CDM,36002045,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,31083.0,20203.95,607.24,31083.0,61
CDM,36002055,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,18098.0,11763.7,534.54,18098.0,61
CDM,36002065,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,31083.0,20203.95,601.72,31083.0,61
CDM,36002075,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,6466.0,4202.9,198.4,6466.0,46
CDM,36002085,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,5846.0,3799.9,416.69,5846.0,46
CDM,36002095,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,4013.0,2608.45,283.94,4013.0,46
CDM,36002105,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,283.94,4525.0,46
CDM,36002115,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,5469.0,3554.85,283.94,5469.0,46
CDM,36002125,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,848.0,551.2,82.69,4001.0,46
CDM,36002135,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,18098.0,11763.7,426.06,18098.0,61
CDM,36002145,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,18098.0,11763.7,584.96,18098.0,61
CDM,36002155,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,31083.0,20203.95,603.72,31083.0,61
CDM,36002170,BIOPSY PANCREA PERCUTANEOUS NEEDLE,7453.0,4844.45,366.62,7453.0,61
CDM,36002235,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1367.0,888.55,283.94,3398.0,46
CDM,36002245,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1660.0,1079.0,283.94,3398.0,46
CDM,36002255,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,144.79,18098.0,61
CDM,36002275,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,432.87,18098.0,61
CDM,36002285,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,550.54,18098.0,61
CDM,36002325,INSERTION PICC W/O IMG GDN < 5 YR,8932.0,5805.8,162.54,8932.0,61
CDM,36002335,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,161.15,8932.0,61
CDM,36002345,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,510.64,18098.0,61
CDM,36002360,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,133.98,3398.0,61
CDM,36002375,RPLCMT CATH CTR VAD SUBQ PORT/PMP,18098.0,11763.7,329.35,18098.0,61
CDM,36002385,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,110.66,8932.0,61
CDM,36002395,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,305.63,18098.0,61
CDM,36002405,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,18098.0,11763.7,475.77,18098.0,61
CDM,36002425,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,101.27,8932.0,61
CDM,36002435,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,18098.0,11763.7,491.86,18098.0,61
CDM,36002445,RMVL TUN CVC W/O SUBQ PORT/PMP,3555.0,2310.75,226.01,3728.0,61
CDM,36002455,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,8932.0,5805.8,311.97,8932.0,61
CDM,36002475,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,18098.0,11763.7,307.7,18098.0,61
CDM,36002485,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,8932.0,5805.8,75.32,8932.0,61
CDM,36002495,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,8932.0,5805.8,102.7,8932.0,61
CDM,36002505,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1211.0,787.15,61.33,4001.0,61
CDM,36002510,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,432.87,18098.0,61
CDM,36002515,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,77.44,3398.0,46
CDM,36002550,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,8932.0,5805.8,299.62,8932.0,61
CDM,36002555,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,17131.0,11135.15,1396.93,51380.79,55
CDM,36002565,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,20388.0,13252.2,639.51,20388.0,61
CDM,36002575,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,50428.0,32778.2,716.83,51380.79,61
CDM,36002580,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,305.63,18098.0,61
CDM,36002595,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,7031.0,4570.15,406.05,7753.23,46
CDM,36002605,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,29774.0,19353.1,659.21,32356.61,61
CDM,36002615,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,18098.0,11763.7,469.62,18098.0,61
CDM,36002625,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,18379.0,11946.35,372.93,18379.0,61
CDM,36002640,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,101.27,8932.0,61
CDM,36002645,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,586.31,18098.0,61
CDM,36002655,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,18098.0,11763.7,504.55,18098.0,61
CDM,36002665,TRANSCATHETER BIOPSY,31083.0,20203.95,370.75,31083.0,61
CDM,36002710,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,9423.0,6124.95,130.06,9423.0,61
CDM,36002720,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,28703.0,18656.95,483.49,28703.0,61
CDM,36002730,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,63.11,3398.0,46
CDM,36002740,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,325.0,211.25,65.08,3398.0,46
CDM,36002755,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,31083.0,20203.95,644.49,31083.0,61
CDM,36002765,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,18098.0,11763.7,566.22,18098.0,61
CDM,36002775,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,18098.0,11763.7,388.11,18098.0,61
CDM,36002780,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,16234.0,10552.1,542.3,16234.0,61
CDM,36002785,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,204.69,18098.0,61
CDM,36002795,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,21468.0,13954.2,1596.53,21468.0,46
CDM,36002805,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,19680.0,12792.0,2928.38,19680.0,46
CDM,36002920,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,21468.0,13954.2,1596.53,21468.0,46
CDM,36002930,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,19680.0,12792.0,2928.38,19680.0,46
CDM,36002AK,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,784.0,509.6,1.1,1073.41,53
CDM,36003025,DIAGNOSTIC BONE MARROW BIOPSIES,6481.0,4212.65,118.95,6481.0,61
CDM,36003035,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,6481.0,4212.65,145.98,6481.0,61
CDM,36003045,INJECTION PROCEDURE LYMPHANGIOGRAPHY,3757.0,2442.05,65.08,3757.0,46
CDM,36003070,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,153.2,6143.0,61
CDM,36003080,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,87.87,3398.0,46
CDM,36003110,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1528.0,993.2,65.08,3398.0,46
CDM,36003125,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,68.83,4001.0,61
CDM,36003145,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1119.0,727.35,174.83,3398.0,61
CDM,36003175,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,4313.0,2803.45,33.17,9496.0,61
CDM,36003190,INSERT GASTROSTOMY TUBE PERCUTANEOUS,8726.0,5671.9,237.67,8726.0,61
CDM,36003200,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,155.14,4778.0,61
CDM,36003205,BIOPSY LIVER NEEDLE PERCUTANEOUS,7453.0,4844.45,148.97,7453.0,61
CDM,36003235,ABLTJ 1/> LVR TUM PRQ RF,26838.0,17444.7,1265.58,26838.0,61
CDM,36003255,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,16234.0,10552.1,542.3,16234.0,61
CDM,36003345,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,16234.0,10552.1,581.07,18145.13,61
CDM,36003355,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,47892.0,31129.8,657.91,47892.0,61
CDM,36003390,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,5539.0,3600.35,271.77,5539.0,46
CDM,36003395,BIOPSY PANCREA PERCUTANEOUS NEEDLE,7453.0,4844.45,366.62,7453.0,61
CDM,36003445,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,180.94,4831.0,61
CDM,36003465,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,143.14,7453.0,61
CDM,36003470,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,4313.0,2803.45,85.55,4831.0,61
CDM,36003485,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,325.0,211.25,65.08,3398.0,46
CDM,36003490,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,68.83,4001.0,61
CDM,36003495,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,16234.0,10552.1,342.36,16234.0,61
CDM,36003500,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,8726.0,5671.9,237.67,8726.0,61
CDM,36003515,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,14478.0,9410.7,364.46,14478.0,61
CDM,36003525,EXCHNG ABSC/CST DRG CATH RAD GID SPX,8726.0,5671.9,120.96,8726.0,61
CDM,36003535,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,661.0,429.65,63.84,3398.0,46
CDM,36003540,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,113.0,4831.0,61
CDM,36003545,INSERT GASTROSTOMY TUBE PERCUTANEOUS,8726.0,5671.9,237.67,8726.0,61
CDM,36003550,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,152.06,4831.0,61
CDM,36003555,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,8726.0,5671.9,237.67,8726.0,61
CDM,36003560,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,234.85,4831.0,61
CDM,36003565,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,5424.0,3525.6,350.56,5424.0,61
CDM,36003575,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,8726.0,5671.9,237.67,8726.0,61
CDM,36003585,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,113.0,4831.0,61
CDM,36003605,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,152.06,4831.0,61
CDM,36003610,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,88.78,3398.0,46
CDM,36003615,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,234.85,4831.0,61
CDM,36003625,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,4313.0,2803.45,85.55,4831.0,61
CDM,36003665,RENAL BIOPSY PRQ TROCAR/NEEDLE,7453.0,4844.45,215.08,7453.0,61
CDM,36003675,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,9423.0,6124.95,432.28,9423.0,61
CDM,36003685,REMOVAL INDWELLING URETERAL STENT PRQ,9423.0,6124.95,390.71,9423.0,61
CDM,36003710,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,4855.0,3155.75,264.78,4855.0,61
CDM,36003715,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,9423.0,6124.95,143.29,9423.0,61
CDM,36003725,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3070.0,1995.5,91.89,3728.0,61
CDM,36003735,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,3237.0,2104.05,162.75,3728.0,61
CDM,36003770,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,9423.0,6124.95,432.28,9423.0,61
CDM,36003780,REMOVAL INDWELLING URETERAL STENT PRQ,9423.0,6124.95,390.71,9423.0,61
CDM,36003800,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,9423.0,6124.95,143.29,9423.0,61
CDM,36003825,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,9423.0,6124.95,130.06,9423.0,61
CDM,36003855,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,241.84,9423.0,61
CDM,36003865,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1048.0,681.2,65.08,9496.0,46
CDM,36003875,NJX RETROGRADE URETHROCSTOGRAPY,1335.0,867.75,65.08,9496.0,46
CDM,36003895,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,39.43,3398.0,61
CDM,36004005,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,831.0,540.15,65.08,3398.0,46
CDM,36004040,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,999.0,649.35,65.08,3398.0,46
CDM,36004240,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1165.0,757.25,251.89,3398.0,46
CDM,36004255,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,49016.0,31860.4,952.29,49016.0,61
CDM,36004265,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,13704.0,8907.6,1934.5,51380.79,55
CDM,36004270,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1367.0,888.55,283.94,3398.0,46
CDM,36004275,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,52240.0,33956.0,1496.86,52240.0,61
CDM,36004285,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,26324.0,17110.6,2229.71,26324.0,46
CDM,36004295,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,37892.0,24629.8,2442.72,37892.0,46
CDM,36004305,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,26324.0,17110.6,3917.01,26324.0,46
CDM,36004310,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3070.0,1995.5,91.89,3728.0,61
CDM,36004325,PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER,17075.0,11098.75,2540.76,17075.0,46
CDM,36004345,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,4855.0,3155.75,264.78,4855.0,61
CDM,36004355,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,107.4,4778.0,61
CDM,36004365,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,155.14,4778.0,61
CDM,36004375,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,194.79,4778.0,61
CDM,36004395,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1579.0,1026.35,65.08,3398.0,46
CDM,36004515,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,25409.0,16515.85,702.12,25409.0,53
CDM,36004620,PLC OCCL DVC ARTERY VEIN,838.0,544.7,50.62,9496.0,46
CDM,36004625,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,4778.0,3105.7,100.23,4778.0,61
CDM,36004745,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,153.2,6143.0,61
CDM,36004760,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,38384.0,24949.6,6695.97,51380.79,61
CDM,36004765,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,87.87,3398.0,46
CDM,36004835,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,6143.0,3992.95,142.24,6143.0,61
CDM,36004855,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,13689.0,8897.85,554.77,17862.53,53
CDM,36004915,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,23729.0,15423.85,237.64,23729.0,61
CDM,36004935,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,23729.0,15423.85,385.02,23729.0,61
CDM,36004940,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,7468.0,4854.2,306.45,9608.0,46
CDM,36004985,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,13474.0,8758.1,326.57,13474.0,61
CDM,36005005,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,914.0,594.1,115.74,3398.0,46
CDM,36005025,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,13474.0,8758.1,326.78,13474.0,61
CDM,36005045,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,3267.0,2123.55,101.69,3398.0,46
CDM,36005165,SIJ INJ - ARTHROGR/ANESTHETIC,1977.0,1285.05,251.27,3728.0,61
CDM,36005450,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,75.85,3398.0,61
CDM,36005490,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,174.5,3728.0,61
CDM,36005540,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,45037.0,29274.05,573.82,53987.6,61
CDM,36005715,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,70.74,4778.0,61
CDM,36005775,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,2550.0,1657.5,140.47,3398.0,46
CDM,36005785,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,11180.0,7267.0,264.04,11180.0,61
CDM,36005795,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,2629.0,1708.85,132.51,3398.0,46
CDM,36005805,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,11180.0,7267.0,309.61,11180.0,61
CDM,36005815,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,2503.0,1626.95,154.44,3398.0,46
CDM,36005835,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,4861.0,3159.65,169.78,4861.0,61
CDM,36005845,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2111.0,1372.15,144.7,4001.0,61
CDM,36005895,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1358.0,882.7,79.3,3398.0,61
CDM,36005905,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,89.11,3728.0,61
CDM,36005915,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,100.22,3398.0,61
CDM,36005935,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,14925.0,9701.25,686.09,14925.0,61
CDM,36005945,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,4501.0,2925.65,348.66,4501.0,46
CDM,36005955,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,32861.0,21359.65,844.02,32861.0,61
CDM,36005965,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,32861.0,21359.65,787.12,32861.0,61
CDM,36005975,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,10937.0,7109.05,361.83,10937.0,46
CDM,36005AK,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,418.0,271.7,1.1,836.09,53
CDM,36006010,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,188.5,3728.0,61
CDM,36006075,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,20926.0,13601.9,560.54,20926.0,61
CDM,36006095,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,17007.0,11054.55,2931.02,17007.0,46
CDM,36006100,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,18098.0,11763.7,467.53,18098.0,61
CDM,36006105,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,7874.0,5118.1,692.16,13135.08,46
CDM,36006110,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,31083.0,20203.95,535.94,31083.0,61
CDM,36006125,ECMO/ECLS INITIATION VENO-ARTERIAL,2757.0,1792.05,566.38,9496.0,46
CDM,36006130,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,18098.0,11763.7,534.54,18098.0,61
CDM,36006140,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,31083.0,20203.95,601.72,31083.0,61
CDM,36006155,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,2673.0,1737.45,582.71,9496.0,46
CDM,36006205,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,14042.0,9127.3,348.58,14042.0,46
CDM,36006215,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,36934.0,24007.1,508.99,36934.0,61
CDM,36006225,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,13832.0,8990.8,250.06,13832.0,46
CDM,36006245,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,65208.0,42385.2,721.98,65208.0,61
CDM,36006255,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,58667.0,38133.55,802.6,58667.0,61
CDM,36006265,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,65208.0,42385.2,962.05,65208.0,61
CDM,36006275,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,45626.0,29656.9,1130.27,45626.0,61
CDM,36006295,BIOPSY SALIVARY GLAND NEEDLE,2896.0,1882.4,87.79,3728.0,61
CDM,36006360,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,7146.0,4644.9,257.53,7146.0,61
CDM,36006405,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,47892.0,31129.8,773.07,47892.0,61
CDM,36006415,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,7453.0,4844.45,334.5,7453.0,61
CDM,36006425,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,7453.0,4844.45,334.03,7453.0,61
CDM,36006445,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,7453.0,4844.45,353.68,7453.0,61
CDM,36006475,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,5451.0,3543.15,203.96,5451.0,61
CDM,36006485,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,5451.0,3543.15,200.87,5451.0,61
CDM,36006495,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,4944.0,3213.6,209.56,4944.0,61
CDM,36006590,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2111.0,1372.15,232.37,4001.0,61
CDM,36006600,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2111.0,1372.15,232.37,4001.0,61
CDM,36006620,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,11180.0,7267.0,280.55,11180.0,61
CDM,36006655,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2111.0,1372.15,144.7,4001.0,61
CDM,36006695,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2111.0,1372.15,170.55,4001.0,61
CDM,36006720,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,4861.0,3159.65,169.78,4861.0,61
CDM,36006725,INJECTION THERAPEUTIC CARPAL TUNNEL,1358.0,882.7,94.46,3398.0,61
CDM,36006740,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,4861.0,3159.65,85.0,4861.0,46
CDM,36006750,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2111.0,1372.15,170.55,4001.0,61
CDM,36006770,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2111.0,1372.15,85.04,3398.0,46
CDM,36006800,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2111.0,1372.15,72.34,3398.0,46
CDM,36006805,UNLISTED PROC LUNG/PLEURA,1845.0,1199.25,521.77,9496.0,61
CDM,36006825,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,18098.0,11763.7,795.93,18098.0,61
CDM,36006835,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,42695.0,27751.75,603.67,62345.36,61
CDM,36006840,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,726.77,40064.0,61
CDM,36006855,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,2888.0,1877.2,272.57,9496.0,46
CDM,36006860,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,36934.0,24007.1,508.99,36934.0,61
CDM,36006865,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,174.5,3728.0,61
CDM,36006880,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,65208.0,42385.2,721.98,65208.0,61
CDM,36006890,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,58667.0,38133.55,802.6,58667.0,61
CDM,36006895,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,8932.0,5805.8,299.62,8932.0,61
CDM,36006900,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,65208.0,42385.2,962.05,65208.0,61
CDM,36006910,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,45626.0,29656.9,1130.27,45626.0,61
CDM,36006915,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,568.58,18098.0,61
CDM,36006940,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,7453.0,4844.45,334.5,7453.0,61
CDM,36006945,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,6837.0,4444.05,148.38,6837.0,46
CDM,36006955,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,4671.0,3036.15,118.5,4671.0,46
CDM,36006970,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,7453.0,4844.45,334.03,7453.0,61
CDM,36006995,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,16234.0,10552.1,119.14,16234.0,61
CDM,36007000,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,7453.0,4844.45,353.68,7453.0,61
CDM,36007005,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,16234.0,10552.1,360.28,16234.0,61
CDM,36007015,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,16234.0,10552.1,450.44,16234.0,61
CDM,36007025,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,16234.0,10552.1,631.72,16234.0,61
CDM,36007035,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,16234.0,10552.1,334.11,16234.0,61
CDM,36007045,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,16234.0,10552.1,224.84,16234.0,61
CDM,36007055,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,4313.0,2803.45,163.34,4831.0,61
CDM,36007065,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,26838.0,17444.7,400.35,26838.0,61
CDM,36007075,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,26838.0,17444.7,724.05,26838.0,61
CDM,36007085,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,26838.0,17444.7,749.2,26838.0,61
CDM,36007090,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,32861.0,21359.65,589.55,32861.0,61
CDM,36007095,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,28703.0,18656.95,571.0,28703.0,61
CDM,36007100,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,14925.0,9701.25,729.97,14925.0,61
CDM,36007105,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,4129.0,2683.85,232.78,4129.0,46
CDM,36007110,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,14925.0,9701.25,686.09,14925.0,61
CDM,36007115,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,3810.0,2476.5,245.43,3810.0,46
CDM,36007120,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,4501.0,2925.65,348.66,4501.0,46
CDM,36007125,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,4661.0,3029.65,268.15,4661.0,46
CDM,36007130,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,32861.0,21359.65,844.02,32861.0,61
CDM,36007135,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,7453.0,4844.45,204.03,7453.0,61
CDM,36007140,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,32861.0,21359.65,787.12,32861.0,61
CDM,36007155,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3070.0,1995.5,226.03,3728.0,61
CDM,36007165,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3070.0,1995.5,110.77,3728.0,61
CDM,36007175,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,9423.0,6124.95,348.19,9423.0,61
CDM,36007185,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,15865.0,10312.25,433.94,15865.0,61
CDM,36007195,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,9423.0,6124.95,324.96,9423.0,61
CDM,36007205,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,168.16,9423.0,61
CDM,36007225,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,604.0,392.6,131.67,5214.91,46
CDM,36007235,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,15865.0,10312.25,346.04,15865.0,61
CDM,36007245,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,15865.0,10312.25,453.43,15865.0,61
CDM,36007255,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,15865.0,10312.25,582.37,15865.0,61
CDM,36007265,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,604.0,392.6,131.67,5214.91,46
CDM,36007270,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,52228.0,33948.2,904.03,87978.22,61
CDM,36007275,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1306.0,848.9,284.71,5214.91,46
CDM,36007280,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,19720.0,12818.0,639.93,23194.66,61
CDM,36007300,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,20926.0,13601.9,639.93,20926.0,61
CDM,36007305,PERQ BALO DILA IC VSPSM EA VSL SM VASC TER,8352.0,5428.8,1242.78,9496.0,46
CDM,36007315,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,11994.0,7796.1,1383.05,17865.0,46
CDM,36007325,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,6801.0,4420.65,979.58,9496.0,46
CDM,36007335,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,6241.0,4056.65,418.49,9496.0,46
CDM,36007380,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1112.0,722.8,52.26,3398.0,61
CDM,36007400,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,258.94,3728.0,61
CDM,36007465,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,6143.0,3992.95,222.35,6143.0,61
CDM,36007550,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,15117.0,9826.05,1975.67,15117.0,46
CDM,36007610,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2111.0,1372.15,144.7,4001.0,61
CDM,36007710,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,6837.0,4444.05,148.38,6837.0,46
CDM,36007730,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,16234.0,10552.1,119.14,16234.0,61
CDM,36007750,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,16234.0,10552.1,450.44,16234.0,61
CDM,36007760,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,16234.0,10552.1,631.72,16234.0,61
CDM,36007770,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,16234.0,10552.1,334.11,16234.0,61
CDM,36007780,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,16234.0,10552.1,224.84,16234.0,61
CDM,36007790,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,4313.0,2803.45,163.34,4831.0,61
CDM,36007800,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,26838.0,17444.7,400.35,26838.0,61
CDM,36007840,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,4129.0,2683.85,232.78,4129.0,46
CDM,36007850,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,3810.0,2476.5,245.43,3810.0,46
CDM,36007860,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,4661.0,3029.65,268.15,4661.0,46
CDM,36007870,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,7453.0,4844.45,204.03,7453.0,61
CDM,36007880,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3070.0,1995.5,226.03,3728.0,61
CDM,36007890,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3070.0,1995.5,110.77,3728.0,61
CDM,36007910,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,9423.0,6124.95,348.19,9423.0,61
CDM,36007930,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,15865.0,10312.25,433.94,15865.0,61
CDM,36007940,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,9423.0,6124.95,324.96,9423.0,61
CDM,36007950,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,168.16,9423.0,61
CDM,36007980,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,15865.0,10312.25,346.04,15865.0,61
CDM,36008000,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,15865.0,10312.25,582.37,15865.0,61
CDM,36008150,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,8932.0,5805.8,283.44,8932.0,61
CDM,36008155,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,13060.0,8489.0,1212.29,13135.08,46
CDM,36008160,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,32784.0,21309.6,403.94,32784.0,61
CDM,36008165,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,8932.0,5805.8,283.44,8932.0,61
CDM,36008170,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,32239.0,20955.35,530.13,32356.61,61
CDM,36008175,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,32784.0,21309.6,403.94,32784.0,61
CDM,36008180,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,32784.0,21309.6,621.39,32784.0,61
CDM,36008185,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,32239.0,20955.35,530.13,32356.61,61
CDM,36008190,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,65208.0,42385.2,748.74,65208.0,61
CDM,36008195,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,32784.0,21309.6,621.39,32784.0,61
CDM,36008200,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,53185.0,34570.25,862.06,53185.0,61
CDM,36008205,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,65208.0,42385.2,748.74,65208.0,61
CDM,36008210,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,16227.0,10547.55,247.51,16227.0,46
CDM,36008215,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,53185.0,34570.25,862.06,53185.0,61
CDM,36008220,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,24406.0,15863.9,348.98,24406.0,46
CDM,36008225,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,16227.0,10547.55,247.51,16227.0,46
CDM,36008230,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,22770.0,14800.5,337.75,22770.0,46
CDM,36008235,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,24406.0,15863.9,348.98,24406.0,46
CDM,36008240,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,32784.0,21309.6,580.7,32784.0,61
CDM,36008245,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,22770.0,14800.5,337.75,22770.0,46
CDM,36008275,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,32784.0,21309.6,500.07,32784.0,61
CDM,36008285,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,5404.0,3512.6,245.21,5404.0,46
CDM,36008335,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,4019.0,2612.35,876.14,9329.0,46
CDM,36008390,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,6143.0,3992.95,181.0,6143.0,61
CDM,36008575,ANES PRE-POST OP BLOCK,659.0,428.35,98.06,659.0,38
CDM,36009285,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,14925.0,9701.25,729.97,14925.0,61
CDM,36009525,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,526.0,341.9,65.08,3398.0,46
CDM,36009585,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,38384.0,24949.6,6695.97,51380.79,61
CDM,36009705,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,2942.0,1912.3,213.19,3398.0,46
CDM,36009905,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,30452.0,19793.8,2495.73,30452.0,46
CDM,36010055,CURETTAGE POSTPARTUM,3681.0,2392.65,306.48,9073.17,61
CDM,36010115,INDCD ABORTION DIL & EVAC,3096.0,2012.4,460.68,3096.0,38
CDM,36010145,SURG TX MISD AB; 1ST TRI,3459.0,2248.35,514.7,3459.0,38
CDM,36010155,SURG TX MISD AB; 2ND TRI,3484.0,2264.6,518.42,3484.0,38
CDM,36010175,OVARIAN CSTC UNI/BILAT,9068.0,5894.2,1349.32,9068.0,38
CDM,36010405,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,18098.0,11763.7,500.64,18098.0,61
CDM,36010445,RMVL PERITONEAL-VENOUS SHUNT,14478.0,9410.7,749.01,14478.0,61
CDM,36010535,STAND BY PERFUSION,2101.0,1365.65,312.63,2101.0,38
CDM,36010545,SPINAL CORD MONITORING,4900.0,3185.0,729.12,4900.0,38
CDM,36010555,MINIMALLY INVASIVE PERFUSION,3707.0,2409.55,551.6,3707.0,38
CDM,36010565,HEART PUMP 1 -1 1/2 HOURS,7098.0,4613.7,1056.18,7098.0,38
CDM,36010575,HEART PUMP 1 1/2-2 HOURS,7913.0,5143.45,1177.45,7913.0,38
CDM,36010585,HEART PUMP 2 -2 1/2 HOURS,8729.0,5673.85,1298.88,8729.0,38
CDM,36010595,HEART PUMP 2 1/2-3 HOURS,9542.0,6202.3,1419.85,9542.0,38
CDM,36010605,HEART PUMP 3 1/2-4 HOURS,11173.0,7262.45,1662.54,11173.0,38
CDM,36010615,HEART PUMP 3 -3 1/2 HOURS,10357.0,6732.05,1541.12,10357.0,38
CDM,36010625,HEART PUMP 4 -4 1/2 HOURS,11988.0,7792.2,1783.81,11988.0,38
CDM,36010635,ABIOMED MONITORING PER HR,261.0,169.65,38.84,261.0,38
CDM,36010675,PROC MATERNITY CARE UNLISTD - IUPC,351.0,228.15,99.26,4001.0,61
CDM,36010705,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,12718.0,8266.7,217.35,12718.0,61
CDM,36010975,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2111.0,1372.15,248.64,3728.0,61
CDM,36010AK,INTRO. OF CATH SUP/INF VENA CAVA,872.0,566.8,1.1,1768.67,53
CDM,36011465,INSERTION INTRAUTERINE DEVICE IUD,502.0,326.3,54.44,3398.0,46
CDM,36011775,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,52228.0,33948.2,904.03,87978.22,61
CDM,36011795,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,31083.0,20203.95,1226.51,31083.0,61
CDM,36011AK,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,1256.0,816.4,1.1,2630.86,53
CDM,36012595,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,29773.0,19352.45,2021.95,29773.0,46
CDM,36012605,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,6478.0,4210.7,1412.2,17865.0,46
CDM,36012615,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,15837.0,10294.05,2243.15,17865.0,46
CDM,36012625,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,15837.0,10294.05,3452.47,17865.0,46
CDM,36012635,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,30452.0,19793.8,2495.73,30452.0,46
CDM,36012645,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,15837.0,10294.05,3452.47,17865.0,46
CDM,36012655,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,15837.0,10294.05,1901.01,15837.0,46
CDM,36012665,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,15837.0,10294.05,2988.66,15837.0,46
CDM,36012675,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,10262.0,6670.3,529.11,10262.0,46
CDM,36012685,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,10262.0,6670.3,1298.76,10262.0,46
CDM,36012695,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,10262.0,6670.3,484.83,10262.0,46
CDM,36012705,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,10262.0,6670.3,1065.55,10262.0,46
CDM,36012715,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,9640.0,6266.0,202.77,9640.0,46
CDM,36012725,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,18660.0,12129.0,441.4,18660.0,46
CDM,36012755,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,10518.0,6836.7,199.55,10518.0,61
CDM,36012795,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,15044.0,9778.6,2238.55,15044.0,46
CDM,36012805,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,15043.0,9777.95,2238.4,15043.0,46
CDM,36012845,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,11448.0,7441.2,128.31,11448.0,61
CDM,36012945,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,15837.0,10294.05,1901.01,15837.0,46
CDM,36012AK,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,1404.0,912.6,1.1,2728.28,53
CDM,36013075,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,65538.0,42599.7,645.24,87978.22,61
CDM,36013085,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,50000.0,32500.0,580.46,62345.36,61
CDM,36013115,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,18660.0,12129.0,337.34,18660.0,46
CDM,36013135,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,26743.0,17382.95,332.65,26743.0,46
CDM,36013235,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,6143.0,3992.95,135.34,6143.0,61
CDM,36013325,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,4778.0,3105.7,167.24,4778.0,61
CDM,36013345,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,169.43,4778.0,61
CDM,36013765,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,188.46,6143.0,61
CDM,36013945,I&D HEMATOMA,3786.0,2460.9,563.36,3786.0,38
CDM,36013AK,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,1008.0,655.2,1.1,2561.67,53
CDM,36014235,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,31082.0,20203.3,971.93,31082.0,61
CDM,36014255,CATHJ UMBILICAL VEIN DX/THER NB,129.0,83.85,28.12,9496.0,46
CDM,36014455,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,1570.0,1020.5,342.26,7821.0,46
CDM,36014515,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,656.0,426.4,143.01,4831.0,46
CDM,36014535,OVARIAN CYSTECTOMY UNI/BI,22708.0,14760.2,1273.21,22708.0,61
CDM,36014815,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,26191.0,17024.15,1822.22,26191.0,46
CDM,36014885,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,1387.0,901.55,55.69,18167.0,46
CDM,36014AK,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,1329.0,863.85,1.1,2567.0,53
CDM,36015245,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,726.77,40064.0,61
CDM,36015355,"D&C SUCTION INCOMP ABORTION, ANY TRIMESTER",8148.0,5296.2,1212.42,8148.0,38
CDM,36015365,D&C SUCTION,8148.0,5296.2,1212.42,8148.0,38
CDM,36015575,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,27821.0,18083.65,1592.1,27821.0,55
CDM,36015AK,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,1404.0,912.6,1.1,2780.62,53
CDM,36016345,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,1945.0,1264.25,127.56,4831.0,46
CDM,36016525,CHANGE CYSTOSTOMY TUBE COMPLICATED,3070.0,1995.5,134.52,3728.0,61
CDM,36016585,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,15117.0,9826.05,1975.67,15117.0,46
CDM,36016745,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,65.08,3398.0,46
CDM,36016765,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,143.54,8932.0,61
CDM,36016805,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,1217.0,791.05,281.07,3398.0,61
CDM,36016815,EXCISION INFECTED GRAFT EXTREMITY,18098.0,11763.7,907.81,18098.0,61
CDM,36017205,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,142.24,23194.66,61
CDM,36017215,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,139.55,4046.0,61
CDM,36017265,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,38008.0,24705.2,771.06,53987.6,61
CDM,36017285,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,142.24,23194.66,61
CDM,36017295,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,139.55,4046.0,61
CDM,36017315,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,2896.0,1882.4,125.67,3728.0,61
CDM,36017485,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,4778.0,3105.7,183.28,4778.0,61
CDM,36017575,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,5488.0,3567.2,444.21,9932.52,61
CDM,36017765,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,10262.0,6670.3,1994.76,10262.0,46
CDM,36017795,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,52558.0,34162.7,1405.45,54375.57,61
CDM,36018055,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,5314.0,3454.1,357.97,8566.0,46
CDM,36018065,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,34625.0,22506.25,727.16,34625.0,46
CDM,36018105,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,147.6,4778.0,61
CDM,36018115,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,177.68,4778.0,61
CDM,36018145,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,13474.0,8758.1,248.9,13474.0,61
CDM,36018155,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,13474.0,8758.1,333.34,13474.0,61
CDM,36018175,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,31502.0,20476.3,2021.39,31502.0,46
CDM,36018305,DISRUPTION-FIBRIN SHEATH W/BALLOON,3448.0,2241.2,571.26,4001.0,61
CDM,36018355,REVASC ENDOV W/IVL INCL ANGIOPLASTY,65208.0,42385.2,2003.13,65208.0,61
CDM,36018365,REVASC ENDOV W/IVL W/STENT INCL ANGIOPLASTY,37311.0,24252.15,3708.64,51380.79,61
CDM,36018375,REVASC ENDOV W/IVL W/ATHERECTOMY INCL ANGIOPLASTY,103251.0,67113.15,3708.64,103251.0,61
CDM,36018385,REVASC ENDOV W/IVL W/STENT-ATHER INCL ANGIOPLASTY,34461.0,22399.65,6695.97,51380.79,61
CDM,36018455,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,7453.0,4844.45,262.66,7453.0,61
CDM,36018495,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,7664.0,4981.6,580.98,62681.75,46
CDM,36018505,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,4539.0,2950.35,263.32,9496.0,46
CDM,36018555,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",26829.0,17438.85,3708.64,32356.61,61
CDM,36018565,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",46149.0,29996.85,6075.0,51380.79,61
CDM,36018575,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",36344.0,23623.6,6075.0,51380.79,61
CDM,36018585,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",38839.0,25245.35,6075.0,51380.79,61
CDM,36018595,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,84.34,3398.0,61
CDM,36018605,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1361.0,884.65,106.2,3398.0,46
CDM,36018615,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,5628.0,3658.2,215.27,5628.0,61
CDM,36018635,CANNULATION THORACIC DUCT,7147.0,4645.55,283.94,9496.0,46
CDM,36018755,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,29787.0,19361.55,2567.92,29787.0,46
CDM,36018915,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,3134.0,2037.1,218.78,13135.08,46
CDM,36019115,JOINT REDUCTION/MANIPULATION,1696.0,1102.4,252.36,1696.0,38
CDM,36019345,ART BYPASS CAROTID-SUBCLAVIAN,28437.0,18484.05,872.27,28437.0,46
CDM,36019365,VISC & INFRAREN ABD 1 PROSTH,31502.0,20476.3,4687.5,31502.0,46
CDM,36019375,VISC & INFRAREN ABD 2 PROSTH,34625.0,22506.25,4831.0,34625.0,46
CDM,36019385,VISC & INFRAREN ABD 3 PROSTH,37750.0,24537.5,4831.0,37750.0,46
CDM,36019395,"EMBO/THROM FEM/POP, AORTAILIAC ART",31082.0,20203.3,1667.62,31082.0,61
CDM,36019415,ART BYP FEMORAL-FEMORAL,21164.0,13756.6,1764.02,21164.0,46
CDM,36019465,ARTVEN ANAST OPN UPR ARM BASLILIC VEN TRANS,31083.0,20203.95,1184.84,31083.0,61
CDM,36019475,TAVR OPEN FEMORAL APPROACH,28437.0,18484.05,2155.09,28437.0,46
CDM,36019865,EMBO/THROM POP/TIBIO/PERONEAL ART,31082.0,20203.3,1547.95,31082.0,61
CDM,36019875,"INJ SCLEROSING SOLUTION, SINGLE VEIN",2297.0,1493.05,64.1,3398.0,61
CDM,36019925,"OPN BRACH ART EXPOS PROS, UNLAT",19786.0,12860.9,212.69,19786.0,46
CDM,36019935,REPAIR BLOOD VESSEL UPPER EXT,18098.0,11763.7,987.9,18098.0,61
CDM,36019955,VISC & INFRAREN ABD 4+ PROSTH,16400.0,10660.0,2440.32,16400.0,46
CDM,36020015,BYP OTH/THN VEIN CAROTID-VERTEBRAL,16506.0,10728.9,872.27,16506.0,46
CDM,36020045,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,4046.0,2629.9,650.1,7445.0,61
CDM,36020115,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,16506.0,10728.9,2082.17,16506.0,46
CDM,36020135,TAVR TRANSAORTIC APPROACH,40822.0,26534.3,2327.31,40822.0,46
CDM,36020145,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,65208.0,42385.2,1270.8,65208.0,61
CDM,36020155,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,65208.0,42385.2,966.79,65208.0,61
CDM,36020165,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,103251.0,67113.15,1226.73,103251.0,61
CDM,36020175,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,65208.0,42385.2,1445.94,65208.0,61
CDM,36020195,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,103251.0,67113.15,603.67,103251.0,61
CDM,36020205,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,103251.0,67113.15,776.67,103251.0,61
CDM,36020265,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,31083.0,20203.95,1309.77,31083.0,61
CDM,36024015,TRANSCERVICAL ABLATION UTERINE FIBROID RF,34016.0,22110.4,683.26,34016.0,61
CDM,36024025,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,49881.0,32422.65,5355.0,49881.0,53
CDM,36024035,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,13756.0,8941.4,1720.7,13756.0,61
CDM,36024045,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,51916.0,33745.4,5355.0,51916.0,47
CDM,36024055,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,13756.0,8941.4,1720.7,13756.0,61
CDM,36024065,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,18098.0,11763.7,460.05,18098.0,61
CDM,36024165,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,4718.0,3066.7,1028.52,9496.0,46
CDM,36024195,LOOP REVISION,3924.0,2550.6,571.26,9496.0,61
CDM,36024265,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,12866.0,8362.9,1546.13,12866.0,61
CDM,36024275,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,14557.0,9462.05,2386.88,14557.0,61
CDM,36024285,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,14557.0,9462.05,639.93,14557.0,61
CDM,36024295,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,14557.0,9462.05,639.93,14557.0,61
CDM,36024305,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,14557.0,9462.05,639.93,14557.0,61
CDM,36024315,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,28534.0,18547.1,5355.0,62345.36,61
CDM,36024325,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2473.0,1607.45,571.26,4001.0,61
CDM,36024335,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,7317.0,4756.05,639.93,7317.0,61
CDM,36024345,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,6481.0,4212.65,531.16,6481.0,61
CDM,36024355,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,5250.0,3412.5,372.14,5250.0,46
CDM,36024365,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,86045.0,55929.25,2084.04,86045.0,53
CDM,36024375,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,418.0,271.7,55.81,418.0,55
CDM,36024385,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,298.0,193.7,73.53,298.0,55
CDM,36024395,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,37961.0,24674.65,7614.0,87978.22,61
CDM,36024405,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,28534.0,18547.1,5355.0,62345.36,61
CDM,36024415,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,10838.0,7044.7,639.93,23194.66,61
CDM,36024425,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,10838.0,7044.7,639.93,23194.66,61
CDM,36024455,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,8900.0,5785.0,1256.32,9496.0,46
CDM,36024525,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,4618.0,3001.7,1006.72,9329.0,46
CDM,36024535,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,4190.0,2723.5,796.47,9496.0,46
CDM,36024545,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),13287.0,8636.55,224.72,13287.0,61
CDM,36024565,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,13324.0,8660.6,221.64,13324.0,61
CDM,36024595,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),13324.0,8660.6,221.64,13324.0,61
CDM,36024615,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),7833.0,5091.45,571.26,9496.0,61
CDM,36024625,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),29447.0,19140.55,133.98,29447.0,61
CDM,36024635,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),39232.0,25500.8,1795.98,39232.0,61
CDM,36024645,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),2043.0,1327.95,304.0,9496.0,46
CDM,36024655,RF ABLATION BILIARY TRACT (COMP CODE 47556),42370.0,27540.5,858.08,42370.0,61
CDM,36024665,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),9423.0,6124.95,224.72,9423.0,61
CDM,36024685,RFA MSK TUMOR (COMP CODE 20982),59187.0,38471.55,221.64,59187.0,61
CDM,36024695,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),6143.0,3992.95,229.66,6143.0,61
CDM,36024705,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),8932.0,5805.8,366.62,8932.0,61
CDM,36024715,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),32861.0,21359.65,221.64,32861.0,61
CDM,36024725,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,1489.0,967.85,421.09,4001.0,61
CDM,36024735,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),6294.0,4091.1,366.62,6294.0,61
CDM,36024745,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),26838.0,17444.7,1795.98,26838.0,61
CDM,36024755,VAGINAL CUFF BIOPSY (COMP CODE 57100),4005.0,2603.25,162.64,4005.0,61
CDM,36024765,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),59187.0,38471.55,221.64,59187.0,61
CDM,36024775,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),59187.0,38471.55,133.98,59187.0,61
CDM,36024785,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),26838.0,17444.7,366.62,26838.0,61
CDM,36024795,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),25651.0,16673.15,366.62,25651.0,61
CDM,36024805,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),32861.0,21359.65,133.98,32861.0,61
CDM,36024815,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),32861.0,21359.65,221.64,32861.0,61
CDM,36024825,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),18098.0,11763.7,571.26,18098.0,61
CDM,36024835,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),6466.0,4202.9,571.26,6466.0,61
CDM,36024845,FAT PAD BIOPSY (COMP CODE 20200),7453.0,4844.45,133.98,7453.0,61
CDM,36024855,VASCULAR EMBOLIZATION WITH PRESSURE-GENERATING CATHETER,35000.0,22750.0,5355.0,51380.79,61
CDM,36024865,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),2037.0,1324.05,229.66,3398.0,61
CDM,36024875,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),4778.0,3105.7,221.64,4778.0,61
CDM,36024885,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),59187.0,38471.55,1795.98,59187.0,61
CDM,36024895,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),8932.0,5805.8,224.72,8932.0,61
CDM,36024905,CRYOABLATION AVM (COMP CODE 20983),32861.0,21359.65,571.26,32861.0,61
CDM,36024915,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),49016.0,31860.4,571.26,49016.0,61
CDM,36024925,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),6294.0,4091.1,571.26,9496.0,61
CDM,36024935,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,6801.0,4420.65,571.26,6801.0,61
CDM,36024945,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),1211.0,787.15,180.2,9496.0,46
CDM,36024955,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),1119.0,727.35,316.45,4831.0,61
CDM,36024965,"INCISION AND DRAINAGE HEMATOMA, VAGINAL OB/POSTPARTUM",3866.0,2512.9,298.24,8141.48,61
CDM,36024985,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,6658.0,4327.7,1451.44,9496.0,46
CDM,36024995,CLTX POST HIP ARTHRP DISLC REQ ANES,6616.0,4300.4,654.6,6616.0,61
CDM,36025005,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,16566.0,10767.9,895.32,16566.0,55
CDM,36025015,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,16566.0,10767.9,895.32,16566.0,55
CDM,36025025,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,16566.0,10767.9,895.32,16566.0,55
CDM,36025035,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,16566.0,10767.9,895.32,16566.0,55
CDM,36025045,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,16566.0,10767.9,895.32,16566.0,55
CDM,36025055,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,16566.0,10767.9,895.32,16566.0,55
CDM,36025065,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,25198.0,16378.7,895.32,25198.0,55
CDM,36025075,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,25198.0,16378.7,895.32,25198.0,55
CDM,36025085,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,25198.0,16378.7,100.03,25198.0,46
CDM,36025115,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,49956.0,32471.4,2755.97,49956.0,55
CDM,36025135,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,16234.0,10552.1,764.23,29793.81,61
CDM,36025145,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,47177.0,30665.05,3708.64,47177.0,61
CDM,36025155,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,22708.0,14760.2,910.16,22708.0,46
CDM,36100050,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,188.46,6143.0,61
CDM,36100055,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1482.0,963.3,87.83,3398.0,46
CDM,36100075,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,873.0,567.45,65.08,3398.0,46
CDM,36100105,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1112.0,722.8,52.26,3398.0,61
CDM,36100135,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,999.0,649.35,65.08,3398.0,46
CDM,36100205,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,59187.0,38471.55,620.59,59187.0,61
CDM,36100215,OSTEOPLASTY,6207.0,4034.55,221.64,6207.0,61
CDM,36100225,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,4778.0,3105.7,183.28,4778.0,61
CDM,36100235,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,169.43,4778.0,61
CDM,36100245,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,6300.0,4095.0,75.0,7753.23,46
CDM,36100255,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,18899.0,12284.35,3026.0,20338.07,61
CDM,36100265,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,28575.0,18573.75,3026.0,28575.0,61
CDM,36100275,EXTERNAL CAROTID ART ONLY UNI,6652.0,4323.8,571.26,6652.0,61
CDM,36100285,INSERTION PERITONEAL-VENOUS SHUNT,11705.0,7608.25,1274.43,11705.0,46
CDM,36100295,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,32784.0,21309.6,580.7,32784.0,61
CDM,36100305,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,7206.0,4683.9,290.73,7206.0,46
CDM,36100315,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,32784.0,21309.6,500.07,32784.0,61
CDM,36100325,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,5404.0,3512.6,245.21,5404.0,46
CDM,36100375,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,12591.0,8184.15,2604.52,12591.0,46
CDM,36100385,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,12591.0,8184.15,2184.65,12591.0,46
CDM,36100395,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,6143.0,3992.95,42.74,6143.0,61
CDM,36100415,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,32784.0,21309.6,580.7,32784.0,61
CDM,36100425,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,7206.0,4683.9,290.73,7206.0,46
CDM,36100435,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2103.0,1366.95,65.08,3398.0,46
CDM,36100465,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,18098.0,11763.7,330.09,18098.0,61
CDM,36100475,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,18098.0,11763.7,388.11,18098.0,61
CDM,36100485,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,9423.0,6124.95,432.28,9423.0,61
CDM,36100495,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,9423.0,6124.95,143.29,9423.0,61
CDM,36100505,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3070.0,1995.5,91.89,3728.0,61
CDM,36100515,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,188.46,6143.0,61
CDM,36100525,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,153.2,6143.0,61
CDM,36100535,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,87.87,3398.0,46
CDM,36100545,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,75.85,3398.0,61
CDM,36100555,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,88.78,3398.0,46
CDM,36100565,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1928.0,1253.2,141.82,3398.0,46
CDM,36100575,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2206.0,1433.9,80.02,3398.0,46
CDM,36100585,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,9423.0,6124.95,130.06,9423.0,61
CDM,36100595,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,3657.0,2377.05,147.18,3657.0,46
CDM,36100665,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,8586.0,5580.9,287.65,8586.0,61
CDM,36100675,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1836.0,1193.4,189.81,4001.0,61
CDM,36100685,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,18899.0,12284.35,3026.0,20338.07,61
CDM,36100695,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,169.43,4778.0,61
CDM,36100705,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,169.43,4778.0,61
CDM,36100825,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,63.11,3398.0,46
CDM,36100835,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,726.77,40064.0,61
CDM,36100855,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,3237.0,2104.05,125.67,3728.0,61
CDM,36100865,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,942.0,612.3,85.98,3398.0,46
CDM,36100875,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,3237.0,2104.05,153.7,3728.0,61
CDM,36100885,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,725.0,471.25,91.3,3398.0,46
CDM,36100935,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,38008.0,24705.2,771.06,53987.6,61
CDM,36100945,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,18098.0,11763.7,819.03,18098.0,61
CDM,36100955,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,142.24,23194.66,61
CDM,36100965,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,139.55,4046.0,61
CDM,36101055,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,384.86,8932.0,61
CDM,36101065,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,404.81,10496.0,46
CDM,36101075,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,147.6,4778.0,61
CDM,36101085,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,177.68,4778.0,61
CDM,36101125,CT CONE BEAM,622.0,404.3,0.87,622.0,61
CDM,36101135,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1165.0,757.25,208.95,4001.0,46
CDM,36101165,COMPLETE REPLACEMENT OF CENTRALLY TUNNELED PORT.,18098.0,11763.7,475.77,18098.0,61
CDM,36101175,MINOR SURGERY LEVEL 1 1ST 30 MIN,3394.0,2206.1,505.03,3394.0,38
CDM,36101185,MINOR SURGERY LEVEL 1 EA ADD 30 MIN,3387.0,2201.55,503.99,3387.0,38
CDM,36101195,MINOR SURGERY LEVEL 2 1ST 30 MIN,4184.0,2719.6,622.58,4184.0,38
CDM,36101205,MINOR SURGERY LEVEL 2 EA ADD 30 MIN,3885.0,2525.25,578.09,3885.0,38
CDM,36101215,MINOR SURGERY LEVEL 3 1ST 30 MIN,4734.0,3077.1,704.42,4734.0,38
CDM,36101225,MINOR SURGERY LEVEL 3 EA ADD 30 MIN,4734.0,3077.1,704.42,4734.0,38
CDM,36140AK,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,704.0,457.6,1.1,1662.37,53
CDM,36200AK,INTRODUCTION CATHETER AORTA,1108.0,720.2,1.1,1941.85,53
CDM,36215AK,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,1835.0,1192.75,1.1,3374.16,53
CDM,36216AK,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,2108.0,1370.2,1.1,3486.01,53
CDM,36217AK,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,2516.0,1635.4,1.1,5808.33,53
CDM,36218AK,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,404.0,262.6,1.1,680.09,53
CDM,36221AK,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,1568.0,1019.2,1.1,5442.3,53
CDM,36222AK,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,2323.0,1509.95,1.1,5442.3,53
CDM,36223AK,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,2530.0,1644.5,1.1,9382.91,53
CDM,36224AK,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,2750.0,1787.5,1.1,9382.91,53
CDM,36225AK,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,2530.0,1644.5,1.1,5442.3,53
CDM,36226AK,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,2750.0,1787.5,1.1,9382.91,53
CDM,36227AK,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,920.0,598.0,1.1,920.0,53
CDM,36228AK,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,1700.0,1105.0,1.1,4106.01,53
CDM,36245AK,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,1860.0,1209.0,1.1,4056.8,53
CDM,36246AK,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,2008.0,1305.2,1.1,2743.97,53
CDM,36247AK,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,2658.0,1727.7,1.1,4647.37,53
CDM,36248AK,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,404.0,262.6,1.1,404.0,53
CDM,36251AK,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UNI,2244.0,1458.6,1.1,5442.3,53
CDM,36252AK,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BILAT,2966.0,1927.9,1.1,5442.3,53
CDM,36253AK,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTERY/S&I UNI,3212.0,2087.8,1.1,9382.91,53
CDM,36299AGRVUAK,"UNLISTED PROCEDURE, VASCULAR INJECTION (COMPARISON CODE 36471)",330.0,214.5,0.01,330.0,28
CDM,36299RVU1AK,INJECTION FOR EGD W/ ECHO TIP (COMP CODE 36481),2232.0,1450.8,0.01,2232.0,28
CDM,36299RVU2AK,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),409.0,265.85,0.01,409.0,28
CDM,36299RVU3AK,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),296.0,192.4,0.01,296.0,28
CDM,36410AK,VNPNXR 3 YEARS/> PHYS/QHP SKILL,79.0,51.35,1.1,79.0,53
CDM,36415AK,COLLECTION VENOUS BLOOD VENIPUNCTURE,40.0,26.0,1.1,40.0,33
CDM,36416AK,COLLECTION CAPILLARY BLOOD,31.0,20.15,1.1,31.0,38
CDM,36430AK,TRANSFUSION BLOOD/BLOOD COMPONENTS,1057.0,687.05,1.1,1057.0,50
CDM,36460AK,TRANSFUSION INTRAUTERINE FETAL,2632.0,1710.8,1.1,2632.0,50
CDM,36465AK,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,940.0,611.0,1.1,4248.84,53
CDM,36466AK,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,1200.0,780.0,1.1,4593.32,53
CDM,36468AK,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,257.0,167.05,1.1,680.96,29
CDM,36470AK,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,300.0,195.0,1.1,680.96,53
CDM,36471AK,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,660.0,429.0,1.1,680.96,53
CDM,36473AK,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,1400.0,910.0,1.1,5442.3,53
CDM,36474AK,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,700.0,455.0,1.1,847.35,53
CDM,36476AK,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,1060.0,689.0,1.1,1060.0,53
CDM,36478AK,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,2332.0,1515.8,1.1,5442.3,53
CDM,36479AK,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,1166.0,757.9,1.1,1166.0,53
CDM,36482AK,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,1400.0,910.0,1.1,9382.91,53
CDM,36483AK,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,700.0,455.0,1.1,700.0,53
CDM,36510AK,CATHJ UMBILICAL VEIN DX/THER NB,436.0,283.4,1.1,436.0,53
CDM,36511AK,THR APHERESIS WHITE BLD CELL,880.0,572.0,1.1,2619.9,50
CDM,36512AK,THR APHERESIS RED BLOOD CELL,880.0,572.0,1.1,2619.9,50
CDM,36513AK,THERAPEU APHERESIS PLATELETS,880.0,572.0,1.1,880.0,50
CDM,36514AK,THERAPEUTIC APHERESIS PLASMA,796.0,517.4,1.1,2619.9,53
CDM,36516AK,THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION,686.0,445.9,1.1,7900.93,53
CDM,36522AK,PHOTOPHERESIS EXTRACORPOREAL,770.0,500.5,1.1,7900.93,53
CDM,36555AK,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,849.0,551.85,1.1,5442.3,53
CDM,36556AK,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,770.0,500.5,1.1,5442.3,53
CDM,36556URVUAK,INSERTION NON TUNNEL CENT VEN CATH >5,250.0,162.5,1.1,5442.3,53
CDM,36558AK,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,2020.0,1313.0,1.1,5442.3,53
CDM,36558URVUAK,INSERTION CATHETER TUNNEL CENTRAL VENOUS,465.0,302.25,1.1,5442.3,53
CDM,36561AK,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,2548.0,1656.2,1.1,5442.3,53
CDM,36561URVUAK,INSERT TUNNELED CENT VENOUS CATH >5YRS,582.0,378.3,1.1,5442.3,53
CDM,36563AK,INSJ TUNNELED CTR VAD W/SUBQ PUMP,2636.0,1713.4,1.1,9382.91,53
CDM,36565AK,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,2548.0,1656.2,1.1,5442.3,53
CDM,36566AK,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,2768.0,1799.2,1.1,13795.55,53
CDM,36568AK,INSERTION PICC W/O IMG GDN < 5 YR,928.0,603.2,1.1,2734.59,50
CDM,36569AK,INSERTION PICC W/O IMG GDN 5 YR/>,836.0,543.4,1.1,2734.59,50
CDM,36569URVUAK,INSERTION PERIPH CENTRAL VENOUS CATH,160.0,104.0,1.1,2734.59,50
CDM,36571AK,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,2240.0,1456.0,1.1,5442.3,53
CDM,36573AK,INSERTION PICC W/RS&I 5 YR >,748.0,486.2,1.1,2734.59,53
CDM,36575AK,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,268.0,174.2,1.1,1073.41,53
CDM,36576AK,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,1196.0,777.4,1.1,2734.59,53
CDM,36578AK,RPLCMT CATH CTR VAD SUBQ PORT/PMP,1316.0,855.4,1.1,5442.3,53
CDM,36580AK,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,576.0,374.4,1.1,2734.59,53
CDM,36581AK,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,1292.0,839.8,1.1,5442.3,53
CDM,36581URVUAK,REPLACE VENOUS ACCESS DEVICE W/O PORT,330.0,214.5,1.1,5442.3,53
CDM,36582AK,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,1996.0,1297.4,1.1,5442.3,53
CDM,36584AK,COMPLETE REPLACEMENT PICC RS&I,480.0,312.0,1.1,2734.59,53
CDM,36585AK,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,1836.0,1193.4,1.1,5442.3,53
CDM,36589AK,RMVL TUN CVC W/O SUBQ PORT/PMP,1003.0,651.95,1.1,1073.41,53
CDM,36589URVUAK,REMOVAL TUNNELED CENTRAL VENOUS CATH,230.0,149.5,1.1,1073.41,53
CDM,36590AK,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,1364.0,886.6,1.1,2734.59,53
CDM,36590URVUAK,REMOVAL OF TUNNELED CENTRAL VENOUS ACCES,335.0,217.75,1.1,2734.59,53
CDM,36591AK,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,36.0,23.4,1.1,218.62,50
CDM,36592AK,COLLECT BLOOD FROM CATHETER VENOUS NOS,59.0,38.35,1.1,218.62,50
CDM,36593AK,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,512.0,332.8,1.1,578.82,50
CDM,36595AK,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,1436.0,933.4,1.1,5442.3,53
CDM,36596AK,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,300.0,195.0,1.1,2734.59,53
CDM,36597AK,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,484.0,314.6,1.1,2734.59,53
CDM,36597URVUAK,REPOSITIONAL  CENTRAL VENOUS CATH,110.0,71.5,1.1,2734.59,53
CDM,36598AK,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,296.0,192.4,1.1,396.48,53
CDM,36600AK,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,128.0,83.2,1.1,218.62,53
CDM,36620AK,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,440.0,286.0,1.1,440.0,50
CDM,36625AK,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,844.0,548.6,1.1,844.0,50
CDM,36660AK,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,560.0,364.0,1.1,560.0,50
CDM,36680AK,PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION,528.0,343.2,1.1,680.96,50
CDM,36800AK,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,1069.0,694.85,1.1,9382.91,50
CDM,36818AK,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,4956.0,3221.4,1.1,9382.91,50
CDM,36818URVUAK,BRACHIAL ARTERY TO CEPHALIC AV GRAFT,1640.0,1066.0,1.1,9382.91,50
CDM,36819AK,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,5316.0,3455.4,1.1,9382.91,50
CDM,36819URVUAK,AV FUSION BY BASILIC VEIN,1344.0,873.6,1.1,9382.91,50
CDM,36821AK,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,4760.0,3094.0,1.1,5442.3,50
CDM,36821URVUAK,AV FUSION DIRECT ANY SITE,1248.0,811.2,1.1,5442.3,50
CDM,36823AK,INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL,9192.0,5974.8,1.1,9192.0,50
CDM,36825AK,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,5668.0,3684.2,1.1,9382.91,50
CDM,36830AK,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,4812.0,3127.8,1.1,9382.91,50
CDM,36830URVUAK,ARTERY-VEIN GRAFT,1202.0,781.3,1.1,9382.91,50
CDM,36831AK,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,4400.0,2860.0,1.1,9382.91,50
CDM,36831URVUAK,ARTERY-VEIN GRAFT,777.0,505.05,1.1,9382.91,50
CDM,36832AK,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,5400.0,3510.0,1.1,9382.91,50
CDM,36832URVUAK,"AV FISTULA REVISION, OPEN",1022.0,664.3,1.1,9382.91,50
CDM,36833AK,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,5800.0,3770.0,1.1,9382.91,50
CDM,36833URVUAK,AV FISTULA REVISION,1118.0,726.7,1.1,9382.91,50
CDM,36836AK,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,2880.0,1872.0,1.1,29938.94,52
CDM,36837AK,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,3720.0,2418.0,1.1,32060.06,52
CDM,36838AK,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,8676.0,5639.4,1.1,9382.91,50
CDM,36901AK,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,1344.0,873.6,1.1,2734.59,53
CDM,36902AK,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,1932.0,1255.8,1.1,9759.23,53
CDM,36903AK,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,2556.0,1661.4,1.1,18783.74,53
CDM,36904AK,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,3000.0,1950.0,1.1,9759.23,53
CDM,36905AK,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,3600.0,2340.0,1.1,18783.74,53
CDM,36907AK,(2017) TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,1200.0,780.0,1.1,1935.14,53
CDM,36909AK,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,1648.0,1071.2,1.1,6212.11,53
CDM,37000170,ANES-PARAVERT BLOCK 15MIN,324.0,210.6,48.21,324.0,38
CDM,37000180,ANES-GENERAL 15MIN,413.0,268.45,61.45,413.0,38
CDM,37000190,ANES-MAC 15MIN,456.0,296.4,67.85,456.0,38
CDM,37000200,ANES-SP-EPI COMBO 15MIN,327.0,212.55,48.66,327.0,38
CDM,37000210,ANES-BIER BLOCK 15MIN,324.0,210.6,48.21,324.0,38
CDM,37000220,ANES-REGIONAL BLOCK 15MIN,381.0,247.65,56.69,381.0,38
CDM,37000270,ANES-EPIDURAL 15MIN,301.0,195.65,44.79,301.0,38
CDM,37000280,ANES-SPINAL 15MIN,339.0,220.35,50.44,339.0,38
CDM,37001235,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,701.0,455.65,20.92,701.0,46
CDM,37001245,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,21.78,276.0,46
CDM,37001255,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,584.0,379.6,127.31,584.0,46
CDM,37001265,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,60.17,276.0,46
CDM,37101245,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,21.78,276.0,46
CDM,37182AK,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,6788.0,4412.2,1.1,6788.0,50
CDM,37184AK,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,3700.0,2405.0,1.1,29938.94,53
CDM,37185AK,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,1443.0,937.95,1.1,1560.53,53
CDM,37186AK,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,2165.0,1407.25,1.1,3880.9,53
CDM,37187AK,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,3423.0,2224.95,1.1,18783.74,53
CDM,37188AK,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,2402.0,1561.3,1.1,5442.3,53
CDM,37191AK,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,1962.0,1275.3,1.1,9382.91,53
CDM,37191URVUAK,INSERTION OF INTRAVASCULAR VENA CAVA,510.0,331.5,1.1,9382.91,53
CDM,37193AK,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,2840.0,1846.0,1.1,5442.3,53
CDM,37195AK,THROMBOLYSIS CEREBRAL IV INFUSION,2075.0,1348.75,1.1,2075.0,38
CDM,37197AK,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,2658.0,1727.7,1.1,5442.3,53
CDM,37200AK,TRANSVASCULAR BIOPSY,1820.0,1183.0,1.1,9382.91,50
CDM,37211AK,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,3100.0,2015.0,1.1,9382.91,50
CDM,37212AK,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,2724.0,1770.6,1.1,5442.3,50
CDM,37213AK,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,1900.0,1235.0,1.1,5442.3,50
CDM,37214AK,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,1096.0,712.4,1.1,5442.3,50
CDM,37215AK,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,7810.0,5076.5,1.1,7810.0,50
CDM,37216AK,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,7192.0,4674.8,1.1,7192.0,33
CDM,37217AK,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,8152.0,5298.8,1.1,8152.0,50
CDM,37218AK,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,5900.0,3835.0,1.1,5900.0,50
CDM,37236AK,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,3500.0,2275.0,1.1,18783.74,53
CDM,37237AK,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,1700.0,1105.0,1.1,4216.95,53
CDM,37238AK,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,2658.0,1727.7,1.1,18783.74,53
CDM,37239AK,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,1307.0,849.55,1.1,5558.32,53
CDM,37241AK,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,3850.0,2502.5,1.1,18783.74,53
CDM,37242AK,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,4312.0,2802.8,1.1,29938.94,53
CDM,37243AK,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,5166.0,3357.9,1.1,28027.45,53
CDM,37244AK,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,6050.0,3932.5,1.1,21444.87,53
CDM,37246AK,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,3080.0,2002.0,1.1,9759.23,53
CDM,37247AK,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,1540.0,1001.0,1.1,1859.65,53
CDM,37248AK,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,2640.0,1716.0,1.1,9759.23,53
CDM,37249AK,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,1307.0,849.55,1.1,1455.57,53
CDM,37252AK,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,792.0,514.8,1.1,3092.6,53
CDM,37253AK,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,634.0,412.1,1.1,634.0,53
CDM,37254AK,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,3212.0,2087.8,1.1,5352.46,35
CDM,37255AK,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,1.1,1330.47,35
CDM,37256AK,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,4730.0,3074.5,1.1,6300.24,35
CDM,37257AK,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,1712.0,1112.8,1.1,1712.0,35
CDM,37258AK,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,3850.0,2502.5,1.1,9158.51,35
CDM,37259AK,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,1760.0,1144.0,1.1,3111.79,35
CDM,37260AK,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,5584.0,3629.6,1.1,21594.73,35
CDM,37261AK,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,1870.0,1215.5,1.1,8598.53,35
CDM,37262AK,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,1320.0,858.0,1.1,8704.67,35
CDM,37263AK,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,3410.0,2216.5,1.1,13897.95,35
CDM,37264AK,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,1.1,5587.38,35
CDM,37265AK,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,4620.0,3003.0,1.1,17485.88,35
CDM,37266AK,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,1760.0,1144.0,1.1,6253.42,35
CDM,37267AK,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,3850.0,2502.5,1.1,13346.71,35
CDM,37268AK,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,1641.0,1066.65,1.1,8589.11,35
CDM,37269AK,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,6490.0,4218.5,1.1,29553.87,35
CDM,37270AK,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,2200.0,1430.0,1.1,8948.16,35
CDM,37271AK,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,3960.0,2574.0,1.1,26968.52,35
CDM,37272AK,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,1760.0,1144.0,1.1,5988.71,35
CDM,37273AK,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,5557.0,3612.05,1.1,33789.35,35
CDM,37274AK,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,2420.0,1573.0,1.1,6385.7,35
CDM,37275AK,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,4840.0,3146.0,1.1,26261.02,35
CDM,37276AK,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,1870.0,1215.5,1.1,8845.13,35
CDM,37277AK,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,6600.0,4290.0,1.1,39393.32,35
CDM,37278AK,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,2640.0,1716.0,1.1,9920.87,35
CDM,37279AK,INTRAVASCULAR LITHOTRIPSY FPVT W/IN SAME ARTERY,1760.0,1144.0,1.1,11836.32,35
CDM,37280AK,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,4312.0,2802.8,1.1,6968.99,35
CDM,37281AK,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,1.1,1905.16,35
CDM,37282AK,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,5416.0,3520.4,1.1,15649.09,35
CDM,37283AK,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,1874.0,1218.1,1.1,2241.8,35
CDM,37284AK,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,4400.0,2860.0,1.1,14434.33,35
CDM,37285AK,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,1470.0,955.5,1.1,7128.51,35
CDM,37286AK,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,5922.0,3849.3,1.1,26517.23,35
CDM,37287AK,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,2200.0,1430.0,1.1,12622.23,35
CDM,37288AK,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,5940.0,3861.0,1.1,19976.47,35
CDM,37289AK,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,2090.0,1358.5,1.1,2395.26,35
CDM,37290AK,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,7480.0,4862.0,1.1,27265.34,35
CDM,37291AK,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,2860.0,1859.0,1.1,2860.0,35
CDM,37292AK,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,6600.0,4290.0,1.1,26188.08,35
CDM,37293AK,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,2860.0,1859.0,1.1,8996.19,35
CDM,37294AK,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,7920.0,5148.0,1.1,38855.89,35
CDM,37295AK,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,3590.0,2333.5,1.1,15355.63,35
CDM,37296AK,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,4840.0,3146.0,1.1,7836.72,35
CDM,37297AK,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,1760.0,1144.0,1.1,2150.48,35
CDM,37298AK,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,6028.0,3918.2,1.1,8824.76,35
CDM,37299AK,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,2200.0,1430.0,1.1,2339.39,35
CDM,37565AK,LIGATION INTERNAL JUGULAR VEIN,4820.0,3133.0,1.1,5442.3,50
CDM,37600AK,LIGATION EXTERNAL CAROTID ARTERY,4968.0,3229.2,1.1,5442.3,50
CDM,37607AK,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,2500.0,1625.0,1.1,5442.3,50
CDM,37607URVUAK,LIGATION OF A-V FISTULA,692.0,449.8,1.1,5442.3,50
CDM,37609AK,LIGATION/BIOPSY TEMPORAL ARTERY,1220.0,793.0,1.1,2768.64,53
CDM,37609URVUAK,TEMPORAL ARTERY PROCEDURE,450.0,292.5,1.1,2768.64,53
CDM,37615AK,LIGATION MAJOR ARTERY NECK,3120.0,2028.0,1.1,5442.3,50
CDM,37616AK,LIGATION MAJOR ARTERY CHEST,7588.0,4932.2,1.1,7588.0,50
CDM,37617AK,LIGATION MAJOR ARTERY ABDOMEN,9516.0,6185.4,1.1,9516.0,50
CDM,37618AK,LIGATION MAJOR ARTERY EXTREMITY,2412.0,1567.8,1.1,2412.0,50
CDM,37619AK,LIGATION OF INFERIOR VENA CAVA,12000.0,7800.0,1.1,12000.0,50
CDM,37650AK,LIGATION OF FEMORAL VEIN,3396.0,2207.4,1.1,5442.3,50
CDM,37660AK,LIGATION OF COMMON ILIAC VEIN,8912.0,5792.8,1.1,8912.0,50
CDM,37700AK,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,1528.0,993.2,1.1,5442.3,50
CDM,37700URVUAK,LIGATION AND DICISION OF LONG SAPH. VEIN,441.0,286.65,1.1,5442.3,50
CDM,37718AK,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,2852.0,1853.8,1.1,5442.3,50
CDM,37722AK,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,3590.0,2333.5,1.1,5442.3,50
CDM,37761AK,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,3652.0,2373.8,1.1,5442.3,50
CDM,37765AK,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,2112.0,1372.8,1.1,5442.3,53
CDM,37765URVUAK,STAB PHLEBECTOMY V/VEINS 10-20,840.0,546.0,1.1,5442.3,53
CDM,37766AK,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,2640.0,1716.0,1.1,5442.3,53
CDM,37766URVUAK,STAB PHLEBECTOMY OF VARICOSE VEINS,935.0,607.75,1.1,5442.3,53
CDM,37785AK,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,1729.0,1123.85,1.1,5442.3,53
CDM,37799AGRVU1AK,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 33417)",4900.0,3185.0,0.01,4900.0,28
CDM,37799AGRVU2AK,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 37765)",1350.0,877.5,0.01,1350.0,28
CDM,37799AGRVU3AK,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 34490)",1840.0,1196.0,0.01,1840.0,28
CDM,37799AGRVU4AK,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 34825)",4198.0,2728.7,0.01,4198.0,28
CDM,37799AGRVU5AK,"UNLISTED PROCEDURE, VASCULAR SURGERY",1554.0,1010.1,0.01,1554.0,28
CDM,37799AGRVU6AK,"UNLISTED PROC, VASC SURGERY COMPARED TO 37785",1297.0,843.05,0.01,1297.0,28
CDM,37799AGRVU7AK,"UNLISTED PROCEDURE, VASCULAR COMPARED TO 26111",1785.0,1160.25,0.01,1785.0,28
CDM,37799AGRVUAK,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 36471)",330.0,214.5,0.01,1073.41,28
CDM,37799AK,UNLISTED PROCEDURE VASCULAR SURGERY,340.0,221.0,0.01,1073.41,28
CDM,37799RVU10AK,EXCISION OF VEIN (COMP CODE 35206),3121.0,2028.65,0.01,3121.0,28
CDM,37799RVU14AK,EXCISION /LIGATION ABDOMINAL VEINS (COMP CODE 35221),11314.0,7354.1,0.01,11314.0,28
CDM,37799RVU22AK,UNLISTED OPEN DILATION INTERNAL CAROTID ARTERY UTILIZIING DILATO,2378.0,1545.7,0.01,2378.0,28
CDM,37799RVU33AK,AORTIC ARTERIAL JUMP GRAFT (COMP CODE 47147),2521.0,1638.65,0.01,2521.0,28
CDM,37799RVU34AK,CREATION OF MESORENAL SHUNT (SUP MESENTERIC VEIN TO RENAL VEIN),14401.0,9360.65,0.01,14401.0,28
CDM,37799RVU35AK,EXCISION OF INTERNAL JUGULAR VEIN TUMOR THROMBUS (COMP CODE 3447,7600.0,4940.0,0.01,7600.0,28
CDM,37799RVU36AK,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,440.0,286.0,0.01,1073.41,28
CDM,37799RVU37AK,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),1436.0,933.4,0.01,1436.0,28
CDM,37799RVU38AK,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),920.0,598.0,0.01,1073.41,28
CDM,37799RVU39AK,CRYOABLATION AVM (COMP CODE 20983),2752.0,1788.8,0.01,2752.0,28
CDM,37799RVU40AK,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),3980.0,2587.0,0.01,3980.0,28
CDM,37799RVU41AK,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,4000.0,2600.0,0.01,4000.0,28
CDM,37799RVU42AK,"EXPLORATION OF VEIN, NOT FOLLOWED BY SURGICAL REPAIR (COMP CODE",2848.0,1851.2,0.01,2848.0,28
CDM,37799RVU6AK,STAB INCISION UNDER 10 (COMP CODE 37765),1350.0,877.5,0.01,1350.0,28
CDM,38100AK,SPLENECTOMY TOTAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,50
CDM,38101AK,SPLENECTOMY PARTIAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,50
CDM,38102AK,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,1916.0,1245.4,1.1,1916.0,50
CDM,38115AK,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,8752.0,5688.8,1.1,8752.0,50
CDM,38120AK,"LAPAROSCOPY, SURGICAL, SPLENECTOMY",6828.0,4438.2,1.1,17575.94,50
CDM,38129AGRVU1AK,"UNLIST LAP PROC, SPLEEN COMPARED TO 47300",5986.0,3890.9,0.01,9852.42,28
CDM,38129AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, SPLEEN (COMPARISON CODE 38101)",2400.0,1560.0,0.01,9852.42,28
CDM,38129RVU1AK,LAPAROSCOPIC PARTIAL SPLENECTOMY (COMP TO 38101),6452.0,4193.8,0.01,9852.42,28
CDM,38205AK,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,660.0,429.0,1.1,660.0,50
CDM,38206AK,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,660.0,429.0,1.1,2619.9,50
CDM,38220AK,DIAGNOSTIC BONE MARROW ASPIRATIONS,480.0,312.0,1.1,2768.64,53
CDM,38221AK,DIAGNOSTIC BONE MARROW BIOPSIES,512.0,332.8,1.1,2768.64,53
CDM,38222AK,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,634.0,412.1,1.1,4850.94,53
CDM,38225AK,CAR-T THERAPY HRVG BLD-DRV T LYMPHCYT PR DAY,854.0,555.1,1.1,854.0,37
CDM,38226AK,CAR-T THERAPY PREPJ BLD-DRV T LYMPHCYT F/TRNS,348.0,226.2,1.1,348.0,37
CDM,38227AK,CAR-T THERAPY RECEIPT & PREPJ CAR-T CELLS F/ADMN,352.0,228.8,1.1,4330.51,37
CDM,38228AK,CAR-T THERAPY AUTOL CAR-T CELL ADMINISTRATION,1320.0,858.0,1.1,1449.2,51
CDM,38230AK,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,1400.0,910.0,1.1,2619.9,50
CDM,38240AK,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,1760.0,1144.0,1.1,93302.27,50
CDM,38241AK,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,1320.0,858.0,1.1,2619.9,50
CDM,38242AK,ALLOGENEIC LYMPHOCYTE INFUSIONS,928.0,603.2,1.1,2619.9,50
CDM,38300URVUAK,"DRAINAGE OF LYMPH NODE, SIMPLE",545.0,354.25,1.1,4850.94,53
CDM,38305AK,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,2672.0,1736.8,1.1,4850.94,50
CDM,38381AK,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,5352.0,3478.8,1.1,5352.0,50
CDM,38500AK,BX/EXC LYMPH NODE OPEN SUPERFICIAL,1516.0,985.4,1.1,6508.54,53
CDM,38500URVUAK,BIOPSY/EXCISION OF LYMPH NODE OPEN,460.0,299.0,1.1,6508.54,53
CDM,38505AK,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,636.0,413.4,1.1,2768.64,53
CDM,38510AK,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,2696.0,1752.4,1.1,6508.54,53
CDM,38520AK,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,2812.0,1827.8,1.1,6508.54,50
CDM,38525AK,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,2572.0,1671.8,1.1,6508.54,50
CDM,38525URVUAK,"BIOPSY/REMOVAL, LYMPH NODES",811.0,527.15,1.1,6508.54,50
CDM,38530AK,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,3336.0,2168.4,1.1,6508.54,50
CDM,38531AK,OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,2696.0,1752.4,1.1,6508.54,50
CDM,38542AK,DISSECTION DEEP JUGULAR NODE,3180.0,2067.0,1.1,9852.42,50
CDM,38555AK,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,6236.0,4053.4,1.1,11133.7,50
CDM,38562AK,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,4424.0,2875.6,1.1,4424.0,50
CDM,38564AK,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,4552.0,2958.8,1.1,4552.0,50
CDM,38570AK,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,3736.0,2428.4,1.1,9852.42,50
CDM,38571AK,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,5280.0,3432.0,1.1,17575.94,50
CDM,38572AK,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,6240.0,4056.0,1.1,17575.94,50
CDM,38573AK,LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX,8000.0,5200.0,1.1,17575.94,50
CDM,38589AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",1500.0,975.0,0.01,9852.42,28
CDM,38589AGRVU2AK,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",1580.0,1027.0,0.01,9852.42,28
CDM,38589AGRVU3AK,"UNLIST LAP PROC, LYMPHATIC SYSTEM COMPARED TO 38747",1610.0,1046.5,0.01,9852.42,28
CDM,38589AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",340.0,221.0,0.01,9852.42,28
CDM,38589AK,UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM,350.0,227.5,0.01,9852.42,28
CDM,38589RVU5AK,UNLISTED PROC; LAP INGUINAL LYMPH NODE DISSECTION (COMPARED TO 3,1360.0,884.0,0.01,9852.42,28
CDM,38589RVU6AK,LAP ROBOTIC RETROPERITONEAL LYMPHADENECTOMY COMP 38780,7016.0,4560.4,0.01,9852.42,28
CDM,38700AK,SUPRAHYOID LYMPHADENECTOMY,5124.0,3330.6,1.1,11133.7,50
CDM,38724AK,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,9580.0,6227.0,1.1,9580.0,50
CDM,38740AK,AXILLARY LYMPHADENECTOMY SUPERFICIAL,4280.0,2782.0,1.1,9852.42,50
CDM,38745AK,AXILLARY LYMPHADENECTOMY COMPLETE,5548.0,3606.2,1.1,9852.42,50
CDM,38745URVUAK,REMOVE ARMPIT LYMPH NODES,1485.0,965.25,1.1,9852.42,50
CDM,38746AK,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,1648.0,1071.2,1.1,1648.0,50
CDM,38747AK,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,1952.0,1268.8,1.1,1952.0,50
CDM,38747URVUAK,ABDOMINAL LYMPHADENECTOMY,640.0,416.0,1.1,910.82,50
CDM,38760AK,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,5448.0,3541.2,1.1,11133.7,50
CDM,38765AK,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,8764.0,5696.6,1.1,8764.0,50
CDM,38770AK,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,5624.0,3655.6,1.1,5624.0,50
CDM,38780AK,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,7080.0,4602.0,1.1,7080.0,50
CDM,38790AK,INJECTION PROCEDURE LYMPHANGIOGRAPHY,568.0,369.2,1.1,568.0,50
CDM,38792AK,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,260.0,169.0,1.1,704.26,53
CDM,38792URVUAK,IDENTIFY SENTINEL NODE,81.0,52.65,1.1,704.26,53
CDM,38900AK,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,1000.0,650.0,1.1,1000.0,50
CDM,38900URVUAK,INTRAPOPERATIVE MAPPING OF LYMPH NODES,360.0,234.0,1.1,469.57,50
CDM,38999AGRVUAK,"UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM (COMPARISON CODE 3",410.0,266.5,0.01,741.89,28
CDM,38999AK,UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,968.0,629.2,0.01,968.0,28
CDM,38999RVU14AK,UNLISTED MAGTRACE INJECTION ADMINISTRATION (COMP CODE 38900),1063.0,690.95,0.01,1063.0,28
CDM,38999RVU4AK,"THERAPEUTIC LVA (COMP 35206, 38308, 69990)",3412.0,2217.8,0.01,3412.0,28
CDM,38999RVU5AK,"UNLISTED PROC, BX OF EPIGASTRIC LYMPH NODE (COMP CODE 38531)",2224.0,1445.6,0.01,2224.0,28
CDM,38999RVU6AK,"IMMEDIATE LVA (COMP 35206, 38308, 69990)",4774.0,3103.1,0.01,4774.0,28
CDM,39000010,WHOLE BLOOD TXFUS PER UNIT,1553.0,1009.45,165.96,1553.0,61
CDM,39000020,CRYOPRECIPITATE EA UNIT,439.0,285.35,58.74,439.0,61
CDM,39000040,RBC LR EA UNIT,1256.0,816.4,165.96,1256.0,61
CDM,39000050,FFP SNGL DONOR WITHIN 8 HR,582.0,378.3,77.88,582.0,61
CDM,39000070,RBC EA UNIT,996.0,647.4,133.35,996.0,61
CDM,39000090,PLT LR EA UNIT,868.0,564.2,116.21,868.0,61
CDM,39000100,PLT PHERESIS LR EA UNIT,3361.0,2184.65,272.25,3361.0,61
CDM,39000120,RBC LR IRRAD EA UNIT,1765.0,1147.25,165.96,1765.0,61
CDM,39000125,SPLIT UNIT,978.0,635.7,131.02,978.0,61
CDM,39000130,WSH LR FROZ DW WB/RBC EA UNIT,1673.0,1087.45,165.96,1673.0,61
CDM,39000195,RED CELLS WASHED EA UNIT,2738.0,1779.7,272.25,2738.0,61
CDM,39000255,PLTS PHERESIS LEUKOR IRR,4662.0,3030.3,272.25,4662.0,61
CDM,39000405,RED CELL FROZ/THAW 1 UNIT,4511.0,2932.15,165.96,4511.0,61
CDM,39000447,"LRBC, CMV NEG",1256.0,816.4,186.89,1256.0,38
CDM,39000448,LRBC IRRADIATED CMV NEG,1506.0,978.9,224.09,1506.0,38
CDM,39000450,"PLASMA, FROZEN UNIT (8-24HR)",585.0,380.25,87.05,585.0,38
CDM,39000452,"PLT, PHER, IRR, L/R, CMV NEG",2490.0,1618.5,370.51,2490.0,38
CDM,39000455,PLATELET RICH PLASMA UNIT,3846.0,2499.9,165.96,3846.0,61
CDM,39000465,PLATELETS IRRADIATED EA UNIT,937.0,609.05,125.46,1078.08,61
CDM,39000475,PLATELETS LEUKORED IRRAD EA UNIT,1417.0,921.05,175.56,1417.0,61
CDM,39000485,PLATELET PHERESIS IRRAD EA UNIT,4055.0,2635.75,272.25,4055.0,61
CDM,39000495,PLASMA CRYOPRECIPITATE REDUCED EA UNIT,1016.0,660.4,2.17,1016.0,61
CDM,39000505,WH BLD OR RBC L/R CMV NEG EA UNIT,1188.0,772.2,140.37,1188.0,61
CDM,39000515,PLT PHER IRR L/R CMV NEG EA UNIT,3169.0,2059.85,272.25,3169.0,61
CDM,39000525,RBC L/R IRR CMV NEG EA UNIT,1538.0,999.7,165.96,1538.0,61
CDM,39000535,FR FRZ PLASMA FRZN 8-24 HOURS EA UNIT,491.0,319.15,65.69,491.0,61
CDM,39000545,FR FRZ PLASMA DONOR RETESTED EA UNIT,338.0,219.7,45.21,338.0,61
CDM,39000555,PLASMA SNGL DONOR PATHOGEN REDUCED FRZN EACH UNIT,2018.0,1311.7,165.96,2018.0,61
CDM,39000565,PLT PHER PATH-RED EA,4052.0,2633.8,272.25,4052.0,61
CDM,39000575,CONVALESCENT PLASMA,491.0,319.15,65.69,491.0,61
CDM,39000655,RED CELL LEUKOREDUCED DEGLYCEROLIZED IRRADIATED,3349.0,2176.85,165.96,3349.0,61
CDM,39010AK,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,5276.0,3429.4,1.1,5276.0,50
CDM,39100000,TXFUS BLOOD/BLOOD COMPONENT,2514.0,1634.1,79.66,3004.0,61
CDM,39100010,TRANSFUSION BLOOD OR BLOOD COMPONENTS,2514.0,1634.1,79.66,3004.0,61
CDM,39200AK,RESECTION OF MEDIASTINAL CYST,6036.0,3923.4,1.1,6036.0,50
CDM,39220AK,RESECTION MEDIASTINAL TUMOR,7820.0,5083.0,1.1,7820.0,50
CDM,39401AK,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,2176.0,1414.4,1.1,9852.42,50
CDM,39402AK,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,2900.0,1885.0,1.1,9852.42,50
CDM,39501AK,REPAIR LACERATION DIAPHRAGM ANY APPROACH,5592.0,3634.8,1.1,5592.0,50
CDM,39540AK,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,5828.0,3788.2,1.1,5828.0,50
CDM,39541AK,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,6300.0,4095.0,1.1,6300.0,50
CDM,39545AK,IMBRICATION DIAPHRAGM EVENTRATION,5868.0,3814.2,1.1,5868.0,50
CDM,39560AK,RESCJ DIAPHRAGM W/SIMPLE REPAIR,5224.0,3395.6,1.1,5224.0,50
CDM,39561AK,RESCJ DIAPHRAGM W/COMPLEX REPAIR,7996.0,5197.4,1.1,7996.0,50
CDM,39599AGRVU1AK,"UNLISTED PROCEDURE, DIAPHRAGM (COMPARISON CODE 39541)",5198.0,3378.7,0.01,1792000.0,28
CDM,39599AGRVU2AK,"UNLISTED PROCEDURE, DIAPHRAGM (COMPARISON CODE 39560)",1670.0,1085.5,0.01,1792000.0,28
CDM,39599AGRVUAK,"UNLISTED PROCEDURE, DIAPHRAGM (COMPARISON CODE 39561)",2580.0,1677.0,0.01,1792000.0,28
CDM,39599AK,DIAPHRAGM SURG PROC UNLISTED,2657.0,1727.05,0.01,1792000.0,28
CDM,39599RVU2AK,UNLISTED PROC; LAP DIAPHRAGM RESECTION (COMP TO 39560),5224.0,3395.6,0.01,1792000.0,28
CDM,39599RVU3AK,"UNLISTED PROC, LAPAROSCOPIC REPAIR OF DIAPHRAGMATIC HERNIA (NON-",4808.0,3125.2,0.01,1792000.0,28
CDM,39599RVU4AK,LAP OR ROBOTIC REPAIR OF DIAPHRAGMATIC HERNIA; CHRONIC (COMP COD,5671.0,3686.15,0.01,1792000.0,28
CDM,39599RVU6AK,UNLISTED THORACOSCOPIC REPAIR CONGENITAL DIAPHRAGMATIC HERNIA-NE,43564.0,28316.6,0.01,1792000.0,28
CDM,40000145,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,1432.0,930.8,37.89,1432.0,61
CDM,40100005,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,0.87,462.83,46
CDM,40100015,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,0.87,591.75,46
CDM,40100045,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,563.0,365.95,0.87,563.0,60
CDM,40100055,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,706.0,458.9,0.87,706.0,60
CDM,40100065,BREAST TOMO,122.0,79.3,0.87,409.57,61
CDM,40100070,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,0.87,462.83,46
CDM,40100080,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,0.87,591.75,46
CDM,40200015,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,734.0,477.1,0.87,734.0,61
CDM,40200020,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,734.0,477.1,0.87,734.0,61
CDM,40200030,US CHEST REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,0.87,734.0,61
CDM,40200045,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,0.87,734.0,61
CDM,40200050,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,0.87,734.0,61
CDM,40200060,US ABDOMINAL REAL TIME W/IMAGE LIMITED,734.0,477.1,0.87,734.0,61
CDM,40200070,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,734.0,477.1,0.87,734.0,61
CDM,40200080,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,734.0,477.1,0.87,734.0,61
CDM,40200090,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,734.0,477.1,0.87,734.0,61
CDM,40200095,ULTRASOUND SPINAL CANAL & CONTENTS,734.0,477.1,0.87,734.0,61
CDM,40200100,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,734.0,477.1,0.87,734.0,61
CDM,40200105,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,711.0,462.15,0.87,711.0,46
CDM,40200110,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,734.0,477.1,0.87,734.0,61
CDM,40200115,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,1668.0,1084.2,0.87,1668.0,61
CDM,40200120,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,711.0,462.15,0.87,711.0,46
CDM,40200125,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,654.0,425.1,0.87,654.0,46
CDM,40200130,US PREGNANT UTERUS LIMITED 1/> FETUSES,734.0,477.1,0.87,734.0,61
CDM,40200135,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,734.0,477.1,0.87,734.0,61
CDM,40200140,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,734.0,477.1,0.87,734.0,61
CDM,40200145,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,426.0,276.9,0.87,426.0,46
CDM,40200150,US TRANSVAGINAL,734.0,477.1,0.87,734.0,61
CDM,40200160,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1668.0,1084.2,0.87,1668.0,61
CDM,40200165,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,734.0,477.1,0.87,734.0,61
CDM,40200170,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,734.0,477.1,0.87,734.0,61
CDM,40200175,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,734.0,477.1,0.87,734.0,61
CDM,40200180,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,0.87,734.0,61
CDM,40200185,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,734.0,477.1,0.87,734.0,61
CDM,40200190,US SCROTUM & CONTENTS,734.0,477.1,0.87,734.0,61
CDM,40200195,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,734.0,477.1,0.87,734.0,61
CDM,40200200,US TRANSRECTAL,734.0,477.1,0.87,734.0,61
CDM,40200205,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,734.0,477.1,0.87,734.0,61
CDM,40200210,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,734.0,477.1,0.87,734.0,61
CDM,40200220,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,734.0,477.1,0.87,734.0,61
CDM,40200225,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,1668.0,1084.2,0.87,1668.0,61
CDM,40200240,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2149.0,1396.85,0.87,2149.0,61
CDM,40200245,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,734.0,477.1,0.87,734.0,61
CDM,40200250,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,0.87,266.0,46
CDM,40200270,US &MNTR PARENCHYMAL TISSUE ABLATION,646.0,419.9,0.87,646.0,46
CDM,40200280,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.87,863.0,46
CDM,40200295,US GUIDANCE AMNIOCENTESIS IMG S&I,366.0,237.9,0.87,366.0,46
CDM,40200300,ULTRASONIC GUIDANCE INTRAOPERATIVE,843.0,547.95,0.87,843.0,46
CDM,40200320,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,734.0,477.1,0.87,734.0,61
CDM,40200325,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1192.0,774.8,0.87,1192.0,46
CDM,40200330,US UNLISTED SOFT TISSUE,333.0,216.45,0.87,409.57,61
CDM,40200355,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,0.87,734.0,61
CDM,40200360,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,0.87,734.0,61
CDM,40200365,US BREAST UNI REAL TIME WITH IMAGE LIMITED,608.0,395.2,0.87,608.0,61
CDM,40200395,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,239.0,155.35,0.87,239.0,46
CDM,40200425,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,734.0,477.1,0.87,734.0,61
CDM,40200455,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,724.0,470.6,0.87,724.0,46
CDM,40200465,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,734.0,477.1,0.87,734.0,61
CDM,40200485,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,7453.0,4844.45,334.03,7453.0,61
CDM,40201025,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.87,863.0,46
CDM,40201075,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,608.0,395.2,0.87,608.0,61
CDM,40201085,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.87,863.0,46
CDM,40201095,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.87,863.0,46
CDM,40201125,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,734.0,477.1,0.87,734.0,61
CDM,40201135,ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION,1030.0,669.5,0.87,1030.0,46
CDM,40201145,ULTRASOUND ELASTOGRAPHY PARENCHYMA,734.0,477.1,0.87,734.0,61
CDM,40201255,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,734.0,477.1,0.87,734.0,61
CDM,40300005,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,140.0,91.0,0.87,192.16,60
CDM,40300025,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,609.0,395.85,0.87,609.0,60
CDM,40300040,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,140.0,91.0,0.87,192.16,60
CDM,40400010,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9008.0,5855.2,0.87,9008.0,53
CDM,40400025,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9008.0,5855.2,0.87,9008.0,53
CDM,40400040,BRAIN IMAGING PET METABOLIC EVALUATION,10064.0,6541.6,0.87,10064.0,53
CDM,40400045,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,0.87,10064.0,53
CDM,40400055,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,0.87,10064.0,53
CDM,40400065,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,0.87,10064.0,53
CDM,40400075,BRAIN IMAGING PET METABOLIC EVALUATION,10064.0,6541.6,0.87,10064.0,53
CDM,40400085,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9008.0,5855.2,0.87,9008.0,53
CDM,40400170,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,0.87,10064.0,53
CDM,40400210,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,0.87,10064.0,53
CDM,40400220,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,0.87,10064.0,53
CDM,40490AK,BIOPSY OF LIP,488.0,317.2,1.1,488.0,53
CDM,40500AK,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,1788.0,1162.2,1.1,5497.86,53
CDM,40510AK,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,1928.0,1253.2,1.1,5497.86,53
CDM,40520AK,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1916.0,1245.4,1.1,5497.86,53
CDM,40527AK,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,3728.0,2423.2,1.1,9999.36,50
CDM,40650AK,RPR LIP FULL THICKNESS VERMILION ONLY,1512.0,982.8,1.1,1601.27,53
CDM,40652AK,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,1772.0,1151.8,1.1,1772.0,53
CDM,40654AK,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,2192.0,1424.8,1.1,2603.78,53
CDM,40761AK,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,6336.0,4118.4,1.1,9999.36,50
CDM,40800AK,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,492.0,319.8,1.1,1200.64,53
CDM,40801AK,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,1052.0,683.8,1.1,1052.0,53
CDM,40804AK,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,520.0,338.0,1.1,1548.29,53
CDM,40805AK,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,1116.0,725.4,1.1,1116.0,53
CDM,40806AK,INCISION LABIAL FRENUM FRENOTOMY,124.0,80.6,1.1,939.01,53
CDM,40808AK,"BIOPSY, MOUTH, VESTIBULE",420.0,273.0,1.1,939.01,53
CDM,40810AK,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,544.0,353.6,1.1,5497.86,53
CDM,40812AK,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,948.0,616.2,1.1,2603.78,53
CDM,40814AK,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,1408.0,915.2,1.1,5497.86,53
CDM,40816AK,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,1508.0,980.2,1.1,5497.86,53
CDM,40819AK,EXC FRENUM LABIAL/BUCCAL,1004.0,652.6,1.1,2603.78,53
CDM,40820AK,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,536.0,348.4,1.1,5497.86,53
CDM,40830AK,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,728.0,473.2,1.1,749.84,53
CDM,40831AK,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,1028.0,668.2,1.1,1028.0,53
CDM,40845AK,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,7744.0,5033.6,1.1,9999.36,53
CDM,40899RVU2AK,TRANSORAL MYECTOMY OF DEPRESSOR ANGULI ORIS MUSCLE (COMP CODE 21,2168.0,1409.2,0.01,2168.0,28
CDM,40900000,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,0.87,566.0,46
CDM,40900005,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1436.0,46
CDM,41000005,RT MONITORING TRANSPORT,486.0,315.9,51.58,486.0,61
CDM,41000020,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,51.58,3004.0,61
CDM,41000030,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,741.0,481.65,26.19,741.0,61
CDM,41000035,HOME CARE INSTRUCTION,124.0,80.6,18.45,124.0,38
CDM,41000040,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,1791.0,61
CDM,41000050,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,3041.0,1976.65,161.32,3041.0,61
CDM,41000060,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,3041.0,1976.65,112.62,3041.0,61
CDM,41000070,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,936.0,608.4,14.65,936.0,61
CDM,41000110,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,936.0,608.4,51.58,936.0,61
CDM,41000115,RT DAILY ASSESSMENT,483.0,313.95,51.58,483.0,61
CDM,41000120,CONTINUOUS INHALATION TREATMENT 1ST HR,593.0,385.45,51.58,593.0,61
CDM,41000130,CONTINUOUS INHALATION TREATMENT EA ADDL HR,162.0,105.3,31.56,162.0,46
CDM,41000140,CPAP VENTILATION CPAP INITIATION&MGMT,936.0,608.4,64.26,936.0,61
CDM,41000155,RESPIRATORY THERAPY EVAL-HOSP,314.0,204.1,51.58,360.65,61
CDM,41000160,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,936.0,608.4,33.06,936.0,61
CDM,41000210,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,593.0,385.45,46.84,593.0,61
CDM,41000220,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,593.0,385.45,51.58,593.0,61
CDM,41000230,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,936.0,608.4,14.65,936.0,61
CDM,41000425,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,936.0,608.4,38.7,936.0,61
CDM,41000435,CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN,181.0,117.65,35.34,181.0,61
CDM,41000605,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,936.0,608.4,33.06,936.0,61
CDM,41000855,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,214.57,3004.0,61
CDM,41000925,CAR SEAT/BED TEST INFT THRU 12 MO EA ADDL 30 MIN,141.0,91.65,14.22,141.0,46
CDM,41000945,BREATH TECH IP 15 MIN,92.0,59.8,13.69,92.0,38
CDM,41000AK,INTRAORAL I&D TONGUE/FLOOR LINGUAL,540.0,351.0,1.1,939.01,53
CDM,41001005,DELIVERY/BIRTHING ROOM RESUSCITATION,4515.0,2934.75,247.02,4515.0,61
CDM,41001045,DELIVERY/BIRTHING ROOM RESUSCITATION,4515.0,2934.75,247.02,4515.0,61
CDM,41001065,INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP,498.0,323.7,51.58,613.76,61
CDM,41001135,DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,2901.0,1885.65,14.65,2901.0,61
CDM,41001145,RESPIRATOR FIT TEST,35.0,22.75,5.21,35.0,38
CDM,41001155,OSHA RESPIRATOR QUESTIONNAIRE REVIEW,35.0,22.75,5.21,35.0,38
CDM,41001165,RESPIRATOR MEDICAL EVALUATION,35.0,22.75,5.21,35.0,38
CDM,41005AK,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,524.0,340.6,1.1,788.54,53
CDM,41008AK,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,1384.0,899.6,1.1,5497.86,53
CDM,41010AK,INCISION LINGUAL FRENUM FRENOTOMY,444.0,288.6,1.1,2603.78,53
CDM,41016AK,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,1676.0,1089.4,1.1,9999.36,53
CDM,41100AK,BIOPSY TONGUE ANTERIOR 2/3,568.0,369.2,1.1,939.01,53
CDM,41105AK,"BIOPSY TONGUE,POSTER 1/3",588.0,382.2,1.1,5497.86,53
CDM,41108AK,"BIOPSY, MOUTH, FLOOR",484.0,314.6,1.1,2768.64,53
CDM,41110AK,EXCISION LESION TONGUE W/O CLOSURE,624.0,405.6,1.1,5497.86,53
CDM,41112AK,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,1132.0,735.8,1.1,5497.86,53
CDM,41113AK,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,1316.0,855.4,1.1,5497.86,53
CDM,41115AK,EXCISION OF LINGUAL FRENUM (FRENECTOMY),716.0,465.4,1.1,2603.78,53
CDM,41116AK,EXCISION LESION FLOOR MOUTH,1008.0,655.2,1.1,5497.86,53
CDM,41120AK,GLOSSECTOMY <ONE-HALF TONGUE,4902.0,3186.3,1.1,9999.36,50
CDM,41135AK,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,12056.0,7836.4,1.1,12056.0,50
CDM,41250AK,"REPAIR TONGUE LACER,<2.5CM",784.0,509.6,1.1,945.06,53
CDM,41251AK,"REPAIR TONGUE LACER,POST 1/3",928.0,603.2,1.1,1052.35,53
CDM,41252AK,"REPAIR TONGUE LACER,2.6CM+/COMPLX",1208.0,785.2,1.1,1208.0,53
CDM,41300005,HYPERBARIC O2 30MIN,552.0,358.8,127.42,552.0,61
CDM,41300035,TRMT NORMAL PT (30MIN),552.0,358.8,127.42,552.0,61
CDM,41300045,TRMT CRITICAL PT (30MIN),552.0,358.8,127.42,552.0,61
CDM,41530AK,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,1400.0,910.0,1.1,5497.86,53
CDM,41599AGRVUAK,"UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH (COMPARISON CODE 1557",1380.0,897.0,0.01,1380.0,28
CDM,41599RVUAK,LASER DESTRUCTION/TONGUE LESION (COMP 41110),562.0,365.3,0.01,562.0,28
CDM,41800AK,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,508.0,330.2,1.1,955.6,53
CDM,41805AK,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,536.0,348.4,1.1,2603.78,53
CDM,41823AK,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,1508.0,980.2,1.1,9999.36,53
CDM,41825AK,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,564.0,366.6,1.1,5497.86,53
CDM,41827AK,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,1685.0,1095.25,1.1,9999.36,53
CDM,41828AK,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,1256.0,816.4,1.1,2603.78,47
CDM,41830AK,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,1380.0,897.0,1.1,5497.86,47
CDM,41870AK,PERIODONTAL MUCOSAL GRAFTING,1563.0,1015.95,1.1,2603.78,32
CDM,41874AK,ALVEOLOPLASTY EACH QUADRANT SPECIFY,1404.0,912.6,1.1,5497.86,47
CDM,41899CAK,PARTIAL BONY IMPACTION EXTRACTION (COMP D7230),357.0,232.05,0.01,417.54,28
CDM,41899DAK,REMOVE RESIDUAL ROOT (COMP D7250),273.0,177.45,0.01,417.54,28
CDM,41899EAK,SIMPLE EXTRACTION ERUPTED TOOTH (COMP D7140),139.0,90.35,0.01,417.54,28
CDM,41899FAK,SOFT TISSUE IMPACTION EXTRACTION (COMP D7220),279.0,181.35,0.01,417.54,28
CDM,41899GAK,SURGICAL EXTRACTION ERUPTED TOOTH (COMP D7210),243.0,157.95,0.01,417.54,28
CDM,41899RVU4AK,SCLEROTHERAPY TO THE ORAL CAVITY (COMP CODE 36470),300.0,195.0,0.01,417.54,28
CDM,42000020,THERA EXER 1,258.0,167.7,37.06,258.0,60
CDM,42000030,NEURMSCL THERAPY 15MIN,261.0,169.65,41.24,261.0,60
CDM,42000040,GAIT TRAINING THERAPY 15M,228.0,148.2,24.68,239.0,60
CDM,42000050,THERA ACTIVITY DIR 15MIN,274.0,178.1,44.62,274.0,60
CDM,42000080,EDUC HOME MGMT EA 15MIN GP,274.0,178.1,24.68,274.0,60
CDM,42000165,BIOFDBK TRAIN ANY METHOD GP,319.0,207.35,23.22,319.0,60
CDM,42000195,CANALITH REPOSITIONING PROCEDURE,240.0,156.0,41.92,240.0,60
CDM,42000205,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,316.0,205.4,47.02,316.0,46
CDM,42000235,APPLY TRACTION MECH GP,194.0,126.1,18.61,239.0,60
CDM,42000255,VASOPNEUMATIC DVC GP,203.0,131.95,14.87,239.0,60
CDM,42000275,ELECTR STIM 15MIN GP,239.0,155.35,18.62,239.0,60
CDM,42000280,PT IONTOPHORESIS 15MIN GP,189.0,122.85,23.82,239.0,60
CDM,42000285,US 15MIN GP,174.0,113.1,17.72,239.0,60
CDM,42000290,HUBBARD 15MIN GP,232.0,150.8,45.89,239.0,60
CDM,42000295,THERA EXER 15MIN,258.0,167.7,37.06,258.0,60
CDM,42000300,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,202.0,131.3,24.68,239.0,60
CDM,42000305,MANUAL THERAPY 15MIN GP,241.0,156.65,35.04,241.0,60
CDM,42000335,PT/OT WORK CONDITION,1004.0,652.6,24.68,1004.0,46
CDM,42000365,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,272.0,176.8,42.65,272.0,60
CDM,42000405,PT WK CNDITIONNG PER 15 MIN,242.0,157.3,36.01,242.0,38
CDM,42000425,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,326.0,211.9,46.97,326.0,60
CDM,42000445,P.T. COMMUNITY REINTEG 15 MIN,176.0,114.4,40.61,239.0,60
CDM,42000565,"PT THERAPEUT PROC/EXER, 15 MIN",258.0,167.7,37.06,258.0,60
CDM,42000615,PT SENSORY INTEGRATIVE TCH/15M,188.0,122.2,53.17,239.0,60
CDM,42000625,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,295.0,191.75,60.21,295.0,60
CDM,42000810,CANALITH REPOSITIONING PROCEDURE,240.0,156.0,41.92,240.0,60
CDM,42000815,ELECTRICAL STIM. UNATTENDED,177.0,115.05,24.68,239.0,46
CDM,42000820,WHIRLPOOL GP,179.0,116.35,20.16,239.0,60
CDM,42000825,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,239.0,155.35,18.62,239.0,60
CDM,42000830,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,174.0,113.1,17.72,239.0,60
CDM,42000835,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,241.0,156.65,35.04,241.0,60
CDM,42000840,GROUP THERAPY GP,234.0,152.1,22.65,239.0,60
CDM,42000845,WHEELCHAIR MGMT EA 15 MIN,254.0,165.1,39.57,254.0,60
CDM,42000865,TEST PHYSCL PERF EA 15MIN GP,272.0,176.8,42.65,272.0,60
CDM,42000875,ORTHO MGMT EXT/TRUNK 15MN GP,295.0,191.75,60.21,295.0,60
CDM,42000880,PROSTHTIC TRAINING EXT 15M GP,270.0,175.5,52.32,270.0,60
CDM,42000895,WND CARE UNATT ELECT STIM 15M,147.0,95.55,14.52,239.0,60
CDM,42000925,AQUATIC THERAPY 15MIN GP,326.0,211.9,46.97,326.0,60
CDM,42000995,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,296.0,192.4,48.65,296.0,60
CDM,42000AK,DRAINAGE ABSCESS PALATE/UVULA,512.0,332.8,1.1,536.59,53
CDM,42001055,WORK HARDENING/CONDITIONING EACH HOUR,503.0,326.95,24.68,503.0,46
CDM,42001075,PARAFFIN,166.0,107.9,7.7,239.0,60
CDM,42001095,WORK HARDENING (ADDL HR),503.0,326.95,24.68,503.0,46
CDM,42001255,"CONTRAST BATH, EA 15 MIN",126.0,81.9,17.37,239.0,60
CDM,42001285,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI,67.0,43.55,9.27,239.0,60
CDM,42001355,ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID,63.0,40.95,6.76,239.0,60
CDM,42001365,CONSULT(RUBBRMD)PER15MIN,74.0,48.1,11.01,239.0,38
CDM,42001375,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,274.0,178.1,24.68,274.0,60
CDM,42001435,ORTH/PROS MGMT EA 15 MIN GP,320.0,208.0,66.46,320.0,60
CDM,42001645,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,21.54,425.0,61
CDM,42001745,"REMOTE MONITORING, INITIAL SUPPLY",257.0,167.05,34.46,257.0,53
CDM,42001755,REMOTE MONITORING 20 MIN,72.0,46.8,15.7,239.0,38
CDM,42001815,REMOTE MONITORING EDUCATION AND SET UP,889.0,577.85,37.45,889.0,61
CDM,42001825,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,267.0,173.55,52.06,267.0,60
CDM,42001835,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,267.0,173.55,29.16,267.0,60
CDM,42002045,VV THERAPEUTIC EXERCISE PT (97110),258.0,167.7,37.06,258.0,60
CDM,42002055,VV NEUROMUSCULAR EDUCATION PT (97112),261.0,169.65,41.24,261.0,60
CDM,42002065,VV GAIT TRAINING THERAPY  (97116),228.0,148.2,24.68,239.0,60
CDM,42002075,VV EVALUATION LOW COMPLEXITY  (97161),605.0,393.25,73.97,605.0,60
CDM,42002085,VV EVALUATION MODERATE COMPLEXITY  (97162),605.0,393.25,73.97,605.0,60
CDM,42002095,VV EVALUATION HIGH COMPLEXITY (97163),605.0,393.25,73.97,605.0,60
CDM,42002105,VV THERAPEUTIC ACTIVITIES (97530),274.0,178.1,44.62,274.0,60
CDM,42002125,VV SELF-CARE HOME MANAGEMENT  PT (97535),274.0,178.1,24.68,274.0,60
CDM,42002135,LOW INTENSITY ESWT CORPUS CAVERNOSUM LOW ENERGY,973.0,632.45,39.43,3004.0,61
CDM,42002185,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,263.0,170.95,35.31,263.0,47
CDM,42002195,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQP,593.0,385.45,37.45,593.0,61
CDM,42002205,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,172.0,111.8,34.46,239.0,53
CDM,42002215,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,72.0,46.8,20.36,239.0,47
CDM,42002225,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,72.0,46.8,20.36,239.0,47
CDM,42002235,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,83.58,1222.0,61
CDM,42002245,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,83.58,1222.0,61
CDM,42100085,GOLF PERFORMANCE,110.0,71.5,16.37,239.0,46
CDM,42100AK,BIOPSY PALATE UVULA,598.0,388.7,1.1,2603.78,53
CDM,42104AK,EXC LESION PALATE UVULA W/O CLOSURE,676.0,439.4,1.1,5497.86,53
CDM,42106AK,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,860.0,559.0,1.1,5497.86,53
CDM,42120AK,RESCJ PALATE/EXTENSIVE RESCJ LESION,4744.0,3083.6,1.1,9999.36,50
CDM,42140AK,UVULECTOMY EXCISION UVULA,680.0,442.0,1.1,5497.86,53
CDM,42145AK,PALATOPHAYNGOPLASTY,3912.0,2542.8,1.1,9999.36,50
CDM,42160AK,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,740.0,481.0,1.1,5497.86,53
CDM,42210AK,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,6012.0,3907.8,1.1,9999.36,50
CDM,42300AK,"DRAIN ABSCESS PAROTID,SIMPLE",792.0,514.8,1.1,2603.78,53
CDM,42330AK,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,904.0,587.6,1.1,5497.86,53
CDM,42335AK,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,1364.0,886.6,1.1,5497.86,53
CDM,42400035,PT EVAL - LOW,605.0,393.25,73.97,605.0,60
CDM,42400045,PT EVAL - MOD,605.0,393.25,73.97,605.0,60
CDM,42400055,PT EVAL - HIGH,605.0,393.25,73.97,605.0,60
CDM,42400065,PT RE-EVAL,383.0,248.95,73.97,383.0,60
CDM,42400075,WORKWELL (NO SHOW),43.0,27.95,6.4,239.0,38
CDM,42400085,WORK SCREEN (WORKWELL),66.0,42.9,9.82,239.0,38
CDM,42400095,WORKWELL (UNIVAL),625.0,406.25,93.0,625.0,38
CDM,42400105,WORKWELL (UNIVAL) CANCL,298.0,193.7,44.34,298.0,38
CDM,42400AK,"BIOPSY SALIVARY GLAND,NEEDLE",343.0,222.95,1.1,1200.64,53
CDM,42405AK,BIOPSY SALIVARY GLAND INCISIONAL,1336.0,868.4,1.1,2603.78,53
CDM,42410AK,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,3828.0,2488.2,1.1,9999.36,50
CDM,42415AK,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,6864.0,4461.6,1.1,9999.36,50
CDM,42420AK,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,7812.0,5077.8,1.1,9999.36,50
CDM,42425AK,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,5368.0,3489.2,1.1,9999.36,50
CDM,42426AK,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,9064.0,5891.6,1.1,9064.0,50
CDM,42440AK,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,2702.0,1756.3,1.1,9999.36,50
CDM,42699RVU1AK,SIALOENDOSCOPY W SALIVARY DUCT STONE EXTRACTION (COMP 31255),2473.0,1607.45,0.01,2473.0,28
CDM,42700AK,"I & D ABSCESS, PERITONSILLAR",668.0,434.2,1.1,668.0,53
CDM,42800AK,BIOPSY OROPHARYNX,576.0,374.4,1.1,2603.78,53
CDM,42804AK,"BIOPSY NASOPHARYNX,SIMPLE",516.0,335.4,1.1,5497.86,53
CDM,42806AK,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,652.0,423.8,1.1,5497.86,53
CDM,42808AK,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,940.0,611.0,1.1,5497.86,53
CDM,42809AK,REMOVE PHARYNX FOREIGN BODY,744.0,483.6,1.1,744.0,53
CDM,42810AK,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,1352.0,878.8,1.1,5497.86,53
CDM,42815AK,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,2924.0,1900.6,1.1,9999.36,50
CDM,42820AK,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,1688.0,1097.2,1.1,9999.36,50
CDM,42821AK,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,1744.0,1133.6,1.1,5497.86,50
CDM,42825AK,TONSILLECTOMY PRIMARY/SECONDARY <AGE 12,1404.0,912.6,1.1,9999.36,50
CDM,42826AK,TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>,1380.0,897.0,1.1,5497.86,50
CDM,42830AK,ADENOIDECTOMY PRIMARY <AGE 12,1060.0,689.0,1.1,5497.86,50
CDM,42831AK,ADENOIDECTOMY PRIMARY AGE 12/>,1124.0,730.6,1.1,5497.86,50
CDM,42870AK,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,2208.0,1435.2,1.1,9999.36,50
CDM,42900AK,SUTURE PHARYNX WOUND/INJURY,2116.0,1375.4,1.1,2603.78,50
CDM,42960AK,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,952.0,618.8,1.1,952.0,50
CDM,42961AK,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,2308.0,1500.2,1.1,2308.0,50
CDM,42962AK,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3256.0,2116.4,1.1,5497.86,50
CDM,43000050,DEVELOPMENTAL TEST LIMITED,316.0,205.4,47.02,316.0,46
CDM,43000075,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,177.0,115.05,24.68,239.0,46
CDM,43000080,PARAFFIN BATH GO,166.0,107.9,7.7,239.0,60
CDM,43000095,IONTOPHORESIS 15MIN GO,189.0,122.85,23.82,239.0,60
CDM,43000105,US 15MIN GO,174.0,113.1,17.72,239.0,60
CDM,43000160,WORK HARDENING INIT 2HR GO,1004.0,652.6,24.68,1004.0,46
CDM,43000170,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,746.0,484.9,42.05,3004.0,46
CDM,43000325,OT WK CNDITIONNG PER 15 MIN,242.0,157.3,36.01,242.0,38
CDM,43000435,THERA FUNC ACTIVITIES 15M,274.0,178.1,44.62,274.0,60
CDM,43000435AK,THERA FUNC ACTIVITIES 15M,274.0,178.1,1.1,274.0,50
CDM,43000465,OT WHEELCHAIR MANAGEMENT 15 MI,254.0,165.1,39.57,254.0,60
CDM,43000465AK,OT WHEELCHAIR MANAGEMENT 15 MI,254.0,165.1,1.1,254.0,50
CDM,43000495,OT ELECTRICAL STIMULATION 15 M,239.0,155.35,18.62,239.0,60
CDM,43000500,THERA EXER 15MIN,258.0,167.7,37.06,258.0,60
CDM,43000510,NEURMSCL THERAPY 15MIN,261.0,169.65,41.24,261.0,60
CDM,43000520,MANUAL THERAPY 15MIN,241.0,156.65,35.04,241.0,60
CDM,43000530,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,274.0,178.1,44.62,274.0,60
CDM,43000550,SENSORY INTEGRATN EA 15M,188.0,122.2,53.17,239.0,60
CDM,43000560,EDUC HOME MGMT EA 15MIN GO,274.0,178.1,24.68,274.0,60
CDM,43000580,WHEELCHAIR MGMT EA 15 MIN,254.0,165.1,39.57,254.0,60
CDM,43000675,OT COMMUNITY REINTEGRATION/15M,176.0,114.4,40.61,239.0,60
CDM,43000780,WHIRLPOOL GO,179.0,116.35,20.16,239.0,60
CDM,43000790,GROUP THERAPY GO,234.0,152.1,22.65,239.0,60
CDM,43000800,TEST PHYSCL PERF EA 15MIN GO,272.0,176.8,42.65,272.0,60
CDM,43000805,ORTHO MGMT EXT/TRUNK 15MN GO,295.0,191.75,60.21,295.0,60
CDM,43000810,PROSTHTIC TRAINING EXT 15M GO,270.0,175.5,52.32,270.0,60
CDM,43000825,COGNITIVE TEST BY HC PRO,662.0,430.3,129.95,662.0,60
CDM,43000845,WC/WH EA ADDTL HR,503.0,326.95,24.68,503.0,46
CDM,43000875,DRIVER ON ROAD PER 60 MINS,100.0,65.0,14.88,239.0,46
CDM,43000925,JOBST COMPRESSION UT,203.0,131.95,14.87,239.0,60
CDM,43000935,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,126.0,81.9,17.37,239.0,60
CDM,43000945,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,202.0,131.3,24.68,239.0,60
CDM,43000995,"CONTRAST BATH, EA 15 MIN",126.0,81.9,17.37,239.0,60
CDM,43001025,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI,67.0,43.55,9.27,239.0,60
CDM,43001035,ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID,63.0,40.95,6.76,239.0,60
CDM,43001045,ELEC STIM - UNAT,177.0,115.05,24.68,239.0,46
CDM,43001065,BIOFDBK TRAIN ANY METHOD GO,319.0,207.35,23.22,319.0,60
CDM,43001115,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,176.0,114.4,40.61,239.0,60
CDM,43001125,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,176.0,114.4,40.61,239.0,60
CDM,43001135,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,296.0,192.4,48.65,296.0,60
CDM,43001145,ERGONOMIC STUDY,281.0,182.65,41.81,281.0,38
CDM,43001155,JOB SITE ANALYSIS,562.0,365.3,83.63,562.0,38
CDM,43001165,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,274.0,178.1,24.68,274.0,60
CDM,43001175,DRIVER'S ON ROAD,100.0,65.0,14.88,239.0,46
CDM,43001205,ORTH/PROS MGMT EA 15 MIN GO,320.0,208.0,66.46,320.0,60
CDM,43001265,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,21.54,425.0,61
CDM,43001275,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,61
CDM,43001285AK,DEVEL TST PHYS/QHP EA ADDL,281.0,182.65,1.1,281.0,53
CDM,43001345,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,239.0,60
CDM,43001355,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,239.0,60
CDM,43001365,LAKEMORE DRIVER SELF CARE (ADL/IADL) PER 15 MIN,72.0,46.8,10.71,239.0,38
CDM,43001375,LAKEMORE DRIVER COMMUNITY MOBILITY/DRIVER TRAINING PER 15 MIN,45.0,29.25,6.7,239.0,38
CDM,43001385,LAKEMORE/MERCY DRIVER BIOPTIC DRIVER TRAINING PER 15 MIN,49.0,31.85,7.29,239.0,38
CDM,43001395,LAKEMORE DRIVER LOW EVAL,388.0,252.2,57.73,388.0,38
CDM,43001405,LAKEMORE DRIVER MODERATE EVAL,359.0,233.35,53.42,359.0,38
CDM,43001415,LAKEMORE/MERCY DRIVER HIGH EVAL,388.0,252.2,57.73,388.0,38
CDM,43001465,VV THERAPEUTIC EXERCISE  OT (97110),258.0,167.7,37.06,258.0,60
CDM,43001475,VV NEUROMUSCULAR EDUCATION  OT (97112),261.0,169.65,41.24,261.0,60
CDM,43001485,VV EVALUATION LOW COMPLEXITY (97165),674.0,438.1,102.68,674.0,60
CDM,43001495,VV EVALUATION MODERATE COMPLEXITY (97166),674.0,438.1,102.68,674.0,60
CDM,43001505,VV EVALUATION HIGH COMPLEXITY (97167),674.0,438.1,102.68,674.0,60
CDM,43001515,VV SELF-CARE HOME MANAGEMENT OT (97535),274.0,178.1,24.68,274.0,60
CDM,43001545,LAKEMORE DRIVER FINAL FITTING OF EQUIPMENT,49.0,31.85,7.29,239.0,38
CDM,43001585,LAKE MORE MERCY DRIVER FINAL FITTING 1,250.0,162.5,37.2,250.0,38
CDM,43001595,LAKE MORE MERCY DRIVER FINAL FITTING 2,350.0,227.5,52.08,350.0,38
CDM,43001655,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,593.0,385.45,16.43,593.0,47
CDM,43001665,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,172.0,111.8,16.43,239.0,47
CDM,43001675,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,72.0,46.8,20.36,239.0,47
CDM,43001685,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,72.0,46.8,20.36,239.0,47
CDM,43100AK,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,3864.0,2511.6,1.1,3864.0,50
CDM,43101AK,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,6828.0,4438.2,1.1,6828.0,50
CDM,43107AK,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,20820.0,13533.0,1.1,20820.0,50
CDM,43117AK,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,23000.0,14950.0,1.1,23000.0,50
CDM,43122AK,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,17672.0,11486.8,1.1,17672.0,50
CDM,43124AK,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,27636.0,17963.4,1.1,27636.0,50
CDM,43180AK,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,3612.0,2347.8,1.1,9999.36,50
CDM,43191AK,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,996.0,647.4,1.1,3248.9,50
CDM,43192AK,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,1116.0,725.4,1.1,3248.9,50
CDM,43193AK,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,1116.0,725.4,1.1,3248.9,50
CDM,43194AK,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,1404.0,912.6,1.1,3248.9,50
CDM,43197AK,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,608.0,395.2,1.1,1548.29,53
CDM,43198AK,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,728.0,473.2,1.1,1548.29,53
CDM,43200AK,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,625.0,406.25,1.1,1548.29,53
CDM,43200URVUAK,ESOPHAGUS ENDOSCOPY,300.0,195.0,1.1,1548.29,53
CDM,43201AK,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,688.0,447.2,1.1,3248.9,53
CDM,43202AK,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,688.0,447.2,1.1,3248.9,53
CDM,43204AK,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,932.0,605.8,1.1,3248.9,50
CDM,43205AK,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,976.0,634.4,1.1,3248.9,50
CDM,43210AK,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,3100.0,2015.0,1.1,17575.94,50
CDM,43212AK,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,1360.0,884.0,1.1,9730.56,50
CDM,43215AK,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,976.0,634.4,1.1,3248.9,53
CDM,43220AK,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,800.0,520.0,1.1,3248.9,53
CDM,43226AK,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,896.0,582.4,1.1,3248.9,53
CDM,43227AK,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,1156.0,751.4,1.1,3248.9,53
CDM,43229AK,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,1396.0,907.4,1.1,6539.01,53
CDM,43231AK,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,1120.0,728.0,1.1,3248.9,51
CDM,43233AK,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,1628.0,1058.2,1.1,3248.9,50
CDM,43235AK,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,836.0,543.4,1.1,1548.29,53
CDM,43235URVUAK,"UPPR GI ENDOSCOPY, DIAGNOSIS",468.0,304.2,1.1,1548.29,53
CDM,43236AK,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,1052.0,683.8,1.1,1548.29,53
CDM,43237AK,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,1527.0,992.55,1.1,3248.9,50
CDM,43238AK,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,1830.0,1189.5,1.1,3248.9,50
CDM,43239AK,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,1052.0,683.8,1.1,1548.29,53
CDM,43239URVUAK,"UPPER GI ENDOSCOPY, BIOPSY",508.0,330.2,1.1,1548.29,53
CDM,43240AK,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,3146.0,2044.9,1.1,9730.56,50
CDM,43241AK,EGD INTRALUMINAL TUBE/CATHETER INSERTION,1096.0,712.4,1.1,3248.9,50
CDM,43242AK,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,2081.0,1352.65,1.1,3248.9,50
CDM,43243AK,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,1879.0,1221.35,1.1,3248.9,50
CDM,43244AK,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,1936.0,1258.4,1.1,3248.9,50
CDM,43245AK,EGD DILATION GASTRIC/DUODENAL STRICTURE,1355.0,880.75,1.1,3248.9,53
CDM,43246AK,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,1566.0,1017.9,1.1,3248.9,50
CDM,43246URVUAK,PLACE GASTROSTOMY TUBE,785.0,510.25,1.1,3248.9,50
CDM,43247AK,EGD FLEXIBLE FOREIGN BODY REMOVAL,1368.0,889.2,1.1,1548.29,53
CDM,43247URVUAK,OPERATIVE UPPER GI ENDOSCOPY,435.0,282.75,1.1,1548.29,53
CDM,43248AK,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,1280.0,832.0,1.1,1548.29,53
CDM,43249AK,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,1175.0,763.75,1.1,3525.33,53
CDM,43249URVUAK,"ESOPH ENDOSCOPY, DILATION",359.0,233.35,1.1,3525.33,53
CDM,43250AK,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,1307.0,849.55,1.1,3248.9,53
CDM,43251AK,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,1527.0,992.55,1.1,3248.9,53
CDM,43251URVUAK,OPERATIVE UPPER GI ENDOSCOPY,516.0,335.4,1.1,3248.9,53
CDM,43253AK,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,2081.0,1352.65,1.1,3248.9,50
CDM,43254AK,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,2143.0,1392.95,1.1,3248.9,50
CDM,43255AK,"EGD WITH CONTROL OF BLEED,",1566.0,1017.9,1.1,3248.9,53
CDM,43255URVUAK,OPERATIVE UPPER GI ENDOSCOPY,632.0,410.8,1.1,3248.9,53
CDM,43259AK,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,1616.0,1050.4,1.1,3248.9,50
CDM,43260AK,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,2340.0,1521.0,1.1,6539.01,50
CDM,43261AK,ERCP W/BIOPSY SINGLE/MULTIPLE,2460.0,1599.0,1.1,6539.01,50
CDM,43262AK,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,2600.0,1690.0,1.1,6539.01,50
CDM,43264AK,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,2917.0,1896.05,1.1,6539.01,50
CDM,43265AK,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,3489.0,2267.85,1.1,9730.56,50
CDM,43266AK,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,1568.0,1019.2,1.1,9730.56,50
CDM,43270AK,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,1604.0,1042.6,1.1,3248.9,53
CDM,43273AK,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,896.0,582.4,1.1,896.0,50
CDM,43274AK,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,3731.0,2425.15,1.1,9730.56,50
CDM,43275AK,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,3018.0,1961.7,1.1,3248.9,50
CDM,43276AK,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,3890.0,2528.5,1.1,9730.56,50
CDM,43277AK,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,2760.0,1794.0,1.1,6539.01,50
CDM,43278AK,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,3168.0,2059.2,1.1,6539.01,50
CDM,43279AK,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,8840.0,5746.0,1.1,8840.0,50
CDM,43280AK,LAPS SURG ESOPG/GSTR FUNDOPLASTY,7240.0,4706.0,1.1,17575.94,50
CDM,43280URVUAK,"LAPAROSCOPY, FUNDOPLASTY",2325.0,1511.25,1.1,17575.94,50
CDM,43281AK,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,10640.0,6916.0,1.1,17575.94,50
CDM,43281URVUAK,"LAPAROSCOPY, REPAIR OF  HERNIA W/O MESH",2780.0,1807.0,1.1,17575.94,50
CDM,43282AK,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,12040.0,7826.0,1.1,17575.94,50
CDM,43283AK,LAPS ESOPHAGEAL LENGTHENING ADDL,1298.0,843.7,1.1,1298.0,50
CDM,43285AK,REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE,4188.0,2722.2,1.1,9852.42,50
CDM,43286AK,ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ,22000.0,14300.0,1.1,22000.0,50
CDM,43287AK,ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ,25200.0,16380.0,1.1,25200.0,50
CDM,43288AK,ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ,26568.0,17269.2,1.1,26568.0,50
CDM,43289RVU3AK,"UNLISTED LAP RESECTION, ESOPHAGEAL DUPLICATION CYST (COMP CODE 4",7340.0,4771.0,0.01,9852.42,28
CDM,43290AK,EGD FLX TRNSORL W/DPLMNT NTRGSTR BARIATRIC BALO,1244.0,808.6,1.1,8673.03,52
CDM,43291AK,EGD FLX TRNSORL W/RMVL NTRGSTR BARIATRIC BALO,1120.0,728.0,1.1,1548.29,52
CDM,43330URVUAK,REPAIR OF ESOPHAGUS,2683.0,1743.95,1.1,4588.66,50
CDM,43332AK,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,7848.0,5101.2,1.1,7848.0,50
CDM,43332URVUAK,"LAP REPAIR, PARAESOPHAGEAL HIATAL HERNIA",2170.0,1410.5,1.1,3930.45,50
CDM,43333AK,LAPT RPR PARAESOPH HIATAL HERNIA W/ MESH,8584.0,5579.6,1.1,8584.0,50
CDM,43335AK,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,9588.0,6232.2,1.1,9588.0,50
CDM,43400035,OT EVAL - LOW,674.0,438.1,102.68,674.0,60
CDM,43400045,OT EVAL - MOD,674.0,438.1,102.68,674.0,60
CDM,43400055,OT EVAL - HIGH,674.0,438.1,102.68,674.0,60
CDM,43400065,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,383.0,248.95,87.79,383.0,60
CDM,43415AK,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,17952.0,11668.8,1.1,17952.0,50
CDM,43450AK,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,563.0,365.95,1.1,1548.29,53
CDM,43453AK,DILATION ESOPHAGUS GUIDE WIRE,564.0,366.6,1.1,3248.9,53
CDM,43460AK,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,1516.0,985.4,1.1,1516.0,50
CDM,43497AK,TRANSORAL LOWER ESOPHAGEAL MYOTOMY,5316.0,3455.4,1.1,9730.56,50
CDM,43499AGRVUAK,"UNLIST PROC, ESOPHAGUS COMPARED TO 43520",3726.0,2421.9,0.01,3726.0,28
CDM,43499AK,ESOPHAGUS SURG PROCEDURE UNLISTED,4326.0,2811.9,0.01,4326.0,28
CDM,43499RVU10AK,UNLISTED PROC; ENDO GASTROESOPH FISTULA PLUG PLCMT (COMP TO 4326,1296.0,842.4,0.01,1548.29,28
CDM,43499RVU11AK,ENDOSCOPIC SUBMUCOSAL DISSECTION OF  ESOPHAGUS - (COMP CODE 4304,9299.0,6044.35,0.01,9299.0,28
CDM,43499RVU12AK,UNLISTED MIN INVASIVE FOKER - ANASTOMOSIS (COMP CODE 43313),20591.0,13384.15,0.01,20591.0,28
CDM,43499RVU14AK,UNLISTED MIN INVASIVE FOKER - STRETCHING (COMP CODE 43425),10642.0,6917.3,0.01,10642.0,28
CDM,43499RVU16AK,"ENDOVAC, ESOPH; EGD (COMP 43235, 97605)",990.0,643.5,0.01,1548.29,28
CDM,43499RVU17AK,"ENDOVAC, ESOPH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2092.0,28
CDM,43499RVU18AK,THORACOSCOPY W/ LIGATION OF TRACHEOESOPH FISTULA & REP OF ESOPHA,19235.0,12502.75,0.01,19235.0,28
CDM,43499RVU2AK,PERORAL ENDOSCOPIC MYOTOMY,9116.0,5925.4,0.01,9116.0,28
CDM,43499RVU5AK,UNLISTED PROC; ORAL ENDOSCOPIC MYOTOMY (COMP TO 43279),7293.0,4740.45,0.01,7293.0,28
CDM,43499RVU7AK,"ENDOVAC, ESOPH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,1548.29,28
CDM,43500AK,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,5116.0,3325.4,1.1,5116.0,50
CDM,43501AK,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,9040.0,5876.0,1.1,9040.0,50
CDM,43520AK,PYLOROMYOTOMY CUTTING PYLORIC MUSC,4516.0,2935.4,1.1,4516.0,50
CDM,43605AK,"BIOPSY OF STOMACH,BY LAPAROTOMY",5488.0,3567.2,1.1,5488.0,50
CDM,43610AK,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,6536.0,4248.4,1.1,6536.0,50
CDM,43611AK,EXC LOCAL MALIGNANT TUMOR STOMACH,8152.0,5298.8,1.1,8152.0,50
CDM,43620AK,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,13616.0,8850.4,1.1,13616.0,50
CDM,43621AK,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,15812.0,10277.8,1.1,15812.0,50
CDM,43631AK,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,9804.0,6372.6,1.1,9804.0,50
CDM,43632AK,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,14056.0,9136.4,1.1,14056.0,50
CDM,43632URVUAK,"REMOVAL OF STOMACH, PARTIAL",3314.0,2154.1,1.1,6989.42,50
CDM,43633AK,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,13256.0,8616.4,1.1,13256.0,50
CDM,43635AK,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,824.0,535.6,1.1,824.0,50
CDM,43640AK,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,7824.0,5085.6,1.1,7824.0,50
CDM,43644AK,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,12936.0,8408.4,1.1,12936.0,50
CDM,43645AK,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,12612.0,8197.8,1.1,12612.0,50
CDM,43648AK,LAP REVISE/REMOVE GASTRIC NEUROSTIM ANTRUM,1543.0,1002.95,1.1,17575.94,38
CDM,43651AK,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,4052.0,2633.8,1.1,9852.42,50
CDM,43653AK,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,3392.0,2204.8,1.1,9852.42,50
CDM,43659AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43840)",2660.0,1729.0,0.01,9852.42,28
CDM,43659AGRVU2AK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43605)",1770.0,1150.5,0.01,9852.42,28
CDM,43659AGRVU3AK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43611)",3590.0,2333.5,0.01,9852.42,28
CDM,43659AGRVU4AK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43631)",4260.0,2769.0,0.01,9852.42,28
CDM,43659AGRVU5AK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43610)",5392.0,3504.8,0.01,9852.42,28
CDM,43659AGRVU6AK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",3775.0,2453.75,0.01,9852.42,28
CDM,43659AGRVU7AK,"UNLIST LAP PROC, STOMACH COMPARED TO 43633",10936.0,7108.4,0.01,10936.0,28
CDM,43659AGRVU8AK,"UNLIST LAP PROC, STOMACH COMPARED TO 43820",7435.0,4832.75,0.01,9852.42,28
CDM,43659AGRVU9AK,"UNLIST LAP PROC, STOMACH COMPARED TO 43825",7181.0,4667.65,0.01,9852.42,28
CDM,43659AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 44680)",2310.0,1501.5,0.01,9852.42,28
CDM,43659AK,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,3888.0,2527.2,0.01,9852.42,28
CDM,43659RVU11AK,ESO/GASTRECTOMY W RY ESO/JEJUNOSTOMY,14637.0,9514.05,0.01,14637.0,28
CDM,43659RVU12AK,LAPAROSCOPIC TOTAL GASTRECTOMY W/ROUX-EN Y ANASTOMOSIS (COMPARIS,13045.0,8479.25,0.01,13045.0,28
CDM,43659RVU13AK,UNLISTED LAPAROSCOPIC PYLOROPLASTY (COMPARED TO 43800),5092.0,3309.8,0.01,9852.42,28
CDM,43659RVU16AK,"LAPAROSCOPIC GASTROJEJUNOSTOMY, WITHOUT VAGOTOMY (COMP 43820)",7435.0,4832.75,0.01,9852.42,28
CDM,43659RVU18AK,LAPAROSCOPIC EXCISION MALIGNANT TUMOR OF STOMACH (COMP 43611),3590.0,2333.5,0.01,9852.42,28
CDM,43659RVU20AK,LAPAROSCOPIC EXCISION ULCER OR BENIGN TUMOR STOMACH (COMP CODE 4,5392.0,3504.8,0.01,9852.42,28
CDM,43659RVU22AK,"UNLISTED PROC, LAP DISTAL GASTRECTOMY W/GASTROJEJUNOSTOMY (COMP",11596.0,7537.4,0.01,11596.0,28
CDM,43659RVU24AK,LAP GASTROTOMY (COMP 43500),4221.0,2743.65,0.01,9852.42,28
CDM,43659RVU25AK,LAP REPAIR GASTRIC FISTULA (COMP 43880),9000.0,5850.0,0.01,9852.42,28
CDM,43659RVU26AK,LAP DUODENAL SWITCH PROCEDURE (COMP 43845),10659.0,6928.35,0.01,10659.0,28
CDM,43659RVU27AK,LAP PARTIAL GASTRECTOMY W RNY RECONSTRUC (COMP 43633),13256.0,8616.4,0.01,13256.0,28
CDM,43659RVU29AK,UNLISTED PROC; LAPAROSCOPIC DISTAL GASTRECTOMY W/GASTROJEJUOSTOM,12276.0,7979.4,0.01,12276.0,28
CDM,43659RVU30AK,"UNLISTED PROC, LAPAROSCOPIC TRUNCAL VAGOTOMY (COMP TO 43640)",6455.0,4195.75,0.01,9852.42,28
CDM,43659RVU31AK,UNLISTED PROC; LAPAROSCOPIC REVISION OF THE GASTRIC BYPASS GASTR,9587.0,6231.55,0.01,9852.42,28
CDM,43659RVU32AK,UNLISTED PROC; LAPARSCOPIC REVISION ROUX-EN-Y GASTRIC BYPASS GAS,10808.0,7025.2,0.01,10808.0,28
CDM,43659RVU33AK,LAPAROSCOPIC REVISION GASTROJEJUNAL ANASTOMOSIS W/EXCISION GASTR,9204.0,5982.6,0.01,9852.42,28
CDM,43659RVU34AK,LAPAROSCOPIC DISTAL GASTRECTOMY W/ROUX-EN-Y GASTROJEJU & LAP TRU,11616.0,7550.4,0.01,11616.0,28
CDM,43659RVU36AK,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH (COMP CODE 43843),9120.0,5928.0,0.01,9852.42,28
CDM,43659RVU38AK,LAPAROSCOPIC GASTROPEXY (COMP CODE 43338),950.0,617.5,0.01,9852.42,28
CDM,43659RVU39AK,LAPAROSCOPIC PYLOROMYOTOMY (COMP CODE 43520),4854.0,3155.1,0.01,9852.42,28
CDM,43659RVU40AK,LAPAROSCOPIC PARTIAL GASTRECTOMY FOR EXCISION OF GASTROCUTANEOUS,8713.0,5663.45,0.01,9852.42,28
CDM,43659RVU41AK,LAP TOTAL GASTRECTOMY W/RESECTION OF THE GASTROJEJUNOSTOMY (COMP,13616.0,8850.4,0.01,13616.0,28
CDM,43659RVU4AK,LAP. OVERSEW GASTR ULCER,5247.0,3410.55,0.01,9852.42,28
CDM,43659RVU5AK,LAP PARTIAL GASTRECTOMY (COMP CODE 43611),7337.0,4769.05,0.01,9852.42,28
CDM,43659RVU6AK,"LAP, GASTROJEJUNOSTOMY (COMP 43820)",6115.0,3974.75,0.01,9852.42,28
CDM,43659RVU7AK,LAP REVISION GASTROJEJUNOSTOMY (COMP 43860),6423.0,4174.95,0.01,9852.42,28
CDM,43659RVUAK,LAPAROSCOPIC PYLOROMYOTOMY (COMP 43800),3728.0,2423.2,0.01,9852.42,28
CDM,43752AK,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,356.0,231.4,1.1,680.96,44
CDM,43753AK,GASTRIC TUBE PLMT W/ASPIR & LAVAGE,180.0,117.0,1.1,535.81,50
CDM,43761AK,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,884.0,574.6,1.1,884.0,53
CDM,43762AK,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,330.0,214.5,1.1,741.3,53
CDM,43763AK,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,564.0,366.6,1.1,1104.2,53
CDM,43774AK,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,6304.0,4097.6,1.1,6539.01,50
CDM,43775AK,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,8967.0,5828.55,1.1,8967.0,50
CDM,43800AK,PYLOROPLASTY,6172.0,4011.8,1.1,6172.0,50
CDM,43820AK,GASTROJEJUNOSTOMY W/O VAGOTOMY,9012.0,5857.8,1.1,9012.0,50
CDM,43830AK,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,4340.0,2821.0,1.1,4340.0,50
CDM,43832AK,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,6936.0,4508.4,1.1,6936.0,50
CDM,43840AK,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,9132.0,5935.8,1.1,9132.0,50
CDM,43848AK,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,13100.0,8515.0,1.1,13100.0,50
CDM,43860AK,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,11156.0,7251.4,1.1,11156.0,50
CDM,43870AK,"CLOSURE OF GASTROSTOMY,SURGICAL",4576.0,2974.4,1.1,6539.01,50
CDM,43880AK,CLOSURE GASTROCOLIC FISTULA,10872.0,7066.8,1.1,10872.0,50
CDM,43882AK,REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN,1772.0,1151.8,1.1,1885.2,38
CDM,43889AK,GSTR RSTCV PX TRNSORL ESG W/ARGON PLASMA COAGJ,5526.0,3591.9,1.1,5526.0,35
CDM,43999AGRVU1AK,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",8927.0,5802.55,0.01,8927.0,28
CDM,43999AGRVU2AK,"UNLISTED PROCEDURE, STOMACH COMPARED TO CPT 43520",3726.0,2421.9,0.01,3726.0,28
CDM,43999AGRVUAK,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43610)",2880.0,1872.0,0.01,2880.0,28
CDM,43999AK,STOMACH SURGERY PROCEDURE UNLISTED,3523.0,2289.95,0.01,3523.0,28
CDM,43999RVU10AK,"PARTIAL GATRECTOMY, PROXIMAL (COMP 43610)",8533.0,5546.45,0.01,8533.0,28
CDM,43999RVU11AK,ENDOSCOPIC PYLOROMYOTOMY (COMP 43520),4700.0,3055.0,0.01,4700.0,28
CDM,43999RVU12AK,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),1364.0,886.6,0.01,1548.29,28
CDM,43999RVU15AK,OPEN GASTROPEXY (COMP TO 44680),5927.0,3852.55,0.01,5927.0,28
CDM,43999RVU19AK,EGD W/ SUTURE REPAIR OF STOMACH (COMP CODE 43840),8219.0,5342.35,0.01,8219.0,28
CDM,43999RVU21AK,ENDOSCOPIC WOUND VAC PLACEMENT (COMP CODE 43235 & 97605),1122.0,729.3,0.01,1548.29,28
CDM,43999RVU22AK,TRANS ORAL GASTRIC OUTLET REDUCTION TORE (COMP CODE 43771),8836.0,5743.4,0.01,8836.0,28
CDM,43999RVU24AK,ENDOSCOPIC SUBMUCOSAL DISSECTION OF STOMACH - (COMP CODE 43611),8662.0,5630.3,0.01,8662.0,28
CDM,43999RVU25AK,OPEN GASTRIC BAND REMOVAL (COMP CODE 43774),6776.0,4404.4,0.01,6776.0,28
CDM,43999RVU26AK,CENTRAL GASTRECTOMY WITH GASTROGASTROSTOMY (COMP 43631),8824.0,5735.6,0.01,8824.0,28
CDM,43999RVU27AK,"ENDOVAC, STOMACH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,1548.29,28
CDM,43999RVU28AK,"ENDOVAC, STOMACH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2092.0,28
CDM,43999RVU29AK,"LIGATION OF GASTRIC VARIED, OPEN (COMP CODE 43244)",1893.0,1230.45,0.01,1893.0,28
CDM,43999RVU30AK,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),884.0,574.6,0.01,1548.29,28
CDM,43999RVU31AK,SLEEVE GASTRECTOMY TO SINGLE ANASTOMOSIS DUODENAL SWITCH (SADIS),13320.0,8658.0,0.01,13320.0,28
CDM,43999RVU32AK,TRANSNASAL EGD W/REMOVAL OF FOREIGN BODY (COMP 43247),1368.0,889.2,0.01,1548.29,28
CDM,43999RVU3AK,"LAP, REVISION NISSEN FUNDOPLASTY (COMP 43280)",7240.0,4706.0,0.01,7240.0,28
CDM,43999RVU4AK,EXC GASTROCUTANEOUS FISTULA (COMP 44640),4221.0,2743.65,0.01,4221.0,28
CDM,43999RVU5AK,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",9866.0,6412.9,0.01,9866.0,28
CDM,43999RVU7AK,PARTIAL GASTRECTOMY (COMP CODE 43610),2880.0,1872.0,0.01,2880.0,28
CDM,43999RVU8AK,UNLISTED PROC; PARTIAL PROXIMAL GASTRECTOMY W/ROUX-EN-Y GASTROJE,10936.0,7108.4,0.01,10936.0,28
CDM,44000040,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,570.0,370.5,56.15,570.0,60
CDM,44000065,STANDARDIZED COGNITIVE PERFORMANCE TESTING,662.0,430.3,129.95,662.0,60
CDM,44000080,ASSESS APHASIA PER HR,480.0,312.0,124.17,480.0,60
CDM,44000090,SPEECH/HEARING THERAPY INDIV,473.0,307.45,56.15,473.0,60
CDM,44000155,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,473.0,307.45,56.15,473.0,60
CDM,44000160,TREAT SWALLOWING DYSFUNCTION,664.0,431.6,67.54,664.0,60
CDM,44000165,SLT-SPEECH/LANGUAG THERAPY GRP,283.0,183.95,30.03,283.0,60
CDM,44000175,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR,775.0,503.75,56.15,775.0,46
CDM,44000185,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,1420.0,923.0,56.15,1420.0,60
CDM,44000225,SLT-THERA SVC COM DEV PRG MOD,629.0,408.85,67.54,629.0,60
CDM,44000265,BEHAV QUAL ANLYS VOICE MO,544.0,353.6,56.15,544.0,60
CDM,44000410,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,544.0,353.6,56.15,544.0,60
CDM,44000435,"SLT-DEVELOPMENTAL TEST,LIM",316.0,205.4,47.02,316.0,46
CDM,44000510,FIT PROSTHTIC VOICE DVC 440,636.0,413.4,56.15,636.0,60
CDM,44000515,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,570.0,370.5,56.15,570.0,60
CDM,44000520,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,829.0,538.85,113.2,829.0,60
CDM,44000525,FEES W CINE OR VIDEO,1084.0,704.6,74.78,1084.0,60
CDM,44000530,COGNITIVE TEST BY HCPRO GN,662.0,430.3,129.95,662.0,60
CDM,44000550,"SENSORY INTEGRATION, EA 1",188.0,122.2,53.17,239.0,60
CDM,44000585,LARYNGEAL FUNCTION STUDIES,516.0,335.4,69.7,516.0,61
CDM,44000605,THER SVC N-SP-GENRATJ DEV PRGRMG&MODIFICAJ,207.0,134.55,24.68,239.0,46
CDM,44000695,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,21.54,425.0,61
CDM,44000705,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,61
CDM,44000715,DEVEL TST PHYS/QHP EA ADDL,302.0,196.3,65.84,302.0,46
CDM,44000755,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,239.0,60
CDM,44000765,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,239.0,60
CDM,44000885,VV SPEECH THERAPY (92507),473.0,307.45,56.15,473.0,60
CDM,44000895,VV FLUENCY EVAL (92521),593.0,385.45,56.15,593.0,60
CDM,44000905,VV SOUND PRODUCTION EVALUATION (92522),573.0,372.45,56.15,573.0,60
CDM,44000915,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523),1002.0,651.3,56.15,1002.0,60
CDM,44000925,VV VOICE EVAL (92524),544.0,353.6,56.15,544.0,60
CDM,44000935,SLT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,31.04,887.0,60
CDM,44000945,SLT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,60
CDM,44000955,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,887.0,576.55,13.13,887.0,60
CDM,44000985,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQ,593.0,385.45,37.45,593.0,61
CDM,44000995,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,172.0,111.8,34.46,239.0,53
CDM,44001005,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,72.0,46.8,20.36,239.0,47
CDM,44001015,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,72.0,46.8,20.36,239.0,47
CDM,44001025,AUDIOGRAM,28.0,18.2,4.17,239.0,38
CDM,44005AK,ENTEROLSS FRING INTSTINAL ADHESION SPX,7384.0,4799.6,1.1,7384.0,50
CDM,44005URVUAK,FREEING OF BOWEL ADHESION,2181.0,1417.65,1.1,3741.83,50
CDM,44010URVUAK,INCISION OF SMALL BOWEL,1586.0,1030.9,1.1,2897.0,50
CDM,44015AK,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,1048.0,681.2,1.1,1048.0,50
CDM,44020AK,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,6488.0,4217.2,1.1,6488.0,50
CDM,44020URVUAK,EXPLORATION OF SMALL BOWEL,2288.0,1487.2,1.1,3338.64,50
CDM,44021AK,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,6524.0,4240.6,1.1,6524.0,50
CDM,44025AK,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,6604.0,4292.6,1.1,6604.0,50
CDM,44025URVUAK,"COLOTOMY, EXPLORATION, BIOPSY OR F.BODY",2180.0,1417.0,1.1,3356.61,50
CDM,44050AK,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,6208.0,4035.2,1.1,6208.0,50
CDM,44050URVUAK,REDUCE BOWEL OBSTRUCTION,1580.0,1027.0,1.1,3211.54,50
CDM,44055AK,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,10252.0,6663.8,1.1,10252.0,50
CDM,44055URVUAK,CORRECT MALROTATION OF BOWEL,3826.0,2486.9,1.1,5100.99,50
CDM,44110AK,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,5616.0,3650.4,1.1,5616.0,50
CDM,44110URVU1AK,EXCISION LESION(S) OF SM / LG INTESTINE,1763.0,1145.95,1.1,2894.51,50
CDM,44110URVUAK,EXCISION OF BOWEL LESION(S),1763.0,1145.95,1.1,2894.51,50
CDM,44111AK,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,6608.0,4295.2,1.1,6608.0,50
CDM,44120AK,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,8328.0,5413.2,1.1,8328.0,50
CDM,44120URVUAK,REMOVAL OF SMALL INTESTINE,2466.0,1602.9,1.1,4187.16,50
CDM,44121AK,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,1776.0,1154.4,1.1,1776.0,50
CDM,44121URVUAK,REMOVAL OF SMALL INTESTINE,455.0,295.75,1.1,825.31,50
CDM,44125AK,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,8813.0,5728.45,1.1,8813.0,50
CDM,44130AK,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,8844.0,5748.6,1.1,8844.0,50
CDM,44139AK,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,892.0,579.8,1.1,892.0,50
CDM,44139URVUAK,MOBILIZATION OF COLON,280.0,182.0,1.1,411.8,50
CDM,44140AK,COLECTOMY PARTIAL W/ANASTOMOSIS,9036.0,5873.4,1.1,9036.0,50
CDM,44140URVUAK,PARTIAL REMOVAL OF COLON,2688.0,1747.2,1.1,4592.08,50
CDM,44141AK,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,11964.0,7776.6,1.1,11964.0,50
CDM,44143AK,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,11116.0,7225.4,1.1,11116.0,50
CDM,44143URVUAK,PARTIAL REMOVAL OF COLON,3249.0,2111.85,1.1,5654.26,50
CDM,44144AK,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,11964.0,7776.6,1.1,11964.0,50
CDM,44144URVUAK,PARTIAL REMOVAL OF COLON,3418.0,2221.7,1.1,6035.04,50
CDM,44145AK,COLECTOMY PRTL W/COLOPROCTOSTOMY,11432.0,7430.8,1.1,11432.0,50
CDM,44145URVUAK,PARTIAL REMOVAL OF COLON,3306.0,2148.9,1.1,5632.91,50
CDM,44146AK,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,14120.0,9178.0,1.1,14120.0,50
CDM,44146URVUAK,PARTIAL REMOVAL OF COLON,4219.0,2742.35,1.1,7145.52,50
CDM,44147AK,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,13476.0,8759.4,1.1,13476.0,50
CDM,44150AK,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,12072.0,7846.8,1.1,12072.0,50
CDM,44150URVUAK,REMOVAL OF COLON,3093.0,2010.45,1.1,6312.11,50
CDM,44151AK,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,13968.0,9079.2,1.1,13968.0,50
CDM,44155AK,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,13768.0,8949.2,1.1,13768.0,50
CDM,44158AK,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,14680.0,9542.0,1.1,14680.0,50
CDM,44160AK,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,8356.0,5431.4,1.1,8356.0,50
CDM,44160URVUAK,REMOVAL OF COLON,2096.0,1362.4,1.1,4247.71,50
CDM,44180AK,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,6108.0,3970.2,1.1,9852.42,50
CDM,44180URVUAK,"LAPAROSCOPY,ENTEROLYSIS",1759.0,1143.35,1.1,9852.42,50
CDM,44186AK,LAPAROSCOPY SURGICAL JEJUNOSTOMY,4152.0,2698.8,1.1,9852.42,50
CDM,44187AK,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,6960.0,4524.0,1.1,6960.0,50
CDM,44188AK,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,7740.0,5031.0,1.1,7740.0,50
CDM,44202AK,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,9356.0,6081.4,1.1,9356.0,50
CDM,44203AK,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,1776.0,1154.4,1.1,1776.0,50
CDM,44204AK,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,10568.0,6869.2,1.1,10568.0,50
CDM,44205AK,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,10098.0,6563.7,1.1,10098.0,50
CDM,44206AK,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,11916.0,7745.4,1.1,11916.0,50
CDM,44207AK,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,14045.0,9129.25,1.1,14045.0,50
CDM,44207URVUAK,"ENTERECTOMY,SMALL INT, SINGLE RESECT",3120.0,2028.0,1.1,6167.95,50
CDM,44208AK,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,14956.0,9721.4,1.1,14956.0,50
CDM,44210AK,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,12036.0,7823.4,1.1,12036.0,50
CDM,44211AK,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,14832.0,9640.8,1.1,14832.0,50
CDM,44212AK,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,13832.0,8990.8,1.1,13832.0,50
CDM,44213AK,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,1400.0,910.0,1.1,1400.0,50
CDM,44213URVUAK,"LAP, MOBIL SPLENIC FL ADD-ON",310.0,201.5,1.1,634.51,50
CDM,44227AK,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,11448.0,7441.2,1.1,11448.0,50
CDM,44238AAK,"LX PROCTOSIGMOID, CAA, ILEOSTOMY",7104.0,4617.6,0.01,9852.42,34
CDM,44238AGRVU1AK,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",1820.0,1183.0,0.01,9852.42,34
CDM,44238AGRVU2AK,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",2500.0,1625.0,0.01,9852.42,34
CDM,44238AGRVU3AK,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",5122.0,3329.3,0.01,9852.42,34
CDM,44238AGRVU4AK,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) COMPARED TO 44144",9870.0,6415.5,0.01,9870.0,34
CDM,44238AGRVUAK,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",2120.0,1378.0,0.01,9852.42,34
CDM,44238AK,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,2575.0,1673.75,0.01,9852.42,34
CDM,44238RVU10AK,LAP EXCISION OF LARGE BOWEL LESION(S) (COMP 44110),3791.0,2464.15,0.01,9852.42,34
CDM,44238RVU11AK,LX EXCISION OF MECKEL'S DIVERTICULUM (COMP CODE 44800),4226.0,2746.9,0.01,9852.42,34
CDM,44238RVU13AK,LAP EXCISION SM BOWEL LESION,2500.0,1625.0,0.01,9852.42,34
CDM,44238RVU14AK,"LAP SUTURE OF SM INTESTINE, SINGLE (COMP 44602)",4495.0,2921.75,0.01,9852.42,34
CDM,44238RVU17AK,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) (COMP CODE 44144)",9870.0,6415.5,0.01,9870.0,34
CDM,44238RVU18AK,LAP REPAIR ENTEROCUTANEOUS FISTULA (COMP 44640),9684.0,6294.6,0.01,9852.42,34
CDM,44238RVU19AK,"LAP REDUCE VOLVULUS,INTUSS,INTERNAL HERNIA (COMP 44050)",5588.0,3632.2,0.01,9852.42,34
CDM,44238RVU1AK,LAPAROSCOPIC STRICTUROPLASTY (COMP 44615),6538.0,4249.7,0.01,9852.42,34
CDM,44238RVU20AK,LAP CLOSURE OF ILEOSIGMOID FISTULA (COMP 44650),5656.0,3676.4,0.01,9852.42,34
CDM,44238RVU21AK,"LAP SUTURE OF LG INTESTINE, SINGLE/MULT (COMP 44604)",5857.0,3807.05,0.01,9852.42,34
CDM,44238RVU22AK,UNLISTED PROC; LAP REVISION OF ILEOSTOMY; COMPLICATED (COMP TO 4,17632.0,11460.8,0.01,17632.0,34
CDM,44238RVU23AK,"UNLISTED PROC, LAP REPAIR OF DUODENAL PERFORATION (COMP TO 44602",8158.0,5302.7,0.01,9852.42,34
CDM,44238RVU24AK,UNLISTED LAPAROSCOPIC COMPLETION PROCTECTOMY WITH ILEOANAL POUCH,14118.5,9177.03,0.01,14118.5,34
CDM,44238RVU28AK,LAP CLOSURE OF ENTEROVESICAL FISTULA W/O RESECTION (COMP 44660),10281.0,6682.65,1.1,10281.0,50
CDM,44238RVU29AK,LAPAROSCOPIC BRAUN ENTEROENTEROSTOMY (COMP 44130),9507.0,6179.55,0.01,9852.42,34
CDM,44238RVU30AK,LAP EXCISION OF CECUM W/O ANASTOMOSIS (COMP 44110),6037.0,3924.05,0.01,9852.42,34
CDM,44238RVU31AK,LAP REVISION COLOSTOMY W/RPR PARACOLOSTOMY HERNIA (COMP 44346),5035.0,3272.75,0.01,9852.42,34
CDM,44238RVU32AK,LAPAROSCOPIC EXCISION SMALL BOWEL LESION/S (COMP 44110),6037.0,3924.05,0.01,9852.42,34
CDM,44238RVU33AK,LAPAROSCOPIC PARTIAL COLECTOMY WITHOUT ANASTOMOSIS (COMP CODE 44,11360.0,7384.0,0.01,11360.0,34
CDM,44238RVU34AK,UNLISTED LAP LADDS PROCEDURE (COMP CODE 44055),9227.0,5997.55,0.01,9852.42,34
CDM,44238RVU35AK,LAPAROSCOPIC ILEOCOLOSTOMY PEXY (COMP 44312),3395.0,2206.75,0.01,9852.42,34
CDM,44238RVU36AK,LAP GRAHAM PATCH INTESTINE (COMP 43840),8219.0,5342.35,0.01,9852.42,34
CDM,44238RVU37AK,LAPAROSCOPIC REMOVAL OF FOREIGN BODY; SMALL INTESTINE (COMP 4402,5840.0,3796.0,0.01,9852.42,34
CDM,44238RVU38AK,LAP REVISION OF ILEAL POUCH W/ RESECTION (COMP 46712),13123.0,8529.95,0.01,13123.0,34
CDM,44238RVU39AK,LAPAROSCOPIC CECOPEXY (COMP CODE 44680),6466.0,4202.9,0.01,9852.42,34
CDM,44238RVU3AK,LAPARSCOPIC CLOSURE ENTEROCOLIC FISTULA (COMP 44650),10096.0,6562.4,0.01,10096.0,34
CDM,44238RVU40AK,LAP COLECTOMY W/REMOVAL OF TI; NO ANASTOMOSIS W/ STOMA (COMP 442,10725.0,6971.25,0.01,10725.0,34
CDM,44238RVU6AK,LX TAKEDOWN OF COLOVESICLE FIST W/RESECT (COMP CODE 44661),10664.0,6931.6,0.01,10664.0,34
CDM,44300AK,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,5500.0,3575.0,1.1,5500.0,50
CDM,44300URVUAK,OPEN BOWEL TO SKIN,1361.0,884.65,1.1,2884.74,50
CDM,44310AK,"ILEOSTOMY/JEJUNOSTOMY,NONTUBE",7740.0,5031.0,1.1,7740.0,50
CDM,44310URVUAK,ILEOSTOMY/JEJUNOSTOMY,2123.0,1379.95,1.1,3551.93,50
CDM,44312AK,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,3772.0,2451.8,1.1,6125.06,50
CDM,44314AK,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,6696.0,4352.4,1.1,6696.0,50
CDM,44320AK,COLOSTOMY/SKIN LEVEL CECOSTOMY,7964.0,5176.6,1.1,7964.0,50
CDM,44340AK,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,3712.0,2412.8,1.1,6125.06,50
CDM,44345AK,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,6888.0,4477.2,1.1,6888.0,50
CDM,44346AK,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,7852.0,5103.8,1.1,7852.0,50
CDM,44360AK,ENDOSCOPY UPPER SMALL INTESTINE,996.0,647.4,1.1,3248.9,50
CDM,44361AK,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,1108.0,720.2,1.1,3248.9,50
CDM,44363AK,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,1356.0,881.4,1.1,3248.9,50
CDM,44364AK,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,1452.0,943.8,1.1,3248.9,50
CDM,44365AK,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,1284.0,834.6,1.1,3248.9,50
CDM,44366AK,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,1720.0,1118.0,1.1,3248.9,50
CDM,44369AK,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,1764.0,1146.6,1.1,3248.9,50
CDM,44370AK,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,1876.0,1219.4,1.1,9730.56,50
CDM,44372AK,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,1720.0,1118.0,1.1,3248.9,50
CDM,44373AK,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,1356.0,881.4,1.1,3248.9,50
CDM,44376AK,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,2060.0,1339.0,1.1,3248.9,50
CDM,44377AK,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,2168.0,1409.2,1.1,3248.9,50
CDM,44378AK,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,2808.0,1825.2,1.1,3248.9,50
CDM,44379AK,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,2944.0,1913.6,1.1,9730.56,50
CDM,44380AK,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,348.0,226.2,1.1,1548.29,53
CDM,44381AK,ILEOSCOPY STOMA W/BALLOON DILATION,552.0,358.8,1.1,3248.9,47
CDM,44382AK,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,468.0,304.2,1.1,1548.29,53
CDM,44384AK,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,1140.0,741.0,1.1,3248.9,44
CDM,44385AK,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,528.0,343.2,1.1,1560.83,53
CDM,44386AK,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,660.0,429.0,1.1,1560.83,53
CDM,44388AK,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,1088.0,707.2,1.1,1560.83,53
CDM,44389AK,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,1329.0,863.85,1.1,2014.21,53
CDM,44390AK,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,1496.0,972.4,1.1,1560.83,53
CDM,44391AK,COLONOSCOPY STOMA CONTROL BLEEDING,1648.0,1071.2,1.1,2109.19,53
CDM,44392AK,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,1412.0,917.8,1.1,2014.21,53
CDM,44394AK,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,1612.0,1047.8,1.1,2014.21,53
CDM,44394URVUAK,COLONOSCOPY W/SNARE,590.0,383.5,1.1,2014.21,53
CDM,44400005,SWALLOW EVAL FUNC FLUORO GN,829.0,538.85,113.2,829.0,60
CDM,44400030,EVALUATE SWALLOWING FUNCTION,570.0,370.5,56.15,570.0,60
CDM,44400045,EVAL OF SPEECH PRODUCTION,573.0,372.45,56.15,573.0,60
CDM,44400050,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,573.0,372.45,56.15,573.0,60
CDM,44400055,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1002.0,651.3,56.15,1002.0,60
CDM,44400060,EVAL SPEECH SOUND LANG COMPREH,1002.0,651.3,56.15,1002.0,60
CDM,44400065,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,544.0,353.6,56.15,544.0,60
CDM,44400075,EVAL OF SPEECH FLUENCY,593.0,385.45,56.15,593.0,60
CDM,44400145,EVAL SPCH - GEN DEV 1 HR,1420.0,923.0,56.15,1420.0,60
CDM,44400155,EVAL SPCH - GEN DEV 30 MN,172.0,111.8,48.64,239.0,60
CDM,44403AK,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,2200.0,1430.0,1.1,2200.0,44
CDM,44404AK,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,1208.0,785.2,1.1,2014.21,47
CDM,44405AK,COLONOSCOPY STOMA W/BALLOON DILATION,1292.0,839.8,1.1,2014.21,47
CDM,44408AK,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,1656.0,1076.4,1.1,1656.0,50
CDM,44500AK,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,172.0,111.8,1.1,1548.29,50
CDM,44602AK,ENTERORRHAPHY SINGLE PERFORATION,9888.0,6427.2,1.1,9888.0,50
CDM,44602URVUAK,"SUTURE, SMALL INTESTINE",2254.0,1465.1,1.1,4828.42,50
CDM,44603AK,ENTERORRHAPHY MULTIPLE PERFORATIONS,11264.0,7321.6,1.1,11264.0,50
CDM,44603URVUAK,"SUTURE, SMALL INTESTINE",3088.0,2007.2,1.1,5534.76,50
CDM,44604AK,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,7264.0,4721.6,1.1,7264.0,50
CDM,44604URVUAK,SUTURE OF LG INTESTINE W/O COLOSTOMY,2230.0,1449.5,1.1,3614.19,50
CDM,44605AK,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,8832.0,5740.8,1.1,8832.0,50
CDM,44615AK,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,7264.0,4721.6,1.1,7264.0,50
CDM,44620AK,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,6349.0,4126.85,1.1,6349.0,50
CDM,44620URVUAK,REPAIR BOWEL OPENING,1910.0,1241.5,1.1,2952.97,50
CDM,44625AK,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,6912.0,4492.8,1.1,6912.0,50
CDM,44626AK,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,11160.0,7254.0,1.1,11160.0,50
CDM,44640AK,CLOSURE INTESTINAL CUTANEOUS FISTULA,9680.0,6292.0,1.1,9680.0,50
CDM,44650AK,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,10048.0,6531.2,1.1,10048.0,50
CDM,44650URVUAK,REPAIR BOWEL FISTULA,3738.0,2429.7,1.1,4919.8,50
CDM,44660AK,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,9564.0,6216.6,1.1,9564.0,50
CDM,44661AK,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,10940.0,7111.0,1.1,10940.0,50
CDM,44680AK,INTESTINAL PLICATION SEPARATE PROCEDURE,7184.0,4669.6,1.1,7184.0,50
CDM,44700AK,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,6992.0,4544.8,1.1,6992.0,50
CDM,44701AK,INTRAOPERATIVE COLONIC LAVAGE,1240.0,806.0,1.1,1240.0,50
CDM,44705AK,PREPARE FECAL MICROBIOTA FOR INSTILLATION,568.0,369.2,1.1,568.0,42
CDM,44799AGRVU1AK,"UNLIST PROC, SMALL INTESTINE COMPARED TO 44110",4633.0,3011.45,0.01,4633.0,28
CDM,44799AGRVU2AK,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44394",1373.0,892.45,0.01,1548.29,28
CDM,44799AGRVU3AK,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44705",469.0,304.85,0.01,1548.29,28
CDM,44799AGRVU4AK,"UNLIST PROC, SMALL INTESTINE COMPARED TO 43265",3105.0,2018.25,0.01,3105.0,28
CDM,44799AGRVU5AK,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 43236",935.0,607.75,0.01,1548.29,28
CDM,44799AGRVUAK,"UNLISTED PROCEDURE, SMALL INTESTINE (COMPARISON CODE 15860)",325.0,211.25,0.01,1548.29,28
CDM,44799AK,UNLISTED PROCEDURE SMALL INTESTINE,335.0,217.75,0.01,1548.29,28
CDM,44799RVU11AK,UNLISTED PROC; DUODENUM EXCLUS W/GASTROTOMY & GASTROJEJUNOSTOMY,10025.0,6516.25,0.01,10025.0,28
CDM,44799RVU12AK,"UNLISTED PROC, OPEN ISOPERISTALTIC GASTROJEJNOSTOMY (COMP CODE 4",10025.0,6516.25,0.01,10025.0,28
CDM,44799RVU18AK,POUCHOSCOPY W/SNARE (COMP 44386),645.0,419.25,0.01,1548.29,28
CDM,44799RVU20AK,REPAIR DUODENAL FISTULA (COMP 44650),4409.0,2865.85,0.01,4409.0,28
CDM,44799RVU26AK,ILEOSCOPY WITH ABLATION VIA STOMA (COMP CODE 44401),1833.0,1191.45,0.01,1833.0,28
CDM,44799RVU28AK,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),2346.0,1524.9,0.01,2346.0,28
CDM,44799RVU30AK,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),881.0,572.65,0.01,1548.29,28
CDM,44799RVU35AK,ENDOSCOPIC SUBMUCOSAL DISSECTION OF SMALL INSTESTINE - (COMP COD,9941.0,6461.65,0.01,9941.0,28
CDM,44799RVU36AK,CORRECTION OF GUT MALROTATION (EG. KAREEM'S PROCEDURE) - (COMP C,11020.0,7163.0,0.01,11020.0,28
CDM,44799RVU37AK,LAPAROSCOPIC OVERSEW OF SMALL BOWEL ANASTOMOSIS (COMP 44620),6204.0,4032.6,1.1,6204.0,50
CDM,44799RVU38AK,ILEOSCOPY W/ CONTROL OF BLEEDING THROUGH THE STOMA (COMP 44378),3018.0,1961.7,0.01,3018.0,28
CDM,44799RVU39AK,"ENDOVAC, SMALL INT; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,1548.29,28
CDM,44799RVU40AK,"ENDOVAC, SMALL INT; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2092.0,28
CDM,44799RVU41AK,"ENDOVAC, SMALL INT; EGD (COMP 43235, 97605)",990.0,643.5,0.01,1548.29,28
CDM,44799RVU42AK,"ENDOVAC, SMALL INT; POUCHOSCOPY (COMP 44385, 97605)",2203.0,1431.95,0.01,2203.0,28
CDM,44799RVU43AK,POUCHOSCOPY W/ STENT PLACEMENT (COMP 44402),1693.0,1100.45,0.01,1693.0,28
CDM,44799RVU44AK,EGD THROUGH ARTIFICIAL STOMA (COMP 44369),1588.0,1032.2,0.01,1588.0,28
CDM,44799RVU45AK,SMALL INTESTINE MYRIAD COLLAGEN MATRIX IMPLANT (COMP 15777),1315.0,854.75,0.01,1548.29,28
CDM,44799RVU46AK,RETROGRADE ENTEROSCOPY W/DILATION (COMP 45386),1659.0,1078.35,0.01,1659.0,28
CDM,44799RVU47AK,EGD W/ CLIPPING OF INTESTINAL FISTULA (COMP 43255),1566.0,1017.9,0.01,1566.0,28
CDM,44799RVU48AK,POUCHOSCOPY W/DECOMPRESSION (COMP 45393),2059.0,1338.35,0.01,2059.0,28
CDM,44799RVU49AK,REVISION OF JEJUNOSTOMY (COMP 44314),6696.0,4352.4,0.01,6696.0,28
CDM,44799RVU4AK,REVISION OF ANASTOMOSIS (COMP 44125),8813.0,5728.45,0.01,8813.0,28
CDM,44800AK,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,4820.0,3133.0,1.1,4820.0,50
CDM,44820AK,EXCISION LESION MESENTERY SEPARATE PROCEDURE,5492.0,3569.8,1.1,5492.0,50
CDM,44850AK,SUTURE MESENTERY SEPARATE PROCEDURE,4844.0,3148.6,1.1,4844.0,50
CDM,44899AGRVU1AK,"UNLISTED PROC, MECKEL'S DIVERTICULUM & THE MESENTERY COMPARED TO",3977.0,2585.05,0.01,1792000.0,28
CDM,44899AGRVUAK,"UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY (COM",1790.0,1163.5,0.01,1792000.0,28
CDM,44899AK,UNLISTED PX MECKEL'S DIVERTICULUM & MESENTERY,1844.0,1198.6,0.01,1792000.0,28
CDM,44899RVU2AK,UNLISTED PROC; LAPAROSCOPIC CORE NEEDLE BIOPSY(IES) MESENTERY PR,2224.0,1445.6,0.01,1792000.0,28
CDM,44900URVUAK,"DRAIN APP ABSCESS, OPEN",1833.0,1191.45,1.1,2696.01,50
CDM,44950AK,APPENDECTOMY,4240.0,2756.0,1.1,12916.74,50
CDM,44950URVUAK,APPENDECTOMY,1086.0,705.9,1.1,12916.74,50
CDM,44955AK,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,612.0,397.8,1.1,612.0,50
CDM,44955URVUAK,APPENDECTOMY ADD-ON,163.0,105.95,1.1,286.61,50
CDM,44960AK,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,5800.0,3770.0,1.1,5800.0,50
CDM,44960URVUAK,APPENDECTOMY,1438.0,934.7,1.1,3011.67,50
CDM,44970AK,LAPAROSCOPIC APPENDECTOMY,3780.0,2457.0,1.1,9852.42,50
CDM,44970URVUAK,"LAPAROSCOPY, APPENDECTOMY",1129.0,733.85,1.1,9852.42,50
CDM,44979AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX",4148.0,2696.2,0.01,9852.42,28
CDM,44979RVU1AK,UNLISTED PROC; LAP DRAINAGE OF APPENDICEAL ABSCESS W/DEBRIDEMENT,4148.0,2696.2,0.01,9852.42,28
CDM,44979RVUAK,LAP APPENDECTOMY AT TIME OTHER SURGERY (COMP CODE 44955),519.0,337.35,0.01,9852.42,28
CDM,45000000,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1838.0,1194.7,93.49,3004.0,61
CDM,45000005,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,596.0,387.4,133.98,3004.0,61
CDM,45000015,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,2111.0,1372.15,133.98,3004.0,61
CDM,45000020,TEMPORARY TRANSCUTANEOUS PACING,3763.0,2445.95,1.97,3763.0,61
CDM,45000025,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,2111.0,1372.15,279.46,3004.0,61
CDM,45000030,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,3763.0,2445.95,184.62,3763.0,61
CDM,45000035,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1199.0,779.35,133.98,3004.0,61
CDM,45000055,I&D HEMATOMA SEROMA/FLUID COLLECTION,4861.0,3159.65,194.37,4861.0,61
CDM,45000065,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,133.98,3004.0,61
CDM,45000075,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,8586.0,5580.9,287.65,8586.0,61
CDM,45000080,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,608.0,395.2,19.97,2453.0,61
CDM,45000090,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,1093.0,710.45,54.56,2453.0,61
CDM,45000100,EMERGENCY DEPARTMENT VISIT LOW MDM,1911.0,1242.15,54.56,2453.0,61
CDM,45000110,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2938.0,1909.7,54.56,2735.0,61
CDM,45000115,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1199.0,779.35,101.57,4001.0,61
CDM,45000120,EMERGENCY DEPARTMENT VISIT HIGH MDM,4230.0,2749.5,54.56,3807.0,61
CDM,45000130,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,5814.0,3779.1,54.56,5232.6,61
CDM,45000140,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,2487.0,1616.55,54.56,2453.0,46
CDM,45000150,VAGINAL DELIVERY ONLY,12718.0,8266.7,1312.36,12718.0,61
CDM,45000185,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,596.0,387.4,130.89,3004.0,61
CDM,45000215,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,178.0,115.7,13.28,2453.0,61
CDM,45000235,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,596.0,387.4,37.85,3004.0,61
CDM,45000245,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,536.0,348.4,29.9,3004.0,46
CDM,45000255,EVACUATION SUBUNGUAL HEMATOMA,387.0,251.55,37.85,3004.0,61
CDM,45000265,EXCISION NAIL MATRIX PERMANENT REMOVAL,1199.0,779.35,170.98,3004.0,61
CDM,45000275,REPAIR NAIL BED,1836.0,1193.4,37.85,3004.0,61
CDM,45000285,WEDGE EXCISION SKIN NAIL FOLD,1199.0,779.35,37.85,3004.0,61
CDM,45000295,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,596.0,387.4,75.18,3004.0,61
CDM,45000305,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,596.0,387.4,99.19,2453.0,61
CDM,45000315,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1199.0,779.35,147.83,4001.0,61
CDM,45000345,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,596.0,387.4,93.88,2453.0,61
CDM,45000355,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,596.0,387.4,98.82,2453.0,61
CDM,45000365,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,596.0,387.4,127.06,3004.0,61
CDM,45000375,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,596.0,387.4,147.83,3004.0,61
CDM,45000395,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1836.0,1193.4,189.81,3004.0,61
CDM,45000415,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1199.0,779.35,189.81,3004.0,61
CDM,45000425,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1199.0,779.35,189.81,3004.0,61
CDM,45000435,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1199.0,779.35,189.81,4001.0,61
CDM,45000445,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1199.0,779.35,189.81,4001.0,61
CDM,45000465,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1199.0,779.35,189.81,3004.0,61
CDM,45000475,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1199.0,779.35,189.81,3004.0,61
CDM,45000485,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1836.0,1193.4,189.81,4001.0,61
CDM,45000495,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1199.0,779.35,189.81,3004.0,61
CDM,45000505,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,189.81,3004.0,61
CDM,45000510,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,39.43,3004.0,61
CDM,45000515,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1199.0,779.35,189.81,3004.0,61
CDM,45000520,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,39.43,3004.0,61
CDM,45000525,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1199.0,779.35,189.81,4001.0,61
CDM,45000585,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1199.0,779.35,309.06,4001.0,61
CDM,45000595,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,1836.0,1193.4,309.06,6561.0,61
CDM,45000625,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,1836.0,1193.4,309.06,6561.0,61
CDM,45000635,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,1836.0,1193.4,309.06,6561.0,61
CDM,45000655,INITIAL TX 1ST DEGREE BURN LOCAL TX,596.0,387.4,77.71,2453.0,61
CDM,45000665,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,596.0,387.4,90.5,3004.0,61
CDM,45000675,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,596.0,387.4,147.83,4001.0,61
CDM,45000685,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1199.0,779.35,189.81,4001.0,61
CDM,45000695,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,60.97,3004.0,61
CDM,45000705,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,4861.0,3159.65,508.17,4861.0,61
CDM,45000725,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,62.0,3004.0,61
CDM,45000735,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,60.84,3004.0,61
CDM,45000745,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,62.63,3004.0,61
CDM,45000755,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,75.85,3004.0,61
CDM,45000845,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,1103.0,716.95,53.21,3004.0,61
CDM,45000885,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,7362.0,4785.3,234.24,7362.0,61
CDM,45000905,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1103.0,716.95,221.64,3004.0,61
CDM,45000915,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45000935,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,7453.0,4844.45,269.15,7453.0,61
CDM,45000945,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,7362.0,4785.3,234.24,7362.0,61
CDM,45000965,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1103.0,716.95,221.64,3004.0,61
CDM,45000970,UNLISTED PROCEDURE CASTING OR STRAPPING,300.0,195.0,44.82,2453.0,61
CDM,45000975,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45000985,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,1103.0,716.95,133.93,2453.0,61
CDM,45000995,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45000AK,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,2520.0,1638.0,1.1,2520.0,50
CDM,45001065,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45001085,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,7362.0,4785.3,234.24,7362.0,61
CDM,45001160,UNLISTED VASC PROCEDURE,3798.0,2468.7,571.26,4001.0,61
CDM,45001400,UNLISTED PROCEDURE RECTUM,1714.0,1114.1,484.72,2606.53,61
CDM,45001440,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,186.33,5424.0,61
CDM,45001915,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45001935,EXPLORATION PENETRATING WOUND SPX EXTREMITY,7453.0,4844.45,189.81,7453.0,61
CDM,45001955,REMOVAL FOREIGN BODY FOOT DEEP,7453.0,4844.45,525.42,7453.0,61
CDM,45001975,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,7453.0,4844.45,235.9,7453.0,61
CDM,45002005,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45002015,DRAINAGE FINGER ABSCESS SIMPLE,914.0,594.1,133.98,2453.0,61
CDM,45002025,DRAINAGE FINGER ABSCESS COMPLICATED,7453.0,4844.45,306.98,7453.0,61
CDM,45002045,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,7362.0,4785.3,927.34,7362.0,61
CDM,45002065,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1103.0,716.95,221.64,4001.0,61
CDM,45002085,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1103.0,716.95,221.64,2453.0,61
CDM,45002095,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1103.0,716.95,221.64,2453.0,61
CDM,45003005,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1103.0,716.95,221.64,4001.0,61
CDM,45003015,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45003025,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1103.0,716.95,221.64,2453.0,61
CDM,45003055,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1103.0,716.95,221.64,2453.0,61
CDM,45003075,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,14925.0,9701.25,927.34,14925.0,61
CDM,45003090,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45004005,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1103.0,716.95,221.64,3004.0,61
CDM,45004015,CLTX POST HIP ARTHRP DISLC W/O ANES,1103.0,716.95,221.64,3004.0,61
CDM,45004035,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,7362.0,4785.3,234.24,7362.0,61
CDM,45004055,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45004075,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1103.0,716.95,221.64,3004.0,61
CDM,45004085,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1103.0,716.95,221.64,3004.0,61
CDM,45004095,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,7362.0,4785.3,234.24,7362.0,61
CDM,45004105,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,7362.0,4785.3,234.24,7362.0,61
CDM,45004125,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45004225,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45004335,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45004355,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1103.0,716.95,221.64,3004.0,61
CDM,45004365,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,3237.0,2104.05,222.17,4001.0,61
CDM,45004385,CLOSED TX TALUS FRACTURE W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45004415,CLTX METAR FX W/MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45004435,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45004445,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1103.0,716.95,186.66,3004.0,61
CDM,45004455,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,1103.0,716.95,154.86,3004.0,61
CDM,45004485,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,726.0,471.9,83.58,2453.0,61
CDM,45004495,APPLICATION LONG ARM SPLINT SHOULDER HAND,726.0,471.9,44.82,2453.0,61
CDM,45004505,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,44.82,2453.0,61
CDM,45004545,STRAPPING SHOULDER,593.0,385.45,31.93,2453.0,61
CDM,45004725,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,593.0,385.45,85.44,2453.0,61
CDM,45004735,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,593.0,385.45,85.44,3004.0,61
CDM,45004745,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,593.0,385.45,85.44,3004.0,61
CDM,45004755,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,593.0,385.45,85.44,3004.0,61
CDM,45004765,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1068.0,694.2,85.44,3004.0,61
CDM,45004775,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,893.0,580.45,85.44,4001.0,61
CDM,45004815,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,214.57,3004.0,61
CDM,45004825,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1068.0,694.2,58.78,3004.0,61
CDM,45004845,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,7933.0,5156.45,211.85,7933.0,61
CDM,45004875,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,893.0,580.45,85.44,4001.0,61
CDM,45004915,TRACHEOBRNCHSC THRU EST TRACHS INC,2343.0,1522.95,192.52,3004.0,61
CDM,45004955,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,261.8,7146.0,61
CDM,45004965,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,2844.0,1848.6,151.96,3004.0,61
CDM,45004975,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,188.5,3004.0,61
CDM,45005015,REPAIR BLOOD VESSEL DIRECT HAND FINGER,18098.0,11763.7,987.9,18098.0,61
CDM,45005055,VNPNXR 3 YEARS/> PHYS/QHP SKILL,222.0,144.3,15.6,2453.0,46
CDM,45005075,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,144.79,18098.0,61
CDM,45005085,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,161.15,8932.0,61
CDM,45005145,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,28.36,2453.0,61
CDM,45005195,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,64.38,3004.0,61
CDM,45005205,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,741.0,481.65,26.19,2453.0,61
CDM,45005225,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,77.44,3004.0,46
CDM,45005235,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2294.0,1491.1,101.45,3004.0,61
CDM,45005255,THROMBOLYSIS CEREBRAL IV INFUSION,1907.0,1239.55,220.33,2453.0,61
CDM,45005295,RPR LIP FULL THICKNESS VERMILION ONLY,2343.0,1522.95,85.44,6561.0,61
CDM,45005305,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2343.0,1522.95,85.44,6561.0,61
CDM,45005315,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,6814.0,4429.1,703.55,6814.0,61
CDM,45005325,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,3237.0,2104.05,205.68,3237.0,61
CDM,45005335,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,2343.0,1522.95,334.18,4001.0,61
CDM,45005365,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,2343.0,1522.95,336.55,3004.0,61
CDM,45005395,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,1836.0,1193.4,85.44,4001.0,61
CDM,45005415,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,593.0,385.45,85.44,3004.0,61
CDM,45005425,DRAINAGE ABSCESS PALATE UVULA,1068.0,694.2,85.44,4001.0,61
CDM,45005445,I&D ABSCESS PERITONSILLAR,1068.0,694.2,85.44,3004.0,61
CDM,45005465,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,2343.0,1522.95,267.26,3004.0,61
CDM,45005505,EGD FLEXIBLE FOREIGN BODY REMOVAL,4313.0,2803.45,295.11,4313.0,61
CDM,45005575,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,5424.0,3525.6,695.58,6561.0,61
CDM,45005585,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,166.87,4194.0,61
CDM,45005595,INCISION THROMBOSED HEMORRHOID EXTERNAL,1119.0,727.35,179.08,3004.0,61
CDM,45005645,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,4313.0,2803.45,121.7,4313.0,61
CDM,45005655,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,180.94,4313.0,61
CDM,45005725,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,241.84,9423.0,61
CDM,45005735,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1119.0,727.35,39.43,3004.0,61
CDM,45005745,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,39.43,3004.0,61
CDM,45005765,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,39.43,3004.0,61
CDM,45005775,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,39.43,3004.0,61
CDM,45005785,CYSTOURETHROSCOPY,3070.0,1995.5,136.91,3070.0,61
CDM,45005795,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,15865.0,10312.25,487.15,15865.0,61
CDM,45005805,CYSTO BLADDER W/URETERAL CATHETERIZATION,9423.0,6124.95,224.94,9423.0,61
CDM,45005855,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1119.0,727.35,39.43,3004.0,61
CDM,45005865,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1119.0,727.35,39.43,2453.0,61
CDM,45005895,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,1119.0,727.35,97.97,3004.0,61
CDM,45005995,DRAINAGE SCROTAL WALL ABSCESS,7453.0,4844.45,278.23,7453.0,61
CDM,45005AK,I&D SUBMUCOSAL ABSCESS RECTUM,808.0,525.2,1.1,2014.21,53
CDM,45006005,I&D VULVA/PERINEAL ABSCESS,1399.0,909.35,54.44,4001.0,61
CDM,45006015,I&D OF BARTHOLINS GLAND ABSCESS,925.0,601.25,54.44,3004.0,61
CDM,45006045,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,925.0,601.25,162.64,2453.0,61
CDM,45006055,COLPORRHAPHY SUTURE INJURY VAGINA,14626.0,9506.9,538.98,14626.0,61
CDM,45006085,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,925.0,601.25,107.03,3004.0,61
CDM,45006095,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,54.44,3004.0,61
CDM,45006105,VAGINAL DELIVERY ONLY,12718.0,8266.7,1312.36,12718.0,61
CDM,45006185,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,107.4,4778.0,61
CDM,45006195,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,155.14,4778.0,61
CDM,45006205,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,194.79,4778.0,61
CDM,45006265,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,84.34,3004.0,61
CDM,45006285,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,87.52,3004.0,61
CDM,45006305,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,70.74,4778.0,61
CDM,45006315,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,593.0,385.45,38.61,2453.0,61
CDM,45006345,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,593.0,385.45,38.61,2453.0,61
CDM,45006385,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1375.0,893.75,157.33,3004.0,61
CDM,45006395,CANTHOTOMY SEPARATE PROCEDURE,10732.0,6975.8,177.88,10732.0,61
CDM,45006435,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,2814.0,1829.1,85.44,3004.0,61
CDM,45006445,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,6481.0,4212.65,263.66,6481.0,61
CDM,45006455,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,2814.0,1829.1,85.44,3004.0,61
CDM,45006465,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,238.0,154.7,50.62,3004.0,61
CDM,45006485,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,777.0,505.05,64.1,3004.0,61
CDM,45006495,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,2453.0,61
CDM,45006525,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,491.0,319.15,17.51,491.0,61
CDM,45006585,DILAT URETHRAL STRIX DILATOR MALE 1ST,1119.0,727.35,39.43,3004.0,61
CDM,45006595,RMVL FB XTRNL AUDITORY CANAL W/O ANES,516.0,335.4,50.62,2453.0,61
CDM,45006685,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,596.0,387.4,123.69,3004.0,61
CDM,45006705,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45006715,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45006725,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,1103.0,716.95,221.64,3004.0,61
CDM,45006735,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,1786.0,1160.9,185.22,3004.0,61
CDM,45006765,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,9423.0,6124.95,358.75,9423.0,61
CDM,45006775,INJECTION AA&/STRD BRACHIAL PLEXUS,6143.0,3992.95,122.8,6143.0,61
CDM,45006795,INJECTION AA&/STRD FEMORAL NERVE,4778.0,3105.7,111.38,4778.0,61
CDM,45006935,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1199.0,779.35,189.81,3004.0,61
CDM,45006945,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,1836.0,1193.4,309.06,6561.0,61
CDM,45006955,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,7453.0,4844.45,243.63,7453.0,61
CDM,45006995,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45007015,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,14925.0,9701.25,234.24,14925.0,61
CDM,45007025,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1222.0,794.3,213.58,3004.0,61
CDM,45007035,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,1222.0,794.3,55.47,2453.0,61
CDM,45007055,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,893.0,580.45,82.35,2453.0,61
CDM,45007075,THORACOTOMY W/CARDIAC MASSAGE,5901.0,3835.65,1286.42,5901.0,46
CDM,45007085,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,4046.0,2629.9,650.1,7445.0,61
CDM,45007125,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,4313.0,2803.45,199.36,4313.0,61
CDM,45007135,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,1068.0,694.2,85.44,2453.0,61
CDM,45007145,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,68.83,4001.0,61
CDM,45007155,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1432.0,930.8,36.93,3004.0,61
CDM,45007165,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,186.33,5424.0,61
CDM,45007175,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,593.0,385.45,67.34,3004.0,61
CDM,45007195,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,21.16,2453.0,61
CDM,45007205,CYSTO W/SIMPLE REMOVAL STONE & STENT,9423.0,6124.95,257.2,9423.0,61
CDM,45007235,REMOVAL EMBEDDED FOREIGN BODY EYELID,1375.0,893.75,157.33,3004.0,61
CDM,45009930,UNLISTED PROCEDURE HANDS OR FINGERS,531.0,345.15,150.17,3004.0,61
CDM,45010090,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,608.0,395.2,19.97,2453.0,61
CDM,45010100,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,1093.0,710.45,54.56,2453.0,61
CDM,45010110,EMERGENCY DEPARTMENT VISIT LOW MDM,1911.0,1242.15,54.56,2453.0,61
CDM,45010120,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2938.0,1909.7,54.56,2735.0,61
CDM,45010130,EMERGENCY DEPARTMENT VISIT HIGH MDM,4230.0,2749.5,54.56,3807.0,61
CDM,45010150,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,746.0,484.9,42.05,3004.0,46
CDM,45010160,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,914.0,594.1,62.56,3004.0,61
CDM,45010320,STRAIGHT CATH - SPECIMEN COLLECTION,63.0,40.95,2.09,3004.0,60
CDM,45010395,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,1068.0,694.2,85.44,3004.0,61
CDM,45010475,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1836.0,1193.4,38.61,2453.0,61
CDM,45010525,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,7362.0,4785.3,654.6,7362.0,61
CDM,45010535,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45010545,CLTX POST HIP ARTHRP DISLC REQ ANES,7362.0,4785.3,654.6,7362.0,61
CDM,45010555,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45010565,CLTX FX GRT TOE PHLX/PHLG W/MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45010605,THORACOTOMY WITH EXPLORATION,2510.0,1631.5,547.18,2917.79,46
CDM,45010645,"UNLISTED PROCEDURE, LIPS",661.0,429.65,186.93,2453.0,61
CDM,45010665,REMOVAL FOREIGN BODY PHARYNX,1836.0,1193.4,85.44,3004.0,61
CDM,45010675,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,204.68,4313.0,61
CDM,45010695,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,4313.0,2803.45,178.27,4313.0,61
CDM,45010805,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,432.87,18098.0,61
CDM,45010815,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45010825,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1222.0,794.3,245.39,2453.0,61
CDM,45011005,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2111.0,1372.15,142.85,3004.0,61
CDM,45011025,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,13165.0,8557.25,830.49,13165.0,61
CDM,45011045,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,5814.0,3779.1,54.56,5232.6,61
CDM,45011055,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,2487.0,1616.55,54.56,2453.0,46
CDM,45011085,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2111.0,1372.15,184.26,4001.0,61
CDM,45011155,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45011165,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1103.0,716.95,221.64,2453.0,61
CDM,45011175,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,1103.0,716.95,221.64,3004.0,61
CDM,45011205,TRANSFUSION BLOOD/BLOOD COMPONENTS,2514.0,1634.1,79.66,3004.0,61
CDM,45011305,DRG OF SKENE'S GLAND ABSCESS OR CYST,9423.0,6124.95,276.57,9423.0,61
CDM,45011315,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,12718.0,8266.7,504.11,12718.0,61
CDM,45011345,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,238.0,154.7,29.05,3004.0,61
CDM,45011355,US ABDOMINAL REAL TIME W/IMAGE LIMITED,734.0,477.1,0.87,734.0,61
CDM,45011365,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,0.87,2453.0,61
CDM,45011375,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,0.87,2453.0,46
CDM,45011425,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,8414.0,5469.1,417.92,8414.0,61
CDM,45011535,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1199.0,779.35,133.98,3004.0,61
CDM,45011575,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1103.0,716.95,221.64,2453.0,61
CDM,45011585,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1103.0,716.95,221.64,2453.0,61
CDM,45011595,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45011605,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,4861.0,3159.65,303.66,4861.0,61
CDM,45011615,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,2111.0,1372.15,189.81,4001.0,61
CDM,45011625,DBRDMT FX&/DISLC SUBQ T/M/F BONE,8586.0,5580.9,444.21,8586.0,61
CDM,45011635,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1836.0,1193.4,189.81,4001.0,61
CDM,45011645,DEBRIDEMENT NAIL ANY METHOD 1-5,178.0,115.7,25.5,3004.0,61
CDM,45011665,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,147.83,4001.0,61
CDM,45011675,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,596.0,387.4,147.83,4001.0,61
CDM,45011685,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1199.0,779.35,147.83,4001.0,61
CDM,45011695,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1199.0,779.35,147.83,4001.0,61
CDM,45011715,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1836.0,1193.4,189.81,4001.0,61
CDM,45011725,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5488.0,3567.2,189.81,5783.06,61
CDM,45011735,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,1836.0,1193.4,189.81,4001.0,61
CDM,45011745,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,1836.0,1193.4,189.81,4001.0,61
CDM,45011755,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,5488.0,3567.2,189.81,5783.06,61
CDM,45011765,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1199.0,779.35,189.81,4001.0,61
CDM,45011825,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,1836.0,1193.4,309.06,4001.0,61
CDM,45011835,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,726.0,471.9,137.45,3004.0,46
CDM,45011845,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1159.0,753.35,210.07,3004.0,46
CDM,45011855,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,603.0,391.95,131.45,6561.0,46
CDM,45011895,EXPLORATION PENETRATING WOUND SPX CHEST,8414.0,5469.1,340.24,8414.0,61
CDM,45011905,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1358.0,882.7,66.78,3004.0,61
CDM,45011925,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,70.52,3004.0,61
CDM,45011935,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1358.0,882.7,69.17,3004.0,61
CDM,45011945,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,14925.0,9701.25,276.11,14925.0,61
CDM,45011955,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,7453.0,4844.45,239.98,7453.0,61
CDM,45011975,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,6814.0,4429.1,99.55,6814.0,61
CDM,45011995,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012005,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45012015,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45012025,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012035,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012045,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012065,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012075,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012085,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012095,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012105,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012115,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,7362.0,4785.3,654.6,7362.0,61
CDM,45012125,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012135,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012155,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,14925.0,9701.25,981.04,14925.0,61
CDM,45012165,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012185,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012205,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1103.0,716.95,221.64,3004.0,61
CDM,45012235,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1103.0,716.95,221.64,2453.0,61
CDM,45012245,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012255,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1103.0,716.95,221.64,3004.0,61
CDM,45012265,CLTX CARPAL BONE FX W/MANJ EACH BONE,7362.0,4785.3,234.24,7362.0,61
CDM,45012275,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1103.0,716.95,221.64,2453.0,61
CDM,45012295,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,7362.0,4785.3,927.34,7445.0,61
CDM,45012305,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012335,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1103.0,716.95,221.64,3004.0,61
CDM,45012345,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012355,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,14925.0,9701.25,850.28,14925.0,61
CDM,45012375,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,14925.0,9701.25,1159.84,14925.0,61
CDM,45012415,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4873.0,3167.45,234.24,4873.0,55
CDM,45012485,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012495,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012505,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012525,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012535,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012545,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012555,CLTX PROX FIBULA/SHFT FX W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012565,CLTX PROX FIBULA/SHFT FX W/MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012575,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012585,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012595,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012605,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,7362.0,4785.3,234.24,7362.0,61
CDM,45012645,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012655,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012665,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45012675,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45012685,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1103.0,716.95,215.18,3004.0,61
CDM,45012705,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,1103.0,716.95,221.64,3004.0,61
CDM,45012725,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,83.58,2453.0,61
CDM,45012735,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,83.58,2453.0,61
CDM,45012755,APPLICATION FINGER SPLINT STATIC,593.0,385.45,44.82,2453.0,61
CDM,45012765,APPLICATION FINGER SPLINT DYNAMIC,273.0,177.45,44.82,2453.0,61
CDM,45012795,STRAPPING ELBOW/WRIST,273.0,177.45,32.91,2453.0,61
CDM,45012805,STRAPPING HAND/FINGER,273.0,177.45,34.11,2453.0,61
CDM,45012825,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1222.0,794.3,83.58,2453.0,61
CDM,45012855,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,44.82,2453.0,61
CDM,45012865,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,44.82,2453.0,61
CDM,45012875,STRAPPING KNEE,593.0,385.45,32.18,2453.0,61
CDM,45012885,STRAPPING ANKLE &/FOOT,726.0,471.9,31.02,2453.0,61
CDM,45012925,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1222.0,794.3,75.3,2453.0,61
CDM,45012955,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,893.0,580.45,85.44,4001.0,61
CDM,45012965,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,6814.0,4429.1,536.04,6814.0,53
CDM,45012975,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1068.0,694.2,214.57,3004.0,53
CDM,45012995,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10508.0,6830.2,2290.74,10508.0,46
CDM,45013025,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,28.36,2453.0,46
CDM,45013035,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,158.0,102.7,2.09,2453.0,46
CDM,45013095,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,18098.0,11763.7,149.37,18098.0,61
CDM,45013175,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1068.0,694.2,85.44,4001.0,61
CDM,45013185,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1068.0,694.2,85.44,4001.0,61
CDM,45013255,ANOSCOPY W/RMVL FOREIGN BODY,4194.0,2726.1,137.31,4194.0,61
CDM,45013275,ASPIRATION BLADDER NEEDLE,1119.0,727.35,66.86,3004.0,61
CDM,45013305,DELIVERY PLACENTA SEPARATE PROCEDURE,12718.0,8266.7,151.5,12718.0,61
CDM,45013315,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,1836.0,1193.4,38.61,2453.0,61
CDM,45013325,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,10491.0,6819.15,302.55,10491.0,61
CDM,45013365,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,734.0,477.1,0.87,734.0,61
CDM,45014575,TRAUMA DR CONSULT NOT NOTIFIED/NO CC,1658.0,1077.7,246.71,2453.0,38
CDM,45014585,TRAUMA TEAM CAT 1 NOT NOTIFIED/NO CC,17209.0,11185.85,2453.0,17209.0,38
CDM,45014595,TRAUMA TEAM CAT 2 NOT NOTIFIED/NO CC,7491.0,4869.15,1114.66,7491.0,38
CDM,45014605,TRAUMA CHRG-CAT 3 NOT NOTIFIED/NO CC,4991.0,3244.15,742.66,4991.0,38
CDM,45014615,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45014625,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45014665,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,89.11,3186.0,61
CDM,45014685,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2111.0,1372.15,189.81,4001.0,61
CDM,45014695,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,2343.0,1522.95,234.24,4001.0,61
CDM,45014705,CLOSED TREATMENT STERNUM FRACTURE,1103.0,716.95,221.64,3004.0,61
CDM,45014715,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,17913.0,11643.45,848.1,20338.07,61
CDM,45014725,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,1068.0,694.2,85.44,3004.0,61
CDM,45014735,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,6814.0,4429.1,339.85,6814.0,61
CDM,45014755,FETAL CONTRACTION STRESS TEST,805.0,523.25,116.89,2453.0,61
CDM,45014765,FETAL NONSTRESS TEST,805.0,523.25,79.6,2453.0,61
CDM,45014775,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,1217.0,791.05,110.8,3004.0,61
CDM,45014785,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,12718.0,8266.7,168.74,12718.0,61
CDM,45014795,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,2453.0,61
CDM,45014855,STREP A ASSAY W/OPTIC,114.0,74.1,0.95,2453.0,60
CDM,45014865,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,100.22,3004.0,61
CDM,45014875,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45014895,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45014915,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2111.0,1372.15,255.47,4001.0,61
CDM,45014955,CLOSED TX OF MANDIBULAR FRACTURE W/O MANIPULATION,2343.0,1522.95,234.24,6561.0,61
CDM,45014965,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45014975,CLTX GREATER TROCHANTERIC FX W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45014985,INJECTION AA&/STRD PUDENDAL NERVE,6143.0,3992.95,93.36,6143.0,61
CDM,45014995,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1103.0,716.95,221.64,3004.0,61
CDM,45015055,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,1820.0,1183.0,234.24,4506.96,55
CDM,45015085,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1103.0,716.95,221.64,3004.0,61
CDM,45015095,CLTX FEM FX PROX END NCK W/O MANJ,1103.0,716.95,221.64,3004.0,61
CDM,45015105,HYMENOTOMY SIMPLE INCISION,14626.0,9506.9,78.08,14626.0,61
CDM,45015135,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,14925.0,9701.25,740.94,14925.0,61
CDM,45015155,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,7933.0,5156.45,298.34,7933.0,61
CDM,45015175,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,18.13,2453.0,61
CDM,45015185,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1119.0,727.35,63.35,3004.0,61
CDM,45015195,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,1119.0,727.35,143.9,3004.0,61
CDM,45015205,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1103.0,716.95,221.64,2453.0,61
CDM,45015215,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,7362.0,4785.3,234.24,7362.0,61
CDM,45015225,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1199.0,779.35,176.23,3004.0,61
CDM,45015235,CLOSED TREATMENT SESAMOID FRACTURE,1103.0,716.95,182.37,3004.0,61
CDM,45015245,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,7362.0,4785.3,234.24,7362.0,61
CDM,45015255,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,265.98,47587.0,61
CDM,45015265,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,76.0,49.4,20.43,2453.0,61
CDM,45015275,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,137.57,4861.0,61
CDM,45015285,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1197.0,778.05,122.46,3004.0,61
CDM,45015295,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,10491.0,6819.15,150.24,10491.0,61
CDM,45015305,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,410.0,266.5,36.15,2453.0,61
CDM,45015315,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1103.0,716.95,221.64,3004.0,61
CDM,45015325,CLOSED TREATMENT COCCYGEAL FRACTURE,1103.0,716.95,221.64,3004.0,61
CDM,45015335,"UNLISTED PROCEDURE, ANUS",1714.0,1114.1,484.72,3004.0,61
CDM,45015345,NASPHARSCOPY INJ PHARYNX,1360.0,884.0,214.57,3004.0,61
CDM,45015355,REMOVAL RESIDUAL ROOT,302.0,196.3,85.41,3004.0,61
CDM,45015365,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,7933.0,5156.45,224.09,7933.0,61
CDM,45015385,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,12718.0,8266.7,631.49,12718.0,61
CDM,45015395,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,1729.0,1123.85,42.56,3004.0,46
CDM,45015405,COLPOCENTESIS SEPARATE PROCEDURE,22708.0,14760.2,133.93,22708.0,61
CDM,45015435,INJ ANES AGENT FAC NERVE,817.0,531.05,229.66,3004.0,61
CDM,45015445,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,384.86,8932.0,61
CDM,45015455,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,404.81,10496.0,46
CDM,45015495,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,79.1,3004.0,61
CDM,45015505,INJECTION AA&/STRD SUPRASCAPULAR NERVE,4778.0,3105.7,95.67,4778.0,61
CDM,45015515,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,7933.0,5156.45,211.85,7933.0,61
CDM,45015525,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,77.56,2453.0,61
CDM,45015535,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,2111.0,1372.15,156.6,3004.0,61
CDM,45015555,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,4778.0,3105.7,100.23,4778.0,61
CDM,45015565,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,4778.0,3105.7,145.52,4778.0,61
CDM,45015575,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1103.0,716.95,221.64,4001.0,61
CDM,45015585,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,14626.0,9506.9,930.71,14626.0,61
CDM,45015595,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,2069.0,1344.85,58.89,4001.0,61
CDM,45015605,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,191.78,3004.0,61
CDM,45015615,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,14925.0,9701.25,927.04,14925.0,61
CDM,45015625,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,2452.0,1593.8,91.44,3004.0,46
CDM,45015635,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1103.0,716.95,221.64,4001.0,61
CDM,45015645,PUNCTURE ASPIRATION CYST BREAST,2111.0,1372.15,72.72,3004.0,61
CDM,45015655,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,7453.0,4844.45,280.53,7453.0,61
CDM,45015665,I&D THYROGLOSSAL DUCT CYST INFECTED,5925.0,3851.25,266.37,5925.0,61
CDM,45015675,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,258.94,3004.0,61
CDM,45015685,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,2069.0,1344.85,42.16,4001.0,61
CDM,45015695,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,8726.0,5671.9,211.72,8726.0,61
CDM,45015705,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,14925.0,9701.25,234.24,14925.0,61
CDM,45015715,INJECTION AA&/STRD SCIATIC NERVE,4778.0,3105.7,123.93,4778.0,61
CDM,45015735,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,4561.0,2964.65,638.31,4629.01,46
CDM,45015745,CLSD TX PELVIC RING FX W/O MANIPULATION,1103.0,716.95,218.97,3004.0,61
CDM,45015755,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,4778.0,3105.7,137.58,4778.0,61
CDM,45015765,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,12718.0,8266.7,240.8,12718.0,61
CDM,45015775,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,36.15,2453.0,61
CDM,45015785,TAP BLOCK UNILATERAL BY INJECTION(S),1407.0,914.55,92.95,4001.0,46
CDM,45015795,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,531.0,345.15,150.17,3004.0,55
CDM,45016185,CL TX MANIBLE FX W/MANIPULATION,6814.0,4429.1,234.24,7445.0,61
CDM,45016395,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,4778.0,3105.7,141.15,4778.0,61
CDM,45016415,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,95.44,3004.0,61
CDM,45016465,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING (45016465),7146.0,4644.9,257.53,7146.0,61
CDM,45016525,"INJECTION, ANESTHETIC AGENT; STELLATE GANGLION",6143.0,3992.95,127.8,6143.0,61
CDM,45016545,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,4336.0,2818.4,117.18,4336.0,46
CDM,45016555,THORACIC FASCIAL PLANE BLOCK BI INJECTION,4336.0,2818.4,130.46,4336.0,46
CDM,45016615,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,753.0,489.45,104.78,3004.0,46
CDM,45016625,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,8900.0,5785.0,1256.32,8900.0,46
CDM,45016635,TRAUMA CAT 1 - NO NOTIFICATION,4227.0,2747.55,628.98,4227.0,38
CDM,45016645,TRAUMA CAT 2 - NO NOTIFICATION,4227.0,2747.55,628.98,4227.0,38
CDM,45016655,TRAUMA CAT 3 - NO NOTIFICATION,4227.0,2747.55,628.98,4227.0,38
CDM,45020AK,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,3424.0,2225.6,1.1,4793.6,50
CDM,45100AK,BX ANORECTAL WALL ANAL APPROACH,1616.0,1050.4,1.1,4793.6,50
CDM,45100URVUAK,BIOPSY OF RECTUM,540.0,351.0,1.1,4793.6,50
CDM,45110AK,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,12304.0,7997.6,1.1,12304.0,50
CDM,45111AK,PRCTECT PRTL RESCJ RECTUM TABDL APPR,7204.0,4682.6,1.1,7204.0,50
CDM,45113AK,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,13288.0,8637.2,1.1,13288.0,50
CDM,45119AK,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,13392.0,8704.8,1.1,13392.0,50
CDM,45123AK,PRCTECT PRTL W/O ANAST PRNL APPR,7544.0,4903.6,1.1,7544.0,50
CDM,45126AK,PELVIC EXENTERATION COLORECTAL MALIGNANCY,19640.0,12766.0,1.1,19640.0,50
CDM,45130AK,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,7400.0,4810.0,1.1,7400.0,50
CDM,45135AK,EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH,8944.0,5813.6,1.1,8944.0,50
CDM,45171AK,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,3252.0,2113.8,1.1,4793.6,50
CDM,45172AK,EXC RCT TUM INCL MUSCULARIS PROPRIA,4852.0,3153.8,1.1,4852.0,50
CDM,45172URVUAK,"EXCISION OF RECTAL TUMOR, TRANSANAL",1800.0,1170.0,1.1,4793.6,50
CDM,45190AK,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,4168.0,2709.2,1.1,4793.6,50
CDM,45300AK,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,320.0,208.0,1.1,1560.83,53
CDM,45303AK,PROCTOSGMDSC RIGID W/DILATION,560.0,364.0,1.1,3111.98,53
CDM,45305AK,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,460.0,299.0,1.1,2014.21,53
CDM,45307AK,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,640.0,416.0,1.1,4793.6,53
CDM,45308AK,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,520.0,338.0,1.1,4793.6,53
CDM,45309AK,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,560.0,364.0,1.1,2014.21,53
CDM,45315AK,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,680.0,442.0,1.1,2014.21,53
CDM,45317AK,PROCTOSGMDSC RIGID CONTROL BLEEDING,760.0,494.0,1.1,2014.21,53
CDM,45320AK,PROCTOSGMDSC RIGID ABLATION LESION,672.0,436.8,1.1,4793.6,53
CDM,45330AK,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,370.0,240.5,1.1,1560.83,53
CDM,45330URVUAK,DIAGNOSTIC SIGMOIDOSCOPY,172.0,111.8,1.1,1560.83,53
CDM,45331AK,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,502.0,326.3,1.1,1560.83,53
CDM,45331URVUAK,SIGMOIDOSCOPY AND BIOPSY,216.0,140.4,1.1,1560.83,53
CDM,45332AK,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,774.0,503.1,1.1,2014.21,53
CDM,45333AK,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,682.0,443.3,1.1,1560.83,53
CDM,45333URVUAK,SIGMOIDOSCOPY & POLYPECTOMY,315.0,204.75,1.1,1560.83,53
CDM,45334AK,SIGMOIDOSCOPY FLX CONTROL BLEEDING,880.0,572.0,1.1,2014.21,53
CDM,45334URVUAK,SIGMOIDOSCOPY FOR BLEEDING,450.0,292.5,1.1,2014.21,53
CDM,45335AK,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,458.0,297.7,1.1,1560.83,53
CDM,45337AK,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,924.0,600.6,1.1,1560.83,50
CDM,45338AK,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,902.0,586.3,1.1,2014.21,53
CDM,45338URVU1AK,SIGMOIDOSCPY W/TUMR REMOVE,317.0,206.05,1.1,2014.21,53
CDM,45338URVUAK,SIGMOIDOSCOPY REMOVAL LESION BY SNARE,317.0,206.05,1.1,2014.21,53
CDM,45340AK,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,550.0,357.5,1.1,2014.21,53
CDM,45341AK,SIGMOIDOSCOPY FLX NDSC US XM,933.0,606.45,1.1,1560.83,50
CDM,45346AK,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,1236.0,803.4,1.1,7452.28,53
CDM,45347AK,SIGMOIDOSCOPY W/PLACEMENT OF STENT,1197.0,778.05,1.1,9730.56,50
CDM,45349AK,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,1549.0,1006.85,1.1,4793.6,44
CDM,45350AK,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),739.0,480.35,1.1,2186.75,47
CDM,45378AK,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,1434.0,932.1,1.1,1560.83,53
CDM,45378URVUAK,COLONOSCOPY,630.0,409.5,1.1,1560.83,53
CDM,45379AK,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),1883.0,1223.95,1.1,2014.21,53
CDM,45380AK,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,1566.0,1017.9,1.1,2014.21,53
CDM,45380URVUAK,COLONOSCOPY AND BIOPSY,706.0,458.9,1.1,2014.21,53
CDM,45381AK,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,1566.0,1017.9,1.1,2014.21,53
CDM,45381URVUAK,"COLONOSCOPY, SUBMUCOUS INJ",703.0,456.95,1.1,2014.21,53
CDM,45382AK,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,1864.0,1211.6,1.1,2197.68,53
CDM,45382URVUAK,COLONOSCOPY/CONTROL BLEEDING,755.0,490.75,1.1,2197.68,53
CDM,45384AK,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,1628.0,1058.2,1.1,2014.21,53
CDM,45385AK,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,2011.0,1307.15,1.1,2014.21,53
CDM,45385URVUAK,LESION REMOVAL COLONOSCOPY,970.0,630.5,1.1,2014.21,53
CDM,45386AK,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,1659.0,1078.35,1.1,2014.21,53
CDM,45386URVUAK,COLONOSCOPY DILATE STRICTURE,490.0,318.5,1.1,2014.21,53
CDM,45388AK,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,2147.0,1395.55,1.1,7989.15,53
CDM,45389AK,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,2096.0,1362.4,1.1,9730.56,50
CDM,45390AK,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,2416.0,1570.4,1.1,4793.6,50
CDM,45391AK,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,1856.0,1206.4,1.1,2014.21,50
CDM,45392AK,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,2200.0,1430.0,1.1,2200.0,50
CDM,45393AK,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,2059.0,1338.35,1.1,2059.0,50
CDM,45393URVUAK,COLONOSCOPY W/DECOMPRESSION,600.0,390.0,1.1,2014.21,50
CDM,45395AK,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,13200.0,8580.0,1.1,13200.0,50
CDM,45397AK,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,14600.0,9490.0,1.1,14600.0,50
CDM,45398AK,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),1680.0,1092.0,1.1,2718.82,53
CDM,45399AGRVU1AK,"UNLISTED PROC, COLON COMPARED TO 44158",12111.0,7872.15,0.01,12111.0,29
CDM,45399AGRVUAK,"UNLISTED PROCEDURE, COLON (COMPARISON CODE 15860)",240.0,156.0,0.01,4167.77,29
CDM,45399AK,UNLISTED PROCEDURE COLON,247.0,160.55,0.01,4167.77,29
CDM,45399RVU10AK,"ENDOVAC, COLON; COLONOSCOPY VIA STOMA (COMP 45388, 97605)",2336.0,1518.4,0.01,4167.77,29
CDM,45399RVU11AK,OPEN RESECTION OF CECUM W/O ANASTOMOSIS (COMP 44110),5055.0,3285.75,0.01,5055.0,29
CDM,45399RVU12AK,SERIAL TRANVERSE COLOPLASTY (COMP 44604),6538.0,4249.7,0.01,6538.0,29
CDM,45399RVU5AK,ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLON - (COMP CODE 44204),11229.0,7298.85,0.01,11229.0,29
CDM,45399RVU6AK,ENDOSCOPIC DEFECT CLOSURE (COMP CODE 44604),7808.0,5075.2,0.01,7808.0,29
CDM,45399RVU7AK,EDOSCOPIC STRICTUROTOMY (COMP 46700),4218.0,2741.7,0.01,4218.0,29
CDM,45399RVU8AK,"ENDOVAC, COLON; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,4167.77,29
CDM,45399RVU9AK,"ENDOVAC, COLON; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,4167.77,29
CDM,45400AK,LAPAROSCOPY PROCTOPEXY PROLAPSE,7776.0,5054.4,1.1,7776.0,50
CDM,45402AK,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,10604.0,6892.6,1.1,10604.0,50
CDM,45499RVU1AK,LX COMP. PROC. IPAA +-ILEOSTOMY (COMP CODE 44211),9768.0,6349.2,0.01,9852.42,28
CDM,45499RVU2AK,LAP EXCISION  RETRORECTAL MASS/TUMOR (COMP 45172),6239.0,4055.35,0.01,9852.42,28
CDM,45499RVU3AK,LAPAROSCOPIC ABDOMINAL PERINEAL EXCISION OF ILEAL J POUCH (COMP,13099.0,8514.35,0.01,13099.0,28
CDM,45499RVU4AK,UNLISTED LAP SWENSON PROCEDURE (COMP CODE 45120),11220.0,7293.0,0.01,11220.0,28
CDM,45499RVU5AK,LAP PARTIAL PROCTECTOMY (COMP 45111),7744.0,5033.6,0.01,9852.42,28
CDM,45499RVU6AK,LAP COMPLETE PROCTECTOMY W/WO COLOANAL ANASTOMOSIS (COMP 45112),14267.0,9273.55,0.01,14267.0,28
CDM,45505AK,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,3344.0,2173.6,1.1,4793.6,50
CDM,45540AK,PROCTOPEXY ABDOMINAL APPROACH,7248.0,4711.2,1.1,7248.0,50
CDM,45541AK,PROCTOPEXY PERINEAL APPROACH,5940.0,3861.0,1.1,5940.0,50
CDM,45560AK,REPAIR RECTOCELE SEPARATE PROCEDURE,4600.0,2990.0,1.1,4793.6,50
CDM,45562AK,EXPL RPR & PRESACRAL DRG RECTAL INJURY,7192.0,4674.8,1.1,7192.0,50
CDM,45563AK,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,10552.0,6858.8,1.1,10552.0,50
CDM,45600005,SPORTS PHYSICAL,47.0,30.55,6.99,47.0,38
CDM,45800AK,CLOSURE RECTOVESICAL FISTULA,8124.0,5280.6,1.1,8124.0,50
CDM,45805AK,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,9328.0,6063.2,1.1,9328.0,50
CDM,45905AK,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,940.0,611.0,1.1,2014.21,50
CDM,45910AK,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,1140.0,741.0,1.1,2014.21,50
CDM,45915AK,RMVL FECAL IMPACTION/FB SPX UNDER ANES,1276.0,829.4,1.1,2014.21,53
CDM,45990AK,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,720.0,468.0,1.1,4793.6,50
CDM,45990URVUAK,"SURG DX EXAM, ANORECTAL",172.0,111.8,1.1,4793.6,50
CDM,45999AGRVUAK,"UNLISTED PROCEDURE, RECTUM (COMPARISON CODE 44604)",2230.0,1449.5,0.01,4167.77,29
CDM,45999AK,RECTUM SURGERY PROCEDURE UNLISTED,2297.0,1493.05,0.01,2297.0,28
CDM,45999RVU2AK,TRANSANAL RPR COLOANAL ANASTOMOSIS (COMP 45505),2397.0,1558.05,0.01,2397.0,28
CDM,45999RVU4AK,"ENDOVAC, RECTUM; COLONOSCOPY VIA STOMA (COMP 44388, 97605)",1217.0,791.05,0.01,1560.83,28
CDM,45999RVU5AK,"ENDOVAC, RECTUM; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,1639.0,28
CDM,45999RVU6AK,"ENDOVAC, RECTUM; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,1560.83,28
CDM,45999RVU7AK,"OPEN REPAIR OF RECTAL FISTULA WO ANASTOMOSIS, TRANS-PERINEAL APP",6484.0,4214.6,0.01,6484.0,28
CDM,45999RVU8AK,REVISION/REDO POUCH AP APPROACH W/W/O STOMA (COMP 46712),13123.0,8529.95,0.01,13123.0,28
CDM,45999RVUAK,REV ILEOANAL RES W/W/O ST (COMP 45113),14000.0,9100.0,0.01,14000.0,28
CDM,46000010,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,720.0,468.0,48.11,720.0,61
CDM,46000020,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1432.0,930.8,69.31,1432.0,61
CDM,46000025,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1432.0,930.8,101.57,1432.0,61
CDM,46000030,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,348.0,226.2,6.5,348.0,46
CDM,46000035,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,720.0,468.0,51.58,720.0,61
CDM,46000040,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,348.0,226.2,7.14,348.0,46
CDM,46000060,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,720.0,468.0,45.97,720.0,61
CDM,46000085,CARDIOPULMONARY EXERCISE TESTING,1432.0,930.8,101.57,1432.0,61
CDM,46000090,NITRIC OXIDE EXPIRED GAS DETERMINATION,118.0,76.7,33.37,118.0,61
CDM,46000100,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1432.0,930.8,86.12,1432.0,61
CDM,46000110,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1432.0,930.8,101.53,1432.0,61
CDM,46000115,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,720.0,468.0,51.58,720.0,61
CDM,46000125,CO DIFFUSING CAPACITY,605.0,393.25,51.58,605.0,46
CDM,46000145,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,348.0,226.2,6.5,348.0,46
CDM,46000155,CAR SEAT CHALLENGE,110.0,71.5,31.11,360.65,61
CDM,46000165,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,348.0,226.2,7.14,348.0,46
CDM,46000175,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,720.0,468.0,45.97,720.0,61
CDM,46000195,PEP THERAPY,113.0,73.45,31.96,360.65,61
CDM,46000205,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,273.0,177.45,26.69,273.0,61
CDM,46000215,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1592.0,1034.8,65.24,1592.0,53
CDM,46000265,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,157.0,102.05,24.67,157.0,61
CDM,46000295,PULMONARY STRESS TESTING,593.0,385.45,51.58,593.0,61
CDM,46001025,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,234.0,152.1,22.65,234.0,60
CDM,46001055,PATIENT-INITIATED SPIROMETRIC RECORDING,1432.0,930.8,59.75,1432.0,61
CDM,46001125,RTM DEV SPLY DATA RESPIR SYS 2-15 DAYS IN 30D PD,263.0,170.95,35.31,263.0,47
CDM,46001135,PULMONARY FUNCTION TEST,60.0,39.0,8.93,60.0,38
CDM,46020AK,PLACEMENT OF SETON,818.0,531.7,1.1,4793.6,51
CDM,46020URVUAK,PLACEMENT OF SETON,538.0,349.7,1.1,4793.6,51
CDM,46030AK,REMOVAL ANAL SETON OTHER MARKER,592.0,384.8,1.1,2014.21,53
CDM,46040AK,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,2148.0,1396.2,1.1,2148.0,53
CDM,46040URVUAK,INCISION OF RECTAL ABSCESS,650.0,422.5,1.1,2014.21,53
CDM,46045AK,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,2348.0,1526.2,1.1,4793.6,50
CDM,46050AK,"I/D PERIANAL ABSCESS, SUPERFICIAL",546.0,354.9,1.1,1560.83,53
CDM,46050URVUAK,INCISION OF ANAL ABSCESS,300.0,195.0,1.1,1560.83,53
CDM,46060AK,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,2548.0,1656.2,1.1,4793.6,50
CDM,46080AK,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,1008.0,655.2,1.1,4793.6,53
CDM,46083AK,INCISION THROMBOSED HEMORRHOID EXTERNAL,580.0,377.0,1.1,689.24,53
CDM,46200AK,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,1436.0,933.4,1.1,4793.6,53
CDM,46200URVUAK,REMOVAL OF ANAL FISSURE,744.0,483.6,1.1,4793.6,53
CDM,46220AK,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,644.0,418.6,1.1,2014.21,53
CDM,46221AK,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,944.0,613.6,1.1,1560.83,53
CDM,46221URVUAK,LIGATION OF HEMORRHOID(S),313.0,203.45,1.1,1560.83,53
CDM,46230AK,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,1048.0,681.2,1.1,4793.6,53
CDM,46230URVUAK,REMOVAL OF ANAL TABS,340.0,221.0,1.1,4793.6,53
CDM,46250AK,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,1700.0,1105.0,1.1,4793.6,53
CDM,46250URVUAK,HEMORRHOIDECTOMY 2 OR MORE COLUMNS,613.0,398.45,1.1,4793.6,53
CDM,46255AK,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,1984.0,1289.6,1.1,4793.6,53
CDM,46255URVU1AK,HEMORRHOIDECTOMY,627.0,407.55,1.1,4793.6,53
CDM,46255URVUAK,HEMORRHOIDECTOMY (COMP CODE 46255),627.0,407.55,1.1,4793.6,53
CDM,46257AK,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,2304.0,1497.6,1.1,4793.6,50
CDM,46258AK,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,2564.0,1666.6,1.1,4793.6,50
CDM,46260AK,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,2692.0,1749.8,1.1,4793.6,50
CDM,46260URVUAK,HEMORRHOIDECTOMY,1063.0,690.95,1.1,4793.6,50
CDM,46261AK,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,3104.0,2017.6,1.1,4793.6,50
CDM,46262AK,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,2848.0,1851.2,1.1,4793.6,50
CDM,46270AK,SURG TX ANAL FISTULA SUBQ,1968.0,1279.2,1.1,4793.6,53
CDM,46270URVUAK,REMOVAL OF ANAL FISTULA,644.0,418.6,1.1,4793.6,53
CDM,46275AK,SURG TX ANAL FISTULA INTERSPHINCTERIC,2168.0,1409.2,1.1,4793.6,53
CDM,46280AK,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,2556.0,1661.4,1.1,4793.6,50
CDM,46280URVUAK,REMOVAL OF ANAL FISTULA,802.0,521.3,1.1,4793.6,50
CDM,46285AK,SURG TX ANAL FISTULA 2ND STAGE,2168.0,1409.2,1.1,4793.6,53
CDM,46288AK,CLSR ANAL FSTL W/RCT ADVMNT FLAP,3124.0,2030.6,1.1,4793.6,50
CDM,46320AK,EXC THROMBOSED HEMORRHOID XTRNL,656.0,426.4,1.1,2014.21,53
CDM,46320URVUAK,REMOVAL OF HEMORRHOID CLOT,235.0,152.75,1.1,2014.21,53
CDM,46500AK,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,696.0,452.4,1.1,1560.83,53
CDM,46505AK,CHEMODENERVATION INTERNAL ANAL SPHINCTER,1272.0,826.8,1.1,2014.21,53
CDM,46600AK,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,242.0,157.3,1.1,391.85,53
CDM,46601AK,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,640.0,416.0,1.1,640.0,47
CDM,46604AK,ANOSCOPY W/DILATION,412.0,267.8,1.1,2128.09,53
CDM,46606AK,ANOSCOPY W/BX SINGLE/MULTIPLE,528.0,343.2,1.1,2014.21,53
CDM,46606URVUAK,ANOSCOPY WITH BIOPSY SINGLE OR MULTI,285.0,185.25,1.1,2014.21,53
CDM,46607AK,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,968.0,629.2,1.1,2014.21,47
CDM,46608AK,"ANOSCOPY,REMOVE FOREIGN BODY",520.0,338.0,1.1,1560.83,53
CDM,46610AK,ANOSCOPY W/RMVL LESION CAUTERY,512.0,332.8,1.1,4793.6,53
CDM,46611AK,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,520.0,338.0,1.1,1560.83,53
CDM,46612AK,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,600.0,390.0,1.1,4793.6,53
CDM,46612URVUAK,ANOSCOPY/ REMOVE LESIONS,3709.0,2410.85,1.1,4793.6,53
CDM,46614AK,"ANOSCOPY,CONTROL BLEEDING",400.0,260.0,1.1,2014.21,53
CDM,46615AK,"ANOSCOPY,ABLATE LESION",600.0,390.0,1.1,4793.6,53
CDM,46700AK,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,3924.0,2550.6,1.1,4793.6,50
CDM,46707AK,RPR ANORECTAL FISTULA W/ PLUG,2556.0,1661.4,1.1,4793.6,50
CDM,46750AK,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,4860.0,3159.0,1.1,4860.0,50
CDM,46761AK,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,6116.0,3975.4,1.1,6116.0,50
CDM,46900AK,DSTRJ LESION ANUS SIMPLE CHEMICAL,764.0,496.6,1.1,792.03,53
CDM,46910AK,DSTRJ LESION ANUS SMPL ELTRDSICCATION,764.0,496.6,1.1,3114.5,53
CDM,46917AK,DSTRJ LESION ANUS SIMPLE LASER SURG,764.0,496.6,1.1,4793.6,53
CDM,46922AK,DSTRJ LESION ANUS SIMPLE SURG EXCISION,764.0,496.6,1.1,4793.6,53
CDM,46922URVUAK,EXCISION OF ANAL LESION(S),351.0,228.15,1.1,4793.6,53
CDM,46924AK,DSTRJ LESION ANUS EXTENSIVE,1124.0,730.6,1.1,4793.6,53
CDM,46924URVUAK,DESTRUCTION OF LESION(S) ANUS EXTENSIVE,354.0,230.1,1.1,4793.6,53
CDM,46930AK,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,644.0,418.6,1.1,2014.21,53
CDM,46940AK,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,940.0,611.0,1.1,4793.6,53
CDM,46942AK,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,828.0,538.2,1.1,1560.83,53
CDM,46945AK,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,1476.0,959.4,1.1,4793.6,51
CDM,46945URVUAK,"HEMORRHOIDECTOMY, INTERNAL BY LIGATION S",431.0,280.15,1.1,4793.6,51
CDM,46946AK,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,1800.0,1170.0,1.1,4793.6,51
CDM,46946URVU1AK,HEMORRHOIDECTOMY INT LIGATION 2 OR MORE,500.0,325.0,1.1,4793.6,51
CDM,46946URVUAK,HEMORRHOIDECTOMY INT RUBBERBAND 2 OR MOR,500.0,325.0,1.1,4793.6,51
CDM,46947AK,HEMORRHOIDOPEXY BY STAPLING,2228.0,1448.2,1.1,4793.6,50
CDM,46948AK,INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN,2228.0,1448.2,1.1,4793.6,50
CDM,46999AGRVU1AK,"UNLIST PROC, ANUS COMPARED TO 46945",746.0,484.9,0.01,1560.83,28
CDM,46999AGRVU2AK,"UNLIST PROC, ANUS COMPARED TO 45100",1333.0,866.45,0.01,1560.83,28
CDM,46999AGRVU3AK,"UNLISTED PROCEDURE, ANUS",1360.0,884.0,0.01,1560.83,28
CDM,46999AGRVU4AK,"UNLIST PROC, ANUS COMPARED TO 46947",1838.0,1194.7,0.01,1838.0,28
CDM,46999AGRVUAK,"UNLISTED PROCEDURE, ANUS",541.0,351.65,0.01,1560.83,28
CDM,46999AK,ANUS SURGERY PROCEDURE UNLISTED,783.0,508.95,0.01,1560.83,28
CDM,46999RVU11AK,POST OP CONTROL OF BLEEDING ANUS (COMP 46945),746.0,484.9,0.01,1560.83,28
CDM,46999RVU12AK,"UNLISTED PROC; TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, SINGLE",1838.0,1194.7,0.01,1838.0,28
CDM,46999RVU13AK,SUBMUCOSAL ANAL INJECTION FOR INFLAMMATION/PAIN (COMP CODE 46505,1367.0,888.55,0.01,1560.83,28
CDM,46999RVU14AK,"REPAIR, CLOSURE OF ANAL FISTULA-OTHER THAN GLUE (COMP 46706)",1049.0,681.85,0.01,1560.83,28
CDM,46999RVU15AK,"HEMORRHOIDECTOMY, EXTERNAL, SINGLE COLUMN (COMP 46255)",1786.0,1160.9,0.01,1786.0,28
CDM,46999RVU16AK,POST OP CONTROL OF BLEEDING-ANUS (COMP CODE 46614),361.0,234.65,0.01,1560.83,28
CDM,46999RVU17AK,EXPLANATION OF ARTIFICIAL BOWEL SPHINCTER (COMP 53446),3968.0,2579.2,0.01,3968.0,28
CDM,46999RVU18AK,"ANOSCOPY W/SUBMUCOSAL INJECTION, ANY SUBSTANCE (COMP 45381)",1566.0,1017.9,0.01,1566.0,28
CDM,46999RVU19AK,LAP ASSISTED CLOACA REPAIR (COMP 46748),27852.0,18103.8,0.01,27852.0,28
CDM,46999RVU3AK,"HEMORROIDECTOMY, EXTERNAL, SINGLE (COMP CODE 46220)",1403.0,911.95,0.01,1560.83,28
CDM,46999RVUAK,ANAL BIOPSY (COMP 45100),363.0,235.95,0.01,1560.83,28
CDM,46999URVUAK,ANUS SURGERY PROCEDURE,760.0,494.0,0.01,1560.83,28
CDM,47000255,AUDIOMETRY EVAL & SPEECH RECOG,626.0,406.9,55.37,626.0,61
CDM,47000535,SPONTANEOUS NYSTAGMUS STUDY,1048.0,681.2,31.75,1048.0,46
CDM,47000545,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,313.0,203.45,31.75,313.0,46
CDM,47000555,EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN,157.0,102.05,23.36,157.0,46
CDM,47000565,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,313.0,203.45,31.75,313.0,46
CDM,47000575,HEARING AID SELECTION SERVICES EA ADDL 15 MIN,157.0,102.05,23.36,157.0,46
CDM,47000585,HEARING AID FITTING SERVICES 1ST 60 MINUTES,626.0,406.9,31.75,626.0,46
CDM,47000595,HEARING AID FITTING SERVICES EA ADDL 15 MINUTES,157.0,102.05,23.36,157.0,46
CDM,47000605,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,313.0,203.45,31.75,313.0,46
CDM,47000615,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,157.0,102.05,23.36,157.0,46
CDM,47000625,BEHAVIORAL VERIFICATION OF AMPLIFICATION,626.0,406.9,31.75,626.0,46
CDM,47000635,HEARING AID MEAS VERIF W/PROBE MICROPHONE,626.0,406.9,31.75,626.0,46
CDM,47000645,HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS,626.0,406.9,31.75,626.0,46
CDM,47000655,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,626.0,406.9,31.75,626.0,46
CDM,47000AK,BIOPSY LIVER NEEDLE PERCUTANEOUS,660.0,429.0,1.1,2768.64,53
CDM,47000URVUAK,NEEDLE BIOPSY OF LIVER,260.0,169.0,1.1,2768.64,53
CDM,47001AK,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,836.0,543.4,1.1,836.0,50
CDM,47010AK,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,7760.0,5044.0,1.1,7760.0,50
CDM,47100015,SPONTANEOUS NYSTAGMUS TEST,516.0,335.4,31.75,516.0,61
CDM,47100020,POSITIONAL NYSTAGMUS TEST,516.0,335.4,31.75,516.0,61
CDM,47100035,OPTOKINETIC NYSTAGMUS TEST,720.0,468.0,29.98,720.0,61
CDM,47100040,OSCILLATING TRACKING TEST,1432.0,930.8,28.2,1432.0,61
CDM,47100060,TYMP & REFLEX THRESH,626.0,406.9,36.85,626.0,61
CDM,47100065,SCREENING TEST PURE TONE AIR ONLY,64.0,41.6,9.52,64.0,46
CDM,47100070,AUDIOMETRY THRESHOLD TEST,516.0,335.4,31.75,516.0,61
CDM,47100075,AUDIOMETRY AIR AND BONE,626.0,406.9,90.44,626.0,61
CDM,47100080,SPEECH AUDIOMETRY THRESHOLD,238.0,154.7,31.75,238.0,61
CDM,47100085,SPEECH RECEPTION THRESHOLD,238.0,154.7,31.75,238.0,61
CDM,47100105,TYMPANOMETRY,157.0,102.05,18.54,157.0,61
CDM,47100140,AUDIOMETRY CONDITION PLAY,626.0,406.9,106.87,626.0,61
CDM,47100155,TEST EVOKED AUDITORY LTD,1246.0,809.9,36.65,1246.0,61
CDM,47100160,TEST EVOKED AUDITORY COMPR,1246.0,809.9,56.81,1246.0,61
CDM,47100175,EVAL AUD REHAB STATUS,626.0,406.9,56.15,626.0,61
CDM,47100200,BASIC VESTIBULAR EVAL,626.0,406.9,144.57,626.0,61
CDM,47100205,CALORIC VEST TEST BITHERMAL,626.0,406.9,65.76,626.0,61
CDM,47100215,CALORIC VEST TEST MONOTHERMAL,626.0,406.9,36.2,626.0,61
CDM,47100235,ACOUSTIC REFLEX THRESHOLD,157.0,102.05,26.33,157.0,61
CDM,47100355,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,186.0,120.9,27.68,186.0,46
CDM,47100525,ASSESSMENT TINNITUS,626.0,406.9,105.58,626.0,61
CDM,47100665,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,631.0,410.15,31.75,631.0,46
CDM,47100AK,WEDGE BIOPSY OF LIVER,5164.0,3356.6,1.1,5164.0,50
CDM,47100URVUAK,WEDGE BIOPSY OF LIVER,1368.0,889.2,1.1,2901.35,50
CDM,47120AK,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,15604.0,10142.6,1.1,15604.0,50
CDM,47122AK,HEPATECTOMY RESCJ TRISEGMENTECTOMY,23792.0,15464.8,1.1,23792.0,50
CDM,47125AK,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,21216.0,13790.4,1.1,21216.0,50
CDM,47130AK,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,22876.0,14869.4,1.1,22876.0,50
CDM,47200005,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,329.0,213.85,24.68,329.0,46
CDM,47350AK,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,8996.0,5847.4,1.1,8996.0,50
CDM,47360AK,MGMT LVR HEMRRG CPLX SUTR WND/INJ,12524.0,8140.6,1.1,12524.0,50
CDM,47361AK,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,21040.0,13676.0,1.1,21040.0,50
CDM,47362AK,MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING,9416.0,6120.4,1.1,9416.0,50
CDM,47370AK,LAPS SURG ABLTJ 1/> LVR TUM RF,8320.0,5408.0,1.1,17575.94,50
CDM,47379AGRVU1AK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47120)",5610.0,3646.5,0.01,9852.42,28
CDM,47379AGRVU2AK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47000)",310.0,201.5,0.01,9852.42,28
CDM,47379AGRVU3AK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47001)",312.0,202.8,0.01,9852.42,28
CDM,47379AGRVU4AK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47010)",6402.0,4161.3,0.01,9852.42,28
CDM,47379AGRVU5AK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47125)",9040.0,5876.0,0.01,9852.42,28
CDM,47379AGRVU6AK,UNLIST LAP LIVER PROC COMPARED TO 47300,5896.0,3832.4,0.01,9852.42,28
CDM,47379AGRVU7AK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER COMPARED TO 47015",4821.0,3133.65,0.01,9852.42,28
CDM,47379AGRVUAK,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47100)",1660.0,1079.0,0.01,9852.42,28
CDM,47379AK,UNLISTED LAPAROSCOPIC PROCEDURE LIVER,6356.0,4131.4,0.01,9852.42,28
CDM,47379RVU13AK,LAP LT LOBECTOMY LIVER (COMP 47125),17503.0,11376.95,0.01,17503.0,28
CDM,47379RVU14AK,LAP EXCISION LIVER CYST (COMP 47010),6985.0,4540.25,0.01,9852.42,28
CDM,47379RVU17AK,LAPAROSCOPIC PARTIAL HEPATIC LOBECTOMY W/ PARTIAL HEPATIC LOBECT,25747.0,16735.55,0.01,25747.0,28
CDM,47379RVU18AK,SURGERY PERFORMED LAPAROSCOPY TOTAL RIGHT HEPATIC LOBECTOMY (COM,18873.0,12267.45,0.01,18873.0,28
CDM,47379RVU19AK,LAPRO DONOR HEPATECTOMY LIVING DONOR LT SEG II & III (47140),25542.0,16602.3,0.01,25542.0,28
CDM,47379RVU1AK,LAPAROSCOPIC LIVER BIOPSY (COMP 47001),2765.0,1797.25,0.01,9852.42,28
CDM,47379RVU20AK,LAPAROSCOPIC POSTOPERATIVE LIVER HEMORRHAGE(COMP CODE 47361),22618.0,14701.7,0.01,22618.0,28
CDM,47379RVU2AK,LAP MARSUPIALIZATION HEPATIC CYST (COMP CODE 47300),5896.0,3832.4,0.01,9852.42,28
CDM,47379RVU4AK,"LAPAROSCOPE PROCEDURE, LI",5610.0,3646.5,0.01,9852.42,28
CDM,47380AK,ABLTJ OPN 1/> LVR TUM RF,9824.0,6385.6,1.1,9824.0,50
CDM,47382AK,ABLTJ 1/> LVR TUM PRQ RF,5988.0,3892.2,1.1,12037.76,53
CDM,47383AK,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,3552.0,2308.8,1.1,19385.1,53
CDM,47384AK,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,3045.0,1979.25,1.1,3045.0,35
CDM,47399RVU1AK,DESTRUCTION/FULGURATION LIVER LESION(S) (COMP 44005),6718.0,4366.7,0.01,6718.0,28
CDM,47399RVU4AK,FLUSHING OF LIVER IN SITU (COMP 47146),2400.0,1560.0,0.01,2400.0,28
CDM,47400AK,HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1,14544.0,9453.6,1.1,14544.0,50
CDM,47420AK,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,9693.0,6300.45,1.1,9693.0,50
CDM,47460AK,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,8208.0,5335.2,1.1,8208.0,50
CDM,47480AK,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,5300.0,3445.0,1.1,5300.0,50
CDM,47490AK,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,2094.0,1361.1,1.1,5906.43,50
CDM,47531AK,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,572.0,371.8,1.1,5906.43,53
CDM,47532AK,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,1870.0,1215.5,1.1,5906.43,53
CDM,47533AK,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,2367.0,1538.55,1.1,5906.43,53
CDM,47534AK,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,3344.0,2173.6,1.1,5906.43,53
CDM,47535AK,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,1738.0,1129.7,1.1,5906.43,53
CDM,47536AK,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,1148.0,746.2,1.1,5906.43,53
CDM,47537AK,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,810.0,526.5,1.1,1615.51,53
CDM,47543AK,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,1200.0,780.0,1.1,1298.39,53
CDM,47550AK,BILIARY NDSC INTRAOPERATIVE,1208.0,785.2,1.1,1208.0,50
CDM,47552AK,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,2412.0,1567.8,1.1,12916.74,50
CDM,47553AK,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,2536.0,1648.4,1.1,12916.74,50
CDM,47562AK,LAPAROSCOPY SURG CHOLECYSTECTOMY,4188.0,2722.2,1.1,9852.42,50
CDM,47562URVUAK,LAPAROSCOPIC CHOLECYSTECTOMY,1406.0,913.9,1.1,9852.42,50
CDM,47563AK,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,4588.0,2982.2,1.1,9852.42,50
CDM,47563URVUAK,LAPARO CHOLECYSTECTOMY/GRAPH,1433.0,931.45,1.1,9852.42,50
CDM,47564AK,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,7200.0,4680.0,1.1,17575.94,50
CDM,47579AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT (COMPARISON CODE 4",9550.0,6207.5,0.01,9852.42,28
CDM,47579AGRVU2AK,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT (COMPARISON CODE 4",3900.0,2535.0,0.01,9852.42,28
CDM,47579AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT (COMPARISON CODE 4",2950.0,1917.5,0.01,9852.42,28
CDM,47579AK-37,UNLISTED PROC; LAPAROSCOPIC CHOLEDOCHODUODENOSTOMY (COMP TO 4776,12646.0,8219.9,0.01,12646.0,28
CDM,47579AK-38,UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT,3039.0,1975.35,0.01,9852.42,28
CDM,47579RVU1AK,"UNLISTED PROC, LAP COMMON BILE DUCT EXPLORATION (COMP CODE 47420",7270.0,4725.5,0.01,9852.42,28
CDM,47579RVU2AK,UNLISTED PROC; LAP CHOLECYSTECTOMY W/EXPLORATION OF COMMON DUCT;,6999.0,4549.35,0.01,9852.42,28
CDM,47579RVU3AK,UNLISTED PROC; LAP REPAIR OF COMMON BILE DUCT INJURY. (COMP TO 4,2950.0,1917.5,0.01,9852.42,28
CDM,47579RVU5AK,OPEN ANASTOMOSIS EXTRAHEPATIC BILIARY DUCTS & GASTROINTESTIONAL,19758.0,12842.7,0.01,19758.0,28
CDM,47579RVU6AK,LAPAROSCOPIC CHOLECYSTOSTOMY TUBE PLACEMENT (COMP CODE 47480),4373.0,2842.45,0.01,9852.42,28
CDM,47579RVU8AK,LAP PORTOENTEROSTOMY (COMP CODE 47701),11492.0,7469.8,0.01,11492.0,28
CDM,47579RVUAK,LAP RESECTION EXTRA BILE DUCT,8547.0,5555.55,0.01,9852.42,28
CDM,47600AK,CHOLECYSTECTOMY,6992.0,4544.8,1.1,6992.0,50
CDM,47600URVUAK,REMOVAL OF GALLBLADDER,2125.0,1381.25,1.1,3669.65,50
CDM,47605AK,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,7392.0,4804.8,1.1,7392.0,50
CDM,47605URVUAK,CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY,1669.0,1084.85,1.1,3872.47,50
CDM,47610AK,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,8368.0,5439.2,1.1,8368.0,50
CDM,47612AK,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,8484.0,5514.6,1.1,8484.0,50
CDM,47700AK,EXPLOR CONG ATRESIA BILE DUCTS,6600.0,4290.0,1.1,6600.0,50
CDM,47711AK,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,10360.0,6734.0,1.1,10360.0,50
CDM,47715AK,EXCISION OF CHOLEDOCHAL CYST,8620.0,5603.0,1.1,8620.0,50
CDM,47720AK,CHOLECYSTOENTEROSTOMY; DIRECT,7336.0,4768.4,1.1,7336.0,50
CDM,47760AK,ANAST EXTRAHEP DUCT TO GI TRACT,15328.0,9963.2,1.1,15328.0,50
CDM,47765AK,ANAST INTRAHEP DUCT TO GI TRACT,20876.0,13569.4,1.1,20876.0,50
CDM,47780AK,"ANAST,ROUX-EN-Y,EXTRAHEP TO GI TRCT",16928.0,11003.2,1.1,16928.0,50
CDM,47785AK,"ANAST,ROUX-EN-Y,INTRAHEP TO GI TRCT",22476.0,14609.4,1.1,22476.0,50
CDM,47801AK,PLACEMENT CHOLEDOCHAL STENT,7040.0,4576.0,1.1,7040.0,50
CDM,47900015,EARMOLD - MONAURAL,66.0,42.9,9.82,66.0,46
CDM,47900025,EARMOLD - BINAURAL,120.0,78.0,17.86,120.0,46
CDM,47900085,HEARING AID REPAIR(12 MO),303.0,196.95,31.75,303.0,46
CDM,47900135,HEAR AID C DIGLTDBIN BTE,2400.0,1560.0,357.12,2400.0,46
CDM,47900145,HEAR AID C DIGLTDBIN DISP,300.0,195.0,31.75,300.0,46
CDM,47900155,HEAR AID C DIGADVMON CIC,2000.0,1300.0,297.6,2000.0,46
CDM,47900165,HEARING AMPLIFIER,250.0,162.5,25.16,250.0,46
CDM,47900175,HEAR AID A BASIC MON ITE,800.0,520.0,119.04,800.0,46
CDM,47900185,HEAR AID A BASIC MON BTE,700.0,455.0,104.16,700.0,46
CDM,47900195,HEAR AID B BASIC BIN ITE,1600.0,1040.0,238.08,1600.0,46
CDM,47900205,HEAR AID B BASIC BIN BTE,1400.0,910.0,208.32,1400.0,46
CDM,47900215,HEAR AID B BASIC BIN DISP,300.0,195.0,31.75,300.0,46
CDM,47900225,HEAR AID D DIGADVBIN DISP,300.0,195.0,31.75,300.0,46
CDM,47900235,HEAR AID A BASIC MON DISP,300.0,195.0,31.75,300.0,46
CDM,47900245,HEAR AID B DIGLTDMON DISP,300.0,195.0,31.75,300.0,46
CDM,47900255,HEAR AID C DIGADVMON DISP,300.0,195.0,31.75,300.0,46
CDM,47900265,HEAR AID D DIGMAXMON DISP,300.0,195.0,31.75,300.0,46
CDM,47900275,HEAR AID B DIGLTDMON CIC,1400.0,910.0,208.32,1400.0,46
CDM,47900285,HEAR AID D DIGMAXMON CIC,2700.0,1755.0,401.76,2700.0,46
CDM,47900295,HEAR AID B DIGLTDMON ITE,1300.0,845.0,193.44,1300.0,46
CDM,47900305,HEAR AID C DIGADVMON ITE,1900.0,1235.0,282.72,1900.0,46
CDM,47900315,HEAR AID D DIGMAXMON ITE,2600.0,1690.0,386.88,2600.0,46
CDM,47900325,HEAR AID B DIGLTDMON BTE,1200.0,780.0,178.56,1200.0,46
CDM,47900335,HEAR AID C DIGADVMON BTE,1800.0,1170.0,267.84,1800.0,46
CDM,47900345,HEAR AID D DIGMAXMON BTE,2750.0,1787.5,409.2,2750.0,46
CDM,47900355,HEAR AID C DIGLTDBIN CIC,2800.0,1820.0,416.64,2800.0,46
CDM,47900365,HEAR AID D DIGADVBIN CIC,4400.0,2860.0,531.62,4400.0,46
CDM,47900375,HEAR AID C DIGLTDBIN ITE,2600.0,1690.0,386.88,2600.0,46
CDM,47900385,HEAR AID D DIGADVBIN ITE,3800.0,2470.0,531.62,3800.0,46
CDM,47900395,HEAR AID D DIGADVBIN BTE,3960.0,2574.0,531.62,3960.0,46
CDM,47900425,HEARING AID REPAIR (AGE 5 YRS+),400.0,260.0,31.75,400.0,46
CDM,47900AK,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,8976.0,5834.4,1.1,8976.0,50
CDM,47999AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT",8547.0,5555.55,0.01,8547.0,28
CDM,47999AGRVUAK,"UNLISTED PROCEDURE, BILIARY TRACT (COMPARISON CODE 47900)",4040.0,2626.0,0.01,4040.0,28
CDM,47999AK,"BILE TRACT SURG PROC, UNLISTED",4161.0,2704.65,0.01,4161.0,28
CDM,47999RVU2AK,BILE DUCT RECONSTRUCTION (COMP CODE 47760),16477.0,10710.05,0.01,16477.0,28
CDM,47999RVU7AK,ERCP W/CONTROL OF BLEED (COMP CODE 44378),2278.0,1480.7,0.01,2278.0,28
CDM,47999RVU8AK,ERCP W/ SUBMUCOSAL INJECTION (TATTOOING) (COMP 43236),1028.0,668.2,0.01,1548.29,28
CDM,47999RVU9AK,RF ABLATION BILIARY TRACT (COMP CODE 47556),3079.0,2001.35,0.01,3079.0,28
CDM,48000005,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,1791.0,61
CDM,48000050,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,214.0,139.1,18.13,214.0,61
CDM,48000055,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,32784.0,21309.6,863.64,32784.0,61
CDM,48000060,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,214.0,139.1,18.13,214.0,61
CDM,48000065,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,30204.0,19632.6,1028.9,32356.61,61
CDM,48000070,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,214.0,139.1,18.13,214.0,61
CDM,48000080,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,214.0,139.1,18.13,214.0,61
CDM,48000085,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,45214.0,29389.1,1077.24,51380.79,61
CDM,48000090,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,214.0,139.1,18.13,214.0,61
CDM,48000100,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,214.0,139.1,18.13,214.0,61
CDM,48000110,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,214.0,139.1,18.13,214.0,61
CDM,48000120,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,18.13,214.0,61
CDM,48000130,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,214.0,139.1,18.13,214.0,61
CDM,48000145,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,302.0,196.3,18.13,302.0,46
CDM,48000150,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,141.0,91.65,18.13,141.0,61
CDM,48000155,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,339.0,220.35,18.13,339.0,46
CDM,48000170,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,173.61,1390.0,61
CDM,48000175,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,214.0,139.1,18.13,214.0,61
CDM,48000185,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,214.0,139.1,18.13,214.0,61
CDM,48000205,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,280.48,3153.0,61
CDM,48000220,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,280.48,3153.0,61
CDM,48000240,BUNDLE OF HIS RECORDING,20747.0,13485.55,1238.33,21861.27,61
CDM,48000245,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3153.0,2049.45,280.48,3153.0,61
CDM,48000250,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,5963.0,3875.95,887.29,11141.72,46
CDM,48000260,INDUCTION ARRHYTHMIA ELECTRICAL PACING,6980.0,4537.0,1121.7,9329.0,61
CDM,48000265,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,4530.0,2944.5,36.15,4530.0,46
CDM,48000270,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,43632.0,28360.8,1238.33,43632.0,61
CDM,48000280,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,43632.0,28360.8,1238.33,43632.0,61
CDM,48000290,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,14588.0,9482.2,1238.33,14588.0,46
CDM,48000300,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,10514.0,6834.1,1238.33,10514.0,46
CDM,48000305,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,1724.0,1120.6,73.53,1724.0,61
CDM,48000310,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,9664.0,6281.6,1238.33,9664.0,46
CDM,48000315,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,528.0,343.2,18.13,528.0,61
CDM,48000330,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,3549.0,2306.85,528.09,9329.0,46
CDM,48000335,2DTTE W CONTR LTD,2053.0,1334.45,280.48,2053.0,61
CDM,48000340,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,585.97,9329.0,46
CDM,48000355,2D TTE W CONTR STRESS,4543.0,2952.95,280.48,4543.0,61
CDM,48000360,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,22091.0,14359.15,942.46,22091.0,61
CDM,48000365,STRESS ECHO W/CONTRAST,4543.0,2952.95,280.48,4543.0,61
CDM,48000375,COUNTERPULSE EXTRNL EA TX,516.0,335.4,68.77,516.0,61
CDM,48000390,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3051.0,1983.15,86.16,3051.0,61
CDM,48000395,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,214.0,139.1,18.13,214.0,61
CDM,48000405,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,214.0,139.1,18.13,214.0,61
CDM,48000515,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,214.0,139.1,18.13,214.0,61
CDM,48008870,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,3763.0,2445.95,184.62,3763.0,61
CDM,48008880,TEMPORARY TRANSCUTANEOUS PACING,3763.0,2445.95,1.97,3763.0,61
CDM,48008900,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,173.61,1390.0,61
CDM,48008910,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,280.48,3153.0,61
CDM,48008920,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,78627.0,51107.55,1356.31,78627.0,61
CDM,48008930,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,74805.0,48623.25,1634.7,74805.0,61
CDM,48008940,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,6877.0,4470.05,497.62,11141.72,46
CDM,48008950,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,69628.0,45258.2,1537.52,73260.44,61
CDM,48008960,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,6667.0,4333.55,498.09,11141.72,46
CDM,48008970,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3153.0,2049.45,280.48,3153.0,61
CDM,48011995,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,585.97,9329.0,46
CDM,48012005,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,6980.0,4537.0,527.4,9329.0,61
CDM,48012015,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,741.0,481.65,49.1,741.0,61
CDM,48012025,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,214.0,139.1,18.13,214.0,61
CDM,48012035,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,214.0,139.1,18.13,214.0,61
CDM,48012045,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,214.0,139.1,18.13,214.0,61
CDM,48012055,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,214.0,139.1,18.13,214.0,61
CDM,48012075,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,214.0,139.1,18.13,214.0,61
CDM,48012085,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,214.0,139.1,18.13,214.0,61
CDM,48012105,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,342.0,222.3,27.18,342.0,61
CDM,48012115AGEX,TELEPHONIC MONITORING,214.0,139.1,18.13,214.0,61
CDM,48012125AGEX,PACEMAKER INTERROGATION,214.0,139.1,18.13,214.0,61
CDM,48012135AGEX,DEFIBRILLATOR INTERROGATION,214.0,139.1,18.13,214.0,61
CDM,48012155AGEX,IMPLANTABLE LOOP RECORDER INTERROGATION,141.0,91.65,18.13,141.0,61
CDM,48012175AGEX,PACEMAKER PROGRAMMING SINGLE,214.0,139.1,18.13,214.0,61
CDM,48012185AGEX,PACEMAKER PROGRAMMING DUAL,214.0,139.1,18.13,214.0,61
CDM,48012195AGEX,PACEMAKER PROGRAMMING MULT,214.0,139.1,18.13,214.0,61
CDM,48012205AGEX,DEFIBRILLATOR PROGRAMMING SINGLE,214.0,139.1,18.13,214.0,61
CDM,48012215AGEX,DEFIBRILLATOR PROGRAMMING DUAL,214.0,139.1,18.13,214.0,61
CDM,48012225AGEX,DEFIBRILLATOR PROGRAMMING MULT,214.0,139.1,18.13,214.0,61
CDM,48012235AGEX,PACEMAKER PERI PROCEDURAL,302.0,196.3,18.13,302.0,46
CDM,48012245AGEX,DEFIBRILLATOR PERI PROCEDURAL,339.0,220.35,18.13,339.0,46
CDM,48012255AGEX,PACEMAKER HEART RHYTHM DATA PRO CODE,214.0,139.1,18.13,214.0,61
CDM,48012265AGEX,DEFIBRILLATOR HEART RHYTHM DATA PRO CODE,214.0,139.1,18.13,214.0,61
CDM,48012295AGEX,TRANS-TELEPHONIC ARRHYTHMIA MONITORING,342.0,222.3,12.14,342.0,61
CDM,48012305AGEX,REM INTERROG SCRMS <30 D PHYS /QHP (LOOP REMOTE),214.0,139.1,34.46,214.0,53
CDM,48012455,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,13342.0,8672.3,472.21,13342.0,46
CDM,48012465,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,280.48,6873.0,46
CDM,48012505,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,38008.0,24705.2,771.06,53987.6,61
CDM,48012515,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,18098.0,11763.7,819.03,18098.0,61
CDM,48012545,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,38626.0,25106.9,544.52,80395.08,61
CDM,48012615,REM INTERROG ICPMS <30 D PHYS/QHP,214.0,139.1,34.46,214.0,53
CDM,48012805,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,20926.0,13601.9,560.54,20926.0,61
CDM,48012885,PROCAINAMIDE INFUSION CHALLENGE,3823.0,2484.95,18.66,3823.0,61
CDM,48012905,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,55185.0,35870.25,8211.53,55185.0,46
CDM,48012915,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,55185.0,35870.25,8211.53,55185.0,46
CDM,48012925,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,55185.0,35870.25,8211.53,55185.0,46
CDM,48012935,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,28973.0,18832.45,5003.75,53987.6,61
CDM,48013035,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,149.0,96.85,18.13,149.0,61
CDM,48013045,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,22742.0,14782.3,5003.75,53987.6,61
CDM,48013055,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,12590.0,8183.5,2386.88,12590.0,61
CDM,48013065,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,22742.0,14782.3,5003.75,53987.6,61
CDM,48013095,REM INTERROG SCRMS <30 D PHYS/QHP,214.0,139.1,34.46,214.0,53
CDM,48013105,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,149.0,96.85,18.13,149.0,61
CDM,48013125,REMOTE INTERROG DEV EVAL CCM-D SYS <90D TECH,149.0,96.85,18.13,149.0,61
CDM,48013135,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,4856.0,3156.4,1121.7,4856.0,61
CDM,48013145,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,4856.0,3156.4,1121.7,4856.0,61
CDM,48013155,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,121.0,78.65,18.0,121.0,38
CDM,48013165,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,149.0,96.85,18.13,149.0,61
CDM,48013175,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,214.0,139.1,34.46,214.0,53
CDM,48013185,ISOPROTERENOL CHALLENGE FOR PVC INDUCTION ONLY (COMP CODE 93623),9664.0,6281.6,18.66,9664.0,61
CDM,48013195,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,907.0,589.55,18.13,907.0,55
CDM,48013205,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,907.0,589.55,18.13,907.0,55
CDM,48020AK,REMOVAL OF PANCREATIC STONE,7636.0,4963.4,1.1,7636.0,50
CDM,48100010,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,3821.0,2483.65,166.33,5395.71,46
CDM,48100040,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5062.0,3290.3,89.44,5062.0,46
CDM,48100050,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,3905.0,2538.25,89.44,3905.0,46
CDM,48100140,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,8932.0,5805.8,154.68,9996.0,61
CDM,48100160,ENDOMYOCARDIAL BIOPSY,18098.0,11763.7,1071.48,18098.0,61
CDM,48100245,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,726.77,40064.0,61
CDM,48100305,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,20959.0,13623.35,2148.89,20959.0,61
CDM,48100310,INTRA-ATRIAL RECORDING,43632.0,28360.8,1238.33,43632.0,61
CDM,48100315,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,36015.0,23409.75,2217.04,36015.0,61
CDM,48100320,RIGHT VENTRICULAR RECORDING,6980.0,4537.0,1121.7,6980.0,61
CDM,48100325,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,65208.0,42385.2,1768.23,65208.0,61
CDM,48100330,INTRA-ATRIAL PACING,43632.0,28360.8,1238.33,43632.0,61
CDM,48100340,INTRAVENTRICULAR PACING,43632.0,28360.8,1238.33,43632.0,61
CDM,48100350,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,13342.0,8672.3,472.21,13342.0,46
CDM,48100370,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,280.48,6873.0,46
CDM,48100375,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,65208.0,42385.2,1045.69,65208.0,61
CDM,48100385,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,5794.0,3766.1,522.24,9608.0,46
CDM,48100585,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,33856.0,22006.4,1590.58,51380.79,61
CDM,48100650,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,18494.0,12021.1,1480.12,18494.0,61
CDM,48100655,PERC DES W/ ANGIO SINGLE MAJOR,41649.0,27071.85,4659.93,41649.0,61
CDM,48100660,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,18494.0,12021.1,1508.2,18494.0,61
CDM,48100665,PERC DES W/ANGIO ADDTL BRANCH,18602.0,12091.3,2451.0,18602.0,46
CDM,48100670,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100675,PERC DES/ATHER/ANGIO 1 MAJ ART,44697.0,29053.05,4659.93,51380.79,61
CDM,48100680,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1518.51,18494.0,61
CDM,48100685,PERC DES/ ATHER/ANGIO ADDTL BR,14577.0,9475.05,2169.06,14577.0,46
CDM,48100690,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100695,PERC DES REVASC CABG 1 VSL,42588.0,27682.2,4659.93,42588.0,61
CDM,48100700,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100705,PERC DES  REVASC CABG ADDTL BR,18602.0,12091.3,2767.98,18602.0,46
CDM,48100710,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100715,PERC DES REVASC W/AMI 1 VSL,33050.0,21482.5,4659.93,33050.0,46
CDM,48100720,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100725,PERC DES REVASC CTO SINGLE VSL,51254.0,33315.1,4659.93,51380.79,61
CDM,48100730,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100740,R & L HRT CATH WINJX HRT ART& L VENTR IMG,18494.0,12021.1,1546.13,18494.0,61
CDM,48100750,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,18494.0,12021.1,1546.13,18494.0,61
CDM,48100760,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,9493.0,6170.45,336.43,9996.0,46
CDM,48100770,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,4530.0,2944.5,36.15,4530.0,46
CDM,48100860,NJX SUPRAVALV AORTOG HRT CATH W/S&I,4586.0,2980.9,61.29,10496.0,46
CDM,48100AK,OPEN BIOPSY OF PANCREAS,5784.0,3759.6,1.1,5784.0,50
CDM,48101015,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,283.94,4525.0,46
CDM,48101035,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,144.79,18098.0,61
CDM,48101065,INSERTION PICC W/O IMG GDN < 5 YR,8932.0,5805.8,162.54,8932.0,61
CDM,48101075,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,18098.0,11763.7,504.55,18098.0,61
CDM,48101125,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,58667.0,38133.55,802.6,58667.0,61
CDM,48101130,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,4625.0,3006.25,688.2,4625.0,46
CDM,48101140,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,4750.0,3087.5,706.8,4750.0,46
CDM,48101150,PRQ CARD ANGIOPLAST 1 ART LC,32784.0,21309.6,863.64,32784.0,61
CDM,48101310,PRQ PLC BM STNT W/ANG 1 VSL LC,42281.0,27482.65,960.18,42281.0,61
CDM,48101510,PRQ BM REVASC CABG 1 VSL,44674.0,29038.1,959.53,44674.0,61
CDM,48102260,CLSR ASD TX CATH W IMP,33856.0,22006.4,1590.58,51380.79,61
CDM,48102325,"CARDIOVERSION, INTERNAL",3763.0,2445.95,315.57,3763.0,61
CDM,48102365,PRQ CARDIAC ANGIOPLAST 1 ART,32784.0,21309.6,863.64,32784.0,61
CDM,48102385,PRQ CARDIAC ANGIO/ARTHRECT 1 ART,30204.0,19632.6,1028.9,32356.61,61
CDM,48102405,PRQ CARDIAC STENT W/ANGIO 1 VSL,42281.0,27482.65,960.18,42281.0,61
CDM,48102445,PRQ CARD REVASC MI 1 VSL,33050.0,21482.5,1078.76,33050.0,46
CDM,48102455,PRQ DES REVASC CHRONIC 1VSL,38342.0,24922.3,1078.55,38342.0,61
CDM,48102515,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,28932.0,18805.8,5003.75,87978.22,61
CDM,48102685,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,7901.0,5135.65,589.05,62681.75,46
CDM,48102695,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,2888.0,1877.2,272.57,4831.0,46
CDM,48102705,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,265.98,47587.0,61
CDM,48102715,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3138.0,2039.7,423.16,18167.0,46
CDM,48102725,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,45214.0,29389.1,1077.24,51380.79,61
CDM,48102765,PERC DES REVASC CTO ADDTL VESSEL,33050.0,21482.5,3398.0,33050.0,46
CDM,48102795,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,38384.0,24949.6,6695.97,51380.79,61
CDM,48103155,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,384.86,8932.0,61
CDM,48103165,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,404.81,10496.0,46
CDM,48103235,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,7664.0,4981.6,580.98,62681.75,46
CDM,48103245,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,4539.0,2950.35,263.32,4831.0,46
CDM,48103285,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,305.63,18098.0,61
CDM,48103305,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,25647.0,16670.55,836.97,29295.35,61
CDM,48103315,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,18098.0,11763.7,500.64,18098.0,61
CDM,48103355,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,21495.0,13971.75,545.02,23194.66,61
CDM,48103365,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,26736.0,17378.4,570.43,29295.35,61
CDM,48103375,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,42964.0,27926.6,598.58,53987.6,61
CDM,48103395,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,20926.0,13601.9,639.93,20926.0,61
CDM,48103405,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,20926.0,13601.9,639.93,20926.0,61
CDM,48103445,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,42062.0,27340.3,598.47,62345.36,61
CDM,48103985,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,3134.0,2037.1,218.78,13135.08,46
CDM,48104125,CARDIOVASCULAR PROCEDURE,1145.0,744.25,18.66,3398.0,61
CDM,48104275,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,17189.0,11172.85,65.08,17189.0,46
CDM,48104285,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,12902.0,8386.3,65.08,12902.0,46
CDM,48104315,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,1367.0,888.55,65.08,3398.0,46
CDM,48104325,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,4623.0,3004.95,65.08,4623.0,46
CDM,48104335,SUBCLAVIAN TRANS-CAROTID TAVR,17587.0,11431.55,571.26,17587.0,61
CDM,48104475,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,59541.0,38701.65,95.44,59541.0,46
CDM,48104485,VENOGRAPHY CHD CORONARY SINUS,59541.0,38701.65,121.05,59541.0,46
CDM,48104495,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,59541.0,38701.65,177.93,59541.0,46
CDM,48104505,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,59541.0,38701.65,179.97,59541.0,46
CDM,48104515,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,5062.0,3290.3,251.7,5395.71,46
CDM,48104525,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,59541.0,38701.65,101.43,59541.0,46
CDM,48104595,INTRAPROCEDURAL CORONARY FRACTIONAL FLOW RESERVE (FFR) WITH 3D F,17254.0,11215.1,321.96,17254.0,46
CDM,48104625,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",465.0,302.25,18.66,3398.0,61
CDM,48104705,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART PERQ TCAT THER,22806.0,14823.9,4659.93,32356.61,61
CDM,48104715,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,12526.0,8141.9,1863.87,12526.0,46
CDM,48104765,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,129228.0,83998.2,4659.93,129228.0,55
CDM,48104775,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,81380.0,52897.0,4659.93,81380.0,55
CDM,48104785,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,33435.0,21732.75,373.58,33435.0,46
CDM,48104795,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48104805,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,67817.0,44081.05,348.67,67817.0,46
CDM,48104815,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48104825,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,67817.0,44081.05,467.79,67817.0,46
CDM,48104835,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48104845,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,374.66,107690.0,46
CDM,48104855,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48104865,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,107690.0,69998.5,515.76,107690.0,46
CDM,48104875,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48104885,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,397.19,107690.0,46
CDM,48104895,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48104905,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,107690.0,69998.5,559.61,107690.0,46
CDM,48104925,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48104935,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,67817.0,44081.05,278.8,67817.0,46
CDM,48104945,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48104955,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,67817.0,44081.05,396.53,67817.0,46
CDM,48104965,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48104975,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,107690.0,69998.5,314.66,107690.0,46
CDM,48104985,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48104995,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,107690.0,69998.5,472.22,107690.0,46
CDM,48105005,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48105015,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,445.16,107690.0,46
CDM,48105025,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48105035,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,107690.0,69998.5,608.42,107690.0,46
CDM,48105045,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48105055,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,618.29,107690.0,46
CDM,48105065,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,6075.0,107690.0,55
CDM,48105075,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,107690.0,69998.5,777.81,107690.0,46
CDM,48105085,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48105095,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,67817.0,44081.05,372.12,67817.0,46
CDM,48105105,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48105115,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,67817.0,44081.05,464.55,67817.0,46
CDM,48105125,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,33435.0,21732.75,2003.13,33435.0,55
CDM,48105135,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,33435.0,21732.75,279.7,33435.0,46
CDM,48105145,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,33435.0,21732.75,2003.13,33435.0,55
CDM,48105155,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,33435.0,21732.75,362.27,33435.0,46
CDM,48105165,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48105175,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,67817.0,44081.05,372.21,67817.0,46
CDM,48105185,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,67817.0,44081.05,3708.64,67817.0,55
CDM,48105195,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,67817.0,44081.05,395.55,67817.0,46
CDM,48105215,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,33435.0,21732.75,2003.13,33435.0,55
CDM,48105225,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,33435.0,21732.75,280.53,33435.0,46
CDM,48105235,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,33435.0,21732.75,2003.13,33435.0,55
CDM,48105265,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,180002.0,117001.3,8422.0,180002.0,55
CDM,48105275,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,14287.0,9286.55,1720.7,14287.0,55
CDM,48105285,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,31526.0,20491.9,5355.0,86489.44,55
CDM,48105AK,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,19704.0,12807.6,1.1,19704.0,50
CDM,48120AK,EXCISION OF PANCREAS LESION,7364.0,4786.6,1.1,7364.0,50
CDM,48140AK,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,10528.0,6843.2,1.1,10528.0,50
CDM,48146AK,PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX,12240.0,7956.0,1.1,12240.0,50
CDM,48148AK,EXCISION AMPULLA VATER,8156.0,5301.4,1.1,8156.0,50
CDM,48150AK,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,21136.0,13738.4,1.1,21136.0,50
CDM,48152AK,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,19460.0,12649.0,1.1,19460.0,50
CDM,48153AK,PNCRTECT W/PANCREATOJEJUNOSTOMY,21116.0,13725.4,1.1,21116.0,50
CDM,48154AK,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,19552.0,12708.8,1.1,19552.0,50
CDM,48155AK,PANCREATECTOMY TOTAL,11780.0,7657.0,1.1,11780.0,50
CDM,48200010,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,1791.0,1164.15,71.26,1791.0,61
CDM,48200015,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,807.0,524.55,25.09,807.0,46
CDM,48300000,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,3783.0,2458.95,0.87,3783.0,61
CDM,48300005,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,734.0,477.1,0.87,734.0,61
CDM,48300010,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1390.0,903.5,223.34,1390.0,61
CDM,48300015,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3153.0,2049.45,280.48,3153.0,61
CDM,48300020,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,280.48,3153.0,61
CDM,48300025,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3153.0,2049.45,271.88,3153.0,61
CDM,48300030,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1066.0,692.9,41.58,1066.0,46
CDM,48300035,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,173.61,1390.0,61
CDM,48300040,ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST,3153.0,2049.45,280.48,3153.0,61
CDM,48300045,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3153.0,2049.45,280.48,3153.0,61
CDM,48300050,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3153.0,2049.45,280.48,3153.0,61
CDM,48300070,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1333.0,866.45,87.63,1333.0,46
CDM,48300075,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,600.0,390.0,43.77,600.0,46
CDM,48300080,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,280.48,3153.0,61
CDM,48300090,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,4048.0,2631.2,280.48,4048.0,46
CDM,48300095,"TTE W/DOPPLER, COMPLETE W/CONT",4543.0,2952.95,280.48,4543.0,61
CDM,48300105,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,4048.0,2631.2,280.48,4048.0,46
CDM,48300165,ECHO LIMITED WITH CONTRAS,2053.0,1334.45,280.48,2053.0,61
CDM,48300215,TEE W/CONTRAST 2D,4543.0,2952.95,280.48,4543.0,61
CDM,48300225,TEE W/CONTRAST CONGENITAL ANOMALIES,4543.0,2952.95,280.48,4543.0,61
CDM,48300235,TTE CONGENITAL ANOMALIES W/CONTRAST,4543.0,2952.95,280.48,4543.0,61
CDM,48300245,"TTE CONGENITAL ANOMALIES, LIMITED W/CONTRAST",4543.0,2952.95,280.48,4543.0,61
CDM,48300275,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3153.0,2049.45,280.48,3153.0,61
CDM,48300295,2D TTE W CONTR STRESS,4543.0,2952.95,280.48,4543.0,61
CDM,48300305,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,69.0,44.85,15.04,324.76,46
CDM,48300315,HOSPITAL MYOCRD STRAIN,69.0,44.85,15.04,324.76,46
CDM,48300325,3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,518.0,336.7,40.85,518.0,46
CDM,48308900,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,173.61,1390.0,61
CDM,48520AK,INT ANAST PANCREATIC CYST GI TRACT DIRECT,7260.0,4719.0,1.1,7260.0,50
CDM,48540AK,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,8776.0,5704.4,1.1,8776.0,50
CDM,48545AK,PANCREATORRHAPHY INJURY,8892.0,5779.8,1.1,8892.0,50
CDM,48547AK,DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ,12152.0,7898.8,1.1,12152.0,50
CDM,48548AK,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,11236.0,7303.4,1.1,11236.0,50
CDM,48999AGRVU1AK,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48120)",2180.0,1417.0,0.01,2180.0,28
CDM,48999AGRVU2AK,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48520)",2150.0,1397.5,0.01,2150.0,28
CDM,48999AGRVU3AK,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48153)",17421.0,11323.65,0.01,17421.0,28
CDM,48999AGRVU4AK,"UNLIST PROC, PANCREAS COMPARED TO 48100",4772.0,3101.8,0.01,4772.0,28
CDM,48999AGRVU5AK,"UNLISTED PROCEDURE, PANCREAS",5673.0,3687.45,0.01,5673.0,28
CDM,48999AGRVUAK,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48140)",3330.0,2164.5,0.01,3330.0,28
CDM,48999AK,PANCREAS SURGERY PROC UNLISTED,2215.0,1439.75,0.01,2215.0,28
CDM,48999RVU11AK,"UNLISTED PROC, LAP PANCREATICODUODENECTOMY W/DISTAL GASTRECTOMY",5037.0,3274.05,0.01,5037.0,28
CDM,48999RVU12AK,UNLISTED PROC; ENDOSCOPIC DEBRIDEMENT OF PANCREATIC PSEUDOCYST (,2327.0,1512.55,0.01,2327.0,28
CDM,48999RVU14AK,LAP PANCREAS DEBRIDEMENT (COMP 48105),16256.0,10566.4,0.01,16256.0,28
CDM,48999RVU18AK,UNLISTED PROC; DUNKING PANCREATIC JEJUNAL ANASTOMOSIS (COMP CODE,9270.0,6025.5,0.01,9270.0,28
CDM,48999RVU19AK,LAPAROSCOPIC PYLORUS PRESERVING PANCREATICODUODENECTOMY (COMP CO,22699.0,14754.35,0.01,22699.0,28
CDM,48999RVU1AK,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM,3330.0,2164.5,0.01,3330.0,28
CDM,48999RVU2AK,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM (COMP CODE 48140),9476.0,6159.4,0.01,9476.0,28
CDM,48999RVU3AK,PANCREATECTOMY CENTRAL,9064.0,5891.6,0.01,9064.0,28
CDM,48999RVU4AK,LAPAROSCOPIC WHIPPLE,17421.0,11323.65,0.01,17421.0,28
CDM,48999RVU5AK,UNLISTED LAP DEBRIDEMENT OF PANCREATIC CYST (COMP CODE 48105),16256.0,10566.4,0.01,16256.0,28
CDM,48999RVU9AK,UNLISTED PROC; LAP PANCREATIC CYST GASTROSTOMY (COMP TO 48520),5990.0,3893.5,0.01,5990.0,28
CDM,48999RVUAK,EGD-PSEUDOCYST NECROSECTOMY (COMP 48105),21189.0,13772.85,0.01,21189.0,28
CDM,49000070,INJECTION PEYRONIE DISEASE,1119.0,727.35,0.01,1119.0,61
CDM,49000AK,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,5016.0,3260.4,1.1,5016.0,50
CDM,49002AK,REOPENING RECENT LAPAROTOMY,7052.0,4583.8,1.1,7052.0,50
CDM,49006135,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,65208.0,42385.2,966.79,65208.0,61
CDM,49006145,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,65208.0,42385.2,1270.8,65208.0,61
CDM,49006235,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,103251.0,67113.15,1226.73,103251.0,61
CDM,49006345,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,65208.0,42385.2,1445.94,65208.0,61
CDM,49006355,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,103251.0,67113.15,603.67,103251.0,61
CDM,49006365,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,103251.0,67113.15,776.67,103251.0,61
CDM,49007225,PTCA W/ IVUS OR OCT,41751.0,27138.15,4659.93,41751.0,46
CDM,49007235,COR ANGIO W/ FFR & 3D MAP,23119.0,15027.35,1546.13,23119.0,46
CDM,49007245,PCTA W/ COR LITHOTRIP,47343.0,30772.95,4659.93,47343.0,46
CDM,49010AK,EXPL RETROPERITONEUM W/WO BX SPX,6424.0,4175.6,1.1,6424.0,50
CDM,49013AK,PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA,3340.0,2171.0,1.1,3340.0,50
CDM,49014AK,REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING,2692.0,1749.8,1.1,2692.0,50
CDM,49020AK,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS OPEN,10668.0,6934.2,1.1,10668.0,50
CDM,49020URVUAK,DRAIN ABDOMINAL ABSCESS,2489.0,1617.85,1.1,5452.69,50
CDM,49060AK,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,7412.0,4817.8,1.1,7412.0,50
CDM,49062AK,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,4888.0,3177.2,1.1,4888.0,50
CDM,49082AK,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,546.0,354.9,1.1,1548.29,53
CDM,49083AK,ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,880.0,572.0,1.1,1548.29,53
CDM,49084AK,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,880.0,572.0,1.1,1548.29,50
CDM,49180AK,BX ABDL/RPR MASS PRQ NDL,761.0,494.65,1.1,2768.64,53
CDM,49185AK,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,940.0,611.0,1.1,4126.98,53
CDM,49186AK,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS,9680.0,6292.0,1.1,9680.0,49
CDM,49187AK,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5.1-10 CM,12606.0,8193.9,1.1,12606.0,49
CDM,49188AK,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM,14960.0,9724.0,1.1,14960.0,49
CDM,49189AK,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 20.1-30 CM,17600.0,11440.0,1.1,17600.0,49
CDM,49190AK,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CYST >30 CM,22000.0,14300.0,1.1,22000.0,49
CDM,49215AK,EXCISE PRESACRAL/SACRAL TUMOR,13612.0,8847.8,1.1,13612.0,50
CDM,49250AK,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,3604.0,2342.6,1.1,5906.43,50
CDM,49255AK,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,5024.0,3265.6,1.1,5024.0,50
CDM,49320AK,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,2262.0,1470.3,1.1,9852.42,50
CDM,49321AK,L'SCOPE W/BIOPSY SINGLE/MULTIPLE,2176.0,1414.4,1.1,9852.42,50
CDM,49321URVUAK,"LAPARSOCOPY, SURGICAL WITH BIOPSY",557.0,362.05,1.1,9852.42,50
CDM,49322AK,L'SCOPE CAVITY/CYST SINGLE/MULTIPLE,2404.0,1562.6,1.1,9852.42,50
CDM,49323AK,L'SCOPE W/DRNG  LYMPHOCELE TO PERIT,4092.0,2659.8,1.1,9852.42,50
CDM,49324AK,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,2528.0,1643.2,1.1,9852.42,50
CDM,49324URVUAK,LAP INSERTION PERM IP CATH,635.0,412.75,1.1,9852.42,50
CDM,49325AK,LAPS W/REVISION INTRAPERITONEAL CATHETER,2728.0,1773.2,1.1,9852.42,50
CDM,49329AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",2310.0,1501.5,0.01,9852.42,28
CDM,49329AGRVU2AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",4670.0,3035.5,0.01,9852.42,28
CDM,49329AGRVU3AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",3520.0,2288.0,0.01,9852.42,28
CDM,49329AGRVU4AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",4500.0,2925.0,0.01,9852.42,28
CDM,49329AGRVU5AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",2475.0,1608.75,0.01,9852.42,28
CDM,49329AGRVU6AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",9943.0,6462.95,0.01,9943.0,28
CDM,49329AGRVU7AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",1545.0,1004.25,0.01,9852.42,28
CDM,49329AGRVU8AK,"UNLIST LAP PROC, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 57107",8105.0,5268.25,0.01,9852.42,28
CDM,49329AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",810.0,526.5,0.01,9852.42,28
CDM,49329AK,UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM,2549.0,1656.85,0.01,9852.42,28
CDM,49329RVU10AK,"UNLISTED LAP REMOVAL FOREIGN BODY , ABD (COMP CODE 49402)",3018.0,1961.7,0.01,9852.42,28
CDM,49329RVU11AK,"LAP LYSIS ADHESIONS,PERITONEAL (COMP CODE 44180)",5013.0,3258.45,0.01,9852.42,28
CDM,49329RVU13AK,LX EXCISION OF RETROPERITONEAL TUMOR (COMP 49203),8655.0,5625.75,0.01,9852.42,28
CDM,49329RVU14AK,LAP DRAINAGE OF ABD ABSCESS (COMP 49020),4670.0,3035.5,0.01,9852.42,28
CDM,49329RVU15AK,LAPAROSCOPIC CREATION OF MYOFASCIAL CUTANEOUS MUSCLE FLAPS (COMP,6999.0,4549.35,0.01,9852.42,28
CDM,49329RVU16AK,"UNLISTED LAPAROSCOPY, ABDOMEN, PERITONEUM AND OMENTUM (COMP CODE",9943.0,6462.95,0.01,9943.0,28
CDM,49329RVU19AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",7307.0,4749.55,0.01,9852.42,28
CDM,49329RVU20AK,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",5024.0,3265.6,0.01,9852.42,28
CDM,49329RVU21AK,"UNLISTED PROC; I&D OF APPENDICEAL ABSCESS, OPEN (COMP CODE 44900",4148.0,2696.2,0.01,9852.42,28
CDM,49329RVU22AK,LAP RELEASE MEDIAN ARCUATE LIGAMENT (COMP 49320),2927.0,1902.55,0.01,9852.42,28
CDM,49329RVU23AK,POST OP LAP EXPLOR & CONTROL HEMORRHAGE ABD (COMP TO 35840),4557.0,2962.05,0.01,9852.42,28
CDM,49329RVU24AK,LAPAROSCOPIC PERITONEAL DIALYSIS CATH REMOVAL (COMP TO 49422),2016.0,1310.4,0.01,9852.42,28
CDM,49329RVU25AK,LAPAROSCOPIC ABDOMINAL MESH REMOVAL (COMP TO 20680),1967.0,1278.55,0.01,9852.42,28
CDM,49329RVU26AK,LAPAROSCOPIC RELEASE OF MEDIAN ARCUATE LIGAMENT (MALS PROC) (COM,5973.0,3882.45,0.01,9852.42,28
CDM,49329RVU28AK,"LAP EXCISION ABD, PERITONEUM, OMENTUM 5CM OR LESS (COMP 49186)",9460.0,6149.0,0.01,9852.42,28
CDM,49329RVU29AK,"LAP,EXCISION ABD, PERITONEUM, OMENTUM 5.1-10CM (COMP 49187)",12320.0,8008.0,0.01,12320.0,28
CDM,49329RVU2AK,LAPAROSCOPIC EVACUATION HEMATOMA (COMP 49002),1967.0,1278.55,0.01,9852.42,28
CDM,49329RVU30AK,"LAP EXCISION ABD, PERITONEUM, OMENTUM 10.1-20CM (COMP 49188)",14620.0,9503.0,0.01,14620.0,28
CDM,49329RVU31AK,"LAP EXCISION ABD, PERITONEUM, OMENTUM 20.1-30CM (COMP 49189)",17200.0,11180.0,0.01,17200.0,28
CDM,49329RVU32AK,"LAP EXCISION ABD, PERITONEUM, OMENTUM GREATER THAN 30CM (COMP 49",21500.0,13975.0,0.01,21500.0,28
CDM,49329RVU33AK,LAP EXCISION OF A PRESACRAL SINUS(FISTULA) TRACT/ABSCESS (COMP 4,15124.0,9830.6,0.01,15124.0,28
CDM,49329RVU3AK,LAPROSCOPIC OMENTAL FLAP INTRA-ABDOMINAL (COMP CODE 49905),711.0,462.15,0.01,9852.42,28
CDM,49329RVU9AK,LAPAROSCOPIC EXCISION OMENTUM (49255),3501.0,2275.65,0.01,9852.42,28
CDM,49402AK,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,5636.0,3663.4,1.1,5906.43,50
CDM,49405AK,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,1600.0,1040.0,1.1,2912.93,53
CDM,49406AK,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,1760.0,1144.0,1.1,2914.0,53
CDM,49418AK,INSJ INTRAPERITONEAL CATHETER W/IMG GID,1584.0,1029.6,1.1,5906.43,53
CDM,49421AK,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,1684.0,1094.6,1.1,5906.43,50
CDM,49421URVUAK,INSERTION PERITONEAL CATH DIALYSIS OPEN,576.0,374.4,1.1,5906.43,50
CDM,49422AK,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,1760.0,1144.0,1.1,5442.3,50
CDM,49423AK,EXCHNG ABSC/CST DRG CATH RAD GID SPX,642.0,417.3,1.1,3248.9,53
CDM,49424AK,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,304.0,197.6,1.1,598.68,53
CDM,49425AK,INSERTION PERITONEAL-VENOUS SHUNT,4888.0,3177.2,1.1,4888.0,50
CDM,49426AK,REVIS PERITONEAL-VENOUS SHUNT,4164.0,2706.6,1.1,5906.43,50
CDM,49427AK,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,392.0,254.8,1.1,392.0,50
CDM,49429AK,RMVL PERITONEAL-VENOUS SHUNT,2976.0,1934.4,1.1,5442.3,50
CDM,49440AK,INSERT GASTROSTOMY TUBE PERCUTANEOUS,1729.0,1123.85,1.1,3248.9,53
CDM,49441AK,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,1808.0,1175.2,1.1,3248.9,53
CDM,49442AK,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,1500.0,975.0,1.1,2613.33,53
CDM,49446AK,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,1224.0,795.6,1.1,3248.9,53
CDM,49450AK,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,544.0,353.6,1.1,1953.01,53
CDM,49451AK,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,736.0,478.4,1.1,2089.63,53
CDM,49452AK,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,1144.0,743.6,1.1,2545.05,53
CDM,49460AK,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,384.0,249.6,1.1,2285.43,53
CDM,49465AK,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,248.0,161.2,1.1,446.34,53
CDM,49505AK,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,3184.0,2069.6,1.1,5906.43,50
CDM,49505URVUAK,REPAIR INGUINAL HERNIA,1050.0,682.5,1.1,5906.43,50
CDM,49507AK,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,3636.0,2363.4,1.1,5906.43,50
CDM,49507URVUAK,REPAIR INGUINAL HERNIA,1354.0,880.1,1.1,5906.43,50
CDM,49520AK,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,3996.0,2597.4,1.1,5906.43,50
CDM,49520URVUAK,REREPAIR INGUINAL HERNIA,1296.0,842.4,1.1,5906.43,50
CDM,49521AK,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,4592.0,2984.8,1.1,12916.74,50
CDM,49525AK,RPR INGUN HERNIA SLIDING ANY AGE,3572.0,2321.8,1.1,5906.43,50
CDM,49540AK,REPAIR LUMBAR HERNIA,4296.0,2792.4,1.1,9852.42,50
CDM,49550AK,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,3596.0,2337.4,1.1,5906.43,50
CDM,49550URVUAK,REPAIR FEMORAL HERNIA,980.0,637.0,1.1,5906.43,50
CDM,49553AK,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,3968.0,2579.2,1.1,5906.43,50
CDM,49555AK,RPR RECRT FEM HERNIA REDUCIBLE,3756.0,2441.4,1.1,5906.43,50
CDM,49557AK,RPR RECRT FEM HRNA INCARCERATED,4648.0,3021.2,1.1,5906.43,50
CDM,49591AK,RPR AA HERNIA 1ST < 3 CM REDUCIBLE,2622.0,1704.3,1.1,5906.43,50
CDM,49592AK,RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,3722.0,2419.3,1.1,9852.42,50
CDM,49593AK,RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,4514.0,2934.1,1.1,5906.43,50
CDM,49594AK,RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,5922.0,3849.3,1.1,9852.42,50
CDM,49595AK,RPR AA HERNIA 1ST > 10 CM REDUCIBLE,6134.0,3987.1,1.1,6134.0,50
CDM,49596AK,RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED,8215.0,5339.75,1.1,8215.0,50
CDM,49613AK,RPR AA HERNIA RECR < 3 CM REDUCIBLE,2968.0,1929.2,1.1,5906.43,50
CDM,49614AK,RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,4100.0,2665.0,1.1,9852.42,50
CDM,49615AK,RPR AA HERNIA RECR 3-10 CM REDUCIBLE,4584.0,2979.6,1.1,5906.43,50
CDM,49616AK,RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,6842.0,4447.3,1.1,6842.0,50
CDM,49617AK,RPR AA HERNIA RECR > 10 CM REDUCIBLE,6412.0,4167.8,1.1,6412.0,50
CDM,49618AK,RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,9068.0,5894.2,1.1,9068.0,50
CDM,49621AK,RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,5480.0,3562.0,1.1,5480.0,50
CDM,49622AK,RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED,6824.0,4435.6,1.1,6824.0,50
CDM,49623AK,RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,1500.0,975.0,1.1,1500.0,50
CDM,49650AK,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,2544.0,1653.6,1.1,9852.42,50
CDM,49650URVUAK,LAPARO HERNIA REPAIR INITIAL,682.0,443.3,1.1,9852.42,50
CDM,49651AK,LAPS SURG RPR RECURRENT INGUINAL HERNIA,3352.0,2178.8,1.1,9852.42,50
CDM,49659AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HER",1680.0,1092.0,0.01,9852.42,28
CDM,49659AK,UNLISTED LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,1250.0,812.5,0.01,9852.42,28
CDM,49659RVU10AK,LAPAROSCOPIC CONGENITAL HERNIA REPAIR W/ MESH (COMP 43282),10837.0,7044.05,0.01,10837.0,28
CDM,49659RVU4AK,LAP. PERISTOMAL HERNIA REPAIR,6478.0,4210.7,0.01,9852.42,28
CDM,49659RVU6AK,LAP REPAIR OF FEMORAL HERNIA (COMP 49550),3827.0,2487.55,0.01,9852.42,28
CDM,49659RVU7AK,LAP REPAIR INITIAL FEMORAL HERNIA; INCAR OR STRANG (COMP CODE 49,3572.0,2321.8,0.01,9852.42,28
CDM,49659RVU8AK,LAPAROSCOPIC REPAIR RECURRENT FEMORAL HERNIA (COMP CODE 49555),3381.0,2197.65,0.01,9852.42,28
CDM,49659RVU9AK,LAP REPAIR OF ACUTE TRAUMATIC DIAPHRAGMATIC HERNIA (COMP 39540),6265.0,4072.25,0.01,9852.42,28
CDM,49900AK,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,4964.0,3226.6,1.1,4964.0,50
CDM,49905AK,OMENTAL FLAP INTRA-ABDOMINAL,2616.0,1700.4,1.1,2616.0,50
CDM,49999AGRVU1AK,"UNLIST PROC, ABD, PERITONEUM AND OMENUM COMPARED TO 49000",4138.0,2689.7,0.01,4138.0,28
CDM,49999AGRVU2AK,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 44",5122.0,3329.3,0.01,5122.0,28
CDM,49999AGRVU3AK,"UNLIST PROC, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 49082",409.0,265.85,0.01,1548.29,28
CDM,49999AGRVUAK,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM (COMPARISON",1560.0,1014.0,0.01,1560.0,28
CDM,49999AK,UNLISTED PROCEDURE ABDOMEN PERITONEUM & OMENTUM,1607.0,1044.55,0.01,1607.0,28
CDM,49999RVU14AK,MESENTERIC OR OMENTUM BIOPSY (COMP 49000),3111.0,2022.15,0.01,3111.0,28
CDM,49999RVU16AK,"OMENTAL FLAP, LAPARCOCOPIC (COMP CODE 49905)",2812.0,1827.8,0.01,2812.0,28
CDM,49999RVU17AK,EXPL OF GROIN WOUND W/ RELEASE OF SCAR FORMATION (COMP CODE 3584,7471.0,4856.15,0.01,7471.0,28
CDM,49999RVU18AK,CORE NEEDLE BIOPSY ABDOMEN/PERITONEUM/OMENTUM AT TIME OF OTHER P,818.0,531.7,0.01,1548.29,28
CDM,49999RVU20AK,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),484.0,314.6,0.01,1548.29,28
CDM,49999RVU21AK,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),1428.0,928.2,0.01,1548.29,28
CDM,49999RVU22AK,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),2620.0,1703.0,0.01,2620.0,28
CDM,49999RVU23AK,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),3552.0,2308.8,0.01,3552.0,28
CDM,49999RVU3AK,"REMOVAL FOREIGN BODY, ABD WALL (COMP CODE 11008)",3152.0,2048.8,0.01,3152.0,28
CDM,50075AK,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,10836.0,7043.4,1.1,10836.0,50
CDM,50080AK,PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION,5460.0,3549.0,1.1,15728.38,50
CDM,50081AK,PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS,9200.0,5980.0,1.1,15728.38,50
CDM,50200AK,RENAL BIOPSY PRQ TROCAR/NEEDLE,1047.0,680.55,1.1,2768.64,53
CDM,50220AK,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,7472.0,4856.8,1.1,7472.0,50
CDM,50225AK,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,8752.0,5688.8,1.1,8752.0,50
CDM,50230AK,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,9524.0,6190.6,1.1,9524.0,50
CDM,50234AK,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,10582.0,6878.3,1.1,10582.0,50
CDM,50240AK,NEPHRECTOMY PARTIAL,9684.0,6294.6,1.1,9684.0,50
CDM,50280AK,EXCIS/UNROOF RENAL CYST,6836.0,4443.4,1.1,6836.0,50
CDM,50382AK,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,2100.0,1365.0,1.1,3478.27,53
CDM,50384AK,REMOVAL INDWELLING URETERAL STENT PRQ,1900.0,1235.0,1.1,3478.27,53
CDM,50387AK,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,700.0,455.0,1.1,3478.27,53
CDM,50389AK,RMVL NFROS TUBE REQ FLUORO GUIDANCE,484.0,314.6,1.1,1357.68,53
CDM,50390AK,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,784.0,509.6,1.1,1200.64,50
CDM,50391AK,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,784.0,509.6,1.1,784.0,53
CDM,50430AK,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,1160.0,754.0,1.1,2070.46,53
CDM,50431AK,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,440.0,286.0,1.1,1166.59,53
CDM,50432AK,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,1600.0,1040.0,1.1,3478.27,53
CDM,50433AK,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,2020.0,1313.0,1.1,5953.02,53
CDM,50434AK,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,1500.0,975.0,1.1,3478.27,53
CDM,50435AK,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,801.0,520.65,1.1,3478.27,53
CDM,50436AK,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,1112.0,722.8,1.1,5953.02,50
CDM,50437AK,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,1940.0,1261.0,1.1,5953.02,50
CDM,50541AK,LAPAROSCOPY SURG ABLATION RENAL CYSTS,6744.0,4383.6,1.1,17575.94,50
CDM,50543AK,LAPAROSC PARTIAL NEPHRECTOMY,10964.0,7126.6,1.1,17575.94,50
CDM,50544AK,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",9348.0,6076.2,1.1,17575.94,50
CDM,50545AK,LAPAROSCOPY RADICAL NEPHRECTOMY,10024.0,6515.6,1.1,10024.0,50
CDM,50546AK,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,8748.0,5686.2,1.1,8748.0,50
CDM,50548AK,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,10144.0,6593.6,1.1,10144.0,50
CDM,50549RVU10AK,LAPAROSCOPIC RENAL AUTOTRANSPLANTATION (COMP CODE 50380),10840.0,7046.0,0.01,10840.0,28
CDM,50549RVU11AK,LAPAROSCOPIC URETEROPLASTY (COMP CODE 50700),6009.0,3905.85,0.01,9852.42,28
CDM,50549RVU12AK,LAPAROSCOPIC RENAL CYST EXCISION (COMP CODE 50280),6836.0,4443.4,0.01,9852.42,28
CDM,50549RVU9AK,"UNLISTED LAPAROSCOPY PROCEDURE, RENAL (COMP CODE 50234)",10341.0,6721.65,0.01,10341.0,28
CDM,50551AK,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,2236.0,1453.4,1.1,8834.56,53
CDM,50555AK,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,2608.0,1695.2,1.1,15728.38,53
CDM,50561AK,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,3032.0,1970.8,1.1,8834.56,53
CDM,50562AK,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,4360.0,2834.0,1.1,15728.38,50
CDM,50574AK,RENAL NDSC NEPHROTOMY W/BIOPSY,4400.0,2860.0,1.1,5953.02,50
CDM,50575AK,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,5584.0,3629.6,1.1,8834.56,50
CDM,50580AK,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,4736.0,3078.4,1.1,8834.56,50
CDM,50590AK,LITHOTRIPSY XTRCORP SHOCK WAVE,3908.0,2540.2,1.1,5953.02,53
CDM,50592AK,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,2620.0,1703.0,1.1,9852.42,53
CDM,50593AK,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,3552.0,2308.8,1.1,17575.94,53
CDM,50605AK,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,6716.0,4365.4,1.1,6716.0,50
CDM,50650AK,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,8281.0,5382.65,1.1,8281.0,50
CDM,50684AK,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,304.0,197.6,1.1,417.52,53
CDM,50688AK,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,480.0,312.0,1.1,3478.27,50
CDM,50690AK,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,9903.0,6436.95,1.1,9903.0,53
CDM,50690AK-26,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,464.0,301.6,1.1,464.0,22
CDM,50693AK,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,1584.0,1029.6,1.1,5953.02,53
CDM,50694AK,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,2100.0,1365.0,1.1,5953.02,53
CDM,50695AK,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,2720.0,1768.0,1.1,5953.02,53
CDM,50706AK,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1520.0,988.0,1.1,2751.74,53
CDM,50715AK,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,8256.0,5366.4,1.1,8256.0,50
CDM,50727AK,REVJ URINARY-CUTANEOUS ANASTAMOSIS,3312.0,2152.8,1.1,5953.02,50
CDM,50760AK,URETEROURETEROSTOMY,8028.0,5218.2,1.1,8028.0,50
CDM,50780AK,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,8778.0,5705.7,1.1,8778.0,50
CDM,50785AK,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,8892.0,5779.8,1.1,8892.0,50
CDM,50800AK,URETEROENTEROSTOMY ANAST URETER INTESTINE,7220.0,4693.0,1.1,7220.0,50
CDM,50820AK,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,9628.0,6258.2,1.1,9628.0,50
CDM,50900AK,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,6016.0,3910.4,1.1,6016.0,50
CDM,50920AK,CLOSURE URETEROCUTANEOUS FISTULA,6324.0,4110.6,1.1,6324.0,50
CDM,50948AK,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,10481.0,6812.65,1.1,17575.94,50
CDM,50949AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, URETER (COMPARISON CODE 50760)",6623.0,4304.95,0.01,9852.42,28
CDM,50949RVU1AK,LAP URETEROURETEROSTOMY (COMP 50760),7226.0,4696.9,0.01,9852.42,28
CDM,50949RVU2AK,LAPAROSCOPIC URETEROLYSIS (COMP 50715),7431.0,4830.15,0.01,9852.42,28
CDM,50949RVU6AK,LAPAROSCOPIC URETERECTOMY WITH BLADDER CUFF (COMP CODE 50650),8093.0,5260.45,0.01,9852.42,28
CDM,50949RVU7AK,LAPAROSCOPIC URETEROCALICOSTOMY (COMP CODE 50750),8488.0,5517.2,0.01,9852.42,28
CDM,50951AK,URETERAL ENDOSCOPY VIA URETEROSTOMY,2332.0,1515.8,1.1,5953.02,53
CDM,51000000,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,593.0,385.45,0.01,593.0,61
CDM,51000005,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,593.0,385.45,0.01,593.0,61
CDM,51000015,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,593.0,385.45,0.01,593.0,61
CDM,51000020,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,46
CDM,51000025,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,593.0,385.45,0.01,593.0,61
CDM,51000190,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,184.0,119.6,0.01,184.0,46
CDM,51000200,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,291.0,189.15,0.01,291.0,46
CDM,51000205,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,144.0,93.6,0.01,144.0,46
CDM,51000210,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,153.0,99.45,0.01,153.0,46
CDM,51000215,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,185.0,120.25,0.01,185.0,46
CDM,51000220,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,211.0,137.15,0.01,211.0,46
CDM,51000225,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,313.0,203.45,0.01,313.0,46
CDM,51000230,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,230.0,149.5,0.01,230.0,46
CDM,51000235,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,243.0,157.95,0.01,243.0,46
CDM,51000240,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,124.0,80.6,0.01,124.0,46
CDM,51000245,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,222.0,144.3,0.01,222.0,46
CDM,51000265,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,889.0,577.85,0.01,889.0,61
CDM,51000270,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,889.0,577.85,0.01,889.0,61
CDM,51000300,INIT PREVENTIVE EXAM NEW,515.0,334.75,0.01,515.0,61
CDM,51000305,PPPS INITIAL VISIT,203.0,131.95,0.01,639.79,60
CDM,51000310,PPPS SUBSEQ VISIT,189.0,122.85,0.01,502.48,60
CDM,51000405,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,46
CDM,51000410,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,150.0,97.5,0.01,150.0,46
CDM,51000415,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,46
CDM,51000420,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,240.0,156.0,0.01,271.21,46
CDM,51000505,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,46
CDM,51000515,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,46
CDM,51000785,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,0.01,105.02,61
CDM,51000795,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,0.01,105.02,61
CDM,51001025,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,46
CDM,51001055,OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES,136.0,88.4,0.01,136.0,46
CDM,51001065,OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES,139.0,90.35,0.01,153.39,46
CDM,51001075,OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES,174.0,113.1,0.01,251.09,46
CDM,51001085,OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES,235.0,152.75,0.01,342.0,46
CDM,51001095,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,46
CDM,51001125,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,46
CDM,51001165,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,147.0,95.55,0.01,147.0,46
CDM,51001235,OFFICE VISIT,515.0,334.75,0.01,515.0,61
CDM,51001555,TELEHEALTH ORIGINATING SITE FEE (W/ PO MODIFIER),43.0,27.95,0.01,60.0,46
CDM,51001825,DEPRESSION SCREEN ANNUAL,119.0,77.35,0.01,119.0,61
CDM,51001845,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,245.0,159.25,0.01,245.0,60
CDM,51001855,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,59.0,38.35,0.01,121.1,60
CDM,51001865,ANNUAL ALCOHOL SCREEN 15 MIN,206.0,133.9,0.01,206.0,61
CDM,51001875,BRIEF ALCOHOL MISUSE COUNSEL,638.0,414.7,0.01,638.0,61
CDM,51001885,HIGH INTEN BEH COUNS STD 30M,638.0,414.7,0.01,638.0,61
CDM,51001895,INTENS BEHAVE THER CARDIO DX,206.0,133.9,0.01,206.0,61
CDM,51001905,BEHAVIOR COUNSEL OBESITY 15M,638.0,414.7,0.01,638.0,61
CDM,51001925,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,0.01,887.0,60
CDM,51001935,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,0.01,887.0,60
CDM,51001945,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,887.0,576.55,0.01,887.0,60
CDM,51001985,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE?,887.0,576.55,0.01,887.0,60
CDM,51001995,PT/OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,0.01,887.0,60
CDM,51002005,PT/OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,0.01,887.0,60
CDM,51002675,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,280.0,182.0,0.01,280.0,46
CDM,51002705,MCHNL SCLP COOL CAP SPLY HEAD MEAS FITG&EDUCAJ,10008.0,6505.2,0.01,10008.0,55
CDM,51002715,MCHNL SCLP COOL HAIR PREPJ CAP PLMT THER&PRECOOL,12078.0,7850.7,0.01,12078.0,46
CDM,51002725,MCHNL SCLP COOL AFTER CHEMO EACH 30 MINUTES,3020.0,1963.0,0.01,3020.0,46
CDM,51002735,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,1836.0,1193.4,0.01,1836.0,46
CDM,51002745,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,263.0,170.95,0.01,263.0,47
CDM,51002755,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,244.0,158.6,0.01,244.0,38
CDM,51002765,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,263.0,170.95,0.01,263.0,47
CDM,51002785,DOT PHYSICAL EXAM,110.0,71.5,0.01,110.0,38
CDM,51002825,PRE-PLACEMENT EXAM,65.0,42.25,0.01,65.0,38
CDM,51002835,PHYSICAL EXAM,65.0,42.25,0.01,65.0,38
CDM,51002845,RETURN TO WORK EXAM,65.0,42.25,0.01,65.0,38
CDM,51040AK,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,1796.0,1167.4,1.1,3478.27,50
CDM,51040URVUAK,CYSTOSTOMY WITH DRAINAGE,802.0,521.3,1.1,3478.27,50
CDM,51045AK,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,3124.0,2030.6,1.1,3478.27,50
CDM,51050AK,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,3188.0,2072.2,1.1,8834.56,50
CDM,51102AK,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,1080.0,702.0,1.1,3478.27,53
CDM,51500AK,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,4420.0,2873.0,1.1,9852.42,50
CDM,51525AK,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,6168.0,4009.2,1.1,6168.0,50
CDM,51530AK,"CYSTOTOMY,EXCIS BLADDER TUMOR",5484.0,3564.6,1.1,5484.0,50
CDM,51550AK,CYSTECTOMY PARTIAL SIMPLE,6892.0,4479.8,1.1,6892.0,50
CDM,51555AK,CYSTECTOMY PARTIAL COMPLICATED,9272.0,6026.8,1.1,9272.0,50
CDM,51565AK,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,9472.0,6156.8,1.1,9472.0,50
CDM,51575AK,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,13672.0,8886.8,1.1,13672.0,50
CDM,51590AK,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,14532.0,9445.8,1.1,14532.0,50
CDM,51595AK,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,16528.0,10743.2,1.1,16528.0,50
CDM,51596AK,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,17704.0,11507.6,1.1,17704.0,50
CDM,51597AK,PELVIC EXENTERATION COMPLETE MALIGNANCY,17144.0,11143.6,1.1,17144.0,50
CDM,51600AK,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,352.0,228.8,1.1,695.32,53
CDM,51610AK,NJX RETROGRADE URETHROCSTOGRAPY,420.0,273.0,1.1,426.19,53
CDM,51700AK,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,264.0,171.6,1.1,421.12,53
CDM,51701AK,INSJ NON-NDWELLG BLADDER CATHETER,220.0,143.0,1.1,220.0,53
CDM,51702AK,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,220.0,143.0,1.1,220.0,53
CDM,51703AK,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,1308.0,850.2,1.1,1308.0,53
CDM,51703AK-26,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,588.0,382.2,1.1,588.0,22
CDM,51705AK,CHANGE CYSTOSTOMY TUBE SIMPLE,360.0,234.0,1.1,421.12,53
CDM,51710AK,CHANGE CYSTOSTOMY TUBE COMPLICATED,540.0,351.0,1.1,1166.59,53
CDM,51715AK,NDSC NJX IMPLT MATRL URT&/BLDR NCK,1492.0,969.8,1.1,5953.02,53
CDM,51720AK,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,383.0,248.95,1.1,1166.59,53
CDM,51721AK,INSJ TRURL ABLTJ TRNSDCR DLVR THRM US PRST8 TISS,1782.0,1158.3,1.1,1782.0,51
CDM,51725AK,"CYSTOMETROGRAM, SIMPLE",664.0,431.6,1.1,751.43,50
CDM,51726AK,BLADDER PRESSURE MEASUREMENT DURING FILLING,1871.0,1216.15,1.1,1871.0,50
CDM,51726AK-26,BLADDER PRESSURE MEASUREMENT DURING FILLING,752.0,488.8,1.1,752.0,44
CDM,51727AK,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,844.0,548.6,1.1,1197.4,50
CDM,51728AK,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,928.0,603.2,1.1,1193.67,50
CDM,51729AK,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,1104.0,717.6,1.1,1267.37,50
CDM,51736AK,SIMPLE UROFLOMETRY,68.0,44.2,1.1,218.62,50
CDM,51741AK,COMPLEX UROFLOMETRY,1500.0,975.0,1.1,1500.0,50
CDM,51741AK-26,COMPLEX UROFLOMETRY,68.0,44.2,1.1,68.0,44
CDM,51784AK,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,1050.0,682.5,1.1,1050.0,50
CDM,51784AK-26,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,330.0,214.5,1.1,330.0,44
CDM,51784AK-TC,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,1.1,720.0,46
CDM,51785AK,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,673.0,437.45,1.1,1426.12,50
CDM,51797AK,VOID PRESSURE STUDIES INTRAABDOMINAL,1487.0,966.55,1.1,1487.0,50
CDM,51797AK-26,VOID PRESSURE STUDIES INTRAABDOMINAL,352.0,228.8,1.1,352.0,44
CDM,51798AK,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,42.0,27.3,1.1,103.94,50
CDM,51840AK,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,4544.0,2953.6,1.1,4544.0,50
CDM,51841AK,ANT VESICOURETHROPEXY/URETHROPEXY COMP,5472.0,3556.8,1.1,5472.0,50
CDM,51860AK,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,5040.0,3276.0,1.1,15728.38,50
CDM,51860URVUAK,REPAIR OF BLADDER WOUND,1380.0,897.0,1.1,15728.38,50
CDM,51865AK,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,6320.0,4108.0,1.1,6320.0,50
CDM,51865URVUAK,REPAIR OF BLADDER WOUND,1555.0,1010.75,1.1,3029.3,50
CDM,51880AK,CLOSE CYSTOSTOMY,3148.0,2046.2,1.1,5953.02,50
CDM,51900005,"EXTRACORPOREAL SHOCK WAVE, LOW INTENSITY",150.0,97.5,0.01,3004.0,61
CDM,51900AK,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,5852.0,3803.8,1.1,5852.0,50
CDM,51999AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",5089.0,3307.85,0.01,9852.42,28
CDM,51999AGRVU2AK,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",16279.0,10581.35,0.01,16279.0,28
CDM,51999AGRVU3AK,"UNLIST LAP PROC, BLADDER COMPARED TO 51900",1940.0,1261.0,0.01,9852.42,28
CDM,51999AGRVUAK,"UNLISTED LAPAROSCOPY PROCDURE, BLADDER (COMPARISON CODE 51860)",2180.0,1417.0,0.01,9852.42,28
CDM,51999AK,"LAP PROCEDURE, UNLISTED, BLADDER",2245.0,1459.25,0.01,9852.42,28
CDM,51999RVU15AK,UNLISTED PROC; LAPAROSCOPIC PARTICAL CYSTECTOMY (COMP TO 51550),2280.0,1482.0,0.01,9852.42,28
CDM,51999RVU16AK,"EXCISION OF URACHAL CYST OR SINUS, W/WO UMBILICAL HERNIA REPAIR",4420.0,2873.0,0.01,9852.42,28
CDM,51999RVU17AK,"STONE REMOVAL FROM BLADDER, LAPAROSCOPIC APPROACH WITH ROBOTIC A",3427.0,2227.55,0.01,9852.42,28
CDM,51999RVU18AK,"LAPAROSCOPIC CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROAC",6290.0,4088.5,0.01,9852.42,28
CDM,51999RVU19AK,UNLISTED LAPAROSCOPIC PROCEDURE BLADDER (COMP CODE 51590),15621.0,10153.65,0.01,15621.0,28
CDM,51999RVU20AK,LAPAROSCOPIC ANTERIOR VAGINECTOMY (COMP CODE 57106),3225.0,2096.25,0.01,9852.42,28
CDM,51999RVU3AK,LAPAROSCOPY PARTIAL CYSTECTOMY (COMP 51555),14126.0,9181.9,0.01,14126.0,28
CDM,51999RVU6AK,ROBOTIC CYSTECTOMY W/ CONDUIT & PELVIC LYMPHADENECTOMY (COMP 515,37762.0,24545.3,0.01,37762.0,28
CDM,51999RVU8AK,ROBOTIC (LAP) PELVIC EXENTERATION (COMP 51597),14144.0,9193.6,0.01,14144.0,28
CDM,52000AK,CYSTOURETHROSCOPY,673.0,437.45,1.1,1166.59,53
CDM,52001AK,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,2176.0,1414.4,1.1,5953.02,53
CDM,52005AK,CYSTO BLADDER W/URETERAL CATHETERIZATION,1043.0,677.95,1.1,3478.27,53
CDM,52007AK,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,1208.0,785.2,1.1,5953.02,53
CDM,52204AK,"CYSTOURETHROSCOPY,BIOPSY",1036.0,673.4,1.1,3478.27,53
CDM,52214AK,CYSTO W/DESTRUCTION OF LESIONS,1400.0,910.0,1.1,5953.02,53
CDM,52224AK,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,1620.0,1053.0,1.1,5953.02,53
CDM,52234AK,CYSTO W/REMOVAL OF TUMORS SMALL,1848.0,1201.2,1.1,5953.02,50
CDM,52235AK,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,2176.0,1414.4,1.1,5953.02,50
CDM,52240AK,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,3300.0,2145.0,1.1,8834.56,50
CDM,52250AK,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,1796.0,1167.4,1.1,5953.02,50
CDM,52260AK,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,1564.0,1016.6,1.1,3478.27,50
CDM,52265AK,"CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH",1176.0,764.4,1.1,3478.27,53
CDM,52270AK,"CYSTOSCOPY,INTERN URETHROTOMY,FEMALE",1344.0,873.6,1.1,3478.27,53
CDM,52275AK,"CYSTOSCOPY,INTERN URETHROTOMY,MALE",1876.0,1219.4,1.1,3478.27,53
CDM,52276AK,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,1996.0,1297.4,1.1,3478.27,50
CDM,52281AK,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,1210.0,786.5,1.1,3478.27,53
CDM,52283AK,"CYSTOSCOPY,STEROID INJ,STRICTURE",1492.0,969.8,1.1,3478.27,53
CDM,52284AK,CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE,1364.0,886.6,1.1,8834.56,52
CDM,52285AK,"CYSTOSCOPY,RX FEMALE URETHRAL SYND",1440.0,936.0,1.1,1440.0,53
CDM,52287AK,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,1280.0,832.0,1.1,3478.27,53
CDM,52290AK,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,1832.0,1190.8,1.1,3478.27,50
CDM,52300AK,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,2120.0,1378.0,1.1,5953.02,50
CDM,52301AK,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,2200.0,1430.0,1.1,5953.02,50
CDM,52310AK,CYSTO W/SIMPLE REMOVAL STONE & STENT,1124.0,730.6,1.1,3478.27,53
CDM,52315AK,CYSTO W/COMPLEX REMOVAL STONE & STENT,2080.0,1352.0,1.1,3478.27,53
CDM,52317AK,LITHOLAPAXY SMPL/SM <2.5 CM,2684.0,1744.6,1.1,5953.02,53
CDM,52318AK,LITHOLAPAXY COMP/LG > 2.5 CM,3672.0,2386.8,1.1,5953.02,50
CDM,52320AK,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,1876.0,1219.4,1.1,5953.02,50
CDM,52327AK,CYSTO W/SUBURTRIC NJX IMPLT MATRL,2072.0,1346.8,1.1,8834.56,50
CDM,52330AK,CYSTO MANJ W/O RMVL URETERAL STONE,2012.0,1307.8,1.1,5953.02,53
CDM,52332AK,CYSTO W/INSERT URETERAL STENT,1128.0,733.2,1.1,5953.02,53
CDM,52334AK,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,1483.0,963.95,1.1,5953.02,50
CDM,52341AK,CYSTO W/URETER STRICTURE TX,2140.0,1391.0,1.1,5953.02,50
CDM,52342AK,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,2340.0,1521.0,1.1,5953.02,50
CDM,52344AK,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,2820.0,1833.0,1.1,5953.02,50
CDM,52345AK,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,3020.0,1963.0,1.1,5953.02,50
CDM,52346AK,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,3432.0,2230.8,1.1,8834.56,50
CDM,52351AK,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,2530.0,1644.5,1.1,5953.02,50
CDM,52352AK,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,2700.0,1755.0,1.1,5953.02,50
CDM,52353AK,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,3000.0,1950.0,1.1,8834.56,50
CDM,52354AK,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,3200.0,2080.0,1.1,8834.56,50
CDM,52355AK,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,3600.0,2340.0,1.1,8834.56,50
CDM,52356AK,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,3200.0,2080.0,1.1,8834.56,50
CDM,52402AK,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,2108.0,1370.2,1.1,5953.02,50
CDM,52441AK,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,1760.0,1144.0,1.1,4128.64,53
CDM,52442AK,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,444.0,288.6,1.1,2801.71,53
CDM,52443AK,CYSTO 1ST TRURL ANT PRST8 COMIS NONRX BALO CATH,1593.0,1035.45,1.1,15055.51,35
CDM,52450AK,TRANSURETHRAL INCISION OF PROSTATE,3112.0,2022.8,1.1,5953.02,50
CDM,52500AK,TRANSURETHRAL RESEC BLADDER NECK,3256.0,2116.4,1.1,5953.02,50
CDM,52597AK,TRURL ROBOTIC-ASSISTED WATERJET RESECTION PRST8,4510.0,2931.5,1.1,4510.0,35
CDM,52601AK,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,5790.0,3763.5,1.1,8834.56,50
CDM,52630AK,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,2620.0,1703.0,1.1,8834.56,50
CDM,52640AK,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,1916.0,1245.4,1.1,5953.02,50
CDM,52648AK,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,28245.0,18359.25,1.1,28245.0,53
CDM,52648AK-26,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,4860.0,3159.0,1.1,4860.0,22
CDM,52649AK,LASER ENUCLEATION PROSTATE W/MORCELLATION,5824.0,3785.6,1.1,8834.56,50
CDM,52700AK,TRURL DRAINAGE PROSTATIC ABSCESS,2996.0,1947.4,1.1,5953.02,50
CDM,53000000,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,76.0,61
CDM,53000005,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,76.0,49.4,20.43,76.0,61
CDM,53000010,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,76.0,49.4,20.43,81.13,61
CDM,53000015,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,76.0,49.4,20.43,102.47,61
CDM,53000025,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,76.0,49.4,20.43,122.4,61
CDM,53000AK,URTT/URTS XTRNL SPX PENDULOUS URETHRA,932.0,605.8,1.1,3478.27,50
CDM,53010AK,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,1780.0,1157.0,1.1,8834.56,50
CDM,53020AK,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,708.0,460.2,1.1,3478.27,50
CDM,53025AK,MEATOTOMY CUTTING MEATUS SPX INFANT,452.0,293.8,1.1,3478.27,50
CDM,53060AK,DRG OF SKENE'S GLAND ABSCESS OR CYST,1072.0,696.8,1.1,3478.27,53
CDM,53200AK,BIOPSY OF URETHRA,1036.0,673.4,1.1,3478.27,53
CDM,53210AK,URETHRECTOMY TOT W/CYSTOST FEMALE,5488.0,3567.2,1.1,5953.02,50
CDM,53230AK,EXC URETHRAL DIVERTICULUM SPX FEMALE,4176.0,2714.4,1.1,8834.56,50
CDM,53260AK,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,1212.0,787.8,1.1,5953.02,53
CDM,53265AK,EXC/FULGURATION URETHRAL CARUNCLE,1268.0,824.2,1.1,3478.27,53
CDM,53270AK,EXCISION OR FULGURATION SKENES GLANDS,1256.0,816.4,1.1,5953.02,53
CDM,53275AK,EXCISION/FULGURATION URETHRAL PROLAPSE,1828.0,1188.2,1.1,5953.02,50
CDM,53400AK,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,5652.0,3673.8,1.1,8834.56,50
CDM,53410AK,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,7072.0,4596.8,1.1,8834.56,50
CDM,53430AK,URETHROPLASTY RCNSTJ FEMALE URETHRA,6972.0,4531.8,1.1,8834.56,50
CDM,53431AK,URTP W/TUBULARIZATION POST URT&/LWR BLDR,8472.0,5506.8,1.1,8834.56,50
CDM,53440AK,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,5344.0,3473.6,1.1,21917.95,50
CDM,53445AK,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,5200.0,3380.0,1.1,34442.24,50
CDM,53446AK,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,4408.0,2865.2,1.1,8834.56,50
CDM,53447AK,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,5712.0,3712.8,1.1,34442.24,50
CDM,53500AK,URETHROLSS TRVG SEC OPN W/CSTO,5200.0,3380.0,1.1,5953.02,50
CDM,53505AK,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,3304.0,2147.6,1.1,8834.56,50
CDM,53600AK,DILAT URETHRAL STRIX DILATOR MALE 1ST,484.0,314.6,1.1,484.0,53
CDM,53601AK,DILAT URETHRAL STRIX DILATOR MALE SBSQ,392.0,254.8,1.1,392.0,53
CDM,53620AK,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,648.0,421.2,1.1,1166.59,53
CDM,53621AK,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,540.0,351.0,1.1,540.0,53
CDM,53660AK,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,284.0,184.6,1.1,284.0,53
CDM,53661AK,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,288.0,187.2,1.1,288.0,53
CDM,53665AK,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,304.0,197.6,1.1,3478.27,50
CDM,53850AK,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,2168.0,1409.2,1.1,5953.02,53
CDM,53854AK,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,2609.0,1695.85,1.1,5953.02,53
CDM,53865AK,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1364.0,886.6,1.1,8993.93,51
CDM,53866AK,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,651.0,423.15,1.1,651.0,51
CDM,53899AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",3887.0,2526.55,0.01,3887.0,28
CDM,53899AGRVUAK,"UNLISTED PROCEDURE, URINARY SYSTEM (COMPARISON CODE 51530)",2280.0,1482.0,0.01,2280.0,28
CDM,53899AK,UROLOGY SURGERY PROCEDURE UNLISTED,2348.0,1526.2,0.01,2348.0,28
CDM,53899RVU16AK,ITIND DEVICE REMOVAL SIMPLE (COMP CODE 52310 SIMPLE),1020.0,663.0,0.01,1020.0,28
CDM,53899RVU17AK,ITIND DEVICE INSERTION (COMP CODE 52441),1539.0,1000.35,0.01,1539.0,28
CDM,53899RVU18AK,ITIND DEVICE REMOVAL COMPLICATED (COMP CODE 52315 COMPLICATED),1888.0,1227.2,0.01,1888.0,28
CDM,53899RVU20AK,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT (COMP CODE 5235,3440.0,2236.0,0.01,3440.0,28
CDM,53899RVU21AK,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),480.0,312.0,0.01,480.0,28
CDM,53899RVU22AK,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),484.0,314.6,0.01,484.0,28
CDM,53899RVU23AK,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,1280.0,832.0,0.01,1280.0,28
CDM,54001AK,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,896.0,582.4,1.1,3478.27,53
CDM,54015AK,"INCIS/DRAIN PENIS,DEEP",2144.0,1393.6,1.1,2768.64,50
CDM,54050AK,DSTRJ LESION PENIS SIMPLE CHEMICAL,568.0,369.2,1.1,680.96,53
CDM,54055AK,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,500.0,325.0,1.1,3114.5,53
CDM,54056AK,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,568.0,369.2,1.1,568.0,53
CDM,54057AK,DSTRJ LESION PENIS SIMPLE LASER,8930.0,5804.5,1.1,8930.0,53
CDM,54057AK-26,DSTRJ LESION PENIS SIMPLE LASER,516.0,335.4,1.1,516.0,22
CDM,54060AK,DSTRJ LESION PENIS SIMPLE SURG EXCISION,792.0,514.8,1.1,3114.5,53
CDM,54065AK,DSTRJ LESION PENIS EXTENSIVE,988.0,642.2,1.1,3114.5,53
CDM,54100AK,BIOPSY PENIS SEPARATE PROCEDURE,760.0,494.0,1.1,2768.64,53
CDM,54105AK,"BIOPSY OF PENIS,DEEP STRUCT",1416.0,920.4,1.1,4850.94,53
CDM,54120AK,"REMOVAL PENIS,PARTIAL",4404.0,2862.6,1.1,5953.02,50
CDM,54125AK,"REMOVAL PENIS,TOTAL",5824.0,3785.6,1.1,5824.0,50
CDM,54150AK,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,760.0,494.0,1.1,3478.27,53
CDM,54160AK,CIRCUMCISION NEONATE,1012.0,657.8,1.1,1166.59,53
CDM,54161AK,CIRCUMCISION AGE >28 DAYS,1328.0,863.2,1.1,3478.27,50
CDM,54162AK,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,1328.0,863.2,1.1,3478.27,53
CDM,54163AK,REP INCOMPLETE CIRCUMCISION,1328.0,863.2,1.1,3478.27,50
CDM,54164AK,FRENULOTOMY OF PENIS,1128.0,733.2,1.1,3478.27,50
CDM,54200AK,INJECTION PEYRONIE DISEASE,444.0,288.6,1.1,444.0,53
CDM,54220AK,IRRIGATION CORPORA CAVERNOSA PRIAPISM,968.0,629.2,1.1,968.0,53
CDM,54235AK,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,476.0,309.4,1.1,476.0,53
CDM,54250AK,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,2007.0,1304.55,1.1,2007.0,50
CDM,54250AK-26,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,888.0,577.2,1.1,888.0,44
CDM,54300AK,PENIS STRAIGHTENING CHORDEE,4480.0,2912.0,1.1,5953.02,50
CDM,54360AK,PLASTIC RPR PENIS CORRECT ANGULATION,5112.0,3322.8,1.1,5953.02,50
CDM,54400AK,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,3668.0,2384.2,1.1,21917.95,50
CDM,54401AK,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,4176.0,2714.4,1.1,34442.24,50
CDM,54405AK,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,5808.0,3775.2,1.1,34442.24,50
CDM,54406AK,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,5156.0,3351.4,1.1,5953.02,50
CDM,54410AK,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,6072.0,3946.8,1.1,34442.24,50
CDM,54415AK,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,3552.0,2308.8,1.1,5953.02,50
CDM,54416AK,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,4832.0,3140.8,1.1,34442.24,50
CDM,54430AK,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,4424.0,2875.6,1.1,4424.0,50
CDM,54435AK,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,2724.0,1770.6,1.1,5953.02,50
CDM,54437AK,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),4600.0,2990.0,1.1,5953.02,50
CDM,54440AK,PLASTIC OPERATION PENIS INJURY,5550.0,3607.5,1.1,5953.02,32
CDM,54450AK,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,448.0,291.2,1.1,448.0,53
CDM,54505AK,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,1400.0,910.0,1.1,5953.02,50
CDM,54512AK,EXC XTRPARENCHYMAL LESION TESTIS,3732.0,2425.8,1.1,5953.02,50
CDM,54520AK,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,2332.0,1515.8,1.1,5953.02,50
CDM,54522AK,PARTIAL ORCHIECTOMY,4100.0,2665.0,1.1,5953.02,50
CDM,54530AK,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,3384.0,2199.6,1.1,5906.43,50
CDM,54535AK,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,5276.0,3429.4,1.1,5953.02,50
CDM,54600AK,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,3056.0,1986.4,1.1,5953.02,50
CDM,54620AK,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,2084.0,1354.6,1.1,5953.02,50
CDM,54640AK,ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,3401.0,2210.65,1.1,5906.43,50
CDM,54650AK,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,5452.0,3543.8,1.1,5906.43,50
CDM,54660AK,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,2296.0,1492.4,1.1,8834.56,50
CDM,54670AK,SUTURE/REPAIR TESTICULAR INJURY,2660.0,1729.0,1.1,5953.02,50
CDM,54680AK,TRANSPLANTATION TESTIS TO THIGH,5616.0,3650.4,1.1,5953.02,50
CDM,54700AK,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,1388.0,902.2,1.1,3478.27,50
CDM,54830AK,EXCISION LOCAL LESION EPIDIDYMIS,2404.0,1562.6,1.1,5953.02,50
CDM,54840AK,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,2108.0,1370.2,1.1,3478.27,50
CDM,54860AK,EPIDIDYMECTOMY UNILATERAL,2780.0,1807.0,1.1,5953.02,50
CDM,54865AK,EXPLORATION OF EPIDIDYMIS W/WO BIOPSY,2539.0,1650.35,1.1,5953.02,50
CDM,55000AK,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,572.0,371.8,1.1,1200.64,53
CDM,55040AK,EXCISION HYDROCELE UNILATERAL,2180.0,1417.0,1.1,5906.43,50
CDM,55040URVUAK,REMOVAL OF HYDROCELE,639.0,415.35,1.1,5906.43,50
CDM,55041AK,EXCISION HYDROCELE BILATERAL,3758.0,2442.7,1.1,5906.43,50
CDM,55060AK,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,2460.0,1599.0,1.1,5953.02,50
CDM,55100AK,DRAINAGE SCROTAL WALL ABSCESS,980.0,637.0,1.1,2768.64,53
CDM,55110AK,EXPLORE SCROTUM,2532.0,1645.8,1.1,5953.02,50
CDM,55120AK,REMOVAL FOREIGN BODY SCROTUM,2288.0,1487.2,1.1,3478.27,50
CDM,55150AK,RESECTION SCROTUM,3256.0,2116.4,1.1,5953.02,50
CDM,55180AK,SCROTOPLASTY COMPLICATED,4712.0,3062.8,1.1,8834.56,50
CDM,55250AK,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,1348.0,876.2,1.1,3478.27,53
CDM,55250URVUAK,REMOVAL OF SPERM DUCT(S),300.0,195.0,1.1,3478.27,53
CDM,55400AK,VASOVASOSTOMY VASOVASORRHAPHY,3788.0,2462.2,1.1,5953.02,50
CDM,55500AK,EXC HYDROCELE SPRMATIC CORD UNI SPX,2488.0,1617.2,1.1,5953.02,50
CDM,55520AK,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,2664.0,1731.6,1.1,5953.02,50
CDM,55520URVUAK,REMOVAL OF SPERM CORD LESION,790.0,513.5,1.1,5953.02,50
CDM,55530AK,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,2300.0,1495.0,1.1,5953.02,50
CDM,55530URVUAK,REVISE SPERMATIC CORD VEINS,670.0,435.5,1.1,5953.02,50
CDM,55540AK,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,3320.0,2158.0,1.1,5906.43,50
CDM,55550AK,LAPS LIGATION SPERMATIC VEINS VARICOCELE,2880.0,1872.0,1.1,9852.42,50
CDM,55559AGRVUAK,"UNLISTED LAPAROSCOY PROCEDURE, SPERMATIC CORD (COMPARISON CODE 5",2664.0,1731.6,0.01,9852.42,28
CDM,55559RVU1AK,LAPAROSCOPIC EXCISION OF SPERMATIC CORD LESION (COMP 55520),2664.0,1731.6,0.01,9852.42,28
CDM,55650AK,VESICULECTOMY ANY APPROACH,5060.0,3289.0,1.1,5060.0,50
CDM,55705AK,BIOPSY PROSTATE INCISIONAL ANY APPROACH,1844.0,1198.6,1.1,5953.02,50
CDM,55706AK,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,2512.0,1632.8,1.1,5953.02,50
CDM,55707AK,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,1157.0,752.05,1.1,1157.0,35
CDM,55708AK,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,1492.0,969.8,1.1,1492.0,35
CDM,55709AK,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,1421.0,923.65,1.1,1511.76,35
CDM,55710AK,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,1676.0,1089.4,1.1,1696.55,35
CDM,55711AK,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,1148.0,746.2,1.1,1148.0,35
CDM,55712AK,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,1364.0,886.6,1.1,1574.3,35
CDM,55713AK,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,1760.0,1144.0,1.1,1983.0,35
CDM,55714AK,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,1593.0,1035.45,1.1,1931.81,35
CDM,55715AK,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,462.0,300.3,1.1,462.0,35
CDM,55720AK,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,3092.0,2009.8,1.1,5953.02,50
CDM,55821AK,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,6072.0,3946.8,1.1,6072.0,50
CDM,55840AK,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,8544.0,5553.6,1.1,8544.0,50
CDM,55845AK,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,11079.0,7201.35,1.1,11079.0,50
CDM,55866AK,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,9882.0,6423.3,1.1,17575.94,50
CDM,55867AK,LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE,7812.0,5077.8,1.1,17575.94,50
CDM,55868AK,LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX,9882.0,6423.3,1.1,9882.0,35
CDM,55869AK,LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC,12060.0,7839.0,1.1,12060.0,35
CDM,55870AK,ELECTROEJACULATION,1032.0,670.8,1.1,1372.67,47
CDM,55873AK,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,5440.0,3536.0,1.1,18631.36,53
CDM,55874AK,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,1212.0,787.8,1.1,9331.98,53
CDM,55875AK,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,5384.0,3499.6,1.1,8834.56,50
CDM,55876AK,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,692.0,449.8,1.1,2365.44,53
CDM,55877AK,ABLATION IRE PRST8 1 OR MORE TUMORS PERCUTANEOUS,5940.0,3861.0,1.1,5940.0,35
CDM,55880AK,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,7092.0,4609.8,1.1,15728.38,50
CDM,55881AK,ABLATION TRANSURETHRAL PRST8 TISSUE W/THERMAL US,4312.0,2802.8,1.1,26896.12,51
CDM,55882AK,ABLT TRURL PRST8 TIS THRM US INS TRURL US TRNSDC,5060.0,3289.0,1.1,27850.59,51
CDM,55899AGRVU1AK,"UNLISTED PROCEDURE, MALE GENITAL SYSTEM (COMPARISON CODE 55821)",5201.0,3380.65,0.01,5201.0,28
CDM,55899AGRVU2AK,"UNLISTED PROCEDURE, MALE GENITAL SYSTEM (COMPARISON CODE 55842)",8169.0,5309.85,0.01,8169.0,28
CDM,55899AGRVU3AK,"UNLIST PROC, MALE GENITAL SYSTEM COMPARED TO 55821",1654.0,1075.1,0.01,1654.0,28
CDM,55899AGRVUAK,"UNLISTED PROCEDURE, MALE GENITAL SYSTEM (COMPARISON CODE 55520)",950.0,617.5,0.01,950.0,28
CDM,55899RVU19AK,FREE FLAP PHALLOPLASTY (COMP CODE 15757),15975.0,10383.75,0.01,15975.0,28
CDM,55899RVU20AK,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),3691.0,2399.15,0.01,3691.0,28
CDM,55899RVU21AK,LAPAROSCOPIC VESICULECTOMY (COMP CODE 55650),5060.0,3289.0,0.01,5060.0,28
CDM,55899RVU22AK,MICROSCOPIC CREMASTERIC LYSIS (COMP CODE 64722),3434.0,2232.1,0.01,3434.0,28
CDM,55899RVU7AK,DENERVATION MICROSURGICAL SPERM CORD (COMP 55530 & 55520),950.0,617.5,0.01,950.0,28
CDM,55920AK,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,3324.0,2160.6,1.1,8492.29,50
CDM,56405AK,I&D VULVA/PERINEAL ABSCESS,596.0,387.4,1.1,596.0,53
CDM,56420AK,I&D OF BARTHOLINS GLAND ABSCESS,576.0,374.4,1.1,620.45,53
CDM,56440AK,MARSUP BARTHOLIN GLAND CYST,1156.0,751.4,1.1,5338.37,50
CDM,56441AK,LYSIS LABIAL ADHESIONS,808.0,525.2,1.1,5338.37,53
CDM,56442AK,"HYMENOTOMY, SIMPLE INCISION",272.0,176.8,1.1,5338.37,50
CDM,56501AK,DESTRUCTION LESIONS VULVA SIMPLE,632.0,410.8,1.1,3114.5,53
CDM,56515AK,DESTRUCTION LESIONS VULVA EXTENSIVE,1355.0,880.75,1.1,3114.5,53
CDM,56605AK,BIOPSY VULVA/PERINEUM 1 LESION SPX,440.0,286.0,1.1,1372.67,53
CDM,56606AK,BIOPSY VULVA/PERINEUM EACH ADDL LESION,220.0,143.0,1.1,220.0,53
CDM,56620AK,VULVECTOMY SIMPLE PARTIAL,3313.0,2153.45,1.1,5338.37,50
CDM,56625AK,VULVECTOMY SIMPLE COMPLETE,4259.0,2768.35,1.1,5338.37,50
CDM,56630AK,VULVECTOMY RADICAL PARTIAL,6512.0,4232.8,1.1,6512.0,50
CDM,56631AK,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,7596.0,4937.4,1.1,7596.0,50
CDM,56632AK,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,8744.0,5683.6,1.1,8744.0,50
CDM,56633AK,VULVECTOMY RADICAL COMPLETE,7848.0,5101.2,1.1,7848.0,50
CDM,56700AK,PRTL HYMENECTOMY/REVJ HYMENAL RING,1136.0,738.4,1.1,5338.37,50
CDM,56740AK,EXC BARTHOLINS GLAND/CYST,1952.0,1268.8,1.1,5338.37,50
CDM,56800AK,PLASTIC REPAIR INTROITUS,1572.0,1021.8,1.1,5338.37,50
CDM,56810AK,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,1716.0,1115.4,1.1,5338.37,50
CDM,56820AK,"COLPOSCOPY, VULVA",600.0,390.0,1.1,600.0,53
CDM,56821AK,COLPOSCOPY VULVA W/BIOPSY,820.0,533.0,1.1,820.0,53
CDM,57000AK,COLPOTOMY W/EXPLORATION,1208.0,785.2,1.1,5338.37,50
CDM,57010AK,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,2736.0,1778.4,1.1,5338.37,50
CDM,57022AK,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,1092.0,709.8,1.1,4850.94,50
CDM,57023AK,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,2072.0,1346.8,1.1,4850.94,50
CDM,57061AK,DESTRUCTION VAGINAL LESIONS SIMPLE,572.0,371.8,1.1,5338.37,53
CDM,57065AK,DESTRUCTION VAGINAL LESIONS EXTENSIVE,1170.0,760.5,1.1,5338.37,53
CDM,57100AK,BIOPSY VAGINAL MUCOSA SIMPLE,480.0,312.0,1.1,1372.67,53
CDM,57105AK,BIOPSY VAGINAL MUCOSA EXTENSIVE,696.0,452.4,1.1,5338.37,53
CDM,57106AK,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,3000.0,1950.0,1.1,5338.37,50
CDM,57107AK,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,9824.0,6385.6,1.1,9824.0,50
CDM,57110AK,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,6192.0,4024.8,1.1,6192.0,50
CDM,57120AK,COLPOCLEISIS LE FORT TYPE,3312.0,2152.8,1.1,8492.29,50
CDM,57130AK,EXCIS VAGINAL SEPTUM,984.0,639.6,1.1,5338.37,53
CDM,57135AK,EXCIS VAGINAL CYST/TUMOR,1080.0,702.0,1.1,5338.37,53
CDM,57150AK,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,200.0,130.0,1.1,200.0,53
CDM,57155AK,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,2266.0,1472.9,1.1,8492.29,53
CDM,57156AK,INSERTION VAGINAL RADIATION DEVICE,969.0,629.85,1.1,969.0,53
CDM,57160AK,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,356.0,231.4,1.1,356.0,53
CDM,57170AK,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,364.0,236.6,1.1,364.0,53
CDM,57180AK,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,652.0,423.8,1.1,666.37,53
CDM,57200AK,COLPORRHAPHY SUTURE INJURY VAGINA,1768.0,1149.2,1.1,5338.37,50
CDM,57210AK,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,2284.0,1484.6,1.1,5338.37,50
CDM,57240AK,ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO,4032.0,2620.8,1.1,8492.29,50
CDM,57250AK,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,4435.0,2882.75,1.1,8492.29,50
CDM,57260AK,CMBND ANTERPOST COLPORRAPHY W/CYSTO,5830.0,3789.5,1.1,8492.29,50
CDM,57265AK,CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR,6000.0,3900.0,1.1,8492.29,50
CDM,57267AK,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,1952.0,1268.8,1.1,1952.0,50
CDM,57268AK,REPAIR ENTEROCELE VAGINAL APPROACH SPX,3028.0,1968.2,1.1,8492.29,50
CDM,57270AK,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,5468.0,3554.2,1.1,5468.0,50
CDM,57280AK,COLPOPEXY ABDOMINAL APPROACH,6688.0,4347.2,1.1,6688.0,50
CDM,57282AK,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,4652.0,3023.8,1.1,12902.4,50
CDM,57283AK,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,4664.0,3031.6,1.1,12902.4,50
CDM,57285AK,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,4640.0,3016.0,1.1,12902.4,50
CDM,57287AK,RMVL/REVJ SLING STRESS INCONTINENCE,4460.0,2899.0,1.1,5338.37,50
CDM,57288AK,SLING OPER STRES INCONTINENCE,5337.0,3469.05,1.1,8492.29,50
CDM,57295AK,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,3128.0,2033.2,1.1,5338.37,50
CDM,57300AK,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,3484.0,2264.6,1.1,5338.37,50
CDM,57305AK,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,6140.0,3991.0,1.1,6140.0,50
CDM,57305URVU1AK,"STENT NON-CORONARY, TEMP",1640.0,1066.0,1.1,3364.69,50
CDM,57305URVUAK,CLOSURE RECTOVAGINAL FISTUAL ABD APPROAC,1640.0,1066.0,1.1,3364.69,50
CDM,57308AK,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,4236.0,2753.4,1.1,4236.0,50
CDM,57310AK,CLOSE URETHROVAGINAL FISTULA,3060.0,1989.0,1.1,12902.4,50
CDM,57330AK,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,5284.0,3434.6,1.1,12902.4,50
CDM,57400AK,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,908.0,590.2,1.1,5338.37,50
CDM,57410AK,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,700.0,455.0,1.1,5338.37,50
CDM,57415AK,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,996.0,647.4,1.1,5338.37,50
CDM,57420AK,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,640.0,416.0,1.1,640.0,53
CDM,57421AK,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,880.0,572.0,1.1,1372.67,53
CDM,57423AK,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,6432.0,4180.8,1.1,17575.94,50
CDM,57425AK,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,6812.0,4427.8,1.1,17575.94,50
CDM,57426AK,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,5720.0,3718.0,1.1,12902.4,50
CDM,57452AK,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,600.0,390.0,1.1,600.0,53
CDM,57454AK,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,932.0,605.8,1.1,932.0,53
CDM,57455AK,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,796.0,517.4,1.1,796.0,53
CDM,57456AK,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,740.0,481.0,1.1,740.0,53
CDM,57460AK,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,1132.0,735.8,1.1,5338.37,53
CDM,57461AK,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,1372.0,891.8,1.1,5338.37,53
CDM,57465AK,COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY,324.0,210.6,1.1,324.0,52
CDM,57500AK,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,528.0,343.2,1.1,1372.67,53
CDM,57505AK,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,476.0,309.4,1.1,1372.67,53
CDM,57510AK,CAUTERY CERVIX ELECTRO/THERMAL,760.0,494.0,1.1,5338.37,53
CDM,57511AK,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,780.0,507.0,1.1,780.0,53
CDM,57513AK,CAUTERY CERVIX LASER ABLATION,780.0,507.0,1.1,5338.37,53
CDM,57520AK,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,1644.0,1068.6,1.1,5338.37,53
CDM,57522AK,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,1468.0,954.2,1.1,5338.37,53
CDM,57530AK,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,2108.0,1370.2,1.1,8492.29,50
CDM,57558AK,DILATION & CURETTAGE CERVICAL STUMP,688.0,447.2,1.1,5338.37,53
CDM,57720AK,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,1844.0,1198.6,1.1,5338.37,50
CDM,57800AK,DILATION CERVICAL CANAL INSTRUMENTAL SPX,308.0,200.2,1.1,5338.37,53
CDM,58100AK,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,532.0,345.8,1.1,532.0,53
CDM,58110AK,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,308.0,200.2,1.1,308.0,53
CDM,58120AK,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,1436.0,933.4,1.1,5338.37,53
CDM,58140AK,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,6316.0,4105.4,1.1,6316.0,50
CDM,58145AK,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,3564.0,2316.6,1.1,5338.37,50
CDM,58146AK,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,8136.0,5288.4,1.1,8136.0,50
CDM,58150AK,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,6924.0,4500.6,1.1,6924.0,50
CDM,58152AK,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,8744.0,5683.6,1.1,8744.0,50
CDM,58180AK,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,6640.0,4316.0,1.1,6640.0,50
CDM,58200AK,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,9240.0,6006.0,1.1,9240.0,50
CDM,58210AK,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,12364.0,8036.6,1.1,12364.0,50
CDM,58240AK,PEL EXNTJ GYNECOLOGIC MAL,19732.0,12825.8,1.1,19732.0,50
CDM,58260AK,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,5660.0,3679.0,1.1,8492.29,50
CDM,58262AK,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,6376.0,4144.4,1.1,8492.29,50
CDM,58263AK,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,6892.0,4479.8,1.1,8492.29,50
CDM,58267AK,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,7344.0,4773.6,1.1,7344.0,50
CDM,58270AK,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,6120.0,3978.0,1.1,8492.29,50
CDM,58275AK,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,6812.0,4427.8,1.1,6812.0,50
CDM,58280AK,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,7332.0,4765.8,1.1,7332.0,50
CDM,58290AK,VAGINAL HYSTERECTOMY UTERUS > 250 GM,8108.0,5270.2,1.1,12902.4,50
CDM,58291AK,VAG HYST > 250 GM RMVL TUBE&/OVARY,8824.0,5735.6,1.1,8824.0,50
CDM,58300AK,INSERT INTRAUTERINE DEVICE,444.0,288.6,1.1,444.0,42
CDM,58301AK,REMOVE INTRAUTERINE DEVICE,559.0,363.35,1.1,559.0,53
CDM,58322AK,ARTIFIC INSEMINATION INTRAUTERIN,440.0,286.0,1.1,440.0,47
CDM,58323AK,SPERM WASHING FOR ARTIF INSEM,92.0,59.8,1.1,340.48,47
CDM,58340AK,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,387.0,251.55,1.1,803.88,53
CDM,58350AK,CHROMOTUBATION OVIDUCT W/MATERIALS,424.0,275.6,1.1,8492.29,47
CDM,58353AK,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,1440.0,936.0,1.1,8492.29,53
CDM,58356AK,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,2564.0,1666.6,1.1,8492.29,53
CDM,58400AK,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,2856.0,1856.4,1.1,2856.0,50
CDM,58541AK,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,4916.0,3195.4,1.1,17575.94,50
CDM,58542AK,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,6230.0,4049.5,1.1,17575.94,50
CDM,58543AK,"LAP, SUPRACERVIAL HYSTERECTOMY, >250G",6332.0,4115.8,1.1,17575.94,50
CDM,58544AK,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,6240.0,4056.0,1.1,17575.94,50
CDM,58545AK,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,6220.0,4043.0,1.1,9852.42,50
CDM,58546AK,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,7976.0,5184.4,1.1,17575.94,50
CDM,58548AK,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,12652.0,8223.8,1.1,12652.0,50
CDM,58550AK,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,6040.0,3926.0,1.1,9852.42,50
CDM,58552AK,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,6764.0,4396.6,1.1,17575.94,50
CDM,58553AK,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,8024.0,5215.6,1.1,17575.94,50
CDM,58554AK,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,9244.0,6008.6,1.1,17575.94,50
CDM,58555AK,"HYSTEROSCOPY, DIAGNOSTIC (SEPARATE",1166.0,757.9,1.1,5338.37,53
CDM,58558AK,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,1835.0,1192.75,1.1,5338.37,53
CDM,58559AK,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,2080.0,1352.0,1.1,8492.29,50
CDM,58560AK,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,2300.0,1495.0,1.1,8492.29,50
CDM,58561AK,HYSTEROSCOPY REMOVAL LEIOMYOMATA,2904.0,1887.6,1.1,8492.29,50
CDM,58562AK,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,1600.0,1040.0,1.1,5338.37,53
CDM,58563AK,HYSTEROSCOPY ENDOMETRIAL ABLATION,1967.0,1278.55,1.1,8492.29,53
CDM,58565AK,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,2848.0,1851.2,1.1,8492.29,53
CDM,58570AK,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,5344.0,3473.6,1.1,17575.94,50
CDM,58571AK,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,6600.0,4290.0,1.1,17575.94,50
CDM,58572AK,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,7792.0,5064.8,1.1,17575.94,50
CDM,58573AK,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,8316.0,5405.4,1.1,17575.94,50
CDM,58575AK,LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC,13040.0,8476.0,1.1,13040.0,50
CDM,58578AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 57530)",1010.0,656.5,0.01,9852.42,28
CDM,58578AGRVU2AK,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 59325)",720.0,468.0,0.01,9852.42,28
CDM,58578AGRVU3AK,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 59350)",1630.0,1059.5,0.01,9852.42,28
CDM,58578AGRVU4AK,"UNLISTED LAP, PROC, UTERUS COMPARED TO 58100",144.0,93.6,0.01,9852.42,28
CDM,58578AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 58400)",920.0,598.0,0.01,9852.42,28
CDM,58578AK,"UNLISTED LAPAROSCOPY PROCEDURE, UTE",1040.0,676.0,0.01,9852.42,28
CDM,58578RVU4AK,UNLISTED PROC; LAP RADICAL TRACHELECTOMY AND BIL OOPHORECTOMY (C,9884.0,6424.6,0.01,9884.0,28
CDM,58578RVU5AK,UNLISTED PROC; ROBOTIC LAPAROSCOPIC TRACHELECTOMY AMPUTATION OF,1739.0,1130.35,0.01,9852.42,28
CDM,58578RVU8AK,LAPAROSCOPIC ISTHMOCELE REPAIR (COMP CODE 58520),5392.0,3504.8,0.01,9852.42,28
CDM,58578RVU9AK,LAPAROSCOPIC CERVICAL STOMA CREATION (COMP CODE 44187),6960.0,4524.0,0.01,9852.42,28
CDM,58580AK,TRANSCERVICAL ABLATION UTERINE FIBROID RF,3172.0,2061.8,1.1,12902.4,52
CDM,58600AK,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,2364.0,1536.6,1.1,5338.37,50
CDM,58605AK,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,2112.0,1372.8,1.1,2112.0,50
CDM,58611AK,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,638.0,414.7,1.1,638.0,50
CDM,58615AK,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,1576.0,1024.4,1.1,5338.37,50
CDM,58660AK,LAPAROSCOPY W/LYSIS OF ADHESION,4636.0,3013.4,1.1,9852.42,50
CDM,58661AK,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,4994.0,3246.1,1.1,9852.42,50
CDM,58662AK,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,4860.0,3159.0,1.1,9852.42,50
CDM,58670AK,LAPAROSCOPY FULGURATION OVIDUCTS,2364.0,1536.6,1.1,9852.42,50
CDM,58671AK,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,2364.0,1536.6,1.1,9852.42,50
CDM,58679AGRVU1AK,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",710.0,461.5,0.01,9852.42,28
CDM,58679AGRVUAK,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",1360.0,884.0,0.01,9852.42,28
CDM,58679AK,"UNLISTED LAPAROSCOPY PROCEDURE, OVI",1401.0,910.65,0.01,9852.42,28
CDM,58679RVU1AK,"UNLISTED PROC, LAPAROSCOPIC BIL OVARIAN TRANSPOSITION (COMP CODE",3887.0,2526.55,0.01,9852.42,28
CDM,58679RVU2AK,UNLISTED LAPAROSCOPIC DETORSION OF OVARY (COMP CODE 49322),2584.0,1679.6,0.01,9852.42,28
CDM,58679RVU4AK,LAPAROSCOPIC UTERINE AND OVARIAN TRANSPOSITION (COMP CODE 58571),6600.0,4290.0,0.01,9852.42,28
CDM,58700AK,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,5180.0,3367.0,1.1,5180.0,50
CDM,58720AK,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,4864.0,3161.6,1.1,4864.0,50
CDM,58740AK,LYSIS OF ADHESIONS SALPINX/OVARY,5960.0,3874.0,1.1,5960.0,50
CDM,58800AK,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,1848.0,1201.2,1.1,5338.37,53
CDM,58805AK,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,2568.0,1669.2,1.1,5338.37,50
CDM,58825AK,"TRANSPOSITION, OVARY(S)",4712.0,3062.8,1.1,4712.0,50
CDM,58925AK,OVARIAN CYSTECTOMY UNI/BI,4972.0,3231.8,1.1,8492.29,50
CDM,58940AK,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,3617.0,2351.05,1.1,3617.0,50
CDM,58940URVUAK,REMOVAL OF OVARY(S),921.0,598.65,1.1,1899.67,50
CDM,58943AK,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,7808.0,5075.2,1.1,7808.0,50
CDM,58950AK,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,7348.0,4776.2,1.1,7348.0,50
CDM,58951AK,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,9704.0,6307.6,1.1,9704.0,50
CDM,58952AK,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,10916.0,7095.4,1.1,10916.0,50
CDM,58953AK,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,13652.0,8873.8,1.1,13652.0,50
CDM,58954AK,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,14852.0,9653.8,1.1,14852.0,50
CDM,58956AK,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,9120.0,5928.0,1.1,9120.0,50
CDM,58958AK,RESCJ RECR OVR TBL PP UTR MAL OMNTC PEL LMPHADEC,11688.0,7597.2,1.1,11688.0,50
CDM,58960AK,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,6316.0,4105.4,1.1,6316.0,50
CDM,58970AK,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,1549.0,1006.85,1.1,1549.0,47
CDM,58974AK,"TRANSFER OF EMBRYO,INTRAUTERINE",1163.0,755.95,1.1,1372.67,32
CDM,58999AGRVU1AK,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL) (COMP",2160.0,1404.0,0.01,2160.0,28
CDM,58999AGRVU2AK,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL) (COMP",870.0,565.5,0.01,870.0,28
CDM,58999AGRVUAK,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL) (COMP",540.0,351.0,0.01,540.0,28
CDM,58999AK,UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL,556.0,361.4,0.01,556.0,28
CDM,58999RVU12AK,"UNLISTED PROC, EXCISION OF VAGINAL CUFF LESION (COMP TO 57135)",891.0,579.15,0.01,891.0,28
CDM,58999RVU20AK,LAPAROSCOPIC RESECTION OF NEOVAGINA (COMP 57110),6656.0,4326.4,0.01,6656.0,28
CDM,58999RVU21AK,LAPAROSCOPIC UTEROSACRAL LIGAMENT SUSPENSION (COMP CODE 57283),4664.0,3031.6,0.01,4664.0,28
CDM,58999RVU22AK,VAGINAL CUFF BIOPSY (COMP CODE 57100),480.0,312.0,0.01,480.0,28
CDM,58999RVU2AK,UNLISTED VAGINAL CUFF REPAIR (COMP CODE 57200),870.0,565.5,0.01,870.0,28
CDM,58999RVUAK,LAPAROSCOPIC REPAIR COLOVAGINAL FISTULA (COMP 57305),3655.0,2375.75,0.01,3655.0,28
CDM,59000AK,AMNIOCENTESIS DIAGNOSIC,520.0,338.0,1.1,1372.67,53
CDM,59001AK,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,1200.0,780.0,1.1,1200.0,50
CDM,59012AK,CORDOCENTESIS(INTRAUTERINE),1376.0,894.4,1.1,1376.0,50
CDM,59015AK,CHORIONIC VILLUS SAMPLING,880.0,572.0,1.1,1372.67,53
CDM,59025AK,FETAL NON-STRESS TEST,1038.0,674.7,1.1,1038.0,50
CDM,59025AK-26,FETAL NON-STRESS TEST,233.0,151.45,1.1,233.0,44
CDM,59025AK-TC,FETAL NON-STRESS TEST,805.0,523.25,1.1,805.0,46
CDM,59120AK,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,5068.0,3294.2,1.1,5068.0,50
CDM,59121AK,TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY,5096.0,3312.4,1.1,5096.0,50
CDM,59136AK,TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER,5700.0,3705.0,1.1,5700.0,50
CDM,59140AK,TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION,2376.0,1544.4,1.1,2376.0,50
CDM,59150AK,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,4916.0,3195.4,1.1,9852.42,50
CDM,59151AK,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,4844.0,3148.6,1.1,9852.42,50
CDM,59160AK,CURETTAGE POSTPARTUM,1104.0,717.6,1.1,5338.37,53
CDM,59200AK,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,528.0,343.2,1.1,548.35,53
CDM,59300AK,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,964.0,626.6,1.1,5338.37,53
CDM,59320AK,CERCLAGE CERVIX PREGNANCY VAGINAL,992.0,644.8,1.1,5338.37,50
CDM,59325AK,CERCLAGE CERVIX PREGNANCY ABDOMINAL,1624.0,1055.6,1.1,1624.0,50
CDM,59400AK,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,14800.0,9620.0,1.1,14800.0,50
CDM,59409AK,VAGINAL DELIVERY ONLY,6323.0,4109.95,1.1,6323.0,50
CDM,59410AK,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,8254.0,5365.1,1.1,8254.0,50
CDM,59412AK,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,684.0,444.6,1.1,5338.37,50
CDM,59414AK,DELIVER PLACENTA,644.0,418.6,1.1,5338.37,50
CDM,59425AK,ANTEPARTUM CARE 4-6 VISIT MIDWIFE,3120.0,2028.0,1.1,3120.0,53
CDM,59426AK,ANTEPARTUM CARE ONLY 7 OR > VISITS.,5720.0,3718.0,1.1,5720.0,53
CDM,59430AK,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,1288.0,837.2,1.1,1288.0,53
CDM,59510AK,OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM,16420.0,10673.0,1.1,16420.0,44
CDM,59514AK,CESAREAN DELIVERY ONLY,7097.0,4613.05,1.1,7097.0,50
CDM,59515AK,CESAREAN DELIVERY+POSTPARTUM CARE,10028.0,6518.2,1.1,10028.0,50
CDM,59525AK,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,3412.0,2217.8,1.1,3412.0,50
CDM,59610AK,ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB,15484.0,10064.6,1.1,15484.0,44
CDM,59612AK,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,6436.0,4183.4,1.1,6436.0,50
CDM,59614AK,VAGINAL DELIVERY & POSTPARTUM CARE VBAC,8192.0,5324.8,1.1,8192.0,50
CDM,59618AK,ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC,16628.0,10808.2,1.1,16628.0,44
CDM,59620AK,CESAREAN DELIVERY ATTEMPTED VBAC,6664.0,4331.6,1.1,6664.0,50
CDM,59622AK,CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA,9328.0,6063.2,1.1,9328.0,50
CDM,59812AK,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,1776.0,1154.4,1.1,5338.37,53
CDM,59820AK,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,1936.0,1258.4,1.1,5338.37,53
CDM,59821AK,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,2036.0,1323.4,1.1,5338.37,53
CDM,59840AK,INDUCED ABORTION DILATION AND CURETTAGE,1204.0,782.6,1.1,5338.37,53
CDM,59841AK,INDUCED ABORTION DILATION & EVACUATION,2260.0,1469.0,1.1,5338.37,53
CDM,59850AK,INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ,2360.0,1534.0,1.1,2360.0,50
CDM,59855AK,INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS,2572.0,1671.8,1.1,2572.0,50
CDM,59856AK,INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC,3116.0,2025.4,1.1,3116.0,50
CDM,59866AK,MULTIFETAL PREGNANCY REDUCTION(S),1596.0,1037.4,1.1,1596.0,44
CDM,59870AK,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,2628.0,1708.2,1.1,5338.37,50
CDM,59871AK,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,852.0,553.8,1.1,5338.37,50
CDM,59897AK,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,1049.0,681.85,0.01,1392.64,29
CDM,59899AGRVU1AK,"UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY (COMPARISON CODE",780.0,507.0,0.01,780.0,28
CDM,59899AGRVUAK,"UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY (COMPARISON CODE",220.0,143.0,0.01,340.48,28
CDM,59899AK,UNLISTED PROCEDURE MATERNITY CARE & DELIVERY,803.0,521.95,0.01,803.0,28
CDM,59899RVU3AK,UNLISTED PROC; POST PARTUM LAPAROTOMY WITH UTERINE INVERSION RED,1630.0,1059.5,0.01,1630.0,28
CDM,59899RVU4AK,JADA PROCEDURE (COMP CODE43460),1629.0,1058.85,0.01,1629.0,28
CDM,60100AK,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,624.0,405.6,1.1,1200.64,53
CDM,60200AK,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,4008.0,2605.2,1.1,9852.42,50
CDM,60210AK,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4492.0,2919.8,1.1,9852.42,50
CDM,60210URVUAK,PARTIAL THYROID EXCISION,1570.0,1020.5,1.1,9852.42,50
CDM,60212AK,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,6572.0,4271.8,1.1,9852.42,50
CDM,60220AK,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4924.0,3200.6,1.1,9852.42,50
CDM,60225AK,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,6508.0,4230.2,1.1,9852.42,50
CDM,60240AK,THYROIDECTOMY TOTAL/COMPLETE,6618.0,4301.7,1.1,9852.42,50
CDM,60252AK,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,8804.0,5722.6,1.1,9999.36,50
CDM,60254AK,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,11368.0,7389.2,1.1,11368.0,50
CDM,60260AK,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,7304.0,4747.6,1.1,9999.36,50
CDM,60270AK,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,9280.0,6032.0,1.1,9280.0,50
CDM,60271AK,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,7048.0,4581.2,1.1,9999.36,50
CDM,60280AK,EXCISION THYROGLOSSAL DUCT CYST/SINUS,2464.0,1601.6,1.1,9852.42,50
CDM,60281AK,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,3528.0,2293.2,1.1,9852.42,50
CDM,60300AK,ASPIRATION AND/OR INJECTION THYROID CYST,388.0,252.2,1.1,1200.64,53
CDM,60500AK,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,6864.0,4461.6,1.1,9999.36,50
CDM,60502AK,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,8460.0,5499.0,1.1,9999.36,50
CDM,60505AK,PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC,9224.0,5995.6,1.1,9224.0,50
CDM,60512AK,PARATHYROID AUTOTRANSPLANTATION ADD-ON,1776.0,1154.4,1.1,1776.0,50
CDM,60520AK,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,6864.0,4461.6,1.1,9999.36,50
CDM,60521AK,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,7672.0,4986.8,1.1,7672.0,50
CDM,60522AK,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,9392.0,6104.8,1.1,9392.0,50
CDM,60540AK,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,7929.0,5153.85,1.1,7929.0,50
CDM,60545AK,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,8372.0,5441.8,1.1,8372.0,50
CDM,60600AK,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,10036.0,6523.4,1.1,10036.0,50
CDM,60650AK,LAPAROSCOPY ADRENALECTOMY PARTIAL OR COM,8292.0,5389.8,1.1,8292.0,50
CDM,60659RVU1AK,"UNLISTED PROC; TRANSORAL ENDOSCOPIC THYROID LOBECTOMY, VESTIBULA",3702.0,2406.3,0.01,9852.42,28
CDM,60659RVU2AK,UNLISTED PROC; TRANSORAL ENDOSCOPIC PARATHYROIDETOMY VESTIBULAR,6286.0,4085.9,0.01,9852.42,28
CDM,60660AK,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,2530.0,1644.5,1.1,7597.35,51
CDM,60661AK,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,1870.0,1215.5,1.1,1870.0,51
CDM,60699RVU4AK,UNLISTED PROC; TRANSORAL ENDOSCOPIC SUBTOTAL THYROIDECTOMY VESTI,5815.0,3779.75,0.01,9852.42,28
CDM,60699RVU5AK,"UNLISTED PROC; TRANSORAL ENDOSCOPIC THYROID LOCECTOMY, VESTIBULA",3699.0,2404.35,0.01,9852.42,28
CDM,60699RVU7AK,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),3197.0,2078.05,0.01,9852.42,28
CDM,60699RVU8AK,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),2620.0,1703.0,0.01,9852.42,28
CDM,60699RVU9AK,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),2808.0,1825.2,0.01,9852.42,28
CDM,60699RVUAK,AUTOTRANS OF CRYO TISSUE (COMP CODE 60512),1599.0,1039.35,0.01,9852.42,28
CDM,61000010,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61000030,CARDIAC MRI W/W/O CONTRAST W/STRESS,5451.0,3543.15,0.87,5451.0,61
CDM,61000045,MRI PRE- OP MAPPING W/WO CONTR,608.0,395.2,0.87,608.0,61
CDM,61000050,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2053.0,1334.45,0.87,2053.0,46
CDM,61000185,MRI BREAST BIL W/ CONTR,5984.0,3889.6,0.87,5984.0,46
CDM,61000205,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,11180.0,7267.0,309.61,11180.0,61
CDM,61000215,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,2503.0,1626.95,154.44,3004.0,46
CDM,61000225,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,11180.0,7267.0,309.61,11180.0,61
CDM,61000235,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,2111.0,1372.15,216.52,6561.0,61
CDM,61000255,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,2111.0,1372.15,109.09,3004.0,46
CDM,61000375,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,1668.0,1084.2,0.87,1668.0,61
CDM,61000385,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,1668.0,1084.2,0.87,1668.0,61
CDM,61000395,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,0.87,4970.0,46
CDM,61000405,MRI BREAST BILAT WO/W CONTR,5984.0,3889.6,0.87,5984.0,46
CDM,61000455,MRI CERVICAL LOCALIZATION W IVCON,2651.0,1723.15,0.87,2651.0,61
CDM,61000465,MRI THORACIC LOCALIZATION W IVCON,2651.0,1723.15,0.87,2651.0,61
CDM,61000475,MRI LUMBAR LOCALIZATION W IVCON,280.0,182.0,0.87,409.57,61
CDM,61000495,WHOLE BODY MRI,10064.0,6541.6,0.87,10064.0,61
CDM,61000515,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,0.87,2455.0,61
CDM,61000665,MRI BREAST LIMITED,225.0,146.25,0.87,409.57,61
CDM,61000675,MRI 3D CAD,1231.0,800.15,0.87,1231.0,61
CDM,61000695,MRI BRAIN LOCALIZATION W IVCON,2651.0,1723.15,0.87,2651.0,61
CDM,61000705,MRI PRE-OP MAPPING W/O CONTRAST,608.0,395.2,0.87,608.0,61
CDM,61000715,MRI PRE-OP MAPPING W/CONTRAST,608.0,395.2,0.87,608.0,61
CDM,61000725,MRI BRAIN W/WO CONTAST PC,2464.0,1601.6,0.87,2464.0,61
CDM,61000735,MMR BRAIN WITH PC,2464.0,1601.6,0.87,2464.0,61
CDM,61000745,MRI BRAIN LOCALIZATION WWO CONT,1929.0,1253.85,0.87,1929.0,61
CDM,61000755,MRI BREAST 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1330.0,864.5,68.91,1330.0,46
CDM,61070AK,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,392.0,254.8,1.1,1180.93,50
CDM,61100000,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,3783.0,2458.95,0.87,3783.0,61
CDM,61100010,MRI ORBIT FACE &/NECK W/O CONTRAST,1668.0,1084.2,0.87,1668.0,61
CDM,61100015,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1228.0,798.2,0.87,1228.0,61
CDM,61100020,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61100025,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,1668.0,1084.2,0.87,1668.0,61
CDM,61100030,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61100040,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61100050,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61100060,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61100090,MRI BRAIN LOCALIZATION WO CONT,1699.0,1104.35,0.87,1699.0,61
CDM,61107AK,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,1996.0,1297.4,1.1,1996.0,50
CDM,61120AK,BURR HOLE VENTRICULAR PUNCTURE,3840.0,2496.0,1.1,3840.0,50
CDM,61140AK,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,6892.0,4479.8,1.1,6892.0,50
CDM,61150AK,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,7560.0,4914.0,1.1,7560.0,50
CDM,61154AK,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,6828.0,4438.2,1.1,6828.0,50
CDM,61200010,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61200020,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61200030,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61200040,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61200050,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61200060,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61200070,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61200080,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61200090,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61210AK,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,2332.0,1515.8,1.1,2332.0,50
CDM,61215AK,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,2340.0,1521.0,1.1,11373.82,50
CDM,61304AK,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,9364.0,6086.6,1.1,9364.0,50
CDM,61305AK,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,12602.0,8191.3,1.1,12602.0,50
CDM,61312AK,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,12068.0,7844.2,1.1,12068.0,50
CDM,61313AK,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11236.0,7303.4,1.1,11236.0,50
CDM,61314AK,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,10360.0,6734.0,1.1,10360.0,50
CDM,61315AK,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11860.0,7709.0,1.1,11860.0,50
CDM,61320AK,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,10968.0,7129.2,1.1,10968.0,50
CDM,61322AK,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,13704.0,8907.6,1.1,13704.0,50
CDM,61323AK,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,14024.0,9115.6,1.1,14024.0,50
CDM,61340AK,SUBTEMPORAL CRANIAL DECOMPRESSION,8044.0,5228.6,1.1,8044.0,50
CDM,61343AK,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,12744.0,8283.6,1.1,12744.0,50
CDM,61345AK,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,11692.0,7599.8,1.1,11692.0,50
CDM,61400000,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61400005,MRI PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61400010,MRI TEMPOROMANDIBULAR JOINT,1668.0,1084.2,0.87,1668.0,61
CDM,61400020,MRI CHEST W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61400025,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1436.0,46
CDM,61400030,MRI CHEST W/CONTRAST MATERIAL,5451.0,3543.15,0.87,5451.0,61
CDM,61400040,MRI CHEST W/O & W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61400050,MRI PELVIS W/O & W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61400060,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400070,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61400080,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,2464.0,1601.6,0.87,2464.0,61
CDM,61400090,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400100,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,5451.0,3543.15,0.87,5451.0,61
CDM,61400110,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61400120,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400130,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61400140,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,2464.0,1601.6,0.87,2464.0,61
CDM,61400145,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,5451.0,3543.15,0.87,5451.0,61
CDM,61400150,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400160,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,5451.0,3543.15,0.87,5451.0,61
CDM,61400170,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61400180,MRI ABDOMEN W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61400190,MRI ABDOMEN W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61400200,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61400210,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,1668.0,1084.2,0.87,1668.0,61
CDM,61400220,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,3783.0,2458.95,0.87,3783.0,61
CDM,61400230,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,2464.0,1601.6,0.87,2464.0,61
CDM,61400240,CARDIAC MRI FOR VELOCITY FLOW MAPPING,566.0,367.9,0.87,566.0,46
CDM,61400250,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1436.0,46
CDM,61400305,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,2464.0,1601.6,0.87,2464.0,61
CDM,61400315,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400325,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400335,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400345,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,1668.0,1084.2,0.87,1668.0,61
CDM,61400385,QUANTITATIVE MRI ANALYSIS OF THE BRAIN,967.0,628.55,202.79,967.0,61
CDM,61400395,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,633.0,411.45,0.87,633.0,61
CDM,61400405,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,410.0,266.5,0.87,410.0,61
CDM,61400415,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,169.0,109.85,0.87,169.0,61
CDM,61400425,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,343.0,222.95,0.87,343.0,46
CDM,61400435,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,608.0,395.2,0.87,608.0,61
CDM,61400445,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,1668.0,1084.2,0.87,1668.0,61
CDM,61458AK,CRNEC SOPL EXPL/DCMPRN CRNL NRV,11536.0,7498.4,1.1,11536.0,50
CDM,61500010,MRA HEAD W/O CONTRST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61500020,MRA HEAD W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61500030,MRA HEAD W/O & W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61500040,MRA NECK W/O CONTRST MATERIAL,1668.0,1084.2,0.87,1668.0,61
CDM,61500050,MRA NECK W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61500060,MRA NECK W/O &W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
CDM,61500AK,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,7672.0,4986.8,1.1,7672.0,50
CDM,61510AK,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,13565.0,8817.25,1.1,13565.0,50
CDM,61512AK,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,14856.0,9656.4,1.1,14856.0,50
CDM,61514AK,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,10892.0,7079.8,1.1,10892.0,50
CDM,61516AK,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,10632.0,6910.8,1.1,10632.0,50
CDM,61518AK,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,15956.0,10371.4,1.1,15956.0,50
CDM,61519AK,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,17372.0,11291.8,1.1,17372.0,50
CDM,61520AK,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,22836.0,14843.4,1.1,22836.0,50
CDM,61524AK,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,13152.0,8548.8,1.1,13152.0,50
CDM,61570AK,CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN,10604.0,6892.6,1.1,10604.0,50
CDM,61571AK,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,11368.0,7389.2,1.1,11368.0,50
CDM,61575AK,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,14624.0,9505.6,1.1,14624.0,50
CDM,61582AK,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,14056.0,9136.4,1.1,14056.0,50
CDM,61583AK,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,15400.0,10010.0,1.1,15400.0,50
CDM,61592AK,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,17232.0,11200.8,1.1,17232.0,50
CDM,61597AK,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,16328.0,10613.2,1.1,16328.0,50
CDM,61600000,MRA LWR EXT W CONTR,6006.0,3903.9,0.87,6006.0,46
CDM,61600005,MRA LWR EXT WO CONTR,6006.0,3903.9,0.87,6006.0,46
CDM,61600010,MRA LWR EXT WO/W CONTR,6006.0,3903.9,0.87,6006.0,46
CDM,61600050,MRA LWR EX WO/W,6006.0,3903.9,0.87,6006.0,46
CDM,61600AK,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,12004.0,7802.6,1.1,12004.0,50
CDM,61601AK,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,13702.0,8906.3,1.1,13702.0,50
CDM,61608AK,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,18216.0,11840.4,1.1,18216.0,50
CDM,61623AK,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,3980.0,2587.0,1.1,18783.74,50
CDM,61624AK,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,8853.0,5754.45,1.1,8853.0,50
CDM,61626AK,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,6640.0,4316.0,1.1,18783.74,50
CDM,61630AK,BALLON ANGIOPLASTY  INTRACRANIAL PERCUTANEOUS,8828.0,5738.2,1.1,8828.0,44
CDM,61635AK,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,9712.0,6312.8,1.1,9712.0,44
CDM,61640AK,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,4928.0,3203.2,1.1,4928.0,33
CDM,61642AK,PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER,3464.0,2251.6,1.1,3464.0,33
CDM,61645AK,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,6600.0,4290.0,1.1,6600.0,50
CDM,61650AK,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,4000.0,2600.0,1.1,4000.0,50
CDM,61651AK,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,1700.0,1105.0,1.1,1700.0,50
CDM,61680AK,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,13020.0,8463.0,1.1,13020.0,50
CDM,61682AK,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,25364.0,16486.6,1.1,25364.0,50
CDM,61686AK,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,27000.0,17550.0,1.1,27000.0,50
CDM,61697AK,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,25360.0,16484.0,1.1,25360.0,50
CDM,61700AK,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,20248.0,13161.2,1.1,20248.0,50
CDM,61702AK,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,24016.0,15610.4,1.1,24016.0,50
CDM,61715AK,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,8801.0,5720.65,1.1,8801.0,36
CDM,61736AK,LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION,7624.0,4955.6,1.1,7624.0,50
CDM,61737AK,LITT LES ICR MLT TRAJECTORIES MLT/CPLX LESIONS,9068.0,5894.2,1.1,9068.0,50
CDM,61750AK,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,7932.0,5155.8,1.1,7932.0,50
CDM,61751AK,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,7516.0,4885.4,1.1,7516.0,50
CDM,61781AK,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,1500.0,975.0,1.1,1500.0,50
CDM,61782AK,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,1399.0,909.35,1.1,1399.0,50
CDM,61783AK,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,1500.0,975.0,1.1,1500.0,50
CDM,61796AK,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,5572.0,3621.8,1.1,5572.0,50
CDM,61797AK,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,1392.0,904.8,1.1,1392.0,50
CDM,61798AK,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,7940.0,5161.0,1.1,7940.0,50
CDM,61799AK,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,1924.0,1250.6,1.1,1924.0,50
CDM,61800005,MRA ABD W CONTR,2579.0,1676.35,0.87,2579.0,46
CDM,61800015,MRA ABD WO CONTR,2579.0,1676.35,0.87,2579.0,46
CDM,61800025,MRA ABD WO/W CONTR,2579.0,1676.35,0.87,2579.0,46
CDM,61800035,MRA CHEST W CONTRAST,6274.0,4078.1,0.87,6274.0,46
CDM,61800040,MRA SPINAL CANAL WO/W,3068.0,1994.2,0.87,3068.0,46
CDM,61800045,MRA CHEST WO CONTR,6274.0,4078.1,0.87,6274.0,46
CDM,61800055,MRA CHEST WO/W CONTR,6274.0,4078.1,0.87,6274.0,46
CDM,61800065,MRA PELV W CONTRL,6296.0,4092.4,0.87,6296.0,46
CDM,61800075,MRA PELV WO CONTRL,6296.0,4092.4,0.87,6296.0,46
CDM,61800080,MRA UPPER EXT WO CONT,4288.0,2787.2,0.87,4288.0,46
CDM,61800085,MRA PELV WO/W CONTR,6296.0,4092.4,0.87,6296.0,46
CDM,61800100,MRA CHEST W CON,6274.0,4078.1,0.87,6274.0,46
CDM,61800105,MRA W/CONTRAST SPINAL CANAL,3068.0,1994.2,0.87,3068.0,46
CDM,61800110,MRA CHEST WO,6274.0,4078.1,0.87,6274.0,46
CDM,61800115,MRA W/O CONTRAST SPINAL CANAL,3068.0,1994.2,0.87,3068.0,46
CDM,61800120,MRA CHEST WO/W,6274.0,4078.1,0.87,6274.0,46
CDM,61800125,MRA UPPER EXT W CONT,6296.0,4092.4,0.87,6296.0,46
CDM,61800150,MRA PELV WO/W CONTR,6296.0,4092.4,0.87,6296.0,46
CDM,61800160,MRA ABD W CONT,2579.0,1676.35,0.87,2579.0,46
CDM,61800170,MRA ABD WO CONT,2579.0,1676.35,0.87,2579.0,46
CDM,61800180,MRA ABDOMEN WO/W CONT,2579.0,1676.35,0.87,2579.0,46
CDM,61800190,MRA UPPER EXT WO/W CONT,4288.0,2787.2,0.87,4288.0,46
CDM,61800AK,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,900.0,585.0,1.1,900.0,50
CDM,61888AK,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,2092.0,1359.8,1.1,23258.37,50
CDM,61889AK,INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,11330.0,7364.5,1.1,11330.0,50
CDM,61891AK,REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,4950.0,3217.5,1.1,37350.66,50
CDM,61892AK,REMOVAL SKULL-MNTD CRANIAL NSTIM PG/RCVR W/CRNOP,6600.0,4290.0,1.1,6600.0,50
CDM,62005AK,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,7052.0,4583.8,1.1,7052.0,50
CDM,62010AK,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,8572.0,5571.8,1.1,8572.0,50
CDM,62100035,MAMMOTOME NEEDLE 11 GAUGE,1220.0,793.0,181.54,1220.0,38
CDM,62100045,VACORA NEEDLE 11 GAUGE,1231.0,800.15,183.17,1231.0,38
CDM,62100055,BARD MONOPTY NEEDLE,98.0,63.7,14.58,98.0,38
CDM,62100065,MAMMOTOME NEEDLE 8 GAUGE,1454.0,945.1,216.36,1454.0,39
CDM,62100225,ACHIEVE NEEDLE,150.0,97.5,22.32,150.0,38
CDM,62100235,MARQUEE NEEDLE,287.0,186.55,42.71,287.0,38
CDM,62100245,EVIVA NEEDLE,767.0,498.55,114.13,767.0,38
CDM,62100255,ATEC HANDPIECE,656.0,426.4,97.61,656.0,38
CDM,62100AK,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,10353.0,6729.45,1.1,10353.0,50
CDM,62140AK,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,5820.0,3783.0,1.1,5820.0,50
CDM,62141AK,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,6428.0,4178.2,1.1,6428.0,50
CDM,62142AK,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,4732.0,3075.8,1.1,4732.0,50
CDM,62143AK,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,5660.0,3679.0,1.1,5660.0,50
CDM,62145AK,CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG,8036.0,5223.4,1.1,8036.0,50
CDM,62161AK,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,8492.0,5519.8,1.1,8492.0,50
CDM,62162AK,NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG,10720.0,6968.0,1.1,10720.0,50
CDM,62164AK,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,11772.0,7651.8,1.1,11772.0,50
CDM,62165AK,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,9292.0,6039.8,1.1,9292.0,50
CDM,62192AK,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,5340.0,3471.0,1.1,5340.0,50
CDM,62200AK,"VENTRICULO-CISTERNOSTOMY,3RD VENT",7716.0,5015.4,1.1,7716.0,50
CDM,62220AK,CREATE SHUNT; VENTRIC-ATR JUGUL AURICL,5640.0,3666.0,1.1,5640.0,50
CDM,62223AK,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,6182.0,4018.3,1.1,6182.0,50
CDM,62225AK,RPLCMT/IRRIGATION VENTRICULAR CATHETER,2724.0,1770.6,1.1,11373.82,50
CDM,62230AK,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,4572.0,2971.8,1.1,11373.82,50
CDM,62252AK,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2395.0,1556.75,1.1,2395.0,50
CDM,62252AK-26,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,326.0,211.9,1.1,326.0,44
CDM,62256AK,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,2952.0,1918.8,1.1,2952.0,50
CDM,62258AK,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,6256.0,4066.4,1.1,6256.0,50
CDM,62263AK,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,2000.0,1300.0,1.1,2100.44,53
CDM,62267AK,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,1200.0,780.0,1.1,1200.64,53
CDM,62270AK,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,537.0,349.05,1.1,1180.93,53
CDM,62272AK,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,632.0,410.8,1.1,1180.93,53
CDM,62273AK,INJECTION EPIDURAL BLOOD/CLOT PATCH,946.0,614.9,1.1,1180.93,53
CDM,62280AK,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,1052.0,683.8,1.1,1555.46,53
CDM,62281AK,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,1064.0,691.6,1.1,1555.46,53
CDM,62282AK,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,1025.0,666.25,1.1,1555.46,53
CDM,62284AK,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,616.0,400.4,1.1,630.91,53
CDM,62290AK,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,1200.0,780.0,1.1,1200.0,53
CDM,62291AK,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1164.0,756.6,1.1,1164.0,53
CDM,62300015,ALGINATE DRSG >16 <=48 SQ IN,78.0,50.7,8.84,93.72,46
CDM,62300145,ALGINATE DRSG 4X4,36.0,23.4,7.85,41.94,46
CDM,62304AK,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,900.0,585.0,1.1,1367.3,53
CDM,62305AK,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,940.0,611.0,1.1,1367.3,53
CDM,62320AK,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,792.0,514.8,1.1,1180.93,53
CDM,62321AK,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,858.0,557.7,1.1,1180.93,53
CDM,62322AK,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,682.0,443.3,1.1,1555.46,53
CDM,62323AK,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,792.0,514.8,1.1,1180.93,53
CDM,62324AK,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,832.0,540.8,1.1,1555.46,53
CDM,62325AK,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,968.0,629.2,1.1,1555.46,53
CDM,62326AK,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,783.0,508.95,1.1,1555.46,53
CDM,62327AK,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,836.0,543.4,1.1,1555.46,53
CDM,62328AK,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,692.0,449.8,1.1,1180.93,52
CDM,62329AK,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,812.0,527.8,1.1,1180.93,52
CDM,62330AK,DCMPRN PERQ PRTL RMVL LIGA FLAVM BI 1NTRSPC LMBR,3520.0,2288.0,1.1,3520.0,35
CDM,62331AK,DCMPRN PRQ PRT RMV LIGA FLAVM BI ADD NTRSPC LMBR,1870.0,1215.5,1.1,1870.0,35
CDM,62350AK,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,2662.0,1730.3,1.1,11373.82,50
CDM,62355AK,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,1420.0,923.0,1.1,3297.28,50
CDM,62361AK,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,2000.0,1300.0,1.1,30449.66,50
CDM,62362AK,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,2464.0,1601.6,1.1,30449.66,50
CDM,62365AK,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,1572.0,1021.8,1.1,11373.82,50
CDM,62367AK,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,211.0,137.15,1.1,510.72,53
CDM,62368AK,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,295.0,191.75,1.1,510.72,53
CDM,62369AK,ANAL SP INF PMP W/REPRG&FILL,295.0,191.75,1.1,510.72,53
CDM,62370AK,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR&REF PHYS,396.0,257.4,1.1,510.72,53
CDM,62380AK,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,5916.0,3845.4,1.1,12214.27,31
CDM,63001AK,LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV,7044.0,4578.6,1.1,12214.27,50
CDM,63003AK,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,7096.0,4612.4,1.1,12214.27,50
CDM,63005AK,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,6572.0,4271.8,1.1,12214.27,50
CDM,63012AK,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,6740.0,4381.0,1.1,12214.27,50
CDM,63015AK,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,8340.0,5421.0,1.1,12214.27,50
CDM,63016AK,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,8812.0,5727.8,1.1,12214.27,50
CDM,63017AK,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,6932.0,4505.8,1.1,12214.27,50
CDM,63020AK,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,5964.0,3876.6,1.1,12214.27,50
CDM,63030AK,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,4800.0,3120.0,1.1,12214.27,50
CDM,63032AK,LAMOT DCMPRN NRV RT RPR ANULR DFCT 1NTRSPC LMBR,1100.0,715.0,1.1,1100.0,35
CDM,63035AK,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,1544.0,1003.6,1.1,1544.0,50
CDM,63042AK,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,7504.0,4877.6,1.1,12214.27,50
CDM,63044AK,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,3744.0,2433.6,1.1,3744.0,38
CDM,63045AK,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL,7180.0,4667.0,1.1,12214.27,50
CDM,63046AK,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC,7590.0,4933.5,1.1,12214.27,50
CDM,63047AK,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR,6763.0,4395.95,1.1,12214.27,50
CDM,63048AK,LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM,1527.0,992.55,1.1,1527.0,50
CDM,63050AK,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,9684.0,6294.6,1.1,9684.0,50
CDM,63051AK,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,11224.0,7295.6,1.1,11224.0,50
CDM,63052AK,LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM,1700.0,1105.0,1.1,1700.0,50
CDM,63053AK,LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM,1512.0,982.8,1.1,1512.0,50
CDM,63055AK,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,9420.0,6123.0,1.1,12214.27,50
CDM,63056AK,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,8744.0,5683.6,1.1,12214.27,50
CDM,63057AK,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,2100.0,1365.0,1.1,2100.0,50
CDM,63075AK,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,7840.0,5096.0,1.1,12214.27,50
CDM,63076AK,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,1616.0,1050.4,1.1,1616.0,50
CDM,63077AK,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,9152.0,5948.8,1.1,9152.0,50
CDM,63081AK,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,10440.0,6786.0,1.1,10440.0,50
CDM,63082AK,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,1744.0,1133.6,1.1,1744.0,50
CDM,63085AK,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1.1,11788.0,50
CDM,63085AK-26,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1.1,11788.0,22
CDM,63086AK,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG,1276.0,829.4,1.1,1276.0,50
CDM,63086AK-26,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG,1276.0,829.4,1.1,1276.0,22
CDM,63087AK,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,15012.0,9757.8,1.1,15012.0,50
CDM,63088AK,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,1728.0,1123.2,1.1,1728.0,50
CDM,63090AK,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,12372.0,8041.8,1.1,12372.0,50
CDM,63091AK,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,1212.0,787.8,1.1,1212.0,50
CDM,63101AK,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,13640.0,8866.0,1.1,13640.0,50
CDM,63102AK,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,15004.0,9752.6,1.1,15004.0,50
CDM,63103AK,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,2121.0,1378.65,1.1,2121.0,50
CDM,63172AK,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,7904.0,5137.6,1.1,7904.0,50
CDM,63200AK,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,9434.0,6132.1,1.1,9434.0,50
CDM,63251AK,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,17856.0,11606.4,1.1,17856.0,50
CDM,63265AK,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,9528.0,6193.2,1.1,12214.27,50
CDM,63266AK,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,9872.0,6416.8,1.1,12214.27,50
CDM,63267AK,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,7780.0,5057.0,1.1,12214.27,50
CDM,63270AK,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,11920.0,7748.0,1.1,11920.0,50
CDM,63271AK,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,11968.0,7779.2,1.1,11968.0,50
CDM,63272AK,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,11000.0,7150.0,1.1,11000.0,50
CDM,63275AK,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,10344.0,6723.6,1.1,10344.0,50
CDM,63276AK,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,10276.0,6679.4,1.1,10276.0,50
CDM,63277AK,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,8956.0,5821.4,1.1,8956.0,50
CDM,63280AK,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,12116.0,7875.4,1.1,12116.0,50
CDM,63281AK,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,11996.0,7797.4,1.1,11996.0,50
CDM,63282AK,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,11260.0,7319.0,1.1,11260.0,50
CDM,63285AK,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,15220.0,9893.0,1.1,15220.0,50
CDM,63286AK,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,15048.0,9781.2,1.1,15048.0,50
CDM,63290AK,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,16328.0,10613.2,1.1,16328.0,50
CDM,63300AK,VCRPEC LES 1 SGM XDRL CERVICAL,10720.0,6968.0,1.1,10720.0,50
CDM,63302AK,VCRPEC LES 1 SEG XDRL THRC THORACOLMBR,12460.0,8099.0,1.1,12460.0,50
CDM,63600050,D5W 500ML,7.5,4.88,1.12,8.86,51
CDM,63600105,"IM 3 DOSE HIB, PRP-OMP",108.0,70.2,7.93,108.0,51
CDM,63600115,"HIB, PRP-T",47.0,30.55,6.99,47.0,51
CDM,63600125,H PAPILLOMA VACC 3 DOSE IM,442.0,287.3,13.37,442.0,51
CDM,63600145,FLU VACCINE NO PRESERV 0.25 ML,74.7,48.56,7.93,74.7,51
CDM,63600160,W IUD COPPER CONTRACEPTIVE,830.0,539.5,2.17,2968.56,51
CDM,63600165,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,7.93,69.7,51
CDM,63600175,FLUMIST VACC NSPR 0.2ML,62.9,40.89,7.93,62.9,51
CDM,63600185,FLU VACC PRSV FREE INC ANTIG,203.3,132.15,7.93,207.12,51
CDM,63600205,PREVNAR13 PNEUMOCOCCAL VACC IM,814.0,529.1,13.37,814.0,51
CDM,63600210,OMNIPAQUE 350 / 500 ML PER ML,8.25,5.36,0.01,22.96,49
CDM,63600215,"RABIES VACCINE, IM",1491.0,969.15,13.37,1491.0,65
CDM,63600225,ROTOVIRUS VAC ORAL USE,309.0,200.85,13.37,309.0,51
CDM,63600235,ROTAVIRUS VAC 2 DOSE ORAL,402.0,261.3,7.93,402.0,51
CDM,63600240,BOTULINUM TOX B INJ PER 100U,40.65,26.42,2.17,667.03,65
CDM,63600250,INCOBOTULINUMTOXIN A 1 UNIT,25.18,16.37,2.17,667.03,65
CDM,63600255,TYPHOID VI 25MCG/0.5ML SYG,441.0,286.65,7.93,441.0,51
CDM,63600265,DTAP-IPV VACC 4-6 YR IM,210.0,136.5,7.93,328.03,51
CDM,63600275,"DTAP-HIB-IP VACCINE, IM",370.0,240.5,7.93,370.0,51
CDM,63600285,DTAP IMMUNIZATION,102.0,66.3,7.93,102.0,51
CDM,63600295,TETANUS-DIPHTHERIA TOXOID PED,222.0,144.3,7.93,222.0,51
CDM,63600330,CEFTRIAXONE PER 250 MG,6.4,4.16,0.82,8.86,51
CDM,63600345,MUMPS RUBELLA MEA,336.0,218.4,7.93,336.0,51
CDM,63600350,CELESTONE IM 3MG,17.0,11.05,2.17,17.12,51
CDM,63600355,MMRV VACCINE,992.0,644.8,7.93,992.0,51
CDM,63600365,INACTIVE POLIO VACCINE,151.0,98.15,7.93,151.0,51
CDM,63600375,TD VACCINE NO PRSRV >= 7 IM,141.0,91.65,7.93,141.0,51
CDM,63600385,TDAP VACCINE >7 IM,170.0,110.5,7.93,170.0,51
CDM,63600395,VARICELLA VIRUS VACCINE LIVE,657.0,427.05,13.37,657.0,51
CDM,63600405,"YELLOW FEVER VACCINE, SQ LIVE",648.0,421.2,13.37,648.0,51
CDM,63600425,PEDIARIX,312.0,202.8,7.93,312.0,51
CDM,63600430,XIAFLEX INJ 0.01 MG,145.79,94.76,2.17,3257.22,65
CDM,63600435,PNEUMOCOCCAL VACCINE 23V,423.0,274.95,7.93,423.0,51
CDM,63600445,MENOMUNE VAC,344.0,223.6,13.37,344.0,51
CDM,63600455,"MENINGOCOCCAL VACCINE, IM",565.0,367.25,13.37,565.0,51
CDM,63600475,ZOSTAVAX VACC INJ,804.0,522.6,13.37,804.0,51
CDM,63600505,HEP B/PEDIATRIC/ADOLESCEN,104.0,67.6,7.93,104.0,51
CDM,63600515,IMMUNIZATION HEPATITIS,258.0,167.7,7.93,258.0,51
CDM,63600525,"HEPATITIS B VACCINE, IMMUNOSUP",230.0,149.5,13.37,346.93,51
CDM,63600535,IM HEPB-HIB VACCINE,132.0,85.8,7.93,132.0,51
CDM,63600570,METHLYPREDNISOLONE 40MG,28.26,18.37,2.17,28.26,51
CDM,63600575,"GAD-BASE MR CONTRAST NOS,1ML",33.0,21.45,0.01,33.0,49
CDM,63600585,"INJ MULTIHANCE 20 ML, PER 1ML",22.0,14.3,0.01,22.96,49
CDM,63600595,"GAD-BASE MR CONTRAST NOS,1ML",32.0,20.8,0.01,32.0,49
CDM,63600605,"INJ EOVIST GADOXETATE DISODIUM, PER 1ML",147.0,95.55,0.01,147.0,49
CDM,63600615,INJ GADOFOSVESET TRISODIUM ML,118.0,76.7,0.01,118.0,49
CDM,63600625,GADAVIST GADOBUTROL INJ 0.1ML,2.99,1.94,0.01,22.96,49
CDM,63600640,DEXAMETH SOD INJ TO 1MG,3.64,2.37,0.2,8.86,51
CDM,63600650,"OMNIPAQUE 350, 150 ML, PER ML",3.48,2.26,0.01,22.96,49
CDM,63600670,"OMNIPAQUE 350, 100 ML, PER ML",8.25,5.36,0.01,22.96,49
CDM,63600745,"ISOVUE 300, 100 ML, PER ML",8.25,5.36,0.01,22.96,49
CDM,63600800,"GENTAMICIN 80 MG, INJ",7.0,4.55,1.04,8.86,51
CDM,63600895,PENICILLIN G BENZ INJ 100000,15.83,10.29,2.17,130.36,65
CDM,63600905,BOTULINUM TOXIN TYPE A/UNIT,47.69,31.0,2.17,667.03,65
CDM,63600955,TORADOL INJ PER 15 MG,2.14,1.39,0.31,8.86,65
CDM,63601275,STRL SALINE SOLN 500 ML=1 UNIT,23.0,14.95,2.17,23.0,51
CDM,63601295,"NRML SALINE SOLUTION, 250 CC",4.5,2.93,0.67,8.86,51
CDM,63601300,TRIAMCINOLONE ACET INJ 10 MG,19.17,12.46,1.32,19.17,51
CDM,63601315,"INFUSION, D-5-W, 1000 CC",27.0,17.55,2.17,27.0,51
CDM,63601320,"TRIPTORELIN PAMOATE, 3.75 MG",1136.24,738.56,2.17,1372.25,65
CDM,63601340,DIAZEPAM INJ TO 5 MG,18.61,12.1,2.17,19.49,51
CDM,63601365,ETONOGESTREL IMPLANT SYSTEM,1851.65,1203.57,2.17,3163.59,51
CDM,63601400,VITAMIN B-12 INJ TO 1000 MCG,8.0,5.2,1.14,8.86,51
CDM,63601415,HYALGAN/SUPARTZ INJ PER DOSE,1822.37,1184.54,2.17,1822.37,51
CDM,63601425,EUFLEXXA INJ PER DOSE,2682.14,1743.39,2.17,2682.14,65
CDM,63601445,SYNVISC OR SYNVISC-ONE 1 MG,115.49,75.07,2.17,369.35,65
CDM,63601475,METHACHOLINE PER 1 MG,5.88,3.82,0.87,47.96,51
CDM,63601685,LEUPROLIDE ACETATE 7.5 MG,1288.48,837.51,2.17,1676.17,65
CDM,63601805,"APLIGRAFT,9978000199",196.99,128.04,43.53,348.8,51
CDM,63601810,"OASIS WOUND MATRIX,8213100015",45.8,29.77,10.12,348.8,51
CDM,63601860,"INJ PERFLUTREN LIP MICROS, ML",547.87,356.12,2.17,547.87,51
CDM,63601955,HEP A/ADULT,308.0,200.2,7.93,308.0,51
CDM,63601960,HEP A/PEDIATRIC ADOLESEN,138.0,89.7,7.93,138.0,51
CDM,63601965,IM ADULT HEPA-HEPB,472.0,306.8,13.37,472.0,51
CDM,63602155,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,13.37,1106.0,51
CDM,63602165,FLU VACCINE 4 VALENT NASAL,57.0,37.05,7.93,65.34,51
CDM,63602195,FLU VAC NO PRSV 4 VAL,70.0,45.5,7.93,70.0,51
CDM,63602215,"DOTAREM INJ 0.1ML, 20 ML",2.27,1.48,0.01,22.96,49
CDM,63602445,MENB RP W/OMV VACCINE IM,852.0,553.8,13.37,852.0,51
CDM,63602455,MENB RLP VACCINE IM,604.0,392.6,13.37,604.0,51
CDM,63602465,FLUZONE QUADRIVALENT MDV,67.0,43.55,7.93,67.0,51
CDM,63602485,DTAP-IPV-HIB-HEPB VACCINE IM,526.05,341.93,7.93,804.51,51
CDM,63602545,LEVONORGESTREL IU 52MG,1548.63,1006.61,2.17,3164.98,51
CDM,63603055,ORAL PRESCIP DRUG NON CHEMO NOS,2.0,1.3,0.3,47.96,51
CDM,63603105,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,13.37,1106.0,51
CDM,63603225,CNTRST RAD OMPQ 240 100ML,8.25,5.36,0.01,22.96,49
CDM,63603385,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,7.93,109.0,51
CDM,63603395,CCK DOSE,320.0,208.0,2.17,320.0,51
CDM,63603465,CYSTOGRAFIN 300ML,1.5,0.98,0.15,22.96,51
CDM,63603505,FENTANYL 100MCG/2ML INJ,18.61,12.1,1.83,18.61,51
CDM,63603645,DRSG GRAFIX CORE 14MM PER SQCM,1697.0,1103.05,117.73,1697.0,51
CDM,63603685,DRSG GRAFIX PRM 14MM PER SQ CM,1697.0,1103.05,117.73,1697.0,51
CDM,63603785,HEPAT B IM GLOB 5ML/0.5ML TRGR,6329.2,4113.98,941.78,6329.2,43
CDM,63603805,KETOROLAC 30MG/ML INJECTION (2 X15MG INJECTION),7.09,4.61,0.31,8.86,65
CDM,63603855,FIRMAGON (240) 1MG (CUH),22.71,14.76,2.17,940.91,65
CDM,63603865,FIRMAGON (80) 1MG (CUH),22.71,14.76,2.17,940.91,65
CDM,63603875,KETOROLAC 15MG,2.14,1.39,0.01,8.86,61
CDM,63603885,BUPIVACAINE 0.25% 10ML VIAL,11.37,7.39,1.69,47.96,51
CDM,63603895,MIDAZOLAM PER 1MG,9.31,6.05,0.25,9.31,51
CDM,63603905,BUPIVACAINE 0.5% 10ML VIAL,10.72,6.97,1.6,47.96,51
CDM,63603915,BUPIVACAINE 0.75% 10ML VIAL,10.64,6.92,1.58,47.96,51
CDM,63603925,MIDAZOLAM HYDRO 2MG VL,18.61,12.1,0.25,18.61,51
CDM,63603935,"HYALURONAN, SYNVISC 2ML SYR",1847.81,1201.08,2.17,1847.81,65
CDM,63603975,DRSG GRAFIX PRM 2X3 PER SQ CM,967.75,629.04,117.73,967.75,51
CDM,63604025,DRSG PURAPLY AM PER SQ CM,591.55,384.51,88.02,591.55,43
CDM,63604035,DRSG OASIS TRI-LAYER PER SQ CM,67.01,43.56,14.81,348.8,51
CDM,63604045,HEPAT B IM GLOB 1ML/0.5ML TRGR,1299.09,844.41,2.17,1299.09,65
CDM,63604165,HEPATITIS B IMMUNE GLOB 0.5ML,697.88,453.62,2.17,697.88,65
CDM,63604215,INFLUENZA VACCINE,74.7,48.56,7.93,74.7,51
CDM,63604335,FLUBLOK TRIVALENT,284.6,184.99,7.93,284.6,51
CDM,63604385,BETAMETHASONE ACET/SOD PHOS 3MG,23.0,14.95,2.17,23.0,51
CDM,63604425,CONTRAST LOCM 200-299,14.36,9.33,0.01,22.96,49
CDM,63604455,LOCM 250-299 MG/ML PER ML,8.25,5.36,0.01,22.96,49
CDM,63604465,CONTR LOCM 300-399 MG 1 ML,8.25,5.36,0.01,22.96,49
CDM,63604605,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,7.93,69.7,51
CDM,63604635,TORADOL (KETOROLAC) 15MG,17.0,11.05,0.31,17.0,65
CDM,63604645,HZV VACC RECOMBINANT IM NJX,777.0,505.05,13.37,777.0,51
CDM,63604715,"DOTAREM INJ 0.1 ML, 10 ML",2.27,1.48,0.01,22.96,49
CDM,63604755,OMNIPAQUE 300 / 500 ML,3.48,2.26,0.01,22.96,49
CDM,63604765,OMNIPAQUE 300 / 200 ML,8.25,5.36,0.01,22.96,49
CDM,63604775,OMNIPAQUE 300 / 150 ML,8.25,5.36,0.01,22.96,49
CDM,63604785,OMNIPAQUE 300 / 100 ML,3.48,2.26,0.01,22.96,49
CDM,63604795,VISIPAQUE 320 / 100 ML,3.48,2.26,0.01,22.96,49
CDM,63604925,LOCM 300-399MG/ML IODINE 1ML,14.36,9.33,0.01,22.96,49
CDM,63604975,DOTAREM 7.5 MMOL SYRING 15ML,2.27,1.48,0.01,22.96,49
CDM,63605005,SINCALIDE 5MCG VIAL,320.0,208.0,2.17,320.0,51
CDM,63605025,HEPB VACC 2 DOSE ADULT IM,562.0,365.3,7.93,562.0,51
CDM,63605055,FLUBLOK QUADRIVALENT PFS,233.0,151.45,7.93,233.0,51
CDM,63605325,DRSG EPIFIX PER SQ CM,1203.35,782.18,117.73,1203.35,51
CDM,63605355,DRSG PURAPLY AM PER SQ CM,591.55,384.51,117.73,591.55,51
CDM,63605535,GRAFT EPIFIX 2X2 PER SQ CM,629.94,409.46,117.73,629.94,51
CDM,63605575,GRAFT EPIFIX 14MM DISC PER SQ CM,399.0,259.35,88.18,399.0,51
CDM,63605655,VISIPAQUE 320/150 ML,3.48,2.26,0.01,22.96,49
CDM,63605685,GRAFT EPIFIX 2 X 3 PER SQ CM MESH,1716.0,1115.4,117.73,1716.0,51
CDM,63605805,GRFT STRAVIX 2CMX2CM,525.0,341.25,116.03,525.0,51
CDM,63605825,AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE,243.0,157.95,7.93,243.0,51
CDM,63606375,PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677,1018.0,661.7,13.37,1018.0,51
CDM,63606385,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,83.0,53.95,7.93,158.71,51
CDM,63606445,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,13.37,617.0,51
CDM,63606475,"HOCM, 350?399 MG/ML IODINE PER ML",1.83,1.19,0.27,22.96,51
CDM,63606525,"AFFINITY, 1.5CM X 1.5CM",1149.99,747.49,117.73,1149.99,51
CDM,63606535,"AFFINITY, 2.5CM X 2.5CM",546.42,355.17,117.73,566.2,51
CDM,63606765,"D5LR, 1000ML",5.14,3.34,0.76,8.86,51
CDM,63606785,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,7.93,102.0,51
CDM,63606795,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,7.93,758.52,51
CDM,63606805,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,7.93,1106.0,51
CDM,63606885,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,7.93,140.93,51
CDM,63606895,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,7.93,278.0,51
CDM,63606905,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,493.0,320.45,7.93,493.0,51
CDM,63606975,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,309.5,2681.91,51
CDM,63606985,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,309.5,2080.0,51
CDM,63607055,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,0.01,785.7,65
CDM,63607075,"CHIKUNGUNYA VACCINE, LIVE",990.0,643.5,13.37,990.0,51
CDM,63607185,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,0.01,22.96,49
CDM,63607245,"CHIKUNGUNYA VACCINE, RECOMBINANT (VIMKUNYA)",991.0,644.15,13.37,991.0,51
CDM,63607255,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,7.93,465.4,51
CDM,63620AK,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,6864.0,4461.6,1.1,6864.0,50
CDM,63621AK,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,1760.0,1144.0,1.1,1760.0,50
CDM,63650AK,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,3146.0,2044.9,1.1,11676.67,53
CDM,63655AK,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,4805.0,3123.25,1.1,37350.66,50
CDM,63661AK,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,2235.0,1452.75,1.1,3297.28,53
CDM,63662AK,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,4840.0,3146.0,1.1,5809.66,50
CDM,63663AK,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,3410.0,2216.5,1.1,11676.67,53
CDM,63664AK,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,5069.0,3294.85,1.1,23258.37,50
CDM,63685AK,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,2284.0,1484.6,1.1,53018.11,50
CDM,63688AK,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,1914.0,1244.1,1.1,5809.66,50
CDM,63700005,SULFACETAMIDE 10% OPH SOL 15ML,8.42,5.47,1.25,8.42,40
CDM,63700015,EMTRICIT/TENOF 200/300 TAB,354.68,230.54,52.78,354.68,40
CDM,63700025,RALTEGRAVIR 400MG TAB,185.1,120.32,27.54,185.1,40
CDM,63707AK,REPR DURAL/CSF LEAK,5060.0,3289.0,1.1,5060.0,50
CDM,63709AK,REPR DURAL/CSF LEAK W LAMINECTOMY,6260.0,4069.0,1.1,6260.0,50
CDM,63710AK,"DURAL GRAFT REPAIR,SPINE DEFECT",6160.0,4004.0,1.1,6160.0,50
CDM,63740AK,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM,5052.0,3283.8,1.1,5052.0,50
CDM,63744AK,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,3576.0,2324.4,1.1,11373.82,50
CDM,64400AK,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,330.0,214.5,1.1,505.34,53
CDM,64405AK,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,414.0,269.1,1.1,505.34,53
CDM,64408AK,INJECTION AA&/STRD VAGUS NERVE,330.0,214.5,1.1,505.34,53
CDM,64415AK,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,660.0,429.0,1.1,1555.46,53
CDM,64416AK,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,792.0,514.8,1.1,1555.46,50
CDM,64417AK,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,576.0,374.4,1.1,1555.46,53
CDM,64418AK,INJECTION AA&/STRD SUPRASCAPULAR NERVE,484.0,314.6,1.1,1180.93,53
CDM,64420AK,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,475.0,308.75,1.1,1180.93,53
CDM,64421AK,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,220.0,143.0,1.1,1555.46,53
CDM,64425AK,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,440.0,286.0,1.1,1180.93,53
CDM,64430AK,INJECTION AA&/STRD PUDENDAL NERVE,6583.0,4278.95,1.1,6583.0,53
CDM,64430AK-26,INJECTION AA&/STRD PUDENDAL NERVE,440.0,286.0,1.1,440.0,22
CDM,64435AK,INJECTION AA&/STRD PARACERVICAL NERVE,330.0,214.5,1.1,1180.93,53
CDM,64445AK,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,612.0,397.8,1.1,1180.93,53
CDM,64446AK,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,770.0,500.5,1.1,1555.46,50
CDM,64447AK,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,590.0,383.5,1.1,1180.93,53
CDM,64448AK,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,739.0,480.35,1.1,1555.46,50
CDM,64449AK,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,559.0,363.35,1.1,1555.46,50
CDM,64450AK,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,330.0,214.5,1.1,1180.93,53
CDM,64451AK,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,669.0,434.85,1.1,1180.93,52
CDM,64454AK,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,669.0,434.85,1.1,1180.93,52
CDM,64455AK,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,330.0,214.5,1.1,505.34,53
CDM,64461AK,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,770.0,500.5,1.1,1180.93,53
CDM,64462AK,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,484.0,314.6,1.1,484.0,53
CDM,64463AK,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,836.0,543.4,1.1,1180.93,53
CDM,64466AK,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,660.0,429.0,1.1,660.0,51
CDM,64467AK,THORACIC FASCIAL PLANE BLOCK UNI CONT INFUSION,766.0,497.9,1.1,766.0,51
CDM,64468AK,THORACIC FASCIAL PLANE BLOCK BI INJECTION,735.0,477.75,1.1,735.0,51
CDM,64469AK,THORACIC FASCIAL PLANE BLOCK BI CONT INFUSION,805.0,523.25,1.1,1086.42,51
CDM,64473AK,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,590.0,383.5,1.1,590.0,51
CDM,64474AK,LOWER XTR FASCIAL PLANE BLOCK UNI CONT INFUSION,735.0,477.75,1.1,735.0,51
CDM,64479AK,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,1008.0,655.2,1.1,1555.46,53
CDM,64480AK,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,528.0,343.2,1.1,528.0,53
CDM,64483AK,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,836.0,543.4,1.1,1555.46,53
CDM,64484AK,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,440.0,286.0,1.1,440.0,53
CDM,64486AK,TAP BLOCK UNILATERAL BY INJECTION(S),528.0,343.2,1.1,528.0,53
CDM,64487AK,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),612.0,397.8,1.1,712.53,53
CDM,64488AK,TAP BLOCK BILATERAL BY INJECTION(S),616.0,400.4,1.1,616.0,53
CDM,64489AK,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),770.0,500.5,1.1,1157.73,53
CDM,64490AK,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,801.0,520.65,1.1,1555.46,53
CDM,64491AK,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,510.0,331.5,1.1,510.0,53
CDM,64492AK,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,510.0,331.5,1.1,510.0,53
CDM,64493AK,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,669.0,434.85,1.1,1555.46,53
CDM,64494AK,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,440.0,286.0,1.1,440.0,53
CDM,64495AK,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,440.0,286.0,1.1,440.0,53
CDM,64505AK,INJECTION ANES AGENT SPHENOPALATINE GANGLION,598.0,388.7,1.1,598.0,53
CDM,64510AK,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,537.0,349.05,1.1,1555.46,53
CDM,64517AK,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,968.0,629.2,1.1,1555.46,53
CDM,64520AK,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,594.0,386.1,1.1,1555.46,53
CDM,64530AK,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,695.0,451.75,1.1,1555.46,53
CDM,64555AK,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,15993.0,10395.45,1.1,15993.0,53
CDM,64555AK-26,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,2304.0,1497.6,1.1,2304.0,22
CDM,64561AK,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,2394.0,1556.1,1.1,11676.67,53
CDM,64566AK,PERC TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,264.0,171.6,1.1,505.34,53
CDM,64567AK,PERQ ELEC NRV FIELD STIMJ CRANIAL NRV W/O IMPLTJ,660.0,429.0,1.1,2941.43,35
CDM,64575AK,OPEN IMPLANTATION NEA PERIPHERAL NERVE,1768.0,1149.2,1.1,23258.37,50
CDM,64580AK,OPEN IMPLANTATION NEA NEUROMUSCULAR,1676.0,1089.4,1.1,37350.66,50
CDM,64581AK,OPEN IMPLANTATION NEA SACRAL NERVE,5368.0,3489.2,1.1,11676.67,50
CDM,64582AK,OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR,5600.0,3640.0,1.1,53018.11,50
CDM,64583AK,REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR,5800.0,3770.0,1.1,23258.37,50
CDM,64584AK,REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR,4800.0,3120.0,1.1,11373.82,50
CDM,64585AK,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,844.0,548.6,1.1,5809.66,53
CDM,64590AK,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,2244.0,1458.6,1.1,37350.66,53
CDM,64595AK,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,1516.0,985.4,1.1,5809.66,53
CDM,64596AK,INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA,2856.0,1856.4,1.1,23258.37,31
CDM,64597AK,INSJ/RPLCMT PERQ ELTRD RA PN INT NSTIM EA ADD RA,2856.0,1856.4,1.1,2856.0,31
CDM,64598AK,REVISION/REMOVAL NSTIM ELTRD ARRAY PN INT NSTIM,1047.0,680.55,1.1,5809.66,31
CDM,64600AK,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,1396.0,907.4,1.1,1555.46,53
CDM,64605AK,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,2260.0,1469.0,1.1,3297.28,53
CDM,64610AK,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,2880.0,1872.0,1.1,3297.28,53
CDM,64611AK,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BI,412.0,267.8,1.1,505.34,53
CDM,64612AK,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,620.0,403.0,1.1,620.0,53
CDM,64615AK,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,814.0,529.1,1.1,814.0,53
CDM,64616AK,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,673.0,437.45,1.1,673.0,53
CDM,64617AK,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,836.0,543.4,1.1,1180.93,53
CDM,64620AK,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,1272.0,826.8,1.1,1555.46,53
CDM,64624AK,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,1000.0,650.0,1.1,3297.28,52
CDM,64625AK,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,1356.0,881.4,1.1,3297.28,52
CDM,64628AK,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,2860.0,1859.0,1.1,22471.68,50
CDM,64629AK,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,1508.0,980.2,1.1,1508.0,50
CDM,64630AK,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,1342.0,872.3,1.1,1555.46,53
CDM,64632AK,DEST BY NEUROLYTIC AGENT; PLANTAR COMM DIG NERVE,541.0,351.65,1.1,541.0,53
CDM,64633AK,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,1461.0,949.65,1.1,3297.28,53
CDM,64634AK,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,581.0,377.65,1.1,839.02,53
CDM,64635AK,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,1461.0,949.65,1.1,3297.28,53
CDM,64636AK,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,510.0,331.5,1.1,788.06,53
CDM,64640AK,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,871.0,566.15,1.1,1555.46,53
CDM,64642AK,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,726.0,471.9,1.1,1180.93,53
CDM,64643AK,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,537.0,349.05,1.1,537.0,53
CDM,64644AK,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,801.0,520.65,1.1,1180.93,53
CDM,64645AK,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,612.0,397.8,1.1,612.0,53
CDM,64646AK,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,792.0,514.8,1.1,1180.93,53
CDM,64647AK,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,844.0,548.6,1.1,1180.93,53
CDM,64650AK,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,280.0,182.0,1.1,505.34,53
CDM,64653AK,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,352.0,228.8,1.1,505.34,53
CDM,64654AK,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,4840.0,3146.0,1.1,4840.0,35
CDM,64655AK,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,4972.0,3231.8,1.1,4972.0,35
CDM,64656AK,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,3524.0,2290.6,1.1,3524.0,35
CDM,64657AK,REMOVAL BAT MODULATION SYSTEM TOTAL SYSTEM,5337.0,3469.05,1.1,5337.0,35
CDM,64658AK,REMOVAL BAT MODULATION SYSTEM LEAD ONLY,3938.0,2559.7,1.1,3938.0,35
CDM,64659AK,REMOVAL BAT MODULATION SYSTEM PG ONLY,3621.0,2353.65,1.1,3621.0,35
CDM,64680AK,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,1175.0,763.75,1.1,1555.46,53
CDM,64681AK,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,1512.0,982.8,1.1,1555.46,53
CDM,64702AK,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,2504.0,1627.6,1.1,3297.28,50
CDM,64704AK,NEUROPLASTY NERVE HAND/FOOT,1876.0,1219.4,1.1,3297.28,50
CDM,64708AK,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,2544.0,1653.6,1.1,3297.28,50
CDM,64712AK,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,3228.0,2098.2,1.1,3297.28,50
CDM,64713AK,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,4560.0,2964.0,1.1,4560.0,50
CDM,64716AK,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,3076.0,1999.4,1.1,3297.28,50
CDM,64718AK,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,2904.0,1887.6,1.1,3297.28,50
CDM,64719AK,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,1988.0,1292.2,1.1,3297.28,50
CDM,64721AK,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,1988.0,1292.2,1.1,3297.28,53
CDM,64727AK,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,1240.0,806.0,1.1,1240.0,50
CDM,64728AK,DCMPRN MEDIAN NRV AT CARPL TUNL PERQ BALO DILAT,1188.0,772.2,1.1,3441.81,35
CDM,64772AK,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,3136.0,2038.4,1.1,3297.28,50
CDM,64774AK,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,2320.0,1508.0,1.1,3297.28,50
CDM,64776AK,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,2240.0,1456.0,1.1,3297.28,50
CDM,64782AK,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,2744.0,1783.6,1.1,3297.28,50
CDM,64784AK,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,4248.0,2761.2,1.1,4248.0,50
CDM,64787AK,IMPLANT NERVE END TO BONE/MUSC,1716.0,1115.4,1.1,1716.0,50
CDM,64788AK,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,2096.0,1362.4,1.1,3297.28,50
CDM,64790AK,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,4840.0,3146.0,1.1,4840.0,50
CDM,64792AK,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,6344.0,4123.6,1.1,11373.82,50
CDM,64795AK,BIOPSY OF NERVE,1204.0,782.6,1.1,3297.28,50
CDM,64820AK,"SYMPATHECTOMY,DIGITAL ARTERIES",4296.0,2792.4,1.1,4296.0,50
CDM,64821AK,SYMPATHECTOMY RADIAL ARTERY,3732.0,2425.8,1.1,5526.53,50
CDM,64822AK,SYMPATHECTOMY ULNAR ARTERY,3732.0,2425.8,1.1,5526.53,50
CDM,64823AK,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,4376.0,2844.4,1.1,5526.53,50
CDM,64831AK,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,3664.0,2381.6,1.1,3664.0,50
CDM,64832AK,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,2260.0,1469.0,1.1,2260.0,50
CDM,64834AK,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,4324.0,2810.6,1.1,11373.82,50
CDM,64835AK,SUTURE 1 NERVE MEDIAN MOTOR THENAR,5161.0,3354.65,1.1,11373.82,50
CDM,64836AK,SUTURE 1 NERVE ULNAR MOTOR,4692.0,3049.8,1.1,11373.82,50
CDM,64837AK,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,2500.0,1625.0,1.1,2500.0,50
CDM,64856AK,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,6028.0,3918.2,1.1,11373.82,50
CDM,64857AK,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,6328.0,4113.2,1.1,11373.82,50
CDM,64859AK,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,1700.0,1105.0,1.1,1700.0,50
CDM,64864AK,SUTURE FACIAL NERVE EXTRACRANIAL,5900.0,3835.0,1.1,11373.82,50
CDM,64868AK,ANAST FACIAL-HYPOGLOSSAL NERVE,5960.0,3874.0,1.1,5960.0,50
CDM,64876AK,"REPAIR NERVE DELAY,SHORTEN BONE",1348.0,876.2,1.1,1348.0,50
CDM,64892AK,"NERVE GRAFT,ARM/LEG,ONE,UP TO 4CM",6296.0,4092.4,1.1,11373.82,50
CDM,64898AK,NERVE GRAFT MULTI STR ARM/LEG; > 4 CM,8388.0,5452.2,1.1,11373.82,50
CDM,64905AK,"NERVE PEDICLE XFER,FIRST STAGE",6044.0,3928.6,1.1,11373.82,50
CDM,64910AK,NERVE REPAIR W/CONDUIT EACH NERVE,4629.0,3008.85,1.1,11373.82,50
CDM,64911AK,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,5600.0,3640.0,1.1,11373.82,50
CDM,64912AK,NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND,4800.0,3120.0,1.1,11373.82,50
CDM,64913AK,NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND,1200.0,780.0,1.1,1200.0,50
CDM,64999AGRVU1AK,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 62223",2410.0,1566.5,0.01,2410.0,28
CDM,64999AGRVU2AK,"UNLISTED PROC, NERVOUS SYSTEM COMPARED TO 64905",4986.0,3240.9,0.01,4986.0,28
CDM,64999AGRVU3AK,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",474.0,308.1,0.01,505.34,28
CDM,64999AGRVUAK,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 15271",160.0,104.0,0.01,505.34,28
CDM,64999RVU18AK,LASER INTERSTITIAL THERMAL THERAPY(LITT,10174.0,6613.1,0.01,10174.0,28
CDM,64999RVU24AK,GANGLION IMPAR BLOCK INJ,419.0,272.35,0.01,505.34,28
CDM,64999RVU44AK,NERVE WRAPPING (COMP CODE 15271),646.0,419.9,0.01,646.0,28
CDM,64999RVU4AK,ENDOS TRANSNASAL INTRACRANIAL BIOPSY (COMP CODE 61570),8526.0,5541.9,0.01,8526.0,28
CDM,64999RVU52AK,"INJ, ANESTHETIC AGENT; CERVICAL PLEXUS (COMP 64425)",578.0,375.7,0.01,578.0,28
CDM,64999RVU54AK,"UNLISTED PROC, INJECTION, ANESTHETIC AGENT, CERVICAL PLEXUS (COM",488.0,317.2,0.01,505.34,28
CDM,64999RVU58AK,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),566.0,367.9,0.01,566.0,28
CDM,64999RVU59AK,APPLICATION OF QUTENZA (CAPSAICIN 8% TOPICAL SYSTEM) (COMP CODE,488.0,317.2,0.01,505.34,28
CDM,64999RVU60AK,GANGLION OF IMPAR BLOCKADE UNDER FLUOROSCOPIC GUIDANCE (COMP COD,171.0,111.15,0.01,505.34,28
CDM,64999RVU61AK,"ERECTOR SPINAE BLOCKAGE, RIGHT T7 UNDER FLUOROSCOPIC GUIDANCE (C",569.0,369.85,0.01,569.0,28
CDM,64999RVU69AK,PECS 1 & PECS 2 UNILAT CONTINUOUS INFUSION CATH (COMP CODE 64487,629.0,408.85,0.01,629.0,28
CDM,64999RVU6AK,MASSETER NRV TO FAC NRV ANASTOMOSIS (COMP 64865),4917.0,3196.05,0.01,4917.0,28
CDM,64999RVU82AK,LARYNGEAL REINNERVATION USING CERVICAL NERVE BRANCHES (COMP CODE,6059.0,3938.35,0.01,6059.0,28
CDM,64999RVU83AK,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),1175.0,763.75,0.01,1175.0,28
CDM,64999RVU84AK,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),414.0,269.1,0.01,505.34,28
CDM,64999RVU85AK,TRANSPALATAL APPROACH FOR REMOVAL OF FOREIGN BODY (61575),14624.0,9505.6,0.01,14624.0,28
CDM,65205AK,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,216.0,140.4,1.1,218.62,51
CDM,65210AK,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,268.0,174.2,1.1,680.96,53
CDM,65220AK,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,312.0,202.8,1.1,680.96,53
CDM,65222AK,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,370.0,240.5,1.1,370.0,53
CDM,65430AK,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,588.0,382.2,1.1,680.96,53
CDM,66160AK,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,5452.0,3543.8,1.1,5452.0,50
CDM,66174AK,TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST,3353.0,2179.45,1.1,6942.21,50
CDM,66683AK,IMPLTJ IRIS PROSTHESIS W/SUTR FIXJ&RPR/RMVL IRIS,4695.0,3051.75,1.1,4695.0,49
CDM,66984AK,XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP,3234.0,2102.1,1.1,3978.24,50
CDM,66989AK,XCAPSL CTRC RMVL INSJ IO LENS PRSTH CPLX INSJ 1+,4852.0,3153.8,1.1,8924.16,50
CDM,66991AK,XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+,4061.0,2639.65,1.1,8924.16,50
CDM,67028AK,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,634.0,412.1,1.1,634.0,53
CDM,67229AK,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,7172.0,4661.8,1.1,7172.0,50
CDM,67299RVU7AK,AUTOLOGOUS RETINAL GRAFT (COMP 67042),6532.0,4245.8,0.01,6532.0,28
CDM,67412AK,ORBITTMY W/O BN FLP W REM LESION,4120.0,2678.0,1.1,4120.0,50
CDM,67516AK,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,673.0,437.45,1.1,673.0,52
CDM,67700AK,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,560.0,364.0,1.1,927.24,53
CDM,67715AK,CANTHOTOMY SEPARATE PROCEDURE,508.0,330.2,1.1,3988.99,53
CDM,67800AK,"EXCIS CHALAZION,SINGLE",564.0,366.6,1.1,564.0,53
CDM,67810AK,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,519.0,337.35,1.1,606.77,53
CDM,67820AK,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,141.0,91.65,1.1,218.62,53
CDM,67875AK,TEMP CLOSURE EYELID BY SUTURE,540.0,351.0,1.1,1729.28,53
CDM,67900AK,REPAIR BROW PTOSIS,3001.0,1950.65,1.1,3988.99,53
CDM,67904AK,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,3507.0,2279.55,1.1,3988.99,53
CDM,67912AK,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,2544.0,1653.6,1.1,3988.99,53
CDM,67914AK,"FIX ECTROPION,SUTURE",1500.0,975.0,1.1,3988.99,53
CDM,67917AK,REPAIR ECTROPION EXTENSIVE,2372.0,1541.8,1.1,3988.99,53
CDM,67935AK,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,2544.0,1653.6,1.1,3988.99,53
CDM,67938AK,"REMOVE EYELID FOREIGN BODY,EMBEDDED",552.0,358.8,1.1,889.47,53
CDM,67950AK,CANTHOPLASTY LATERAL,2636.0,1713.4,1.1,3988.99,53
CDM,67999RVU3AK,FACELIFT - ENDOSCOPIC,2760.0,1794.0,0.01,2760.0,28
CDM,67999RVU4AK,FOREHEAD LIFT - ENDOSCOPIC,3346.0,2174.9,0.01,3346.0,28
CDM,67999RVU5AK,"ORBICULARIS OCULI LATERAL MYECTOMY, UNILATERAL (COMP CODE 15823)",2996.0,1947.4,0.01,2996.0,28
CDM,68100005,TRAUMA LVL 1 - CAT 1 - NO CC,4227.0,2747.55,628.98,4227.0,48
CDM,68100015,TRAUMA LVL 1 - CAT 1,5293.0,3440.45,54.56,5293.0,71
CDM,68100025,TRAUMA LVL 1 - CAT 2,5293.0,3440.45,54.56,5293.0,71
CDM,68100035,TRAUMA LVL 1 - CAT 3,5293.0,3440.45,54.56,5293.0,71
CDM,68100045,TRAUMA LVL 1 - CAT 2 - NO CC,4227.0,2747.55,628.98,4227.0,48
CDM,68100055,TRAUMA LVL 1 - CAT 3 - NO CC,4227.0,2747.55,628.98,4227.0,48
CDM,68200005,TRAUMA LVL 2 - CAT 1 - NO CC,4227.0,2747.55,628.98,4227.0,48
CDM,68200035,TRAUMA LVL 2 - CAT 3 - NO CC,4227.0,2747.55,628.98,4227.0,48
CDM,68841AK,INSJ RX ELUTING IMPLT PUNCTAL DILAT LAC CANAL EA,216.0,140.4,1.1,3988.99,52
CDM,69000AK,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,660.0,429.0,1.1,1200.64,53
CDM,69005AK,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,864.0,561.6,1.1,2768.64,53
CDM,69020AK,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,612.0,397.8,1.1,1200.64,53
CDM,69090AK,EAR PIERCING,67.0,43.55,1.1,176.73,32
CDM,69100AK,BIOPSY EXTERNAL EAR,324.0,210.6,1.1,417.54,53
CDM,69100URVUAK,BIOPSY OF EXTERNAL EAR,167.0,108.55,1.1,417.54,53
CDM,69110AK,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,1412.0,917.8,1.1,4850.94,53
CDM,69145AK,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,1080.0,702.0,1.1,4850.94,53
CDM,69200AK,RMVL FB XTRNL AUDITORY CANAL W/O ANES,339.0,220.35,1.1,339.0,53
CDM,69205AK,RMVL FB XTRNL AUDITORY CANAL ANES,532.0,345.8,1.1,2768.64,50
CDM,69209AK,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,258.0,167.7,1.1,258.0,50
CDM,69210AK,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,268.0,174.2,1.1,268.0,53
CDM,69220AK,"DEBRID MASTOIDECTOM CAVITY,SIMP",332.0,215.8,1.1,342.27,53
CDM,69399RVU1AK,REVISION OF OSSEOINTEGRATED BONE ANCHORED IMPANT ABUTMENT (COMP,3164.0,2056.6,0.01,3164.0,28
CDM,69399RVU2AK,ENDOSCOPIC EXTERNAL AUDITORY CANAL (COMP CODE 69200),339.0,220.35,0.01,417.54,28
CDM,69420AK,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,552.0,358.8,1.1,634.79,53
CDM,69421AK,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,783.0,508.95,1.1,5497.86,50
CDM,69433AK,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,628.0,408.2,1.1,939.01,53
CDM,69436AK,TYMPANOSTOMY GENERAL ANESTHESIA,884.0,574.6,1.1,2603.78,50
CDM,69501AK,TRANSMASTOID ANTROTOMY,3684.0,2394.6,1.1,9999.36,50
CDM,69540AK,EXCISION AURAL POLYP,500.0,325.0,1.1,2603.78,53
CDM,69610AK,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,1967.0,1278.55,1.1,2603.78,53
CDM,69620AK,MYRINGOPLASTY,2653.0,1724.45,1.1,5497.86,53
CDM,69631AK,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,4020.0,2613.0,1.1,9999.36,50
CDM,69636AK,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,6172.0,4011.8,1.1,9999.36,50
CDM,69643AK,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,6860.0,4459.0,1.1,9999.36,50
CDM,69644AK,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,6892.0,4479.8,1.1,9999.36,50
CDM,69645AK,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,6684.0,4344.6,1.1,9999.36,50
CDM,69705AK,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,1200.0,780.0,1.1,9999.36,52
CDM,69706AK,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,1708.0,1110.2,1.1,9999.36,52
CDM,69716AK,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,3612.0,2347.8,1.1,22471.68,50
CDM,69719AK,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,4162.0,2705.3,1.1,22471.68,50
CDM,69726AK,REMOVAL OI IMPLT SKULL PERQ ATTACHMENT ESP,2544.0,1653.6,1.1,5526.53,50
CDM,69727AK,REMOVAL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP<100,2952.0,1918.8,1.1,5526.53,50
CDM,69728AK,RMVL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP>=100,3400.0,2210.0,1.1,5526.53,50
CDM,69729AK,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,3988.0,2592.2,1.1,22471.68,50
CDM,69730AK,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,4100.0,2665.0,1.1,22471.68,50
CDM,69801AK,LABYRINTHOTOMY TRANSCANAL,906.0,588.9,1.1,2603.78,53
CDM,69905AK,"EXCIS LABYRINTH,TRANSCANAL",4954.0,3220.1,1.1,9999.36,50
CDM,69990AK,MICROSURG TQS REQ USE OPERATING MICROSCOPE,1384.0,899.6,1.1,1384.0,50
CDM,70000045,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,44.82,726.0,61
CDM,70030AK,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,687.0,446.55,1.1,687.0,51
CDM,70030AK-26,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,79.0,51.35,1.1,79.0,45
CDM,70100AK,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,680.0,442.0,1.1,680.0,51
CDM,70100AK-26,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,72.0,46.8,1.1,72.0,45
CDM,70110AK,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,834.0,542.1,1.1,834.0,51
CDM,70110AK-26,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,100.0,65.0,1.1,100.0,45
CDM,70140AK,RADEX FACIAL BONES < 3 VIEWS,684.0,444.6,1.1,684.0,51
CDM,70140AK-26,RADEX FACIAL BONES < 3 VIEWS,76.0,49.4,1.1,76.0,45
CDM,70150AK,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,838.0,544.7,1.1,838.0,51
CDM,70150AK-26,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,104.0,67.6,1.1,104.0,45
CDM,70160AK,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,676.0,439.4,1.1,676.0,51
CDM,70160AK-26,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,68.0,44.2,1.1,68.0,45
CDM,70200AK,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,846.0,549.9,1.1,846.0,51
CDM,70200AK-26,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,112.0,72.8,1.1,112.0,45
CDM,70210AK,RADEX SINUSES PARANASAL <3 VIEWS,676.0,439.4,1.1,676.0,51
CDM,70210AK-26,RADEX SINUSES PARANASAL <3 VIEWS,68.0,44.2,1.1,68.0,45
CDM,70220AK,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,705.0,458.25,1.1,705.0,51
CDM,70220AK-26,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,97.0,63.05,1.1,97.0,45
CDM,70250AK,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,813.0,528.45,1.1,813.0,51
CDM,70250AK-26,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,79.0,51.35,1.1,79.0,45
CDM,70260AK,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,846.0,549.9,1.1,846.0,51
CDM,70260AK-26,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,112.0,72.8,1.1,112.0,45
CDM,70300AK,RADIOLOGIC EXAMINATION TEETH 1 VIEW,648.0,421.2,1.1,648.0,51
CDM,70300AK-26,RADIOLOGIC EXAMINATION TEETH 1 VIEW,40.0,26.0,1.1,40.0,45
CDM,70320AK,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,1756.0,1141.4,1.1,1756.0,51
CDM,70320AK-26,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,88.0,57.2,1.1,88.0,45
CDM,70330AK,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,704.0,457.6,1.1,704.0,51
CDM,70330AK-26,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,96.0,62.4,1.1,96.0,45
CDM,70336AK,MRI TEMPOROMANDIBULAR JOINT,592.0,384.8,1.1,592.0,45
CDM,70350AK,CEPHALOGRAM ORTHODONTIC,676.0,439.4,1.1,676.0,51
CDM,70350AK-26,CEPHALOGRAM ORTHODONTIC,68.0,44.2,1.1,68.0,45
CDM,70355AK,ORTHOPANTOGRAM,696.0,452.4,1.1,696.0,51
CDM,70355AK-26,ORTHOPANTOGRAM,88.0,57.2,1.1,88.0,45
CDM,70360AK,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,687.0,446.55,1.1,687.0,51
CDM,70360AK-TC,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,608.0,395.2,1.1,608.0,46
CDM,70450AK,CT HEAD/BRAIN W/O CONTRAST MATERIAL,1108.0,720.2,1.1,1108.0,51
CDM,70450AK-26,CT HEAD/BRAIN W/O CONTRAST MATERIAL,374.0,243.1,1.1,374.0,45
CDM,70450AK-TC,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,46
CDM,70460AK,CT HEAD/BRAIN W/CONTRAST MATERIAL,497.0,323.05,1.1,497.0,45
CDM,70470AK,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1787.0,1161.55,1.1,1787.0,51
CDM,70470AK-26,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,559.0,363.35,1.1,559.0,45
CDM,70470AK-TC,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,46
CDM,70471AK,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,3559.0,2313.35,1.1,3559.0,36
CDM,70471AK-26,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,1100.0,715.0,1.1,1100.0,36
CDM,70471AK-TC,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,2459.0,1598.35,1.1,2459.0,37
CDM,70472AK,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1567.0,1018.55,1.1,1567.0,36
CDM,70472AK-26,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,339.0,220.35,1.1,339.0,36
CDM,70472AK-TC,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1228.0,798.2,1.1,1228.0,37
CDM,70473AK,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1676.0,1089.4,1.1,1676.0,36
CDM,70473AK-26,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,440.0,286.0,1.1,440.0,36
CDM,70473AK-TC,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1236.0,803.4,1.1,1236.0,37
CDM,70480AK,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,1297.0,843.05,1.1,1297.0,51
CDM,70480AK-26,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,563.0,365.95,1.1,563.0,45
CDM,70480AK-TC,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,734.0,477.1,1.1,734.0,46
CDM,70481AK,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,497.0,323.05,1.1,497.0,45
CDM,70482AK,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,559.0,363.35,1.1,559.0,45
CDM,70486AK,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,1108.0,720.2,1.1,1108.0,51
CDM,70486AK-26,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,374.0,243.1,1.1,374.0,45
CDM,70487AK,CT MAXILLOFACIAL W/CONTRAST MATERIAL,497.0,323.05,1.1,497.0,45
CDM,70488AK,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,559.0,363.35,1.1,559.0,45
CDM,70490AK,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,563.0,365.95,1.1,563.0,45
CDM,70491AK,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1835.0,1192.75,1.1,1835.0,51
CDM,70491AK-26,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,607.0,394.55,1.1,607.0,45
CDM,70491AK-TC,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,46
CDM,70492AK,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,713.0,463.45,1.1,713.0,45
CDM,70496AK,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1998.0,1298.7,1.1,1998.0,51
CDM,70496AK-26,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,770.0,500.5,1.1,770.0,45
CDM,70496AK-TC,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,46
CDM,70498AK,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1998.0,1298.7,1.1,1998.0,51
CDM,70498AK-26,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,770.0,500.5,1.1,770.0,45
CDM,70498AK-TC,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,46
CDM,70540AK,MRI ORBIT FACE &/NECK W/O CONTRAST,594.0,386.1,1.1,594.0,45
CDM,70542AK,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,3112.0,2022.8,1.1,3112.0,51
CDM,70542AK-26,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,648.0,421.2,1.1,648.0,45
CDM,70542AK-TC,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,46
CDM,70543AK,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3324.0,2160.6,1.1,3324.0,51
CDM,70543AK-26,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,860.0,559.0,1.1,860.0,45
CDM,70543AK-TC,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,46
CDM,70544AK,"MRA, HEAD W/O CONTRAST",2148.0,1396.2,1.1,2148.0,51
CDM,70544AK-26,"MRA, HEAD W/O CONTRAST",480.0,312.0,1.1,480.0,45
CDM,70544AK-TC,"MRA, HEAD W/O CONTRAST",1668.0,1084.2,1.1,1668.0,46
CDM,70546AK,MRA; HEAD W & WO CONTRAST,651.0,423.15,1.1,651.0,45
CDM,70547AK,"MRA, NECK; W/O CONTRAST",2196.0,1427.4,1.1,2196.0,51
CDM,70547AK-26,"MRA, NECK; W/O CONTRAST",528.0,343.2,1.1,528.0,45
CDM,70547AK-TC,"MRA, NECK; W/O CONTRAST",1668.0,1084.2,1.1,1668.0,46
CDM,70549AK,"MRA,NECK; W/WO CONTRAST",3184.0,2069.6,1.1,3184.0,51
CDM,70549AK-26,"MRA,NECK; W/WO CONTRAST",720.0,468.0,1.1,720.0,45
CDM,70551AK,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,2319.0,1507.35,1.1,2319.0,51
CDM,70551AK-26,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,651.0,423.15,1.1,651.0,45
CDM,70551AK-TC,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,1668.0,46
CDM,70552AK,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,783.0,508.95,1.1,783.0,45
CDM,70553AK,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,3360.0,2184.0,1.1,3360.0,51
CDM,70553AK-26,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,1008.0,655.2,1.1,1008.0,45
CDM,70553AK-TC,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,2375.0,1543.75,1.1,2375.0,46
CDM,71000010,PHASE II RECOVERY 1ST 30 MIN,489.0,317.85,72.76,489.0,38
CDM,71000020,PHASE II RECOVERY EA ADD 15 MI,150.0,97.5,22.32,150.0,38
CDM,71000060,PHASE I RECOVERY EA ADD 15 MIN,150.0,97.5,22.32,150.0,38
CDM,71000070,PHASE I RECOVERY 1ST 30 MIN,549.0,356.85,81.69,549.0,38
CDM,71000385,OB OR RECOVERY,814.0,529.1,121.12,814.0,38
CDM,71000395,OB VAG RECOVERY,717.0,466.05,106.69,717.0,38
CDM,71000415,RECOVERY ROOM BASE RATE,405.0,263.25,60.26,405.0,38
CDM,71000435,RECOVERY CARE PER HOUR - DEL,405.0,263.25,60.26,405.0,38
CDM,71000510,RECOVERY OUTSIDE DELIVERY,360.0,234.0,53.57,360.0,38
CDM,71000695,RECOVERY ROOM MED/SURG > 24 HRS PER HR (MANUAL),98.0,63.7,14.58,98.0,38
CDM,71000705,RECOVERY ROOM PERINATAL > 24 HRS PER HR (MANUAL),157.0,102.05,23.36,157.0,38
CDM,71000715,RECOVERY ROOM ORTHO > 24 HRS PER HR (MANUAL),98.0,63.7,14.58,98.0,38
CDM,71000725,RECOVERY ROOM ONCOLOGY > 24 HRS PER HR (MANUAL),98.0,63.7,14.58,98.0,38
CDM,71000735,RECOVERY ROOM 6100 PSYCH > 24 HRS PER HR (MANUAL),116.0,75.4,17.26,116.0,38
CDM,71000745,RECOVERY ROOM 6400 PSYCH > 24 HRS PER HR (MANUAL),116.0,75.4,17.26,116.0,38
CDM,71000755,RECOVERY ROOM L&D/OB TRIAGE > 24 HRS PER HR (MANUAL),90.0,58.5,13.39,90.0,38
CDM,71000765,RECOVERY ROOM PACU > 24 HRS PER HR (MANUAL),333.0,216.45,49.55,333.0,38
CDM,71000875,EXTENDED RECOVERY,2218.0,1441.7,330.04,2218.0,38
CDM,71000885,OP-POST IR/CATH/IMAGING RECOVERY,1458.0,947.7,216.95,1458.0,38
CDM,71045AK,RADIOLOGIC EXAM CHEST SINGLE VIEW,687.0,446.55,1.1,687.0,51
CDM,71045AK-26,RADIOLOGIC EXAM CHEST SINGLE VIEW,79.0,51.35,1.1,79.0,45
CDM,71046AK,RADIOLOGIC EXAM CHEST 2 VIEWS,705.0,458.25,1.1,705.0,51
CDM,71046AK-26,RADIOLOGIC EXAM CHEST 2 VIEWS,97.0,63.05,1.1,97.0,45
CDM,71046AK-TC,RADIOLOGIC EXAM CHEST 2 VIEWS,562.0,365.3,1.1,562.0,46
CDM,71047AK,RADIOLOGIC EXAM CHEST 3 VIEWS,727.0,472.55,1.1,727.0,51
CDM,71047AK-26,RADIOLOGIC EXAM CHEST 3 VIEWS,119.0,77.35,1.1,119.0,45
CDM,71048AK,RADIOLOGIC EXAM CHEST 4+ VIEWS,870.0,565.5,1.1,870.0,51
CDM,71048AK-26,RADIOLOGIC EXAM CHEST 4+ VIEWS,136.0,88.4,1.1,136.0,45
CDM,71100AK,RADEX RIBS UNILATERAL 2 VIEWS,696.0,452.4,1.1,696.0,51
CDM,71100AK-26,RADEX RIBS UNILATERAL 2 VIEWS,88.0,57.2,1.1,88.0,45
CDM,71101AK,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,842.0,547.3,1.1,842.0,51
CDM,71101AK-26,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,108.0,70.2,1.1,108.0,45
CDM,71110AK,RADEX RIBS BILATERAL 3 VIEWS,862.0,560.3,1.1,862.0,51
CDM,71110AK-26,RADEX RIBS BILATERAL 3 VIEWS,128.0,83.2,1.1,128.0,45
CDM,71111AK,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,862.0,560.3,1.1,862.0,51
CDM,71111AK-26,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,128.0,83.2,1.1,128.0,45
CDM,71120AK,RADEX STERNUM MINIMUM 2 VIEWS,696.0,452.4,1.1,696.0,51
CDM,71120AK-26,RADEX STERNUM MINIMUM 2 VIEWS,88.0,57.2,1.1,88.0,45
CDM,71130AK,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,705.0,458.25,1.1,705.0,51
CDM,71130AK-26,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,97.0,63.05,1.1,97.0,45
CDM,71250AK,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,1144.0,743.6,1.1,1144.0,51
CDM,71250AK-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,475.0,308.75,1.1,475.0,45
CDM,71250AK-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,679.0,441.35,1.1,679.0,46
CDM,71260AK,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1634.0,1062.1,1.1,1634.0,51
CDM,71260AK-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,510.0,331.5,1.1,510.0,45
CDM,71260AK-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1135.0,737.75,1.1,1135.0,46
CDM,71270AK,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,550.0,357.5,1.1,550.0,45
CDM,71271AK,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,1209.0,785.85,1.1,1209.0,51
CDM,71271AK-26,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,475.0,308.75,1.1,475.0,45
CDM,71275AK,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,2029.0,1318.85,1.1,2029.0,51
CDM,71275AK-26,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,801.0,520.65,1.1,801.0,45
CDM,71275AK-TC,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,46
CDM,71550AK,MRI CHEST W/O CONTRAST MATERIAL,584.0,379.6,1.1,584.0,45
CDM,71552AK,MRI CHEST W/O & W/CONTRAST MATERIAL,904.0,587.6,1.1,904.0,45
CDM,7155526AK-26-39,MR ANGIO CHEST (MRA),796.0,517.4,1.1,796.0,45
CDM,7155526AK-26-40,MRA CHEST W/O & W/CONTRAST MATERIAL,796.0,517.4,1.1,796.0,45
CDM,71555AK-26,MRA CHEST WITH OR W/O CONT,796.0,517.4,1.1,796.0,45
CDM,71555AK-41,MRA CHEST WITH OR W/O CONT,7070.0,4595.5,1.1,7070.0,51
CDM,71555AK-42,MR ANGIO CHEST (MRA),7070.0,4595.5,1.1,7070.0,51
CDM,71555AK-43,MRA CHEST W/O & W/CONTRAST MATERIAL,7070.0,4595.5,1.1,7070.0,51
CDM,71555CAK,MRA CHEST W CONTRAST,7070.0,4595.5,1.1,7070.0,51
CDM,71555CAK-26,MRA CHEST W CONTRAST,796.0,517.4,1.1,796.0,45
CDM,71555CAK-TC,MRA CHEST W CONTRAST,6274.0,4078.1,1.1,6274.0,46
CDM,71555TCAK-TC-44,MR ANGIO CHEST (MRA),6274.0,4078.1,1.1,6274.0,46
CDM,71555TCAK-TC-45,MRA CHEST W/O & W/CONTRAST MATERIAL,6274.0,4078.1,1.1,6274.0,46
CDM,72000045,DELIVERY OF PLACENTA,12718.0,8266.7,151.5,12718.0,61
CDM,72000055,D AND C,4940.0,3211.0,735.07,4940.0,38
CDM,72000065,EVAC OF HEMATOMA,3021.0,1963.65,449.52,3021.0,38
CDM,72000075,PEUA (PELVIC EX UNDER ANESTH),926.0,601.9,137.79,926.0,38
CDM,72000085,REPAIR LACER/EXAM UNDER ANESTH,2228.0,1448.2,331.53,2228.0,38
CDM,72000095,CESAREAN SECTION SINGLE,7913.0,5143.45,1177.45,7913.0,38
CDM,72000105,CESAREAN SECTION TWINS,8853.0,5754.45,1317.33,8853.0,38
CDM,72000115,CESAREAN SECTION MULTI>2,9168.0,5959.2,1364.2,9168.0,38
CDM,72000125,TUBAL LIGATION,1239.0,805.35,184.36,1239.0,38
CDM,72000135,HYSTERECTOMY,2904.0,1887.6,432.12,2904.0,38
CDM,72000145,POSTPARTUM TUBAL,7074.0,4598.1,1052.61,7074.0,38
CDM,72000155,CYST/MOLE REMOVAL,324.0,210.6,48.21,324.0,38
CDM,72000195,"CERCLAGE CERVIX, PREG VAG",4791.0,3114.15,712.9,4791.0,38
CDM,72000205,CERCLAGE - REMOVAL,4791.0,3114.15,712.9,4791.0,38
CDM,72000215,DELIVERY OF PLACENTA ONLY,12718.0,8266.7,151.5,12718.0,61
CDM,72000225,PUBS W/TRANSFUSION,2468.0,1604.2,367.24,2468.0,38
CDM,72000235,DILATION W/CURETTAGE/EVAC,4940.0,3211.0,735.07,4940.0,38
CDM,72000245,CLASS I INITIAL,1369.0,889.85,203.71,1369.0,38
CDM,72000255,CLASS I PER MINUTE,38.0,24.7,5.65,38.0,38
CDM,72000265,CLASS II INITIAL,2796.0,1817.4,416.04,2796.0,38
CDM,72000275,CLASS II PER MINUTE,38.0,24.7,5.65,38.0,38
CDM,72000355,VAGINAL DEL TWINS W/DBL SET-UP,670.0,435.5,99.7,670.0,38
CDM,72000375,VAGINAL DELIVERY W/DBL SET-UP,670.0,435.5,99.7,670.0,38
CDM,72000385,AMNIOINFUSION,629.0,408.85,93.6,629.0,38
CDM,72000395,LABOR ROOM - PER HOUR,377.0,245.05,56.1,377.0,38
CDM,72000415,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,1217.0,791.05,281.07,3004.0,61
CDM,72000425,FETAL MONITORING LABOR PHYS WRITTEN REPORT,380.0,247.0,82.84,380.0,46
CDM,72000465,FETAL NST TEST,805.0,523.25,79.6,805.0,61
CDM,72000515,FETAL NST TEST,805.0,523.25,79.6,805.0,61
CDM,72000535,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,1217.0,791.05,110.8,3004.0,61
CDM,72001005,EPISIOTOMY OR VAGINAL RPR,3136.0,2038.4,466.64,3136.0,38
CDM,72020AK,RADEX SPINE 1 VIEW SPECIFY LEVEL,672.0,436.8,1.1,672.0,51
CDM,72020AK-26,RADEX SPINE 1 VIEW SPECIFY LEVEL,64.0,41.6,1.1,64.0,45
CDM,72040AK,RADEX SPINE CERVICAL 2 OR 3 VIEWS,705.0,458.25,1.1,705.0,51
CDM,72040AK-26,RADEX SPINE CERVICAL 2 OR 3 VIEWS,97.0,63.05,1.1,97.0,45
CDM,72050AK,RADEX SPINE CERVICAL 4 OR 5 VIEWS,853.0,554.45,1.1,853.0,51
CDM,72050AK-26,RADEX SPINE CERVICAL 4 OR 5 VIEWS,119.0,77.35,1.1,119.0,45
CDM,72052AK,RADEX SPINE CERVICAL 6 OR MORE VIEWS,866.0,562.9,1.1,866.0,51
CDM,72052AK-26,RADEX SPINE CERVICAL 6 OR MORE VIEWS,132.0,85.8,1.1,132.0,45
CDM,72070AK,RADEX SPINE THORACIC 2 VIEWS,822.0,534.3,1.1,822.0,51
CDM,72070AK-26,RADEX SPINE THORACIC 2 VIEWS,88.0,57.2,1.1,88.0,45
CDM,72072AK,RADEX SPINE THORACIC 3 VIEWS,835.0,542.75,1.1,835.0,51
CDM,72072AK-26,RADEX SPINE THORACIC 3 VIEWS,101.0,65.65,1.1,101.0,45
CDM,72074AK,RADEX SPINE THORACIC MINIMUM 4 VIEWS,110.0,71.5,1.1,110.0,45
CDM,72080AK,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,692.0,449.8,1.1,692.0,51
CDM,72080AK-26,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,84.0,54.6,1.1,84.0,45
CDM,72081AK,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,722.0,469.3,1.1,722.0,51
CDM,72081AK-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,114.0,74.1,1.1,114.0,45
CDM,72081AK-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,1.1,608.0,46
CDM,72082AK,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,870.0,565.5,1.1,870.0,51
CDM,72082AK-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,136.0,88.4,1.1,136.0,45
CDM,72082AK-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,1.1,734.0,46
CDM,72083AK,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,888.0,577.2,1.1,888.0,51
CDM,72083AK-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,154.0,100.1,1.1,154.0,45
CDM,72083AK-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,734.0,477.1,1.1,734.0,46
CDM,72084AK,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,914.0,594.1,1.1,914.0,51
CDM,72084AK-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,180.0,117.0,1.1,180.0,45
CDM,72084AK-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,734.0,477.1,1.1,734.0,46
CDM,72100AK,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,831.0,540.15,1.1,831.0,51
CDM,72100AK-26,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,97.0,63.05,1.1,97.0,45
CDM,72110AK,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,848.0,551.2,1.1,848.0,51
CDM,72110AK-26,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,114.0,74.1,1.1,114.0,45
CDM,72114AK,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,866.0,562.9,1.1,866.0,51
CDM,72114AK-26,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,132.0,85.8,1.1,132.0,45
CDM,72120AK,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,831.0,540.15,1.1,831.0,51
CDM,72120AK-26,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,97.0,63.05,1.1,97.0,45
CDM,72120AK-TC,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,734.0,477.1,1.1,734.0,46
CDM,72125AK,CT CERVICAL SPINE W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,45
CDM,72126AK,CT CERVICAL SPINE W/CONTRAST MATERIAL,488.0,317.2,1.1,488.0,45
CDM,72127AK,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,508.0,330.2,1.1,508.0,45
CDM,72128AK,CT THORACIC SPINE W/O CONTRAST MATERIAL,1134.0,737.1,1.1,1134.0,51
CDM,72128AK-26,CT THORACIC SPINE W/O CONTRAST MATERIAL,400.0,260.0,1.1,400.0,45
CDM,72128AK-TC,CT THORACIC SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,46
CDM,72129AK,CT THORACIC SPINE W/CONTRAST MATERIAL,1716.0,1115.4,1.1,1716.0,51
CDM,72129AK-26,CT THORACIC SPINE W/CONTRAST MATERIAL,488.0,317.2,1.1,488.0,45
CDM,72129AK-TC,CT THORACIC SPINE W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,46
CDM,72130AK,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1736.0,1128.4,1.1,1736.0,51
CDM,72130AK-26,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,508.0,330.2,1.1,508.0,45
CDM,72130AK-TC,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,46
CDM,72131AK,CT LUMBAR SPINE W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,45
CDM,72132AK,CT LUMBAR SPINE W/CONTRAST MATERIAL,3001.0,1950.65,1.1,3001.0,51
CDM,72132AK-26,CT LUMBAR SPINE W/CONTRAST MATERIAL,537.0,349.05,1.1,537.0,45
CDM,72132AK-TC,CT LUMBAR SPINE W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,46
CDM,72133AK,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1787.0,1161.55,1.1,1787.0,51
CDM,72133AK-26,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,599.0,389.35,1.1,599.0,45
CDM,72133AK-TC,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,46
CDM,72141AK,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,2319.0,1507.35,1.1,2319.0,51
CDM,72141AK-26,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,651.0,423.15,1.1,651.0,45
CDM,72141AK-TC,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,1668.0,1084.2,1.1,1668.0,46
CDM,72142AK,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,3247.0,2110.55,1.1,3247.0,51
CDM,72142AK-26,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,783.0,508.95,1.1,783.0,45
CDM,72142AK-TC,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,46
CDM,72146AK,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,2319.0,1507.35,1.1,2319.0,51
CDM,72146AK-26,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,651.0,423.15,1.1,651.0,45
CDM,72146AK-TC,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,1668.0,1084.2,1.1,1668.0,46
CDM,72147AK,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,3247.0,2110.55,1.1,3247.0,51
CDM,72147AK-26,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,783.0,508.95,1.1,783.0,45
CDM,72147AK-TC,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,46
CDM,72148AK,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,2260.0,1469.0,1.1,2260.0,51
CDM,72148AK-26,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,592.0,384.8,1.1,592.0,45
CDM,72149AK,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,712.0,462.8,1.1,712.0,45
CDM,72156AK,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,3472.0,2256.8,1.1,3472.0,51
CDM,72156AK-26,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,1008.0,655.2,1.1,1008.0,45
CDM,72156AK-TC,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,46
CDM,72157AK,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,3380.0,2197.0,1.1,3380.0,51
CDM,72157AK-26,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,916.0,595.4,1.1,916.0,45
CDM,72157AK-TC,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,46
CDM,72158AK,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,3380.0,2197.0,1.1,3380.0,51
CDM,72158AK-26,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,916.0,595.4,1.1,916.0,45
CDM,72158AK-TC,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,46
CDM,7215926AK,MR ANGIO SPINE (MRA),720.0,468.0,1.1,720.0,45
CDM,72159AK-26,MRA SPINE WITH OR W/O CONT,720.0,468.0,1.1,720.0,45
CDM,72159AK-46,MRA SPINE WITH OR W/O CONT,3788.0,2462.2,1.1,3788.0,51
CDM,72159AK-47,MR ANGIO SPINE (MRA),3788.0,2462.2,1.1,3788.0,51
CDM,72159AK-TC,MRA SPINE WITH OR W/O CONT,3068.0,1994.2,1.1,3068.0,46
CDM,72159CAK,MRA WO/W CONTRAST SPINAL CANAL,3788.0,2462.2,1.1,3788.0,51
CDM,72159CAK-26,MRA WO/W CONTRAST SPINAL CANAL,720.0,468.0,1.1,720.0,45
CDM,72159CAK-TC,MRA WO/W CONTRAST SPINAL CANAL,3068.0,1994.2,1.1,3068.0,46
CDM,72159TCAK,MR ANGIO SPINE (MRA),3068.0,1994.2,1.1,3068.0,46
CDM,72170AK,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,809.0,525.85,1.1,809.0,51
CDM,72170AK-26,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,75.0,48.75,1.1,75.0,45
CDM,72190AK,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,844.0,548.6,1.1,844.0,51
CDM,72190AK-26,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,110.0,71.5,1.1,110.0,45
CDM,72191AK,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,724.0,470.6,1.1,724.0,45
CDM,72192AK,CT PELVIS W/O CONTRAST MATERIAL,436.0,283.4,1.1,436.0,45
CDM,72193AK,CT PELVIS W/CONTRAST MATERIAL,1738.0,1129.7,1.1,1738.0,51
CDM,72193AK-26,CT PELVIS W/CONTRAST MATERIAL,510.0,331.5,1.1,510.0,45
CDM,72193AK-TC,CT PELVIS W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,46
CDM,72194AK,CT PELVIS W/O & W/CONTRAST MATERIAL,537.0,349.05,1.1,537.0,45
CDM,72195AK,MRI PELVIS W/O CONTRAST MATERIAL,2310.0,1501.5,1.1,2310.0,51
CDM,72195AK-26,MRI PELVIS W/O CONTRAST MATERIAL,642.0,417.3,1.1,642.0,45
CDM,72195AK-TC,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,1668.0,46
CDM,72196AK,MRI PELVIS W/CONTRAST MATERIAL,761.0,494.65,1.1,761.0,45
CDM,72197AK,MRI PELVIS W/O & W/CONTRAST MATERIAL,3432.0,2230.8,1.1,3432.0,51
CDM,72197AK-26,MRI PELVIS W/O & W/CONTRAST MATERIAL,968.0,629.2,1.1,968.0,45
CDM,72197AK-TC,MRI PELVIS W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,46
CDM,7219826AK,MRA PELVIS W/WO CONTRAST MATERIAL,792.0,514.8,1.1,792.0,45
CDM,72198AK,MRA PELVIS W/WO CONTRAST MATERIAL,7088.0,4607.2,1.1,7088.0,51
CDM,72198AK-26,MRA PELVIS WITH OR W/O CONT,792.0,514.8,1.1,792.0,45
CDM,72198BAK,MR ANGIO PELVIS(MRA),7088.0,4607.2,1.1,7088.0,22
CDM,72198BAK-26,MR ANGIO PELVIS(MRA),792.0,514.8,1.1,792.0,22
CDM,72198BAK-TC,MR ANGIO PELVIS(MRA),6296.0,4092.4,1.1,6296.0,24
CDM,72198CAK,MRA PELV W CONTRL,7088.0,4607.2,1.1,7088.0,51
CDM,72198CAK-26,MRA PELV W CONTRL,792.0,514.8,1.1,792.0,45
CDM,72198CAK-TC,MRA PELV W CONTRL,6296.0,4092.4,1.1,6296.0,46
CDM,72198DAK,MRA PELV WO CONTRL,7088.0,4607.2,1.1,7088.0,51
CDM,72198DAK-26,MRA PELV WO CONTRL,792.0,514.8,1.1,792.0,45
CDM,72198DAK-TC,MRA PELV WO CONTRL,6296.0,4092.4,1.1,6296.0,46
CDM,72198TCAK,MRA PELVIS W/WO CONTRAST MATERIAL,6296.0,4092.4,1.1,6296.0,46
CDM,72200035,VAG DEL SNGL,3778.0,2455.7,562.17,3778.0,38
CDM,72200045,VAG DEL TWINS,4566.0,2967.9,679.42,4566.0,38
CDM,72200095,VAG DEL FETAL DEMISE,2861.0,1859.65,425.72,2861.0,38
CDM,72200115,VAG DEL>=3,6976.0,4534.4,1038.03,6976.0,38
CDM,72200135,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,12718.0,8266.7,618.36,12718.0,61
CDM,72200AK,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,809.0,525.85,1.1,809.0,51
CDM,72200AK-26,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,75.0,48.75,1.1,75.0,45
CDM,72202AK,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,835.0,542.75,1.1,835.0,51
CDM,72202AK-26,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,101.0,65.65,1.1,101.0,45
CDM,72220AK,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,676.0,439.4,1.1,676.0,51
CDM,72220AK-26,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,68.0,44.2,1.1,68.0,45
CDM,72240AK,MYELOGRAPHY CERVICAL RS&I,5815.0,3779.75,1.1,5815.0,51
CDM,72240AK-26,MYELOGRAPHY CERVICAL RS&I,364.0,236.6,1.1,364.0,45
CDM,72240AK-TC,MYELOGRAPHY CERVICAL RS&I,5451.0,3543.15,1.1,5451.0,46
CDM,72265AK,MYELOGRAPY LUMBOSACRAL RS&I,5783.0,3758.95,1.1,5783.0,51
CDM,72265AK-26,MYELOGRAPY LUMBOSACRAL RS&I,332.0,215.8,1.1,332.0,45
CDM,72265AK-TC,MYELOGRAPY LUMBOSACRAL RS&I,5451.0,3543.15,1.1,5451.0,46
CDM,72270AK,MYELOGRAPY 2/MORE REGIONS RS&I,5983.0,3888.95,1.1,5983.0,51
CDM,72270AK-26,MYELOGRAPY 2/MORE REGIONS RS&I,532.0,345.8,1.1,532.0,45
CDM,72270AK-TC,MYELOGRAPY 2/MORE REGIONS RS&I,5451.0,3543.15,1.1,5451.0,46
CDM,72295AK,DISKOGRAPY LUMBAR RS&I,332.0,215.8,1.1,3297.28,51
CDM,72295AK-26,DISKOGRAPY LUMBAR RS&I,332.0,215.8,1.1,332.0,45
CDM,72295AK-TC,DISKOGRAPY LUMBAR RS&I,13474.0,8758.1,1.1,13474.0,46
CDM,72300005,CIRCUMCISION NEONATE,3070.0,1995.5,246.28,4001.0,61
CDM,72300025,CIRCUMCISION SCN,9423.0,6124.95,165.05,9423.0,61
CDM,72900005,LEVEL 1 - ANESTH CHRG,615.0,399.75,91.51,615.0,38
CDM,72900015,LEVEL 2 - ANESTH CHRG,1246.0,809.9,185.4,1246.0,38
CDM,72900025,LEVEL 3 - ANESTH CHRG,1871.0,1216.15,278.4,1871.0,38
CDM,73000005,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,342.0,222.3,12.14,342.0,61
CDM,73000035,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,415.0,269.75,18.66,415.0,46
CDM,73000200,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,342.0,222.3,11.52,342.0,61
CDM,73000245AK,EKG FOR INITIAL PREVENT EXAM,391.0,254.15,1.1,391.0,44
CDM,73000265,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,516.0,335.4,18.66,516.0,61
CDM,73000275,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,516.0,335.4,18.66,516.0,61
CDM,73000285,EKG W/INTERPRETATION,70.0,45.5,10.42,70.0,38
CDM,73000AK,RADEX CLAVICLE COMPLETE,672.0,436.8,1.1,672.0,51
CDM,73000AK-26,RADEX CLAVICLE COMPLETE,64.0,41.6,1.1,64.0,45
CDM,73010AK,RADEX SCAPULA COMPLETE,809.0,525.85,1.1,809.0,51
CDM,73010AK-26,RADEX SCAPULA COMPLETE,75.0,48.75,1.1,75.0,45
CDM,73020AK,RADEX SHOULDER 1 VIEW,674.0,438.1,1.1,674.0,51
CDM,73020AK-26,RADEX SHOULDER 1 VIEW,66.0,42.9,1.1,66.0,45
CDM,73030AK,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,687.0,446.55,1.1,687.0,51
CDM,73030AK-26,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,79.0,51.35,1.1,79.0,45
CDM,73030AK-TC,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,562.0,365.3,1.1,562.0,46
CDM,73040AK,RADEX SHOULDER ARTHROGRAPHY RS&I,2702.0,1756.3,1.1,2702.0,51
CDM,73040AK-26,RADEX SHOULDER ARTHROGRAPHY RS&I,238.0,154.7,1.1,238.0,45
CDM,73050AK,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,687.0,446.55,1.1,687.0,51
CDM,73050AK-26,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,79.0,51.35,1.1,79.0,45
CDM,73060AK,RADEX HUMERUS MINIMUM 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73060AK-26,RADEX HUMERUS MINIMUM 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73070AK,RADEX ELBOW 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73070AK-26,RADEX ELBOW 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73080AK,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,676.0,439.4,1.1,676.0,51
CDM,73080AK-26,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,68.0,44.2,1.1,68.0,45
CDM,73090AK,RADEX FOREARM 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73090AK-26,RADEX FOREARM 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73092AK,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,798.0,518.7,1.1,798.0,51
CDM,73092AK-26,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73100010,XTRNL ECG & 48 HR RECORDING,741.0,481.65,33.44,741.0,61
CDM,73100025,EXTERNAL ECG SCANNING ANALYSIS REPORT,342.0,222.3,54.88,342.0,61
CDM,73100030,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,214.0,139.1,14.65,214.0,53
CDM,73100035,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,528.0,343.2,84.81,528.0,53
CDM,73100125,EXTERNAL ECG REC>48HR<7D RECORDING,226.0,146.9,21.54,226.0,61
CDM,73100135,EXTERNAL ECG REC>7D<15D RECORDING,226.0,146.9,21.54,226.0,61
CDM,73100AK,RADEX WRIST 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73100AK-26,RADEX WRIST 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73110AK,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,51
CDM,73110AK-26,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,45
CDM,73120AK,RADEX HAND 2 VIEWS,798.0,518.7,1.1,798.0,51
CDM,73120AK-26,RADEX HAND 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73130AK,RADEX HAND MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,51
CDM,73130AK-26,RADEX HAND MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,45
CDM,73140AK,RADEX FINGR MINIMUM 2 VIEWS,660.0,429.0,1.1,660.0,51
CDM,73140AK-26,RADEX FINGR MINIMUM 2 VIEWS,52.0,33.8,1.1,52.0,45
CDM,73200005,TELEMETRY,289.0,187.85,18.66,360.65,61
CDM,73200AK,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,1174.0,763.1,1.1,1174.0,51
CDM,73200AK-26,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,45
CDM,73200AK-TC,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,46
CDM,73201AK,CT UPPER EXTREMITY W/CONTRAST MATERIAL,510.0,331.5,1.1,510.0,45
CDM,73206AK,CT ANGIOGRAPHY UPPER EXTREMITY,724.0,470.6,1.1,724.0,45
CDM,73218AK,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,540.0,351.0,1.1,540.0,45
CDM,73220AK,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,860.0,559.0,1.1,860.0,45
CDM,73221AK,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,540.0,351.0,1.1,540.0,45
CDM,73222AK,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,648.0,421.2,1.1,648.0,45
CDM,73223AK,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,860.0,559.0,1.1,860.0,45
CDM,7322526AK,MR ANGIO UPPER EXTREM,692.0,449.8,1.1,692.0,45
CDM,73225AK-26,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,692.0,449.8,1.1,692.0,45
CDM,73225AK-48,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,4980.0,3237.0,1.1,4980.0,51
CDM,73225AK-49,MR ANGIO UPPER EXTREM,7088.0,4607.2,1.1,7088.0,51
CDM,73225AK-TC,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,4288.0,2787.2,1.1,4288.0,46
CDM,73225CAK,MRA UPPER EXT WO CONT,4980.0,3237.0,1.1,4980.0,51
CDM,73225CAK-26,MRA UPPER EXT WO CONT,692.0,449.8,1.1,692.0,45
CDM,73225CAK-TC,MRA UPPER EXT WO CONT,4288.0,2787.2,1.1,4288.0,46
CDM,73225TCAK,MR ANGIO UPPER EXTREM,6296.0,4092.4,1.1,6296.0,46
CDM,73501AK,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,79.0,51.35,1.1,155.9,51
CDM,73501AK-26,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,79.0,51.35,1.1,79.0,45
CDM,73501AK-TC,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,1.1,608.0,46
CDM,73502AK,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,705.0,458.25,1.1,705.0,51
CDM,73502AK-26,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,97.0,63.05,1.1,97.0,45
CDM,73502AK-TC,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,1.1,608.0,46
CDM,73503AK,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,853.0,554.45,1.1,853.0,51
CDM,73503AK-26,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,119.0,77.35,1.1,119.0,45
CDM,73521AK,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,822.0,534.3,1.1,822.0,51
CDM,73521AK-26,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,88.0,57.2,1.1,88.0,45
CDM,73521AK-TC,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,734.0,477.1,1.1,734.0,46
CDM,73522AK,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,862.0,560.3,1.1,862.0,51
CDM,73522AK-26,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,128.0,83.2,1.1,128.0,45
CDM,73522AK-TC,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,1.1,734.0,46
CDM,73523AK,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,858.0,557.7,1.1,858.0,51
CDM,73523AK-26,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,124.0,80.6,1.1,124.0,45
CDM,73523AK-TC,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,1.1,734.0,46
CDM,73525AK,RADEX HIP ARTHROGRAPHY RS&I,2680.0,1742.0,1.1,2680.0,51
CDM,73525AK-26,RADEX HIP ARTHROGRAPHY RS&I,216.0,140.4,1.1,216.0,45
CDM,73551AK,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,672.0,436.8,1.1,672.0,51
CDM,73551AK-26,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,64.0,41.6,1.1,64.0,45
CDM,73551AK-TC,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,1.1,608.0,46
CDM,73552AK,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,687.0,446.55,1.1,687.0,51
CDM,73552AK-26,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,79.0,51.35,1.1,79.0,45
CDM,73552AK-TC,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,46
CDM,73560AK,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,678.0,440.7,1.1,678.0,51
CDM,73560AK-26,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,70.0,45.5,1.1,70.0,45
CDM,73562AK,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,687.0,446.55,1.1,687.0,51
CDM,73562AK-26,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,79.0,51.35,1.1,79.0,45
CDM,73564AK,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,831.0,540.15,1.1,831.0,51
CDM,73564AK-26,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,97.0,63.05,1.1,97.0,45
CDM,73565AK,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,672.0,436.8,1.1,672.0,51
CDM,73565AK-26,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,64.0,41.6,1.1,64.0,45
CDM,73590AK,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73590AK-26,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73592AK,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,678.0,440.7,1.1,678.0,51
CDM,73592AK-26,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,70.0,45.5,1.1,70.0,45
CDM,73600AK,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73600AK-26,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73610AK,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,51
CDM,73610AK-26,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,45
CDM,73620AK,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73620AK-26,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73630AK,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,51
CDM,73630AK-26,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,45
CDM,73630AK-TC,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,562.0,365.3,1.1,562.0,46
CDM,73650AK,RADEX CALCANEUS MINIMUM 2 VIEWS,672.0,436.8,1.1,672.0,51
CDM,73650AK-26,RADEX CALCANEUS MINIMUM 2 VIEWS,64.0,41.6,1.1,64.0,45
CDM,73660AK,RADEX TOE MINIMUM 2 VIEWS,660.0,429.0,1.1,660.0,51
CDM,73660AK-26,RADEX TOE MINIMUM 2 VIEWS,52.0,33.8,1.1,52.0,45
CDM,73700AK,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,45
CDM,73701AK,CT LOWER EXTREMITY W/CONTRAST MATERIAL,510.0,331.5,1.1,510.0,45
CDM,73702AK,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,537.0,349.05,1.1,537.0,45
CDM,73706AK,CT ANGIOGRAPHY LOWER EXTREMITY,760.0,494.0,1.1,760.0,45
CDM,73718AK,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,594.0,386.1,1.1,594.0,45
CDM,73719AK,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,713.0,463.45,1.1,713.0,45
CDM,73720AK,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,946.0,614.9,1.1,946.0,45
CDM,73721AK,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,594.0,386.1,1.1,594.0,45
CDM,73722AK,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,713.0,463.45,1.1,713.0,45
CDM,73723AK,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,946.0,614.9,1.1,946.0,45
CDM,7372526AK-26-50,MR ANGIO LOWER EXTREM (MRA),728.0,473.2,1.1,728.0,45
CDM,7372526AK-26-51,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,728.0,473.2,1.1,728.0,45
CDM,73725AK-52,MR ANGIO LOWER EXTREM (MRA),6734.0,4377.1,1.1,6734.0,51
CDM,73725AK-53,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,6734.0,4377.1,1.1,6734.0,51
CDM,73725CAK,MRA LWR EXT W CONTRL,6734.0,4377.1,1.1,6734.0,51
CDM,73725CAK-26,MRA LWR EXT W CONTRL,728.0,473.2,1.1,728.0,45
CDM,73725CAK-TC,MRA LWR EXT W CONTRL,6006.0,3903.9,1.1,6006.0,46
CDM,73725TCAK-TC-54,MR ANGIO LOWER EXTREM (MRA),6006.0,3903.9,1.1,6006.0,46
CDM,73725TCAK-TC-55,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,6006.0,3903.9,1.1,6006.0,46
CDM,74000010,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,3661.0,2379.65,490.26,3661.0,53
CDM,74000020,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,68.51,1080.0,61
CDM,74000025,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,3661.0,2379.65,353.04,3661.0,53
CDM,74000030,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,53
CDM,74000040,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,53
CDM,74000050,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2149.0,1396.85,204.28,2149.0,61
CDM,74000060,EEG EXTENDED MONITORING 61-119 MINUTES,2149.0,1396.85,204.28,2149.0,61
CDM,74000070,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2149.0,1396.85,167.47,2149.0,61
CDM,74000080,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2149.0,1396.85,167.47,2149.0,61
CDM,74000090,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2149.0,1396.85,167.47,2149.0,61
CDM,74000100,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,3661.0,2379.65,167.47,3661.0,61
CDM,74000115,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,68.51,1080.0,61
CDM,74000160,EEG NONINTRACRANIAL SURGERY,1193.0,775.45,167.47,1193.0,46
CDM,74000365,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,53
CDM,74000375,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,53
CDM,74000425,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1080.0,702.0,144.57,1080.0,61
CDM,74000435,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,2149.0,1396.85,167.47,2149.0,61
CDM,74000445,EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,2149.0,1396.85,167.47,2149.0,61
CDM,74000455,EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,2149.0,1396.85,167.47,2149.0,61
CDM,74000465,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,3661.0,2379.65,353.04,3661.0,61
CDM,74000475,EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,3661.0,2379.65,353.04,3661.0,61
CDM,74000485,EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,3661.0,2379.65,353.04,3661.0,61
CDM,74000495,VEEG BY TECH 2-12 HOURS UNMONITORED,2149.0,1396.85,167.47,2149.0,61
CDM,74000505,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2149.0,1396.85,167.47,2149.0,61
CDM,74000515,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,3661.0,2379.65,167.47,3661.0,61
CDM,74000525,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,3661.0,2379.65,353.04,3661.0,61
CDM,74000535,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,3661.0,2379.65,353.04,3661.0,61
CDM,74000545,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,7020.0,4563.0,552.3,7020.0,61
CDM,74000615,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS W/O PRGRMG,544.0,353.6,73.53,544.0,55
CDM,74000625,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS PRGRMG 1ST,389.0,252.85,73.53,389.0,55
CDM,74000655,REM MNTR S-SCLP IMPL CONT BI EEG SYS FITG SET-UP,544.0,353.6,68.77,544.0,55
CDM,74018AK,RADIOLOGIC EXAM ABDOMEN 1 VIEW,687.0,446.55,1.1,687.0,51
CDM,74018AK-26,RADIOLOGIC EXAM ABDOMEN 1 VIEW,79.0,51.35,1.1,79.0,45
CDM,74019AK,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,835.0,542.75,1.1,835.0,51
CDM,74019AK-26,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,101.0,65.65,1.1,101.0,45
CDM,74021AK,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,853.0,554.45,1.1,853.0,51
CDM,74021AK-26,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,119.0,77.35,1.1,119.0,45
CDM,74022AK,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,875.0,568.75,1.1,875.0,51
CDM,74022AK-26,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,141.0,91.65,1.1,141.0,45
CDM,74150AK,CT ABDOMEN W/O CONTRAST,1258.0,817.7,1.1,1258.0,51
CDM,74150AK-26,CT ABDOMEN W/O CONTRAST,524.0,340.6,1.1,524.0,45
CDM,74150AK-TC,CT ABDOMEN W/O CONTRAST,734.0,477.1,1.1,734.0,46
CDM,74160AK,CT ABDOMEN W/CONTRAST,1787.0,1161.55,1.1,1787.0,51
CDM,74160AK-26,CT ABDOMEN W/CONTRAST,559.0,363.35,1.1,559.0,45
CDM,74160AK-TC,CT ABDOMEN W/CONTRAST,1228.0,798.2,1.1,1228.0,46
CDM,74170AK,CT ABDOMEN W & W/O CONTRAST,1844.0,1198.6,1.1,1844.0,51
CDM,74170AK-26,CT ABDOMEN W & W/O CONTRAST,616.0,400.4,1.1,616.0,45
CDM,74170AK-TC,CT ABDOMEN W & W/O CONTRAST,1228.0,798.2,1.1,1228.0,46
CDM,74174AK,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,968.0,629.2,1.1,968.0,45
CDM,74175AK,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,728.0,473.2,1.1,728.0,45
CDM,74176AK,CT ABD & PELVIS W/O CONTRAST,766.0,497.9,1.1,766.0,45
CDM,74177AK,CT ABD & PELVIS W/CONTRAST,3265.0,2122.25,1.1,3265.0,51
CDM,74177AK-26,CT ABD & PELVIS W/CONTRAST,801.0,520.65,1.1,801.0,45
CDM,74177AK-TC,CT ABD & PELVIS W/CONTRAST,2375.0,1543.75,1.1,2375.0,46
CDM,74178AK,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,3268.0,2124.2,1.1,3268.0,51
CDM,74178AK-26,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,804.0,522.6,1.1,804.0,45
CDM,74178AK-TC,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,2464.0,1601.6,1.1,2464.0,46
CDM,74181AK,"MRI, ABDOMEN (MRI)",2252.0,1463.8,1.1,2252.0,51
CDM,74181AK-26,"MRI, ABDOMEN (MRI)",584.0,379.6,1.1,584.0,45
CDM,74181AK-TC,"MRI, ABDOMEN (MRI)",1668.0,1084.2,1.1,1668.0,46
CDM,74182AK,MRI ABDOMEN W/CONTRAST MATERIAL,761.0,494.65,1.1,761.0,45
CDM,74183AK,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,968.0,629.2,1.1,968.0,45
CDM,7418526AK,MR ABDOMINAL AORTA ANGIOGRAM,720.0,468.0,1.1,720.0,45
CDM,74185AK-26,MRA ABD WITH OR W/O CONT,720.0,468.0,1.1,720.0,45
CDM,74185AK-56,MRA ABD WITH OR W/O CONT,3299.0,2144.35,1.1,3299.0,51
CDM,74185AK-57,MR ABDOMINAL AORTA ANGIOGRAM,3299.0,2144.35,1.1,3299.0,51
CDM,74185AK-TC,MRA ABD WITH OR W/O CONT,2579.0,1676.35,1.1,2579.0,46
CDM,74185CAK,MRA ABD W CONTR,3299.0,2144.35,1.1,3299.0,51
CDM,74185CAK-26,MRA ABD W CONTR,720.0,468.0,1.1,720.0,45
CDM,74185CAK-TC,MRA ABD W CONTR,2579.0,1676.35,1.1,2579.0,46
CDM,74185TCAK,MR ABDOMINAL AORTA ANGIOGRAM,2579.0,1676.35,1.1,2579.0,46
CDM,74220AK,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,240.0,156.0,1.1,240.0,45
CDM,74221AK,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1508.0,980.2,1.1,1508.0,51
CDM,74221AK-26,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,280.0,182.0,1.1,280.0,45
CDM,74230AK,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,212.0,137.8,1.1,212.0,45
CDM,74240AK,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,320.0,208.0,1.1,320.0,45
CDM,74246AK,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,360.0,234.0,1.1,360.0,45
CDM,74248AK,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,1075.0,698.75,1.1,1075.0,51
CDM,74248AK-26,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,280.0,182.0,1.1,280.0,45
CDM,74250AK,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,324.0,210.6,1.1,324.0,45
CDM,74251AK,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,468.0,304.2,1.1,468.0,45
CDM,74270AK,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,416.0,270.4,1.1,416.0,45
CDM,74280AK,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,504.0,327.6,1.1,504.0,45
CDM,74300AK,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1227.0,797.55,1.1,1227.0,39
CDM,74300AK-26,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,126.0,81.9,1.1,126.0,45
CDM,74300AK-TC,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1101.0,715.65,1.1,1101.0,34
CDM,74301AK,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,82.0,53.3,1.1,82.0,45
CDM,74328AK,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,620.0,403.0,1.1,620.0,39
CDM,74328AK-26,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,184.0,119.6,1.1,184.0,45
CDM,74328AK-TC,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,1.1,436.0,34
CDM,74329AK,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,219.0,142.35,1.1,219.0,45
CDM,74330AK,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,260.0,169.0,1.1,260.0,45
CDM,74340AK,INTRO LONG GI TUBE W/FLUORO/FILMS,211.0,137.15,1.1,211.0,45
CDM,74360AK,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,211.0,137.15,1.1,211.0,45
CDM,74400AK,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1444.0,938.6,1.1,1444.0,51
CDM,74400AK-26,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,216.0,140.4,1.1,216.0,45
CDM,74420AK,UROGRAPHY RETROGRADE WITH/WO KUB,2672.0,1736.8,1.1,2672.0,51
CDM,74420AK-26,UROGRAPHY RETROGRADE WITH/WO KUB,208.0,135.2,1.1,208.0,45
CDM,74420AK-TC,UROGRAPHY RETROGRADE WITH/WO KUB,2464.0,1601.6,1.1,2464.0,46
CDM,74425AK,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2668.0,1734.2,1.1,2668.0,51
CDM,74425AK-26,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,204.0,132.6,1.1,204.0,45
CDM,74430AK,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2605.0,1693.25,1.1,2605.0,51
CDM,74430AK-26,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,141.0,91.65,1.1,141.0,45
CDM,74430AK-TC,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2464.0,1601.6,1.1,2464.0,46
CDM,74450AK,URETHROCYSTOGRAPHY RETROGRADE RS&I,1800.0,1170.0,1.1,1800.0,39
CDM,74450AK-26,URETHROCYSTOGRAPHY RETROGRADE RS&I,132.0,85.8,1.1,132.0,45
CDM,74450AK-TC,URETHROCYSTOGRAPHY RETROGRADE RS&I,1668.0,1084.2,1.1,1668.0,34
CDM,74455AK,URETHROCYSTOGRAPHY VOIDING RS&I,1800.0,1170.0,1.1,1800.0,51
CDM,74455AK-26,URETHROCYSTOGRAPHY VOIDING RS&I,132.0,85.8,1.1,132.0,45
CDM,74455AK-TC,URETHROCYSTOGRAPHY VOIDING RS&I,1668.0,1084.2,1.1,1668.0,46
CDM,74740AK,HYSTEROSALPINGOGRAPHY RS&I,152.0,98.8,1.1,152.0,45
CDM,75000155,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,204.68,4831.0,61
CDM,75001255,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,5424.0,3525.6,695.58,6561.0,61
CDM,75001275,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,166.87,4194.0,61
CDM,75001325,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,4194.0,2726.1,320.67,4194.0,61
CDM,75001405,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,186.33,5424.0,61
CDM,75001435,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,593.0,385.45,67.34,3398.0,61
CDM,75001535,DSTRJ LESION ANUS SIMPLE SURG EXCISION,12615.0,8199.75,225.42,12615.0,61
CDM,75001685,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,2441.0,1586.65,237.67,3398.0,61
CDM,75001925,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,5424.0,3525.6,197.84,5424.0,61
CDM,75001975,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,8726.0,5671.9,453.21,8726.0,61
CDM,75002625,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,237.67,4831.0,61
CDM,75004050,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,4313.0,2803.45,237.67,4831.0,61
CDM,75004110,UNLISTED PROCEDURE ANUS,1714.0,1114.1,484.72,3728.0,61
CDM,75005615,SIGMSCPY FLEX W/WO SPEC SC,1326.0,861.9,197.31,1326.0,38
CDM,75011995,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,4313.0,2803.45,237.67,4831.0,61
CDM,75012215,GI LEVEL 1 1ST 30 MIN,3394.0,2206.1,505.03,3394.0,38
CDM,75012225,GI LEVEL 2 1ST 30 MIN,4184.0,2719.6,622.58,4184.0,38
CDM,75012235,GI LEVEL 3 1ST 30 MIN,4715.0,3064.75,701.59,4715.0,38
CDM,75012245,GI LEVEL 4 1ST 30 MIN,5175.0,3363.75,770.04,5175.0,38
CDM,75012255,GI LEVEL 5 1ST 30 MIN,5815.0,3779.75,865.27,5815.0,38
CDM,75012265,GI LEVEL 1 EA ADD 30 MIN,2499.0,1624.35,371.85,2499.0,38
CDM,75012275,GI LEVEL 2 EA ADD 30 MIN,3283.0,2133.95,488.51,3283.0,38
CDM,75012285,GI LEVEL 3 EA ADD 30 MIN,3831.0,2490.15,570.05,3831.0,38
CDM,75012295,GI LEVEL 4 EA ADD 30 MIN,4297.0,2793.05,639.39,4297.0,38
CDM,75012305,GI LEVEL 5 EA ADD 30 MIN,4966.0,3227.9,738.94,4966.0,38
CDM,75012765,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,516.0,335.4,119.1,3398.0,61
CDM,75012895,RECTAL SENSATION TONE&COMPLIANCE STUDY,1522.0,989.3,204.28,2451.0,55
CDM,75012905,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1754.0,1140.1,310.96,2451.0,55
CDM,75557AK,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,2608.0,1695.2,1.1,2608.0,51
CDM,75557AK-26,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,940.0,611.0,1.1,940.0,45
CDM,75561AK,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,3608.0,2345.2,1.1,3608.0,51
CDM,75561AK-26,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,1144.0,743.6,1.1,1144.0,45
CDM,75565AK,CARDIAC MRI FOR VELOCITY FLOW MAPPING,676.0,439.4,1.1,676.0,51
CDM,75565AK-26,CARDIAC MRI FOR VELOCITY FLOW MAPPING,110.0,71.5,1.1,110.0,45
CDM,75571AAK,CT CALCIUM SCORING - SELF PAY,840.0,546.0,1.1,840.0,51
CDM,75571AAK-26,CT CALCIUM SCORING - SELF PAY,232.0,150.8,1.1,232.0,45
CDM,75571AAK-TC,CT CALCIUM SCORING - SELF PAY,608.0,395.2,1.1,608.0,46
CDM,75571AK,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,840.0,546.0,1.1,840.0,51
CDM,75571AK-26,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,232.0,150.8,1.1,232.0,45
CDM,75572AK,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,700.0,455.0,1.1,700.0,45
CDM,75573AK,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,1020.0,663.0,1.1,1020.0,45
CDM,75574AK,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,3424.0,2225.6,1.1,3424.0,51
CDM,75574AK-26,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,960.0,624.0,1.1,960.0,45
CDM,75577AK,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6932.0,4505.8,1.1,6932.0,36
CDM,75577AK-26,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,374.0,243.1,1.1,374.0,36
CDM,75577AK-TC,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6558.0,4262.7,1.1,6558.0,37
CDM,75580AK,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7350.0,4777.5,1.1,7350.0,51
CDM,75580AK-26,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,330.0,214.5,1.1,330.0,45
CDM,75580AK-TC,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7020.0,4563.0,1.1,7020.0,46
CDM,75600AK,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21914.0,14244.1,1.1,21914.0,51
CDM,75600AK-26,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,196.0,127.4,1.1,196.0,45
CDM,75600AK-TC,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,21718.0,46
CDM,75605AK,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37801.0,24570.65,1.1,37801.0,51
CDM,75605AK-26,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,502.0,326.3,1.1,502.0,45
CDM,75625AK,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,22294.0,14491.1,1.1,22294.0,51
CDM,75625AK-26,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,576.0,374.4,1.1,576.0,45
CDM,75630AK,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,22518.0,14636.7,1.1,22518.0,51
CDM,75630AK-26,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,800.0,520.0,1.1,800.0,45
CDM,75630AK-TC,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,21718.0,14116.7,1.1,21718.0,46
CDM,75635AK,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,960.0,624.0,1.1,1114.78,51
CDM,75635AK-26,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,960.0,624.0,1.1,960.0,45
CDM,75705AK,ANGIOGRAPHY SPINAL SELECTIVE RS&I,38171.0,24811.15,1.1,38171.0,51
CDM,75705AK-26,ANGIOGRAPHY SPINAL SELECTIVE RS&I,872.0,566.8,1.1,872.0,45
CDM,75710AK,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,22418.0,14571.7,1.1,22418.0,51
CDM,75710AK-26,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,700.0,455.0,1.1,700.0,45
CDM,75710AK-TC,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,21718.0,14116.7,1.1,21718.0,46
CDM,75716AK,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,22506.0,14628.9,1.1,22506.0,51
CDM,75716AK-26,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,788.0,512.2,1.1,788.0,45
CDM,75726AK,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,38119.0,24777.35,1.1,38119.0,51
CDM,75726AK-26,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,820.0,533.0,1.1,820.0,45
CDM,75736AK,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,456.0,296.4,1.1,456.0,45
CDM,75741AK,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,524.0,340.6,1.1,524.0,45
CDM,75743AK,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,22382.0,14548.3,1.1,22382.0,51
CDM,75743AK-26,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,664.0,431.6,1.1,664.0,45
CDM,75746AK,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,502.0,326.3,1.1,502.0,45
CDM,75756AK,ANGIOGRAPHY INTERNAL MAMMARY RS&I,456.0,296.4,1.1,456.0,45
CDM,75774AK,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4586.0,2980.9,1.1,4586.0,51
CDM,75774AK-26,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,404.0,262.6,1.1,404.0,45
CDM,75809AK,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,207.0,134.55,1.1,207.0,45
CDM,75820AK,VENOGRAPHY EXTREMITY UNILATERAL RS&I,11139.0,7240.35,1.1,11139.0,51
CDM,75820AK-26,VENOGRAPHY EXTREMITY UNILATERAL RS&I,420.0,273.0,1.1,420.0,45
CDM,75822AK,VENOGRAPHY EXTREMITY BILATERAL RS&I,11311.0,7352.15,1.1,11311.0,51
CDM,75822AK-26,VENOGRAPHY EXTREMITY BILATERAL RS&I,592.0,384.8,1.1,592.0,45
CDM,75825AK,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,22220.0,14443.0,1.1,22220.0,51
CDM,75825AK-26,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,502.0,326.3,1.1,502.0,45
CDM,75827AK,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,11175.0,7263.75,1.1,11175.0,51
CDM,75827AK-26,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,456.0,296.4,1.1,456.0,45
CDM,75831AK,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,456.0,296.4,1.1,456.0,45
CDM,75840AK,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,22174.0,14413.1,1.1,22174.0,51
CDM,75840AK-26,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,456.0,296.4,1.1,456.0,45
CDM,75860AK,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,22174.0,14413.1,1.1,22174.0,51
CDM,75860AK-26,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,456.0,296.4,1.1,456.0,45
CDM,75870AK,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,502.0,326.3,1.1,502.0,45
CDM,75872AK,VENOGRAM EPIDURAL,4768.0,3099.2,1.1,4768.0,51
CDM,75872AK-26,VENOGRAM EPIDURAL,502.0,326.3,1.1,502.0,45
CDM,75872AK-TC,VENOGRAM EPIDURAL,4266.0,2772.9,1.1,4266.0,46
CDM,75889AK,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,456.0,296.4,1.1,456.0,45
CDM,75894AK,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3637.0,2364.05,1.1,3637.0,50
CDM,75894AK-26,TRANSCATHETER EMBOLIZATION ANY METH RS&I,524.0,340.6,1.1,524.0,45
CDM,75898AK,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,22378.0,14545.7,1.1,22378.0,50
CDM,75898AK-26,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,660.0,429.0,1.1,660.0,45
CDM,75898AK-TC,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,1.1,21718.0,45
CDM,75901AK,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,916.0,595.4,1.1,916.0,51
CDM,75901AK-26,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,196.0,127.4,1.1,196.0,45
CDM,75970AK,TRANSVASCULAR BIOPSY,4002.0,2601.3,1.1,4002.0,39
CDM,75970AK-26,TRANSVASCULAR BIOPSY,332.0,215.8,1.1,332.0,45
CDM,75984AK,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,332.0,215.8,1.1,332.0,45
CDM,75989AK,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2603.0,1691.95,1.1,2603.0,51
CDM,75989AK-26,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,476.0,309.4,1.1,476.0,45
CDM,76000AK,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1788.0,1162.2,1.1,1788.0,51
CDM,76000AK-26,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,120.0,78.0,1.1,120.0,45
CDM,76010AK,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,680.0,442.0,1.1,680.0,51
CDM,76010AK-26,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,72.0,46.8,1.1,72.0,45
CDM,76014AK,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,322.0,209.3,1.1,322.0,50
CDM,76014AK-26,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,153.0,99.45,1.1,153.0,23
CDM,76014AK-TC,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,169.0,109.85,1.1,169.0,23
CDM,76015AK,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,1059.0,688.35,1.1,1059.0,50
CDM,76015AK-26,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,716.0,465.4,1.1,716.0,23
CDM,76015AK-TC,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,343.0,222.95,1.1,343.0,23
CDM,76016AK,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,872.0,566.8,1.1,872.0,50
CDM,76016AK-26,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,264.0,171.6,1.1,264.0,44
CDM,76016AK-TC,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,608.0,395.2,1.1,608.0,45
CDM,76017AK,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,2002.0,1301.3,1.1,2002.0,50
CDM,76017AK-26,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,334.0,217.1,1.1,334.0,44
CDM,76017AK-TC,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,1668.0,1084.2,1.1,1668.0,45
CDM,76018AK,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,963.0,625.95,1.1,963.0,50
CDM,76018AK-26,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,330.0,214.5,1.1,330.0,44
CDM,76018AK-TC,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,633.0,411.45,1.1,633.0,45
CDM,76019AK,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,674.0,438.1,1.1,674.0,50
CDM,76019AK-26,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,264.0,171.6,1.1,264.0,44
CDM,76019AK-TC,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,410.0,266.5,1.1,410.0,45
CDM,76080AK,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3999.0,2599.35,1.1,3999.0,51
CDM,76080AK-26,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,216.0,140.4,1.1,216.0,45
CDM,76098AK,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,124.0,80.6,1.1,124.0,45
CDM,76100010,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,0.01,3004.0,46
CDM,76100040,THERAPEUTIC APHERESIS PLATELETS,2514.0,1634.1,0.01,4001.0,61
CDM,76100055,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1838.0,1194.7,0.01,3004.0,61
CDM,76100080,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,0.01,3004.0,61
CDM,76100085,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,596.0,387.4,0.01,3004.0,61
CDM,76100095,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1199.0,779.35,0.01,3004.0,61
CDM,76100100,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,61
CDM,76100120,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,46
CDM,76100125,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1199.0,779.35,0.01,3004.0,61
CDM,76100135,I&D HEMATOMA SEROMA/FLUID COLLECTION,4861.0,3159.65,0.01,4861.0,61
CDM,76100145,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,8586.0,5580.9,0.01,8586.0,61
CDM,76100150,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,0.01,9423.0,61
CDM,76100160,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,0.01,3004.0,61
CDM,76100170,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,0.01,3004.0,61
CDM,76100180,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,0.01,3004.0,61
CDM,76100185,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1199.0,779.35,0.01,4001.0,61
CDM,76100190,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,0.01,273.0,61
CDM,76100195,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,4861.0,3159.65,0.01,4861.0,61
CDM,76100200,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,0.01,4778.0,61
CDM,76100205,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,2452.0,1593.8,0.01,3004.0,46
CDM,76100215,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,596.0,387.4,0.01,3004.0,61
CDM,76100225,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,596.0,387.4,0.01,3004.0,61
CDM,76100230,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,0.01,3004.0,61
CDM,76100240,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,0.01,741.0,61
CDM,76100245,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,338.0,219.7,0.01,338.0,46
CDM,76100255,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,596.0,387.4,0.01,596.0,61
CDM,76100265,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,596.0,387.4,0.01,596.0,61
CDM,76100275,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,596.0,387.4,0.01,596.0,61
CDM,76100285,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,596.0,387.4,0.01,596.0,61
CDM,76100290,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,0.01,4313.0,61
CDM,76100295,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,596.0,387.4,0.01,596.0,61
CDM,76100300,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,925.0,601.25,0.01,3004.0,61
CDM,76100325,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2111.0,1372.15,0.01,3004.0,61
CDM,76100330,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,8586.0,5580.9,0.01,8586.0,61
CDM,76100335,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1199.0,779.35,0.01,3004.0,61
CDM,76100340,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2111.0,1372.15,0.01,4001.0,61
CDM,76100345,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,0.01,3004.0,61
CDM,76100350,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,2111.0,1372.15,0.01,4001.0,61
CDM,76100355,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2111.0,1372.15,0.01,3004.0,61
CDM,76100360,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2111.0,1372.15,0.01,3004.0,61
CDM,76100365,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100370,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100375,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100380,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100385,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,0.01,4861.0,61
CDM,76100390,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,8586.0,5580.9,0.01,8586.0,61
CDM,76100395,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2111.0,1372.15,0.01,4001.0,61
CDM,76100405,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100410,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,0.01,3004.0,61
CDM,76100415,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100430,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,1199.0,779.35,0.01,3004.0,61
CDM,76100435,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,2111.0,1372.15,0.01,3004.0,61
CDM,76100440,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,2111.0,1372.15,0.01,4001.0,61
CDM,76100465,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,4861.0,3159.65,0.01,4861.0,61
CDM,76100485,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2111.0,1372.15,0.01,4001.0,61
CDM,76100490,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,2111.0,1372.15,0.01,4001.0,61
CDM,76100510,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,178.0,115.7,0.01,178.0,61
CDM,76100520,DEBRIDEMENT NAIL ANY METHOD 1-5,178.0,115.7,0.01,3004.0,61
CDM,76100525,DEBRIDEMENT NAIL ANY METHOD 6/>,178.0,115.7,0.01,3004.0,61
CDM,76100530,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,596.0,387.4,0.01,3004.0,61
CDM,76100535,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,536.0,348.4,0.01,3004.0,46
CDM,76100540,EVACUATION SUBUNGUAL HEMATOMA,387.0,251.55,0.01,3004.0,61
CDM,76100545,EXCISION NAIL MATRIX PERMANENT REMOVAL,1199.0,779.35,0.01,3004.0,61
CDM,76100550,BIOPSY NAIL UNIT SEPARATE PROCEDURE,2111.0,1372.15,0.01,3004.0,61
CDM,76100580,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,596.0,387.4,0.01,3004.0,61
CDM,76100610,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,914.0,594.1,0.01,914.0,61
CDM,76100630,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,1197.0,778.05,0.01,3004.0,61
CDM,76100635,INSERTION DRUG DELIVERY IMPLANT,387.0,251.55,0.01,3004.0,61
CDM,76100640,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1197.0,778.05,0.01,3004.0,61
CDM,76100645,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,1197.0,778.05,0.01,3004.0,61
CDM,76100650,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,596.0,387.4,0.01,3004.0,61
CDM,76100660,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,596.0,387.4,0.01,3004.0,61
CDM,76100670,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,596.0,387.4,0.01,596.0,61
CDM,76100675,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,596.0,387.4,0.01,596.0,61
CDM,76100680,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,914.0,594.1,0.01,914.0,61
CDM,76100685,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1199.0,779.35,0.01,3004.0,61
CDM,76100690,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1199.0,779.35,0.01,3004.0,61
CDM,76100695,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1199.0,779.35,0.01,4001.0,61
CDM,76100700,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1199.0,779.35,0.01,4001.0,61
CDM,76100710,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1199.0,779.35,0.01,3004.0,61
CDM,76100715,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1199.0,779.35,0.01,3004.0,61
CDM,76100730,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1199.0,779.35,0.01,3004.0,61
CDM,76100735,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,0.01,3004.0,61
CDM,76100750,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,61
CDM,76100755,REPAIR COMPLEX TRUNK 1.1-2.5 CM,1836.0,1193.4,0.01,4001.0,61
CDM,76100760,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,314.0,204.1,0.01,3004.0,46
CDM,76100765,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,1836.0,1193.4,0.01,4001.0,61
CDM,76100770,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,61
CDM,76100780,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1199.0,779.35,0.01,4001.0,61
CDM,76100785,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,61
CDM,76100800,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,1836.0,1193.4,0.01,6561.0,61
CDM,76100805,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,61
CDM,76100840,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,5488.0,3567.2,0.01,6561.0,61
CDM,76100850,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,10983.0,7138.95,0.01,10983.0,61
CDM,76100870,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,61
CDM,76100885,FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<,5488.0,3567.2,0.01,6561.0,61
CDM,76100925,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,5488.0,3567.2,0.01,5488.0,61
CDM,76100930,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,5488.0,3567.2,0.01,5488.0,46
CDM,76100935,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,10983.0,7138.95,0.01,10983.0,61
CDM,76100940,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,10983.0,7138.95,0.01,10983.0,46
CDM,76100945,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,5488.0,3567.2,0.01,5488.0,61
CDM,76100950,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,5488.0,3567.2,0.01,5488.0,46
CDM,76101105,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,596.0,387.4,0.01,3004.0,61
CDM,76101120,DESTRUCTION PREMALIGNANT LESION 1ST,596.0,387.4,0.01,3004.0,61
CDM,76101125,DESTRUCTION PREMALIGNANT LESION 2-14 EA,334.0,217.1,0.01,3004.0,46
CDM,76101130,DESTRUCTION PREMALIGNANT LESION 15/>,1199.0,779.35,0.01,3004.0,61
CDM,76101150,DESTRUCTION BENIGN LESIONS UP TO 14,596.0,387.4,0.01,3004.0,61
CDM,76101155,DESTRUCTION BENIGN LESIONS 15/>,596.0,387.4,0.01,3004.0,61
CDM,76101160,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,0.01,3004.0,61
CDM,76101295,PUNCTURE ASPIRATION CYST BREAST,2111.0,1372.15,0.01,3004.0,61
CDM,76101300,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,257.0,167.05,0.01,3004.0,46
CDM,76101315,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,11488.0,7467.2,0.01,11488.0,61
CDM,76101345,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,7453.0,4844.45,0.01,7453.0,61
CDM,76101350,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,0.01,7453.0,61
CDM,76101360,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,0.01,3004.0,46
CDM,76101370,INJECTION THERAPEUTIC CARPAL TUNNEL,1358.0,882.7,0.01,3004.0,61
CDM,76101375,INJECTION ENZYME PALMAR FASCIAL CORD,1358.0,882.7,0.01,3004.0,61
CDM,76101380,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1358.0,882.7,0.01,3004.0,61
CDM,76101385,INJECTION SINGLE TENDON ORIGIN/INSERTION,1358.0,882.7,0.01,3004.0,61
CDM,76101390,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,0.01,3004.0,61
CDM,76101395,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,0.01,3004.0,61
CDM,76101405,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76101415,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76101420,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76101425,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1358.0,882.7,0.01,3004.0,61
CDM,76101430,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,7453.0,4844.45,0.01,7453.0,61
CDM,76101435,REMOVAL IMPLANT DEEP,13165.0,8557.25,0.01,13165.0,61
CDM,76101455,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,7453.0,4844.45,0.01,7453.0,61
CDM,76101460,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,7453.0,4844.45,0.01,7453.0,61
CDM,76101465,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,13165.0,8557.25,0.01,13165.0,61
CDM,76101610,BIOPSY SOFT TISSUE NECK/THORAX,7453.0,4844.45,0.01,7453.0,61
CDM,76101635,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,7453.0,4844.45,0.01,7453.0,61
CDM,76101640,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,7453.0,4844.45,0.01,7453.0,61
CDM,76101645,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,7453.0,4844.45,0.01,7453.0,61
CDM,76101675,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,7453.0,4844.45,0.01,7453.0,61
CDM,76101695,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101705,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101710,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101720,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76101750,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,13165.0,8557.25,0.01,13165.0,61
CDM,76101755,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,7453.0,4844.45,0.01,7453.0,61
CDM,76101760,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101765,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76101780,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76101795,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101805,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76101830,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,7453.0,4844.45,0.01,7453.0,61
CDM,76101840,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101850,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76101855,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1103.0,716.95,0.01,3004.0,61
CDM,76101865,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76101870,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,7362.0,4785.3,0.01,7362.0,61
CDM,76101880,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1103.0,716.95,0.01,1103.0,61
CDM,76101885,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1103.0,716.95,0.01,3004.0,61
CDM,76101890,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1103.0,716.95,0.01,1103.0,61
CDM,76101910,FASCIOTOMY PALMAR PERCUTANEOUS,7362.0,4785.3,0.01,7445.0,61
CDM,76101920,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,1103.0,716.95,0.01,3004.0,61
CDM,76101930,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1103.0,716.95,0.01,1103.0,61
CDM,76101955,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1103.0,716.95,0.01,1103.0,61
CDM,76101960,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1103.0,716.95,0.01,3004.0,61
CDM,76101985,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1103.0,716.95,0.01,1103.0,61
CDM,76101995,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1103.0,716.95,0.01,1103.0,61
CDM,76102020,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,728.0,473.2,0.01,3004.0,46
CDM,76102025,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1928.0,1253.2,0.01,3004.0,46
CDM,76102040,CLTX FEM FX PROX END NCK W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102075,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102085,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102090,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102095,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102100,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1103.0,716.95,0.01,3004.0,61
CDM,76102110,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,7362.0,4785.3,0.01,7362.0,61
CDM,76102130,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102140,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102150,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102160,CLTX PROX FIBULA/SHFT FX W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102165,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102175,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102180,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,0.01,1222.0,61
CDM,76102185,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102195,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,2896.0,1882.4,0.01,4001.0,61
CDM,76102205,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,0.01,593.0,61
CDM,76102220,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102225,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102230,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102235,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76102240,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102245,APPLICATION LONG LEG CAST THIGH-TOE,1222.0,794.3,0.01,3004.0,61
CDM,76102250,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76102260,CLOSED TREATMENT SESAMOID FRACTURE,1103.0,716.95,0.01,3004.0,61
CDM,76102265,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,1222.0,794.3,0.01,1222.0,61
CDM,76102280,APPLICATION RIGID TOTAL CONTACT LEG CAST,1222.0,794.3,0.01,1222.0,61
CDM,76102305,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,0.01,726.0,61
CDM,76102335,STRAPPING UNNA BOOT,726.0,471.9,0.01,726.0,61
CDM,76102345,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,726.0,471.9,0.01,726.0,61
CDM,76102420,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,593.0,385.45,0.01,3004.0,61
CDM,76102445,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,893.0,580.45,0.01,4001.0,61
CDM,76102475,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,0.01,3004.0,61
CDM,76102515,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,893.0,580.45,0.01,4001.0,61
CDM,76102540,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,7933.0,5156.45,0.01,7933.0,61
CDM,76102550,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,7933.0,5156.45,0.01,7933.0,61
CDM,76102555,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,7933.0,5156.45,0.01,7933.0,61
CDM,76102560,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,7933.0,5156.45,0.01,7933.0,61
CDM,76102565,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,31843.0,20697.95,0.01,31843.0,61
CDM,76102570,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,1624.0,1055.6,0.01,3004.0,46
CDM,76102575,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,16960.0,11024.0,0.01,16960.0,61
CDM,76102580,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,16960.0,11024.0,0.01,16960.0,61
CDM,76102595,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,1184.0,769.6,0.01,4001.0,46
CDM,76102610,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,7933.0,5156.45,0.01,7933.0,61
CDM,76102635,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,16234.0,10552.1,0.01,16234.0,61
CDM,76102645,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,0.01,3004.0,61
CDM,76102650,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,2844.0,1848.6,0.01,3004.0,61
CDM,76102655,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,0.01,3004.0,61
CDM,76102660,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,8726.0,5671.9,0.01,8726.0,61
CDM,76102665,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,7146.0,4644.9,0.01,7146.0,61
CDM,76102700,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,0.01,246.0,46
CDM,76102705,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,0.01,3555.0,61
CDM,76102720,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,2297.0,1493.05,0.01,3004.0,61
CDM,76102730,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,2297.0,1493.05,0.01,3004.0,61
CDM,76102740,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,2297.0,1493.05,0.01,3004.0,61
CDM,76102755,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,18098.0,11763.7,0.01,18098.0,61
CDM,76102760,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,5550.0,3607.5,0.01,5550.0,46
CDM,76102775,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,0.01,8932.0,61
CDM,76102795,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,0.01,8932.0,61
CDM,76102805,RMVL TUN CVC W/O SUBQ PORT/PMP,3555.0,2310.75,0.01,3555.0,61
CDM,76102815,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,8932.0,5805.8,0.01,8932.0,61
CDM,76102825,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,0.01,741.0,61
CDM,76102830,COLLECT BLOOD FROM CATHETER VENOUS NOS,741.0,481.65,0.01,741.0,61
CDM,76102840,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,741.0,481.65,0.01,741.0,61
CDM,76102850,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,18098.0,11763.7,0.01,18098.0,61
CDM,76102885,DIAGNOSTIC BONE MARROW ASPIRATIONS,6481.0,4212.65,0.01,6481.0,61
CDM,76102890,DIAGNOSTIC BONE MARROW BIOPSIES,6481.0,4212.65,0.01,6481.0,61
CDM,76102900,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,6481.0,4212.65,0.01,6481.0,61
CDM,76102915,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,1607.0,1044.55,0.01,3004.0,61
CDM,76102965,INCISION LINGUAL FRENUM FRENOTOMY,6814.0,4429.1,0.01,6814.0,61
CDM,76103035,REMOVAL RESIDUAL ROOT,302.0,196.3,0.01,3004.0,61
CDM,76103065,BIOPSY SALIVARY GLAND NEEDLE,3237.0,2104.05,0.01,3237.0,61
CDM,76103220,BIOPSY LIVER NEEDLE PERCUTANEOUS,7453.0,4844.45,0.01,7453.0,61
CDM,76103230,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,4313.0,2803.45,0.01,4313.0,61
CDM,76103235,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,0.01,4313.0,61
CDM,76103255,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1112.0,722.8,0.01,3004.0,61
CDM,76103265,RENAL BIOPSY PRQ TROCAR/NEEDLE,7453.0,4844.45,0.01,7453.0,61
CDM,76103300,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,0.01,9423.0,61
CDM,76103305,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1048.0,681.2,0.01,1048.0,46
CDM,76103310,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1119.0,727.35,0.01,3004.0,61
CDM,76103315,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,0.01,3004.0,61
CDM,76103320,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,0.01,3004.0,61
CDM,76103325,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,0.01,3004.0,61
CDM,76103330,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,0.01,3004.0,61
CDM,76103335,NDSC NJX IMPLT MATRL URT&/BLDR NCK,15865.0,10312.25,0.01,15865.0,61
CDM,76103340,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,3070.0,1995.5,0.01,3070.0,61
CDM,76103345,SIMPLE CYSTOMETROGRAM,1119.0,727.35,0.01,3004.0,61
CDM,76103350,BLADDER PRESSURE MEASUREMENT DURING FILLING,1119.0,727.35,0.01,3004.0,61
CDM,76103355,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,3070.0,1995.5,226.03,3070.0,61
CDM,76103360,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,3070.0,1995.5,0.01,3070.0,61
CDM,76103365,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3070.0,1995.5,0.01,3070.0,61
CDM,76103375,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,106.62,720.0,61
CDM,76103390,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,0.01,273.0,61
CDM,76103395,CYSTOURETHROSCOPY,3070.0,1995.5,0.01,3070.0,61
CDM,76103400,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,15865.0,10312.25,0.01,15865.0,61
CDM,76103410,CYSTOURETHROSCOPY WITH BIOPSY,9423.0,6124.95,0.01,9423.0,61
CDM,76103415,CYSTO W/DESTRUCTION OF LESIONS,15865.0,10312.25,0.01,15865.0,61
CDM,76103420,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,15865.0,10312.25,0.01,15865.0,61
CDM,76103435,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,9423.0,6124.95,0.01,9423.0,61
CDM,76103440,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,9423.0,6124.95,0.01,9423.0,61
CDM,76103450,CYSTO W/SIMPLE REMOVAL STONE & STENT,9423.0,6124.95,0.01,9423.0,61
CDM,76103455,CYSTO W/COMPLEX REMOVAL STONE & STENT,9423.0,6124.95,0.01,9423.0,61
CDM,76103520,DILAT URETHRAL STRIX DILATOR MALE 1ST,1119.0,727.35,0.01,3004.0,61
CDM,76103525,DILAT URETHRAL STRIX DILATOR MALE SBSQ,593.0,385.45,0.01,3004.0,61
CDM,76103530,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,3070.0,1995.5,0.01,3070.0,61
CDM,76103535,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,1119.0,727.35,0.01,3004.0,61
CDM,76103540,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,720.0,468.0,0.01,3004.0,61
CDM,76103545,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,593.0,385.45,0.01,593.0,61
CDM,76103575,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,9423.0,6124.95,0.01,9423.0,61
CDM,76103585,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,8414.0,5469.1,0.01,8414.0,61
CDM,76103600,DSTRJ LESION PENIS SIMPLE SURG EXCISION,8414.0,5469.1,0.01,8414.0,61
CDM,76103610,BIOPSY PENIS SEPARATE PROCEDURE,7453.0,4844.45,0.01,7453.0,61
CDM,76103615,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,9423.0,6124.95,0.01,9423.0,61
CDM,76103630,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,9423.0,6124.95,0.01,9423.0,61
CDM,76103635,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1119.0,727.35,0.01,1119.0,61
CDM,76103660,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,3237.0,2104.05,0.01,3237.0,61
CDM,76103680,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,9423.0,6124.95,0.01,9423.0,61
CDM,76103695,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,6294.0,4091.1,0.01,6294.0,61
CDM,76103710,I&D VULVA/PERINEAL ABSCESS,1399.0,909.35,0.01,4001.0,61
CDM,76103715,I&D OF BARTHOLINS GLAND ABSCESS,925.0,601.25,0.01,3004.0,61
CDM,76103735,BIOPSY VULVA/PERINEUM 1 LESION SPX,4005.0,2603.25,0.01,4005.0,61
CDM,76103740,BIOPSY VULVA/PERINEUM EACH ADDL LESION,784.0,509.6,0.01,3004.0,46
CDM,76103745,COLPOSCOPY VULVA,925.0,601.25,0.01,3004.0,61
CDM,76103750,COLPOSCOPY VULVA W/BIOPSY,1399.0,909.35,0.01,3004.0,61
CDM,76103765,BIOPSY VAGINAL MUCOSA SIMPLE,4005.0,2603.25,0.01,4005.0,61
CDM,76103775,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,925.0,601.25,0.01,925.0,61
CDM,76103790,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1399.0,909.35,0.01,3004.0,61
CDM,76103795,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,4005.0,2603.25,0.01,4005.0,61
CDM,76103800,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,925.0,601.25,0.01,4001.0,61
CDM,76103805,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,1399.0,909.35,0.01,4001.0,61
CDM,76103810,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,1399.0,909.35,0.01,3004.0,61
CDM,76103815,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,1399.0,909.35,0.01,3004.0,61
CDM,76103825,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,14626.0,9506.9,0.01,14626.0,61
CDM,76103830,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,4005.0,2603.25,0.01,4005.0,61
CDM,76103835,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,4005.0,2603.25,0.01,4005.0,61
CDM,76103855,DILATION CERVICAL CANAL INSTRUMENTAL SPX,14626.0,9506.9,0.01,14626.0,61
CDM,76103860,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,925.0,601.25,0.01,3004.0,61
CDM,76103865,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,447.0,290.55,0.01,3004.0,46
CDM,76103875,INSERTION INTRAUTERINE DEVICE IUD,502.0,326.3,0.01,3004.0,46
CDM,76103880,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,0.01,3004.0,61
CDM,76103885,ARTIFICIAL INSEMINATION INTRA-UTERINE,925.0,601.25,0.01,925.0,61
CDM,76103895,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,831.0,540.15,0.01,3004.0,46
CDM,76103965,AMNIOCENTESIS DIAGNOSIC,3483.0,2263.95,0.01,3483.0,61
CDM,76103970,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,1217.0,791.05,0.01,3004.0,61
CDM,76103980,CHORIONIC VILLUS SAMPLING,3483.0,2263.95,0.01,3483.0,61
CDM,76103995,FETAL NONSTRESS TEST,805.0,523.25,79.6,805.0,61
CDM,76104015,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,1217.0,791.05,0.01,3004.0,61
CDM,76104070,ASPIRATION AND/OR INJECTION THYROID CYST,2814.0,1829.1,0.01,3004.0,61
CDM,76104085,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,4778.0,3105.7,0.01,4778.0,61
CDM,76104090,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2069.0,1344.85,0.01,2069.0,61
CDM,76104100,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,0.01,4778.0,61
CDM,76104105,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,0.01,4778.0,61
CDM,76104110,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,0.01,4778.0,61
CDM,76104115,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,6143.0,3992.95,0.01,6143.0,61
CDM,76104135,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2103.0,1366.95,0.01,3004.0,46
CDM,76104230,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,0.01,3004.0,61
CDM,76104240,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,0.01,3004.0,61
CDM,76104265,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,6143.0,3992.95,0.01,6143.0,61
CDM,76104280,INJECTION AA&/STRD SUPRASCAPULAR NERVE,4778.0,3105.7,0.01,4778.0,61
CDM,76104285,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,4778.0,3105.7,0.01,4778.0,61
CDM,76104290,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,6143.0,3992.95,0.01,6143.0,61
CDM,76104295,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,4778.0,3105.7,0.01,4778.0,61
CDM,76104300,INJECTION AA&/STRD PUDENDAL NERVE,6143.0,3992.95,0.01,6143.0,61
CDM,76104310,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,4778.0,3105.7,0.01,4778.0,61
CDM,76104320,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,4778.0,3105.7,0.01,4778.0,61
CDM,76104335,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,0.01,4778.0,61
CDM,76104340,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,2037.0,1324.05,0.01,3004.0,61
CDM,76104345,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76104350,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1361.0,884.65,0.01,3004.0,46
CDM,76104355,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76104360,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1482.0,963.3,0.01,3004.0,46
CDM,76104365,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76104370,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,656.0,426.4,0.01,3004.0,46
CDM,76104375,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,656.0,426.4,0.01,3004.0,46
CDM,76104380,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76104385,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,0.01,3004.0,46
CDM,76104390,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,0.01,3004.0,46
CDM,76104395,INJECTION ANES AGENT SPHENOPALATINE GANGLION,2037.0,1324.05,0.01,3004.0,61
CDM,76104405,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,6143.0,3992.95,0.01,6143.0,61
CDM,76104410,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,6143.0,3992.95,0.01,6143.0,61
CDM,76104415,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,6143.0,3992.95,0.01,6143.0,61
CDM,76104420,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,6143.0,3992.95,0.01,6143.0,61
CDM,76104430,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,24426.0,15876.9,0.01,24426.0,53
CDM,76104435,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2037.0,1324.05,0.01,3004.0,61
CDM,76104440,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,23729.0,15423.85,0.01,23729.0,61
CDM,76104465,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,2037.0,1324.05,0.01,3004.0,61
CDM,76104480,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,2037.0,1324.05,0.01,3004.0,61
CDM,76104485,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,6143.0,3992.95,0.01,6143.0,61
CDM,76104510,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,6143.0,3992.95,0.01,6143.0,61
CDM,76104520,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,13474.0,8758.1,0.01,13474.0,61
CDM,76104525,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,914.0,594.1,0.01,3004.0,46
CDM,76104530,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,13474.0,8758.1,0.01,13474.0,61
CDM,76104535,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,3267.0,2123.55,0.01,3267.0,46
CDM,76104540,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,6143.0,3992.95,0.01,6143.0,61
CDM,76104545,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,2037.0,1324.05,0.01,3004.0,61
CDM,76104550,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,2037.0,1324.05,0.01,3004.0,61
CDM,76104555,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,6143.0,3992.95,0.01,6143.0,61
CDM,76104645,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,10491.0,6819.15,0.01,10491.0,61
CDM,76104715,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,1526.0,991.9,0.01,3004.0,61
CDM,76104825,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,1375.0,893.75,0.01,3004.0,61
CDM,76104965,BIOPSY EXTERNAL EAR,929.0,603.85,0.01,929.0,61
CDM,76104985,RMVL FB XTRNL AUDITORY CANAL W/O ANES,516.0,335.4,0.01,516.0,61
CDM,76104990,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,238.0,154.7,0.01,3004.0,61
CDM,76105050,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,0.01,1791.0,61
CDM,76105060,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,410.0,266.5,0.01,410.0,61
CDM,76105070,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,914.0,594.1,0.01,3004.0,61
CDM,76105075,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,746.0,484.9,0.01,3004.0,46
CDM,76105085,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,914.0,594.1,0.01,914.0,61
CDM,76105155,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,22708.0,14760.2,492.09,22708.0,61
CDM,76105165,INSERTION VAGINAL RADIATION DEVICE,1399.0,909.35,0.01,4001.0,61
CDM,76105210,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,0.01,1222.0,61
CDM,76105215,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,726.0,471.9,0.01,726.0,61
CDM,76105220,APPLICATION LONG ARM SPLINT SHOULDER HAND,726.0,471.9,0.01,726.0,61
CDM,76105230,APPLICATION FINGER SPLINT STATIC,593.0,385.45,0.01,593.0,61
CDM,76105245,STRAPPING HAND/FINGER,273.0,177.45,0.01,273.0,61
CDM,76105275,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1222.0,794.3,0.01,1222.0,61
CDM,76105320,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,7933.0,5156.45,0.01,7933.0,61
CDM,76105360,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,0.01,3004.0,61
CDM,76105395,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,18098.0,11763.7,0.01,18098.0,61
CDM,76105410,CYSTO W/REMOVAL OF TUMORS SMALL,15865.0,10312.25,0.01,15865.0,61
CDM,76105475,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,4861.0,3159.65,0.01,4861.0,61
CDM,76105505,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,0.01,3004.0,61
CDM,76105515,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1836.0,1193.4,0.01,4001.0,61
CDM,76105525,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,596.0,387.4,0.01,3004.0,61
CDM,76105535,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,1199.0,779.35,0.01,1199.0,61
CDM,76105545,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,1199.0,779.35,0.01,1199.0,61
CDM,76105555,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,596.0,387.4,0.01,596.0,61
CDM,76105565,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,11180.0,7267.0,0.01,11180.0,61
CDM,76105575,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,2629.0,1708.85,0.01,3004.0,46
CDM,76105585,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1358.0,882.7,0.01,3004.0,61
CDM,76105595,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,0.01,3186.0,61
CDM,76105605,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,0.01,3004.0,61
CDM,76105615,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1103.0,716.95,0.01,3004.0,61
CDM,76105635,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,7453.0,4844.45,0.01,7453.0,61
CDM,76105665,CLOSED TREATMENT COCCYGEAL FRACTURE,1103.0,716.95,0.01,3004.0,61
CDM,76105675,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76105685,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,7362.0,4785.3,0.01,7362.0,61
CDM,76105705,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,1836.0,1193.4,0.01,3004.0,61
CDM,76105765,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),7933.0,5156.45,0.01,7933.0,61
CDM,76105775,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,14918.0,9696.7,0.01,14918.0,53
CDM,76105795,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,1729.0,1123.85,0.01,3004.0,46
CDM,76105855,INCISION LABIAL FRENUM FRENOTOMY,2343.0,1522.95,0.01,3004.0,61
CDM,76105905,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,0.01,4194.0,61
CDM,76105915,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,5424.0,3525.6,0.01,5424.0,61
CDM,76105935,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,0.01,5424.0,61
CDM,76105955,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,596.0,387.4,0.01,3004.0,61
CDM,76106025,TAP BLOCK UNILATERAL BY INJECTION(S),1407.0,914.55,0.01,4001.0,46
CDM,76106065,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,1199.0,779.35,0.01,1199.0,61
CDM,76106095,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,2037.0,1324.05,0.01,3004.0,61
CDM,76106115,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,4778.0,3105.7,0.01,4778.0,61
CDM,76106125,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,2766.0,1797.9,0.01,3004.0,46
CDM,76106135,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,4778.0,3105.7,0.01,4778.0,61
CDM,76106145,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,2229.0,1448.85,0.01,3004.0,46
CDM,76106155,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,4778.0,3105.7,0.01,4778.0,61
CDM,76106205,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1838.0,1194.7,0.01,1838.0,61
CDM,76106275,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,596.0,387.4,0.01,596.0,61
CDM,76106285,REPAIR COMPLEX TRUNK 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,61
CDM,76106305,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,4861.0,3159.65,0.01,4861.0,61
CDM,76106335,NJX RETROGRADE URETHROCSTOGRAPY,1335.0,867.75,0.01,1335.0,46
CDM,76106355,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,1596.0,1037.4,0.01,1596.0,61
CDM,76106365,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2111.0,1372.15,0.01,4001.0,61
CDM,76106375,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,299.0,194.35,0.01,3004.0,46
CDM,76106395,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,596.0,387.4,0.01,3004.0,61
CDM,76106425,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,603.0,391.95,0.01,6561.0,46
CDM,76106445,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,10983.0,7138.95,0.01,10983.0,61
CDM,76106455,FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<,5488.0,3567.2,0.01,5488.0,46
CDM,76106475,BLEPHAROPLASTY LOWER EYELID,5488.0,3567.2,0.01,6561.0,61
CDM,76106515,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2111.0,1372.15,0.01,4001.0,61
CDM,76106545,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,7453.0,4844.45,0.01,7453.0,61
CDM,76106605,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,7453.0,4844.45,0.01,7453.0,61
CDM,76106625,ABDOMINAL FAT PAD BIOPSY,2008.0,1305.2,0.01,3004.0,61
CDM,76106655,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1103.0,716.95,0.01,3004.0,61
CDM,76106715,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1103.0,716.95,0.01,1103.0,61
CDM,76106725,CLTX GREATER TROCHANTERIC FX W/O MANJ,1103.0,716.95,0.01,3004.0,61
CDM,76106845,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1068.0,694.2,0.01,3004.0,61
CDM,76106925,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,3601.0,2340.65,0.01,3601.0,46
CDM,76106945,VNPNXR 3 YEARS/> PHYS/QHP SKILL,222.0,144.3,0.01,222.0,46
CDM,76106955,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,61
CDM,76106965,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,3555.0,2310.75,0.01,4001.0,61
CDM,76106985,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,27212.0,17687.8,0.01,27212.0,61
CDM,76106995,NASPHARSCOPY INJ PHARYNX,1360.0,884.0,0.01,3004.0,61
CDM,76107035,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,7453.0,4844.45,0.01,7453.0,61
CDM,76107125,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,2814.0,1829.1,0.01,3004.0,61
CDM,76107145,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,4778.0,3105.7,0.01,4778.0,61
CDM,76107155,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,1322.0,859.3,0.01,3004.0,46
CDM,76107175,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,6143.0,3992.95,0.01,6143.0,61
CDM,76107185,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,4778.0,3105.7,0.01,4778.0,61
CDM,76107245,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,238.0,154.7,0.01,3004.0,61
CDM,76107265,DEBRID PURULENT MID EAR,302.0,196.3,0.01,3004.0,61
CDM,76107275,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,3763.0,2445.95,184.62,3763.0,61
CDM,76108015,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,0.01,7146.0,61
CDM,76108025,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,4861.0,3159.65,0.01,4861.0,61
CDM,76108065,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,5488.0,3567.2,0.01,5783.06,61
CDM,76108085,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<,5488.0,3567.2,0.01,5783.06,61
CDM,76108105,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,14925.0,9701.25,0.01,14925.0,61
CDM,76108165,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,0.01,7146.0,61
CDM,76108205,CLSD TX PELVIC RING FX W/O MANIPULATION,1103.0,716.95,0.01,3004.0,61
CDM,76108225,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,7933.0,5156.45,0.01,7933.0,61
CDM,76108245,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,18098.0,11763.7,0.01,18098.0,61
CDM,76108255,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,5279.0,3431.35,0.01,5279.0,46
CDM,76108275,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,4778.0,3105.7,0.01,4778.0,61
CDM,76108295,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,0.01,4778.0,61
CDM,76108445,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,0.01,7453.0,61
CDM,76108535,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1786.0,1160.9,0.01,3004.0,61
CDM,76108635,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2206.0,1433.9,0.01,3004.0,46
CDM,76108645,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,0.01,3041.0,46
CDM,76108655,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,3904.0,2537.6,0.01,3904.0,46
CDM,76108665,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2775.0,1803.75,0.01,3004.0,46
CDM,76108675,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,3225.0,2096.25,0.01,3225.0,46
CDM,76108715,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,7505.0,4878.25,0.01,7505.0,46
CDM,76108725,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,7638.0,4964.7,0.01,7638.0,46
CDM,76108735,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,8125.0,5281.25,0.01,8125.0,46
CDM,76108745,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,990.0,643.5,0.01,4001.0,46
CDM,76108755,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,4013.0,2608.45,0.01,4013.0,46
CDM,76108765,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,0.01,4525.0,46
CDM,76108775,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,5469.0,3554.85,0.01,5469.0,46
CDM,76108785,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,848.0,551.2,0.01,4001.0,46
CDM,76108795,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1367.0,888.55,0.01,3004.0,46
CDM,76108805,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1660.0,1079.0,0.01,3004.0,46
CDM,76108825,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1211.0,787.15,0.01,4001.0,61
CDM,76108845,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,20388.0,13252.2,0.01,20388.0,61
CDM,76108855,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,50428.0,32778.2,0.01,51380.79,61
CDM,76108865,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,5539.0,3600.35,0.01,5539.0,46
CDM,76108885,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,29774.0,19353.1,0.01,32356.61,61
CDM,76108895,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,18098.0,11763.7,0.01,18098.0,61
CDM,76108905,TRANSCATHETER BIOPSY,31083.0,20203.95,0.01,31083.0,61
CDM,76108915,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,19680.0,12792.0,0.01,19680.0,46
CDM,76108925,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,0.01,4001.0,61
CDM,76108945,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,16234.0,10552.1,0.01,16234.0,61
CDM,76108955,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,28703.0,18656.95,0.01,28703.0,61
CDM,76108965,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,28703.0,18656.95,0.01,28703.0,61
CDM,76108975,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,16234.0,10552.1,0.01,18145.13,61
CDM,76108985,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,47892.0,31129.8,0.01,47892.0,61
CDM,76109005,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,661.0,429.65,0.01,3004.0,46
CDM,76109015,RMV/RPLC INDW URET BI-S,9423.0,6124.95,0.01,9423.0,61
CDM,76109035,RMV ONLY INDW URET BI-S,9423.0,6124.95,0.01,9423.0,61
CDM,76109055,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3070.0,1995.5,0.01,3070.0,61
CDM,76109115,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,46
CDM,76109135,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,46
CDM,76109215,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,46
CDM,76109225,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,46
CDM,76109245,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,240.0,156.0,0.01,271.21,46
CDM,76109255,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,240.0,156.0,0.01,271.21,46
CDM,76109275,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,486.0,315.9,0.01,3004.0,46
CDM,76109285,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,5451.0,3543.15,0.01,5451.0,61
CDM,76109295,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,5451.0,3543.15,0.01,5451.0,61
CDM,76109305,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2037.0,1324.05,0.01,3004.0,61
CDM,76109315,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,0.01,7453.0,61
CDM,76109325,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2111.0,1372.15,0.01,4001.0,61
CDM,76109335,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,4861.0,3159.65,0.01,4861.0,61
CDM,76109345,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,4861.0,3159.65,0.01,4861.0,46
CDM,76109355,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,4855.0,3155.75,0.01,4855.0,61
CDM,76109365,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,26838.0,17444.7,0.01,26838.0,61
CDM,76109375,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,26838.0,17444.7,0.01,26838.0,61
CDM,76109385,BIOPSY PLEURA PERCUTANEOUS NEEDLE,7453.0,4844.45,0.01,7453.0,61
CDM,76109395,SURFACE LASER SPIDER VEINS,364.0,236.6,0.01,4001.0,61
CDM,76109405,STAB PHLEBECTOMY VV <10 INCN,3400.0,2210.0,0.01,4001.0,61
CDM,76109415,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,18098.0,11763.7,0.01,18098.0,61
CDM,76109425,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,18098.0,11763.7,0.01,18098.0,61
CDM,76109445,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,14925.0,9701.25,0.01,14925.0,61
CDM,76109465,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,4455.0,2895.75,0.01,7445.0,61
CDM,76109475,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,12718.0,8266.7,0.01,12718.0,61
CDM,76109485,INJECTION THERAPEUTIC CARPAL TUNNEL,1358.0,882.7,0.01,3004.0,61
CDM,76109505,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76109575,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,0.01,1222.0,61
CDM,76109585,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,0.01,593.0,61
CDM,76109595,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1222.0,794.3,0.01,1222.0,61
CDM,76109605,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,0.01,726.0,61
CDM,76109675,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76109775,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,6143.0,3992.95,0.01,6143.0,61
CDM,76109845,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,5488.0,3567.2,0.01,5488.0,61
CDM,76109865,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2111.0,1372.15,0.01,3004.0,46
CDM,76109875,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2111.0,1372.15,0.01,3004.0,46
CDM,76109885,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,0.01,726.0,61
CDM,76109905,COLLECTION CAPILLARY BLOOD SPECIMEN,48.0,31.2,0.01,48.0,46
CDM,76109925,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,23385.0,15200.25,0.01,23385.0,61
CDM,76109935,EXC/FULGURATION URETHRAL CARUNCLE,9423.0,6124.95,0.01,9423.0,61
CDM,76109945,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,9423.0,6124.95,0.01,9423.0,61
CDM,76109965,FETAL CONTRACTION STRESS TEST,805.0,523.25,0.01,805.0,61
CDM,76109985,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,6143.0,3992.95,0.01,6143.0,61
CDM,76110005,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1838.0,1194.7,0.01,1838.0,61
CDM,76110025,EYE IRRIGATION,136.0,88.4,0.01,136.0,38
CDM,76110055,CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME,3070.0,1995.5,0.01,4001.0,61
CDM,76110065,DRAINAGE SCROTAL WALL ABSCESS,7453.0,4844.45,0.01,7453.0,61
CDM,76110085,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1358.0,882.7,0.01,3004.0,61
CDM,76110095,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76110105,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76110115,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1928.0,1253.2,0.01,3004.0,46
CDM,76110135,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,25409.0,16515.85,0.01,25409.0,53
CDM,76110145,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,0.01,3004.0,61
CDM,76110155,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,0.01,3004.0,61
CDM,76110165,INJECTION AA&/STRD SUPRASCAPULAR NERVE,4778.0,3105.7,0.01,4778.0,61
CDM,76110175,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,0.01,4778.0,61
CDM,76110185,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76110195,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1482.0,963.3,0.01,3004.0,46
CDM,76110205,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76110215,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,656.0,426.4,0.01,3004.0,46
CDM,76110225,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,656.0,426.4,0.01,3004.0,46
CDM,76110235,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,0.01,6143.0,61
CDM,76110245,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,0.01,3004.0,46
CDM,76110255,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,0.01,3004.0,46
CDM,76110265,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,13474.0,8758.1,0.01,13474.0,61
CDM,76110275,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,914.0,594.1,0.01,3004.0,46
CDM,76110285,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,13474.0,8758.1,0.01,13474.0,61
CDM,76110295,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,3267.0,2123.55,0.01,3267.0,46
CDM,76110305,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,6143.0,3992.95,0.01,6143.0,61
CDM,76110315,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,0.01,3004.0,61
CDM,76110325,INJECTION ANES AGENT SPHENOPALATINE GANGLION,2037.0,1324.05,0.01,3004.0,61
CDM,76110335,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,13689.0,8897.85,0.01,17862.53,53
CDM,76110345,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,5451.0,3543.15,0.01,5451.0,61
CDM,76110355,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,6481.0,4212.65,0.01,6481.0,61
CDM,76110365,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,5488.0,3567.2,0.01,5488.0,61
CDM,76110375,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,726.0,471.9,0.01,726.0,61
CDM,76110385,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,2297.0,1493.05,0.01,3004.0,61
CDM,76110445,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,6143.0,3992.95,0.01,6143.0,61
CDM,76110455,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,0.01,7453.0,61
CDM,76110465,CATH FOR COLL SPECIMEN,63.0,40.95,0.01,3004.0,60
CDM,76110475,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,23729.0,15423.85,0.01,23729.0,61
CDM,76110485,REVISION/RMVL PERIPHERAL/GASTRIC NPGR,23729.0,15423.85,0.01,23729.0,61
CDM,76110555,TENOTOMY SHOULDER AREA 1 TENDON,32861.0,21359.65,0.01,32861.0,61
CDM,76110605,DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM,3815.0,2479.75,0.01,3815.0,46
CDM,76110615,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,12718.0,8266.7,0.01,12718.0,61
CDM,76110665,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,14925.0,9701.25,0.01,14925.0,61
CDM,76110685,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,7362.0,4785.3,0.01,7362.0,61
CDM,76110695,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,14925.0,9701.25,0.01,14925.0,61
CDM,76110795,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,9423.0,6124.95,0.01,9423.0,61
CDM,76110805,FETAL INVAS PROC W/US GUIDANCE,630.0,409.5,0.01,3004.0,61
CDM,76110825,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,6143.0,3992.95,0.01,6143.0,61
CDM,76110835,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,0.01,4778.0,61
CDM,76110865,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,0.01,4778.0,61
CDM,76110875,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,6143.0,3992.95,0.01,6143.0,61
CDM,76110885,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,0.01,3004.0,61
CDM,76110895,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,0.01,3004.0,61
CDM,76110905,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,0.01,4778.0,61
CDM,76110915,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,0.01,4778.0,61
CDM,76110925,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,0.01,741.0,61
CDM,76110985,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,868.0,564.2,0.01,868.0,46
CDM,76111005,ARTERIAL LINE INSERT,1392.0,904.8,0.01,1392.0,38
CDM,76111015,IABP INSERT,4064.0,2641.6,0.01,4064.0,38
CDM,76111075,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3138.0,2039.7,0.01,5793.81,46
CDM,76111095,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,0.01,47587.0,61
CDM,76111115,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,8932.0,5805.8,0.01,9996.0,61
CDM,76111235,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1579.0,1026.35,0.01,3004.0,46
CDM,76111335,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,11448.0,7441.2,0.01,11448.0,61
CDM,76111445,CT LUNG LOCALIZATION,1845.0,1199.25,0.01,1845.0,61
CDM,76111485,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3070.0,1995.5,0.01,3070.0,61
CDM,76111495,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,18098.0,11763.7,0.01,18098.0,61
CDM,76111515,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,10518.0,6836.7,0.01,10518.0,61
CDM,76111565,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,12718.0,8266.7,0.01,12718.0,61
CDM,76111765,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,11448.0,7441.2,0.01,11448.0,61
CDM,76111855,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,61
CDM,76111905,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,9423.0,6124.95,0.01,9423.0,61
CDM,76112045,AMPUTATION TOE INTERPHALANGEAL JOINT,14833.0,9641.45,0.01,14833.0,61
CDM,76112085,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,29447.0,19140.55,0.01,29447.0,61
CDM,76112095,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,32861.0,21359.65,0.01,32861.0,61
CDM,76112105,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,10937.0,7109.05,0.01,10937.0,46
CDM,76112235,DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR,13474.0,8758.1,0.01,13474.0,61
CDM,76112455,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1528.0,993.2,0.01,3004.0,46
CDM,76112635,RPR LIP FULL THICKNESS VERMILION ONLY,2343.0,1522.95,0.01,6561.0,61
CDM,76112745,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,3237.0,2104.05,0.01,3237.0,61
CDM,76112755,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,942.0,612.3,0.01,3004.0,46
CDM,76112765,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,3237.0,2104.05,0.01,3237.0,61
CDM,76112775,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1471.0,956.15,0.01,3004.0,46
CDM,76112785,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,0.01,3004.0,61
CDM,76112795,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,184.0,119.6,0.01,3004.0,46
CDM,76112805,TANGENTIAL BIOPSY SKIN SINGLE LESION,596.0,387.4,0.01,3004.0,61
CDM,76112815,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,159.0,103.35,0.01,3004.0,46
CDM,76112845,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,0.01,3004.0,61
CDM,76112855,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,283.0,183.95,0.01,3004.0,46
CDM,76112945,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,61
CDM,76112985,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,8667.0,5633.55,0.01,8667.0,46
CDM,76112995,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,0.01,3004.0,61
CDM,76113055,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,5488.0,3567.2,0.01,5488.0,46
CDM,76113105,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,1017.0,661.05,0.01,3004.0,46
CDM,76113115,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1119.0,727.35,0.01,3004.0,61
CDM,76113125,PROC MATERNITY CARE UNLISTED,379.0,246.35,0.01,4001.0,61
CDM,76113155,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2111.0,1372.15,0.01,4001.0,61
CDM,76113165,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,617.0,401.05,0.01,3004.0,46
CDM,76113175,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,32861.0,21359.65,0.01,32861.0,61
CDM,76113185,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,761.0,494.65,0.01,3004.0,46
CDM,76113195,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,0.01,3004.0,46
CDM,76113205,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,0.01,3004.0,46
CDM,76113215,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,0.01,3004.0,46
CDM,76113225,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,16234.0,10552.1,0.01,16234.0,61
CDM,76113235,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,7453.0,4844.45,0.01,7453.0,61
CDM,76113245,EXCHNG ABSC/CST DRG CATH RAD GID SPX,8726.0,5671.9,0.01,8726.0,61
CDM,76113255,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,0.01,4313.0,61
CDM,76113265,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,3237.0,2104.05,0.01,3237.0,61
CDM,76113275,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3070.0,1995.5,0.01,3070.0,61
CDM,76113285,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,999.0,649.35,0.01,3004.0,46
CDM,76113315,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,5451.0,3543.15,0.01,5451.0,61
CDM,76113365,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,0.01,3004.0,61
CDM,76113395,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,4313.0,2803.45,0.01,4313.0,61
CDM,76113405,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,0.01,9423.0,61
CDM,76113415,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,239.0,155.35,0.01,239.0,60
CDM,76113425,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,177.0,115.05,0.01,177.0,46
CDM,76113455,UNLISTED PROCEDURE NOSE,812.0,527.8,0.01,3004.0,61
CDM,76113535,DRAINAGE SCROTAL WALL ABSCESS,7453.0,4844.45,0.01,7453.0,61
CDM,76113575,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,900.0,585.0,0.01,900.0,61
CDM,76113625,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,4861.0,3159.65,0.01,4861.0,61
CDM,76113765,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,113.0,73.45,0.01,3004.0,61
CDM,76113775,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,0.01,3004.0,61
CDM,76113845,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,0.01,8932.0,61
CDM,76113855,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,0.01,4778.0,61
CDM,76113865,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,0.01,4778.0,61
CDM,76113875,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,4778.0,3105.7,0.01,4778.0,61
CDM,76113885,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,4778.0,3105.7,0.01,4778.0,61
CDM,76113895,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,13474.0,8758.1,0.01,13474.0,61
CDM,76113905,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,13474.0,8758.1,0.01,13474.0,61
CDM,76113935,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,7752.0,5038.8,0.01,17862.53,61
CDM,76113945,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,13756.0,8941.4,0.01,13756.0,61
CDM,76113965,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,15317.0,9956.05,0.01,15317.0,61
CDM,76114015,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,0.01,8932.0,61
CDM,76114025,CHANGE CYSTOSTOMY TUBE COMPLICATED,3070.0,1995.5,0.01,3070.0,61
CDM,76114065,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,252.0,163.8,0.01,252.0,46
CDM,76114225,ASPIRATION & INJECTION TREATMENT BONE CYST,3237.0,2104.05,0.01,3237.0,61
CDM,76114285,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,889.0,577.85,0.01,889.0,61
CDM,76114355,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,32784.0,21309.6,0.01,32784.0,61
CDM,76114395,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,0.01,4313.0,61
CDM,76114425,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1836.0,1193.4,0.01,4001.0,61
CDM,76114435,INJECTION PROCEDURE LYMPHANGIOGRAPHY,3757.0,2442.05,0.01,3757.0,46
CDM,76114525,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1119.0,727.35,0.01,3004.0,61
CDM,76114565,HYSTEROSCOPY REMOVAL LEIOMYOMATA,22708.0,14760.2,0.01,22708.0,61
CDM,76114605,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,726.0,471.9,0.01,726.0,61
CDM,76114615,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,7453.0,4844.45,0.01,7453.0,61
CDM,76114635,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,7453.0,4844.45,0.01,7453.0,61
CDM,76114705,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,7362.0,4785.3,0.01,7362.0,61
CDM,76114745,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,23385.0,15200.25,0.01,23385.0,61
CDM,76114755,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,14478.0,9410.7,0.01,14478.0,61
CDM,76114765,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,8932.0,5805.8,0.01,8932.0,61
CDM,76114835,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,59187.0,38471.55,0.01,59187.0,61
CDM,76114845,PROC MUSSKL SYS UNLISTD,2543.0,1652.95,0.01,3004.0,61
CDM,76114855,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,26695.0,17351.75,0.01,29793.81,61
CDM,76114865,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,18098.0,11763.7,0.01,18098.0,61
CDM,76114875,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,61
CDM,76114885,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,0.01,8932.0,61
CDM,76114895,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,0.01,18098.0,61
CDM,76114905,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,18098.0,11763.7,0.01,18098.0,61
CDM,76114925,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,31083.0,20203.95,0.01,31083.0,61
CDM,76114935,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,18379.0,11946.35,0.01,18379.0,61
CDM,76114945,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,0.01,18098.0,61
CDM,76114955,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,31083.0,20203.95,0.01,31083.0,61
CDM,76114965,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,18098.0,11763.7,0.01,18098.0,61
CDM,76114975,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,0.01,18098.0,61
CDM,76115025,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,16234.0,10552.1,0.01,16234.0,61
CDM,76115045,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,9423.0,6124.95,0.01,9423.0,61
CDM,76115055,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,25651.0,16673.15,0.01,29793.81,61
CDM,76115065,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,15865.0,10312.25,0.01,15865.0,61
CDM,76115075,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,15865.0,10312.25,0.01,15865.0,61
CDM,76115085,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,15865.0,10312.25,0.01,15865.0,61
CDM,76115105,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,49016.0,31860.4,0.01,49016.0,61
CDM,76115115,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,52240.0,33956.0,0.01,52240.0,61
CDM,76115185,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,0.01,4313.0,61
CDM,76115235,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,8932.0,5805.8,0.01,8932.0,61
CDM,76115655,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,65208.0,42385.2,0.01,65208.0,61
CDM,76115665,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,103251.0,67113.15,0.01,103251.0,61
CDM,76115685,REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA,751.0,488.15,0.01,3004.0,46
CDM,76115705,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,27212.0,17687.8,0.01,27212.0,61
CDM,76115715,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,65208.0,42385.2,0.01,65208.0,61
CDM,76115725,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,65208.0,42385.2,0.01,65208.0,61
CDM,76115795,NONCONTACT R-T FLUOR WND IMG 1ST ANATOMIC SITE CPT,1246.0,809.9,0.01,1246.0,61
CDM,76115805,NONCONTACT R-T FLUOR WND IMG EA ADDL ANATOMIC SITE,653.0,424.45,0.01,653.0,46
CDM,76115825,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,18098.0,11763.7,0.01,18098.0,61
CDM,76115835,NPWT (WOUND VAT),821.0,533.65,0.01,821.0,38
CDM,76116095,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,7362.0,4785.3,0.01,7362.0,61
CDM,76116115,CIRCUMCISION NEONATE,3070.0,1995.5,0.01,4001.0,61
CDM,76116125,"OSTEOPATHIC MANIP,1-2 BODY REGN",76.0,49.4,0.01,76.0,61
CDM,76116135,MANUAL REDUCTION OF INGUINAL HERNIA (COMP CODE 49505),2866.0,1862.9,0.01,3004.0,61
CDM,76116245,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,1526.0,991.9,0.01,1526.0,61
CDM,76116325,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,18098.0,11763.7,0.01,18098.0,61
CDM,76116335,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,18098.0,11763.7,0.01,18098.0,61
CDM,76116345,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,0.01,10496.0,46
CDM,76116385,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,6814.0,4429.1,0.01,6814.0,53
CDM,76116395,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1068.0,694.2,0.01,3004.0,53
CDM,76116405,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,31083.0,20203.95,0.01,31083.0,61
CDM,76116425,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,1489.0,967.85,0.01,1489.0,46
CDM,76116435,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,4778.0,3105.7,0.01,4778.0,61
CDM,76116445,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,18098.0,11763.7,0.01,18098.0,61
CDM,76116455,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,47587.0,30931.55,0.01,47587.0,61
CDM,76116465,INSERTION PICC W/O IMG GDN < 5 YR,8932.0,5805.8,0.01,8932.0,61
CDM,76116475,INSERTION PICC W/RS&I < 5 YR,3555.0,2310.75,0.01,3555.0,61
CDM,76116485,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,2289.0,1487.85,0.01,2289.0,61
CDM,76116495,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2289.0,1487.85,0.01,2289.0,61
CDM,76116505,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,5314.0,3454.1,0.01,8566.0,46
CDM,76116515,MAM STEREO BREAST BX FIRST LES,11180.0,7267.0,0.01,11180.0,61
CDM,76116525,CT GD DRAIN PERI/RETROPERI PER,7453.0,4844.45,0.01,7453.0,61
CDM,76116785,BEDSIDE PERIPHERAL NERVE BLOCK,609.0,395.85,0.01,609.0,38
CDM,76116955,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,5488.0,3567.2,0.01,5783.06,61
CDM,76116965,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,5488.0,3567.2,0.01,5488.0,46
CDM,76116975,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,21752.0,14138.8,0.01,21752.0,61
CDM,76116985,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,21752.0,14138.8,0.01,21752.0,46
CDM,76116995,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,5488.0,3567.2,0.01,5783.06,61
CDM,76117005,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,5488.0,3567.2,0.01,5488.0,46
CDM,76117015,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,5488.0,3567.2,0.01,5783.06,61
CDM,76117025,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,5488.0,3567.2,0.01,5488.0,46
CDM,76117045,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,0.01,4001.0,61
CDM,76117065,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,33521.0,21788.65,0.01,33521.0,61
CDM,76117075,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1119.0,727.35,0.01,3004.0,61
CDM,76117095,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,1138.0,739.7,0.01,1138.0,46
CDM,76117155,EXCISION TROCHANTERIC BURSA/CALCIFICATION,14925.0,9701.25,0.01,14925.0,61
CDM,76117185,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),821.0,533.65,0.01,3004.0,61
CDM,76117255,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1199.0,779.35,0.01,4001.0,61
CDM,76117265,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,6814.0,4429.1,0.01,6814.0,61
CDM,76117275,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,14918.0,9696.7,0.01,14918.0,61
CDM,76117285,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,7362.0,4785.3,0.01,7362.0,61
CDM,76117295,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,6814.0,4429.1,0.01,6814.0,61
CDM,76117355,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,4313.0,2803.45,0.01,4313.0,61
CDM,76117365,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,13165.0,8557.25,0.01,13165.0,61
CDM,76117375,BEDSIDE PROCEDURE 1ST 30 MIN,3394.0,2206.1,0.01,3394.0,38
CDM,76117385,BEDSIDE PROCEDURE EA ADDL 30 MIN,2499.0,1624.35,0.01,2499.0,38
CDM,76117405,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,831.0,540.15,0.01,2451.0,46
CDM,76117415,DRG OF SKENE'S GLAND ABSCESS OR CYST,965.0,627.25,0.01,5859.03,61
CDM,76117435,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,16566.0,10767.9,0.01,16566.0,55
CDM,76117445,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,16566.0,10767.9,0.01,16566.0,55
CDM,76117455,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,16566.0,10767.9,0.01,16566.0,55
CDM,76117465,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,16566.0,10767.9,0.01,16566.0,55
CDM,76117475,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,16566.0,10767.9,0.01,16566.0,55
CDM,76117485,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,16566.0,10767.9,0.01,16566.0,55
CDM,76117495,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,25198.0,16378.7,0.01,25198.0,55
CDM,76117505,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,25198.0,16378.7,0.01,25198.0,55
CDM,76117515,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,25198.0,16378.7,0.01,25198.0,46
CDM,76117525,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,9423.0,6124.95,0.01,9423.0,61
CDM,76117545,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,7933.0,5156.45,0.01,7933.0,61
CDM,76120AK,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,152.0,98.8,1.1,152.0,45
CDM,76140AK,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,1873.0,1217.45,1.1,1873.0,30
CDM,76140AK-26,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,141.0,91.65,1.1,141.0,23
CDM,76140AK-TC,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,1732.0,1125.8,1.1,1732.0,23
CDM,76200225,DIRECT ADMISSION HOSP OBSERV,240.0,156.0,35.71,13224.0,47
CDM,76200295,DIR ADMIT FOR HOSP OBV CARE,2452.0,1593.8,54.56,13224.0,62
CDM,76200635,OBSERVATION MED/SURG > 24 HRS PER HR (MANUAL),92.0,59.8,13.69,13224.0,47
CDM,76200645,OBSERVATION PERINATAL > 24 HRS PER HR (MANUAL),161.0,104.65,23.96,13224.0,47
CDM,76200655,OBSERVATION ORTHO > 24 HRS PER HR (MANUAL),92.0,59.8,13.69,13224.0,47
CDM,76200665,OBSERVATION ONCOLOGY > 24 HRS PER HR (MANUAL),92.0,59.8,13.69,13224.0,47
CDM,76200675,OBSERVATION 6100 PSYCH > 24 HRS PER HR (MANUAL),119.0,77.35,17.71,13224.0,47
CDM,76200685,OBSERVATION 6400 PSYCH > 24 HRS PER HR (MANUAL),109.0,70.85,16.22,13224.0,47
CDM,76200695,OBSERVATION L&D/OB TRIAGE > 24 HRS PER HR (MANUAL),83.0,53.95,12.35,13224.0,47
CDM,76200705,OBSERVATION PACU > 24 HRS PER HR (MANUAL),343.0,222.95,51.04,13224.0,47
CDM,76201235,OBSERVATION PER HR-FIRST HOUR,1011.0,657.15,150.44,13224.0,47
CDM,76201265,OBSERVATION CARVE-OUT PER HR,133.0,86.45,19.79,13224.0,47
CDM,76201275,OBSERV CARVE OUT 60 MINUTES GRP 9,133.0,86.45,19.79,13224.0,47
CDM,76201315,OBSERV CARVE OUT 60 MINUTES GRP 1,133.0,86.45,19.79,13224.0,47
CDM,76201325,OBSERV CARVE OUT GRP 7,133.0,86.45,19.79,13224.0,47
CDM,76201335,OBSERV CARVE OUT GRP 8,133.0,86.45,19.79,13224.0,47
CDM,76201345,OBSERV CARVE OUT 60 MINUTES GRP 2,133.0,86.45,19.79,13224.0,47
CDM,76201355,OBSERV CARVE OUT 60 MINUTES GRP 3,133.0,86.45,19.79,13224.0,47
CDM,76201365,OBSERV CARVE OUT 60 MINUTES GRP 4,133.0,86.45,19.79,13224.0,47
CDM,76201375,OBSERV CARVE OUT 60 MINUTES GRP 5,133.0,86.45,19.79,13224.0,47
CDM,76201385,OBSERV CARVE OUT 60 MINUTES GRP 6,133.0,86.45,19.79,13224.0,47
CDM,76201395,OBSERV CARVE OUT 60 MINUTES GRP 10,133.0,86.45,19.79,13224.0,47
CDM,76376AK,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,654.0,425.1,1.1,654.0,51
CDM,76376AK-26,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,88.0,57.2,1.1,88.0,45
CDM,76377AK,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1752.0,1138.8,1.1,1752.0,51
CDM,76377AK-26,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,316.0,205.4,1.1,316.0,45
CDM,76377AK-TC,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,1.1,1436.0,46
CDM,76380AK,CT LIMITED/LOCALIZED FOLLOW UP STUDY,1000.0,650.0,1.1,1000.0,51
CDM,76380AK-26,CT LIMITED/LOCALIZED FOLLOW UP STUDY,392.0,254.8,1.1,392.0,45
CDM,76391AK,MAGNETIC RESONANCE ELASTOGRAPHY,2152.0,1398.8,1.1,2152.0,51
CDM,76391AK-26,MAGNETIC RESONANCE ELASTOGRAPHY,484.0,314.6,1.1,484.0,45
CDM,76496RVU10AK,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),22174.0,14413.1,0.01,22174.0,35
CDM,76496RVU10AK-26,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),456.0,296.4,1.1,456.0,23
CDM,76496RVU10AK-TC,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),21718.0,14116.7,1.1,21718.0,24
CDM,76496RVU11AK,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,35
CDM,76496RVU11AK-26,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,23
CDM,76496RVU11AK-TC,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,1.1,37299.0,24
CDM,76496RVU12AK,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",22220.0,14443.0,0.01,22220.0,35
CDM,76496RVU12AK-26,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",502.0,326.3,1.1,502.0,23
CDM,76496RVU12AK-TC,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",21718.0,14116.7,1.1,21718.0,24
CDM,76496RVU13AK,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),22174.0,14413.1,0.01,22174.0,35
CDM,76496RVU13AK-26,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),456.0,296.4,1.1,456.0,23
CDM,76496RVU13AK-TC,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),21718.0,14116.7,1.1,21718.0,24
CDM,76496RVU14AK,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,35
CDM,76496RVU14AK-26,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,23
CDM,76496RVU14AK-TC,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),37229.0,24198.85,1.1,37229.0,24
CDM,76496RVU15AK,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,35
CDM,76496RVU15AK-26,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,23
CDM,76496RVU15AK-TC,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,1.1,37299.0,24
CDM,76496RVU16AK,VENOGRAM SPLENIC VEIN (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,35
CDM,76496RVU16AK-26,VENOGRAM SPLENIC VEIN (COMP CODE 75891),456.0,296.4,1.1,456.0,23
CDM,76496RVU16AK-TC,VENOGRAM SPLENIC VEIN (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,24
CDM,76496RVU17AK,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,35
CDM,76496RVU17AK-26,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,23
CDM,76496RVU17AK-TC,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),37299.0,24244.35,1.1,37299.0,24
CDM,76496RVU18AK,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4586.0,2980.9,0.01,4586.0,35
CDM,76496RVU18AK-26,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),404.0,262.6,1.1,404.0,23
CDM,76496RVU18AK-TC,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4182.0,2718.3,1.1,4182.0,24
CDM,76496RVU19AK,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,35
CDM,76496RVU19AK-26,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),456.0,296.4,1.1,456.0,23
CDM,76496RVU19AK-TC,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,24
CDM,76496RVU1AK,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),20311.0,13202.15,0.01,20311.0,35
CDM,76496RVU1AK-26,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),631.0,410.15,1.1,631.0,23
CDM,76496RVU1AK-TC,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),19680.0,12792.0,1.1,19680.0,24
CDM,76496RVU20AK,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),11139.0,7240.35,0.01,11139.0,35
CDM,76496RVU20AK-26,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),420.0,273.0,1.1,420.0,23
CDM,76496RVU20AK-TC,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),10719.0,6967.35,1.1,10719.0,24
CDM,76496RVU21AK,VENOGRAM CARDINAL VARIX (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,35
CDM,76496RVU21AK-26,VENOGRAM CARDINAL VARIX (COMP CODE 75891),456.0,296.4,1.1,456.0,23
CDM,76496RVU21AK-TC,VENOGRAM CARDINAL VARIX (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,24
CDM,76496RVU2AK,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),4236.0,2753.4,0.01,4236.0,35
CDM,76496RVU2AK-26,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),364.0,236.6,1.1,364.0,23
CDM,76496RVU2AK-TC,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),3872.0,2516.8,1.1,3872.0,24
CDM,76496RVU3AK,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),34714.0,22564.1,0.01,34714.0,35
CDM,76496RVU3AK-26,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),785.0,510.25,1.1,785.0,23
CDM,76496RVU3AK-TC,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),33929.0,22053.85,1.1,33929.0,24
CDM,76496RVU4AK,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),34340.0,22321.0,0.01,34340.0,35
CDM,76496RVU4AK-26,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),411.0,267.15,1.1,411.0,23
CDM,76496RVU4AK-TC,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),33929.0,22053.85,1.1,33929.0,24
CDM,76496RVU5AK,VENOGRAM AZYGOS VEIN (COMP CODE 75705),34714.0,22564.1,0.01,34714.0,35
CDM,76496RVU5AK-26,VENOGRAM AZYGOS VEIN (COMP CODE 75705),785.0,510.25,1.1,785.0,23
CDM,76496RVU5AK-TC,VENOGRAM AZYGOS VEIN (COMP CODE 75705),33929.0,22053.85,1.1,33929.0,24
CDM,76496RVU6AK,VENOGRAM GASTRIC VEIN (COMP CODE 75891),20091.0,13059.15,0.01,20091.0,35
CDM,76496RVU6AK-26,VENOGRAM GASTRIC VEIN (COMP CODE 75891),411.0,267.15,1.1,411.0,23
CDM,76496RVU6AK-TC,VENOGRAM GASTRIC VEIN (COMP CODE 75891),19680.0,12792.0,1.1,19680.0,24
CDM,76496RVU7AK,VENOGRAM GONADAL VEIN (COMP CODE 75831),20091.0,13059.15,0.01,20091.0,35
CDM,76496RVU7AK-26,VENOGRAM GONADAL VEIN (COMP CODE 75831),411.0,267.15,1.1,411.0,23
CDM,76496RVU7AK-TC,VENOGRAM GONADAL VEIN (COMP CODE 75831),19680.0,12792.0,1.1,19680.0,24
CDM,76496RVU8AK,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),20091.0,13059.15,0.01,20091.0,35
CDM,76496RVU8AK-26,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),411.0,267.15,1.1,411.0,23
CDM,76496RVU8AK-TC,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),19680.0,12792.0,1.1,19680.0,24
CDM,76496RVU9AK,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,35
CDM,76496RVU9AK-26,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),456.0,296.4,1.1,456.0,23
CDM,76496RVU9AK-TC,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,24
CDM,76497AK,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,55.0,35.75,1.1,55.0,23
CDM,76497WBAK,LOW DOSE WHOLE BODY CT (COMP CODE 78813),10864.0,7061.6,0.01,10864.0,35
CDM,76497WBAK-26,LOW DOSE WHOLE BODY CT (COMP CODE 78813),800.0,520.0,1.1,800.0,23
CDM,76497WBAK-TC,LOW DOSE WHOLE BODY CT (COMP CODE 78813),10064.0,6541.6,1.1,10064.0,24
CDM,76498AAK,MRI GAMMA KNIFE LOCAL W CONT,3042.0,1977.3,0.01,3042.0,35
CDM,76498AAK-26,MRI GAMMA KNIFE LOCAL W CONT,587.0,381.55,1.1,587.0,23
CDM,76498AAK-TC,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,1.1,2455.0,24
CDM,76498AK,UNLISTED MAGNETIC RESONANCE PROCED,66.0,42.9,1.1,66.0,23
CDM,76498BAK,MRI BREAST LIMITED,350.0,227.5,0.01,350.0,35
CDM,76498BAK-26,MRI BREAST LIMITED,125.0,81.25,1.1,125.0,23
CDM,76498BAK-TC,MRI BREAST LIMITED,225.0,146.25,1.1,225.0,24
CDM,76498CAK,MRI CERVICAL LOCALIZATION W IVCON,3230.0,2099.5,0.01,3230.0,35
CDM,76498CAK-26,MRI CERVICAL LOCALIZATION W IVCON,579.0,376.35,1.1,579.0,23
CDM,76498CAK-TC,MRI CERVICAL LOCALIZATION W IVCON,2651.0,1723.15,1.1,2651.0,24
CDM,76498DAK,MRI BRAIN LOCALIZATION WO CONT,4018.0,2611.7,0.01,4018.0,35
CDM,76498DAK-26,MRI BRAIN LOCALIZATION WO CONT,2319.0,1507.35,1.1,2319.0,23
CDM,76498DAK-TC,MRI BRAIN LOCALIZATION WO CONT,1699.0,1104.35,1.1,1699.0,24
CDM,76498GAK,MRI BRAIN LOCALIZATION WWO CONT,2685.0,1745.25,0.01,2685.0,35
CDM,76498GAK-26,MRI BRAIN LOCALIZATION WWO CONT,756.0,491.4,1.1,756.0,23
CDM,76498GAK-TC,MRI BRAIN LOCALIZATION WWO CONT,1929.0,1253.85,1.1,1929.0,24
CDM,76498LAK,MRI LUMBAR LOCALIZATION W IVCON,3238.0,2104.7,0.01,3238.0,35
CDM,76498LAK-26,MRI LUMBAR LOCALIZATION W IVCON,587.0,381.55,1.1,587.0,23
CDM,76498LAK-TC,MRI LUMBAR LOCALIZATION W IVCON,2651.0,1723.15,1.1,2651.0,24
CDM,76498PAK,MRI PROSTATE LIMITED WO IVCON,350.0,227.5,0.01,350.0,35
CDM,76498PAK-26,MRI PROSTATE LIMITED WO IVCON,70.0,45.5,1.1,70.0,23
CDM,76498PAK-TC,MRI PROSTATE LIMITED WO IVCON,280.0,182.0,1.1,280.0,24
CDM,76498POM1AK,MRI PRE-OP MAPPING W/CONTRAST,1237.0,804.05,0.01,1237.0,35
CDM,76498POM1AK-26,MRI PRE-OP MAPPING W/CONTRAST,629.0,408.85,1.1,629.0,23
CDM,76498POM1AK-TC,MRI PRE-OP MAPPING W/CONTRAST,608.0,395.2,1.1,608.0,24
CDM,76498POM2AK,MRI PRE-OP MAPPING W/WO CNTRST,1443.0,937.95,0.01,1443.0,35
CDM,76498POM2AK-26,MRI PRE-OP MAPPING W/WO CNTRST,835.0,542.75,1.1,835.0,23
CDM,76498POM2AK-TC,MRI PRE-OP MAPPING W/WO CNTRST,608.0,395.2,1.1,608.0,24
CDM,76498POMAK,MRI PRE-OP MAPPING W/O CONTRST,1131.0,735.15,0.01,1131.0,35
CDM,76498POMAK-26,MRI PRE-OP MAPPING W/O CONTRST,523.0,339.95,1.1,523.0,23
CDM,76498POMAK-TC,MRI PRE-OP MAPPING W/O CONTRST,608.0,395.2,1.1,608.0,24
CDM,76498RVU1AK,MRI BRAIN W/WO CONTRAST PC,3243.0,2107.95,0.01,3243.0,35
CDM,76498RVU1AK-26,MRI BRAIN W/WO CONTRAST PC,779.0,506.35,1.1,779.0,23
CDM,76498RVU1AK-TC,MRI BRAIN W/WO CONTRAST PC,2464.0,1601.6,1.1,2464.0,24
CDM,76498RVU2AK,MRI 3D CAD (COMP CODE 76377),1488.0,967.2,0.01,1488.0,35
CDM,76498RVU2AK-TC,MRI 3D CAD (COMP CODE 76377),1231.0,800.15,1.1,1231.0,24
CDM,76498RVU3AK,WHOLE BODY MRI (COMP CODE 78816),10965.0,7127.25,0.01,10965.0,35
CDM,76498RVU3AK-26,WHOLE BODY MRI (COMP CODE 78816),901.0,585.65,1.1,901.0,23
CDM,76498RVU3AK-TC,WHOLE BODY MRI (COMP CODE 78816),10064.0,6541.6,1.1,10064.0,24
CDM,76498RVUAK,MMR BRAIN WITH PC,3051.0,1983.15,0.01,3051.0,35
CDM,76498RVUAK-26,MMR BRAIN WITH PC,587.0,381.55,1.1,587.0,23
CDM,76498RVUAK-TC,MMR BRAIN WITH PC,2464.0,1601.6,1.1,2464.0,24
CDM,76498TAK,MRI THORACIC LOCALIZATION W IVCON,3230.0,2099.5,0.01,3230.0,35
CDM,76498TAK-26,MRI THORACIC LOCALIZATION W IVCON,579.0,376.35,1.1,579.0,23
CDM,76498TAK-TC,MRI THORACIC LOCALIZATION W IVCON,2651.0,1723.15,1.1,2651.0,24
CDM,76499AK,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,577.0,375.05,0.01,577.0,29
CDM,76499BDAK,BD WHOLE BODY COMPOSITION,819.0,532.35,0.01,819.0,29
CDM,76499BDAK-26,BD WHOLE BODY COMPOSITION,85.0,55.25,0.01,85.0,29
CDM,76499BDAK-TC,BD WHOLE BODY COMPOSITION,734.0,477.1,0.01,734.0,29
CDM,76499RVU1AK,3D RENDERING LIVER (DONOR) S&I,2535.0,1647.75,0.01,2535.0,29
CDM,76499RVU1AK-26,3D RENDERING LIVER (DONOR) S&I,1099.0,714.35,0.01,1099.0,29
CDM,76499RVU1AK-TC,3D RENDERING LIVER (DONOR) S&I,1436.0,933.4,0.01,1436.0,29
CDM,76499RVU2AK,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),2935.0,1907.75,0.01,2935.0,29
CDM,76499RVU2AK-26,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),162.0,105.3,0.01,162.0,29
CDM,76499RVU2AK-TC,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),2773.0,1802.45,0.01,2773.0,29
CDM,76499RVU3AK,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",21750.0,14137.5,0.01,21750.0,29
CDM,76499RVU3AK-26,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",32.0,20.8,0.01,32.0,29
CDM,76499RVU3AK-TC,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",21718.0,14116.7,0.01,21718.0,29
CDM,76499RVU4AK,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),819.0,532.35,0.01,819.0,29
CDM,76499RVU4AK-26,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),85.0,55.25,0.01,85.0,29
CDM,76499RVU4AK-TC,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),734.0,477.1,0.01,734.0,29
CDM,76499RVU7AK,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),11223.0,7294.95,0.01,11223.0,29
CDM,76499RVU7AK-26,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),504.0,327.6,0.01,504.0,29
CDM,76499RVU7AK-TC,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),10719.0,6967.35,0.01,10719.0,29
CDM,76499RVUAK,CT ABDOMEN W/O SCREENING,1258.0,817.7,0.01,1258.0,29
CDM,76499RVUAK-26,CT ABDOMEN W/O SCREENING,524.0,340.6,0.01,524.0,29
CDM,76499RVUAK-TC,CT ABDOMEN W/O SCREENING,734.0,477.1,0.01,734.0,29
CDM,76506AK,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,252.0,163.8,1.1,252.0,45
CDM,76511AK,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,1016.0,660.4,1.1,1016.0,51
CDM,76511AK-26,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,282.0,183.3,1.1,282.0,45
CDM,76512AK,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,980.0,637.0,1.1,980.0,51
CDM,76512AK-26,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,246.0,159.9,1.1,246.0,45
CDM,76514AK,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,231.0,150.15,1.1,231.0,51
CDM,76514AK-26,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,62.0,40.3,1.1,62.0,45
CDM,76529AK,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,228.0,148.2,1.1,279.6,51
CDM,76536AK,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,980.0,637.0,1.1,980.0,51
CDM,76536AK-26,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,246.0,159.9,1.1,246.0,45
CDM,76604AK,US CHEST REAL TIME W/IMAGE DOCUMENTATION,970.0,630.5,1.1,970.0,51
CDM,76604AK-26,US CHEST REAL TIME W/IMAGE DOCUMENTATION,236.0,153.4,1.1,236.0,45
CDM,76604AK-TC,US CHEST REAL TIME W/IMAGE DOCUMENTATION,679.0,441.35,1.1,679.0,46
CDM,76641AK,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,1055.0,685.75,1.1,1055.0,51
CDM,76641AK-26,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,321.0,208.65,1.1,321.0,45
CDM,76642AK,US BREAST UNI REAL TIME WITH IMAGE LIMITED,907.0,589.55,1.1,907.0,51
CDM,76642AK-26,US BREAST UNI REAL TIME WITH IMAGE LIMITED,299.0,194.35,1.1,299.0,45
CDM,76700AK,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,356.0,231.4,1.1,356.0,45
CDM,76705AK,US ABDOMINAL REAL TIME W/IMAGE LIMITED,994.0,646.1,1.1,994.0,51
CDM,76705AK-26,US ABDOMINAL REAL TIME W/IMAGE LIMITED,260.0,169.0,1.1,260.0,45
CDM,76705AK-TC,US ABDOMINAL REAL TIME W/IMAGE LIMITED,679.0,441.35,1.1,679.0,46
CDM,76706AK,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,220.0,143.0,1.1,220.0,39
CDM,76770AK,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,998.0,648.7,1.1,998.0,51
CDM,76770AK-26,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,326.0,211.9,1.1,326.0,45
CDM,76770AK-TC,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,679.0,441.35,1.1,679.0,46
CDM,76775AK,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,966.0,627.9,1.1,966.0,51
CDM,76775AK-26,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,232.0,150.8,1.1,232.0,45
CDM,76775AK-TC,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,734.0,477.1,1.1,734.0,46
CDM,76776AK,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,1038.0,674.7,1.1,1038.0,51
CDM,76776AK-26,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,304.0,197.6,1.1,304.0,45
CDM,76800AK,ULTRASOUND SPINAL CANAL & CONTENTS,452.0,293.8,1.1,452.0,45
CDM,76801AK,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,1170.0,760.5,1.1,1170.0,51
CDM,76801AK-26,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,436.0,283.4,1.1,436.0,45
CDM,76801AK-TC,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,734.0,477.1,1.1,734.0,46
CDM,76802AK,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,1076.0,699.4,1.1,1076.0,51
CDM,76802AK-26,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,365.0,237.25,1.1,365.0,45
CDM,76802AK-TC,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,711.0,462.15,1.1,711.0,46
CDM,76805AK,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,1130.0,734.5,1.1,1130.0,51
CDM,76805AK-26,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,396.0,257.4,1.1,396.0,45
CDM,76805AK-TC,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,734.0,477.1,1.1,734.0,46
CDM,76810AK,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,1103.0,716.95,1.1,1103.0,51
CDM,76810AK-26,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,392.0,254.8,1.1,392.0,45
CDM,76810AK-TC,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,711.0,462.15,1.1,711.0,46
CDM,76811AK,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,2428.0,1578.2,1.1,2428.0,51
CDM,76811AK-26,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,760.0,494.0,1.1,760.0,45
CDM,76811AK-TC,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,1668.0,1084.2,1.1,1668.0,46
CDM,76812AK,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,1366.0,887.9,1.1,1366.0,51
CDM,76812AK-26,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,712.0,462.8,1.1,712.0,45
CDM,76812AK-TC,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,654.0,425.1,1.1,654.0,46
CDM,76813AK,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,1206.0,783.9,1.1,1206.0,51
CDM,76813AK-26,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,472.0,306.8,1.1,472.0,45
CDM,76813AK-TC,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,734.0,477.1,1.1,734.0,46
CDM,76814AK,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,822.0,534.3,1.1,822.0,51
CDM,76814AK-26,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,396.0,257.4,1.1,396.0,45
CDM,76814AK-TC,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,426.0,276.9,1.1,426.0,46
CDM,76815AK,US PREGNANT UTERUS LIMITED 1/> FETUSES,1020.0,663.0,1.1,1020.0,51
CDM,76815AK-26,US PREGNANT UTERUS LIMITED 1/> FETUSES,286.0,185.9,1.1,286.0,45
CDM,76815AK-TC,US PREGNANT UTERUS LIMITED 1/> FETUSES,734.0,477.1,1.1,734.0,46
CDM,76816AK,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,1108.0,720.2,1.1,1108.0,51
CDM,76816AK-26,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,374.0,243.1,1.1,374.0,45
CDM,76816AK-TC,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,734.0,477.1,1.1,734.0,46
CDM,76817AK,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,1034.0,672.1,1.1,1034.0,51
CDM,76817AK-26,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,300.0,195.0,1.1,300.0,45
CDM,76817AK-TC,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,734.0,477.1,1.1,734.0,46
CDM,76818AK,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,1154.0,750.1,1.1,1154.0,51
CDM,76818AK-26,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,420.0,273.0,1.1,420.0,45
CDM,76818AK-TC,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,734.0,477.1,1.1,734.0,46
CDM,76819AK,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,1073.0,697.45,1.1,1073.0,51
CDM,76819AK-26,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,339.0,220.35,1.1,339.0,45
CDM,76819AK-TC,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,734.0,477.1,1.1,734.0,46
CDM,76820AK,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,954.0,620.1,1.1,954.0,51
CDM,76820AK-26,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,220.0,143.0,1.1,220.0,45
CDM,76820AK-TC,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,734.0,477.1,1.1,734.0,46
CDM,76821AK,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,1014.0,659.1,1.1,1014.0,51
CDM,76821AK-26,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,280.0,182.0,1.1,280.0,45
CDM,76821AK-TC,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,734.0,477.1,1.1,734.0,46
CDM,76825AK,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,4451.0,2893.15,1.1,4451.0,51
CDM,76825AK-26,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,668.0,434.2,1.1,668.0,45
CDM,76826AK,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,2033.0,1321.45,1.1,2033.0,51
CDM,76826AK-26,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,365.0,237.25,1.1,365.0,45
CDM,76827AK,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,966.0,627.9,1.1,966.0,51
CDM,76827AK-26,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,232.0,150.8,1.1,232.0,45
CDM,76828AK,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,958.0,622.7,1.1,958.0,51
CDM,76828AK-26,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,224.0,145.6,1.1,224.0,45
CDM,76830AK,US TRANSVAGINAL,1038.0,674.7,1.1,1038.0,51
CDM,76830AK-26,US TRANSVAGINAL,304.0,197.6,1.1,304.0,45
CDM,76831AK,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1956.0,1271.4,1.1,1956.0,51
CDM,76831AK-26,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,288.0,187.2,1.1,288.0,45
CDM,76856AK,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,1038.0,674.7,1.1,1038.0,51
CDM,76856AK-26,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,304.0,197.6,1.1,304.0,45
CDM,76856AK-TC,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,734.0,477.1,1.1,734.0,46
CDM,76857AK,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,934.0,607.1,1.1,934.0,51
CDM,76857AK-26,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,200.0,130.0,1.1,200.0,45
CDM,76870AK,US SCROTUM & CONTENTS,990.0,643.5,1.1,990.0,51
CDM,76870AK-26,US SCROTUM & CONTENTS,256.0,166.4,1.1,256.0,45
CDM,76872AK,"US, TRANSRECTAL",1010.0,656.5,1.1,1010.0,51
CDM,76872AK-26,"US, TRANSRECTAL",276.0,179.4,1.1,276.0,45
CDM,76873AK,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,1416.0,920.4,1.1,1416.0,51
CDM,76873AK-26,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,682.0,443.3,1.1,682.0,45
CDM,76881AK,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,1130.0,734.5,1.1,1130.0,51
CDM,76881AK-26,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,396.0,257.4,1.1,396.0,45
CDM,76882AK,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,1038.0,674.7,1.1,1038.0,51
CDM,76882AK-26,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,304.0,197.6,1.1,304.0,45
CDM,76885AK,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,296.0,192.4,1.1,296.0,45
CDM,76886AK,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,248.0,161.2,1.1,248.0,45
CDM,76936AK,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2945.0,1914.25,1.1,2945.0,51
CDM,76936AK-26,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,796.0,517.4,1.1,796.0,45
CDM,76937AK,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,398.0,258.7,1.1,398.0,51
CDM,76937AK-26,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,132.0,85.8,1.1,132.0,45
CDM,76940AK,US &MNTR PARENCHYMAL TISSUE ABLATION,1498.0,973.7,1.1,1498.0,39
CDM,76940AK-26,US &MNTR PARENCHYMAL TISSUE ABLATION,800.0,520.0,1.1,800.0,45
CDM,76941AK,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,1260.0,819.0,1.1,1260.0,39
CDM,76941AK-26,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,536.0,348.4,1.1,536.0,45
CDM,76941AK-TC,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,724.0,470.6,1.1,724.0,34
CDM,76942AK,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1158.0,752.7,1.1,1158.0,51
CDM,76942AK-26,US GUIDANCE NEEDLE PLACEMENT IMG S&I,295.0,191.75,1.1,295.0,45
CDM,76942AK-TC,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,1.1,863.0,46
CDM,76945AK,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,507.0,329.55,1.1,507.0,39
CDM,76945AK-26,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,268.0,174.2,1.1,268.0,45
CDM,76946AK,US GUIDANCE AMNIOCENTESIS IMG S&I,518.0,336.7,1.1,518.0,51
CDM,76946AK-26,US GUIDANCE AMNIOCENTESIS IMG S&I,152.0,98.8,1.1,152.0,45
CDM,76946AK-TC,US GUIDANCE AMNIOCENTESIS IMG S&I,366.0,237.9,1.1,366.0,46
CDM,76965AK,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1728.0,1123.2,1.1,1728.0,51
CDM,76965AK-26,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,536.0,348.4,1.1,536.0,45
CDM,76975AK,GI ENDOSCOPIC US S&I,324.0,210.6,1.1,775.75,39
CDM,76978AK,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1876.0,1219.4,1.1,1876.0,51
CDM,76978AK-26,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,648.0,421.2,1.1,648.0,45
CDM,76979AK,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,1106.0,718.9,1.1,1106.0,51
CDM,76979AK-26,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,340.0,221.0,1.1,340.0,45
CDM,76981AK,ULTRASOUND ELASTOGRAPHY PARENCHYMA,994.0,646.1,1.1,994.0,51
CDM,76981AK-26,ULTRASOUND ELASTOGRAPHY PARENCHYMA,260.0,169.0,1.1,260.0,45
CDM,76982AK,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,970.0,630.5,1.1,970.0,51
CDM,76982AK-26,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,236.0,153.4,1.1,236.0,45
CDM,76983AK,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1218.0,791.7,1.1,1218.0,51
CDM,76983AK-26,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,188.0,122.2,1.1,188.0,45
CDM,76998AK,INTRA OP ULTRASONIC GUIDANCE,1243.0,807.95,1.1,1243.0,39
CDM,76998AK-26,INTRA OP ULTRASONIC GUIDANCE,400.0,260.0,1.1,400.0,45
CDM,77000000,SCREEN CERV/VAG & PELV/BREAST,370.0,240.5,45.16,370.0,61
CDM,77000025,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,27.0,17.55,5.89,27.0,46
CDM,77000035,VISIT TO DETERM LDCT ELIG,370.0,240.5,44.26,370.0,61
CDM,77001000,HEP SCREEN HIGH RISK/OTHER,234.0,152.1,22.75,234.0,60
CDM,77001AK,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,990.0,643.5,1.1,990.0,51
CDM,77001AK-26,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,167.0,108.55,1.1,167.0,45
CDM,77002AK,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,1076.0,699.4,1.1,1076.0,51
CDM,77002AK-26,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,238.0,154.7,1.1,238.0,45
CDM,77003AK,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,1260.0,819.0,1.1,1260.0,51
CDM,77003AK-26,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,264.0,171.6,1.1,264.0,45
CDM,77003AK-TC,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,996.0,647.4,1.1,996.0,46
CDM,77011AK,CT GUIDANCE STEREOTACTIC LOCALIZATION,2011.0,1307.15,1.1,2011.0,51
CDM,77011AK-26,CT GUIDANCE STEREOTACTIC LOCALIZATION,484.0,314.6,1.1,484.0,45
CDM,77011AK-TC,CT GUIDANCE STEREOTACTIC LOCALIZATION,1527.0,992.55,1.1,1527.0,46
CDM,77012AK,CT GUIDANCE NEEDLE PLACEMENT,2793.0,1815.45,1.1,2793.0,51
CDM,77012AK-26,CT GUIDANCE NEEDLE PLACEMENT,600.0,390.0,1.1,600.0,45
CDM,77013AK,CT GUIDANCE &MONITORING VISC TISS ABLATION,4189.0,2722.85,1.1,4189.0,39
CDM,77013AK-26,CT GUIDANCE &MONITORING VISC TISS ABLATION,1596.0,1037.4,1.1,1596.0,45
CDM,77013AK-TC,CT GUIDANCE &MONITORING VISC TISS ABLATION,2593.0,1685.45,1.1,2593.0,34
CDM,77046AK,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,2306.0,1498.9,1.1,2306.0,51
CDM,77046AK-26,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,638.0,414.7,1.1,638.0,45
CDM,77047AK,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2372.0,1541.8,1.1,2372.0,51
CDM,77047AK-26,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,704.0,457.6,1.1,704.0,45
CDM,77048AK,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,5810.0,3776.5,1.1,5810.0,51
CDM,77048AK-26,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,840.0,546.0,1.1,840.0,45
CDM,77049AAK,MRI BREAST BILAT W CONTR,6904.0,4487.6,1.1,6904.0,51
CDM,77049AAK-26,MRI BREAST BILAT W CONTR,920.0,598.0,1.1,920.0,45
CDM,77049AAK-TC,MRI BREAST BILAT W CONTR,5984.0,3889.6,1.1,5984.0,46
CDM,77049AK,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,6904.0,4487.6,1.1,6904.0,51
CDM,77049AK-26,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,920.0,598.0,1.1,920.0,45
CDM,77049BAK,MRI BREAST BILAT WO/W CONTR,6904.0,4487.6,1.1,6904.0,51
CDM,77049BAK-26,MRI BREAST BILAT WO/W CONTR,920.0,598.0,1.1,920.0,45
CDM,77049BAK-TC,MRI BREAST BILAT WO/W CONTR,5984.0,3889.6,1.1,5984.0,46
CDM,77061AK,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,171.0,111.15,1.1,332.37,33
CDM,77061AK-26,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,60.0,39.0,1.1,142.04,27
CDM,77061AK-TC,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,1.1,226.55,28
CDM,77062AK-26,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,78.0,50.7,1.1,141.36,27
CDM,77062AK-TC,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,1.1,290.61,28
CDM,77063AK,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,380.0,247.0,1.1,380.0,51
CDM,77063AK-26,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,240.0,156.0,1.1,240.0,45
CDM,77063AK-TC,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,140.0,91.0,1.1,140.0,46
CDM,77065AK,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,887.0,576.55,1.1,887.0,51
CDM,77065AK-26,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,324.0,210.6,1.1,324.0,45
CDM,77065AK-TC,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,563.0,365.95,1.1,563.0,46
CDM,77066AK-26,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,400.0,260.0,1.1,400.0,45
CDM,77066AK-TC,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,706.0,458.9,1.1,706.0,46
CDM,77067AK,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,913.0,593.45,1.1,913.0,51
CDM,77067AK-26,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,304.0,197.6,1.1,304.0,45
CDM,77067AK-TC,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,609.0,395.85,1.1,609.0,46
CDM,77071AK,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,180.0,117.0,1.1,180.6,51
CDM,77072AK,BONE AGE STUDIES,810.0,526.5,1.1,810.0,51
CDM,77072AK-26,BONE AGE STUDIES,76.0,49.4,1.1,76.0,45
CDM,77073AK,BONE LENGTH STUDIES,838.0,544.7,1.1,838.0,51
CDM,77073AK-26,BONE LENGTH STUDIES,104.0,67.6,1.1,104.0,45
CDM,77073AK-TC,BONE LENGTH STUDIES,734.0,477.1,1.1,734.0,46
CDM,77074AK,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,928.0,603.2,1.1,928.0,51
CDM,77074AK-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,194.0,126.1,1.1,194.0,45
CDM,77075AK,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,242.0,157.3,1.1,242.0,45
CDM,77076AK,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,280.0,182.0,1.1,280.0,45
CDM,77077AK,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,132.0,85.8,1.1,132.0,45
CDM,77080AK,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,822.0,534.3,1.1,822.0,51
CDM,77080AK-26,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,88.0,57.2,1.1,88.0,45
CDM,77080AK-TC,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,734.0,477.1,1.1,734.0,46
CDM,77081AK,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,696.0,452.4,1.1,696.0,51
CDM,77081AK-26,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,88.0,57.2,1.1,88.0,45
CDM,77081AK-TC,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,608.0,395.2,1.1,608.0,46
CDM,77085AK-26,DXA BONE DENSITY STUDY AXIAL SKELETON,132.0,85.8,1.1,132.0,45
CDM,77085AK-TC,DXA BONE DENSITY STUDY AXIAL SKELETON,734.0,477.1,1.1,734.0,46
CDM,77086AK,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,75.0,48.75,1.1,75.0,45
CDM,77089AK,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,88.0,57.2,1.1,131.82,51
CDM,77090AK,TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,474.0,308.1,1.1,474.0,51
CDM,77091AK,TBS TECHNICAL CALCULATION ONLY,158.0,102.7,1.1,158.0,51
CDM,77092AK,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,88.0,57.2,1.1,88.0,51
CDM,77100010,ADMIN VACCINE SNGL,214.0,139.1,13.56,214.0,61
CDM,77100015,IMMUNE ADMIN ORAL/NAS 1ST,214.0,139.1,13.56,214.0,61
CDM,77100020,IMM ADMIN ORAL/NASAL ADDL,190.0,123.5,13.56,190.0,46
CDM,77100030,ADMIN VACCINE EA ADD,64.0,41.6,13.56,64.0,46
CDM,77100040,ADMIN VACCINE FLU,214.0,139.1,13.56,214.0,61
CDM,77100045,ADMIN HEPATITIS B VACCINE,185.0,120.25,13.56,185.0,61
CDM,77100050,ADMIN VACCINE PNEUMONIA,214.0,139.1,13.56,214.0,61
CDM,77100065,IMMUNIZ INJ-HEP B VACC ONLY,214.0,139.1,13.56,214.0,61
CDM,77100075,IM ADMIN 1ST/ONLY COMPONENT,70.0,45.5,13.56,70.0,46
CDM,77100125,ADMIN FLU VACCINE,185.0,120.25,13.56,185.0,61
CDM,77100165,VFC IM ADMIN 1ST/ONLY THRU 18,21.25,13.81,4.63,48.52,46
CDM,77100355,ADM TOCILIZU COVID-19 1ST,1802.0,1171.3,220.33,1802.0,61
CDM,77100365,ADM TOCILIZU COVID-19 2ND,1802.0,1171.3,220.33,1802.0,61
CDM,77100585,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,33.0,21.45,9.33,201.81,61
CDM,77100625,ADMINISTRATION COVID VACCINE,286.0,185.9,1.0,286.0,60
CDM,77100695,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,1.0,113.91,60
CDM,77100705,"VFC ADMIN BEYFORTUS, W/COUNSELING",21.25,13.81,4.63,62.93,46
CDM,77100725,"ADMIN BEYFORTUS IM INJ, W/ COUNSELING",158.0,102.7,13.56,158.0,46
CDM,77100735,ADMIN BEYFORTUS IM INJ,158.0,102.7,13.56,158.0,46
CDM,77100755,PEMIVIBART INFUSION (IV INFUSION FOR IMMUNE-COMPROMISED COVID-19,1800.0,1170.0,220.33,1800.0,61
CDM,77100765,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,286.0,185.9,13.56,286.0,46
CDM,77100775,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,70.0,45.5,10.42,79.56,46
CDM,77100785,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,70.0,45.5,10.42,79.56,46
CDM,77100795,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,70.0,45.5,10.42,79.56,46
CDM,77261AK,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,572.0,371.8,1.1,572.0,51
CDM,77263AK,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1382.0,898.3,1.1,1382.0,51
CDM,77280AK,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,1224.0,795.6,1.1,1224.0,51
CDM,77280AK-26,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,308.0,200.2,1.1,308.0,45
CDM,77285AK,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,462.0,300.3,1.1,462.0,45
CDM,77290AK,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,3212.0,2087.8,1.1,3212.0,51
CDM,77290AK-26,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,686.0,445.9,1.1,686.0,45
CDM,77293AK,RESPIRATORY MOTION MANAGEMENT SIMULATION,3861.0,2509.65,1.1,3861.0,51
CDM,77293AK-26,RESPIRATORY MOTION MANAGEMENT SIMULATION,880.0,572.0,1.1,880.0,45
CDM,77295AK,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,11329.0,7363.85,1.1,11329.0,51
CDM,77295AK-26,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,1888.0,1227.2,1.1,1888.0,45
CDM,77300AK,BASIC RAD DOSIMETRY CALCULATION,1189.0,772.85,1.1,1189.0,51
CDM,77300AK-26,BASIC RAD DOSIMETRY CALCULATION,273.0,177.45,1.1,273.0,45
CDM,77301AK,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,12957.0,8422.05,1.1,12957.0,51
CDM,77301AK-26,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,3516.0,2285.4,1.1,3516.0,45
CDM,77306AK,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,3142.0,2042.3,1.1,3142.0,51
CDM,77306AK-26,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,616.0,400.4,1.1,616.0,45
CDM,77307AK,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,3802.0,2471.3,1.1,3802.0,51
CDM,77307AK-26,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,1276.0,829.4,1.1,1276.0,45
CDM,77318AK,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,3802.0,2471.3,1.1,3802.0,51
CDM,77318AK-26,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,1276.0,829.4,1.1,1276.0,45
CDM,77321AK,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2944.0,1913.6,1.1,2944.0,51
CDM,77321AK-26,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,418.0,271.7,1.1,418.0,45
CDM,77331AK,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,1299.0,844.35,1.1,1299.0,51
CDM,77331AK-26,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,383.0,248.95,1.1,383.0,45
CDM,77332AK,TX DEVICES DESIGN/CONSTR SIMPLE,1114.0,724.1,1.1,1114.0,51
CDM,77332AK-26,TX DEVICES DESIGN/CONSTR SIMPLE,198.0,128.7,1.1,198.0,45
CDM,77333AK,TX DEVICES DESIGN/CONSTR INTERMED,330.0,214.5,1.1,330.0,45
CDM,77334AK,TX DEVICES DESIGN/CONSTR COMPLEX,3032.0,1970.8,1.1,3032.0,51
CDM,77334AK-26,TX DEVICES DESIGN/CONSTR COMPLEX,506.0,328.9,1.1,506.0,45
CDM,77336AK,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1091.0,709.15,1.1,1091.0,51
CDM,77338AK,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,4414.0,2869.1,1.1,4414.0,51
CDM,77338AK-26,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,1888.0,1227.2,1.1,1888.0,45
CDM,77370AK,SPECIAL RADIATION PHYSICS CONSULT,1131.0,735.15,1.1,1131.0,51
CDM,77373AK,STEREOTACTIC BODY RADIATION DELIVERY,14050.0,9132.5,1.1,14050.0,51
CDM,77387AK,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,1.1,336.36,50
CDM,77387AK-26,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,1.1,299.0,41
CDM,77402AK,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,1.1,897.0,50
CDM,77407AK,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,1.1,3388.0,50
CDM,77412AK,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,4855.0,3155.75,1.1,4855.0,50
CDM,77417AK,THERAPEUTIC RADIOLOGY PORT IMAGES(S),586.0,380.9,1.1,586.0,40
CDM,77427AK,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,1483.0,963.95,1.1,1483.0,51
CDM,77431AK,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,796.0,517.4,1.1,796.0,51
CDM,77435AK,STEREOTACTIC BODY RADIATION MANAGEMENT,5223.0,3394.95,1.1,5223.0,51
CDM,77470AK,SPECIAL TREATMENT PROCEDURE,4884.0,3174.6,1.1,4884.0,51
CDM,77470AK-26,SPECIAL TREATMENT PROCEDURE,893.0,580.45,1.1,893.0,45
CDM,77605AK,HYPERTHERMIA EXTERNAL GENERATED DEEP,736.0,478.4,1.1,3103.51,51
CDM,77761AK,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,1540.0,1001.0,1.1,1540.0,45
CDM,77763AK,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,3464.0,2251.6,1.1,3464.0,45
CDM,77771AK,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,5796.0,3767.4,1.1,5796.0,51
CDM,77778AK,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,8650.0,5622.5,1.1,8650.0,51
CDM,77778AK-26,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,3863.0,2510.95,1.1,3863.0,45
CDM,77790AK,SUPERVISION HANDLING LOADING RADIATION SOURCE,1407.0,914.55,1.1,1407.0,51
CDM,77790AK-26,SUPERVISION HANDLING LOADING RADIATION SOURCE,446.0,289.9,1.1,446.0,29
CDM,78000005,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,102.0,66.3,14.49,102.0,60
CDM,78000015,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,208.0,135.2,28.26,208.0,60
CDM,78000025,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,313.0,203.45,17.35,313.0,60
CDM,78000045,"HOPD MNTL HLT, GRP",89.0,57.85,25.17,121.1,61
CDM,78014AK,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2993.0,1945.45,1.1,2993.0,51
CDM,78014AK-26,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,220.0,143.0,1.1,220.0,45
CDM,78014AK-TC,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2773.0,1802.45,1.1,2773.0,46
CDM,78018AK,THYROID CARCINOMA METASTASES IMG WHOLE BODY,344.0,223.6,1.1,344.0,45
CDM,78020AK,THYROID CARCINOMA METASTASES UPTAKE,1123.0,729.95,1.1,1123.0,51
CDM,78020AK-26,THYROID CARCINOMA METASTASES UPTAKE,240.0,156.0,1.1,240.0,45
CDM,78020AK-TC,THYROID CARCINOMA METASTASES UPTAKE,883.0,573.95,1.1,883.0,46
CDM,78071AK,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,480.0,312.0,1.1,480.0,45
CDM,78072AK,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,4354.0,2830.1,1.1,4354.0,51
CDM,78072AK-26,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,640.0,416.0,1.1,640.0,45
CDM,78072AK-TC,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,3714.0,2414.1,1.1,3714.0,46
CDM,78102AK,"BONE MARROW IMAGING, LTD",2993.0,1945.45,1.1,2993.0,51
CDM,78102AK-26,"BONE MARROW IMAGING, LTD",220.0,143.0,1.1,220.0,45
CDM,78102AK-TC,"BONE MARROW IMAGING, LTD",2773.0,1802.45,1.1,2773.0,46
CDM,78122AK,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,180.0,117.0,1.1,180.0,45
CDM,78195AK,LYMPHATICS & LYMPH NODES IMAGING,480.0,312.0,1.1,480.0,45
CDM,78226AK,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,3069.0,1994.85,1.1,3069.0,51
CDM,78226AK-26,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,296.0,192.4,1.1,296.0,45
CDM,78227AK,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,4110.0,2671.5,1.1,4110.0,51
CDM,78227AK-26,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,396.0,257.4,1.1,396.0,45
CDM,78264AK,GASTRIC EMPTYING STUDY,3121.0,2028.65,1.1,3121.0,51
CDM,78264AK-26,GASTRIC EMPTYING STUDY,348.0,226.2,1.1,348.0,45
CDM,78278AK,ACUTE GI BLOOD LOSS IMAGING,3169.0,2059.85,1.1,3169.0,51
CDM,78278AK-26,ACUTE GI BLOOD LOSS IMAGING,396.0,257.4,1.1,396.0,45
CDM,78290AK,INTESTINE IMAGING,3072.0,1996.8,1.1,3072.0,51
CDM,78290AK-26,INTESTINE IMAGING,299.0,194.35,1.1,299.0,45
CDM,78290AK-TC,INTESTINE IMAGING,2773.0,1802.45,1.1,2773.0,46
CDM,78300AK,BONE &/JOINT IMAGING LIMITED AREA,3021.0,1963.65,1.1,3021.0,51
CDM,78300AK-26,BONE &/JOINT IMAGING LIMITED AREA,248.0,161.2,1.1,248.0,45
CDM,78300AK-TC,BONE &/JOINT IMAGING LIMITED AREA,2773.0,1802.45,1.1,2773.0,46
CDM,78306AK,BONE &/JOINT IMAGING WHOLE BODY,3151.0,2048.15,1.1,3151.0,51
CDM,78306AK-26,BONE &/JOINT IMAGING WHOLE BODY,378.0,245.7,1.1,378.0,45
CDM,78315AK,BONE &/JOINT IMAGING 3 PHASE STUDY,3181.0,2067.65,1.1,3181.0,51
CDM,78315AK-26,BONE &/JOINT IMAGING 3 PHASE STUDY,408.0,265.2,1.1,408.0,45
CDM,78428AK,CARDIAC SHUNT DETECTION,3085.0,2005.25,1.1,3085.0,51
CDM,78428AK-26,CARDIAC SHUNT DETECTION,312.0,202.8,1.1,312.0,45
CDM,78428AK-TC,CARDIAC SHUNT DETECTION,2773.0,1802.45,1.1,2773.0,46
CDM,78429AK,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10768.0,6999.2,1.1,10768.0,27
CDM,78429AK-26,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,704.0,457.6,1.1,704.0,45
CDM,78430AK,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10732.0,6975.8,1.1,10732.0,27
CDM,78430AK-26,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,668.0,434.2,1.1,668.0,45
CDM,78431AK,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,16288.0,10587.2,1.1,16288.0,33
CDM,78431AK-26,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,760.0,494.0,1.1,760.0,45
CDM,78431AK-TC,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,14584.0,9479.6,1.1,14584.0,28
CDM,78433AK,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,14362.0,9335.3,1.1,14362.0,27
CDM,78433AK-26,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,904.0,587.6,1.1,904.0,45
CDM,78433AK-TC,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,12640.0,8216.0,1.1,12640.0,28
CDM,78434AK,AQMBF PET REST AND PHARMACOLOGIC STRESS,3461.0,2249.65,1.1,3461.0,27
CDM,78434AK-26,AQMBF PET REST AND PHARMACOLOGIC STRESS,252.0,163.8,1.1,252.0,45
CDM,78451AK,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,607.0,394.55,1.1,607.0,45
CDM,78452AK,MYOCARDIAL SPECT MULTIPLE STUDIES,9721.0,6318.65,1.1,9721.0,51
CDM,78452AK-26,MYOCARDIAL SPECT MULTIPLE STUDIES,713.0,463.45,1.1,713.0,45
CDM,78452AK-TC,MYOCARDIAL SPECT MULTIPLE STUDIES,9008.0,5855.2,1.1,9008.0,46
CDM,78454AK,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,536.0,348.4,1.1,536.0,45
CDM,78472AK,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,392.0,254.8,1.1,392.0,45
CDM,78473AK,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,588.0,382.2,1.1,588.0,45
CDM,78481AK,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,392.0,254.8,1.1,392.0,45
CDM,78483AK,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,4302.0,2796.3,1.1,4302.0,51
CDM,78483AK-26,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,588.0,382.2,1.1,588.0,45
CDM,78580AK,PULMONARY PERFUSION IMAGING PARTICULATE,3069.0,1994.85,1.1,3069.0,51
CDM,78580AK-26,PULMONARY PERFUSION IMAGING PARTICULATE,296.0,192.4,1.1,296.0,45
CDM,78582AK,PULMONARY VENTILATION & PERFUSION IMAGING,4142.0,2692.3,1.1,4142.0,51
CDM,78582AK-26,PULMONARY VENTILATION & PERFUSION IMAGING,428.0,278.2,1.1,428.0,45
CDM,78597AK,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,300.0,195.0,1.1,300.0,45
CDM,78601AK,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,204.0,132.6,1.1,204.0,45
CDM,78610AK,"BRAIN IMAGING, VASC FLOW ONLY",3834.0,2492.1,1.1,3834.0,51
CDM,78610AK-26,"BRAIN IMAGING, VASC FLOW ONLY",120.0,78.0,1.1,120.0,45
CDM,78610AK-TC,"BRAIN IMAGING, VASC FLOW ONLY",3714.0,2414.1,1.1,3714.0,46
CDM,78707AK,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,384.0,249.6,1.1,384.0,45
CDM,78708AK,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,4198.0,2728.7,1.1,4198.0,51
CDM,78708AK-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,484.0,314.6,1.1,484.0,45
CDM,78709AK,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,4278.0,2780.7,1.1,4278.0,51
CDM,78709AK-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,564.0,366.6,1.1,564.0,45
CDM,78740AK,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,3001.0,1950.65,1.1,3001.0,51
CDM,78740AK-26,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,228.0,148.2,1.1,228.0,45
CDM,78800AK,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3029.0,1968.85,1.1,3029.0,51
CDM,78800AK-26,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,256.0,166.4,1.1,256.0,45
CDM,78800AK-TC,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,2773.0,1802.45,1.1,2773.0,46
CDM,78802AK,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9360.0,6084.0,1.1,9360.0,51
CDM,78802AK-26,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,352.0,228.8,1.1,352.0,45
CDM,78802AK-TC,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9008.0,5855.2,1.1,9008.0,46
CDM,78803AK,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9488.0,6167.2,1.1,9488.0,51
CDM,78803AK-26,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,480.0,312.0,1.1,480.0,45
CDM,78815AK,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,11040.0,7176.0,1.1,11040.0,39
CDM,78815AK-26,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,976.0,634.4,1.1,976.0,45
CDM,78815AK-TC,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,1.1,10064.0,34
CDM,78816AK,PET IMAGING FOR CT ATTENUATION WHOLE BODY,11064.0,7191.6,1.1,11064.0,39
CDM,78816AK-26,PET IMAGING FOR CT ATTENUATION WHOLE BODY,1000.0,650.0,1.1,1000.0,45
CDM,78816AK-TC,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,1.1,10064.0,34
CDM,78830AK,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9604.0,6242.6,1.1,9604.0,51
CDM,78830AK-26,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,596.0,387.4,1.1,596.0,45
CDM,78832AK,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10912.0,7092.8,1.1,10912.0,51
CDM,78832AK-26,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,848.0,551.2,1.1,848.0,45
CDM,78835AK,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,598.0,388.7,1.1,598.0,51
CDM,78835AK-26,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,188.0,122.2,1.1,188.0,45
CDM,78835AK-TC,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,410.0,266.5,1.1,410.0,46
CDM,78999RVU1AK,MRI FUSION TO PET (COMP CODE 76376),743.0,482.95,0.01,743.0,29
CDM,78999RVU1AK-26,MRI FUSION TO PET (COMP CODE 76376),87.0,56.55,0.01,87.0,29
CDM,78999RVU1AK-TC,MRI FUSION TO PET (COMP CODE 76376),656.0,426.4,0.01,656.0,29
CDM,79000045,LITHOTRIPSY / ELECTRODE,1617.0,1051.05,240.61,1617.0,38
CDM,79005AK,RP THERAPY ORAL ADMINISTRATION,2266.0,1472.9,1.1,2266.0,51
CDM,79005AK-26,RP THERAPY ORAL ADMINISTRATION,720.0,468.0,1.1,720.0,45
CDM,79005AK-TC,RP THERAPY ORAL ADMINISTRATION,1546.0,1004.9,1.1,1546.0,46
CDM,79101AK,RP THERAPY INTRAVENOUS ADMINISTRATION,2330.0,1514.5,1.1,2330.0,51
CDM,79101AK-26,RP THERAPY INTRAVENOUS ADMINISTRATION,784.0,509.6,1.1,784.0,45
CDM,79101AK-TC,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,1.1,1546.0,46
CDM,79445AK,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,2506.0,1628.9,1.1,2506.0,39
CDM,79445AK-26,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,960.0,624.0,1.1,960.0,45
CDM,79445AK-TC,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,1.1,1546.0,34
CDM,80053AK,COMPREHENSIVE METABOLIC PANEL,73.0,47.45,1.1,73.0,32
CDM,80061AK,LIPID PANEL,92.0,59.8,1.1,92.0,32
CDM,80076AK,HEPATIC FUNCTION PNL,56.0,36.4,1.1,56.0,32
CDM,80100010,HEMO 1 EVAL IP,4828.0,3138.2,124.44,4828.0,61
CDM,80100065,CRRT,1560.0,1014.0,232.13,1560.0,38
CDM,80100075,CRRT MONITORING,681.0,442.65,101.33,681.0,38
CDM,80200025,MAINT PERITONEAL DIALYSIS,1862.0,1210.3,277.07,1862.0,38
CDM,80305AK,DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY,87.0,56.55,1.1,87.0,32
CDM,80306AK,DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS,118.0,76.7,1.1,118.0,32
CDM,80307AK,DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE,429.0,278.85,1.1,429.0,32
CDM,81000AK,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,28.0,18.2,1.1,28.0,32
CDM,81001AK,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,22.0,14.3,1.1,22.0,32
CDM,81002AK,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,24.0,15.6,1.1,24.0,32
CDM,81003AK,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,16.0,10.4,1.1,16.0,32
CDM,81025AK,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,59.0,38.35,1.1,59.0,32
CDM,81205AK,BCKDHB GENE ANALYSIS COMMON VARIANTS,655.0,425.75,1.1,655.0,32
CDM,81500055,SYPHILIS TEST QUAL,29.0,18.85,0.95,29.0,60
CDM,81500065,CMV AB,99.0,64.35,0.95,99.0,60
CDM,81500085,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,0.95,95.0,60
CDM,81500095,HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,60
CDM,81500105,HEP C AB,98.0,63.7,0.95,98.0,60
CDM,81500135,HEP B SURFACE AG EIA,71.0,46.15,0.95,71.0,60
CDM,81900015,SYPHILIS TEST QUAL,29.0,18.85,0.95,29.0,60
CDM,81900020,CMV AB,99.0,64.35,0.95,99.0,60
CDM,81900030,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,0.95,95.0,60
CDM,81900035,HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,60
CDM,81900045,HEP C AB,98.0,63.7,0.95,98.0,60
CDM,81900075,HEP B SURFACE AG EIA,71.0,46.15,0.95,71.0,60
CDM,82000020,HEMODIALYSIS,4828.0,3138.2,124.44,4828.0,61
CDM,82043AK,URINE ALBUMIN QUANTITATIVE,40.0,26.0,1.1,40.0,32
CDM,82044AK,URINE ALBUMIN SEMIQUANTITATIVE,43.0,27.95,1.1,43.0,32
CDM,82075AK,ASSAY OF ALCOHOL (ETHANOL) BREATH,207.0,134.55,1.1,207.0,32
CDM,82270AK,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,30.0,19.5,1.1,30.0,32
CDM,82271AK,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,37.0,24.05,1.1,37.0,32
CDM,82272AK,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,29.0,18.85,1.1,29.0,33
CDM,82274AK,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,110.0,71.5,1.1,110.0,32
CDM,82330AK,CALCIUM IONIZED BLD,94.0,61.1,1.1,94.0,32
CDM,82435AK,CHLORIDE BLD,32.0,20.8,1.1,32.0,32
CDM,82550AK,CREATINE KINASE TOTAL,45.0,29.25,1.1,45.0,32
CDM,82565AK,CREATININE; BLOOD,35.0,22.75,1.1,35.0,32
CDM,82570AK,CREATININE OTHER SOURCE,36.0,23.4,1.1,36.0,32
CDM,82803AK,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,180.0,117.0,1.1,180.0,32
CDM,82947AK,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,27.0,17.55,1.1,27.0,32
CDM,82948AK,GLUCOSE BLOOD REAGENT STRIP,35.0,22.75,1.1,35.0,32
CDM,82962AK,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,23.0,14.95,1.1,23.0,32
CDM,83000000,PERITONEAL DIALYSIS NON-CAPD,2938.0,1909.7,147.66,2938.0,61
CDM,83036AK,HEMOGLOBIN GLYCOSYLATED A1C,67.0,43.55,1.1,67.0,32
CDM,83037AK,HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE,67.0,43.55,1.1,67.0,32
CDM,83605AK,ASSAY OF LACTATE,80.0,52.0,1.1,80.0,32
CDM,83880AK,NATRIURETIC PEPTIDE,271.0,176.15,1.1,271.0,32
CDM,83986AK,PH BODY FLUID NOT ELSEWHERE SPECIFIED,25.0,16.25,1.1,25.0,32
CDM,84000000,PERITONEAL DIALYSIS CAPD,2938.0,1909.7,147.66,2938.0,61
CDM,84132AK,POTASSIUM SERUM PLASMA/WHOLE BLOOD,33.0,21.45,1.1,33.0,32
CDM,84153AK,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,127.0,82.55,1.1,127.0,32
CDM,84154AK,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,127.0,82.55,1.1,127.0,32
CDM,84295AK,SODIUM SERUM PLASMA OR WHOLE BLOOD,33.0,21.45,1.1,33.0,32
CDM,84403AK,ASSAY OF TESTOSTERONE TOTAL,178.0,115.7,1.1,178.0,32
CDM,84520AK,ASSAY OF UREA NITROGEN QUANTITATIVE,27.0,17.55,1.1,27.0,32
CDM,84703AK,GONADOTROPIN CHORIONIC QUALITATIVE,52.0,33.8,1.1,52.0,32
CDM,85000010,PERITONEAL DIALYSIS CCPD,2938.0,1909.7,147.66,2938.0,61
CDM,85014AK,BLOOD COUNT HEMATOCRIT,16.0,10.4,1.1,16.0,32
CDM,85018AK,BLOOD COUNT HEMOGLOBIN,16.0,10.4,1.1,16.0,32
CDM,85025AK,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,54.0,35.1,1.1,54.0,32
CDM,85027AK,BLOOD COUNT COMPLETE AUTOMATED,45.0,29.25,1.1,45.0,32
CDM,85045AK,BLOOD COUNT RETICULOCYTE AUTOMATED,28.0,18.2,1.1,28.0,32
CDM,85049AK,BLOOD COUNT PLATELET AUTOMATED,31.0,20.15,1.1,31.0,32
CDM,85060AK,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,198.0,128.7,1.1,198.0,44
CDM,85097AK,BONE MARROW SMEAR INTERPRETATION,414.0,269.1,1.1,1467.65,47
CDM,85576AK,PLATELET AGGREGATION IN VITRO EACH AGENT,163.0,105.95,1.1,163.0,33
CDM,85576AK-26,PLATELET AGGREGATION IN VITRO EACH AGENT,163.0,105.95,1.1,163.0,44
CDM,85610AK,PROTHROMBIN TIME,30.0,19.5,1.1,30.0,32
CDM,85610NORVUAK,PROTHROMBIN TIME,25.0,16.25,1.1,25.0,32
CDM,86036AK,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,83.0,53.95,1.1,83.0,31
CDM,86077AK,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,414.0,269.1,1.1,414.0,47
CDM,86078AK,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,414.0,269.1,1.1,414.0,47
CDM,86308AK,HETEROPHILE ANTIBODIES SCREEN,36.0,23.4,1.1,36.0,32
CDM,86318AK,IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH,125.0,81.25,1.1,125.0,32
CDM,86334AK,IMMUNOFIX E-PHORESIS SERUM,163.0,105.95,1.1,163.0,44
CDM,86403AK,PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY,80.0,52.0,1.1,80.0,32
CDM,86480AK,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON,428.0,278.2,1.1,428.0,32
CDM,86580AK,SKIN TEST TUBERCULOSIS INTRADERMAL,46.0,29.9,1.1,50.18,44
CDM,86706AK,HEPATITIS B SURF ANTIBODY HBSAB,74.0,48.1,1.1,74.0,32
CDM,86708AK,HEPATITIS A ANTIBODY HAAB,85.0,55.25,1.1,85.0,32
CDM,86735AK,ANTIBODY MUMPS,90.0,58.5,1.1,90.0,32
CDM,86762AK,ANTIBODY RUBELLA,99.0,64.35,1.1,99.0,32
CDM,86765AK,ANTIBODY RUBEOLA,89.0,57.85,1.1,89.0,32
CDM,86787AK,ANTIBODY VARICELLA-ZOSTER,89.0,57.85,1.1,89.0,32
CDM,86803AK,HEPATITIS C AB TEST,98.0,63.7,1.1,98.0,32
CDM,87210AK,SMR PRIM SRC WET MOUNT NFCT AGT,40.0,26.0,1.1,40.0,32
CDM,87220AK,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,29.0,18.85,1.1,29.0,32
CDM,87220NORVUAK,TISSUE EXAM FOR FUNGI,23.0,14.95,1.1,23.0,32
CDM,87502AK,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,661.0,429.65,1.1,661.0,32
CDM,87635AK,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,354.0,230.1,1.1,354.0,32
CDM,87637AK,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,560.0,364.0,1.1,560.0,32
CDM,87651AK,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,32
CDM,87651POCAK,STREP A (MOLECULAR),217.0,141.05,1.1,217.0,32
CDM,87804AK,IAADIADOO INFLUENZA,114.0,74.1,1.1,114.0,32
CDM,87807AK,IAADIADOO RESPIRATORY SYNCTIAL VIRUS,90.0,58.5,1.1,90.0,32
CDM,87880AK,IAADIADOO STREPTOCOCCUS GROUP A,114.0,74.1,1.1,114.0,32
CDM,88104AK,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,246.0,159.9,1.1,246.0,44
CDM,88108AK,CYTP CONCENTRATION SMEARS & INTERPRETATION,194.0,126.1,1.1,194.0,44
CDM,88112AK,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,246.0,159.9,1.1,246.0,44
CDM,88121AK,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,440.0,286.0,1.1,944.8,44
CDM,88141AK,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,114.0,74.1,1.1,114.0,44
CDM,88160AK,CYTP SMRS ANY OTH SRC SCR&INTERPJ,220.0,143.0,1.1,220.0,44
CDM,88172AK,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,304.0,197.6,1.1,304.0,44
CDM,88173AK,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,612.0,397.8,1.1,612.0,44
CDM,88177AK,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,185.0,120.25,1.1,185.0,44
CDM,88271AK,MOLECULAR CYTOGENETICS DNA PROBE EACH,148.0,96.2,1.1,148.0,32
CDM,88300AK,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,1.1,35.0,44
CDM,88302AK,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,57.0,37.05,1.1,74.56,44
CDM,88302AK-26,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,57.0,37.05,1.1,57.0,44
CDM,88302AK-TC,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,196.0,127.4,1.1,196.0,46
CDM,88304AK,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,97.0,63.05,1.1,97.0,44
CDM,88305AK,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,330.0,214.5,1.1,330.0,44
CDM,88305AK-26,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,330.0,214.5,1.1,330.0,44
CDM,88305AK-TC,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,369.0,239.85,1.1,369.0,46
CDM,88307AK,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,700.0,455.0,1.1,700.0,44
CDM,88309AK,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1232.0,800.8,1.1,1232.0,44
CDM,88311AK,DECALCIFICATION PROCEDURE,106.0,68.9,1.1,106.0,44
CDM,88312AK,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,238.0,154.7,1.1,238.0,44
CDM,88313AK,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,106.0,68.9,1.1,106.0,44
CDM,88321AK,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,717.0,466.05,1.1,717.0,22
CDM,88331AK,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,524.0,340.6,1.1,524.0,44
CDM,88332AK,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,260.0,169.0,1.1,260.0,44
CDM,88333AK,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,528.0,343.2,1.1,528.0,44
CDM,88334AK,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,321.0,208.65,1.1,321.0,44
CDM,88341AK,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,246.0,159.9,1.1,246.0,44
CDM,88342AK,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,308.0,200.2,1.1,308.0,44
CDM,88344AK,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,339.0,220.35,1.1,339.0,44
CDM,88360AK,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,374.0,243.1,1.1,374.0,44
CDM,88364AK,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,308.0,200.2,1.1,308.0,44
CDM,88365AK,IN SITU HYBRIDIZATION 1ST PROBE STAIN,387.0,251.55,1.1,387.0,44
CDM,88377AK,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,616.0,400.4,1.1,616.0,44
CDM,88900025,CRRT - SINGLE EVALUATION,2938.0,1909.7,147.66,2938.0,61
CDM,89060AK,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,163.0,105.95,1.1,163.0,33
CDM,89300AK,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,68.0,44.2,1.1,68.0,32
CDM,90000000,PSYCHOTHERAPY COMPLEX INTERACTIVE,153.0,99.45,19.57,153.0,46
CDM,90000005,PSYCHIATRIC DIAGNOSTIC EVALUATION,482.0,313.3,136.31,497.49,61
CDM,90000010,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,482.0,313.3,136.31,497.49,61
CDM,90000040,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,94.44,497.49,61
CDM,90000045,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,597.0,388.05,91.67,597.0,46
CDM,90000085,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,934.0,607.1,204.28,934.0,61
CDM,90000095,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,934.0,607.1,204.28,934.0,61
CDM,90000115,TCRANIAL MAGN STIM TX PLAN,934.0,607.1,204.28,934.0,61
CDM,90000125,CD CASE MGT PER MIN(ADM),3.0,1.95,0.45,38.09,46
CDM,90000135,CD CASE MGMT,60.0,39.0,8.93,145.96,46
CDM,90000145,CD ATP (ADM),2000.0,1300.0,297.6,2000.0,38
CDM,90000155,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,638.0,414.7,32.9,638.0,61
CDM,90000175,SUD CASE MGMT PER 15 MIN (MCAID),60.0,39.0,8.93,60.0,38
CDM,90000185,PSYTX FAMILY W/O PT,482.0,313.3,126.06,497.49,61
CDM,90000195,BH CASE MGMT PER 15 MIN,60.0,39.0,8.93,60.0,38
CDM,90000205,MULTI FAMILY GROUP THERAPY,482.0,313.3,52.53,497.49,61
CDM,90000225,CANS ASSESSMENT,192.0,124.8,28.57,192.0,46
CDM,90000225AK,CANS ASSESSMENT,133.0,86.45,1.1,1592889.09,34
CDM,90000235,CRISIS MOBILE RESPONSE,477.0,310.05,70.98,477.0,46
CDM,90000235AK,CRISIS MOBILE RESPONSE,133.0,86.45,1.1,1791901.44,28
CDM,90000245,CRISIS MOBILE RESPONSE FU,140.0,91.0,20.83,140.0,46
CDM,90000245AK,CRISIS MOBILE RESPONSE FU,133.0,86.45,1.1,473.41,29
CDM,90000255,MRSS STABILIZATION SERVICE,35.0,22.75,5.21,145.96,46
CDM,90000255AK,MRSS STABILIZATION SERVICE,133.0,86.45,1.1,1791901.44,28
CDM,90000265,MOD CARE COOR FULL MONTH,415.0,269.75,61.75,415.0,38
CDM,90000265AK,MOD CARE COOR FULL MONTH,133.0,86.45,1.1,1791901.44,28
CDM,90000275,MOD CARE COOR PARTIAL MONTH,208.0,135.2,30.95,208.0,38
CDM,90000275AK,MOD CARE COOR PARTIAL MONTH,133.0,86.45,1.1,1791901.44,28
CDM,90000285,MULTI SYSTEMIC THERAPY FOR JUVENILES (MST),42.0,27.3,6.25,44.68,46
CDM,90000285AK,MULTI SYSTEMIC THERAPY FOR JUVENILES (MST),133.0,86.45,1.1,133.0,29
CDM,90000295,FUNCTIONAL FAMILY THERAPY FOR JUVENILES (FFT),35.0,22.75,5.21,35.0,38
CDM,90000295AK,FUNCTIONAL FAMILY THERAPY FOR JUVENILES (FFT),133.0,86.45,1.1,133.0,29
CDM,90000305,INTENSIVE HOME BASED TREATMENT,38.0,24.7,5.65,38.0,38
CDM,90000305AK,INTENSIVE HOME BASED TREATMENT,133.0,86.45,1.1,133.0,29
CDM,90000315,VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,94.44,497.49,61
CDM,90000325,VIRTUAL PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,597.0,388.05,91.67,597.0,46
CDM,90000335,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,934.0,607.1,138.98,934.0,46
CDM,90000345,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,934.0,607.1,138.98,934.0,46
CDM,90100000,ELECTROCONVULSIVE THERAPY,1592.0,1034.8,190.81,2406.92,74
CDM,90380AK,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,1.1,2080.0,28
CDM,90381AK,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,1.1,2080.0,28
CDM,90400005,ACTIVITY THERAPY PHP ONLY,234.0,152.1,22.65,234.0,60
CDM,90460AK,IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID,96.0,62.4,1.1,96.0,50
CDM,90460VFCAK,VFC IM ADMIN/ONLY THRU 18,21.25,13.81,1.1,74.35,50
CDM,90461AK,IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID,72.0,46.8,1.1,72.0,44
CDM,90471AK,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,68.0,44.2,1.1,120.06,50
CDM,90472AK,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,60.0,39.0,1.1,60.0,50
CDM,90473AK,IM ADM INTRANSL/ORAL 1 VACCINE,68.0,44.2,1.1,120.06,50
CDM,90474AK,IM ADM INTRANSL/ORAL EA VACCINE,60.0,39.0,1.1,60.0,50
CDM,90480AK,ADMINISTRATION COVID VACCINE (2023-2024),293.0,190.45,1.1,293.0,32
CDM,90480VFCAK,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,1.1,138.2,32
CDM,90481AK,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,286.0,185.9,1.1,286.0,22
CDM,90482AK,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,106.0,68.9,1.1,106.0,23
CDM,90483AK,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,220.0,143.0,1.1,220.0,23
CDM,90484AK,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,330.0,214.5,1.1,330.0,23
CDM,90500005,IOP HALF DAY RATE,834.0,542.1,36.05,834.0,63
CDM,90500045,MEDICAID DAY TRTMT 3 HRS,932.0,605.8,138.68,932.0,41
CDM,90500055,VIRTUAL VISIT IOP HALF DAY RATE,834.0,542.1,36.05,834.0,63
CDM,90589AK,CHIKUNGUNYA VIRUS VACCINE LIVE FOR IM USE,990.0,643.5,1.1,1791901.44,27
CDM,90593AK,"CHIKUNGUNYA VACCINE, RECOMBINANT (VIMKUNYA)",991.0,644.15,1.1,991.0,24
CDM,90600005,CD IOP DAY,834.0,542.1,36.05,834.0,63
CDM,90600015,CD IOP DAY (ADM),532.0,345.8,79.16,532.0,48
CDM,90600025,VIRTUAL VISIT CD IOP DAY,834.0,542.1,36.05,834.0,63
CDM,90619AK,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,1.1,617.0,26
CDM,90620AK,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,852.0,553.8,1.1,852.0,28
CDM,90621AK,MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM,604.0,392.6,1.1,604.0,28
CDM,90632AK,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,308.0,200.2,1.1,308.0,28
CDM,90633AK,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,138.0,89.7,1.1,138.0,28
CDM,90636AK,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,472.0,306.8,1.1,472.0,28
CDM,90647AK,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,108.0,70.2,1.1,108.0,28
CDM,90648AK,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,47.0,30.55,1.1,47.0,28
CDM,90649AK,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,442.0,287.3,1.1,442.0,28
CDM,90651AK,9VHPV VACC 2/3 DOSE SCHED IM USE,1106.0,718.9,1.1,1106.0,28
CDM,90656AK,IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE,74.7,48.56,1.1,74.7,28
CDM,90658AK,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,1.1,69.7,28
CDM,90660AK,LAIV3 VACCINE LIVE FOR INTRANASAL USE,62.9,40.89,1.1,62.9,28
CDM,90662AK,IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM,203.3,132.15,1.1,203.3,28
CDM,90670AK,PCV13 VACCINE FOR INTRAMUSCULAR USE,814.0,529.1,1.1,814.0,28
CDM,90672AK,LAIV4 VACCINE FOR INTRANASAL USE,57.0,37.05,1.1,57.0,28
CDM,90673AK,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,284.6,184.99,1.1,284.6,28
CDM,90674AK,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,1.1,109.0,28
CDM,90675AK,"RABIES VACCINE, IM",1491.0,969.15,1.1,1491.0,28
CDM,90677AK,PCV20 VACCINE FOR INTRAMUSCULAR USE,1018.0,661.7,1.1,1018.0,28
CDM,90678AAK,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,1.1,1106.0,28
CDM,90678AK,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,1106.0,718.9,1.1,1106.0,28
CDM,90679AK,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,1.1,602.11,28
CDM,90680AK,RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,309.0,200.85,1.1,309.0,28
CDM,90681AK,RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE,402.0,261.3,1.1,402.0,28
CDM,90682AK,RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM,233.0,151.45,1.1,233.0,28
CDM,90685AK,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,34.0,22.1,1.1,41.22,27
CDM,90686AK,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,70.0,45.5,1.1,70.0,28
CDM,90687AK,IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE,33.0,21.45,1.1,33.0,28
CDM,90688AK,IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE,67.0,43.55,1.1,67.0,28
CDM,90689AK,IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE,44.0,28.6,1.1,44.0,23
CDM,90691AK,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,441.0,286.65,1.1,441.0,28
CDM,90694AK,AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE,243.0,157.95,1.1,243.0,28
CDM,90696AK,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,210.0,136.5,1.1,210.0,28
CDM,90697AK,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,526.05,341.93,1.1,526.05,28
CDM,90698AK,DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE,370.0,240.5,1.1,370.0,28
CDM,90700AAK,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,1.1,102.0,28
CDM,90700AK,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,102.0,66.3,1.1,102.0,28
CDM,90707AK,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,336.0,218.4,1.1,336.0,28
CDM,90710AK,"MMR+VARICELLA,SQ-COMBINED VACCINE",992.0,644.8,1.1,992.0,28
CDM,90713AK,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,151.0,98.15,1.1,151.0,28
CDM,90714AK,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,141.0,91.65,1.1,141.0,28
CDM,90715AK,TDAP VACCINE 7 YRS/> IM,170.0,110.5,1.1,170.0,28
CDM,90716AK,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,657.0,427.05,1.1,657.0,28
CDM,90723AK,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,312.0,202.8,1.1,312.0,28
CDM,90732AK,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,423.0,274.95,1.1,423.0,28
CDM,90733AK,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,344.0,223.6,1.1,344.0,28
CDM,90734AK,MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,565.0,367.25,1.1,565.0,28
CDM,90736AK,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,804.0,522.6,1.1,804.0,28
CDM,90739AK,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,562.0,365.3,1.1,562.0,28
CDM,90743AK,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,139.0,90.35,1.1,139.0,28
CDM,90744AK,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,104.0,67.6,1.1,104.0,28
CDM,90746AK,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,258.0,167.7,1.1,258.0,28
CDM,90747AK,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,230.0,149.5,1.1,287.74,28
CDM,90748AK,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,132.0,85.8,1.1,132.0,28
CDM,90750AK,HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,777.0,505.05,1.1,777.0,28
CDM,90759AK,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,83.0,53.95,1.1,132.61,27
CDM,90785AK,PSYCHOTHERAPY COMPLEX INTERACTIVE,145.0,94.25,1.1,145.0,53
CDM,90791AK,PSYCHIATRIC DIAGNOSTIC EVALUATION,1536.0,998.4,1.1,1536.0,53
CDM,90792AK,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,1664.0,1081.6,1.1,1664.0,53
CDM,90832AK,PSYCHOTHERAPY 30 MINUTES PATIENT,744.0,483.6,1.1,744.0,53
CDM,90833AK,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,656.0,426.4,1.1,656.0,53
CDM,90834AK,PSYCHOTHERAPY 45 MINUTES WITH PATIENT,980.0,637.0,1.1,980.0,53
CDM,90836AK,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,832.0,540.8,1.1,832.0,53
CDM,90837AK,PSYCHOTHERAPY 60 MINUTES WITH PATIENT,1452.0,943.8,1.1,1452.0,53
CDM,90838AK,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,1096.0,712.4,1.1,1096.0,53
CDM,90839AK,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINS,1509.0,980.85,1.1,1509.0,53
CDM,90840AK,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,722.0,469.3,1.1,722.0,53
CDM,90846AK,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,1052.0,683.8,1.1,1052.0,53
CDM,90847AK,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,1096.0,712.4,1.1,1096.0,53
CDM,90849AK,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,260.0,169.0,1.1,272.38,53
CDM,90853AK,GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.0,53
CDM,90867AK,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,584.0,379.6,1.1,1239.34,38
CDM,90868AK,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,584.0,379.6,1.1,585.93,38
CDM,90869AK,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MNGT,584.0,379.6,1.1,1517.59,38
CDM,90870AK,ELECTROCONVULSIVE THERAPY,1000.0,650.0,1.1,1000.0,53
CDM,90875AK,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,480.0,312.0,1.1,480.0,36
CDM,90876AK,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,760.0,494.0,1.1,760.0,36
CDM,90901AK,"BIOFEEDBACK TRAINING,ANY MODALITY",180.0,117.0,1.1,180.0,47
CDM,90912AK,BFB TRAING W/EMG &AMP;/MANOMETRY 1ST 15 MIN CNTCT,396.0,257.4,1.1,396.0,46
CDM,90913AK,BFB TRAING W/EMG&AMP;/MANOMETRY EA ADDL 15 MIN CNTCT,220.0,143.0,1.1,220.0,46
CDM,90935AK,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,651.0,423.15,1.1,1193.47,50
CDM,90937AK,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,928.0,603.2,1.1,928.0,50
CDM,90945AK,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,686.0,445.9,1.1,756.22,50
CDM,90947AK,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,1008.0,655.2,1.1,1008.0,50
CDM,91010AK,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,3004.0,1952.6,1.1,3004.0,50
CDM,91010AK-26,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,563.0,365.95,1.1,563.0,44
CDM,91034AK,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,2829.0,1838.85,1.1,2829.0,50
CDM,91034AK-26,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,388.0,252.2,1.1,388.0,44
CDM,91035AK,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,700.0,455.0,1.1,1498.68,50
CDM,91037AK,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1820.0,1183.0,1.1,1820.0,50
CDM,91037AK-26,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,388.0,252.2,1.1,388.0,44
CDM,91037AK-TC,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1432.0,930.8,1.1,1432.0,46
CDM,91110AK,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,5299.0,3444.35,1.1,5299.0,50
CDM,91110AK-26,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,986.0,640.9,1.1,986.0,44
CDM,91110AK-TC,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,1.1,4313.0,46
CDM,91113AK,GI TRACT IMAGING INTRALUMINAL COLON I&R,964.0,626.6,1.1,2948.17,50
CDM,91124AK,RECTAL SENSATION TONE&COMPLIANCE STUDY,2864.0,1861.6,1.1,2864.0,35
CDM,91124AK-26,RECTAL SENSATION TONE&COMPLIANCE STUDY,1342.0,872.3,1.1,1342.0,35
CDM,91124AK-TC,RECTAL SENSATION TONE&COMPLIANCE STUDY,1522.0,989.3,1.1,1522.0,37
CDM,91125AK,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,2942.0,1912.3,1.1,2942.0,35
CDM,91125AK-26,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1188.0,772.2,1.1,1188.0,35
CDM,91125AK-TC,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1754.0,1140.1,1.1,1754.0,37
CDM,91200005,PHP PER DIEM RATE,1844.0,1198.6,118.99,1844.0,48
CDM,91200045,MEDICAID DAY TRTMT HOURLY,616.0,400.4,91.66,952.0,41
CDM,91299AGRVUAK,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE (COMPARISON CODE,1860.0,1209.0,0.01,1860.0,28
CDM,91299AK,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,1916.0,1245.4,0.01,1916.0,28
CDM,91318AK,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,1.1,140.0,28
CDM,91319AK,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,1.1,278.0,28
CDM,91320AK,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,532.7,346.26,1.1,532.7,28
CDM,91321AK,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,1.1,465.4,28
CDM,91400000,PSYCHOTHERAPY COMPLEX INTERACTIVE,153.0,99.45,19.57,153.0,46
CDM,91400025,PSYCHOTHERAPY W/PATIENT 30 MINUTES,482.0,313.3,75.49,497.49,61
CDM,91400030,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN,162.0,105.3,35.32,162.0,46
CDM,91400035,PSYCHOTHERAPY W/PATIENT 45 MINUTES,482.0,313.3,94.44,497.49,61
CDM,91400040,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN,189.0,122.85,41.2,189.0,46
CDM,91400045,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,94.44,497.49,61
CDM,91400105,PSYCHOTHERAPY W/PATIENT 30 MINUTES,482.0,313.3,75.49,497.49,61
CDM,91400115,PSYCHOTHERAPY W/PATIENT 45 MINUTES,482.0,313.3,94.44,497.49,61
CDM,91400125,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,94.44,497.49,61
CDM,91400135,CD CRISISINTV PERHR(ADM),357.0,232.05,47.45,357.0,46
CDM,91400145,CD IND COUNS-15 MIN (ADM),93.0,60.45,13.84,93.0,46
CDM,91400225,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,425.0,276.25,85.47,425.0,61
CDM,91400235,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,739.0,480.35,144.46,739.0,61
CDM,91400295,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,355.0,230.75,52.82,355.0,46
CDM,91400305,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,355.0,230.75,52.82,355.0,46
CDM,91400315,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,355.0,230.75,52.82,355.0,46
CDM,91500000,GROUP THERAPY,278.0,180.7,36.05,284.74,61
CDM,91500035,GRP TX DBT SKILL,278.0,180.7,36.05,284.74,61
CDM,91500045,EXT AFTERCARE THPY GRP OP ONLY,278.0,180.7,36.05,284.74,61
CDM,91500055,GROUP THPY-DBT SKILLS OP ONLY,278.0,180.7,36.05,284.74,61
CDM,91500065,GROUP THERAPY IP 6100,278.0,180.7,36.05,284.74,61
CDM,91500075,GROUP THERAPY W/O PHY PHP,278.0,180.7,36.05,284.74,61
CDM,91500085,CD GRP COUNS-15 MIN(ADM),33.0,21.45,4.91,121.1,46
CDM,91500125,CD IOP GROUP THERAPY,178.0,115.7,26.49,178.0,46
CDM,91500135,PSYCHOTHERAPY COMPLEX INTERACTIVE,153.0,99.45,19.57,153.0,46
CDM,91500145,GROUP THERAPY PER 15 MIN (MCAID),39.0,25.35,5.8,39.0,38
CDM,91500155,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,137.0,89.05,27.53,167.27,61
CDM,91500165,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,137.0,89.05,27.53,167.27,61
CDM,91500175,GROUP THERAPY (OP),278.0,180.7,36.05,284.74,61
CDM,91500215,VIRTUAL VISIT CD IOP GROUP THERAPY,178.0,115.7,26.49,178.0,46
CDM,91500225,VIRTUAL VISIT MH IOP GROUP THERAPY,278.0,180.7,36.05,284.74,61
CDM,91500235,VIRTUAL VISIT AFTERCARE GROUP,278.0,180.7,36.05,284.74,61
CDM,91600000,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,482.0,313.3,126.06,497.49,61
CDM,91600005,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,482.0,313.3,126.06,497.49,61
CDM,91600045,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,27.53,167.27,61
CDM,91600055,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,27.53,167.27,61
CDM,91800015,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,316.0,205.4,47.02,316.0,46
CDM,91800025,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,2149.0,1396.85,124.63,2149.0,61
CDM,91800055,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,66.0,42.9,6.18,104.69,61
CDM,91800075,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1080.0,702.0,121.73,1080.0,61
CDM,91800085,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,302.0,196.3,65.84,302.0,46
CDM,91800095,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,390.0,253.5,85.02,390.0,46
CDM,91800105,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,934.0,607.1,154.5,934.0,61
CDM,91800115,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,390.0,253.5,85.02,390.0,46
CDM,91800125,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1592.0,1034.8,163.81,1592.0,61
CDM,91800135,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,390.0,253.5,85.02,390.0,46
CDM,91800145,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,387.0,251.55,42.45,387.0,61
CDM,91800155,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,390.0,253.5,33.21,390.0,46
CDM,91800165,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,1197.0,778.05,45.32,1252.1,61
CDM,91800175,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,390.0,253.5,45.32,390.0,46
CDM,91800185,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,73.0,47.45,3.09,189.67,61
CDM,91800355,VIRTUAL BRIEF EMOTIONAL/BEHAV ASSMT,66.0,42.9,6.18,104.69,61
CDM,92000005,COMPLEX UROFLOMETRY,1432.0,930.8,23.3,1432.0,61
CDM,92000025,VOID PRESSURE STUDIES INTRAABDOMINAL,1135.0,737.75,0.01,3004.0,46
CDM,92000040,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2149.0,1396.85,204.28,2149.0,61
CDM,92000045,FETAL NONSTRESS TEST,805.0,523.25,79.6,805.0,61
CDM,92000130,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,889.0,577.85,31.71,889.0,61
CDM,92000140,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,633.0,411.45,67.24,633.0,61
CDM,92000150,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,633.0,411.45,68.82,633.0,61
CDM,92000155,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,273.0,177.45,37.89,273.0,61
CDM,92000310,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,77.56,741.0,61
CDM,92000315,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,515.0,334.75,68.77,515.0,61
CDM,92000380,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,180.0,117.0,26.78,180.0,46
CDM,92000420,XM VIRTUAL - SINGLE INDIVIDUAL,425.0,276.25,21.54,425.0,61
CDM,92000620,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,68.51,1080.0,61
CDM,92000625,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,106.62,720.0,61
CDM,92000675,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,900.0,585.0,68.77,900.0,61
CDM,92000805,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,257.0,167.05,34.46,257.0,61
CDM,92000815,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,633.0,411.45,73.53,633.0,61
CDM,92000825,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,633.0,411.45,73.53,633.0,61
CDM,92000835,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,359.0,233.35,73.53,359.0,46
CDM,92000885,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,77.56,741.0,61
CDM,92000935,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3070.0,1995.5,226.03,3070.0,61
CDM,92001085,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,633.0,411.45,18.13,633.0,61
CDM,92001095,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,633.0,411.45,18.13,633.0,61
CDM,92001105,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,2069.0,1344.85,18.13,2069.0,61
CDM,92001115,INTERROGATION WITHOUT PROGRAMMING IPNSS,633.0,411.45,18.13,633.0,61
CDM,92001125,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,367.0,238.55,73.53,367.0,61
CDM,92001135,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,367.0,238.55,73.53,367.0,61
CDM,92001145,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,515.0,334.75,68.77,515.0,61
CDM,92001155,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,626.0,406.9,18.13,626.0,61
CDM,92001185,RISK ASCVD TST ONCE PR 12 MO,370.0,240.5,15.81,370.0,61
CDM,92001195,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,98.0,63.7,22.63,98.0,61
CDM,92001235,LIFT TEST/PHYSICAL ABILITY,45.0,29.25,6.7,45.0,38
CDM,92001255,TITMUS VISION,45.0,29.25,6.7,45.0,38
CDM,92001285,ASCVD RSK MNG CLIN STF PR MO,370.0,240.5,15.81,370.0,53
CDM,92083AK,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,813.0,528.45,1.1,813.0,50
CDM,92083AK-26,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,220.0,143.0,1.1,220.0,44
CDM,92100010,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1390.0,903.5,119.27,1390.0,61
CDM,92100020,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,77.56,611.0,61
CDM,92100030,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1390.0,903.5,119.27,1390.0,61
CDM,92100040,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,611.0,397.15,77.56,611.0,61
CDM,92100060,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,611.0,397.15,98.26,611.0,61
CDM,92100070,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,611.0,397.15,77.56,611.0,61
CDM,92100080,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,77.56,741.0,61
CDM,92100085,PHLEBOTEST EXTREMITY STUDY,154.0,100.1,22.63,154.0,61
CDM,92100090,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,900.0,585.0,86.16,900.0,61
CDM,92100100,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,900.0,585.0,77.56,900.0,61
CDM,92100110,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,119.27,1390.0,61
CDM,92100115,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1390.0,903.5,77.56,1390.0,61
CDM,92100120,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,77.56,611.0,61
CDM,92100125,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,611.0,397.15,77.56,611.0,61
CDM,92100130,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,77.56,1390.0,61
CDM,92100140,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,77.56,611.0,61
CDM,92100150,DUP SCAN EXT VEIN BILAT,1390.0,903.5,119.27,1390.0,61
CDM,92100160,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,611.0,397.15,77.56,611.0,61
CDM,92100170,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1390.0,903.5,119.27,1390.0,61
CDM,92100175,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,1634.0,1062.1,119.27,1634.0,46
CDM,92100180,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,611.0,397.15,98.26,611.0,61
CDM,92100185,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,745.0,484.25,119.27,745.0,46
CDM,92100190,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1390.0,903.5,119.27,1390.0,61
CDM,92100195,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,745.0,484.25,119.27,745.0,46
CDM,92100200,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,611.0,397.15,77.56,611.0,61
CDM,92100205,US TEMPORAL ARTERIES (COMP CODE 93880),1261.0,819.65,22.63,1261.0,61
CDM,92100230,DUPLEX SCAN HEMODIALYSIS ACCESS,611.0,397.15,77.56,611.0,61
CDM,92100240,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1390.0,903.5,119.27,1390.0,61
CDM,92100250,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,611.0,397.15,98.26,611.0,61
CDM,92100AK,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,268.0,174.2,1.1,277.87,53
CDM,92132AK,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,401.0,260.65,1.1,401.0,50
CDM,92132AK-26,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,128.0,83.2,1.1,128.0,44
CDM,92133AK,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,409.0,265.85,1.1,409.0,50
CDM,92133AK-26,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,136.0,88.4,1.1,136.0,44
CDM,92134AK,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,414.0,269.1,1.1,414.0,50
CDM,92134AK-26,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,141.0,91.65,1.1,141.0,44
CDM,92136AK,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,238.0,154.7,1.1,238.0,44
CDM,92137AK,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,282.0,183.3,1.1,282.0,43
CDM,92200010,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,119.1,889.0,61
CDM,92200020,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,119.1,889.0,61
CDM,92200035,NEEDLE EMG GUID W/CHEMODENERVATION,782.0,508.3,132.01,782.0,46
CDM,92200050,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,121.73,1080.0,61
CDM,92200110,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2149.0,1396.85,163.82,2149.0,61
CDM,92200120,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,889.0,577.85,119.1,889.0,61
CDM,92200200,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1080.0,702.0,121.73,1080.0,61
CDM,92200210,NERVE CONDUCTION STUDIES 1-2 STUDIES,1080.0,702.0,144.57,1080.0,61
CDM,92200220,NERVE CONDUCTION STUDIES 3-4 STUDIES,2149.0,1396.85,186.51,2149.0,61
CDM,92200230,NERVE CONDUCTION STUDIES 5-6 STUDIES,2149.0,1396.85,204.28,2149.0,61
CDM,92200240,NERVE CONDUCTION STUDIES 7-8 STUDIES,2149.0,1396.85,287.73,2149.0,61
CDM,92200250,NERVE CONDUCTION STUDIES 9-10 STUDIES,3661.0,2379.65,310.96,3661.0,61
CDM,92200260,NERVE CONDUCTION STUDIES 11-12 STUDIES,3661.0,2379.65,310.96,3661.0,61
CDM,92200270,NERVE CONDUCTION STUDIES 13/> STUDIES,3661.0,2379.65,310.96,3661.0,61
CDM,92200290,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,997.0,648.05,106.62,997.0,46
CDM,92200300,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1466.0,952.9,161.66,1466.0,46
CDM,92200310,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,558.0,362.7,121.64,558.0,46
CDM,92201AK,OPSCPY EXTND RTA DRAWING &AMP; SCL DEPRSN I&AMP;R UNI/BI,176.0,114.4,1.1,176.0,52
CDM,92202AK,OPSCPY EXTND OPTIC NRV/MACULA DRAWING I&AMP;R UNI/BI,114.0,74.1,1.1,114.0,52
CDM,92227AK,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/BI,21.0,13.65,1.1,103.94,50
CDM,92284AK,DARK ADAPTATION XM W/INTERPRETATION & REPORT,1938.0,1259.7,1.1,1938.0,50
CDM,92284AK-26,DARK ADAPTATION XM W/INTERPRETATION & REPORT,102.0,66.3,1.1,102.0,40
CDM,92288AK,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,75.0,48.75,1.1,75.0,23
CDM,92310AK,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,468.0,304.2,1.1,468.0,42
CDM,92311AK,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,432.0,280.8,1.1,680.96,53
CDM,92400000,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,6.36,2406.92,53
CDM,92400015,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,73.0,47.45,6.26,141.96,61
CDM,92400020,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,165.0,107.25,12.25,165.0,61
CDM,92400025,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,1.97,165.35,61
CDM,92400040,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,408.0,265.2,9.01,2406.92,53
CDM,92400060,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1592.0,1034.8,65.24,1592.0,53
CDM,92400065,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,1592.0,1034.8,129.7,1592.0,61
CDM,92400070,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,276.0,179.4,60.17,276.0,46
CDM,92400075,RAPID DESENSITIZATION PROCEDURE EACH HOUR,1197.0,778.05,179.17,1252.1,53
CDM,92502AK,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,604.0,392.6,1.1,939.01,50
CDM,92504AK,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,79.0,51.35,1.1,94.94,53
CDM,92507AK,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,520.0,338.0,1.1,520.0,50
CDM,92508AK,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,132.0,85.8,1.1,132.0,50
CDM,92511AK,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,268.0,174.2,1.1,385.01,53
CDM,92520AK,LARYNGEAL FUNCTION STUDY,300.0,195.0,1.1,300.0,53
CDM,92521AK,"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)",896.0,582.4,1.1,896.0,50
CDM,92522AK,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,768.0,499.2,1.1,768.0,50
CDM,92523AK,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1536.0,998.4,1.1,1536.0,50
CDM,92524AK,BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE,768.0,499.2,1.1,768.0,50
CDM,92526AK,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,536.0,348.4,1.1,536.0,50
CDM,92532AK,POSITIONAL NYSTAGMUS STUDY,215.0,139.75,1.1,215.0,32
CDM,92537AK,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,890.0,578.5,1.1,890.0,50
CDM,92537AK-26,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,264.0,171.6,1.1,264.0,44
CDM,92540AK,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,1286.0,835.9,1.1,1286.0,50
CDM,92540AK-26,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,660.0,429.0,1.1,660.0,44
CDM,92541AK,SPONTANEOUS NYSTAGMUS TEST,692.0,449.8,1.1,692.0,50
CDM,92541AK-26,SPONTANEOUS NYSTAGMUS TEST,176.0,114.4,1.1,176.0,44
CDM,92542AK,POSITIONAL NYSTAGMUS TEST,727.0,472.55,1.1,727.0,50
CDM,92542AK-26,POSITIONAL NYSTAGMUS TEST,211.0,137.15,1.1,211.0,44
CDM,92547AK,USE VERTICAL ELECTRODES,187.0,121.55,1.1,187.0,50
CDM,92550AK,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,154.0,100.1,1.1,267.01,50
CDM,92551AK,SCREENING TEST PURE TONE AIR ONLY,62.0,40.3,1.1,62.0,39
CDM,92552AK,PURE TONE AUDIOMETRY AIR ONLY,127.0,82.55,1.1,218.62,50
CDM,92553AK,PURE TONE AUDIOMETRY AIR & BONE,166.0,107.9,1.1,267.01,50
CDM,92555AK,SPEECH AUDIOMETRY THRESHOLD,84.0,54.6,1.1,103.94,50
CDM,92556AK,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,147.0,95.55,1.1,147.0,50
CDM,92557AK,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,264.0,171.6,1.1,267.01,53
CDM,92563AK,TONE DECAY,98.0,63.7,1.1,105.89,50
CDM,92567AK,TYMPANOMETRY,88.0,57.2,1.1,88.0,53
CDM,92568AK,ACOUSTIC REFLEX,116.0,75.4,1.1,116.0,53
CDM,92570AK,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,242.0,157.3,1.1,267.01,53
CDM,92577AK,SPEECH STENGER,144.0,93.6,1.1,915.71,50
CDM,92582AK,CONDITIONING PLAY AUDIOMETRY,168.0,109.2,1.1,267.01,50
CDM,92587AK,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,1400.0,910.0,1.1,1400.0,50
CDM,92587AK-26,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,154.0,100.1,1.1,154.0,44
CDM,92588AK,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,1488.0,967.2,1.1,1488.0,50
CDM,92588AK-26,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,242.0,157.3,1.1,242.0,44
CDM,92597AK,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,504.0,327.6,1.1,504.0,50
CDM,92607AK,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,740.0,481.0,1.1,740.0,50
CDM,92608AK,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,280.0,182.0,1.1,280.0,50
CDM,92609AK,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,600.0,390.0,1.1,600.0,50
CDM,92610AK,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,520.0,338.0,1.1,520.0,53
CDM,92611AK,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,536.0,348.4,1.1,536.0,50
CDM,92616AK,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,752.0,488.8,1.1,752.0,53
CDM,92628AK,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,100.0,65.0,1.1,100.0,22
CDM,92631AK,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,100.0,65.0,1.1,100.0,22
CDM,92634AK,HEARING AID FITTING SERVICES 1ST 60 MINUTES,300.0,195.0,1.1,300.0,22
CDM,92636AK,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,50.0,32.5,1.1,50.0,22
CDM,92637AK,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,25.0,16.25,1.1,25.0,22
CDM,92642AK,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,100.0,65.0,1.1,100.0,22
CDM,92650AK,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,110.0,71.5,1.1,110.0,39
CDM,92651AK,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,400.0,260.0,1.1,535.81,50
CDM,92652AK,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,600.0,390.0,1.1,600.0,50
CDM,92653AK,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,420.0,273.0,1.1,535.81,50
CDM,92900025,SANE EVAL,700.0,455.0,104.16,700.0,46
CDM,92900035,SANE EVAL,818.0,531.7,121.72,818.0,38
CDM,92920AK,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,4334.0,2817.1,1.1,9759.23,50
CDM,92924AK,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,4696.0,3052.4,1.1,18783.74,50
CDM,92928AK,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,4822.0,3134.3,1.1,18783.74,50
CDM,92930AK,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,5280.0,3432.0,1.1,5280.0,35
CDM,92933AK,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,5408.0,3515.2,1.1,29938.94,50
CDM,92937AK,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,4818.0,3131.7,1.1,18783.74,50
CDM,92941AK,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,4924.0,3200.6,1.1,4924.0,50
CDM,92943AK,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,5416.0,3520.4,1.1,18783.74,50
CDM,92945AK,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,6600.0,4290.0,1.1,6600.0,35
CDM,92950AK,CARDIO-PULMONARY RESUSCITATION,1760.0,1144.0,1.1,1760.0,53
CDM,92960AK,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,880.0,572.0,1.1,1111.04,53
CDM,92961AK,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,1736.0,1128.4,1.1,1736.0,50
CDM,92972AK,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,1307.0,849.55,1.1,1307.0,50
CDM,92973AK,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,1312.0,852.8,1.1,1312.0,50
CDM,92978AK,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5854.0,3805.1,1.1,5854.0,38
CDM,92978AK-26,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,792.0,514.8,1.1,792.0,44
CDM,92979AK,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,576.0,374.4,1.1,576.0,44
CDM,92986AK,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,9040.0,5876.0,1.1,9759.23,50
CDM,92997AK,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,4792.0,3114.8,1.1,18783.74,50
CDM,93000AK,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,75.0,48.75,1.1,75.0,50
CDM,93005AK,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,295.0,191.75,1.1,295.0,50
CDM,93010AK,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,75.0,48.75,1.1,75.0,50
CDM,93015AK,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,330.0,214.5,1.1,330.0,50
CDM,93016AK,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,198.0,128.7,1.1,198.0,50
CDM,93018AK,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,132.0,85.8,1.1,132.0,50
CDM,93041AK,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,72.0,46.8,1.1,103.94,50
CDM,93042AGEXAK,TRANS-TELEPHONIC ARRHYTHMIA MONITORING,20.0,13.0,1.1,23.09,50
CDM,93042AK,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,66.0,42.9,1.1,66.0,50
CDM,93145AK,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,286.0,185.9,1.1,286.0,35
CDM,93146AK,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,396.0,257.4,1.1,396.0,35
CDM,93150AK,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,374.0,243.1,1.1,374.0,52
CDM,93151AK,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,352.0,228.8,1.1,352.0,52
CDM,93152AK,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,801.0,520.65,1.1,801.0,52
CDM,93153AK,INTERROGATION WITHOUT PROGRAMMING IPNSS,189.0,122.85,1.1,189.0,52
CDM,93224AK,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,172.0,111.8,1.1,236.26,50
CDM,93225AK,XTRNL ECG & 48 HR RECORDING,357.0,232.05,1.1,357.0,50
CDM,93226AK,EXTERNAL ECG SCANNING ANALYSIS REPORT,750.0,487.5,1.1,750.0,50
CDM,93227AK,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,172.0,111.8,1.1,172.0,50
CDM,93228AK,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,211.0,137.15,1.1,211.0,50
CDM,93242AK,EXTERNAL ECG REC>48HR<7D RECORDING,328.0,213.2,1.1,328.0,50
CDM,93243AK,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,370.0,240.5,1.1,730.57,50
CDM,93244AK,EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION,200.0,130.0,1.1,200.0,50
CDM,93245AK,EXTERNAL ECG REC>7D<15D SCAN ALYS REPORT R&I,220.0,143.0,1.1,893.75,50
CDM,93246AK,EXTERNAL ECG REC>7D<15D RECORDING,328.0,213.2,1.1,328.0,50
CDM,93247AK,EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT,370.0,240.5,1.1,767.95,50
CDM,93248AK,EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION,242.0,157.3,1.1,242.0,50
CDM,93260AK,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,588.0,382.2,1.1,588.0,50
CDM,93260AK-26,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,374.0,243.1,1.1,374.0,44
CDM,93261AK,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,540.0,351.0,1.1,540.0,50
CDM,93261AK-26,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,326.0,211.9,1.1,326.0,44
CDM,93261AK-TC,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,214.0,139.1,1.1,214.0,46
CDM,93264AK,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,308.0,200.2,1.1,308.0,53
CDM,93268AK,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,208.0,135.2,1.1,575.22,50
CDM,93270AK,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,537.0,349.05,1.1,537.0,50
CDM,93272AK,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,208.0,135.2,1.1,208.0,50
CDM,93279AGEXAK,PACEMAKER PROGRAMMING SINGLE,260.0,169.0,1.1,260.0,50
CDM,93279AK,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,474.0,308.1,1.1,474.0,50
CDM,93279AK-26,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,260.0,169.0,1.1,260.0,44
CDM,93280AGEXAK,PACEMAKER PROGRAMMING DUAL,308.0,200.2,1.1,308.0,50
CDM,93280AK,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,522.0,339.3,1.1,522.0,50
CDM,93280AK-26,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,308.0,200.2,1.1,308.0,44
CDM,93281AGEXAK,PACEMAKER PROGRAMMING MULT,374.0,243.1,1.1,374.0,50
CDM,93281AK,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,588.0,382.2,1.1,588.0,50
CDM,93281AK-26,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,374.0,243.1,1.1,374.0,44
CDM,93282AGEXAK,DEFIBRILLATOR PROGRAMMING SINGLE,374.0,243.1,1.1,374.0,50
CDM,93282AK,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,588.0,382.2,1.1,588.0,50
CDM,93282AK-26,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,374.0,243.1,1.1,374.0,44
CDM,93283AGEXAK,DEFIBRILLATOR PROGRAMMING DUAL,506.0,328.9,1.1,506.0,50
CDM,93283AK,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,720.0,468.0,1.1,720.0,50
CDM,93283AK-26,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,506.0,328.9,1.1,506.0,44
CDM,93284AGEXAK,DEFIBRILLATOR PROGRAMMING MULT,550.0,357.5,1.1,550.0,50
CDM,93284AK,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,764.0,496.6,1.1,764.0,50
CDM,93284AK-26,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,550.0,357.5,1.1,550.0,44
CDM,93285AK,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,422.0,274.3,1.1,422.0,50
CDM,93285AK-26,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,208.0,135.2,1.1,208.0,44
CDM,93286AGEXAK,PACEMAKER PERI PROCEDURAL,132.0,85.8,1.1,150.82,50
CDM,93286AK,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,434.0,282.1,1.1,434.0,50
CDM,93286AK-26,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,132.0,85.8,1.1,132.0,44
CDM,93287AGEXAK,DEFIBRILLATOR PERI PROCEDURAL,198.0,128.7,1.1,198.0,50
CDM,93287AK,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,537.0,349.05,1.1,537.0,50
CDM,93287AK-26,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,198.0,128.7,1.1,198.0,44
CDM,93288AGEXAK,PACEMAKER INTERROGATION,172.0,111.8,1.1,185.24,50
CDM,93288AK,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,386.0,250.9,1.1,386.0,50
CDM,93288AK-26,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,172.0,111.8,1.1,172.0,44
CDM,93289AGEXAK,DEFIBRILLATOR INTERROGATION,544.0,353.6,1.1,544.0,50
CDM,93289AGEXAK-26,DEFIBRILLATOR INTERROGATION,330.0,214.5,1.1,330.0,44
CDM,93289AK,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,544.0,353.6,1.1,544.0,50
CDM,93289AK-26,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,330.0,214.5,1.1,330.0,44
CDM,93290AGEXAK,PHYSIOLOGICAL MONITOR INTERROGATION,189.0,122.85,1.1,189.0,50
CDM,93290AK,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,403.0,261.95,1.1,403.0,50
CDM,93290AK-26,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,189.0,122.85,1.1,189.0,44
CDM,93291AGEXAK,IMPLANTABLE LOOP RECORDER INTERROGATION,163.0,105.95,1.1,163.26,50
CDM,93291AK,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,304.0,197.6,1.1,304.0,50
CDM,93291AK-26,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,163.0,105.95,1.1,163.0,44
CDM,93292AGEXAK,WEARABLE DEFIBRILLATOR INTERROGATION,172.0,111.8,1.1,172.0,50
CDM,93292AK,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,172.0,111.8,1.1,172.0,50
CDM,93293AGEXAK,TELEPHONIC MONITORING,136.0,88.4,1.1,148.78,50
CDM,93293AK,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,350.0,227.5,1.1,350.0,50
CDM,93293AK-26,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,136.0,88.4,1.1,136.0,44
CDM,93294AK,REM INTERROG PM/LDLS PM <90 D PHYS/QHP,240.0,156.0,1.1,240.0,50
CDM,93295AK,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,326.0,211.9,1.1,326.0,50
CDM,93296AGEXAK,DEFIBRILLATOR HEART RHYTHM DATA PRO CODE,89.0,57.85,1.1,89.0,50
CDM,93296AK,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,99.0,64.35,1.1,99.0,50
CDM,93297AK,REM INTERROG ICPMS <30 D PHYS/QHP,422.0,274.3,1.1,422.0,50
CDM,93297AK-26,REM INTERROG ICPMS <30 D PHYS/QHP,208.0,135.2,1.1,208.0,38
CDM,93298AK,REM INTERROG SCRMS <30 D PHYS/QHP,422.0,274.3,1.1,422.0,50
CDM,93298AK-26,REM INTERROG SCRMS <30 D PHYS/QHP,208.0,135.2,1.1,208.0,38
CDM,93303AK,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,572.0,371.8,1.1,572.0,44
CDM,93304AK,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,330.0,214.5,1.1,330.0,44
CDM,93306AK,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3795.0,2466.75,1.1,3795.0,50
CDM,93306AK-26,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,642.0,417.3,1.1,642.0,44
CDM,93307AK,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1795.0,1166.75,1.1,1795.0,50
CDM,93307AK-26,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,405.0,263.25,1.1,405.0,44
CDM,93307AK-TC,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1390.0,903.5,1.1,1390.0,46
CDM,93308AK,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1623.0,1054.95,1.1,1623.0,50
CDM,93308AK-26,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,233.0,151.45,1.1,233.0,44
CDM,93312AK,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,4165.0,2707.25,1.1,4165.0,50
CDM,93312AK-26,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,1012.0,657.8,1.1,1012.0,44
CDM,93312AK-TC,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,1.1,3153.0,46
CDM,93313AK,ECHO R-T 2D W/PROBE PLACEMENT ONLY,114.0,74.1,1.1,942.59,50
CDM,93314AK,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,814.0,529.1,1.1,814.0,50
CDM,93315AK,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,1184.0,769.6,1.1,2003.07,38
CDM,93317AK,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,1.1,894.56,38
CDM,93318AK,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,4099.0,2664.35,1.1,4099.0,38
CDM,93318AK-26,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,946.0,614.9,1.1,946.0,44
CDM,93319AK,ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,220.0,143.0,1.1,220.0,52
CDM,93320AK,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,167.0,108.55,1.1,167.0,44
CDM,93321AK,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,666.0,432.9,1.1,666.0,50
CDM,93321AK-26,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,66.0,42.9,1.1,66.0,44
CDM,93321AK-TC,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,600.0,390.0,1.1,600.0,46
CDM,93325AK,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1097.0,713.05,1.1,1097.0,50
CDM,93325AK-26,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,31.0,20.15,1.1,31.0,44
CDM,93350AK,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3795.0,2466.75,1.1,3795.0,50
CDM,93350AK-26,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,642.0,417.3,1.1,642.0,44
CDM,93351AK,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,770.0,500.5,1.1,770.0,44
CDM,93355AK,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,2050.0,1332.5,1.1,2050.0,50
CDM,93356AK,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,106.0,68.9,1.1,121.34,52
CDM,93451AK,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,19581.0,12727.65,1.1,19581.0,50
CDM,93451AK-26,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,1087.0,706.55,1.1,1087.0,44
CDM,93451AK-TC,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,18494.0,12021.1,1.1,18494.0,40
CDM,93452AK,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,1980.0,1287.0,1.1,1980.0,44
CDM,93453AK,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,21130.0,13734.5,1.1,21130.0,50
CDM,93453AK-26,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,2636.0,1713.4,1.1,2636.0,44
CDM,93454AK,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,20492.0,13319.8,1.1,20492.0,50
CDM,93454AK-26,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,1998.0,1298.7,1.1,1998.0,44
CDM,93454AK-TC,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,40
CDM,93455AK,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,20822.0,13534.3,1.1,20822.0,50
CDM,93455AK-26,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,2328.0,1513.2,1.1,2328.0,44
CDM,93456AK,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,21090.0,13708.5,1.1,21090.0,50
CDM,93456AK-26,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,2596.0,1687.4,1.1,2596.0,44
CDM,93457AK,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,21416.0,13920.4,1.1,21416.0,50
CDM,93457AK-26,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,2922.0,1899.3,1.1,2922.0,44
CDM,93458AK,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,20958.0,13622.7,1.1,20958.0,50
CDM,93458AK-26,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,2464.0,1601.6,1.1,2464.0,44
CDM,93458AK-TC,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,40
CDM,93459AK,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,21288.0,13837.2,1.1,21288.0,50
CDM,93459AK-26,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,2794.0,1816.1,1.1,2794.0,44
CDM,93460AK,R & L HRT CATH WINJX HRT ART& L VENTR IMG,21618.0,14051.7,1.1,21618.0,50
CDM,93460AK-26,R & L HRT CATH WINJX HRT ART& L VENTR IMG,3124.0,2030.6,1.1,3124.0,44
CDM,93460AK-TC,R & L HRT CATH WINJX HRT ART& L VENTR IMG,18494.0,12021.1,1.1,18494.0,40
CDM,93461AK,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,21948.0,14266.2,1.1,21948.0,50
CDM,93461AK-26,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,3454.0,2245.1,1.1,3454.0,44
CDM,93462AK,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,1641.0,1066.65,1.1,1641.0,50
CDM,93463AK,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,880.0,572.0,1.1,880.0,50
CDM,93503AK,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,880.0,572.0,1.1,2734.59,50
CDM,93505AK,ENDOMYOCARDIAL BIOPSY,19911.0,12942.15,1.1,19911.0,50
CDM,93505AK-26,ENDOMYOCARDIAL BIOPSY,1813.0,1178.45,1.1,1813.0,44
CDM,93567AK,NJX SUPRAVALV AORTOG HRT CATH W/S&I,308.0,200.2,1.1,308.0,51
CDM,93569AK,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,343.0,222.95,1.1,343.0,50
CDM,93571AK,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,5232.0,3400.8,1.1,7735.57,38
CDM,93571AK-26,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,607.0,394.55,1.1,607.0,44
CDM,93572AK,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,5190.0,3373.5,1.1,7719.15,38
CDM,93572AK-26,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,440.0,286.0,1.1,440.0,44
CDM,93573AK,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,572.0,371.8,1.1,572.0,50
CDM,93574AK,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,634.0,412.1,1.1,634.0,50
CDM,93575AK,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,845.0,549.25,1.1,845.0,50
CDM,93580AK,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,7907.0,5139.55,1.1,29938.94,50
CDM,93584AK,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,528.0,343.2,1.1,528.0,50
CDM,93585AK,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,497.0,323.05,1.1,497.0,50
CDM,93586AK,VENOGRAPHY CHD CORONARY SINUS,629.0,408.85,1.1,629.0,50
CDM,93587AK,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,928.0,603.2,1.1,928.0,50
CDM,93588AK,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,937.0,609.05,1.1,937.0,50
CDM,93593AK,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,1596.0,1037.4,1.1,5564.16,26
CDM,93594AK,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,2440.0,1586.0,1.1,5564.16,26
CDM,93595AK,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,2541.0,1651.65,1.1,5564.16,26
CDM,93596AK,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,2736.0,1778.4,1.1,5564.16,26
CDM,93597AK,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,3552.0,2308.8,1.1,6276.37,26
CDM,93598AK,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,634.0,412.1,1.1,634.0,26
CDM,93600AK,BUNDLE OF HIS RECORDING,21680.0,14092.0,1.1,21680.0,38
CDM,93600AK-26,BUNDLE OF HIS RECORDING,933.0,606.45,1.1,933.0,44
CDM,93602AK,INTRA-ATRIAL RECORDING,44565.0,28967.25,1.1,44565.0,38
CDM,93602AK-26,INTRA-ATRIAL RECORDING,933.0,606.45,1.1,933.0,44
CDM,93603AK,RIGHT VENTRICULAR RECORDING,7913.0,5143.45,1.1,7913.0,38
CDM,93603AK-26,RIGHT VENTRICULAR RECORDING,933.0,606.45,1.1,933.0,44
CDM,93609AK,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,8140.0,5291.0,1.1,8140.0,38
CDM,93609AK-26,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,2177.0,1415.05,1.1,2177.0,44
CDM,93610AK,INTRA-ATRIAL PACING,44961.0,29224.65,1.1,44961.0,38
CDM,93610AK-26,INTRA-ATRIAL PACING,1329.0,863.85,1.1,1329.0,44
CDM,93612AK,INTRAVENTRICULAR PACING,44961.0,29224.65,1.1,44961.0,38
CDM,93612AK-26,INTRAVENTRICULAR PACING,1329.0,863.85,1.1,1329.0,44
CDM,93613AK,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,2092.0,1359.8,1.1,2092.0,50
CDM,93618AK,INDUCTION ARRHYTHMIA ELECTRICAL PACING,8675.0,5638.75,1.1,8675.0,38
CDM,93618AK-26,INDUCTION ARRHYTHMIA ELECTRICAL PACING,1695.0,1101.75,1.1,1695.0,44
CDM,93619AK,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,46632.0,30310.8,1.1,46632.0,38
CDM,93619AK-26,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,3000.0,1950.0,1.1,3000.0,44
CDM,93620AK,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,48613.0,31598.45,1.1,48613.0,38
CDM,93620AK-26,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,4981.0,3237.65,1.1,4981.0,44
CDM,93621AK,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,15248.0,9911.2,1.1,15248.0,38
CDM,93621AK-26,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,660.0,429.0,1.1,660.0,44
CDM,93622AK,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,1313.0,853.45,1.1,1313.0,44
CDM,93623AK,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,10095.0,6561.75,1.1,10095.0,38
CDM,93623AK-26,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,431.0,280.15,1.1,431.0,44
CDM,93631AK,INTRAOP EPICAR& ENDOCAR PACG& MAPG,3340.0,2171.0,1.1,3340.0,38
CDM,93641AK,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,6433.0,4181.45,1.1,6433.0,38
CDM,93641AK-26,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,2495.0,1621.75,1.1,2495.0,44
CDM,93642AK,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,9017.0,5861.05,1.1,9017.0,50
CDM,93642AK-26,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,2037.0,1324.05,1.1,2037.0,44
CDM,93644AK,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,1338.0,869.7,1.1,1338.0,44
CDM,93650AK,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,4096.0,2662.4,1.1,12751.87,50
CDM,93653AK,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,6600.0,4290.0,1.1,40551.17,50
CDM,93654AK,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,7964.0,5176.6,1.1,40551.17,50
CDM,93655AK,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,2420.0,1573.0,1.1,2420.0,50
CDM,93656AK,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,7480.0,4862.0,1.1,40551.17,50
CDM,93657AK,ABLATE L/R ATRIAL FIBRIL W/ ISOLATED PULM VEIN,2420.0,1573.0,1.1,2420.0,50
CDM,93660AK,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3883.0,2523.95,1.1,3883.0,50
CDM,93660AK-26,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,832.0,540.8,1.1,832.0,44
CDM,93662AK,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,7507.0,4879.55,1.1,7507.0,38
CDM,93662AK-26,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,634.0,412.1,1.1,634.0,44
CDM,93724AK,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2147.0,1395.55,1.1,2147.0,44
CDM,93750AK,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,330.0,214.5,1.1,330.0,53
CDM,93784AK,AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R,167.0,108.55,1.1,167.0,44
CDM,93792AK,PT/CAREGIVER TRAINJ FOR INITIATION HOME INR MNTR,535.0,347.75,1.1,535.0,50
CDM,93793AK,ANTICOAGULANT MGMT FOR PT TAKING WARFARIN,79.0,51.35,1.1,79.0,50
CDM,93798AK,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,112.0,72.8,1.1,225.79,53
CDM,93799AGRVUAK,UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE  (COMPARISON CODE 9,680.0,442.0,0.01,680.0,28
CDM,93799AK,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,700.0,455.0,0.01,700.0,28
CDM,93880AK,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1742.0,1132.3,1.1,1742.0,50
CDM,93880AK-26,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,352.0,228.8,1.1,352.0,44
CDM,93882AK,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,811.0,527.15,1.1,811.0,50
CDM,93882AK-26,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,200.0,130.0,1.1,200.0,44
CDM,93882AK-TC,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,1.1,611.0,46
CDM,93886AK,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1750.0,1137.5,1.1,1750.0,50
CDM,93886AK-26,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,360.0,234.0,1.1,360.0,44
CDM,93886AK-TC,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1390.0,903.5,1.1,1390.0,46
CDM,93888AK,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,321.0,208.65,1.1,321.0,44
CDM,93896AK,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,356.0,231.4,1.1,356.0,43
CDM,93897AK,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,321.0,208.65,1.1,321.0,43
CDM,93898AK,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,374.0,243.1,1.1,374.0,43
CDM,93922AK,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,851.0,553.15,1.1,851.0,50
CDM,93922AK-26,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,110.0,71.5,1.1,110.0,44
CDM,93922AK-TC,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,1.1,741.0,46
CDM,93923AK,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,1098.0,713.7,1.1,1098.0,50
CDM,93923AK-26,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,198.0,128.7,1.1,198.0,44
CDM,93924AK,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,1100.0,715.0,1.1,1100.0,50
CDM,93924AK-26,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,200.0,130.0,1.1,200.0,44
CDM,93924AK-TC,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,900.0,585.0,1.1,900.0,46
CDM,93925AK,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1710.0,1111.5,1.1,1710.0,50
CDM,93925AK-26,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,320.0,208.0,1.1,320.0,44
CDM,93926AK,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,811.0,527.15,1.1,811.0,50
CDM,93926AK-26,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,200.0,130.0,1.1,200.0,44
CDM,93930AK,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1710.0,1111.5,1.1,1710.0,50
CDM,93930AK-26,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,320.0,208.0,1.1,320.0,44
CDM,93931AK,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,811.0,527.15,1.1,811.0,50
CDM,93931AK-26,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,200.0,130.0,1.1,200.0,44
CDM,93970AK,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1670.0,1085.5,1.1,1670.0,50
CDM,93970AK-26,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,280.0,182.0,1.1,280.0,44
CDM,93971AK,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,809.0,525.85,1.1,809.0,50
CDM,93971AK-26,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,198.0,128.7,1.1,198.0,44
CDM,93975AK,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1900.0,1235.0,1.1,1900.0,50
CDM,93975AK-26,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,510.0,331.5,1.1,510.0,44
CDM,93975AK-TC,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1261.0,819.65,1.1,1261.0,46
CDM,93976AK,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,963.0,625.95,1.1,963.0,50
CDM,93976AK-26,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,352.0,228.8,1.1,352.0,44
CDM,93976AK-TC,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,566.0,367.9,1.1,566.0,46
CDM,93978AK,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1742.0,1132.3,1.1,1742.0,50
CDM,93978AK-26,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,352.0,228.8,1.1,352.0,44
CDM,93979AK,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,831.0,540.15,1.1,831.0,50
CDM,93979AK-26,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,220.0,143.0,1.1,220.0,44
CDM,93980AK,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,1111.0,722.15,1.1,1111.0,50
CDM,93980AK-26,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,500.0,325.0,1.1,500.0,44
CDM,93985AK,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1710.0,1111.5,1.1,1710.0,50
CDM,93985AK-26,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,320.0,208.0,1.1,320.0,44
CDM,93985AK-TC,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1390.0,903.5,1.1,1390.0,46
CDM,93986AK,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,811.0,527.15,1.1,811.0,50
CDM,93986AK-26,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,200.0,130.0,1.1,200.0,44
CDM,93986AK-TC,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,611.0,397.15,1.1,611.0,46
CDM,93990AK,DUPLEX SCAN HEMODIALYSIS ACCESS,811.0,527.15,1.1,811.0,50
CDM,93990AK-26,DUPLEX SCAN HEMODIALYSIS ACCESS,200.0,130.0,1.1,200.0,44
CDM,93990AK-TC,DUPLEX SCAN HEMODIALYSIS ACCESS,611.0,397.15,1.1,611.0,46
CDM,93998RVU1AK,US TEMPORAL ARTERIES (COMP CODE 93880),345.0,224.25,0.01,345.0,29
CDM,94000015,THERAPEUTIC APHERESIS RED BLOOD CELLS,9426.0,6126.9,181.97,9426.0,61
CDM,94000025,THERAPEUTIC APHERESIS PLASMA PHERESIS,9426.0,6126.9,160.39,9426.0,61
CDM,94000045,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,131220.0,85293.0,407.59,176302.27,61
CDM,94000070,IMMUNOTHERAPY 1 INJ,138.0,89.7,15.75,138.0,61
CDM,94000075,IMMUNOTHERAPY>=2 INJ,198.0,128.7,15.75,198.0,61
CDM,94000085,VENOM INSECT 1 VIAL,138.0,89.7,5.6,138.0,61
CDM,94000090,VENOM MULTIDOSE 2 VIAL,138.0,89.7,5.6,138.0,61
CDM,94000095,VENOM MULTIDOSE 3 VIAL,214.0,139.1,5.6,214.0,61
CDM,94000100,VENOM MULTIDOSE 4 VIAL,214.0,139.1,5.6,214.0,61
CDM,94000105,VENOM MULTIDOSE 5 VIAL,214.0,139.1,5.6,214.0,61
CDM,94000115,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,5.6,131.25,61
CDM,94000125,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,410.0,266.5,36.15,410.0,61
CDM,94000180,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,33.0,21.45,9.33,81.07,61
CDM,94000185,ACUPUNCTURE 1/> NDLS W/O ESTIM EACH ADDL 15 MIN,33.0,21.45,7.19,44.8,46
CDM,94000190,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,33.0,21.45,9.33,81.07,61
CDM,94000195,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,33.0,21.45,7.19,45.6,46
CDM,94000200,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,76.0,49.4,20.43,76.0,61
CDM,94000205,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,76.0,49.4,20.43,76.0,61
CDM,94000210,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,76.0,49.4,20.43,81.52,61
CDM,94000215,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,123.0,79.95,18.3,123.0,46
CDM,94000220,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,889.0,577.85,28.36,889.0,61
CDM,94000415,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,118.0,76.7,17.56,118.0,46
CDM,94000425,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,255.0,165.75,37.4,255.0,46
CDM,94000535,MINI-BAL RT,432.0,280.8,51.58,432.0,61
CDM,94000585,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,112.0,72.8,31.67,112.0,61
CDM,94002AK,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,876.0,569.4,1.1,1069.82,50
CDM,94003AK,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,603.0,391.95,1.1,1069.82,50
CDM,94004AK,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,400.0,260.0,1.1,400.0,44
CDM,94010AK,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,795.0,516.75,1.1,795.0,50
CDM,94010AK-26,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,75.0,48.75,1.1,75.0,44
CDM,94011AK,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT-2 YR,700.0,455.0,1.1,700.0,50
CDM,94060AK,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1529.0,993.85,1.1,1529.0,50
CDM,94060AK-26,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,97.0,63.05,1.1,97.0,44
CDM,94070AK,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1672.0,1086.8,1.1,1672.0,50
CDM,94070AK-26,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,240.0,156.0,1.1,240.0,44
CDM,94150AK,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,748.0,486.2,1.1,748.0,39
CDM,94150AK-26,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,28.0,18.2,1.1,28.0,33
CDM,94200000,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,35.63,212.0,60
CDM,94200005,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,29.84,180.0,60
CDM,94200015,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,16.62,100.0,60
CDM,94200030,EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS,95.0,61.75,14.14,95.0,46
CDM,94200050,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,89.0,57.85,20.47,105.02,61
CDM,94200055,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,89.0,57.85,25.17,105.02,61
CDM,94200060,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,126.0,81.9,18.75,126.0,46
CDM,94200075,GENETIC COUNSEL 15 MINS,95.0,61.75,14.14,95.0,46
CDM,94200080,EDUCATION,45.0,29.25,6.7,45.0,38
CDM,94200090,ETN INPATIENT- 15 MIN,101.0,65.65,15.03,101.0,38
CDM,94200185,MGMT DIABETES GROUP 30MIN,121.0,78.65,19.66,121.0,60
CDM,94200285,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,35.63,212.0,60
CDM,94200295,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,29.84,180.0,60
CDM,94200345,LACTATION CLASS,102.0,66.3,15.18,102.0,46
CDM,94200385,IP INDIV EDUCATION/PER 30 MIN,96.0,62.4,14.28,96.0,38
CDM,94200395,IP INDIV EDUCATION/PER 15 MIN,46.0,29.9,6.84,46.0,38
CDM,94200405,CARD THER PHASE I MOD,100.0,65.0,14.88,100.0,38
CDM,94200415,CARD THER PHASE I LVL 1,464.0,301.6,69.04,464.0,38
CDM,94200425,CARD THER PHASE I LVL 2,741.0,481.65,110.26,741.0,38
CDM,94200435,CARD THER PHASE I LVL 3,1014.0,659.1,150.88,1014.0,38
CDM,94200445,CARD THER PHASE I LVL 4,1095.0,711.75,162.94,1095.0,38
CDM,94200465,PARENTING CLASSES PER SESSION,15.0,9.75,2.23,15.0,38
CDM,94200475,INFANT SAFETY/CPR PER SESSION,15.0,9.75,2.23,15.0,38
CDM,94200485,HEART FAILURE REHAB 3/WK,94.0,61.1,13.99,94.0,38
CDM,94200545,ED & TRG GRP PHP,243.0,157.95,36.16,243.0,38
CDM,94200555,EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT,126.0,81.9,18.75,126.0,46
CDM,94200565,CHILDBIRTH ED PER SESSION,97.0,63.05,14.43,97.0,38
CDM,94200605,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,16.62,100.0,60
CDM,94200655,CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT,238.0,154.7,31.04,238.0,61
CDM,94200735,WEEKEND C/B PREP 2 CLASS,59.0,38.35,8.78,59.0,38
CDM,94201185,VIRTUAL MGMT DIABETES SNGL 30 MIN,126.0,81.9,18.75,126.0,46
CDM,94201265,SUPPLY OF DIGITAL DEVICE,515.0,334.75,31.04,515.0,61
CDM,94201275,MONTHLY TX FOR DMHT 20MINS,515.0,334.75,53.42,515.0,53
CDM,94201285,ADD 20 M OF MONTHLY TX,258.0,167.7,51.83,258.0,38
CDM,94300010,REHAB CARD PHASE II,724.0,470.6,14.87,724.0,61
CDM,94300020,REHAB CARD OP DEPT W ECG,724.0,470.6,23.57,724.0,61
CDM,94300035,CARD THER PHASE III 2/WK,34.0,22.1,5.06,34.0,38
CDM,94300045,CARD THER PHASE III 3/WK,46.0,29.9,6.84,46.0,38
CDM,94300055,PR PHASE III REHAB-INTERMED,40.0,26.0,5.95,40.0,38
CDM,94300065,CARD PHASE III TO 3/WK,72.0,46.8,18.66,360.65,61
CDM,94300105,FOLLOWUP REASSSESSMENT,724.0,470.6,23.57,724.0,61
CDM,94375AK,RESPIRATORY FLOW VOLUME LOOP,124.0,80.6,1.1,535.81,50
CDM,94400005,CD ASSESSMENT (UPDATE),482.0,313.3,136.31,497.49,61
CDM,94400015,CD ASSMT PER MIN (ADM),3.0,1.95,0.45,181.38,46
CDM,94400025,CD SCREEN IP (20-30 MIN),86.0,55.9,12.8,86.0,38
CDM,94400035,CD SCREEN IP (45-50 MIN),146.0,94.9,21.72,146.0,38
CDM,94400045,OP AMB DETOX (DRUG),720.0,468.0,8.4,720.0,46
CDM,94450AK,BREATHING RESPONSE TO HYPOXIA,844.0,548.6,1.1,844.0,50
CDM,94450AK-26,BREATHING RESPONSE TO HYPOXIA,176.0,114.4,1.1,176.0,44
CDM,94450AK-TC,BREATHING RESPONSE TO HYPOXIA,720.0,468.0,1.1,720.0,46
CDM,94452AK,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,729.0,473.85,1.1,729.0,50
CDM,94452AK-26,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,136.0,88.4,1.1,136.0,44
CDM,94453AK,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,769.0,499.85,1.1,769.0,50
CDM,94453AK-26,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,176.0,114.4,1.1,176.0,44
CDM,94617AK,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,901.0,585.65,1.1,901.0,50
CDM,94617AK-26,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,308.0,200.2,1.1,308.0,44
CDM,94618AK,PULMONARY STRESS TESTING,785.0,510.25,1.1,785.0,50
CDM,94618AK-26,PULMONARY STRESS TESTING,192.0,124.8,1.1,192.0,44
CDM,94619AK,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,469.0,304.85,1.1,469.0,50
CDM,94619AK-26,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,196.0,127.4,1.1,196.0,44
CDM,94621AK,CARDIOPULMONARY EXERCISE TESTING,2000.0,1300.0,1.1,2000.0,50
CDM,94621AK-26,CARDIOPULMONARY EXERCISE TESTING,568.0,369.2,1.1,568.0,44
CDM,94621AK-TC,CARDIOPULMONARY EXERCISE TESTING,1432.0,930.8,1.1,1432.0,46
CDM,94625AK,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,158.0,102.7,1.1,189.14,52
CDM,94640AK,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,154.0,100.1,1.1,363.78,50
CDM,94642AK,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,359.0,233.35,1.1,363.78,32
CDM,94664AK,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,124.0,80.6,1.1,363.78,50
CDM,94681AK,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1520.0,988.0,1.1,1520.0,50
CDM,94681AK-26,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,88.0,57.2,1.1,88.0,44
CDM,94690AK,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,28.0,18.2,1.1,152.71,50
CDM,94726AK,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1546.0,1004.9,1.1,1546.0,50
CDM,94726AK-26,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,114.0,74.1,1.1,114.0,44
CDM,94727AK,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,834.0,542.1,1.1,834.0,50
CDM,94727AK-26,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,114.0,74.1,1.1,114.0,44
CDM,94729AK,DIFFUSING CAPACITY,681.0,442.65,1.1,681.0,50
CDM,94729AK-26,DIFFUSING CAPACITY,76.0,49.4,1.1,76.0,44
CDM,94760AK,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,120.0,78.0,1.1,120.0,44
CDM,94761AK,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,198.0,128.7,1.1,198.0,44
CDM,94800025,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,273.0,177.45,27.26,273.0,61
CDM,94800035,PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,273.0,177.45,27.26,273.0,61
CDM,95004AK,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,1.1,1784.83,50
CDM,95012AK,NITRIC OXIDE EXPIRED GAS DETERMINATION,71.0,46.15,1.1,71.0,50
CDM,95017AK,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,28.0,18.2,1.1,50.18,53
CDM,95018AK,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,165.0,107.25,1.1,165.0,53
CDM,95024AK,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,0.62,163.0,53
CDM,95028AK,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,48.0,31.2,1.1,68.1,50
CDM,95044AK,PATCH TEST(S) SPECIFY NUMBER,408.0,265.2,1.1,1784.83,50
CDM,95076AK,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,660.0,429.0,1.1,915.71,53
CDM,95079AK,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,607.0,394.55,1.1,607.0,53
CDM,95115AK,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,60.0,39.0,1.1,80.64,50
CDM,95117AK,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,198.0,128.7,1.1,198.0,50
CDM,95145AK,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,24.0,15.6,1.1,106.53,53
CDM,95146AK,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,24.0,15.6,1.1,195.15,53
CDM,95147AK,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,24.0,15.6,1.1,188.72,53
CDM,95148AK,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,24.0,15.6,1.1,278.42,53
CDM,95149AK,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,24.0,15.6,1.1,368.12,53
CDM,95165AK,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,1.1,124.0,53
CDM,95180AK,RAPID DESENSITIZATION PROCEDURE EACH HOUR,804.0,522.6,1.1,804.0,53
CDM,95250AK,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,393.0,255.45,1.1,464.13,50
CDM,95251AK,CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,280.0,182.0,1.1,280.0,50
CDM,95700AK,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,659.0,428.35,1.1,659.0,38
CDM,95705AK,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,1396.0,907.4,1.1,1396.0,38
CDM,95708AK,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,1396.0,907.4,1.1,1396.0,38
CDM,95711AK,VEEG BY TECH 2-12 HOURS UNMONITORED,2614.0,1699.1,1.1,2614.0,38
CDM,95712AK,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2614.0,1699.1,1.1,2614.0,38
CDM,95713AK,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,2614.0,1699.1,1.1,2614.0,38
CDM,95714AK,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,2614.0,1699.1,1.1,2614.0,38
CDM,95715AK,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,2614.0,1699.1,1.1,2614.0,38
CDM,95716AK,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,2614.0,1699.1,1.1,2934.58,38
CDM,95717AK,EEG PHYS/QHP 2-12 HR WITHOUT VIDEO,880.0,572.0,1.1,880.0,52
CDM,95718AK,EEG PHYS/QHP 2-12 HR WITH VEEG,1100.0,715.0,1.1,1100.0,52
CDM,95719AK,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID,1320.0,858.0,1.1,1320.0,52
CDM,95720AK,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG,1698.0,1103.7,1.1,1698.0,52
CDM,95722AK,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG,2068.0,1344.2,1.1,2068.0,52
CDM,95723AK,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO,2090.0,1358.5,1.1,2090.0,52
CDM,95724AK,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG,2640.0,1716.0,1.1,2640.0,52
CDM,95725AK,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/O VID,2376.0,1544.4,1.1,2376.0,52
CDM,95726AK,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/VEEG,3335.0,2167.75,1.1,3335.0,52
CDM,95800AK,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,340.0,221.0,1.1,485.0,50
CDM,95803AK,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,360.0,234.0,1.1,452.94,50
CDM,95805AK,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,4189.0,2722.85,1.1,4189.0,50
CDM,95805AK-26,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,528.0,343.2,1.1,528.0,44
CDM,95806AK,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1489.0,967.85,1.1,1489.0,50
CDM,95806AK-26,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,409.0,265.85,1.1,409.0,44
CDM,95806AK-TC,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,1.1,1080.0,46
CDM,95807AK,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,4224.0,2745.6,1.1,4224.0,50
CDM,95807AK-26,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,563.0,365.95,1.1,563.0,44
CDM,95808AK,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,766.0,497.9,1.1,766.0,44
CDM,95810AK,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,8120.0,5278.0,1.1,8120.0,50
CDM,95810AK-26,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,1100.0,715.0,1.1,1100.0,44
CDM,95811AK,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,8164.0,5306.6,1.1,8164.0,50
CDM,95811AK-26,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,1144.0,743.6,1.1,1144.0,44
CDM,95812AK,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2581.0,1677.65,1.1,2581.0,50
CDM,95812AK-26,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,432.0,280.8,1.1,432.0,44
CDM,95812AK-TC,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2149.0,1396.85,1.1,2149.0,46
CDM,95813AK,EEG EXTENDED MONITORING 61-119 MINUTES,2801.0,1820.65,1.1,2801.0,50
CDM,95813AK-26,EEG EXTENDED MONITORING 61-119 MINUTES,652.0,423.8,1.1,652.0,44
CDM,95813AK-TC,EEG EXTENDED MONITORING 61-119 MINUTES,2149.0,1396.85,1.1,2149.0,46
CDM,95816AK,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2624.0,1705.6,1.1,2624.0,50
CDM,95816AK-26,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,475.0,308.75,1.1,475.0,44
CDM,95816AK-TC,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2149.0,1396.85,1.1,2149.0,46
CDM,95819AK,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2624.0,1705.6,1.1,2624.0,50
CDM,95819AK-26,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,475.0,308.75,1.1,475.0,44
CDM,95822AK,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2624.0,1705.6,1.1,2624.0,50
CDM,95822AK-26,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,475.0,308.75,1.1,475.0,44
CDM,95822AK-TC,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2149.0,1396.85,1.1,2149.0,46
CDM,95824AK,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,296.0,192.4,1.1,296.0,44
CDM,95836AK,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,792.0,514.8,1.1,792.0,50
CDM,95857AK,CHOLINESTERASE INHIBITOR CHALLENGE TEST,212.0,137.8,1.1,535.81,53
CDM,95860AK,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,1273.0,827.45,1.1,1273.0,50
CDM,95860AK-26,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,384.0,249.6,1.1,384.0,44
CDM,95861AK,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,1505.0,978.25,1.1,1505.0,50
CDM,95861AK-26,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,616.0,400.4,1.1,616.0,44
CDM,95863AK,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,748.0,486.2,1.1,748.0,50
CDM,95864AK,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1876.0,1219.4,1.1,1876.0,50
CDM,95864AK-26,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,796.0,517.4,1.1,796.0,44
CDM,95865AK,NEEDLE ELECTROMYOGRAPHY LARYNX,1517.0,986.05,1.1,1517.0,50
CDM,95865AK-26,NEEDLE ELECTROMYOGRAPHY LARYNX,628.0,408.2,1.1,628.0,44
CDM,95866AK,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1580.0,1027.0,1.1,1580.0,50
CDM,95866AK-26,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,500.0,325.0,1.1,500.0,44
CDM,95867AK,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2465.0,1602.25,1.1,2465.0,50
CDM,95867AK-26,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,316.0,205.4,1.1,316.0,44
CDM,95868AK,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2621.0,1703.65,1.1,2621.0,50
CDM,95868AK-26,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,472.0,306.8,1.1,472.0,44
CDM,95869AK,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2297.0,1493.05,1.1,2297.0,50
CDM,95869AK-26,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,148.0,96.2,1.1,148.0,44
CDM,95870AK,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,1037.0,674.05,1.1,1037.0,50
CDM,95870AK-26,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,148.0,96.2,1.1,148.0,44
CDM,95872AK,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,2232.0,1450.8,1.1,2232.0,50
CDM,95872AK-26,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1152.0,748.8,1.1,1152.0,44
CDM,95873AK,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,238.0,154.7,1.1,238.0,50
CDM,95873AK-26,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,163.0,105.95,1.1,163.0,44
CDM,95874AK,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,945.0,614.25,1.1,945.0,50
CDM,95874AK-26,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,163.0,105.95,1.1,163.0,44
CDM,95875AK,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,440.0,286.0,1.1,447.9,50
CDM,95885AK,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,1137.0,739.05,1.1,1137.0,50
CDM,95885AK-26,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,140.0,91.0,1.1,140.0,44
CDM,95886AK,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,378.0,245.7,1.1,378.0,50
CDM,95886AK-26,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,378.0,245.7,1.1,378.0,44
CDM,95887AK,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,870.0,565.5,1.1,870.0,50
CDM,95887AK-26,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,312.0,202.8,1.1,312.0,44
CDM,95907AK,NERVE CONDUCTION STUDIES 1-2 STUDIES,1520.0,988.0,1.1,1520.0,50
CDM,95907AK-26,NERVE CONDUCTION STUDIES 1-2 STUDIES,440.0,286.0,1.1,440.0,44
CDM,95908AK,NERVE CONDUCTION STUDIES 3-4 STUDIES,2699.0,1754.35,1.1,2699.0,50
CDM,95908AK-26,NERVE CONDUCTION STUDIES 3-4 STUDIES,550.0,357.5,1.1,550.0,44
CDM,95909AK,NERVE CONDUCTION STUDIES 5-6 STUDIES,2809.0,1825.85,1.1,2809.0,50
CDM,95909AK-26,NERVE CONDUCTION STUDIES 5-6 STUDIES,660.0,429.0,1.1,660.0,44
CDM,95910AK,NERVE CONDUCTION STUDIES 7-8 STUDIES,3029.0,1968.85,1.1,3029.0,50
CDM,95910AK-26,NERVE CONDUCTION STUDIES 7-8 STUDIES,880.0,572.0,1.1,880.0,44
CDM,95911AK,NERVE CONDUCTION STUDIES 9-10 STUDIES,4761.0,3094.65,1.1,4761.0,50
CDM,95911AK-26,NERVE CONDUCTION STUDIES 9-10 STUDIES,1100.0,715.0,1.1,1100.0,44
CDM,95912AK,NERVE CONDUCTION STUDIES 11-12 STUDIES,4981.0,3237.65,1.1,4981.0,50
CDM,95912AK-26,NERVE CONDUCTION STUDIES 11-12 STUDIES,1320.0,858.0,1.1,1320.0,44
CDM,95913AK,NERVE CONDUCTION STUDIES 13/> STUDIES,5227.0,3397.55,1.1,5227.0,50
CDM,95913AK-26,NERVE CONDUCTION STUDIES 13/> STUDIES,1566.0,1017.9,1.1,1566.0,44
CDM,95919AK,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,72.0,46.8,1.1,218.62,50
CDM,95921AK,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1440.0,936.0,1.1,1440.0,50
CDM,95921AK-26,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,360.0,234.0,1.1,360.0,44
CDM,95922AK,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,1273.0,827.45,1.1,1273.0,50
CDM,95922AK-26,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,384.0,249.6,1.1,384.0,44
CDM,95930AK,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2289.0,1487.85,1.1,2289.0,50
CDM,95930AK-26,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,140.0,91.0,1.1,140.0,44
CDM,95930AK-TC,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2149.0,1396.85,1.1,2149.0,46
CDM,95933AK,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,646.0,419.9,1.1,646.0,50
CDM,95933AK-26,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,236.0,153.4,1.1,236.0,44
CDM,95937AK,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1340.0,871.0,1.1,1340.0,50
CDM,95937AK-26,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,260.0,169.0,1.1,260.0,44
CDM,95937AK-TC,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1080.0,702.0,1.1,1080.0,46
CDM,95955AK,EEG NONINTRACRANIAL SURGERY,1597.0,1038.05,1.1,1597.0,50
CDM,95955AK-26,EEG NONINTRACRANIAL SURGERY,404.0,262.6,1.1,404.0,44
CDM,95955AK-TC,EEG NONINTRACRANIAL SURGERY,1193.0,775.45,1.1,1193.0,46
CDM,95957AK,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,1.1,900.29,50
CDM,95961AK,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,8208.0,5335.2,1.1,8208.0,50
CDM,95961AK-26,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,1188.0,772.2,1.1,1188.0,44
CDM,95970AK,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,154.0,100.1,1.1,218.62,53
CDM,95971AK,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,343.0,222.95,1.1,343.0,53
CDM,95972AK,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,352.0,228.8,1.1,352.0,53
CDM,95976AK,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,321.0,208.65,1.1,321.0,53
CDM,95977AK,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,388.0,252.2,1.1,388.0,53
CDM,95980AK,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,320.0,208.0,1.1,320.0,50
CDM,95981AK,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,120.0,78.0,1.1,126.95,53
CDM,95982AK,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,260.0,169.0,1.1,260.0,53
CDM,95983AK,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,400.0,260.0,1.1,400.0,53
CDM,95984AK,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,352.0,228.8,1.1,352.0,53
CDM,95990AK,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,217.0,141.05,1.1,578.82,50
CDM,95991AK,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,339.0,220.35,1.1,505.34,53
CDM,95992AK,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,1.1,300.0,53
CDM,96000035,MED SOM PER 15 MIN (ADM),107.0,69.55,15.92,107.0,38
CDM,96041AK,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,650.0,422.5,1.1,650.0,31
CDM,96105AK,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,700.0,455.0,1.1,700.0,50
CDM,96110AK,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,36.0,23.4,1.1,36.0,39
CDM,96112AK,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1024.0,665.6,1.1,1024.0,53
CDM,96113AK,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,464.0,301.6,1.1,464.0,53
CDM,96116AK,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,744.0,483.6,1.1,744.0,53
CDM,96121AK,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,752.0,488.8,1.1,752.0,53
CDM,96125AK,STANDARDIZED COGNITIVE PERFORMANCE TESTING,680.0,442.0,1.1,680.0,50
CDM,96127AK,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,66.0,42.9,1.1,68.1,50
CDM,96127DABAK,DEPRESSION SCREENING AUTO BILLING,66.0,42.9,1.1,68.1,50
CDM,96130AK,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1126.0,731.9,1.1,1126.0,53
CDM,96131AK,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,862.0,560.3,1.1,862.0,53
CDM,96132AK,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1126.0,731.9,1.1,1126.0,53
CDM,96133AK,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,862.0,560.3,1.1,862.0,53
CDM,96136AK,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,242.0,157.3,1.1,242.0,53
CDM,96137AK,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,202.0,131.3,1.1,202.0,53
CDM,96138AK,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,788.0,512.2,1.1,788.0,44
CDM,96139AK,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,788.0,512.2,1.1,788.0,44
CDM,96146AK,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,203.0,131.95,1.1,203.0,50
CDM,96156AK,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,46
CDM,96158AK,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,46
CDM,96159AK,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,46
CDM,96160AK,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,1.1,46.0,50
CDM,96161AK,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,1.1,89.0,50
CDM,96164AK,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,46
CDM,96165AK,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,44.0,46
CDM,96167AK,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,46
CDM,96168AK,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,46
CDM,96170AK,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,35
CDM,96171AK,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,35
CDM,96202AK,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,172.0,111.8,1.1,172.0,46
CDM,96203AK,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,48.0,31.2,1.1,48.0,44
CDM,96360AK,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,75.0,48.75,1.1,365.57,50
CDM,96361AK,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,40.0,26.0,1.1,80.64,50
CDM,96365AK,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,92.0,59.8,1.1,365.57,50
CDM,96366AK,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,79.0,51.35,1.1,80.64,50
CDM,96367AK,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,84.0,54.6,1.1,120.06,50
CDM,96368AK,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,75.0,48.75,1.1,75.0,50
CDM,96372AK,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,491.0,319.15,1.1,491.0,50
CDM,96374AK,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,79.0,51.35,1.1,365.57,50
CDM,96375AK,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,44.0,28.6,1.1,80.64,50
CDM,96376AK,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,390.0,253.5,1.1,390.0,38
CDM,96377AK,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,75.0,48.75,1.1,80.64,50
CDM,96380AK,"ADMIN BEYFORTUS IM INJ,W/ COUNSELING",158.0,102.7,1.1,158.0,44
CDM,96380VFCAK,"VFC ADMIN BEYFORTUS IM INJ,W/ COUNSELING",21.25,13.81,1.1,71.19,44
CDM,96381AK,ADMIN BEYFORTUS IM INJ,158.0,102.7,1.1,158.0,44
CDM,96401AK,"CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM",92.0,59.8,1.1,234.61,50
CDM,96402AK,CHEMOTHER HORMON ANTINEOPL SUB-Q/IM,84.0,54.6,1.1,120.06,50
CDM,96405AK,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,229.0,148.85,1.1,274.11,53
CDM,96406AK,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,352.0,228.8,1.1,427.89,53
CDM,96411AK,"CHEMOTHER, IV PUSH,EA ADD DRUG",88.0,57.2,1.1,178.95,50
CDM,96413AK,"CHEMOTHER, IV INFUSION, 1 HR",123.0,79.95,1.1,578.82,50
CDM,96415AK,"CHEMOTHER, IV INFUSION, EA ADD HR",84.0,54.6,1.1,120.06,50
CDM,96416AK,CHEMOTHER PROLONG INFUSE W/PUMP,92.0,59.8,1.1,578.82,50
CDM,96417AK,"CHEMOTHER, IV INFUSE, EACH SEQU INFUS",92.0,59.8,1.1,207.9,50
CDM,96420AK,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,75.0,48.75,1.1,578.82,50
CDM,96422AK,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,68.0,44.2,1.1,578.82,50
CDM,96446AK,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,163.0,105.95,1.1,614.4,53
CDM,96450AK,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,612.0,397.8,1.1,612.0,53
CDM,96521AK,"REFILL/MAINT, PORTABLE PUMP",92.0,59.8,1.1,405.98,50
CDM,96523AK,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,18.0,11.7,1.1,103.94,50
CDM,96542AK,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,300.0,195.0,1.1,578.82,53
CDM,96547AK,INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES,2612.0,1697.8,1.1,2612.0,44
CDM,96548AK,INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES,1200.0,780.0,1.1,1649.73,44
CDM,96549RVU3AK,UNLISTED PROC;  HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY VIA TE,541.0,351.65,0.01,541.0,28
CDM,96912AK,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,167.0,108.55,1.1,321.61,50
CDM,96NBBCONAK-58,BODY BEAUTIFUL CONSULTS,25.0,16.25,1.1,25.0,22
CDM,96NBBCONAK-59,BODY BEAUTIFUL CONSULTS,25.0,16.25,1.1,25.0,22
CDM,96NCGAK,CLEANSING GEL,36.0,23.4,1.1,36.0,22
CDM,96NCLAK,CLENZIDERM,93.0,60.45,1.1,93.0,22
CDM,96NDLAK,DAY LOTION,50.0,32.5,1.1,50.0,22
CDM,96NENECAK,ELASTIDERM NIGHT EYE CREAM,80.0,52.0,1.1,80.0,22
CDM,96NMDAK-60,MICRODERMABRASIONS,103.0,66.95,1.1,103.0,22
CDM,96NMDAK-61,MICRODERMABRASIONS,103.0,66.95,1.1,103.0,22
CDM,96NNCAK,NIGHT CREAM,81.0,52.65,1.1,81.0,22
CDM,96NSGAK,SUN GUARD,38.0,24.7,1.1,38.0,22
CDM,97010AK,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,24.0,15.6,1.1,24.0,33
CDM,97012AK,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,100.0,65.0,1.1,100.0,50
CDM,97014AK,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,72.0,46.8,1.1,72.0,33
CDM,97016AK,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,72.0,46.8,1.1,72.0,50
CDM,97018AK,APPL MODALITY 1/> AREAS PARAFFIN BATH,24.0,15.6,1.1,24.0,50
CDM,97022AK,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,68.0,44.2,1.1,68.0,50
CDM,97026AK,APPLICATION MODALITY 1/> AREAS INFRARED,26.0,16.9,1.1,26.0,44
CDM,97032AK,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,100.0,65.0,1.1,100.0,50
CDM,97033AK,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,104.0,67.6,1.1,104.0,44
CDM,97034AK,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,84.0,54.6,1.1,84.0,50
CDM,97035AK,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,84.0,54.6,1.1,84.0,50
CDM,97039AK,UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND,163.0,105.95,1.1,1792000.0,28
CDM,97110AK,"THERAPEUTIC EXERCISES RE, EA 15 MIN.",198.0,128.7,1.1,198.0,50
CDM,97110NOEXAK,"THERAPEUTIC EXERCISES RE, EA 15 MIN",45.0,29.25,1.1,98.79,50
CDM,97112AK,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,220.0,143.0,1.1,220.0,50
CDM,97124AK,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,140.0,91.0,1.1,140.0,50
CDM,97129AK,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,200.0,130.0,1.1,200.0,52
CDM,97130AK,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,192.0,124.8,1.1,192.0,50
CDM,97140AK,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,189.0,122.85,1.1,189.0,50
CDM,97150AK,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,116.0,75.4,1.1,116.0,50
CDM,97151AK,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,119.0,77.35,1.1,294.38,32
CDM,97152AK,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,293.0,190.45,1.1,293.0,32
CDM,97153AK,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,246.0,159.9,1.1,246.0,32
CDM,97154AK,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,181.0,117.65,1.1,181.0,32
CDM,97155AK,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,246.0,159.9,1.1,272.38,32
CDM,97156AK,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,98.0,63.7,1.1,294.38,32
CDM,97157AK,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,1.1,137.0,32
CDM,97158AK,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,75.0,48.75,1.1,75.0,32
CDM,97165AK,OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS,616.0,400.4,1.1,616.0,50
CDM,97166AK,OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS,616.0,400.4,1.1,616.0,50
CDM,97167AK,OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS,616.0,400.4,1.1,616.0,50
CDM,97168AK,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,384.0,249.6,1.1,384.0,50
CDM,97530AK,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,176.0,114.4,1.1,176.0,50
CDM,97533AK,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,192.0,124.8,1.1,207.99,50
CDM,97535AK,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,180.0,117.0,1.1,180.0,50
CDM,97537AK,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,192.0,124.8,1.1,192.0,50
CDM,97542AK,WHEELCHAIR MGMT EA 15 MIN,192.0,124.8,1.1,192.0,50
CDM,97550AK,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,440.0,286.0,1.1,440.0,52
CDM,97551AK,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,238.0,154.7,1.1,238.0,52
CDM,97552AK,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,101.0,65.65,1.1,101.0,52
CDM,97597AK,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,308.0,200.2,1.1,342.27,53
CDM,97598AK,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,220.0,143.0,1.1,220.0,53
CDM,97602AK,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,144.0,93.6,1.1,342.27,32
CDM,97605AK,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,242.0,157.3,1.1,342.27,53
CDM,97606AK,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,264.0,171.6,1.1,680.96,53
CDM,97607AK,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,180.0,117.0,1.1,1175.79,52
CDM,97608AK,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,202.0,131.3,1.1,1181.12,52
CDM,97750AK,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,180.0,117.0,1.1,180.0,50
CDM,97760AK,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,50
CDM,97761AK,PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,50
CDM,97763AK,ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,192.0,124.8,1.1,192.0,50
CDM,97802AK,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,1.1,212.0,53
CDM,97803AK,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,1.1,180.0,53
CDM,97804AK,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,1.1,100.0,53
CDM,97810AK,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,76.0,49.4,1.1,128.63,53
CDM,97810NOEXAK,ACUPUNCT W/O STIMUL 15 MIN,70.0,45.5,1.1,128.63,53
CDM,97811AK,ACUPUNCTURE 1/> NDLS W/O ESTIM EACH ADDL 15 MIN,76.0,49.4,1.1,97.67,53
CDM,97813AK,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,76.0,49.4,1.1,151.55,53
CDM,97814AK,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,76.0,49.4,1.1,123.83,53
CDM,98000AK,SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN,372.0,241.8,1.1,372.0,39
CDM,9800127AK,ONLINE BASIC REVIEW,20.0,13.0,1.1,20.0,22
CDM,9800129AK,ONLINE BASIC TRTMNT PLAN,49.0,31.85,1.1,49.0,22
CDM,9800130AK,ONLINE MODERATE REVIEW,75.0,48.75,1.1,75.0,22
CDM,9800131AK,ONLINE MODERATE PLAN,100.0,65.0,1.1,100.0,22
CDM,98001AK,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,39
CDM,98002AK,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,39
CDM,9800311AK,GASTRIC LAP BAND ADJUSTMENT (COMP CODE 36598),56.0,36.4,0.01,1548.29,28
CDM,9800314AK,SMARTPHONE MONITORING 30 DAY,50.0,32.5,0.01,267.01,28
CDM,9800315AK,SMARTPHONE MONITORING CHRONIC,20.0,13.0,0.01,267.01,28
CDM,9800357AK,EGD/EUS GASTROJAJUNOSTOMY LAMS (COMP 43266 AND 43237),5000.0,3250.0,0.01,5000.0,28
CDM,98003AK,SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,33
CDM,9800442AK,"VIRTUAL INITIAL HOSPITAL CARE, E&M (30 MIN)",652.0,423.8,1.1,652.0,50
CDM,9800443AK,VIRTUAL 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,50
CDM,9800444AK,1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES,1400.0,910.0,1.1,1400.0,50
CDM,9800445AK,VIRTUAL  SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,50
CDM,9800446AK,VIRTUAL SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,50
CDM,9800447AK,VIRTUAL SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,50
CDM,9800449AK,IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES,600.0,390.0,1.1,600.0,39
CDM,9800450AK,VIRTUAL INPATIENT CONSULTATION SERVICES (45 MIN),880.0,572.0,1.1,880.0,39
CDM,9800451AK,IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES,1197.0,778.05,1.1,1197.0,39
CDM,9800452AK,IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES,1698.0,1103.7,1.1,1698.0,39
CDM,9800459AK,VIRTUAL VISIT PSYCH DIAGNOSTIC EVAL,1536.0,998.4,1.1,1536.0,53
CDM,9800460AK,VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS,744.0,483.6,1.1,744.0,53
CDM,9800461AK,VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS,980.0,637.0,1.1,980.0,53
CDM,9800462AK,VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS,1452.0,943.8,1.1,1452.0,53
CDM,9800463AK,VIRTUAL VISIT FAMILY PSYTX W/PATIENT,1096.0,712.4,1.1,1096.0,53
CDM,9800464AK,VIRTUAL VISIT GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.0,53
CDM,9800476AK,OD EST ONLINE E&M LEVEL 1,79.0,51.35,1.1,79.0,53
CDM,9800477AK,OD EST ONLINE E&M LEVEL 2,280.0,182.0,1.1,280.0,53
CDM,9800478AK,OD EST ONLINE E&M LEVEL 3,520.0,338.0,1.1,520.0,53
CDM,9800479AK,OD EST ONLINE E&M LEVEL 4,768.0,499.2,1.1,768.0,53
CDM,9800480AK,OD EST ONLINE E&M LEVEL 5,1120.0,728.0,1.1,1120.0,53
CDM,9800482AK,OD NEW ONLINE E&M LEVEL 2,372.0,241.8,1.1,372.0,53
CDM,9800483AK,OD NEW ONLINE E&M LEVEL 3,640.0,416.0,1.1,640.0,53
CDM,9800484AK,OD NEW ONLINE E&M LEVEL 4,1040.0,676.0,1.1,1040.0,53
CDM,9800485AK,OD NEW ONLINE E&M LEVEL 5,1400.0,910.0,1.1,1400.0,53
CDM,9800489AK,"VIRTUAL VISIT MNT, INITIAL, EA. 15 MIN INCREMENT 97802",212.0,137.8,1.1,212.0,53
CDM,9800490AK,"SCLEROTHERAPY/VARICOSE VEINS, SINGLE VEIN",225.0,146.25,1.1,680.96,53
CDM,9800491AK,"SCHLEROTHERAPY/VARICOSE VEINS, MULTIPLE VEINS",500.0,325.0,1.1,680.96,53
CDM,9800492AK,SCLEROTHERAPY/SPIDER VEINS-SINGLE OR MULTIPLE INJECTIONS,350.0,227.5,1.1,680.96,29
CDM,9800495AK,LAYER CLOSURE OF EAR LOBES,415.0,269.75,1.1,941.23,53
CDM,9800496AK,LASER RESURFACING/PARTIAL FACE,650.0,422.5,1.1,1794.52,47
CDM,9800497AK,LASER RESURFACING/OTHER THAN FACE,600.0,390.0,1.1,4850.94,47
CDM,9800498AK,LASER CVP LESIONS,300.0,195.0,1.1,1143.19,53
CDM,98004AK,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,39
CDM,9800501AK,"EAR PIERCING, BOTH EARS W/EARRINGS",50.0,32.5,1.1,176.73,32
CDM,9800502AK,TATTOO REMOVAL,300.0,195.0,1.1,1489.46,47
CDM,9800503AK,MICRODERMABRASION,300.0,195.0,1.1,1489.46,47
CDM,9800504AK,LASER RESURFACING/SUPERFICIAL,500.0,325.0,1.1,1489.46,47
CDM,9800525AK,VIRTUAL VISIT DIAGNOSTIC EVAL W/MEDICAL  (PSYCHIATRISTS/MID LEVE,1664.0,1081.6,1.1,1664.0,53
CDM,9800565AK,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (30 MIN),656.0,426.4,1.1,656.0,53
CDM,9800575AK,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (45 MIN),832.0,540.8,1.1,832.0,53
CDM,9800585AK,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (60 MIN),1096.0,712.4,1.1,1096.0,53
CDM,9800595AK,VIRTUAL VISIT FAMILY PSYCHOTHERAPY W/O PATIENT,1052.0,683.8,1.1,1052.0,53
CDM,98005AK,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,39
CDM,9800635AK,JOINT VENTURE DIGITAL SECOND OPINION,500.0,325.0,1.1,500.0,22
CDM,9800675AK,"VIRTUAL VISIT MNT, RE ASSES, EA. 15 MIN INCREMENT 97803",180.0,117.0,1.1,180.0,53
CDM,9800676AK,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,100.0,65.0,1.1,100.0,47
CDM,9800677AK,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,200.0,130.0,1.1,200.0,47
CDM,9800678AK,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,300.0,195.0,1.1,300.0,47
CDM,9800683AK,VV OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,42
CDM,9800684AK,VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,1.1,720.0,42
CDM,9800685AK,VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,42
CDM,9800686AK,VV OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,42
CDM,9800687AK,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,52
CDM,9800688AK,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,52
CDM,9800689AK,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES,120.0,78.0,1.1,120.0,52
CDM,9800699,VIRTUAL VISIT GROUP THERAPY,278.0,180.7,36.05,284.74,61
CDM,98006AK,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,39
CDM,9800702AK,"VV MNT GROUP, EA. 30 MIN",100.0,65.0,1.1,100.0,53
CDM,9800737AK,PULMONARY STRESS TEST (6-MINUTE WALK) INTERP ONLY,192.0,124.8,1.1,218.62,50
CDM,9800748AK,VIRTUAL MGMT DIABETES SNGL 30 MIN,77.0,50.05,1.1,93.26,33
CDM,9800749AK,"VIRTUAL MGMT DIABETES GRP 30 MIN, 2-4 PT",77.0,50.05,1.1,77.0,33
CDM,9800750AK,"VIRTUAL MGMT DIABETES GRP 30 MIN, 5-8 PT",33.0,21.45,1.1,33.28,33
CDM,9800776AK,JV MULTIDISCIPLINARY BOARD REVIEW,700.0,455.0,1.1,700.0,22
CDM,9800783AK,"PHENOL CHEMICAL PEEL, EACH ADDL AREA",1900.0,1235.0,1.1,1900.0,47
CDM,9800784AK,"PHENOL CHEMICAL PEEL, FULL FACE",3600.0,2340.0,1.1,3600.0,47
CDM,98007AK,SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,33
CDM,9800844AK,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,65.0,42.25,1.1,65.0,52
CDM,9800845AK,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,80.0,52.0,1.1,80.0,52
CDM,9800846AK,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,120.0,78.0,1.1,120.0,52
CDM,9800871AK,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,65.0,42.25,1.1,65.0,44
CDM,9800881AK,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,80.0,52.0,1.1,80.0,46
CDM,9800891AK,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,120.0,78.0,1.1,120.0,46
CDM,98008AK,SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN,360.0,234.0,1.1,360.0,39
CDM,9800911AK,VV?PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,39
CDM,9800912AK,VIRTUAL IP/OBS DISCHARGE =/<30 MIN,600.0,390.0,1.1,600.0,50
CDM,9800913AK,VIRTUAL IP/OBS DISCHARGE DAY > 30 MIN,860.0,559.0,1.1,860.0,50
CDM,9800917AK,VIRTUAL PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,41
CDM,9800980AK,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,1.1,785.7,27
CDM,9800981AK,VV HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,46
CDM,9800982AK,VV HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,46
CDM,9800983AK,VV HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,46
CDM,9800984AK,VV PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,1.1,46.0,50
CDM,9800985AK,VV CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,1.1,89.0,50
CDM,9800986AK,VV HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,46
CDM,9800987AK,VV HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,44.0,46
CDM,9800988AK,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,46
CDM,9800989AK,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,46
CDM,9800990AK,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,35
CDM,9800991AK,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,35
CDM,9800992AK,VV HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN (99234),800.0,520.0,1.1,800.0,50
CDM,9800993AK,VV HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN (99235),1296.0,842.4,1.1,1296.0,50
CDM,9800994AK,VV HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN (99236),1720.0,1118.0,1.1,1720.0,50
CDM,98009AK,SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN,620.0,403.0,1.1,620.0,39
CDM,9801018AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?SF MDM 15 MIN,372.0,241.8,1.1,372.0,39
CDM,9801019AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,39
CDM,9801020AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,39
CDM,9801021AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,33
CDM,9801022AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,39
CDM,9801023AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,39
CDM,9801024AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,39
CDM,9801025AK,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,33
CDM,9801047AK,AUDIOGRAM,28.0,18.2,1.1,28.0,22
CDM,9801051AK,DOT PHYSICAL EXAM,110.0,71.5,1.1,110.0,22
CDM,9801052AK,EKG W/INTERPRETATION,70.0,45.5,1.1,70.0,22
CDM,9801057AK,LIFT TEST/PHYSICAL ABILITY,45.0,29.25,1.1,45.0,22
CDM,9801059AK,PRE-PLACEMENT EXAM,65.0,42.25,1.1,65.0,22
CDM,9801060AK,PHYSICAL EXAM,65.0,42.25,1.1,65.0,22
CDM,9801061AK,PULMONARY FUNCTION TEST,60.0,39.0,1.1,60.0,22
CDM,9801062AK,RESPIRATOR FIT TEST,35.0,22.75,1.1,35.0,22
CDM,9801063AK,OSHA RESPIRATOR QUESTIONNAIRE REVIEW,35.0,22.75,1.1,35.0,22
CDM,9801064AK,RESPIRATOR MEDICAL EVALUATION,35.0,22.75,1.1,35.0,22
CDM,9801065AK,RETURN TO WORK EXAM,65.0,42.25,1.1,65.0,22
CDM,9801068AK,TB SKIN TEST,30.0,19.5,1.1,30.0,22
CDM,9801069AK,TITMUS VISION,45.0,29.25,1.1,45.0,22
CDM,9801070AK,URINE COLLECTION ONLY,25.0,16.25,1.1,25.0,22
CDM,9801073AK,"X-RAY, CHEST, 2 VIEWS",105.0,68.25,1.1,105.0,22
CDM,9801074AK,RAPID URINE DRUG SCREEN 10-PANEL - MEDTOX,65.0,42.25,1.1,65.0,22
CDM,9801075AK,RAPID URINE DRUG SCREEN 5-PANEL - MEDTOX,65.0,42.25,1.1,65.0,22
CDM,9801077AK,URINE DRUG SCREEN 10-PANEL - MEDTOX,50.0,32.5,1.1,50.0,22
CDM,9801083AK,URINE DRUG SCREEN 12-PANEL - MEDTOX,95.0,61.75,1.1,95.0,22
CDM,9801084AK,URINE DRUG SCREEN 4-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,22
CDM,9801085AK,URINE DRUG SCREEN 5-PANEL - MEDTOX,50.0,32.5,1.1,50.0,22
CDM,9801087AK,URINE DRUG SCREEN 9-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,22
CDM,9801088AK,URINE DRUG SCREEN DOT - MEDTOX,50.0,32.5,1.1,50.0,22
CDM,9801090AK,URINE DRUG SCREEN CRL WS66 - CRL,95.0,61.75,1.1,95.0,22
CDM,9801092AK,HAIR DRUG SCREEN 5-PANEL - OMEGA,105.0,68.25,1.1,105.0,22
CDM,9801099AK,BREATH ALCOHOL TEST - CCAW / WW,30.0,19.5,1.1,30.0,22
CDM,98010AK,SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN,968.0,629.2,1.1,968.0,39
CDM,9801191AK,PRP WITH EXOMES,1250.0,812.5,1.1,1250.0,32
CDM,98011AK,SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN,1280.0,832.0,1.1,1280.0,33
CDM,9801201AK,TB SKIN TESTING (2-STEP) (RETURN TO CLINIC FOR READING WITHIN 48,60.0,39.0,1.1,60.0,22
CDM,98012AK,SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN,260.0,169.0,1.1,260.0,39
CDM,98013AK,SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN,480.0,312.0,1.1,480.0,39
CDM,98014AK,SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN,700.0,455.0,1.1,700.0,39
CDM,98015AK,SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,33
CDM,98016AK,BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN,132.0,85.8,1.1,132.0,51
CDM,98925AK,"OSTEOPATHIC MANIP,1-2 BODY REGN",202.0,131.3,1.1,202.0,53
CDM,98926AK,"OSTEOPATHIC MANIP,3-4 BODY REGN",312.0,202.8,1.1,312.0,53
CDM,98927AK,"OSTEOPATHIC MANIP,5-6 BODY REGN",422.0,274.3,1.1,422.0,53
CDM,98928AK,"OSTEOPATHIC MANIP,7-8 BODY REGN",532.0,345.8,1.1,532.0,53
CDM,98929AK,"OSTEOPATHIC MANIP,9-10 BODY REGN",642.0,417.3,1.1,642.0,53
CDM,98940AK,"CHIROPRAC MANIP,SPINAL,1-2 REGIONS",202.0,131.3,1.1,202.0,53
CDM,98940NOEXAK,"CHIROPRAC MANIP,SPINAL,1-2 REGIONS",40.0,26.0,1.1,92.5,53
CDM,98941AK,"CHIROPRAC MANIP,SPINAL,3-4 REGIONS",312.0,202.8,1.1,312.0,53
CDM,98941NOEXAK,"CHIROPRAC MANIP,SPINAL,3-4 REGIONS",60.0,39.0,1.1,133.51,53
CDM,98942AK,"CHIROPRAC MANIP,SPINAL,5 REGIONS",422.0,274.3,1.1,422.0,53
CDM,98943AK,"CHIROPRAC MANIP,EXTRASPINAL,1+ REGNS",184.0,119.6,1.1,184.0,36
CDM,98943NOEXAK,"CHIROPRAC MANIP, EXTRASPINAL, 1+ REGNS",40.0,26.0,1.1,88.73,36
CDM,98960AK,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,77.0,50.05,1.1,93.26,33
CDM,98961AK,EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS,77.0,50.05,1.1,77.0,33
CDM,98962AK,EDUCATION&TRAINING PT SELF-MGMT NQHP 5-8 PTS,33.0,21.45,1.1,33.28,33
CDM,98970AK,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN,65.0,42.25,1.1,65.0,44
CDM,98971AK,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN,80.0,52.0,1.1,80.0,46
CDM,98972AK,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN,120.0,78.0,1.1,120.0,46
CDM,98978AK,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,258.0,167.7,1.1,258.0,31
CDM,98979AK,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,263.0,170.95,1.1,263.0,35
CDM,98980AK,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,248.0,161.2,1.1,248.0,52
CDM,98981AK,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,244.0,158.6,1.1,244.0,52
CDM,98985AK,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,59.0,38.35,1.1,121.62,35
CDM,98986AK,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,258.0,167.7,1.1,258.0,22
CDM,9899071JAK,JUVEDERM ULTRA,550.0,357.5,1.1,550.0,22
CDM,9899071JVAK,JUVEDERM VOLLURE,750.0,487.5,1.1,750.0,22
CDM,9899071KAK,KYBELLAINJECTION,600.0,390.0,1.1,600.0,22
CDM,9899071VAK,JUVEDERM VOLUMA,900.0,585.0,1.1,900.0,22
CDM,9899071VBAK,JUVEDERM VOLBELLA XC,400.0,260.0,1.1,400.0,22
CDM,9899201AK,WORK PERMIT PHYSICAL EXAM,59.0,38.35,1.1,59.0,22
CDM,9899202CAK,COSMETIC CONSULTATION,100.0,65.0,1.1,100.0,22
CDM,9899456AK,EMPLOYMENT PHYSICAL EXAM,108.0,70.2,1.1,108.0,22
CDM,9899499AK,DOT PHYSICAL,200.0,130.0,0.01,1545999.98,28
CDM,9899999BAK,BOTOX COSMETIC,525.0,341.25,1.1,525.0,22
CDM,9899999HAK,HYALURONIC ACID TX,250.0,162.5,1.1,250.0,22
CDM,9899999RAK,BOTOX RETURN,475.0,308.75,1.1,475.0,22
CDM,98BLUEPAK,BLUE PEEL,250.0,162.5,1.1,250.0,22
CDM,98BRAAK,SURGICAL BRA,31.0,20.15,1.1,31.0,22
CDM,98CLFGAK,CLENZIDERM FOAM GEL,35.0,22.75,1.1,35.0,22
CDM,98CLPTAK,CLENZIDERM PORE THERAPY,35.0,22.75,1.1,35.0,22
CDM,98CLSGAK,CLENZIDERM SERUM GEL,70.0,45.5,1.1,70.0,22
CDM,98COOLSCLPTAK,COOL SCULPT,750.0,487.5,1.1,750.0,22
CDM,98DERMAAK,DERMAPLANE  ADDITIONAL,50.0,32.5,1.1,50.0,22
CDM,98DPLANEAK,DERMAPLANE,140.0,91.0,1.1,140.0,22
CDM,98EARBIAK,"EARLOBE REPAIR, BILAT",700.0,455.0,1.1,700.0,22
CDM,98EARUNAK,"EARLOBE REPAIR, UNILAT",500.0,325.0,1.1,500.0,22
CDM,98ELASTAK,ELASTIDERM CREAM,98.0,63.7,1.1,98.0,22
CDM,98ELASTGAK,ELASTIDERM GEL,98.0,63.7,1.1,98.0,22
CDM,98ELASTSAK,ELASTIDERM SERUM,98.0,63.7,1.1,98.0,22
CDM,98EXCSCAK,COSMETIC EXC SCAR,500.0,325.0,1.1,500.0,22
CDM,98FACBRAK,FACIAL BRA,20.0,13.0,1.1,20.0,22
CDM,98ILLUMAK,ILLUMINIZE PEEL,145.0,94.25,1.1,145.0,22
CDM,98LATSAK,LATISSE 5ML,180.0,117.0,1.1,180.0,22
CDM,98LATSSETAK,LATISSE 5ML,300.0,195.0,1.1,300.0,22
CDM,98LESREAK,COSMETIC LESION REMOVAL,250.0,162.5,1.1,250.0,22
CDM,98MBARBAK,AGE REVERSAL BUNDLE,269.0,174.85,1.1,269.0,22
CDM,98MBATAK,A-TEAM,92.0,59.8,1.1,92.0,22
CDM,98MBBCAK,BRIGHTAMIN-C,105.0,68.25,1.1,105.0,22
CDM,98MBBFAK,LET ME CLARIFY PROA LOTION,53.0,34.45,1.1,53.0,22
CDM,98MBCATSAK,CALM AFTER THE STORM GPH LOTION,83.0,53.95,1.1,83.0,22
CDM,98MBCIAK,SOOTHING BUNDLE,193.0,125.45,1.1,193.0,22
CDM,98MBCRAK,CLEAN ROUTINE,28.0,18.2,1.1,28.0,22
CDM,98MBEIAK,CLARIFYING BUNDLE,220.0,143.0,1.1,220.0,22
CDM,98MBFIBAK,FUTURE IS BRIGHT,75.0,48.75,1.1,75.0,22
CDM,98MBLMCAK,LET ME CLARIFY,57.0,37.05,1.1,57.0,22
CDM,98MBMHAK,MYHERO,197.0,128.05,1.1,197.0,22
CDM,98MBMHCAK,MY HERO CREAM,127.0,82.55,1.1,127.0,22
CDM,98MBMHLAK,MY HERO LOTION,101.0,65.65,1.1,101.0,22
CDM,98MBNCAK,NECK-CESSITY,110.0,71.5,1.1,110.0,22
CDM,98MBPSAK,PROTECT AND SERVEE SPF30,57.0,37.05,1.1,57.0,22
CDM,98MBRIAK,REVERSE IT KIT,265.0,172.25,1.1,265.0,22
CDM,98MBTCAK,TAKE CONTROL,27.0,17.55,1.1,27.0,22
CDM,98MBYAK,YOUTHIFEYE,87.0,56.55,1.1,87.0,22
CDM,98MBYOAK,YOUTH OVERNIGHT,97.0,63.05,1.1,97.0,22
CDM,98MICPRP30AK,MICRO NEEDLING W/PRP 30CC,1350.0,877.5,1.1,1350.0,22
CDM,98MICPRP30X4AK,MICRO NEEDLING W/PRP PACKAGE 30CC (4 TX),4800.0,3120.0,1.1,4800.0,22
CDM,98MICPRP60X6AK,MICRO NEEDLING W/PRP PACKAGE 60CC (4 TX),7400.0,4810.0,1.1,7400.0,22
CDM,98MICRODERMAK,MICRODERMABRASION,140.0,91.0,1.1,140.0,22
CDM,98MICROGFAK,MICRO NEEDLING WITH GROWTH FACTOR,350.0,227.5,1.1,350.0,22
CDM,98MICROPKGAK,MICRO NEEDLING PACKAGE (4 TX),1200.0,780.0,1.1,1200.0,22
CDM,98MICRPRP60AK,MICRO NEEDLING W/PRP 60 CC,2050.0,1332.5,1.1,2050.0,22
CDM,98NI24CCAK,GENTLE CLEANSING CREAM,30.0,19.5,1.1,30.0,22
CDM,98NI24CSAK,PHYSICAL SCRUB,35.0,22.75,1.1,35.0,22
CDM,98NI24SCAK,STRENGTHENING COMPLEX,85.0,55.25,1.1,85.0,22
CDM,98NSAK,NO SHOW FOR APPT CHARGE,25.0,16.25,1.1,25.0,22
CDM,98OBBFXAK,BLENDER FX,79.0,51.35,1.1,79.0,22
CDM,98OBBLAK,BLENDER,91.0,59.15,1.1,91.0,22
CDM,98OBCBTAK,C-BALANCING TONER,36.0,23.4,1.1,36.0,22
CDM,98OBCCLAK,C--CLEANSING GEL,37.0,24.05,1.1,37.0,22
CDM,98OBCCSAK,C-CLARIFYING SERUM N-D,108.0,70.2,1.1,108.0,22
CDM,98OBCEBAK,PROFESSIONAL-C PEPTIDE COMPLEX,81.0,52.65,1.1,81.0,22
CDM,98OBCEDAK,C-EXFOLIATING DAY CREAM,61.0,39.65,1.1,61.0,22
CDM,98OBCFXAK,CLEAR FX,83.0,53.95,1.1,83.0,22
CDM,98OBCLEAK,CLEAR,95.0,61.75,1.1,95.0,22
CDM,98OBCPCAK,PROFESSIONAL-C EYE BRIGHTENER,99.0,64.35,1.1,99.0,22
CDM,98OBCSAK,*C-CLARIFYING SERUM N-O,108.0,70.2,1.1,108.0,22
CDM,98OBCSUAK,C-SUNGUARD SPF 30,63.0,40.95,1.1,63.0,22
CDM,98OBCTNAK,*C-THERAPY NIGHT CREAM,93.0,60.45,1.1,93.0,22
CDM,98OBEXEAK,EXFODERM,65.0,42.25,1.1,65.0,22
CDM,98OBEXFAK,EXFODERM FORTE,65.0,42.25,1.1,65.0,22
CDM,98OBFGEAK,FOAMING GEL,37.0,24.05,1.1,37.0,22
CDM,98OBGCLAK,GENTLE CLEANSER,37.0,24.05,1.1,37.0,22
CDM,98OBHYDAK,OBHYD,44.0,28.6,1.1,44.0,22
CDM,98OBHYDLAK,OBAJI HYDRATE LUXE,63.0,40.95,1.1,63.0,22
CDM,98OBPRAK,BLUE PEEL RADIANCE,125.0,81.25,1.1,125.0,22
CDM,98OBROSCAK,GENTLE CLEANSER,36.0,23.4,1.1,36.0,22
CDM,98OBSSCAK,OBAGI SUNSHIELD SPF 50 COOL,46.0,29.9,1.1,46.0,22
CDM,98OBSSDAK,OBAGI SUN SHIELD SPF50,46.0,29.9,1.1,46.0,22
CDM,98OBSSMAK,OBAGI SUNSHIELD SPF 50 MATTE,46.0,29.9,1.1,46.0,22
CDM,98OBSSWAK,SUN SHIELD SPF WARM,46.0,29.9,1.1,46.0,22
CDM,98OBSUBAK,SUNBLOCK SPF 32,44.0,28.6,1.1,44.0,22
CDM,98OBSUCAK,SUNSCREEN SPF 35,46.0,29.9,1.1,46.0,22
CDM,98OBSUFAK,SUNFADER,76.0,49.4,1.1,76.0,22
CDM,98OBTONAK,TONER,37.0,24.05,1.1,37.0,22
CDM,98OBTR1AK,TRETINOIN CREAM 1%,64.0,41.6,1.1,64.0,22
CDM,98OBTRAAK,OBAGI TRAVEL SET,210.0,136.5,1.1,210.0,22
CDM,98OBTRADAK,OBAGI TRAVEL SET N-D,215.0,139.75,1.1,215.0,22
CDM,98OBTRAOAK,OBTRA TRAVEL OBTRAO NOR TO OIL,215.0,139.75,1.1,215.0,22
CDM,98OBTRO2AK,TRETINOIN CR .025%,34.5,22.43,1.1,34.5,22
CDM,98OBTRSAK,TRETINOIN CR. .05%,57.0,37.05,1.1,57.0,22
CDM,98PDERPAK,PERFECT DERMA PEEL,250.0,162.5,1.1,250.0,22
CDM,98PDPBOAK,PERFECT DERM PEEL W/BOOST,300.0,195.0,1.1,300.0,22
CDM,98PL30AK,PLATELET RICH PLASMA 30CC,1000.0,650.0,1.1,1000.0,22
CDM,98PL60AK,PLATELET RICH PLASMA 60CC,1700.0,1105.0,1.1,1700.0,22
CDM,98PLPKG30AK,PLATELET RICH PLASMA PACKAGE 30CC,3500.0,2275.0,1.1,3500.0,22
CDM,98PLPKG60AK,PLATELET RICH PLASMA PACKAGE 60CC,6200.0,4030.0,1.1,6200.0,22
CDM,98PRECISAK,VIPEEL W/ PRECISION,300.0,195.0,1.1,300.0,22
CDM,98PREVAGAK,PREVAGE MD,118.0,76.7,1.1,118.0,22
CDM,98PROC10AK,PROFESSIONAL-C 10%,68.0,44.2,1.1,68.0,22
CDM,98PROC15AK,PROFESSIONAL-C 15%,82.0,53.3,1.1,82.0,22
CDM,98PROC20AK,PROFESSIONAL-C 20%,102.0,66.3,1.1,102.0,22
CDM,98PROC5AK,PROFESSIONAL-C 5%,48.0,31.2,1.1,48.0,22
CDM,98PRPAK,PRP-PLATELET RICH PLASMA CONSULT,52.0,33.8,1.1,52.0,22
CDM,98REJUVENIZAK,REJUVENIZE PEEL,195.0,126.75,1.1,195.0,22
CDM,98RSAK,REAL SELF CONSULTATION,50.0,32.5,1.1,50.0,22
CDM,98SHIPPINGAK,SHIPPING,8.0,5.2,1.1,8.0,22
CDM,98SPORTAK,SPORTS PHYSICAL,35.0,22.75,1.1,35.0,22
CDM,98TATREAK,TATOO REMOVAL/EXCIS,750.0,487.5,1.1,750.0,22
CDM,98VIDAFAK,DAILY ANTIOXIDANT SERUM,110.0,71.5,1.1,110.0,22
CDM,98VIEFCAK,EXFOLIATING FACIAL CLEANSER,46.0,29.9,1.1,46.0,22
CDM,98VINRCAK,NIGHT RENEWAL FACIAL CREAM,83.0,53.95,1.1,83.0,22
CDM,98VIPEELAK,VIPEEL,250.0,162.5,1.1,250.0,22
CDM,98VIRFCAK,REPLENISH FACIAL CLEANSER,25.0,16.25,1.1,25.0,22
CDM,98VIRHCAK,REPLENISH HYDRATING CREAM,50.0,32.5,1.1,50.0,22
CDM,98VITAAK,VITALIZED PEEL,165.0,107.25,1.1,165.0,22
CDM,98VIVTAK,VIBRANCE THERAPY,119.0,77.35,1.1,119.0,22
CDM,98XRAYSAK,PAT PURCH COPIES XRAY SHEETS,6.0,3.9,1.1,6.0,22
CDM,99000005,BABY CARE/CPR BUNDLE,90.0,58.5,13.39,90.0,38
CDM,99000015,CBE/BF/BABY CARE BUNDLE,139.0,90.35,20.68,139.0,38
CDM,99000025,BASIC BABY CARE,42.0,27.3,6.25,42.0,38
CDM,99000035,CHILDBIRTH ED (JUST THE FACTS),105.0,68.25,15.62,105.0,38
CDM,99000045,CHILDBIRTH EDUC CLASS,105.0,68.25,15.62,105.0,38
CDM,99000055,CHILDBIRTH EDC-LIFESTYLES/AGHS,71.0,46.15,10.56,71.0,38
CDM,99000065,BREAST FEEDING CLASS,35.0,22.75,5.21,35.0,38
CDM,99000075,ADVANCED BREAST FEEDING CLASS,16.0,10.4,2.38,16.0,38
CDM,99000085,NEW FATHERS BOOT CAMP(COUPON),34.0,22.1,5.06,34.0,38
CDM,99000095,CPR INFANT/CHILD SAFETY,28.0,18.2,4.17,28.0,38
CDM,99000AK,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,42.0,27.3,1.1,42.0,32
CDM,99070AK,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,49.0,31.85,0.01,49.0,29
CDM,99078AK,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,79.0,51.35,1.1,79.0,35
CDM,99080AK,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,129.0,83.85,1.1,129.0,29
CDM,99091AK,COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D,484.0,314.6,1.1,484.0,44
CDM,99100015,THERAPEUTIC PHLEBOTOMY,889.0,577.85,28.36,889.0,61
CDM,99135AK,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,136.0,88.4,1.1,691.04,30
CDM,99140AK,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,137.0,89.05,1.1,276.42,30
CDM,99151AK,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,220.0,143.0,1.1,220.0,53
CDM,99152AAK,MODERATE SEDATION FOR ENDOSCOPY,110.0,71.5,1.1,163.46,53
CDM,99152AK,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,110.0,71.5,1.1,163.46,53
CDM,99153AK,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,110.0,71.5,1.1,110.0,50
CDM,99155AK,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,760.0,494.0,1.1,760.0,50
CDM,99156AK,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,660.0,429.0,1.1,660.0,50
CDM,99157AK,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,500.0,325.0,1.1,500.0,50
CDM,99173AK,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,52.0,33.8,1.1,52.0,39
CDM,99174AK,INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL &AMP; RPT,72.0,46.8,1.1,72.0,39
CDM,99183AK,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION,844.0,548.6,1.1,844.0,50
CDM,99188AK,APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP,80.0,52.0,1.1,80.0,42
CDM,99195AK,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,368.0,239.2,1.1,368.0,50
CDM,99202AK,OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES,372.0,241.8,1.1,372.0,53
CDM,99203AK,OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES,640.0,416.0,1.1,640.0,53
CDM,99204AK,OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES,1040.0,676.0,1.1,1040.0,53
CDM,99205AK,OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES,1400.0,910.0,1.1,1400.0,53
CDM,99211AK,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,79.0,51.35,1.1,79.0,53
CDM,99212AK,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN,280.0,182.0,1.1,280.0,53
CDM,99213AK,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN,520.0,338.0,1.1,520.0,53
CDM,99214AK,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN,768.0,499.2,1.1,768.0,53
CDM,99215AK,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,53
CDM,99221AIAK,"INITIAL HOSPITAL CARE, LEVEL I",652.0,423.8,1.1,652.0,50
CDM,99221AK,1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES,652.0,423.8,1.1,652.0,50
CDM,99222AK,1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,50
CDM,99231AK,SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,50
CDM,99232AK,SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,50
CDM,99233AK,SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,50
CDM,99234AK,HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN,800.0,520.0,1.1,800.0,50
CDM,99235AK,HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN,1296.0,842.4,1.1,1296.0,50
CDM,99236AK,HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN,1720.0,1118.0,1.1,1720.0,50
CDM,99238AK,HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<,600.0,390.0,1.1,600.0,50
CDM,99239AK,HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN,860.0,559.0,1.1,860.0,50
CDM,99242AK,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,42
CDM,99243AK,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,1.1,720.0,42
CDM,99244AK,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,42
CDM,99245AK,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,42
CDM,99253AK,IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES,880.0,572.0,1.1,880.0,39
CDM,99281AK,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,110.0,71.5,1.1,130.78,50
CDM,99282AK,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,409.0,265.85,1.1,368.1,50
CDM,99283AK,EMERGENCY DEPARTMENT VISIT LOW MDM,704.0,457.6,1.1,633.6,50
CDM,99284AK,EMERGENCY DEPARTMENT VISIT MODERATE MDM,1206.0,783.9,1.1,1085.4,50
CDM,99285AK,EMERGENCY DEPARTMENT VISIT HIGH MDM,1760.0,1144.0,1.1,1584.0,50
CDM,99291AK,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,1980.0,1287.0,1.1,1980.0,53
CDM,99292AK,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,990.0,643.5,1.1,990.0,53
CDM,99304AK,INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN,600.0,390.0,1.1,600.0,50
CDM,99305AK,INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES,1000.0,650.0,1.1,1000.0,50
CDM,99306AK,INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES,1400.0,910.0,1.1,1400.0,50
CDM,99307AK,SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES,280.0,182.0,1.1,280.0,50
CDM,99308AK,SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES,520.0,338.0,1.1,520.0,50
CDM,99309AK,SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES,768.0,499.2,1.1,768.0,50
CDM,99310AK,SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES,1120.0,728.0,1.1,1120.0,50
CDM,99315AK,NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME,600.0,390.0,1.1,600.0,50
CDM,99316AK,NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME,1000.0,650.0,1.1,1000.0,50
CDM,99341AK,HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES,440.0,286.0,1.1,440.0,50
CDM,99342AK,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,726.0,471.9,1.1,726.0,50
CDM,99342OSCAK,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,432.0,280.8,1.1,432.0,50
CDM,99343OSCAK,"HOME VISIT,NEW PATIENT,LEVEL III",679.0,441.35,1.1,679.0,22
CDM,99344AK,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,1263.0,820.95,1.1,1263.0,50
CDM,99344OSCAK,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,961.0,624.65,1.1,961.0,50
CDM,99345AK,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1707.0,1109.55,1.1,1707.0,50
CDM,99345OSCAK,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1163.0,755.95,1.1,1163.0,50
CDM,99347AK,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,396.0,257.4,1.1,396.0,50
CDM,99347OSCAK,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,268.0,174.2,1.1,268.0,50
CDM,99348AK,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,660.0,429.0,1.1,660.0,50
CDM,99348OSCAK,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,268.0,174.2,1.1,268.0,50
CDM,99349AK,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,1074.0,698.1,1.1,1074.0,50
CDM,99349OSCAK,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,624.0,405.6,1.1,624.0,50
CDM,99350AK,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,1584.0,1029.6,1.1,1584.0,50
CDM,99350OSCAK,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,880.0,572.0,1.1,880.0,50
CDM,99358AK,PROLONGED E&M SERVICE-1ST HOUR,792.0,514.8,1.1,792.0,35
CDM,99359AK,"PROLONGED SERV,NO CONTCT,EA ADD 1/2",330.0,214.5,1.1,330.0,33
CDM,99360AK,"PHYSICIAN STANDBY SERV,EA 30 MIN",480.0,312.0,1.1,480.0,33
CDM,99367AK,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,440.0,286.0,1.1,440.0,33
CDM,99368AK,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,288.0,187.2,1.1,288.0,33
CDM,99374AK,"HOME HEALTH CARE SUPERV,15-29 MIN",440.0,286.0,1.1,440.0,36
CDM,99379AK,"NURSING FAC CARE SUPERVN,15-29 MIN",440.0,286.0,1.1,440.0,36
CDM,99381AK,"PREVENTIVE VISIT,NEW,INFANT",600.0,390.0,1.1,600.0,42
CDM,99382AK,"PREVENTIVE VISIT,NEW,AGE 1-4",640.0,416.0,1.1,640.0,42
CDM,99383AK,"PREVENTIVE VISIT,NEW,AGE5-11",680.0,442.0,1.1,680.0,42
CDM,99384AK,WELLNESS EXAMS NEW 12-17 YRS,800.0,520.0,1.1,800.0,42
CDM,99385AK,WELLNESS EXAM NEW 18-39 YRS,768.0,499.2,1.1,768.0,42
CDM,99386AK,WELLNESS EXAMS NEW 40-64 YRS,932.0,605.8,1.1,932.0,42
CDM,99387AK,WELLNESS EXAMS NEW 65+ YRS,1000.0,650.0,1.1,1000.0,42
CDM,99391AK,"PREVENTIVE VISIT,EST,INFANT",548.0,356.2,1.1,548.0,42
CDM,99392AK,"PREVENTIVE VISIT,EST,AGE 1-4",600.0,390.0,1.1,600.0,42
CDM,99393AK,"PREVENTIVE VISIT,EST,AGE5-11",600.0,390.0,1.1,600.0,42
CDM,99394AK,"PREVENTIVE VISIT,EST,12-17",680.0,442.0,1.1,680.0,42
CDM,99395AK,WELLNESS EXAMS EST 18-39 YRS,700.0,455.0,1.1,700.0,42
CDM,99396AK,WELLNESS EXAMS EST 40-64 YRS,760.0,494.0,1.1,760.0,42
CDM,99397AK,WELLNESS EXAMS EST 65+ YRS,800.0,520.0,1.1,800.0,42
CDM,99401AK,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,192.0,124.8,1.1,192.0,42
CDM,99402AK,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,392.0,254.8,1.1,392.0,42
CDM,99403AK,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,584.0,379.6,1.1,584.0,42
CDM,99404AK,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,780.0,507.0,1.1,780.0,42
CDM,99406AK,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,96.0,62.4,1.1,96.0,53
CDM,99407AK,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,200.0,130.0,1.1,200.0,53
CDM,99408AK,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,260.0,169.0,1.1,260.0,36
CDM,99409AK,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,520.0,338.0,1.1,520.0,36
CDM,99415AK,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,273.0,177.45,1.1,273.0,50
CDM,99416AK,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,273.0,177.45,1.1,273.0,50
CDM,99417AK,PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,41
CDM,99418AK,PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,39
CDM,99421AK,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,52
CDM,99422AK,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,52
CDM,99423AK,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 21+ MINUTES,120.0,78.0,1.1,120.0,52
CDM,99424AK,PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO,580.0,377.0,1.1,580.0,46
CDM,99425AK,PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO,400.0,260.0,1.1,400.0,46
CDM,99426AK,PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO,400.0,260.0,1.1,400.0,46
CDM,99427AK,PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO,284.0,184.6,1.1,284.0,46
CDM,99429AK,UNLISTED PREVENTIVE MEDICINE SERVICE,94.0,61.1,0.01,1545999.98,28
CDM,99437AK,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,440.0,286.0,1.1,440.0,46
CDM,99439AK,CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN,280.0,182.0,1.1,280.0,46
CDM,99445AK,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,37.0,24.05,1.1,123.2,35
CDM,99446AK,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN,154.0,100.1,1.1,154.0,50
CDM,99447AK,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN,280.0,182.0,1.1,280.0,50
CDM,99448AK,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN,420.0,273.0,1.1,420.0,50
CDM,99449AK,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN,560.0,364.0,1.1,560.0,50
CDM,99450AK,LIFE/DISABILITY EVALUATION,651.0,423.15,1.1,651.0,29
CDM,99451AK,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN,280.0,182.0,1.1,280.0,50
CDM,99452AK,NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN,280.0,182.0,1.1,280.0,50
CDM,99453AK,REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP,37.0,24.05,1.1,194.72,50
CDM,99454AK,REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D,118.0,76.7,1.1,118.0,50
CDM,99455AK,WORK RELATED/MED DBLT XM TREATING PHYS,193.0,125.45,1.1,193.0,29
CDM,99456AK,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,918.0,596.7,1.1,918.0,29
CDM,99457AK,REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH,244.0,158.6,1.1,244.0,53
CDM,99459AK,PELVIC EXAMINATION,53.0,34.45,1.1,53.0,50
CDM,99460AK,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,768.0,499.2,1.1,768.0,50
CDM,99462AK,SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN,336.0,218.4,1.1,336.0,50
CDM,99463AK,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,852.0,553.8,1.1,852.0,50
CDM,99464AK,ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN,600.0,390.0,1.1,600.0,50
CDM,99465AK,DELIVERY/BIRTHING ROOM RESUSCITATION,1172.0,761.8,1.1,1172.0,50
CDM,99468AK,1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<,8122.0,5279.3,1.1,8122.0,50
CDM,99469AK,SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<,3516.0,2285.4,1.1,3516.0,50
CDM,99470AK,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,136.0,88.4,1.1,136.0,35
CDM,99471AK,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,7031.0,4570.15,1.1,7031.0,50
CDM,99472AK,SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO,3516.0,2285.4,1.1,3516.0,50
CDM,99473AK,SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION,221.0,143.65,1.1,221.0,50
CDM,99474AK,SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD,72.0,46.8,1.1,72.0,52
CDM,99477AK,INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL,3080.0,2002.0,1.1,3080.0,50
CDM,99478AK,SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS,1210.0,786.5,1.1,1210.0,50
CDM,99479AK,SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS,1100.0,715.0,1.1,1100.0,50
CDM,99480AK,SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS,1056.0,686.4,1.1,1056.0,50
CDM,99483AK,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,1690.0,1098.5,1.1,1690.0,53
CDM,99484AK,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,372.0,241.8,1.1,372.0,47
CDM,99487AK,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,724.0,470.6,1.1,724.0,47
CDM,99490AK,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,400.0,260.0,1.1,400.0,47
CDM,99491AK,CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH,600.0,390.0,1.1,600.0,46
CDM,99492AK,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,827.0,537.55,1.1,827.0,47
CDM,99493AK,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,902.0,586.3,1.1,902.0,47
CDM,99494AK,1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS,361.0,234.65,1.1,361.0,47
CDM,99495AK,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,1112.0,722.8,1.1,1112.0,47
CDM,99496AK,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,1516.0,985.4,1.1,1516.0,47
CDM,99497AK,ADVANCE CARE PLANNING FIRST 30 MINS,600.0,390.0,1.1,600.0,53
CDM,99498AK,ADVANCE CARE PLANNING EA ADDL 30 MINS,560.0,364.0,1.1,560.0,53
CDM,9949907AK,SPORTS EXAM OR PHYSICAL,35.0,22.75,0.01,1545999.98,28
CDM,99499BUSAK,BUS PHYSICAL,50.0,32.5,0.01,1545999.98,28
CDM,99499CEAK,COSMETIC ESTABLISHED,75.0,48.75,0.01,1545999.98,28
CDM,99499DAK,COSMETIC ASSESSMENT,99.0,64.35,0.01,1545999.98,28
CDM,A4266AK,DIAPHRAGM,89.0,57.85,1.1,91.02,29
CDM,A4336AK,PR URETHRAL INSERT,148.0,96.2,1.1,148.0,33
CDM,A4357AK,BEDSIDE DRAINAGE BAG,18.0,11.7,1.1,44.6,33
CDM,A4358AK,URINARY LEG BAG,10.0,6.5,1.1,30.48,33
CDM,A4467AK,BELT STRAP SLEEV GRMNT COVER,48.0,31.2,1.1,111.78,29
CDM,A4561AK,"PESSARY RUBBER, ANY TYPE",53.0,34.45,1.1,94.19,33
CDM,A4562AK,"PESSARY, NON RUBBER,ANY TYPE",89.0,57.85,1.1,233.98,33
CDM,A4565AK,SLINGS,21.0,13.65,1.1,35.38,33
CDM,A4570AK,SPLINT,31.0,20.15,1.1,50.1,32
CDM,A4590AK,SPECIAL CASTING MATERIAL,41.0,26.65,1.1,64.51,32
CDM,A4648AK,IMPLANTABLE TISSUE MARKER,1337.0,869.05,1.1,1337.0,29
CDM,A6533AK,GC STOCKING THIGHLNGTH 18-30,57.0,37.05,1.1,155.49,33
CDM,A9270FAK,TORIC IOL WORKUP,1127.0,732.55,0.01,1127.0,29
CDM,A9573AK,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,1.02,6.08,25
CDM,A9607AK,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",460.0,299.0,1.1,460.0,25
CDM,A9999AK,"MISCELLANEOUS DME SUPPLY OR ACCESSORY, NOT OTHERWISE SPECIFIED",62.0,40.3,0.01,1792000.0,28
CDM,AA84999AK,ALLIED GENERIC LAB CODE,5.0,3.25,0.01,1612801.79,28
CDM,AA99199AK,UNLISTED SPECIAL SERVICE OR REPORT,5.0,3.25,0.01,1792000.0,28
CDM,AA99202AK,NEW PATIENT VISIT LEVEL 2,25.0,16.25,1.1,152.94,53
CDM,AA99203AK,NEW PATIENT VISIT LEVEL 3,25.0,16.25,1.1,237.5,53
CDM,AA99204AK,NEW PATIENT VISIT LEVEL 4,25.0,16.25,1.1,357.22,53
CDM,AA99205AK,NEW PATIENT VISIT LEVEL 5,25.0,16.25,1.1,471.66,53
CDM,AA99211AK,EST PATIENT VISIT LEVEL 1,25.0,16.25,1.1,45.66,53
CDM,AA99212AK,EST PATIENT VISIT LEVEL 2,25.0,16.25,1.1,113.21,53
CDM,AA99213AK,EST PATIENT VISIT LEVEL 3,25.0,16.25,1.1,181.76,53
CDM,AA99214AK,EST PATIENT VISIT LEVEL 4,25.0,16.25,1.1,257.54,53
CDM,AA99215AK,EST PATIENT VISIT LEVEL 5,25.0,16.25,1.1,361.57,53
CDM,AA99381AK,INIT PM E/M NEW PAT INF <1 YR,25.0,16.25,1.1,230.81,42
CDM,AA99382AK,INIT PM E/M NEW PAT 1-4 YRS,25.0,16.25,1.1,241.67,42
CDM,AA99383AK,PREV VISIT NEW AGE 5-11,25.0,16.25,1.1,251.08,42
CDM,AA99384AK,PREV VISIT NEW AGE 12-17,25.0,16.25,1.1,282.18,42
CDM,AA99385AK,PREV VISIT NEW AGE 18-39,25.0,16.25,1.1,274.24,42
CDM,AA99386AK,PREV VISIT NEW AGE 40-64,25.0,16.25,1.1,316.84,42
CDM,AA99397AK,PER PM REEVAL EST PAT 65+ YR,25.0,16.25,1.1,282.85,42
CDM,AA99401AK,"PREVENT COUNSEL,INDIV,15 MIN",25.0,16.25,1.1,80.85,42
CDM,AA99402AK,"PREVENT COUNSEL,INDIV,30 MIN",25.0,16.25,1.1,132.87,42
CDM,AA99403AK,"PREVENT COUNSEL,INDIV,45 MIN",25.0,16.25,1.1,183.44,42
CDM,AA99404AK,"PREVENT COUNSEL,INDIV,60 MIN",25.0,16.25,1.1,234.72,42
CDM,AA99406AK,BEHAV CHNG SMOKING 3-10,25.0,16.25,1.1,42.27,53
CDM,AA99407AK,BEHAV CHNG SMOKING > 10,25.0,16.25,1.1,58.85,53
CDM,AA99408AK,"AUDIT/DAST, 15-30 MIN",25.0,16.25,1.1,73.3,36
CDM,AA99409AK,"AUDIT/DAST, OVER 30 MIN",25.0,16.25,1.1,141.9,36
CDM,AA99455AK,WORK RELATED DISABILITY EXAM,25.0,16.25,1.1,187.58,29
CDM,AA99495AK,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,25.0,16.25,1.1,437.96,47
CDM,AA99496AK,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,25.0,16.25,1.1,592.58,47
CDM,AA99499AK,CLINIC VISIT LAB CHARGE,5.0,3.25,0.01,1545999.98,28
CDM,BATTEAK,BATTERIES,5.0,3.25,1.27,5.0,22
CDM,BSP99212AK,BOY SCOUT PHYSICAL,30.0,19.5,1.1,113.21,53
CDM,C1897AK,"LEAD, NEUROSTIM TEST KIT",135.0,87.75,1.1,135.0,22
CDM,C7568AK,COR ANGIO W/FLOW RESRV,3045.0,1979.25,1.1,3045.0,22
CDM,C7569AK,PTCA W/ IVUS OR OCT,5702.0,3706.3,1.1,5702.0,22
CDM,C7570AK,COR ANGIO W/FFR & 3D MAP,2605.0,1693.25,1.1,2605.0,22
CDM,C7571AK,PCTA W/ COR LITHOTRIP,6129.0,3983.85,1.1,6129.0,22
CDM,C9809AK,GEN 2 SMART TIP 190,700.0,455.0,1.1,700.0,22
CDM,C9810AK,COLD THERAPY NON-OPIOID DEV,174.0,113.1,1.1,174.0,22
CDM,C9817AK,CRYPNM CMPRS NONOPIOID DEV,174.0,113.1,1.1,174.0,22
CDM,COSANES105AK,COSMETIC ANES 1 HOUR 45 MINUTES,1351.0,878.15,1.1,1351.0,22
CDM,COSANES120AK,COSMETIC ANES 2 HOURS,1448.0,941.2,1.1,1448.0,22
CDM,COSANES135AK,COSMETIC ANES 2 HOURS 15 MINUTES,1544.0,1003.6,1.1,1544.0,22
CDM,COSANES150AK,COSMETIC ANES 2 HOURS 30 MINUTES,1641.0,1066.65,1.1,1641.0,22
CDM,COSANES165AK,COSMETIC ANES 2 HOURS 45 MINUTES,1737.0,1129.05,1.1,1737.0,22
CDM,COSANES180AK,COSMETIC ANES 3 HOURS,1834.0,1192.1,1.1,1834.0,22
CDM,COSANES195AK,COSMETIC ANES 3 HOURS 15 MINUTES,1930.0,1254.5,1.1,1930.0,22
CDM,COSANES210AK,COSMETIC ANES 3 HOURS 30 MINUTES,2027.0,1317.55,1.1,2027.0,22
CDM,COSANES225AK,COSMETIC ANES 3 HOURS 45 MINUTES,2123.0,1379.95,1.1,2123.0,22
CDM,COSANES240AK,COSMETIC ANES 4 HOURS,2220.0,1443.0,1.1,2220.0,22
CDM,COSANES255AK,COSMETIC ANES 4 HOURS 15 MINUTES,2316.0,1505.4,1.1,2316.0,22
CDM,COSANES270AK,COSMETIC ANES 4 HOURS 30 MINUTES,2413.0,1568.45,1.1,2413.0,22
CDM,COSANES285AK,COSMETIC ANES 4 HOURS 45 MINUTES,2509.0,1630.85,1.1,2509.0,22
CDM,COSANES300AK,COSMETIC ANES 5 HOURS,2606.0,1693.9,1.1,2606.0,22
CDM,COSANES30AK,COSMETIC ANES 30 MINUTES,579.0,376.35,1.1,579.0,22
CDM,COSANES315AK,COSMETIC ANES 5 HOURS 15 MINUTES,2702.0,1756.3,1.1,2702.0,22
CDM,COSANES330AK,COSMETIC ANES 5 HOURS 30 MINUTES,2799.0,1819.35,1.1,2799.0,22
CDM,COSANES345AK,COSMETIC ANES 5 HOURS 45 MINUTES,2895.0,1881.75,1.1,2895.0,22
CDM,COSANES360AK,COSMETIC ANES 6 HOURS,2992.0,1944.8,1.1,2992.0,22
CDM,COSANES375AK,COSMETIC ANES 6 HOURS 15 MINUTES,3088.0,2007.2,1.1,3088.0,22
CDM,COSANES390AK,COSMETIC ANES 6 HOURS 30 MINUTES,3185.0,2070.25,1.1,3185.0,22
CDM,COSANES405AK,COSMETIC ANES 6 HOURS 45 MINUTES,3281.0,2132.65,1.1,3281.0,22
CDM,COSANES420AK,COSMETIC ANES 7 HOURS,3378.0,2195.7,1.1,3378.0,22
CDM,COSANES435AK,COSMETIC ANES 7 HOURS 15 MINUTES,3474.0,2258.1,1.1,3474.0,22
CDM,COSANES450AK,COSMETIC ANES 7 HOURS 30 MINUTES,3571.0,2321.15,1.1,3571.0,22
CDM,COSANES45AK,COSMETIC ANES 45 MINUTES,772.0,501.8,1.1,772.0,22
CDM,COSANES465AK,COSMETIC ANES 7 HOURS 45 MINUTES,3667.0,2383.55,1.1,3667.0,22
CDM,COSANES480AK,COSMETIC ANES 8 HOURS,3764.0,2446.6,1.1,3764.0,22
CDM,COSANES495AK,COSMETIC ANES 8 HOURS 15 MINUTES,3860.0,2509.0,1.1,3860.0,22
CDM,COSANES510AK,COSMETIC ANES 8 HOURS 30 MINUTES,3957.0,2572.05,1.1,3957.0,22
CDM,COSANES525AK,COSMETIC ANES 8 HOURS 45 MINUTES,4053.0,2634.45,1.1,4053.0,22
CDM,COSANES540AK,COSMETIC ANES 9 HOURS,4150.0,2697.5,1.1,4150.0,22
CDM,COSANES555AK,COSMETIC ANES 9 HOURS 15 MINUTES,4247.0,2760.55,1.1,4247.0,22
CDM,COSANES570AK,COSMETIC ANES 9 HOURS 30 MINUTES,4343.0,2822.95,1.1,4343.0,22
CDM,COSANES585AK,COSMETIC ANES 9 HOURS 45 MINUTES,4440.0,2886.0,1.1,4440.0,22
CDM,COSANES600AK,COSMETIC ANES 10 HOURS,4536.0,2948.4,1.1,4536.0,22
CDM,COSANES60AK,COSMETIC ANES 1 HOUR,1062.0,690.3,1.1,1062.0,22
CDM,COSANES75AK,COSMETIC ANES 1 HOUR 15 MINUTES,1158.0,752.7,1.1,1158.0,22
CDM,COSANES90AK,COSMETIC ANES 1 HOUR 30 MINUTES,1258.0,817.7,1.1,1258.0,22
CDM,COSNANES100AK,NON CCF PHYSICIANS COSMETIC CASES,1351.0,878.15,1.1,1351.0,22
CDM,COSOR105,COSMETIC OR 1 HOUR 45 MINUTES,1925.0,1251.25,286.44,1925.0,38
CDM,COSOR120,COSMETIC OR 2 HOURS,2200.0,1430.0,327.36,2200.0,38
CDM,COSOR135,COSMETIC OR 2 HOURS 15 MINUTES,2475.0,1608.75,368.28,2475.0,38
CDM,COSOR150,COSMETIC OR 2 HOURS 30 MINUTES,2750.0,1787.5,409.2,2750.0,38
CDM,COSOR165,COSMETIC OR 2 HOURS 45 MINUTES,3025.0,1966.25,450.12,3025.0,38
CDM,COSOR180,COSMETIC OR 3 HOURS,3300.0,2145.0,491.04,3300.0,38
CDM,COSOR195,COSMETIC OR 3 HOURS 15 MINUTES,3575.0,2323.75,531.96,3575.0,38
CDM,COSOR210,COSMETIC OR 3 HOURS 30 MINUTES,3850.0,2502.5,572.88,3850.0,38
CDM,COSOR225,COSMETIC OR 3 HOURS 45 MINUTES,4125.0,2681.25,613.8,4125.0,38
CDM,COSOR240,COSMETIC OR 4 HOURS,4400.0,2860.0,654.72,4400.0,38
CDM,COSOR255,COSMETIC OR 4 HOURS 15 MINUTES,4675.0,3038.75,695.64,4675.0,38
CDM,COSOR270,COSMETIC OR 4 HOURS 30 MINUTES,4950.0,3217.5,736.56,4950.0,38
CDM,COSOR285,COSMETIC OR 4 HOURS 45 MINUTES,5225.0,3396.25,777.48,5225.0,38
CDM,COSOR30,COSMETIC OR 30 MINUTES,962.0,625.3,143.15,962.0,38
CDM,COSOR300,COSMETIC OR 5 HOURS,5500.0,3575.0,818.4,5500.0,38
CDM,COSOR315,COSMETIC OR 5 HOURS 15 MINUTES,5775.0,3753.75,859.32,5775.0,38
CDM,COSOR330,COSMETIC OR 5 HOURS 30 MINUTES - 9 HOURS 30 MINUTES,7837.0,5094.05,1166.15,7837.0,38
CDM,COSOR45,COSMETIC OR 45 MINUTES,1082.0,703.3,161.0,1082.0,38
CDM,COSOR60,COSMETIC OR 1 HOUR,1100.0,715.0,163.68,1100.0,38
CDM,COSOR75,COSMETIC OR 1 HOUR 15 MINUTES,1375.0,893.75,204.6,1375.0,38
CDM,COSOR90,COSMETIC OR 1 HOUR 30 MINUTES,1650.0,1072.5,245.52,1650.0,38
CDM,CP99212AK,COLLEGE PHYSICAL,30.0,19.5,1.1,113.21,53
CDM,D0120AK,PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT,95.0,61.75,1.1,95.0,31
CDM,D0140AK,LIMITED ORAL EVALUATION - PROBLEM FOCUSED,125.0,81.25,1.1,145.11,31
CDM,D0145AK,ORAL EVALUATION FOR A PATIENT UNDER THREE YEARS OF AGE AND COUNS,100.0,65.0,1.1,100.0,31
CDM,D0150AK,COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT,160.0,104.0,1.1,424.99,31
CDM,D0160AK,"DETAILED AND EXTENSIVE ORAL EVALUATION - PROBLEM FOCUSED, BY REP",225.0,146.25,1.1,424.99,31
CDM,D0170AK,"RE-EVALUATION - LIMITED, PROBLEM FOCUSED (ESTABLISHED PATIENT; N",115.0,74.75,1.1,424.99,31
CDM,D0180.1AK,ANNUAL PERIDONTAL RECALL,160.0,104.0,1.1,286.78,31
CDM,D0180AK,COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIEN,160.0,104.0,1.1,286.78,31
CDM,D0190AK,SCREENING OF A PATIENT,120.0,78.0,1.1,120.0,31
CDM,D0191AK,ASSESSMENT OF A PATIENT,120.0,78.0,1.1,120.0,31
CDM,D0210AK,INTRAORAL - COMPREHENSIVE OF RADIOGRAPHIC IMAGES,200.0,130.0,1.1,279.87,31
CDM,D0220AK,INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE,50.0,32.5,1.1,51.83,31
CDM,D0230AK,INTRAORAL - PERIAPICAL EACH ADDITIONAL RADIOGRAPHIC IMAGE,40.0,26.0,1.1,41.46,31
CDM,D0240AK,INTRAORAL - OCCLUSAL RADIOGRAPHIC IMAGE,50.0,32.5,1.1,79.47,31
CDM,D0251AK,EXTRA-ORAL POSTERIOR DENTAL RADIOGRAPHIC IMAGE,100.0,65.0,1.1,141.67,31
CDM,D0270AK,BITEWING - SINGLE RADIOGRAPHIC IMAGE,45.0,29.25,1.1,55.28,31
CDM,D0272AK,BITEWINGS - TWO RADIOGRAPHIC IMAGES,75.0,48.75,1.1,82.92,31
CDM,D0273AK,BITEWINGS - THREE RADIOGRAPHIC IMAGES,85.0,55.25,1.1,85.0,31
CDM,D0274AK,BITEWINGS - FOUR RADIOGRAPHIC IMAGES,100.0,65.0,1.1,117.48,31
CDM,D0277AK,VERTICAL BITEWINGS - 7 TO 8 RADIOGRAPHIC IMAGES,150.0,97.5,1.1,150.0,31
CDM,D0310AK,DENTAL SALIOGRAPHY,500.0,325.0,1.1,967.45,31
CDM,D0320AK,DENTAL TMJ ARTHROGRAM INCL I,750.0,487.5,1.1,1658.49,31
CDM,D0321AK,"OTHER TEMPOROMANDIBULAR JOINT RADIOGRAPHIC IMAGES, BY REPORT",250.0,162.5,1.1,1658.49,31
CDM,D0322AK,TOMOGRAPHIC SURVEY,650.0,422.5,1.1,1330.25,31
CDM,D0330AK,PANORAMIC RADIOGRAPHIC IMAGE,175.0,113.75,1.1,228.04,31
CDM,D0340AK,"2D CEPHALOMETRIC RADIOGRAPHIC IMAGE ? ACQUISITION, MEASUREMENT A",170.0,110.5,1.1,283.32,31
CDM,D0350AK,2D ORAL/FACIAL PHOTOGRAPHIC IMAGE OBTAINED INTRA-ORALLY OR EXTRA,100.0,65.0,1.1,283.32,31
CDM,D0363AK,"CONE BEAM, THREE DIMENSIONAL",150.0,97.5,1.1,150.0,22
CDM,D0364AK,CONE BEAM CT CAPTURE AND INTERPRETATION WITH LIMITED FIELD OF VI,350.0,227.5,1.1,524.1,31
CDM,D0365AK,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,31
CDM,D0366AK,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,31
CDM,D0367AK,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF BO,400.0,260.0,1.1,524.1,31
CDM,D0368AK,CONE BEAM CT CAPTURE AND INTERPRETATION FOR TMJ SERIES INCLUDING,500.0,325.0,1.1,766.86,31
CDM,D0369AK,MAXILLOFACIAL MRI CAPTURE AND INTERPRETATION,900.0,585.0,1.1,1364.8,31
CDM,D0370AK,MAXILLOFACIAL ULTRASOUND CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,31
CDM,D0371AK,SIALOENDOSCOPY CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,31
CDM,D0380AK,CONE BEAM CT IMAGE CAPTURE WITH LIMITED FIELD OF VIEW ? LESS THA,400.0,260.0,1.1,418.41,31
CDM,D0381AK,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,31
CDM,D0382AK,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,31
CDM,D0383AK,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF BOTH JAWS; WITH,400.0,260.0,1.1,418.41,31
CDM,D0384AK,CONE BEAM CT IMAGE CAPTURE FOR TMJ SERIES INCLUDING TWO OR MORE,500.0,325.0,1.1,611.83,31
CDM,D0385AK,MAXILLOFACIAL MRI IMAGE CAPTURE,700.0,455.0,1.1,991.0,31
CDM,D0386AK,MAXILLOFACIAL ULTRASOUND IMAGE CAPTURE,360.0,234.0,1.1,360.0,31
CDM,D0391AK,INTERPRETATION OF DIAGNOSTIC IMAGE BY A PRACTITIONER NOT ASSOCIA,375.0,243.75,1.1,486.59,31
CDM,D0393AK,VIRTUAL TREATMENT SIMULATION USING 3D IMAGE VOLUME OR SURFACE SC,400.0,260.0,1.1,623.76,25
CDM,D0394AK,DIGITAL SUBTRACTION OF TWO OR MORE IMAGES OR IMAGE VOLUMES OF TH,400.0,260.0,1.1,400.0,25
CDM,D0395AK,FUSION OF TWO OR MORE 3D IMAGE VOLUMES OF ONE OR MORE MODALITIES,450.0,292.5,1.1,450.0,25
CDM,D0411AK,HBA1C IN-OFFICE POINT OF SERVICE TESTING,100.0,65.0,1.1,100.0,25
CDM,D0412AK,BLOOD GLUCOSE LEVEL TEST ? IN-OFFICE USING A GLUCOSE METER,100.0,65.0,0.01,100.0,31
CDM,D0414AK,LABORATORY PROCESSING OF MICROBIAL SPECIMEN TO INCLUDE CULTURE A,250.0,162.5,0.01,250.0,31
CDM,D0415AK,COLLECTION OF MICROORGANISMS FOR CULTURE AND SENSITIVITY,270.0,175.5,1.1,270.0,31
CDM,D0416AK,VIRAL CULTURE,200.0,130.0,1.1,200.0,31
CDM,D0417AK,COLLECTION AND PREPERATION OF SALIVA SAMPLE FOR LABORATORY ANALY,275.0,178.75,1.1,275.0,31
CDM,D0418AK,ANALYSIS OF SALIVA SAMPLE - LABORATORY,200.0,130.0,1.1,200.0,31
CDM,D0419AK,ASSESSMENT OF SALIVARY FLOW BY MEASUREMENT,200.0,130.0,1.1,200.0,25
CDM,D0422AK,COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORA,200.0,130.0,1.1,200.0,31
CDM,D0423AK,GENETIC TEST FOR SUSCEPTIBILITY TO DISEASES ? SPECIMEN ANALYSIS,300.0,195.0,1.1,300.0,28
CDM,D0425AK,CARIES SUSCEPTIBILITY TESTS,125.0,81.25,1.1,125.0,31
CDM,D0431AK,ADJUNCTIVE PRE-DIAGNOSTIC TEST THAT AIDS IN DETECTION OF MUCOSAL,85.0,55.25,1.1,85.0,31
CDM,D0460AK,PULP VITALITY TESTS,75.0,48.75,1.1,89.84,31
CDM,D0470AK,DIAGNOSTIC CASTS,180.0,117.0,1.1,193.49,31
CDM,D0472AK,"ACCESSION OF TISSUE, GROSS EXAMINATION, PREPARATION AND TRANSMIS",200.0,130.0,1.1,200.0,31
CDM,D0473AK,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, PREPARAT",250.0,162.5,1.1,250.0,31
CDM,D0474AK,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, INCLUDIN",275.0,178.75,1.1,275.0,31
CDM,D0475AK,DECALCIFICATION PROCEDURE,300.0,195.0,1.1,300.0,31
CDM,D0476AK,SPECIAL STAINS FOR MICROORGANISMS,375.0,243.75,1.1,375.0,31
CDM,D0477AK,"SPECIAL STAINS, NOT FOR MICROORGANISMS",400.0,260.0,1.1,400.0,31
CDM,D0478AK,IMMUNOHISTOCHEMICAL STAINS,200.0,130.0,1.1,207.31,31
CDM,D0479AK,"TISSUE IN-SITU HYBRIDIZATION, INCLUDING INTERPRETATION",300.0,195.0,1.1,300.0,31
CDM,D0480AK,"ACCESSION OF EXFOLIATIVE CYTOLOGIC SMEARS, MICROSCOPIC EXAMINATI",200.0,130.0,1.1,200.0,31
CDM,D0482AK,DIRECT IMMUNOFLUORESCENCE,150.0,97.5,1.1,150.0,31
CDM,D0483AK,INDIRECT IMMUNOFLUORESCENCE,175.0,113.75,1.1,175.0,31
CDM,D0484AK,CONSULTATION ON SLIDES PREPARED ELSEWHERE,200.0,130.0,1.1,200.0,31
CDM,D0485AK,"CONSULTATION, INCLUDING PREPARATION OF SLIDES FROM BIOPSY MATERI",400.0,260.0,1.1,400.0,31
CDM,D0502AK,"OTHER ORAL PATHOLOGY PROCEDURES, BY REPORT",200.0,130.0,0.01,200.0,31
CDM,D0600AK,"NON-IONIZING DIAGNOSTIC PROCEDURE CAPABLE OF QUANTIFYING, MONITO",100.0,65.0,0.01,100.0,28
CDM,D0601AK,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF LOW",100.0,65.0,1.1,100.0,25
CDM,D0602AK,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF MODE",100.0,65.0,1.1,100.0,25
CDM,D0603AK,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF HIGH",100.0,65.0,1.1,100.0,25
CDM,D0999AK,"UNSPECIFIED DIAGNOSTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,28
CDM,D1110.3AK,PROPHYLAXIS-ADULT PARTIAL MOUTH,75.0,48.75,1.1,165.86,31
CDM,D1110AK,PROPHYLAXIS - ADULT,125.0,81.25,1.1,165.86,31
CDM,D1120AK,PROPHYLAXIS - CHILD,100.0,65.0,1.1,114.02,31
CDM,D1206AK,TOPICAL APPLICATION OF FLUORIDE VARNISH,50.0,32.5,1.1,176.21,31
CDM,D1208AK,TOPICAL APPLICATION OF FLUORIDE ? EXCLUDING VARNISH,50.0,32.5,1.1,72.56,31
CDM,D1208ORDAK,APPLICATION OF FLOURIDE VARNISH,30.0,19.5,1.1,72.56,31
CDM,D1320AK,TOBACCO COUNSELING FOR THE CONTROL AND PREVENTION OF ORAL DISEAS,30.0,19.5,1.1,93.29,31
CDM,D1351AK,SEALANT - PER TOOTH,75.0,48.75,1.1,103.66,31
CDM,D1352AK,PREVENTIVE RESIN RESTORATION IN A MODERATE TO HIGH CARIES RISK P,160.0,104.0,1.1,160.0,30
CDM,D1353AK,SEALANT REPAIR ? PER TOOTH,75.0,48.75,1.1,107.8,31
CDM,D1354AK,INTERIM CARIES ARRESTING MEDICAMENT APPLICATION ? PER TOOTH,125.0,81.25,1.1,167.45,31
CDM,D1510AK,SPACE MAINTAINER - FIXED - UNILATERAL,450.0,292.5,1.1,670.31,31
CDM,D1516AK,"SPACE MAINTAINER ? FIXED ? BILATERAL, MAXILLARY",500.0,325.0,1.1,1371.71,31
CDM,D1517AK,"SPACE MAINTAINER ? FIXED ? BILATERAL, MANDIBULAR",550.0,357.5,1.1,1371.71,31
CDM,D1520AK,SPACE MAINTAINER - REMOVABLE - UNILATERAL,500.0,325.0,1.1,832.7,31
CDM,D1526AK,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MAXILLARY",600.0,390.0,1.1,1285.32,31
CDM,D1527AK,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MANDIBULAR",600.0,390.0,1.1,1285.32,31
CDM,D1551AK,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MAXILLARY,150.0,97.5,1.1,179.67,31
CDM,D1552AK,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MANDIBULAR,150.0,97.5,1.1,179.67,31
CDM,D1553AK,RE-CEMENT OR RE-BOND UNILATERAL SPACE MAINTAINER - PER QUADRANT,160.0,104.0,1.1,160.0,31
CDM,D1556AK,REMOVAL OF FIXED UNILATERAL SPACE MAINTAINER - PER QUADRANT,150.0,97.5,1.1,179.67,31
CDM,D1557AK,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MAXILLARY,165.0,107.25,1.1,179.67,31
CDM,D1558AK,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MANDIBULAR,180.0,117.0,1.1,180.0,31
CDM,D1575AK,DISTAL SHOE SPACE MAINTAINER ? FIXED ? UNILATERAL,520.0,338.0,1.1,863.79,31
CDM,D1999AK,"UNSPECIFIED PREVENTIVE PROCEDURE, BY REPORT",160.0,104.0,1.1,160.0,22
CDM,D2140AK,"AMALGAM - ONE SURFACE, PRIMARY OR PERMANENT",200.0,130.0,1.1,231.49,31
CDM,D2150AK,"AMALGAM - TWO SURFACES, PRIMARY OR PERMANENT",280.0,182.0,1.1,300.61,31
CDM,D2160AK,"AMALGAM - THREE SURFACES, PRIMARY OR PERMANENT",350.0,227.5,1.1,362.8,31
CDM,D2161AK,"AMALGAM - FOUR OR MORE SURFACES, PRIMARY OR PERMANENT",400.0,260.0,1.1,442.26,31
CDM,D2330AK,"RESIN-BASED COMPOSITE - ONE SURFACE, ANTERIOR",260.0,169.0,1.1,276.42,31
CDM,D2331AK,"RESIN-BASED COMPOSITE - TWO SURFACES, ANTERIOR",300.0,195.0,1.1,352.43,31
CDM,D2332AK,"RESIN-BASED COMPOSITE - THREE SURFACES, ANTERIOR",350.0,227.5,1.1,428.44,31
CDM,D2335AK,RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES (ANTERIOR),450.0,292.5,1.1,507.91,31
CDM,D2390AK,"RESIN-BASED COMPOSITE CROWN, ANTERIOR",700.0,455.0,1.1,700.0,31
CDM,D2391AK,"RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR",275.0,178.75,1.1,310.96,31
CDM,D2392AK,"RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR",350.0,227.5,1.1,428.44,31
CDM,D2393AK,"RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR",425.0,276.25,1.1,532.1,31
CDM,D2394AK,"RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR",500.0,325.0,1.1,532.1,31
CDM,D2510AK,INLAY - METALLIC - ONE SURFACE,1300.0,845.0,1.1,1551.37,31
CDM,D2520AK,INLAY - METALLIC - TWO SURFACES,1400.0,910.0,1.1,1758.69,31
CDM,D2530AK,INLAY - METALLIC - THREE OR MORE SURFACES,1500.0,975.0,1.1,2028.19,31
CDM,D2542AK,ONLAY - METALLIC - TWO SURFACES,2000.0,1300.0,1.1,2073.11,31
CDM,D2543AK,ONLAY - METALLIC - THREE SURFACES,2000.0,1300.0,1.1,2080.02,31
CDM,D2544AK,ONLAY - METALLIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2162.94,31
CDM,D2610AK,INLAY - PORCELAIN/CERAMIC - ONE SURFACE,2000.0,1300.0,1.1,2000.0,31
CDM,D2620AK,INLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
CDM,D2630AK,INLAY - PORCELAIN/CERAMIC - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2052.38,31
CDM,D2642AK,ONLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
CDM,D2643AK,ONLAY - PORCELAIN/CERAMIC - THREE SURFACES,2000.0,1300.0,1.1,2149.12,31
CDM,D2644AK,ONLAY - PORCELAIN/CERAMIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2280.42,31
CDM,D2650AK,INLAY - RESIN-BASED COMPOSITE - ONE SURFACE,2000.0,1300.0,1.1,2000.0,31
CDM,D2651AK,INLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
CDM,D2652AK,INLAY - RESIN-BASED COMPOSITE - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2000.0,31
CDM,D2662AK,ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
CDM,D2663AK,ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES,2000.0,1300.0,1.1,2000.0,31
CDM,D2664AK,ONLAY - RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2055.84,31
CDM,D2710AK,CROWN - RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,31
CDM,D2712AK,CROWN - 3/4CROWN RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,31
CDM,D2720AK,CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2280.42,31
CDM,D2721AK,CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2138.75,31
CDM,D2722AK,CROWN - RESIN WITH NOBLE METAL,1600.0,1040.0,1.1,2183.67,31
CDM,D2740.5AK,CEREC CROWN,1600.0,1040.0,1.1,1600.0,22
CDM,D2740AK,CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2342.62,31
CDM,D2750AK,CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1675.0,1088.75,1.1,2308.07,31
CDM,D2751AK,CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1525.0,991.25,1.1,2149.12,31
CDM,D2752AK,CROWN - PORCELAIN FUSED TO NOBLE METAL,1650.0,1072.5,1.1,2204.41,31
CDM,D2753AK,CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1650.0,1072.5,1.1,2501.56,31
CDM,D2780AK,CROWN - 3/4 CAST HIGH NOBLE METAL,1650.0,1072.5,1.1,2073.11,31
CDM,D2781AK,CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2073.11,31
CDM,D2782AK,CROWN - 3/4 CAST NOBLE METAL,1625.0,1056.25,1.1,2073.11,31
CDM,D2783AK,CROWN - 3/4 PORCELAIN/CERAMIC,1625.0,1056.25,1.1,2073.11,31
CDM,D2790AK,CROWN - FULL CAST HIGH NOBLE METAL,1750.0,1137.5,1.1,2228.6,31
CDM,D2791AK,CROWN - FULL CAST PREDOMINANTLY BASE METAL,1625.0,1056.25,1.1,2111.12,31
CDM,D2792AK,CROWN - FULL CAST NOBLE METAL,1675.0,1088.75,1.1,2149.12,31
CDM,D2794AK,CROWN - TITANIUM,1650.0,1072.5,1.1,2149.12,31
CDM,D2799AK,PROVISIONAL CROWN? FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS,600.0,390.0,1.1,2073.11,31
CDM,D2910AK,"RE-CEMENT OR RE-BOND INLAY, ONLAY, VENEER OR PARTIAL COVERAGE RE",175.0,113.75,1.1,200.4,31
CDM,D2915AK,RE-CEMENT OR RE-BOND INDIRECTLY FABRICATED OR PREFABRICATED POST,160.0,104.0,1.1,200.4,31
CDM,D2920AK,RE-CEMENT OR RE-BOND CROWN,180.0,117.0,1.1,207.31,31
CDM,D2921AK,"REATTACHMENT OF TOOTH FRAGMENT, INCISAL EDGE OR CUSP",350.0,227.5,1.1,350.0,25
CDM,D2929AK,PREFABRICATED PORCELAIN/CERAMIC CROWN ? PRIMARY TOOTH,550.0,357.5,1.1,550.0,31
CDM,D2930AK,PREFABRICATED STAINLESS STEEL CROWN - PRIMARY TOOTH,400.0,260.0,1.1,566.65,31
CDM,D2931AK,PREFABRICATED STAINLESS STEEL CROWN - PERMANENT TOOTH,500.0,325.0,1.1,639.21,31
CDM,D2932AK,PREFABRICATED RESIN CROWN,510.0,331.5,1.1,694.49,31
CDM,D2940AK,PLACEMENT OF INTERIM DIRECT RESTORATION,200.0,130.0,1.1,214.22,31
CDM,D2941AK,INTERIM THERAPEUTIC RESTORATION ? PRIMARY DENTITION,275.0,178.75,1.1,275.0,23
CDM,D2949AK,RESTORATIVE FOUNDATION FOR AN INDIRECT RESTORATION,300.0,195.0,1.1,300.0,25
CDM,D2950AK,"CORE BUILDUP, INCLUDING ANY PINS WHEN REQUIRED",450.0,292.5,1.1,539.01,31
CDM,D2951AK,"PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION",100.0,65.0,1.1,114.02,31
CDM,D2952AK,"POST AND CORE IN ADDITION TO CROWN, INDIRECTLY FABRICATED",600.0,390.0,1.1,822.34,31
CDM,D2954AK,PREFABRICATED POST AND CORE IN ADDITION TO CROWN,450.0,292.5,1.1,680.67,31
CDM,D2955AK,POST REMOVAL,400.0,260.0,1.1,511.38,31
CDM,D2957AK,EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH,300.0,195.0,1.1,300.0,31
CDM,D2960AK,LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE,1000.0,650.0,1.1,1668.85,31
CDM,D2961AK,LABIAL VENEER (RESIN LAMINATE) - LABORATORY,1500.0,975.0,1.1,1869.26,31
CDM,D2962AK,LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY,1700.0,1105.0,1.1,2031.65,31
CDM,D2971AK,ADDITIONAL PROCEDURES TO CONSTRUCT NEW CROWN UNDER EXISTING PART,425.0,276.25,1.1,483.73,31
CDM,D2980AK,CROWN REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,570.11,31
CDM,D2981AK,INLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,28
CDM,D2982AK,ONLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,28
CDM,D2983AK,VENEER REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,430.0,279.5,1.1,430.0,28
CDM,D2999.3AK,CUSTOM WHITENING TRAYS - 2 TRAYS,200.0,130.0,0.01,200.0,28
CDM,D2999.4AK,CUSTOM WHITENING TRAYS - 1 TRAY,175.0,113.75,0.01,175.0,28
CDM,D2999AK,"UNSPECIFIED RESTORATIVE PROCEDURE, BY REPORT",400.0,260.0,0.01,400.0,28
CDM,D3110AK,PULP CAP - DIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,141.67,31
CDM,D3120AK,PULP CAP - INDIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,125.0,31
CDM,D3220AK,THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION) - REMOVAL OF,325.0,211.25,1.1,331.7,31
CDM,D3221AK,"PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH",350.0,227.5,1.1,350.0,31
CDM,D3222AK,PARTIAL PULPOTOMY FOR APEXOGENESIS - PERMANENT TOOTH WITH INCOMP,425.0,276.25,1.1,425.0,31
CDM,D3230AK,"PULPAL THERAPY (RESORBABLE FILLING) - ANTERIOR, PRIMARY TOOTH (E",400.0,260.0,1.1,604.67,31
CDM,D3240AK,"PULPAL THERAPY (RESORBABLE FILLING) - POSTERIOR, PRIMARY TOOTH (",430.0,279.5,1.1,430.0,31
CDM,D3310AK,"ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION)",1100.0,715.0,1.1,1402.8,31
CDM,D3320AK,"ENDODONTIC THERAPY, PREMOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1200.0,780.0,1.1,1710.32,31
CDM,D3330AK,"ENDODONTIC THERAPY, MOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1500.0,975.0,1.1,2211.32,31
CDM,D3331AK,TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS,900.0,585.0,1.1,900.0,31
CDM,D3332AK,"INCOMPLETE ENDODONTIC THERAPY; INOPERABLE, UNRESTORABLE OR FRACT",600.0,390.0,1.1,1174.77,31
CDM,D3346AK,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - ANTERIOR,1300.0,845.0,1.1,1886.52,31
CDM,D3347AK,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - PREMOLAR,1400.0,910.0,1.1,2225.14,31
CDM,D3348AK,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - MOLAR,1700.0,1105.0,1.1,2674.32,31
CDM,D3352AK,APEXIFICATION/RECALCIFICATION ? INTERIM MEDICATION REPLACEMENT,400.0,260.0,1.1,400.0,31
CDM,D3353AK,APEXIFICATION/RECALCIFICATION - FINAL VISIT (INCLUDES COMPLETED,750.0,487.5,1.1,1171.3,31
CDM,D3355AK,PULPAL REGENERATION - INITIAL VISIT,600.0,390.0,1.1,600.0,25
CDM,D3356AK,PULPAL REGENERATION - INTERIM MEDICATION REPLACEMENT,500.0,325.0,1.1,500.0,25
CDM,D3357AK,PULPAL REGENERATION - COMPLETION OF TREATMENT,850.0,552.5,1.1,850.0,25
CDM,D3410AK,APICOECTOMY - ANTERIOR,1100.0,715.0,1.1,1603.21,31
CDM,D3421AK,APICOECTOMY - PREMOLAR (FIRST ROOT),1225.0,796.25,1.1,1751.78,31
CDM,D3425AK,APICOECTOMY - MOLAR (FIRST ROOT),1350.0,877.5,1.1,1979.82,31
CDM,D3426AK,APICOECTOMY (EACH ADDITIONAL ROOT),650.0,422.5,1.1,659.95,31
CDM,D3428AK,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? PER TOOTH,575.0,373.75,1.1,575.0,25
CDM,D3429AK,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? EACH ADDI,500.0,325.0,1.1,500.0,25
CDM,D3430AK,RETROGRADE FILLING - PER ROOT,430.0,279.5,1.1,483.73,31
CDM,D3431AK,BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATIO,850.0,552.5,1.1,963.0,25
CDM,D3432AK,"GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CON",575.0,373.75,1.1,1178.4,25
CDM,D3450AK,ROOT AMPUTATION - PER ROOT,600.0,390.0,1.1,984.73,31
CDM,D3460AK,ENDODONTIC ENDOSSEOUS IMPLANT,2000.0,1300.0,1.1,4723.23,31
CDM,D3470AK,INTENTIONAL REIMPLANTATION (INCLUDING NECESSARY SPLINTING),1100.0,715.0,1.1,1962.55,31
CDM,D3471AK,SURGICAL REPAIR OF ROOT RESORPTION - ANTERIOR,900.0,585.0,1.1,2048.93,31
CDM,D3472AK,SURGICAL REPAIR OF ROOT RESORPTION ? PREMOLAR,900.0,585.0,1.1,2366.81,31
CDM,D3473AK,SURGICAL REPAIR OF ROOT RESORPTION ? MOLAR,1000.0,650.0,1.1,2660.49,31
CDM,D3501AK,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,31
CDM,D3502AK,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,31
CDM,D3503AK,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,31
CDM,D3910AK,SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM,300.0,195.0,1.1,300.0,31
CDM,D3920AK,"HEMISECTION (INCLUDING ANY ROOT REMOVAL), NOT INCLUDING ROOT CAN",700.0,455.0,1.1,767.05,31
CDM,D3921AK,DECORONATION OR SUBMERGENCE OF AN ERUPTED TOOTH,550.0,357.5,1.1,1005.46,31
CDM,D3950AK,CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST,350.0,227.5,1.1,350.0,31
CDM,D3999AK,"UNSPECIFIED ENDODONTIC PROCEDURE, BY REPORT",500.0,325.0,0.01,500.0,28
CDM,D4210AK,GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR,1000.0,650.0,1.1,1219.68,31
CDM,D4211AK,GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE CONTIGUOUS TEETH OR,600.0,390.0,1.1,600.0,31
CDM,D4240AK,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE C",1100.0,715.0,1.1,1437.35,31
CDM,D4241AK,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE C",900.0,585.0,1.1,1437.35,31
CDM,D4249AK,CLINICAL CROWN LENGTHENING ? HARD TISSUE,1200.0,780.0,1.1,1641.22,31
CDM,D4260AK,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1500.0,975.0,1.1,2321.88,31
CDM,D4261AK,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1200.0,780.0,1.1,2321.88,31
CDM,D4263AK,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? FIRST SITE IN,575.0,373.75,1.1,1751.78,31
CDM,D4264AK,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? EACH ADDITIONA,450.0,292.5,1.1,1330.25,31
CDM,D4265AK,BIO MTRLS TO AID SOFT/OS REG,700.0,455.0,1.1,1872.7,31
CDM,D4266AK,"GUIDED TISSUE REGENERATION, NATURAL TEETH - RESORBABLE BARRIER,",500.0,325.0,1.1,1872.7,31
CDM,D4267AK,"GUIDED TISSUE REGENERATION, NATURAL TEETH ? NON-RESORBABLE BARRI",600.0,390.0,1.1,1983.28,31
CDM,D4268AK,"SURGICAL REVISION PROCEDURE, PER TOOTH",800.0,520.0,1.1,800.0,31
CDM,D4270AK,PEDICLE SOFT TISSUE GRAFT PROCEDURE,1100.0,715.0,1.1,1717.23,31
CDM,D4273AK,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,1300.0,845.0,1.1,1883.08,31
CDM,D4274AK,"MESIAL/DISTAL WEDGE PROCEDURE, SINGLE TOOTH (WHEN NOT PERFORMED",700.0,455.0,1.1,700.0,31
CDM,D4275AK,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT (INCLUDING RECIPIENT SITE,1450.0,942.5,1.1,1765.6,31
CDM,D4276AK,"COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PER TOOTH",1300.0,845.0,1.1,1883.08,31
CDM,D4277AK,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1300.0,845.0,1.1,1790.14,31
CDM,D4278AK,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1000.0,650.0,1.1,1765.6,31
CDM,D4283AK,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,600.0,390.0,1.1,1917.64,31
CDM,D4285AK,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING RECI,650.0,422.5,1.1,1917.64,31
CDM,D4321AK,PROVISIONAL SPLINTING - EXTRACORONAL,418.0,271.7,1.1,418.0,22
CDM,D4323AK,SPLINT ? EXTRA-CORONAL; NATURAL TEETH OR PROSTHETIC CROWNS,675.0,438.75,1.1,929.44,31
CDM,D4341AK,PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QU,350.0,227.5,1.1,480.26,31
CDM,D4342AK,PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH PER QU,275.0,178.75,1.1,480.26,31
CDM,D4346AK,SCALING IN PRESENCE OF GENERALIZED MODERATE OR SEVERE GINGIVAL I,250.0,162.5,1.1,536.66,31
CDM,D4355AK,FULL MOUTH DEBRIDEMENT TO ENABLE A COMPREHENSIVE?PERIODONTAL?EVA,230.0,149.5,1.1,317.87,31
CDM,D4381.1AK,LOCAL DELIV ANTIMICRB 1ST SITE,50.0,32.5,1.1,362.8,31
CDM,D4381AK,LOCALIZED DELIVERY OF ANTIMICROBIAL AGENTS VIA A CONTROLLED RELE,85.0,55.25,1.1,362.8,31
CDM,D4910AK,PERIODONTAL MAINTENANCE,180.0,117.0,1.1,286.78,31
CDM,D4920AK,UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENT,150.0,97.5,1.1,245.33,31
CDM,D4921AK,GINGIVAL IRRIGATION?WITH A MEDICINAL AGENT?? PER QUADRANT,100.0,65.0,1.1,100.0,25
CDM,D4999AK,"UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,28
CDM,D5110AK,COMPLETE DENTURE - MAXILLARY,3000.0,1950.0,1.1,3000.0,31
CDM,D5120AK,COMPLETE DENTURE - MANDIBULAR,3000.0,1950.0,1.1,3000.0,31
CDM,D5211AK,"MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CLA",2100.0,1365.0,1.1,2228.6,31
CDM,D5212AK,"MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CL",2100.0,1365.0,1.1,2587.93,31
CDM,D5213AK,MAXILLARY PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENT,3000.0,1950.0,1.1,3000.0,31
CDM,D5214AK,MANDIBULAR PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DEN,3000.0,1950.0,1.1,3000.0,31
CDM,D5221AK,IMMEDIATE MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,31
CDM,D5222AK,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,31
CDM,D5223AK,IMMEDIATE MAXILLARY PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,31
CDM,D5224AK,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,31
CDM,D5225AK,"MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,",2100.0,1365.0,1.1,2916.18,31
CDM,D5226AK,MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,2100.0,1365.0,1.1,2916.18,31
CDM,D5227AK,IMMEDIATE MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING A,2000.0,1300.0,1.1,3064.75,31
CDM,D5228AK,IMMEDIATE MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING,2000.0,1300.0,1.1,3064.75,31
CDM,D5282AK,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,31
CDM,D5283AK,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,31
CDM,D5284AK,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE FLEXIBLE BASE (IN,1500.0,975.0,1.1,1820.88,31
CDM,D5286AK,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE RESIN (INCLUDING,1500.0,975.0,1.1,1820.88,31
CDM,D5410AK,ADJUST COMPLETE DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,31
CDM,D5411AK,ADJUST COMPLETE DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,31
CDM,D5421AK,ADJUST PARTIAL DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,31
CDM,D5422AK,ADJUST PARTIAL DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,31
CDM,D5511AK,"REPAIR BROKEN COMPLETE DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,31
CDM,D5512AK,"REPAIR BROKEN COMPLETE DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,31
CDM,D5520AK,RELACE MISSING OR BROKEN TEETH - COMPLETE DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,31
CDM,D5611AK,"REPAIR RESIN PARTIAL DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,31
CDM,D5612AK,"REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,31
CDM,D5621AK,"REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR",425.0,276.25,1.1,611.57,31
CDM,D5622AK,"REPAIR CAST PARTIAL FRAMEWORK, MAXILLARY",425.0,276.25,1.1,611.57,31
CDM,D5630AK,REPAIR OR REPLACE BROKEN RETENTIVE CLASPING MATERIALS ? PER TOOT,400.0,260.0,1.1,411.16,31
CDM,D5640AK,REPLACE MISSING OR BROKEN TEETH - PARTIAL DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,31
CDM,D5650AK,ADD TOOTH TO EXISTING PARTIAL DENTURE (PER TOOTH),350.0,227.5,1.1,362.8,31
CDM,D5660AK,ADD CLASP TO EXISTING PARTIAL DENTURE - PER TOOTH,400.0,260.0,1.1,431.91,31
CDM,D5710AK,REBASE COMPLETE MAXILLARY DENTURE,800.0,520.0,1.1,1071.11,31
CDM,D5711AK,REBASE COMPLETE MANDIBULAR DENTURE,800.0,520.0,1.1,1022.73,31
CDM,D5720AK,REBASE MAXILLARY PARTIAL DENTURE,800.0,520.0,1.1,1012.36,31
CDM,D5721AK,REBASE MANDIBULAR PARTIAL DENTURE,800.0,520.0,1.1,1012.36,31
CDM,D5730AK,RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,31
CDM,D5731AK,RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,31
CDM,D5740AK,RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,31
CDM,D5741AK,RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,31
CDM,D5750AK,RELINE COMPLETE MAXILLARY DENTURE (LABORATORY),800.0,520.0,1.1,808.52,31
CDM,D5751AK,RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY),800.0,520.0,1.1,808.52,31
CDM,D5765AK,SOFT LINER FOR COMPLETE OR PARTIAL REMOVABLE DENTURE ? INDIRECT,500.0,325.0,1.1,1098.75,28
CDM,D5810AK,INTERIM COMPLETE DENTURE (MAXILLARY),1000.0,650.0,1.1,1278.41,31
CDM,D5811AK,INTERIM COMPLETE DENTURE (MANDIBULAR),1000.0,650.0,1.1,1371.71,31
CDM,D5820.2AK,ESSIX APPLIANCE - MAXILLARY,300.0,195.0,1.1,988.19,31
CDM,D5820AK,INTERIM PARTIAL DENTURE (MAXILLARY),300.0,195.0,1.1,988.19,31
CDM,D5821.2AK,ESSIX APPLIANCE - MANDIBULAR,300.0,195.0,1.1,1046.92,31
CDM,D5821AK,INTERIM PARTIAL DENTURE (MANDIBULAR),500.0,325.0,1.1,1046.92,31
CDM,D5850AK,"TISSUE CONDITIONING, MAXILLARY",200.0,130.0,1.1,241.86,31
CDM,D5851AK,"TISSUE CONDITIONING, MANDIBULAR",200.0,130.0,1.1,252.23,31
CDM,D5867AK,REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION A,500.0,325.0,1.1,500.0,31
CDM,D5875AK,MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY,500.0,325.0,1.1,500.0,31
CDM,D5899AK,"UNSPECIFIED REMOVABLE PROSTHODONTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,28
CDM,D5911AK,FACIAL MOULAGE (SECTIONAL),650.0,422.5,1.1,670.31,31
CDM,D5912AK,FACIAL MOULAGE (COMPLETE),700.0,455.0,1.1,700.0,31
CDM,D5913AK,NASAL PROSTHESIS,8000.0,5200.0,1.1,14100.61,31
CDM,D5914AK,AURICULAR PROSTHESIS,9000.0,5850.0,1.1,14100.61,31
CDM,D5915AK,ORBITAL PROSTHESIS,8500.0,5525.0,1.1,19082.98,31
CDM,D5916AK,OCULAR PROSTHESIS,6000.0,3900.0,1.1,10632.79,31
CDM,D5922AK,NASAL SEPTAL PROSTHESIS,4000.0,2600.0,1.1,5182.77,31
CDM,D5931AK,"OBTURATOR PROSTHESIS, SURGICAL",5000.0,3250.0,1.1,7591.04,31
CDM,D5932AK,"OBTURATOR PROSTHESIS, DEFINITIVE",7000.0,4550.0,1.1,14200.81,31
CDM,D5933AK,"OBTURATOR PROSTHESIS, MODIFICATION",850.0,552.5,1.1,1138.69,31
CDM,D5986AK,FLUORIDE GEL CARRIER,200.0,130.0,1.1,269.51,31
CDM,D5988AK,SURGICAL SPLINT,800.0,520.0,1.1,5079.12,31
CDM,D5991AK,VESICULOBULLOUS DISEASE MEDICAMENT CARRIER,350.0,227.5,1.1,350.0,31
CDM,D5992AK,"ADJUST MAXILLOFACIAL PROSTHETIC APPLIANCE, BY REPORT",250.0,162.5,1.1,325.71,31
CDM,D5999AK,"UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT",2000.0,1300.0,0.01,2000.0,28
CDM,D6010AK,SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT,2500.0,1625.0,1.1,4412.27,31
CDM,D6013AK,SURGICAL PLACEMENT OF MINI IMPLANT,1000.0,650.0,1.1,1543.8,25
CDM,D6050AK,SURGICAL PLACEMENT: TRANSOSTEAL IMPLANT,7000.0,4550.0,1.1,12590.69,31
CDM,D6051AK,PLACEMENT OF INTERIM IMPLANT ABUTMENT,700.0,455.0,1.1,700.0,31
CDM,D6052AK,SEMI-PRECISION ATTACHMENT ABUTMENT,581.0,377.65,1.1,581.0,22
CDM,D6055AK,CONNECTING BAR ? IMPLANT SUPPORTED OR ABUTMENT SUPPORTED,4000.0,2600.0,1.1,4000.0,31
CDM,D6056AK,PREFABRICATED ABUTMENT ? INCLUDES MODIFICATION AND PLACEMENT,900.0,585.0,1.1,1036.55,31
CDM,D6057AK,CUSTOM FABRICATED ABUTMENT ? INCLUDES PLACEMENT,1100.0,715.0,1.1,2936.91,31
CDM,D6058AK,ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN,1800.0,1170.0,1.1,4146.22,31
CDM,D6059AK,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (HIGH NOBLE ME,1800.0,1170.0,1.1,4146.22,31
CDM,D6060AK,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY,1800.0,1170.0,1.1,4491.74,31
CDM,D6061AK,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,4491.74,31
CDM,D6062AK,ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL),1800.0,1170.0,1.1,3437.91,31
CDM,D6063AK,ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL),1800.0,1170.0,1.1,1800.0,31
CDM,D6064AK,ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,1800.0,31
CDM,D6065AK,IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN,2000.0,1300.0,1.1,3455.19,31
CDM,D6066AK,"IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN (TITANIUM, TITA",2000.0,1300.0,1.1,4750.89,31
CDM,D6067AK,"IMPLANT SUPPORTED METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NO",2000.0,1300.0,1.1,3109.67,31
CDM,D6068AK,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC FPD,1800.0,1170.0,1.1,1800.0,31
CDM,D6069AK,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HI,1800.0,1170.0,1.1,3627.95,31
CDM,D6070AK,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PR,1800.0,1170.0,1.1,2332.25,31
CDM,D6071AK,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NO,1800.0,1170.0,1.1,2515.38,31
CDM,D6072AK,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL,1800.0,1170.0,1.1,1800.0,31
CDM,D6073AK,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BA,1800.0,1170.0,1.1,1800.0,31
CDM,D6074AK,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL),1800.0,1170.0,1.1,1800.0,31
CDM,D6075AK,IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD,2000.0,1300.0,1.1,2000.0,31
CDM,D6076AK,IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (TIT,2000.0,1300.0,1.1,2000.0,31
CDM,D6077AK,"IMPLANT SUPPORTED RETAINER FOR CAST METAL FPD (TITANIUM, TITANIU",2000.0,1300.0,1.1,2000.0,31
CDM,D6080AK,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH FIXED HYBRID PRO,400.0,260.0,1.1,400.0,31
CDM,D6081AK,"SCALING/DEBRIDEMENT OF SINGLE IMPLANT IN PRESENCE OF MUCOSITIS,",250.0,162.5,0.01,306.32,31
CDM,D6082AK,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE,2000.0,1300.0,1.1,3990.74,31
CDM,D6083AK,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO NOBLE ALLOYS,2000.0,1300.0,1.1,3990.74,31
CDM,D6084AK,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITANI,2000.0,1300.0,1.1,3990.74,31
CDM,D6085AK,PROVISIONAL IMPLANT CROWN,700.0,455.0,1.1,700.0,31
CDM,D6086AK,IMPLANT SUPPORTED CROWN - PREDOMINANTLY BASE ALLOYS,2000.0,1300.0,1.1,3507.02,31
CDM,D6087AK,IMPLANT SUPPORTED CROWN - NOBLE ALLOYS,2000.0,1300.0,1.1,3507.02,31
CDM,D6088AK,IMPLANT SUPPORTED CROWN - TITANIUM AND TITANIUM ALLOYS,2000.0,1300.0,1.1,3507.02,31
CDM,D6090AK,REPAIR OF IMPLANT/ABUTMENT SUPPORTED PROSTHESIS,1000.0,650.0,1.1,2073.11,31
CDM,D6091AK,REPLACEMENT OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR F,500.0,325.0,1.1,539.36,31
CDM,D6094AK,ABUTMENT SUPPORTED CROWN - (TITANIUM),2000.0,1300.0,1.1,2073.11,31
CDM,D6095AK,"REPAIR IMPLANT ABUTMENT, BY REPORT",900.0,585.0,1.1,900.0,23
CDM,D6096AK,REMOVE BROKEN IMPLANT RETAINING SCREW,1000.0,650.0,1.1,1000.0,31
CDM,D6097AK,ABUTMENT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITAN,2000.0,1300.0,1.1,3911.26,31
CDM,D6098AK,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO PREDOMINANTLY BA,2000.0,1300.0,1.1,3911.26,31
CDM,D6099AK,IMPLANT SUPPORTED RETAINER FOR FPD - PORCELAIN FUSED TO NOBLE AL,2000.0,1300.0,1.1,3990.74,31
CDM,D6100AK,"IMPLANT REMOVAL, BY REPORT",900.0,585.0,1.1,1036.55,31
CDM,D6101AK,DEBRIDEMENT OF A PERI-IMPLANT DEFECT OR DEFECTS SURROUNDING A SI,900.0,585.0,1.1,900.0,31
CDM,D6104AK,BONE GRAFT AT TIME OF IMPLANT PLACEMENT,575.0,373.75,1.1,2073.11,31
CDM,D6110AK,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,31
CDM,D6111AK,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,31
CDM,D6112AK,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,31
CDM,D6113AK,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,31
CDM,D6116AK,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,31
CDM,D6117AK,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,31
CDM,D6120AK,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TIT,1600.0,1040.0,1.1,3911.26,31
CDM,D6121AK,IMPLANT SUPPORTED RETAINER FOR METAL FPD - PREDOMINANTLY BASE AL,1600.0,1040.0,1.1,3624.49,31
CDM,D6122AK,IMPLANT SUPPORTED RETAINER FOR METAL FPD - NOBLE ALLOYS,1600.0,1040.0,1.1,3914.72,31
CDM,D6123AK,IMPLANT SUPPORTED RETAINER FOR METAL FPD - TITANIUM AND TITANIUM,1600.0,1040.0,1.1,3624.49,31
CDM,D6190.1AK,SURGICAL INDEX - NON-GUIDED,350.0,227.5,1.1,2073.11,31
CDM,D6194AK,ABUTMENT SUPPORTED RETAINER CROWN FOR FPD (TITANIUM),1600.0,1040.0,1.1,2073.11,31
CDM,D6195AK,ABUTMENT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TI,1600.0,1040.0,1.1,3911.26,31
CDM,D6198AK,REMOVE INTERIM IMPLANT COMPONENT,400.0,260.0,1.1,400.0,31
CDM,D6199.2AK,RESIDENT IMPLANT PROMO,2200.0,1430.0,1.1,2619.04,28
CDM,D6210AK,PONTIC - CAST HIGH NOBLE METAL,1500.0,975.0,1.1,2176.76,31
CDM,D6211AK,PONTIC - CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2038.56,31
CDM,D6212AK,PONTIC - CAST NOBLE METAL,1500.0,975.0,1.1,2121.48,31
CDM,D6214AK,PONTIC - TITANIUM,1500.0,975.0,1.1,2121.48,31
CDM,D6240AK,PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL,1500.0,975.0,1.1,2149.12,31
CDM,D6241AK,PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1983.28,31
CDM,D6242AK,PONTIC - PORCELAIN FUSED TO NOBLE METAL,1500.0,975.0,1.1,2093.84,31
CDM,D6243AK,PONTIC - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1500.0,975.0,1.1,2501.56,31
CDM,D6245AK,PONTIC - PORCELAIN/CERAMIC,1500.0,975.0,1.1,2073.11,31
CDM,D6250AK,PONTIC - RESIN WITH HIGH NOBLE METAL,1500.0,975.0,1.1,2121.48,31
CDM,D6251AK,PONTIC - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1955.64,31
CDM,D6252AK,PONTIC - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2017.83,31
CDM,D6253AK,PROVISIONAL PONTIC - FURTHER TREATMENT OR COMPLETION OF DIAGNOSI,500.0,325.0,1.1,2017.83,31
CDM,D6545AK,RETAINER - CAST METAL FOR RESIN BONDED FIXED PROSTHESIS,1200.0,780.0,1.1,1200.0,31
CDM,D6548AK,RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,1300.0,31
CDM,D6549AK,RETAINER ? FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,2332.25,31
CDM,D6600AK,"RETAINER INLAY - PORCELAIN/CERAMIC, TWO SURFACES",1400.0,910.0,1.1,1872.7,31
CDM,D6601AK,"RETAINER INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,31
CDM,D6602AK,"RETAINER INLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,31
CDM,D6603AK,"RETAINER INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,31
CDM,D6604AK,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,31
CDM,D6605AK,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1500.0,975.0,1.1,2149.12,31
CDM,D6606AK,"RETAINER INLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,1872.7,31
CDM,D6607AK,"RETAINER INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2149.12,31
CDM,D6608AK,"RETAINER ONLAY - PORCELAIN/CERAMIC, TWO SURFACES",1500.0,975.0,1.1,2200.95,31
CDM,D6609AK,"RETAINER ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,31
CDM,D6610AK,"RETAINER ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1600.0,1040.0,1.1,2200.95,31
CDM,D6611AK,"RETAINER ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,31
CDM,D6612AK,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,31
CDM,D6613AK,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1600.0,1040.0,1.1,2200.95,31
CDM,D6614AK,"RETAINER ONLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,31
CDM,D6615AK,"RETAINER ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,31
CDM,D6624AK,RETAINER INLAY - TITANIUM,1500.0,975.0,1.1,1872.7,31
CDM,D6634AK,RETAINER ONLAY - TITANIUM,1600.0,1040.0,1.1,2200.95,31
CDM,D6710AK,RETAINER CROWN - INDIRECT RESIN BASED COMPOSITE,1500.0,975.0,1.1,2394.44,31
CDM,D6720AK,RETAINER CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2394.44,31
CDM,D6721AK,RETAINER CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2270.05,31
CDM,D6722AK,RETAINER CROWN - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2311.51,31
CDM,D6740AK,RETAINER CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2418.63,31
CDM,D6750AK,RETAINER CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1600.0,1040.0,1.1,2453.18,31
CDM,D6751AK,RETAINER CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2287.33,31
CDM,D6752AK,RETAINER CROWN - PORCELAIN FUSED TO NOBLE METAL,1600.0,1040.0,1.1,2342.62,31
CDM,D6753AK,RETAINER CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,31
CDM,D6780AK,RETAINER CROWN - 3/4 CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2311.51,31
CDM,D6781AK,RETAINER CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2314.98,31
CDM,D6782AK,RETAINER CROWN - 3/4 CAST NOBLE METAL,1600.0,1040.0,1.1,2314.98,31
CDM,D6783AK,RETAINER CROWN - 3/4 PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2314.98,31
CDM,D6784AK,RETAINER CROWN 3/4 - TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,31
CDM,D6790AK,RETAINER CROWN - FULL CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2366.81,31
CDM,D6791AK,RETAINER CROWN - FULL CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2242.41,31
CDM,D6792AK,RETAINER CROWN - FULL CAST NOBLE METAL,1600.0,1040.0,1.1,2325.33,31
CDM,D6793AK,PROVISIONAL RETAINER CROWN,500.0,325.0,1.1,2270.05,31
CDM,D6794AK,RETAINER CROWN - TITANIUM,1600.0,1040.0,1.1,2270.05,31
CDM,D6920AK,CONNECTOR BAR,1600.0,1040.0,1.1,1600.0,31
CDM,D6930AK,RE-CEMENT OR RE-BOND FIXED PARTIAL DENTURE,250.0,162.5,1.1,286.78,31
CDM,D6940AK,STRESS BREAKER,700.0,455.0,1.1,700.0,31
CDM,D6950AK,PRECISION ATTACHMENT,900.0,585.0,1.1,1271.51,31
CDM,D6973AK,CORE BUILD UP FOR RETAINER,245.0,159.25,1.1,245.0,22
CDM,D6999AK,"UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE, BY REPORT",900.0,585.0,0.01,900.0,28
CDM,D7140AK,"EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORC",300.0,195.0,1.1,300.0,31
CDM,D7210AK,"EXTRACTION, ERUPTED TOOTH REQUIRING REMOVAL OF BONE AND/OR SECTI",400.0,260.0,1.1,463.0,31
CDM,D7220AK,REMOVAL OF IMPACTED TOOTH - SOFT TISSUE,500.0,325.0,1.1,580.48,31
CDM,D7230AK,REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY,550.0,357.5,1.1,773.96,31
CDM,D7250AK,REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE),400.0,260.0,1.1,490.63,31
CDM,D7251AK,"CORONECTOMY ? INTENTIONAL PARTIAL TOOTH REMOVAL, IMPACTED TEETH",600.0,390.0,1.1,770.61,31
CDM,D7260AK,OROANTRAL FISTULA CLOSURE,1600.0,1040.0,1.1,4816.53,31
CDM,D7261AK,PRIMARY CLOSURE OF A SINUS PERFORATION,1100.0,715.0,1.1,4720.48,31
CDM,D7270AK,TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSE,800.0,520.0,1.1,998.54,31
CDM,D7272AK,TOOTH TRANSPLANTATION (INCLUDES REIMPLANTATION FROM ONE SITE TO,1000.0,650.0,1.1,1420.08,31
CDM,D7282AK,MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION,600.0,390.0,1.1,925.99,31
CDM,D7283AK,PLACEMENT OF DEVICE TO FACILITATE ERUPTION OF IMPACTED TOOTH,600.0,390.0,1.1,925.99,31
CDM,D7285AK,"INCISIONAL BIOPSY OF ORAL TISSUE-HARD (BONE, TOOTH)",800.0,520.0,1.1,1934.9,31
CDM,D7286AK,INCISIONAL BIOPSY OF ORAL TISSUE-SOFT,500.0,325.0,1.1,794.69,31
CDM,D7287AK,EXFOLIATIVE CYTOLOGICAL SAMPLE COLLECTION,300.0,195.0,1.1,300.0,31
CDM,D7288AK,BRUSH BIOPSY - TRANSEPITHELIAL SAMPLE COLLECTION,300.0,195.0,1.1,1934.9,31
CDM,D7290AK,SURGICAL REPOSITIONING OF TEETH,600.0,390.0,1.1,1339.03,31
CDM,D7291AK,"TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT",400.0,260.0,1.1,1036.55,31
CDM,D7292AK,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE [SCREW RETAINED PLATE] R,3900.0,2535.0,1.1,8519.64,31
CDM,D7295AK,HARVEST OF BONE FOR USE IN AUTOGENOUS GRAFTING PROCEDURE,1400.0,910.0,1.1,2272.05,31
CDM,D7296AK,"CORTICOTOMY ? ONE TO THREE TEETH OR TOOTH SPACES, PER QUADRANT",1800.0,1170.0,1.1,1948.1,31
CDM,D7297AK,"CORTICOTOMY ? FOUR OR MORE TEETH OR TOOTH SPACES, PER QUADRANT",1500.0,975.0,1.1,2028.4,31
CDM,D7310AK,ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEE,500.0,325.0,1.1,542.47,31
CDM,D7320AK,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE,700.0,455.0,1.1,2418.63,31
CDM,D7321AK,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE,600.0,390.0,1.1,2418.63,31
CDM,D7340AK,VESTIBULOPLASTY - RIDGE EXTENSION (SECONDARY EPITHELIALIZATION),1800.0,1170.0,1.1,4329.35,31
CDM,D7350AK,"VESTIBULOPLASTY - RIDGE EXTENSION (INCLUDING SOFT TISSUE GRAFTS,",3600.0,2340.0,1.1,13533.95,31
CDM,D7410AK,EXCISION OF BENIGN LESION UP TO 1.25 CM,600.0,390.0,1.1,3006.01,31
CDM,D7411AK,EXCISION OF BENIGN LESION GREATER THAN 1.25 CM,800.0,520.0,1.1,800.0,31
CDM,D7412AK,"EXCISION OF BENIGN LESION, COMPLICATED",1500.0,975.0,1.1,2947.27,31
CDM,D7413AK,EXCISION OF MALIGNANT LESION UP TO 1.25 CM,1000.0,650.0,1.1,3044.02,31
CDM,D7414AK,EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM,1500.0,975.0,1.1,4733.6,31
CDM,D7415AK,"EXCISION OF MALIGNANT LESION, COMPLICATED",1600.0,1040.0,1.1,4733.6,31
CDM,D7440AK,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER UP TO 1.25 CM,1200.0,780.0,1.1,3044.02,31
CDM,D7441AK,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER GREATER THAN 1.25,2100.0,1365.0,1.1,4733.6,31
CDM,D7450AK,REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER UP,900.0,585.0,1.1,1724.13,31
CDM,D7471AK,REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE),900.0,585.0,1.1,1727.59,31
CDM,D7472AK,REMOVAL OF TORUS PALATINUS,1300.0,845.0,1.1,1727.59,31
CDM,D7473AK,REMOVE TORUS MANDIBULARIS,1300.0,845.0,1.1,1727.59,31
CDM,D7485AK,SURG REDUCT OSSEOUSTUBEROSIT,1100.0,715.0,1.1,2363.34,31
CDM,D7490AK,RADICAL RESECTION OF MAXILLA OR MANDIBLE,9500.0,6175.0,1.1,24431.61,31
CDM,D7510AK,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE,400.0,260.0,1.1,518.28,31
CDM,D7511AK,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPL,500.0,325.0,1.1,518.28,31
CDM,D7521AK,INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE - COMPL,800.0,520.0,1.1,2463.55,31
CDM,D7540AK,"REMOVAL OF REACTION PRODUCING FOREIGN BODIES, MUSCULOSKELETAL SY",900.0,585.0,1.1,984.73,31
CDM,D7550AK,PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE,500.0,325.0,1.1,615.02,31
CDM,D7560AK,MAXILLARY SINUSOTOMY FOR REMOVAL OF TOOTH FRAGMENT OR FOREIGN BO,2000.0,1300.0,1.1,4871.81,31
CDM,D7670AK,"ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH",2000.0,1300.0,1.1,3842.16,31
CDM,D7810AK,TMJ OPEN REDUCT-DISLOCATION,6000.0,3900.0,1.1,8665.61,31
CDM,D7820AK,CLOSED REDUCTION OF DISLOCATION,900.0,585.0,1.1,1420.08,31
CDM,D7880AK,"OCCLUSAL ORTHOTIC DEVICE, BY REPORT",1400.0,910.0,1.1,1506.46,31
CDM,D7881AK,OCCLUSAL ORTHOTIC DEVICE ADJUSTMENT,250.0,162.5,1.1,518.28,31
CDM,D7899AK,"UNSPECIFIED TMD THERAPY, BY REPORT",700.0,455.0,0.01,700.0,28
CDM,D7921AK,COLLECTION AND APPLICATION OF AUTOLOGOUS BLOOD CONCENTRATE PRODU,600.0,390.0,1.1,1420.08,31
CDM,D7922AK,PLACEMENT OF INTRA-SOCKET BIOLOGICAL DRESSING TO AID IN HEMOSTAS,150.0,97.5,1.1,324.8,25
CDM,D7944AK,BONE CUTTING SEGMENTED,9000.0,5850.0,1.1,16152.99,31
CDM,D7950AK,"OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR",3700.0,2405.0,1.1,3700.0,31
CDM,D7951AK,SINUS AUGMENTATION WITH BONE OR BONE SUBSTITUTES VIA A LATERAL O,3900.0,2535.0,1.1,3900.0,31
CDM,D7952AK,SINUS AUGMENTATION VIA A VERTICAL APPROACH,2800.0,1820.0,1.1,2800.0,31
CDM,D7953AK,BONE REPLACEMENT GRAFT FOR RIDGE PRESERVATION - PER SITE,900.0,585.0,1.1,2764.15,31
CDM,D7955AK,REPAIR OF MAXILLOFACIAL SOFT AND/OR HARD TISSUE DEFECT,4000.0,2600.0,1.1,17275.92,31
CDM,D7970AK,EXCISION OF HYPERPLASTIC TISSUE - PER ARCH,700.0,455.0,1.1,1174.77,31
CDM,D7971AK,EXCISION OF PERICORONAL GINGIVA,400.0,260.0,1.1,400.0,31
CDM,D7972AK,SURGICAL REDUCTION OF FIBROUS TUBEROSITY,1000.0,650.0,1.1,1000.0,31
CDM,D7979AK,NON ? SURGICAL SIALOLITHOTOMY,850.0,552.5,1.1,850.0,25
CDM,D7999AK,"UNSPECIFIED ORAL SURGERY PROCEDURE, BY REPORT",850.0,552.5,0.01,850.0,28
CDM,D8010AK,LIMITED ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION,3500.0,2275.0,1.1,3500.0,31
CDM,D8020AK,LIMITED ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION,3000.0,1950.0,1.1,4837.26,31
CDM,D8080AK,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION,5500.0,3575.0,1.1,16584.89,31
CDM,D8090.1AK,REFINEMENT ORTHODONTIC TREATMENT OF THE ADULT DENTITION,200.0,130.0,1.1,17275.92,31
CDM,D8090AK,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADULT DENTITION,6000.0,3900.0,1.1,17275.92,31
CDM,D8210AK,REMOVABLE APPLIANCE THERAPY,500.0,325.0,1.1,853.88,31
CDM,D8660AK,PRE-ORTHODONTIC TREATMENT EXAMINATION TO MONITOR GROWTH AND DEVE,400.0,260.0,1.1,400.0,31
CDM,D8670AK,PERIODIC ORTHODONTIC TREATMENT VISIT,400.0,260.0,1.1,525.19,31
CDM,D8680.1AK,ORTHODONTIC RETENTION UPPER,250.0,162.5,1.1,1154.03,31
CDM,D8680.2AK,ORTHODONTIC RETENTION LOWER,250.0,162.5,1.1,1154.03,31
CDM,D8680AK,"ORTHODONTIC RETENTION (REMOVAL OF APPLIANCES, CONSTRUCTION AND P",600.0,390.0,1.1,1154.03,31
CDM,D8681AK,REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT,275.0,178.75,1.1,863.79,31
CDM,D8695AK,REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN C,300.0,195.0,1.1,300.0,25
CDM,D8696AK,REPAIR OF ORTHODONTIC APPLIANCE - MAXILLARY,250.0,162.5,1.1,518.28,31
CDM,D8697AK,REPAIR OF ORTHODONTIC APPLIANCE - MANDIBULAR,250.0,162.5,1.1,518.28,31
CDM,D8698AK,RE-CEMENT OR RE-BOND FIXED RETAINER - MAXILLARY,300.0,195.0,1.1,863.79,31
CDM,D8699AK,RE-CEMENT OR RE-BOND FIXED RETAINER - MANDIBULAR,300.0,195.0,1.1,863.79,31
CDM,D8701AK,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MAXILLARY",250.0,162.5,1.1,863.79,31
CDM,D8702AK,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MANDIBULAR",250.0,162.5,1.1,863.79,31
CDM,D8703AK,REPLACEMENT OF LOST OR BROKEN RETAINER - MAXILLARY,200.0,130.0,1.1,863.79,31
CDM,D8704AK,REPLACEMENT OF LOST OR BROKEN RETAINER - MANDIBULAR,200.0,130.0,1.1,863.79,31
CDM,D8999.1AK,ORTHODONTIC RECORDS,300.0,195.0,0.01,300.0,28
CDM,D8999.2AK,INVISALIGN UPCHARGES,2200.0,1430.0,0.01,2200.0,28
CDM,D8999AK,"UNSPECIFIED ORTHODONTIC PROCEDURE, BY REPORT",600.0,390.0,0.01,600.0,28
CDM,D9110AK,PALLIATIVE TREATMENT OF DENTAL PAIN ??PER VISIT,175.0,113.75,1.1,183.13,31
CDM,D9120AK,FIXED PARTIAL DENTURE SECTIONING,300.0,195.0,1.1,570.11,31
CDM,D9130AK,TEMPOROMANDIBULAR JOINT DYSFUNCTION ? NON-INVASIVE PHYSICAL THER,300.0,195.0,0.01,300.0,31
CDM,D9210AK,LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL P,100.0,65.0,1.1,100.0,31
CDM,D9219AK,"EVALUATION FOR MODERATE SEDATION, DEEP SEDATION OR GENERAL ANEST",150.0,97.5,1.1,150.0,22
CDM,D9222AK,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MI,350.0,227.5,1.1,494.09,31
CDM,D9223AK,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA ? EACH SUBSEQ,300.0,195.0,1.1,300.0,31
CDM,D9230AK,"INHALATION OF NITROUS OXIDE/ANALGESIA, ANXIOLYSIS",100.0,65.0,1.1,100.2,31
CDM,D9243AK,ADMINISTRATION OF MODERATE SEDATION - INTRAVENOUS - EACH SUBSEQU,350.0,227.5,1.1,350.0,31
CDM,D9311AK,CONSULTATION WITH A MEDICAL HEALTH CARE PROFESSIONAL,250.0,162.5,1.1,290.24,31
CDM,D9420AK,HOSPITAL OR AMBULATORY SURGICAL CENTER CALL,400.0,260.0,1.1,708.31,31
CDM,D9430AK,OFFICE VISIT FOR OBSERVATION (DURING REGULARLY SCHEDULED HOURS),100.0,65.0,1.1,131.3,31
CDM,D9440AK,OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS,250.0,162.5,1.1,250.0,31
CDM,D9450AK,"CASE PRESENTATION,?SUBSEQUENT TO?DETAILED AND EXTENSIVE TREATMEN",240.0,156.0,1.1,390.43,31
CDM,D9613AK,INFILTRATION OF SUSTAINED RELEASE THERAPEUTIC DRUG ? SINGLE OR M,260.0,169.0,0.01,260.0,31
CDM,D9630AK,DRUGS OR MEDICAMENTS DISPENSED IN THE OFFICE FOR HOME USE,65.0,42.25,1.1,86.39,31
CDM,D9910AK,APPLICATION OF DESENSITIZING MEDICAMENT,75.0,48.75,1.1,82.92,31
CDM,D9911AK,APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURF,100.0,65.0,1.1,224.59,31
CDM,D9912AK,PRE-VISIT PATIENT SCREENING,180.0,117.0,1.1,1257.69,31
CDM,D9932AK,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,31
CDM,D9933AK,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MANDIBULA",125.0,81.25,1.1,224.59,31
CDM,D9934AK,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,31
CDM,D9935AK,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MANDIBULAR",125.0,81.25,1.1,224.59,31
CDM,D9941AK,FABRICATION OF ATHLETIC MOUTHGUARD,350.0,227.5,1.1,350.0,31
CDM,D9942AK,REPAIR AND/OR RELINE OF OCCLUSAL GUARD,300.0,195.0,1.1,1364.8,31
CDM,D9943AK,OCCLUSAL GUARD ADJUSTMENT,175.0,113.75,1.1,324.79,31
CDM,D9944AK,"OCCLUSAL GUARD ? HARD APPLIANCE, FULL ARCH",1600.0,1040.0,1.1,1600.0,31
CDM,D9945AK,"OCCLUSAL GUARD ? SOFT APPLIANCE, FULL ARCH",700.0,455.0,1.1,700.0,31
CDM,D9946AK,"OCCLUSAL GUARD ? HARD APPLIANCE, PARTIAL ARCH",700.0,455.0,0.01,700.0,31
CDM,D9947AK,CUSTOM SLEEP APNEA APPLIANCE FABRICATION AND PLACEMENT,4000.0,2600.0,1.1,4000.0,31
CDM,D9949AK,REPAIR OF CUSTOM SLEEP APNEA APPLIANCE,500.0,325.0,1.1,1257.69,28
CDM,D9951AK,OCCLUSAL ADJUSTMENT - LIMITED,250.0,162.5,1.1,250.0,31
CDM,D9952AK,OCCLUSAL ADJUSTMENT - COMPLETE,900.0,585.0,1.1,1323.34,31
CDM,D9970AK,ENAMEL MICROABRASION,250.0,162.5,1.1,250.0,31
CDM,D9971AK,ODONTOPLASTY 1 - 2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS,200.0,130.0,1.1,200.0,31
CDM,D9974AK,INTERNAL BLEACHING - PER TOOTH,350.0,227.5,1.1,350.0,31
CDM,D9975AK,"EXTERNAL BLEACHING FOR HOME APPLICATION, PER ARCH; INCLUDES MATE",400.0,260.0,1.1,400.0,31
CDM,D9986AK,MISSED APPOINTMENT,75.0,48.75,1.1,127.85,28
CDM,D9990AK,CERTIFIED TRANSLATION OR SIGN-LANGUAGE SERVICES ? PER VISIT,125.0,81.25,0.01,125.0,31
CDM,D9991AK,DENTAL CASE MANAGEMENT ? ADDRESSING APPOINTMENT COMPLIANCE BARRI,125.0,81.25,0.01,125.0,31
CDM,D9992AK,DENTAL CASE MANAGEMENT ? CARE COORDINATION,172.0,111.8,0.01,172.0,31
CDM,D9993AK,DENTAL CASE MANAGEMENT ? MOTIVATIONAL INTERVIEWING,125.0,81.25,0.01,125.0,31
CDM,D9994AK,DENTAL CASE MANAGEMENT ? PATIENT EDUCATION TO IMPROVE ORAL HEALT,100.0,65.0,0.01,100.0,31
CDM,D9995AK,TELEDENTISTRY ? SYNCHRONOUS; REAL-TIME ENCOUNTER,300.0,195.0,1.1,300.0,25
CDM,D9996AK,TELEDENTISTRY ? ASYNCHRONOUS; INFORMATION STORED AND FORWARDED T,175.0,113.75,1.1,175.0,25
CDM,D9997AK,DENTAL CASE MANAGEMENT - PATIENTS WITH SPECIAL HEALTH CARE NEEDS,150.0,97.5,1.1,150.0,25
CDM,D9999AK,"UNSPECIFIED ADJUNCTIVE PROCEDURE, BY REPORT",300.0,195.0,0.01,300.0,28
CDM,DOT80305AK,DOT 5 PANEL URINE DRUG SCREEN,35.0,22.75,1.1,35.0,32
CDM,E0100AK,CANES OF ANY MATERIAL,40.0,26.0,1.1,68.69,32
CDM,FFD99455AK,FIT FOR DUTY,63.5,41.28,1.1,187.58,29
CDM,G0008AK,ADMIN FLU VIRUS VACCINE,68.0,44.2,1.1,120.06,50
CDM,G0008NORVUAK,ADMIN FLU VACCINE,33.0,21.45,1.1,80.64,33
CDM,G0009AK,MEDICAR PT ADMIN.PNEUMOCCAL VIR,43.0,27.95,1.1,80.64,33
CDM,G0010AK,HEPATITIS B ADMINIS,99.0,64.35,1.1,99.0,33
CDM,G0101AK,"CERV/VAG CANC SCRN,PELV/BREAST EXAM",198.0,128.7,1.1,198.0,51
CDM,G0102AK,PROSTATE CA SCREENING; DRE,79.0,51.35,1.1,79.0,45
CDM,G0103AK,"PSA, TOTAL SCREENING",76.0,49.4,1.1,76.0,32
CDM,G0104AK,SCREENING SIGMOIDOSCOPY,370.0,240.5,1.1,1560.83,45
CDM,G0105AK,"COLONOSCOPY, SCREENING, HIGH RISK",1434.0,932.1,1.1,1560.83,45
CDM,G0108AK,"DIAB OUTPT TRAINING INDIV, PER SESSN",396.0,257.4,1.1,396.0,50
CDM,G0121AK,COLONOSCOPY SCRN NOT HIGH RISK,1434.0,932.1,1.1,1560.83,45
CDM,G0121URVUAK,COLONOSCOPY MCR SCREENING,657.0,427.05,1.1,1560.83,45
CDM,G0127AK,"TRIMMING DYSTROPHIC NAILS,ANY NUMBER",75.0,48.75,1.1,103.94,45
CDM,G0136AK,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED SOCIAL DETERMIN",79.0,51.35,1.1,79.0,44
CDM,G0168AK,WOUND CLOSURE BY ADHESIVE,136.0,88.4,1.1,401.5,45
CDM,G0179AK,MD RECERTIFICATION HHA PT,198.0,128.7,1.1,198.0,44
CDM,G0180AK,MD CERTIFICATION HHA PATIENT,295.0,191.75,1.1,295.0,44
CDM,G0181AK,HOME HEALTH CARE SUPERVISION,761.0,494.65,1.1,761.0,44
CDM,G0235AK,PET NOT OTHERWISE SPECIFIED,8870.0,5765.5,0.01,8870.0,28
CDM,G0235AK-26,PET NOT OTHERWISE SPECIFIED,643.0,417.95,1.1,643.0,22
CDM,G0235AK-TC,PET NOT OTHERWISE SPECIFIED,8227.0,5347.55,1.1,8227.0,24
CDM,G0238AK,"OTH RESP PROC, INDIV",119.0,77.35,1.1,119.0,44
CDM,G0250AK,MD REVIEW INTERPRET OF TEST,79.0,51.35,1.1,79.0,44
CDM,G0268AK,REMOVAL OF IMPACTED WAX MD,268.0,174.2,1.1,268.0,45
CDM,G0270AK,MEDICAL NUTRITION THERAPY; REASSESSMENT,198.0,128.7,1.1,198.0,45
CDM,G0279AK,"TOMOSYNTHESIS, MAMMO",351.0,228.15,1.1,351.0,51
CDM,G0279AK-26,"TOMOSYNTHESIS, MAMMO",264.0,171.6,1.1,264.0,45
CDM,G0279AK-TC,"TOMOSYNTHESIS, MAMMO",87.0,56.55,1.1,87.0,46
CDM,G0283AK,ELEC STIM OTHER THAN WOUND,79.0,51.35,1.1,79.0,44
CDM,G0289AK,"ARTHRO, LOOSE BODY + CHONDRO",651.0,423.15,1.1,651.0,44
CDM,G0296AK,VISIT TO DETERM LDCT ELIG,229.0,148.85,1.1,229.0,51
CDM,G0310AK,5-15 MINS TIME,78.0,50.7,0.01,1791901.44,28
CDM,G0316AK,PROLONG INPT EVAL ADD15 M,268.0,174.2,1.1,268.0,50
CDM,G0317AK,PROLONG NURSIN FAC EVAL 15M,244.0,158.6,1.1,244.0,50
CDM,G0318AK,PROLONG HOME EVAL ADD 15M,244.0,158.6,1.1,244.0,50
CDM,G0328AK,FECAL BLOOD SCRN IMMUNOASSAY,51.0,33.15,1.1,51.0,32
CDM,G0372AK,MD SERVICE REQUIRED FOR PMD,75.0,48.75,1.1,75.0,44
CDM,G0390AK,TRAUMA RESPONS W/HOSP CRITI,433.0,281.45,1.1,2016.71,28
CDM,G0396AK,ALCOHOL/SUBS INTERV 15-30MN,286.0,185.9,1.1,286.0,51
CDM,G0397AK,ALCOHOL/SUBS INTERV >30 MIN,572.0,371.8,1.1,572.0,51
CDM,G0398AK,HOME SLEEP TEST/TYPE 2 PORTA,573.0,372.45,1.1,714.51,32
CDM,G0399AK,HOME SLEEP TEST/TYPE 3 PORTA,706.0,458.9,1.1,706.0,32
CDM,G0402AK,INITIAL PREVENTIVE EXAM,1144.0,743.6,1.1,1144.0,45
CDM,G0403AK,EKG FOR INITIAL PREVENT EXAM,75.0,48.75,1.1,75.0,44
CDM,G0404AK,EKG TRACING FOR INITIAL PREV,279.0,181.35,1.1,279.0,44
CDM,G0405AK,EKG INTERPRET & REPORT PREVE,75.0,48.75,1.1,75.0,44
CDM,G0406AK,TELEHEALTH FOLLOW-UP INPT CONSULTATION 15 MINS,334.0,217.1,1.1,334.0,50
CDM,G0407AK,TELEHEALTH FOLLOW-UP INPT CONSULTATION 25 MINS,612.0,397.8,1.1,612.0,50
CDM,G0408AK,TELEHEALTH FOLLOW-UP INPT CONSULTATION 35 MINS,880.0,572.0,1.1,880.0,50
CDM,G0413AK,PELVIC RING FRACTURE UNI/BIL,6921.0,4498.65,1.1,12214.27,44
CDM,G0414AK,PELVIC RING FX TREAT INT FIX,6446.0,4189.9,1.1,6446.0,44
CDM,G0415AK,OPEN TX POST PELVIC FXCTURE,9209.0,5985.85,1.1,9209.0,44
CDM,G0416AK,SAT BIOPSY PROSTATE 1-20 SPC,1440.0,936.0,1.1,1440.0,44
CDM,G0425AK,PR INPT TELEHEALTH CONSULT 30M,845.0,549.25,1.1,845.0,50
CDM,G0426AK,PR INPT TELEHEALTH CONSULT 50M,1148.0,746.2,1.1,1148.0,50
CDM,G0427AK,PR INPT TELEHEALTH CON 70/>M,1698.0,1103.7,1.1,1698.0,50
CDM,G0438AK,"PPPS, INITIAL VISIT",1040.0,676.0,1.1,1040.0,44
CDM,G0439AK,"PPPS, SUBSEQ VISIT",768.0,499.2,1.1,768.0,44
CDM,G0442AK,ANNUAL ALCOHOL SCREEN 15 MIN,72.0,46.8,1.1,72.0,45
CDM,G0444AK,DEPRESSION SCREEN ANNUAL,79.0,51.35,1.1,79.0,45
CDM,G0446AK,INTENS BEHAVE THER CARDIO DX,264.0,171.6,1.1,264.0,45
CDM,G0447AK,BEHAVIOR COUNSEL OBESITY 15M,264.0,171.6,1.1,264.0,45
CDM,G0455AK,FECAL MICROBIOTA PREP INSTILL,590.0,383.5,1.1,1560.83,45
CDM,G0480AAK,ONE DRUG CONFIRMATION,55.0,35.75,1.1,277.16,32
CDM,G0481AAK,ENTIRE PANEL CONFIRMATION,72.0,46.8,1.1,379.28,32
CDM,G0481AK,DRUG TEST DEF 8-14 CLASSES,651.0,423.15,1.1,651.0,32
CDM,G0500AK,MOD SEDAT ENDO SERVICE >5YRS,44.0,28.6,1.1,179.7,45
CDM,G0537AK,RISK ASCVD TST ONCE PR 12 MO,79.0,51.35,1.1,79.0,43
CDM,G0538AK,ASCVD RSK MNG CLIN STF PR MO,79.0,51.35,1.1,79.0,43
CDM,G0545AK,INFECTIOUS DISEASE CONFIRMED/SUSPECTED INHERENT TO INPATIENT OR,392.0,254.8,1.1,392.0,43
CDM,G0552AK,SUPPLY OF DIGITAL DEVICE,248.0,161.2,1.1,248.0,24
CDM,G0553AK,MONTHLY TX FOR DMHT 20MINS,273.0,177.45,1.1,273.0,37
CDM,G0554AK,ADD 20 M OF MONTHLY TX,268.0,174.2,1.1,268.0,37
CDM,G0556AK,ADV PRIM CARE MGMT LVL 1,110.0,71.5,1.1,110.0,43
CDM,G0557AK,ADV PRIM CARE MGMT LVL 2,339.0,220.35,1.1,339.0,43
CDM,G0558AK,ADV PRIM CARE MGMT LVL 3,735.0,477.75,1.1,735.0,43
CDM,G0559AK,POST-OP FOLLOW-UP PROVIDED BY A DIFFERENT PRACTICE FROM THE SURG,70.0,45.5,1.1,70.0,43
CDM,G0571AK,INTRAOP NERVE CRYOABLATION,598.0,388.7,1.1,598.0,35
CDM,G2211AK,VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC,145.0,94.25,1.1,145.0,44
CDM,G2212AK,PROLONG OUTPT/OFFICE VIS,268.0,174.2,1.1,268.0,50
CDM,G2213AK,INITIAT MED ASSIST TX IN ER,572.0,371.8,1.1,572.0,44
CDM,G3002AK,"CHRONIC PAIN MANAGEMENT AND TREATMENT, MONTHLY 30 MINUTES",638.0,414.7,1.1,638.0,44
CDM,G3003AK,"CHRONIC PAIN MANAGEMENT AND TREATMENT, MONTHLY EACH ADDITIONAL 1",220.0,143.0,1.1,220.0,44
CDM,GL11422AK,EXC H-F-NK-SP B9+MARG 1.1-2,1980.0,1287.0,1.1,2768.64,53
CDM,GL51715AK,ENDOSCOPIC INJECTION/IMPLANT,3498.0,2273.7,1.1,5953.02,53
CDM,GL51728AK,CYSTOMETROGRAM W/VP,794.0,516.1,1.1,1193.67,50
CDM,GL51729AK,CYSTOMETROGRAM W/VP&UP,834.0,542.1,1.1,1267.37,50
CDM,GL51741AK,ELECTRO-UROFLOWMETRY- FIRST,364.0,236.6,1.1,535.81,50
CDM,GL51784AK,ANAL/URINARY MUSCLE STUDY,397.0,258.05,1.1,397.0,50
CDM,GL51797AK,INTRAABDOMINAL PRESSURE TES,350.0,227.5,1.1,626.88,50
CDM,GL52000AK,CYSTOSCOPY,1614.0,1049.1,1.1,1614.0,53
CDM,GL52204AK,CYSTOSCOPY W/BIOPSY(S),3543.0,2302.95,1.1,3543.0,53
CDM,GL52214AK,CYSTOSCOPY AND TREATMENT,4396.0,2857.4,1.1,5953.02,53
CDM,GL52224AK,CYSTOSCOPY AND TREATMENT,4436.0,2883.4,1.1,5953.02,53
CDM,GL52281AK-62,CYSTOSCOPY AND TREATMENT,3573.0,2322.45,1.1,3573.0,53
CDM,GL52281AK-63,CYSTOSCOPY AND TREATMENT,3573.0,2322.45,1.1,3573.0,53
CDM,GL52285AK,CYSTOSCOPY AND TREATMENT,1859.0,1208.35,1.1,1859.0,53
CDM,GL52287AK,CYSTOURETHROSCOPY W/INJ CHEMO,1866.0,1212.9,1.1,3478.27,53
CDM,GL52315AK,CYSTOSCOPY AND TREATMENT,2943.0,1912.95,1.1,3478.27,53
CDM,GL52648AK,LASER SURGERY OF PROSTATE,9651.0,6273.15,1.1,9651.0,53
CDM,GL54055AK,DESTRUCTION- PENIS LESION(S,2545.0,1654.25,1.1,3114.5,53
CDM,GL55000AK,DRAINAGE OF HYDROCELE,1033.0,671.45,1.1,1200.64,53
CDM,GL55110AK,EXPLORE SCROTUM,638.0,414.7,1.1,5953.02,50
CDM,GL55250AK,REMOVAL OF SPERM DUCT(S),1300.0,845.0,1.1,3478.27,53
CDM,GL76872AK,US- TRANSRECTAL,354.0,230.1,1.1,528.3,51
CDM,GL76942AK,ECHO GUIDE FOR BIOPSY,952.0,618.8,1.1,952.0,51
CDM,GP99212AK,GENERAL PHYSICAL,30.0,19.5,1.1,113.21,53
CDM,H0050AK,ALCOHOL/DRUG SERVICE 15 MIN,222.0,144.3,1.1,222.0,29
CDM,H1000AK,PRENATAL CARE ATRISK ASSESSM,281.0,182.65,1.1,281.0,35
CDM,H1001AK,ANTEPARTUM MANAGEMENT,48.0,31.2,1.1,48.0,35
CDM,HASUPAK,HEARING AID SUPPLY,10.0,6.5,1.1,10.0,22
CDM,J0561AK,PENICILLIN G BENZATHINE INJ,31.0,20.15,1.1,55.94,27
CDM,J0585AAK,BOTOX PER UNIT,14.0,9.1,1.1,14.0,27
CDM,J0585AK,BOTULINUM TOXIN A PER 1 UNIT,11.0,7.15,1.1,11.39,27
CDM,J0690AK,CEFAZOLIN SODIUM INJECTION,33.0,21.45,0.83,33.0,27
CDM,J0696AK,CEFTRIAXONE SODIUM INJECTION,32.0,20.8,0.49,32.0,27
CDM,J0702AK,BETAMETHASONE ACET&SOD PHOSP,20.0,13.0,1.1,20.0,27
CDM,J0735AK,"CLONIDINE HCL,1 MG",174.0,113.1,1.1,174.0,27
CDM,J0897AK,DENOSUMAB INJECTION,28.0,18.2,1.1,62.28,27
CDM,J1000AK,ADMIN DEPO-ESTRADIOL INJ,23.0,14.95,1.1,90.68,27
CDM,J1020AK,METHYLPREDNISOLONE 20 MG INJ,7.0,4.55,1.1,12.54,24
CDM,J1040AK,METHYLPREDNISOLONE 80 MG INJ,26.0,16.9,1.1,26.0,24
CDM,J1100AK,DEXAMETHOSONE SODIUM PHOS,20.0,13.0,0.09,20.0,27
CDM,J1200AK,DIPHENHYDRAMINE HCL INJECTIO,21.0,13.65,0.66,21.0,27
CDM,J1580AK,GENTAMICIN PER 80MG,17.0,11.05,1.1,17.0,27
CDM,J1885AK,KETOROLAC TROMETHAMINE INJ,20.0,13.0,0.44,20.0,27
CDM,J1941AK,"INJ, FUROSCIX, 20 MG",882.8,573.82,1.1,1791901.44,25
CDM,J1950AK,LEUPROLIDE ACETATE /3.75 MG,1768.0,1149.2,1.1,3700.02,27
CDM,J2315AK,"NALTREXONE, DEPOT FORM",6.0,3.9,1.1,7.43,27
CDM,J2360AK,ORPHENADRINE INJ TO 60 MG,24.0,15.6,1.1,24.0,27
CDM,J2550AK,PROMETHAZINE HCL INJECTION,21.0,13.65,1.1,21.0,27
CDM,J2790AK,RHO D IMMUNE GLOBULIN INJ,142.0,92.3,1.1,145.15,27
CDM,J2791AK,RHOPHYLAC INJECTION,64.0,41.6,1.1,64.0,27
CDM,J2795AK,ROPIVACAINE HCL INJ 1 MG,7.0,4.55,0.06,7.0,27
CDM,J3245AK,"INJ., TILDRAKIZUMAB, 1 MB",500.95,325.62,1.1,500.95,27
CDM,J3301AAK,KENALOG 10MG,300.0,195.0,0.87,300.0,27
CDM,J3301AK,KENALOG PER 10MG,14.0,9.1,0.87,14.0,27
CDM,J3302AK,TRIAMCINOLONE DIACETATE INJ,6.0,3.9,0.46,6.0,26
CDM,J3304AK,INJ TRIAMCINOLONE ACE XR 1MG,73.0,47.45,1.1,73.0,27
CDM,J3357AK,USTEKINUMAB INJECTION,402.0,261.3,1.1,402.46,27
CDM,J3420AK,ADMIN VITAMIN B12 INJ,9.0,5.85,0.67,9.0,27
CDM,J3480AK,"POTASSIUM CHLORIDE, PER 2 MEQ",14.0,9.1,0.01,14.0,27
CDM,J3590CAK,JUVADERM VOLBELLA 1CC SYRINGE,725.0,471.25,1.1,725.0,22
CDM,J3590DAK,JUVADERM VOLUMA,800.0,520.0,1.1,800.0,22
CDM,J3590FAK,JUVEDERM ULTRA XC  .55CC,455.0,295.75,1.1,455.0,22
CDM,J3590GAK,JUVEDERM ULTRA  XC 1CC,600.0,390.0,1.1,600.0,22
CDM,J3590HAK,JUVEDERM ULTRA PLUS,600.0,390.0,1.1,600.0,22
CDM,J3590LAK,RESTYLANE 1CC SYRINGE,600.0,390.0,1.1,600.0,22
CDM,J3590UAK,JUVEDERM ULTRA PLUS .55CC,455.0,295.75,1.1,455.0,22
CDM,J3590XAK,RESTYLANE EYELIGHT .5,400.0,260.0,1.1,400.0,22
CDM,J7040AK,NORMAL SALINE SOLUTION INFUS,4.0,2.6,0.99,4.0,27
CDM,J7296AK,"LEVONORGESTREL-RELEASING INTR CONTRACEPTIVE  (KYLEENA), 19.5 MG",1653.0,1074.45,1.1,1811.71,26
CDM,J7297AK,LEVONORGESTREL IU 52MG 3 YR,1133.0,736.45,1.1,1544.7,26
CDM,J7298AK,LEVONORGESTREL IU 52MG 5 YR,1530.0,994.5,1.1,2014.21,26
CDM,J7300AK,INTRAUT COPPER CONTRACEPTIVE,916.0,595.4,1.1,1874.43,26
CDM,J7301AK,SKYLA,1223.0,794.95,1.1,2553.6,26
CDM,J7307AK,ETONOGESTREL IMPLANT SYSTEM,1499.0,974.35,1.1,1996.29,26
CDM,J7321AK,HYALGAN/SUPARTZ INJ PER DOSE,312.0,202.8,1.1,312.0,27
CDM,J7323AK,EUFLEXXA INJ PER DOSE,312.0,202.8,1.1,312.0,27
CDM,J7324AK,ORTHOVISC INJ PER DOSE,317.0,206.05,1.1,317.0,27
CDM,J7325AK,SYNVISC OR SYNVISC-ONE,23.0,14.95,1.1,23.0,27
CDM,J7326AK,GEL-ONE PER DOSE,1015.0,659.75,1.1,1015.0,26
CDM,J7613AK,ALBUTEROL UNIT DOSE,11.0,7.15,0.06,11.0,27
CDM,J9155AK,DEGARELIX INJECTION,6.0,3.9,1.1,9.29,27
CDM,J9202AK,GOSERELIN ACETATE IMPLANT,656.0,426.4,1.1,1563.74,27
CDM,J9217AK,LEUPROLIDE ACETATE SUSPNSION,820.0,533.0,1.1,820.0,27
CDM,L0120AK,"CERVICAL, FLEXIBLE, NON-ADJUSTABLE",41.0,26.65,1.1,104.79,33
CDM,L0172AK,SEMI-RIGID CERVICAL COLLAR,161.0,104.65,1.1,561.19,33
CDM,L0627AK,LO SAGITT RIGID PANEL PREFAB,611.0,397.15,1.1,1628.64,33
CDM,L0637AK,LSO SAG-CORONAL PANEL PREFAB,1507.0,979.55,1.1,5133.37,33
CDM,L1810AK,KO ELASTIC W/JOINTS,165.0,107.25,1.1,407.92,33
CDM,L1812AK,OA REACTION BRACE,153.0,99.45,1.1,294.32,33
CDM,L1812ORDAK,KO ELASTIC W/JOINTS PRE OTS,135.0,87.75,1.1,135.0,22
CDM,L1820AK,KO ELAS W/ CONDYLE PADS & JO,211.0,137.15,1.1,563.13,33
CDM,L1830AK,"KO IMMOBILIZER, CANVAS LONGITUDE",124.0,80.6,1.1,255.71,33
CDM,L1832AK,"KO ADJUSTABLE KNEE JOINTS,RIGID",1023.0,664.95,1.1,2729.31,33
CDM,L1843AK,KO SINGLE UPRIGHT CUSTOM FIT,1024.0,665.6,1.1,3555.38,33
CDM,L1845AK,"KO DOUBLE UPRIGHT, CUSTOM FITTED",1244.0,808.6,1.1,3319.22,33
CDM,L1846AK,"KO DOUBLE UPRIGHT, MOLDED",1738.0,1129.7,1.1,4636.16,33
CDM,L1852AK,KO DOUBLE UPRIGHT PREFAB OTS,612.0,397.8,1.1,2401.88,33
CDM,L1902AK,"ASO ANKLE GAUNTLET, CUSTOM FITTED",111.0,72.15,1.1,295.77,33
CDM,L3020AK,FOOT INSERT REMOVABLE LONG/MT SPPT,194.0,126.1,1.1,786.15,33
CDM,L3060AK,FOOT ARCH SUPPORT REMV LONG/METATAR,154.0,100.1,1.1,292.27,33
CDM,L3170AK,FOOT PLASTIC HEEL STABILIZER,84.0,54.6,1.1,201.54,33
CDM,L3260AK,AMBULATORY SURGICAL BOOT EAC,26.0,16.9,1.1,48.82,32
CDM,L3332AK,SHOE LIFT,110.0,71.5,1.1,292.27,33
CDM,L3480AK,HEEL PAD AND DEPRESSION FOR SPUR,39.0,25.35,1.1,246.87,33
CDM,L3650AK,SHOULDER ORTHOSIS,333.0,216.45,1.1,333.0,33
CDM,L3670AK,SHLDR ORTHOSIS ACROMIO/CLAVICULAR,124.0,80.6,1.1,409.96,33
CDM,L3675AK,"SHLDR ORTHOSIS,VEST TYPE ABDUC RESTR",232.0,150.8,1.1,632.95,33
CDM,L3760AK,"EO WITHJOINT, PREFABRICATED",516.0,335.4,1.1,1803.51,33
CDM,L3761AK,"EO W/ADJ JOINT, PREFAB, OFF THE SHELF",152.0,98.8,1.1,1803.51,33
CDM,L3807AK,WHFO W INFLATABLE AIRCHAMBER,419.0,272.35,1.1,901.69,33
CDM,L3808AK,"WHFO, RIGID W/O JOINTS",25.0,16.25,1.1,1284.6,33
CDM,L3908AK,WHFO WRIST EXTENSION CONTROL,98.0,63.7,1.1,264.4,33
CDM,L3917AK,PREFAB METACARPL FX ORTHOSIS,12.0,7.8,1.1,380.79,33
CDM,L3923AK,HFO W/O JOINTS PF,100.0,65.0,1.1,348.35,33
CDM,L3927AK,FO PIP/DIP W/O JOINT/SPRING,13.0,8.45,1.1,126.22,33
CDM,L3960AK,SEWHO ABDUCTION POSITIONING,254.0,165.1,1.1,2876.16,33
CDM,L3980AK,"UPPER LIMB FX ORTHOSIS, HUMERAL",524.0,340.6,1.1,1395.1,33
CDM,L3982AK,"UPPER LIMB FX ORTHOSIS, RADIUS/ULNA",657.0,427.05,1.1,1416.56,33
CDM,L3984AK,"UPPER LIMB FX ORTHOSIS, WRIST",314.0,204.1,1.1,1247.87,33
CDM,L4210AK,"REPAIR OF ORTHOTIC DEVICE, MINOR",113.0,73.45,1.1,113.0,29
CDM,L4350AK,PNEUMATIC ANKLE CNTRL SPLINT,75.0,48.75,1.1,383.38,33
CDM,L4360AK,PNEUMATIC WALKING SPLINT,385.0,250.25,1.1,1025.88,33
CDM,L4386AK,NON-PNEUM WALK BOOT PREFAB,235.0,152.75,1.1,628.25,33
CDM,L4387AK,NON-PNEUM WALK BOOT PRE OTS,153.0,99.45,1.1,628.25,33
CDM,L4387ORDAK,NON-PNEUM WALK BOOT PRE OTS,65.0,42.25,1.1,65.0,22
CDM,L4396AK,ANKLE CONTRACTURE SPLINT,190.0,123.5,1.1,664.95,33
CDM,L8606AK,SYNTHETIC IMPLNT URINARY 1ML,635.0,412.75,1.1,815.32,33
CDM,M0076AK,PROLOTHERAPY,185.0,120.25,1.1,185.0,29
CDM,M0249AK,ADM TOCILIZU COVID-19 1ST,361.0,234.65,1.1,1189.24,28
CDM,M0250AK,ADM TOCILIZU COVID-19 2ND,361.0,234.65,1.1,1189.24,28
CDM,P9612AK,"CATH COLL SPEC,1 PT,ALL PLACES SERVC",63.0,40.95,1.1,63.0,33
CDM,PKG54405AK,PENILE IMPLANT,42000.0,27300.0,1.1,42000.0,50
CDM,PKG6699FEMTONLAK,FEMTO LASER NO LENS,1900.0,1235.0,1.1,1900.0,22
CDM,PKG90867AK,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,485.0,315.25,1.1,1239.34,38
CDM,PKG90868AK,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,485.0,315.25,1.1,585.93,38
CDM,PKG90869AK,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,515.0,334.75,1.1,1517.59,38
CDM,PKGA270TRAK,TRULIGN,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA270VFEMTOAK,VIVITY W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA290ATAK,ACTIVEFOCUS TORIC2.5,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA2970ATFEMTOAK,ACTIVEFOCUS TORIC2.5 WFEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA2970RFEMTOAK,RESTOR W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA2970SYAK,SYNERGY,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA2970SYFEMTOAK,SYNERGY W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA2970TRFEMTOAK,TRULIGN,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA9270CAK,CRYSTALENS,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270CFEMTOAK,CRYSTALENS W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA9270PAK,PANOPTIX,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270PFEMTOAK,PANOPTIX W/FEMTO,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270PTAK,PANOPTIX TORIC (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270PTFEMTOAK,PANOPTIX TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA9270RAK,RESTOR,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270RTAK,RESTOR TORIC,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270SAK,SYMFONY,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270SFEMTOAK,SYMFONY W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA9270STAK,SYMFONY TORIC,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270STFEMTOAK,SYMFONY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA9270SYTAK,SYNERGY TORIC,2900.0,1885.0,1.1,2900.0,22
CDM,PKGA9270SYTFEMTOAK,SYNERGY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,22
CDM,PKGA9270TAK,TORIC? (INC EYHANCE AND CLAREON TORIC),1400.0,910.0,1.1,1400.0,22
CDM,PKGA9270TFEMTOAK,TORIC W/FEMTO,1900.0,1235.0,1.1,1900.0,22
CDM,PKGA9270VTAK,VIVITY (TORIC)? (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,22
CDM,PKGFETALINJAK,FETAL INJECTION,1500.0,975.0,1.1,1500.0,22
CDM,PKGICGAK,ICG PACKAGE,3434.0,2232.1,1.1,3434.0,22
CDM,PKGTERMCONSULTAK,PREGNANCY TERMINATION CONSULT,950.0,617.5,1.1,950.0,22
CDM,Q0091AK,PAP SMEAR,163.0,105.95,1.1,163.0,45
CDM,Q2038AK,"PR FLUZONE VACC, 3 YRS & >, IM",65.0,42.25,1.1,101.21,28
CDM,Q4006AK,CAST SUP LONG ARM ADULT FBRG,52.0,33.8,1.1,119.97,39
CDM,Q4008AK,CAST SUP LONG ARM PED FBRGLS,52.0,33.8,1.1,59.94,39
CDM,Q4009AK,CAST SUP SHT ARM ADULT PLSTR,83.0,53.95,1.1,83.0,39
CDM,Q4010AK,CAST SUP SHT ARM ADULT FBRGL,47.0,30.55,1.1,79.96,39
CDM,Q4011AK,CAST SUP SHT ARM PED PLASTER,29.0,18.85,1.1,29.0,39
CDM,Q4012AK,CAST SUP SHT ARM PED FBRGLAS,47.0,30.55,1.1,47.0,39
CDM,Q4014AK,CAST SUP GAUNTLET FIBERGLASS,47.0,30.55,1.1,109.12,39
CDM,Q4016AK,CAST SUP GAUNTLET FBRGLS,47.0,30.55,1.1,54.53,39
CDM,Q4017AK,CAST SUP LNG ARM SPLINT PLST,77.0,50.05,1.1,77.0,39
CDM,Q4018AK,CAST SUP LNG ARM SPLINT FBRG,52.0,33.8,1.1,59.6,39
CDM,Q4020AK,CAST SUP LNG ARM SPLNT PED F,55.0,35.75,1.1,55.0,39
CDM,Q4021AK,CAST SUP SHT ARM SPLINT PLST,29.0,18.85,1.1,29.0,39
CDM,Q4022AK,CAST SUP SHT ARM SPLINT FBRG,47.0,30.55,1.1,49.97,39
CDM,Q4024AK,CAST SUP SHT ARM SPLNT PED F,46.0,29.9,1.1,46.0,39
CDM,Q4030AK,CAST SUP LONG LEG FIBERGLASS,94.0,61.1,1.1,312.49,39
CDM,Q4032AK,CAST SUP LNG LEG FBRGLS,55.0,35.75,1.1,156.24,39
CDM,Q4035AK,CAST SUP LNGLEG CYLNDR PED P,32.0,20.8,1.1,55.35,39
CDM,Q4038AK,CAST SUP SHRT LEG FIBERGLASS,51.0,33.15,1.1,169.2,39
CDM,Q4040AK,CAST SUP SHRT LEG PED FBRGLS,47.0,30.55,1.1,84.59,39
CDM,Q4041AK,CAST SUP LNG LEG SPLNT PLSTR,32.0,20.8,1.1,82.13,39
CDM,Q4042AK,CAST SUP LNG LEG SPLNT FBRGL,52.0,33.8,1.1,140.22,39
CDM,Q4043AK,CAST SUP LNG LEG SPLNT PED P,44.0,28.6,1.1,44.0,39
CDM,Q4044AK,CAST SUP LNG LEG SPLNT PED F,55.0,35.75,1.1,70.2,39
CDM,Q4045AK,CAST SUP SHT LEG SPLNT PLSTR,85.0,55.25,1.1,85.0,39
CDM,Q4046AK,CAST SUP SHT LEG SPLNT FBRGL,47.0,30.55,1.1,76.67,39
CDM,Q4047AK,CAST SUP SHT LEG SPLNT PED P,7.0,4.55,1.1,23.73,39
CDM,Q4048AK,CAST SUP SHT LEG SPLNT FIBERGLASS,47.0,30.55,1.1,47.0,39
CDM,Q4049AK,"FINGER SPLINT, STATIC",9.0,5.85,1.1,9.0,33
CDM,S0190AK,"MIFEPRISTONE, ORAL, 200 MG",103.2,67.08,1.1,103.2,26
CDM,S0353AK,CANCER TREATMENT PLAN INITIAL,463.0,300.95,1.1,575.23,23
CDM,S0354AK,CANCER TREATMENT PLAN CHANGE,463.0,300.95,1.1,716.8,23
CDM,S0610AK,"GYN EXAM, NEW PT., ANNUAL",373.0,242.45,1.1,373.0,29
CDM,S0612AK,"GYN EXAM, EST PT., ANNUAL",303.0,196.95,1.1,303.0,29
CDM,S2068AK,BREAST DIEP FLAP RECONSTRUCT,21547.0,14005.55,1.1,31963.9,29
CDM,S2900AK,ROBOTIC SURGICAL SYSTEM,526.0,341.9,0.01,526.0,29
CDM,S4989AK,CONTRACEPT IUD,1929.0,1253.85,1.1,1939.72,32
CDM,S5150AK,BEHAVIORAL HEALTH RESPITE 15 MIN - 3HR,10.0,6.5,1.1,1791901.44,28
CDM,S5151AK,BEHAVIORAL HEALTH RESPITE PER DIEM 3+HOURS,106.0,68.9,1.1,1791901.44,28
CDM,SP99212AK,UPS SPORTS PHYSICAL FAM,30.0,19.5,1.1,30.0,22
CDM,SP99213AK,UPS SPORTS PHYSICAL,35.0,22.75,1.1,35.0,22
CDM,TB286580AK,TB SKIN TEST 2,15.0,9.75,1.1,50.18,44
CDM,TB86580AK,TB SKIN TEST,15.0,9.75,1.1,50.18,44
CDM,UH93010AK,PRO FEE - EKG,15.0,9.75,1.1,27.57,50
CDM,UH93016AK,PF CARDIAC STRESS TEST SUPERV,39.0,25.35,1.1,71.01,50
CDM,UH93018AK,PRO FEE - CARDIAC STRESS TEST,26.0,16.9,1.1,47.05,50
CDM,UH93227AK,PRO FEE - HOLTER MONITOR,46.25,30.06,1.1,61.85,50
CDM,UH93228AK,PF - MOBILE CARDIAC TELEMETRY,47.0,30.55,1.1,85.72,50
CDM,UH93306AK,PRO FEE - ECHO COMPLETE,138.5,90.03,1.1,942.59,50
CDM,UH93308AK,PRO FEE - LIMITED 2D,45.0,29.25,1.1,417.54,50
CDM,UH93314AK,PRO FEE - TEE,160.0,104.0,1.1,749.78,50
CDM,UH99156AK,PF MODERATE SEDATION INITIAL 15,137.75,89.54,1.1,259.38,50
CDM,UH99157AK,PF MODERATE SEDATION EA ADDL 15,111.5,72.48,1.1,210.25,50
CDM,UHG0405AK,PRO FEE - INITIAL PREVENT PHY,15.0,9.75,1.1,27.57,44
CDM,UPS80305AK,DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE,16.0,10.4,1.1,30.52,32
CDM,UPS80307AK,DRUG TEST PRSMV INSTRMT CHEMISTRY ANALYZER,56.0,36.4,1.1,150.51,32
CDM,UPSWWA6250AK,SILVADINE CREAM,25.75,16.74,1.1,25.75,29
CDM,UPSWWJ1100AK,DECADRON 4MG/1ML VIAL,8.0,5.2,0.09,8.0,27
CDM,UPSWWJ1885AK,TORODOL 30MG OR 60MG ML INJECTION,8.0,5.2,0.44,8.0,27
CDM,UPSWWJ3301AK,KENALOG 40MG/ML INJECTION,25.5,16.58,0.87,25.5,27
CDM,UPSWWJ7613AK,ALBUTEROL SULF .083,1.75,1.14,0.06,1.75,27
CDM,UPSWWS0020AK,BUPIVACAINE 0.5% VIAL 30ML,11.5,7.48,1.1,11.5,22
CDM,V36468AK,INJECTION(S) SPIDER VEINS,110.0,71.5,1.1,680.96,29
CDM,V36470AK,INJECTION THERAPY OF VEIN,114.0,74.1,1.1,680.96,53
CDM,V36471AK,INJECTION THERAPY OF VEINS,114.0,74.1,1.1,680.96,53
CDM,V36478AK,ENDOVENOUS LASER 1ST VEIN,650.0,422.5,1.1,5442.3,53
CDM,V36479AK,ENDOVENOUS LASER VEIN ADDON,321.0,208.65,1.1,995.75,53
CDM,V37700AK,REVISE LEG VEIN,485.0,315.25,1.1,5442.3,50
CDM,V37761AK,LIGATE LEG VEINS OPEN,1100.0,715.0,1.1,5442.3,50
CDM,V37765AK,PHLEB VEINS - EXTREM - TO 20,2112.0,1372.8,1.1,5442.3,53
CDM,V37766AK,PHLEB VEINS - EXTREM 20+,2640.0,1716.0,1.1,5442.3,53
CDM,V37799AK,VASCULAR SURGERY PROCEDURE,110.0,71.5,0.01,1073.41,28
CDM,V5010AK,ASSESSMENT FOR HEARING AID,122.0,79.3,1.1,179.2,32
CDM,V5014AK,HEARING AID REPAIR/MODIFYING,307.0,199.55,1.1,358.4,32
CDM,V5090AK,"DISPENSING FEE, MONAURAL",459.0,298.35,1.1,806.4,32
CDM,V5110AK,HEARING AID DISPENSING FEE,459.0,298.35,1.1,1209.6,32
CDM,V5254AAK,"HEARING AID DIGITAL MONAURAL CIC, BASIC",1238.0,804.7,1.1,4146.22,32
CDM,V5254AK,"HEARING ID, DIGIT, MON, CIC",643.0,417.95,1.1,4146.22,32
CDM,V5254BAK,"HEARING AID DIGITAL MONAURAL CIC, INTERMEDIATE",2338.0,1519.7,1.1,4146.22,32
CDM,V5254CAK,"HEARING AID DIGITAL MONAURAL CIC, PREMIUM",3438.0,2234.7,1.1,4146.22,32
CDM,V5255AAK,"HEARING AID DIGITAL MONAURAL ITC, BASIC",1238.0,804.7,1.1,4146.22,32
CDM,V5255AK,"HEARING AID, DIGIT, MON, ITC",643.0,417.95,1.1,4146.22,32
CDM,V5255BAK,"HEARING AID DIGITAL MONAURAL ITC, INTERMEDIATE",2338.0,1519.7,1.1,4146.22,32
CDM,V5255CAK,"HEARING AID DIGITAL MONAURAL ITC, PREMIUM",3438.0,2234.7,1.1,4146.22,32
CDM,V5256AAK,"HEARING AID DIGITAL MONAURAL ITE, BASIC",1238.0,804.7,1.1,4146.22,32
CDM,V5256AK,"HEARING AID, DIGIT, MON, ITE",643.0,417.95,1.1,4146.22,32
CDM,V5256BAK,"HEARING AID DIGITAL MONAURAL ITE, INTERMEDIATE",2338.0,1519.7,1.1,4146.22,32
CDM,V5256CAK,"HEARING AID DIGITAL MONAURAL ITE, PREMIUM",3438.0,2234.7,1.1,4146.22,32
CDM,V5257AAK,"HEARING AID DIGITAL MONAURAL BTE, BASIC",1238.0,804.7,1.1,3455.19,32
CDM,V5257AK,"HEARING AID, DIGIT, MON, BTE",643.0,417.95,1.1,3455.19,32
CDM,V5257BAK,"HEARING AID DIGITAL MONAURAL BTE, INTERMEDIATE",2338.0,1519.7,1.1,3455.19,32
CDM,V5257CAK,"HEARING AID DIGITAL MONAURAL BTE, PREMIUM",3438.0,2234.7,1.1,3455.19,32
CDM,V5258AAK,"HEARING AID DIGITAL BINAURAL CIC, BASIC",2998.0,1948.7,1.1,9674.51,32
CDM,V5258AK,"HEARING AID, DIGIT, BIN, CIC",1867.0,1213.55,1.1,9674.51,32
CDM,V5258BAK,"HEARING AID DIGITAL BINAURAL CIC, INTERMEDIATE",5198.0,3378.7,1.1,9674.51,32
CDM,V5258CAK,"HEARING AID DIGITAL BINAURAL CIC, PREMIUM",7398.0,4808.7,1.1,9674.51,32
CDM,V5259AAK,"HEARING AID DIGITAL BINAURAL ITC, BASIC",2998.0,1948.7,1.1,9674.51,32
CDM,V5259AK,"HEARING AID, DIGIT, BIN, ITC",1867.0,1213.55,1.1,9674.51,32
CDM,V5259BAK,"HEARING AID DIGITAL BINAURAL ITC, INTERMEDIATE",5198.0,3378.7,1.1,9674.51,32
CDM,V5259CAK,"HEARING AID DIGITAL BINAURAL ITC, PREMIUM",7398.0,4808.7,1.1,9674.51,32
CDM,V5260AAK,"HEARING AID DIGITAL BINAURAL ITE, BASIC",2998.0,1948.7,1.1,9674.51,32
CDM,V5260AK,"HEARING AID, DIGIT, BIN, ITE",1867.0,1213.55,1.1,9674.51,32
CDM,V5260BAK,"HEARING AID DIGITAL BINAURAL ITE, INTERMEDIATE",5198.0,3378.7,1.1,9674.51,32
CDM,V5260CAK,"HEARING AID DIGITAL BINAURAL ITE, PREMIUM",7398.0,4808.7,1.1,9674.51,32
CDM,V5261AAK,"HEARING AID DIGITAL BINAURAL BTE, BASIC",2998.0,1948.7,1.1,6910.37,32
CDM,V5261AK,"HEARING AID, DIGIT, BIN, BTE",1867.0,1213.55,1.1,6910.37,32
CDM,V5261BAK,"HEARING AID DIGITAL BINAURAL BTE, INTERMEDIATE",5198.0,3378.7,1.1,6910.37,32
CDM,V5261CAK,"HEARING AID DIGITAL BINAURAL BTE, PREMIUM",7398.0,4808.7,1.1,7398.0,32
CDM,V5264AK,EAR MOLD/INSERT,85.0,55.25,1.1,169.3,29
CDM,V76937AK,US GUIDE VASCULAR ACCESS,29.0,18.85,1.1,129.82,51
CDM,V76942AK,ECHO GUIDE FOR BIOPSY,66.0,42.9,1.1,193.59,51
CDM,V93880AK,EXTRACRANIAL STUDY,53.0,34.45,1.1,622.04,50
CDM,V93931AK,UPPER EXTREMITY STUDY,200.0,130.0,1.1,401.32,50
CDM,V93970AK,EXTREMITY STUDY,57.0,37.05,1.1,612.29,50
CDM,V93971AK,EXTREMITY STUDY,36.0,23.4,1.1,387.98,50
CDM,V93990AK,DOPPLER FLOW TESTING,228.0,148.2,1.1,418.04,50
CDM,V99202AK,OFFICE/OUTPATIENT VISIT NEW,68.0,44.2,1.1,152.94,53
CDM,V99203AK,OFFICE/OUTPATIENT VISIT NEW,103.0,66.95,1.1,237.5,53
CDM,V99204AK,OFFICE/OUTPATIENT VISIT NEW,175.0,113.75,1.1,357.22,53
CDM,V99212AK,OFFICE/OUTPATIENT VISIT EST,35.0,22.75,1.1,113.21,53
CDM,V99213AK,OFFICE/OUTPATIENT VISIT EST,68.0,44.2,1.1,181.76,53
CDM,V99214AK,OFFICE/OUTPATIENT VISIT EST,106.0,68.9,1.1,257.54,53
CDM,V99215AK,OFFICE/OUTPATIENT VISIT EST,150.0,97.5,1.1,361.57,53
CDM,V99243AK,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,140.0,91.0,1.1,239.69,42
CDM,WP99212AK,WORK PERMIT PHYSICAL,30.0,19.5,1.1,113.21,53
CPT,CorniaIP,Cornea (Inpatient ),,,26700.0,26700.0,2
CPT,CorniaOP,Cornea (Outpatient),,,19700.0,19700.0,2
CPT,MULVISC,Multivisceral - Adult & Pediatric,,,26700.0,26700.0,2
HCPCS,0001A,ADM SARSCOV2 30MCG/0.3ML 1ST,,,44.81,44.81,1
HCPCS,0001A,Adm sarscov2 30mcg/0.3ml 1st,,,13.56,15.7,8
HCPCS,0001F,Heart failure composite,,,8.48,9.82,8
HCPCS,0001U,RBC DNA HEA 35 AG 11 BLD GRP,,,720.0,2950.42,20
HCPCS,0001U,Rbc dna hea 35 ag 11 bld grp,,,137.41,159.1,8
HCPCS,0002A,ADM SARSCOV2 30MCG/0.3ML 2ND,,,44.81,44.81,1
HCPCS,0002A,Adm sarscov2 30mcg/0.3ml 2nd,,,13.56,15.7,8
HCPCS,0002M,LIVER DIS 10 ASSAYS W/ASH,,,503.4,2062.83,19
HCPCS,0002M,Liver dis 10 assays w/ash,,,87.06,100.8,8
HCPCS,0002U,ONC CLRCT 3 UR METAB ALG PLP,,,25.0,102.45,20
HCPCS,0002U,Onc clrct 3 ur metab alg plp,,,14.4,16.68,8
HCPCS,0003A,Adm sarscov2 30mcg/0.3ml 3rd,,,13.56,15.7,8
HCPCS,0003M,LIVER DIS 10 ASSAYS W/NASH,,,503.4,2062.83,19
HCPCS,0003M,Liver dis 10 assays w/nash,,,87.06,100.8,8
HCPCS,0003U,ONC OVAR 5 PRTN SER ALG SCOR,,,950.0,3892.91,20
HCPCS,0003U,Onc ovar 5 prtn ser alg scor,,,137.41,159.1,8
HCPCS,0004A,Adm sarscov2 30mcg/0.3ml bst,,,13.56,15.7,8
HCPCS,0004M,SCOLIOSIS DNA ALYS,,,79.0,323.73,19
HCPCS,0004M,Scoliosis dna alys,,,66.63,77.15,8
HCPCS,0005F,Osteoarthritis composite,,,8.48,9.82,8
HCPCS,0005U,ONCO PRST8 3 GENE UR ALG,,,760.0,3114.33,20
HCPCS,0005U,Onco prst8 3 gene ur alg,,,137.41,159.1,8
HCPCS,0006M,ONC HEP GENE RISK CLASSIFIER,,,150.0,614.67,19
HCPCS,0006M,Onc hep gene risk classifier,,,92.46,107.06,8
HCPCS,0007M,ONC GASTRO 51 GENE NOMOGRAM,,,375.0,1536.68,19
HCPCS,0007M,Onc gastro 51 gene nomogram,,,87.06,100.8,8
HCPCS,0007U,RX TEST PRSMV UR W/DEF CONF,,,114.43,468.91,20
HCPCS,0007U,Rx test prsmv ur w/def conf,,,27.64,32.0,8
HCPCS,0008U,HPYLORI DETCJ ABX RSTNC DNA,,,597.91,2450.12,20
HCPCS,0008U,Hpylori detcj abx rstnc dna,,,87.06,100.8,8
HCPCS,0009U,ONC BRST CA ERBB2 AMP/NONAMP,,,107.0,438.46,20
HCPCS,0009U,Onc brst ca erbb2 amp/nonamp,,,66.63,77.15,8
HCPCS,00100,Anes px salivary gland w/bx,,,159.23,184.37,8
HCPCS,00102,Anes px plstc rpr cleft lip,,,159.23,184.37,8
HCPCS,00103,Anes rcnstv px eyelid,,,159.23,184.37,8
HCPCS,00104,Anes electroconvulsive ther,,,159.23,184.37,8
HCPCS,0010U,NFCT DS STRN TYP WHL GEN SEQ,,,427.26,1750.83,20
HCPCS,0010U,Nfct ds strn typ whl gen seq,,,87.06,100.8,8
HCPCS,0011A,ADM SARSCOV2 100MCG/0.5ML1ST,,,44.81,44.81,1
HCPCS,0011A,Adm sarscov2 100mcg/0.5ml1st,,,13.56,15.7,8
HCPCS,0011M,ONC PRST8 CA MRNA 12 GEN ALG,,,760.0,3114.33,20
HCPCS,0011M,Onc prst8 ca mrna 12 gen alg,,,137.41,159.1,8
HCPCS,0011U,RX MNTR LC-MS/MS ORAL FLUID,,,114.43,468.91,20
HCPCS,0011U,Rx mntr lc-ms/ms oral fluid,,,27.64,32.0,8
HCPCS,00120,Anes px ear w/bx nos,,,159.23,184.37,8
HCPCS,00124,Anes px ear otoscopy,,,159.23,184.37,8
HCPCS,00126,Anes px ear tympanotomy,,,159.23,184.37,8
HCPCS,0012A,ADM SARSCOV2 100MCG/0.5ML2ND,,,44.81,44.81,1
HCPCS,0012A,Adm sarscov2 100mcg/0.5ml2nd,,,13.56,15.7,8
HCPCS,0012F,Cap bacterial assess,,,8.48,9.82,8
HCPCS,0012M,ONC MRNA 5 GEN RSK URTHL CA,,,760.0,3114.33,20
HCPCS,0012M,Onc mrna 5 gen rsk urthl ca,,,137.41,159.1,8
HCPCS,0012U,GERMLN DO GENE REARGMT DETCJ,,,2818.39,2818.39,1
HCPCS,0012U,Germln do gene reargmt detcj,,,533.45,617.68,8
HCPCS,0013A,Adm sarscov2 100mcg/0.5ml3rd,,,13.56,15.7,8
HCPCS,0013M,ONC MRNA 5 GEN RECR URTHL CA,,,760.0,3114.33,20
HCPCS,0013M,Onc mrna 5 gen recr urthl ca,,,137.41,159.1,8
HCPCS,0013U,ONC SLD ORG NEO GENE REARGMT,,,2818.39,2818.39,1
HCPCS,0013U,Onc sld org neo gene reargmt,,,533.45,617.68,8
HCPCS,00140,Anes procedures on eye nos,,,159.23,184.37,8
HCPCS,00142,Anes px on eye lens surgery,,,159.23,184.37,8
HCPCS,00144,Anes px eye corneal trnspl,,,159.23,184.37,8
HCPCS,00145,Anes px eye vitreortnl surg,,,159.23,184.37,8
HCPCS,00147,Anes px on eye iridectomy,,,159.23,184.37,8
HCPCS,00148,Anes px eye ophthalmoscopy,,,159.23,184.37,8
HCPCS,0014A,Fee covid-19 vac 2 res,,,13.56,15.7,8
HCPCS,0014F,Comp preop assess cat surg,,,8.48,9.82,8
HCPCS,0014M,LIVER DS ALYS 3 BMRK SRM ALG,,,197.4,197.4,1
HCPCS,0014M,Liver ds alys 3 bmrk srm alg,,,92.46,107.06,8
HCPCS,0014U,HEM HMTLMF NEO GENE REARGMT,,,2818.39,2818.39,1
HCPCS,0014U,Hem hmtlmf neo gene reargmt,,,533.45,617.68,8
HCPCS,0015F,Melan follow-up complete,,,8.48,9.82,8
HCPCS,0015M,ADRNL CORTCL TUM BCHM ASY 25,,,1305.37,5349.15,20
HCPCS,0015M,Adrnl cortcl tum bchm asy 25,,,66.63,77.15,8
HCPCS,00160,Anes px nose&sinus nos,,,159.23,184.37,8
HCPCS,00162,Anes px nose&sinus rad surg,,,159.23,184.37,8
HCPCS,00164,Anes px nose&sins bx sft tis,,,159.23,184.37,8
HCPCS,0016M,ONC BLADDER MRNA 219 GEN ALG,,,3489.63,14299.81,20
HCPCS,0016M,Onc bladder mrna 219 gen alg,,,66.63,77.15,8
HCPCS,0016U,ONC HMTLMF NEO RNA BCR/ABL1,,,163.96,671.88,20
HCPCS,0016U,Onc hmtlmf neo rna bcr/abl1,,,92.46,107.06,8
HCPCS,00170,Anes intraoral px nos,,,159.23,184.37,8
HCPCS,00172,Anes ntroral px rpr clft pal,,,159.23,184.37,8
HCPCS,00174,Anes ntrorl exc rtrphrng tum,,,159.23,184.37,8
HCPCS,00176,Anes intraoral px rad surg,,,159.23,184.37,8
HCPCS,0017M,ONC DLBCL MRNA 20 GENES ALG,,,2510.21,10286.34,20
HCPCS,0017M,Onc dlbcl mrna 20 genes alg,,,533.45,617.68,8
HCPCS,0017U,ONC HMTLMF NEO JAK2 MUT DNA,,,91.66,375.6,20
HCPCS,0017U,Onc hmtlmf neo jak2 mut dna,,,66.63,77.15,8
HCPCS,0018M,TRNSPLJ RNL MEAS CD154+CLL,,,640.73,2625.58,19
HCPCS,0018M,Trnsplj rnl meas cd154+cll,,,41.47,48.02,8
HCPCS,0018U,ONC THYR 10 MICRORNA SEQ ALG,,,3002.09,12301.96,20
HCPCS,0018U,Onc thyr 10 microrna seq alg,,,533.45,617.68,8
HCPCS,00190,Anes px facial b1/skull nos,,,159.23,184.37,8
HCPCS,00192,Anes px fcl b1/skl rad surg,,,159.23,184.37,8
HCPCS,0019M,CV DS PLASMA ALYS PRTN BMRK,,,712.4,2919.27,19
HCPCS,0019M,Cv ds plasma alys prtn bmrk,,,66.63,77.15,8
HCPCS,0019U,ONC RNA TISS PREDICT ALG,,,3675.0,15059.42,20
HCPCS,0019U,Onc rna tiss predict alg,,,533.45,617.68,8
HCPCS,0020M,ONC CNS ALYS 30000 DNA LOCI,,,2500.0,10244.5,14
HCPCS,0020M,Onc cns alys 30000 dna loci,,,66.63,77.15,8
HCPCS,00210,Anes intracranial px nos,,,159.23,184.37,8
HCPCS,00211,Anes icr px crnec/crnot hmtm,,,159.23,184.37,8
HCPCS,00212,Anes icr px subdural taps,,,159.23,184.37,8
HCPCS,00214,Anes icr px burr holes,,,159.23,184.37,8
HCPCS,00215,Anes icr px crnop/elvtn fx,,,159.23,184.37,8
HCPCS,00216,Anes icr px vascular px,,,159.23,184.37,8
HCPCS,00218,Anes icr px in sitting pos,,,159.23,184.37,8
HCPCS,0021A,Adm sarscov2 5x1010vp/.5ml 1,,,13.56,15.7,8
HCPCS,0021U,ONC PRST8 DETCJ 8 AUTOANTB,,,760.0,3114.33,20
HCPCS,0021U,Onc prst8 detcj 8 autoantb,,,137.41,159.1,8
HCPCS,00220,Anes icr px csf shunting px,,,159.23,184.37,8
HCPCS,00222,Anes icr px ecoag icr nrv,,,159.23,184.37,8
HCPCS,0022A,Adm sarscov2 5x1010vp/.5ml 2,,,13.56,15.7,8
HCPCS,0022U,TGSAP NSM LUNG NEO DNA&RNA23,,,1950.0,7990.71,20
HCPCS,0022U,Tgsap nsm lung neo dna&rna23,,,87.06,100.8,8
HCPCS,0023A,Fee covid-19 vac 3 booster,,,13.56,15.7,8
HCPCS,0023U,ONC AML DNA DETCJ/NONDETCJ,,,248.51,1018.34,20
HCPCS,0023U,Onc aml dna detcj/nondetcj,,,92.46,107.06,8
HCPCS,0024A,Fee covid-19 vac 3 res,,,13.56,15.7,8
HCPCS,0024U,GLYCA NUC MR SPECTRSC QUAN,,,34.19,140.1,20
HCPCS,0024U,Glyca nuc mr spectrsc quan,,,16.56,19.17,8
HCPCS,0025U,TENOFOVIR LIQ CHROM UR QUAN,,,96.1,468.91,20
HCPCS,0025U,Tenofovir liq chrom ur quan,,,27.64,32.0,8
HCPCS,0026U,ONC THYR DNA&MRNA 112 GENES,,,3600.0,14752.08,20
HCPCS,0026U,Onc thyr dna&mrna 112 genes,,,533.45,617.68,8
HCPCS,0027U,JAK2 GENE TRGT SEQ ALYS,,,121.91,499.56,20
HCPCS,0027U,Jak2 gene trgt seq alys,,,66.63,77.15,8
HCPCS,0029U,RX METAB ADVRS TRGT SEQ ALYS,,,742.27,3041.67,20
HCPCS,0029U,Rx metab advrs trgt seq alys,,,137.41,159.1,8
HCPCS,00300,Anes all px integ h/n/ptrunk,,,159.23,184.37,8
HCPCS,0030U,RX METAB WARF TRGT SEQ ALYS,,,134.13,549.64,20
HCPCS,0030U,Rx metab warf trgt seq alys,,,92.46,107.06,8
HCPCS,0031A,Adm sarscov2 vac ad26 .5ml,,,13.56,44.81,9
HCPCS,0031U,CYP1A2 GENE,,,174.81,716.34,20
HCPCS,0031U,Cyp1a2 gene,,,92.46,107.06,8
HCPCS,00320,Anes all px neck nos 1yr/>,,,159.23,184.37,8
HCPCS,00322,Anes all px nck ndl bx thyr,,,159.23,184.37,8
HCPCS,00326,Anes all px larynx&trach<1yr,,,159.23,184.37,8
HCPCS,0032A,Fee covid-19 vac 4 dose 2,,,13.56,15.7,8
HCPCS,0032U,COMT GENE,,,174.81,716.34,20
HCPCS,0032U,Comt gene,,,92.46,107.06,8
HCPCS,0033A,Fee covid-19 vac 4 booster,,,13.56,15.7,8
HCPCS,0033U,HTR2A HTR2C GENES,,,349.62,391.7,6
HCPCS,0033U,Htr2a htr2c genes,,,92.46,107.06,8
HCPCS,0034A,Adm sarscov2 vac ad26 .5ml b,,,13.56,15.7,8
HCPCS,0034U,TPMT NUDT15 GENES,,,466.17,1910.27,20
HCPCS,0034U,Tpmt nudt15 genes,,,87.06,100.8,8
HCPCS,00350,Anes px major vsl neck nos,,,159.23,184.37,8
HCPCS,00352,Anes px maj vsl nck smpl lig,,,159.23,184.37,8
HCPCS,0035U,CJD NEURO CSF QUAL,3733.0,2426.45,75.0,3733.0,60
HCPCS,0036U,XOME TUM & NML SPEC SEQ ALYS,,,4780.0,19587.48,20
HCPCS,0036U,Xome tum & nml spec seq alys,,,533.45,617.68,8
HCPCS,0037U,TRGT GEN SEQ DNA 324 GENES,,,3500.0,14342.3,20
HCPCS,0037U,Trgt gen seq dna 324 genes,,,533.45,617.68,8
HCPCS,0038U,VITAMIN D SRM MICROSAMP QUAN,,,29.6,121.29,20
HCPCS,0038U,Vitamin d srm microsamp quan,,,16.56,19.17,8
HCPCS,0039U,DNA ANTB 2STRAND HI AVIDITY,,,13.74,56.3,20
HCPCS,0039U,Dna antb 2strand hi avidity,,,18.32,21.21,8
HCPCS,00400,Anes integumentary sys nos,,,159.23,184.37,8
HCPCS,00402,Anes integ sys rcnstv breast,,,159.23,184.37,8
HCPCS,00404,Anes integ sys rad/modf brst,,,159.23,184.37,8
HCPCS,00406,Anes integ sys rad brst dsj,,,159.23,184.37,8
HCPCS,0040U,BCR/ABL1 GENE MAJOR BP QUAN,,,409.9,1679.69,20
HCPCS,0040U,Bcr/abl1 gene major bp quan,,,87.06,100.8,8
HCPCS,00410,Anes integ sys conv arrhyt,,,159.23,184.37,8
HCPCS,0041A,Adm sarscov2 5mcg/0.5ml 1st,,,13.56,15.7,8
HCPCS,0041U,B BRGDRFERI ANTB 5 PRTN IGM,,,17.21,70.52,20
HCPCS,0041U,B brgdrferi antb 5 prtn igm,,,18.32,21.21,8
HCPCS,0042A,Adm sarscov2 5mcg/0.5ml 2nd,,,13.56,15.7,8
HCPCS,0042T,Ct perfusion w/contrast cbf,,,312.54,361.89,8
HCPCS,0042U,B BRGDRFERI ANTB 12 PRTN IGG,,,17.21,70.52,20
HCPCS,0042U,B brgdrferi antb 12 prtn igg,,,18.32,21.21,8
HCPCS,0043A,Fee covid-19 vac 5 booster,,,13.56,15.7,8
HCPCS,0043U,TBRF B GRP ANTB 4 PRTN IGM,,,14.86,60.89,20
HCPCS,0043U,Tbrf b grp antb 4 prtn igm,,,18.32,21.21,8
HCPCS,0044A,Adm sarscov2 5mcg/0.5ml bst,,,13.56,15.7,8
HCPCS,0044U,TBRF B GRP ANTB 4 PRTN IGG,,,14.86,60.89,20
HCPCS,0044U,Tbrf b grp antb 4 prtn igg,,,18.32,21.21,8
HCPCS,00450,Anes px clav&scapula nos,,,159.23,184.37,8
HCPCS,00454,Anes px clav&scapula bx clav,,,159.23,184.37,8
HCPCS,0045U,ONC BRST DUX CARC IS 12 GENE,,,3873.0,15870.78,20
HCPCS,0045U,Onc brst dux carc is 12 gene,,,533.45,617.68,8
HCPCS,0046U,FLT3 ITD MRD ASSAY,2811.0,1827.15,75.0,2811.0,60
HCPCS,00470,Anes partial rib rescj nos,,,159.23,184.37,8
HCPCS,00472,Anes prtl rib rescj thoracop,,,159.23,184.37,8
HCPCS,00474,Anes prtl rib rescj rad px,,,159.23,184.37,8
HCPCS,0047U,ONC PRST8 MRNA 17 GENE ALG,,,3873.0,15870.78,20
HCPCS,0047U,Onc prst8 mrna 17 gene alg,,,533.45,617.68,8
HCPCS,0048U,ONC SLD ORG NEO DNA 468 GENE,,,2919.6,11963.94,20
HCPCS,0048U,Onc sld org neo dna 468 gene,,,533.45,617.68,8
HCPCS,0049U,NPM1 GENE ANALYSIS QUAN,,,407.43,1669.57,20
HCPCS,0049U,Npm1 gene analysis quan,,,87.06,100.8,8
HCPCS,00500,Anes all px on esophagus,,,159.23,184.37,8
HCPCS,0050U,TRGT GEN SEQ DNA 194 GENES,,,2916.6,11951.64,20
HCPCS,0050U,Trgt gen seq dna 194 genes,,,533.45,617.68,8
HCPCS,0051A,Adm sarscv2 30mcg trs-sucr 1,,,13.56,15.7,8
HCPCS,0051U,RX MNTR LC-MS/MS UR/BLD 31,,,217.03,1011.83,20
HCPCS,0051U,Rx mntr lc-ms/ms ur/bld 31,,,59.88,69.33,8
HCPCS,00520,Anes closed chest px nos,,,159.23,184.37,8
HCPCS,00522,Anes clsd ch px ndl bx pleur,,,159.23,184.37,8
HCPCS,00524,Anes clsd ch px pneumocents,,,159.23,184.37,8
HCPCS,00528,Anes clsd ch mediast&thrc wo,,,159.23,184.37,8
HCPCS,00529,Anes clsd ch mediast&thrc w/,,,159.23,184.37,8
HCPCS,0052A,Adm sarscv2 30mcg trs-sucr 2,,,13.56,15.7,8
HCPCS,0052U,LPOPRTN BLD W/5 MAJ CLASSES,,,33.86,138.75,20
HCPCS,0052U,Lpoprtn bld w/5 maj classes,,,16.56,19.17,8
HCPCS,00530,Anes perm transvns pm insj,,,159.23,184.37,8
HCPCS,00532,Anes access ctr venous crcj,,,159.23,184.37,8
HCPCS,00534,Anes insertion/rplcmt cvdfb,,,159.23,184.37,8
HCPCS,00537,Anes cardiac ep procedures,,,159.23,184.37,8
HCPCS,00539,Anes tracheobronchial rcnstj,,,159.23,184.37,8
HCPCS,0053A,Adm sarscv2 30mcg trs-sucr 3,,,13.56,15.7,8
HCPCS,0053U,ONC PRST8 CA FISH ALYS 4 GEN,,,2274.34,2274.34,1
HCPCS,0053U,Onc prst8 ca fish alys 4 gen,,,533.45,617.68,8
HCPCS,00540,Anes thoracotomy px nos,,,159.23,184.37,8
HCPCS,00541,Anes thrcm px 1 lung vntj,,,159.23,184.37,8
HCPCS,00542,Anes thrcm px decortication,,,159.23,184.37,8
HCPCS,00546,Anes thrcm px pulm rescj,,,159.23,184.37,8
HCPCS,00548,Anes thrcm px trach&bronchi,,,159.23,184.37,8
HCPCS,0054A,Adm sarscv2 30mcg trs-sucr b,,,13.56,15.7,8
HCPCS,0054T,Bone srgry cmptr fluor image,,,68.91,79.79,8
HCPCS,0054T,CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES,118.0,76.7,0.01,486.52,32
HCPCS,0054U,RX MNTR 14+ DRUGS & SBSTS,,,166.89,814.4,20
HCPCS,0054U,Rx mntr 14+ drugs & sbsts,,,59.88,69.33,8
HCPCS,00550,Anes for sternal debridement,,,159.23,184.37,8
HCPCS,0055T,Bone srgry cmptr ct/mri imag,,,68.91,79.79,8
HCPCS,0055T,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,730.0,474.5,0.01,820.62,32
HCPCS,0055U,CARD HRT TRNSPL 96 DNA SEQ,,,3240.0,13276.87,20
HCPCS,0055U,Card hrt trnspl 96 dna seq,,,533.45,617.68,8
HCPCS,00560,Anes px heart w/o pump oxtj,,,159.23,184.37,8
HCPCS,00561,Anes px heart w/pump<1 yr,,,159.23,184.37,8
HCPCS,00562,Anes px hrt w/pump age 1yr+,,,159.23,184.37,8
HCPCS,00563,Anes px heart w/pmp crc arst,,,159.23,184.37,8
HCPCS,00566,Anes direct cabg w/o pump,,,159.23,184.37,8
HCPCS,00567,Anes direct cabg w/pump,,,159.23,184.37,8
HCPCS,0056U,HEM AML DNA GENE REARGMT,,,2818.39,2818.39,1
HCPCS,0056U,Hem aml dna gene reargmt,,,533.45,617.68,8
HCPCS,00580,Anes heart/lung transplant,,,159.23,184.37,8
HCPCS,0058T,Cryopreservation ovary tiss,,,19.72,22.84,8
HCPCS,0058U,ONC MERKEL CLL CARC SRM QUAN,,,322.96,1323.43,20
HCPCS,0058U,Onc merkel cll carc srm quan,,,92.46,107.06,8
HCPCS,0059U,ONC MERKEL CLL CARC SRM +/-,,,322.96,1323.43,20
HCPCS,0059U,Onc merkel cll carc srm +/-,,,92.46,107.06,8
HCPCS,00600,Anes px crv spine&cord nos,,,159.23,184.37,8
HCPCS,00604,Anes px crv spn&cord sitting,,,159.23,184.37,8
HCPCS,0060U,TWN ZYG GEN SEQ ALYS CHRMS2,,,759.05,3110.44,20
HCPCS,0060U,Twn zyg gen seq alys chrms2,,,137.41,159.1,8
HCPCS,0061A,Fee covid-19 vac 7 dose 1,,,13.56,15.7,8
HCPCS,0061U,TC MEAS 5 BMRK SFDI M-S ALYS,,,25.1,102.85,20
HCPCS,0061U,Tc meas 5 bmrk sfdi m-s alys,,,7.32,8.48,8
HCPCS,00620,Anes px thrc spine&cord nos,,,159.23,184.37,8
HCPCS,00625,Anes thrc spine wo 1lng vent,,,159.23,184.37,8
HCPCS,00626,Anes thrc spine w/1 lng vent,,,159.23,184.37,8
HCPCS,0062A,Fee covid-19 vac 7 dose 2,,,13.56,15.7,8
HCPCS,0062U,AI SLE IGG&IGM ALYS 80 BMRK,,,380.72,1560.11,20
HCPCS,0062U,Ai sle igg&igm alys 80 bmrk,,,87.06,100.8,8
HCPCS,00630,Anes px lumbar region nos,,,159.23,184.37,8
HCPCS,00632,Anes px lumbar sympathectomy,,,159.23,184.37,8
HCPCS,00635,Anes dx/ther lumbar pnxr,,,159.23,184.37,8
HCPCS,0063A,Fee covid-19 vac 7 booster,,,13.56,15.7,8
HCPCS,0063U,NEURO AUTISM 32 AMINES ALG,,,750.0,3073.35,20
HCPCS,0063U,Neuro autism 32 amines alg,,,137.41,159.1,8
HCPCS,00640,Anes spine manipulation,,,159.23,184.37,8
HCPCS,0064A,Adm sarscov2 50mcg/0.25mlbst,,,13.56,15.7,8
HCPCS,0064U,ANTB TP TOTAL&RPR IA QUAL,,,31.33,128.38,20
HCPCS,0064U,Antb tp total&rpr ia qual,,,22.75,26.35,8
HCPCS,0065U,SYFLS TST NONTREPONEMAL ANTB,,,18.09,74.13,20
HCPCS,0065U,Syfls tst nontreponemal antb,,,18.32,21.21,8
HCPCS,0066U,PAMG-1 IA CERVICO-VAG FLUID,,,17.13,17.13,1
HCPCS,0066U,Pamg-1 ia cervico-vag fluid,,,14.4,16.68,8
HCPCS,00670,Anes xtnsv sp&spi cord px,,,159.23,184.37,8
HCPCS,0067U,ONC BRST IMHCHEM PRFL 4 BMRK,,,1897.0,7773.53,20
HCPCS,0067U,Onc brst imhchem prfl 4 bmrk,,,533.45,617.68,8
HCPCS,0068U,CANDIDA SPECIES PNL AMP PRB,,,142.63,584.47,20
HCPCS,0068U,Candida species pnl amp prb,,,39.01,45.17,8
HCPCS,0069U,ONC CLRCT MICRORNA MIR-31-3P,,,380.0,1557.16,20
HCPCS,0069U,Onc clrct microrna mir-31-3p,,,87.06,100.8,8
HCPCS,00700,Anes px upr ant abd wall nos,,,159.23,184.37,8
HCPCS,00702,Anes upr ant abd wall lvr bx,,,159.23,184.37,8
HCPCS,0070U,CYP2D6 GEN COM&SLCT RAR VRNT,,,676.37,2771.63,20
HCPCS,0070U,Cyp2d6 gen com&slct rar vrnt,,,137.41,159.1,8
HCPCS,0071A,Adm sarscv2 10mcg trs-sucr 1,,,13.56,15.7,8
HCPCS,0071T,US LEIOMYOMATA ABLATE <200,,,2937.82,9073.17,19
HCPCS,0071T,Us leiomyomata ablate <200,,,2525.01,2923.69,8
HCPCS,0071U,CYP2D6 FULL GENE SEQUENCE,,,600.0,2458.68,20
HCPCS,0071U,Cyp2d6 full gene sequence,,,87.06,100.8,8
HCPCS,0072A,Adm sarscv2 10mcg trs-sucr 2,,,13.56,15.7,8
HCPCS,0072T,FCSD US ABLTJ LEIOMYOM>=200,,,2937.82,9073.17,19
HCPCS,0072T,Fcsd us abltj leiomyom>=200,,,2525.01,2923.69,8
HCPCS,0072U,CYP2D6 GEN CYP2D6-2D7 HYBRID,,,450.91,1847.74,20
HCPCS,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,87.06,100.8,8
HCPCS,00730,Anes px upper pst abdl wall,,,159.23,184.37,8
HCPCS,00731,Anes upr gi ndsc px nos,,,159.23,184.37,8
HCPCS,00732,Anes upr gi ndsc px ercp,,,159.23,184.37,8
HCPCS,0073A,Adm sarscv2 10mcg trs-sucr 3,,,13.56,15.7,8
HCPCS,0073U,CYP2D6 GEN CYP2D7-2D6 HYBRID,,,450.91,1847.74,20
HCPCS,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,87.06,100.8,8
HCPCS,0074A,Adm sarscv2 10mcg trs-sucr b,,,13.56,15.7,8
HCPCS,0074U,CYP2D6 NONDUPLICATED GENE,,,450.91,1847.74,20
HCPCS,0074U,Cyp2d6 nonduplicated gene,,,87.06,100.8,8
HCPCS,00750,Anes hrna rpr upr abd nos,,,159.23,184.37,8
HCPCS,00752,Anes hrna rpr lmbr&vnt&/dehs,,,159.23,184.37,8
HCPCS,00754,Anes hrna rpr omphalocele,,,159.23,184.37,8
HCPCS,00756,Anes hrna rpr diphrg hrna,,,159.23,184.37,8
HCPCS,0075T,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,6555.5,4261.075,1.1,9213.0,78
HCPCS,0075U,CYP2D6 5' GENE DUP/MLT,,,450.91,1847.74,20
HCPCS,0075U,Cyp2d6 5' gene dup/mlt,,,87.06,100.8,8
HCPCS,0076T,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,4264.0,2771.6,1.1,1791901.44,77
HCPCS,0076U,CYP2D6 3' GENE DUP/MLT,,,450.91,1847.74,20
HCPCS,0076U,Cyp2d6 3' gene dup/mlt,,,87.06,100.8,8
HCPCS,00770,Anes px maj abd blood vessel,,,159.23,184.37,8
HCPCS,0077U,IG PARAPROTEIN QUAL BLD/UR,,,43.43,177.97,20
HCPCS,0077U,Ig paraprotein qual bld/ur,,,22.75,26.35,8
HCPCS,0078U,PAIN MGT OPI USE GNOTYP PNL,,,505.18,505.18,1
HCPCS,0078U,Pain mgt opi use gnotyp pnl,,,87.06,100.8,8
HCPCS,00790,Anes iper upr abd nos,,,159.23,184.37,8
HCPCS,00792,Anes iper upr abd prtl hptc,,,159.23,184.37,8
HCPCS,00794,Anes iper upr abd pncrtect,,,159.23,184.37,8
HCPCS,00796,Anes iper upr abd lvr trnspl,,,159.23,184.37,8
HCPCS,00797,Anes iper upr abd gstr px mo,,,159.23,184.37,8
HCPCS,0079U,Cmprtv dna alys mlt snps,,,66.63,77.15,8
HCPCS,00800,Anes px lwr ant abdl wal nos,,,159.23,184.37,8
HCPCS,00802,Anes px lwr abdl wal pannic,,,159.23,184.37,8
HCPCS,0080U,ONC LNG 5 CLIN RSK FACTR ALG,,,3520.0,14424.26,20
HCPCS,0080U,Onc lng 5 clin rsk factr alg,,,533.45,617.68,8
HCPCS,00811,Anes lwr intst ndsc nos,,,159.23,184.37,8
HCPCS,00812,Anes lwr intst scr colsc,,,159.23,184.37,8
HCPCS,00813,Anes upr lwr gi ndsc px,,,159.23,184.37,8
HCPCS,0081A,Adm sarscv2 3mcg trs-sucr 1,,,13.56,15.7,8
HCPCS,00820,Anes px lwr post abdl wall,,,159.23,184.37,8
HCPCS,0082A,Adm sarscv2 3mcg trs-sucr 2,,,13.56,15.7,8
HCPCS,0082U,RX TEST DEF 90+ RX/SBSTS UR,,,246.92,1011.83,20
HCPCS,0082U,Rx test def 90+ rx/sbsts ur,,,59.88,69.33,8
HCPCS,00830,Anes hernia rpr lwr abd nos,,,159.23,184.37,8
HCPCS,00832,Anes hernia repair vnt&incal,,,159.23,184.37,8
HCPCS,00834,Anes hernia repair<1 yr age,,,159.23,184.37,8
HCPCS,00836,Anes hrna rpr<37wk brth<50,,,159.23,184.37,8
HCPCS,0083A,Adm sarscv2 3mcg trs-sucr 3,,,13.56,15.7,8
HCPCS,0083U,ONC RSPSE CHEMO CNTRST TOMOG,,,167.35,685.77,20
HCPCS,0083U,Onc rspse chemo cntrst tomog,,,48.21,55.83,8
HCPCS,00840,Anes iper px lower abd nos,,,159.23,184.37,8
HCPCS,00842,Anes iper px amniocentesis,,,159.23,184.37,8
HCPCS,00844,Anes iper px abdmnprnl rescj,,,159.23,184.37,8
HCPCS,00846,Anes iper px rad hystrectomy,,,159.23,184.37,8
HCPCS,00848,Anes iper px pel exentration,,,159.23,184.37,8
HCPCS,0084A,Fee covid-19 vac 9 res,,,13.56,15.7,8
HCPCS,0084U,RBC DNA GNOTYP 10 BLD GROUPS,,,720.0,2950.42,20
HCPCS,0084U,Rbc dna gnotyp 10 bld groups,,,137.41,159.1,8
HCPCS,00851,Anes iper px tubal ligation,,,159.23,184.37,8
HCPCS,0085T,Breath test heart reject,,,9.33,10.8,8
HCPCS,00860,Anes xtrprtl px lwr abd nos,,,159.23,184.37,8
HCPCS,00862,Anes xtrprtl lwr abd rnl px,,,159.23,184.37,8
HCPCS,00864,Anes xtrprt lwr abd tot cstc,,,159.23,184.37,8
HCPCS,00865,Anes xtrprt lwr abd prst8ect,,,159.23,184.37,8
HCPCS,00866,Anes xtrprt lw abd adrnlctmy,,,159.23,184.37,8
HCPCS,00868,Anes xtrprtl px rnl transpl,,,159.23,184.37,8
HCPCS,0086U,NFCT DS BACT&FNG ORG ID 6+,,,200.0,819.56,20
HCPCS,0086U,Nfct ds bact&fng org id 6+,,,39.01,45.17,8
HCPCS,00870,Anes xtrprtl cystolithotomy,,,159.23,184.37,8
HCPCS,00872,Anes lithotrp esw water bath,,,159.23,184.37,8
HCPCS,00873,Anes lithotrp esw wo wtr bth,,,159.23,184.37,8
HCPCS,0087U,CRD HRT TRNSPL MRNA 1283 GEN,,,3159.42,12946.67,20
HCPCS,0087U,Crd hrt trnspl mrna 1283 gen,,,533.45,617.68,8
HCPCS,00880,Anes maj lwr abd vessel nos,,,159.23,184.37,8
HCPCS,00882,Anes maj lwr adb vsl ivc lig,,,159.23,184.37,8
HCPCS,0088U,TRNSPLJ KDN ALGRFT REJ 1494,,,3159.42,12946.67,20
HCPCS,0088U,Trnsplj kdn algrft rej 1494,,,533.45,617.68,8
HCPCS,0089U,ONC MLNMA PRAME & LINC00518,,,760.0,3114.33,20
HCPCS,0089U,Onc mlnma prame & linc00518,,,137.41,159.1,8
HCPCS,00902,Anes anorectal px,,,159.23,184.37,8
HCPCS,00904,Anes radical perineal px,,,159.23,184.37,8
HCPCS,00906,Anes vulvectomy,,,159.23,184.37,8
HCPCS,00908,Anes perineal prostatectomy,,,159.23,184.37,8
HCPCS,0090U,ONC CUTAN MLNMA MRNA 23 GENE,,,1950.0,7990.71,20
HCPCS,0090U,Onc cutan mlnma mrna 23 gene,,,533.45,617.68,8
HCPCS,00910,Anes transurethral px nos,,,159.23,184.37,8
HCPCS,00912,Anes trurl px rescj bldr tum,,,159.23,184.37,8
HCPCS,00914,Anes trurl px rescj prst8,,,159.23,184.37,8
HCPCS,00916,Anes trurl px rescj bleeding,,,159.23,184.37,8
HCPCS,00918,Anes trurl px urtrl cal rmvl,,,159.23,184.37,8
HCPCS,0091A,Adm sarscov2 50 mcg/.5 ml1st,,,13.56,15.7,8
HCPCS,0091U,Onc clrct scr whl bld alg,,,22.75,26.35,8
HCPCS,00920,Anes px male genitalia nos,,,159.23,184.37,8
HCPCS,00921,Anes px male genitalia vasec,,,159.23,184.37,8
HCPCS,00922,Anes px male gent sem ves,,,159.23,184.37,8
HCPCS,00924,Anes male gent undscnd tstis,,,159.23,184.37,8
HCPCS,00926,Anes male gent rad orch ing,,,159.23,184.37,8
HCPCS,00928,Anes male gent rad orch abd,,,159.23,184.37,8
HCPCS,0092A,Adm sarscov2 50 mcg/.5 ml2nd,,,13.56,15.7,8
HCPCS,0092U,ONC LNG 3 PRTN BMRK PLSM ALG,,,2488.0,10195.33,20
HCPCS,0092U,Onc lng 3 prtn bmrk plsm alg,,,533.45,617.68,8
HCPCS,00930,Anes px male gent orchiopexy,,,159.23,184.37,8
HCPCS,00932,Anes male gent compl amp pns,,,159.23,184.37,8
HCPCS,00934,Anes rad amp penis ingun lym,,,159.23,184.37,8
HCPCS,00936,Anes rad amp pns ingun&ilac,,,159.23,184.37,8
HCPCS,00938,Anes insj penile prosthesis,,,159.23,184.37,8
HCPCS,0093A,Adm sarscov2 50 mcg/.5 ml3rd,,,13.56,15.7,8
HCPCS,0093U,RX MNTR 65 COM DRUGS URINE,,,62.14,254.64,20
HCPCS,0093U,Rx mntr 65 com drugs urine,,,27.64,32.0,8
HCPCS,00940,Anes vaginal px nos,,,159.23,184.37,8
HCPCS,00942,Anes vag px clptmy vgnc clpr,,,159.23,184.37,8
HCPCS,00944,Anes vag px vag hysterectomy,,,159.23,184.37,8
HCPCS,00948,Anes vag px crv cerclage,,,159.23,184.37,8
HCPCS,0094A,Adm sarscov2 50 mcg/.5 mlbst,,,13.56,15.7,8
HCPCS,0094U,GENOME RAPID SEQUENCE ALYS,,,7582.2,31070.34,20
HCPCS,0094U,Genome rapid sequence alys,,,533.45,617.68,8
HCPCS,00950,Anes vag px culdoscopy,,,159.23,184.37,8
HCPCS,00952,Anes vag px hystsc&/hsg,,,159.23,184.37,8
HCPCS,0095T,Rmvl artific disc addl crvcl,,,11158.03,12919.82,8
HCPCS,0095U,EE 2 PRTN BMRK MBP ELISA EST,,,771.98,3163.42,20
HCPCS,0095U,Ee 2 prtn bmrk elisa est,,,137.41,159.1,8
HCPCS,0096U,HPV HI RISK TYPES MALE URINE,,,35.09,143.79,20
HCPCS,0096U,Hpv hi risk types male urine,,,26.69,30.9,8
HCPCS,0097U,Gi pathogen 22 targets,,,39.01,406.73,9
HCPCS,0098T,Rev artific disc addl,,,11158.03,12919.82,8
HCPCS,0098U,Respir pathogen 14 targets,,,39.01,45.17,8
HCPCS,0099U,Respir pathogen 20 targets,,,39.01,45.17,8
HCPCS,0100T,Prosth retina receive&gen,,,1684.99,1951.04,8
HCPCS,0100U,Respir pathogen 21 targets,,,39.01,45.17,8
HCPCS,0101A,Fee covid-19 vac 11 dose 1,,,13.56,15.7,8
HCPCS,0101T,ESW MUSCSKEL SYS NOS,,,221.64,691.37,19
HCPCS,0101T,"EXTRACORP SHOCKWV TX,HI ENRG",180.0,117.0,1.1,1725.52,34
HCPCS,0101T,Esw muscskel sys nos,,,234.24,271.23,8
HCPCS,0101U,HERED COLON CA DO 15 GENES,,,1743.95,7146.36,20
HCPCS,0101U,Hered colon ca do 15 genes,,,533.45,617.68,8
HCPCS,0102A,Fee covid-19 vac 11 dose 2,,,13.56,15.7,8
HCPCS,0102T,ESW PHY ANES LAT HMRL EPCNDL,,,2997.95,9170.92,19
HCPCS,0102T,Esw phy anes lat hmrl epcndl,,,2599.83,3010.33,8
HCPCS,0102U,HERED BRST CA RLTD DO 17 GEN,,,1303.95,5343.33,20
HCPCS,0102U,Hered brst ca rltd do 17 gen,,,533.45,617.68,8
HCPCS,0103A,Fee covid-19 vac 11 booster,,,13.56,15.7,8
HCPCS,0103U,HERED OVA CA PNL 24 GENES,,,1743.95,7146.36,20
HCPCS,0103U,Hered ova ca pnl 24 genes,,,533.45,617.68,8
HCPCS,0104A,Adm sarscov2 5mcg/.5ml as03b,,,13.56,15.7,8
HCPCS,0105U,NEPH CKD MULT ECLIA TUM NEC,,,950.0,3892.91,20
HCPCS,0105U,Neph ckd mult eclia tum nec,,,137.41,159.1,8
HCPCS,0106T,TOUCH QUANT SENSORY TEST,,,35.34,104.69,19
HCPCS,0106T,Touch quant sensory test,,,310.96,360.06,8
HCPCS,0106U,GSTR EMPTG 7 TIMED BRTH SPEC,,,874.49,3583.49,20
HCPCS,0106U,Gstr emptg 7 timed brth spec,,,137.41,159.1,8
HCPCS,0107T,VIBRATE QUANT SENSORY TEST,,,35.34,104.69,19
HCPCS,0107T,Vibrate quant sensory test,,,310.96,360.06,8
HCPCS,0107U,C DIFF TOX AG DETCJ IA STOOL,,,16.0,65.56,20
HCPCS,0107U,C diff tox ag detcj ia stool,,,13.21,15.29,8
HCPCS,0108T,COOL QUANT SENSORY TEST,,,54.88,165.35,19
HCPCS,0108T,Cool quant sensory test,,,310.96,360.06,8
HCPCS,0108U,GI BARRETT ESOPH 9 PRTN BMRK,,,2815.76,20284.11,20
HCPCS,0108U,Gi barrett esoph 9 prtn bmrk,,,533.45,617.68,8
HCPCS,0109T,HEAT QUANT SENSORY TEST,,,35.34,104.69,19
HCPCS,0109T,Heat quant sensory test,,,310.96,360.06,8
HCPCS,0109U,ID ASPERGILLUS DNA 4 SPECIES,,,142.63,584.47,20
HCPCS,0109U,Id aspergillus dna 4 species,,,39.01,45.17,8
HCPCS,0110T,NOS QUANT SENSORY TEST,,,119.1,372.91,19
HCPCS,0110T,Nos quant sensory test,,,310.96,360.06,8
HCPCS,0110U,RX MNTR 1+ORAL ONC RX&SBSTS,,,27.11,111.09,20
HCPCS,0110U,Rx mntr 1+oral onc rx&sbsts,,,23.91,27.69,8
HCPCS,01112,Anes bone marrow aspir&/bx,,,159.23,184.37,8
HCPCS,0111A,Adm sarscov2 25mcg/0.25ml1st,,,13.56,15.7,8
HCPCS,0111T,Rbc membranes fatty acids,,,21.97,25.44,8
HCPCS,0111U,ONC COLON CA KRAS&NRAS ALYS,,,682.29,2795.89,20
HCPCS,0111U,Onc colon ca kras&nras alys,,,137.41,159.1,8
HCPCS,01120,Anes px on bony pelvis,,,159.23,184.37,8
HCPCS,0112A,Adm sarscov2 25mcg/0.25ml2nd,,,13.56,15.7,8
HCPCS,0112U,IADI 16S&18S RRNA GENES,,,356.13,1459.35,20
HCPCS,0112U,Iadi 16s&18s rrna genes,,,39.01,45.17,8
HCPCS,01130,Anes body cast appl/revj,,,159.23,184.37,8
HCPCS,0113A,Adm sarscov2 25mcg/0.25ml3rd,,,13.56,15.7,8
HCPCS,0113U,ONC PRST8 PCA3&TMPRSS2-ERG,,,760.0,3114.33,20
HCPCS,0113U,Onc prst8 pca3&tmprss2-erg,,,137.41,159.1,8
HCPCS,01140,Anes ntrplvabdmnl amputation,,,159.23,184.37,8
HCPCS,0114U,GI BARRETTS ESOPH VIM&CCNA1,,,1938.01,7941.58,20
HCPCS,0114U,Gi barretts esoph vim&ccna1,,,533.45,617.68,8
HCPCS,01150,Anes rad px tumor of pelvis,,,159.23,184.37,8
HCPCS,0115U,RESPIR IADNA 18 VIRAL&2 BACT,,,275.35,1128.33,20
HCPCS,0115U,Respir iadna 18 viral&2 bact,,,92.46,107.06,8
HCPCS,01160,Anes clsd px symph pub/si jt,,,159.23,184.37,8
HCPCS,0116U,RX MNTR NZM IA 35+ORAL FLU,,,246.92,1011.83,20
HCPCS,0116U,Rx mntr nzm ia 35+oral flu,,,59.88,69.33,8
HCPCS,01170,Anes opn px symph pub/si jt,,,159.23,184.37,8
HCPCS,01173,Anes opn rpr fx disrpj plvs,,,159.23,184.37,8
HCPCS,0117U,PAIN MGMT 11 ENDOGENOUS ANAL,,,840.65,3444.82,20
HCPCS,0117U,Pain mgmt 11 endogenous anal,,,137.41,159.1,8
HCPCS,0118U,TRNSPLJ DON-DRV CLL-FR DNA,,,2753.25,11282.27,20
HCPCS,0118U,Trnsplj don-drv cll-fr dna,,,533.45,617.68,8
HCPCS,0119U,CRD CERAMIDES LIQ CHROM PLSM,,,83.76,343.23,20
HCPCS,0119U,Crd ceramides liq chrom plsm,,,29.28,33.9,8
HCPCS,01200,Anes all closed px hip joint,,,159.23,184.37,8
HCPCS,01202,Anes arthroscopic px hip jt,,,159.23,184.37,8
HCPCS,0120U,ONC B CLL LYMPHM MRNA 58 GEN,,,2510.21,10286.34,20
HCPCS,0120U,Onc b cll lymphm mrna 58 gen,,,533.45,617.68,8
HCPCS,01210,Anes open px hip joint nos,,,159.23,184.37,8
HCPCS,01212,Anes open px hip jt disrtcj,,,159.23,184.37,8
HCPCS,01214,Anes open px tot hip arthrp,,,159.23,184.37,8
HCPCS,01215,Anes opn revj tot hip arthrp,,,159.23,184.37,8
HCPCS,0121A,Adm sarscv2 bvl 30mcg/.3ml 1,,,13.56,15.7,8
HCPCS,0121U,SC DIS VCAM-1 WHOLE BLOOD,,,509.2,2086.6,20
HCPCS,0121U,Sc dis vcam-1 whole blood,,,87.06,100.8,8
HCPCS,01220,Anes clsd px upper 2/3 femur,,,159.23,184.37,8
HCPCS,0122U,SC DIS P-SELECTIN WHL BLOOD,,,526.23,2156.39,20
HCPCS,0122U,Sc dis p-selectin whl blood,,,87.06,100.8,8
HCPCS,01230,Anes opn upper 2/3 femur nos,,,159.23,184.37,8
HCPCS,01232,Anes opn px upr 2/3 fem amp,,,159.23,184.37,8
HCPCS,01234,Anes opn upr 2/3 fem rad res,,,159.23,184.37,8
HCPCS,0123U,MCHNL FRAGILITY RBC PRFLG,,,357.63,1465.5,20
HCPCS,0123U,Mchnl fragility rbc prflg,,,87.06,100.8,8
HCPCS,0124A,Adm sarscv2 bvl 30mcg/.3ml a,,,13.56,15.7,8
HCPCS,01250,Anes all px nrv musc upr leg,,,159.23,184.37,8
HCPCS,01260,Anes all px veins upper leg,,,159.23,184.37,8
HCPCS,0126T,Chd risk imt study,,,77.56,89.8,8
HCPCS,01270,Anes px arteries upr leg nos,,,159.23,184.37,8
HCPCS,01272,Anes px art femoral art lig,,,159.23,184.37,8
HCPCS,01274,Anes px art fem art emblc,,,159.23,184.37,8
HCPCS,0129U,HERED BRST CA RLTD DO PANEL,,,1303.95,5343.33,20
HCPCS,0129U,Hered brst ca rltd do panel,,,533.45,617.68,8
HCPCS,0130U,HERED COLON CA DO MRNA PNL,,,584.9,2396.8,20
HCPCS,0130U,Hered colon ca do mrna pnl,,,87.06,100.8,8
HCPCS,0131U,HERED BRST CA RLTD DO PNL 13,,,710.0,795.46,6
HCPCS,0131U,Hered brst ca rltd do pnl 13,,,137.41,159.1,8
HCPCS,01320,Anes all px nrv msc kne&/pop,,,159.23,184.37,8
HCPCS,0132U,HERED OVA CA RLTD DO PNL 17,,,741.64,830.9,6
HCPCS,0132U,Hered ova ca rltd do pnl 17,,,137.41,159.1,8
HCPCS,0133U,HERED PRST8 CA RLTD DO 11,,,690.29,2828.67,20
HCPCS,0133U,Hered prst8 ca rltd do 11,,,137.41,159.1,8
HCPCS,01340,Anes clsd px lower 1/3 femur,,,159.23,184.37,8
HCPCS,0134A,Adm sarscv2 bvl 50mcg/.5ml a,,,13.56,15.7,8
HCPCS,0134U,HERED PAN CA MRNA PNL 18 GEN,,,748.39,3066.75,20
HCPCS,0134U,Hered pan ca mrna pnl 18 gen,,,137.41,159.1,8
HCPCS,0135U,HERED GYN CA MRNA PNL 12 GEN,,,700.56,784.89,6
HCPCS,0135U,Hered gyn ca mrna pnl 12 gen,,,137.41,159.1,8
HCPCS,01360,Anes open px lower 1/3 femur,,,159.23,184.37,8
HCPCS,0136U,ATM MRNA SEQ ALYS,,,407.43,1669.57,20
HCPCS,0136U,Atm mrna seq alys,,,87.06,100.8,8
HCPCS,0137U,PALB2 MRNA SEQ ALYS,,,282.88,1159.19,20
HCPCS,0137U,Palb2 mrna seq alys,,,92.46,107.06,8
HCPCS,01380,Anes all clsd px knee joint,,,159.23,184.37,8
HCPCS,01382,Anes dx arthrs px knee jt,,,159.23,184.37,8
HCPCS,0138U,BRCA1 BRCA2 MRNA SEQ ALYS,,,468.33,1919.12,20
HCPCS,0138U,Brca1 brca2 mrna seq alys,,,87.06,100.8,8
HCPCS,01390,Anes cls px upr tib fib&/pat,,,159.23,184.37,8
HCPCS,01392,Anes opn px upr tib fib&/pat,,,159.23,184.37,8
HCPCS,0139U,NEURO AUSTM MEAS 6 C METABLT,,,840.27,840.27,1
HCPCS,0139U,Neuro austm meas 6 c metablt,,,66.63,77.15,8
HCPCS,01400,Anes opn/arthrs knee jt nos,,,159.23,184.37,8
HCPCS,01402,Anes opn/arth tot kne arthrp,,,159.23,184.37,8
HCPCS,01404,Anes opn/arthrs disrtcj knee,,,159.23,184.37,8
HCPCS,0140U,NFCT DS FUNGI DNA 15 TRGT,,,156.75,642.33,20
HCPCS,0140U,Nfct ds fungi dna 15 trgt,,,26.69,30.9,8
HCPCS,0141A,Adm srscv2 bvl 25mcg/.25ml 1,,,13.56,15.7,8
HCPCS,0141U,NFCT DS BACT&FNG GRAM POS,,,156.75,642.33,20
HCPCS,0141U,Nfct ds bact&fng gram pos,,,39.01,45.17,8
HCPCS,01420,Anes cst appl rmv/rpr kne jt,,,159.23,184.37,8
HCPCS,0142A,Adm srscv2 bvl 25mcg/.25ml 2,,,13.56,15.7,8
HCPCS,0142U,NFCT DS BACT&FNG GRAM NEG,,,156.75,642.33,20
HCPCS,0142U,Nfct ds bact&fng gram neg,,,39.01,45.17,8
HCPCS,01430,Anes px veins knee&pop nos,,,159.23,184.37,8
HCPCS,01432,Anes px vn knee&pop av fstl,,,159.23,184.37,8
HCPCS,0143U,DRUG ASSAY 120+ RX/METABLT,,,128.2,128.2,1
HCPCS,0143U,Drug assay 120+ rx/metablt,,,59.88,69.33,8
HCPCS,01440,Anes px art knee&pop nos,,,159.23,184.37,8
HCPCS,01442,Anes px art knee&pop teaec,,,159.23,184.37,8
HCPCS,01444,Anes px art knee&pop exc&grf,,,159.23,184.37,8
HCPCS,0144A,Adm srscv2 bvl 25mcg/.25ml a,,,13.56,15.7,8
HCPCS,0144U,DRUG ASSAY 160+ RX/METABLT,,,128.2,128.2,1
HCPCS,0144U,Drug assay 160+ rx/metablt,,,59.88,69.33,8
HCPCS,0145U,DRUG ASSAY 65+ RX/METABLT,,,128.2,128.2,1
HCPCS,0145U,Drug assay 65+ rx/metablt,,,27.64,32.0,8
HCPCS,01462,Anes clsd px lower l/a/f,,,159.23,184.37,8
HCPCS,01464,Anes arthrs px ankle&/foot,,,159.23,184.37,8
HCPCS,0146U,DRUG ASSAY 80+ RX/METABLT,,,128.2,128.2,1
HCPCS,0146U,Drug assay 80+ rx/metablt,,,27.64,32.0,8
HCPCS,01470,Anes px nrv msc lw l/a/f nos,,,159.23,184.37,8
HCPCS,01472,Anes rpr rpt achilles tendon,,,159.23,184.37,8
HCPCS,01474,Anes gastrocnemius recession,,,159.23,184.37,8
HCPCS,0147U,DRUG ASSAY 85+ RX/METABLT,,,128.2,128.2,1
HCPCS,0147U,Drug assay 85+ rx/metablt,,,27.64,32.0,8
HCPCS,01480,Anes open px lower l/a/f nos,,,159.23,184.37,8
HCPCS,01482,Anes opn lwr l/a/f rad rescj,,,159.23,184.37,8
HCPCS,01484,Anes opn lw l/a/f oste/ostpl,,,159.23,184.37,8
HCPCS,01486,Anes open total ankle rplcmt,,,159.23,184.37,8
HCPCS,0148U,DRUG ASSAY 100+ RX/METABLT,,,128.2,128.2,1
HCPCS,0148U,Drug assay 100+ rx/metablt,,,27.64,32.0,8
HCPCS,01490,Anes lwr leg cst app rmv/rpr,,,159.23,184.37,8
HCPCS,0149U,DRUG ASSAY 60+ RX/METABLT,,,128.2,128.2,1
HCPCS,0149U,Drug assay 60+ rx/metablt,,,27.64,32.0,8
HCPCS,01500,Anes px art lower leg nos,,,159.23,184.37,8
HCPCS,01502,Anes px art lower leg emblc,,,159.23,184.37,8
HCPCS,0150U,DRUG ASSAY 120+ RX/METABLT,,,128.2,128.2,1
HCPCS,0150U,Drug assay 120+ rx/metablt,,,27.64,32.0,8
HCPCS,0151A,Adm sarscv2 bvl 10mcg/.2ml 1,,,13.56,15.7,8
HCPCS,0151U,Nfct bct/vir resp nfctj 33,,,39.01,214.1,9
HCPCS,01520,Anes px veins lower leg nos,,,159.23,184.37,8
HCPCS,01522,Anes px vn lwr leg ven thrmb,,,159.23,184.37,8
HCPCS,0152U,MICROBIAL CELL-FREE DNA BY NGS,14671.0,9536.15,75.0,14671.0,60
HCPCS,0153U,ONC BREAST MRNA 101 GENES,,,3159.42,12946.67,20
HCPCS,0153U,Onc breast mrna 101 genes,,,87.06,100.8,8
HCPCS,0154A,Adm sarscv2 bvl 10mcg/.2ml a,,,13.56,15.7,8
HCPCS,0154U,ONC URTHL CA RNA FGFR3 GENE,,,482.14,1975.71,20
HCPCS,0154U,Onc urthl ca rna fgfr3 gene,,,87.06,100.8,8
HCPCS,0155U,ONC BRST CA DNA PIK3CA GENE,,,274.83,1126.2,20
HCPCS,0155U,Onc brst ca dna pik3ca gene,,,92.46,107.06,8
HCPCS,0156U,COPY NUMBER SEQUENCE ALYS,,,1740.0,7130.17,20
HCPCS,0156U,Copy number sequence alys,,,66.63,77.15,8
HCPCS,0157U,APC MRNA SEQ ALYS,,,282.88,1159.19,20
HCPCS,0157U,Apc mrna seq alys,,,87.06,100.8,8
HCPCS,0158U,MLH1 MRNA SEQ ALYS,,,282.88,1159.19,20
HCPCS,0158U,Mlh1 mrna seq alys,,,66.63,77.15,8
HCPCS,0159U,MSH2 MRNA SEQ ALYS,,,282.88,1159.19,20
HCPCS,0159U,Msh2 mrna seq alys,,,66.63,77.15,8
HCPCS,0160U,MSH6 MRNA SEQ ALYS,,,282.88,1159.19,20
HCPCS,0160U,Msh6 mrna seq alys,,,66.63,77.15,8
HCPCS,01610,Anes all px nrv musc sho&ax,,,159.23,184.37,8
HCPCS,0161U,PMS2 MRNA SEQ ALYS,,,282.88,1159.19,20
HCPCS,0161U,Pms2 mrna seq alys,,,87.06,100.8,8
HCPCS,01620,Anes clsd px shoulder joint,,,159.23,184.37,8
HCPCS,01622,Anes dx arthr px shoulder jt,,,159.23,184.37,8
HCPCS,0162U,HERED COLON CA TRGT MRNA PNL,,,486.54,1993.74,20
HCPCS,0162U,Hered colon ca trgt mrna pnl,,,87.06,100.8,8
HCPCS,01630,Anes opn/arthr px sho jt nos,,,159.23,184.37,8
HCPCS,01634,Anes open/arthrs sho disrtcj,,,159.23,184.37,8
HCPCS,01636,Anes open/arthr ntrthrc amp,,,159.23,184.37,8
HCPCS,01638,Anes opn/arthr tot sho rplcm,,,159.23,184.37,8
HCPCS,0163T,Tot disc arthrp ea addl lmbr,,,11158.03,12919.82,8
HCPCS,0163U,ONC CLRCT SCR 3 PRTN ALG,,,437.78,1601.22,4
HCPCS,0163U,Onc clrct scr 3 prtn alg,,,66.63,77.15,8
HCPCS,0164A,Adm srscv2 bvl 10mcg/0.2ml a,,,13.56,15.7,8
HCPCS,0164T,Remove lumb artif disc addl,,,11158.03,12919.82,8
HCPCS,0164U,GI IBS IA ANTI-CDTB&VINCULIN,,,112.02,459.04,20
HCPCS,0164U,Gi ibs ia anti-cdtb&vinculin,,,92.46,107.06,8
HCPCS,01650,Anes art sho&ax nos,,,159.23,184.37,8
HCPCS,01652,Anes art sho&ax ax-brch arsm,,,159.23,184.37,8
HCPCS,01654,Anes art sho&ax bypass grf,,,159.23,184.37,8
HCPCS,01656,Anes art sho&ax ax-fem bpg,,,159.23,184.37,8
HCPCS,0165T,Revise lumb artif disc addl,,,11158.03,12919.82,8
HCPCS,0165U,PEANUT ALLG ASMT EPI PRB ALL,,,463.76,1900.4,20
HCPCS,0165U,Peanut allg asmt epi,,,22.75,26.35,8
HCPCS,0166U,LIVER DS 10 BIOCHEM ASY SRM,,,503.4,2062.83,20
HCPCS,0166U,Liver ds 10 biochem asy srm,,,87.06,100.8,8
HCPCS,01670,Anes all px vn shoulder&ax,,,159.23,184.37,8
HCPCS,0167U,CHORNC GONADOTROPIN HCG IA,,,8.42,8.42,1
HCPCS,0167U,Chornc gonadotropin hcg ia,,,17.46,20.22,8
HCPCS,01680,Anes sho cast appl rmvl/rpr,,,159.23,184.37,8
HCPCS,0168U,FTL ANEUPLOIDY DNA SEQ ALYS,,,850.41,850.41,1
HCPCS,0168U,Ftl aneuploidy dna seq alys,,,137.41,159.1,8
HCPCS,0169U,NUDT15&TPMT GENE COM VRNT,,,466.17,1910.27,20
HCPCS,0169U,Nudt15&tpmt gene com vrnt,,,87.06,100.8,8
HCPCS,0170U,NEURO ASD RNA NEXT GEN SEQ,,,1950.0,7990.71,20
HCPCS,0170U,Neuro asd rna next gen seq,,,533.45,617.68,8
HCPCS,01710,Anes px nrv musc upr a&e nos,,,159.23,184.37,8
HCPCS,01712,Anes px nrv msc upr a&e tnot,,,159.23,184.37,8
HCPCS,01714,Anes nrv msc upr a&e tnplsty,,,159.23,184.37,8
HCPCS,01716,Anes nrv msc upr a&e tndsis,,,159.23,184.37,8
HCPCS,0171A,Adm sarscv2 bvl 3mcg/0.2ml 1,,,13.56,15.7,8
HCPCS,0171U,TRGT GEN SEQ ALYS PNL DNA 23,,,1519.06,6224.8,20
HCPCS,0171U,Trgt gen seq alys pnl dna 23,,,87.06,100.8,8
HCPCS,0172A,Adm sarscv2 bvl 3mcg/0.2ml 2,,,13.56,15.7,8
HCPCS,0172U,ONC SLD TUM ALYS BRCA1 BRCA2,,,3030.0,12416.33,20
HCPCS,0172U,Onc sld tum alys brca1 brca2,,,533.45,617.68,8
HCPCS,01730,Anes clsd px humerus&elbow,,,159.23,184.37,8
HCPCS,01732,Anes dx arthrs px elbow jt,,,159.23,184.37,8
HCPCS,0173A,Adm sarscv2 bvl 3mcg/0.2ml 3,,,13.56,15.7,8
HCPCS,0173U,PSYC GEN ALYS PANEL 14 GENES,,,466.17,1910.27,20
HCPCS,0173U,Psyc gen alys panel 14 genes,,,66.63,77.15,8
HCPCS,01740,Anes opn/arthrs px elbw nos,,,159.23,184.37,8
HCPCS,01742,Anes opn/arthrs elbw osteot,,,159.23,184.37,8
HCPCS,01744,Anes opn/arthrs elbw rpr hum,,,159.23,184.37,8
HCPCS,0174A,Adm sarscv2 bvl 3mcg/0.2ml a,,,13.56,15.7,8
HCPCS,0174T,Cad cxr with interp,,,68.91,79.79,8
HCPCS,0174U,ONC SOLID TUMOR 30 PRTN TRGT,,,1305.37,5349.15,20
HCPCS,0174U,Onc solid tumor 30 prtn trgt,,,66.63,77.15,8
HCPCS,01756,Anes opn/arthrs elbw rad px,,,159.23,184.37,8
HCPCS,01758,Anes opn/arthrs elbw exc cst,,,159.23,184.37,8
HCPCS,0175T,Cad cxr remote,,,68.91,79.79,8
HCPCS,0175U,PSYC GEN ALYS PANEL 15 GENES,,,1336.09,5475.03,20
HCPCS,0175U,Psyc gen alys panel 15 genes,,,533.45,617.68,8
HCPCS,01760,Anes opn/arthr elb tot rplct,,,159.23,184.37,8
HCPCS,0176U,CDTB&VINCULIN IGG ANTB IA,,,64.19,263.04,20
HCPCS,0176U,Cdtb&vinculin igg antb ia,,,22.75,26.35,8
HCPCS,01770,Anes px art upr arm&elbw nos,,,159.23,184.37,8
HCPCS,01772,Anes art upr arm&elbw emblc,,,159.23,184.37,8
HCPCS,0177U,ONC BRST CA DNA PIK3CA 11,,,274.83,1126.2,20
HCPCS,0177U,Onc brst ca dna pik3ca 11,,,92.46,107.06,8
HCPCS,01780,Anes px vn upr arm&elbw nos,,,159.23,184.37,8
HCPCS,01782,Anes vn upr arm&elbw phlbrpy,,,159.23,184.37,8
HCPCS,0178U,PEANUT ALLG ASMT EPI CLIN RX,,,459.86,1884.41,20
HCPCS,0178U,Peanut allg asmt epi clin rx,,,18.32,21.21,8
HCPCS,0179U,ONC NONSM CLL LNG CA ALYS 23,,,1943.21,7962.89,20
HCPCS,0179U,Onc nonsm cll lng ca alys 23,,,66.63,77.15,8
HCPCS,0180U,ABO GNOTYP ABO 7 EXONS,,,274.83,1126.2,20
HCPCS,0180U,Abo gnotyp abo 7 exons,,,66.63,77.15,8
HCPCS,01810,Anes px nrv musc f/arm wrst,,,159.23,184.37,8
HCPCS,0181U,CO GNOTYP AQP1 EXON 1,,,185.2,758.91,20
HCPCS,0181U,Co gnotyp aqp1 exon 1,,,92.46,107.06,8
HCPCS,01820,Anes clsd px rds u/w/h bones,,,159.23,184.37,8
HCPCS,01829,Anes dx arthroscopic px wrst,,,159.23,184.37,8
HCPCS,0182U,CROM GNOTYP CD55 EXONS 1-10,,,301.35,1234.87,20
HCPCS,0182U,Crom gnotyp cd55 exons 1-10,,,92.46,107.06,8
HCPCS,01830,Anes arthr/ndsc wrst/hnd nos,,,159.23,184.37,8
HCPCS,01832,Anes arthr/ndsc tot wrst rpl,,,159.23,184.37,8
HCPCS,0183U,DI GNOTYP SLC4A1 EXON 19,,,185.2,758.91,20
HCPCS,0183U,Di gnotyp slc4a1 exon 19,,,92.46,107.06,8
HCPCS,01840,Anes art f/arm wrst&hnd nos,,,159.23,184.37,8
HCPCS,01842,Anes art farm wrst&hnd emblc,,,159.23,184.37,8
HCPCS,01844,Anes vasc shunt/shunt revj,,,159.23,184.37,8
HCPCS,0184T,EXC RECTAL TUMOR ENDOSCOPIC,,,5500.28,17015.8,19
HCPCS,0184T,Exc rectal tumor endoscopic,,,1457.88,1688.07,8
HCPCS,0184T,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,7239.0,4705.35,1.1,9730.56,34
HCPCS,0184U,DO GNOTYP ART4 EXON 2,,,185.2,758.91,20
HCPCS,0184U,Do gnotyp art4 exon 2,,,92.46,107.06,8
HCPCS,01850,Anes vein f/arm wrst&hnd nos,,,159.23,184.37,8
HCPCS,01852,Anes px vn f/arm phlbrrhaphy,,,159.23,184.37,8
HCPCS,0185U,FUT1 GNOTYP FUT1 EXON 4,,,185.2,758.91,20
HCPCS,0185U,Fut1 gnotyp fut1 exon 4,,,92.46,107.06,8
HCPCS,01860,Anes forearm wrist/hand cast,,,159.23,184.37,8
HCPCS,0186U,FUT2 GNOTYP FUT2 EXON 2,,,185.2,758.91,20
HCPCS,0186U,Fut2 gnotyp fut2 exon 2,,,92.46,107.06,8
HCPCS,0187U,FY GNOTYP ACKR1 EXONS 1-2,,,274.83,1126.2,20
HCPCS,0187U,Fy gnotyp ackr1 exons 1-2,,,92.46,107.06,8
HCPCS,0188U,GE GNOTYP GYPC EXONS 1-4,,,274.83,1126.2,20
HCPCS,0188U,Ge gnotyp gypc exons 1-4,,,92.46,107.06,8
HCPCS,0189U,GYPA GNOTYP NTRNS 1 5 EXON 2,,,274.83,1126.2,20
HCPCS,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,92.46,107.06,8
HCPCS,0190U,GYPB GNOTYP NTRNS 1 5 SEUX 3,,,274.83,1126.2,20
HCPCS,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,92.46,107.06,8
HCPCS,01916,Anes dx arteriography/vngrph,,,159.23,184.37,8
HCPCS,0191T,Insert ant segment drain int,,,1921.59,2225.0,8
HCPCS,0191U,IN GNOTYP CD44 EXONS 2 3 6,,,274.83,1126.2,20
HCPCS,0191U,In gnotyp cd44 exons 2 3 6,,,92.46,107.06,8
HCPCS,01920,Anes cardiac catheterization,,,159.23,184.37,8
HCPCS,01922,Anes n-invas img/radj ther,,,159.23,184.37,8
HCPCS,01924,Anes ther ivntl rad artl nos,,,159.23,184.37,8
HCPCS,01925,Anes ivntl rad artl crtd/c,,,159.23,184.37,8
HCPCS,01926,Anes ivntl rad icr icar/aort,,,159.23,184.37,8
HCPCS,0192U,JK GNOTYP SLC14A1 EXON 9,,,274.83,1126.2,20
HCPCS,0192U,Jk gnotyp slc14a1 exon 9,,,92.46,107.06,8
HCPCS,01930,Anes ther ivntl rad ven nos,,,159.23,184.37,8
HCPCS,01931,Anes ivnt rad ntrhpt/prt crc,,,159.23,184.37,8
HCPCS,01932,Anes th ivnt rad ntrthrc/jug,,,159.23,184.37,8
HCPCS,01933,Anes ther ivntl rad px icr,,,159.23,184.37,8
HCPCS,01935,Anesth perc img dx sp proc,,,159.23,184.37,8
HCPCS,01936,Anesth perc img tx sp proc,,,159.23,184.37,8
HCPCS,01937,Anes drg/aspir crv/thrc,,,159.23,184.37,8
HCPCS,01938,Anes drg/aspir lmbr/sac,,,159.23,184.37,8
HCPCS,01939,Anes nulyt agt crv/thrc,,,159.23,184.37,8
HCPCS,0193U,JR GNOTYP ABCG2 EXONS 2-26,,,282.88,1159.19,20
HCPCS,0193U,Jr gnotyp abcg2 exons 2-26,,,92.46,107.06,8
HCPCS,01940,Anes nulyt agt lmbr/sac,,,159.23,184.37,8
HCPCS,01941,Anes neuromd/ntrvrt crv/thrc,,,159.23,184.37,8
HCPCS,01942,Anes neuromd/ntrvrt lmbr/sac,,,159.23,184.37,8
HCPCS,0194U,KEL GNOTYP KEL EXON 8,,,185.2,758.91,20
HCPCS,0194U,Kel gnotyp kel exon 8,,,92.46,107.06,8
HCPCS,01951,Anes 2&3 burn less 4 % tbsa,,,159.23,184.37,8
HCPCS,01952,Anes 2&3 burn 4-9% tbsa,,,159.23,184.37,8
HCPCS,01953,Anes 2&3 burn ea add 9% tbsa,,,159.23,184.37,8
HCPCS,01958,Anes xtrnl cephalic version,,,159.23,184.37,8
HCPCS,0195U,KLF1 TARGETED SEQUENCING,,,375.25,1537.7,20
HCPCS,0195U,Klf1 targeted sequencing,,,87.06,100.8,8
HCPCS,01960,Anes vaginal delivery only,,,159.23,184.37,8
HCPCS,01961,Anes cesarean delivery only,,,159.23,184.37,8
HCPCS,01962,Anes urgent hysterectomy,,,159.23,184.37,8
HCPCS,01963,Anes cesarean hysterectomy,,,159.23,184.37,8
HCPCS,01965,Anes incompl/missed ab px,,,159.23,184.37,8
HCPCS,01966,Anes induced abortion px,,,159.23,184.37,8
HCPCS,01967,Neuraxl lbr anes vag dlvr,,,159.23,184.37,8
HCPCS,01968,Anes/analg cs dlvr neuraxial,,,159.23,184.37,8
HCPCS,01969,Anes c hyst flwg neuraxial,,,159.23,184.37,8
HCPCS,0196U,LU GNOTYP BCAM EXON 3,,,185.2,758.91,20
HCPCS,0196U,Lu gnotyp bcam exon 3,,,92.46,107.06,8
HCPCS,0197U,LW GNOTYP ICAM4 EXON 1,,,185.2,758.91,20
HCPCS,0197U,Lw gnotyp icam4 exon 1,,,92.46,107.06,8
HCPCS,0198T,OCULAR BLOOD FLOW MEASURE,,,119.1,372.91,19
HCPCS,0198T,Ocular blood flow measure,,,38.61,44.7,8
HCPCS,0198U,RHD&RHCE GNTYP RHD1-10&RHCE5,,,282.88,1159.19,20
HCPCS,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,92.46,107.06,8
HCPCS,01990,Physiol support hrvg organs,,,159.23,184.37,8
HCPCS,01991,Anes dx/ther nrv blk&inj oth,,,159.23,184.37,8
HCPCS,01992,Anes dx/ther nrv blk&inj prn,,,159.23,184.37,8
HCPCS,01996,Dly hosp mgmt edrl rx admin,,,159.23,184.37,8
HCPCS,01999,Unlisted anes procedure,,,159.23,184.37,8
HCPCS,0199U,SC GNOTYP ERMAP EXONS 4 12,,,274.83,1126.2,20
HCPCS,0199U,Sc gnotyp ermap exons 4 12,,,92.46,107.06,8
HCPCS,0200T,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,18899.0,12284.35,3026.0,20338.07,122
HCPCS,0200U,XK GNOTYP XK EXONS 1-3,,,274.83,1126.2,20
HCPCS,0200U,Xk gnotyp xk exons 1-3,,,92.46,107.06,8
HCPCS,0201T,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,20703.0,13456.95,1.1,28575.0,92
HCPCS,0201U,YT GNOTYP ACHE EXON 2,,,185.2,758.91,20
HCPCS,0201U,Yt gnotyp ache exon 2,,,92.46,107.06,8
HCPCS,0202T,POST VERT ARTHRPLST 1 LUMBAR,,,12146.38,35984.87,13
HCPCS,0202T,Post vert arthrplst 1 lumbar,,,3026.0,3503.79,8
HCPCS,0202U,"FILM ARRAY, RESPIRATORY 22 TARGETS",2876.0,1869.4,87.06,2876.0,60
HCPCS,0203U,AI IBD MRNA XPRSN PRFL 17,,,760.0,3114.33,20
HCPCS,0203U,Ai ibd mrna xprsn prfl 17,,,137.41,159.1,8
HCPCS,0204U,ONC THYR MRNA XPRSN ALYS 593,,,3271.01,3271.01,1
HCPCS,0204U,Onc thyr mrna xprsn alys 593,,,533.45,617.68,8
HCPCS,0205U,OPH AMD ALYS 3 GENE VARIANTS,,,47.0,192.6,20
HCPCS,0205U,Oph amd alys 3 gene variants,,,66.63,77.15,8
HCPCS,0206U,NEURO ALZHEIMER CELL AGGREGJ,,,2215.4,9078.27,20
HCPCS,0206U,Neuro alzheimer cell aggregj,,,66.63,77.15,8
HCPCS,0207T,CLEAR EYELID GLAND W/HEAT,,,119.1,372.91,19
HCPCS,0207T,Clear eyelid gland w/heat,,,38.61,44.7,8
HCPCS,0207U,NEURO ALZHEIMER QUAN IMAGING,,,572.73,2094.8,4
HCPCS,0207U,Neuro alzheimer quan imaging,,,92.46,107.06,8
HCPCS,0208T,AUDIOMETRY AIR ONLY,,,35.34,104.69,19
HCPCS,0208T,Audiometry air only,,,31.75,36.76,8
HCPCS,0208U,Onc mtc mrna xprsn alys 108,,,87.06,100.8,8
HCPCS,0209T,AUDIOMETRY AIR & BONE,,,35.34,104.69,19
HCPCS,0209T,Audiometry air & bone,,,31.75,36.76,8
HCPCS,0209U,CYTOG CONST ALYS INTERROG,,,787.15,3225.58,20
HCPCS,0209U,Cytog const alys interrog,,,66.63,77.15,8
HCPCS,0210T,SPEECH AUDIOMETRY THRESHOLD,,,35.34,104.69,19
HCPCS,0210T,Speech audiometry threshold,,,31.75,36.76,8
HCPCS,0210U,SYPHILIS TST ANTB IA QUAN,,,18.63,76.34,20
HCPCS,0210U,Syphilis tst antb ia quan,,,18.32,21.21,8
HCPCS,0211T,SPEECH AUDIOM THRESH & RECOG,,,35.34,104.69,19
HCPCS,0211T,Speech audiom thresh & recog,,,31.75,36.76,8
HCPCS,0211U,ONC PAN-TUMOR DNA&RNA NEXT-GENERATION SEQUENCING-CARIS,58339.0,37920.35,533.45,58339.0,55
HCPCS,0212T,COMPRE AUDIOMETRY EVALUATION,,,121.73,360.65,19
HCPCS,0212T,Compre audiometry evaluation,,,31.75,36.76,8
HCPCS,0212U,RARE DS GEN DNA ALYS PROBAND,,,5475.2,22436.27,20
HCPCS,0212U,Rare ds gen dna alys proband,,,66.63,77.15,8
HCPCS,0213T,NJX PARAVERT W/US CER/THOR,,,822.61,2479.04,19
HCPCS,0213T,Njx paravert w/us cer/thor,,,448.9,519.78,8
HCPCS,0213U,RARE DS GEN DNA ALYS EA COMP,,,2709.95,11104.83,20
HCPCS,0213U,Rare ds gen dna alys ea comp,,,66.63,77.15,8
HCPCS,0214T,Njx paravert w/us cer/thor,,,448.9,519.78,8
HCPCS,0214U,RARE DS XOM DNA ALYS PROBAND,,,5224.6,21409.37,20
HCPCS,0214U,Rare ds xom dna alys proband,,,533.45,617.68,8
HCPCS,0215T,Njx paravert w/us cer/thor,,,448.9,519.78,8
HCPCS,0215U,RARE DS XOM DNA ALYS EA COMP,,,2574.65,10550.4,20
HCPCS,0215U,Rare ds xom dna alys ea comp,,,533.45,617.68,8
HCPCS,0216T,NJX PARAVERT W/US LUMB/SAC,,,822.61,2479.04,19
HCPCS,0216T,Njx paravert w/us lumb/sac,,,448.9,519.78,8
HCPCS,0216U,NEURO INH ATAXIA DNA 12 COM,,,1537.02,6298.4,20
HCPCS,0216U,Neuro inh ataxia dna 12 com,,,66.63,77.15,8
HCPCS,0217T,Njx paravert w/us lumb/sac,,,448.9,519.78,8
HCPCS,0217U,NEURO INH ATAXIA DNA 51 GENE,,,2198.35,9008.4,20
HCPCS,0217U,Neuro inh ataxia dna 51 gene,,,66.63,77.15,8
HCPCS,0218T,Njx paravert w/us lumb/sac,,,448.9,519.78,8
HCPCS,0218U,NEURO MUSC DYS DMD SEQ ALYS,,,2279.0,9338.89,20
HCPCS,0218U,Neuro musc dys dmd seq alys,,,533.45,617.68,8
HCPCS,0219T,PLMT POST FACET IMPLT CERV,,,12146.38,35984.87,13
HCPCS,0219T,Plmt post facet implt cerv,,,11158.03,12919.82,8
HCPCS,0219U,NFCT AGT HIV GNRJ SEQ ALYS,,,725.0,2970.91,20
HCPCS,0219U,Nfct agt hiv gnrj seq alys,,,22.75,26.35,8
HCPCS,0220T,PLMT POST FACET IMPLT THOR,,,12146.38,35984.87,13
HCPCS,0220T,Plmt post facet implt thor,,,7403.35,8572.3,8
HCPCS,0220U,ONC BRST CA AI ASSMT 12 FEAT,,,706.25,2894.07,20
HCPCS,0220U,Onc brst ca ai assmt 12 feat,,,36.09,41.79,8
HCPCS,0221T,PLMT POST FACET IMPLT LUMB,,,6600.66,20338.07,19
HCPCS,0221T,Plmt post facet implt lumb,,,3026.0,3503.79,8
HCPCS,0221U,ABO GNOTYP NEXT GNRJ SEQ ABO,,,274.83,1126.2,20
HCPCS,0221U,Abo gnotyp next gnrj seq abo,,,66.63,77.15,8
HCPCS,0222T,Plmt post facet implt addl,,,3026.0,3503.79,8
HCPCS,0222U,RHD&RHCE GNTYP NEXT GNRJ SEQ,,,282.88,1159.19,20
HCPCS,0222U,Rhd&rhce gntyp next gnrj seq,,,66.63,77.15,8
HCPCS,0223U,NFCT DS 22 TRGT SARS-COV-2,,,416.78,1707.88,20
HCPCS,0223U,Nfct ds 22 trgt sars-cov-2,,,39.01,45.17,8
HCPCS,0224U,ANTIBODY SARS-COV-2 TITER(S),,,42.13,210.75,21
HCPCS,0224U,Antibody sars-cov-2 titer(s),,,26.69,30.9,8
HCPCS,0225U,NFCT DS DNA&RNA 21 SARSCOV2,,,416.78,1707.88,20
HCPCS,0225U,Nfct ds dna&rna 21 sarscov2,,,39.01,45.17,8
HCPCS,0226U,SVNT SARSCOV2 ELISA PLSM SRM,,,42.28,173.25,21
HCPCS,0226U,Svnt sarscov2 elisa plsm srm,,,22.75,26.35,8
HCPCS,0227U,RX ASY PRSMV 30+RX/METABLT,,,62.14,254.64,20
HCPCS,0227U,Rx asy prsmv 30+rx/metablt,,,27.64,32.0,8
HCPCS,0228T,Njx tfrml eprl w/us cer/thor,,,448.9,519.78,8
HCPCS,0228U,ONC PRST8 MA MOLEC PRFL ALG,,,173.03,709.04,19
HCPCS,0228U,Onc prst8 ma molec prfl alg,,,87.06,100.8,8
HCPCS,0229T,Njx tfrml eprl w/us cer/thor,,,448.9,519.78,8
HCPCS,0229U,BCAT1&IKZF1 PRMTR MTHLN ALYS,,,215.11,1573.56,20
HCPCS,0229U,Bcat1&ikzf1 prmtr mthyln aly,,,87.06,100.8,8
HCPCS,0230T,Njx tfrml eprl w/us lumb/sac,,,448.9,519.78,8
HCPCS,0230U,AR FULL SEQUENCE ANALYSIS,,,301.35,1234.87,20
HCPCS,0230U,Ar full sequence analysis,,,92.46,107.06,8
HCPCS,0231T,Njx tfrml eprl w/us lumb/sac,,,448.9,519.78,8
HCPCS,0231U,CACNA1A FULL GENE ANALYSIS,,,846.27,3467.85,20
HCPCS,0231U,Cacna1a full gene analysis,,,137.41,159.1,8
HCPCS,0232T,NJX PLATELET PLASMA,750.0,487.5,1.1,1039.24,32
HCPCS,0232T,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,1173.0,762.45,0.01,1596.0,93
HCPCS,0232T,PRP WITH EXOMES,1250.0,812.5,1.1,1250.0,32
HCPCS,0232U,CSTB FULL GENE ANALYSIS,,,274.83,1126.2,20
HCPCS,0232U,Cstb full gene analysis,,,92.46,107.06,8
HCPCS,0233U,FXN GENE ANALYSIS,,,274.83,1126.2,20
HCPCS,0233U,Fxn gene analysis,,,92.46,107.06,8
HCPCS,0234T,TRLUML PERIP ATHRC RENAL ART,,,10478.46,32356.61,19
HCPCS,0234T,Trluml perip athrc renal art,,,8291.28,9600.43,8
HCPCS,0234U,MECP2 FULL GENE ANALYSIS,,,527.87,2163.11,20
HCPCS,0234U,Mecp2 full gene analysis,,,87.06,100.8,8
HCPCS,0235T,Trluml perip athrc visceral,,,3708.64,4294.21,8
HCPCS,0235U,PTEN FULL GENE ANALYSIS,,,600.0,2458.68,20
HCPCS,0235U,Pten full gene analysis,,,87.06,100.8,8
HCPCS,0236T,TRLUML PERIP ATHRC ABD AORTA,,,10478.46,32356.61,19
HCPCS,0236T,Trluml perip athrc abd aorta,,,6695.97,7753.23,8
HCPCS,0236U,SMN1&SMN2 FULL GENE ANALYSIS,,,602.7,2469.74,20
HCPCS,0236U,Smn1&smn2 full gene analysis,,,137.41,159.1,8
HCPCS,0237T,TRLUML PERIP ATHRC BRCHIOCPH,,,10478.46,32356.61,19
HCPCS,0237T,Trluml perip athrc brchiocph,,,6695.97,7753.23,8
HCPCS,0237U,CAR ION CHNLPTHY GEN SEQ PNL,,,584.9,2396.8,20
HCPCS,0237U,Car ion chnlpthy gen seq pnl,,,87.06,100.8,8
HCPCS,0238T,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,38384.0,24949.6,6695.97,51380.79,183
HCPCS,0238U,ONC LNCH SYN GEN DNA SEQ ALY,,,584.9,2396.8,20
HCPCS,0238U,Onc lnch syn gen dna seq aly,,,87.06,100.8,8
HCPCS,0239U,TRGT GEN SEQ ALYS PNL 311+,,,3500.0,14342.3,20
HCPCS,0239U,Trgt gen seq alys pnl 311+,,,533.45,617.68,8
HCPCS,0240U,NFCT DS VIR RESP RNA 3 TRGT,,,142.63,159.8,8
HCPCS,0240U,Nfct ds vir resp rna 3 trgt,,,26.69,30.9,8
HCPCS,0240UQW,NFCT DS VIR RESP RNA 3 TRGT,,,159.8,159.8,1
HCPCS,0241U,NFCT DS VIR RESP RNA 4 TRGT,,,142.63,159.8,8
HCPCS,0241U,Nfct ds vir resp rna 4 trgt,,,26.69,30.9,8
HCPCS,0241UQW,NFCT DS VIR RESP RNA 4 TRGT,,,159.8,159.8,1
HCPCS,0242U,TRGT GEN SEQ ALYS PNL 55-74,,,5000.0,20489.0,20
HCPCS,0242U,Trgt gen seq alys pnl 55-74,,,533.45,617.68,8
HCPCS,0243U,OB PE BIOCHEM ASSAY PGF ALG,,,64.41,263.94,20
HCPCS,0243U,Ob pe biochem assay pgf alg,,,66.63,77.15,8
HCPCS,0244U,ONC SOLID ORGN DNA 257 GENES,,,3500.0,14342.3,20
HCPCS,0244U,Onc solid orgn dna 257 genes,,,87.06,100.8,8
HCPCS,0245U,ONC THYR MUT ALYS 10 GEN&37,,,1266.07,5188.1,19
HCPCS,0245U,Onc thyr mut alys 10 gen&37,,,87.06,100.8,8
HCPCS,0246U,RBC DNA GNOTYP 16 BLD GROUPS,,,720.0,2950.42,20
HCPCS,0246U,Rbc dna gnotyp 16 bld groups,,,137.41,159.1,8
HCPCS,0247U,OB PRTRM BRTH IBP4 SHBG MEAS,,,750.0,3073.35,20
HCPCS,0247U,Ob prtrm brth ibp4 shbg meas,,,14.4,16.68,8
HCPCS,0248U,ONC SPHRD CELL CUL 12 RX PNL,,,3033.86,12432.15,19
HCPCS,0248U,Onc sphrd cell cul 12 rx pnl,,,87.06,100.8,8
HCPCS,0249U,ONC BRST ALYS 32 PHSPRTN ALG,,,2219.13,9093.55,19
HCPCS,0249U,Onc brst alys 32 phsprtn alg,,,87.06,100.8,8
HCPCS,0250U,ONC SLD ORG NEO DNA 505 GENE,,,2919.6,11963.94,20
HCPCS,0250U,Onc sld org neo dna 505 gene,,,533.45,617.68,8
HCPCS,0251U,HEPCIDIN-25 ELISA SERUM/PLSM,,,17.27,70.77,20
HCPCS,0251U,Hepcidin-25 elisa serum/plsm,,,14.4,16.68,8
HCPCS,0252U,FTL ANEUPLOIDY STR ALYS DNA,,,759.05,3110.44,19
HCPCS,0252U,Ftl aneuploidy str alys dna,,,87.06,100.8,8
HCPCS,0253T,INSERT AQUEOUS DRAIN DEVICE,,,3717.04,11585.35,19
HCPCS,0253T,Insert aqueous drain device,,,1921.59,2225.0,8
HCPCS,0253U,RPRDTVE MED RNA GEN PRFL 238,,,3159.42,12946.67,19
HCPCS,0253U,Rprdtve med rna gen prfl 238,,,87.06,100.8,8
HCPCS,0254U,REPRDTVE MED ALYS 24 CHRMSM,,,759.05,3110.44,19
HCPCS,0254U,Reprdtve med alys 24 chrmsm,,,87.06,100.8,8
HCPCS,0255U,ANDROLOGY INFERTILITY ASSMT,,,31.6,129.49,19
HCPCS,0255U,Andrology infertility assmt,,,19.72,22.84,8
HCPCS,0256U,TMA/TMAO PRFL LCMS/MS UR ALG,,,159.95,655.44,19
HCPCS,0256U,Tma/tmao prfl lcms/ms ur alg,,,66.63,77.15,8
HCPCS,0257U,VLCAD LEUK NZM ACTV WHL BLD,,,712.47,2919.56,19
HCPCS,0257U,Vlcad leuk nzm actv whl bld,,,14.4,16.68,8
HCPCS,0258U,AI PSOR MRNA 50-100 GEN ALG,,,3675.0,15059.42,20
HCPCS,0258U,Ai psor mrna 50-100 gen alg,,,66.63,77.15,8
HCPCS,0259U,NEPH CKD NUC MRS MEAS GFR,,,52.71,216.0,20
HCPCS,0259U,Neph ckd nuc mrs meas gfr,,,16.56,19.17,8
HCPCS,0260U,RARE DS ID OPT GENOME MAPG,,,1263.53,5177.69,19
HCPCS,0260U,Rare ds id opt genome mapg,,,66.63,77.15,8
HCPCS,0261U,ONC CLRCT CA IMG ALYS W/AI,,,2513.25,10298.8,20
HCPCS,0261U,Onc clrct ca img alys w/ai,,,66.63,77.15,8
HCPCS,0262U,ONC SLD TUM RT-PCR 7 GEN,,,3200.0,13112.96,19
HCPCS,0262U,Onc sld tum rt-pcr 7 gen,,,66.63,77.15,8
HCPCS,0263T,IM B1 MRW CEL THER CMPL,,,4120.64,12207.81,19
HCPCS,0263T,Im b1 mrw cel ther cmpl,,,1372.76,1589.51,8
HCPCS,0263U,NEURO ASD MEAS 16 C METBLT,,,750.0,3073.35,20
HCPCS,0263U,Neuro asd meas 16 c metblt,,,137.41,159.1,8
HCPCS,0264T,IM B1 MRW CEL THER XCL HRVST,,,4120.64,12207.81,19
HCPCS,0264T,Im b1 mrw cel ther xcl hrvst,,,1372.76,1589.51,8
HCPCS,0264U,RARE DS ID OPT GENOME MAPG,,,1263.53,5177.69,19
HCPCS,0264U,Rare ds id opt genome mapg,,,66.63,77.15,8
HCPCS,0265T,IM B1 MRW CEL THER HRVST ONL,,,4120.64,12207.81,19
HCPCS,0265T,Im b1 mrw cel ther hrvst onl,,,1372.76,1589.51,8
HCPCS,0265U,RAR DO WHL GN&MTCDRL DNA ALS,,,5475.8,22438.73,19
HCPCS,0265U,Rar do whl gn&mtcdrl dna als,,,66.63,77.15,8
HCPCS,0266T,IMPLT/RPL CRTD SNS DEV TOTAL,,,41579.56,44905.93,6
HCPCS,0266T,Implt/rpl crtd sns dev total,,,15220.57,17623.82,8
HCPCS,0266U,UNXPL CNST HRTBL DO GN XPRSN,,,3200.0,13112.96,19
HCPCS,0266U,Unxpl cnst hrtbl do gn xprsn,,,66.63,77.15,8
HCPCS,0267T,IMPLT/RPL CRTD SNS DEV LEAD,,,3177.58,3431.78,6
HCPCS,0267T,Implt/rpl crtd sns dev lead,,,1720.7,1992.39,8
HCPCS,0267U,RARE DO ID OPT GEN MAPG&SEQ,,,6739.33,27616.43,19
HCPCS,0267U,Rare do id opt gen mapg&seq,,,66.63,77.15,8
HCPCS,0268T,IMPLT/RPL CRTD SNS DEV GEN,,,28156.99,30409.55,6
HCPCS,0268T,Implt/rpl crtd sns dev gen,,,15220.57,17623.82,8
HCPCS,0268U,HEM AHUS GEN SEQ ALYS 15 GEN,,,608.17,2492.16,19
HCPCS,0268U,Hem ahus gen seq alys 15 gen,,,66.63,77.15,8
HCPCS,0269T,REV/REMVL CRTD SNS DEV TOTAL,,,5917.23,6390.61,6
HCPCS,0269T,Rev/remvl crtd sns dev total,,,1720.7,1992.39,8
HCPCS,0269U,HEM AUT DM CGEN TRMBCTPNA 22,,,608.17,2492.16,19
HCPCS,0269U,Hem aut dm cgen trmbctpna 22,,,66.63,77.15,8
HCPCS,0270T,REV/REMVL CRTD SNS DEV LEAD,,,3177.58,3431.78,6
HCPCS,0270T,Rev/remvl crtd sns dev lead,,,1720.7,1992.39,8
HCPCS,0270U,HEM CGEN COAGJ DO 20 GENES,,,608.17,2492.16,19
HCPCS,0270U,Hem cgen coagj do 20 genes,,,66.63,77.15,8
HCPCS,0271T,REV/REMVL CRTD SNS DEV GEN,,,3177.58,3431.78,6
HCPCS,0271T,Rev/remvl crtd sns dev gen,,,1720.7,1992.39,8
HCPCS,0271U,HEM CGEN NEUTROPENIA 24 GEN,,,608.17,2492.16,19
HCPCS,0271U,Hem cgen neutropenia 24 gen,,,66.63,77.15,8
HCPCS,0272T,INTERROGATE CRTD SNS DEV,,,144.57,156.13,6
HCPCS,0272T,Interrogate crtd sns dev,,,18.13,20.99,8
HCPCS,0272U,HEM GENETIC BLD DO 60 GENES,,,608.17,2492.16,19
HCPCS,0272U,Hem genetic bld do 60 genes,,,66.63,77.15,8
HCPCS,0273T,INTERROGATE CRTD SNS W/PGRMG,,,144.57,156.13,6
HCPCS,0273T,Interrogate crtd sns w/pgrmg,,,18.13,20.99,8
HCPCS,0273U,HEM GEN HYPRFIBRNLYSIS 9 GEN,,,608.17,2492.16,19
HCPCS,0273U,Hem gen hyprfibrnlysis 8 gen,,,66.63,77.15,8
HCPCS,0274T,PRQ LAMOT/LAM DCMPR CRV/THRC,,,6600.66,20338.07,19
HCPCS,0274T,Prq lamot/lam dcmpr crv/thrc,,,3026.0,3503.79,8
HCPCS,0274U,HEM GEN PLTLT DO 62 GENES,,,608.17,2492.16,19
HCPCS,0274U,Hem gen pltlt do 62 genes,,,66.63,77.15,8
HCPCS,0275T,PERQ LAMOT/LAM LUMBAR,,,6600.66,7128.72,6
HCPCS,0275T,Perq lamot/lam lumbar,,,3026.0,3503.79,8
HCPCS,0275U,HEM HEPRN NDUC TRMBCTPNA SRM,,,18.37,75.28,20
HCPCS,0275U,Hem heprn nduc trmbctpna srm,,,7.7,8.92,8
HCPCS,0276U,HEM INH THROMBOCYTOPENIA 42,,,2448.56,10033.71,19
HCPCS,0276U,Hem inh thrombocytopenia 42,,,66.63,77.15,8
HCPCS,0277U,HEM GEN PLTLT FUNCJ DO 40,,,608.17,2492.16,19
HCPCS,0277U,Hem gen pltlt funcj do 40,,,66.63,77.15,8
HCPCS,0278T,TEMPR,,,121.73,360.65,19
HCPCS,0278T,Tempr,,,310.96,360.06,8
HCPCS,0278U,HEM GEN THROMBOSIS 14 GENES,,,608.17,2492.16,19
HCPCS,0278U,Hem gen thrombosis 14 genes,,,66.63,77.15,8
HCPCS,0279U,HEM VW FACTOR&CLGN III BNDG,,,11.53,47.25,20
HCPCS,0279U,Hem vw factor&clgn iii bndg,,,7.7,8.92,8
HCPCS,0280U,HEM VW FACTOR&CLGN IV BNDG,,,17.27,70.77,20
HCPCS,0280U,Hem vw factor&clgn iv bndg,,,7.7,8.92,8
HCPCS,0281U,HEM VWD PROPEPTIDE AG LVL,,,17.27,70.77,20
HCPCS,0281U,Hem vwd propeptide ag lvl,,,7.7,8.92,8
HCPCS,0282U,RED CELL GENOTYPING,4968.0,3229.2,137.41,4968.0,60
HCPCS,0283U,VW FACTOR TYPE 2B EVAL PLSM,,,18.4,75.4,20
HCPCS,0283U,Vw factor type 2b eval plsm,,,7.7,8.92,8
HCPCS,0284U,VW FACTOR TYPE 2N EVAL PLSM,,,17.27,70.77,20
HCPCS,0284U,Vw factor type 2n eval plsm,,,7.7,8.92,8
HCPCS,0285U,ONC DS PROG&RSPSE MNTR RADJ,,,443.31,1816.6,19
HCPCS,0285U,Onc ds prog&rspse mntr radj,,,66.63,77.15,8
HCPCS,0286U,CEP72 NUDT15&TPMT GENE ALYS,,,134.13,549.64,19
HCPCS,0286U,Cep72 nudt15&tpmt gene alys,,,92.46,107.06,8
HCPCS,0287U,ONC THYR DNA&MRNA 112 GENES,,,3600.0,14752.08,19
HCPCS,0287U,Onc thyr dna&mrna 112 genes,,,533.45,617.68,8
HCPCS,0288U,ONC LUNG MRNA QUAN PCR 11&3,,,3873.0,15870.78,19
HCPCS,0288U,Onc lung mrna quan pcr 11&3,,,533.45,617.68,8
HCPCS,0289U,NEURO ALZHEIMER MRNA 24 GEN,,,760.0,3114.33,19
HCPCS,0289U,Neuro alzheimer mrna 24 gen,,,137.41,159.1,8
HCPCS,0290T,Laser inc for pkp/lkp recip,,,2202.53,2550.3,8
HCPCS,0290U,PAIN MGMT MRNA GEN XPRSN 36,,,760.0,3114.33,19
HCPCS,0290U,Pain mgmt mrna gen xprsn 36,,,137.41,159.1,8
HCPCS,0291U,PSYC MOOD DO MRNA 144 GENES,,,1755.0,7191.64,19
HCPCS,0291U,Psyc mood do mrna 144 genes,,,533.45,617.68,8
HCPCS,0292U,PSYC STRS DO MRNA 72 GENES,,,1755.0,7191.64,19
HCPCS,0292U,Psyc strs do mrna 72 genes,,,533.45,617.68,8
HCPCS,0293U,PSYC SUICIDAL IDEA MRNA 54,,,760.0,3114.33,19
HCPCS,0293U,Psyc suicidal idea mrna 54,,,137.41,159.1,8
HCPCS,0294U,LNGVTY&MRTLTY RSK MRNA 18GEN,,,1710.0,3114.33,3
HCPCS,0294U,Lngvty&mrtlty rsk mrna 18gen,,,137.41,159.1,8
HCPCS,0295T,Ext ecg complete,,,68.77,79.63,8
HCPCS,0295U,ONC BRST DUX CARC 7 PROTEINS,,,4268.25,22271.54,19
HCPCS,0295U,Onc brst dux carc 7 proteins,,,533.45,617.68,8
HCPCS,0296T,Ext ecg recording,,,68.77,79.63,8
HCPCS,0296U,ONC ORL&/OROP CA 20 MLC FEAT,,,1950.0,7990.71,19
HCPCS,0296U,Onc orl&/orop ca 20 mlc feat,,,533.45,617.68,8
HCPCS,0297T,Ext ecg scan w/report,,,68.77,79.63,8
HCPCS,0297U,ONC PAN TUM WHL GEN SEQ DNA,,,2919.6,11963.94,19
HCPCS,0297U,Onc pan tum whl gen seq dna,,,533.45,617.68,8
HCPCS,0298T,Ext ecg review and interp,,,68.77,79.63,8
HCPCS,0298U,ONC PAN TUM WHL TRNS SEQ RNA,,,2919.6,11963.94,19
HCPCS,0298U,Onc pan tum whl trns seq rna,,,533.45,617.68,8
HCPCS,0299U,ONC PAN TUM WHL GEN OPT MAPG,,,1863.22,7635.1,19
HCPCS,0299U,Onc pan tum whl gen opt mapg,,,66.63,77.15,8
HCPCS,0300U,ONC PAN TUM WHL GEN SEQ&OPT,,,4183.13,17141.63,19
HCPCS,0300U,Onc pan tum whl gen seq&opt,,,66.63,77.15,8
HCPCS,0301U,IADNA BARTONELLA DDPCR,,,262.72,1076.57,19
HCPCS,0301U,Iadna bartonella ddpcr,,,26.69,30.9,8
HCPCS,0302U,IADNA BRTNLA DDPCR FLWG LIQ,,,361.37,1480.82,19
HCPCS,0302U,Iadna brtnla ddpcr flwg liq,,,26.69,30.9,8
HCPCS,0303U,HEM RBC ADS WHL BLD HYPOXIC,,,2201.62,9021.8,19
HCPCS,0303U,Hem rbc ads whl bld hypoxic,,,6.74,7.8,8
HCPCS,0304U,HEM RBC ADS WHL BLD NORMOXIC,,,2075.8,8506.21,19
HCPCS,0304U,Hem rbc ads whl bld normoxic,,,6.74,7.8,8
HCPCS,0305U,HEM RBC FNCLTY&DFRM SHR STRS,,,662.58,2715.12,19
HCPCS,0305U,Hem rbc fnclty&dfrm shr strs,,,6.74,7.8,8
HCPCS,0306U,ONC MRD NXT-GNRJ ALYS 1ST,,,3878.45,15893.11,19
HCPCS,0306U,Onc mrd nxt-gnrj alys 1st,,,66.63,77.15,8
HCPCS,0307U,ONC MRD NXT-GNRJ ALYS SBSQ,,,794.49,3255.66,19
HCPCS,0307U,Onc mrd nxt-gnrj alys sbsq,,,66.63,77.15,8
HCPCS,0308T,INSJ OCULAR TELESCOPE PROSTH,,,15168.46,46137.2,19
HCPCS,0308T,Insj ocular telescope prosth,,,1921.59,2225.0,8
HCPCS,0308U,CRD CAD ALYS 3 PRTN 3 PARAM,,,390.75,1601.22,19
HCPCS,0308U,Crd cad alys 3 prtn 3 param,,,66.63,77.15,8
HCPCS,0309U,CRD CV DS ALY 4 PRTN PLM ALG,,,390.75,1601.22,19
HCPCS,0309U,Crd cv ds aly 4 prtn plm alg,,,66.63,77.15,8
HCPCS,0310U,PED VSCLTS KD ALYS 3 BMRKS,,,390.75,1601.22,19
HCPCS,0310U,Ped vsclts kd alys 3 bmrks,,,66.63,77.15,8
HCPCS,0311U,NFCT DS BCT QUAN ANTMCRB SC,,,8.08,33.11,19
HCPCS,0311U,Nfct ds bct quan antmcrb sc,,,13.21,15.29,8
HCPCS,0312T,Laps impltj nstim vagus,,,15220.57,17623.82,8
HCPCS,0312U,AI DS SLE ALYS 8 IGG AUTOANT,,,840.65,3444.82,19
HCPCS,0312U,Ai ds sle alys 8 igg autoant,,,137.41,159.1,8
HCPCS,0313T,Laps rmvl nstim array vagus,,,1720.7,1992.39,8
HCPCS,0313U,ONC PNCRS DNA&MRNA SEQ 74,,,3600.0,14752.08,19
HCPCS,0313U,Onc pncrs dna&mrna seq 74,,,533.45,617.68,8
HCPCS,0314T,Laps rmvl vgl arry&pls gen,,,1720.7,1992.39,8
HCPCS,0314U,ONC CUTAN MLNMA MRNA 35 GENE,,,1950.0,7990.71,19
HCPCS,0314U,Onc cutan mlnma mrna 35 gene,,,533.45,617.68,8
HCPCS,0315T,Rmvl vagus nerve pls gen,,,1720.7,1992.39,8
HCPCS,0315U,ONC CUTAN SQ CLL CA MRNA 40,,,8500.0,34831.3,19
HCPCS,0315U,Onc cutan sq cll ca mrna 40,,,533.45,617.68,8
HCPCS,0316T,Replc vagus nerve pls gen,,,15220.57,17623.82,8
HCPCS,0316U,B BRGDRFERI LYME DS OSPA EVL,,,18.66,76.46,19
HCPCS,0316U,B brgdrferi lyme ds ospa evl,,,13.21,15.29,8
HCPCS,0317T,Elec alys vagus nrv pls gen,,,18.13,20.99,8
HCPCS,0317U,ONC LUNG CA 4-PRB FISH ASSAY,,,2030.0,8318.53,19
HCPCS,0317U,Onc lung ca 4-prb fish assay,,,533.45,617.68,8
HCPCS,0318U,PED WHL GEN MTHYLTN ALYS 50+,,,1770.48,7255.07,19
HCPCS,0318U,Ped whl gen mthyltn alys 50+,,,66.63,77.15,8
HCPCS,0319U,NEPH RNA PRETRNSPL PERPH BLD,,,2650.0,10859.17,19
HCPCS,0319U,Neph rna pretrnspl perph bld,,,66.63,77.15,8
HCPCS,0320U,NEPH RNA PSTTRNSPL PERPH BLD,,,2650.0,10859.17,19
HCPCS,0320U,Neph rna psttrnspl perph bld,,,66.63,77.15,8
HCPCS,0321U,IADNA GU PTHGN 20BCT&FNG ORG,,,634.84,2601.45,19
HCPCS,0321U,Iadna gu pthgn 20bct&fng org,,,87.06,100.8,8
HCPCS,0322U,NEURO ASD MEAS 14 ACYL CARN,,,750.0,3073.35,19
HCPCS,0322U,Neuro asd meas 14 acyl carn,,,137.41,159.1,8
HCPCS,0323U,IADNA CNS PTHGN NEXT GEN SEQ,,,2126.2,8712.74,19
HCPCS,0323U,Iadna cns pthgn next gen seq,,,533.45,617.68,8
HCPCS,0324U,Onc ovar sphrd cell 4 rx pnl,,,533.45,617.68,8
HCPCS,0325U,Onc ovar sphrd cell parp,,,533.45,617.68,8
HCPCS,0326U,TRGT GEN SEQ ALYS PNL 83+,,,5000.0,20489.0,19
HCPCS,0326U,Trgt gen seq alys pnl 83+,,,66.63,77.15,8
HCPCS,0327U,FTL ANEUPLOIDY TRSMY DNA SEQ,,,795.0,3257.75,19
HCPCS,0327U,Ftl aneuploidy trsmy dna seq,,,137.41,159.1,8
HCPCS,0328U,DRUG ASSAY 120+ RX&METABLT,,,114.43,468.91,19
HCPCS,0328U,Drug assay 120+ rx&metablt,,,27.64,32.0,8
HCPCS,0329T,Mntr io press 24hrs/> uni/bi,,,38.61,44.7,8
HCPCS,0329U,ONC NEO XOME&TRNS SEQ ALYS,,,3437.98,14088.15,19
HCPCS,0329U,Onc neo xome&trns seq alys,,,66.63,77.15,8
HCPCS,0330T,TEAR FILM IMG UNI/BI W/I&R,,,35.34,104.69,19
HCPCS,0330T,Tear film img uni/bi w/i&r,,,68.91,79.79,8
HCPCS,0330U,IADNA VAG PTHGN PANEL 27 ORG,,,416.78,1707.88,19
HCPCS,0330U,Iadna vag pthgn panel 27 org,,,26.69,30.9,8
HCPCS,0331T,HEART SYMP IMAGE PLNR,,,1206.24,3628.7,19
HCPCS,0331T,Heart symp image plnr,,,705.42,816.81,8
HCPCS,0331U,ONC HL NEO OPT GEN MAPPING,,,1863.22,7635.1,19
HCPCS,0331U,Onc hl neo opt gen mapping,,,66.63,77.15,8
HCPCS,0332T,HEART SYMP IMAGE PLNR SPECT,,,1206.24,3628.7,19
HCPCS,0332T,Heart symp image plnr spect,,,705.42,816.81,8
HCPCS,0332U,ONC PAN TUM GEN PRFLG 8 DNA,,,1142.06,4679.93,19
HCPCS,0332U,Onc pan tum gen prflg 8 dna,,,66.63,77.15,8
HCPCS,0333T,Visual ep scr acuity auto,,,310.96,360.06,8
HCPCS,0333U,ONC LVR SURVEILANC HCC CFDNA,,,662.32,2714.05,19
HCPCS,0333U,Onc lvr surveilanc hcc cfdna,,,66.63,77.15,8
HCPCS,0334U,ONC SLD ORGN TGSA DNA 84/+,,,3500.0,14342.3,19
HCPCS,0334U,Onc sld orgn tgsa dna 84/+,,,533.45,617.68,8
HCPCS,0335T,INSJ SINUS TARSI IMPLANT,,,6600.66,20338.07,19
HCPCS,0335T,Insj sinus tarsi implant,,,1392.99,1612.93,8
HCPCS,0335U,RARE DS WHL GEN SEQ FETAL,,,5224.6,21409.37,19
HCPCS,0335U,Rare ds whl gen seq feta,,,533.45,617.68,8
HCPCS,0336U,RARE DS WHL GEN SEQ BLD/SLV,,,2574.65,10550.4,19
HCPCS,0336U,Rare ds whl gen seq bld/slv,,,533.45,617.68,8
HCPCS,0337U,ONC PLSM CELL DO&MYELOMA ID,,,2435.0,9978.14,19
HCPCS,0337U,Onc plsm cell do&myeloma id,,,66.63,77.15,8
HCPCS,0338T,TRANSCATH RENAL SYMP DENERV UNI,7571.0,4921.15,1.1,18417.4,31
HCPCS,0338T,TRNSCTH RENAL SYMP DENRV UNL,,,5268.09,15952.59,19
HCPCS,0338T,Trnscth renal symp denrv unl,,,8291.28,9600.43,8
HCPCS,0338U,ONC SLD TUM CRCG TUM CL SLCT,,,2435.0,9978.14,19
HCPCS,0338U,Onc sld tum crcg tum cl slct,,,66.63,77.15,8
HCPCS,0339T,TRANSCATH RENAL SYMP DENERV BILAT,8704.0,5657.6,1.1,29389.56,31
HCPCS,0339T,TRNSCTH RENAL SYMP DENRV BIL,,,5268.09,15952.59,19
HCPCS,0339T,Trnscth renal symp denrv bil,,,8291.28,9600.43,8
HCPCS,0339U,ONC PRST8 MRNA HOXC6 & DLX1,,,760.0,3114.33,19
HCPCS,0339U,Onc prst8 mrna hoxc6 & dlx1,,,137.41,159.1,8
HCPCS,0340U,ONC PAN CA ALYS MRD PLASMA,,,3590.0,14711.1,20
HCPCS,0340U,Onc pan ca alys mrd plasma,,,66.63,77.15,8
HCPCS,0341U,FTL ANEUP DNA SEQ CMPR ALYS,,,1900.2,7786.64,19
HCPCS,0341U,Ftl aneup dna seq cmpr alys,,,66.63,77.15,8
HCPCS,0342T,THXP APHERESIS W/HDL DELIP,,,4120.64,12207.81,19
HCPCS,0342T,Thxp apheresis w/hdl delip,,,1372.76,1589.51,8
HCPCS,0342U,ONC PNCRTC CA MULT IA ECLIA,,,2018.25,3675.73,3
HCPCS,0342U,Onc pncrtc ca mult ia eclia,,,137.41,159.1,8
HCPCS,0343U,ONC PRST8 XOM ALY 442 SNCRNA,,,760.0,3114.33,19
HCPCS,0343U,Onc prst8 xom aly 442 sncrna,,,137.41,159.1,8
HCPCS,0344U,HEP NAFLD SEMIQ EVL 28 LIPID,,,792.17,3246.15,19
HCPCS,0344U,Hep nafld semiq evl 28 lipid,,,66.63,77.15,8
HCPCS,0345T,Transcath mtral vlve repair,,,11343.93,13135.08,8
HCPCS,0345U,PSYC GENOM ALYS PNL 15 GEN,,,1336.09,5475.03,19
HCPCS,0345U,Psyc genom alys pnl 15 gen,,,533.45,617.68,8
HCPCS,0346U,Beta amyl ab40&ab42 lc-ms/ms,,,14.4,16.68,8
HCPCS,0347T,INS BONE DEVICE FOR RSA,,,54.88,165.35,19
HCPCS,0347T,Ins bone device for rsa,,,199.7,231.23,8
HCPCS,0347U,RX METAB/PCX DNA 16 GEN ALYS,,,1336.09,5475.03,19
HCPCS,0347U,Rx metab/pcx dna 16 gen alys,,,533.45,617.68,8
HCPCS,0348T,RSA SPINE EXAM,,,98.26,551.66,20
HCPCS,0348T,Rsa spine exam,,,45.07,52.18,8
HCPCS,0348U,RX METAB/PCX DNA 25 GEN ALYS,,,742.27,3041.67,19
HCPCS,0348U,Rx metab/pcx dna 25 gen alys,,,137.41,159.1,8
HCPCS,0349T,RSA UPPER EXTR EXAM,,,98.26,551.66,20
HCPCS,0349T,Rsa upper extr exam,,,45.07,52.18,8
HCPCS,0349U,RX METAB/PCX DNA 27GEN RX IA,,,742.27,3041.67,19
HCPCS,0349U,Rx metab/pcx dna 27gen rx ia,,,137.41,159.1,8
HCPCS,0350T,RSA LOWER EXTR EXAM,,,81.36,409.57,20
HCPCS,0350T,Rsa lower extr exam,,,45.07,52.18,8
HCPCS,0350U,RX METAB/PCX DNA 27 GEN ALYS,,,1336.09,5475.03,19
HCPCS,0350U,Rx metab/pcx dna 27 gen alys,,,533.45,617.68,8
HCPCS,0351T,Intraop oct brst/node spec,,,68.91,79.79,8
HCPCS,0351U,NFCT DS BCT/VIRAL TRAIL IP10,,,260.5,1067.48,19
HCPCS,0351U,Nfct ds bct/viral trail ip10,,,66.63,77.15,8
HCPCS,0352T,OCT BRST/NODE I&R PER SPEC,,,4917.83,4917.83,1
HCPCS,0352T,Oct brst/node i&r per spec,,,68.91,79.79,8
HCPCS,0352U,Nfct ds bv&vaginitis amp prb,,,26.69,30.9,8
HCPCS,0353T,Intraop oct breast cavity,,,68.91,79.79,8
HCPCS,0353U,Iadna chlmyd&gonorr amp prb,,,13.21,15.29,8
HCPCS,0354T,OCT BREAST SURG CAVITY I&R,,,4917.83,4917.83,1
HCPCS,0354T,Oct breast surg cavity i&r,,,68.91,79.79,8
HCPCS,0354U,Hpv hi rsk qual mrna e6/e7,,,26.69,30.9,8
HCPCS,0355T,Gi tract capsule endoscopy,,,237.67,275.2,8
HCPCS,0355U,APOL1 RISK VARIANTS,,,137.0,561.4,19
HCPCS,0355U,Apol1 risk variants,,,66.63,77.15,8
HCPCS,0356T,Insrt drug device for iop,,,38.61,44.7,8
HCPCS,0356U,ONC OROP/ANAL 17 DNA DDPCR,,,1800.0,7376.04,19
HCPCS,0356U,Onc orop/anal 17 dna ddpcr,,,66.63,77.15,8
HCPCS,0357U,Onc mlnma ai quan alys 142,,,92.46,107.06,8
HCPCS,0358T,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,98.0,63.7,22.63,98.0,61
HCPCS,0358U,NEURO ALYS ß-AMYL 1-42&1-40,,,260.5,1067.48,19
HCPCS,0358U,Neuro alys b-amyl 1-42&1-40,,,92.46,107.06,8
HCPCS,0359U,ONC PRST8 CA ALYS ALL PSA,,,760.0,3114.33,19
HCPCS,0359U,Onc prst8 ca alys all psa,,,14.4,16.68,8
HCPCS,0360U,ONC LUNG ELISA 7 AUTOANT ALG,,,782.93,3444.82,19
HCPCS,0360U,Onc lung elisa 7 autoant alg,,,66.63,77.15,8
HCPCS,0361U,NEURFLMNT LT CHN DIG IA QUAN,,,116.23,125.53,5
HCPCS,0361U,Neurflmnt lt chn dig ia quan,,,13.21,15.29,8
HCPCS,0362T,BEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME,293.0,190.45,1.1,294.52,31
HCPCS,0362T,BHV ID SUPRT ASSMT EA 15 MIN,,,27.53,105.02,19
HCPCS,0362T,Bhv id suprt assmt ea 15 min,,,156.65,181.38,8
HCPCS,0362U,ONC PAP THYR CA RNA 82&10,,,3600.0,14752.08,19
HCPCS,0362U,Onc pap thyr ca rna 82&10,,,66.63,77.15,8
HCPCS,0363U,ONC URTHL MRNA 5 GEN ALG,,,760.0,3114.33,19
HCPCS,0363U,Onc urthl mrna 5 gen alg,,,66.63,77.15,8
HCPCS,0364U,ONC HL NEO GEN SEQ ALYS ALG,,,2007.25,8225.31,19
HCPCS,0364U,Onc hl neo gen seq alys alg,,,66.63,77.15,8
HCPCS,0365U,ONC BLDR 10 UR HRBR URTHL CA,,,897.0,3675.73,19
HCPCS,0365U,Onc bldr 10 ur hrbr urthl ca,,,66.63,77.15,8
HCPCS,0366U,ONC BLDR 10 PRB RECR BLDR CA,,,897.0,3675.73,19
HCPCS,0366U,Onc bldr 10 prb recr bldr ca,,,66.63,77.15,8
HCPCS,0367U,ONC BLDR 10 FLWG TRURL RESCJ,,,902.18,3696.95,19
HCPCS,0367U,Onc bldr 10 flwg trurl rescj,,,66.63,77.15,8
HCPCS,0368U,ONC CLRCT CA MUT&MTHYLTN MRK,,,937.76,1707.88,3
HCPCS,0368U,Onc clrct ca mut&mthyltn mrk,,,66.63,77.15,8
HCPCS,0369U,IADNA GI PTHGN 31 ORG&21 ARG,,,416.78,450.12,5
HCPCS,0369U,Iadna gi pthgn 31 org&21 arg,,,39.01,45.17,8
HCPCS,0370U,IADNA SURG WND PTHGN 34&21,,,416.78,450.12,5
HCPCS,0370U,Iadna surg wnd pthgn 34&21,,,39.01,45.17,8
HCPCS,0371U,IADNA GU PTHGN SEMIQ DNA16&1,,,416.78,1707.88,19
HCPCS,0371U,Iadna gu pthgn semiq dna16&1,,,39.01,45.17,8
HCPCS,0372U,NFCT DS GU PTHGN ARG DETCJ,,,416.78,1707.88,19
HCPCS,0372U,Nfct ds gu pthgn arg detcj,,,26.69,30.9,8
HCPCS,0373T,ADAPT BHV TX EA 15 MIN,,,27.53,105.02,19
HCPCS,0373T,ADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME,191.0,124.15,1.1,266.89,31
HCPCS,0373T,Adapt bhv tx ea 15 min,,,156.65,181.38,8
HCPCS,0373U,IADNA RSP TR NFCT 17 8 13&16,,,416.78,450.12,5
HCPCS,0373U,Iadna rsp tr nfct 17 8 13&16,,,26.69,30.9,8
HCPCS,0374U,IADNA GU PTHGN 21 ORG&21ARG,,,416.78,450.12,5
HCPCS,0374U,Iadna gu pthgn 21 org&21arg,,,39.01,45.17,8
HCPCS,0375U,ONC OVRN BCHM ASY 7 PRTN ALG,,,897.0,3675.73,19
HCPCS,0375U,Onc ovrn bchm asy 7 prtn alg,,,66.63,77.15,8
HCPCS,0376T,Insert ant segment drain int,,,1921.59,2225.0,8
HCPCS,0376U,ONC PRST8 CA IMG ALYS 128,,,706.25,2894.07,19
HCPCS,0376U,Onc prst8 ca img alys 128,,,66.63,77.15,8
HCPCS,0377U,CV DS QUAN ADVSRM/PLSM LPRTN,,,47.58,194.97,19
HCPCS,0377U,Cv ds quan advsrm/plsm lprtn,,,66.63,77.15,8
HCPCS,0378U,RFC1 REPEAT XPNSJ VRNT ALYS,,,137.0,561.4,19
HCPCS,0378U,Rfc1 repeat xpnsj vrnt alys,,,66.63,77.15,8
HCPCS,0379T,VIS FIELD ASSMNT TECH SUPPT,,,35.34,104.69,19
HCPCS,0379U,TGSAP SL OR NEO DNA523&RNA55,,,3288.51,13475.66,19
HCPCS,0379U,Tgsap sl or neo dna523&rna55,,,66.63,77.15,8
HCPCS,0380U,Rx metb advrs trgt sq aly 20,,,66.63,77.15,8
HCPCS,0381T,Ext h rate epi sz 14 days,,,68.77,79.63,8
HCPCS,0381U,MAPLE SYRUP UR DS MNTR QUAN,,,44.12,180.79,19
HCPCS,0381U,Maple syrup ur ds mntr quan,,,66.63,77.15,8
HCPCS,0382T,Ext h rate sz 14 day ri only,,,68.77,79.63,8
HCPCS,0382U,HYPRPHENYLALNINMIA MNTR QUAN,,,51.64,211.61,19
HCPCS,0382U,Hyprphenylalninmia mntr quan,,,66.63,77.15,8
HCPCS,0383U,TYROSINEMIA TYP I MNTR QUAN,,,52.05,213.29,19
HCPCS,0383U,Tyrosinemia typ i mntr quan,,,66.63,77.15,8
HCPCS,0384U,NEPH CKD RSK HI STG KDN DS,,,750.0,3073.35,19
HCPCS,0384U,Neph ckd rsk hi stg kdn ds,,,66.63,77.15,8
HCPCS,0385U,NEPH CKD ALG RSK DBTC KDN DS,,,390.75,1601.22,19
HCPCS,0385U,Neph ckd alg rsk dbtc kdn ds,,,66.63,77.15,8
HCPCS,0386U,Gi barrett esoph mthyltn aly,,,66.63,77.15,8
HCPCS,0387U,ONC MLNMA AMBRA1&AMLO,,,948.5,3886.76,19
HCPCS,0387U,Onc mlnma ambra1&amlo,,,66.63,77.15,8
HCPCS,0388U,ONC NONSM CLL LNG CA 37 GEN,,,3500.0,14342.3,19
HCPCS,0388U,Onc nonsm cll lng ca 37 gen,,,66.63,77.15,8
HCPCS,0389U,PED FBRL KD IFI27&MCEMP1 RNA,,,70.2,287.67,19
HCPCS,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,66.63,77.15,8
HCPCS,0390U,OB PE KDR ENG&RBP4 IA ALG,,,64.41,263.94,19
HCPCS,0390U,Ob pe kdr eng&rbp4 ia alg,,,66.63,77.15,8
HCPCS,0391U,ONC SLD TUM DNA&RNA 437 GEN,,,3600.0,14752.08,19
HCPCS,0391U,Onc sld tum dna&rna 437 gen,,,66.63,77.15,8
HCPCS,0392U,RX METAB GEN-RX IA 16 GENES,,,1336.09,5475.03,19
HCPCS,0392U,Rx metab genrx ia 16 genes,,,66.63,77.15,8
HCPCS,0393U,NEU PRKSN MSFL a-SYNCLN PRTN,,,540.99,2216.87,19
HCPCS,0393U,Neu prksn msfl a-syncln prtn,,,66.63,77.15,8
HCPCS,0394T,HDR ELCTRNC SKN SURF BRCHYTX,,,242.99,262.43,6
HCPCS,0394T,Hdr elctrnc skn surf brchytx,,,108.37,125.48,8
HCPCS,0394U,PFAS 16 PFAS COMPND LC MS/MS,,,198.74,814.4,19
HCPCS,0394U,Pfas 16 pfas compnd lc ms/ms,,,14.4,16.68,8
HCPCS,0395T,HDR ELCTR NTRST/NTRCV BRCHTX,,,641.07,1952.11,19
HCPCS,0395T,Hdr elctr ntrst/ntrcv brchtx,,,284.58,329.52,8
HCPCS,0395U,ONC LNG MULTIOMICS PLSM ALG,,,797.45,3267.79,19
HCPCS,0395U,Onc lng multiomics plsm alg,,,66.63,77.15,8
HCPCS,0396T,Intraop kinetic balnce sensr,,,1971.0,2282.21,8
HCPCS,0396U,Ob preimpltj tst 300000 dna,,,66.63,77.15,8
HCPCS,0397T,Ercp w/optical endomicroscpy,,,2272.63,2631.46,8
HCPCS,0397U,Onc nonsm cll lng ca 109,,,66.63,77.15,8
HCPCS,0398U,GI BARET ESPH DNA MTHYLN ALY,,,1755.0,7191.64,19
HCPCS,0398U,Gi baret esph dna mthyln aly,,,66.63,77.15,8
HCPCS,0399U,NEURO CERE FOLATE DEFNCY SRM,,,300.0,1229.34,19
HCPCS,0399U,Neuro cere folate defncy srm,,,66.63,77.15,8
HCPCS,0400T,Mltispectrl digital les alys,,,7.32,8.48,8
HCPCS,0400U,OB XPND CAR SCR 145 GENES,,,3277.98,5970.0,3
HCPCS,0400U,Ob xpnd car scr 145 genes,,,66.63,77.15,8
HCPCS,0401T,Mltispectrl digital les alys,,,7.32,8.48,8
HCPCS,0401U,CRD C HRT DS 9 GEN 12 VRNTS,,,489.68,2006.61,19
HCPCS,0401U,Crd c hrt ds 9 gen 12 vrnts,,,66.63,77.15,8
HCPCS,0402T,COLGN CRS-LINK CRN&PACHYMTRY,,,2155.61,6663.73,19
HCPCS,0402T,Colgn crs-link crn&pachymtry,,,252.71,292.61,8
HCPCS,0402U,NFCT AGT STI MULT AMP PRB TQ,,,142.63,584.47,19
HCPCS,0402U,Nfct agt sti mult amp prb tq,,,13.21,15.29,8
HCPCS,0403T,Diabetes prev standard curr,,,35.45,41.05,8
HCPCS,0403U,ONC PRST8 MRNA 18 GEN 1ST UR,,,760.0,3114.33,19
HCPCS,0403U,Onc prst8 mrna 18 gen 1st ur,,,66.63,77.15,8
HCPCS,0404T,Trnscrv uterin fibroid abltj,,,4365.95,5055.31,8
HCPCS,0404U,ONC BRST SEMIQ MEAS THYM KN,,,322.96,1323.43,19
HCPCS,0404U,Onc brst semiq meas thym kn,,,66.63,77.15,8
HCPCS,0405T,Ovrsght xtrcorp liv asst pat,,,321.96,372.8,8
HCPCS,0405U,ONC PNCRTC 59 MTHLTN BLK MRK,,,1770.48,7255.07,19
HCPCS,0405U,Onc pncrtc 59 mthltn blk mrk,,,66.63,77.15,8
HCPCS,0406U,ONC LUNG FLOW CYTMTRY 5 MRK,,,760.0,3114.33,19
HCPCS,0406U,Onc lung flow cytmtry 5 mrk,,,66.63,77.15,8
HCPCS,0407U,NEPH DBTC CKD MULT ECLIA ALG,,,950.0,3892.91,19
HCPCS,0407U,Neph dbtc ckd mult eclia alg,,,66.63,77.15,8
HCPCS,0408T,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,28932.0,18805.8,5003.75,87978.22,61
HCPCS,0408U,IAAD BLK AC WV BSNSR SARSCV2,,,14.13,57.9,19
HCPCS,0408U,Iaad blk ac wv bsnsr sarscv2,,,26.69,30.9,8
HCPCS,0409T,INSJ/RPLC CAR MODULJ PLS GN,,,20739.83,62345.36,19
HCPCS,0409T,Insj/rplc car modulj pls gn,,,17330.27,20066.63,8
HCPCS,0409U,ONC SLD TUM DNA 80 & RNA 36,,,2919.6,11963.94,19
HCPCS,0409U,Onc sld tum dna 80 & rna 36,,,66.63,77.15,8
HCPCS,0410T,INSJ/RPLC CAR MODULJ ATR ELT,,,7646.84,23194.66,19
HCPCS,0410T,Insj/rplc car modulj atr elt,,,639.93,740.97,8
HCPCS,0410U,ONC PNCRTC DNA WHL GN SEQ 5-,,,1160.0,4753.45,19
HCPCS,0410U,Onc pncrtc dna whl gn seq 5-,,,66.63,77.15,8
HCPCS,0411T,INSJ/RPLC CAR MODULJ VNT ELT,,,7646.84,23194.66,19
HCPCS,0411T,Insj/rplc car modulj vnt elt,,,639.93,740.97,8
HCPCS,0411U,PSYC GENOM ALYS PNL 15 GEN,,,1336.09,5475.03,19
HCPCS,0411U,Psyc genom alys pnl 15 gen,,,533.45,617.68,8
HCPCS,0412T,RMVL CARDIAC MODULJ PLS GEN,,,3362.64,10474.13,19
HCPCS,0412T,Rmvl cardiac modulj pls gen,,,2386.88,2763.76,8
HCPCS,0412U,BETA AMYLOID Aß42/40 IMPRCIP,,,750.0,3073.35,19
HCPCS,0412U,Beta amyloid ab42/40 imprcip,,,14.4,16.68,8
HCPCS,0413T,RMVL CAR MODULJ TRANVNS ELT,,,3362.64,10474.13,19
HCPCS,0413T,Rmvl car modulj tranvns elt,,,639.93,740.97,8
HCPCS,0413U,ONC HL NEO OPT GEN MAPG DNA,,,1263.53,5177.69,19
HCPCS,0413U,Onc hl neo opt gen mapg dna,,,66.63,77.15,8
HCPCS,0414T,RMVL & RPL CAR MODULJ PLS GN,,,20739.83,62345.36,19
HCPCS,0414T,Rmvl & rpl car modulj pls gn,,,17330.27,20066.63,8
HCPCS,0414U,ONC LNG AUG ALG ALY WHL SLD8,,,706.25,2894.07,19
HCPCS,0414U,Onc lng aug alg aly whl sld8,,,66.63,77.15,8
HCPCS,0415T,REPOS CAR MODULJ TRANVNS ELT,,,571.26,1758.23,19
HCPCS,0415T,Repos car modulj tranvns elt,,,639.93,740.97,8
HCPCS,0415U,CV DS ACS BLD ALG 5 YR SCORE,,,390.75,1601.22,19
HCPCS,0415U,Cv ds acs bld alg 5 yr score,,,66.63,77.15,8
HCPCS,0416T,RELOC SKIN POCKET PLS GEN,,,1690.17,5783.06,19
HCPCS,0416T,Reloc skin pocket pls gen,,,639.93,740.97,8
HCPCS,0416U,Iadna gu pthgn 20bct&fng org,,,66.63,77.15,8
HCPCS,0417T,PRGRMG EVAL CARDIAC MODULJ,,,34.46,104.61,19
HCPCS,0417T,Prgrmg eval cardiac modulj,,,18.13,20.99,8
HCPCS,0417U,RARE DS ALYS 335 NUC GENES,,,2842.53,11648.12,19
HCPCS,0417U,Rare ds alys 335 nuc genes,,,66.63,77.15,8
HCPCS,0418T,INTERRO EVAL CARDIAC MODULJ,,,34.46,104.61,19
HCPCS,0418T,Interro eval cardiac modulj,,,18.13,20.99,8
HCPCS,0418U,ONC BRST AUG ALG ALY WHL SL8,,,706.25,2894.07,19
HCPCS,0418U,Onc brst aug alg aly whl sl8,,,36.09,41.79,8
HCPCS,0419T,DSTRJ NEUROFIBROMA XTNSV,,,565.6,2071.51,19
HCPCS,0419T,Dstrj neurofibroma xtnsv,,,133.98,155.13,8
HCPCS,0419U,NRPSYC GEN SEQ VRNT ALY 13,,,1336.09,5475.03,19
HCPCS,0419U,Nrpsyc gen seq vrnt aly 13,,,66.63,77.15,8
HCPCS,0420T,DSTRJ NEUROFIBROMA XTNSV,,,565.6,2071.51,19
HCPCS,0420T,Dstrj neurofibroma xtnsv,,,133.98,155.13,8
HCPCS,0420U,ONC URTHL MRNA XPRSN 6 SNP,,,1328.32,5443.19,14
HCPCS,0420U,Onc urthl mrna xprsn 6 snp,,,66.63,77.15,8
HCPCS,0421T,WATERJET PROSTATE ABLTJ CMPL,,,8544.18,9483.0,7
HCPCS,0421T,Waterjet prostate abltj cmpl,,,2607.32,3019.01,8
HCPCS,0421U,ONC CLRCT SCR SGL AMP 8 RNA,,,1144.97,2085.25,3
HCPCS,0421U,Onc clrct scr sgl amp 8 rna,,,66.63,77.15,8
HCPCS,0422T,TACTILE BREAST IMG UNI/BI,,,81.36,409.57,20
HCPCS,0422T,Tactile breast img uni/bi,,,41.14,47.64,8
HCPCS,0422U,ONC PAN SOLID TUM ALYS DNA,,,1943.21,7962.89,14
HCPCS,0422U,Onc pan solid tum alys dna,,,66.63,77.15,8
HCPCS,0423T,Assay secretory type ii pla2,,,16.56,19.17,8
HCPCS,0423U,PSYC GENOMIC ALYS PNL 26 GEN,,,416.78,1707.88,19
HCPCS,0423U,Psyc genomic alys pnl 26 gen,,,66.63,77.15,8
HCPCS,0424T,Insj/rplc nstim apnea compl,,,15220.57,17623.82,8
HCPCS,0424U,ONC PRST8 XOM ALYS 53 SNCRNA,,,760.0,3114.33,19
HCPCS,0424U,Onc prst8 xom alys 53 sncrna,,,66.63,77.15,8
HCPCS,0425U,GENOM RPD SEQ ALYS EA CMPRTR,,,4094.39,16777.99,14
HCPCS,0425U,Genom rpd seq alys ea cmprtr,,,66.63,77.15,8
HCPCS,0426U,GENOME ULTRA-RAPID SEQ ALYS,,,7582.2,31070.34,14
HCPCS,0426U,Genome ultra-rapid seq alys,,,66.63,77.15,8
HCPCS,0427T,Insj/rplc nstim apnea pls gn,,,15220.57,17623.82,8
HCPCS,0427U,MONOCYTE DSTRBJ WDTH WHL BLD,,,4.48,18.36,19
HCPCS,0427U,Monocyte dstrbj wdth whl bld,,,6.74,7.8,8
HCPCS,0428T,Rmvl nstim apnea pls gen,,,1720.7,1992.39,8
HCPCS,0428U,Onc brst ctdna alys 56/> gen,,,66.63,77.15,8
HCPCS,0429T,Rmvl nstim apnea sen ld,,,1720.7,1992.39,8
HCPCS,0429U,HPV OROP SWAB 14 HI-RISK TYP,,,35.09,143.79,19
HCPCS,0429U,Hpv orop swab 14 hi-risk typ,,,26.69,30.9,8
HCPCS,0430T,Rmvl nstim apnea stimj ld,,,1720.7,1992.39,8
HCPCS,0430U,GI MALABS AAT CALPRO PNCRTC,,,61.54,252.18,19
HCPCS,0430U,Gi malabs aat calpro pncrtc,,,14.4,16.68,8
HCPCS,0431T,Rmvl/rplc nstim apnea pls gn,,,15220.57,17623.82,8
HCPCS,0431U,SPSDEV GLYCINE RECEPTOR ALPHA1 IGG,252.0,163.8,14.4,252.0,60
HCPCS,0432T,Repos nstim apnea stimj ld,,,1720.7,1992.39,8
HCPCS,0432U,KLHL11 ANTB SR/CSF ASY QUAL,,,36.57,149.86,19
HCPCS,0432U,Klhl11 antb sr/csf asy qual,,,14.4,16.68,8
HCPCS,0433T,Repos nstim apnea sensing ld,,,1720.7,1992.39,8
HCPCS,0433U,ONC PRST8 5 DNA REG MRK PCR,,,760.0,3114.33,19
HCPCS,0433U,Onc prst8 5 dna reg mrk pcr,,,66.63,77.15,8
HCPCS,0434T,Interro eval npgs apnea,,,18.13,20.99,8
HCPCS,0434U,RX METAB ADVRS VRNT ALYS 25,,,416.78,1707.88,19
HCPCS,0434U,Rx metab advrs vrnt alys 25,,,66.63,77.15,8
HCPCS,0435T,Prgrmg eval npgs apnea 1 ses,,,18.13,20.99,8
HCPCS,0435U,ONC CHEMO RX CYTOX CSC 14 RX,,,3033.86,12432.15,19
HCPCS,0435U,Onc chemo rx cytox csc 14 rx,,,14.54,16.83,8
HCPCS,0436T,Prgrmg eval npgs apnea study,,,18.13,20.99,8
HCPCS,0436U,ONC LNG PLSM ALYS 388 PRTN,,,1504.24,6164.07,14
HCPCS,0436U,Onc lng plsm alys 388 prtn,,,66.63,77.15,8
HCPCS,0437T,IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL,2128.0,1383.2,1.1,2128.0,32
HCPCS,0437T,Impltj synth rnfcmt abdl wal,,,2692.69,3117.85,8
HCPCS,0437U,PSYC ANXIETY DO MRNA 15 BMRK,,,760.0,3114.33,19
HCPCS,0437U,Psyc anxiety do mrna 15 bmrk,,,66.63,77.15,8
HCPCS,0438U,RX METAB ADVRS VRNT ALYS 33,,,416.78,1707.88,19
HCPCS,0438U,Rx metab advrs vrnt alys 33,,,66.63,77.15,8
HCPCS,0439T,Myocrd contrast prfuj echo,,,280.48,324.76,8
HCPCS,0439U,CRD CHD DNA ALYS 5 SNP 3 DNA,,,854.0,3499.52,14
HCPCS,0439U,Crd chd dna alys 5 snp 3 dna,,,66.63,77.15,8
HCPCS,0440T,ABLTJ PERC UXTR/PERPH NRV,,,1804.32,5473.19,19
HCPCS,0440T,Abltj perc uxtr/perph nrv,,,865.36,1002.0,8
HCPCS,0440U,CRD CHD DNA ALYS 10 SNP 6DNA,,,854.0,3499.52,14
HCPCS,0440U,Crd chd dna alys 10 snp 6dna,,,66.63,77.15,8
HCPCS,0441T,ABLTJ PERC LXTR/PERPH NRV,,,1804.32,5473.19,19
HCPCS,0441T,Abltj perc lxtr/perph nrv,,,865.36,1002.0,8
HCPCS,0441U,NFCT DS BCT FNGL/VIRAL SEMIQ,,,444.08,1819.75,14
HCPCS,0441U,Nfct ds bct fngl/viral semiq,,,66.63,77.15,8
HCPCS,0442T,ABLTJ PERC PLEX/TRNCL NRV,,,5917.23,24597.37,19
HCPCS,0442T,Abltj perc plex/trncl nrv,,,2822.5,3268.16,8
HCPCS,0442U,NFCT DS RESPIR NFCTJ MXA&CRP,,,41.38,169.57,19
HCPCS,0442U,Nfct ds respir nfctj mxa&crp,,,66.63,77.15,8
HCPCS,0443T,R-t spctrl alys prst8 tiss,,,29.68,34.36,8
HCPCS,0443U,NEURFLMNT LT CHN ULTRSENS IA,,,116.23,476.29,14
HCPCS,0443U,Neurflmnt lt chn ultrsens ia,,,13.21,15.29,8
HCPCS,0444T,1st plmt drug elut oc ins,,,36.15,41.86,8
HCPCS,0444U,ONC SLD ORGN NEO TGSAP 361,,,2919.6,11963.94,19
HCPCS,0444U,Onc sld orgn neo tgsap 361,,,66.63,77.15,8
HCPCS,0445T,Sbsqt plmt drug elut oc ins,,,36.15,41.86,8
HCPCS,0445U,ABETA42 & PTAU181 ECLIA CSF,,,260.5,1067.48,19
HCPCS,0445U,Abeta42 & ptau181 eclia csf,,,66.63,77.15,8
HCPCS,0446T,INSJ IMPLTBL GLUCOSE SENSOR,,,1690.17,11660.94,19
HCPCS,0446T,Insj impltbl glucose sensor,,,309.06,357.86,8
HCPCS,0446U,AI DS SLE ALYS 10 CYTOKINE,,,840.65,3444.82,19
HCPCS,0446U,Ai ds sle alys 10 cytokine,,,66.63,77.15,8
HCPCS,0447T,RMVL IMPLTBL GLUCOSE SENSOR,,,183.59,562.35,19
HCPCS,0447T,Rmvl impltbl glucose sensor,,,133.98,155.13,8
HCPCS,0447U,AI DS SLE ALYS 11 CYTOKINE,,,840.65,3444.82,19
HCPCS,0447U,Ai ds sle alys 11 cytokine,,,66.63,77.15,8
HCPCS,0448T,REMVL INSJ IMPLTBL GLUC SENS,,,1690.17,11660.94,19
HCPCS,0448T,Remvl insj impltbl gluc sens,,,309.06,357.86,8
HCPCS,0448U,Onc lng&cln ca dna qual ngs,,,66.63,77.15,8
HCPCS,0449T,INSJ AQUEOUS DRAIN DEV 1ST,,,4767.47,14914.8,19
HCPCS,0449T,Insj aqueous drain dev 1st,,,1921.59,2225.0,8
HCPCS,0449U,CAR SCR SEV INH COND 5 GENES,,,4105.98,7477.99,3
HCPCS,0449U,Car scr sev inh cond 5 genes,,,66.63,77.15,8
HCPCS,0450T,Insj aqueous drain dev each,,,1921.59,2225.0,8
HCPCS,0450U,ONC MM LC-MS/MS MONOC P-PRTN,,,43.43,46.9,5
HCPCS,0450U,Onc mm lc-ms/ms monoc p-prtn,,,66.63,77.15,8
HCPCS,0451T,Insj/rplcmt aortic ventr sys,,,54134.24,62681.75,8
HCPCS,0451U,ONC MM LC-MS/MS PEP ION QUAN,,,43.43,46.9,5
HCPCS,0451U,Onc mm lc-ms/ms pep ion quan,,,66.63,77.15,8
HCPCS,0452T,Insj/rplcmt dev vasc seal,,,54134.24,62681.75,8
HCPCS,0452U,ONC BLDR MTHYL PENK LTE-QMSP,,,192.0,786.78,19
HCPCS,0452U,Onc bldr mthyl penk lte-qmsp,,,66.63,77.15,8
HCPCS,0453T,Insj/rplcmt mech-elec ntrfce,,,54134.24,62681.75,8
HCPCS,0453U,ONC CLRCT CA CFDNA QPCR ASY,,,192.0,786.78,19
HCPCS,0453U,Onc clrct ca cfdna qpcr asy,,,66.63,77.15,8
HCPCS,0454T,Insj/rplcmt subq electrode,,,54134.24,62681.75,8
HCPCS,0454U,RARE DS ID OPT GENOME MAPG,,,1263.53,5177.69,19
HCPCS,0454U,Rare ds id opt genome mapg,,,66.63,77.15,8
HCPCS,0455T,Remvl aortic ventr cmpl sys,,,2386.88,2763.76,8
HCPCS,0455U,NFCT AGT STI MULT AMP PRB UR,,,142.63,584.47,19
HCPCS,0455U,Nfct agt sti mult amp prb ur,,,13.21,15.29,8
HCPCS,0456T,Remvl aortic dev vasc seal,,,2386.88,2763.76,8
HCPCS,0456U,Ai ra ngs 19 genes anti-ccp,,,66.63,77.15,8
HCPCS,0457T,Remvl mech-elec skin ntrfce,,,2386.88,2763.76,8
HCPCS,0457U,PFAS 9 CMPND LC-MS/MS PLS/SR,,,198.74,814.4,19
HCPCS,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,14.4,16.68,8
HCPCS,0458T,Remvl subq electrode,,,639.93,740.97,8
HCPCS,0458U,ONC BRST CA S100 A8&A9 ELISA,,,260.5,1067.48,19
HCPCS,0458U,Onc brst ca s100 a8&a9 elisa,,,66.63,77.15,8
HCPCS,0459T,Relocaj rplcmt aortic ventr,,,54134.24,62681.75,8
HCPCS,0459U,ABETA42 & TTAU ECLIA CSF,,,260.5,1067.48,19
HCPCS,0459U,Abeta42 & ttau eclia csf,,,66.63,77.15,8
HCPCS,0460T,Repos aortic ventr dev eltrd,,,639.93,740.97,8
HCPCS,0460U,ONC WHL BLD/BUCC RTPCR 24GEN,,,917.08,3758.01,14
HCPCS,0460U,Onc whl bld/bucc rtpcr 24gen,,,66.63,77.15,8
HCPCS,0461T,Repos aortic contrpulsj dev,,,2386.88,2763.76,8
HCPCS,0461U,ONC RXGENOM ALYS RTPCR 24GEN,,,917.08,3758.01,14
HCPCS,0461U,Onc rxgenom alys rtpcr 24gen,,,66.63,77.15,8
HCPCS,0462T,Prgrmg eval aortic ventr sys,,,18.13,20.99,8
HCPCS,0462U,MELATONIN LVL TST SLP STD7/9,,,17.27,70.77,19
HCPCS,0462U,Melatonin lvl tst slp std7/9,,,66.63,77.15,8
HCPCS,0463T,Interrog aortic ventr sys,,,18.13,20.99,8
HCPCS,0463U,ONC CRVX MRNA GENXPRSN 14BMK,,,760.0,3114.33,14
HCPCS,0463U,Onc crvx mrna genxprsn 14bmk,,,66.63,77.15,8
HCPCS,0464T,VISUAL EP TEST FOR GLAUCOMA,,,121.73,360.65,19
HCPCS,0464T,Visual ep test for glaucoma,,,38.61,44.7,8
HCPCS,0464U,ONC CLRCT SCR QRTSA DNA MRK,,,591.92,2425.57,14
HCPCS,0464U,Onc clrct scr qrtsa dna mrk,,,66.63,77.15,8
HCPCS,0465T,Supchrdl njx rx w/o supply,,,36.15,41.86,8
HCPCS,0465U,ONC URTHL CARC DNA QMSP 2GEN,,,1938.01,7941.58,19
HCPCS,0465U,Onc urthl carc dna qmsp 2gen,,,66.63,77.15,8
HCPCS,0466T,Insj ch wal respir eltrd/ra,,,15220.57,17623.82,8
HCPCS,0466U,CRD CAD DNA GWAS 564856 SNP,,,345.43,1415.5,14
HCPCS,0466U,Crd cad dna gwas 564856 snp,,,66.63,77.15,8
HCPCS,0467T,Revj/rplmnt ch respir eltrd,,,1720.7,1992.39,8
HCPCS,0467U,ONC BLDR DNA NGS 60GEN&ANEUP,,,1519.06,6224.8,19
HCPCS,0467U,Onc bldr dna ngs 60gen&aneup,,,66.63,77.15,8
HCPCS,0468T,Rmvl ch wal respir eltrd/ra,,,1720.7,1992.39,8
HCPCS,0468U,HEP NASH MIR-34A5P A2M YKL40,,,251.7,1031.42,19
HCPCS,0468U,Hep nash mir34a5p a2m ykl40,,,66.63,77.15,8
HCPCS,0469T,Rta polarize scan oc scr bi,,,37.89,43.87,8
HCPCS,0469U,RARE DS WHL GEN SEQ FTL SAMP,,,1197.94,4908.92,19
HCPCS,0469U,Rare ds whl gen seq ftl samp,,,66.63,77.15,8
HCPCS,0470T,Oct skn img acquisj i&r 1st,,,56.72,65.67,8
HCPCS,0470U,ONC OROP DETCJ MRD 8 DNA HPV,,,597.91,2450.12,14
HCPCS,0470U,Onc orop detcj mrd 8 dna hpv,,,66.63,77.15,8
HCPCS,0471T,Oct skn img acquisj i&r addl,,,56.72,65.67,8
HCPCS,0471U,ONC CLRC CA 35 VRN KRAS&NRAS,,,760.0,3114.33,19
HCPCS,0471U,Onc clrc ca 35 vrn kras&nras,,,66.63,77.15,8
HCPCS,0472T,PRGRMG IO RTA ELTRD RA,,,277.11,860.86,19
HCPCS,0472T,Prgrmg io rta eltrd ra,,,18.13,20.99,8
HCPCS,0472U,CA VI PSP&SP1 ANTB SJÖGREN,,,27.9,114.33,14
HCPCS,0472U,Ca vi psp&sp1 antb sjogren,,,66.63,77.15,8
HCPCS,0473T,REPRGRMG IO RTA ELTRD RA,,,84.81,266.47,19
HCPCS,0473T,Reprgrmg io rta eltrd ra,,,18.13,20.99,8
HCPCS,0473U,ONC SLD TUM BLD/SLV 648 GENE,,,4500.0,18440.1,19
HCPCS,0473U,Onc sld tum bld/slv 648 gene,,,66.63,77.15,8
HCPCS,0474T,INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR,5757.0,3742.05,1.1,5757.0,32
HCPCS,0474T,Insj aqueous drg dev io rsvr,,,1921.59,2225.0,8
HCPCS,0474U,HERED PAN CA GSAP 88GENE NGS,,,1303.95,5343.33,19
HCPCS,0474U,Hered pan ca gsap 88gene ngs,,,66.63,77.15,8
HCPCS,0475T,Rec ftl car sgl 3 ch i&r,,,18.66,21.6,8
HCPCS,0475U,HERED PRST8 CA GSAP 23 GENES,,,1303.95,5343.33,19
HCPCS,0475U,Hered prst8 ca gsap 23 genes,,,66.63,77.15,8
HCPCS,0476T,Rec ftl car sgl elec tr data,,,18.66,21.6,8
HCPCS,0476U,RX METAB PSYC 14GEN&CYP2D6,,,416.78,1707.88,19
HCPCS,0476U,Rx metab psyc 14gen&cyp2d6,,,137.41,159.1,8
HCPCS,0477T,Rec ftl car sgl xrtj alys,,,18.66,21.6,8
HCPCS,0477U,RX METAB PSY 14&CYP2D6 GN-RX,,,416.78,1707.88,19
HCPCS,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,137.41,159.1,8
HCPCS,0478T,Rec ftl car 3 ch rev i&r,,,18.66,21.6,8
HCPCS,0478U,ONC NSCLC DNA&RNA DPCR 9GENS,,,552.99,2266.04,14
HCPCS,0478U,Onc nsclc dna&rna dpcr 9gens,,,66.63,77.15,8
HCPCS,0479T,FXJL ABL LSR 1ST 100 SQ CM,,,565.6,2071.51,19
HCPCS,0479T,Fxjl abl lsr 1st 100 sq cm,,,189.81,219.78,8
HCPCS,0479U,TAU PHOSPHORYLATED PTAU217,,,17.27,70.77,19
HCPCS,0479U,Tau phosphorylated ptau217,,,66.63,77.15,8
HCPCS,0480T,Fxjl abl lsr ea addl 100sqcm,,,189.81,219.78,8
HCPCS,0480U,NFCT DS CSF METAG NGS ALYS,,,2126.2,8712.74,19
HCPCS,0480U,Nfct ds csf metag ngs alys,,,66.63,77.15,8
HCPCS,0481T,NJX AUTOL WBC CONCENTRATE,,,368.71,1252.1,19
HCPCS,0481T,Njx autol wbc concentrate,,,360.34,417.23,8
HCPCS,0481U,IDH1 IDH2&TERT PROMOTER NGS,,,674.24,2762.9,19
HCPCS,0481U,Idh1 idh2&tert promoter ngs,,,66.63,77.15,8
HCPCS,0482U,OB PE BIOCHEM ASY SFLT1&PLGF,,,128.82,527.88,19
HCPCS,0482U,Ob pe biochem asy sflt1&plgf,,,66.63,77.15,8
HCPCS,0483T,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,13335.5,8668.075,1.1,1791901.44,77
HCPCS,0483U,NFCT DS NG GYRA S91F PT MUT,,,35.09,143.79,14
HCPCS,0483U,Nfct ds ng gyra s91f pt mut,,,13.21,15.29,8
HCPCS,0484T,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,20803.5,13522.275,1.1,1791901.44,77
HCPCS,0484U,NFCT DS MGEN 23S RRNA PT MUT,,,35.09,143.79,14
HCPCS,0484U,Nfct ds mgen 23s rrna pt mut,,,13.21,15.29,8
HCPCS,0485T,OCT MID EAR I&R UNILATERAL,,,35.34,104.69,19
HCPCS,0485T,Oct mid ear i&r unilateral,,,31.75,36.76,8
HCPCS,0485U,ONC SOL TUM CFDNA&RNA NGS GM,,,3649.48,14954.84,14
HCPCS,0485U,Onc sol tum cfdna&rna ngs gm,,,66.63,77.15,8
HCPCS,0486T,OCT MID EAR I&R BILATERAL,,,35.34,104.69,19
HCPCS,0486T,Oct mid ear i&r bilateral,,,31.75,36.76,8
HCPCS,0486U,ONC PAN SOL TUM NGS CFCTDNA,,,1644.25,6737.81,14
HCPCS,0486U,Onc pan sol tum ngs cfctdna,,,66.63,77.15,8
HCPCS,0487T,Trvg biomchn mapg w/reprt,,,77.56,89.8,8
HCPCS,0487U,ONC SOL TUM CFCDNA TGSAP 84,,,2919.6,11963.94,19
HCPCS,0487U,Onc sol tum cfcdna tgsap 84,,,66.63,77.15,8
HCPCS,0488U,OB FETAL AG NIPT CFDNA ALYS,,,1707.87,3110.44,3
HCPCS,0488U,Ob fetal ag nipt cfdna alys,,,66.63,77.15,8
HCPCS,0489T,Regn cell tx scldr hands,,,360.34,417.23,8
HCPCS,0489U,OB SGNIPT CFDNA SEQ ALYS 1+,,,2595.65,4727.3,3
HCPCS,0489U,Ob sgnipt cfdna seq alys 1+,,,66.63,77.15,8
HCPCS,0490T,Regn cell tx scldr h mlt inj,,,360.34,417.23,8
HCPCS,0490U,ONC CUTAN/UVEAL MLNMA CD146,,,2435.0,9978.14,19
HCPCS,0490U,Onc cutan/uveal mlnma cd146,,,66.63,77.15,8
HCPCS,0491T,Abl lsr opn wnd 1st 20 sqcm,,,189.81,219.78,8
HCPCS,0491U,ONC SOL TUM CTC SLCT ER PRTN,,,2435.0,9978.14,19
HCPCS,0491U,Onc sol tum ctc slct er prtn,,,66.63,77.15,8
HCPCS,0492T,Abl lsr opn wnd addl 20 sqcm,,,189.81,219.78,8
HCPCS,0492U,ONC SOL TUM CTC SLCTN PD-L1,,,2435.0,9978.14,19
HCPCS,0492U,Onc sol tum ctc slctn pd-l1,,,66.63,77.15,8
HCPCS,0493T,Cntc near ifr spectrsc wound,,,68.91,79.79,8
HCPCS,0493U,TRNSPL MED QUAN DD-CFDNA NGS,,,2753.25,11282.27,19
HCPCS,0493U,Trnspl med quan dd-cfdna ngs,,,533.45,617.68,8
HCPCS,0494T,Prep & cannulj cdvr don lung,,,975.94,1130.04,8
HCPCS,0494U,RBC AG FTL RHD GENE ALYS NGS,,,759.05,3110.44,19
HCPCS,0494U,Rbc ag ftl rhd gene alys ngs,,,66.63,77.15,8
HCPCS,0495T,Mntr cdvr don lng 1st 2 hrs,,,975.94,1130.04,8
HCPCS,0495U,ONC PRST8 ALYS CRCG PLSM PRT,,,760.0,3114.33,19
HCPCS,0495U,Onc prst8 alys crcg plsm prt,,,66.63,77.15,8
HCPCS,0496T,Mntr cdvr don lng ea addl hr,,,975.94,1130.04,8
HCPCS,0496U,ONC CLRCT CFDNA 8/7 GENES,,,485.86,1990.96,14
HCPCS,0496U,Onc clrct cfdna 8/7 genes,,,92.46,107.06,8
HCPCS,0497T,Xtrnl pt act ecg in-off conn,,,18.66,21.6,8
HCPCS,0497U,ONC PRST8 MRNA RT-PCR 6GENES,,,3873.0,15870.78,19
HCPCS,0497U,Onc prst8 mrna rt-pcr 6genes,,,66.63,77.15,8
HCPCS,0498T,Xtrnl pt act ecg r&i pr 30 d,,,18.66,21.6,8
HCPCS,0498U,ONC CLRCT NGS MUT DETC 43GEN,,,1345.31,5512.81,14
HCPCS,0498U,Onc clrct ngs mut detc 43gen,,,66.63,77.15,8
HCPCS,0499T,Cysto f/urtl strix/stenosis,,,1676.36,1941.05,8
HCPCS,0499U,ONC CLRCT&LNG DNA NGS 8GENES,,,597.91,2450.12,19
HCPCS,0499U,Onc clrct&lng dna ngs 8genes,,,66.63,77.15,8
HCPCS,0500F,Initial prenatal care visit,,,8.48,9.82,8
HCPCS,0500T,Hpv 5+ hi risk hpv types,,,13.21,15.29,8
HCPCS,0500U,AUTOINFLAM DS VEXAS SYND DNA,,,175.4,718.75,19
HCPCS,0500U,Autoinflam ds vexas synd dna,,,66.63,77.15,8
HCPCS,0501F,Prenatal flow sheet,,,8.48,9.82,8
HCPCS,0501T,Cor ffr derived cor cta data,,,359.94,416.77,8
HCPCS,0501U,ONC CLRC BLD QUAN MEAS CFDNA,,,432.0,786.78,3
HCPCS,0501U,Onc clrc bld quan meas cfdna,,,66.63,77.15,8
HCPCS,0502F,Subsequent prenatal care,,,8.48,9.82,8
HCPCS,0502T,Cor ffr data prep & transmis,,,68.91,79.79,8
HCPCS,0502U,HPV E6/E7 MRK HI-RSK TYP CRV,,,35.09,143.79,19
HCPCS,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,66.63,77.15,8
HCPCS,0503F,Postpartum care visit,,,8.48,9.82,8
HCPCS,0503T,Cor ffr alys gnrj ffr mdl,,,359.94,416.77,8
HCPCS,0503U,NEURO ALZ DS ßAMYL&TAU PRTN,,,750.0,3073.35,19
HCPCS,0503U,Neuro alz ds bamyl&tau prtn,,,66.63,77.15,8
HCPCS,0504T,Cor ffr data review i&r,,,68.91,79.79,8
HCPCS,0504U,NFCT DS UTI ID 17 PATH ORGS,,,416.78,1707.88,19
HCPCS,0504U,Nfct ds uti id 17 path orgs,,,39.01,45.17,8
HCPCS,0505F,Hemodialysis plan docd,,,8.48,9.82,8
HCPCS,0505T,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,47177.0,30665.05,3708.64,47177.0,61
HCPCS,0505U,NFCT DS VAG INFCTJ ID 32ORGS,,,679.77,2785.56,19
HCPCS,0505U,Nfct ds vag infctj id 32orgs,,,13.21,15.29,8
HCPCS,0506T,MAC PGMT OPT DNS MEAS HFP,,,54.88,165.35,19
HCPCS,0506T,Mac pgmt opt dns meas hfp,,,37.89,43.87,8
HCPCS,0506U,GI BARRETTS ESOPHGL CELL 89,,,1938.01,7941.58,19
HCPCS,0506U,Gi barretts esophgl cell 89,,,66.63,77.15,8
HCPCS,0507F,Periton dialysis plan docd,,,8.48,9.82,8
HCPCS,0507T,NEAR IFR 2IMG MIBMN GLND I&R,,,54.88,165.35,19
HCPCS,0507T,Near ifr 2img mibmn glnd i&r,,,37.89,43.87,8
HCPCS,0507U,ONC OVR DNA WHOLE GEN W/5HMC,,,1160.0,4753.45,19
HCPCS,0507U,Onc ovr dna whole gen w/5hmc,,,66.63,77.15,8
HCPCS,0508U,Trnsplj med dd-cfdna 40 snps,,,66.63,77.15,8
HCPCS,0509F,Urine incon plan docd,,,8.48,9.82,8
HCPCS,0509T,PATTERN ERG W/I&R,,,204.28,605.2,19
HCPCS,0509T,Pattern erg w/i&r,,,38.61,44.7,8
HCPCS,0509U,Trnsplj med dd-cfdna<12 snps,,,66.63,77.15,8
HCPCS,0510T,RMVL SINUS TARSI IMPLANT,,,2997.95,9170.92,19
HCPCS,0510T,Rmvl sinus tarsi implant,,,1392.99,1612.93,8
HCPCS,0510U,ONC PNCRTC CA ALG ALYS 16GEN,,,473.91,1941.99,14
HCPCS,0510U,Onc pncrtc ca alg alys 16gen,,,66.63,77.15,8
HCPCS,0511T,RMVL&RINSJ SINUS TARSI IMPLT,,,6600.66,20338.07,19
HCPCS,0511T,Rmvl&rinsj sinus tarsi implt,,,3246.83,3759.49,8
HCPCS,0511U,ONC SOL TUM 3DMICROENVIR 36+,,,3033.86,12432.15,19
HCPCS,0511U,Onc sol tum 3dmicroenvir 36+,,,66.63,77.15,8
HCPCS,0512T,ESW INTEG WND HLG 1ST WND,,,183.59,562.35,19
HCPCS,0512T,Esw integ wnd hlg 1st wnd,,,189.81,219.78,8
HCPCS,0512U,ONC PRST8 ALYS DGTZ IMG MSI,,,706.25,2894.07,19
HCPCS,0512U,Onc prst8 alys dgtz img msi,,,66.63,77.15,8
HCPCS,0513F,Elev bp plan of care docd,,,8.48,9.82,8
HCPCS,0513T,Esw integ wnd hlg ea addl,,,189.81,219.78,8
HCPCS,0513U,ONC PRST8 ALG ALYS MSI&HRD,,,706.25,2894.07,19
HCPCS,0513U,Onc prst8 alg alys msi&hrd,,,66.63,77.15,8
HCPCS,0514F,Care plan hgb docd esa pt,,,8.48,9.82,8
HCPCS,0514T,Intraop vis axis id pt fixj,,,38.61,44.7,8
HCPCS,0514U,GI IBD IA QUAN DETER ADL LVL,,,38.57,158.05,19
HCPCS,0514U,Gi ibd ia quan deter adl lvl,,,14.54,16.83,8
HCPCS,0515T,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,13216.0,8590.4,1.1,40246.53,31
HCPCS,0515T,INSJ WCS LV COMPL SYS,,,20739.83,62345.36,19
HCPCS,0515T,Insj wcs lv compl sys,,,5003.75,5793.81,8
HCPCS,0515U,GI IBD IA QUAN DETER IFX LVL,,,38.57,158.05,19
HCPCS,0515U,Gi ibd ia quan deter ifx lvl,,,14.54,16.83,8
HCPCS,0516F,Anemia plan of care docd,,,8.48,9.82,8
HCPCS,0516T,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,13216.0,8590.4,1.1,18231.81,31
HCPCS,0516T,INSJ WCS LV ELTRD ONLY,,,9669.76,29295.35,19
HCPCS,0516T,Insj wcs lv eltrd only,,,639.93,740.97,8
HCPCS,0516U,RX METAB RXGENOMIC GNOTYP 40,,,416.78,1707.88,19
HCPCS,0516U,Rx metab rxgenomic gnotyp 40,,,66.63,77.15,8
HCPCS,0517F,Glaucoma plan of care docd,,,8.48,9.82,8
HCPCS,0517T,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,13216.0,8590.4,1.1,18231.81,31
HCPCS,0517T,INSJ WCS LV BOTH COMPNT PG,,,9669.76,29295.35,19
HCPCS,0517T,Insj wcs lv both compnt pg,,,5003.75,5793.81,8
HCPCS,0517U,THER RX MNTR 80+ PSYACTIV RX,,,246.92,1011.83,19
HCPCS,0517U,Ther rx mntr 80+ psyactiv rx,,,14.54,16.83,8
HCPCS,0518F,Fall plan of care docd,,,8.48,9.82,8
HCPCS,0518T,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,2529.0,1643.85,1.1,6705.66,31
HCPCS,0518T,RMVL PG WCS LV BATTERY ONLY,,,3362.64,10474.13,19
HCPCS,0518T,Rmvl pg wcs lv battery only,,,2386.88,2763.76,8
HCPCS,0518U,THER RX MNTR 90+ PN&MTL HLTH,,,246.92,1011.83,19
HCPCS,0518U,Ther rx mntr 90+ pn&mtl hlth,,,14.54,16.83,8
HCPCS,0519F,Pland chemo docd b/4 txmnt,,,8.48,9.82,8
HCPCS,0519T,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,2529.0,1643.85,1.1,18231.81,31
HCPCS,0519T,RMV&RPLCMT PG WCS LV BOTH,,,9669.76,29295.35,19
HCPCS,0519T,Rmv&rplcmt pg wcs lv both,,,5003.75,5793.81,8
HCPCS,0519U,THER RX MNTR MEDS P/D/A 110+,,,246.92,1011.83,19
HCPCS,0519U,Ther rx mntr meds p/d/a 110+,,,14.54,16.83,8
HCPCS,0520F,Rad dos limts b/4 3d rad,,,8.48,9.82,8
HCPCS,0520T,RMV&RPLCMT PG WCS LV BATTERY,,,9669.76,29295.35,19
HCPCS,0520T,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,2529.0,1643.85,1.1,18231.81,31
HCPCS,0520T,Rmv&rplcmt pg wcs lv battery,,,17330.27,20066.63,8
HCPCS,0520U,THER RX MNTR 200+ RX/SBSTS,,,246.92,1011.83,19
HCPCS,0520U,Ther rx mntr 200+ rx/sbsts,,,14.54,16.83,8
HCPCS,0521F,Plan of care 4 pain docd,,,8.48,9.82,8
HCPCS,0521T,INTERROG DEV EVAL WCS IP,,,22.63,81.07,19
HCPCS,0521T,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,308.0,200.2,1.1,308.0,31
HCPCS,0521T,Interrog dev eval wcs ip,,,18.13,20.99,8
HCPCS,0521U,RF IGA&IGM CCP ANTB SR-A IA,,,51.8,212.27,14
HCPCS,0521U,Rf iga&igm ccp antb sr-a ia,,,66.63,77.15,8
HCPCS,0522T,PRGRMG DEV EVAL WCS IP,,,34.46,104.61,19
HCPCS,0522T,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,403.0,261.95,1.1,403.0,31
HCPCS,0522T,Prgrmg dev eval wcs ip,,,18.13,20.99,8
HCPCS,0522U,CA VI PSP&SP1 ANTB CL SEMIQL,,,260.5,1067.48,14
HCPCS,0522U,Ca vi psp&sp1 antb cl semiql,,,66.63,77.15,8
HCPCS,0523T,INTRAPROCEDURAL CORONARY FFP W/3D FUNCJL MAPPING,2593.0,1685.45,1.1,7735.57,32
HCPCS,0523T,INTRAPROCEDURAL CORONARY FRACTIONAL FLOW RESERVE (FFR) WITH 3D F,17254.0,11215.1,321.96,17254.0,46
HCPCS,0523U,ONC SOLTUM DNA NGS SNV 22GEN,,,1352.09,5540.59,14
HCPCS,0523U,Onc soltum dna ngs snv 22gen,,,66.63,77.15,8
HCPCS,0524T,EV CATH DIR CHEM ABLTJ W/IMG,,,2908.23,8849.94,19
HCPCS,0524T,Ev cath dir chem abltj w/img,,,1698.96,1967.22,8
HCPCS,0524U,OB PE SFLT-1/PLGF IA SRM/PLS,,,128.82,527.88,14
HCPCS,0524U,Ob pe sflt-1/plgf ia srm/pls,,,66.63,77.15,8
HCPCS,0525F,Initial visit for episode,,,8.48,9.82,8
HCPCS,0525T,INSJ/RPLCMT COMPL IIMS,,,17621.37,53987.6,19
HCPCS,0525T,Insj/rplcmt compl iims,,,5003.75,5793.81,8
HCPCS,0525U,ONC SPHRD CELL CUL 11-RX PNL,,,3033.86,12432.15,14
HCPCS,0525U,Onc sphrd cell cul 11-rx pnl,,,66.63,77.15,8
HCPCS,0526F,Subs visit for episode,,,8.48,9.82,8
HCPCS,0526T,INSJ/RPLCMT IIMS ELTRD ONLY,,,7646.84,23194.66,19
HCPCS,0526T,Insj/rplcmt iims eltrd only,,,639.93,740.97,8
HCPCS,0526U,Nefro rnl trnspl quan cxcl10,,,66.63,77.15,8
HCPCS,0527T,INSJ/RPLCMT IIMS IMPLT MNTR,,,7646.84,23194.66,19
HCPCS,0527T,Insj/rplcmt iims implt mntr,,,5003.75,5793.81,8
HCPCS,0527U,HSV 1&2 VZV AMP PRB TQ PTHGN,,,142.63,584.47,14
HCPCS,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,13.21,15.29,8
HCPCS,0528F,Rcmnd flw-up 10 yrs docd,,,8.48,9.82,8
HCPCS,0528T,PRGRMG DEV EVAL IIMS IP,,,34.46,104.61,19
HCPCS,0528T,Prgrmg dev eval iims ip,,,18.13,20.99,8
HCPCS,0528U,LRT IAD 18BCT/8VIR&7ARG RNA,,,634.84,2601.45,14
HCPCS,0528U,Lrt iad 18bct/8vir&7arg rna,,,13.21,15.29,8
HCPCS,0529F,Intrvl 3/>yr pts clnscp docd,,,8.48,9.82,8
HCPCS,0529T,INTERROG DEV EVAL IIMS IP,,,34.46,104.61,19
HCPCS,0529T,Interrog dev eval iims ip,,,18.13,20.99,8
HCPCS,0529U,Hem vte snp f2&f5 gen leiden,,,66.63,77.15,8
HCPCS,0530T,REMOVAL COMPLETE IIMS,,,3362.64,10474.13,19
HCPCS,0530T,Removal complete iims,,,2386.88,2763.76,8
HCPCS,0530U,ONC PAN-SOL TUM CTDNA 77 GEN,,,2919.6,11963.94,14
HCPCS,0530U,Onc pan-sol tum ctdna 77 gen,,,66.63,77.15,8
HCPCS,0531T,REMOVAL IIMS ELECTRODE ONLY,,,3362.64,10474.13,19
HCPCS,0531T,Removal iims electrode only,,,639.93,740.97,8
HCPCS,0531U,Nfct ds afb&inv fng 673orgs,,,66.63,77.15,8
HCPCS,0532T,REMOVAL IIMS IMPLT MNTR ONLY,,,3362.64,10474.13,19
HCPCS,0532T,Removal iims implt mntr only,,,2386.88,2763.76,8
HCPCS,0532U,RARE DS WHLGEN&MITOCHDRL DNA,,,5031.2,20616.85,14
HCPCS,0532U,Rare ds whlgen&mitochdrl dna,,,66.63,77.15,8
HCPCS,0533T,Cont rec mvmt do 6-10 days,,,68.77,79.63,8
HCPCS,0533U,RX METAB ADVRS GNOTYP 16GENS,,,416.78,1707.88,14
HCPCS,0533U,Rx metab advrs gnotyp 16gens,,,66.63,77.15,8
HCPCS,0534T,Cont rec mvmt do setup&train,,,31.04,35.94,8
HCPCS,0534U,Onc prst8 mirna snp 32 vrnt,,,66.63,77.15,8
HCPCS,0535F,Dyspnea mngmnt plan docd,,,8.48,9.82,8
HCPCS,0535T,Cont rec mvmt do reprt cnfig,,,68.77,79.63,8
HCPCS,0535U,PFAS LC-MS/MS PLSM/SRM QUAN,,,62.14,254.64,14
HCPCS,0535U,Pfas lc-ms/ms plsm/srm quan,,,14.4,16.68,8
HCPCS,0536T,Cont rec mvmt do dl w/i&r,,,68.77,79.63,8
HCPCS,0536U,RBCAG FTL RHD PCR ALYS EXON4,,,192.0,786.78,14
HCPCS,0536U,Rbcag ftl rhd pcr alys exon4,,,66.63,77.15,8
HCPCS,0537T,Bld drv t lymphcyt car-t cll,,,118.45,137.15,8
HCPCS,0537U,ONC CLRCT CA CFDNA >2500 DMR,,,1495.0,6126.21,14
HCPCS,0537U,Onc clrct ca cfdna >2500 dmr,,,66.63,77.15,8
HCPCS,0538T,Bld drv t lymphcyt prep trns,,,118.45,137.15,8
HCPCS,0538U,ONC SOL TUM NGTS FFPE 600GEN,,,2989.55,12250.58,14
HCPCS,0538U,Onc sol tum ngts ffpe 600gen,,,66.63,77.15,8
HCPCS,0539T,Receipt&prep car-t cll admn,,,118.45,137.15,8
HCPCS,0539U,ONC SOL TUMOR CFCTDNA 152GEN,,,3288.51,13475.66,14
HCPCS,0539U,Onc sol tumor cfctdna 152gen,,,66.63,77.15,8
HCPCS,0540F,Gluco mngmnt plan docd,,,8.48,9.82,8
HCPCS,0540T,Car-t cll admn autologous,,,118.45,137.15,8
HCPCS,0540U,TRNSPLJ MED QUAN DD-CFDNA,,,2753.25,11282.27,14
HCPCS,0540U,Trnsplj med quan dd-cfdna,,,66.63,77.15,8
HCPCS,0541T,MYOCARDIAL IMAGING MCG,,,353.04,1045.9,19
HCPCS,0541T,Myocardial imaging mcg,,,202.79,234.81,8
HCPCS,0541U,Cv ds hdl rct cec lc-ms/ms 5,,,66.63,77.15,8
HCPCS,0542T,Myocardial imaging mcg i&r,,,202.79,234.81,8
HCPCS,0542U,Nefro renal trnspl ur nmr 84,,,66.63,77.15,8
HCPCS,0543T,Ta mv rpr w/artif chord tend,,,11343.93,13135.08,8
HCPCS,0543U,ONC SOL TUM NGS DNA 517 GENS,,,2989.55,12250.58,14
HCPCS,0543U,Onc sol tum ngs dna 517 gens,,,66.63,77.15,8
HCPCS,0544T,Tcat mv annulus rcnstj,,,11343.93,13135.08,8
HCPCS,0544U,Nefro trnsp mntr 48vrnt dpcr,,,66.63,77.15,8
HCPCS,0545F,Follow up care plan mdd docd,,,8.48,9.82,8
HCPCS,0545T,Tcat tv annulus rcnstj,,,11343.93,13135.08,8
HCPCS,0545U,ACHR ANTB ID IMFLUOR LIVECLL,,,37.73,154.61,14
HCPCS,0545U,Achr antb id imfluor livecll,,,18.32,21.21,8
HCPCS,0546T,Rf spectrsc ntraop mrgn asmt,,,68.91,79.79,8
HCPCS,0546U,LDNS LRP4 ANTB IMFLR LIVECLL,,,37.73,154.61,14
HCPCS,0546U,Ldns lrp4 antb imflr livecll,,,18.32,21.21,8
HCPCS,0547T,B1 MATRL QUAL TST MCRIND TIB,,,1331.89,1331.89,1
HCPCS,0547U,NEURFLMNT LT CHN CLEIA PLSM,,,116.23,476.29,14
HCPCS,0547U,Neurflmnt lt chn cleia plsm,,,13.21,15.29,8
HCPCS,0548T,Tprnl balo cntnc dev bi,,,2885.48,3341.09,8
HCPCS,0548U,GFAP CLEIA PLASMA,,,116.23,476.29,14
HCPCS,0548U,Gfap cleia plasma,,,13.21,15.29,8
HCPCS,0549T,Tprnl balo cntnc dev uni,,,1676.36,1941.05,8
HCPCS,0549U,ONC URTHL DNA MTHYLTD RT PCR,,,760.0,3114.33,14
HCPCS,0549U,Onc urthl dna mthyltd rt pcr,,,66.63,77.15,8
HCPCS,0550F,Cytopath report nongyn spcmn,,,8.48,9.82,8
HCPCS,0550T,Tprnl balo cntnc dev rmvl ea,,,1676.36,1941.05,8
HCPCS,0550U,Onc prst8 elisa tot&free psa,,,14.4,16.68,8
HCPCS,0551F,Cytopath report non routine,,,8.48,9.82,8
HCPCS,0551T,Tprnl balo cntnc dev adjmt,,,226.03,261.72,8
HCPCS,0551U,Tp ptau217 ult dgt prtn detj,,,66.63,77.15,8
HCPCS,0552T,Low-level laser therapy,,,24.68,28.58,8
HCPCS,0552U,Repr med pga gdo te bx locus,,,66.63,77.15,8
HCPCS,0553T,Perq tcat iliac anast implt,,,6695.97,7753.23,8
HCPCS,0553U,REPR MED PGA EMBRY TE STRUX,,,759.05,3110.44,14
HCPCS,0553U,Repr med pga embry te strux,,,66.63,77.15,8
HCPCS,0554T,B1 STR & FX RSK ANALYSIS,,,192.53,192.53,1
HCPCS,0554U,REPR MED PGA 24CHRM TE BX QC,,,759.05,3110.44,14
HCPCS,0554U,Repr med pga 24chrm te bx qc,,,66.63,77.15,8
HCPCS,0555F,Symptom mgmnt plan care docd,,,8.48,9.82,8
HCPCS,0555T,B1 STR&FX RSK TRANSMIS DATA,,,22.63,124.9,20
HCPCS,0555T,B1 str&fx rsk transmis data,,,68.91,79.79,8
HCPCS,0555U,REPR MED PGA EMBRYONIC TE QC,,,759.05,3110.44,14
HCPCS,0555U,Repr med pga embryonic te qc,,,66.63,77.15,8
HCPCS,0556F,Plan care lipid control docd,,,8.48,9.82,8
HCPCS,0556T,B1 STR & FX RSK ASSESSMENT,,,223.34,1165.03,20
HCPCS,0556U,NFCT DS P-S DNA&RNA 12 TRGTS,,,142.63,584.47,14
HCPCS,0556U,Nfct ds p-s dna&rna 12 trgts,,,66.63,77.15,8
HCPCS,0557F,Plan caremng angnl symptdocd,,,8.48,9.82,8
HCPCS,0557T,B1 STR & FX RSK I&R,,,47.7,47.7,1
HCPCS,0557T,B1 str & fx rsk i&r,,,321.96,372.8,8
HCPCS,0557U,NFCT DS BV DNA MRK VAG FLUID,,,262.99,1077.68,14
HCPCS,0557U,Nfct ds bv dna mrk vag fluid,,,66.63,77.15,8
HCPCS,0558T,CT SCAN F/BIOMCHN CT ALYS,,,81.36,409.57,20
HCPCS,0558T,Ct scan f/biomchn ct alys,,,56.72,65.67,8
HCPCS,0558U,ONC CLRCT ELISA BF7 AG SERUM,,,20.81,85.28,14
HCPCS,0558U,Onc clrct elisa bf7 ag serum,,,66.63,77.15,8
HCPCS,0559T,ANTMC MDL 3D PRINT 1ST CMPNT,,,54.88,372.91,20
HCPCS,0559T,Antmc mdl 3d print 1st cmpnt,,,68.91,79.79,8
HCPCS,0559U,ONC BRS QUAN ELISA BF9AG SRM,,,20.81,85.28,14
HCPCS,0559U,Onc brs quan elisa bf9ag srm,,,66.63,77.15,8
HCPCS,0560T,Antmc mdl 3d print ea addl,,,68.91,79.79,8
HCPCS,0560U,ONC MRD GSA CFDNA BASELINE,,,3878.45,15893.11,14
HCPCS,0560U,Onc mrd gsa cfdna baseline,,,66.63,77.15,8
HCPCS,0561T,ANTMC GUIDE 3D PRINT 1ST GD,,,54.88,372.91,20
HCPCS,0561T,Antmc guide 3d print 1st gd,,,68.91,79.79,8
HCPCS,0561U,ONC MRD GSA CFDNA SUBSEQUENT,,,794.49,3255.66,14
HCPCS,0561U,Onc mrd gsa cfdna subsequent,,,66.63,77.15,8
HCPCS,0562T,Antmc guide 3d print ea addl,,,68.91,79.79,8
HCPCS,0562U,ONC SOL TUM TGSA 33GENS SNVS,,,597.91,2450.12,14
HCPCS,0562U,Onc sol tum tgsa 33gens snvs,,,66.63,77.15,8
HCPCS,0563T,EVAC MEIBOMIAN GLND HEAT BI,,,54.88,165.35,19
HCPCS,0563T,Evac meibomian glnd heat bi,,,38.61,44.7,8
HCPCS,0563U,NFCT DS PTHGN-SNA 11VIR&4BCT,,,416.78,1707.88,14
HCPCS,0563U,Nfct ds pthgn-sna 11vir&4bct,,,66.63,77.15,8
HCPCS,0564T,Onc chemo rx cytotox csc 14,,,14.54,16.83,8
HCPCS,0564U,NFCT DS PTHGN-SNA 10VIR&4BCT,,,416.78,1707.88,14
HCPCS,0564U,Nfct ds pthgn-sna 10vir&4bct,,,66.63,77.15,8
HCPCS,0565T,Autol cell implt adps hrvg,,,199.7,231.23,8
HCPCS,0565U,ONC HCC NGS DETC 6626EPIGALT,,,1160.0,4753.45,14
HCPCS,0565U,Onc hcc ngs detc 6626epigalt,,,66.63,77.15,8
HCPCS,0566T,Autol cell implt adps njx,,,138.73,160.63,8
HCPCS,0566U,ONC LNG QPCR-BSD ALYS 13DMRS,,,416.78,1707.88,14
HCPCS,0566U,Onc lng qpcr-bsd alys 13dmrs,,,66.63,77.15,8
HCPCS,0567T,Perm flp tube occls w/implt,,,1352.51,1566.06,8
HCPCS,0567U,RARE DS WHL GEN SEQ SRS&LRS,,,5031.2,20616.85,14
HCPCS,0567U,Rare ds whl gen seq srs&lrs,,,66.63,77.15,8
HCPCS,0568T,Intro mix saline&air f/ssg,,,89.44,103.57,8
HCPCS,0568U,NEUROL DEMENTIA BAMYL PTAU,,,897.0,3675.73,14
HCPCS,0568U,Neurol dementia bamyl ptau,,,66.63,77.15,8
HCPCS,0569T,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,11278.0,7330.7,1.1,11278.0,32
HCPCS,0569T,Ttvr perq appr 1st prosth,,,11343.93,13135.08,8
HCPCS,0569U,Onc sol tum ngs tmm>20000dmr,,,66.63,77.15,8
HCPCS,0570T,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,11278.0,7330.7,1.1,1791901.44,31
HCPCS,0570T,Ttvr perq ea addl prosth,,,11343.93,13135.08,8
HCPCS,0570U,NEUROL TBI ALYS GFAP&UCH-L1,,,260.5,1067.48,14
HCPCS,0570U,Neurol tbi alys gfap&uch-l1,,,66.63,77.15,8
HCPCS,0571T,INSJ/RPLCMT ICDS SS ELTRD,,,29624.26,87978.22,19
HCPCS,0571T,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,9806.0,6373.9,1.1,56172.03,31
HCPCS,0571T,Insj/rplcmt icds ss eltrd,,,17330.27,20066.63,8
HCPCS,0571U,ONC SOL TUM DNA80&RNA10G NGS,,,2919.6,11963.94,14
HCPCS,0571U,Onc sol tum dna80&rna10g ngs,,,66.63,77.15,8
HCPCS,0572T,INSERTION SS DFB ELECTRODE,,,7646.84,23194.66,19
HCPCS,0572T,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,2484.0,1614.6,1.1,14506.24,31
HCPCS,0572T,Insertion ss dfb electrode,,,639.93,740.97,8
HCPCS,0572U,Onc prst8 httl qfish whl bld,,,66.63,77.15,8
HCPCS,0573T,REMOVAL SS DFB ELECTRODE,,,3362.64,10474.13,19
HCPCS,0573T,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,10278.0,6680.7,1.1,10278.0,31
HCPCS,0573T,Removal ss dfb electrode,,,639.93,740.97,8
HCPCS,0573U,Onc pancreas 3bmrk pclf alg,,,66.63,77.15,8
HCPCS,0574T,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,2835.0,1842.75,1.1,6705.66,31
HCPCS,0574T,REPOS PREV SS IMPL DFB ELTRD,,,3362.64,10474.13,19
HCPCS,0574T,Repos prev ss impl dfb eltrd,,,639.93,740.97,8
HCPCS,0574U,Mtb cfp-10 serum/plsm lc-ms,,,26.69,30.9,8
HCPCS,0575F,Hiv rna plan care docd,,,8.48,9.82,8
HCPCS,0575T,PRGRMG DEV EVAL ICDS SS IP,,,34.46,104.61,19
HCPCS,0575T,PROGRAMMING DEV EVAL ICDS W/SS ELTRD IN PERSON,299.0,194.35,1.1,299.0,31
HCPCS,0575T,Prgrmg dev eval icds ss ip,,,18.13,20.99,8
HCPCS,0575U,TRNSPLJ MED LAR RTPCR 4GENES,,,380.0,1557.16,14
HCPCS,0575U,Trnsplj med lar rtpcr 4genes,,,66.63,77.15,8
HCPCS,0576T,INTERROG DEV EVAL ICDS SS IP,,,34.46,104.61,19
HCPCS,0576T,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,402.0,261.3,1.1,402.0,32
HCPCS,0576T,Interrog dev eval icds ss ip,,,18.13,20.99,8
HCPCS,0576U,TRNSPLJ MED LAR QUAN DDCFDNA,,,3240.0,13276.87,14
HCPCS,0576U,Trnsplj med lar quan ddcfdna,,,66.63,77.15,8
HCPCS,0577T,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,2414.0,1569.1,1.1,2414.0,31
HCPCS,0577T,EPHYS EVAL ICDS SS,,,1121.7,3412.58,19
HCPCS,0577T,Ephys eval icds ss,,,1238.33,1433.86,8
HCPCS,0577U,ONC OVR SERUM ALYS 39 GPS,,,246.92,1011.83,14
HCPCS,0577U,Onc ovr serum alys 39 gps,,,66.63,77.15,8
HCPCS,0578T,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D PHY/QHP,662.0,430.3,1.1,1791901.44,31
HCPCS,0578T,Rem interrog dev icds phys,,,18.13,20.99,8
HCPCS,0578U,ONC CUTAN MLN RNA QPCR 10GEN,,,3873.0,15870.78,14
HCPCS,0578U,Onc cutan mln rna qpcr 10gen,,,66.63,77.15,8
HCPCS,0579T,REM INTERROG DEV ICDS TECH,,,34.46,104.61,19
HCPCS,0579T,Rem interrog dev icds tech,,,18.13,20.99,8
HCPCS,0579U,NFRO DBTC CKD ELISA APOA4,,,390.75,1601.22,14
HCPCS,0579U,Nfro dbtc ckd elisa apoa4,,,66.63,77.15,8
HCPCS,0580F,Multidisciplinary care plan,,,8.48,9.82,8
HCPCS,0580T,RMVL SS IMPL DFB PG ONLY,,,3362.64,10474.13,19
HCPCS,0580T,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,1407.0,914.55,1.1,6705.66,31
HCPCS,0580T,Rmvl ss impl dfb pg only,,,639.93,740.97,8
HCPCS,0580U,BBRGDRFERI LD ANTB DETCJ 31,,,17.21,70.52,14
HCPCS,0580U,Bbrgdrferi ld antb detcj 31,,,18.32,21.21,8
HCPCS,0581F,Pt trnsfrd from anesth to cc,,,8.48,9.82,8
HCPCS,0581T,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,15317.0,9956.05,0.01,15317.0,61
HCPCS,0581U,TRNSPL MED ANTB NOHLA 39TRGT,,,325.8,1335.06,14
HCPCS,0581U,Trnspl med antb nohla 39trgt,,,53.63,62.1,8
HCPCS,0582F,No trnsfr from anesth to cc,,,8.48,9.82,8
HCPCS,0582T,TRURL ABLTJ MAL PRST8 TISS,,,12482.03,36979.25,13
HCPCS,0582T,Trurl abltj mal prst8 tiss,,,2607.32,3019.01,8
HCPCS,0582U,RARE DS RPD WHLGEN DNA VRNTS,,,7582.2,31070.34,14
HCPCS,0582U,Rare ds rpd whlgen dna vrnts,,,66.63,77.15,8
HCPCS,0583F,Transfer care checklist used,,,8.48,9.82,8
HCPCS,0583T,TMPST AUTO TUBE DLVR SYS,,,1368.67,4348.85,19
HCPCS,0583T,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,1949.0,1266.85,1.1,2603.78,43
HCPCS,0583T,Tmpst auto tube dlvr sys,,,745.85,863.61,8
HCPCS,0583U,RARE DS RPD WHLGEN CMPTR DNA,,,3791.1,15535.17,14
HCPCS,0583U,Rare ds rpd whlgen cmptr dna,,,66.63,77.15,8
HCPCS,0584F,No transfercare chklist used,,,8.48,9.82,8
HCPCS,0584T,Perq islet cell transplant,,,2755.97,3191.12,8
HCPCS,0584U,NEURO CSF PRION PRTN QUAL,,,540.99,2216.87,14
HCPCS,0584U,Neuro csf prion prtn qual,,,66.63,77.15,8
HCPCS,0585T,Laps islet cell transplant,,,2755.97,3191.12,8
HCPCS,0585U,TGSAP SO NEO CFDNA 521 GENES,,,2919.6,11963.94,14
HCPCS,0585U,Tgsap so neo cfdna 521 genes,,,66.63,77.15,8
HCPCS,0586T,Open islet cell transplant,,,2755.97,3191.12,8
HCPCS,0586U,ONC MRNA GEN XPRSN 216 GENES,,,2919.6,11963.94,14
HCPCS,0586U,Onc mrna gen xprsn 216 genes,,,66.63,77.15,8
HCPCS,0587T,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,5612.5,3648.125,0.01,17862.53,92
HCPCS,0587U,THER RX MNTR 60-150RX&METABL,,,114.43,468.91,14
HCPCS,0587U,Ther rx mntr 60150rx&metabl,,,14.54,16.83,8
HCPCS,0588T,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,8278.0,5380.7,0.01,13756.0,92
HCPCS,0588U,NFCT DS BCT/VIR 32GENES MRNA,,,760.0,3114.33,14
HCPCS,0588U,Nfct ds bct/vir 32genes mrna,,,66.63,77.15,8
HCPCS,0589T,ELEC ALYS SMPL PRGRMG IINS,,,84.81,266.47,19
HCPCS,0589T,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,351.0,228.15,1.1,351.0,31
HCPCS,0589T,Elec alys smpl prgrmg iins,,,73.53,85.14,8
HCPCS,0589U,PFAS24CMPND HI-PERF LC-MS/MS,,,198.74,814.4,14
HCPCS,0589U,Pfas24cmpnd hiperf lc-ms/ms,,,14.4,16.68,8
HCPCS,0590T,ELEC ALYS CPLX PRGRMG IINS,,,84.81,266.47,19
HCPCS,0590T,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,654.0,425.1,1.1,654.0,31
HCPCS,0590T,Elec alys cplx prgrmg iins,,,73.53,85.14,8
HCPCS,0590U,Nfct ds bct&fngl dna 44 orgs,,,39.01,45.17,8
HCPCS,0591T,Hlth&wb coaching indiv 1st,,,31.04,35.94,8
HCPCS,0591U,ONC PRST8 CA 3PRTNS PLSM SRM,,,760.0,3114.33,14
HCPCS,0591U,Onc prst8 ca 3prtns plsm srm,,,66.63,77.15,8
HCPCS,0592T,Hlth&wb coaching indiv f-up,,,31.04,35.94,8
HCPCS,0592U,ONC HL NEO DNA TGS 417 GENES,,,2919.6,11963.94,14
HCPCS,0592U,Onc hl neo dna tgs 417 genes,,,66.63,77.15,8
HCPCS,0593T,Hlth&wb coaching group,,,35.45,41.05,8
HCPCS,0593U,NFCT DS GU PTHGN DNA 46TRGT,,,634.84,2601.45,14
HCPCS,0593U,Nfct ds gu pthgn dna 46trgt,,,39.01,45.17,8
HCPCS,0594T,OSTEOT HUM XTRNL LNGTH DEV,,,6600.66,20338.07,19
HCPCS,0594T,Osteot hum xtrnl lngth dev,,,2599.83,3010.33,8
HCPCS,0594U,Nfct ds sepsis pncrtc spc,,,39.01,45.17,8
HCPCS,0595U,NFCT DS TFP VCTRBRN&ZOONOTIC,,,262.99,1077.68,14
HCPCS,0595U,Nfct ds tfp vctrbrn&zoonotic,,,39.01,45.17,8
HCPCS,0596T,TEMP FML IU VLV-PMP 1ST INSJ,,,616.73,1954.42,19
HCPCS,0596T,Temp fml iu vlv-pmp 1st insj,,,226.03,261.72,8
HCPCS,0596U,Neuro alzds plsm 3dstnct isp,,,14.4,16.68,8
HCPCS,0597T,TEMP FML IU VALVE-PMP RPLCMT,,,616.73,1954.42,19
HCPCS,0597T,Temp fml iu valve-pmp rplcmt,,,226.03,261.72,8
HCPCS,0597U,Onc breast rna xprsn 329gens,,,66.63,77.15,8
HCPCS,0598T,NONCONTACT R-T FLUOR WND IMG 1ST ANATOMIC SITE CPT,1246.0,809.9,0.01,1246.0,61
HCPCS,0598U,GI IBS IGG ANTB 18FOOD ITEMS,,,300.0,1229.34,14
HCPCS,0598U,Gi ibs igg antb 18food items,,,66.63,77.15,8
HCPCS,0599T,NONCONTACT R-T FLUOR WND IMG EA ADDL ANATOMIC SITE,653.0,424.45,0.01,653.0,46
HCPCS,0599U,ONC PNCRTC CA MULT IA SERUM,,,897.0,3675.73,14
HCPCS,0599U,Onc pncrtc ca mult ia serum,,,66.63,77.15,8
HCPCS,0600T,ABLT IRE 1+ O/T LV/PRST8 PRQ,,,9619.76,29793.81,19
HCPCS,0600T,Ablt ire 1+ o/t lv/prst8 prq,,,1611.33,1865.75,8
HCPCS,0600U,Nfct ds wnd infctj 65orgs&30,,,13.21,15.29,8
HCPCS,0601T,ABLTJ IRE 1+TUMORS OPEN,,,9619.76,29793.81,19
HCPCS,0601T,Abltj ire 1+tumors open,,,1611.33,1865.75,8
HCPCS,0601T,IRE ABLATION 1+TUMORS PR ORGN W/FLUOR & US GDN OPN,13390.0,8703.5,1.1,17575.94,31
HCPCS,0601U,Nfct ds pji alys 11 bmrks ia,,,66.63,77.15,8
HCPCS,0602T,TRANSDERMAL GFR MEASUREMENTS,,,1019.23,1019.23,1
HCPCS,0602T,Transdermal gfr measurements,,,14.4,16.68,8
HCPCS,0602U,Endocrin dm ins gen mthyltn,,,66.63,77.15,8
HCPCS,0603T,TRANSDERMAL GFR MONITORING,,,2571.95,2571.95,1
HCPCS,0603T,Transdermal gfr monitoring,,,14.4,16.68,8
HCPCS,0603U,Rx asy prsmv 77rx/metablt ur,,,23.91,27.69,8
HCPCS,0604T,REM OCT RTA DEV SETUP&EDUCAJ,,,601.13,601.13,1
HCPCS,0604T,Rem oct rta dev setup&educaj,,,37.89,43.87,8
HCPCS,0604U,All&immunology crae 4bk pep,,,14.4,16.68,8
HCPCS,0605T,REM OCT RTA TECHL SPRT MIN 8,,,188.08,188.08,1
HCPCS,0605T,Rem oct rta techl sprt min 8,,,37.89,43.87,8
HCPCS,0605U,All&immunology hat tpsab1,,,66.63,77.15,8
HCPCS,0606T,REM OCT RTA PHYS/QHP EA 30D,,,146.61,146.61,1
HCPCS,0606T,Rem oct rta phys/qhp ea 30d,,,321.96,372.8,8
HCPCS,0606U,Hem red cll memb do rbc oge,,,6.74,7.8,8
HCPCS,0607T,Rem mntr pulm flu mntr setup,,,68.77,79.63,8
HCPCS,0607U,Reprdtve med ema rtpcr 31bct,,,66.63,77.15,8
HCPCS,0608T,Rem mntr pulm flu mntr alys,,,68.77,79.63,8
HCPCS,0608U,Reprdtve med ema rtpcr 10bct,,,66.63,77.15,8
HCPCS,0609T,MRS DISC PAIN ACQUISJ DATA,,,223.34,1165.03,20
HCPCS,0609T,Mrs disc pain acquisj data,,,202.79,234.81,8
HCPCS,0609U,Onc prostate ia tot&free psa,,,14.4,16.68,8
HCPCS,0610T,Mrs disc pain transmis data,,,68.77,79.63,8
HCPCS,0610U,Nfct ds antmcr sc phenotypic,,,13.21,15.29,8
HCPCS,0611T,MRS DISC PAIN ALG ALYS DATA,,,223.34,1165.03,20
HCPCS,0611T,Mrs disc pain alg alys data,,,68.77,79.63,8
HCPCS,0611U,Onc lvr alys >1000 mr cfdna,,,66.63,77.15,8
HCPCS,0612T,MRS DISCOGENIC PAIN I&R,,,143.08,143.08,1
HCPCS,0612T,Mrs discogenic pain i&r,,,321.96,372.8,8
HCPCS,0612U,Onc lvr alys >1000 mr cfdna,,,66.63,77.15,8
HCPCS,0613T,Perq tcat intratrl septl sht,,,11343.93,13135.08,8
HCPCS,0613U,Onc uc dna mthyltn&mut 6bmrk,,,66.63,77.15,8
HCPCS,0614T,RMVL&RPLCMT SS IMPL DFB PG,,,20739.83,62345.36,19
HCPCS,0614T,Rmvl&rplcmt ss impl dfb pg,,,17330.27,20066.63,8
HCPCS,0614U,Iem pmd alys 4 nzm cplx page,,,16.56,19.17,8
HCPCS,0615T,AUTO ALYS BINOCULAR EYE MVMT,,,119.1,372.91,19
HCPCS,0615T,Auto alys binocular eye mvmt,,,38.61,44.7,8
HCPCS,0615U,Bbrgdrferi ld antb detcj 26,,,18.32,21.21,8
HCPCS,0616T,Insertion of iris prosthesis,,,302.55,350.32,8
HCPCS,0616U,Neurol dementia alys >30000,,,66.63,77.15,8
HCPCS,0617T,Insj iris prosth w/rmvl&insj,,,1921.59,2225.0,8
HCPCS,0617U,Cv ascvd dna alys >20000,,,66.63,77.15,8
HCPCS,0618T,Insj iris prosth sec io lens,,,1921.59,2225.0,8
HCPCS,0618U,Psyc bd dna mthyl alys>10000,,,66.63,77.15,8
HCPCS,0619T,CYSTO W/PRST8 COMMISSUROTOMY,,,8544.18,9227.72,6
HCPCS,0619T,Cysto w/prst8 commissurotomy,,,2607.32,3019.01,8
HCPCS,0619U,Pulm copd dna alys >18000,,,66.63,77.15,8
HCPCS,0620T,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,12104.0,7867.6,1.1,49281.79,31
HCPCS,0620T,EVASC VEN ARTLZ TIBL/PRNL VN,,,32339.76,123455.58,19
HCPCS,0620T,Evasc ven artlz tibl/prnl vn,,,6695.97,7753.23,8
HCPCS,0620U,Onc hcc dna mthyln alys>5000,,,66.63,77.15,8
HCPCS,0621T,TRABECULOSTOMY INTERNO LASER,,,3717.04,11585.35,19
HCPCS,0621T,Trabeculostomy interno laser,,,302.55,350.32,8
HCPCS,0621U,Nfct ds lb dna alys>10000,,,66.63,77.15,8
HCPCS,0622T,TRABECULOSTOMY AB INTERNO LASER W/OPH ENDOSCOPE,3772.0,2451.8,1.1,1791901.44,31
HCPCS,0622T,Trabeculostomy int lsr w/scp,,,302.55,350.32,8
HCPCS,0622U,Psyc mdd dna alys >20000,,,66.63,77.15,8
HCPCS,0623T,Auto quantification c plaque,,,56.72,65.67,8
HCPCS,0623U,Ai ms dna mthyl alys >5000,,,66.63,77.15,8
HCPCS,0624T,Auto quan c plaq data prep,,,68.91,79.79,8
HCPCS,0624U,Hep nash dna mthyl alys 5000,,,66.63,77.15,8
HCPCS,0625T,AUTO QUAN C PLAQ CPTR ALYS,,,878.24,948.5,6
HCPCS,0625T,Auto quan c plaq cptr alys,,,68.91,79.79,8
HCPCS,0625U,Endocrinol op dna alys>5000,,,66.63,77.15,8
HCPCS,0626T,Auto quan c plaq i&r,,,68.91,79.79,8
HCPCS,0626U,Neurol pd dna alys >20000,,,66.63,77.15,8
HCPCS,0627T,PERQ NJX ALGC FLUOR LMBR 1ST,,,11888.68,35984.87,19
HCPCS,0627T,Perq njx algc fluor lmbr 1st,,,3026.0,3503.79,8
HCPCS,0627U,Psyc scz dna alys >15000,,,66.63,77.15,8
HCPCS,0628T,Perq njx algc fluor lmbr ea,,,3026.0,3503.79,8
HCPCS,0628U,Nfro kdn ds genetic cond 449,,,66.63,77.15,8
HCPCS,0629T,PERQ NJX ALGC CT LMBR 1ST,,,11888.68,35984.87,19
HCPCS,0629T,Perq njx algc ct lmbr 1st,,,3026.0,3503.79,8
HCPCS,0629U,Nfct ds tb dna aly 1trgt pcr,,,66.63,77.15,8
HCPCS,0630T,Perq njx algc ct lmbr ea,,,3026.0,3503.79,8
HCPCS,0630U,Onc brst mrna gen prflg 80,,,66.63,77.15,8
HCPCS,0631T,TC VIS LIT HYPERSPECTRAL IMG,,,22.63,24.44,6
HCPCS,0631T,Tc vis lit hyperspectral img,,,68.91,79.79,8
HCPCS,0632T,PERQ TCAT US ABLTJ NRV P-ART,,,16591.65,51380.79,19
HCPCS,0632T,Perq tcat us abltj nrv p-art,,,4659.93,5395.71,8
HCPCS,0633T,CT BREAST W/3D UNI C-,,,98.26,551.66,20
HCPCS,0633T,Ct breast w/3d uni c-,,,145.8,168.82,8
HCPCS,0634T,CT BREAST W/3D UNI C+,,,164.49,903.92,20
HCPCS,0634T,Ct breast w/3d uni c+,,,145.8,168.82,8
HCPCS,0635T,CT BREAST W/3D UNI C-/C+,,,164.49,903.92,20
HCPCS,0635T,Ct breast w/3d uni c-/c+,,,145.8,168.82,8
HCPCS,0636T,CT BREAST W/3D BI C-,,,223.34,1165.03,20
HCPCS,0636T,Ct breast w/3d bi c-,,,312.54,361.89,8
HCPCS,0637T,CT BREAST W/3D BI C+,,,329.98,1863.61,20
HCPCS,0637T,Ct breast w/3d bi c+,,,312.54,361.89,8
HCPCS,0638T,CT BREAST W/3D BI C-/C+,,,329.98,1863.61,20
HCPCS,0638T,Ct breast w/3d bi c-/c+,,,312.54,361.89,8
HCPCS,0639T,WRLS SKN SNR ANISOTROPY MEAS,,,425.7,425.7,1
HCPCS,0639T,Wrls skn snr anisotropy meas,,,68.77,79.63,8
HCPCS,0640T,NCNTC IFR SPCTRSC O/T PAD 1,,,35.34,104.69,19
HCPCS,0640T,Ncntc ifr spctrsc o/t pad 1,,,68.91,79.79,8
HCPCS,0641T,Ncntc nr ifr spctrsc wnd img,,,68.91,79.79,8
HCPCS,0642T,Ncntc nr ifr spctrsc wnd i&r,,,321.96,372.8,8
HCPCS,0643T,Tcat l ventr rstrj dev implt,,,11343.93,13135.08,8
HCPCS,0644T,TCAT RMVL/DBLK ICAR MAS PERQ,,,5268.09,15952.59,19
HCPCS,0644T,Tcat rmvl/dblk icar mas perq,,,4659.93,5395.71,8
HCPCS,0645T,TCAT IMPLTJ C SINS RDCTJ DEV,,,16591.65,51380.79,19
HCPCS,0645T,Tcat impltj c sins rdctj dev,,,4659.93,5395.71,8
HCPCS,0646T,Ttvi/rplcmt w/prstc vlv perq,,,11343.93,13135.08,8
HCPCS,0647T,INSJ GTUBE PERQ MAG GASTRPXY,,,1752.78,5378.41,19
HCPCS,0647T,Insj gtube perq mag gastrpxy,,,237.67,275.2,8
HCPCS,0648T,QUAN MR TIS WO MRI 1ORGN,,,878.24,2607.63,20
HCPCS,0648T,Quan mr tis wo mri 1orgn,,,202.79,234.81,8
HCPCS,0649T,QUAN MR TISS W/MRI 1ORGN,,,878.24,2607.63,19
HCPCS,0649T,Quan mr tiss w/mri 1orgn,,,202.79,234.81,8
HCPCS,0650T,PRGRMG DEV EVAL SCRMS REMOTE,,,34.46,104.61,19
HCPCS,0650T,Prgrmg dev eval scrms remote,,,18.13,20.99,8
HCPCS,0651T,MAG CTRLD CAPSULE ENDOSCOPY,,,858.08,2542.14,19
HCPCS,0651T,Mag ctrld capsule endoscopy,,,237.67,275.2,8
HCPCS,0652T,EGD FLEXIBLE TRANSNASAL DX W/COLLJ SPEC BR/WA,1037.0,674.05,1.1,3248.9,25
HCPCS,0652T,EGD FLX TRANSNASAL DX BR/WA,,,1752.78,5378.41,19
HCPCS,0652T,Egd flx transnasal dx br/wa,,,619.37,717.17,8
HCPCS,0653T,EGD FLX TRANSNASAL BX 1/MLT,,,1752.78,5378.41,19
HCPCS,0653T,Egd flx transnasal bx 1/mlt,,,619.37,717.17,8
HCPCS,0654T,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,1055.0,685.75,1.1,6539.01,26
HCPCS,0654T,EGD FLX TRANSNASAL TUBE/CATH,,,3515.31,10806.3,19
HCPCS,0654T,Egd flx transnasal tube/cath,,,619.37,717.17,8
HCPCS,0655T,TPRNL FOCAL ABLTJ MAL PRST8,,,4697.16,15028.3,19
HCPCS,0655T,Tprnl focal abltj mal prst8,,,2607.32,3019.01,8
HCPCS,0656T,ANT LMBR VRT BDY TETH <7 SEG,,,16588.34,49144.62,13
HCPCS,0656T,Ant lmbr vrt bdy teth <7 seg,,,11158.03,12919.82,8
HCPCS,0657T,ANT LMBR VRT BDY TETH 8+ SEG,,,16588.34,49144.62,13
HCPCS,0657T,Ant lmbr vrt bdy teth 8+ seg,,,11158.03,12919.82,8
HCPCS,0658T,ELEC IMPD SPECTRSC 1+SKN LES,,,54.88,281.79,20
HCPCS,0658T,Elec impd spectrsc 1+skn les,,,7.32,8.48,8
HCPCS,0659T,Tcat intra-c nfs supersat o2,,,4659.93,5395.71,8
HCPCS,0660T,IMPLT ANT SGM IO NBIO RX SYS,,,3717.04,11585.35,19
HCPCS,0660T,Implt ant sgm io nbio rx sys,,,157.33,182.17,8
HCPCS,0661T,RMVL&RIMPLTJ ANT SGM IMPLT,,,3717.04,11585.35,19
HCPCS,0661T,Rmvl&rimpltj ant sgm implt,,,157.33,182.17,8
HCPCS,0662T,SCALP COOL 1ST MEAS&CALBRJ,,,1617.43,1746.82,6
HCPCS,0662T,Scalp cool 1st meas&calbrj,,,7.32,8.48,8
HCPCS,0663T,Scalp cool plmt mntr rmvl,,,7.32,8.48,8
HCPCS,0664T,Don hysterectomy open cdvr,,,975.94,1130.04,8
HCPCS,0665T,Don hysterectomy open liv,,,2525.01,2923.69,8
HCPCS,0666T,Don hysterectomy laps liv,,,2525.01,2923.69,8
HCPCS,0667T,Don hysterectomy rcp uter,,,975.94,1130.04,8
HCPCS,0668T,Bkbench prep don uter algrft,,,975.94,1130.04,8
HCPCS,0669T,Bkbench rcnstj don uter ven,,,975.94,1130.04,8
HCPCS,0670T,Bkbench rcnstj don uter artl,,,975.94,1130.04,8
HCPCS,0671T,INSJ ANT SGM AQ DRG DEV 1+,,,4767.47,14914.8,19
HCPCS,0671T,Insj ant sgm aq drg dev 1+,,,302.55,350.32,8
HCPCS,0672T,Ndovag cryg rf remdl tiss,,,39.43,45.66,8
HCPCS,0673T,ABLTJ B9 THYR NDUL PERQ LASR,,,1497.07,4629.18,19
HCPCS,0673T,Abltj b9 thyr ndul perq lasr,,,745.85,863.61,8
HCPCS,0674T,LAPS INSJ NW/RPCMT PRM ISDSS,,,28156.99,86489.44,19
HCPCS,0675T,LAPS INSJ NW/RPCMT ISDSS 1LD,,,10541.85,31231.28,19
HCPCS,0675T,Laps insj nw/rpcmt isdss 1ld,,,1720.7,1992.39,8
HCPCS,0676T,Laps insj nw/rpcmt isdss ea,,,1720.7,1992.39,8
HCPCS,0677T,LAPS REPOS LEAD ISDSS 1ST LD,,,9619.76,29793.81,19
HCPCS,0677T,Laps repos lead isdss 1st ld,,,1720.7,1992.39,8
HCPCS,0678T,Laps repos lead isdss ea add,,,1720.7,1992.39,8
HCPCS,0679T,LAPS RMVL LEAD ISDSS,,,9619.76,29793.81,19
HCPCS,0679T,Laps rmvl lead isdss,,,1720.7,1992.39,8
HCPCS,0680T,INSJ/RPLCMT PG ONLY ISDSS,,,18354.0,54375.57,19
HCPCS,0681T,RLCJ PULSE GEN ONLY ISDSS,,,3177.58,9799.05,19
HCPCS,0681T,Rlcj pulse gen only isdss,,,1720.7,1992.39,8
HCPCS,0682T,REMOVAL PULSE GEN ONLY ISDSS,,,3177.58,9799.05,19
HCPCS,0682T,Removal pulse gen only isdss,,,1720.7,1992.39,8
HCPCS,0683T,PRGRMG DEV EVAL ISDSS IP,,,34.46,104.61,19
HCPCS,0683T,PROGRAMMING DEVICE EVALUATION IN PERSON ISDSS,291.0,189.15,1.1,1791901.44,28
HCPCS,0683T,Prgrmg dev eval isdss ip,,,18.13,20.99,8
HCPCS,0684T,PERIPROCEDURAL DEVICE EVALUATION IN PERSON ISDSS,53.0,34.45,1.1,1791901.44,28
HCPCS,0684T,Peri-px dev eval isdss ip,,,18.13,20.99,8
HCPCS,0685T,INTERROG DEV EVAL ISDSS IP,,,34.46,104.61,19
HCPCS,0685T,INTERROGATION DEVICE EVALUATION IN PERSON ISDSS,126.0,81.9,1.1,1791901.44,28
HCPCS,0685T,Interrog dev eval isdss ip,,,18.13,20.99,8
HCPCS,0686T,HISTOTRIPSY MAL HEPATCEL TIS,,,16170.11,63283.79,20
HCPCS,0686T,Histotripsy mal hepatcel tis,,,237.67,275.2,8
HCPCS,0687T,Tx amblyopia dev setup 1st,,,38.61,44.7,8
HCPCS,0689T,QUAN US TIS CHARAC W/O DX US,,,81.36,418.21,20
HCPCS,0689T,Quan us tis charac w/o dx us,,,77.56,89.8,8
HCPCS,0690T,Quan us tis charac w/dx us,,,77.56,89.8,8
HCPCS,0691T,AUTO ALYS XST CT STD VRT FX,,,42.89,42.89,1
HCPCS,0692T,THERAPEUTIC ULTRAFILTRATION,,,1473.45,4365.23,19
HCPCS,0692T,Therapeutic ultrafiltration,,,220.33,255.12,8
HCPCS,0693T,COMPRE FUL BDY 3D MTN ALYS,,,323.86,1774.42,20
HCPCS,0693T,Compre ful bdy 3d mtn alys,,,310.96,360.06,8
HCPCS,0694T,3d vol img&rcnstj brst/ax,,,68.91,79.79,8
HCPCS,0695T,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM IMPLT,82.0,53.3,1.1,661.95,31
HCPCS,0695T,Bdy srf mpg pm/cvdfb tm impl,,,18.66,21.6,8
HCPCS,0696T,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM F/UP,82.0,53.3,1.1,661.95,31
HCPCS,0696T,BDY SURF MAPG PM/CVDFB F/UP,,,34.46,104.61,19
HCPCS,0696T,Bdy surf mapg pm/cvdfb f/up,,,18.66,21.6,8
HCPCS,0697T,QUAN MR TIS WO MRI MLT ORGN,,,878.24,2607.63,20
HCPCS,0697T,Quan mr tis wo mri mlt orgn,,,202.79,234.81,8
HCPCS,0698T,QUAN MR TISS W/MRI MLT ORGN,,,878.24,2607.63,19
HCPCS,0698T,Quan mr tiss w/mri mlt orgn,,,202.79,234.81,8
HCPCS,0699T,NJX PST CHMBR EYE MEDICATION,,,2107.35,6468.48,19
HCPCS,0699T,Njx pst chmbr eye medication,,,319.13,369.52,8
HCPCS,0700T,MOLEC FLUOR IMG SUS NEV 1ST,,,180.14,180.14,1
HCPCS,0700T,Molec fluor img sus nev 1st,,,7.32,8.48,8
HCPCS,0701T,MOLEC FLUOR IMG SUS NEV EA,,,53.21,53.21,1
HCPCS,0701T,Molec fluor img sus nev ea,,,7.32,8.48,8
HCPCS,0704T,Rem tx amblyopia setup&edu,,,38.61,44.7,8
HCPCS,0707T,NJX B1 SUB MTRL SBCHDRL DFCT,,,2997.95,9170.92,19
HCPCS,0707T,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,966.0,627.9,1.1,5526.53,31
HCPCS,0707T,Njx b1 sub mtrl sbchdrl dfct,,,138.73,160.63,8
HCPCS,0708T,Id ca immntx prep & 1st njx,,,220.33,255.12,8
HCPCS,0709T,Id ca immntx each addl njx,,,220.33,255.12,8
HCPCS,0710T,N-INVAS ARTL PLAQ ALYS DATA PRP QUAN REVIEW I&R,1016.0,660.4,1.1,1791901.44,28
HCPCS,0710T,N-invas artl plaq alys,,,56.72,65.67,8
HCPCS,0711T,N-nvs artl plaq alys dat prp,,,68.91,79.79,8
HCPCS,0712T,N-NVS ARTL PLAQ ALYS QUAN,,,81.36,605.2,19
HCPCS,0712T,N-nvs artl plaq alys quan,,,56.72,65.67,8
HCPCS,0713T,N-INVAS ARTL PLAQ ALYS DATA REVIEW I&R,1016.0,660.4,1.1,1791901.44,28
HCPCS,0713T,N-nvs artl plaq alys rvw i&r,,,68.91,79.79,8
HCPCS,0714T,TPLA B9 PRST8 HYPRPLSA<50ML,,,4697.16,15028.3,19
HCPCS,0714T,Tpla b9 prst8 hyprplsa<50ml,,,2607.32,3019.01,8
HCPCS,0715T,Perq trluml coronry lithotrp,,,4659.93,5395.71,8
HCPCS,0716T,CAR ACOUS WAVFRM REC CAD RSK,,,54.88,165.35,19
HCPCS,0716T,Car acous wavfrm rec cad rsk,,,18.66,21.6,8
HCPCS,0717T,ADRC THER PRTL RC TEAR,,,3352.64,9932.52,19
HCPCS,0717T,Adrc ther prtl rc tear,,,199.7,231.23,8
HCPCS,0718T,ADRC THER PRTL RC TEAR NJX,,,3352.64,9932.52,19
HCPCS,0718T,Adrc ther prtl rc tear njx,,,138.73,160.63,8
HCPCS,0719T,Pst vrt jt rplcmt lmbr 1 sgm,,,3026.0,3503.79,8
HCPCS,0720T,PRQ ELC NRV STIM CN WO IMPLT,,,940.05,1015.25,6
HCPCS,0720T,Prq elc nrv stim cn wo implt,,,310.96,360.06,8
HCPCS,0721T,QUAN CT TISS CHARAC W/O CT,,,601.05,3293.17,20
HCPCS,0721T,Quan ct tiss charac w/o ct,,,145.8,168.82,8
HCPCS,0722T,QUAN CT TISS CHARAC W/CT,,,601.05,1784.6,19
HCPCS,0722T,Quan ct tiss charac w/ct,,,145.8,168.82,8
HCPCS,0723T,QMRCP W/O DX MRI SM ANAT SES,,,878.24,4811.92,20
HCPCS,0723T,Qmrcp w/o dx mri sm anat ses,,,202.79,234.81,8
HCPCS,0724T,QMRCP W/DX MRI SAME ANATOMY,,,878.24,2607.63,19
HCPCS,0724T,Qmrcp w/dx mri same anatomy,,,202.79,234.81,8
HCPCS,0725T,Vestibular dev impltj uni,,,2695.9,3121.57,8
HCPCS,0726T,Rmvl implt vstibular dev uni,,,2151.73,2491.48,8
HCPCS,0727T,Rmvl&rplcmt implt vstblr dev,,,2695.9,3121.57,8
HCPCS,0728T,Dx alys vstblr implt uni 1st,,,18.13,20.99,8
HCPCS,0729T,Dx alys vstblr implt uni sbq,,,18.13,20.99,8
HCPCS,0730T,Trabeculotomy lsr w/oct gdn,,,1921.59,2225.0,8
HCPCS,0731T,AUGMNT AI-BASED FCL PHNT A/R,,,54.88,165.35,19
HCPCS,0731T,Augmnt ai-based fcl phnt a/r,,,68.91,79.79,8
HCPCS,0732T,Immntx admn electroporatn im,,,36.15,41.86,8
HCPCS,0733T,REM R-T MTN NREHAB THER SPLY,,,323.86,961.57,19
HCPCS,0734T,Rem r-t mtn nrehab tx mgmt,,,68.77,79.63,8
HCPCS,0735T,Prep tum cav iort prim crnot,,,2142.24,2480.49,8
HCPCS,0736T,COLONIC LAVAGE 35+L WATER,,,121.73,360.65,19
HCPCS,0736T,Colonic lavage 35+l water,,,26.64,30.84,8
HCPCS,0737T,XENOGRAFT IMPLTJ ARTCLR SURF,,,11888.68,35984.87,19
HCPCS,0737T,Xenograft impltj artclr surf,,,1453.77,1683.31,8
HCPCS,0738T,Tx pln mag fld abltj prst8,,,83.9,97.15,8
HCPCS,0739T,Abltj mal prst8 mag fld ndct,,,2607.32,3019.01,8
HCPCS,0740T,REM AUTON ALG INSULIN DOSE 1ST SETUP& PT EDUCAJ,297.0,193.05,1.1,297.0,31
HCPCS,0740T,REM AUTON ALG NSLN CAL SETUP,,,54.88,165.35,19
HCPCS,0740T,Rem auton alg nsln cal setup,,,31.04,35.94,8
HCPCS,0741T,REM AUTON ALG NSLN DATA COLL,,,34.46,104.61,19
HCPCS,0741T,REM AUTON ALG NSLN DOS CAL SW DATA COLL TRANSMIS,465.0,302.25,1.1,465.0,31
HCPCS,0742T,AQMBF SPECT W/EXERCISE/RX STRESS & REST,585.0,380.25,1.1,585.0,25
HCPCS,0742T,Aqmbf spect xers/strs & rest,,,705.42,816.81,8
HCPCS,0743T,B1 STR & FX RSK VRT FX ASSMT,,,223.34,1223.71,20
HCPCS,0743T,BONE STRENGTH & FRACTURE RSK CNCRNT VRT FX ASSMT,96.0,62.4,1.1,1791901.44,30
HCPCS,0744T,INSERTION BIOPROSTHETIC VALVE OPEN FEMORAL VEIN,7136.0,4638.4,1.1,9382.91,31
HCPCS,0744T,INSJ BIOPROSTC VLV FEM VN,,,4994.76,15596.41,19
HCPCS,0744T,Insj bioprostc vlv fem vn,,,2221.81,2572.63,8
HCPCS,0745T,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,33720.0,21918.0,1.1,1791901.44,77
HCPCS,0746T,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,33720.0,21918.0,1.1,1791901.44,77
HCPCS,0747T,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,33720.0,21918.0,1.1,1791901.44,77
HCPCS,0748T,NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS,997.0,648.05,1.1,1791901.44,31
HCPCS,0748T,Njx stm cl prdct anl sft tis,,,863.18,999.47,8
HCPCS,0751T,Dgtz gls mcrscp sld level ii,,,29.68,34.36,8
HCPCS,0752T,Dgtz gls mcrscp sld lvl iii,,,29.68,34.36,8
HCPCS,0753T,Dgtz gls mcrscp sld level iv,,,29.68,34.36,8
HCPCS,0754T,Dgtz gls mcrscp sld level v,,,54.37,62.95,8
HCPCS,0755T,Dgtz gls mcrscp sld level vi,,,54.37,62.95,8
HCPCS,0756T,Dgtz gls mcrscp sld spc grpi,,,29.68,34.36,8
HCPCS,0757T,Dgtz gls mcrscp sl spc grpii,,,29.68,34.36,8
HCPCS,0758T,Dgtz gls mcrscp sl spc hchem,,,54.37,62.95,8
HCPCS,0759T,Dgtz gls mcrscp sl sp grpiii,,,54.37,62.95,8
HCPCS,0760T,Dgtz gls mcrscp sl imm 1st,,,54.37,62.95,8
HCPCS,0761T,Dgtz gls mcrscp sl imm ea 1,,,54.37,62.95,8
HCPCS,0762T,Dgtz gls mcrscp sl imm ea m,,,54.37,62.95,8
HCPCS,0763T,Dgtz gls mcrscp mphmtrc alys,,,54.37,62.95,8
HCPCS,0764T,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,407.0,264.54999999999995,1.1,1791901.44,92
HCPCS,0765T,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,407.0,264.54999999999995,1.1,1791901.44,92
HCPCS,0766T,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN 1ST NERVE,308.0,200.2,1.1,741.48,28
HCPCS,0766T,TC MAG STIMJ PN 1ST NERVE,,,204.28,605.2,19
HCPCS,0766T,Tc mag stimj pn 1st nerve,,,310.96,360.06,8
HCPCS,0767T,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN EA ADD NRV,308.0,200.2,1.1,741.48,28
HCPCS,0767T,Tc mag stimj pn ea addl nrv,,,310.96,360.06,8
HCPCS,0768T,Tc mag stimj pn sbsq tx 1nrv,,,310.96,360.06,8
HCPCS,0769T,Tc mag stimj pn sbsq tx ea,,,310.96,360.06,8
HCPCS,0770T,Vr technology assist therapy,,,50.62,58.61,8
HCPCS,0771T,Vr px dissoc svc sm phy 1st,,,321.96,372.8,8
HCPCS,0772T,Vr px dissoc svc sm phy ea,,,321.96,372.8,8
HCPCS,0773T,Vr px dissoc svc oth phy 1st,,,321.96,372.8,8
HCPCS,0774T,Vr px dissoc svc oth phy ea,,,321.96,372.8,8
HCPCS,0775T,Arthrd si jt prq iartic impl,,,11158.03,12919.82,8
HCPCS,0776T,THERAPEUTIC INDUCTION OF INTRA-BRAIN HYPOTHERMIA,1906.0,1238.9,1.1,1791901.44,28
HCPCS,0776T,Ther indctj ntrabrn hypthrm,,,321.96,372.8,8
HCPCS,0777T,R-T PRESSURE SENSING EPIDURAL GUIDANCE SYSTEM,993.0,645.45,1.1,993.0,31
HCPCS,0777T,R-t prs sensing edrl gdn sys,,,448.9,519.78,8
HCPCS,0778T,SMMG CNCRNT APPL IMU SNR,,,121.73,736.25,20
HCPCS,0778T,SMMG CNCRNT APPL IMU SNR MEAS ROM POST GAIT MUSC,174.0,113.1,1.1,267.01,28
HCPCS,0778T,Smmg cncrnt appl imu snr,,,26.64,30.84,8
HCPCS,0779T,GI MYOELECTRICAL ACTIVITY STUDY STMCH-COLON I&R,69.0,44.85,1.1,1092.16,31
HCPCS,0779T,GI MYOELECTRICAL ACTV STUDY,,,353.04,1045.9,19
HCPCS,0779T,Gi myoelectrical actv study,,,310.96,360.06,8
HCPCS,0780T,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,559.5,363.67499999999995,1.1,3398.0,92
HCPCS,0781T,BRNCHSC RF DSTRJ PULM NRV BI MAINSTEM BRONCHI,1177.0,765.05,1.1,1791901.44,28
HCPCS,0781T,Brnchsc rf dstrj pulm nrv bi,,,884.47,1024.12,8
HCPCS,0782T,BRNCHSC RF DSTRJ PULM NRV UNI MAINSTEM BRONCHUS,1177.0,765.05,1.1,1791901.44,28
HCPCS,0782T,Brnchsc rf dstrj plm nrv uni,,,884.47,1024.12,8
HCPCS,0783T,TC AURICULAR NSTIMJ SETUP CALIBRATION &PT EDUCAJ,174.0,113.1,1.1,741.48,31
HCPCS,0783T,TC AURICULR NEUROSTIMULATION,,,121.73,360.65,19
HCPCS,0783T,Tc auriculr neurostimulation,,,68.77,79.63,8
HCPCS,0784T,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,26713.5,17363.775,1.1,49881.0,84
HCPCS,0785T,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,8165.0,5307.25,1.1,13756.0,92
HCPCS,0786T,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,27306.5,17749.225000000002,1.1,51916.0,78
HCPCS,0787T,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,7401.5,4810.974999999999,1.1,13756.0,92
HCPCS,0788T,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,377.5,245.375,1.1,388.0,92
HCPCS,0789T,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,382.0,248.3,1.1,397.0,92
HCPCS,0790T,REVJ RPLCMT/RMVL VRT TETHRG,,,16588.34,49144.62,13
HCPCS,0790T,Revj rplcmt/rmvl vrt tethrg,,,11158.03,12919.82,8
HCPCS,0791T,Motr cog vr gait train ea 15,,,24.68,28.58,8
HCPCS,0792T,Appl slvr diamn fluoride 38%,,,802.93,929.71,8
HCPCS,0793T,PRQ TCAT THRM ABLT NRV P-ART,,,16591.65,51380.79,19
HCPCS,0793T,Prq tcat thrm ablt nrv p-art,,,4659.93,5395.71,8
HCPCS,0794T,PT SPEC ALG RX-ONC TX OPTION,,,54.88,165.35,19
HCPCS,0794T,Pt spec alg rx-onc tx option,,,66.63,77.15,8
HCPCS,0795T,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,16420.0,10673.0,1.1,53987.6,85
HCPCS,0796T,TCAT INS 2CHMBR LDLS PM RA,,,17621.37,53987.6,19
HCPCS,0796T,Tcat ins 2chmbr ldls pm ra,,,5003.75,5793.81,8
HCPCS,0797T,TCAT INS 2CHMBR LDLS PM RV,,,17621.37,53987.6,19
HCPCS,0797T,Tcat ins 2chmbr ldls pm rv,,,5003.75,5793.81,8
HCPCS,0798T,TCAT RMV 2CHMBR LDLS PM CMPL,,,2908.23,8849.94,19
HCPCS,0798T,Tcat rmv 2chmbr ldls pm cmpl,,,2386.88,2763.76,8
HCPCS,0799T,TCAT RMVL 2CHMBR LDLS PM RA,,,2908.23,8849.94,19
HCPCS,0799T,Tcat rmvl 2chmbr ldls pm ra,,,5003.75,5793.81,8
HCPCS,0800T,TCAT RMVL 2CHMBR LDLS PM RV,,,2908.23,8849.94,19
HCPCS,0800T,Tcat rmvl 2chmbr ldls pm rv,,,5003.75,5793.81,8
HCPCS,0801T,TCAT RMV&RPL 2CHMBR LDLS PM,,,17621.37,53987.6,19
HCPCS,0801T,Tcat rmv&rpl 2chmbr ldls pm,,,5003.75,5793.81,8
HCPCS,0802T,TCAT RMV&RPL2CHMB LDLS PM RA,,,17621.37,53987.6,19
HCPCS,0802T,Tcat rmv&rpl2chmb ldls pm ra,,,5003.75,5793.81,8
HCPCS,0803T,TCAT RMV&RPL2CHMB LDLS PM RV,,,17621.37,53987.6,19
HCPCS,0803T,Tcat rmv&rpl2chmb ldls pm rv,,,5003.75,5793.81,8
HCPCS,0804T,PRGRMG EVL LDLS PM 2CHMBR IP,,,34.46,104.61,19
HCPCS,0804T,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,246.0,159.9,1.1,246.0,24
HCPCS,0804T,Prgrmg evl ldls pm 2chmbr ip,,,18.13,20.99,8
HCPCS,0805T,Tcat s&ivc prstc vl impl prq,,,11343.93,13135.08,8
HCPCS,0806T,Tcat s&ivc prstc vl impl opn,,,11343.93,13135.08,8
HCPCS,0807T,PULM TISS VNTJ ALYS PREV CT,,,204.28,736.25,20
HCPCS,0807T,Pulm tiss vntj alys prev ct,,,145.8,168.82,8
HCPCS,0808T,PULM TISS VNTJ ALYS W/CT,,,204.28,1417.82,20
HCPCS,0808T,Pulm tiss vntj alys w/ct,,,145.8,168.82,8
HCPCS,0809T,Arthrd si jt prq tfx&implt,,,8887.35,10290.62,8
HCPCS,0810T,SUBRTA NJX RX AGT W/VTRC,,,3927.38,11660.94,19
HCPCS,0810T,Subrta njx rx agt w/vtrc,,,2290.15,2651.75,8
HCPCS,0811T,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,299.5,194.675,1.1,515.0,91
HCPCS,0812T,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,355.0,230.75,1.1,626.0,89
HCPCS,0813T,EGD VOL ADJMT BARIATRIC BALO,,,858.08,2542.14,19
HCPCS,0813T,Egd vol adjmt bariatric balo,,,237.67,275.2,8
HCPCS,0814T,Prq njx biod osteo matrl fem,,,2435.09,2819.58,8
HCPCS,0816T,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ,2856.0,1856.4,1.1,37350.66,30
HCPCS,0816T,OPN INSJ/RPLCMT INS PTN SUBQ,,,18354.0,54375.57,19
HCPCS,0816T,Opn insj/rplcmt ins ptn subq,,,15220.57,17623.82,8
HCPCS,0817T,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBF,2192.0,1424.8,1.1,37350.66,29
HCPCS,0817T,OPN INSJ/RPLCMT INS PTN SUBF,,,18354.0,54375.57,19
HCPCS,0817T,Opn insj/rplcmt ins ptn subf,,,15220.57,17623.82,8
HCPCS,0818T,REVJ/RMVL INS PTN SUBQ,,,3177.58,9799.05,19
HCPCS,0818T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS,2529.0,1643.85,1.1,5809.66,30
HCPCS,0818T,Revj/rmvl ins ptn subq,,,1720.7,1992.39,8
HCPCS,0819T,REVJ/RMVL INS PTN SUBF,,,3177.58,9799.05,19
HCPCS,0819T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL,2529.0,1643.85,1.1,5809.66,28
HCPCS,0819T,Revj/rmvl ins ptn subf,,,1720.7,1992.39,8
HCPCS,0820T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,1038.5,675.025,1.1,1791901.44,77
HCPCS,0821T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,1038.5,675.025,1.1,1722.0,77
HCPCS,0822T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,1038.5,675.025,1.1,1722.0,77
HCPCS,0823T,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,13304.5,8647.925,1.1,53987.6,85
HCPCS,0824T,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,7073.5,4597.775,1.1,12590.0,85
HCPCS,0825T,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,12672.5,8237.125,1.1,53987.6,85
HCPCS,0826T,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,323.0,209.95,1.1,472.0,133
HCPCS,0827T,Dgtz gls mcrscp cytp smears,,,36.09,41.79,8
HCPCS,0828T,Dgtz gls mcrscp cytp smpl fl,,,36.09,41.79,8
HCPCS,0829T,Dgtz gls mcrscp cytp conctrj,,,36.09,41.79,8
HCPCS,0830T,Dgtz gls mcrscp cytp slctv,,,36.09,41.79,8
HCPCS,0831T,Dgtz gls mcrscp cytp c/v,,,12.13,14.05,8
HCPCS,0832T,Dgtz gls mcrscp cytp oth scr,,,36.09,41.79,8
HCPCS,0833T,Dgtz gls mcrscp cytp oth prp,,,36.09,41.79,8
HCPCS,0834T,Dgtz gls mcrscp cytp oth xtn,,,36.09,41.79,8
HCPCS,0835T,Dgtz gls mcrscp fna 1st ea,,,48.21,55.83,8
HCPCS,0836T,Dgtz gls mcrscp fna ea addl,,,48.21,55.83,8
HCPCS,0837T,Dgtz gls mcrscp fna i&r,,,36.09,41.79,8
HCPCS,0838T,Dgtz gls mcrscp cslt sld els,,,27.56,31.91,8
HCPCS,0839T,Dgtz gls mcrscp cslt mat prp,,,27.56,31.91,8
HCPCS,0840T,Dgtz gls mcrscp cslt compre,,,27.56,31.91,8
HCPCS,0841T,Dgtz gls mcrscp pth cslt 1st,,,27.56,31.91,8
HCPCS,0842T,Dgtz gls mcrscp pth cslt ea,,,27.56,31.91,8
HCPCS,0843T,Dgtz gls mcrscp cslt cyt 1st,,,27.56,31.91,8
HCPCS,0844T,Dgtz gls mcrscp cslt cyt ea,,,27.56,31.91,8
HCPCS,0845T,Dgtz gls mcrscp imfluor 1st,,,29.68,34.36,8
HCPCS,0846T,Dgtz gls mcrscp imfluor ea,,,29.68,34.36,8
HCPCS,0847T,Dgtz gls mcrscp xm arch tiss,,,36.09,41.79,8
HCPCS,0848T,Dgtz gls mcrscp ish 1st,,,54.37,62.95,8
HCPCS,0849T,Dgtz gls mcrscp ish ea adl 1,,,29.68,34.36,8
HCPCS,0850T,Dgtz gls mcrscp ish ea mult,,,54.37,62.95,8
HCPCS,0851T,Dgtz gls mcrscp mphmtrc 1st,,,54.37,62.95,8
HCPCS,0852T,Dgtz gls mcrscp mphmtrc ea 1,,,29.68,34.36,8
HCPCS,0853T,Dgtz gls mcrscp mphmtrc ea m,,,54.37,62.95,8
HCPCS,0854T,Dgtz gls mcrscp bld smr prph,,,6.74,7.8,8
HCPCS,0855T,Dgtz gls mcrscp b1 marow smr,,,137.41,159.1,8
HCPCS,0856T,Dgtz gls mcrscp electron mic,,,54.37,62.95,8
HCPCS,0857T,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,425.0,276.25,1.1,787.0,138
HCPCS,0858T,Ext trnscranl mag stimj meas,,,427.56,495.07,8
HCPCS,0859T,Ncntc ifr spctrsc o/t pad ea,,,68.91,79.79,8
HCPCS,0860T,Ncntc ifr spctrsc scr pad,,,68.91,79.79,8
HCPCS,0861T,RMVL PG WCS LV BOTH COMPNT,,,3362.64,10474.13,19
HCPCS,0861T,Rmvl pg wcs lv both compnt,,,2386.88,2763.76,8
HCPCS,0862T,RLCJ PG WCS LV BATTERY ONLY,,,1690.17,5783.06,19
HCPCS,0862T,Rlcj pg wcs lv battery only,,,639.93,740.97,8
HCPCS,0863T,RLCJ PG WCS LV TRNSMTR ONLY,,,1690.17,5783.06,19
HCPCS,0863T,Rlcj pg wcs lv trnsmtr only,,,639.93,740.97,8
HCPCS,0864T,LOW INTENSITY ESWT CORPUS CAVERNOSUM LOW ENERGY,973.0,632.45,39.43,3004.0,61
HCPCS,0865T,QUAN MRI ALYS BRN W/O DX MRI,,,223.34,1181.95,20
HCPCS,0865T,Quan mri alys brn w/o dx mri,,,202.79,234.81,8
HCPCS,0866T,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,967.0,628.55,1.1,1237.0,92
HCPCS,0866T,QUANTITATIVE MRI ANALYSIS OF THE BRAIN,967.0,628.55,202.79,967.0,61
HCPCS,0867T,TPLA B9 PRST8 HYPRPLSA>=50ML,,,4697.16,15028.3,19
HCPCS,0867T,Tpla b9 prst8 hyprplsa>=50ml,,,2607.32,3019.01,8
HCPCS,0868T,HI-RES GASTRIC EP MAPPING,,,353.04,1045.9,19
HCPCS,0868T,Hi-res gastric ep mapping,,,237.67,275.2,8
HCPCS,0869T,NJX B1 SUB MTRL HW FIXJ AUG,,,2997.95,9170.92,19
HCPCS,0869T,Njx b1 sub mtrl hw fixj aug,,,138.73,160.63,8
HCPCS,0870T,IMP SUBQ PRTL ASCTS PMP SYS,,,32411.16,96021.31,13
HCPCS,0870T,Imp subq prtl ascts pmp sys,,,2755.97,3191.12,8
HCPCS,0871T,RPLCMT SUBQ PRTL ASCITES PMP,,,25466.01,75445.61,13
HCPCS,0871T,Rplcmt subq prtl ascites pmp,,,1611.33,1865.75,8
HCPCS,0872T,RPLCMT NDWLLG BLDR&PRTL CATH,,,3387.33,10035.32,13
HCPCS,0872T,Rplcmt ndwllg bldr&prtl cath,,,1611.33,1865.75,8
HCPCS,0873T,REVJ SUBQ PRTL ASCT PMP SYS,,,3387.33,10035.32,13
HCPCS,0873T,Revj subq prtl asct pmp sys,,,1611.33,1865.75,8
HCPCS,0874T,RMVL PERTL ASCITES PMP SYS,,,3387.33,10035.32,13
HCPCS,0874T,Rmvl pertl ascites pmp sys,,,1611.33,1865.75,8
HCPCS,0875T,PRGRM SUBQ PRTL ASCT PMP SYS,,,35.31,104.61,13
HCPCS,0875T,Prgrm subq prtl asct pmp sys,,,18.13,20.99,8
HCPCS,0876T,Duplex scan hemo fstl lmtd,,,77.56,89.8,8
HCPCS,0877T,AUGMNT ALYS CH CT ILD W/O CT,,,601.05,1784.6,19
HCPCS,0877T,Augmnt alys ch ct ild w/o ct,,,145.8,168.82,8
HCPCS,0878T,AUGMNT ALYS CH CT ILD W/CT,,,601.05,1784.6,19
HCPCS,0878T,Augmnt alys ch ct ild w/ct,,,145.8,168.82,8
HCPCS,0879T,Augmnt alys ch ct ild prep,,,68.91,79.79,8
HCPCS,0880T,Augmnt alys ch ct ild i&r,,,68.91,79.79,8
HCPCS,0881T,CRYOTHERAPY ORAL CAVITY,,,368.71,1252.1,19
HCPCS,0881T,Cryotherapy oral cavity,,,321.96,372.8,8
HCPCS,0882T,Intraop ther estim pn ue 1st,,,865.36,1002.0,8
HCPCS,0883T,Intraop ther estim pn ue ea,,,865.36,1002.0,8
HCPCS,0884T,ESPHGSC FLX 1ST TNDSC DILAT,,,5500.28,17015.8,19
HCPCS,0884T,Esphgsc flx 1st tndsc dilat,,,1191.17,1379.25,8
HCPCS,0885T,COLSC FLX 1ST TNDSC DILAT,,,5500.28,17015.8,19
HCPCS,0886T,SGMDSC FLX 1ST TNDSC DILAT,,,5500.28,17015.8,19
HCPCS,0887T,End-tidal ctrl inhaled anes,,,159.23,184.37,8
HCPCS,0888T,HISTOTRIPSY MAL RENAL TISSUE,,,16170.11,88596.29,20
HCPCS,0888T,Histotripsy mal renal tissue,,,4503.79,5214.91,8
HCPCS,0889T,PRSNLZ TRGT DVL ARHFCMRIGTBS,,,878.24,2607.63,19
HCPCS,0889T,Prsnlz trgt dvl arhfcmrigtbs,,,427.56,495.07,8
HCPCS,0890T,ARHFCMRIGTBS 1ST TX DAY,,,3465.39,10289.22,19
HCPCS,0890T,Arhfcmrigtbs 1st tx day,,,427.56,495.07,8
HCPCS,0891T,ARHFCMRIGTBS SBSQ TX DAY,,,3465.39,10289.22,19
HCPCS,0891T,Arhfcmrigtbs sbsq tx day,,,427.56,495.07,8
HCPCS,0892T,ARHFCMRIGTBS SBSQ PER TX DAY,,,3465.39,10289.22,19
HCPCS,0892T,Arhfcmrigtbs sbsq per tx day,,,427.56,495.07,8
HCPCS,0893T,N-INVAS ASSMT BLD OXYGNATION,,,54.88,372.91,19
HCPCS,0893T,N-invas assmt bld oxygnation,,,26.64,30.84,8
HCPCS,0894T,CANNULJ LVR ALGRFT PREPJ CONNJ NRMTHRMC PRFU DEV,6094.0,3961.1,1.1,6094.0,30
HCPCS,0894T,Cannulation liver allograft,,,975.94,1130.04,8
HCPCS,0895T,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV 1ST 4 HOURS,3924.0,2550.6,1.1,3924.0,24
HCPCS,0895T,Connj lvr algrft prfu dev 1,,,975.94,1130.04,8
HCPCS,0896T,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV EA ADDL HOUR,1666.0,1082.9,1.1,1666.0,24
HCPCS,0896T,Connj lvr algrft prfu dev ea,,,975.94,1130.04,8
HCPCS,0897T,N-INVAS AUGMNT ARRHYT ALYS,,,812.43,2406.92,19
HCPCS,0897T,N-invas augmnt arrhyt alys,,,321.96,372.8,8
HCPCS,0898T,N-INVAS PRST8 CANCER EST MAP,,,812.43,2406.92,19
HCPCS,0898T,N-invas prst8 cancer est map,,,68.91,79.79,8
HCPCS,0899T,N-invas deter aqmbf aug cmr,,,202.79,234.81,8
HCPCS,0900T,N-invas est aqmbf asstv cmr,,,202.79,234.81,8
HCPCS,0901T,Plmt bone marrow smplg port,,,89.44,103.57,8
HCPCS,0902T,QTC NTRVL AUGMNT ALG ALY ECG,,,119.1,372.91,19
HCPCS,0902T,Qtc ntrvl augmnt alg aly ecg,,,18.66,21.6,8
HCPCS,0903T,Ecg alg 12 lead reduced i&r,,,18.66,21.6,8
HCPCS,0904T,ECG ALG 12 LD RDCD TRCG ONLY,,,54.88,165.35,19
HCPCS,0904T,Ecg alg 12 ld rdcd trcg only,,,18.66,21.6,8
HCPCS,0905T,Ecg alg 12 ld rdcd i&r only,,,18.66,21.6,8
HCPCS,0906T,COMS THER 1ST APPL<=50 SQ CM,,,183.59,562.35,19
HCPCS,0906T,Coms ther 1st appl<=50 sq cm,,,147.83,171.17,8
HCPCS,0907T,Coms ther ea addl<=50 sq cm,,,147.83,171.17,8
HCPCS,0908T,OPEN IMPLTJ INT NEUROSTIMULATION SYS VAGUS NERVE,4180.0,2717.0,1.1,4180.0,28
HCPCS,0908T,OPN IMP INT NSTM SYS VGS NRV,,,29193.76,86489.44,13
HCPCS,0909T,REPLACEMENT INT NEUROSTIMULATION SYS VAGUS NERVE,5108.0,3320.2,1.1,5108.0,28
HCPCS,0909T,RPLCMT INT NSTIM SYS VGS NRV,,,29193.76,86489.44,13
HCPCS,0910T,REMOVAL INT NEUROSTIMULATION SYS VAGUS NERVE,4226.0,2746.9,1.1,4226.0,28
HCPCS,0910T,RMVL INT NSTIM SYS VAGUS NRV,,,3307.59,9799.05,13
HCPCS,0910T,Rmvl int nstim sys vagus nrv,,,1720.7,1992.39,8
HCPCS,0911T,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,290.5,188.825,1.1,418.0,83
HCPCS,0912T,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,330.5,214.825,1.1,363.0,83
HCPCS,0913T,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART,2708.0,1760.2,1.1,2708.0,29
HCPCS,0913T,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART PERQ TCAT THER,22806.0,14823.9,4659.93,32356.61,61
HCPCS,0914T,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,7617.0,4951.05,1.1,12526.0,74
HCPCS,0915T,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,21594.0,14036.1,1.1,87978.22,89
HCPCS,0916T,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,15434.0,10032.099999999999,1.1,62345.36,89
HCPCS,0917T,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,6649.0,4321.85,1.1,23194.66,89
HCPCS,0918T,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,6649.0,4321.85,1.1,23194.66,89
HCPCS,0919T,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,7996.5,5197.724999999999,1.1,14557.0,89
HCPCS,0920T,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,9116.0,5925.4,1.1,14557.0,89
HCPCS,0921T,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,9116.0,5925.4,1.1,14557.0,89
HCPCS,0922T,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,9116.0,5925.4,1.1,14557.0,89
HCPCS,0923T,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,15432.0,10030.8,1.1,62345.36,89
HCPCS,0924T,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2272.0,1476.8000000000002,1.1,4001.0,89
HCPCS,0925T,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,5121.5,3328.9750000000004,1.1,7317.0,89
HCPCS,0926T,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,510.5,331.825,1.1,872.0,89
HCPCS,0927T,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,269.5,175.175,1.1,390.0,89
HCPCS,0928T,REMOTE INTERROG DEV EVAL CCM-D SYS <90D PHYS/QHP,279.0,181.35,1.1,279.0,28
HCPCS,0928T,Rem interrog dev ccm-d phys,,,18.13,20.99,8
HCPCS,0929T,REMOTE INTERROG DEV EVAL CCM-D SYS <90D TECH,149.0,96.85,18.13,149.0,61
HCPCS,0930T,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,5041.5,3276.9750000000004,1.1,5227.0,89
HCPCS,0931T,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,5041.5,3276.9750000000004,1.1,5227.0,89
HCPCS,0932T,N-INVS DET HRT FAIL AUG ECHO,,,277.11,860.86,19
HCPCS,0932T,N-invs det hrt fail aug echo,,,73.53,85.14,8
HCPCS,0933T,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,7826.0,5086.9,1.1,12866.0,89
HCPCS,0934T,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,223.0,144.95,1.1,325.0,66
HCPCS,0935T,CYSTO W/RNL PEL SYMPATHETIC DNRVTJ RF ABLTJ BI,3715.0,2414.75,1.1,3715.0,28
HCPCS,0935T,Cysto w/rnl pel symp dnrvtj,,,797.19,923.07,8
HCPCS,0936T,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,28.0,18.2,1.1,1858.16,29
HCPCS,0936T,Photobiomodulation ther rta,,,157.33,182.17,8
HCPCS,0937T,XTRNL ECG REC>15D<30D REC SCAN ALYS RVW&INTERPJ,256.0,166.4,1.1,857.19,28
HCPCS,0937T,Xtrnl ecg rec>15d<30d,,,68.77,79.63,8
HCPCS,0938T,Xtrnl ecg rec>15d<30d rec,,,68.77,79.63,8
HCPCS,0939T,Xtrnl ecg rec>15d<30d scan,,,68.77,79.63,8
HCPCS,0940T,XTRNL ECG REC>15D<30D REVIEW&INTERPJ PHYS/QHP,256.0,166.4,1.1,5185.26,28
HCPCS,0940T,Xtrnl ecg rec>15d<30d r&i,,,68.77,79.63,8
HCPCS,0941T,CYSTO FLX INSJ&XPNSJ PROSTATIC URTL SCAFFOLD,762.0,495.3,1.1,762.0,28
HCPCS,0941T,Cysto flx ins&xpns urtl scaf,,,895.32,1036.68,8
HCPCS,0942T,CYSTO FLX RMVL&RPLCMT PROSTATIC URTL SCAFFOLD,1306.0,848.9,1.1,3359.91,28
HCPCS,0942T,Cysto flx rmv&rplc urtl scaf,,,895.32,1036.68,8
HCPCS,0943T,CYSTO FLX REMOVAL PROSTATIC URETHRAL SCAFFOLD,1306.0,848.9,1.1,2392.5,28
HCPCS,0943T,Cysto flx rmvl urtl scaffold,,,895.32,1036.68,8
HCPCS,0944T,3D CNTR SIMULA TRGT LVR LES,,,223.34,1223.71,20
HCPCS,0944T,3D CONTOUR SIMULAJ TRGT LVR LES&MRGN MICRWV ABLT,93.0,60.45,1.1,801.19,28
HCPCS,0944T,3d cntr simula trgt lvr les,,,68.91,79.79,8
HCPCS,0945T,Intraop assmt abnl tum tiss,,,68.91,79.79,8
HCPCS,0946T,ORTHO IMPL MVMT ALYS PAIR CT,,,98.26,538.36,20
HCPCS,0946T,Ortho impl mvmt alys pair ct,,,145.8,168.82,8
HCPCS,0947T,MRGFUS STRTCTC BLD-BRN BARR DISRPJ MBUBB RSN8TR,7488.0,4867.2,1.1,7488.0,22
HCPCS,0948T,Rem interrog dev ccm phys,,,18.13,20.99,8
HCPCS,0949T,REM INTERROG DEV CCM TECH,,,35.31,104.61,13
HCPCS,0949T,Rem interrog dev ccm tech,,,18.13,20.99,8
HCPCS,0950T,ABLTJ B9 PRST8 TISSUE HIFU,,,8956.0,26533.05,13
HCPCS,0950T,Abltj b9 prst8 tissue hifu,,,2607.32,3019.01,8
HCPCS,0950T,PR ABLTJ B9 PRST8 TISSUE TRANSRECTAL HIFU W/US GDN,7092.0,4609.8,1.1,7092.0,28
HCPCS,0951T,Tot impl amei 1st plmt,,,7765.06,8991.13,8
HCPCS,0952T,Tot impl amei rev/rplc mstdc,,,7765.06,8991.13,8
HCPCS,0953T,Tot impl amei rev/rplc w/o,,,2151.73,2491.48,8
HCPCS,0954T,Tot impl amei rplc snd proc,,,1237.01,1432.33,8
HCPCS,0955T,Tot impl amei removal,,,1237.01,1432.33,8
HCPCS,0956T,PRT CRN CH CR&TUN ELT S-SCLP,,,25670.88,76052.54,13
HCPCS,0956T,Prt crn ch cr&tun elt s-sclp,,,15220.57,17623.82,8
HCPCS,0957T,REV S-SCLP ELTR RA RCVR&TLMT,,,1521.28,4506.96,13
HCPCS,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,1720.7,1992.39,8
HCPCS,0958T,RMV S-SCLP ELTR RA RCVR&TLMT,,,3095.56,9170.92,13
HCPCS,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,1720.7,1992.39,8
HCPCS,0959T,RMV/RPLC MAGNET COIL ASSEM,,,1562.54,4629.18,13
HCPCS,0959T,Rmv/rplc magnet coil assem,,,1720.7,1992.39,8
HCPCS,0960T,RPL S-SCLP ELTR RA RCVR&TLMT,,,25670.88,76052.54,13
HCPCS,0960T,Rpl s-sclp eltr ra rcvr&tlmt,,,15220.57,17623.82,8
HCPCS,0961T,Shortwave ifr radiation img,,,54.37,62.95,8
HCPCS,0962T,ASSTV ALG ALYS ACOUS&ECG REC,,,125.87,372.91,13
HCPCS,0962T,Asstv alg alys acous&ecg rec,,,68.77,79.63,8
HCPCS,0963T,ANOSC SBMCSL NJX BULKING AGT,,,1132.12,3354.0,13
HCPCS,0964T,I&CUST PREP JAW XPNSJ 1ARCH,,,3136.68,9292.73,13
HCPCS,0964T,I&cust prep jaw xpnsj 1arch,,,1358.5,1573.0,8
HCPCS,0965T,I&CST PRP JW XPN DL ARCH NON,,,3136.68,9292.73,13
HCPCS,0965T,I&cst prp jw xpn dl arch non,,,1358.5,1573.0,8
HCPCS,0966T,I&CST PRP JW XPN DL ARCH FXD,,,3136.68,9292.73,13
HCPCS,0966T,I&cst prp jw xpn dl arch fxd,,,1358.5,1573.0,8
HCPCS,0967T,TRANAL INS TMP CLRC ANST DEV,,,1132.12,3354.0,13
HCPCS,0967T,Tranal ins tmp clrc anst dev,,,2751.32,3185.74,8
HCPCS,0968T,Insj/rplcmt epcrnl nstim sys,,,15220.57,17623.82,8
HCPCS,0969T,Removal epicranial nstim sys,,,1720.7,1992.39,8
HCPCS,0970T,ABLT B9 BRST TUM PERQ LSR EA,,,3704.3,10974.37,13
HCPCS,0970T,Ablt b9 brst tum perq lsr ea,,,819.01,948.33,8
HCPCS,0971T,ABLT MAL BRST TUM PQ LSR UNI,,,3704.3,10974.37,13
HCPCS,0971T,Ablt mal brst tum pq lsr uni,,,819.01,948.33,8
HCPCS,0972T,Asstv alg clsfctn burn hlg,,,68.91,79.79,8
HCPCS,0973T,SLCTV NZMTC DBRDMT T/A/L 1ST,,,384.59,1139.4,13
HCPCS,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,444.21,514.35,8
HCPCS,0974T,Slctv nzmtc dbrdmt t/a/l ea,,,189.81,219.78,8
HCPCS,0975T,SLCTV NZMTC DBRDMT S/N/HF 1,,,384.59,1139.4,13
HCPCS,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,444.21,514.35,8
HCPCS,0976T,Slctv nzmtc dbrdmt s/n/hf ea,,,189.81,219.78,8
HCPCS,0977T,UPR GI BLD DETCJ SNR CAPSULE,,,858.08,2542.14,13
HCPCS,0977T,Upr gi bld detcj snr capsule,,,237.67,275.2,8
HCPCS,0978T,Submucosal cryolysis therapy,,,321.96,372.8,8
HCPCS,0979T,Sbmcsl crylys ther sft palt,,,321.96,372.8,8
HCPCS,0980T,Sbmcsl crylys ther tng&tnsl,,,321.96,372.8,8
HCPCS,0981T,TCAT IMPL WRLS IVC SNR,,,17343.14,51380.79,13
HCPCS,0981T,Tcat impl wrls ivc snr,,,5003.75,5793.81,8
HCPCS,0982T,REM MNTR IMPL IVC SNR SET-UP,,,125.96,373.16,13
HCPCS,0982T,Rem mntr impl ivc snr set-up,,,68.77,79.63,8
HCPCS,0983T,REM MNTR IMPL IVC SNR PHYS,,,35.31,104.61,13
HCPCS,0984T,Iv img xtrc cere vsl oct 1st,,,534.53,618.93,8
HCPCS,0985T,Iv img xtrc cere vsl oct ea,,,534.53,618.93,8
HCPCS,0986T,Iv img icr cere vsl oct 1st,,,534.53,618.93,8
HCPCS,0987T,Iv img icr cere vsl oct ea,,,534.53,618.93,8
HCPCS,0988T,OPEN INSJ/RPLCMT INT NSTIMJ SYS PTN SUBQ&SUBF,2192.0,1424.8,1.1,2192.0,22
HCPCS,0988T,Opn ins/rplc ins ptn sbq&sbf,,,15220.57,17623.82,8
HCPCS,0989T,REVJ/RMVL INS PTN SUBQ&SUBF,,,3307.59,9799.05,13
HCPCS,0989T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBQ&SUBF,2529.0,1643.85,1.1,2529.0,22
HCPCS,0989T,Revj/rmvl ins ptn subq&subf,,,1720.7,1992.39,8
HCPCS,0990T,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,609.0,395.85,0.01,2451.0,68
HCPCS,0991T,CYSTO LO-NRG LITHOTRP&ACOUS ACTUATED MICROSPHERE,3200.0,2080.0,1.1,3200.0,22
HCPCS,0991T,CYSTO LO-NRG LITHTRP&MCRSPHR,,,8956.0,26533.05,13
HCPCS,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,1680.64,1946.0,8
HCPCS,0992T,N-INVAS ASSMT CAR RSK W/O CT,,,225.74,668.77,13
HCPCS,0992T,N-invas assmt car rsk w/o ct,,,145.8,168.82,8
HCPCS,0993T,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,975.0,633.75,1.1,1291.0,121
HCPCS,0994T,Evasc dlvr a-wal stbl rx prq,,,8291.28,9600.43,8
HCPCS,0995T,Evasc dlvr a-wal stbl rx opn,,,2082.17,2410.94,8
HCPCS,0996T,INS&SCLR FIX CAPS BAG PROSTH,,,2183.38,6468.48,13
HCPCS,0996T,Ins&sclr fix caps bag prosth,,,1047.84,1213.29,8
HCPCS,0997T,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,759.0,493.35,1.1,934.0,68
HCPCS,0998T,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,759.0,493.35,1.1,934.0,68
HCPCS,0999T,Autol musc cell therapy hrvg,,,1254.9,1453.05,8
HCPCS,10004,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,668.5,434.525,0.01,3004.0,99
HCPCS,10005,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,2896.0,1882.4,0.01,3728.0,236
HCPCS,10006,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,691.0,449.15,0.01,3398.0,145
HCPCS,10007,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,3237.0,2104.05,153.7,3728.0,61
HCPCS,10007,FINE NEEDLE ASPIRATION BX W/FLUORO GDN 1ST LESION,724.0,470.6,1.1,1200.64,53
HCPCS,10008,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,598.5,389.025,1.1,3398.0,99
HCPCS,10009,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,2070.5,1345.825,0.01,3237.0,114
HCPCS,1000F,Tobacco use assessed,,,8.48,9.82,8
HCPCS,1000T,Autol musc cell therapy admn,,,846.52,980.18,8
HCPCS,10010,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1065.5,692.575,0.01,3004.0,99
HCPCS,10011,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,1206.0,783.9,1.1,1537.59,31
HCPCS,10011,FNA BX W/MR GDN 1ST LES,,,650.1,1984.79,19
HCPCS,10011,Fna bx w/mr gdn 1st les,,,305.36,353.57,8
HCPCS,10012,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,605.0,393.25,1.1,929.99,31
HCPCS,10012,Fna bx w/mr gdn ea addl,,,305.36,353.57,8
HCPCS,1001T,Autol musc cell therapy njx,,,863.18,999.47,8
HCPCS,10021,FINE NEEDLE ASP W/O IMG,1838.0,1194.7,0.01,3004.0,61
HCPCS,10021,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1145.5,744.575,0.01,3004.0,175
HCPCS,1002F,Assess anginal symptom/level,,,8.48,9.82,8
HCPCS,1002T,AIR DISPLACMNT PLETHYSMOGRAP,,,27.36,81.07,13
HCPCS,1002T,Air displacmnt plethysmograp,,,68.77,79.63,8
HCPCS,10030,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,1605.5,1043.575,0.01,4001.0,297
HCPCS,10035,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,1395.5,907.075,0.01,4001.0,236
HCPCS,10036,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,478.5,311.025,0.01,3004.0,99
HCPCS,1003F,Level of activity assess,,,8.48,9.82,8
HCPCS,1003T,ARTHRP 1ST CRP/MTCRPL PROSTC,,,12146.38,35984.87,13
HCPCS,1003T,Arthrp 1st crp/mtcrpl prostc,,,1890.92,2189.48,8
HCPCS,10040,ACNE SURGERY,275.5,179.075,1.1,400.0,106
HCPCS,10040,ACNE SURGERY OF SKIN ABSCESS,151.0,98.15,1.1,383.79,53
HCPCS,10040,EXTRACTION,,,183.59,562.35,19
HCPCS,10040,Extraction,,,133.98,155.13,8
HCPCS,1004F,Clin symp vol ovrld assess,,,8.48,9.82,8
HCPCS,1004T,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS W/O PRGRMG,544.0,353.6,73.53,544.0,55
HCPCS,1005F,Asthma symptoms evaluate,,,8.48,9.82,8
HCPCS,1005T,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS PRGRMG 1ST,389.0,252.85,73.53,389.0,55
HCPCS,10060,DRAINAGE OF SKIN ABSCESS,169.0,109.85,1.1,416.21,53
HCPCS,10060,"I & D ABSCESS, SINGLE",169.0,109.85,1.1,416.21,53
HCPCS,10060,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,566.5,368.225,0.01,3004.0,175
HCPCS,10061,DRAINAGE OF SKIN ABSCESS,302.0,196.3,1.1,710.76,53
HCPCS,10061,"I & D, ABCESS COMPLEX MULTIP",302.0,196.3,1.1,710.76,53
HCPCS,10061,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1138.5,740.0250000000001,0.01,3004.0,175
HCPCS,1006F,Osteoarthritis assess,,,8.48,9.82,8
HCPCS,1006T,Elec alys s-scl eeg prgrm ea,,,73.53,85.14,8
HCPCS,1007F,Anti-inflm/anlgsc otc assess,,,8.48,9.82,8
HCPCS,1007T,Eeg impl s-sclp eeg w/o vid,,,167.47,193.91,8
HCPCS,10080,DRAINAGE OF PILONIDAL CYST,253.0,164.45,1.1,1200.64,53
HCPCS,10080,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,1324.0,860.6,1.1,3004.0,114
HCPCS,10081,DRAIN PILONIDAL CYST COMPLIC,450.0,292.5,1.1,1200.64,53
HCPCS,10081,DRAINAGE OF PILONIDAL CYST,450.0,292.5,1.1,1200.64,53
HCPCS,10081,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,1605.5,1043.575,1.1,3004.0,114
HCPCS,1008F,Gi/renal risk assess,,,8.48,9.82,8
HCPCS,1008T,REM MNTR S-SCLP IMPL CONT BI EEG SYS FITG SET-UP,544.0,353.6,68.77,544.0,55
HCPCS,1010F,Severity angina by actvty,,,8.48,9.82,8
HCPCS,1010T,CPTR OPH ALYS MONOC EYE MVMT,,,125.87,372.91,13
HCPCS,1010T,Cptr oph alys monoc eye mvmt,,,37.89,43.87,8
HCPCS,1011F,Angina present,,,8.48,9.82,8
HCPCS,1011T,Pbm therapy of oral cavity,,,85.44,98.93,8
HCPCS,10120,INCIS & REMOV FB SUBCUTANEOUS,209.0,135.85,1.1,680.96,53
HCPCS,10120,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,868.0,564.2,0.01,3004.0,175
HCPCS,10120,REMOVE FOREIGN BODY,209.0,135.85,1.1,680.96,53
HCPCS,10121,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,3033.5,1971.775,0.01,4861.0,175
HCPCS,1012F,Angina absent,,,8.48,9.82,8
HCPCS,1012T,MTRZ AB NTRNO TRPH SCL/TR MW,,,3910.54,11585.35,13
HCPCS,1012T,Mtrz ab ntrno trph scl/tr mw,,,1921.59,2225.0,8
HCPCS,1013T,LAP SRG IMP/RPL ESO NEA&PG/R,,,18354.0,54375.57,13
HCPCS,1013T,Lap srg imp/rpl eso nea&pg/r,,,15220.57,17623.82,8
HCPCS,10140,DRAINAGE OF HEMATOMA/FLUID,234.0,152.1,1.1,2768.64,53
HCPCS,10140,"I & D HEMATOMA, SEROMA",234.0,152.1,1.1,2768.64,53
HCPCS,10140,I&D HEMATOMA SEROMA/FLUID COLLECTION,2778.0,1805.7,0.01,4861.0,236
HCPCS,1014T,LAP RV/RMV ESO SPH NSTM ELTR,,,10541.85,31231.28,13
HCPCS,1014T,Lap rv/rmv eso sph nstm eltr,,,1720.7,1992.39,8
HCPCS,1015F,Copd symptoms assess,,,8.48,9.82,8
HCPCS,1015T,REV/RMV LW ESOPH SPHNC NPG/R,,,3307.59,9799.05,13
HCPCS,1015T,Rev/rmv lw esoph sphnc npg/r,,,1720.7,1992.39,8
HCPCS,10160,"PUNC ASP; ABSCESS, HEMATO",187.0,121.55,1.1,680.96,53
HCPCS,10160,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,849.5,552.175,0.01,3398.0,297
HCPCS,10160,PUNCTURE DRAINAGE OF LESION,187.0,121.55,1.1,680.96,53
HCPCS,1016T,Elec alys npgs esoph intraop,,,73.53,85.14,8
HCPCS,1017T,ELEC ALY NPGS ESOPH SBSQ W/O,,,55.81,165.35,13
HCPCS,1017T,Elec aly npgs esoph sbsq w/o,,,18.13,20.99,8
HCPCS,10180,"COMPLEX DRAINAGE, WOUND",379.0,246.35,1.1,4850.94,53
HCPCS,10180,"I & D, COMP POSTOP INFECTION",379.0,246.35,1.1,4850.94,53
HCPCS,10180,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,4753.0,3089.45,0.01,8586.0,236
HCPCS,1018F,Assess dyspnea not present,,,8.48,9.82,8
HCPCS,1018T,ELEC ALYS NPGS ESOPH SBSQ W/,,,35.31,104.61,13
HCPCS,1018T,Elec alys npgs esoph sbsq w/,,,18.13,20.99,8
HCPCS,1019F,Assess dyspnea present,,,8.48,9.82,8
HCPCS,1019T,LYMPHOVENOUS BYPASS PER XTR,,,6282.11,18611.38,13
HCPCS,1019T,Lymphovenous bypass per xtr,,,1795.98,2079.56,8
HCPCS,1020T,RAMAN SPECTROSCOPY 1+SKN LES,,,55.81,305.12,14
HCPCS,1020T,Raman spectroscopy 1+skn les,,,7.32,8.48,8
HCPCS,1021T,ACTIVE THRC IRRIGATION SPX,,,593.48,1758.23,13
HCPCS,1021T,Active thrc irrigation spx,,,603.71,699.03,8
HCPCS,1022F,Pneumo imm status assess,,,8.48,9.82,8
HCPCS,1022T,Prq tis dsplmt ntra-abdl/pel,,,534.53,618.93,8
HCPCS,1023T,Prq tis dsplmt intrathoracic,,,534.53,618.93,8
HCPCS,1024T,Perq tiss dsplmt soft tissue,,,534.53,618.93,8
HCPCS,1025T,ALT ELEC FLD DOS&DLV SIM MDL,,,127.16,376.73,13
HCPCS,1025T,Alt elec fld dos&dlv sim mdl,,,83.9,97.15,8
HCPCS,1026F,Co-morbid condition assess,,,8.48,9.82,8
HCPCS,1030F,Influenza imm status assess,,,8.48,9.82,8
HCPCS,1031F,Smoking & 2nd hand assessed,,,8.48,9.82,8
HCPCS,1032F,Smoker/exposed 2nd hnd smoke,,,8.48,9.82,8
HCPCS,1033F,Tobacco nonsmoker nor 2ndhnd,,,8.48,9.82,8
HCPCS,1034F,Current tobacco smoker,,,8.48,9.82,8
HCPCS,1035F,Smokeless tobacco user,,,8.48,9.82,8
HCPCS,1036F,Tobacco non-user,,,8.48,9.82,8
HCPCS,1038F,Persistent asthma,,,8.48,9.82,8
HCPCS,1039F,Intermittent asthma,,,8.48,9.82,8
HCPCS,1040F,Dsm-5 info mdd docd,,,8.48,9.82,8
HCPCS,1050F,History of mole changes,,,8.48,9.82,8
HCPCS,1052F,Type location activityassess,,,8.48,9.82,8
HCPCS,1055F,Visual funct status assess,,,8.48,9.82,8
HCPCS,1060F,Doc perm/cont/parox atr fib,,,8.48,9.82,8
HCPCS,1061F,Doc lack perm&cont&parox fib,,,8.48,9.82,8
HCPCS,1065F,Ischm stroke symp lt3 hrsb/4,,,8.48,9.82,8
HCPCS,1066F,Ischm stroke sx onset>=3hr,,,8.48,9.82,8
HCPCS,1070F,Alarm symp assessed-absent,,,8.48,9.82,8
HCPCS,1071F,Alarm symp assessed-1+ prsnt,,,8.48,9.82,8
HCPCS,1090F,Pres/absn urine incon assess,,,8.48,9.82,8
HCPCS,1091F,Urine incon characterized,,,8.48,9.82,8
HCPCS,11000,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,1038.0,674.7,0.01,3004.0,114
HCPCS,11000,DEBRIDE INFECTED SKIN,86.0,55.9,1.1,1071.62,53
HCPCS,11000,DEBRIDEMENT UP TO 10%,86.0,55.9,1.1,1071.62,53
HCPCS,11001,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,209.5,136.175,0.01,3004.0,99
HCPCS,11004,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,2729.0,1773.85,0.01,4320.0,96
HCPCS,11004,DEBRIDE GENITALIA & PERINEUM,944.0,613.6,1.1,1941.29,50
HCPCS,11004,DEBRIDE SKIN/SUBCU/MUSC/FASC EXT GENITAL,944.0,613.6,1.1,1941.29,50
HCPCS,11005,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,5696.0,3702.4,1.1,5696.0,50
HCPCS,11005,Dbrdmt skin abdominal wall,,,444.21,514.35,8
HCPCS,11006,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,5240.0,3406.0,1.1,5240.0,50
HCPCS,11006,"DEBRIDE SKIN/SUBC/MUSC/FAS ABD,EXT GEN,P",1151.0,748.15,1.1,2394.89,50
HCPCS,11006,Dbrdmt skin xtrnl gent per,,,444.21,514.35,8
HCPCS,11008,REMOVAL OF MESH,510.0,331.5,1.1,935.52,50
HCPCS,11008,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,2000.0,1300.0,1.1,2000.0,50
HCPCS,11008,Rmv prstc mtrl/mesh abd wall,,,444.21,514.35,8
HCPCS,1100F,Ptfalls assess-docd ge2>/yr,,,8.48,9.82,8
HCPCS,11010,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,1977.5,1285.375,1.1,4001.0,114
HCPCS,11010,DEBRIDE SKIN AT FX SITE,765.0,497.25,1.1,1508.5,53
HCPCS,11010,"DEBRIDE SKIN, FX",765.0,497.25,1.1,1508.5,53
HCPCS,11011,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2142.5,1392.625,1.1,4001.0,114
HCPCS,11011,DEBRIDE SKIN MUSC AT FX SITE,887.0,576.55,1.1,1661.98,53
HCPCS,11011,"DEBRIDE SKIN/MUSCLE, FX",887.0,576.55,1.1,1661.98,53
HCPCS,11012,DBRDMT FX&/DISLC SUBQ T/M/F BONE,5804.5,3772.9249999999997,1.1,8586.0,114
HCPCS,11012,DEB SKIN BONE AT FX SITE,1302.0,846.3,1.1,4850.94,53
HCPCS,11012,"DEBRIDE SKIN/MUSCLE/BONE, FX",1302.0,846.3,1.1,4850.94,53
HCPCS,1101F,Pt falls assess-docd le1/yr,,,8.48,9.82,8
HCPCS,11042,DEBRIDE SKIN AND SUBQ TISSU,182.0,118.3,1.1,680.96,53
HCPCS,11042,DEBRIDE SKIN/TISSUE,182.0,118.3,1.1,680.96,53
HCPCS,11042,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,821.5,533.975,0.01,4001.0,236
HCPCS,11043,"DEBRI;CURRET,SKIN/SUBQ/MUS",410.0,266.5,1.1,1071.62,53
HCPCS,11043,DEBRIDE TISSUE/MUSCLE,410.0,266.5,1.1,1071.62,53
HCPCS,11043,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1512.0,982.8000000000001,0.01,4001.0,236
HCPCS,11044,DEB BONE 20 SQ CM/<,561.0,364.65,1.1,2768.64,53
HCPCS,11044,DEBRIDE TISSUE/MUSCLE/BONE,561.0,364.65,1.1,2768.64,53
HCPCS,11044,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,3332.5,2166.125,0.01,4861.0,114
HCPCS,11045,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,964.5,626.925,0.01,3004.0,145
HCPCS,11046,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,1432.0,930.8,0.01,3004.0,145
HCPCS,11047,DEBRIDEMENT BONE EA ADDL 20 SQ CM/<,720.0,468.0,1.1,720.0,53
HCPCS,11047,DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM,3815.0,2479.75,0.01,3815.0,46
HCPCS,11055,PARE BENIGN LES; SGL,76.0,49.4,1.1,342.27,53
HCPCS,11055,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,375.0,243.75,0.01,3004.0,114
HCPCS,11055,TRIM SKIN LESION,76.0,49.4,1.1,342.27,53
HCPCS,11056,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,408.0,265.2,0.01,3004.0,114
HCPCS,11056,TRIM SKIN LESIONS 2 TO 4,114.0,74.1,1.1,342.27,53
HCPCS,11056,"TRIM SKIN LESIONS, 2 TO 4",114.0,74.1,1.1,342.27,53
HCPCS,11057,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,441.0,286.65,0.01,3004.0,114
HCPCS,11057,TRIM SKIN LESIONS OVER 4,108.0,70.2,1.1,342.27,53
HCPCS,11057,"TRIM SKIN LESIONS, OVER 4",108.0,70.2,1.1,342.27,53
HCPCS,11102,TANGENTIAL BIOPSY SKIN SINGLE LESION,443.0,287.95,0.01,3004.0,114
HCPCS,11103,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,163.0,105.94999999999999,0.01,3004.0,99
HCPCS,11104,PUNCH BIOPSY SKIN SINGLE LESION,782.0,508.3,0.01,3004.0,175
HCPCS,11105,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,191.0,124.14999999999999,0.01,3004.0,99
HCPCS,11106,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,0.01,3004.0,122
HCPCS,11106,INCISIONAL BIOSPY SKIN SINGLE LESION,404.0,262.6,1.1,1071.62,53
HCPCS,11107,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,249.5,162.175,0.01,3004.0,99
HCPCS,1110F,Pt lft inpt fac w/in 60 days,,,8.48,9.82,8
HCPCS,1111F,Dschrg med/current med merge,,,8.48,9.82,8
HCPCS,1116F,Auric/peri pain assessed,,,8.48,9.82,8
HCPCS,1118F,Gerd symps assessed 12 month,,,8.48,9.82,8
HCPCS,1119F,Init eval for condition,,,8.48,9.82,8
HCPCS,11200,REM SKIN TAGS; <=15 LESIONS,130.0,84.5,1.1,342.27,53
HCPCS,11200,REMOVAL OF SKIN TAGS,130.0,84.5,1.1,342.27,53
HCPCS,11200,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,478.5,311.025,0.01,3004.0,175
HCPCS,11200,SKIN TAG REMOVAL 1 - 15,250.0,162.5,1.1,342.27,53
HCPCS,11201,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,233.0,151.45,0.01,338.0,99
HCPCS,1121F,Subs eval for condition,,,8.48,9.82,8
HCPCS,1123F,Acp discuss/dscn mkr docd,,,8.48,9.82,8
HCPCS,1124F,Acp discuss-no dscnmkr docd,,,8.48,9.82,8
HCPCS,1125F,Amnt pain noted pain prsnt,,,8.48,9.82,8
HCPCS,1126F,Amnt pain noted none prsnt,,,8.48,9.82,8
HCPCS,1127F,New episode for condition,,,8.48,9.82,8
HCPCS,1128F,Subs episode for condition,,,8.48,9.82,8
HCPCS,11300,SHAVE LES T/A/L; 0.5CM/<,111.0,72.15,1.1,680.96,53
HCPCS,11300,SHAVE SKIN LESION,111.0,72.15,1.1,680.96,53
HCPCS,11300,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,731.5,475.475,0.01,1199.0,114
HCPCS,11301,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,496.0,322.4,0.01,596.0,114
HCPCS,11302,SHAVE LES T/A/L; 1.1-2.0CM,181.0,117.65,1.1,453.78,53
HCPCS,11302,SHAVE SKIN LESION,181.0,117.65,1.1,453.78,53
HCPCS,11302,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,529.0,343.85,0.01,596.0,114
HCPCS,11303,SHAVE LES T/A/L; > 2.0CM,215.0,139.75,1.1,680.96,53
HCPCS,11303,SHAVE SKIN LESION,215.0,139.75,1.1,680.96,53
HCPCS,11303,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,874.5,568.425,0.01,1199.0,114
HCPCS,11305,SHAVE LES S/N/H/F/G; 0.5CM/<,113.0,73.45,1.1,349.05,53
HCPCS,11305,SHAVE SKIN LESION,113.0,73.45,1.1,349.05,53
HCPCS,11305,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,474.0,308.1,0.01,596.0,114
HCPCS,11306,SHAVE LES S/N/H/F/G; 0.6-1.0CM,157.0,102.05,1.1,406.74,53
HCPCS,11306,SHAVE SKIN LESION,157.0,102.05,1.1,406.74,53
HCPCS,11306,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,509.0,330.85,0.01,596.0,114
HCPCS,11307,SHAVE SKIN LESION,185.0,120.25,1.1,461.93,53
HCPCS,11307,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,562.0,365.29999999999995,0.01,596.0,114
HCPCS,11308,SHAVE SKIN LESION,210.0,136.5,1.1,680.96,53
HCPCS,11308,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,920.5,598.325,0.01,1199.0,114
HCPCS,1130F,Bk pain & fxn assessed,,,8.48,9.82,8
HCPCS,11310,SHAVE SKIN LESION,137.0,89.05,1.1,384.8,53
HCPCS,11310,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,474.0,308.1,0.01,596.0,114
HCPCS,11311,SHAVE SKIN LESION,175.0,113.75,1.1,453.38,53
HCPCS,11311,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,540.0,351.0,0.01,596.0,114
HCPCS,11312,SHAVE SKIN LESION,203.0,131.95,1.1,680.96,53
HCPCS,11312,SHAVE SKIN LESION 1.1-2.0 CM,,,369.16,1139.4,19
HCPCS,11312,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,572.0,371.8,1.1,680.96,53
HCPCS,11312,Shave skin lesion 1.1-2.0 cm,,,133.98,155.13,8
HCPCS,11313,SHAVE SKIN LESION,256.0,166.4,1.1,680.96,53
HCPCS,11313,SHAVE SKIN LESION >2.0 CM,,,369.16,1139.4,19
HCPCS,11313,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,739.0,480.35,1.1,739.0,53
HCPCS,11313,Shave skin lesion >2.0 cm,,,133.98,155.13,8
HCPCS,1134F,Epsd bk pain for 6 wks/<,,,8.48,9.82,8
HCPCS,1135F,Epsd bk pain for >6 wks,,,8.48,9.82,8
HCPCS,1136F,Epsd bk pain for 12 wks/<,,,8.48,9.82,8
HCPCS,1137F,Epsd bk pain for >12 wks,,,8.48,9.82,8
HCPCS,11400,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2111.0,1372.15,0.01,3004.0,122
HCPCS,11400,"REM LESION TRUNK,ARM, LEG <0.5 CM",360.0,234.0,1.1,1200.64,53
HCPCS,11400,REMOVAL OF SKIN LESION,180.0,117.0,1.1,1200.64,53
HCPCS,11401,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1199.0,779.35,0.01,3004.0,122
HCPCS,11401,"REM LESION TRUNK,ARM,LEG 0.6 -1.0CM",563.0,365.95,1.1,680.96,53
HCPCS,11401,REMOVAL OF SKIN LESION,220.0,143.0,1.1,680.96,53
HCPCS,11402,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,0.01,3004.0,122
HCPCS,11402,"REM LESIO TRUNK,ARM,LEG 1.1 -2.0CM",638.0,414.7,1.1,1200.64,53
HCPCS,11402,REMOVAL OF SKIN LESION,246.0,159.9,1.1,1200.64,53
HCPCS,11403,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2111.0,1372.15,0.01,3728.0,122
HCPCS,11403,"REM LESIO TRUNK,ARM,LEG 2.1-3.0CM",810.0,526.5,1.1,1200.64,53
HCPCS,11403,REMOVAL OF SKIN LESION,287.0,186.55,1.1,1200.64,53
HCPCS,11404,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11404,"REM LESIO TRUNK,ARM,LEG 3.0-4.0CM",928.0,603.2,1.1,2768.64,53
HCPCS,11404,REMOVAL OF SKIN LESION,327.0,212.55,1.1,2768.64,53
HCPCS,11406,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11406,"REM LESION TRUNK,ARM,LEG > 4.0CM",1549.0,1006.85,1.1,2768.64,53
HCPCS,11406,REMOVAL OF SKIN LESION,465.0,302.25,1.1,2768.64,53
HCPCS,11420,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,0.01,4861.0,122
HCPCS,11420,"REM LESION NEC,HAND,SCAL<0.5CM",453.0,294.45,1.1,2768.64,53
HCPCS,11420,REMOVAL OF SKIN LESION,181.0,117.65,1.1,2768.64,53
HCPCS,11421,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2111.0,1372.15,0.01,4001.0,61
HCPCS,11421,"REM LESION NEC,HND,SCAL 0.6-1.0CM",647.0,420.55,1.1,1200.64,53
HCPCS,11421,REMOVAL OF SKIN LESION,234.0,152.1,1.1,1200.64,53
HCPCS,11422,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11422,EXC H-F-NK-SP B9+MARG 1.1-2,1980.0,1287.0,1.1,2768.64,53
HCPCS,11422,"REM LESION NEC,HND,SCAL,FEET,GENITALIA 1.1-2.0CM",739.0,480.35,1.1,2768.64,53
HCPCS,11422,REMOVAL OF SKIN LESION,272.0,176.8,1.1,2768.64,53
HCPCS,11423,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11423,"REM LESION NEC,HND,SCAL 2.1-3.0CM",906.0,588.9,1.1,2768.64,53
HCPCS,11423,REMOVAL OF SKIN LESION,311.0,202.15,1.1,2768.64,53
HCPCS,11424,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11424,"REM LESION NEC,HND,SCAL 3.1-4.0CM",1091.0,709.15,1.1,2768.64,53
HCPCS,11424,REMOVAL OF SKIN LESION,361.0,234.65,1.1,2768.64,53
HCPCS,11426,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,8586.0,5580.9,0.01,8586.0,61
HCPCS,11426,"REM LESION NECK,HAND,SCAL >4.0CM",1800.0,1170.0,1.1,4850.94,53
HCPCS,11426,REMOVAL OF SKIN LESION,508.0,330.2,1.1,4850.94,53
HCPCS,11440,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2111.0,1372.15,0.01,4001.0,122
HCPCS,11440,"REM LESION FACE,EAR,EYEL <5MM",462.0,300.3,1.1,1200.64,53
HCPCS,11440,REMOVAL OF SKIN LESION,202.0,131.3,1.1,1200.64,53
HCPCS,11441,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,2111.0,1372.15,0.01,4001.0,61
HCPCS,11441,"REM LESION FACE,EAR,EYE 0.6-1CM",673.0,437.45,1.1,1200.64,53
HCPCS,11441,REMOVAL OF SKIN LESION,256.0,166.4,1.1,1200.64,53
HCPCS,11442,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2111.0,1372.15,0.01,3004.0,61
HCPCS,11442,"REM LESION FACE,EAR,EYE 1.1-2 CM",779.0,506.35,1.1,1200.64,53
HCPCS,11442,REMOVAL OF SKIN LESION,290.0,188.5,1.1,1200.64,53
HCPCS,11443,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11443,"REM LESION FACE,EAR,EYE 2.1-3 CM",1030.0,669.5,1.1,2768.64,53
HCPCS,11443,REMOVAL OF SKIN LESION,348.0,226.2,1.1,2768.64,53
HCPCS,11444,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11444,"REM LESION FACE,EAR,EYE 3.1-4 CM",1404.0,912.6,1.1,2768.64,53
HCPCS,11444,REMOVAL OF SKIN LESION,436.0,283.4,1.1,2768.64,53
HCPCS,11446,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,8586.0,5580.9,0.01,8586.0,61
HCPCS,11446,"REM LESION FACE,EAR,EYE >4CM",2112.0,1372.8,1.1,4850.94,53
HCPCS,11446,REMOVAL OF SKIN LESION,750.0,487.5,1.1,4850.94,53
HCPCS,11450,EXC SKN HDRDNT AX SMPL/NTRM,,,2644.48,8141.48,19
HCPCS,11450,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,1288.0,837.2,1.1,4850.94,53
HCPCS,11450,Exc skn hdrdnt ax smpl/ntrm,,,1360.39,1575.19,8
HCPCS,11450,"REMOVAL, SWEAT GLAND LESION",585.0,380.25,1.1,4850.94,53
HCPCS,11451,EXC SKN HDRDNT AX COMPLEX,,,2644.48,8141.48,19
HCPCS,11451,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,1772.0,1151.8,1.1,4850.94,53
HCPCS,11451,Exc skn hdrdnt ax complex,,,1360.39,1575.19,8
HCPCS,11451,"REMOVAL, SWEAT GLAND LESION",950.0,617.5,1.1,4850.94,53
HCPCS,11462,EXC SKN HDRDNT ING SMPL/NTRM,,,2644.48,8141.48,19
HCPCS,11462,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,1200.0,780.0,1.1,4850.94,53
HCPCS,11462,Exc skn hdrdnt ing smpl/ntrm,,,1360.39,1575.19,8
HCPCS,11462,"REMOVAL, SWEAT GLAND LESION",3040.0,1976.0,1.1,4850.94,53
HCPCS,11463,EXC SKN HDRDNT ING COMPLEX,,,2644.48,8141.48,19
HCPCS,11463,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,1772.0,1151.8,1.1,4850.94,53
HCPCS,11463,Exc skn hdrdnt ing complex,,,1360.39,1575.19,8
HCPCS,11463,"REMOVAL, SWEAT GLAND LESION",3709.0,2410.85,1.1,4850.94,53
HCPCS,11470,EXC SKN H/P/P/U SMPL/NTRM,,,2644.48,8141.48,19
HCPCS,11470,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,1496.0,972.4,1.1,4850.94,53
HCPCS,11470,Exc skn h/p/p/u smpl/ntrm,,,1360.39,1575.19,8
HCPCS,11470,"REMOVAL, SWEAT GLAND LESION",3040.0,1976.0,1.1,4850.94,53
HCPCS,11471,EXC SKN H/P/P/U COMPLEX,,,2644.48,8141.48,19
HCPCS,11471,EXCISION H/P/P/U COMPLEX REPAIR,1956.0,1271.4,1.1,4850.94,53
HCPCS,11471,Exc skn h/p/p/u complex,,,1360.39,1575.19,8
HCPCS,11471,"REMOVAL, SWEAT GLAND LESION",3709.0,2410.85,1.1,4850.94,53
HCPCS,1150F,Doc pt rsk death w/in 1yr,,,8.48,9.82,8
HCPCS,1151F,Doc no pt rsk death w/in 1yr,,,8.48,9.82,8
HCPCS,1152F,Doc advncd dis comfort 1st,,,8.48,9.82,8
HCPCS,1153F,Doc advncd dis cmfrt not 1st,,,8.48,9.82,8
HCPCS,1157F,Advnc care plan in rcrd,,,8.48,9.82,8
HCPCS,1158F,Advnc care plan tlk docd,,,8.48,9.82,8
HCPCS,1159F,Med list docd in rcrd,,,8.48,9.82,8
HCPCS,11600,EXC TR-EXT MAL+MARG 0.5 CM/<,,,650.1,1984.79,19
HCPCS,11600,Exc tr-ext mal+marg 0.5 cm/<,,,309.06,357.86,8
HCPCS,11600,MAL REM LESION 0.5 CM OR LESS,717.0,466.05,1.1,1200.64,53
HCPCS,11600,REMOVAL OF SKIN LESION,285.0,185.25,1.1,1200.64,53
HCPCS,11601,EXC TR-EXT MAL+MARG 0.6-1 CM,,,650.1,1984.79,19
HCPCS,11601,Exc tr-ext mal+marg 0.6-1 cm,,,309.06,357.86,8
HCPCS,11601,"MAL LESION TRUNK,ARM,LEG 0.6-1.0CM",911.0,592.15,1.1,1200.64,53
HCPCS,11601,REMOVAL OF SKIN LESION,344.0,223.6,1.1,1200.64,53
HCPCS,11602,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,1199.0,779.35,0.01,3004.0,61
HCPCS,11602,"MAL LESION TRUNK,ARM,LEG 1.1-2.0 CM",999.0,649.35,1.1,999.0,53
HCPCS,11602,REMOVAL OF SKIN LESION,378.0,245.7,1.1,811.59,53
HCPCS,11603,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,2111.0,1372.15,0.01,3004.0,61
HCPCS,11603,"MAL LESION TRUNK,ARM,LEG 2.1-3.0 CM",1241.0,806.65,1.1,1241.0,53
HCPCS,11603,REMOVAL OF SKIN LESION,430.0,279.5,1.1,1200.64,53
HCPCS,11604,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,2111.0,1372.15,0.01,4001.0,61
HCPCS,11604,"MAL LESION TRUNK,ARM,LEG 3.1-4.0 CM",1395.0,906.75,1.1,1395.0,53
HCPCS,11604,REMOVAL OF SKIN LESION,482.0,313.3,1.1,1200.64,53
HCPCS,11606,EXC TR-EXT MAL+MARG >4 CM,,,1497.07,4629.18,19
HCPCS,11606,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,2209.0,1435.85,1.1,2768.64,53
HCPCS,11606,Exc tr-ext mal+marg >4 cm,,,1360.39,1575.19,8
HCPCS,11606,REMOVAL OF SKIN LESION,677.0,440.05,1.1,2768.64,53
HCPCS,1160F,Rvw meds by rx/dr in rcrd,,,8.48,9.82,8
HCPCS,11620,EXC H-F-NK-SP MAL+MARG 0.5/<,,,1497.07,4629.18,19
HCPCS,11620,Exc h-f-nk-sp mal+marg 0.5/<,,,841.82,974.74,8
HCPCS,11620,"MAL LESION TRUNK,ARM,LEG<0.5CM",656.0,426.4,1.1,2768.64,53
HCPCS,11620,REMOVAL OF SKIN LESION,296.0,192.4,1.1,2768.64,53
HCPCS,11621,EXC S/N/H/F/G MAL+MRG 0.6-1,,,650.1,1984.79,19
HCPCS,11621,Exc s/n/h/f/g mal+mrg 0.6-1,,,309.06,357.86,8
HCPCS,11621,"MAL LESION NECK,HAND,SCAL 0.6-1CM",832.0,540.8,1.1,1200.64,53
HCPCS,11621,REMOVAL OF SKIN LESION,359.0,233.35,1.1,1200.64,53
HCPCS,11622,EXC S/N/H/F/G MAL+MRG 1.1-2,,,650.1,1984.79,19
HCPCS,11622,Exc s/n/h/f/g mal+mrg 1.1-2,,,309.06,357.86,8
HCPCS,11622,"MAL LESION NECK,HAND,SCAL 1.1-2CM",964.0,626.6,1.1,1200.64,53
HCPCS,11622,REMOVAL OF SKIN LESION,409.0,265.85,1.1,1200.64,53
HCPCS,11623,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,4861.0,3159.65,0.01,4861.0,61
HCPCS,11623,"MAL LESION NECK,HAND,SCAL 2.1-3CM",1244.0,808.6,1.1,2768.64,53
HCPCS,11623,REMOVAL OF SKIN LESION,483.0,313.95,1.1,2768.64,53
HCPCS,11624,EXC S/N/H/F/G MAL+MRG 3.1-4,,,1497.07,4629.18,19
HCPCS,11624,Exc s/n/h/f/g mal+mrg 3.1-4,,,841.82,974.74,8
HCPCS,11624,"MAL LESION NECK,HAND,SCAL 3.1-4CM",1448.0,941.2,1.1,2768.64,53
HCPCS,11624,REMOVAL OF SKIN LESION,600.0,390.0,1.1,2768.64,53
HCPCS,11626,EXC S/N/H/F/G MAL+MRG >4 CM,,,2644.48,8141.48,19
HCPCS,11626,EXC SKIN MALIG >4CM REMAINDR BODY,1844.0,1198.6,1.1,4850.94,53
HCPCS,11626,Exc s/n/h/f/g mal+mrg >4 cm,,,1360.39,1575.19,8
HCPCS,11626,REMOVAL OF SKIN LESION,725.0,471.25,1.1,4850.94,53
HCPCS,11640,EXC F/E/E/N/L MAL+MRG 0.5CM<,,,650.1,1984.79,19
HCPCS,11640,Exc f/e/e/n/l mal+mrg 0.5cm<,,,309.06,357.86,8
HCPCS,11640,"MAL LESION FACE,EAR,EYEL <5MM",668.0,434.2,1.1,1200.64,53
HCPCS,11640,REMOVAL OF SKIN LESION,319.0,207.35,1.1,1200.64,53
HCPCS,11641,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2111.0,1372.15,0.01,4001.0,122
HCPCS,11641,"MAL LESION FACE,EAR,EYEL 0.6-1CM",868.0,564.2,1.1,1200.64,53
HCPCS,11641,REMOVAL OF SKIN LESION,389.0,252.85,1.1,1200.64,53
HCPCS,11642,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,2111.0,1372.15,0.01,4001.0,61
HCPCS,11642,"MAL LESION FACE,EAR,EYEL 1.1-2CM",1048.0,681.2,1.1,1200.64,53
HCPCS,11642,REMOVAL OF SKIN LESION,451.0,293.15,1.1,1200.64,53
HCPCS,11643,EXC F/E/E/N/L MAL+MRG 2.1-3,,,1497.07,4629.18,19
HCPCS,11643,Exc f/e/e/n/l mal+mrg 2.1-3,,,841.82,974.74,8
HCPCS,11643,"MAL LESION FACE,EAR,EYEL 2.1-3CM",1368.0,889.2,1.1,2768.64,53
HCPCS,11643,REMOVAL OF SKIN LESION,535.0,347.75,1.1,2768.64,53
HCPCS,11644,EXC F/E/E/N/L MAL+MRG 3.1-4,,,1497.07,4629.18,19
HCPCS,11644,Exc f/e/e/n/l mal+mrg 3.1-4,,,841.82,974.74,8
HCPCS,11644,"MAL LESION FACE,EAR,EYEL 3.1-4CM",1736.0,1128.4,1.1,2768.64,53
HCPCS,11644,REMOVAL OF SKIN LESION,656.0,426.4,1.1,2768.64,53
HCPCS,11646,EXC F/E/E/N/L MAL+MRG >4 CM,,,2644.48,8141.48,19
HCPCS,11646,Exc f/e/e/n/l mal+mrg >4 cm,,,1360.39,1575.19,8
HCPCS,11646,"MAL LESION FACE,EAR,EYEL >4.0CM",2504.0,1627.6,1.1,4850.94,53
HCPCS,11646,REMOVAL OF SKIN LESION,844.0,548.6,1.1,4850.94,53
HCPCS,1170F,Fxnl status assessed,,,8.48,9.82,8
HCPCS,11719,TRIM NAIL(S),34.0,22.1,1.1,103.94,47
HCPCS,11719,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,126.5,82.225,0.01,2453.0,169
HCPCS,11720,DEBRIDEMENT NAIL ANY METHOD 1-5,178.0,115.7,0.01,3004.0,122
HCPCS,11720,"DEBRIDEMENT OF NAIL(S), 1-5",141.0,91.65,1.1,141.0,53
HCPCS,11721,DEBRIDEMENT NAIL ANY METHOD 6/>,178.0,115.7,0.01,3004.0,61
HCPCS,11721,"DEBRIDEMENT OF NAILS, 6 OR MORE",238.0,154.7,1.1,238.0,53
HCPCS,11730,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,529.0,343.85,0.01,3004.0,175
HCPCS,11730,REMOVAL OF NAIL PLATE,148.0,96.2,1.1,381.01,53
HCPCS,11732,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,344.0,223.6,0.01,3004.0,145
HCPCS,11740,DRAIN BLOOD FROM UNDER NAIL,74.0,48.1,1.1,218.62,53
HCPCS,11740,EVAC. SUBUNGUAL HEMATOMA,148.0,96.2,1.1,218.62,53
HCPCS,11740,EVACUATION SUBUNGUAL HEMATOMA,387.0,251.55,0.01,3004.0,122
HCPCS,11750,EXCISION NAIL MATRIX PERMANENT REMOVAL,947.0,615.55,0.01,3004.0,175
HCPCS,11750,REMOVAL OF NAIL BED,340.0,221.0,1.1,680.96,53
HCPCS,11755,BIOPSY NAIL UNIT SEPARATE PROCEDURE,1305.5,848.575,0.01,3004.0,114
HCPCS,11755,"BIOPSY, NAIL UNIT",210.0,136.5,1.1,1200.64,53
HCPCS,1175F,Function stat assessed rvwd,,,8.48,9.82,8
HCPCS,11760,REPAIR NAIL BED,1836.0,1193.4,37.85,3004.0,61
HCPCS,11760,REPAIR OF NAIL BED,364.0,236.6,1.1,1071.62,53
HCPCS,11760,"REPAIR OF NAIL BED, SIMPLE",652.0,423.8,1.1,1071.62,53
HCPCS,11762,RECONSTRUC OF NAIL BED W GRAFT,1176.0,764.4,1.1,3114.5,53
HCPCS,11762,RECONSTRUCTION OF NAIL BED,,,1690.17,5783.06,19
HCPCS,11762,Reconstruction of nail bed,,,841.82,974.74,8
HCPCS,11765,"EXCISION OF NAIL FOLD, TOE",237.0,154.05,1.1,680.96,53
HCPCS,11765,WEDGE EXCISION SKIN NAIL FOLD,843.5,548.275,1.1,3004.0,114
HCPCS,11770,EXC PILONIDAL CYST SIMPLE,,,2644.48,8141.48,19
HCPCS,11770,EXCISION PILONIDAL CYST/SINUS SIMPLE,1170.0,760.5,1.1,4850.94,53
HCPCS,11770,Exc pilonidal cyst simple,,,841.82,974.74,8
HCPCS,11770,REMOVAL OF PILONIDAL LESION,466.0,302.9,1.1,4850.94,53
HCPCS,11771,EXC PILONIDAL CYST XTNSV,,,2644.48,8141.48,19
HCPCS,11771,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,2680.0,1742.0,1.1,4850.94,53
HCPCS,11771,Exc pilonidal cyst xtnsv,,,1360.39,1575.19,8
HCPCS,11771,REMOVAL OF PILONIDAL LESION,1250.0,812.5,1.1,4850.94,53
HCPCS,11772,EXC PILONIDAL CYST COMP,,,2644.48,8141.48,19
HCPCS,11772,EXCISION PILONIDAL CYST/SINUS COMPLICATED,3234.0,2102.1,1.1,4850.94,53
HCPCS,11772,Exc pilonidal cyst comp,,,1360.39,1575.19,8
HCPCS,11772,REMOVAL OF PILONIDAL LESION,1600.0,1040.0,1.1,4850.94,53
HCPCS,1180F,Thromboemb risk assessed,,,8.48,9.82,8
HCPCS,1181F,Neuropsychia sympts assessed,,,8.48,9.82,8
HCPCS,1182F,Neuropsychi sympt 1+present,,,8.48,9.82,8
HCPCS,1183F,Neuropsychiatric symp absent,,,8.48,9.82,8
HCPCS,11900,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,412.5,268.125,0.01,3004.0,114
HCPCS,11901,INJECT SKIN LESIONS >7,,,183.59,562.35,19
HCPCS,11901,INJECTION INTRALESIONAL >7 LESIONS,352.0,228.8,1.1,352.0,53
HCPCS,11901,Inject skin lesions >7,,,133.98,155.13,8
HCPCS,11920,CORRECT SKIN COLOR 6.0 CM/<,,,565.6,2071.51,19
HCPCS,11920,Correct skin color 6.0 cm/<,,,309.06,357.86,8
HCPCS,11920,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,644.0,418.6,1.1,1071.62,53
HCPCS,11921,CORRECT SKN COLOR 6.1-20.0CM,,,565.6,2071.51,19
HCPCS,11921,Correct skn color 6.1-20.0cm,,,309.06,357.86,8
HCPCS,11921,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,772.0,501.8,1.1,1071.62,53
HCPCS,11922,Correct skin color ea 20.0cm,,,309.06,357.86,8
HCPCS,11922,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,196.0,127.4,1.1,202.23,53
HCPCS,11950,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,336.0,218.4,1.1,342.27,53
HCPCS,11950,SUBQ NJX FILLING MATRL 1CC/<,,,183.59,562.35,19
HCPCS,11950,Subq njx filling matrl 1cc/<,,,309.06,357.86,8
HCPCS,11951,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,476.0,309.4,1.1,1071.62,53
HCPCS,11951,SUBQ NJX FIL MATRL 1.1-5.0CC,,,565.6,2071.51,19
HCPCS,11951,Subq njx fil matrl 1.1-5.0cc,,,309.06,357.86,8
HCPCS,11952,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,676.0,439.4,1.1,1071.62,53
HCPCS,11952,SUBQ NJX FIL MATRL 5.1-10CC,,,565.6,2071.51,19
HCPCS,11952,Subq njx fil matrl 5.1-10cc,,,309.06,357.86,8
HCPCS,11954,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,740.0,481.0,1.1,1071.62,53
HCPCS,11954,SUBQ NJX FIL MATRL>10.0 CC,,,565.6,2071.51,19
HCPCS,11954,Subq njx fil matrl>10.0 cc,,,841.82,974.74,8
HCPCS,11960,INSERT TISSUE EXPANDER(S),,,3352.64,9932.52,19
HCPCS,11960,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,4596.0,2987.4,1.1,6125.06,50
HCPCS,11960,Insert tissue expander(s),,,1360.39,1575.19,8
HCPCS,11970,REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT,3296.0,2142.4,1.1,12214.27,50
HCPCS,11970,RPLCMT TISS XPNDR PERM IMPLT,,,6600.66,20338.07,19
HCPCS,11970,Rplcmt tiss xpndr perm implt,,,2444.11,2830.03,8
HCPCS,11971,REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT,2808.0,1825.2,1.1,4850.94,51
HCPCS,11971,RMVL TIS XPNDR WO INSJ IMPLT,,,2644.48,8141.48,19
HCPCS,11971,Rmvl tis xpndr wo insj implt,,,819.01,948.33,8
HCPCS,11976,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,1411.5,917.475,1.1,3004.0,114
HCPCS,11980,SUBCUTANEOUS HORMONE PELLET IMPLANT,440.0,286.0,1.1,680.96,53
HCPCS,11980,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,1197.0,778.05,0.01,3004.0,61
HCPCS,11981,INSERT DRUG IMPLANT DEVICE,502.0,326.3,1.1,502.0,53
HCPCS,11981,INSERTION DRUG DELIVERY IMPLANT,387.0,251.55,0.01,3004.0,61
HCPCS,11982,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,893.5,580.775,0.01,3004.0,175
HCPCS,11983,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,1018.5,662.025,0.01,3004.0,114
HCPCS,12001,"SIMP REPAIR SCALP,NECK,TRK <2.5CM",370.0,240.5,1.1,370.0,53
HCPCS,12001,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,596.0,387.4,0.01,3004.0,122
HCPCS,12002,"SIMP REPAIR SCALP,NECK,TRK 2.6-7.5CM",502.0,326.3,1.1,502.0,53
HCPCS,12002,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,596.0,387.4,99.19,2453.0,61
HCPCS,12004,"SIMP REPAIR SCALP,NECK,TRK 7.6-12.5CM",634.0,412.1,1.1,634.0,53
HCPCS,12004,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,596.0,387.4,0.01,3004.0,122
HCPCS,12005,"SIMP REPAIR SCALP,NECK,TRK 12.6-20CM",867.0,563.55,1.1,867.0,53
HCPCS,12005,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1199.0,779.35,147.83,4001.0,61
HCPCS,12006,REPR SUPERF WND BODY 20.1-30,1052.0,683.8,1.1,1052.0,53
HCPCS,12006,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,0.01,4001.0,122
HCPCS,12007,REPR SUPERF WND BODY >30CM,1276.0,829.4,1.1,1276.0,53
HCPCS,12007,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,596.0,387.4,147.83,4001.0,61
HCPCS,1200F,Seizure type& frequ docd,,,8.48,9.82,8
HCPCS,12011,"SIMP REPAIR FACE,EAR,EYE <2.5CM",471.0,306.15,1.1,471.0,53
HCPCS,12011,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,596.0,387.4,0.01,2453.0,122
HCPCS,12013,"SIMP REPAIR FACE,EAR,EYE 2.6-5CM",537.0,349.05,1.1,537.0,53
HCPCS,12013,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,596.0,387.4,0.01,2453.0,122
HCPCS,12014,"SIMP REPAIR FACE,EAR,EYE 5.1-7.5CM",691.0,449.15,1.1,691.0,53
HCPCS,12014,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,596.0,387.4,0.01,3004.0,122
HCPCS,12015,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5CM",871.0,566.15,1.1,871.0,53
HCPCS,12015,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,596.0,387.4,147.83,3004.0,61
HCPCS,12016,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1189.0,772.85,0.01,4001.0,114
HCPCS,12016,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1199.0,779.35,147.83,4001.0,61
HCPCS,12017,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1199.0,779.35,147.83,4001.0,61
HCPCS,12017,SREP F/E/N/L/MM 20.1-30.0CM,1399.0,909.35,1.1,1399.0,50
HCPCS,12018,RPR F/E/E/N/L/M >30.0 CM,,,183.59,562.35,19
HCPCS,12018,Rpr f/e/e/n/l/m >30.0 cm,,,147.83,171.17,8
HCPCS,12020,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1505.5,978.575,1.1,3004.0,114
HCPCS,12021,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1015.5,660.075,1.1,3004.0,114
HCPCS,12031,"INT REPAIR SCALP,AXL,TRUNK <2.5CM",880.0,572.0,1.1,880.0,53
HCPCS,12031,LAYER CLOSURE OF WOUND(S),352.0,228.8,1.1,870.74,53
HCPCS,12031,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1199.0,779.35,0.01,3004.0,122
HCPCS,12032,"INT REPAIR SCALP,AXL,TRUNK 2.6-7.5CM",1109.0,720.85,1.1,1109.0,53
HCPCS,12032,LAYER CLOSURE OF WOUND(S),444.0,288.6,1.1,1006.01,53
HCPCS,12032,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1199.0,779.35,0.01,3004.0,122
HCPCS,12034,"INT REPAIR SCALP,AXL,TRUNK 7.6-12.5CM",1307.0,849.55,1.1,1307.0,53
HCPCS,12034,LAYER CLOSURE OF WOUND(S),452.0,293.8,1.1,1110.84,53
HCPCS,12034,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1199.0,779.35,0.01,4001.0,122
HCPCS,12035,"INT REPAIR SCALP,AXL,TRUNK 12.6-20CM",1540.0,1001.0,1.1,1540.0,53
HCPCS,12035,LAYER CLOSURE OF WOUND(S),549.0,356.85,1.1,1297.81,53
HCPCS,12035,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1199.0,779.35,0.01,4001.0,122
HCPCS,12036,LAYER CLOSURE OF WOUND(S),630.0,409.5,1.1,1445.54,53
HCPCS,12036,"LAYR CLOS WND TRUNK,ARM,LEG 20.1-30",1861.0,1209.65,1.1,1861.0,53
HCPCS,12036,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1836.0,1193.4,0.01,4001.0,122
HCPCS,12037,LAYER CLOSURE OF WOUND(S),3151.0,2048.15,1.1,3151.0,53
HCPCS,12037,"LAYR CLOS WND TRUNK,ARM,LEG >30CM",2200.0,1430.0,1.1,3114.5,53
HCPCS,12037,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5488.0,3567.2,189.81,5783.06,61
HCPCS,12041,INT REPAIR NECK/HANDS/FEET/XTRNL GENT <2.5CM,924.0,600.6,1.1,924.0,53
HCPCS,12041,LAYER CLOSURE OF WOUND(S),371.0,241.15,1.1,875.17,53
HCPCS,12041,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1199.0,779.35,0.01,3004.0,122
HCPCS,12042,"INT REPAIR NECK,HANDS,FEET, GENIT, 2.6-7.5 CM",1228.0,798.2,1.1,1228.0,53
HCPCS,12042,LAYER CLOSURE OF WOUND(S),428.0,278.2,1.1,1028.37,53
HCPCS,12042,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1199.0,779.35,0.01,3004.0,122
HCPCS,12044,"INT REPAIR SCALP,NEC,TRK 7.6-12.5CM",1404.0,912.6,1.1,1404.0,53
HCPCS,12044,LAYER CLOSURE OF WOUND(S),509.0,330.85,1.1,1265.46,53
HCPCS,12044,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1836.0,1193.4,189.81,4001.0,61
HCPCS,12045,"INT REPAIR SCALP,NEC,TRK 12.6-20CM",1650.0,1072.5,1.1,1650.0,53
HCPCS,12045,LAYER CLOSURE OF WOUND(S),650.0,422.5,1.1,1383.14,53
HCPCS,12045,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,1836.0,1193.4,189.81,4001.0,61
HCPCS,12046,LAYER CLOSURE OF WOUND(S),2840.0,1846.0,1.1,2840.0,53
HCPCS,12046,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,1836.0,1193.4,189.81,4001.0,61
HCPCS,12047,LAYR CLOS WND REST BODY >30CM,2178.0,1415.7,1.1,3114.5,53
HCPCS,12047,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,5488.0,3567.2,189.81,5783.06,61
HCPCS,12051,"INT REPAIR FACE,EAR,EYE <2.5CM",1025.0,666.25,1.1,1025.0,53
HCPCS,12051,LAYER CLOSURE OF EAR LOBES,415.0,269.75,1.1,941.23,53
HCPCS,12051,LAYER CLOSURE OF WOUND(S),393.0,255.45,1.1,941.23,53
HCPCS,12051,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1199.0,779.35,0.01,3004.0,122
HCPCS,12052,"INT REPAIR FACE,EAR,EYE 2.6-5CM",1263.0,820.95,1.1,1263.0,53
HCPCS,12052,LAYER CLOSURE OF WOUND(S),452.0,293.8,1.1,1050.2,53
HCPCS,12052,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,0.01,3004.0,183
HCPCS,12053,"INT REPAIR FACE,EAR,EYE 5.1-7.5CM",1395.0,906.75,1.1,1395.0,53
HCPCS,12053,LAYER CLOSURE OF WOUND(S),560.0,364.0,1.1,1210.24,53
HCPCS,12053,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1199.0,779.35,189.81,3004.0,61
HCPCS,12054,"INT REPAIR FAC,EAR,EYE 7.6-12.5CM",1540.0,1001.0,1.1,1540.0,53
HCPCS,12054,LAYER CLOSURE OF WOUND(S),700.0,455.0,1.1,1283.21,53
HCPCS,12054,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1199.0,779.35,189.81,4001.0,61
HCPCS,12055,"INT REPAIR FAC,EAR,EYE 12.6-20CM",1980.0,1287.0,1.1,1980.0,53
HCPCS,12055,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1199.0,779.35,189.81,4001.0,61
HCPCS,12056,INTMD RPR FACE/MM 20.1-30.0,,,369.16,3398.0,20
HCPCS,12056,Intmd rpr face/mm 20.1-30.0,,,189.81,219.78,8
HCPCS,12056,"LAYR CLOS WND FACE,FACIAL 20.1-30",2332.0,1515.8,1.1,2332.0,53
HCPCS,12057,INTMD RPR FACE/MM >30.0 CM,,,369.16,1139.4,19
HCPCS,12057,Intmd rpr face/mm >30.0 cm,,,189.81,219.78,8
HCPCS,12057,LAYER CLOSURE OF WOUND(S),3151.0,2048.15,1.1,3151.0,53
HCPCS,1205F,Epi etiol synd rvwd and docd,,,8.48,9.82,8
HCPCS,1220F,Pt screened for depression,,,8.48,9.82,8
HCPCS,13100,REPAIR COMPLEX TRUNK 1.1-2.5 CM,1836.0,1193.4,0.01,4001.0,61
HCPCS,13100,REPR CMPL WND TRUNK 1.1-2.5CM,1200.0,780.0,1.1,1200.0,53
HCPCS,13101,REPAIR COMPLEX TRUNK 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,61
HCPCS,13101,REPR CMPL WND TRUNK 2.6-7.5CM,1400.0,910.0,1.1,1400.0,53
HCPCS,13102,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,405.0,263.25,0.01,3004.0,99
HCPCS,13120,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,1836.0,1193.4,0.01,4001.0,122
HCPCS,13120,"REPR CMPL WND SCALP,EXTR 1.1-2.5",1292.0,839.8,1.1,1292.0,53
HCPCS,13121,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,122
HCPCS,13121,"REPR CMPL WND SCALP,EXTR 2.6-7.5",1600.0,1040.0,1.1,1600.0,53
HCPCS,13122,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,651.0,423.15,1.1,3004.0,99
HCPCS,13131,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1199.0,779.35,0.01,4001.0,122
HCPCS,13131,"REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",1492.0,969.8,1.1,1492.0,53
HCPCS,13132,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,122
HCPCS,13132,"REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",2103.0,1366.95,1.1,2103.0,53
HCPCS,13133,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1061.5,689.975,1.1,3004.0,99
HCPCS,13151,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,1836.0,1193.4,0.01,6561.0,122
HCPCS,13151,"REPR CMPL WND LID,NOS,EAR 1.1-2.5",1736.0,1128.4,1.1,1736.0,53
HCPCS,13152,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,1836.0,1193.4,0.01,6561.0,122
HCPCS,13152,"REPR CMPL WND LID,NOS,EAR 2.5-7.5",2136.0,1388.4,1.1,2136.0,53
HCPCS,13153,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,777.5,505.375,0.01,6561.0,145
HCPCS,13160,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,5152.0,3348.8,1.1,9932.52,111
HCPCS,14000,SKIN TISSUE REARRANGEMENT,1010.0,656.5,1.1,3114.5,53
HCPCS,14000,TIS TRNFR TRUNK 10 SQ CM/<,,,1690.17,5783.06,19
HCPCS,14000,TISSUE REARRAN TRUNK DEF <10SCM,2548.0,1656.2,1.1,3114.5,53
HCPCS,14000,Tis trnfr trunk 10 sq cm/<,,,1166.12,1350.24,8
HCPCS,14001,SKIN TISSUE REARRANGEMENT,1310.0,851.5,1.1,3114.5,53
HCPCS,14001,TIS TRNFR TRUNK 10.1-30SQCM,,,1690.17,5783.06,19
HCPCS,14001,TISSUE REARRAN TRUNK  10.1-30SCM,3512.0,2282.8,1.1,3512.0,53
HCPCS,14001,Tis trnfr trunk 10.1-30sqcm,,,1166.12,1350.24,8
HCPCS,1400F,Prkns diag rviewed,,,8.48,9.82,8
HCPCS,14020,SKIN TISSUE REARRANGEMENT,1067.0,693.55,1.1,3114.5,53
HCPCS,14020,TIS TRNFR S/A/L 10 SQ CM/<,,,1690.17,5783.06,19
HCPCS,14020,"TISSUE REARRA SCALP,EXTRE LT 10SCM",2888.0,1877.2,1.1,3114.5,53
HCPCS,14020,Tis trnfr s/a/l 10 sq cm/<,,,1166.12,1350.24,8
HCPCS,14021,"ADJ TISS XFER SCALP,EXTREM 10.1-30",3888.0,2527.2,1.1,3888.0,53
HCPCS,14021,SKIN TISSUE REARRANGEMENT,1344.0,873.6,1.1,3114.5,53
HCPCS,14021,TIS TRNFR S/A/L 10.1-30 SQCM,,,1690.17,5783.06,19
HCPCS,14021,Tis trnfr s/a/l 10.1-30 sqcm,,,1166.12,1350.24,8
HCPCS,14040,SKIN TISSUE REARRANGEMENT,1194.0,776.1,1.1,3114.5,53
HCPCS,14040,TIS TRNFR F/C/C/M/N/A/G/H/F,,,1690.17,5783.06,19
HCPCS,14040,"TISSUE REARR MOUTH,FORE  <10SCM",3440.0,2236.0,1.1,3440.0,53
HCPCS,14040,Tis trnfr f/c/c/m/n/a/g/h/f,,,1166.12,1350.24,8
HCPCS,14041,SKIN TISSUE REARRANGEMENT,4361.0,2834.65,1.1,4361.0,53
HCPCS,14041,TIS TRNFR F/C/C/M/N/A/G/H/F,,,1690.17,5783.06,19
HCPCS,14041,"TISSUE REARR MOUTH,FORE 10.1-30SCM",4332.0,2815.8,1.1,4332.0,53
HCPCS,14041,Tis trnfr f/c/c/m/n/a/g/h/f,,,1166.12,1350.24,8
HCPCS,14060,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,5488.0,3567.2,0.01,6561.0,61
HCPCS,14060,SKIN TISSUE REARRANGEMENT,1260.0,819.0,1.1,3114.5,53
HCPCS,14060,"TISSUE REARR LIP,EAR,EYE GT 10 SCM",4061.0,2639.65,1.1,4061.0,53
HCPCS,14061,TIS TRNFR E/N/E/L10.1-30SQCM,,,1690.17,5783.06,19
HCPCS,14061,"TISSUE REARR LIP,EAR,EYE 10.1-30SCM",5051.0,3283.15,1.1,5051.0,53
HCPCS,14061,Tis trnfr e/n/e/l10.1-30sqcm,,,1166.12,1350.24,8
HCPCS,14301,ADJA TSSU TRANSFER/REARR ANY 30.1CM/60.0,1810.0,1176.5,1.1,6125.06,53
HCPCS,14301,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,10983.0,7138.95,0.01,10983.0,61
HCPCS,14301,ATT/R ANY AREA DEFECT 30.1-60SQCM,5060.0,3289.0,1.1,6125.06,53
HCPCS,14302,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,1641.0,1066.65,1.1,1641.0,50
HCPCS,14302,Tis trnfr addl 30 sq cm,,,1166.12,1350.24,8
HCPCS,14350,FILLETED FINGER/TOE FLAP,,,1690.17,5783.06,19
HCPCS,14350,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,4420.0,2873.0,1.1,4420.0,50
HCPCS,14350,Filleted finger/toe flap,,,1166.12,1350.24,8
HCPCS,14350,SKIN TISSUE REARRANGEMENT,1500.0,975.0,1.1,3114.5,50
HCPCS,1450F,Symptoms improved/consist,,,8.48,9.82,8
HCPCS,1451F,Sympt show clin import drop,,,8.48,9.82,8
HCPCS,1460F,Qual card diag prior 12 mons,,,8.48,9.82,8
HCPCS,1461F,No qual card diag prior12mon,,,8.48,9.82,8
HCPCS,1490F,Dem severity classified mild,,,8.48,9.82,8
HCPCS,1491F,Dem severity classified mod,,,8.48,9.82,8
HCPCS,1493F,Dem severity class severe,,,8.48,9.82,8
HCPCS,1494F,Cognit assessed and reviewed,,,8.48,9.82,8
HCPCS,15002,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,1606.0,1043.9,1.1,3114.5,53
HCPCS,15002,WOUND PREP TRK/ARM/LEG,,,699.22,2071.51,19
HCPCS,15002,Wound prep trk/arm/leg,,,444.21,514.35,8
HCPCS,15003,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,320.0,208.0,1.1,320.0,53
HCPCS,15003,Wound prep addl 100 cm,,,189.81,219.78,8
HCPCS,15004,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,1832.0,1190.8,1.1,1832.0,53
HCPCS,15004,WOUND PREP F/N/HF/G,,,384.59,1139.4,19
HCPCS,15004,Wound prep f/n/hf/g,,,444.21,514.35,8
HCPCS,15005,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,640.0,416.0,1.1,640.0,53
HCPCS,15005,Wnd prep f/n/hf/g addl cm,,,189.81,219.78,8
HCPCS,1500F,Symptom&sign symm polyneuro,,,8.48,9.82,8
HCPCS,15011,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,3208.5,2085.525,0.01,5783.06,90
HCPCS,15012,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,3208.5,2085.525,0.01,5488.0,75
HCPCS,15013,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,11724.0,7620.599999999999,0.01,21752.0,90
HCPCS,15014,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,11724.0,7620.599999999999,0.01,21752.0,75
HCPCS,15015,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,3092.5,2010.125,0.01,5783.06,90
HCPCS,15016,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,3092.5,2010.125,0.01,5488.0,75
HCPCS,15017,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,3169.0,2059.85,0.01,5783.06,90
HCPCS,15018,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,3169.0,2059.85,0.01,5488.0,75
HCPCS,1501F,Not initial eval for cond,,,8.48,9.82,8
HCPCS,1502F,Pt queried pain fxn w/ instr,,,8.48,9.82,8
HCPCS,1503F,Pt queried symp resp insuff,,,8.48,9.82,8
HCPCS,15040,HARVEST CULTURED SKIN GRAFT,,,1690.17,5783.06,19
HCPCS,15040,Harvest cultured skin graft,,,1166.12,1350.24,8
HCPCS,1504F,Pt has resp insufficiency,,,8.48,9.82,8
HCPCS,15050,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,2228.0,1448.2,1.1,2228.0,53
HCPCS,15050,PINCH GRAFT UP TO 2 CM DIAM,,,565.6,2071.51,19
HCPCS,15050,Pinch graft up to 2 cm diam,,,309.06,357.86,8
HCPCS,1505F,Pt has no resp insufficiency,,,8.48,9.82,8
HCPCS,15100,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,3960.0,2574.0,1.1,3960.0,53
HCPCS,15100,SPLT AGRFT T/A/L 1ST 100SQCM,,,1690.17,5783.06,19
HCPCS,15100,Splt agrft t/a/l 1st 100sqcm,,,1166.12,1350.24,8
HCPCS,15101,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,688.0,447.2,1.1,688.0,53
HCPCS,15101,Splt agrft t/a/l ea addl 100,,,1166.12,1350.24,8
HCPCS,15110,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,5157.5,3352.375,0.01,5783.06,114
HCPCS,15111,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,740.0,481.0,1.1,740.0,53
HCPCS,15111,Epidrm agrft t/a/l ea addl,,,1166.12,1350.24,8
HCPCS,15115,EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100SQCM,4963.0,3225.95,1.1,4963.0,53
HCPCS,15115,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<,5488.0,3567.2,0.01,5783.06,61
HCPCS,15116,EPIDRM A-GRFT F/N/HF/G ADDL 100 SQ CM/1% BA,1000.0,650.0,1.1,1000.0,53
HCPCS,15116,Epdrm agrft f/s/n/h/f/g/m ea,,,1166.12,1350.24,8
HCPCS,15120,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,7521.5,4888.975,0.01,10983.0,114
HCPCS,15121,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,800.0,520.0,1.1,800.0,53
HCPCS,15121,Splt agrft f/s/n/h/f/g/m ea,,,1166.12,1350.24,8
HCPCS,15130,DRM AGRFT T/A/L 1ST 100 SQCM,,,1690.17,5783.06,19
HCPCS,15130,Drm agrft t/a/l 1st 100 sqcm,,,1166.12,1350.24,8
HCPCS,15131,Drm agrft t/a/l ea addl,,,1166.12,1350.24,8
HCPCS,15135,DRM AGRFT F/S/N/H/F/G/M 1ST,,,3352.64,9932.52,19
HCPCS,15135,Drm agrft f/s/n/h/f/g/m 1st,,,1166.12,1350.24,8
HCPCS,15136,Drm agrft f/s/n/h/f/g/m ea,,,1166.12,1350.24,8
HCPCS,15150,TIS CLTR SKN AGRFT T/A/L 1ST,,,1690.17,5783.06,19
HCPCS,15150,Tis cltr skn agrft t/a/l 1st,,,1166.12,1350.24,8
HCPCS,15151,Tis cltr skn agrft t/a/l add,,,1166.12,1350.24,8
HCPCS,15152,Tis cltr skn agrft t/a/l ea,,,1166.12,1350.24,8
HCPCS,15155,TIS CLTR AGRFT F/S/N/H/F/G 1,,,3352.64,9932.52,19
HCPCS,15155,Tis cltr agrft f/s/n/h/f/g 1,,,1166.12,1350.24,8
HCPCS,15156,Tis clt agrft f/s/n/h/f/g ad,,,1166.12,1350.24,8
HCPCS,15157,Tis clt agrft f/s/n/h/f/g ea,,,1166.12,1350.24,8
HCPCS,15200,FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<,5488.0,3567.2,0.01,6561.0,61
HCPCS,15200,FULL GRAFT PROC TRUNK <20 SQCM,3660.0,2379.0,1.1,3660.0,53
HCPCS,15201,FULL GRAFT PROC TRUNK ADD 20 SQCM,581.0,377.65,1.1,581.0,53
HCPCS,15201,Fth/gft fr trnk each addl,,,1166.12,1350.24,8
HCPCS,15220,FTH/GFT FR S/A/L 20 SQ CM/<,,,1690.17,5783.06,19
HCPCS,15220,"FULL THICKNESS GRAFT SCALP, ARMS LEGS 20 SQ CM OR LESS",3236.0,2103.4,1.1,3236.0,53
HCPCS,15220,Fth/gft fr s/a/l 20 sq cm/<,,,1166.12,1350.24,8
HCPCS,15221,FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<,5488.0,3567.2,0.01,5488.0,46
HCPCS,15221,"FULL GRAFT PROC SCALP,ARM ADD 20SQCM",476.0,309.4,1.1,476.0,53
HCPCS,15240,FTH/GFT F/C/C/M/N/AX/G/H/F20,,,1690.17,5783.06,19
HCPCS,15240,Fth/gft f/c/c/m/n/ax/g/h/f20,,,1166.12,1350.24,8
HCPCS,15240,SKIN GRAFT HAND <20 SQ CM,4164.0,2706.6,1.1,4164.0,53
HCPCS,15241,Fth/gft f/c/c/m/n/a/g/h/f ea,,,1166.12,1350.24,8
HCPCS,15241,SKIN GRAFT HAND ADD'L 20 SCM,818.0,531.7,1.1,818.0,53
HCPCS,15260,FTH/GFT FR N/E/E/L 20 SQCM/<,,,1690.17,5783.06,19
HCPCS,15260,Fth/gft fr n/e/e/l 20 sqcm/<,,,1166.12,1350.24,8
HCPCS,15260,SKIN GRAFT NOSE <20 SQ CM,4656.0,3026.4,1.1,4656.0,53
HCPCS,15261,Fth/gft fr n/e/e/l each addl,,,1166.12,1350.24,8
HCPCS,15261,SKIN GRAFT NOSE ADD'L 20SCM,892.0,579.8,1.1,892.0,53
HCPCS,15271,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,5488.0,3567.2,0.01,5488.0,122
HCPCS,15271,APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM,660.0,429.0,1.1,3114.5,53
HCPCS,15272,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,5488.0,3567.2,0.01,5488.0,46
HCPCS,15272,APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM,145.0,94.25,1.1,145.0,53
HCPCS,15273,APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM,1400.0,910.0,1.1,6125.06,53
HCPCS,15273,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,10983.0,7138.95,0.01,10983.0,61
HCPCS,15274,APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM,320.0,208.0,1.1,320.0,53
HCPCS,15274,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,10983.0,7138.95,0.01,10983.0,46
HCPCS,15275,SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM,732.0,475.8,1.1,3114.5,53
HCPCS,15275,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,5488.0,3567.2,0.01,5488.0,122
HCPCS,15276,SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM,200.0,130.0,1.1,200.0,53
HCPCS,15276,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,5488.0,3567.2,0.01,5488.0,92
HCPCS,15277,SKN SUB GRFT F/N/HF/G CHILD,,,1690.17,5783.06,19
HCPCS,15277,SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM,1600.0,1040.0,1.1,3114.5,53
HCPCS,15277,Skn sub grft f/n/hf/g child,,,1166.12,1350.24,8
HCPCS,15278,SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM,400.0,260.0,1.1,400.0,53
HCPCS,15278,Skn sub grft f/n/hf/g ch add,,,1166.12,1350.24,8
HCPCS,15570,SKIN PEDICLE FLAP TRUNK,,,1690.17,5783.06,19
HCPCS,15570,Skin pedicle flap trunk,,,1166.12,1350.24,8
HCPCS,15572,SKIN PEDICLE FLAP ARMS/LEGS,,,3352.64,9932.52,19
HCPCS,15572,Skin pedicle flap arms/legs,,,1166.12,1350.24,8
HCPCS,15574,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,4280.0,2782.0,1.1,4280.0,53
HCPCS,15574,PEDCLE FH/CH/CH/M/N/AX/G/H/F,,,1690.17,5783.06,19
HCPCS,15574,Pedcle fh/ch/ch/m/n/ax/g/h/f,,,1166.12,1350.24,8
HCPCS,15576,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,3748.0,2436.2,1.1,3748.0,53
HCPCS,15576,PEDICLE E/N/E/L/NTRORAL,,,1690.17,5783.06,19
HCPCS,15576,Pedicle e/n/e/l/ntroral,,,1166.12,1350.24,8
HCPCS,15600,DELAY FLAP TRUNK,,,3352.64,9932.52,19
HCPCS,15600,DELAY/SECTN FLAP TRUNK,804.0,522.6,1.1,6125.06,53
HCPCS,15600,Delay flap trunk,,,1166.12,1350.24,8
HCPCS,15610,DELAY FLAP ARMS/LEGS,,,1690.17,5783.06,19
HCPCS,15610,Delay flap arms/legs,,,1166.12,1350.24,8
HCPCS,15620,DELAY FLAP F/C/C/N/AX/G/H/F,,,1690.17,5783.06,19
HCPCS,15620,"DELAY/SECTN FLAP FACE,GENIT,HAND,FT",1500.0,975.0,1.1,3114.5,53
HCPCS,15620,Delay flap f/c/c/n/ax/g/h/f,,,1166.12,1350.24,8
HCPCS,15630,DELAY FLAP EYE/NOS/EAR/LIP,,,1690.17,5783.06,19
HCPCS,15630,"DELAY/SECTN FLAP LID,NOS,EAR,LIP",1632.0,1060.8,1.1,3114.5,53
HCPCS,15630,Delay flap eye/nos/ear/lip,,,1166.12,1350.24,8
HCPCS,15650,TRANSFER SKIN PEDICLE FLAP,,,1690.17,5783.06,19
HCPCS,15650,Transfer skin pedicle flap,,,1166.12,1350.24,8
HCPCS,15730,MDFC FLAP W/PRSRV VASC PEDCL,,,3352.64,9932.52,19
HCPCS,15730,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,5400.0,3510.0,1.1,6125.06,53
HCPCS,15730,Mdfc flap w/prsrv vasc pedcl,,,1166.12,1350.24,8
HCPCS,15731,FOREHEAD FLAP W/VASC PEDICLE,5752.0,3738.8,1.1,9932.52,72
HCPCS,15731,Forehead flap w/vasc pedicle,,,1166.12,1350.24,8
HCPCS,15733,MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL,6272.0,4076.8,1.1,6272.0,50
HCPCS,15733,MUSC MYOQ/FSCQ FLP H&N PEDCL,,,3352.64,9932.52,19
HCPCS,15733,Musc myoq/fscq flp h&n pedcl,,,1166.12,1350.24,8
HCPCS,15734,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,9200.0,5980.0,1.1,9200.0,50
HCPCS,15734,MUSCLE-SKIN GRAFT TRUNK,,,3352.64,9932.52,19
HCPCS,15734,Muscle-skin graft trunk,,,1166.12,1350.24,8
HCPCS,15736,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,6816.0,4430.4,1.1,6816.0,50
HCPCS,15736,MUSCLE-SKIN GRAFT ARM,,,1690.17,5783.06,19
HCPCS,15736,Muscle-skin graft arm,,,1166.12,1350.24,8
HCPCS,15738,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,8378.0,5445.7,1.1,8378.0,50
HCPCS,15738,MUSCLE-SKIN GRAFT LEG,,,3352.64,9932.52,19
HCPCS,15738,Muscle-skin graft leg,,,1166.12,1350.24,8
HCPCS,15740,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,4720.0,3068.0,1.1,4720.0,53
HCPCS,15740,ISLAND PEDICLE FLAP GRAFT,,,1690.17,5783.06,19
HCPCS,15740,Island pedicle flap graft,,,1166.12,1350.24,8
HCPCS,15750,NEUROVASCULAR PEDICLE FLAP,,,3352.64,9932.52,19
HCPCS,15750,NEUROVASCULAR PEDICLE GRAFT,5184.0,3369.6,1.1,6125.06,50
HCPCS,15750,Neurovascular pedicle flap,,,1166.12,1350.24,8
HCPCS,15756,FREE MUSC FLAP W MICROVASC ANAST,14776.0,9604.4,1.1,14776.0,50
HCPCS,15756,Free myo/skin flap microvasc,,,1166.12,1350.24,8
HCPCS,15757,Free skin flap microvasc,,,1166.12,1350.24,8
HCPCS,15758,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,14760.0,9594.0,1.1,14760.0,50
HCPCS,15758,Free fascial flap microvasc,,,1166.12,1350.24,8
HCPCS,15760,COMPOSITE SKIN GRAFT,,,1690.17,5783.06,19
HCPCS,15760,Composite skin graft,,,1166.12,1350.24,8
HCPCS,15769,FAT INJECTIONS FOR BUTTOCK AUGMENT (BBL) - MODERATE,1500.0,975.0,1.1,6125.06,50
HCPCS,15769,GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC,2672.0,1736.8,1.1,6125.06,50
HCPCS,15769,GRFG AUTOL SOFT TISS DIR EXC,,,3352.64,9932.52,19
HCPCS,15769,Grfg autol soft tiss dir exc,,,1166.12,1350.24,8
HCPCS,15770,DERMA-FAT-FASCIA GRAFT,,,3352.64,9932.52,19
HCPCS,15770,Derma-fat-fascia graft,,,1166.12,1350.24,8
HCPCS,15770,"GRAFT,DERMA-FAT-FASCIA",3942.0,2562.3,1.1,6125.06,50
HCPCS,15771,GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS,2961.0,1924.65,1.1,6125.06,52
HCPCS,15771,GRFG AUTOL FAT LIPO 50 CC/<,,,3352.64,9932.52,19
HCPCS,15771,Grfg autol fat lipo 50 cc/<,,,1166.12,1350.24,8
HCPCS,15772,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC,1100.0,715.0,1.1,1100.0,52
HCPCS,15772,Grfg autol fat lipo ea addl,,,1166.12,1350.24,8
HCPCS,15773,FAT INJECTION FACE/NECK INC REVOLVE - MODERATE,990.0,643.5,1.1,3114.5,52
HCPCS,15773,GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS,2732.0,1775.8,1.1,3114.5,52
HCPCS,15773,GRFG AUTOL FAT LIPO 25 CC/<,,,1690.17,5783.06,19
HCPCS,15773,Grfg autol fat lipo 25 cc/<,,,1166.12,1350.24,8
HCPCS,15774,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC,964.0,626.6,1.1,964.0,52
HCPCS,15774,Gfrg autol fat lipo ea addl,,,1166.12,1350.24,8
HCPCS,15775,HAIR TRNSPL 1-15 PUNCH GRFTS,,,369.16,1139.4,19
HCPCS,15775,Hair trnspl 1-15 punch grfts,,,309.06,357.86,8
HCPCS,15776,HAIR TRNSPL >15 PUNCH GRAFTS,,,369.16,1139.4,19
HCPCS,15776,Hair trnspl >15 punch grafts,,,309.06,357.86,8
HCPCS,15777,ACELLULAR DERM MATRIX IMPLT,,,3398.0,3398.0,1
HCPCS,15777,Acellular derm matrix implt,,,1166.12,1350.24,8
HCPCS,15777,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,1460.0,949.0,1.1,1460.0,50
HCPCS,15778,IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA,2820.0,1833.0,1.1,2820.0,50
HCPCS,15778,Impl absrb msh/prsth dly cls,,,1166.12,1350.24,8
HCPCS,15780,DERMABRASION TOTAL FACE,,,2644.48,8141.48,19
HCPCS,15780,Dermabrasion total face,,,464.84,538.24,8
HCPCS,15781,DERMABRAS RX SKIN SGMENT FACE,2008.0,1305.2,1.1,2008.0,47
HCPCS,15781,DERMABRASION SEGMENTAL FACE,,,650.1,1984.79,19
HCPCS,15781,Dermabrasion segmental face,,,464.84,538.24,8
HCPCS,15781,LASER RESURFACING/PARTIAL FACE,650.0,422.5,1.1,1794.52,47
HCPCS,15782,DERMABRASION OTHER THAN FACE,,,2644.48,8141.48,19
HCPCS,15782,Dermabrasion other than face,,,464.84,538.24,8
HCPCS,15782,LASER RESURFACING/OTHER THAN FACE,600.0,390.0,1.1,4850.94,47
HCPCS,15783,DERMABRASION SUPRFL ANY SITE,,,369.16,1139.4,19
HCPCS,15783,Dermabrasion suprfl any site,,,464.84,538.24,8
HCPCS,15783,LASER RESURFACING/SUPERFICIAL,500.0,325.0,1.1,1489.46,47
HCPCS,15783,MICRODERMABRASION,300.0,195.0,1.1,1489.46,47
HCPCS,15783,TATTOO REMOVAL,300.0,195.0,1.1,1489.46,47
HCPCS,15786,ABRAS SINGLE LESION,832.0,540.8,1.1,832.0,53
HCPCS,15786,ABRASION LESION SINGLE,,,183.59,562.35,19
HCPCS,15786,Abrasion lesion single,,,133.98,155.13,8
HCPCS,15787,Abrasion lesions add-on,,,133.98,155.13,8
HCPCS,15788,"CHEM PEEL, FACE, EPIDERM",836.0,543.4,1.1,1275.31,47
HCPCS,15788,CHEMICAL PEEL FACIAL EPIDRM,,,369.16,1139.4,19
HCPCS,15788,Chemical peel facial epidrm,,,133.98,155.13,8
HCPCS,15789,"CHEM PEEL, FACE, DERMAL",1964.0,1276.6,1.1,1964.0,47
HCPCS,15789,CHEMICAL PEEL FACIAL DERMAL,,,565.6,2071.51,19
HCPCS,15789,Chemical peel facial dermal,,,133.98,155.13,8
HCPCS,15789,"PHENOL CHEMICAL PEEL, EACH ADDL AREA",1900.0,1235.0,1.1,1900.0,47
HCPCS,15789,"PHENOL CHEMICAL PEEL, FULL FACE",3600.0,2340.0,1.1,3600.0,47
HCPCS,15792,CHEM PEEL NONFACIAL EPIDRM,,,565.6,2071.51,19
HCPCS,15792,"CHEM PEEL, NONFACIAL EPIDERM",744.0,483.6,1.1,1094.09,47
HCPCS,15792,Chem peel nonfacial epidrm,,,133.98,155.13,8
HCPCS,15793,CHEMICAL PEEL NONFACIAL DRM,,,369.16,1139.4,19
HCPCS,15793,Chemical peel nonfacial drm,,,133.98,155.13,8
HCPCS,15819,CERVICOPLASTY   (REMOVAL EXCESS NECK SKIN),3000.0,1950.0,1.1,3114.5,24
HCPCS,15819,Plastic surgery neck,,,1360.39,1575.19,8
HCPCS,15820,BLEPHAROPLASTY LOWER EYELID,5488.0,3567.2,0.01,6561.0,61
HCPCS,15820,BLEPHAROPLASTY LOWER LID,2759.0,1793.35,1.1,3114.5,47
HCPCS,15821,BLEPHARP LWR EYELID FAT PAD,,,1690.17,5783.06,19
HCPCS,15821,Blepharp lwr eyelid fat pad,,,1360.39,1575.19,8
HCPCS,15822,BLEPHAROPLASTY UPPER EYELID,2033.0,1321.45,1.1,5783.06,66
HCPCS,15822,Blepharoplasty upper eyelid,,,1360.39,1575.19,8
HCPCS,15823,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,2996.0,1947.4,1.1,3114.5,53
HCPCS,15823,BLEPHARP UPR EYELID XCSV SKN,,,1690.17,5783.06,19
HCPCS,15823,Blepharp upr eyelid xcsv skn,,,1360.39,1575.19,8
HCPCS,15824,RHYTIDECTOMY FOREHEAD,4486.0,2915.9,1.1,5783.06,51
HCPCS,15824,Rhytidectomy forehead,,,1360.39,1575.19,8
HCPCS,15825,RHYTDCT NCK PLTYSML TGHTG,,,3352.64,9932.52,19
HCPCS,15825,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,5845.0,3799.25,1.1,6125.06,32
HCPCS,15825,Rhytdct nck pltysml tghtg,,,1360.39,1575.19,8
HCPCS,15826,RHYTIDECTOMY GLBLR FRN LINES,,,3352.64,9932.52,19
HCPCS,15826,Rhytidectomy glblr frn lines,,,1360.39,1575.19,8
HCPCS,15828,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,1.1,8610.0,32
HCPCS,15828,RHYTIDECTOMY CHEEK CHN & NCK,,,3352.64,9932.52,19
HCPCS,15828,Rhytidectomy cheek chn & nck,,,1360.39,1575.19,8
HCPCS,15829,RHYTIDECTOMY SMAS FLAP,9126.0,5931.9,1.1,9932.52,51
HCPCS,15829,Rhytidectomy smas flap,,,1360.39,1575.19,8
HCPCS,15830,EXC EXCESSIVE SKIN ABDOMEN,,,6025.7,18611.38,20
HCPCS,15830,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,6844.0,4448.6,1.1,11133.7,50
HCPCS,15830,Exc excessive skin abdomen,,,1360.39,1575.19,8
HCPCS,15832,EXC EXCESSIVE SKIN THIGH,,,2644.48,8141.48,19
HCPCS,15832,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,5654.0,3675.1,1.1,5654.0,44
HCPCS,15832,Exc excessive skin thigh,,,1360.39,1575.19,8
HCPCS,15833,EXC EXCESSIVE SKIN LEG,,,2644.48,8141.48,19
HCPCS,15833,Exc excessive skin leg,,,1360.39,1575.19,8
HCPCS,15834,EXC EXCESSIVE SKIN HIP,,,2644.48,8141.48,19
HCPCS,15834,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,4868.0,3164.2,1.1,4868.0,44
HCPCS,15834,Exc excessive skin hip,,,1360.39,1575.19,8
HCPCS,15835,EXC EXCESSIVE SKIN BUTTOCK,,,2644.48,8141.48,19
HCPCS,15835,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,5196.0,3377.4,1.1,5196.0,44
HCPCS,15835,Exc excessive skin buttock,,,1360.39,1575.19,8
HCPCS,15836,EXC EXCESSIVE SKIN ARM,,,2644.48,8141.48,19
HCPCS,15836,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,4668.0,3034.2,1.1,4850.94,44
HCPCS,15836,Exc excessive skin arm,,,1360.39,1575.19,8
HCPCS,15837,EXC EXCSV SKIN FOREARM/HAND,,,2644.48,8141.48,19
HCPCS,15837,Exc excsv skin forearm/hand,,,1360.39,1575.19,8
HCPCS,15838,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,3300.0,2145.0,1.1,4850.94,44
HCPCS,15838,EXC EXCSV SUBMENTAL FAT PAD,,,2644.48,8141.48,19
HCPCS,15838,Exc excsv submental fat pad,,,1360.39,1575.19,8
HCPCS,15839,EXC EXCESSIVE SKN OTHER AREA,,,2644.48,8141.48,19
HCPCS,15839,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,4200.0,2730.0,1.1,4850.94,53
HCPCS,15839,Exc excessive skn other area,,,1360.39,1575.19,8
HCPCS,15840,NERVE PALSY FASCIAL GRAFT,,,3352.64,9932.52,19
HCPCS,15840,Nerve palsy fascial graft,,,1166.12,1350.24,8
HCPCS,15841,NERVE PALSY MUSCLE GRAFT,,,3352.64,9932.52,19
HCPCS,15841,Nerve palsy muscle graft,,,1166.12,1350.24,8
HCPCS,15842,NERVE PALSY MICROSURG GRAFT,,,1690.17,5783.06,19
HCPCS,15842,Nerve palsy microsurg graft,,,1166.12,1350.24,8
HCPCS,15845,SKIN AND MUSCLE REPAIR FACE,,,3352.64,9932.52,19
HCPCS,15845,Skin and muscle repair face,,,1166.12,1350.24,8
HCPCS,15847,ABDOMINOPLASTY ADD-ON  (INCL FLEUR DE LIS),1000.0,650.0,1.1,2068.22,38
HCPCS,15847,"EXCISE EXCESS SKIN TISSUE,ABDOMEN, ADD-ON",5828.0,3788.2,1.1,5828.0,38
HCPCS,15847,Exc skin abd add-on,,,1360.39,1575.19,8
HCPCS,15850,Remove sutures same surgeon,,,841.82,974.74,8
HCPCS,15851,REMOVAL SUTR/STAPLE REQ ANES,,,1690.17,5783.06,19
HCPCS,15851,REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA,440.0,286.0,1.1,3114.5,53
HCPCS,15851,Removal sutr/staple req anes,,,841.82,974.74,8
HCPCS,15852,DRESSING CHANGE NOT FOR BURN,,,565.6,2071.51,19
HCPCS,15852,DRESSING CHANGE UNDER ANESTHESIA,344.0,223.6,1.1,1071.62,50
HCPCS,15852,Dressing change not for burn,,,147.83,171.17,8
HCPCS,15853,REMOVAL SUTURES OR STAPLES NOT REQUIRING ANESTHESIA,364.0,236.6,1.1,364.0,50
HCPCS,15853,REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA,751.0,488.15,0.01,3004.0,46
HCPCS,15854,Removal sutr&stapl xreq anes,,,50.62,58.61,8
HCPCS,15860,IV NJX TST VASC FLO FLAP/GRF,,,368.71,1252.1,19
HCPCS,15860,Iv njx tst vasc flo flap/grf,,,65.08,75.36,8
HCPCS,15860,TEST FOR BLOOD FLOW IN GRAFT,780.0,507.0,1.1,780.0,50
HCPCS,15865,REMOVAL SUTURES & STAPLES NOT REQUIRING ANESTHESIA,337.0,219.05,1.1,337.0,22
HCPCS,15876,"SUCT ASSIS LIPECTOMY,HEAD/NECK",2456.0,1596.4,1.1,6125.06,35
HCPCS,15876,SUCTION LIPECTOMY HEAD&NECK,,,3352.64,9932.52,19
HCPCS,15876,Suction lipectomy head&neck,,,1360.39,1575.19,8
HCPCS,15877,"SUCT ASSIS LIPECTOMY,TRUNK",4640.0,3016.0,1.1,6125.06,35
HCPCS,15877,SUCTION LIPECTOMY TRUNK,,,3352.64,9932.52,19
HCPCS,15877,Suction lipectomy trunk,,,1360.39,1575.19,8
HCPCS,15878,"SUCT ASSIS LIPECTOMY,UP EXTREM",4777.0,3105.05,1.1,4777.0,35
HCPCS,15878,SUCTION LIPECTOMY UPR EXTREM,,,1690.17,5783.06,19
HCPCS,15878,Suction lipectomy upr extrem,,,1360.39,1575.19,8
HCPCS,15879,"SUCT ASSIS LIPECTOMY,LOW EXTREM",4640.0,3016.0,1.1,6125.06,35
HCPCS,15879,SUCTION LIPECTOMY LWR EXTREM,,,3352.64,9932.52,19
HCPCS,15879,Suction lipectomy lwr extrem,,,1360.39,1575.19,8
HCPCS,15920,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,3316.0,2155.4,1.1,4850.94,50
HCPCS,15920,EXC COCCYGL PR ULC PRIM SUTR,,,2644.48,8141.48,19
HCPCS,15920,Exc coccygl pr ulc prim sutr,,,444.21,514.35,8
HCPCS,15922,EXC COCCYGL PR ULC FLAP CLSR,,,3352.64,9932.52,19
HCPCS,15922,Exc coccygl pr ulc flap clsr,,,444.21,514.35,8
HCPCS,15931,EXC SACRAL PR ULC PRIM SUTR,,,2644.48,8141.48,19
HCPCS,15931,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,4028.0,2618.2,1.1,4850.94,50
HCPCS,15931,Exc sacral pr ulc prim sutr,,,444.21,514.35,8
HCPCS,15933,EXC SAC PR ULC PRIM STR OSTC,,,2644.48,8141.48,19
HCPCS,15933,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,4708.0,3060.2,1.1,4850.94,50
HCPCS,15933,Exc sac pr ulc prim str ostc,,,444.21,514.35,8
HCPCS,15934,EXC SACRAL PR ULC SKN FLAP,,,3352.64,9932.52,19
HCPCS,15934,Exc sacral pr ulc skn flap,,,444.21,514.35,8
HCPCS,15935,EXC SAC PR ULC SKN FLP OSTC,,,3352.64,9932.52,19
HCPCS,15935,Exc sac pr ulc skn flp ostc,,,444.21,514.35,8
HCPCS,15936,EXC SAC PR ULC PREP MUS FLAP,,,1690.17,5783.06,19
HCPCS,15936,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,5264.0,3421.6,1.1,5264.0,50
HCPCS,15936,Exc sac pr ulc prep mus flap,,,444.21,514.35,8
HCPCS,15937,EXC SAC PR ULC PREP MUS OSTC,,,1690.17,5783.06,19
HCPCS,15937,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,6056.0,3936.4,1.1,6056.0,50
HCPCS,15937,Exc sac pr ulc prep mus ostc,,,444.21,514.35,8
HCPCS,15940,EXC ISCHIAL PR ULC PRIM SUTR,,,2644.48,8141.48,19
HCPCS,15940,Exc ischial pr ulc prim sutr,,,444.21,514.35,8
HCPCS,15941,EXC ISCH PR ULC PRM SUT OSTC,,,2644.48,8141.48,19
HCPCS,15941,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,4964.0,3226.6,1.1,4964.0,50
HCPCS,15941,Exc isch pr ulc prm sut ostc,,,444.21,514.35,8
HCPCS,15944,EXC ISCH PR ULC SKN FLP CLSR,,,3352.64,9932.52,19
HCPCS,15944,Exc isch pr ulc skn flp clsr,,,444.21,514.35,8
HCPCS,15945,EXC ISCH PR ULC SKN FLP OSTC,,,1690.17,5783.06,19
HCPCS,15945,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,5500.0,3575.0,1.1,5500.0,50
HCPCS,15945,Exc isch pr ulc skn flp ostc,,,444.21,514.35,8
HCPCS,15946,EXC ISCH PR ULC PREP MUS FLP,,,1690.17,5783.06,19
HCPCS,15946,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,9648.0,6271.2,1.1,9648.0,50
HCPCS,15946,Exc isch pr ulc prep mus flp,,,444.21,514.35,8
HCPCS,15950,EXC TRCHNTR PR ULC PRIM SUTR,,,1497.07,4629.18,19
HCPCS,15950,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,3212.0,2087.8,1.1,3212.0,50
HCPCS,15950,Exc trchntr pr ulc prim sutr,,,444.21,514.35,8
HCPCS,15951,EXC TRCHNTR PR ULC OSTC,,,2644.48,8141.48,19
HCPCS,15951,Exc trchntr pr ulc ostc,,,444.21,514.35,8
HCPCS,15952,EXC TRCHNTR PR ULC FLP CLSR,,,1690.17,5783.06,19
HCPCS,15952,Exc trchntr pr ulc flp clsr,,,444.21,514.35,8
HCPCS,15953,EXC TRCHNTR PR ULC FLP OSTC,,,3352.64,9932.52,19
HCPCS,15953,Exc trchntr pr ulc flp ostc,,,444.21,514.35,8
HCPCS,15956,EXC TRCHNTR PR ULC PREP FLAP,,,1690.17,5783.06,19
HCPCS,15956,Exc trchntr pr ulc prep flap,,,444.21,514.35,8
HCPCS,15958,EXC TRCHNTR PR ULC PREP OSTC,,,3352.64,9932.52,19
HCPCS,15958,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,6700.0,4355.0,1.1,6700.0,50
HCPCS,15958,Exc trchntr pr ulc prep ostc,,,444.21,514.35,8
HCPCS,15999,UNLISTED PX EXC PRESSURE ULC,,,650.1,1984.79,19
HCPCS,15999,Unlisted px exc pressure ulc,,,147.83,171.17,8
HCPCS,16000,INITIAL TX 1ST DEGREE BURN LOCAL TX,596.0,387.4,77.71,2453.0,61
HCPCS,16000,"INITIAL TX, FIRST DEGREE BURN, LOCAL TREATMENT",356.0,231.4,1.1,356.0,53
HCPCS,16020,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,454.0,295.1,0.01,3004.0,175
HCPCS,16025,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,646.0,419.9,1.1,4001.0,114
HCPCS,16030,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1015.5,660.075,1.1,4001.0,114
HCPCS,16035,ESCHAROTOMY 1ST INCISION,,,369.16,1139.4,19
HCPCS,16035,ESCHAROTOMY; INIT INC,1496.0,972.4,1.1,1496.0,50
HCPCS,16035,Escharotomy 1st incision,,,189.81,219.78,8
HCPCS,16036,Escharotomy ea addl incision,,,189.81,219.78,8
HCPCS,17000,DESTROY BENIGN/PREMAL LESION,122.0,79.3,1.1,342.27,53
HCPCS,17000,DESTRUCTION PREMALIGNANT LESION 1ST,596.0,387.4,0.01,3004.0,61
HCPCS,17000,"DESTRUCTION, 1ST LESION",268.0,174.2,1.1,342.27,53
HCPCS,17003,"DESTRUC BENIGN/PREMAL,2-14 LESIONS",18.0,11.7,1.1,21.76,53
HCPCS,17003,DESTRUCTION PREMALIGNANT LESION 2-14 EA,334.0,217.1,0.01,3004.0,46
HCPCS,17004,"DESTRUC BENIGN/PREMAL,>15 LESIONS",603.0,391.95,1.1,680.96,53
HCPCS,17004,DESTRUCTION PREMALIGNANT LESION 15/>,1199.0,779.35,0.01,3004.0,61
HCPCS,17106,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1624.0,1055.6,1.1,1624.0,53
HCPCS,17106,DESTRUCTION OF SKIN LESIONS,330.0,214.5,1.1,1143.19,53
HCPCS,17106,DSTR CUT VSC PRLF LES<10SQCM,,,369.16,1139.4,19
HCPCS,17106,Dstr cut vsc prlf les<10sqcm,,,464.84,538.24,8
HCPCS,17106,LASER CVP LESIONS,300.0,195.0,1.1,1143.19,53
HCPCS,17107,"DESTR,CUTAN VASC LESION 10-50SCM",2108.0,1370.2,1.1,2108.0,53
HCPCS,17107,DESTRUCTION OF SKIN LESIONS,656.0,426.4,1.1,1482.3,53
HCPCS,17107,DSTR CUT VSC PRLF LES10-50SQ,,,565.6,2071.51,19
HCPCS,17107,Dstr cut vsc prlf les10-50sq,,,464.84,538.24,8
HCPCS,17108,DESTRUC CUT/VASC >50 SQ CM,3296.0,2142.4,1.1,3296.0,53
HCPCS,17108,DESTRUCTION OF SKIN LESIONS,1050.0,682.5,1.1,3114.5,53
HCPCS,17108,DSTR CUT VSC PRLF LES>50SQCM,,,1690.17,5783.06,19
HCPCS,17108,Dstr cut vsc prlf les>50sqcm,,,464.84,538.24,8
HCPCS,17110,"DESTRUCT LESION, UP TO 14",158.0,102.7,1.1,372.57,53
HCPCS,17110,DESTRUCTION BENIGN LESIONS UP TO 14,452.0,293.79999999999995,0.01,3004.0,114
HCPCS,17110,KERATOSES DESTRUCTION UP TO 14,200.0,130.0,1.1,372.57,53
HCPCS,17111,"DESTRUC FLAT WARTS, 15 OR MORE",427.0,277.55,1.1,436.77,53
HCPCS,17111,"DESTRUCT LESION, 15 OR MORE",198.0,128.7,1.1,436.77,53
HCPCS,17111,DESTRUCTION BENIGN LESIONS 15/>,596.0,387.4,0.01,3004.0,61
HCPCS,17111,KERATOSES DESTRUCTION 15 OR MORE,250.0,162.5,1.1,436.77,53
HCPCS,17250,CHEM CAUTER GRANULAR TISSUE,220.0,143.0,1.1,342.27,53
HCPCS,17250,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,0.01,3004.0,122
HCPCS,17250,"CHEMICAL CAUTERY, TISSUE",114.0,74.1,1.1,342.27,53
HCPCS,17260,"DESTR MALIG TRUNK,EXTREM <0.5 CM",422.0,274.3,1.1,422.0,53
HCPCS,17260,DESTRUCTION OF SKIN LESIONS,157.0,102.05,1.1,342.27,53
HCPCS,17260,DSTRJ MAL LES T/A/L 0.5 CM/<,,,183.59,562.35,19
HCPCS,17260,Dstrj mal les t/a/l 0.5 cm/<,,,133.98,155.13,8
HCPCS,17261,"DESTR MALIG TRUNK,EXTREM 0.6-1 CM",537.0,349.05,1.1,537.0,53
HCPCS,17261,DESTRUCTION OF SKIN LESIONS,220.0,143.0,1.1,488.81,53
HCPCS,17261,DSTRJ MAL LES T/A/L .6-1.0CM,,,183.59,562.35,19
HCPCS,17261,Dstrj mal les t/a/l .6-1.0cm,,,133.98,155.13,8
HCPCS,17262,"DESTR MALIG TRUNK,EXTREM 1.1-2 CM",717.0,466.05,1.1,717.0,53
HCPCS,17262,DESTRUCTION OF SKIN LESIONS,291.0,189.15,1.1,592.33,53
HCPCS,17262,DSTRJ MAL LES T/A/L 1.1-2.0,,,183.59,562.35,19
HCPCS,17262,Dstrj mal les t/a/l 1.1-2.0,,,133.98,155.13,8
HCPCS,17263,"DESTR MALIG TRUNK,EXTREM 2.1-3 CM",810.0,526.5,1.1,810.0,53
HCPCS,17263,DESTRUCTION OF SKIN LESIONS,319.0,207.35,1.1,640.59,53
HCPCS,17263,DSTRJ MAL LES T/A/L 2.1-3.0,,,183.59,562.35,19
HCPCS,17263,Dstrj mal les t/a/l 2.1-3.0,,,133.98,155.13,8
HCPCS,17264,"DESTR MALIG TRUNK,EXTREM 3.1-4 CM",876.0,569.4,1.1,876.0,53
HCPCS,17264,DESTRUCTION OF SKIN LESIONS,343.0,222.95,1.1,686.1,53
HCPCS,17264,DSTRJ MAL LES T/A/L 3.1-4.0,,,369.16,1139.4,19
HCPCS,17264,Dstrj mal les t/a/l 3.1-4.0,,,133.98,155.13,8
HCPCS,17266,"DESTR MALIG TRUNK,EXTREM >4.0 CM",1052.0,683.8,1.1,1052.0,53
HCPCS,17266,DESTRUCTION OF SKIN LESIONS,390.0,253.5,1.1,784.01,53
HCPCS,17266,DSTRJ MAL LES T/A/L >4.0 CM,,,369.16,1139.4,19
HCPCS,17266,Dstrj mal les t/a/l >4.0 cm,,,133.98,155.13,8
HCPCS,17270,"DESTR MALIG SCAL,NCK,HAND <0.5 CM",548.0,356.2,1.1,548.0,53
HCPCS,17270,DESTRUCTION OF SKIN LESIONS,250.0,162.5,1.1,497.65,53
HCPCS,17270,DSTR MAL LES S/N/H/F/G .5 /<,,,183.59,562.35,19
HCPCS,17270,Dstr mal les s/n/h/f/g .5 /<,,,133.98,155.13,8
HCPCS,17271,"DESTR MALIG SCAL,NCK,HAND 0.6-1 CM",616.0,400.4,1.1,616.0,53
HCPCS,17271,DESTRUCTION OF SKIN LESIONS,273.0,177.45,1.1,552.8,53
HCPCS,17271,DSTR MAL LES S/N/H/F/G 0.6-1,,,183.59,562.35,19
HCPCS,17271,Dstr mal les s/n/h/f/g 0.6-1,,,133.98,155.13,8
HCPCS,17272,"DESTR MALIG SCAL,NCK,HAND 1.1-2 CM",728.0,473.2,1.1,728.0,53
HCPCS,17272,DESTRUCTION OF SKIN LESIONS,311.0,202.15,1.1,626.49,53
HCPCS,17272,DSTR MAL LES S/N/H/F/G 1.1-2,,,183.59,562.35,19
HCPCS,17272,Dstr mal les s/n/h/f/g 1.1-2,,,133.98,155.13,8
HCPCS,17273,"DESTR MALIG SCAL,NCK,HAND 2.1-3 CM",840.0,546.0,1.1,840.0,53
HCPCS,17273,DESTRUCTION OF SKIN LESIONS,348.0,226.2,1.1,695.05,53
HCPCS,17273,DSTR MAL LES S/N/H/F/G 2.1-3,,,369.16,1139.4,19
HCPCS,17273,Dstr mal les s/n/h/f/g 2.1-3,,,133.98,155.13,8
HCPCS,17274,"DESTR MALIG SCAL,NCK,HAND 3.1-4 CM",1056.0,686.4,1.1,1056.0,53
HCPCS,17274,DESTRUCTION OF SKIN LESIONS,412.0,267.8,1.1,815.77,53
HCPCS,17274,DSTR MAL LES S/N/H/F/G 3.1-4,,,369.16,1139.4,19
HCPCS,17274,Dstr mal les s/n/h/f/g 3.1-4,,,133.98,155.13,8
HCPCS,17276,"DESTR MALIG SCAL,NCK,HAND >4 CM",1300.0,845.0,1.1,1300.0,53
HCPCS,17276,DESTRUCTION OF SKIN LESIONS,481.0,312.65,1.1,949.45,53
HCPCS,17276,DSTR MAL LES S/N/H/F/G >4.0,,,369.16,1139.4,19
HCPCS,17276,Dstr mal les s/n/h/f/g >4.0,,,133.98,155.13,8
HCPCS,17280,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,488.0,317.2,1.1,488.0,53
HCPCS,17280,DESTRUCTION OF SKIN LESIONS,234.0,152.1,1.1,463.17,53
HCPCS,17280,DSTR MAL LS F/E/E/N/L/M .5/<,,,183.59,562.35,19
HCPCS,17280,Dstr mal ls f/e/e/n/l/m .5/<,,,133.98,155.13,8
HCPCS,17281,"DESTR MALIG FACE,NOSE,LIP 0.6-1 CM",708.0,460.2,1.1,708.0,53
HCPCS,17281,DESTRUCTION OF SKIN LESIONS,297.0,193.05,1.1,680.96,53
HCPCS,17281,DSTR MAL LS F/E/E/N/L/M .6-1,,,183.59,562.35,19
HCPCS,17281,Dstr mal ls f/e/e/n/l/m .6-1,,,133.98,155.13,8
HCPCS,17282,"DESTR MALIG FACE,NOSE,LIP 1.1-2 CM",836.0,543.4,1.1,836.0,53
HCPCS,17282,DESTRUCTION OF SKIN LESIONS,322.0,209.3,1.1,684.26,53
HCPCS,17282,DSTR MAL LS F/E/E/N/L/M1.1-2,,,183.59,562.35,19
HCPCS,17282,Dstr mal ls f/e/e/n/l/m1.1-2,,,133.98,155.13,8
HCPCS,17283,"DESTR MALIG FACE,NOSE,LIP 2.1-3 CM",1076.0,699.4,1.1,1076.0,53
HCPCS,17283,DESTRUCTION OF SKIN LESIONS,411.0,267.15,1.1,809.86,53
HCPCS,17283,DSTR MAL LS F/E/E/N/L/M2.1-3,,,369.16,1139.4,19
HCPCS,17283,Dstr mal ls f/e/e/n/l/m2.1-3,,,133.98,155.13,8
HCPCS,17284,"DESTR MALIG FACE,NOSE,LIP 3.1-4 CM",1280.0,832.0,1.1,1280.0,53
HCPCS,17284,DESTRUCTION OF SKIN LESIONS,471.0,306.15,1.1,1071.62,53
HCPCS,17284,DSTR MAL LS F/E/E/N/L/M3.1-4,,,565.6,2071.51,19
HCPCS,17284,Dstr mal ls f/e/e/n/l/m3.1-4,,,133.98,155.13,8
HCPCS,17286,"DESTR MALIG FACE,NOSE,LIP >4CM",1792.0,1164.8,1.1,1792.0,53
HCPCS,17286,DESTRUCTION OF SKIN LESIONS,611.0,397.15,1.1,1184.05,53
HCPCS,17286,DSTR MAL LS F/E/E/N/L/M>4.0,,,565.6,2071.51,19
HCPCS,17286,Dstr mal ls f/e/e/n/l/m>4.0,,,133.98,155.13,8
HCPCS,17311,MOHS 1 STAGE H/N/HF/G,,,565.6,2071.51,19
HCPCS,17311,Mohs 1 stage h/n/hf/g,,,191.71,221.98,8
HCPCS,17312,Mohs addl stage,,,191.71,221.98,8
HCPCS,17313,MOHS 1 STAGE T/A/L,,,565.6,2071.51,19
HCPCS,17313,Mohs 1 stage t/a/l,,,191.71,221.98,8
HCPCS,17314,Mohs addl stage t/a/l,,,191.71,221.98,8
HCPCS,17315,Mohs surg addl block,,,191.71,221.98,8
HCPCS,17340,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,308.0,200.2,1.1,308.0,53
HCPCS,17340,CRYOTHERAPY FOR ACNE,,,54.88,165.35,19
HCPCS,17340,Cryotherapy for acne,,,133.98,155.13,8
HCPCS,17360,CHEMICAL EXFOLIATION ACNE,584.0,379.6,1.1,584.0,72
HCPCS,17360,Chemical exfoliation acne,,,133.98,155.13,8
HCPCS,17380,ELECTROLYSIS EPILATION EA 30,,,565.6,2071.51,19
HCPCS,17380,Electrolysis epilation ea 30,,,133.98,155.13,8
HCPCS,17999,CERVICOPLASTY (REMOVAL EXCESS NECK SKIN),990.0,643.5,0.01,990.0,28
HCPCS,17999,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),15823.5,10285.275,0.01,29447.0,89
HCPCS,17999,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),17806.5,11574.225,0.01,32861.0,89
HCPCS,17999,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 3 LARGE (COMP CODE 15780),2200.0,1430.0,0.01,2200.0,28
HCPCS,17999,"FACIAL RESURFACING, LASER (COMP CODE 17108)",3183.0,2068.95,0.01,3183.0,28
HCPCS,17999,FAT PAD BIOPSY (COMP CODE 20200),4018.5,2612.025,0.01,7453.0,89
HCPCS,17999,MICRONEEDLING SMALL (COMP CODE 15781),250.0,162.5,0.01,342.27,28
HCPCS,17999,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,89
HCPCS,17999,STERNOHYOID/OMOHYOID ROTNAL MSCLE FLAP RPR ESOPHAGL INJRY (COMP,9200.0,5980.0,0.01,9200.0,28
HCPCS,17999,SUBDERMAL RADIOFREQUENCY ABDOMEN (5X8 AREA) OR UPPER BACK (COMP,1875.0,1218.75,0.01,1875.0,28
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, KNEES, BOTH (COMP 15780)",1250.0,812.5,0.01,1250.0,28
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, LOWER FACE & NECK SCULPTING (COMP 1578",4375.0,2843.75,0.01,4375.0,28
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, POSTERIOR ARMS, BOTH (COMP 15782)",3125.0,2031.25,0.01,3125.0,28
HCPCS,17999,UMBILICOPLASTY (COMPARABLE CODE 49591),2533.0,1646.45,0.01,2533.0,28
HCPCS,17999,"UNLIST PROC, SKIN, MUCOUS MEMBRANE & SUBCUT TISSUE COMP TO 15777",1205.0,783.25,0.01,1205.0,28
HCPCS,17999,UNLISTED PROCEDURE SKIN COMP CPT 13131,1343.0,872.95,0.01,1343.0,28
HCPCS,17999,"UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSU",1252.0,813.8,0.01,1252.0,28
HCPCS,17999,UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,401.0,260.65,0.01,401.0,28
HCPCS,17999,WOUND ELECTROCAUTERIZATION/CONTROL OF BLEEDING (COMP 20103),1923.0,1249.95,0.01,1923.0,28
HCPCS,19000,DRAINAGE OF BREAST LESION,208.0,135.2,1.1,1200.64,53
HCPCS,19000,PUNC ASP ABS BRST UNI,2111.0,1372.15,0.01,3004.0,61
HCPCS,19000,PUNCTURE ASPIRATION CYST BREAST,1223.5,795.2750000000001,0.01,3004.0,175
HCPCS,19001,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,212.5,138.125,0.01,3004.0,99
HCPCS,19020,INCISION OF BREAST LESION,473.0,307.45,1.1,2768.64,53
HCPCS,19020,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,3196.5,2077.725,0.01,4861.0,175
HCPCS,19030,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,486.0,315.9,0.01,3004.0,46
HCPCS,19081,"BREAST BIOPSY NEEDLE LOCALIZATION, 1ST",320.0,208.0,1.1,2768.64,53
HCPCS,19081,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,6314.0,4104.1,1.1,11180.0,175
HCPCS,19081,MAM STEREO BREAST BX FIRST LES,11180.0,7267.0,0.01,11180.0,61
HCPCS,19082,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,1638.0,1064.7,1.1,3398.0,145
HCPCS,19083,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,6272.0,4076.8,0.01,11180.0,175
HCPCS,19084,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,1655.5,1076.075,0.01,3398.0,145
HCPCS,19085,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,6391.0,4154.15,1.1,11180.0,236
HCPCS,19086,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,1652.0,1073.8,1.1,3398.0,145
HCPCS,19100,BREAST BIOPSY UNI,4861.0,3159.65,0.01,4861.0,61
HCPCS,19100,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,2684.5,1744.925,0.01,4861.0,114
HCPCS,19100,BX BREAST PERCUT W/O IMAGE,197.0,128.05,1.1,2768.64,53
HCPCS,19101,BIOPSY BREAST OPEN INCISIONAL,1292.0,839.8,1.1,6508.54,53
HCPCS,19101,BIOPSY OF BREAST OPEN,,,3538.18,10974.37,19
HCPCS,19101,"BIOPSY OF BREAST, OPEN",480.0,312.0,1.1,6508.54,53
HCPCS,19101,Biopsy of breast open,,,819.01,948.33,8
HCPCS,19105,CRYOSURG ABLATE FA EACH,,,3538.18,10974.37,19
HCPCS,19105,Cryosurg ablate fa each,,,819.01,948.33,8
HCPCS,19110,NIPPLE EXPLORATION,1776.0,1154.4,1.1,10974.37,72
HCPCS,19110,Nipple exploration,,,819.01,948.33,8
HCPCS,19112,EXCISE BREAST DUCT FISTULA,,,3538.18,10974.37,19
HCPCS,19112,EXCISION LACTIFEROUS DUCT FISTULA,1524.0,990.6,1.1,6508.54,53
HCPCS,19112,Excise breast duct fistula,,,819.01,948.33,8
HCPCS,19120,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,6928.0,4503.2,0.01,11488.0,114
HCPCS,19120,REMOVAL OF BREAST LESION,657.0,427.05,1.1,6508.54,53
HCPCS,19125,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,2944.0,1913.6,1.1,6508.54,53
HCPCS,19125,EXCISION BREAST LESION,,,3538.18,10974.37,19
HCPCS,19125,"EXCISION, BREAST LESION",886.0,575.9,1.1,6508.54,53
HCPCS,19125,Excision breast lesion,,,819.01,948.33,8
HCPCS,19126,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,1172.0,761.8,1.1,1172.0,50
HCPCS,19126,Excision addl breast lesion,,,819.01,948.33,8
HCPCS,19281,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,2830.5,1839.825,0.01,4861.0,236
HCPCS,19282,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,2650.5,1722.825,0.01,4861.0,145
HCPCS,19283,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,1495.5,972.075,0.01,4001.0,236
HCPCS,19284,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,1275.5,829.075,0.01,3398.0,145
HCPCS,19285,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,1429.5,929.1750000000001,0.01,4001.0,175
HCPCS,19286,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,1242.5,807.625,0.01,3398.0,145
HCPCS,19287,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,1565.5,1017.575,1.1,6561.0,114
HCPCS,19288,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,1311.5,852.475,1.1,3004.0,99
HCPCS,19294,PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY,1200.0,780.0,1.1,1200.0,50
HCPCS,19294,Prepj tum cav iort prtl mast,,,3875.91,4487.9,8
HCPCS,19296,PLACE PO BREAST CATH FOR RAD,,,7732.66,22908.77,19
HCPCS,19296,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,1452.0,943.8,1.1,16095.74,53
HCPCS,19296,Place po breast cath for rad,,,2444.11,2830.03,8
HCPCS,19297,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,688.0,447.2,1.1,688.0,50
HCPCS,19297,Place breast cath for rad,,,3875.91,4487.9,8
HCPCS,19298,PLACE BREAST RAD TUBE/CATHS,,,6025.7,38625.91,19
HCPCS,19298,Place breast rad tube/caths,,,2444.11,2830.03,8
HCPCS,19300,MASTECTOMY FOR GYNECOMASTIA,2124.0,1380.6,1.1,10974.37,72
HCPCS,19300,Mastectomy for gynecomastia,,,819.01,948.33,8
HCPCS,19300,REMOVAL OF BREAST TISSUE,786.0,510.9,1.1,6508.54,53
HCPCS,19301,"MASTECTOMY, PARTIAL",4052.0,2633.8,1.1,6508.54,50
HCPCS,19301,PARTIAL MASTECTOMY,1205.0,783.25,1.1,10974.37,70
HCPCS,19301,Partial mastectomy,,,2444.11,2830.03,8
HCPCS,19302,"MASTECTOMY,PARTIAL,  WITH AXILLARY LYMPHADENECTOMY",5596.0,3637.4,1.1,11133.7,50
HCPCS,19302,P-MASTECTOMY W/LN REMOVAL,1430.0,929.5,1.1,18611.38,69
HCPCS,19302,P-mastectomy w/ln removal,,,2444.11,2830.03,8
HCPCS,19303,MAST SIMPLE COMPLETE,,,6025.7,18611.38,20
HCPCS,19303,"MASTECTOMY, SIMPLE, COMPLETE",3934.0,2557.1,1.1,11133.7,100
HCPCS,19303,Mast simple complete,,,2444.11,2830.03,8
HCPCS,19305,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,6984.0,4539.6,1.1,6984.0,50
HCPCS,19305,"MAST, RADICAL",2205.0,1433.25,1.1,3939.95,50
HCPCS,19305,Mast radical,,,3875.91,4487.9,8
HCPCS,19306,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,7252.0,4713.8,1.1,7252.0,50
HCPCS,19306,Mast rad urban type,,,3875.91,4487.9,8
HCPCS,19307,MAST MOD RAD,,,6025.7,18611.38,19
HCPCS,19307,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,7196.0,4677.4,1.1,11133.7,50
HCPCS,19307,"MASTECTOMY, MOD RAD, INCL AX LYM NO",2219.0,1442.35,1.1,11133.7,50
HCPCS,19307,Mast mod rad,,,3875.91,4487.9,8
HCPCS,19316,MASTOPEXY,4880.0,3172.0,1.1,18611.38,69
HCPCS,19316,Mastopexy,,,2444.11,2830.03,8
HCPCS,19318,BREAST REDUCTION,,,6025.7,18611.38,19
HCPCS,19318,BREAST REDUCTION FEMALE - MODERATE,1820.0,1183.0,1.1,11133.7,50
HCPCS,19318,Breast reduction,,,3875.91,4487.9,8
HCPCS,19318,REDUCTION OF LARGE BREAST,7053.0,4584.45,1.1,11133.7,50
HCPCS,19324,Enlarge breast,,,819.01,948.33,8
HCPCS,19325,BREAST AUG (GEL) - MODERATE,2500.0,1625.0,1.1,16095.74,50
HCPCS,19325,BREAST AUGMENTATION W/IMPLT,,,7732.66,22908.77,19
HCPCS,19325,BREAST AUGMENTATION WITH IMPLANT,3573.0,2322.45,1.1,16095.74,50
HCPCS,19325,Breast augmentation w/implt,,,2444.11,2830.03,8
HCPCS,19328,REMOVAL OF BREAST IMPLANT,2976.0,1934.4,1.1,6508.54,50
HCPCS,19328,RMVL INTACT BREAST IMPLANT,,,3538.18,10974.37,19
HCPCS,19328,Rmvl intact breast implant,,,2444.11,2830.03,8
HCPCS,19330,RMVL RUPTURED BREAST IMPLANT,,,3538.18,10974.37,19
HCPCS,19330,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,3600.0,2340.0,1.1,6508.54,50
HCPCS,19330,Rmvl ruptured breast implant,,,2444.11,2830.03,8
HCPCS,19340,INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY,4192.0,2724.8,1.1,11133.7,50
HCPCS,19340,INSJ BREAST IMPLT SM D MAST,,,6025.7,22908.77,19
HCPCS,19340,Insj breast implt sm d mast,,,2444.11,2830.03,8
HCPCS,19342,INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY,4611.0,2997.15,1.1,16095.74,50
HCPCS,19342,INSJ/RPLCMT BRST IMPLT SEP D,,,7732.66,22908.77,19
HCPCS,19342,Insj/rplcmt brst implt sep d,,,2444.11,2830.03,8
HCPCS,19350,NIPPLE/AREOLA RECONSTRUCTION,4008.0,2605.2,1.1,10974.37,72
HCPCS,19350,Nipple/areola reconstruction,,,2444.11,2830.03,8
HCPCS,19355,CORRECT INVERTED NIPPLE(S),3408.0,2215.2,1.1,10974.37,72
HCPCS,19355,Correct inverted nipple(s),,,2444.11,2830.03,8
HCPCS,19355,INVERTED NIPPPLE CORRECTION,1600.0,1040.0,1.1,6508.54,53
HCPCS,19357,BREAST RECONSTRUC W TISS EXPANDR,6530.0,4244.5,1.1,30087.68,50
HCPCS,19357,TISS XPNDR PLMT BRST RCNSTJ,,,9608.0,38625.91,20
HCPCS,19357,Tiss xpndr plmt brst rcnstj,,,3875.91,4487.9,8
HCPCS,19361,BREAST RECONSTRUC W LAT DORSI FLAP,9344.0,6073.6,1.1,9344.0,50
HCPCS,19361,Brst rcnstj latsms drsi flap,,,3875.91,4487.9,8
HCPCS,19364,BREAST RECONSTRUC W FREE FLAP,18735.0,12177.75,1.1,18735.0,50
HCPCS,19364,Brst rcnstj free flap,,,3875.91,4487.9,8
HCPCS,19366,Breast reconstruction,,,3875.91,4487.9,8
HCPCS,19367,BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP,10720.0,6968.0,1.1,10720.0,50
HCPCS,19367,Brst rcnstj 1 pdcl tram flap,,,3875.91,4487.9,8
HCPCS,19368,Brst rcnstj 1pdcl tram anast,,,3875.91,4487.9,8
HCPCS,19369,Brst rcnstj 2 pdcl tram flap,,,3875.91,4487.9,8
HCPCS,19370,REVISION PERI-IMPLANT CAPSULE BREAST,4035.0,2622.75,1.1,6508.54,50
HCPCS,19370,REVJ PERI-IMPLT CAPSULE BRST,,,3538.18,10974.37,19
HCPCS,19370,Revj peri-implt capsule brst,,,2444.11,2830.03,8
HCPCS,19371,PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE,4391.0,2854.15,1.1,6508.54,50
HCPCS,19371,PERI-IMPLT CAPSLC BRST COMPL,,,3538.18,10974.37,19
HCPCS,19371,Peri-implt capslc brst compl,,,2444.11,2830.03,8
HCPCS,19380,REVISE BREAST RECONSTRUCTION,4915.0,3194.75,1.1,11133.7,50
HCPCS,19380,REVJ RECONSTRUCTED BREAST,,,6025.7,18611.38,19
HCPCS,19380,Revj reconstructed breast,,,2444.11,2830.03,8
HCPCS,19396,DESIGN CUSTOM BREAST IMPLANT,,,3538.18,10974.37,19
HCPCS,19396,Design custom breast implant,,,819.01,948.33,8
HCPCS,19499,ENDOSCOPIC MASTECTOMY (COMP CODE 19303),6000.0,3900.0,0.01,6508.54,28
HCPCS,19499,UNLISTED PROCEDURE BREAST,,,3538.18,10974.37,19
HCPCS,19499,Unlisted procedure breast,,,819.01,948.33,8
HCPCS,2000F,Blood pressure measure,,,8.48,9.82,8
HCPCS,2001F,Weight record,,,8.48,9.82,8
HCPCS,2002F,Clin sign vol ovrld assess,,,8.48,9.82,8
HCPCS,2004F,Initial exam involved joints,,,8.48,9.82,8
HCPCS,20100,EXPL PENTRG WOUND NECK,,,470.54,1511.66,19
HCPCS,20100,EXPLORATION PENETRATING WOUND SPX NECK,4152.0,2698.8,1.1,4152.0,50
HCPCS,20100,Expl pentrg wound neck,,,444.21,514.35,8
HCPCS,20101,EXPLORATION PENETRATING WOUND SPX CHEST,4853.0,3154.4500000000003,1.1,8414.0,114
HCPCS,20102,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,5003.0,3251.9500000000003,1.1,8414.0,114
HCPCS,20102,"EXPLORE WOUND, ABDOMEN",535.0,347.75,1.1,3114.5,53
HCPCS,20103,EXPLORATION PENETRATING WOUND SPX EXTREMITY,4794.5,3116.425,1.1,7453.0,114
HCPCS,20103,"EXPLORE WOUND, EXTREMITY",1056.0,686.4,1.1,2768.64,53
HCPCS,2010F,Vital signs recorded,,,8.48,9.82,8
HCPCS,2014F,Mental status assess,,,8.48,9.82,8
HCPCS,20150,EXCISION EPIPHYSEAL BAR,,,2997.95,9170.92,19
HCPCS,20150,Excision epiphyseal bar,,,1072.58,1241.93,8
HCPCS,2015F,Asthma impairment assessed,,,8.48,9.82,8
HCPCS,2016F,Asthma risk assessed,,,8.48,9.82,8
HCPCS,2018F,Hydration status assess,,,8.48,9.82,8
HCPCS,2019F,Dilated macul exam done,,,8.48,9.82,8
HCPCS,20200,BIOPSY MUSCLE SUPERFICIAL,584.0,379.6,1.1,2768.64,53
HCPCS,20200,MUSCLE BIOPSY SUPERFICIAL,,,1497.07,4629.18,19
HCPCS,20200,Muscle biopsy superficial,,,1072.58,1241.93,8
HCPCS,20205,DEEP MUSCLE BIOPSY,702.5,456.625,1.1,8141.48,125
HCPCS,20205,Deep muscle biopsy,,,1072.58,1241.93,8
HCPCS,20206,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,3924.5,2550.9249999999997,0.01,7453.0,175
HCPCS,2020F,Dilated fundus eval done,,,8.48,9.82,8
HCPCS,2021F,Dilat macular exam done,,,8.48,9.82,8
HCPCS,20220,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,0.01,7453.0,183
HCPCS,20220,"BONE BIOPSY,TROCAR/NEEDLE SUPERF",660.0,429.0,1.1,2768.64,53
HCPCS,20225,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,0.01,7453.0,183
HCPCS,20225,"BONE BIOPSY,TROCAR/NEEDLE DEEP",980.0,637.0,1.1,2768.64,53
HCPCS,2022F,Dilat rta xm evc rtnopthy,,,8.48,9.82,8
HCPCS,2023F,Dilat rta xm w/o rtnopthy,,,8.48,9.82,8
HCPCS,20240,BIOPSY BONE OPEN SUPERFICIAL,1148.0,746.2,1.1,4850.94,50
HCPCS,20240,BONE BIOPSY OPEN SUPERFICIAL,,,2644.48,8141.48,19
HCPCS,20240,Bone biopsy open superficial,,,1072.58,1241.93,8
HCPCS,20245,BIOPSY BONE OPEN DEEP,2640.0,1716.0,1.1,4850.94,50
HCPCS,20245,BONE BIOPSY OPEN DEEP,,,2644.48,8141.48,19
HCPCS,20245,Bone biopsy open deep,,,1072.58,1241.93,8
HCPCS,2024F,7 fld rta photo evc rtnopthy,,,8.48,9.82,8
HCPCS,20250,BIOPSY VRT BDY OPEN THORACIC,,,2997.95,9170.92,19
HCPCS,20250,Biopsy vrt bdy open thoracic,,,3026.0,3503.79,8
HCPCS,20251,BIOPSY VRT BDY OPEN LMBR/CRV,,,6600.66,20338.07,19
HCPCS,20251,Biopsy vrt bdy open lmbr/crv,,,3026.0,3503.79,8
HCPCS,2025F,7 fld rta photo w/o rtnopthy,,,8.48,9.82,8
HCPCS,2026F,Eye img valid evc rtnopthy,,,8.48,9.82,8
HCPCS,2027F,Optic nerve head eval done,,,8.48,9.82,8
HCPCS,2028F,Foot exam performed,,,8.48,9.82,8
HCPCS,2029F,Complete phys skin exam done,,,8.48,9.82,8
HCPCS,2030F,H2o stat docd normal,,,8.48,9.82,8
HCPCS,2031F,H2o stat docd dehydrated,,,8.48,9.82,8
HCPCS,2033F,Eye img valid w/o rtnopthy,,,8.48,9.82,8
HCPCS,2035F,Tymp memb motion examd,,,8.48,9.82,8
HCPCS,2040F,Bk pn xm on init visit date,,,8.48,9.82,8
HCPCS,2044F,Doc mntl tst b/4 bk trxmnt,,,8.48,9.82,8
HCPCS,20500,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,3663.0,2380.9500000000003,1.1,6814.0,114
HCPCS,20501,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,0.01,3398.0,138
HCPCS,2050F,Wound char size etc docd,,,8.48,9.82,8
HCPCS,20520,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,4106.5,2669.225,0.01,7453.0,175
HCPCS,20520,REMOVAL OF FOREIGN BODY,401.0,260.65,1.1,2768.64,53
HCPCS,20525,REMOVAL OF FOREIGN BODY,790.0,513.5,1.1,4850.94,53
HCPCS,20525,RMVL FB MUSC/TDN DEEP/COMP,,,2644.48,8141.48,19
HCPCS,20525,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1416.0,920.4,1.1,4850.94,53
HCPCS,20525,Rmvl fb musc/tdn deep/comp,,,1072.58,1241.93,8
HCPCS,20526,INJECTION THERAPEUTIC CARPAL TUNNEL,886.0,575.9000000000001,0.01,3398.0,236
HCPCS,20526,INJECTION THERAPUTIC CARPAL TUNNEL,129.0,83.85,1.1,505.34,53
HCPCS,20527,INJECTION ENZYME PALMAR FASCIAL CORD,879.0,571.35,0.01,3004.0,114
HCPCS,20550,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,844.0,548.6,0.01,3004.0,236
HCPCS,20551,INJECTION SINGLE TENDON ORIGIN/INSERTION,844.0,548.6,0.01,3004.0,114
HCPCS,20552,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,0.01,3398.0,183
HCPCS,20552,"TRIGGER POINT INJ,SINGLE OR MULT PT",96.0,62.4,1.1,505.34,53
HCPCS,20552,TRIGGER POINT INJECTION MULTI 1-2 MUSCLE GR,290.0,188.5,1.1,505.34,53
HCPCS,20553,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,0.01,3004.0,122
HCPCS,20553,TRIGGER POINT INJECTION MULTI 3+ MUSCLE GRP,330.0,214.5,1.1,505.34,53
HCPCS,20553,"TRIGGER POINT, SNGL/MULT, 3+ MUSCLES",103.0,66.95,1.1,505.34,53
HCPCS,20555,PLACE NDL MUSC/TIS FOR RT,,,2997.95,9170.92,19
HCPCS,20555,Place ndl musc/tis for rt,,,1072.58,1241.93,8
HCPCS,20560,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,127.0,82.55000000000001,0.01,3004.0,113
HCPCS,20561,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,162.0,105.30000000000001,0.01,3004.0,113
HCPCS,20600,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,824.0,535.6,0.01,3398.0,297
HCPCS,20600,"DRAIN/INJECT, JOINT/BURSA",96.0,62.4,1.1,505.34,53
HCPCS,20604,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,875.0,568.75,0.01,3398.0,175
HCPCS,20605,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,828.5,538.525,0.01,3398.0,358
HCPCS,20605,"DRAIN/INJECT, JOINT/BURSA",111.0,72.15,1.1,505.34,53
HCPCS,20606,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,1813.0,1178.45,0.01,3728.0,236
HCPCS,2060F,Pt intrvwd on/before dx mdd,,,8.48,9.82,8
HCPCS,20610,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,853.0,554.45,0.01,3398.0,480
HCPCS,20610,"DRAIN/INJECT, JOINT/BURSA",166.0,107.9,1.1,505.34,53
HCPCS,20611,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,921.0,598.6500000000001,0.01,3398.0,297
HCPCS,20612,ASPIRATE/INJECT GANGLION CYST(S),100.0,65.0,1.1,505.34,53
HCPCS,20612,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,833.0,541.45,0.01,3398.0,236
HCPCS,20615,ASPIRATION & INJECTION TREATMENT BONE CYST,3237.0,2104.05,0.01,3237.0,61
HCPCS,20650,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,7918.5,5147.025,1.1,14925.0,114
HCPCS,20660,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,1600.0,1040.0,1.1,2743.55,50
HCPCS,20660,APPLY REM FIXATION DEVICE,,,1478.75,4506.96,19
HCPCS,20660,Apply rem fixation device,,,1311.41,1518.47,8
HCPCS,20661,APPLICATION HALO CRANIAL,,,1521.28,4506.96,13
HCPCS,20661,APPLICATION HALO CRANIAL INCLUDING REMOVAL,2104.0,1367.6,1.1,2104.0,50
HCPCS,20661,Application halo cranial,,,1311.41,1518.47,8
HCPCS,20662,APPLICATION HALO PELVIC,,,1478.75,4506.96,19
HCPCS,20662,Application halo pelvic,,,1311.41,1518.47,8
HCPCS,20663,APPLICATION HALO FEMORAL,,,2997.95,9170.92,19
HCPCS,20663,Application halo femoral,,,1311.41,1518.47,8
HCPCS,20664,APPL HALO CRANIAL 6+PINS,,,1521.28,4506.96,13
HCPCS,20664,Appl halo cranial 6+pins,,,1311.41,1518.47,8
HCPCS,20665,RMVL TONGS/HALO ANTHR INDIV,,,368.71,1252.1,19
HCPCS,20665,Rmvl tongs/halo anthr indiv,,,199.7,231.23,8
HCPCS,20670,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,4120.5,2678.325,0.01,7453.0,175
HCPCS,20680,REMOVAL DEEP IMPLANT,2622.0,1704.3,1.1,4850.94,53
HCPCS,20680,REMOVAL IMPLANT DEEP,13165.0,8557.25,0.01,13165.0,61
HCPCS,20690,APPL UNIPLN UNI EXT FIXJ SYS,,,6600.66,20338.07,19
HCPCS,20690,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,3512.0,2282.8,1.1,12214.27,50
HCPCS,20690,Appl unipln uni ext fixj sys,,,1311.41,1518.47,8
HCPCS,20692,APPL MLTPLN UNI EXT FIXJ SYS,,,11888.68,35984.87,19
HCPCS,20692,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,6508.0,4230.2,1.1,22471.68,50
HCPCS,20692,Appl mltpln uni ext fixj sys,,,1311.41,1518.47,8
HCPCS,20693,ADJMT/REVJ EXT FIXJ SYS ANES,,,6600.66,20338.07,19
HCPCS,20693,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,2424.0,1575.6,1.1,12214.27,50
HCPCS,20693,Adjmt/revj ext fixj sys anes,,,1311.41,1518.47,8
HCPCS,20694,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,1712.0,1112.8,1.1,2743.55,53
HCPCS,20694,RMVL EXT FIXJ SYS UNDER ANES,,,1478.75,4506.96,19
HCPCS,20694,Rmvl ext fixj sys under anes,,,1311.41,1518.47,8
HCPCS,20696,APP MLTPLN UNI XTRNL FIX 1ST,,,16992.04,76052.54,19
HCPCS,20696,App mltpln uni xtrnl fix 1st,,,1311.41,1518.47,8
HCPCS,20696,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,7024.0,4565.6,1.1,31818.75,50
HCPCS,20697,APP MLTPLN UNI XTRNL FIX XCH,,,1478.75,4506.96,19
HCPCS,20697,App mltpln uni xtrnl fix xch,,,1311.41,1518.47,8
HCPCS,20700,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,600.0,390.0,1.1,600.0,50
HCPCS,20700,Mnl prep&insj dp rx dlvr dev,,,63.3,73.29,8
HCPCS,20701,REMOVAL DEEP DRUG DELIVERY DEVICE,497.0,323.05,1.1,497.0,50
HCPCS,20701,Rmvl deep rx delivery device,,,63.3,73.29,8
HCPCS,20702,MANUAL PREP&AMP;INSJ INTRAMEDULLARY DRUG DLVR DEVICE,1000.0,650.0,1.1,1000.0,50
HCPCS,20702,Mnl prep&insj imed rx dev,,,63.3,73.29,8
HCPCS,20703,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,720.0,468.0,1.1,720.0,50
HCPCS,20703,Rmvl imed rx delivery device,,,63.3,73.29,8
HCPCS,20704,MANUAL PREP&AMP;INSJ I-ARTIC DRUG DELIVERY DEVICE,1040.0,676.0,1.1,1040.0,50
HCPCS,20704,Mnl prep&insj i-artic rx dev,,,63.3,73.29,8
HCPCS,20705,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,860.0,559.0,1.1,860.0,50
HCPCS,20705,Rmvl i-artic rx delivery dev,,,63.3,73.29,8
HCPCS,20802,REPLANTATION ARM COMPLETE,,,16588.34,49144.62,13
HCPCS,20802,Replantation arm complete,,,5239.24,6066.49,8
HCPCS,20805,REPLANT FOREARM COMPLETE,,,16588.34,49144.62,13
HCPCS,20805,Replant forearm complete,,,3304.21,3825.93,8
HCPCS,20808,REPLANTATION HAND COMPLETE,,,16588.34,49144.62,13
HCPCS,20808,Replantation hand complete,,,1518.4,1758.15,8
HCPCS,20816,REPLANTATION DIGIT COMPLETE,,,1521.28,4506.96,13
HCPCS,20816,Replantation digit complete,,,1518.4,1758.15,8
HCPCS,20822,REPLANTATION DIGIT COMPLETE,,,1478.75,4506.96,19
HCPCS,20822,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,11730.0,7624.5,1.1,11730.0,50
HCPCS,20822,Replantation digit complete,,,1518.4,1758.15,8
HCPCS,20824,REPLANTATION THUMB COMPLETE,,,1521.28,4506.96,13
HCPCS,20824,Replantation thumb complete,,,1518.4,1758.15,8
HCPCS,20827,REPLANTATION THUMB COMPLETE,,,1521.28,4506.96,13
HCPCS,20827,RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION,10992.0,7144.8,1.1,10992.0,50
HCPCS,20827,Replantation thumb complete,,,1518.4,1758.15,8
HCPCS,20838,REPLANTATION FOOT COMPLETE,,,16588.34,49144.62,13
HCPCS,20838,Replantation foot complete,,,3246.83,3759.49,8
HCPCS,20900,BONE GRAFT ANY DONOR AREA MINOR/SMALL,1200.0,780.0,1.1,12214.27,53
HCPCS,20900,REMOVAL OF BONE FOR GRAFT,,,6600.66,20338.07,19
HCPCS,20900,Removal of bone for graft,,,1166.12,1350.24,8
HCPCS,20902,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,1832.0,1190.8,1.1,12214.27,50
HCPCS,20902,REMOVAL OF BONE FOR GRAFT,,,6600.66,20338.07,20
HCPCS,20902,Removal of bone for graft,,,1166.12,1350.24,8
HCPCS,20910,CARTILAGE GRAFT COSTOCHONDRAL,2212.0,1437.8,1.1,2212.0,50
HCPCS,20910,REMOVE CARTILAGE FOR GRAFT,,,565.6,2071.51,19
HCPCS,20910,Remove cartilage for graft,,,1166.12,1350.24,8
HCPCS,20912,CARTILAGE GRAFT NASAL SEPTUM,2616.0,1700.4,1.1,6125.06,50
HCPCS,20912,REMOVE CARTILAGE FOR GRAFT,,,3352.64,9932.52,19
HCPCS,20912,Remove cartilage for graft,,,1166.12,1350.24,8
HCPCS,20920,REMOVAL OF FASCIA FOR GRAFT,,,1690.17,5783.06,19
HCPCS,20920,Removal of fascia for graft,,,1166.12,1350.24,8
HCPCS,20922,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,2772.0,1801.8,1.1,3114.5,53
HCPCS,20922,REMOVAL OF FASCIA FOR GRAFT,,,1690.17,5783.06,19
HCPCS,20922,Removal of fascia for graft,,,1166.12,1350.24,8
HCPCS,20924,REMOVAL OF TENDON FOR GRAFT,,,6600.66,20338.07,19
HCPCS,20924,Removal of tendon for graft,,,1166.12,1350.24,8
HCPCS,20924,TENDON GRAFT FROM A DISTANCE,2672.0,1736.8,1.1,12214.27,50
HCPCS,20930,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,767.0,498.55,1.1,767.0,32
HCPCS,20930,Sp bone algrft morsel add-on,,,7403.35,8572.3,8
HCPCS,20931,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,724.0,470.6,1.1,724.0,50
HCPCS,20931,SP BONE ALGRFT STRUCT ADD-ON,,,3398.0,3398.0,1
HCPCS,20931,Sp bone algrft struct add-on,,,7403.35,8572.3,8
HCPCS,20932,Osteoart algrft w/surf & b1,,,1166.12,1350.24,8
HCPCS,20933,HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL,4776.0,3104.4,1.1,4776.0,50
HCPCS,20933,Hemicrt intrclry algrft prtl,,,1166.12,1350.24,8
HCPCS,20934,Intercalary algrft compl,,,1166.12,1350.24,8
HCPCS,20936,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,1089.0,707.85,1.1,1089.0,32
HCPCS,20936,SP BONE AGRFT LOCAL ADD-ON,,,7821.0,7821.0,1
HCPCS,20936,Sp bone agrft local add-on,,,7403.35,8572.3,8
HCPCS,20937,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,1116.0,725.4,1.1,1116.0,50
HCPCS,20937,Sp bone agrft morsel add-on,,,7403.35,8572.3,8
HCPCS,20938,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,1208.0,785.2,1.1,1208.0,50
HCPCS,20938,Sp bone agrft struct add-on,,,7403.35,8572.3,8
HCPCS,20939,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,464.0,301.6,1.1,464.0,50
HCPCS,20939,Bone marrow aspir bone grfg,,,7403.35,8572.3,8
HCPCS,20950,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,504.0,327.6,1.1,1200.64,53
HCPCS,20950,MNTR INTRSTITIAL FLUID PRESS,,,650.1,1984.79,19
HCPCS,20950,Mntr intrstitial fluid press,,,199.7,231.23,8
HCPCS,20955,FIBULA BONE GRAFT MICROVASC,,,6864.94,20338.07,13
HCPCS,20955,Fibula bone graft microvasc,,,4234.94,4903.61,8
HCPCS,20956,ILIAC BONE GRAFT MICROVASC,,,6864.94,20338.07,13
HCPCS,20956,Iliac bone graft microvasc,,,2435.09,2819.58,8
HCPCS,20957,MT BONE GRAFT MICROVASC,,,6864.94,20338.07,13
HCPCS,20957,Mt bone graft microvasc,,,3246.83,3759.49,8
HCPCS,20962,OTHER BONE GRAFT MICROVASC,,,6864.94,20338.07,13
HCPCS,20962,Other bone graft microvasc,,,4234.94,4903.61,8
HCPCS,20969,BONE/SKIN GRAFT MICROVASC,,,6864.94,20338.07,13
HCPCS,20969,Bone/skin graft microvasc,,,4234.94,4903.61,8
HCPCS,20970,BONE/SKIN GRAFT ILIAC CREST,,,6864.94,20338.07,13
HCPCS,20970,Bone/skin graft iliac crest,,,2435.09,2819.58,8
HCPCS,20972,BONE/SKIN GRAFT METATARSAL,,,6600.66,20338.07,19
HCPCS,20972,Bone/skin graft metatarsal,,,3246.83,3759.49,8
HCPCS,20973,BONE/SKIN GRAFT GREAT TOE,,,6600.66,20338.07,19
HCPCS,20973,Bone/skin graft great toe,,,3246.83,3759.49,8
HCPCS,20974,ESTIM AID BONE HEALG N-INVAS,,,61.71,169.7,22
HCPCS,20974,Estim aid bone healg n-invas,,,199.7,231.23,8
HCPCS,20975,ELECTRICAL STIMULATION BONE HEALING INVASIVE,1040.0,676.0,1.1,1040.0,50
HCPCS,20975,Estim aid bone healg invasiv,,,1072.58,1241.93,8
HCPCS,20979,LW NTSTY US STIMJ BONE HEALG,,,22.63,81.07,19
HCPCS,20979,Lw ntsty us stimj bone healg,,,199.7,231.23,8
HCPCS,20982,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,30997.5,20148.375,0.01,59187.0,236
HCPCS,20983,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,17806.5,11574.225,0.01,32861.0,175
HCPCS,20985,Cptr-asst dir ms px,,,68.91,79.79,8
HCPCS,20999,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),17806.5,11574.225,0.01,32861.0,89
HCPCS,20999,"EXTRACORPOREAL SHOCK WAVE, LOW INTENSITY",150.0,97.5,0.01,3004.0,89
HCPCS,20999,"MARROW ASPIRATION, PROXIMAL TIBIA (COMP CODE 38222)",383.0,248.95,0.01,403.2,28
HCPCS,20999,PROC MUSSKL SYS UNLISTD,2543.0,1652.95,0.01,3004.0,61
HCPCS,20999,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,89
HCPCS,20999,REMOVAL OF CEMENT FROM THE DISTAL FEMUR AND PLACEMENT OF COMPLET,4290.0,2788.5,0.01,4290.0,28
HCPCS,20999,RFA MSK TUMOR (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,89
HCPCS,20999,UNLISTED PROC; REMOVED DISPLACED INGUINAL HERNIA MESH (COMP TO 2,1967.0,1278.55,0.01,1967.0,28
HCPCS,20999,"UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL",383.0,248.95,0.01,403.2,28
HCPCS,20999,"UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL (COMPARISON",930.0,604.5,0.01,930.0,28
HCPCS,21010,INCISION OF JAW JOINT,,,2996.53,9292.73,19
HCPCS,21010,Incision of jaw joint,,,1634.67,1892.77,8
HCPCS,21011,EXC TUMOR FACE/SCALP SUBQ <2CM,550.0,357.5,1.1,2768.64,53
HCPCS,21011,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,1196.0,777.4,1.1,2768.64,53
HCPCS,21011,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,7453.0,4844.45,0.01,7453.0,61
HCPCS,21012,EXC TUMOR FACE/SCALP SUBQ 2CM OR>,750.0,487.5,1.1,2768.64,50
HCPCS,21012,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,7453.0,4844.45,0.01,7453.0,61
HCPCS,21012,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,1780.0,1157.0,1.1,2768.64,50
HCPCS,21013,EXC TUMOR FACE/SCALP SUBFASCIAL <2CM,853.0,554.45,1.1,2768.64,53
HCPCS,21013,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,2168.0,1409.2,1.1,2768.64,53
HCPCS,21013,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,7453.0,4844.45,0.01,7453.0,61
HCPCS,21014,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,13165.0,8557.25,0.01,13165.0,61
HCPCS,21014,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,2852.0,1853.8,1.1,4850.94,50
HCPCS,21015,RESECT FACE/SCALP TUM < 2 CM,,,2644.48,8141.48,19
HCPCS,21015,Resect face/scalp tum < 2 cm,,,1072.58,1241.93,8
HCPCS,21016,RESECT FACE/SCALP TUM 2 CM/>,,,2644.48,8141.48,19
HCPCS,21016,Resect face/scalp tum 2 cm/>,,,1072.58,1241.93,8
HCPCS,21025,EXCISION BONE MANDIBLE,4012.0,2607.8,1.1,9999.36,53
HCPCS,21025,EXCISION OF BONE LOWER JAW,,,5465.95,16592.38,19
HCPCS,21025,Excision of bone lower jaw,,,1634.67,1892.77,8
HCPCS,21026,EXCISION OF FACIAL BONE(S),2280.0,1482.0,1.1,16592.38,72
HCPCS,21026,Excision of facial bone(s),,,1634.67,1892.77,8
HCPCS,21029,CONTOUR OF FACE BONE LESION,,,2996.53,9292.73,19
HCPCS,21029,Contour of face bone lesion,,,1634.67,1892.77,8
HCPCS,21029,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,3356.0,2181.4,1.1,5497.86,53
HCPCS,21030,EXCISE MAX/ZYGOMA B9 TUMOR,,,5465.95,16592.38,19
HCPCS,21030,Excise max/zygoma b9 tumor,,,1634.67,1892.77,8
HCPCS,21031,EXCISION TORUS MANDIBULARIS,1320.0,858.0,1.1,5497.86,53
HCPCS,21031,REMOVE EXOSTOSIS MANDIBLE,,,2996.53,9292.73,19
HCPCS,21031,Remove exostosis mandible,,,1634.67,1892.77,8
HCPCS,21032,EXCISION MAXILLARY TORUS PALATINUS,1336.0,868.4,1.1,5497.86,53
HCPCS,21032,REMOVE EXOSTOSIS MAXILLA,,,2996.53,9292.73,19
HCPCS,21032,Remove exostosis maxilla,,,1634.67,1892.77,8
HCPCS,21034,EXCISE MAX/ZYGOMA MAL TUMOR,,,5465.95,16592.38,19
HCPCS,21034,Excise max/zygoma mal tumor,,,3594.14,4161.63,8
HCPCS,21040,EXCISE MANDIBLE LESION,,,2996.53,9292.73,19
HCPCS,21040,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,1964.0,1276.6,1.1,5497.86,53
HCPCS,21040,Excise mandible lesion,,,1634.67,1892.77,8
HCPCS,21044,REMOVAL OF JAW BONE LESION,,,5465.95,16592.38,19
HCPCS,21044,Removal of jaw bone lesion,,,3594.14,4161.63,8
HCPCS,21045,EXTENSIVE JAW SURGERY,,,5600.62,16592.38,13
HCPCS,21045,Extensive jaw surgery,,,3594.14,4161.63,8
HCPCS,21046,REMOVE MANDIBLE CYST COMPLEX,,,5465.95,16592.38,19
HCPCS,21046,Remove mandible cyst complex,,,3594.14,4161.63,8
HCPCS,21047,EXCISE LWR JAW CYST W/REPAIR,,,5465.95,16592.38,19
HCPCS,21047,Excise lwr jaw cyst w/repair,,,3594.14,4161.63,8
HCPCS,21048,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,5884.0,3824.6,1.1,9999.36,50
HCPCS,21048,REMOVE MAXILLA CYST COMPLEX,,,5465.95,16592.38,19
HCPCS,21048,Remove maxilla cyst complex,,,3594.14,4161.63,8
HCPCS,21049,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,7728.0,5023.2,1.1,9999.36,50
HCPCS,21049,EXCIS UPPR JAW CYST W/REPAIR,,,5465.95,16592.38,19
HCPCS,21049,Excis uppr jaw cyst w/repair,,,3594.14,4161.63,8
HCPCS,21050,REMOVAL OF JAW JOINT,,,5465.95,16592.38,19
HCPCS,21050,Removal of jaw joint,,,3594.14,4161.63,8
HCPCS,21060,REMOVE JAW JOINT CARTILAGE,,,5465.95,16592.38,19
HCPCS,21060,Remove jaw joint cartilage,,,3594.14,4161.63,8
HCPCS,21070,REMOVE CORONOID PROCESS,,,5465.95,16592.38,19
HCPCS,21070,Remove coronoid process,,,3594.14,4161.63,8
HCPCS,21073,MNPJ OF TMJ W/ANESTH,,,1368.67,4348.85,19
HCPCS,21073,Mnpj of tmj w/anesth,,,654.6,757.96,8
HCPCS,21076,IMPRES&PREP SURG OBT PROSTH,,,1368.67,4348.85,19
HCPCS,21076,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,5360.0,3484.0,1.1,5360.0,53
HCPCS,21076,Impres&prep surg obt prosth,,,1358.5,1573.0,8
HCPCS,21077,IMPRES&PREP ORBITAL PROSTH,,,5465.95,16592.38,19
HCPCS,21077,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,13480.0,8762.0,1.1,13480.0,53
HCPCS,21077,Impres&prep orbital prosth,,,1358.5,1573.0,8
HCPCS,21079,IMPRES&PREP INTRM OBT PROSTH,,,2996.53,9292.73,19
HCPCS,21079,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,8924.0,5800.6,1.1,8924.0,53
HCPCS,21079,Impres&prep intrm obt prosth,,,1358.5,1573.0,8
HCPCS,21080,IMPRES&PREP DEF OBT PROSTH,,,2996.53,9292.73,19
HCPCS,21080,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,10024.0,6515.6,1.1,10024.0,53
HCPCS,21080,Impres&prep def obt prosth,,,1358.5,1573.0,8
HCPCS,21081,IMPRES&PREP MNDBL RES PROSTH,,,5465.95,16592.38,19
HCPCS,21081,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,9140.0,5941.0,1.1,9999.36,53
HCPCS,21081,Impres&prep mndbl res prosth,,,1358.5,1573.0,8
HCPCS,21082,IMPRES&PREP PALTL AUG PROSTH,,,2996.53,9292.73,19
HCPCS,21082,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,8336.0,5418.4,1.1,8336.0,53
HCPCS,21082,Impres&prep paltl aug prosth,,,1358.5,1573.0,8
HCPCS,21083,IMPRES&PREP PALTL LFT PROSTH,,,2996.53,9292.73,19
HCPCS,21083,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,7708.0,5010.2,1.1,7708.0,53
HCPCS,21083,Impres&prep paltl lft prosth,,,1358.5,1573.0,8
HCPCS,21084,IMPRES&PREP SP AID PROSTH,,,2996.53,9292.73,19
HCPCS,21084,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,8992.0,5844.8,1.1,8992.0,53
HCPCS,21084,Impres&prep sp aid prosth,,,1358.5,1573.0,8
HCPCS,21085,IMPRES&PREP ORAL SURG SPLINT,,,214.57,663.85,19
HCPCS,21085,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,3596.0,2337.4,1.1,3596.0,53
HCPCS,21085,Impres&prep oral surg splint,,,1358.5,1573.0,8
HCPCS,21086,IMPRES&PREP AURICULAR PROSTH,,,2996.53,9292.73,19
HCPCS,21086,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,9952.0,6468.8,1.1,9952.0,53
HCPCS,21086,Impres&prep auricular prosth,,,1358.5,1573.0,8
HCPCS,21087,IMPRES&PREP NASAL PROSTH,,,5465.95,16592.38,19
HCPCS,21087,IMPRESSION & PREPARATION NASAL PROSTHESIS,9952.0,6468.8,1.1,9999.36,53
HCPCS,21087,Impres&prep nasal prosth,,,1358.5,1573.0,8
HCPCS,21088,IMPRES&PREP FACIAL PROSTH,,,2996.53,9292.73,19
HCPCS,21088,IMPRESSION & PREPARATION FACIAL PROSTHESIS,7736.0,5028.4,1.1,9976.48,32
HCPCS,21088,Impres&prep facial prosth,,,1358.5,1573.0,8
HCPCS,21089,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,1040.0,676.0,0.01,1040.0,28
HCPCS,21089,UNLISTED MAXLFCL PROSTH PX,,,214.57,663.85,19
HCPCS,21089,Unlisted maxlfcl prosth px,,,1358.5,1573.0,8
HCPCS,21100,MAXILLOFACIAL FIXATION,,,5465.95,16592.38,19
HCPCS,21100,Maxillofacial fixation,,,1311.41,1518.47,8
HCPCS,21110,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,2396.0,1557.4,1.1,2844.06,53
HCPCS,21110,INTERDENTAL FIXATION,,,1368.67,4348.85,19
HCPCS,21110,Interdental fixation,,,1358.5,1573.0,8
HCPCS,21116,Injection jaw joint x-ray,,,65.08,75.36,8
HCPCS,21120,GENIOPLASTY AUGMENTATION,,,5465.95,16592.38,19
HCPCS,21120,Genioplasty augmentation,,,3594.14,4161.63,8
HCPCS,21121,GENIOP SLDG OSTEOT 1,,,2996.53,9292.73,19
HCPCS,21121,Geniop sldg osteot 1,,,1634.67,1892.77,8
HCPCS,21122,GENIOP SLDG OSTEOT 2/>,,,5465.95,16592.38,19
HCPCS,21122,Geniop sldg osteot 2/>,,,3594.14,4161.63,8
HCPCS,21123,GENIOP SLDG AUGMENTATION,,,2996.53,9292.73,19
HCPCS,21123,Geniop sldg augmentation,,,1634.67,1892.77,8
HCPCS,21125,AUGMENTATION MNDBLR PROSTC,,,5465.95,16592.38,19
HCPCS,21125,Augmentation mndblr prostc,,,3594.14,4161.63,8
HCPCS,21127,AUGMENTATION MNDBLR B1 GRF,,,5465.95,16592.38,19
HCPCS,21127,Augmentation mndblr b1 grf,,,3594.14,4161.63,8
HCPCS,21137,RDCTJ FOREHEAD CNTRG ONLY,,,2996.53,9292.73,19
HCPCS,21137,Rdctj forehead cntrg only,,,3594.14,4161.63,8
HCPCS,21138,RDCTJ FOREHEAD CNTRG&PROSTC,,,5465.95,16592.38,19
HCPCS,21138,Rdctj forehead cntrg&prostc,,,3594.14,4161.63,8
HCPCS,21139,RDCTJ FOREHEAD CNTRG&SETBACK,,,5465.95,16592.38,19
HCPCS,21139,Rdctj forehead cntrg&setback,,,3594.14,4161.63,8
HCPCS,21141,RCNSTJ MIDFACE LEFORT I 1PC,,,5465.95,16592.38,19
HCPCS,21141,"RECONST FACE,LEFORT I,1 PIECE",7828.0,5088.2,1.1,9999.36,50
HCPCS,21141,Rcnstj midface lefort i 1pc,,,3594.14,4161.63,8
HCPCS,21142,RCNSTJ MIDFACE LEFORT I 2PCS,,,5465.95,16592.38,19
HCPCS,21142,Rcnstj midface lefort i 2pcs,,,3594.14,4161.63,8
HCPCS,21143,RCNSTJ MDFACE LEFORT I 3/>PC,,,5465.95,16592.38,19
HCPCS,21143,Rcnstj mdface lefort i 3/>pc,,,3594.14,4161.63,8
HCPCS,21145,RCNSTJ MDFC LEFORT I 1 W/GRF,,,5600.62,16592.38,13
HCPCS,21145,Rcnstj mdfc lefort i 1 w/grf,,,3594.14,4161.63,8
HCPCS,21146,RCNSTJ MDFC LEFORT I 2 W/GRF,,,5600.62,16592.38,13
HCPCS,21146,Rcnstj mdfc lefort i 2 w/grf,,,3594.14,4161.63,8
HCPCS,21147,RCNSTJ MDFC LEFORT I 3/>GRF,,,5600.62,16592.38,13
HCPCS,21147,Rcnstj mdfc lefort i 3/>grf,,,3594.14,4161.63,8
HCPCS,21150,RCNSTJ MDFC LEFRTII ANT NTRU,,,5465.95,16592.38,19
HCPCS,21150,Rcnstj mdfc lefrtii ant ntru,,,3594.14,4161.63,8
HCPCS,21151,RCNSTJ MDFC LEFRTII W/B1 GRF,,,5600.62,16592.38,13
HCPCS,21151,Rcnstj mdfc lefrtii w/b1 grf,,,3594.14,4161.63,8
HCPCS,21154,RCNSTJ MDFC LEFORT III W/O I,,,5600.62,16592.38,13
HCPCS,21154,Rcnstj mdfc lefort iii w/o i,,,3594.14,4161.63,8
HCPCS,21155,RCNSTJ MDFC LEFORT III W/I,,,5600.62,16592.38,13
HCPCS,21155,Rcnstj mdfc lefort iii w/i,,,3594.14,4161.63,8
HCPCS,21159,RCNST MDFC LFRTIII ADVM WO I,,,5600.62,16592.38,13
HCPCS,21159,Rcnst mdfc lfrtiii advm wo i,,,3594.14,4161.63,8
HCPCS,21160,RCNST MDFC LFRTIII ADVM W/I,,,5600.62,16592.38,13
HCPCS,21160,Rcnst mdfc lfrtiii advm w/i,,,3594.14,4161.63,8
HCPCS,21172,RCNST SUPR-LAT ORB RM&LW FHD,,,5465.95,16592.38,19
HCPCS,21172,Rcnst supr-lat orb rm&lw fhd,,,3594.14,4161.63,8
HCPCS,21175,RCNST BFRNT SP ORB RM&LW FHD,,,5465.95,16592.38,19
HCPCS,21175,Rcnst bfrnt sp orb rm&lw fhd,,,3594.14,4161.63,8
HCPCS,21179,RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC,9060.0,5889.0,1.1,9060.0,50
HCPCS,21179,RCNSTJ FOREHEAD WITH GRAFTS,,,5600.62,16592.38,13
HCPCS,21179,Rcnstj forehead with grafts,,,3594.14,4161.63,8
HCPCS,21180,RCNSTJ FOREHEAD W/AUTOGRAFT,,,5600.62,16592.38,13
HCPCS,21180,Rcnstj forehead w/autograft,,,3594.14,4161.63,8
HCPCS,21181,RCNST CNTRG B9 TUM CRNL XTRC,,,5465.95,16592.38,19
HCPCS,21181,Rcnst cntrg b9 tum crnl xtrc,,,1634.67,1892.77,8
HCPCS,21182,RECONSTRUCT CRANIAL BONE,,,5600.62,16592.38,13
HCPCS,21182,Reconstruct cranial bone,,,3594.14,4161.63,8
HCPCS,21183,RECONSTRUCT CRANIAL BONE,,,5600.62,16592.38,13
HCPCS,21183,Reconstruct cranial bone,,,3594.14,4161.63,8
HCPCS,21184,RECONSTRUCT CRANIAL BONE,,,5600.62,16592.38,13
HCPCS,21184,Reconstruct cranial bone,,,3594.14,4161.63,8
HCPCS,21188,RECONSTRUCTION OF MIDFACE,,,5600.62,16592.38,13
HCPCS,21188,Reconstruction of midface,,,1634.67,1892.77,8
HCPCS,21193,RECONST LWR JAW W/O GRAFT,,,5465.95,16592.38,19
HCPCS,21193,Reconst lwr jaw w/o graft,,,1634.67,1892.77,8
HCPCS,21194,RECONST LWR JAW W/GRAFT,,,5465.95,16592.38,19
HCPCS,21194,Reconst lwr jaw w/graft,,,3594.14,4161.63,8
HCPCS,21195,RECONST LWR JAW W/O FIXATION,,,5465.95,16592.38,19
HCPCS,21195,Reconst lwr jaw w/o fixation,,,3594.14,4161.63,8
HCPCS,21196,RECONST LWR JAW W/FIXATION,,,5465.95,16592.38,19
HCPCS,21196,Reconst lwr jaw w/fixation,,,3594.14,4161.63,8
HCPCS,21198,RECONSTR LWR JAW SEGMENT,,,5465.95,16592.38,19
HCPCS,21198,Reconstr lwr jaw segment,,,3594.14,4161.63,8
HCPCS,21199,RECONSTR LWR JAW W/ADVANCE,,,5465.95,16592.38,19
HCPCS,21199,Reconstr lwr jaw w/advance,,,1634.67,1892.77,8
HCPCS,21206,RECONSTRUCT UPPER JAW BONE,,,5465.95,16592.38,19
HCPCS,21206,Reconstruct upper jaw bone,,,3594.14,4161.63,8
HCPCS,21208,AUGMENTATION OF FACIAL BONES,,,5465.95,16592.38,19
HCPCS,21208,Augmentation of facial bones,,,3594.14,4161.63,8
HCPCS,21209,REDUCTION OF FACIAL BONES,,,5465.95,16592.38,19
HCPCS,21209,Reduction of facial bones,,,3594.14,4161.63,8
HCPCS,21210,CHEECK IMPLANT W BONE GRAFT,2000.0,1300.0,1.1,9999.36,53
HCPCS,21210,FACE BONE GRAFT,,,5465.95,16592.38,19
HCPCS,21210,Face bone graft,,,3594.14,4161.63,8
HCPCS,21210,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,5144.0,3343.6,1.1,9999.36,53
HCPCS,21215,GRAFT BONE MANDIBLE,4892.0,3179.8,1.1,13314.11,53
HCPCS,21215,LOWER JAW BONE GRAFT,,,5465.95,16592.38,19
HCPCS,21215,Lower jaw bone graft,,,3594.14,4161.63,8
HCPCS,21230,RIB CARTILAGE GRAFT,,,5465.95,16592.38,19
HCPCS,21230,Rib cartilage graft,,,3594.14,4161.63,8
HCPCS,21235,EAR CARTILAGE GRAFT,,,5465.95,16592.38,19
HCPCS,21235,Ear cartilage graft,,,1634.67,1892.77,8
HCPCS,21235,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,3000.0,1950.0,1.1,9999.36,53
HCPCS,21240,RECONSTRUCTION OF JAW JOINT,,,5465.95,16592.38,19
HCPCS,21240,Reconstruction of jaw joint,,,3594.14,4161.63,8
HCPCS,21242,RECONSTRUCTION OF JAW JOINT,,,5465.95,16592.38,19
HCPCS,21242,Reconstruction of jaw joint,,,3594.14,4161.63,8
HCPCS,21243,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,9812.0,6377.8,1.1,31818.75,50
HCPCS,21243,RECONSTRUCTION OF JAW JOINT,,,16992.04,76052.54,19
HCPCS,21243,Reconstruction of jaw joint,,,6256.68,7244.58,8
HCPCS,21244,RECONSTRUCTION OF LOWER JAW,,,5465.95,16592.38,19
HCPCS,21244,Reconstruction of lower jaw,,,3594.14,4161.63,8
HCPCS,21245,RECONSTRUCTION OF JAW,,,5465.95,16592.38,19
HCPCS,21245,Reconstruction of jaw,,,3594.14,4161.63,8
HCPCS,21246,RECONSTRUCTION OF JAW,,,5465.95,16592.38,19
HCPCS,21246,Reconstruction of jaw,,,3594.14,4161.63,8
HCPCS,21247,RECONSTRUCT LOWER JAW BONE,,,5600.62,16592.38,13
HCPCS,21247,Reconstruct lower jaw bone,,,3594.14,4161.63,8
HCPCS,21248,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,5096.0,3312.4,1.1,9999.36,53
HCPCS,21248,RECONSTRUCTION OF JAW,,,5465.95,16592.38,19
HCPCS,21248,Reconstruction of jaw,,,3594.14,4161.63,8
HCPCS,21249,RECONSTRUCTION OF JAW,,,5465.95,16592.38,19
HCPCS,21249,Reconstruction of jaw,,,3594.14,4161.63,8
HCPCS,21255,RECONSTRUCT LOWER JAW BONE,,,5465.95,16592.38,19
HCPCS,21255,Reconstruct lower jaw bone,,,3594.14,4161.63,8
HCPCS,21256,RECONSTRUCTION OF ORBIT,,,5465.95,16592.38,19
HCPCS,21256,Reconstruction of orbit,,,3594.14,4161.63,8
HCPCS,21260,REVISE EYE SOCKETS,,,5465.95,16592.38,19
HCPCS,21260,Revise eye sockets,,,3594.14,4161.63,8
HCPCS,21261,REVISE EYE SOCKETS,,,5465.95,16592.38,19
HCPCS,21261,Revise eye sockets,,,3594.14,4161.63,8
HCPCS,21263,REVISE EYE SOCKETS,,,5465.95,16592.38,19
HCPCS,21263,Revise eye sockets,,,3594.14,4161.63,8
HCPCS,21267,REVISE EYE SOCKETS,,,5465.95,16592.38,19
HCPCS,21267,Revise eye sockets,,,1634.67,1892.77,8
HCPCS,21268,REVISE EYE SOCKETS,,,5600.62,16592.38,13
HCPCS,21268,Revise eye sockets,,,3594.14,4161.63,8
HCPCS,21270,AUGMENTATION CHEEK BONE,,,5465.95,16592.38,19
HCPCS,21270,Augmentation cheek bone,,,3594.14,4161.63,8
HCPCS,21270,CHEECK IMPLANT W/O BONE GRAFT,2000.0,1300.0,1.1,9999.36,53
HCPCS,21275,REVISION ORBITOFACIAL BONES,,,5465.95,16592.38,19
HCPCS,21275,Revision orbitofacial bones,,,1634.67,1892.77,8
HCPCS,21280,MEDIAL CANTHOPEXY,,,2996.53,9292.73,19
HCPCS,21280,Medial canthopexy,,,1684.99,1951.04,8
HCPCS,21282,CANTHOPEXY,1538.0,999.7,1.1,5497.86,50
HCPCS,21282,LATERAL CANTHOPEXY,,,2996.53,9292.73,19
HCPCS,21282,Lateral canthopexy,,,1684.99,1951.04,8
HCPCS,21295,REVISION OF JAW MUSCLE/BONE,,,1368.67,4348.85,19
HCPCS,21295,Revision of jaw muscle/bone,,,1634.67,1892.77,8
HCPCS,21296,REVISION OF JAW MUSCLE/BONE,,,2996.53,9292.73,19
HCPCS,21296,Revision of jaw muscle/bone,,,1634.67,1892.77,8
HCPCS,21299,COMPLEX SCULPTING & CARVING OF CADAVERIC RIB EAR CARTILAGE FRAME,4022.0,2614.3,0.01,4022.0,28
HCPCS,21299,"TRANS-OSTEAL PLATING FOR MANDIBLE RECONSTRUCTION, INTRAORAL, WIT",4904.0,3187.6,0.01,4904.0,28
HCPCS,21299,UNLISTED CRANFCL&MAXLFCL PX,,,214.57,663.85,19
HCPCS,21299,Unlisted cranfcl&maxlfcl px,,,1634.67,1892.77,8
HCPCS,21310,Closed tx nose fx w/o manj,,,234.24,271.23,8
HCPCS,21315,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,3618.0,2351.7000000000003,1.1,6814.0,114
HCPCS,21320,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,700.0,455.0,1.1,5497.86,53
HCPCS,21320,CLSD TX NSL FX W/MNPJ&STABLJ,,,2996.53,9292.73,19
HCPCS,21320,Clsd tx nsl fx w/mnpj&stablj,,,234.24,271.23,8
HCPCS,21325,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,1672.0,1086.8,1.1,5497.86,50
HCPCS,21325,OPEN TX NOSE FX UNCOMPLICATD,,,2996.53,9292.73,19
HCPCS,21325,Open tx nose fx uncomplicatd,,,1634.67,1892.77,8
HCPCS,21330,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,2316.0,1505.4,1.1,9999.36,50
HCPCS,21330,OPEN TX NOSE FX W/SKELE FIXJ,,,5465.95,16592.38,19
HCPCS,21330,Open tx nose fx w/skele fixj,,,1634.67,1892.77,8
HCPCS,21335,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,3608.0,2345.2,1.1,5497.86,50
HCPCS,21335,OPEN TX NOSE & SEPTAL FX,,,2996.53,9292.73,19
HCPCS,21335,Open tx nose & septal fx,,,1634.67,1892.77,8
HCPCS,21336,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,2708.0,1760.2,1.1,5526.53,50
HCPCS,21336,OPEN TX SEPTAL FX W/WO STABJ,,,2997.95,9170.92,19
HCPCS,21336,Open tx septal fx w/wo stabj,,,2860.13,3311.73,8
HCPCS,21337,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,1356.0,881.4,1.1,5497.86,53
HCPCS,21337,CLOSED TX SEPTAL&NOSE FX,,,2996.53,9292.73,19
HCPCS,21337,Closed tx septal&nose fx,,,234.24,271.23,8
HCPCS,21338,OPEN NASOETHMOID FX W/O FIXJ,,,5465.95,16592.38,19
HCPCS,21338,Open nasoethmoid fx w/o fixj,,,3594.14,4161.63,8
HCPCS,21339,OPEN NASOETHMOID FX W/ FIXJ,,,5465.95,16592.38,19
HCPCS,21339,Open nasoethmoid fx w/ fixj,,,3594.14,4161.63,8
HCPCS,21340,PERQ TX NASOETHMOID FX,,,2996.53,9292.73,19
HCPCS,21340,Perq tx nasoethmoid fx,,,1634.67,1892.77,8
HCPCS,21343,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,5728.0,3723.2,1.1,5728.0,50
HCPCS,21343,OPEN TX DPRSD FRONT SINUS FX,,,5600.62,16592.38,13
HCPCS,21343,Open tx dprsd front sinus fx,,,1634.67,1892.77,8
HCPCS,21344,OPEN TX COMPL FRONT SINUS FX,,,5600.62,16592.38,13
HCPCS,21344,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,8628.0,5608.2,1.1,8628.0,50
HCPCS,21344,Open tx compl front sinus fx,,,3594.14,4161.63,8
HCPCS,21345,CLOSED TX NOSE/JAW FX,,,1368.67,4348.85,19
HCPCS,21345,Closed tx nose/jaw fx,,,234.24,271.23,8
HCPCS,21346,OPN TX NASOMAX FX W/FIXJ,,,5465.95,16592.38,19
HCPCS,21346,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,4580.0,2977.0,1.1,9999.36,50
HCPCS,21346,Opn tx nasomax fx w/fixj,,,3594.14,4161.63,8
HCPCS,21347,OPN TX NASOMAX FX MULTPLE,,,5465.95,16592.38,19
HCPCS,21347,OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN,5412.0,3517.8,1.1,9999.36,50
HCPCS,21347,Opn tx nasomax fx multple,,,3594.14,4161.63,8
HCPCS,21348,OPN TX NASOMAX FX W/GRAFT,,,5600.62,16592.38,13
HCPCS,21348,Opn tx nasomax fx w/graft,,,3594.14,4161.63,8
HCPCS,21355,PERQ TX MALAR FRACTURE,,,2996.53,9292.73,19
HCPCS,21355,Perq tx malar fracture,,,1634.67,1892.77,8
HCPCS,21356,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,1932.0,1255.8,1.1,9999.36,53
HCPCS,21356,OPN TX DPRSD ZYGOMATIC ARCH,,,5465.95,16592.38,19
HCPCS,21356,Opn tx dprsd zygomatic arch,,,1634.67,1892.77,8
HCPCS,21360,OPEN TX DEPRESSED MALAR FRACTURE,2876.0,1869.4,1.1,9999.36,50
HCPCS,21360,OPN TX DPRSD MALAR FRACTURE,,,5465.95,16592.38,19
HCPCS,21360,Opn tx dprsd malar fracture,,,1634.67,1892.77,8
HCPCS,21365,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,6708.0,4360.2,1.1,9999.36,50
HCPCS,21365,OPN TX COMPLX MALAR FX,,,5465.95,16592.38,19
HCPCS,21365,Opn tx complx malar fx,,,3594.14,4161.63,8
HCPCS,21366,OPN TX COMPLX MALAR W/GRFT,,,5465.95,16592.38,19
HCPCS,21366,Opn tx complx malar w/grft,,,3594.14,4161.63,8
HCPCS,21385,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,3828.0,2488.2,1.1,9999.36,50
HCPCS,21385,OPN TX ORBIT FX TRANSANTRAL,,,5465.95,16592.38,19
HCPCS,21385,Opn tx orbit fx transantral,,,3594.14,4161.63,8
HCPCS,21386,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,3828.0,2488.2,1.1,9999.36,50
HCPCS,21386,OPN TX ORBIT FX PERIORBITAL,,,5465.95,16592.38,19
HCPCS,21386,Opn tx orbit fx periorbital,,,3594.14,4161.63,8
HCPCS,21387,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,4044.0,2628.6,1.1,9999.36,50
HCPCS,21387,OPN TX ORBIT FX COMBINED,,,5465.95,16592.38,19
HCPCS,21387,Opn tx orbit fx combined,,,3594.14,4161.63,8
HCPCS,21390,OPN TX ORBIT PERIORBTL IMPLT,,,5465.95,16592.38,19
HCPCS,21390,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,4492.0,2919.8,1.1,9999.36,50
HCPCS,21390,Opn tx orbit periorbtl implt,,,3594.14,4161.63,8
HCPCS,21395,OPN TX ORBIT PERIORBT W/GRFT,,,5465.95,16592.38,19
HCPCS,21395,Opn tx orbit periorbt w/grft,,,3594.14,4161.63,8
HCPCS,21400,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,1471.5,956.475,1.1,4001.0,114
HCPCS,21401,CLOSED TX ORBIT W/MANIPULJ,,,1368.67,4348.85,19
HCPCS,21401,Closed tx orbit w/manipulj,,,234.24,271.23,8
HCPCS,21406,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,2968.0,1929.2,1.1,9999.36,50
HCPCS,21406,OPN TX ORBIT FX W/O IMPLANT,,,5465.95,16592.38,19
HCPCS,21406,Opn tx orbit fx w/o implant,,,3594.14,4161.63,8
HCPCS,21407,OPN TX ORBIT FX W/IMPLANT,,,5465.95,16592.38,19
HCPCS,21407,Opn tx orbit fx w/implant,,,1634.67,1892.77,8
HCPCS,21408,OPN TX ORBIT FX W/BONE GRFT,,,5465.95,16592.38,19
HCPCS,21408,Opn tx orbit fx w/bone grft,,,1634.67,1892.77,8
HCPCS,21421,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,2408.0,1565.2,1.1,5497.86,53
HCPCS,21421,CLTX PALATAL/MAX FX WIRE FIX,,,2996.53,9292.73,19
HCPCS,21421,Cltx palatal/max fx wire fix,,,1634.67,1892.77,8
HCPCS,21422,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,3492.0,2269.8,1.1,9999.36,50
HCPCS,21422,OPTX PALATAL/MAX FRACTURE,,,5465.95,16592.38,19
HCPCS,21422,Optx palatal/max fracture,,,3594.14,4161.63,8
HCPCS,21423,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,4340.0,2821.0,1.1,4340.0,50
HCPCS,21423,OPTX PALATAL/MAX FX COMP,,,5600.62,16592.38,13
HCPCS,21423,Optx palatal/max fx comp,,,3594.14,4161.63,8
HCPCS,21431,CLTX CRANIOFACIAL SEPARATION,,,5600.62,16592.38,13
HCPCS,21431,Cltx craniofacial separation,,,3594.14,4161.63,8
HCPCS,21432,OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ,3528.0,2293.2,1.1,3528.0,50
HCPCS,21432,OPTX CRANFCL SEP W/WIRING,,,5600.62,16592.38,13
HCPCS,21432,Optx cranfcl sep w/wiring,,,3594.14,4161.63,8
HCPCS,21433,OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR,10516.0,6835.4,1.1,10516.0,50
HCPCS,21433,OPTX CRANFCL SEP COMP MLT,,,5600.62,16592.38,13
HCPCS,21433,Optx cranfcl sep comp mlt,,,3594.14,4161.63,8
HCPCS,21435,OPTX CRNFC SEP COMP INT&/XTR,,,5600.62,16592.38,13
HCPCS,21435,Optx crnfc sep comp int&/xtr,,,3594.14,4161.63,8
HCPCS,21436,OPTX CRNFCL SEP COMP MLT INT,,,5600.62,16592.38,13
HCPCS,21436,Optx crnfcl sep comp mlt int,,,3594.14,4161.63,8
HCPCS,21440,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,1376.0,894.4,1.1,5497.86,53
HCPCS,21440,CLTX MNDBLR/MAX ALV RIDGE FX,,,2996.53,9292.73,19
HCPCS,21440,Cltx mndblr/max alv ridge fx,,,1634.67,1892.77,8
HCPCS,21445,OPTX MNDBLR/MAX ALV RIDGE FX,,,5465.95,16592.38,19
HCPCS,21445,Optx mndblr/max alv ridge fx,,,3594.14,4161.63,8
HCPCS,21450,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1484.0,964.6,1.1,1945.16,53
HCPCS,21450,CLOSED TX OF MANDIBULAR FRACTURE W/O MANIPULATION,2343.0,1522.95,234.24,6561.0,61
HCPCS,21451,CL TX MANIBLE FX W/MANIPULATION,6814.0,4429.1,234.24,7445.0,61
HCPCS,21451,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,2260.0,1469.0,1.1,2603.78,53
HCPCS,21452,PERQ TX MNDBLR FX XTRNL FIXJ,,,5465.95,16592.38,19
HCPCS,21452,Perq tx mndblr fx xtrnl fixj,,,3594.14,4161.63,8
HCPCS,21453,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,2656.0,1726.4,1.1,9999.36,53
HCPCS,21453,CLTX MNDBLR FX NTRDNTL FIXJ,,,5465.95,16592.38,19
HCPCS,21453,Cltx mndblr fx ntrdntl fixj,,,3594.14,4161.63,8
HCPCS,21454,OPTX MNDBLR FX XTRNL FIXJ,,,5465.95,16592.38,19
HCPCS,21454,Optx mndblr fx xtrnl fixj,,,3594.14,4161.63,8
HCPCS,21461,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,3724.0,2420.6,1.1,9999.36,53
HCPCS,21461,OPTX MNDBLR FX WO NTRDNTL,,,5465.95,16592.38,19
HCPCS,21461,Optx mndblr fx wo ntrdntl,,,3594.14,4161.63,8
HCPCS,21462,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,4404.0,2862.6,1.1,9999.36,53
HCPCS,21462,OPTX MNDBLR FX W/NTRDNTL,,,5465.95,16592.38,19
HCPCS,21462,Optx mndblr fx w/ntrdntl,,,3594.14,4161.63,8
HCPCS,21465,OPTX MNDBLR CNDYLR FX,,,5465.95,16592.38,19
HCPCS,21465,Optx mndblr cndylr fx,,,3594.14,4161.63,8
HCPCS,21470,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,7016.0,4560.4,1.1,9999.36,50
HCPCS,21470,OPTX COMPLICATED MNDBLR FX,,,5465.95,16592.38,19
HCPCS,21470,Optx complicated mndblr fx,,,3594.14,4161.63,8
HCPCS,21480,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,685.5,445.57500000000005,1.1,3004.0,114
HCPCS,21485,CLTX TMPRMAND DISLC COMP,,,1368.67,4348.85,19
HCPCS,21485,Cltx tmprmand dislc comp,,,654.6,757.96,8
HCPCS,21490,OPTX TMPRMAND DISLOCATION,,,2996.53,9292.73,19
HCPCS,21490,Optx tmprmand dislocation,,,1634.67,1892.77,8
HCPCS,21497,INTERDENTAL WIRG OTH/THN FX,,,1368.67,4348.85,19
HCPCS,21497,INTERDENTAL WIRING OTHER THAN FRACTURE,1856.0,1206.4,1.1,2603.78,53
HCPCS,21497,Interdental wirg oth/thn fx,,,1358.5,1573.0,8
HCPCS,21499,UNLISTED MUSCSKEL PX HEAD,,,214.57,663.85,19
HCPCS,21499,Unlisted muscskel px head,,,1634.67,1892.77,8
HCPCS,21501,DRAIN NECK/CHEST LESION,665.0,432.25,1.1,4850.94,53
HCPCS,21501,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,1592.0,1034.8,1.1,4850.94,53
HCPCS,21501,I&D DP ABSC/HMTMA SFT TS NCK,,,2644.48,8141.48,19
HCPCS,21501,I&d dp absc/hmtma sft ts nck,,,1367.07,1582.92,8
HCPCS,21502,I&D DP ABS/HMTM NCK RIB OSTC,,,2997.95,9170.92,19
HCPCS,21502,I&d dp abs/hmtm nck rib ostc,,,1367.07,1582.92,8
HCPCS,21510,INC DEEP OPNG B1 CRTX THORAX,,,3095.56,9170.92,13
HCPCS,21510,INCISION DEEP OPENING BONE CORTEX THORAX,2480.0,1612.0,1.1,2480.0,50
HCPCS,21510,Inc deep opng b1 crtx thorax,,,1367.07,1582.92,8
HCPCS,21550,BIOPSY OF NECK/CHEST,538.0,349.7,1.1,2768.64,53
HCPCS,21550,BIOPSY SOFT TISSUE NECK/CHEST,844.0,548.6,1.1,2768.64,53
HCPCS,21550,BIOPSY SOFT TISSUE NECK/THORAX,7453.0,4844.45,0.01,7453.0,122
HCPCS,21552,EXC NECK LES SC 3 CM/>,,,2644.48,8141.48,20
HCPCS,21552,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,2596.0,1687.4,1.1,4850.94,50
HCPCS,21552,EXCISE TUMOR NECK SUBQ 3CM OR >,988.0,642.2,1.1,4850.94,50
HCPCS,21552,Exc neck les sc 3 cm/>,,,1367.07,1582.92,8
HCPCS,21554,EXC NECK TUM DEEP 5 CM/>,,,2644.48,8141.48,20
HCPCS,21554,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,4452.0,2893.8,1.1,4850.94,50
HCPCS,21554,Exc neck tum deep 5 cm/>,,,1367.07,1582.92,8
HCPCS,21554,REMOVE TUMOR NECK/CHEST 5CM OR >,1604.0,1042.6,1.1,4850.94,50
HCPCS,21555,EXC NECK LES SC < 3 CM,,,1497.07,4629.18,19
HCPCS,21555,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
HCPCS,21555,Exc neck les sc < 3 cm,,,1367.07,1582.92,8
HCPCS,21555,"REMOVE LESION, NECK/CHEST",651.0,423.15,1.1,2768.64,53
HCPCS,21556,EXC NECK TUM DEEP < 5 CM,,,2644.48,8141.48,19
HCPCS,21556,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,3064.0,1991.6,1.1,4850.94,50
HCPCS,21556,Exc neck tum deep < 5 cm,,,1367.07,1582.92,8
HCPCS,21556,"REMOVE LESION, NECK/CHEST",1074.0,698.1,1.1,4850.94,50
HCPCS,21557,"REMOVE TUMOR, NECK/CHEST",2044.0,1328.6,1.1,4850.94,50
HCPCS,21557,RESECT NECK THORAX TUMOR<5CM,,,2644.48,8141.48,19
HCPCS,21557,Resect neck thorax tumor<5cm,,,1367.07,1582.92,8
HCPCS,21558,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,8632.0,5610.8,1.1,8632.0,50
HCPCS,21558,REMOVE TUMOR NECK/CHEST 5CM OR >,3242.0,2107.3,1.1,4850.94,50
HCPCS,21558,RESECT NECK TUMOR 5 CM/>,,,2644.48,8141.48,19
HCPCS,21558,Resect neck tumor 5 cm/>,,,2519.91,2917.79,8
HCPCS,21600,EXCISION RIB PARTIAL,2904.0,1887.6,1.1,12214.27,50
HCPCS,21600,PARTIAL REMOVAL OF RIB,,,6600.66,20338.07,19
HCPCS,21600,Partial removal of rib,,,1367.07,1582.92,8
HCPCS,21601,EXC CHEST WALL TUMOR W/RIBS,,,2644.48,8141.48,19
HCPCS,21601,EXCISION CHEST WALL TUMOR INCLUDING RIBS,7112.0,4622.8,1.1,7112.0,50
HCPCS,21601,Exc chest wall tumor w/ribs,,,1367.07,1582.92,8
HCPCS,21602,EXC CH WAL TUM W/O LYMPHADEC,,,6864.94,20338.07,13
HCPCS,21602,EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC,8876.0,5769.4,1.1,8876.0,50
HCPCS,21602,Exc ch wal tum w/o lymphadec,,,2519.91,2917.79,8
HCPCS,21603,EXC CH WAL TUM W/LYMPHADEC,,,6864.94,20338.07,13
HCPCS,21603,EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC,10068.0,6544.2,1.1,10068.0,50
HCPCS,21603,Exc ch wal tum w/lymphadec,,,2519.91,2917.79,8
HCPCS,21610,COSTOTRANSVERSECTOMY,,,2997.95,9170.92,19
HCPCS,21610,Costotransversectomy,,,3026.0,3503.79,8
HCPCS,21615,EXCISION 1ST &/CERVICAL RIB,4180.0,2717.0,1.1,20338.07,63
HCPCS,21615,Excision 1st &/cervical rib,,,2519.91,2917.79,8
HCPCS,21616,EXC 1ST&/CRV RIB W/SYMPTH,,,6864.94,20338.07,13
HCPCS,21616,Exc 1st&/crv rib w/sympth,,,2519.91,2917.79,8
HCPCS,21620,OSTECTOMY STERNUM PARTIAL,2912.0,1892.8,1.1,9170.92,63
HCPCS,21620,Ostectomy sternum partial,,,1367.07,1582.92,8
HCPCS,21627,STERNAL DEBRIDEMENT,2920.0,1898.0,1.1,9170.92,63
HCPCS,21627,Sternal debridement,,,1367.07,1582.92,8
HCPCS,21630,RADICAL RESECTION STERNUM,,,6864.94,20338.07,13
HCPCS,21630,Radical resection sternum,,,2519.91,2917.79,8
HCPCS,21632,Extensive sternum surgery,,,2519.91,2917.79,8
HCPCS,21685,HYOID MYOTOMY & SUSPENSION,,,5465.95,16592.38,19
HCPCS,21685,Hyoid myotomy & suspension,,,3594.14,4161.63,8
HCPCS,21700,REVISION OF NECK MUSCLE,,,6600.66,20338.07,19
HCPCS,21700,Revision of neck muscle,,,3026.0,3503.79,8
HCPCS,21705,REVISION OF NECK MUSCLE/RIB,,,6864.94,20338.07,13
HCPCS,21705,Revision of neck muscle/rib,,,3026.0,3503.79,8
HCPCS,21720,REVISION OF NECK MUSCLE,,,2997.95,9170.92,19
HCPCS,21720,Revision of neck muscle,,,1367.07,1582.92,8
HCPCS,21725,REVISION OF NECK MUSCLE,,,650.1,1984.79,19
HCPCS,21725,Revision of neck muscle,,,3026.0,3503.79,8
HCPCS,21740,RECONSTRUCTION OF STERNUM,,,6864.94,20338.07,13
HCPCS,21740,Reconstruction of sternum,,,2519.91,2917.79,8
HCPCS,21742,REPAIR STERN/NUSS W/O SCOPE,,,2997.95,9170.92,19
HCPCS,21742,Repair stern/nuss w/o scope,,,1367.07,1582.92,8
HCPCS,21743,REPAIR STERNUM/NUSS W/SCOPE,,,2997.95,9170.92,19
HCPCS,21743,Repair sternum/nuss w/scope,,,1367.07,1582.92,8
HCPCS,21750,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,4560.0,2964.0,1.1,4560.0,50
HCPCS,21750,REPAIR OF STERNUM SEPARATION,,,6864.94,20338.07,13
HCPCS,21750,Repair of sternum separation,,,2519.91,2917.79,8
HCPCS,21811,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,4316.0,2805.4,1.1,12214.27,50
HCPCS,21811,OPTX OF RIB FX W/FIXJ SCOPE,,,6600.66,20338.07,19
HCPCS,21811,Optx of rib fx w/fixj scope,,,2860.13,3311.73,8
HCPCS,21812,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,5200.0,3380.0,1.1,12214.27,50
HCPCS,21812,TREATMENT OF RIB FRACTURE,,,6600.66,20338.07,19
HCPCS,21812,Treatment of rib fracture,,,2860.13,3311.73,8
HCPCS,21813,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,7044.0,4578.6,1.1,7044.0,50
HCPCS,21813,TREATMENT OF RIB FRACTURE,,,1478.75,4506.96,19
HCPCS,21813,Treatment of rib fracture,,,2860.13,3311.73,8
HCPCS,21820,CLOSED TREATMENT STERNUM FRACTURE,823.5,535.2750000000001,1.1,3004.0,114
HCPCS,21825,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,3104.0,2017.6,1.1,3104.0,50
HCPCS,21825,TREAT STERNUM FRACTURE,,,6864.94,20338.07,13
HCPCS,21825,Treat sternum fracture,,,2860.13,3311.73,8
HCPCS,21899,PLATYSMAL MYOTOMY FOR SYNKINESIS/TIGHTNESS FOR FACIAL NERVE SPAS,2494.0,1621.1,0.01,2494.0,28
HCPCS,21899,STERNAL NONUNION TAKEDOWN (COMP CODE 27470),6171.0,4011.15,0.01,6171.0,28
HCPCS,21899,UNLISTED PROCEDURE NECK/THORAX,2318.0,1506.7,0.01,2318.0,28
HCPCS,21899,"UNLISTED PROCEDURE, NECK OR THORAX (COMPARISON CODE 21740)",2250.0,1462.5,0.01,2250.0,28
HCPCS,21899,"UNLISTED PROCEDURE, NECK OR THORAX (COMPARISON CODE 23044)",2505.0,1628.25,0.01,2505.0,28
HCPCS,21899,"UNLISTED PROCEDURE, NECK OR THORAX (COMPARISON CODE 49652)",4224.0,2745.6,0.01,4224.0,28
HCPCS,21899,UNLISTED PX NECK/THORAX,,,214.57,663.85,19
HCPCS,21899,Unlisted px neck/thorax,,,1367.07,1582.92,8
HCPCS,21920,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,4148.5,2696.525,0.01,7453.0,114
HCPCS,21925,BIOPSY SOFT TISSUE BACK/FLANK DEEP,1852.0,1203.8,1.1,2768.64,53
HCPCS,21925,BIOPSY SOFT TISSUE OF BACK,,,1497.07,4629.18,19
HCPCS,21925,Biopsy soft tissue of back,,,1072.58,1241.93,8
HCPCS,21930,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,4714.5,3064.425,0.01,7453.0,114
HCPCS,21930,"REMOVE LESION, BACK OR FLANK",805.0,523.25,1.1,2768.64,53
HCPCS,21931,EXCISE TUMOR BACK/FLANK 3CM OR >,1050.0,682.5,1.1,2768.64,50
HCPCS,21931,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,7453.0,4844.45,0.01,7453.0,61
HCPCS,21931,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,2752.0,1788.8,1.1,2768.64,50
HCPCS,21932,EXC BACK TUM DEEP < 5 CM,,,2644.48,8141.48,19
HCPCS,21932,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,3928.0,2553.2,1.1,4850.94,50
HCPCS,21932,EXCISE TUMOR BACK/FLANK < 5CM,1700.0,1105.0,1.1,4850.94,50
HCPCS,21932,Exc back tum deep < 5 cm,,,1072.58,1241.93,8
HCPCS,21933,EXC BACK TUM DEEP 5 CM/>,,,2644.48,8141.48,19
HCPCS,21933,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,4452.0,2893.8,1.1,4850.94,50
HCPCS,21933,EXCISE TUMOR BACK\FLANK 5CM OR >,1622.0,1054.3,1.1,4850.94,50
HCPCS,21933,Exc back tum deep 5 cm/>,,,1072.58,1241.93,8
HCPCS,21935,RESECT BACK TUM < 5 CM,,,2644.48,8141.48,19
HCPCS,21935,Resect back tum < 5 cm,,,1072.58,1241.93,8
HCPCS,21936,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,9020.0,5863.0,1.1,9020.0,50
HCPCS,21936,RESECT BACK TUM 5 CM/>,,,2644.48,8141.48,19
HCPCS,21936,Resect back tum 5 cm/>,,,1072.58,1241.93,8
HCPCS,22010,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,5100.0,3315.0,1.1,5100.0,50
HCPCS,22010,I&D P-SPINE C/T/CERV-THOR,,,6864.94,20338.07,13
HCPCS,22010,I&d p-spine c/t/cerv-thor,,,7403.35,8572.3,8
HCPCS,22015,I&D ABSCESS P-SPINE L/S/LS,,,6864.94,20338.07,13
HCPCS,22015,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,5056.0,3286.4,1.1,5056.0,50
HCPCS,22015,I&d abscess p-spine l/s/ls,,,7403.35,8572.3,8
HCPCS,22100,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,4400.0,2860.0,1.1,12214.27,50
HCPCS,22100,REMOVE PART OF NECK VERTEBRA,,,6600.66,20338.07,19
HCPCS,22100,Remove part of neck vertebra,,,3026.0,3503.79,8
HCPCS,22101,REMOVE PART THORAX VERTEBRA,,,6600.66,20338.07,19
HCPCS,22101,Remove part thorax vertebra,,,3026.0,3503.79,8
HCPCS,22102,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,4432.0,2880.8,1.1,12214.27,50
HCPCS,22102,REMOVE PART LUMBAR VERTEBRA,,,6600.66,20338.07,19
HCPCS,22102,Remove part lumbar vertebra,,,3026.0,3503.79,8
HCPCS,22103,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,936.0,608.4,1.1,936.0,50
HCPCS,22103,Remove extra spine segment,,,3026.0,3503.79,8
HCPCS,22110,REMOVE PART OF NECK VERTEBRA,,,6864.94,20338.07,13
HCPCS,22110,Remove part of neck vertebra,,,7403.35,8572.3,8
HCPCS,22112,REMOVE PART THORAX VERTEBRA,,,6864.94,20338.07,13
HCPCS,22112,Remove part thorax vertebra,,,7403.35,8572.3,8
HCPCS,22114,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,5628.0,3658.2,1.1,5628.0,50
HCPCS,22114,REMOVE PART LUMBAR VERTEBRA,,,6864.94,20338.07,13
HCPCS,22114,Remove part lumbar vertebra,,,7403.35,8572.3,8
HCPCS,22116,Remove extra spine segment,,,7403.35,8572.3,8
HCPCS,22206,INCIS SPINE 3 COLUMN THORAC,,,6864.94,20338.07,13
HCPCS,22206,Incis spine 3 column thorac,,,3026.0,3503.79,8
HCPCS,22207,INCIS SPINE 3 COLUMN LUMBAR,,,6864.94,20338.07,13
HCPCS,22207,Incis spine 3 column lumbar,,,3026.0,3503.79,8
HCPCS,22207,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,14672.0,9536.8,1.1,14672.0,50
HCPCS,22208,Incis spine 3 column adl seg,,,3026.0,3503.79,8
HCPCS,22210,INCIS 1 VERTEBRAL SEG CERV,,,6864.94,20338.07,13
HCPCS,22210,Incis 1 vertebral seg cerv,,,3026.0,3503.79,8
HCPCS,22210,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,10152.0,6598.8,1.1,10152.0,50
HCPCS,22212,INCIS 1 VERTEBRAL SEG THORAC,,,6864.94,20338.07,13
HCPCS,22212,Incis 1 vertebral seg thorac,,,3026.0,3503.79,8
HCPCS,22212,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,8396.0,5457.4,1.1,8396.0,50
HCPCS,22214,INCIS 1 VERTEBRAL SEG LUMBAR,,,6864.94,20338.07,13
HCPCS,22214,Incis 1 vertebral seg lumbar,,,3026.0,3503.79,8
HCPCS,22214,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,8408.0,5465.2,1.1,8408.0,50
HCPCS,22216,Incis addl spine segment,,,7403.35,8572.3,8
HCPCS,22216,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,2653.0,1724.45,1.1,2653.0,50
HCPCS,22220,OSTEOT DSC ANT 1 VRT SGM CRV,,,6864.94,20338.07,13
HCPCS,22220,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV,9176.0,5964.4,1.1,9176.0,50
HCPCS,22220,Osteot dsc ant 1 vrt sgm crv,,,3026.0,3503.79,8
HCPCS,22222,OSTEOT DSC ANT 1VRT SGM THRC,,,6864.94,20338.07,13
HCPCS,22222,Osteot dsc ant 1vrt sgm thrc,,,3026.0,3503.79,8
HCPCS,22224,OSTEOT DSC ANT 1VRT SGM LMBR,,,6864.94,20338.07,13
HCPCS,22224,Osteot dsc ant 1vrt sgm lmbr,,,3026.0,3503.79,8
HCPCS,22226,Osteot dsc ant 1vrt sgm ea,,,3026.0,3503.79,8
HCPCS,22310,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1241.5,806.975,0.01,3004.0,175
HCPCS,22315,CLOSED TX VERT FX W/MANJ,,,2997.95,9170.92,19
HCPCS,22315,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,4044.0,2628.6,1.1,5526.53,53
HCPCS,22315,Closed tx vert fx w/manj,,,234.24,271.23,8
HCPCS,22318,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,9088.0,5907.2,1.1,9088.0,50
HCPCS,22318,TREAT ODONTOID FX W/O GRAFT,,,12146.38,35984.87,13
HCPCS,22318,Treat odontoid fx w/o graft,,,7403.35,8572.3,8
HCPCS,22319,TREAT ODONTOID FX W/GRAFT,,,12146.38,35984.87,13
HCPCS,22319,Treat odontoid fx w/graft,,,7403.35,8572.3,8
HCPCS,22325,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,7948.0,5166.2,1.1,7948.0,50
HCPCS,22325,TREAT SPINE FRACTURE,,,12146.38,35984.87,13
HCPCS,22325,Treat spine fracture,,,7403.35,8572.3,8
HCPCS,22326,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,8336.0,5418.4,1.1,8336.0,50
HCPCS,22326,TREAT NECK SPINE FRACTURE,,,12146.38,35984.87,13
HCPCS,22326,Treat neck spine fracture,,,7403.35,8572.3,8
HCPCS,22327,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,8308.0,5400.2,1.1,8308.0,50
HCPCS,22327,TREAT THORAX SPINE FRACTURE,,,12146.38,35984.87,13
HCPCS,22327,Treat thorax spine fracture,,,7403.35,8572.3,8
HCPCS,22328,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,1840.0,1196.0,1.1,1840.0,50
HCPCS,22328,Treat each add spine fx,,,7403.35,8572.3,8
HCPCS,22505,MANIPULATION OF SPINE,,,1478.75,4506.96,19
HCPCS,22505,Manipulation of spine,,,654.6,757.96,8
HCPCS,22510,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,9042.5,5877.625,1.1,14925.0,175
HCPCS,22511,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,8928.5,5803.525,1.1,14925.0,175
HCPCS,22512,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,3050.5,1982.825,1.1,4501.0,145
HCPCS,22513,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,29447.0,19140.55,0.01,32861.0,236
HCPCS,22514,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,18028.5,11718.525000000001,0.01,32861.0,236
HCPCS,22515,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,6348.5,4126.525,0.01,10937.0,145
HCPCS,22526,Idet single level,,,3026.0,3503.79,8
HCPCS,22526,"PERC INTRADISC ELECTRO ANNULOPLASTY, SINGLE LEVEL",2340.0,1521.0,1.1,6472.18,42
HCPCS,22527,Idet 1 or more levels,,,3026.0,3503.79,8
HCPCS,22527,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,1212.0,787.8,1.1,5305.19,42
HCPCS,22532,ARTHRD LAT XTRCVTRY TQ THRC,,,12146.38,35984.87,13
HCPCS,22532,Arthrd lat xtrcvtry tq thrc,,,11158.03,12919.82,8
HCPCS,22533,ARTHRD LAT XTRCVTRY TQ LMBR,,,16588.34,49144.62,13
HCPCS,22533,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,9916.0,6445.4,1.1,9916.0,50
HCPCS,22533,Arthrd lat xtrcvtry tq lmbr,,,11158.03,12919.82,8
HCPCS,22534,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,2396.0,1557.4,1.1,2396.0,50
HCPCS,22534,Arthrd lat xtrcvtry tq ea ad,,,11158.03,12919.82,8
HCPCS,22548,ARTHRD ANT TORAL/XORAL C1-C2,,,12146.38,35984.87,13
HCPCS,22548,Arthrd ant toral/xoral c1-c2,,,11158.03,12919.82,8
HCPCS,22551,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,11000.0,7150.0,1.1,22471.68,50
HCPCS,22551,ARTHRD ANT NTRBDY CERVICAL,,,9608.0,35984.87,20
HCPCS,22551,Arthrd ant ntrbdy cervical,,,7403.35,8572.3,8
HCPCS,22552,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,2600.0,1690.0,1.1,2600.0,50
HCPCS,22552,Arthrd ant ntrbd cervical ea,,,7403.35,8572.3,8
HCPCS,22554,ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2,7784.0,5059.6,1.1,22471.68,50
HCPCS,22554,ARTHRD ANT NTRBD MIN DSC CRV,,,11888.68,35984.87,19
HCPCS,22554,Arthrd ant ntrbd min dsc crv,,,7403.35,8572.3,8
HCPCS,22556,ARTHRD ANT INTERBODY MIN DSC THORACIC,9880.0,6422.0,1.1,9880.0,50
HCPCS,22556,ARTHRD ANT NTRBD MIN DSC THC,,,16588.34,49144.62,13
HCPCS,22556,Arthrd ant ntrbd min dsc thc,,,11158.03,12919.82,8
HCPCS,22558,ARTHRD ANT INTERBODY MIN DSC LUMBAR,10353.0,6729.45,1.1,10353.0,50
HCPCS,22558,ARTHRD ANT NTRBD MIN DSC LUM,,,25670.88,76052.54,13
HCPCS,22558,Arthrd ant ntrbd min dsc lum,,,7403.35,8572.3,8
HCPCS,22585,ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE,2429.0,1578.85,1.1,2429.0,50
HCPCS,22585,Arthrd ant ntrbd min dsc ea,,,7403.35,8572.3,8
HCPCS,22586,ARTHRD PRE-SAC NTRBDY L5-S1,,,16588.34,49144.62,13
HCPCS,22586,Arthrd pre-sac ntrbdy l5-s1,,,7403.35,8572.3,8
HCPCS,22590,ARTHRD PST TQ CRANIOCERVICAL,,,12146.38,35984.87,13
HCPCS,22590,ARTHRODESIS POSTERIOR CRANIOCERVICAL,8704.0,5657.6,1.1,8704.0,50
HCPCS,22590,Arthrd pst tq craniocervical,,,11158.03,12919.82,8
HCPCS,22595,ARTHRD PST TQ ATLAS-AXIS,,,12146.38,35984.87,13
HCPCS,22595,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,8256.0,5366.4,1.1,8256.0,50
HCPCS,22595,Arthrd pst tq atlas-axis,,,11158.03,12919.82,8
HCPCS,22600,ARTHRD PST TQ 1NTRSPC CRV,,,16588.34,49144.62,13
HCPCS,22600,ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT,6960.0,4524.0,1.1,6960.0,50
HCPCS,22600,Arthrd pst tq 1ntrspc crv,,,7403.35,8572.3,8
HCPCS,22610,ARTHRD PST TQ 1NTRSPC THRC,,,16588.34,49144.62,13
HCPCS,22610,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC,7603.0,4941.95,1.1,7603.0,50
HCPCS,22610,Arthrd pst tq 1ntrspc thrc,,,11158.03,12919.82,8
HCPCS,22612,ARTHRD PST TQ 1NTRSPC LUMBAR,,,16588.34,49144.62,19
HCPCS,22612,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR,10353.0,6729.45,1.1,31818.75,50
HCPCS,22612,Arthrd pst tq 1ntrspc lumbar,,,7403.35,8572.3,8
HCPCS,22614,ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC,2829.0,1838.85,1.1,2829.0,50
HCPCS,22614,Arthrd pst tq 1ntrspc ea add,,,7403.35,8572.3,8
HCPCS,22630,ARTHRD PST TQ 1NTRSPC LUM,,,16992.04,76052.54,19
HCPCS,22630,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR,9720.0,6318.0,1.1,31818.75,50
HCPCS,22630,Arthrd pst tq 1ntrspc lum,,,7403.35,8572.3,8
HCPCS,22632,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL,2297.0,1493.05,1.1,2297.0,50
HCPCS,22632,Arthrd pst tq 1ntrspc lm ea,,,7403.35,8572.3,8
HCPCS,22633,ARTHRD CMBN 1NTRSPC LUMBAR,,,16992.04,76052.54,19
HCPCS,22633,ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR,11792.0,7664.8,1.1,31818.75,50
HCPCS,22633,Arthrd cmbn 1ntrspc lumbar,,,11158.03,12919.82,8
HCPCS,22634,ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL,3502.0,2276.3,1.1,3502.0,50
HCPCS,22634,Arthrd cmbn 1ntrspc ea addl,,,7403.35,8572.3,8
HCPCS,22800,ARTHRD PST DFRM<6 VRT SGM,,,16588.34,49144.62,13
HCPCS,22800,ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM,8580.0,5577.0,1.1,8580.0,50
HCPCS,22800,Arthrd pst dfrm<6 vrt sgm,,,11158.03,12919.82,8
HCPCS,22802,ARTHRD PST DFRM 7-12 VRT SGM,,,16588.34,49144.62,13
HCPCS,22802,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM,14128.0,9183.2,1.1,14128.0,50
HCPCS,22802,Arthrd pst dfrm 7-12 vrt sgm,,,11158.03,12919.82,8
HCPCS,22804,ARTHRD PST DFRM 13+ VRT SGM,,,16588.34,49144.62,13
HCPCS,22804,Arthrd pst dfrm 13+ vrt sgm,,,11158.03,12919.82,8
HCPCS,22808,ARTHRD ANT DFRM 2-3 VRT SGM,,,16588.34,49144.62,13
HCPCS,22808,Arthrd ant dfrm 2-3 vrt sgm,,,11158.03,12919.82,8
HCPCS,22810,ARTHRD ANT DFRM 4-7 VRT SGM,,,16588.34,49144.62,13
HCPCS,22810,Arthrd ant dfrm 4-7 vrt sgm,,,11158.03,12919.82,8
HCPCS,22812,ARTHRD ANT DFRM 8+ VRT SGM,,,16588.34,49144.62,13
HCPCS,22812,Arthrd ant dfrm 8+ vrt sgm,,,11158.03,12919.82,8
HCPCS,22818,KYPHECTOMY 1-2 SEGMENTS,,,16588.34,49144.62,13
HCPCS,22818,Kyphectomy 1-2 segments,,,11158.03,12919.82,8
HCPCS,22819,KYPHECTOMY 3 OR MORE,,,16588.34,49144.62,13
HCPCS,22819,Kyphectomy 3 or more,,,11158.03,12919.82,8
HCPCS,22830,EXPLORATION OF SPINAL FUSION,4937.0,3209.05,1.1,20338.07,63
HCPCS,22830,Exploration of spinal fusion,,,3026.0,3503.79,8
HCPCS,22836,ANT THORACIC VRT BODY TETHERING <7 VRT SEGMENTS,14080.0,9152.0,1.1,14080.0,50
HCPCS,22836,ANT THRC VRT BODY TETHRG <7,,,16588.34,49144.62,13
HCPCS,22836,Ant thrc vrt body tethrg <7,,,11158.03,12919.82,8
HCPCS,22837,ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS,15620.0,10153.0,1.1,15620.0,50
HCPCS,22837,ANT THRC VRT BODY TETHRG 8+,,,16588.34,49144.62,13
HCPCS,22837,Ant thrc vrt body tethrg 8+,,,11158.03,12919.82,8
HCPCS,22838,REV RPLC/RMV THRC VRT TETHRG,,,16588.34,49144.62,13
HCPCS,22838,REVJ RPLCMT/RMVL THORACIC VRT BODY TETHERING,15840.0,10296.0,1.1,15840.0,50
HCPCS,22838,Rev rplc/rmv thrc vrt tethrg,,,11158.03,12919.82,8
HCPCS,22840,Insert spine fixation device,,,11158.03,12919.82,8
HCPCS,22840,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,5509.0,3580.85,1.1,5509.0,50
HCPCS,22841,Insert spine fixation device,,,7403.35,8572.3,8
HCPCS,22842,Insert spine fixation device,,,7403.35,8572.3,8
HCPCS,22842,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,5526.0,3591.9,1.1,5526.0,50
HCPCS,22843,Insert spine fixation device,,,7403.35,8572.3,8
HCPCS,22843,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,5914.0,3844.1,1.1,5914.0,50
HCPCS,22844,Insert spine fixation device,,,7403.35,8572.3,8
HCPCS,22844,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,7225.0,4696.25,1.1,7225.0,50
HCPCS,22845,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,5254.0,3415.1,1.1,5254.0,50
HCPCS,22845,Insert spine fixation device,,,7403.35,8572.3,8
HCPCS,22846,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,5456.0,3546.4,1.1,5456.0,50
HCPCS,22846,Insert spine fixation device,,,11158.03,12919.82,8
HCPCS,22847,Insert spine fixation device,,,11158.03,12919.82,8
HCPCS,22848,Insert pelv fixation device,,,3026.0,3503.79,8
HCPCS,22848,PELVIC FIXATION OTHER THAN SACRUM,2636.0,1713.4,1.1,2636.0,50
HCPCS,22849,REINSERT SPINAL FIXATION,,,12146.38,35984.87,13
HCPCS,22849,REINSERTION SPINAL FIXATION DEVICE,8435.0,5482.75,1.1,8435.0,50
HCPCS,22849,Reinsert spinal fixation,,,7403.35,8572.3,8
HCPCS,22850,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,3928.0,2553.2,1.1,3928.0,50
HCPCS,22850,REMOVE SPINE FIXATION DEVICE,,,6864.94,20338.07,13
HCPCS,22850,Remove spine fixation device,,,3026.0,3503.79,8
HCPCS,22852,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,3748.0,2436.2,1.1,3748.0,50
HCPCS,22852,REMOVE SPINE FIXATION DEVICE,,,6864.94,20338.07,13
HCPCS,22852,Remove spine fixation device,,,3026.0,3503.79,8
HCPCS,22853,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD,1870.0,1215.5,1.1,1870.0,50
HCPCS,22853,INSJ BIOMECHANICAL DEVICE,,,3398.0,3398.0,1
HCPCS,22853,Insj biomechanical device,,,7403.35,8572.3,8
HCPCS,22854,INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD,2420.0,1573.0,1.1,2420.0,50
HCPCS,22854,Insj biomechanical device,,,11158.03,12919.82,8
HCPCS,22855,REMOVAL ANTERIOR INSTRMJ,,,6864.94,20338.07,13
HCPCS,22855,REMOVAL ANTERIOR INSTRUMENTATION,6978.0,4535.7,1.1,6978.0,50
HCPCS,22855,Removal anterior instrmj,,,3026.0,3503.79,8
HCPCS,22856,TOT DISC ARTHRP 1NTRSPC CRV,,,16588.34,49144.62,19
HCPCS,22856,TOTAL DISC ARTHRP ANT DSC 1 INTERSPACE CERVICAL,10582.0,6878.3,1.1,31818.75,50
HCPCS,22856,Tot disc arthrp 1ntrspc crv,,,11158.03,12919.82,8
HCPCS,22857,TOT DISC ARTHRP 1NTRSPC LMBR,,,16588.34,49144.62,13
HCPCS,22857,TOT DISC ARTHRP ANT DSC SINGLE INTERSPACE LUMBAR,10852.0,7053.8,1.1,10852.0,50
HCPCS,22857,Tot disc arthrp 1ntrspc lmbr,,,7403.35,8572.3,8
HCPCS,22858,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,3360.0,2184.0,1.1,3360.0,50
HCPCS,22858,Tot disc arthrp 2nd lvl crv,,,11158.03,12919.82,8
HCPCS,22859,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD,2420.0,1573.0,1.1,2420.0,50
HCPCS,22859,Insj biomechanical device,,,7403.35,8572.3,8
HCPCS,22860,TOTAL DISC ARTHRP ANT SECOND INTERSPACE LUMBAR,2752.0,1788.8,1.1,2752.0,44
HCPCS,22860,Tot disc arthrp 2ntrspc lmbr,,,7403.35,8572.3,8
HCPCS,22861,REV RPLCM ARTHRP 1NTRSPC CRV,,,16588.34,49144.62,13
HCPCS,22861,Rev rplcm arthrp 1ntrspc crv,,,7403.35,8572.3,8
HCPCS,22862,REV RPLCM RTHRP 1NTRSPC LMBR,,,16588.34,49144.62,13
HCPCS,22862,Rev rplcm rthrp 1ntrspc lmbr,,,7403.35,8572.3,8
HCPCS,22864,RMVL TOT ARTHRP 1NTRSPC CRV,,,6864.94,20338.07,13
HCPCS,22864,Rmvl tot arthrp 1ntrspc crv,,,7403.35,8572.3,8
HCPCS,22865,RMVL TOT ARTHRP 1NTRSPC LMBR,,,6864.94,20338.07,13
HCPCS,22865,Rmvl tot arthrp 1ntrspc lmbr,,,7403.35,8572.3,8
HCPCS,22867,INSJ STABLJ DEV W/DCMPRN,,,16588.34,49144.62,19
HCPCS,22867,Insj stablj dev w/dcmprn,,,11158.03,12919.82,8
HCPCS,22868,Insj stablj dev w/dcmprn,,,11158.03,12919.82,8
HCPCS,22869,INSJ STABLJ DEV W/O DCMPRN,,,11888.68,35984.87,19
HCPCS,22869,Insj stablj dev w/o dcmprn,,,7403.35,8572.3,8
HCPCS,22870,Insj stablj dev w/o dcmprn,,,7403.35,8572.3,8
HCPCS,22899,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,8084.5,5254.925,0.01,13324.0,89
HCPCS,22899,UNLISTED SPINE SURGERY OR PROCEDURE,601.0,390.65,0.01,601.0,28
HCPCS,22900,EXC ABDL TUM DEEP < 5 CM,,,2644.48,8141.48,19
HCPCS,22900,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,3328.0,2163.2,1.1,4850.94,50
HCPCS,22900,Exc abdl tum deep < 5 cm,,,1072.58,1241.93,8
HCPCS,22900,REMOVE ABDOMINAL WALL LESION,1430.0,929.5,1.1,4850.94,50
HCPCS,22901,EXC ABDL TUM DEEP 5 CM/>,,,2644.48,8141.48,19
HCPCS,22901,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,4044.0,2628.6,1.1,4850.94,50
HCPCS,22901,EXCISE TUMOR ABDOML WALL 5CM OR >,1449.0,941.85,1.1,4850.94,50
HCPCS,22901,Exc abdl tum deep 5 cm/>,,,1072.58,1241.93,8
HCPCS,22902,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,4610.5,2996.825,0.01,7453.0,114
HCPCS,22902,EXCISE TUMOR ABD WALL <3CM,723.0,469.95,1.1,2768.64,53
HCPCS,22903,EXC ABD LES SC 3 CM/>,,,2644.48,8141.48,19
HCPCS,22903,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,2556.0,1661.4,1.1,4850.94,50
HCPCS,22903,EXCISE TUMOR ABD WALL 3CM OR >,955.0,620.75,1.1,4850.94,50
HCPCS,22903,Exc abd les sc 3 cm/>,,,1072.58,1241.93,8
HCPCS,22904,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,6676.0,4339.4,1.1,6676.0,50
HCPCS,22904,RADICAL RESECT ABD TUMOR<5CM,,,2644.48,8141.48,19
HCPCS,22904,Radical resect abd tumor<5cm,,,1072.58,1241.93,8
HCPCS,22905,RAD RESECT ABD TUMOR 5 CM/>,,,2644.48,8141.48,19
HCPCS,22905,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,8632.0,5610.8,1.1,8632.0,50
HCPCS,22905,Rad resect abd tumor 5 cm/>,,,1072.58,1241.93,8
HCPCS,22999,ABDOMEN WALL SURG PROC UNLISTED,4052.0,2633.8,0.01,4052.0,28
HCPCS,22999,ABDOMINAL FAT PAD BIOPSY,2008.0,1305.2,0.01,3004.0,61
HCPCS,22999,EXPLORATORY OF ABDOMEN (COMP CODE 20102),1592.0,1034.8,0.01,1592.0,28
HCPCS,22999,REMOVAL OF MESH ABD WALL (COMP 20680),2457.0,1597.05,0.01,2457.0,28
HCPCS,23000,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,1792.0,1164.8,1.1,4850.94,53
HCPCS,23000,RMVL SBDLTD CLCREOUS DEP OPN,,,2644.48,8141.48,19
HCPCS,23000,Rmvl sbdltd clcreous dep opn,,,1072.58,1241.93,8
HCPCS,23020,CAPSULAR CONTRACTURE RELEASE,3744.0,2433.6,1.1,9170.92,69
HCPCS,23020,Capsular contracture release,,,2599.83,3010.33,8
HCPCS,23030,I&D SHOULDER DEEP ABSC/HMTMA,,,2644.48,8141.48,19
HCPCS,23030,I&D SHOULDER DEEP ABSCESS/HEMATOMA,1388.0,902.2,1.1,4850.94,53
HCPCS,23030,I&d shoulder deep absc/hmtma,,,1072.58,1241.93,8
HCPCS,23031,I&D SHOULDER INFECTED BURSA,,,2644.48,8141.48,19
HCPCS,23031,I&d shoulder infected bursa,,,1072.58,1241.93,8
HCPCS,23035,INCISION BONE CORTEX SHO,,,1478.75,4506.96,19
HCPCS,23035,INCISION BONE CORTEX SHOULDER AREA,3664.0,2381.6,1.1,3664.0,50
HCPCS,23035,Incision bone cortex sho,,,2599.83,3010.33,8
HCPCS,23040,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,4290.0,2788.5,1.1,5526.53,50
HCPCS,23040,ARTHRT GH JT EXPL/DRG/RMV FB,,,2997.95,9170.92,19
HCPCS,23040,Arthrt gh jt expl/drg/rmv fb,,,2599.83,3010.33,8
HCPCS,23044,ARTHRT AC SC JT EXP/RMVL FB,,,2997.95,9170.92,19
HCPCS,23044,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,3036.0,1973.4,1.1,5526.53,50
HCPCS,23044,Arthrt ac sc jt exp/rmvl fb,,,2599.83,3010.33,8
HCPCS,23065,BIOPSY SHOULDER TISSUES,,,1497.07,4629.18,19
HCPCS,23065,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,920.0,598.0,1.1,2768.64,53
HCPCS,23065,Biopsy shoulder tissues,,,1072.58,1241.93,8
HCPCS,23066,BIOPSY SHOULDER TISSUES,,,2644.48,8141.48,19
HCPCS,23066,BIOPSY SOFT TISSUE SHOULDER DEEP,1720.0,1118.0,1.1,4850.94,53
HCPCS,23066,Biopsy shoulder tissues,,,1072.58,1241.93,8
HCPCS,23071,EXCISE TUMOR SHOULDER AREA 3CM OR >,908.0,590.2,1.1,2768.64,50
HCPCS,23071,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,7453.0,4844.45,0.01,7453.0,61
HCPCS,23071,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,2364.0,1536.6,1.1,2768.64,50
HCPCS,23073,EXC SHOULDER TUM DEEP 5 CM/>,,,2644.48,8141.48,19
HCPCS,23073,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,4052.0,2633.8,1.1,4850.94,50
HCPCS,23073,EXCISE TUMOR SHOULDER AREA 5CM OR >,1505.0,978.25,1.1,4850.94,50
HCPCS,23073,Exc shoulder tum deep 5 cm/>,,,1072.58,1241.93,8
HCPCS,23075,EXC SHOULDER LES SC < 3 CM,,,1497.07,4629.18,19
HCPCS,23075,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,1684.0,1094.6,1.1,2768.64,53
HCPCS,23075,Exc shoulder les sc < 3 cm,,,1072.58,1241.93,8
HCPCS,23075,REMOVAL OF SHOULDER LESION,578.0,375.7,1.1,2768.64,53
HCPCS,23076,EXC SHOULDER TUM DEEP < 5 CM,,,2644.48,8141.48,19
HCPCS,23076,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,2964.0,1926.6,1.1,4850.94,50
HCPCS,23076,Exc shoulder tum deep < 5 cm,,,1072.58,1241.93,8
HCPCS,23076,REMOVAL OF SHOULDER LESION,1156.0,751.4,1.1,4850.94,50
HCPCS,23077,RAD RESCJ TUM SHOULDER<5 CM,,,2644.48,8141.48,19
HCPCS,23077,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,7064.0,4591.6,1.1,7064.0,50
HCPCS,23077,Rad rescj tum shoulder<5 cm,,,2599.83,3010.33,8
HCPCS,23078,RAD RESCJ TUM SHOULDER 5CM/>,,,2644.48,8141.48,19
HCPCS,23078,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,9020.0,5863.0,1.1,9020.0,50
HCPCS,23078,Rad rescj tum shoulder 5cm/>,,,2599.83,3010.33,8
HCPCS,23100,ARTHROTOMY GLENHUMRL JT W/BX,,,2997.95,9170.92,19
HCPCS,23100,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,2480.0,1612.0,1.1,5526.53,50
HCPCS,23100,Arthrotomy glenhumrl jt w/bx,,,2599.83,3010.33,8
HCPCS,23101,ARTHRT ACRMCLV/STRNCLAV JT,,,2997.95,9170.92,19
HCPCS,23101,Arthrt acrmclv/strnclav jt,,,2599.83,3010.33,8
HCPCS,23105,ARTHROTOMY GLENOHUMERAL JT,,,6600.66,20338.07,19
HCPCS,23105,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,3392.0,2204.8,1.1,12214.27,50
HCPCS,23105,Arthrotomy glenohumeral jt,,,2599.83,3010.33,8
HCPCS,23106,ARTHROTOMY STRNCLAV JOINT,,,2997.95,9170.92,19
HCPCS,23106,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,2452.0,1593.8,1.1,5526.53,50
HCPCS,23106,Arthrotomy strnclav joint,,,2599.83,3010.33,8
HCPCS,23107,ARTHRT GLENHUMRL JT W/EXPL,,,6600.66,20338.07,19
HCPCS,23107,Arthrt glenhumrl jt w/expl,,,2599.83,3010.33,8
HCPCS,23120,CLAVICULECTOMY PARTIAL,3252.0,2113.8,1.1,9170.92,69
HCPCS,23120,Claviculectomy partial,,,2599.83,3010.33,8
HCPCS,23125,CLAVICULECTOMY TOTAL,,,2997.95,9170.92,19
HCPCS,23125,Claviculectomy total,,,2599.83,3010.33,8
HCPCS,23130,ACROMP/ACROMIONECTOMY PRTL,,,2997.95,9170.92,19
HCPCS,23130,Acromp/acromionectomy prtl,,,2599.83,3010.33,8
HCPCS,23130,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,3419.0,2222.35,1.1,5526.53,50
HCPCS,23140,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,2848.0,1851.2,1.1,5526.53,50
HCPCS,23140,REMOVAL OF BONE LESION,,,2997.95,9170.92,19
HCPCS,23140,Removal of bone lesion,,,2599.83,3010.33,8
HCPCS,23145,REMOVAL OF BONE LESION,,,2997.95,9170.92,19
HCPCS,23145,Removal of bone lesion,,,2599.83,3010.33,8
HCPCS,23146,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,3232.0,2100.8,1.1,12214.27,50
HCPCS,23146,REMOVAL OF BONE LESION,,,6600.66,20338.07,19
HCPCS,23146,Removal of bone lesion,,,2599.83,3010.33,8
HCPCS,23150,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,3564.0,2316.6,1.1,5526.53,50
HCPCS,23150,REMOVAL OF HUMERUS LESION,,,2997.95,9170.92,19
HCPCS,23150,Removal of humerus lesion,,,2599.83,3010.33,8
HCPCS,23155,REMOVAL OF HUMERUS LESION,,,6600.66,20338.07,19
HCPCS,23155,Removal of humerus lesion,,,2599.83,3010.33,8
HCPCS,23156,REMOVAL OF HUMERUS LESION,,,6600.66,20338.07,19
HCPCS,23156,Removal of humerus lesion,,,2599.83,3010.33,8
HCPCS,23170,SEQUESTRECTOMY CLAVICLE,,,2997.95,9170.92,19
HCPCS,23170,Sequestrectomy clavicle,,,2599.83,3010.33,8
HCPCS,23172,SEQUESTRECTOMY SCAPULA,,,2997.95,9170.92,19
HCPCS,23172,Sequestrectomy scapula,,,2599.83,3010.33,8
HCPCS,23174,SQSTRCTMY HUMRL HEAD SRG NCK,,,6600.66,20338.07,19
HCPCS,23174,Sqstrctmy humrl head srg nck,,,2599.83,3010.33,8
HCPCS,23180,PRTL EXCISION BONE CLAVICLE,,,6600.66,20338.07,19
HCPCS,23180,Prtl excision bone clavicle,,,2599.83,3010.33,8
HCPCS,23182,PARTIAL EXCISION BONE SCAPULA,3444.0,2238.6,1.1,12214.27,50
HCPCS,23182,PRTL EXCISION BONE SCAPULA,,,6600.66,20338.07,19
HCPCS,23182,Prtl excision bone scapula,,,2599.83,3010.33,8
HCPCS,23184,PARTIAL EXCISION BONE PROXIMAL HUMERUS,3960.0,2574.0,1.1,12214.27,50
HCPCS,23184,PRTL EXCISION BONE PROX HUM,,,6600.66,20338.07,19
HCPCS,23184,Prtl excision bone prox hum,,,2599.83,3010.33,8
HCPCS,23190,OSTECTOMY SCAPULA PARTIAL,2988.0,1942.2,1.1,9170.92,69
HCPCS,23190,Ostectomy scapula partial,,,2599.83,3010.33,8
HCPCS,23195,RESECTION HUMERAL HEAD,4144.0,2693.6,1.1,20338.07,69
HCPCS,23195,Resection humeral head,,,2599.83,3010.33,8
HCPCS,23200,RADICAL RESCJ TUMOR CLAVICLE,,,6864.94,20338.07,13
HCPCS,23200,Radical rescj tumor clavicle,,,2599.83,3010.33,8
HCPCS,23210,RAD RESECT SCAPULA FOR TUMOR,10884.0,7074.6,1.1,10884.0,50
HCPCS,23210,RADICAL RESCJ TUMOR SCAPULA,,,6864.94,20338.07,13
HCPCS,23210,Radical rescj tumor scapula,,,2599.83,3010.33,8
HCPCS,23220,RADICAL RESCJ TUMOR PROX HUM,,,6864.94,20338.07,13
HCPCS,23220,Radical rescj tumor prox hum,,,2599.83,3010.33,8
HCPCS,23330,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,4106.5,2669.225,1.1,7453.0,114
HCPCS,23333,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,2400.0,1560.0,1.1,4850.94,50
HCPCS,23333,REMOVE SHOULDER FB DEEP,,,2644.48,8141.48,19
HCPCS,23333,Remove shoulder fb deep,,,1072.58,1241.93,8
HCPCS,23334,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,6200.0,4030.0,1.1,6200.0,50
HCPCS,23334,SHOULDER PROSTHESIS REMOVAL,,,2644.48,20338.07,19
HCPCS,23334,Shoulder prosthesis removal,,,2599.83,3010.33,8
HCPCS,23335,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,7600.0,4940.0,1.1,7600.0,50
HCPCS,23335,SHOULDER PROSTHESIS REMOVAL,,,6864.94,20338.07,13
HCPCS,23335,Shoulder prosthesis removal,,,2599.83,3010.33,8
HCPCS,23350,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,580.5,377.325,0.01,3398.0,191
HCPCS,23395,MUSCLE TRANSFER SHOULDER/ARM,,,6600.66,20338.07,19
HCPCS,23395,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,7416.0,4820.4,1.1,12214.27,50
HCPCS,23395,Muscle transfer shoulder/arm,,,2599.83,3010.33,8
HCPCS,23397,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,6704.0,4357.6,1.1,12214.27,50
HCPCS,23397,MUSCLE TRANSFERS,,,6600.66,20338.07,19
HCPCS,23397,Muscle transfers,,,2599.83,3010.33,8
HCPCS,23400,FIXATION OF SHOULDER BLADE,,,6600.66,20338.07,19
HCPCS,23400,Fixation of shoulder blade,,,2599.83,3010.33,8
HCPCS,23400,SCAPULOPEXY,5548.0,3606.2,1.1,12214.27,50
HCPCS,23405,TENOTOMY SHOULDER AREA 1 TENDON,18138.5,11790.025000000001,0.01,32861.0,111
HCPCS,23406,INCISE TENDON(S) & MUSCLE(S),,,6600.66,20338.07,19
HCPCS,23406,Incise tendon(s) & muscle(s),,,2599.83,3010.33,8
HCPCS,23406,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,4404.0,2862.6,1.1,12214.27,50
HCPCS,23410,OPEN REPAIR OF ROTATOR CUFF ACUTE,4556.0,2961.4,1.1,12214.27,50
HCPCS,23410,REPAIR ROTATOR CUFF ACUTE,,,6600.66,20338.07,19
HCPCS,23410,Repair rotator cuff acute,,,2599.83,3010.33,8
HCPCS,23412,OPEN REPAIR OF ROTATOR CUFF CHRONIC,4772.0,3101.8,1.1,12214.27,50
HCPCS,23412,REPAIR ROTATOR CUFF CHRONIC,,,6600.66,20338.07,19
HCPCS,23412,Repair rotator cuff chronic,,,2599.83,3010.33,8
HCPCS,23415,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,3692.0,2399.8,1.1,12214.27,50
HCPCS,23415,RELEASE OF SHOULDER LIGAMENT,,,6600.66,20338.07,19
HCPCS,23415,Release of shoulder ligament,,,2599.83,3010.33,8
HCPCS,23420,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,5416.0,3520.4,1.1,12214.27,50
HCPCS,23420,REPAIR OF SHOULDER,,,6600.66,20338.07,19
HCPCS,23420,Repair of shoulder,,,2599.83,3010.33,8
HCPCS,23430,REPAIR BICEPS TENDON,,,6600.66,20338.07,19
HCPCS,23430,Repair biceps tendon,,,2599.83,3010.33,8
HCPCS,23430,TENODESIS LONG TENDON BICEPS,4068.0,2644.2,1.1,12214.27,50
HCPCS,23440,REMOVE/TRANSPLANT TENDON,,,6600.66,20338.07,19
HCPCS,23440,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,4256.0,2766.4,1.1,12214.27,50
HCPCS,23440,Remove/transplant tendon,,,2599.83,3010.33,8
HCPCS,23450,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,5480.0,3562.0,1.1,12214.27,50
HCPCS,23450,REPAIR SHOULDER CAPSULE,,,6600.66,20338.07,19
HCPCS,23450,Repair shoulder capsule,,,2599.83,3010.33,8
HCPCS,23455,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,5868.0,3814.2,1.1,12214.27,50
HCPCS,23455,REPAIR SHOULDER CAPSULE,,,6600.66,20338.07,19
HCPCS,23455,Repair shoulder capsule,,,2599.83,3010.33,8
HCPCS,23460,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,6961.0,4524.65,1.1,12214.27,50
HCPCS,23460,REPAIR SHOULDER CAPSULE,,,6600.66,20338.07,19
HCPCS,23460,Repair shoulder capsule,,,2599.83,3010.33,8
HCPCS,23462,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,6288.0,4087.2,1.1,12214.27,50
HCPCS,23462,REPAIR SHOULDER CAPSULE,,,6600.66,20338.07,19
HCPCS,23462,Repair shoulder capsule,,,2599.83,3010.33,8
HCPCS,23465,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,6520.0,4238.0,1.1,12214.27,50
HCPCS,23465,REPAIR SHOULDER CAPSULE,,,6600.66,20338.07,19
HCPCS,23465,Repair shoulder capsule,,,2599.83,3010.33,8
HCPCS,23466,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,6952.0,4518.8,1.1,12214.27,50
HCPCS,23466,REPAIR SHOULDER CAPSULE,,,6600.66,20338.07,19
HCPCS,23466,Repair shoulder capsule,,,2599.83,3010.33,8
HCPCS,23470,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,7156.0,4651.4,1.1,22471.68,50
HCPCS,23470,RECONSTRUCT SHOULDER JOINT,,,11888.68,35984.87,19
HCPCS,23470,Reconstruct shoulder joint,,,6256.68,7244.58,8
HCPCS,23472,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,9737.0,6329.05,1.1,31818.75,50
HCPCS,23472,RECONSTRUCT SHOULDER JOINT,,,16588.34,49144.62,19
HCPCS,23472,Reconstruct shoulder joint,,,6256.68,7244.58,8
HCPCS,23473,REVIS RECONST SHOULDER JOINT,,,11888.68,35984.87,19
HCPCS,23473,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,10000.0,6500.0,1.1,22471.68,50
HCPCS,23473,Revis reconst shoulder joint,,,6256.68,7244.58,8
HCPCS,23474,REVIS RECONST SHOULDER JOINT,,,12146.38,35984.87,13
HCPCS,23474,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,10884.0,7074.6,1.1,10884.0,50
HCPCS,23474,Revis reconst shoulder joint,,,6256.68,7244.58,8
HCPCS,23480,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,4616.0,3000.4,1.1,12214.27,50
HCPCS,23480,REVISION OF COLLAR BONE,,,6600.66,20338.07,19
HCPCS,23480,Revision of collar bone,,,2599.83,3010.33,8
HCPCS,23485,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,5564.0,3616.6,1.1,22471.68,50
HCPCS,23485,REVISION OF COLLAR BONE,,,11888.68,35984.87,19
HCPCS,23485,Revision of collar bone,,,5239.24,6066.49,8
HCPCS,23490,REINFORCE CLAVICLE,,,6600.66,20338.07,19
HCPCS,23490,Reinforce clavicle,,,2599.83,3010.33,8
HCPCS,23491,REINFORCE SHOULDER BONES,,,11888.68,35984.87,19
HCPCS,23491,Reinforce shoulder bones,,,2599.83,3010.33,8
HCPCS,23500,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1037.5,674.375,0.01,3004.0,175
HCPCS,23505,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,4447.0,2890.55,1.1,7362.0,114
HCPCS,23515,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,3876.0,2519.4,1.1,12214.27,50
HCPCS,23515,OPTX CLAVICULAR FX W/INT FIX,,,6600.66,20338.07,19
HCPCS,23515,Optx clavicular fx w/int fix,,,2860.13,3311.73,8
HCPCS,23520,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,4139.0,2690.35,1.1,7362.0,114
HCPCS,23525,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,1516.0,985.4,1.1,1516.0,53
HCPCS,23525,CLTX STRNCLAV DISLC W/MNPJ,,,221.64,691.37,19
HCPCS,23525,Cltx strnclav dislc w/mnpj,,,234.24,271.23,8
HCPCS,23530,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,2992.0,1944.8,1.1,12214.27,50
HCPCS,23530,OPTX STRNCLAV DISLC AQT/CHRN,,,6600.66,20338.07,19
HCPCS,23530,Optx strnclav dislc aqt/chrn,,,2860.13,3311.73,8
HCPCS,23532,OPTX STRCLV DSLC AQ/CHRN GRF,,,6600.66,20338.07,19
HCPCS,23532,Optx strclv dslc aq/chrn grf,,,2860.13,3311.73,8
HCPCS,23540,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1023.5,665.2750000000001,1.1,3004.0,114
HCPCS,23545,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1237.5,804.375,1.1,3004.0,114
HCPCS,23550,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,3036.0,1973.4,1.1,12214.27,50
HCPCS,23550,OPTX ACROMCLV DISLC AQT/CHRN,,,6600.66,20338.07,19
HCPCS,23550,Optx acromclv dislc aqt/chrn,,,2860.13,3311.73,8
HCPCS,23552,OPTX ACRCLV DSLC AQ/CHRN GRF,,,6600.66,20338.07,19
HCPCS,23552,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3528.0,2293.2,1.1,12214.27,50
HCPCS,23552,Optx acrclv dslc aq/chrn grf,,,2860.13,3311.73,8
HCPCS,23570,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1023.5,665.2750000000001,0.01,3004.0,175
HCPCS,23575,CLTX SCAP FX W/MNPJ +-TRACTJ,,,1478.75,4506.96,19
HCPCS,23575,Cltx scap fx w/mnpj +-tractj,,,234.24,271.23,8
HCPCS,23585,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,5692.0,3699.8,1.1,12214.27,50
HCPCS,23585,OPTX SCAPULAR FX W/INT FIXJ,,,6600.66,20338.07,19
HCPCS,23585,Optx scapular fx w/int fixj,,,2860.13,3311.73,8
HCPCS,23600,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1151.5,748.475,0.01,3004.0,175
HCPCS,23605,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,4693.0,3050.45,1.1,7362.0,114
HCPCS,23615,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,4920.0,3198.0,1.1,22471.68,50
HCPCS,23615,OPTX PROX HUMRL FX W/INT FIX,,,11888.68,35984.87,19
HCPCS,23615,Optx prox humrl fx w/int fix,,,2860.13,3311.73,8
HCPCS,23616,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,7348.0,4776.2,1.1,31818.75,50
HCPCS,23616,OPTX PRX HMRL FX FIX RPR RPL,,,16588.34,49144.62,19
HCPCS,23616,Optx prx hmrl fx fix rpr rpl,,,2860.13,3311.73,8
HCPCS,23620,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1061.5,689.975,0.01,3004.0,175
HCPCS,23625,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,4501.0,2925.65,1.1,7362.0,114
HCPCS,23630,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,4228.0,2748.2,1.1,12214.27,50
HCPCS,23630,OPTX GR HMRL TBRS FX INT FIX,,,6600.66,20338.07,19
HCPCS,23630,Optx gr hmrl tbrs fx int fix,,,2860.13,3311.73,8
HCPCS,23650,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1328.0,863.2,1.1,3004.0,114
HCPCS,23655,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,4728.0,3073.2,1.1,7362.0,111
HCPCS,23660,OPEN RX ACUTE SHLDR DISLOC,3064.0,1991.6,1.1,12214.27,50
HCPCS,23660,OPTX ACUTE SHOULDER DISLC,,,6600.66,20338.07,19
HCPCS,23660,Optx acute shoulder dislc,,,2860.13,3311.73,8
HCPCS,23665,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,4613.0,2998.45,1.1,7362.0,114
HCPCS,23670,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,4912.0,3192.8,1.1,12214.27,50
HCPCS,23670,OPTX SHO DISLC FX,,,6600.66,20338.07,19
HCPCS,23670,Optx sho dislc fx,,,2860.13,3311.73,8
HCPCS,23675,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,7362.0,4785.3,234.24,7362.0,61
HCPCS,23680,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,5260.0,3419.0,1.1,22471.68,50
HCPCS,23680,OPTX SHO DISLC NECK FX FIXJ,,,11888.68,35984.87,19
HCPCS,23680,Optx sho dislc neck fx fixj,,,2860.13,3311.73,8
HCPCS,23700,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,1028.0,668.2,1.1,2743.55,50
HCPCS,23700,MNPJ ANES SHO JT FIXJ APRATS,,,1478.75,4506.96,19
HCPCS,23700,Mnpj anes sho jt fixj aprats,,,654.6,757.96,8
HCPCS,23800,ARTHRODESIS GLENOHUMERAL JOINT,5892.0,3829.8,1.1,12214.27,50
HCPCS,23800,ARTHRODESIS GLENOHUMERAL JT,,,6600.66,20338.07,19
HCPCS,23800,Arthrodesis glenohumeral jt,,,2599.83,3010.33,8
HCPCS,23802,ARTHRD GLENOHUMERAL JT W/GRF,,,11888.68,35984.87,19
HCPCS,23802,Arthrd glenohumeral jt w/grf,,,5239.24,6066.49,8
HCPCS,23900,INTERTHORACOSCAPULAR AMPUTATION,8288.0,5387.2,1.1,8288.0,50
HCPCS,23900,INTERTHORACOSCPLR AMPUTATION,,,12146.38,35984.87,13
HCPCS,23900,Interthoracoscplr amputation,,,5239.24,6066.49,8
HCPCS,23920,DISARTICULATION SHOULDER,6492.0,4219.8,1.1,35984.87,63
HCPCS,23920,Disarticulation shoulder,,,5239.24,6066.49,8
HCPCS,23921,DISARTICULATION SHO SEC CLSR,,,1690.17,5783.06,19
HCPCS,23921,Disarticulation sho sec clsr,,,1072.58,1241.93,8
HCPCS,23929,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),18160.5,11804.325,0.01,32861.0,89
HCPCS,23929,"UNLISTED PROC, OPEN POSTERIOR REMPLISSAGE PROC (COMP TO 23465)",1542.0,1002.3,0.01,1542.0,28
HCPCS,23929,UNLISTED PROC; OPEN REMPLISSATE PROC (COMP TO 23410),3801.0,2470.65,0.01,3801.0,28
HCPCS,23929,UNLISTED PROC; OPEN TENODESIS OF SHORT HEAD OF THE BICEPS TENDON,1542.0,1002.3,0.01,1542.0,28
HCPCS,23929,"UNLISTED PROCEDURE, SHOULDER COMPARED TO CPT 23466",5214.0,3389.1,0.01,5214.0,28
HCPCS,23930,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,1196.0,777.4,1.1,4850.94,53
HCPCS,23930,I&D UPR A/E DP ABSC/HMTMA,,,2644.48,8141.48,19
HCPCS,23930,I&d upr a/e dp absc/hmtma,,,1072.58,1241.93,8
HCPCS,23931,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,4094.5,2661.4249999999997,0.01,7453.0,175
HCPCS,23935,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,2552.0,1658.8,1.1,5526.53,50
HCPCS,23935,INC DP OPN B1 CRTX HUM/ELBW,,,2997.95,9170.92,19
HCPCS,23935,Inc dp opn b1 crtx hum/elbw,,,3304.21,3825.93,8
HCPCS,24000,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,2432.0,1580.8,1.1,5526.53,50
HCPCS,24000,ARTHRT ELBW EXPL DRG/RMVL FB,,,2997.95,9170.92,19
HCPCS,24000,Arthrt elbw expl drg/rmvl fb,,,981.04,1135.94,8
HCPCS,24006,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,4286.0,2785.9,1.1,5526.53,50
HCPCS,24006,ARTHRT ELBW CAPSL EXC RLS,,,2997.95,9170.92,19
HCPCS,24006,Arthrt elbw capsl exc rls,,,981.04,1135.94,8
HCPCS,24065,BIOPSY ARM/ELBOW SOFT TISSUE,397.0,258.05,1.1,4629.18,72
HCPCS,24065,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",852.0,553.8,1.1,2768.64,53
HCPCS,24065,Biopsy arm/elbow soft tissue,,,1072.58,1241.93,8
HCPCS,24066,BIOPSY ARM/ELBOW SOFT TISSUE,1004.0,652.6,1.1,8141.48,72
HCPCS,24066,"BX ARM/ELBOW SOFT TISSUE,DEEP",2140.0,1391.0,1.1,4850.94,53
HCPCS,24066,Biopsy arm/elbow soft tissue,,,1072.58,1241.93,8
HCPCS,24071,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,2280.0,1482.0,1.1,4850.94,50
HCPCS,24071,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,13165.0,8557.25,0.01,13165.0,61
HCPCS,24071,EXCISE TUMOR UPPR ARM/ELBOW 3CM OR >,881.0,572.65,1.1,4850.94,50
HCPCS,24073,EX ARM/ELBOW TUM DEEP 5 CM/>,,,2644.48,8141.48,19
HCPCS,24073,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,4052.0,2633.8,1.1,4850.94,50
HCPCS,24073,EXCISE TUMOR UPPR ARM/ELBOW 5CM OR >,1060.0,689.0,1.1,4850.94,50
HCPCS,24073,Ex arm/elbow tum deep 5 cm/>,,,981.04,1135.94,8
HCPCS,24075,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,4659.5,3028.675,0.01,7453.0,114
HCPCS,24075,REMOVE ARM/ELBOW LESION,673.0,437.45,1.1,2768.64,53
HCPCS,24076,EX ARM/ELBOW TUM DEEP < 5 CM,,,2644.48,8141.48,19
HCPCS,24076,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,3260.0,2119.0,1.1,4850.94,50
HCPCS,24076,Ex arm/elbow tum deep < 5 cm,,,1072.58,1241.93,8
HCPCS,24076,REMOVE ARM/ELBOW LESION,1094.0,711.1,1.1,4850.94,50
HCPCS,24077,RAD RESCJ TUM TISS A/E <5CM,,,2644.48,8141.48,19
HCPCS,24077,Rad rescj tum tiss a/e <5cm,,,2599.83,3010.33,8
HCPCS,24079,RAD RESCJ TUM TISS A/E 5 CM+,,,2644.48,8141.48,19
HCPCS,24079,Rad rescj tum tiss a/e 5 cm+,,,2599.83,3010.33,8
HCPCS,24100,ARTHRT ELBW SYNOVIAL BX ONLY,,,2997.95,9170.92,19
HCPCS,24100,Arthrt elbw synovial bx only,,,981.04,1135.94,8
HCPCS,24101,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,2520.0,1638.0,1.1,5526.53,50
HCPCS,24101,ARTHRT ELBW JT EXPL BX RMVL,,,2997.95,9170.92,19
HCPCS,24101,Arthrt elbw jt expl bx rmvl,,,981.04,1135.94,8
HCPCS,24102,ARTHROTOMY ELBOW W/SYNOVECTOMY,3304.0,2147.6,1.1,5526.53,50
HCPCS,24102,ARTHRT ELBOW W/SYNOVECTOMY,,,2997.95,9170.92,19
HCPCS,24102,Arthrt elbow w/synovectomy,,,981.04,1135.94,8
HCPCS,24105,EXCISION OLECRANON BURSA,1512.0,982.8,1.1,9170.92,69
HCPCS,24105,Excision olecranon bursa,,,981.04,1135.94,8
HCPCS,24110,EXC/CURTG B1 CST/B9 TUM HUM,,,2997.95,9170.92,19
HCPCS,24110,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,3032.0,1970.8,1.1,5526.53,50
HCPCS,24110,Exc/curtg b1 cst/b9 tum hum,,,2599.83,3010.33,8
HCPCS,24115,EXC/CRTG B1 CST/TUM HUM AGRF,,,6600.66,20338.07,19
HCPCS,24115,Exc/crtg b1 cst/tum hum agrf,,,2599.83,3010.33,8
HCPCS,24116,EXC/CRTG B1 CST/TUM HUM ALGR,,,6600.66,20338.07,19
HCPCS,24116,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,4892.0,3179.8,1.1,12214.27,50
HCPCS,24116,Exc/crtg b1 cst/tum hum algr,,,2599.83,3010.33,8
HCPCS,24120,EXC/CRTG B1 CST/B9 TUM RDS,,,2997.95,9170.92,19
HCPCS,24120,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,2728.0,1773.2,1.1,5526.53,50
HCPCS,24120,Exc/crtg b1 cst/b9 tum rds,,,981.04,1135.94,8
HCPCS,24125,EXC/CRTG B1 CST/TUM RDS AGRF,,,2997.95,9170.92,19
HCPCS,24125,Exc/crtg b1 cst/tum rds agrf,,,981.04,1135.94,8
HCPCS,24126,EXC/CRTG B1 CST/TUM RDS ALGR,,,6600.66,20338.07,19
HCPCS,24126,Exc/crtg b1 cst/tum rds algr,,,3304.21,3825.93,8
HCPCS,24130,EXCISION RADIAL HEAD,2568.0,1669.2,1.1,9170.92,69
HCPCS,24130,Excision radial head,,,3304.21,3825.93,8
HCPCS,24134,SEQUESTRECTOMY SHFT/DSTL HUM,,,6600.66,20338.07,19
HCPCS,24134,Sequestrectomy shft/dstl hum,,,2599.83,3010.33,8
HCPCS,24136,SEQUESTRECTOMY RADIAL H/N,,,2997.95,9170.92,19
HCPCS,24136,Sequestrectomy radial h/n,,,981.04,1135.94,8
HCPCS,24138,SEQUESTRECTOMY OLECRN PROCES,,,6600.66,20338.07,19
HCPCS,24138,Sequestrectomy olecrn proces,,,3304.21,3825.93,8
HCPCS,24140,PARTIAL EXC BONE HUMERUS,,,2997.95,9170.92,19
HCPCS,24140,PARTIAL REMOVAL HUMERUS,3820.0,2483.0,1.1,5526.53,50
HCPCS,24140,Partial exc bone humerus,,,2599.83,3010.33,8
HCPCS,24145,PRTL EXC BONE RADIAL H/N,,,6600.66,20338.07,19
HCPCS,24145,Prtl exc bone radial h/n,,,3304.21,3825.93,8
HCPCS,24147,PARTIAL REMOVAL OLECRANNON PROCESS,3136.0,2038.4,1.1,5526.53,50
HCPCS,24147,PRTL EXC BONE OLECRN PROCESS,,,2997.95,9170.92,19
HCPCS,24147,Prtl exc bone olecrn process,,,981.04,1135.94,8
HCPCS,24149,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,7137.0,4639.05,1.1,12214.27,50
HCPCS,24149,RADICAL RESECTION OF ELBOW,,,6600.66,20338.07,19
HCPCS,24149,Radical resection of elbow,,,3304.21,3825.93,8
HCPCS,24150,RAD RESCJ TUM DSTL/SHFT HUM,,,6600.66,20338.07,19
HCPCS,24150,Rad rescj tum dstl/shft hum,,,2599.83,3010.33,8
HCPCS,24152,RAD RESECTION TUM RADIAL H/N,,,6600.66,20338.07,19
HCPCS,24152,Rad resection tum radial h/n,,,3304.21,3825.93,8
HCPCS,24155,RESECTION OF ELBOW JOINT,,,2997.95,9170.92,19
HCPCS,24155,Resection of elbow joint,,,981.04,1135.94,8
HCPCS,24160,RMVL PROSTHHUMRL&ULNAR CMPNT,,,2997.95,9170.92,19
HCPCS,24160,Rmvl prosthhumrl&ulnar cmpnt,,,981.04,1135.94,8
HCPCS,24164,PROSTHESIS REMOVAL RADIAL HEAD,4000.0,2600.0,1.1,5526.53,50
HCPCS,24164,REMOVAL PROSTH RADIAL HEAD,,,2997.95,9170.92,19
HCPCS,24164,Removal prosth radial head,,,981.04,1135.94,8
HCPCS,24200,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,4088.5,2657.525,1.1,7453.0,114
HCPCS,24201,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,1880.0,1222.0,1.1,4850.94,53
HCPCS,24201,RMVL FB UPPER ARM/ELBW DEEP,,,2644.48,8141.48,19
HCPCS,24201,Rmvl fb upper arm/elbw deep,,,1072.58,1241.93,8
HCPCS,24220,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,0.01,3398.0,138
HCPCS,24300,MANIPULATION ELBOW W/ANESTH,1616.0,1050.4,1.1,2743.55,50
HCPCS,24300,MNPJ ELBOW UNDER ANES,,,1478.75,4506.96,19
HCPCS,24300,Mnpj elbow under anes,,,654.6,757.96,8
HCPCS,24301,MUSC/TDN TRANSFER UPR A/E 1,,,6600.66,20338.07,19
HCPCS,24301,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,4152.0,2698.8,1.1,12214.27,50
HCPCS,24301,Musc/tdn transfer upr a/e 1,,,3304.21,3825.93,8
HCPCS,24305,"ARM/ELBOW TENDON LENGTHEN,SINGLE,EA",3048.0,1981.2,1.1,5526.53,50
HCPCS,24305,TENDON LNGTH UPR A/E EA TDN,,,2997.95,9170.92,19
HCPCS,24305,Tendon lngth upr a/e ea tdn,,,981.04,1135.94,8
HCPCS,24310,"TENOTOMY,ELBOW-SHLDR,SINGL,EACH",2448.0,1591.2,1.1,5526.53,50
HCPCS,24310,TNOT OPN ELBW TO SHO EA TDN,,,2997.95,9170.92,19
HCPCS,24310,Tnot opn elbw to sho ea tdn,,,2599.83,3010.33,8
HCPCS,24320,TENOPLASTY ELBOW TO SHO 1,,,6600.66,20338.07,19
HCPCS,24320,"TENOPLASTY,ELB-SHLDR,MUSC XFER,SINGL",4344.0,2823.6,1.1,12214.27,50
HCPCS,24320,Tenoplasty elbow to sho 1,,,2599.83,3010.33,8
HCPCS,24330,FLEXOR-PLASTY ELBOW,,,6600.66,20338.07,19
HCPCS,24330,Flexor-plasty elbow,,,3304.21,3825.93,8
HCPCS,24331,FLEXOR-PLASTY ELBW W/ADVMNT,,,6600.66,20338.07,19
HCPCS,24331,Flexor-plasty elbw w/advmnt,,,981.04,1135.94,8
HCPCS,24332,TENOLYSIS TRICEPS,,,2997.95,9170.92,19
HCPCS,24332,"TENOLYSIS, TRICEPS",3164.0,2056.6,1.1,5526.53,50
HCPCS,24332,Tenolysis triceps,,,2599.83,3010.33,8
HCPCS,24340,TENODESIS BICEPS TDN AT ELBW,,,6600.66,20338.07,19
HCPCS,24340,Tenodesis biceps tdn at elbw,,,2599.83,3010.33,8
HCPCS,24341,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,3796.0,2467.4,1.1,12214.27,50
HCPCS,24341,RPR TDN/MUSC UPR A/E EACH,,,6600.66,20338.07,19
HCPCS,24341,Rpr tdn/musc upr a/e each,,,2599.83,3010.33,8
HCPCS,24342,REPAIR OF RUPTURED TENDON,,,6600.66,20338.07,19
HCPCS,24342,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,4344.0,2823.6,1.1,12214.27,50
HCPCS,24342,Repair of ruptured tendon,,,2599.83,3010.33,8
HCPCS,24343,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,5526.53,50
HCPCS,24343,REPR ELBOW LAT LIGMNT W/TISS,,,2997.95,9170.92,19
HCPCS,24343,Repr elbow lat ligmnt w/tiss,,,981.04,1135.94,8
HCPCS,24344,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,6084.0,3954.6,1.1,12214.27,50
HCPCS,24344,RECONSTRUCT ELBOW LAT LIGMNT,,,6600.66,20338.07,19
HCPCS,24344,Reconstruct elbow lat ligmnt,,,3304.21,3825.93,8
HCPCS,24345,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,12214.27,50
HCPCS,24345,REPR ELBW MED LIGMNT W/TISSU,,,6600.66,20338.07,19
HCPCS,24345,Repr elbw med ligmnt w/tissu,,,3304.21,3825.93,8
HCPCS,24346,RECONSTRUCT ELBOW MED LIGMNT,,,11888.68,35984.87,19
HCPCS,24346,Reconstruct elbow med ligmnt,,,3304.21,3825.93,8
HCPCS,24357,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,8550.5,5557.825,0.01,14925.0,111
HCPCS,24358,REPAIR ELBOW W/DEB OPEN,,,2997.95,9170.92,19
HCPCS,24358,Repair elbow w/deb open,,,981.04,1135.94,8
HCPCS,24358,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,2664.0,1731.6,1.1,5526.53,50
HCPCS,24359,REPAIR ELBOW DEB/ATTCH OPEN,,,2997.95,9170.92,19
HCPCS,24359,Repair elbow deb/attch open,,,981.04,1135.94,8
HCPCS,24359,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,3592.0,2334.8,1.1,5526.53,50
HCPCS,24360,"ARTHROPLASTY,ELBOW,W MEMBRANE",5575.0,3623.75,1.1,12214.27,50
HCPCS,24360,RECONSTRUCT ELBOW JOINT,,,6600.66,20338.07,19
HCPCS,24360,Reconstruct elbow joint,,,1890.92,2189.48,8
HCPCS,24361,RECONSTRUCT ELBOW JOINT,,,16588.34,49144.62,19
HCPCS,24361,Reconstruct elbow joint,,,6256.68,7244.58,8
HCPCS,24362,RECONSTRUCT ELBOW JOINT,,,11888.68,35984.87,19
HCPCS,24362,Reconstruct elbow joint,,,6256.68,7244.58,8
HCPCS,24363,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,8800.0,5720.0,1.1,31818.75,50
HCPCS,24363,REPLACE ELBOW JOINT,,,16588.34,49144.62,19
HCPCS,24363,Replace elbow joint,,,6256.68,7244.58,8
HCPCS,24365,RECONSTRUCT HEAD OF RADIUS,,,11888.68,35984.87,19
HCPCS,24365,Reconstruct head of radius,,,6256.68,7244.58,8
HCPCS,24366,ARTHROPLASTY RADIAL HEAD W/IMPLANT,3744.0,2433.6,1.1,22471.68,50
HCPCS,24366,RECONSTRUCT HEAD OF RADIUS,,,11888.68,35984.87,19
HCPCS,24366,Reconstruct head of radius,,,6256.68,7244.58,8
HCPCS,24370,REVISE RECONST ELBOW JOINT,,,11888.68,35984.87,19
HCPCS,24370,Revise reconst elbow joint,,,6256.68,7244.58,8
HCPCS,24371,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,11000.0,7150.0,1.1,31818.75,50
HCPCS,24371,REVISE RECONST ELBOW JOINT,,,16588.34,49144.62,19
HCPCS,24371,Revise reconst elbow joint,,,6256.68,7244.58,8
HCPCS,24400,OSTEOT HUMERUS W/WO INT FIXJ,,,6600.66,20338.07,19
HCPCS,24400,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,4985.0,3240.25,1.1,12214.27,50
HCPCS,24400,Osteot humerus w/wo int fixj,,,2599.83,3010.33,8
HCPCS,24410,MLT OSTEOT RLGNM IMED RD HUM,,,11888.68,35984.87,19
HCPCS,24410,Mlt osteot rlgnm imed rd hum,,,2599.83,3010.33,8
HCPCS,24420,OSTEOPLASTY HUMERUS,,,6600.66,20338.07,19
HCPCS,24420,Osteoplasty humerus,,,2599.83,3010.33,8
HCPCS,24430,REPAIR NON/MALUNION HUMERUS W/O GRAFT,6100.0,3965.0,1.1,22471.68,50
HCPCS,24430,RPR NON/MAL HUMERUS WO GRAFT,,,11888.68,35984.87,19
HCPCS,24430,Rpr non/mal humerus wo graft,,,5239.24,6066.49,8
HCPCS,24435,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,5996.0,3897.4,1.1,22471.68,50
HCPCS,24435,RPR NON/MAL HUM WITH AGRFT,,,11888.68,35984.87,19
HCPCS,24435,Rpr non/mal hum with agrft,,,5239.24,6066.49,8
HCPCS,24470,HEMIEPIPHYSEAL ARREST,,,2997.95,9170.92,19
HCPCS,24470,Hemiepiphyseal arrest,,,981.04,1135.94,8
HCPCS,24495,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,3364.0,2186.6,1.1,12214.27,50
HCPCS,24495,DECOMPRESSION FASCT FOREARM,,,6600.66,20338.07,19
HCPCS,24495,Decompression fasct forearm,,,3304.21,3825.93,8
HCPCS,24498,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,4912.0,3192.8,1.1,22471.68,50
HCPCS,24498,PROPH TX W/WO MTHYLMTHCRYLT,,,11888.68,35984.87,19
HCPCS,24498,Proph tx w/wo mthylmthcrylt,,,2599.83,3010.33,8
HCPCS,24500,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1301.5,845.975,0.01,3004.0,175
HCPCS,24505,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,4759.0,3093.3500000000004,1.1,7362.0,114
HCPCS,24515,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,4848.0,3151.2,1.1,22471.68,50
HCPCS,24515,OPTX HUMRL SHFT FX PLATE/SCR,,,11888.68,35984.87,19
HCPCS,24515,Optx humrl shft fx plate/scr,,,2860.13,3311.73,8
HCPCS,24516,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,4876.0,3169.4,1.1,22471.68,50
HCPCS,24516,TX HUMRL SHAFT FX IMED IMPLT,,,11888.68,35984.87,19
HCPCS,24516,Tx humrl shaft fx imed implt,,,2860.13,3311.73,8
HCPCS,24530,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1289.5,838.175,0.01,3004.0,175
HCPCS,24535,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,5103.0,3316.95,1.1,7362.0,114
HCPCS,24538,PRQ SKEL FIX SPRCNDLR HUM FX,,,6600.66,20338.07,19
HCPCS,24538,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,4299.0,2794.35,1.1,12214.27,50
HCPCS,24538,Prq skel fix sprcndlr hum fx,,,2860.13,3311.73,8
HCPCS,24545,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,5260.0,3419.0,1.1,22471.68,50
HCPCS,24545,OPTX HUM FX WO NTRCNDYLR XTN,,,11888.68,35984.87,19
HCPCS,24545,Optx hum fx wo ntrcndylr xtn,,,2860.13,3311.73,8
HCPCS,24546,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,5964.0,3876.6,1.1,22471.68,50
HCPCS,24546,OPTX HUM FX W/NTRCNDYLR XTN,,,11888.68,35984.87,19
HCPCS,24546,Optx hum fx w/ntrcndylr xtn,,,2860.13,3311.73,8
HCPCS,24560,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1147.5,745.875,0.01,3004.0,175
HCPCS,24565,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,7362.0,4785.3,234.24,7362.0,61
HCPCS,24566,PRQ SKEL FIX EPCNDYLR HUM FX,,,1478.75,4506.96,19
HCPCS,24566,Prq skel fix epcndylr hum fx,,,2860.13,3311.73,8
HCPCS,24575,OPEN TX HUMERAL EPICONDYLAR FRACTURE,3884.0,2524.6,1.1,22471.68,50
HCPCS,24575,OPTX HUMERAL EPCNDYLR FX,,,11888.68,35984.87,19
HCPCS,24575,Optx humeral epcndylr fx,,,2860.13,3311.73,8
HCPCS,24576,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1224.5,795.925,1.1,3004.0,114
HCPCS,24577,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,5003.0,3251.95,1.1,7362.0,114
HCPCS,24579,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,4576.0,2974.4,1.1,22471.68,50
HCPCS,24579,OPTX HUMRL CNDYLR FRACTURE,,,11888.68,35984.87,19
HCPCS,24579,Optx humrl cndylr fracture,,,2860.13,3311.73,8
HCPCS,24582,PRQ SKEL FIX HUMRL CNDYLR FX,,,6600.66,20338.07,19
HCPCS,24582,Prq skel fix humrl cndylr fx,,,2860.13,3311.73,8
HCPCS,24586,OPTX PARTCLR FX&/DISLC ELBOW,,,11888.68,35984.87,19
HCPCS,24586,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,6312.0,4102.8,1.1,22471.68,50
HCPCS,24586,Optx partclr fx&/dislc elbow,,,2860.13,3311.73,8
HCPCS,24587,OPTX PARTCLR FX&/DSLC ELBW W,,,11888.68,35984.87,19
HCPCS,24587,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,6316.0,4105.4,1.1,22471.68,50
HCPCS,24587,Optx partclr fx&/dslc elbw w,,,2860.13,3311.73,8
HCPCS,24600,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1425.5,926.575,0.01,3004.0,175
HCPCS,24605,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,4809.0,3125.8500000000004,1.1,7362.0,111
HCPCS,24615,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,3932.0,2555.8,1.1,12214.27,50
HCPCS,24615,OPTX AQT/CHRNC ELBOW DISLC,,,6600.66,20338.07,19
HCPCS,24615,Optx aqt/chrnc elbow dislc,,,2860.13,3311.73,8
HCPCS,24620,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,5125.0,3331.25,0.01,7362.0,172
HCPCS,24635,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,3520.0,2288.0,1.1,12214.27,50
HCPCS,24635,OPTX MONTEGGIA FX DISLC ELBW,,,6600.66,20338.07,19
HCPCS,24635,Optx monteggia fx dislc elbw,,,2860.13,3311.73,8
HCPCS,24640,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,826.5,537.225,1.1,2453.0,114
HCPCS,24650,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1059.5,688.675,0.01,3004.0,236
HCPCS,24655,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,4697.5,3053.375,1.1,7362.0,114
HCPCS,24665,OPEN TX RADIAL HEAD/NECK FRACTURE,3344.0,2173.6,1.1,12214.27,50
HCPCS,24665,OPTX RADIAL HEAD/NECK FX,,,6600.66,20338.07,19
HCPCS,24665,Optx radial head/neck fx,,,2860.13,3311.73,8
HCPCS,24666,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,3944.0,2563.6,1.1,22471.68,50
HCPCS,24666,OPTX RADIAL HEAD/NCK FX RPLC,,,11888.68,35984.87,19
HCPCS,24666,Optx radial head/nck fx rplc,,,2860.13,3311.73,8
HCPCS,24670,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1089.5,708.175,0.01,3004.0,175
HCPCS,24675,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,4663.0,3030.95,1.1,7362.0,114
HCPCS,24685,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,3348.0,2176.2,1.1,12214.27,50
HCPCS,24685,OPTX ULNAR FX PROX END W/FIX,,,6600.66,20338.07,19
HCPCS,24685,Optx ulnar fx prox end w/fix,,,2860.13,3311.73,8
HCPCS,24800,ARTHRODESIS ELBW JOINT LOCAL,,,6600.66,20338.07,19
HCPCS,24800,Arthrodesis elbw joint local,,,3304.21,3825.93,8
HCPCS,24802,ARTHRD ELBOW JT AUTOG GRAFT,,,11888.68,35984.87,19
HCPCS,24802,Arthrd elbow jt autog graft,,,3304.21,3825.93,8
HCPCS,24900,AMPUTATION OF UPPER ARM,,,12146.38,35984.87,13
HCPCS,24900,"AMPUTATN ARM,THRU HUMERUS,PRIM CLOS",4072.0,2646.8,1.1,4072.0,50
HCPCS,24900,Amputation of upper arm,,,5239.24,6066.49,8
HCPCS,24920,AMPUTATE ARM-HUMER; OP CIRCULAR,4052.0,2633.8,1.1,4052.0,50
HCPCS,24920,AMPUTATION OF UPPER ARM,,,12146.38,35984.87,13
HCPCS,24920,Amputation of upper arm,,,5239.24,6066.49,8
HCPCS,24925,AMPUTATION FOLLOW-UP SURGERY,,,2997.95,9170.92,19
HCPCS,24925,"AMPUTATN ARM,THRU HUMER,SECOND CL",2920.0,1898.0,1.1,5526.53,50
HCPCS,24925,Amputation follow-up surgery,,,2599.83,3010.33,8
HCPCS,24930,AMPUTATE ARM-HUMERUS RE-AMPUT,4332.0,2815.8,1.1,4332.0,50
HCPCS,24930,AMPUTATION FOLLOW-UP SURGERY,,,6864.94,20338.07,13
HCPCS,24930,Amputation follow-up surgery,,,5239.24,6066.49,8
HCPCS,24931,AMPUTATE UPPER ARM & IMPLANT,,,12146.38,35984.87,13
HCPCS,24931,Amputate upper arm & implant,,,5239.24,6066.49,8
HCPCS,24935,REVISION OF AMPUTATION,,,6600.66,20338.07,19
HCPCS,24935,Revision of amputation,,,2599.83,3010.33,8
HCPCS,24940,REVISION OF UPPER ARM,,,12146.38,35984.87,13
HCPCS,24940,Revision of upper arm,,,2599.83,3010.33,8
HCPCS,24999,UNLISTED PX HUMERUS/ELBOW,,,221.64,691.37,19
HCPCS,24999,UPPER ARM COMPARTMENT DECOMPRESSON FASCIOTOMY/RELEASE WITH COMP,1621.0,1053.65,0.01,1621.0,28
HCPCS,24999,Unlisted px humerus/elbow,,,234.24,271.23,8
HCPCS,25000,INCISION EXTENSOR TENDON SHEATH WRIST,1420.0,923.0,1.1,2743.55,50
HCPCS,25000,INCISION OF TENDON SHEATH,,,1478.75,4506.96,19
HCPCS,25000,Incision of tendon sheath,,,981.04,1135.94,8
HCPCS,25001,INCISE FLEXOR CARPI RADIALIS,,,2997.95,9170.92,19
HCPCS,25001,INCISE FLX TENDN SHEATH WRST,1516.0,985.4,1.1,5526.53,50
HCPCS,25001,Incise flexor carpi radialis,,,927.34,1073.77,8
HCPCS,25020,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,2424.0,1575.6,1.1,2743.55,50
HCPCS,25020,DECOMPRESS FOREARM 1 SPACE,,,1478.75,4506.96,19
HCPCS,25020,Decompress forearm 1 space,,,981.04,1135.94,8
HCPCS,25023,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,5532.0,3595.8,1.1,5532.0,50
HCPCS,25023,DECOMPRESS FOREARM 1 SPACE,,,2997.95,9170.92,19
HCPCS,25023,Decompress forearm 1 space,,,981.04,1135.94,8
HCPCS,25024,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,4316.0,2805.4,1.1,5526.53,50
HCPCS,25024,DECOMPRESS FOREARM 2 SPACES,,,2997.95,9170.92,19
HCPCS,25024,Decompress forearm 2 spaces,,,981.04,1135.94,8
HCPCS,25025,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,7176.0,4664.4,1.1,7176.0,50
HCPCS,25025,DECOMPRESS FOREARM 2 SPACES,,,1478.75,4506.96,19
HCPCS,25025,Decompress forearm 2 spaces,,,981.04,1135.94,8
HCPCS,25028,I&D F/ARM&/WRST DP ABSC/HMTM,,,2997.95,9170.92,19
HCPCS,25028,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,2156.0,1401.4,1.1,5526.53,50
HCPCS,25028,I&d f/arm&/wrst dp absc/hmtm,,,981.04,1135.94,8
HCPCS,25031,I&D FOREARM&/WRIST BURSA,,,1478.75,4506.96,19
HCPCS,25031,I&d forearm&/wrist bursa,,,981.04,1135.94,8
HCPCS,25031,INCISION & DRAINAGE FOREARM&/WRIST BURSA,1704.0,1107.6,1.1,2743.55,50
HCPCS,25035,INC DP BONE CRTX F/ARM&/WRST,,,6600.66,20338.07,19
HCPCS,25035,INCISION DEEP BONE CORTEX FOREARM&/WRIST,3060.0,1989.0,1.1,12214.27,50
HCPCS,25035,Inc dp bone crtx f/arm&/wrst,,,3304.21,3825.93,8
HCPCS,25040,ARTHRT RDCRPL/MIDCARPL JT,,,2997.95,9170.92,19
HCPCS,25040,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,3000.0,1950.0,1.1,5526.53,50
HCPCS,25040,Arthrt rdcrpl/midcarpl jt,,,981.04,1135.94,8
HCPCS,25065,BIOPSY FOREARM SOFT TISSUES,,,1497.07,4629.18,19
HCPCS,25065,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,816.0,530.4,1.1,2768.64,53
HCPCS,25065,Biopsy forearm soft tissues,,,981.04,1135.94,8
HCPCS,25066,BIOPSY FOREARM SOFT TISSUES,999.0,649.35,1.1,8141.48,69
HCPCS,25066,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,1708.0,1110.2,1.1,4850.94,50
HCPCS,25066,Biopsy forearm soft tissues,,,981.04,1135.94,8
HCPCS,25071,EXC FOREARM LES SC 3 CM/>,,,1497.07,4629.18,19
HCPCS,25071,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,2364.0,1536.6,1.1,2768.64,50
HCPCS,25071,EXCISE TUMOR FOREARM\WRIST 3CM OR >,922.0,599.3,1.1,2768.64,50
HCPCS,25071,Exc forearm les sc 3 cm/>,,,981.04,1135.94,8
HCPCS,25073,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,8008.5,5205.525,0.01,13165.0,111
HCPCS,25075,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,4518.5,2937.0249999999996,0.01,7453.0,114
HCPCS,25075,REMOVAL OF FOREARM LESION,682.0,443.3,1.1,2768.64,53
HCPCS,25076,EXC FOREARM TUM DEEP < 3 CM,,,1497.07,4629.18,19
HCPCS,25076,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,2696.0,1752.4,1.1,2768.64,50
HCPCS,25076,Exc forearm tum deep < 3 cm,,,981.04,1135.94,8
HCPCS,25076,REMOVAL OF FOREARM LESION,1223.0,794.95,1.1,2768.64,50
HCPCS,25077,RESECT FOREARM/WRIST TUM<3CM,,,2644.48,8141.48,19
HCPCS,25077,Resect forearm/wrist tum<3cm,,,3304.21,3825.93,8
HCPCS,25078,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,7076.0,4599.4,1.1,7076.0,50
HCPCS,25078,RESECT FORARM/WRIST TUM 3CM>,,,2644.48,8141.48,19
HCPCS,25078,Resect forarm/wrist tum 3cm>,,,3304.21,3825.93,8
HCPCS,25085,CAPSULOTOMY WRIST,2256.0,1466.4,1.1,5526.53,50
HCPCS,25085,INCISION OF WRIST CAPSULE,,,2997.95,9170.92,19
HCPCS,25085,Incision of wrist capsule,,,981.04,1135.94,8
HCPCS,25100,BIOPSY OF WRIST JOINT,,,2997.95,9170.92,19
HCPCS,25100,Biopsy of wrist joint,,,981.04,1135.94,8
HCPCS,25101,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,1932.0,1255.8,1.1,5526.53,50
HCPCS,25101,EXPLORE/TREAT WRIST JOINT,,,2997.95,9170.92,19
HCPCS,25101,Explore/treat wrist joint,,,981.04,1135.94,8
HCPCS,25105,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,2408.0,1565.2,1.1,5526.53,50
HCPCS,25105,REMOVE WRIST JOINT LINING,,,2997.95,9170.92,19
HCPCS,25105,Remove wrist joint lining,,,981.04,1135.94,8
HCPCS,25107,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,3080.0,2002.0,1.1,5526.53,50
HCPCS,25107,REMOVE WRIST JOINT CARTILAGE,,,2997.95,9170.92,19
HCPCS,25107,Remove wrist joint cartilage,,,981.04,1135.94,8
HCPCS,25109,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,2776.0,1804.4,1.1,5526.53,50
HCPCS,25109,EXCISE TENDON FOREARM/WRIST,,,2997.95,9170.92,19
HCPCS,25109,Excise tendon forearm/wrist,,,981.04,1135.94,8
HCPCS,25110,"EXCIS TENDON SHEATH LESN,WRIST/FORE",1616.0,1050.4,1.1,2743.55,50
HCPCS,25110,REMOVE WRIST TENDON LESION,,,1478.75,4506.96,19
HCPCS,25110,Remove wrist tendon lesion,,,981.04,1135.94,8
HCPCS,25111,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,1412.0,917.8,1.1,2743.55,50
HCPCS,25111,REMOVE WRIST TENDON LESION,,,1478.75,4506.96,19
HCPCS,25111,Remove wrist tendon lesion,,,927.34,1073.77,8
HCPCS,25112,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,1868.0,1214.2,1.1,2743.55,50
HCPCS,25112,REREMOVE WRIST TENDON LESION,,,1478.75,4506.96,19
HCPCS,25112,Reremove wrist tendon lesion,,,927.34,1073.77,8
HCPCS,25115,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,4036.0,2623.4,1.1,4036.0,50
HCPCS,25115,REMOVE WRIST/FOREARM LESION,,,1478.75,4506.96,19
HCPCS,25115,Remove wrist/forearm lesion,,,981.04,1135.94,8
HCPCS,25116,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,3024.0,1965.6,1.1,5526.53,50
HCPCS,25116,REMOVE WRIST/FOREARM LESION,,,2997.95,9170.92,19
HCPCS,25116,Remove wrist/forearm lesion,,,981.04,1135.94,8
HCPCS,25118,EXCISE WRIST TENDON SHEATH,,,1478.75,4506.96,19
HCPCS,25118,Excise wrist tendon sheath,,,981.04,1135.94,8
HCPCS,25118,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,1804.0,1172.6,1.1,2743.55,50
HCPCS,25119,PARTIAL REMOVAL OF ULNA,,,2997.95,9170.92,19
HCPCS,25119,Partial removal of ulna,,,981.04,1135.94,8
HCPCS,25119,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,2484.0,1614.6,1.1,5526.53,50
HCPCS,25120,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,2508.0,1630.2,1.1,5526.53,50
HCPCS,25120,REMOVAL OF FOREARM LESION,,,2997.95,9170.92,19
HCPCS,25120,Removal of forearm lesion,,,981.04,1135.94,8
HCPCS,25125,REMOVE/GRAFT FOREARM LESION,,,1478.75,4506.96,19
HCPCS,25125,Remove/graft forearm lesion,,,981.04,1135.94,8
HCPCS,25126,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,3096.0,2012.4,1.1,5526.53,50
HCPCS,25126,REMOVE/GRAFT FOREARM LESION,,,2997.95,9170.92,19
HCPCS,25126,Remove/graft forearm lesion,,,981.04,1135.94,8
HCPCS,25130,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,2172.0,1411.8,1.1,5526.53,50
HCPCS,25130,REMOVAL OF WRIST LESION,,,2997.95,9170.92,19
HCPCS,25130,Removal of wrist lesion,,,981.04,1135.94,8
HCPCS,25135,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,2832.0,1840.8,1.1,12214.27,50
HCPCS,25135,REMOVE & GRAFT WRIST LESION,,,6600.66,20338.07,19
HCPCS,25135,Remove & graft wrist lesion,,,981.04,1135.94,8
HCPCS,25136,REMOVE & GRAFT WRIST LESION,,,6600.66,20338.07,19
HCPCS,25136,Remove & graft wrist lesion,,,1518.4,1758.15,8
HCPCS,25145,REMOVE FOREARM BONE LESION,,,2997.95,9170.92,19
HCPCS,25145,Remove forearm bone lesion,,,3304.21,3825.93,8
HCPCS,25150,"PART REMOVAL BONE,ULNA",2952.0,1918.8,1.1,5526.53,50
HCPCS,25150,PARTIAL REMOVAL OF ULNA,,,2997.95,9170.92,19
HCPCS,25150,Partial removal of ulna,,,981.04,1135.94,8
HCPCS,25151,PARTIAL REMOVAL OF RADIUS,,,2997.95,9170.92,19
HCPCS,25151,Partial removal of radius,,,981.04,1135.94,8
HCPCS,25170,RESECT RADIUS/ULNAR TUMOR,,,6600.66,20338.07,19
HCPCS,25170,Resect radius/ulnar tumor,,,3304.21,3825.93,8
HCPCS,25210,CARPECTOMY 1 BONE,2448.0,1591.2,1.1,5526.53,50
HCPCS,25210,REMOVAL OF WRIST BONE,,,2997.95,9170.92,19
HCPCS,25210,Removal of wrist bone,,,927.34,1073.77,8
HCPCS,25215,CARPECTOMY ALL BONES PROXIMAL ROW,3256.0,2116.4,1.1,5526.53,50
HCPCS,25215,REMOVAL OF WRIST BONES,,,2997.95,9170.92,19
HCPCS,25215,Removal of wrist bones,,,1518.4,1758.15,8
HCPCS,25230,PARTIAL REMOVAL OF RADIUS,,,2997.95,9170.92,19
HCPCS,25230,Partial removal of radius,,,981.04,1135.94,8
HCPCS,25230,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,2148.0,1396.2,1.1,5526.53,50
HCPCS,25240,"EXCIS DISTAL ULNA,PART/COMPLETE",2124.0,1380.6,1.1,5526.53,50
HCPCS,25240,PARTIAL REMOVAL OF ULNA,,,2997.95,9170.92,19
HCPCS,25240,Partial removal of ulna,,,981.04,1135.94,8
HCPCS,25246,INJECTION FOR WRIST ARTHROGRAM,580.0,377.0,1.1,651.72,53
HCPCS,25246,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,0.01,3398.0,138
HCPCS,25248,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,2124.0,1380.6,1.1,2743.55,50
HCPCS,25248,REMOVE FOREARM FOREIGN BODY,,,1478.75,4506.96,19
HCPCS,25248,Remove forearm foreign body,,,981.04,1135.94,8
HCPCS,25250,REMOVAL OF WRIST PROSTHESIS,,,1478.75,4506.96,19
HCPCS,25250,Removal of wrist prosthesis,,,981.04,1135.94,8
HCPCS,25251,REMOVAL OF WRIST PROSTHESIS,,,2997.95,9170.92,19
HCPCS,25251,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,3928.0,2553.2,1.1,5526.53,50
HCPCS,25251,Removal of wrist prosthesis,,,981.04,1135.94,8
HCPCS,25259,MANIPULATE WRIST W/ANESTHES,1616.0,1050.4,1.1,4506.96,69
HCPCS,25259,Manipulate wrist w/anesthes,,,654.6,757.96,8
HCPCS,25260,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,9070.5,5895.825,1.1,14925.0,111
HCPCS,25263,REPAIR FOREARM TENDON/MUSCLE,,,6600.66,20338.07,19
HCPCS,25263,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,3216.0,2090.4,1.1,12214.27,50
HCPCS,25263,Repair forearm tendon/muscle,,,981.04,1135.94,8
HCPCS,25265,REPAIR FOREARM TENDON/MUSCLE,,,2997.95,9170.92,19
HCPCS,25265,Repair forearm tendon/muscle,,,981.04,1135.94,8
HCPCS,25270,REPAIR FOREARM TENDON/MUSCLE,,,2997.95,9170.92,19
HCPCS,25270,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,2468.0,1604.2,1.1,5526.53,50
HCPCS,25270,Repair forearm tendon/muscle,,,981.04,1135.94,8
HCPCS,25272,REPAIR FOREARM TENDON/MUSCLE,,,2997.95,9170.92,19
HCPCS,25272,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,2884.0,1874.6,1.1,5526.53,50
HCPCS,25272,Repair forearm tendon/muscle,,,981.04,1135.94,8
HCPCS,25274,REPAIR FOREARM TENDON/MUSCLE,,,2997.95,9170.92,19
HCPCS,25274,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,3576.0,2324.4,1.1,5526.53,50
HCPCS,25274,Repair forearm tendon/muscle,,,981.04,1135.94,8
HCPCS,25275,REPAIR FOREARM TENDON SHEATH,,,2997.95,9170.92,19
HCPCS,25275,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,3584.0,2329.6,1.1,5526.53,50
HCPCS,25275,Repair forearm tendon sheath,,,981.04,1135.94,8
HCPCS,25280,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,2956.0,1921.4,1.1,5526.53,50
HCPCS,25280,REVISE WRIST/FOREARM TENDON,,,2997.95,9170.92,19
HCPCS,25280,Revise wrist/forearm tendon,,,981.04,1135.94,8
HCPCS,25290,INCISE WRIST/FOREARM TENDON,,,2997.95,9170.92,19
HCPCS,25290,Incise wrist/forearm tendon,,,981.04,1135.94,8
HCPCS,25290,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2172.0,1411.8,1.1,5526.53,50
HCPCS,25295,RELEASE WRIST/FOREARM TENDON,,,2997.95,9170.92,19
HCPCS,25295,Release wrist/forearm tendon,,,981.04,1135.94,8
HCPCS,25295,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2688.0,1747.2,1.1,5526.53,50
HCPCS,25300,FUSION OF TENDONS AT WRIST,,,2997.95,9170.92,19
HCPCS,25300,Fusion of tendons at wrist,,,3304.21,3825.93,8
HCPCS,25300,TENODESIS WRIST FLEXORS FINGERS,3608.0,2345.2,1.1,5526.53,50
HCPCS,25301,FUSION OF TENDONS AT WRIST,,,2997.95,9170.92,19
HCPCS,25301,Fusion of tendons at wrist,,,981.04,1135.94,8
HCPCS,25301,TENODESIS WRIST EXTENSORS FINGERS,3436.0,2233.4,1.1,5526.53,50
HCPCS,25310,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,3960.0,2574.0,1.1,5526.53,50
HCPCS,25310,TRANSPLANT FOREARM TENDON,,,2997.95,9170.92,19
HCPCS,25310,Transplant forearm tendon,,,981.04,1135.94,8
HCPCS,25312,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,4321.0,2808.65,1.1,5526.53,50
HCPCS,25312,TRANSPLANT FOREARM TENDON,,,2997.95,9170.92,19
HCPCS,25312,Transplant forearm tendon,,,981.04,1135.94,8
HCPCS,25315,REVISE PALSY HAND TENDON(S),,,6600.66,20338.07,19
HCPCS,25315,Revise palsy hand tendon(s),,,1518.4,1758.15,8
HCPCS,25316,REVISE PALSY HAND TENDON(S),,,6600.66,20338.07,19
HCPCS,25316,Revise palsy hand tendon(s),,,1518.4,1758.15,8
HCPCS,25320,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,5100.0,3315.0,1.1,12214.27,50
HCPCS,25320,REPAIR/REVISE WRIST JOINT,,,6600.66,20338.07,19
HCPCS,25320,Repair/revise wrist joint,,,3304.21,3825.93,8
HCPCS,25332,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,4696.0,3052.4,1.1,5526.53,50
HCPCS,25332,REVISE WRIST JOINT,,,2997.95,9170.92,19
HCPCS,25332,Revise wrist joint,,,1890.92,2189.48,8
HCPCS,25335,CENTRALIZATION WRIST ON ULNA,,,2997.95,9170.92,19
HCPCS,25335,Centralization wrist on ulna,,,981.04,1135.94,8
HCPCS,25337,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,4692.0,3049.8,1.1,12214.27,50
HCPCS,25337,RECONSTRUCT ULNA/RADIOULNAR,,,6600.66,20338.07,19
HCPCS,25337,Reconstruct ulna/radioulnar,,,3304.21,3825.93,8
HCPCS,25350,"OSTEOTOMY RADIUS,DISTAL THIRD",3636.0,2363.4,1.1,12214.27,50
HCPCS,25350,REVISION OF RADIUS,,,6600.66,20338.07,19
HCPCS,25350,Revision of radius,,,3304.21,3825.93,8
HCPCS,25355,REVISION OF RADIUS,,,2997.95,9170.92,19
HCPCS,25355,Revision of radius,,,981.04,1135.94,8
HCPCS,25360,OSTEOTOMY ULNA,3496.0,2272.4,1.1,12214.27,50
HCPCS,25360,REVISION OF ULNA,,,6600.66,20338.07,19
HCPCS,25360,Revision of ulna,,,3304.21,3825.93,8
HCPCS,25365,REVISE RADIUS & ULNA,,,11888.68,35984.87,19
HCPCS,25365,Revise radius & ulna,,,3304.21,3825.93,8
HCPCS,25370,REVISE RADIUS OR ULNA,,,2997.95,9170.92,19
HCPCS,25370,Revise radius or ulna,,,981.04,1135.94,8
HCPCS,25375,REVISE RADIUS & ULNA,,,2997.95,9170.92,19
HCPCS,25375,Revise radius & ulna,,,981.04,1135.94,8
HCPCS,25390,OSTEOPLASTY RADIUS/ULNA SHORTENING,4280.0,2782.0,1.1,12214.27,50
HCPCS,25390,SHORTEN RADIUS OR ULNA,,,6600.66,20338.07,19
HCPCS,25390,Shorten radius or ulna,,,3304.21,3825.93,8
HCPCS,25391,LENGTHEN RADIUS OR ULNA,,,11888.68,35984.87,19
HCPCS,25391,Lengthen radius or ulna,,,3304.21,3825.93,8
HCPCS,25392,SHORTEN RADIUS & ULNA,,,6600.66,20338.07,19
HCPCS,25392,Shorten radius & ulna,,,3304.21,3825.93,8
HCPCS,25393,LENGTHEN RADIUS & ULNA,,,6600.66,20338.07,19
HCPCS,25393,Lengthen radius & ulna,,,3304.21,3825.93,8
HCPCS,25394,REPAIR CARPAL BONE SHORTEN,,,2997.95,9170.92,19
HCPCS,25394,Repair carpal bone shorten,,,1518.4,1758.15,8
HCPCS,25400,REPAIR RADIUS OR ULNA,,,6600.66,20338.07,19
HCPCS,25400,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,4512.0,2932.8,1.1,12214.27,50
HCPCS,25400,Repair radius or ulna,,,3304.21,3825.93,8
HCPCS,25405,REPAIR/GRAFT RADIUS OR ULNA,,,6600.66,20338.07,19
HCPCS,25405,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,6004.0,3902.6,1.1,12214.27,50
HCPCS,25405,Repair/graft radius or ulna,,,3304.21,3825.93,8
HCPCS,25415,REPAIR RADIUS & ULNA,,,6600.66,20338.07,19
HCPCS,25415,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,5520.0,3588.0,1.1,12214.27,50
HCPCS,25415,Repair radius & ulna,,,3304.21,3825.93,8
HCPCS,25420,REPAIR/GRAFT RADIUS & ULNA,,,6600.66,20338.07,19
HCPCS,25420,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,6816.0,4430.4,1.1,12214.27,50
HCPCS,25420,Repair/graft radius & ulna,,,3304.21,3825.93,8
HCPCS,25425,REPAIR/GRAFT RADIUS OR ULNA,,,6600.66,20338.07,19
HCPCS,25425,Repair/graft radius or ulna,,,3304.21,3825.93,8
HCPCS,25426,REPAIR/GRAFT RADIUS & ULNA,,,2997.95,9170.92,19
HCPCS,25426,Repair/graft radius & ulna,,,3304.21,3825.93,8
HCPCS,25430,VASC GRAFT INTO CARPAL BONE,,,2997.95,9170.92,19
HCPCS,25430,VASC PEDICL INTO CARPAL BONE,3884.0,2524.6,1.1,5526.53,50
HCPCS,25430,Vasc graft into carpal bone,,,1518.4,1758.15,8
HCPCS,25431,REPAIR NONUNION CARPAL BONE,,,6600.66,20338.07,19
HCPCS,25431,Repair nonunion carpal bone,,,2860.13,3311.73,8
HCPCS,25440,REPAIR NONU SCPHD CARPL B1,,,6600.66,20338.07,19
HCPCS,25440,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,4272.0,2776.8,1.1,12214.27,50
HCPCS,25440,Repair nonu scphd carpl b1,,,3304.21,3825.93,8
HCPCS,25441,ARTHRP W/PROSTC DSTL RDS,,,11888.68,35984.87,19
HCPCS,25441,Arthrp w/prostc dstl rds,,,6256.68,7244.58,8
HCPCS,25442,ARTHRP W/PROSTC DSTL ULNA,,,16588.34,49144.62,19
HCPCS,25442,Arthrp w/prostc dstl ulna,,,6256.68,7244.58,8
HCPCS,25443,ARTHRP PROSTC DSTL SCPH CRPL,,,6600.66,20338.07,19
HCPCS,25443,Arthrp prostc dstl scph crpl,,,1890.92,2189.48,8
HCPCS,25444,ARTHRP W/PROSTC LUNATE,,,11888.68,35984.87,19
HCPCS,25444,Arthrp w/prostc lunate,,,6256.68,7244.58,8
HCPCS,25445,ARTHRP W/PROSTC TRAPEZIUM,,,6600.66,20338.07,19
HCPCS,25445,Arthrp w/prostc trapezium,,,1890.92,2189.48,8
HCPCS,25446,ARTHRP W/PROSTC DST RDS&CRPS,,,16588.34,49144.62,19
HCPCS,25446,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,6920.0,4498.0,1.1,31818.75,50
HCPCS,25446,Arthrp w/prostc dst rds&crps,,,6256.68,7244.58,8
HCPCS,25447,ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION,4200.0,2730.0,1.1,5526.53,50
HCPCS,25447,ARTHRP NTRCRP/CRP/MTCR NTRPS,,,2997.95,9170.92,19
HCPCS,25447,Arthrp ntrcrp/crp/mtcr ntrps,,,1890.92,2189.48,8
HCPCS,25448,ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION,5214.0,3389.1,1.1,5214.0,49
HCPCS,25448,ARTHRP NTRCRPL/CRP/MTCRP SSP,,,2997.95,9170.92,19
HCPCS,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,1890.92,2189.48,8
HCPCS,25449,REVJ ARTHRP WRIST JOINT,,,6600.66,20338.07,19
HCPCS,25449,Revj arthrp wrist joint,,,1890.92,2189.48,8
HCPCS,25450,EPIPHYSL ARRST DSTL RDS/ULNA,,,2997.95,9170.92,19
HCPCS,25450,Epiphysl arrst dstl rds/ulna,,,981.04,1135.94,8
HCPCS,25455,EPIPHYSL ARRST DSTL RDS&ULNA,,,2997.95,9170.92,19
HCPCS,25455,Epiphysl arrst dstl rds&ulna,,,981.04,1135.94,8
HCPCS,25490,PROPHYLACTIC TX RADIUS,,,6600.66,20338.07,19
HCPCS,25490,Prophylactic tx radius,,,3304.21,3825.93,8
HCPCS,25491,PROPHYLACTIC TX ULNA,,,11888.68,35984.87,19
HCPCS,25491,Prophylactic tx ulna,,,3304.21,3825.93,8
HCPCS,25492,PROPHYLACTIC TX RADIUS&ULNA,,,2997.95,9170.92,19
HCPCS,25492,Prophylactic tx radius&ulna,,,981.04,1135.94,8
HCPCS,25500,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1071.5,696.475,0.01,3004.0,175
HCPCS,25505,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,4771.0,3101.15,1.1,7362.0,114
HCPCS,25515,OPEN TREATMENT RADIAL SHAFT FRACTURE,3520.0,2288.0,1.1,12214.27,50
HCPCS,25515,OPTX RADIAL SHAFT FRACTURE,,,6600.66,20338.07,19
HCPCS,25515,Optx radial shaft fracture,,,2860.13,3311.73,8
HCPCS,25520,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,2600.0,1690.0,1.1,2743.55,53
HCPCS,25520,CLTX RDL SHFT FX&DISLC,,,1478.75,4506.96,19
HCPCS,25520,Cltx rdl shft fx&dislc,,,234.24,271.23,8
HCPCS,25525,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,4220.0,2743.0,1.1,12214.27,50
HCPCS,25525,OPTX RDL SHFT FX&CLTX RAD/UL,,,6600.66,20338.07,19
HCPCS,25525,Optx rdl shft fx&cltx rad/ul,,,2860.13,3311.73,8
HCPCS,25526,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,5260.0,3419.0,1.1,12214.27,50
HCPCS,25526,OPTX RDL SHFT FX&DSTL RAD/UL,,,6600.66,20338.07,19
HCPCS,25526,Optx rdl shft fx&dstl rad/ul,,,2860.13,3311.73,8
HCPCS,25530,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,999.5,649.675,0.01,3004.0,175
HCPCS,25535,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,2144.0,1393.6,1.1,2144.0,53
HCPCS,25535,CLTX ULNAR SHFT FX W/MNPJ,,,221.64,691.37,19
HCPCS,25535,Cltx ulnar shft fx w/mnpj,,,234.24,271.23,8
HCPCS,25545,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,3176.0,2064.4,1.1,12214.27,50
HCPCS,25545,OPTX ULNAR SHFT FX INT FIXJ,,,6600.66,20338.07,19
HCPCS,25545,Optx ulnar shft fx int fixj,,,2860.13,3311.73,8
HCPCS,25560,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1069.5,695.175,0.01,3004.0,175
HCPCS,25565,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,4851.0,3153.15,1.1,7362.0,114
HCPCS,25574,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,3520.0,2288.0,1.1,12214.27,50
HCPCS,25574,OPTX RDL&ULN SHFT FX RDS/ULN,,,6600.66,20338.07,19
HCPCS,25574,Optx rdl&uln shft fx rds/uln,,,2860.13,3311.73,8
HCPCS,25575,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,4916.0,3195.4,1.1,12214.27,50
HCPCS,25575,OPTX RDL&ULN SHFT FX RDS&ULN,,,6600.66,20338.07,19
HCPCS,25575,Optx rdl&uln shft fx rds&uln,,,2860.13,3311.73,8
HCPCS,25600,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1107.5,719.875,0.01,3004.0,175
HCPCS,25605,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,4931.0,3205.15,0.01,7362.0,175
HCPCS,25606,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,3324.0,2160.6,1.1,5526.53,50
HCPCS,25606,PERQ SKEL FIXJ DSTL RDL FX,,,2997.95,9170.92,19
HCPCS,25606,Perq skel fixj dstl rdl fx,,,2860.13,3311.73,8
HCPCS,25607,"OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR",4206.0,2733.9,1.1,12214.27,50
HCPCS,25607,OPTX DST RD XARTC FX/EPI SEP,,,6600.66,20338.07,19
HCPCS,25607,Optx dst rd xartc fx/epi sep,,,2860.13,3311.73,8
HCPCS,25608,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG",4871.0,3166.15,1.1,12214.27,50
HCPCS,25608,OPTX DST RD XART FX/EPI SEP2,,,6600.66,20338.07,19
HCPCS,25608,Optx dst rd xart fx/epi sep2,,,2860.13,3311.73,8
HCPCS,25609,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG",6327.0,4112.55,1.1,12214.27,50
HCPCS,25609,OPTX DST RD XART FX/EP SEP3+,,,6600.66,20338.07,19
HCPCS,25609,Optx dst rd xart fx/ep sep3+,,,2860.13,3311.73,8
HCPCS,25622,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1109.5,721.175,0.01,2453.0,175
HCPCS,25624,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,4635.0,3012.75,1.1,7362.0,114
HCPCS,25628,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,3868.0,2514.2,1.1,12214.27,50
HCPCS,25628,OPTX CARPL SCPHD FX INT FIXJ,,,6600.66,20338.07,19
HCPCS,25628,Optx carpl scphd fx int fixj,,,2860.13,3311.73,8
HCPCS,25630,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1218.0,791.7,0.01,3004.0,175
HCPCS,25635,CLTX CARPAL BONE FX W/MANJ EACH BONE,4695.0,3051.75,1.1,7362.0,114
HCPCS,25645,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,2968.0,1929.2,1.1,5526.53,50
HCPCS,25645,OPTX CRPL FX OTH/THN SCPH EA,,,2997.95,9170.92,19
HCPCS,25645,Optx crpl fx oth/thn scph ea,,,2860.13,3311.73,8
HCPCS,25650,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1197.5,778.375,0.01,2453.0,175
HCPCS,25651,PERQ SKEL FIX ULNAR STYLD FX,,,2997.95,9170.92,19
HCPCS,25651,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,2328.0,1513.2,1.1,5526.53,50
HCPCS,25651,Perq skel fix ulnar styld fx,,,2860.13,3311.73,8
HCPCS,25652,OPEN TREATMENT ULNAR STYLOID FRACTURE,3224.0,2095.6,1.1,12214.27,50
HCPCS,25652,OPTX ULNAR STYLOID FRACTURE,,,6600.66,20338.07,19
HCPCS,25652,Optx ulnar styloid fracture,,,2860.13,3311.73,8
HCPCS,25660,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1547.5,1005.875,1.1,3004.0,111
HCPCS,25670,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,3236.0,2103.4,1.1,12214.27,50
HCPCS,25670,OPTX RDCRPL/NTRCRPL DISLC 1+,,,6600.66,20338.07,19
HCPCS,25670,Optx rdcrpl/ntrcrpl dislc 1+,,,2860.13,3311.73,8
HCPCS,25671,PERQ SKEL FIX RAD/ULN DISLC,,,2997.95,9170.92,19
HCPCS,25671,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,2584.0,1679.6,1.1,5526.53,50
HCPCS,25671,Perq skel fix rad/uln dislc,,,2860.13,3311.73,8
HCPCS,25675,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1529.5,994.1750000000001,1.1,3004.0,114
HCPCS,25676,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,3316.0,2155.4,1.1,12214.27,50
HCPCS,25676,OPTX RAD/ULN DISLC AQT/CHRNC,,,6600.66,20338.07,19
HCPCS,25676,Optx rad/uln dislc aqt/chrnc,,,2860.13,3311.73,8
HCPCS,25680,CLTX TRNS-SCPHPRLNR FX MNPJ,,,221.64,691.37,19
HCPCS,25680,Cltx trns-scphprlnr fx mnpj,,,234.24,271.23,8
HCPCS,25685,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,4036.0,2623.4,1.1,12214.27,50
HCPCS,25685,OPTX TRNS-SCPHPRLNR FX DISLC,,,6600.66,20338.07,19
HCPCS,25685,Optx trns-scphprlnr fx dislc,,,2860.13,3311.73,8
HCPCS,25690,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,4825.0,3136.25,1.1,7362.0,111
HCPCS,25695,OPEN TREATMENT LUNATE DISLOCATION,3404.0,2212.6,1.1,12214.27,50
HCPCS,25695,OPTX LUNATE DISLOCATION,,,6600.66,20338.07,19
HCPCS,25695,Optx lunate dislocation,,,2860.13,3311.73,8
HCPCS,25800,ARTHRD WRIST COMPLETE WO GRF,,,6600.66,20338.07,19
HCPCS,25800,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,4431.0,2880.15,1.1,12214.27,50
HCPCS,25800,Arthrd wrist complete wo grf,,,3304.21,3825.93,8
HCPCS,25805,ARTHRD WRIST W/SLIDING GRAFT,,,6600.66,20338.07,19
HCPCS,25805,Arthrd wrist w/sliding graft,,,3304.21,3825.93,8
HCPCS,25810,ARTHRD WRST ILIAC/OTH AGRFT,,,11888.68,35984.87,19
HCPCS,25810,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,4780.0,3107.0,1.1,22471.68,50
HCPCS,25810,Arthrd wrst iliac/oth agrft,,,3304.21,3825.93,8
HCPCS,25820,ARTHRD WRIST LMTD W/O B1 GRF,,,6600.66,20338.07,19
HCPCS,25820,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,3056.0,1986.4,1.1,12214.27,50
HCPCS,25820,Arthrd wrist lmtd w/o b1 grf,,,1518.4,1758.15,8
HCPCS,25825,ARTHRD WRIST WITH AUTOGRAFT,,,6600.66,20338.07,19
HCPCS,25825,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,3876.0,2519.4,1.1,12214.27,50
HCPCS,25825,Arthrd wrist with autograft,,,1518.4,1758.15,8
HCPCS,25830,ARTHRD DST RAD/UL JT SGM RSC,,,6600.66,20338.07,19
HCPCS,25830,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,4352.0,2828.8,1.1,12214.27,50
HCPCS,25830,Arthrd dst rad/ul jt sgm rsc,,,3304.21,3825.93,8
HCPCS,25900,AMPUTATION FOREARM THROUGH RADIUS & ULNA,3844.0,2498.6,1.1,3844.0,50
HCPCS,25900,AMPUTATION OF FOREARM,,,6864.94,20338.07,13
HCPCS,25900,Amputation of forearm,,,3304.21,3825.93,8
HCPCS,25905,AMPUTATION OF FOREARM,,,6864.94,20338.07,13
HCPCS,25905,Amputation of forearm,,,5239.24,6066.49,8
HCPCS,25907,AMPUTATION FOLLOW-UP SURGERY,,,2997.95,9170.92,19
HCPCS,25907,Amputation follow-up surgery,,,981.04,1135.94,8
HCPCS,25909,AMPUTATION FOLLOW-UP SURGERY,,,6600.66,20338.07,19
HCPCS,25909,Amputation follow-up surgery,,,3304.21,3825.93,8
HCPCS,25915,AMPUTATION OF FOREARM,,,6864.94,20338.07,13
HCPCS,25915,Amputation of forearm,,,5239.24,6066.49,8
HCPCS,25920,AMPUTATE HAND AT WRIST,,,3095.56,9170.92,13
HCPCS,25920,Amputate hand at wrist,,,3304.21,3825.93,8
HCPCS,25920,DISARTICULATION THROUGH WRIST,3612.0,2347.8,1.1,3612.0,50
HCPCS,25922,AMPUTATE HAND AT WRIST,,,1478.75,4506.96,19
HCPCS,25922,Amputate hand at wrist,,,981.04,1135.94,8
HCPCS,25924,AMPUTATION FOLLOW-UP SURGERY,,,3095.56,9170.92,13
HCPCS,25924,Amputation follow-up surgery,,,3304.21,3825.93,8
HCPCS,25927,AMPUTATION OF HAND,,,3095.56,9170.92,13
HCPCS,25927,Amputation of hand,,,1518.4,1758.15,8
HCPCS,25929,AMPUTATION FOLLOW-UP SURGERY,,,1690.17,5783.06,19
HCPCS,25929,Amputation follow-up surgery,,,927.34,1073.77,8
HCPCS,25931,AMPUTATION FOLLOW-UP SURGERY,,,2997.95,9170.92,19
HCPCS,25931,Amputation follow-up surgery,,,981.04,1135.94,8
HCPCS,25999,DECOMPRESSION OF THE DISTAL RADIUS (COMP CODE 25035),3060.0,1989.0,0.01,3060.0,28
HCPCS,25999,RESURFACING OF THE CAPITATE (COMP CODE 25444),4911.0,3192.15,0.01,4911.0,28
HCPCS,25999,"UNLISTED PROCEDURE, FOREARM AND WRIST",2000.0,1300.0,0.01,2000.0,28
HCPCS,25999,UNLISTED PX FOREARM/WRIST,,,221.64,691.37,19
HCPCS,25999,Unlisted px forearm/wrist,,,234.24,271.23,8
HCPCS,26010,DRAIN FINGER ABSCESS SIMPLE,700.0,455.0,1.1,1134.89,53
HCPCS,26010,DRAINAGE FINGER ABSCESS SIMPLE,914.0,594.1,133.98,2453.0,61
HCPCS,26011,DRAIN FINGER ABSCESS COMPL,986.0,640.9,1.1,2768.64,53
HCPCS,26011,DRAINAGE FINGER ABSCESS COMPLICATED,7453.0,4844.45,306.98,7453.0,61
HCPCS,26020,DRAIN HAND TENDON SHEATH,2736.0,1778.4,1.1,5526.53,50
HCPCS,26020,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,14925.0,9701.25,927.04,14925.0,61
HCPCS,26025,DRAINAGE OF PALM BURSA,,,2997.95,9170.92,19
HCPCS,26025,"DRAINAGE PALM BURSA,SINGLE",2032.0,1320.8,1.1,5526.53,50
HCPCS,26025,Drainage of palm bursa,,,927.34,1073.77,8
HCPCS,26030,DRAINAGE OF PALM BURSAS,,,2997.95,9170.92,19
HCPCS,26030,"DRAINAGE PALM BURSA,MULTIP/COMPLX",2500.0,1625.0,1.1,5526.53,50
HCPCS,26030,Drainage of palm bursas,,,927.34,1073.77,8
HCPCS,26034,INCIS DEEP FINGR/HAND BONE LESN,2652.0,1723.8,1.1,2743.55,50
HCPCS,26034,TREAT HAND BONE LESION,,,1478.75,4506.96,19
HCPCS,26034,Treat hand bone lesion,,,927.34,1073.77,8
HCPCS,26035,DECOMPRESS FINGERS/HAND,,,2997.95,9170.92,19
HCPCS,26035,"DECOMPRESS FINGERS/HAND,INJECT INJ",4548.0,2956.2,1.1,5526.53,50
HCPCS,26035,Decompress fingers/hand,,,1518.4,1758.15,8
HCPCS,26037,DECOMPRESS FASCIOTOMY FINGR/HAND,3028.0,1968.2,1.1,5526.53,50
HCPCS,26037,DECOMPRESS FINGERS/HAND,,,2997.95,9170.92,19
HCPCS,26037,Decompress fingers/hand,,,1518.4,1758.15,8
HCPCS,26040,FASCIOTOMY PALMAR PERCUTANEOUS,4373.0,2842.4500000000003,0.01,7445.0,111
HCPCS,26045,FASCIOTOMY PALMAR OPEN PARTIAL,2292.0,1489.8,1.1,5526.53,50
HCPCS,26045,RELEASE PALM CONTRACTURE,,,2997.95,9170.92,19
HCPCS,26045,Release palm contracture,,,927.34,1073.77,8
HCPCS,26055,INCISE FINGER TENDON SHEATH,1368.0,889.2,1.1,4831.0,73
HCPCS,26055,Incise finger tendon sheath,,,927.34,1073.77,8
HCPCS,26060,INCISION OF FINGER TENDON,,,1478.75,4506.96,19
HCPCS,26060,Incision of finger tendon,,,927.34,1073.77,8
HCPCS,26060,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,1164.0,756.6,1.1,2743.55,50
HCPCS,26070,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,1524.0,990.6,1.1,2743.55,50
HCPCS,26070,EXPLORE/TREAT HAND JOINT,,,1478.75,4506.96,19
HCPCS,26070,Explore/treat hand joint,,,927.34,1073.77,8
HCPCS,26075,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,1564.0,1016.6,1.1,5526.53,50
HCPCS,26075,EXPLORE/TREAT FINGER JOINT,,,2997.95,9170.92,19
HCPCS,26075,Explore/treat finger joint,,,927.34,1073.77,8
HCPCS,26080,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,1788.0,1162.2,1.1,2743.55,50
HCPCS,26080,EXPLORE/TREAT FINGER JOINT,,,1478.75,4506.96,19
HCPCS,26080,Explore/treat finger joint,,,927.34,1073.77,8
HCPCS,26100,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,1516.0,985.4,1.1,5526.53,50
HCPCS,26100,BIOPSY HAND JOINT LINING,,,2997.95,9170.92,19
HCPCS,26100,Biopsy hand joint lining,,,927.34,1073.77,8
HCPCS,26105,BIOPSY FINGER JOINT LINING,,,2997.95,9170.92,19
HCPCS,26105,Biopsy finger joint lining,,,927.34,1073.77,8
HCPCS,26110,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,1460.0,949.0,1.1,2743.55,50
HCPCS,26110,BIOPSY FINGER JOINT LINING,,,1478.75,4506.96,19
HCPCS,26110,Biopsy finger joint lining,,,927.34,1073.77,8
HCPCS,26111,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,2168.0,1409.2,1.1,2768.64,50
HCPCS,26111,EXC HAND LES SC 1.5 CM/>,,,1497.07,4629.18,19
HCPCS,26111,EXCISION HAND LES SC 1.5 CM/>,930.0,604.5,1.1,2768.64,50
HCPCS,26111,Exc hand les sc 1.5 cm/>,,,927.34,1073.77,8
HCPCS,26113,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,2852.0,1853.8,1.1,2852.0,50
HCPCS,26113,EXC HAND TUM DEEP 1.5 CM/>,,,1497.07,4629.18,19
HCPCS,26113,Exc hand tum deep 1.5 cm/>,,,927.34,1073.77,8
HCPCS,26115,EXC HAND LES SC < 1.5 CM,,,1497.07,4629.18,19
HCPCS,26115,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,1584.0,1029.6,1.1,2768.64,53
HCPCS,26115,Exc hand les sc < 1.5 cm,,,927.34,1073.77,8
HCPCS,26115,REMOVAL OF HAND LESION,799.0,519.35,1.1,2768.64,53
HCPCS,26116,EXC HAND TUM DEEP < 1.5 CM,,,1497.07,4629.18,19
HCPCS,26116,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,2696.0,1752.4,1.1,2768.64,50
HCPCS,26116,Exc hand tum deep < 1.5 cm,,,927.34,1073.77,8
HCPCS,26116,REMOVAL OF HAND LESION,1075.0,698.75,1.1,2768.64,50
HCPCS,26117,RAD RESECT HAND TUMOR < 3 CM,,,2644.48,8141.48,19
HCPCS,26117,Rad resect hand tumor < 3 cm,,,1518.4,1758.15,8
HCPCS,26118,RAD RESECT HAND TUMOR 3 CM/>,,,2644.48,8141.48,19
HCPCS,26118,Rad resect hand tumor 3 cm/>,,,1518.4,1758.15,8
HCPCS,26121,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,3092.0,2009.8,1.1,5526.53,50
HCPCS,26121,RELEASE PALM CONTRACTURE,,,2997.95,9170.92,19
HCPCS,26121,Release palm contracture,,,1518.4,1758.15,8
HCPCS,26123,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,4352.0,2828.8,1.1,5526.53,50
HCPCS,26123,RELEASE PALM CONTRACTURE,,,2997.95,9170.92,19
HCPCS,26123,Release palm contracture,,,1518.4,1758.15,8
HCPCS,26125,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,1840.0,1196.0,1.1,1840.0,50
HCPCS,26125,Release palm contracture,,,1518.4,1758.15,8
HCPCS,26130,REMOVE WRIST JOINT LINING,,,2997.95,9170.92,19
HCPCS,26130,Remove wrist joint lining,,,927.34,1073.77,8
HCPCS,26130,SYNOVECTOMY CARPOMETACARPAL JOINT,2236.0,1453.4,1.1,5526.53,50
HCPCS,26135,REVISE FINGER JOINT EACH,,,2997.95,9170.92,19
HCPCS,26135,Revise finger joint each,,,1518.4,1758.15,8
HCPCS,26135,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,2852.0,1853.8,1.1,5526.53,50
HCPCS,26140,REVISE FINGER JOINT EACH,,,1478.75,4506.96,19
HCPCS,26140,Revise finger joint each,,,927.34,1073.77,8
HCPCS,26140,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,2536.0,1648.4,1.1,2743.55,50
HCPCS,26145,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,2596.0,1687.4,1.1,2743.55,50
HCPCS,26145,TENDON EXCISION PALM/FINGER,,,1478.75,4506.96,19
HCPCS,26145,Tendon excision palm/finger,,,1518.4,1758.15,8
HCPCS,26160,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,1571.0,1021.15,1.1,2743.55,53
HCPCS,26160,REMOVE TENDON SHEATH LESION,,,1478.75,4506.96,19
HCPCS,26160,Remove tendon sheath lesion,,,927.34,1073.77,8
HCPCS,26170,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,1964.0,1276.6,1.1,2743.55,50
HCPCS,26170,REMOVAL OF PALM TENDON EACH,,,1478.75,4506.96,19
HCPCS,26170,Removal of palm tendon each,,,927.34,1073.77,8
HCPCS,26180,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,2140.0,1391.0,1.1,2743.55,50
HCPCS,26180,REMOVAL OF FINGER TENDON,,,1478.75,4506.96,19
HCPCS,26180,Removal of finger tendon,,,927.34,1073.77,8
HCPCS,26185,REMOVE FINGER BONE,,,1478.75,4506.96,19
HCPCS,26185,Remove finger bone,,,927.34,1073.77,8
HCPCS,26200,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,2260.0,1469.0,1.1,2743.55,50
HCPCS,26200,REMOVE HAND BONE LESION,,,1478.75,4506.96,19
HCPCS,26200,Remove hand bone lesion,,,927.34,1073.77,8
HCPCS,26205,REMOVE/GRAFT BONE LESION,,,6600.66,20338.07,19
HCPCS,26205,Remove/graft bone lesion,,,1518.4,1758.15,8
HCPCS,26210,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,2128.0,1383.2,1.1,2743.55,50
HCPCS,26210,REMOVAL OF FINGER LESION,,,1478.75,4506.96,19
HCPCS,26210,Removal of finger lesion,,,927.34,1073.77,8
HCPCS,26215,REMOVE/GRAFT FINGER LESION,,,2997.95,9170.92,19
HCPCS,26215,Remove/graft finger lesion,,,1518.4,1758.15,8
HCPCS,26230,"PART REMV BONE,METACARPAL",2588.0,1682.2,1.1,5526.53,50
HCPCS,26230,PARTIAL REMOVAL OF HAND BONE,,,2997.95,9170.92,19
HCPCS,26230,Partial removal of hand bone,,,1518.4,1758.15,8
HCPCS,26235,"PART REMV BONE,PROX/MID PHALANX",2532.0,1645.8,1.1,2743.55,50
HCPCS,26235,PARTIAL REMOVAL FINGER BONE,,,1478.75,4506.96,19
HCPCS,26235,Partial removal finger bone,,,1518.4,1758.15,8
HCPCS,26236,"PART REMV BONE,DISTAL PHALANX",2184.0,1419.6,1.1,2743.55,50
HCPCS,26236,PARTIAL REMOVAL FINGER BONE,,,1478.75,4506.96,19
HCPCS,26236,Partial removal finger bone,,,927.34,1073.77,8
HCPCS,26250,EXTENSIVE HAND SURGERY,,,2997.95,9170.92,19
HCPCS,26250,Extensive hand surgery,,,927.34,1073.77,8
HCPCS,26260,RESECT PROX FINGER TUMOR,,,2997.95,9170.92,19
HCPCS,26260,Resect prox finger tumor,,,1518.4,1758.15,8
HCPCS,26262,RESECT DISTAL FINGER TUMOR,,,1478.75,4506.96,19
HCPCS,26262,Resect distal finger tumor,,,927.34,1073.77,8
HCPCS,26320,REMOVAL OF IMPLANT FROM HAND,,,1497.07,4629.18,19
HCPCS,26320,REMOVAL OF IMPLANT FROM HAND/FINGR,1640.0,1066.0,1.1,2768.64,50
HCPCS,26320,Removal of implant from hand,,,927.34,1073.77,8
HCPCS,26340,MANIPULATE FINGER W/ANESTH,,,1478.75,4506.96,19
HCPCS,26340,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,1120.0,728.0,1.1,2743.55,50
HCPCS,26340,Manipulate finger w/anesth,,,654.6,757.96,8
HCPCS,26341,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,733.5,476.77500000000003,0.01,3004.0,114
HCPCS,26350,REPAIR FINGER/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26350,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,2484.0,1614.6,1.1,5526.53,50
HCPCS,26350,Repair finger/hand tendon,,,927.34,1073.77,8
HCPCS,26352,REPAIR/GRAFT HAND TENDON,,,6600.66,20338.07,19
HCPCS,26352,Repair/graft hand tendon,,,1518.4,1758.15,8
HCPCS,26356,REPAIR FINGER/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26356,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,3824.0,2485.6,1.1,5526.53,50
HCPCS,26356,Repair finger/hand tendon,,,1518.4,1758.15,8
HCPCS,26357,REPAIR FINGER/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26357,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,4400.0,2860.0,1.1,5526.53,50
HCPCS,26357,Repair finger/hand tendon,,,1518.4,1758.15,8
HCPCS,26358,REPAIR/GRAFT HAND TENDON,,,6600.66,20338.07,19
HCPCS,26358,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,5040.0,3276.0,1.1,12214.27,50
HCPCS,26358,Repair/graft hand tendon,,,1518.4,1758.15,8
HCPCS,26370,REPAIR FINGER/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26370,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,2912.0,1892.8,1.1,5526.53,50
HCPCS,26370,Repair finger/hand tendon,,,1518.4,1758.15,8
HCPCS,26372,REPAIR/GRAFT HAND TENDON,,,6600.66,20338.07,19
HCPCS,26372,Repair/graft hand tendon,,,1518.4,1758.15,8
HCPCS,26373,REPAIR FINGER/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26373,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,3364.0,2186.6,1.1,5526.53,50
HCPCS,26373,Repair finger/hand tendon,,,1518.4,1758.15,8
HCPCS,26390,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,3772.0,2451.8,1.1,12214.27,50
HCPCS,26390,REVISE HAND/FINGER TENDON,,,6600.66,20338.07,19
HCPCS,26390,Revise hand/finger tendon,,,1518.4,1758.15,8
HCPCS,26392,REPAIR/GRAFT HAND TENDON,,,6600.66,20338.07,19
HCPCS,26392,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,4200.0,2730.0,1.1,12214.27,50
HCPCS,26392,Repair/graft hand tendon,,,1518.4,1758.15,8
HCPCS,26410,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,4635.0,3012.75,1.1,7362.0,111
HCPCS,26412,REPAIR/GRAFT HAND TENDON,,,2997.95,9170.92,19
HCPCS,26412,Repair/graft hand tendon,,,1518.4,1758.15,8
HCPCS,26415,EXCISION HAND/FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26415,Excision hand/finger tendon,,,1518.4,1758.15,8
HCPCS,26416,GRAFT HAND OR FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26416,Graft hand or finger tendon,,,1518.4,1758.15,8
HCPCS,26418,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,4575.0,2973.75,1.1,7445.0,111
HCPCS,26420,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,2776.0,1804.4,1.1,5526.53,50
HCPCS,26420,REPAIR/GRAFT FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26420,Repair/graft finger tendon,,,1518.4,1758.15,8
HCPCS,26426,REPAIR FINGER/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26426,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,2528.0,1643.2,1.1,5526.53,50
HCPCS,26426,Repair finger/hand tendon,,,1518.4,1758.15,8
HCPCS,26428,REPAIR/GRAFT FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26428,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,2960.0,1924.0,1.1,5526.53,50
HCPCS,26428,Repair/graft finger tendon,,,1518.4,1758.15,8
HCPCS,26432,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,1664.0,1081.6,1.1,2743.55,50
HCPCS,26432,REPAIR FINGER TENDON,,,1478.75,4506.96,19
HCPCS,26432,Repair finger tendon,,,927.34,1073.77,8
HCPCS,26433,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,1880.0,1222.0,1.1,5526.53,50
HCPCS,26433,REPAIR FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26433,Repair finger tendon,,,927.34,1073.77,8
HCPCS,26434,REPAIR/GRAFT FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26434,Repair/graft finger tendon,,,1518.4,1758.15,8
HCPCS,26437,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,2396.0,1557.4,1.1,5526.53,50
HCPCS,26437,REALIGNMENT OF TENDONS,,,2997.95,9170.92,19
HCPCS,26437,Realignment of tendons,,,927.34,1073.77,8
HCPCS,26440,RELEASE PALM/FINGER TENDON,,,1478.75,4506.96,19
HCPCS,26440,Release palm/finger tendon,,,927.34,1073.77,8
HCPCS,26440,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,2064.0,1341.6,1.1,2743.55,50
HCPCS,26442,RELEASE PALM & FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26442,Release palm & finger tendon,,,1518.4,1758.15,8
HCPCS,26442,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,4290.0,2788.5,1.1,5526.53,50
HCPCS,26445,RELEASE HAND/FINGER TENDON,,,2997.95,9170.92,19
HCPCS,26445,Release hand/finger tendon,,,927.34,1073.77,8
HCPCS,26445,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,1780.0,1157.0,1.1,5526.53,50
HCPCS,26449,RELEASE FOREARM/HAND TENDON,,,2997.95,9170.92,19
HCPCS,26449,Release forearm/hand tendon,,,927.34,1073.77,8
HCPCS,26449,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,3436.0,2233.4,1.1,5526.53,50
HCPCS,26450,INCISION OF PALM TENDON,,,2997.95,9170.92,19
HCPCS,26450,Incision of palm tendon,,,927.34,1073.77,8
HCPCS,26450,"TENOTOMY PALM FLEX,SINGLE,OPEN,EACH",1516.0,985.4,1.1,5526.53,50
HCPCS,26455,INCISION OF FINGER TENDON,,,1478.75,4506.96,19
HCPCS,26455,Incision of finger tendon,,,927.34,1073.77,8
HCPCS,26455,"TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH",1504.0,977.6,1.1,2743.55,50
HCPCS,26460,INCISE HAND/FINGER TENDON,,,1478.75,4506.96,19
HCPCS,26460,Incise hand/finger tendon,,,927.34,1073.77,8
HCPCS,26460,"TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH",1432.0,930.8,1.1,2743.55,50
HCPCS,26471,FUSION OF FINGER TENDONS,,,2997.95,9170.92,19
HCPCS,26471,Fusion of finger tendons,,,927.34,1073.77,8
HCPCS,26471,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,2360.0,1534.0,1.1,5526.53,50
HCPCS,26474,FUSION OF FINGER TENDONS,,,1478.75,4506.96,19
HCPCS,26474,Fusion of finger tendons,,,927.34,1073.77,8
HCPCS,26476,TENDON LENGTHENING,,,2997.95,9170.92,19
HCPCS,26476,Tendon lengthening,,,927.34,1073.77,8
HCPCS,26477,TENDON SHORTENING,,,2997.95,9170.92,19
HCPCS,26477,Tendon shortening,,,927.34,1073.77,8
HCPCS,26478,LENGTHENING OF HAND TENDON,,,2997.95,9170.92,19
HCPCS,26478,Lengthening of hand tendon,,,927.34,1073.77,8
HCPCS,26478,"TENDON LENGTHENING,FLEX,HAND/FINGR",2388.0,1552.2,1.1,5526.53,50
HCPCS,26479,SHORTENING OF HAND TENDON,,,2997.95,9170.92,19
HCPCS,26479,Shortening of hand tendon,,,927.34,1073.77,8
HCPCS,26480,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,3600.0,2340.0,1.1,5526.53,50
HCPCS,26480,TRANSPLANT HAND TENDON,,,2997.95,9170.92,19
HCPCS,26480,Transplant hand tendon,,,1518.4,1758.15,8
HCPCS,26483,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,3392.0,2204.8,1.1,5526.53,50
HCPCS,26483,TRANSPLANT/GRAFT HAND TENDON,,,2997.95,9170.92,19
HCPCS,26483,Transplant/graft hand tendon,,,1518.4,1758.15,8
HCPCS,26485,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,3156.0,2051.4,1.1,5526.53,50
HCPCS,26485,TRANSPLANT PALM TENDON,,,2997.95,9170.92,19
HCPCS,26485,Transplant palm tendon,,,1518.4,1758.15,8
HCPCS,26489,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,3944.0,2563.6,1.1,5526.53,50
HCPCS,26489,TRANSPLANT/GRAFT PALM TENDON,,,2997.95,9170.92,19
HCPCS,26489,Transplant/graft palm tendon,,,1518.4,1758.15,8
HCPCS,26490,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,3440.0,2236.0,1.1,5526.53,50
HCPCS,26490,REVISE THUMB TENDON,,,2997.95,9170.92,19
HCPCS,26490,Revise thumb tendon,,,1518.4,1758.15,8
HCPCS,26492,OPPONENSPLASTY TDN TR W/GRF EA TDN,3936.0,2558.4,1.1,5526.53,50
HCPCS,26492,TENDON TRANSFER WITH GRAFT,,,2997.95,9170.92,19
HCPCS,26492,Tendon transfer with graft,,,1518.4,1758.15,8
HCPCS,26494,HAND TENDON/MUSCLE TRANSFER,,,2997.95,9170.92,19
HCPCS,26494,Hand tendon/muscle transfer,,,1518.4,1758.15,8
HCPCS,26496,OPPONENSPLASTY OTHER METHODS,3912.0,2542.8,1.1,5526.53,50
HCPCS,26496,REVISE THUMB TENDON,,,2997.95,9170.92,19
HCPCS,26496,Revise thumb tendon,,,1518.4,1758.15,8
HCPCS,26497,FINGER TENDON TRANSFER,,,2997.95,9170.92,19
HCPCS,26497,Finger tendon transfer,,,1518.4,1758.15,8
HCPCS,26497,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,3904.0,2537.6,1.1,5526.53,50
HCPCS,26498,FINGER TENDON TRANSFER,,,2997.95,9170.92,19
HCPCS,26498,Finger tendon transfer,,,1518.4,1758.15,8
HCPCS,26498,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,5684.0,3694.6,1.1,5684.0,50
HCPCS,26499,CORRECTION CLAW FINGER OTHER,,,2997.95,9170.92,19
HCPCS,26499,Correction claw finger other,,,1518.4,1758.15,8
HCPCS,26500,HAND TENDON RECONSTRUCTION,,,6600.66,20338.07,19
HCPCS,26500,Hand tendon reconstruction,,,1518.4,1758.15,8
HCPCS,26500,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,2452.0,1593.8,1.1,12214.27,50
HCPCS,26502,HAND TENDON RECONSTRUCTION,,,2997.95,9170.92,19
HCPCS,26502,Hand tendon reconstruction,,,1518.4,1758.15,8
HCPCS,26502,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,2924.0,1900.6,1.1,5526.53,50
HCPCS,26508,RELEASE THUMB CONTRACTURE,,,2997.95,9170.92,19
HCPCS,26508,Release thumb contracture,,,927.34,1073.77,8
HCPCS,26510,CROSS INTRINSIC TRANSFER EACH TENDON,2240.0,1456.0,1.1,5526.53,50
HCPCS,26510,THUMB TENDON TRANSFER,,,2997.95,9170.92,19
HCPCS,26510,Thumb tendon transfer,,,1518.4,1758.15,8
HCPCS,26516,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,2928.0,1903.2,1.1,5526.53,50
HCPCS,26516,FUSION OF KNUCKLE JOINT,,,2997.95,9170.92,19
HCPCS,26516,Fusion of knuckle joint,,,927.34,1073.77,8
HCPCS,26517,FUSION OF KNUCKLE JOINTS,,,2997.95,9170.92,19
HCPCS,26517,Fusion of knuckle joints,,,927.34,1073.77,8
HCPCS,26518,FUSION OF KNUCKLE JOINTS,,,6600.66,20338.07,19
HCPCS,26518,Fusion of knuckle joints,,,1518.4,1758.15,8
HCPCS,26520,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,2188.0,1422.2,1.1,5526.53,50
HCPCS,26520,RELEASE KNUCKLE CONTRACTURE,,,2997.95,9170.92,19
HCPCS,26520,Release knuckle contracture,,,927.34,1073.77,8
HCPCS,26525,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,2200.0,1430.0,1.1,2743.55,50
HCPCS,26525,RELEASE FINGER CONTRACTURE,,,1478.75,4506.96,19
HCPCS,26525,Release finger contracture,,,927.34,1073.77,8
HCPCS,26530,REVISE KNUCKLE JOINT,,,6600.66,20338.07,19
HCPCS,26530,Revise knuckle joint,,,1890.92,2189.48,8
HCPCS,26531,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,3252.0,2113.8,1.1,12214.27,50
HCPCS,26531,REVISE KNUCKLE WITH IMPLANT,,,6600.66,20338.07,19
HCPCS,26531,Revise knuckle with implant,,,1890.92,2189.48,8
HCPCS,26535,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,8544.5,5553.925,1.1,14925.0,111
HCPCS,26536,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,2624.0,1705.6,1.1,12214.27,50
HCPCS,26536,REVISE/IMPLANT FINGER JOINT,,,6600.66,20338.07,19
HCPCS,26536,Revise/implant finger joint,,,1890.92,2189.48,8
HCPCS,26540,REPAIR HAND JOINT,,,2997.95,9170.92,19
HCPCS,26540,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,2640.0,1716.0,1.1,5526.53,50
HCPCS,26540,Repair hand joint,,,927.34,1073.77,8
HCPCS,26541,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,3524.0,2290.6,1.1,5526.53,50
HCPCS,26541,REPAIR HAND JOINT WITH GRAFT,,,2997.95,9170.92,19
HCPCS,26541,Repair hand joint with graft,,,1518.4,1758.15,8
HCPCS,26542,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,2780.0,1807.0,1.1,5526.53,50
HCPCS,26542,REPAIR HAND JOINT WITH GRAFT,,,2997.95,9170.92,19
HCPCS,26542,Repair hand joint with graft,,,1518.4,1758.15,8
HCPCS,26545,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,2844.0,1848.6,1.1,5526.53,50
HCPCS,26545,RECONSTRUCT FINGER JOINT,,,2997.95,9170.92,19
HCPCS,26545,Reconstruct finger joint,,,1518.4,1758.15,8
HCPCS,26546,REPAIR NONUNION HAND,,,6600.66,20338.07,19
HCPCS,26546,RPR NON-UNION MTCRPL/PHALANX,4332.0,2815.8,1.1,12214.27,50
HCPCS,26546,Repair nonunion hand,,,1518.4,1758.15,8
HCPCS,26548,RECONSTRUCT FINGER JOINT,,,2997.95,9170.92,19
HCPCS,26548,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,3288.0,2137.2,1.1,5526.53,50
HCPCS,26548,Reconstruct finger joint,,,1518.4,1758.15,8
HCPCS,26550,POLLICIZATION DIGIT,,,2997.95,9170.92,19
HCPCS,26550,Pollicization digit,,,1518.4,1758.15,8
HCPCS,26551,GREAT TOE-HAND TRANSFER,,,6864.94,20338.07,13
HCPCS,26551,Great toe-hand transfer,,,3246.83,3759.49,8
HCPCS,26553,SINGLE TRANSFER TOE-HAND,,,6864.94,20338.07,13
HCPCS,26553,Single transfer toe-hand,,,3246.83,3759.49,8
HCPCS,26554,DOUBLE TRANSFER TOE-HAND,,,6864.94,20338.07,13
HCPCS,26554,Double transfer toe-hand,,,3246.83,3759.49,8
HCPCS,26555,POSITIONAL CHANGE OF FINGER,,,6600.66,20338.07,19
HCPCS,26555,Positional change of finger,,,1518.4,1758.15,8
HCPCS,26556,TOE JOINT TRANSFER,,,6864.94,20338.07,13
HCPCS,26556,Toe joint transfer,,,3246.83,3759.49,8
HCPCS,26560,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,7362.0,4785.3,0.01,7362.0,61
HCPCS,26561,REPAIR OF WEB FINGER,,,2997.95,9170.92,19
HCPCS,26561,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,4440.0,2886.0,1.1,5526.53,50
HCPCS,26561,Repair of web finger,,,1518.4,1758.15,8
HCPCS,26562,REPAIR OF WEB FINGER,,,2997.95,9170.92,19
HCPCS,26562,REPAIR SYNDACTYLY EACH SPACE COMPLEX,6672.0,4336.8,1.1,6672.0,50
HCPCS,26562,Repair of web finger,,,1518.4,1758.15,8
HCPCS,26565,CORRECT METACARPAL FLAW,,,2997.95,9170.92,19
HCPCS,26565,Correct metacarpal flaw,,,1518.4,1758.15,8
HCPCS,26565,OSTEOTOMY METACARPAL EACH,2764.0,1796.6,1.1,5526.53,50
HCPCS,26567,CORRECT FINGER DEFORMITY,,,2997.95,9170.92,19
HCPCS,26567,Correct finger deformity,,,1518.4,1758.15,8
HCPCS,26567,OSTEOTOMY PHALANX FINGER EACH,2796.0,1817.4,1.1,5526.53,50
HCPCS,26568,LENGTHEN METACARPAL/FINGER,,,6600.66,20338.07,19
HCPCS,26568,Lengthen metacarpal/finger,,,1518.4,1758.15,8
HCPCS,26580,REPAIR CLEFT HAND,,,2997.95,9170.92,19
HCPCS,26580,Repair cleft hand,,,1518.4,1758.15,8
HCPCS,26587,RECONSTRUCT EXTRA FINGER,,,2997.95,9170.92,19
HCPCS,26587,Reconstruct extra finger,,,1518.4,1758.15,8
HCPCS,26590,REPAIR FINGER DEFORMITY,,,1478.75,4506.96,19
HCPCS,26590,Repair finger deformity,,,1518.4,1758.15,8
HCPCS,26591,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,1487.0,966.55,1.1,5526.53,50
HCPCS,26591,REPAIR MUSCLES OF HAND,,,2997.95,9170.92,19
HCPCS,26591,Repair muscles of hand,,,1518.4,1758.15,8
HCPCS,26593,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,2200.0,1430.0,1.1,5526.53,50
HCPCS,26593,RELEASE MUSCLES OF HAND,,,2997.95,9170.92,19
HCPCS,26593,Release muscles of hand,,,927.34,1073.77,8
HCPCS,26596,EXCISION CONSTRICTING TISSUE,,,2997.95,9170.92,19
HCPCS,26596,Excision constricting tissue,,,1518.4,1758.15,8
HCPCS,26600,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1123.5,730.2750000000001,0.01,2453.0,175
HCPCS,26605,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1218.0,791.7,1.1,4001.0,114
HCPCS,26607,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,2192.0,1424.8,1.1,5526.53,50
HCPCS,26607,TREAT METACARPAL FRACTURE,,,2997.95,9170.92,19
HCPCS,26607,Treat metacarpal fracture,,,234.24,271.23,8
HCPCS,26608,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,2220.0,1443.0,1.1,5526.53,50
HCPCS,26608,TREAT METACARPAL FRACTURE,,,2997.95,9170.92,19
HCPCS,26608,Treat metacarpal fracture,,,2860.13,3311.73,8
HCPCS,26615,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,2828.0,1838.2,1.1,5526.53,50
HCPCS,26615,TREAT METACARPAL FRACTURE,,,2997.95,9608.0,20
HCPCS,26615,Treat metacarpal fracture,,,2860.13,3311.73,8
HCPCS,26641,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1377.5,895.375,1.1,2453.0,114
HCPCS,26645,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,4597.0,2988.05,1.1,7362.0,114
HCPCS,26650,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,2140.0,1391.0,1.1,5526.53,50
HCPCS,26650,TREAT THUMB FRACTURE,,,2997.95,9170.92,19
HCPCS,26650,Treat thumb fracture,,,2860.13,3311.73,8
HCPCS,26665,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,3176.0,2064.4,1.1,5526.53,50
HCPCS,26665,TREAT THUMB FRACTURE,,,2997.95,9170.92,19
HCPCS,26665,Treat thumb fracture,,,2860.13,3311.73,8
HCPCS,26670,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1317.5,856.375,1.1,2453.0,114
HCPCS,26675,TREAT HAND DISLOCATION,,,1478.75,4506.96,19
HCPCS,26675,Treat hand dislocation,,,654.6,757.96,8
HCPCS,26676,PIN HAND DISLOCATION,,,2997.95,9170.92,19
HCPCS,26676,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,2296.0,1492.4,1.1,5526.53,50
HCPCS,26676,Pin hand dislocation,,,2860.13,3311.73,8
HCPCS,26685,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,2828.0,1838.2,1.1,5526.53,50
HCPCS,26685,TREAT HAND DISLOCATION,,,2997.95,9170.92,19
HCPCS,26685,Treat hand dislocation,,,2860.13,3311.73,8
HCPCS,26686,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,3268.0,2124.2,1.1,5526.53,50
HCPCS,26686,TREAT HAND DISLOCATION,,,2997.95,9170.92,19
HCPCS,26686,Treat hand dislocation,,,2860.13,3311.73,8
HCPCS,26700,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1317.5,856.375,0.01,2453.0,175
HCPCS,26705,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,7362.0,4785.3,0.01,7362.0,61
HCPCS,26706,PIN KNUCKLE DISLOCATION,,,2997.95,9170.92,19
HCPCS,26706,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,2124.0,1380.6,1.1,5526.53,50
HCPCS,26706,Pin knuckle dislocation,,,2860.13,3311.73,8
HCPCS,26715,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,2812.0,1827.8,1.1,5526.53,50
HCPCS,26715,TREAT KNUCKLE DISLOCATION,,,2997.95,9170.92,19
HCPCS,26715,Treat knuckle dislocation,,,2860.13,3311.73,8
HCPCS,26720,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,938.5,610.0250000000001,0.01,3004.0,175
HCPCS,26725,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1317.0,856.05,1.1,4001.0,114
HCPCS,26727,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,2168.0,1409.2,1.1,5526.53,50
HCPCS,26727,TREAT FINGER FRACTURE EACH,,,2997.95,9170.92,19
HCPCS,26727,Treat finger fracture each,,,2860.13,3311.73,8
HCPCS,26735,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,2968.0,1929.2,1.1,5526.53,50
HCPCS,26735,TREAT FINGER FRACTURE EACH,,,2997.95,9170.92,19
HCPCS,26735,Treat finger fracture each,,,2860.13,3311.73,8
HCPCS,26740,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,965.5,627.575,1.1,3004.0,114
HCPCS,26742,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,4479.0,2911.3500000000004,1.1,7362.0,114
HCPCS,26746,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,3920.0,2548.0,1.1,5526.53,50
HCPCS,26746,TREAT FINGER FRACTURE EACH,,,2997.95,9170.92,19
HCPCS,26746,Treat finger fracture each,,,2860.13,3311.73,8
HCPCS,26750,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,911.5,592.475,0.01,2453.0,175
HCPCS,26755,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1197.5,778.375,1.1,2453.0,114
HCPCS,26756,PIN FINGER FRACTURE EACH,,,2997.95,9170.92,19
HCPCS,26756,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,1832.0,1190.8,1.1,5526.53,50
HCPCS,26756,Pin finger fracture each,,,2860.13,3311.73,8
HCPCS,26765,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,8634.5,5612.425,1.1,14925.0,111
HCPCS,26770,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1181.5,767.975,0.01,2453.0,175
HCPCS,26775,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1391.0,904.15,1.1,2453.0,114
HCPCS,26776,PIN FINGER DISLOCATION,,,2997.95,9170.92,19
HCPCS,26776,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,1996.0,1297.4,1.1,5526.53,50
HCPCS,26776,Pin finger dislocation,,,2860.13,3311.73,8
HCPCS,26785,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,2640.0,1716.0,1.1,5526.53,50
HCPCS,26785,TREAT FINGER DISLOCATION,,,2997.95,9170.92,19
HCPCS,26785,Treat finger dislocation,,,2860.13,3311.73,8
HCPCS,26820,THUMB FUSION WITH GRAFT,,,6600.66,20338.07,19
HCPCS,26820,Thumb fusion with graft,,,1518.4,1758.15,8
HCPCS,26841,FUSION OF THUMB,,,6600.66,20338.07,19
HCPCS,26841,Fusion of thumb,,,1518.4,1758.15,8
HCPCS,26842,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,3396.0,2207.4,1.1,12214.27,50
HCPCS,26842,THUMB FUSION WITH GRAFT,,,6600.66,20338.07,19
HCPCS,26842,Thumb fusion with graft,,,1518.4,1758.15,8
HCPCS,26843,FUSION OF HAND JOINT,,,6600.66,20338.07,19
HCPCS,26843,Fusion of hand joint,,,927.34,1073.77,8
HCPCS,26844,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,3592.0,2334.8,1.1,12214.27,50
HCPCS,26844,FUSION/GRAFT OF HAND JOINT,,,6600.66,20338.07,19
HCPCS,26844,Fusion/graft of hand joint,,,1518.4,1758.15,8
HCPCS,26850,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,2856.0,1856.4,1.1,12214.27,50
HCPCS,26850,FUSION OF KNUCKLE,,,6600.66,20338.07,19
HCPCS,26850,Fusion of knuckle,,,1518.4,1758.15,8
HCPCS,26852,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,3484.0,2264.6,1.1,12214.27,50
HCPCS,26852,FUSION OF KNUCKLE WITH GRAFT,,,6600.66,20338.07,19
HCPCS,26852,Fusion of knuckle with graft,,,1518.4,1758.15,8
HCPCS,26860,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,1952.0,1268.8,1.1,5526.53,50
HCPCS,26860,FUSION OF FINGER JOINT,,,2997.95,9170.92,19
HCPCS,26860,Fusion of finger joint,,,927.34,1073.77,8
HCPCS,26861,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,696.0,452.4,1.1,696.0,50
HCPCS,26861,Fusion of finger jnt add-on,,,927.34,1073.77,8
HCPCS,26862,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,3024.0,1965.6,1.1,5526.53,50
HCPCS,26862,FUSION/GRAFT OF FINGER JOINT,,,2997.95,9170.92,19
HCPCS,26862,Fusion/graft of finger joint,,,927.34,1073.77,8
HCPCS,26863,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,1556.0,1011.4,1.1,1556.0,50
HCPCS,26863,Fuse/graft added joint,,,927.34,1073.77,8
HCPCS,26910,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,3116.0,2025.4,1.1,5526.53,50
HCPCS,26910,AMPUTATE METACARPAL BONE,,,2997.95,9170.92,19
HCPCS,26910,Amputate metacarpal bone,,,1518.4,1758.15,8
HCPCS,26951,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,8670.5,5635.825,1.1,14925.0,111
HCPCS,26952,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,8758.5,5693.025,1.1,14925.0,111
HCPCS,26989,UNLISTED PROC; TENODESIS RINGER FINGER TO SMALL FINGER (COMP TO,1947.0,1265.55,0.01,1947.0,28
HCPCS,26989,UNLISTED PROCEDURE HANDS OR FINGERS,531.0,345.15,150.17,3004.0,61
HCPCS,26989,UNLISTED RADICAL TENOSYNOVECTOMY ECD TENDON (COMP CODE 26145),2758.25,1792.86,0.01,2758.25,28
HCPCS,26990,DRAINAGE OF PELVIS LESION,1280.0,832.0,1.1,9170.92,69
HCPCS,26990,Drainage of pelvis lesion,,,2435.09,2819.58,8
HCPCS,26990,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,3180.0,2067.0,1.1,5526.53,50
HCPCS,26991,DRAINAGE OF PELVIS BURSA,,,1478.75,4506.96,19
HCPCS,26991,Drainage of pelvis bursa,,,1072.58,1241.93,8
HCPCS,26991,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,2824.0,1835.6,1.1,2824.0,53
HCPCS,26992,DRAINAGE OF BONE LESION,,,3095.56,9170.92,13
HCPCS,26992,Drainage of bone lesion,,,2435.09,2819.58,8
HCPCS,26992,INCISION BONE CORTEX PELVIS&/HIP JOINT,5392.0,3504.8,1.1,5392.0,50
HCPCS,27000,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,4829.0,3138.8500000000004,0.01,7362.0,111
HCPCS,27001,TENOTOMY ADDUCTOR HIP OPEN,2856.0,1856.4,1.1,9170.92,69
HCPCS,27001,Tenotomy adductor hip open,,,2435.09,2819.58,8
HCPCS,27003,TNOT ADDUCTR SUBQ OPN NEURCT,,,6600.66,20338.07,19
HCPCS,27003,Tnot adductr subq opn neurct,,,2435.09,2819.58,8
HCPCS,27005,TENOTOMY HIP FLEXOR OPEN,,,3095.56,9170.92,13
HCPCS,27005,Tenotomy hip flexor open,,,2435.09,2819.58,8
HCPCS,27006,TENOTOMY ABDUCTOR&/XTNSR HIP,,,2997.95,9170.92,19
HCPCS,27006,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,4044.0,2628.6,1.1,5526.53,50
HCPCS,27006,Tenotomy abductor&/xtnsr hip,,,2435.09,2819.58,8
HCPCS,27025,FASCIOTOMY HIP/THIGH ANY TYP,,,3095.56,9170.92,13
HCPCS,27025,FASCIOTOMY HIP/THIGH ANY TYPE,5156.0,3351.4,1.1,5156.0,50
HCPCS,27025,Fasciotomy hip/thigh any typ,,,2435.09,2819.58,8
HCPCS,27027,DCMPRN FASCT PEL COMPARTMENT,,,6600.66,20338.07,19
HCPCS,27027,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,5216.0,3390.4,1.1,12214.27,50
HCPCS,27027,Dcmprn fasct pel compartment,,,2435.09,2819.58,8
HCPCS,27030,ARTHROTOMY HIP W/DRAINAGE,5460.0,3549.0,1.1,20338.07,63
HCPCS,27030,Arthrotomy hip w/drainage,,,2435.09,2819.58,8
HCPCS,27033,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,5644.0,3668.6,1.1,12214.27,50
HCPCS,27033,ARTHRT HIP EXPL/RMV LOOSE/FB,,,6600.66,20338.07,19
HCPCS,27033,Arthrt hip expl/rmv loose/fb,,,2435.09,2819.58,8
HCPCS,27035,DENERVATION OF HIP JOINT,,,2997.95,9170.92,19
HCPCS,27035,Denervation of hip joint,,,2435.09,2819.58,8
HCPCS,27036,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,5752.0,3738.8,1.1,5752.0,50
HCPCS,27036,CAPSULECTOMY/CAPSULOTOMY HIP,,,6864.94,20338.07,13
HCPCS,27036,Capsulectomy/capsulotomy hip,,,2435.09,2819.58,8
HCPCS,27040,BIOPSY OF SOFT TISSUES,,,1497.07,4629.18,19
HCPCS,27040,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,1168.0,759.2,1.1,2768.64,53
HCPCS,27040,Biopsy of soft tissues,,,1072.58,1241.93,8
HCPCS,27041,BIOPSY OF SOFT TISSUES,,,1497.07,4629.18,19
HCPCS,27041,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,4072.0,2646.8,1.1,4072.0,50
HCPCS,27041,Biopsy of soft tissues,,,1072.58,1241.93,8
HCPCS,27043,EXC HIP PELVIS LES SC 3 CM/>,,,2644.48,8141.48,19
HCPCS,27043,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,2752.0,1788.8,1.1,4850.94,50
HCPCS,27043,Exc hip pelvis les sc 3 cm/>,,,1072.58,1241.93,8
HCPCS,27045,EXC HIP/PELV TUM DEEP 5 CM/>,,,2644.48,8141.48,19
HCPCS,27045,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,4452.0,2893.8,1.1,4850.94,50
HCPCS,27045,Exc hip/pelv tum deep 5 cm/>,,,1072.58,1241.93,8
HCPCS,27047,EXC HIP/PELVIS LES SC < 3 CM,,,2644.48,8141.48,19
HCPCS,27047,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,2174.0,1413.1,1.1,4850.94,53
HCPCS,27047,Exc hip/pelvis les sc < 3 cm,,,1072.58,1241.93,8
HCPCS,27048,EXC HIP/PELV TUM DEEP < 5 CM,,,2644.48,8141.48,19
HCPCS,27048,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,3540.0,2301.0,1.1,4850.94,50
HCPCS,27048,Exc hip/pelv tum deep < 5 cm,,,1072.58,1241.93,8
HCPCS,27049,RESECT HIP/PELV TUM < 5 CM,,,2644.48,8141.48,19
HCPCS,27049,Resect hip/pelv tum < 5 cm,,,2435.09,2819.58,8
HCPCS,27050,BIOPSY OF SACROILIAC JOINT,,,1478.75,4506.96,19
HCPCS,27050,Biopsy of sacroiliac joint,,,2435.09,2819.58,8
HCPCS,27052,ARTHROTOMY W/BIOPSY HIP JOINT,2968.0,1929.2,1.1,2968.0,50
HCPCS,27052,BIOPSY OF HIP JOINT,,,1478.75,4506.96,19
HCPCS,27052,Biopsy of hip joint,,,2435.09,2819.58,8
HCPCS,27054,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,3684.0,2394.6,1.1,3684.0,50
HCPCS,27054,REMOVAL OF HIP JOINT LINING,,,3095.56,9170.92,13
HCPCS,27054,Removal of hip joint lining,,,2435.09,2819.58,8
HCPCS,27057,BUTTOCK FASCIOTOMY W/DBRDMT,,,1478.75,4506.96,19
HCPCS,27057,Buttock fasciotomy w/dbrdmt,,,2435.09,2819.58,8
HCPCS,27059,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,11740.0,7631.0,1.1,11740.0,50
HCPCS,27059,RESECT HIP/PELV TUM 5 CM/>,,,2644.48,8141.48,19
HCPCS,27059,Resect hip/pelv tum 5 cm/>,,,2435.09,2819.58,8
HCPCS,27060,REMOVAL OF ISCHIAL BURSA,,,6600.66,20338.07,19
HCPCS,27060,Removal of ischial bursa,,,2435.09,2819.58,8
HCPCS,27062,EXCISION TROCHANTERIC BURSA/CALCIFICATION,8612.5,5598.125,0.01,14925.0,111
HCPCS,27065,REMOVE HIP BONE LES SUPER,,,6600.66,20338.07,19
HCPCS,27065,Remove hip bone les super,,,2435.09,2819.58,8
HCPCS,27066,EXCISION BONE CYST/BENIGN TUMOR DEEP,4480.0,2912.0,1.1,5526.53,50
HCPCS,27066,REMOVE HIP BONE LES DEEP,,,2997.95,9170.92,19
HCPCS,27066,Remove hip bone les deep,,,2435.09,2819.58,8
HCPCS,27067,REMOVE/GRAFT HIP BONE LESION,,,6600.66,20338.07,19
HCPCS,27067,Remove/graft hip bone lesion,,,2435.09,2819.58,8
HCPCS,27070,PART REMOVE HIP BONE SUPER,,,3095.56,9170.92,13
HCPCS,27070,Part remove hip bone super,,,2435.09,2819.58,8
HCPCS,27071,PART REMOVAL HIP BONE DEEP,,,3095.56,9170.92,13
HCPCS,27071,Part removal hip bone deep,,,2435.09,2819.58,8
HCPCS,27075,RESECT HIP TUMOR,,,6864.94,20338.07,13
HCPCS,27075,Resect hip tumor,,,2435.09,2819.58,8
HCPCS,27076,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,16084.0,10454.6,1.1,16084.0,50
HCPCS,27076,RESECT HIP TUM INCL ACETABUL,,,6864.94,20338.07,13
HCPCS,27076,Resect hip tum incl acetabul,,,2435.09,2819.58,8
HCPCS,27077,RESECT HIP TUM W/INNOM BONE,,,6864.94,20338.07,13
HCPCS,27077,Resect hip tum w/innom bone,,,8887.35,10290.62,8
HCPCS,27078,RSECT HIP TUM INCL FEMUR,,,6864.94,20338.07,13
HCPCS,27078,Rsect hip tum incl femur,,,2435.09,2819.58,8
HCPCS,27080,COCCYGECTOMY PRIMARY,2756.0,1791.4,1.1,5526.53,50
HCPCS,27080,REMOVAL OF TAIL BONE,,,2997.95,9170.92,19
HCPCS,27080,Removal of tail bone,,,2435.09,2819.58,8
HCPCS,27086,REMOVE HIP FOREIGN BODY,,,2644.48,8141.48,19
HCPCS,27086,Remove hip foreign body,,,1072.58,1241.93,8
HCPCS,27087,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,3532.0,2295.8,1.1,5526.53,50
HCPCS,27087,REMOVE HIP FOREIGN BODY,,,2997.95,9170.92,19
HCPCS,27087,Remove hip foreign body,,,2435.09,2819.58,8
HCPCS,27090,REMOVAL OF HIP PROSTHESIS,4676.0,3039.4,1.1,20338.07,63
HCPCS,27090,Removal of hip prosthesis,,,2435.09,2819.58,8
HCPCS,27091,REMOVAL OF HIP PROSTHESIS,,,12146.38,35984.87,13
HCPCS,27091,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,9740.0,6331.0,1.1,9740.0,50
HCPCS,27091,Removal of hip prosthesis,,,2435.09,2819.58,8
HCPCS,27093,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,624.0,405.6,0.01,3398.0,191
HCPCS,27095,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,873.0,567.45,65.08,3398.0,46
HCPCS,27096,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1289.5,838.175,0.01,3398.0,237
HCPCS,27097,REVISION OF HIP TENDON,,,2997.95,9170.92,19
HCPCS,27097,Revision of hip tendon,,,2435.09,2819.58,8
HCPCS,27098,ADDUCTOR TRANSFER TO ISCHIUM,4101.0,2665.65,1.1,5526.53,50
HCPCS,27098,TRANSFER TENDON TO PELVIS,,,2997.95,9170.92,19
HCPCS,27098,Transfer tendon to pelvis,,,2435.09,2819.58,8
HCPCS,27100,TRANSFER OF ABDOMINAL MUSCLE,,,6600.66,20338.07,19
HCPCS,27100,Transfer of abdominal muscle,,,2435.09,2819.58,8
HCPCS,27105,TRANSFER OF SPINAL MUSCLE,,,2997.95,9170.92,19
HCPCS,27105,Transfer of spinal muscle,,,2435.09,2819.58,8
HCPCS,27110,TRANSFER OF ILIOPSOAS MUSCLE,,,6600.66,20338.07,19
HCPCS,27110,Transfer of iliopsoas muscle,,,2435.09,2819.58,8
HCPCS,27111,TRANSFER OF ILIOPSOAS MUSCLE,,,2997.95,9170.92,19
HCPCS,27111,Transfer of iliopsoas muscle,,,2435.09,2819.58,8
HCPCS,27120,RECONSTRUCTION OF HIP SOCKET,,,12146.38,35984.87,13
HCPCS,27120,Reconstruction of hip socket,,,2435.09,2819.58,8
HCPCS,27122,ACETABULOPLASTY RESECTION FEMORAL HEAD,6436.0,4183.4,1.1,6436.0,50
HCPCS,27122,RECONSTRUCTION OF HIP SOCKET,,,6864.94,20338.07,13
HCPCS,27122,Reconstruction of hip socket,,,2435.09,2819.58,8
HCPCS,27125,HEMIARTHROPLASTY HIP PARTIAL,6656.0,4326.4,1.1,6656.0,50
HCPCS,27125,PARTIAL HIP REPLACEMENT,,,12146.38,35984.87,13
HCPCS,27125,Partial hip replacement,,,1890.92,2189.48,8
HCPCS,27130,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,8624.0,5605.6,1.1,22471.68,50
HCPCS,27130,TOTAL HIP ARTHROPLASTY,,,11888.68,35984.87,20
HCPCS,27130,Total hip arthroplasty,,,6256.68,7244.58,8
HCPCS,27132,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,11304.0,7347.6,1.1,11304.0,50
HCPCS,27132,TOTAL HIP ARTHROPLASTY,,,12146.38,35984.87,13
HCPCS,27132,Total hip arthroplasty,,,6256.68,7244.58,8
HCPCS,27134,REVISE HIP JOINT REPLACEMENT,,,12146.38,35984.87,13
HCPCS,27134,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,13323.0,8659.95,1.1,13323.0,50
HCPCS,27134,Revise hip joint replacement,,,6256.68,7244.58,8
HCPCS,27137,REVISE HIP JOINT REPLACEMENT,,,12146.38,35984.87,13
HCPCS,27137,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,9988.0,6492.2,1.1,9988.0,50
HCPCS,27137,Revise hip joint replacement,,,6256.68,7244.58,8
HCPCS,27138,REVISE HIP JOINT REPLACEMENT,,,12146.38,35984.87,13
HCPCS,27138,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,10428.0,6778.2,1.1,10428.0,50
HCPCS,27138,Revise hip joint replacement,,,6256.68,7244.58,8
HCPCS,27140,TRANSPLANT FEMUR RIDGE,,,6864.94,20338.07,13
HCPCS,27140,Transplant femur ridge,,,2435.09,2819.58,8
HCPCS,27146,INCISION OF HIP BONE,,,6864.94,20338.07,13
HCPCS,27146,Incision of hip bone,,,2435.09,2819.58,8
HCPCS,27147,REVISION OF HIP BONE,,,6864.94,20338.07,13
HCPCS,27147,Revision of hip bone,,,2435.09,2819.58,8
HCPCS,27151,INCISION OF HIP BONES,,,6864.94,20338.07,13
HCPCS,27151,Incision of hip bones,,,2435.09,2819.58,8
HCPCS,27156,REVISION OF HIP BONES,,,6864.94,20338.07,13
HCPCS,27156,Revision of hip bones,,,2435.09,2819.58,8
HCPCS,27158,REVISION OF PELVIS,,,6864.94,20338.07,13
HCPCS,27158,Revision of pelvis,,,2435.09,2819.58,8
HCPCS,27161,INCISION OF NECK OF FEMUR,,,6864.94,20338.07,13
HCPCS,27161,Incision of neck of femur,,,2435.09,2819.58,8
HCPCS,27161,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,7156.0,4651.4,1.1,7156.0,50
HCPCS,27165,INCISION/FIXATION OF FEMUR,,,6864.94,20338.07,13
HCPCS,27165,Incision/fixation of femur,,,2435.09,2819.58,8
HCPCS,27165,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,8116.0,5275.4,1.1,8116.0,50
HCPCS,27170,REPAIR/GRAFT FEMUR HEAD/NECK,,,6864.94,20338.07,13
HCPCS,27170,Repair/graft femur head/neck,,,2435.09,2819.58,8
HCPCS,27175,TREAT SLIPPED EPIPHYSIS,,,3095.56,9170.92,13
HCPCS,27175,Treat slipped epiphysis,,,2860.13,3311.73,8
HCPCS,27176,TREAT SLIPPED EPIPHYSIS,,,3095.56,9170.92,13
HCPCS,27176,Treat slipped epiphysis,,,2435.09,2819.58,8
HCPCS,27177,TREAT SLIPPED EPIPHYSIS,,,3095.56,9170.92,13
HCPCS,27177,Treat slipped epiphysis,,,2435.09,2819.58,8
HCPCS,27178,TREAT SLIPPED EPIPHYSIS,,,3095.56,9170.92,13
HCPCS,27178,Treat slipped epiphysis,,,2860.13,3311.73,8
HCPCS,27179,REVISE HEAD/NECK OF FEMUR,,,6600.66,20338.07,19
HCPCS,27179,Revise head/neck of femur,,,2435.09,2819.58,8
HCPCS,27181,TREAT SLIPPED EPIPHYSIS,,,6864.94,20338.07,13
HCPCS,27181,Treat slipped epiphysis,,,2860.13,3311.73,8
HCPCS,27185,REVISION OF FEMUR EPIPHYSIS,,,3095.56,9170.92,13
HCPCS,27185,Revision of femur epiphysis,,,2435.09,2819.58,8
HCPCS,27187,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,5692.0,3699.8,1.1,5692.0,50
HCPCS,27187,REINFORCE HIP BONES,,,6864.94,20338.07,13
HCPCS,27187,Reinforce hip bones,,,2435.09,2819.58,8
HCPCS,27197,CLSD TX PELVIC RING FX W/O MANIPULATION,888.0,577.2,0.01,3004.0,172
HCPCS,27198,CLSD TX PELVIC RING FX,,,221.64,691.37,19
HCPCS,27198,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,2090.0,1358.5,1.1,2090.0,50
HCPCS,27198,Clsd tx pelvic ring fx,,,234.24,271.23,8
HCPCS,27200,CLOSED TREATMENT COCCYGEAL FRACTURE,935.5,608.075,0.01,3004.0,175
HCPCS,27202,TREAT TAIL BONE FRACTURE,,,2997.95,9170.92,19
HCPCS,27202,Treat tail bone fracture,,,2860.13,3311.73,8
HCPCS,27215,OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD,4180.0,2717.0,1.1,4180.0,39
HCPCS,27215,Treat pelvic fracture(s),,,2860.13,3311.73,8
HCPCS,27216,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,6292.0,4089.8,1.1,6292.0,39
HCPCS,27216,Treat pelvic ring fracture,,,2860.13,3311.73,8
HCPCS,27217,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,6446.0,4189.9,1.1,6446.0,39
HCPCS,27217,Treat pelvic ring fracture,,,2860.13,3311.73,8
HCPCS,27218,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,8372.0,5441.8,1.1,8372.0,39
HCPCS,27218,Treat pelvic ring fracture,,,2860.13,3311.73,8
HCPCS,27220,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1761.5,1144.975,0.01,2453.0,175
HCPCS,27222,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,3087.5,2006.875,1.1,5644.0,105
HCPCS,27226,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,6228.0,4048.2,1.1,6228.0,50
HCPCS,27226,TREAT HIP WALL FRACTURE,,,6864.94,20338.07,13
HCPCS,27226,Treat hip wall fracture,,,2860.13,3311.73,8
HCPCS,27227,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,10164.0,6606.6,1.1,10164.0,50
HCPCS,27227,TREAT HIP FRACTURE(S),,,6864.94,20338.07,13
HCPCS,27227,Treat hip fracture(s),,,2860.13,3311.73,8
HCPCS,27228,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,11732.0,7625.8,1.1,11732.0,50
HCPCS,27228,TREAT HIP FRACTURE(S),,,6864.94,20338.07,13
HCPCS,27228,Treat hip fracture(s),,,2860.13,3311.73,8
HCPCS,27230,CLTX FEM FX PROX END NCK W/O MANJ,1713.5,1113.775,0.01,3004.0,175
HCPCS,27232,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4780.5,3107.325,1.1,4873.0,105
HCPCS,27235,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,5200.0,3380.0,1.1,12214.27,50
HCPCS,27235,TREAT THIGH FRACTURE,,,6600.66,20338.07,19
HCPCS,27235,Treat thigh fracture,,,2860.13,3311.73,8
HCPCS,27236,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,7044.0,4578.6,1.1,7044.0,50
HCPCS,27236,TREAT THIGH FRACTURE,,,6864.94,20338.07,13
HCPCS,27236,Treat thigh fracture,,,2860.13,3311.73,8
HCPCS,27238,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,4831.0,3140.15,1.1,7362.0,111
HCPCS,27240,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,1820.0,1183.0,234.24,4506.96,55
HCPCS,27244,TREAT THIGH FRACTURE,,,6864.94,20338.07,13
HCPCS,27244,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,7272.0,4726.8,1.1,7272.0,50
HCPCS,27244,Treat thigh fracture,,,2435.09,2819.58,8
HCPCS,27245,TREAT THIGH FRACTURE,,,6864.94,20338.07,13
HCPCS,27245,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,7272.0,4726.8,1.1,7272.0,50
HCPCS,27245,Treat thigh fracture,,,2435.09,2819.58,8
HCPCS,27246,CLTX GREATER TROCHANTERIC FX W/O MANJ,1517.5,986.375,0.01,3004.0,175
HCPCS,27248,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,4312.0,2802.8,1.1,4312.0,50
HCPCS,27248,TREAT THIGH FRACTURE,,,6864.94,20338.07,13
HCPCS,27248,Treat thigh fracture,,,2860.13,3311.73,8
HCPCS,27250,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1392.0,904.8000000000001,1.1,3004.0,111
HCPCS,27252,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,4853.0,3154.45,1.1,4853.0,50
HCPCS,27252,TREAT HIP DISLOCATION,,,1478.75,4506.96,19
HCPCS,27252,Treat hip dislocation,,,654.6,757.96,8
HCPCS,27253,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,5432.0,3530.8,1.1,5432.0,50
HCPCS,27253,TREAT HIP DISLOCATION,,,3095.56,9170.92,13
HCPCS,27253,Treat hip dislocation,,,2860.13,3311.73,8
HCPCS,27254,TREAT HIP DISLOCATION,,,6864.94,20338.07,13
HCPCS,27254,Treat hip dislocation,,,2435.09,2819.58,8
HCPCS,27256,TREAT HIP DISLOCATION,,,221.64,691.37,19
HCPCS,27256,Treat hip dislocation,,,234.24,271.23,8
HCPCS,27257,TREAT HIP DISLOCATION,,,1478.75,4506.96,19
HCPCS,27257,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,2152.0,1398.8,1.1,2743.55,50
HCPCS,27257,Treat hip dislocation,,,654.6,757.96,8
HCPCS,27258,TREAT HIP DISLOCATION,,,3095.56,9170.92,13
HCPCS,27258,Treat hip dislocation,,,2435.09,2819.58,8
HCPCS,27259,TREAT HIP DISLOCATION,,,3095.56,9170.92,13
HCPCS,27259,Treat hip dislocation,,,2435.09,2819.58,8
HCPCS,27265,CLTX POST HIP ARTHRP DISLC W/O ANES,1599.5,1039.6750000000002,1.1,3004.0,111
HCPCS,27266,CLTX POST HIP ARTHRP DISLC REQ ANES,6616.0,4300.4,1.1,7362.0,172
HCPCS,27267,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,8562.5,5565.625,1.1,14925.0,111
HCPCS,27268,CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ,2848.0,1851.2,1.1,2848.0,50
HCPCS,27268,CLTX THIGH FX W/MNPJ,,,1521.28,4506.96,13
HCPCS,27268,Cltx thigh fx w/mnpj,,,234.24,271.23,8
HCPCS,27269,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,7556.0,4911.4,1.1,7556.0,50
HCPCS,27269,OPTX THIGH FX,,,6864.94,20338.07,13
HCPCS,27269,Optx thigh fx,,,2860.13,3311.73,8
HCPCS,27275,MANIPULATION HIP JOINT W ANESTHESIA,928.0,603.2,1.1,2743.55,50
HCPCS,27275,MANIPULATION OF HIP JOINT,,,1478.75,4506.96,19
HCPCS,27275,Manipulation of hip joint,,,654.6,757.96,8
HCPCS,27278,ARTHRD SI JT PLMT IARTIC DEV,,,16588.34,49144.62,19
HCPCS,27278,ARTHRD SI JT PRQ W/PLMT IARTIC IMPLT WO TFXJ DEV,3458.0,2247.7,1.1,37661.58,52
HCPCS,27278,Arthrd si jt plmt iartic dev,,,11158.03,12919.82,8
HCPCS,27279,ARTHRD SI JT PLMT TARTCLR DV,,,16588.34,49144.62,19
HCPCS,27279,Arthrd si jt plmt tartclr dv,,,8887.35,10290.62,8
HCPCS,27280,ARTHR SI JT OPN B1GRF INSTRM,,,16588.34,49144.62,13
HCPCS,27280,ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ,8000.0,5200.0,1.1,8000.0,50
HCPCS,27280,Arthr si jt opn b1grf instrm,,,8887.35,10290.62,8
HCPCS,27282,ARTHRODESIS SYMPHYSIS PUBIS,,,3095.56,9170.92,13
HCPCS,27282,Arthrodesis symphysis pubis,,,8887.35,10290.62,8
HCPCS,27284,ARTHRODESIS HIP JOINT,,,12146.38,35984.87,13
HCPCS,27284,Arthrodesis hip joint,,,8887.35,10290.62,8
HCPCS,27286,ARTHRD HIP JT SBTRCHC OSTEOT,,,12146.38,35984.87,13
HCPCS,27286,Arthrd hip jt sbtrchc osteot,,,8887.35,10290.62,8
HCPCS,27290,AMPUTATION OF LEG AT HIP,,,16588.34,49144.62,13
HCPCS,27290,Amputation of leg at hip,,,8887.35,10290.62,8
HCPCS,27295,AMPUTATION OF LEG AT HIP,,,16588.34,49144.62,13
HCPCS,27295,Amputation of leg at hip,,,8887.35,10290.62,8
HCPCS,27295,DISARTICULATION OF HIP,7864.0,5111.6,1.1,7864.0,50
HCPCS,27299,ABDUCTOR ANCHOR RECONSTRUCTION (COMP CODE 27100),4880.0,3172.0,0.01,4880.0,28
HCPCS,27299,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),7981.5,5187.975,0.01,13324.0,89
HCPCS,27299,GLUTEUS MEDIUS/MINIMUS REPAIR (COMP CODE 27385),2458.0,1597.7,0.01,2458.0,28
HCPCS,27299,OPEN PX TO RPR ABDUCTOR MUSCULATURE TO TUMOR PROSTHESIS (COMP CO,4101.0,2665.65,0.01,4101.0,28
HCPCS,27299,OSTEOPLASTY,6207.0,4034.55,221.64,6207.0,61
HCPCS,27299,PELVIS/HIP JOINT SURGERY UNLISTED,2318.0,1506.7,0.01,2318.0,28
HCPCS,27299,POSTERIOR CAPSULAR RECONSTRUCTION (COMP CODE 27100),4540.0,2951.0,0.01,4540.0,28
HCPCS,27299,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",914.0,594.1,0.01,914.0,28
HCPCS,27299,"UNLISTED PROC, PELVIS OR HIP JOINT COMPARED TO 29916",2250.0,1462.5,0.01,2250.0,28
HCPCS,27299,UNLISTED PROC; CORE DECOMPRESSION OF FEMORAL HEAD (COMP TO 27235,4290.0,2788.5,0.01,4290.0,28
HCPCS,27299,UNLISTED PROC; OPEN TREATMENT TOTAL HIP REPLACEMENT DISLOCATION,2501.0,1625.65,0.01,2501.0,28
HCPCS,27299,"UNLISTED PROCEDURE, PELVIS OR HIP JOINT (COMPARISON CODE 22511)",2501.0,1625.65,0.01,2501.0,28
HCPCS,27301,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,7938.5,5160.025,1.1,13165.0,114
HCPCS,27303,DRAINAGE OF BONE LESION,,,3095.56,9170.92,13
HCPCS,27303,Drainage of bone lesion,,,1971.0,2282.21,8
HCPCS,27303,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,3452.0,2243.8,1.1,3452.0,50
HCPCS,27305,"FASCIOTOMY,ILIOTIBIAL,OPEN",2472.0,1606.8,1.1,5526.53,50
HCPCS,27305,INCISE THIGH TENDON & FASCIA,,,2997.95,9170.92,19
HCPCS,27305,Incise thigh tendon & fascia,,,2435.09,2819.58,8
HCPCS,27306,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,8410.5,5466.825,0.01,14925.0,111
HCPCS,27307,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,8674.5,5638.425,0.01,14925.0,111
HCPCS,27310,ARTHRT KNE W/EXPL DRG/RMVL FB,4000.0,2600.0,1.1,5526.53,50
HCPCS,27310,EXPLORATION OF KNEE JOINT,,,2997.95,9170.92,19
HCPCS,27310,Exploration of knee joint,,,1971.0,2282.21,8
HCPCS,27323,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,932.0,605.8,1.1,2768.64,53
HCPCS,27323,BIOPSY THIGH SOFT TISSUES,,,1497.07,4629.18,19
HCPCS,27323,Biopsy thigh soft tissues,,,1072.58,1241.93,8
HCPCS,27324,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,2016.0,1310.4,1.1,4850.94,50
HCPCS,27324,BIOPSY THIGH SOFT TISSUES,,,2644.48,8141.48,19
HCPCS,27324,Biopsy thigh soft tissues,,,1072.58,1241.93,8
HCPCS,27325,NEURECTOMY HAMSTRING,,,1804.32,5473.19,19
HCPCS,27325,Neurectomy hamstring,,,2435.09,2819.58,8
HCPCS,27326,NEURECTOMY POPLITEAL,,,1804.32,5473.19,19
HCPCS,27326,Neurectomy popliteal,,,1971.0,2282.21,8
HCPCS,27327,EXC THIGH/KNEE LES SC < 3 CM,,,1497.07,6831.0,20
HCPCS,27327,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
HCPCS,27327,Exc thigh/knee les sc < 3 cm,,,1072.58,1241.93,8
HCPCS,27328,EXC THIGH/KNEE TUM DEEP <5CM,,,2644.48,8141.48,19
HCPCS,27328,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,3540.0,2301.0,1.1,4850.94,50
HCPCS,27328,Exc thigh/knee tum deep <5cm,,,1072.58,1241.93,8
HCPCS,27329,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,6288.0,4087.2,1.1,6288.0,50
HCPCS,27329,RESECT THIGH/KNEE TUM < 5 CM,,,2644.48,8141.48,19
HCPCS,27329,Resect thigh/knee tum < 5 cm,,,1971.0,2282.21,8
HCPCS,27330,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,2044.0,1328.6,1.1,5526.53,50
HCPCS,27330,BIOPSY KNEE JOINT LINING,,,2997.95,9170.92,19
HCPCS,27330,Biopsy knee joint lining,,,1971.0,2282.21,8
HCPCS,27331,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,2408.0,1565.2,1.1,5526.53,50
HCPCS,27331,EXPLORE/TREAT KNEE JOINT,,,2997.95,9170.92,19
HCPCS,27331,Explore/treat knee joint,,,1971.0,2282.21,8
HCPCS,27332,REMOVAL OF KNEE CARTILAGE,,,2997.95,9170.92,19
HCPCS,27332,Removal of knee cartilage,,,1971.0,2282.21,8
HCPCS,27333,REMOVAL OF KNEE CARTILAGE,,,2997.95,9170.92,19
HCPCS,27333,Removal of knee cartilage,,,1971.0,2282.21,8
HCPCS,27334,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,3676.0,2389.4,1.1,5526.53,50
HCPCS,27334,REMOVE KNEE JOINT LINING,,,2997.95,9170.92,19
HCPCS,27334,Remove knee joint lining,,,1971.0,2282.21,8
HCPCS,27335,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,4220.0,2743.0,1.1,12214.27,50
HCPCS,27335,REMOVE KNEE JOINT LINING,,,6600.66,20338.07,19
HCPCS,27335,Remove knee joint lining,,,4234.94,4903.61,8
HCPCS,27337,EXC THIGH/KNEE LES SC 3 CM/>,,,2644.48,8141.48,20
HCPCS,27337,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,2364.0,1536.6,1.1,4850.94,50
HCPCS,27337,EXICSN TUMR SFT TSSUE THIGH OR KNEE >3CM,910.0,591.5,1.1,4850.94,50
HCPCS,27337,Exc thigh/knee les sc 3 cm/>,,,1072.58,1241.93,8
HCPCS,27339,EXC THIGH/KNEE TUM DEP 5CM/>,,,2644.48,8141.48,19
HCPCS,27339,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,4452.0,2893.8,1.1,4850.94,50
HCPCS,27339,"EXCISION TUMOR, THIGH, KNEE, 5 CM >",1641.0,1066.65,1.1,4850.94,50
HCPCS,27339,Exc thigh/knee tum dep 5cm/>,,,1072.58,1241.93,8
HCPCS,27340,EXCISION PREPATELLAR BURSA,1728.0,1123.2,1.1,5526.53,50
HCPCS,27340,REMOVAL OF KNEECAP BURSA,,,2997.95,9170.92,19
HCPCS,27340,Removal of kneecap bursa,,,1971.0,2282.21,8
HCPCS,27345,EXCISION SYNOVIAL CYST POPLITEAL SPACE,2436.0,1583.4,1.1,5526.53,50
HCPCS,27345,REMOVAL OF KNEE CYST,,,2997.95,9170.92,19
HCPCS,27345,Removal of knee cyst,,,1971.0,2282.21,8
HCPCS,27347,EXCISION LESION MENISCUS/CAPSULE KNEE,2692.0,1749.8,1.1,5526.53,50
HCPCS,27347,REMOVE KNEE CYST,,,2997.95,9170.92,19
HCPCS,27347,Remove knee cyst,,,1971.0,2282.21,8
HCPCS,27350,PATELLECTOMY/HEMIPATELLECTOMY,3464.0,2251.6,1.1,12214.27,50
HCPCS,27350,REMOVAL OF KNEECAP,,,6600.66,20338.07,19
HCPCS,27350,Removal of kneecap,,,1971.0,2282.21,8
HCPCS,27355,EXCISION/CURETTAGE CYST/TUMOR FEMUR,3200.0,2080.0,1.1,5526.53,50
HCPCS,27355,REMOVE FEMUR LESION,,,2997.95,9170.92,19
HCPCS,27355,Remove femur lesion,,,2435.09,2819.58,8
HCPCS,27356,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,4036.0,2623.4,1.1,22471.68,50
HCPCS,27356,REMOVE FEMUR LESION/GRAFT,,,11888.68,35984.87,19
HCPCS,27356,Remove femur lesion/graft,,,2435.09,2819.58,8
HCPCS,27357,REMOVE FEMUR LESION/GRAFT,,,6600.66,20338.07,19
HCPCS,27357,Remove femur lesion/graft,,,2435.09,2819.58,8
HCPCS,27358,Remove femur lesion/fixation,,,2435.09,2819.58,8
HCPCS,27360,PARTIAL REMOVAL LEG BONE(S),,,2997.95,9170.92,19
HCPCS,27360,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,4584.0,2979.6,1.1,5526.53,50
HCPCS,27360,Partial removal leg bone(s),,,1971.0,2282.21,8
HCPCS,27364,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,9796.0,6367.4,1.1,9796.0,50
HCPCS,27364,RESECT THIGH/KNEE TUM 5 CM/>,,,2644.48,8141.48,19
HCPCS,27364,Resect thigh/knee tum 5 cm/>,,,1971.0,2282.21,8
HCPCS,27365,"RAD RESEC TUMOR,FEMUR OR KNEE",12884.0,8374.6,1.1,12884.0,50
HCPCS,27365,RESECT FEMUR/KNEE TUMOR,,,3095.56,9170.92,13
HCPCS,27365,Resect femur/knee tumor,,,2435.09,2819.58,8
HCPCS,27369,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,0.01,3398.0,92
HCPCS,27369,NJX PX CNTRST KNE ARTHG CONTRST ENHNCD CT/MRI KNE,308.0,200.2,1.1,608.77,53
HCPCS,27372,REMOVAL OF FOREIGN BODY,837.0,544.05,1.1,8141.48,72
HCPCS,27372,"REMV FOREIGN BODY,KNEE/THIGH,DEEP",2084.0,1354.6,1.1,4850.94,53
HCPCS,27372,Removal of foreign body,,,1072.58,1241.93,8
HCPCS,27380,REPAIR OF KNEECAP TENDON,,,6600.66,20338.07,20
HCPCS,27380,Repair of kneecap tendon,,,1971.0,2282.21,8
HCPCS,27380,SUTURE INFRAPATELLAR TENDON PRIMARY,2980.0,1937.0,1.1,12214.27,50
HCPCS,27381,REPAIR/GRAFT KNEECAP TENDON,,,6600.66,20338.07,19
HCPCS,27381,Repair/graft kneecap tendon,,,4234.94,4903.61,8
HCPCS,27381,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,4304.0,2797.6,1.1,12214.27,50
HCPCS,27385,REPAIR OF THIGH MUSCLE,,,6600.66,20338.07,19
HCPCS,27385,Repair of thigh muscle,,,2435.09,2819.58,8
HCPCS,27385,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,3049.0,1981.85,1.1,12214.27,50
HCPCS,27386,REPAIR/GRAFT OF THIGH MUSCLE,,,6600.66,20338.07,19
HCPCS,27386,Repair/graft of thigh muscle,,,2435.09,2819.58,8
HCPCS,27386,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,4452.0,2893.8,1.1,12214.27,50
HCPCS,27390,INCISION OF THIGH TENDON,,,2997.95,9170.92,19
HCPCS,27390,Incision of thigh tendon,,,2435.09,2819.58,8
HCPCS,27391,INCISION OF THIGH TENDONS,,,2997.95,9170.92,19
HCPCS,27391,Incision of thigh tendons,,,2435.09,2819.58,8
HCPCS,27392,INCISION OF THIGH TENDONS,,,2997.95,9170.92,19
HCPCS,27392,Incision of thigh tendons,,,2435.09,2819.58,8
HCPCS,27393,LENGTHENING OF THIGH TENDON,,,6600.66,20338.07,19
HCPCS,27393,Lengthening of thigh tendon,,,2435.09,2819.58,8
HCPCS,27394,LENGTHENING OF THIGH TENDONS,,,6600.66,20338.07,19
HCPCS,27394,Lengthening of thigh tendons,,,2435.09,2819.58,8
HCPCS,27395,LENGTHENING OF THIGH TENDONS,,,2997.95,9170.92,19
HCPCS,27395,Lengthening of thigh tendons,,,2435.09,2819.58,8
HCPCS,27396,TRANSPLANT OF THIGH TENDON,,,6600.66,20338.07,19
HCPCS,27396,Transplant of thigh tendon,,,2435.09,2819.58,8
HCPCS,27397,TRANSPLANTS OF THIGH TENDONS,,,6600.66,20338.07,19
HCPCS,27397,Transplants of thigh tendons,,,2435.09,2819.58,8
HCPCS,27400,REVISE THIGH MUSCLES/TENDONS,,,6600.66,20338.07,19
HCPCS,27400,Revise thigh muscles/tendons,,,2435.09,2819.58,8
HCPCS,27403,ARTHROTOMY W/MENISCUS REPAIR KNEE,3448.0,2241.2,1.1,12214.27,50
HCPCS,27403,REPAIR OF KNEE CARTILAGE,,,6600.66,20338.07,19
HCPCS,27403,Repair of knee cartilage,,,1971.0,2282.21,8
HCPCS,27405,REPAIR OF KNEE LIGAMENT,,,6600.66,20338.07,19
HCPCS,27405,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,3632.0,2360.8,1.1,12214.27,50
HCPCS,27405,Repair of knee ligament,,,4234.94,4903.61,8
HCPCS,27407,REPAIR OF KNEE LIGAMENT,,,6600.66,20338.07,19
HCPCS,27407,Repair of knee ligament,,,4234.94,4903.61,8
HCPCS,27409,REPAIR OF KNEE LIGAMENTS,,,6600.66,20338.07,19
HCPCS,27409,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,5484.0,3564.6,1.1,12214.27,50
HCPCS,27409,Repair of knee ligaments,,,4234.94,4903.61,8
HCPCS,27412,AUTOCHONDROCYTE IMPLANT KNEE,,,6600.66,20338.07,19
HCPCS,27412,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,9896.0,6432.4,1.1,12214.27,50
HCPCS,27412,Autochondrocyte implant knee,,,3451.33,3996.28,8
HCPCS,27415,OSTEOCHONDRAL KNEE ALLOGRAFT,8000.0,5200.0,1.1,35984.87,69
HCPCS,27415,Osteochondral knee allograft,,,3451.33,3996.28,8
HCPCS,27416,OSTEOCHONDRAL KNEE AUTOGRAFT,,,6600.66,20338.07,19
HCPCS,27416,Osteochondral knee autograft,,,4234.94,4903.61,8
HCPCS,27418,ANTERIOR TIBIAL TUBERCLEPLASTY,4640.0,3016.0,1.1,12214.27,50
HCPCS,27418,REPAIR DEGENERATED KNEECAP,,,6600.66,20338.07,19
HCPCS,27418,Repair degenerated kneecap,,,4234.94,4903.61,8
HCPCS,27420,RCNSTJ DISLOCATING PATELLA,4104.0,2667.6,1.1,12214.27,50
HCPCS,27420,REVISION OF UNSTABLE KNEECAP,,,6600.66,20338.07,19
HCPCS,27420,Revision of unstable kneecap,,,4234.94,4903.61,8
HCPCS,27422,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,4084.0,2654.6,1.1,12214.27,50
HCPCS,27422,REVISION OF UNSTABLE KNEECAP,,,6600.66,20338.07,19
HCPCS,27422,Revision of unstable kneecap,,,4234.94,4903.61,8
HCPCS,27424,REVISION/REMOVAL OF KNEECAP,,,6600.66,20338.07,19
HCPCS,27424,Revision/removal of kneecap,,,4234.94,4903.61,8
HCPCS,27425,LAT RETINACULAR RELEASE OPEN,,,2997.95,9170.92,19
HCPCS,27425,LATERAL RETINACULAR RELEASE OPEN,2156.0,1401.4,1.1,5526.53,50
HCPCS,27425,Lat retinacular release open,,,1971.0,2282.21,8
HCPCS,27427,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,3916.0,2545.4,1.1,12214.27,50
HCPCS,27427,RECONSTRUCTION KNEE,,,6600.66,20338.07,19
HCPCS,27427,Reconstruction knee,,,4234.94,4903.61,8
HCPCS,27428,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,6232.0,4050.8,1.1,22471.68,50
HCPCS,27428,RECONSTRUCTION KNEE,,,11888.68,35984.87,19
HCPCS,27428,Reconstruction knee,,,4234.94,4903.61,8
HCPCS,27429,RECONSTRUCTION KNEE,,,11888.68,35984.87,19
HCPCS,27429,Reconstruction knee,,,4234.94,4903.61,8
HCPCS,27430,QUADRICEPSPLASTY,4064.0,2641.6,1.1,12214.27,50
HCPCS,27430,REVISION OF THIGH MUSCLES,,,6600.66,20338.07,19
HCPCS,27430,Revision of thigh muscles,,,2435.09,2819.58,8
HCPCS,27435,INCISION OF KNEE JOINT,,,2997.95,9170.92,19
HCPCS,27435,Incision of knee joint,,,1971.0,2282.21,8
HCPCS,27437,ARTHROPLASTY PATELLA W/O PROSTHESIS,3572.0,2321.8,1.1,12214.27,50
HCPCS,27437,REVISE KNEECAP,,,6600.66,20338.07,19
HCPCS,27437,Revise kneecap,,,1890.92,2189.48,8
HCPCS,27438,ARTHROPLASTY PATELLA W/PROSTHESIS,4756.0,3091.4,1.1,22471.68,50
HCPCS,27438,REVISE KNEECAP WITH IMPLANT,,,11888.68,35984.87,19
HCPCS,27438,Revise kneecap with implant,,,6256.68,7244.58,8
HCPCS,27440,REVISION OF KNEE JOINT,,,11888.68,35984.87,19
HCPCS,27440,Revision of knee joint,,,6256.68,7244.58,8
HCPCS,27441,REVISION OF KNEE JOINT,,,11888.68,35984.87,19
HCPCS,27441,Revision of knee joint,,,6256.68,7244.58,8
HCPCS,27442,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,4948.0,3216.2,1.1,22471.68,50
HCPCS,27442,REVISION OF KNEE JOINT,,,11888.68,35984.87,19
HCPCS,27442,Revision of knee joint,,,6256.68,7244.58,8
HCPCS,27443,REVISION OF KNEE JOINT,,,11888.68,35984.87,19
HCPCS,27443,Revision of knee joint,,,6256.68,7244.58,8
HCPCS,27445,Revision of knee joint,,,6256.68,7244.58,8
HCPCS,27446,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,6852.0,4453.8,1.1,22471.68,50
HCPCS,27446,REVISION OF KNEE JOINT,,,11888.68,35984.87,19
HCPCS,27446,Revision of knee joint,,,6256.68,7244.58,8
HCPCS,27447,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,7840.0,5096.0,1.1,22471.68,50
HCPCS,27447,TOTAL KNEE ARTHROPLASTY,,,11888.68,35984.87,20
HCPCS,27447,Total knee arthroplasty,,,6256.68,7244.58,8
HCPCS,27448,INCISION OF THIGH,,,6864.94,20338.07,13
HCPCS,27448,Incision of thigh,,,2435.09,2819.58,8
HCPCS,27448,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,4640.0,3016.0,1.1,4640.0,50
HCPCS,27450,INCISION OF THIGH,,,6864.94,20338.07,13
HCPCS,27450,Incision of thigh,,,2435.09,2819.58,8
HCPCS,27450,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,5844.0,3798.6,1.1,5844.0,50
HCPCS,27454,REALIGNMENT OF THIGH BONE,,,6864.94,20338.07,13
HCPCS,27454,Realignment of thigh bone,,,2435.09,2819.58,8
HCPCS,27455,REALIGNMENT OF KNEE,,,6864.94,20338.07,13
HCPCS,27455,Realignment of knee,,,4234.94,4903.61,8
HCPCS,27457,REALIGNMENT OF KNEE,,,6864.94,20338.07,13
HCPCS,27457,Realignment of knee,,,4234.94,4903.61,8
HCPCS,27458,OSTEOT FEMUR IMED LNGTH DEV,,,6864.94,20338.07,13
HCPCS,27458,OSTEOT FEMUR UNI INSJ XTRNL CTRLD IMED LNGTH DEV,11726.0,7621.9,1.1,11726.0,35
HCPCS,27458,Osteot femur imed lngth dev,,,2435.09,2819.58,8
HCPCS,27465,SHORTENING OF THIGH BONE,,,6864.94,20338.07,13
HCPCS,27465,Shortening of thigh bone,,,2435.09,2819.58,8
HCPCS,27466,LENGTHENING OF THIGH BONE,,,6864.94,20338.07,13
HCPCS,27466,Lengthening of thigh bone,,,2435.09,2819.58,8
HCPCS,27468,Shorten/lengthen thighs,,,2435.09,2819.58,8
HCPCS,27470,REPAIR OF THIGH,,,6864.94,20338.07,13
HCPCS,27470,RPR NON/MAL FEMUR DSTL H/N W/O GRF,6856.0,4456.4,1.1,6856.0,50
HCPCS,27470,Repair of thigh,,,2435.09,2819.58,8
HCPCS,27472,REPAIR/GRAFT OF THIGH,,,6864.94,20338.07,13
HCPCS,27472,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,8237.0,5354.05,1.1,8237.0,50
HCPCS,27472,Repair/graft of thigh,,,2435.09,2819.58,8
HCPCS,27475,SURGERY TO STOP LEG GROWTH,,,6600.66,20338.07,19
HCPCS,27475,Surgery to stop leg growth,,,2435.09,2819.58,8
HCPCS,27477,SURGERY TO STOP LEG GROWTH,,,6600.66,20338.07,19
HCPCS,27477,Surgery to stop leg growth,,,1971.0,2282.21,8
HCPCS,27479,SURGERY TO STOP LEG GROWTH,,,6600.66,20338.07,19
HCPCS,27479,Surgery to stop leg growth,,,4234.94,4903.61,8
HCPCS,27485,SURGERY TO STOP LEG GROWTH,,,6600.66,20338.07,19
HCPCS,27485,Surgery to stop leg growth,,,1971.0,2282.21,8
HCPCS,27486,REVISE/REPLACE KNEE JOINT,,,12146.38,35984.87,13
HCPCS,27486,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,8448.0,5491.2,1.1,8448.0,50
HCPCS,27486,Revise/replace knee joint,,,6256.68,7244.58,8
HCPCS,27487,REVISE/REPLACE KNEE JOINT,,,16588.34,49144.62,13
HCPCS,27487,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,10844.0,7048.6,1.1,10844.0,50
HCPCS,27487,Revise/replace knee joint,,,6256.68,7244.58,8
HCPCS,27488,REMOVAL OF KNEE PROSTHESIS,,,12146.38,35984.87,13
HCPCS,27488,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,7040.0,4576.0,1.1,7040.0,50
HCPCS,27488,Removal of knee prosthesis,,,4234.94,4903.61,8
HCPCS,27495,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,6616.0,4300.4,1.1,6616.0,50
HCPCS,27495,REINFORCE THIGH,,,6864.94,20338.07,13
HCPCS,27495,Reinforce thigh,,,2435.09,2819.58,8
HCPCS,27496,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,2712.0,1762.8,1.1,5526.53,50
HCPCS,27496,DECOMPRESSION OF THIGH/KNEE,,,2997.95,9170.92,19
HCPCS,27496,Decompression of thigh/knee,,,2435.09,2819.58,8
HCPCS,27497,DECOMPRESSION OF THIGH/KNEE,,,2997.95,9170.92,19
HCPCS,27497,Decompression of thigh/knee,,,1971.0,2282.21,8
HCPCS,27498,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,3464.0,2251.6,1.1,3464.0,50
HCPCS,27498,DECOMPRESSION OF THIGH/KNEE,,,1478.75,4506.96,19
HCPCS,27498,Decompression of thigh/knee,,,1971.0,2282.21,8
HCPCS,27499,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,3772.0,2451.8,1.1,12214.27,50
HCPCS,27499,DECOMPRESSION OF THIGH/KNEE,,,6600.66,20338.07,19
HCPCS,27499,Decompression of thigh/knee,,,1971.0,2282.21,8
HCPCS,27500,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1811.5,1177.475,0.01,3004.0,175
HCPCS,27501,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1841.5,1196.975,1.1,4001.0,114
HCPCS,27502,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,5953.0,3869.45,1.1,7362.0,111
HCPCS,27503,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,4508.0,2930.2,1.1,4508.0,50
HCPCS,27503,TREATMENT OF THIGH FRACTURE,,,1478.75,4506.96,19
HCPCS,27503,Treatment of thigh fracture,,,234.24,271.23,8
HCPCS,27506,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,7860.0,5109.0,1.1,7860.0,50
HCPCS,27506,TREATMENT OF THIGH FRACTURE,,,6864.94,20338.07,13
HCPCS,27506,Treatment of thigh fracture,,,2435.09,2819.58,8
HCPCS,27507,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5792.0,3764.8,1.1,5792.0,50
HCPCS,27507,TREATMENT OF THIGH FRACTURE,,,6864.94,20338.07,13
HCPCS,27507,Treatment of thigh fracture,,,2860.13,3311.73,8
HCPCS,27508,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1791.5,1164.475,0.01,3004.0,175
HCPCS,27509,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,3256.0,2116.4,1.1,12214.27,50
HCPCS,27509,TREATMENT OF THIGH FRACTURE,,,6600.66,20338.07,19
HCPCS,27509,Treatment of thigh fracture,,,2860.13,3311.73,8
HCPCS,27510,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,5641.0,3666.65,1.1,7362.0,111
HCPCS,27511,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,6648.0,4321.2,1.1,6648.0,50
HCPCS,27511,TREATMENT OF THIGH FRACTURE,,,12146.38,35984.87,13
HCPCS,27511,Treatment of thigh fracture,,,2860.13,3311.73,8
HCPCS,27513,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,8470.0,5505.5,1.1,8470.0,50
HCPCS,27513,TREATMENT OF THIGH FRACTURE,,,12146.38,35984.87,13
HCPCS,27513,Treatment of thigh fracture,,,2860.13,3311.73,8
HCPCS,27514,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,5840.0,3796.0,1.1,5840.0,50
HCPCS,27514,TREATMENT OF THIGH FRACTURE,,,12146.38,35984.87,13
HCPCS,27514,Treatment of thigh fracture,,,2860.13,3311.73,8
HCPCS,27516,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,2236.0,1453.4,1.1,2236.0,53
HCPCS,27516,TREAT THIGH FX GROWTH PLATE,,,221.64,691.37,19
HCPCS,27516,Treat thigh fx growth plate,,,234.24,271.23,8
HCPCS,27517,TREAT THIGH FX GROWTH PLATE,,,1478.75,4506.96,19
HCPCS,27517,Treat thigh fx growth plate,,,234.24,271.23,8
HCPCS,27519,TREAT THIGH FX GROWTH PLATE,,,6864.94,20338.07,13
HCPCS,27519,Treat thigh fx growth plate,,,2435.09,2819.58,8
HCPCS,27520,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1159.5,753.675,0.01,3004.0,175
HCPCS,27524,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,4148.0,2696.2,1.1,12214.27,50
HCPCS,27524,TREAT KNEECAP FRACTURE,,,6600.66,20338.07,19
HCPCS,27524,Treat kneecap fracture,,,2860.13,3311.73,8
HCPCS,27530,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1134.5,737.425,0.01,3004.0,175
HCPCS,27532,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,9123.5,5930.275,1.1,14925.0,114
HCPCS,27535,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,5364.0,3486.6,1.1,5364.0,50
HCPCS,27535,TREAT KNEE FRACTURE,,,6864.94,20338.07,13
HCPCS,27535,Treat knee fracture,,,2860.13,3311.73,8
HCPCS,27536,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,6956.0,4521.4,1.1,6956.0,50
HCPCS,27536,TREAT KNEE FRACTURE,,,6864.94,20338.07,13
HCPCS,27536,Treat knee fracture,,,2860.13,3311.73,8
HCPCS,27538,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1569.5,1020.1750000000001,0.01,3004.0,175
HCPCS,27540,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,4520.0,2938.0,1.1,4520.0,50
HCPCS,27540,TREAT KNEE FRACTURE,,,6864.94,20338.07,13
HCPCS,27540,Treat knee fracture,,,2860.13,3311.73,8
HCPCS,27550,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1747.5,1135.875,1.1,3004.0,114
HCPCS,27552,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,3272.0,2126.8,1.1,3272.0,50
HCPCS,27552,TREAT KNEE DISLOCATION,,,1478.75,4506.96,19
HCPCS,27552,Treat knee dislocation,,,654.6,757.96,8
HCPCS,27556,TREAT KNEE DISLOCATION,,,6864.94,20338.07,13
HCPCS,27556,Treat knee dislocation,,,4234.94,4903.61,8
HCPCS,27557,OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR,6996.0,4547.4,1.1,6996.0,50
HCPCS,27557,TREAT KNEE DISLOCATION,,,6864.94,20338.07,13
HCPCS,27557,Treat knee dislocation,,,4234.94,4903.61,8
HCPCS,27558,TREAT KNEE DISLOCATION,,,6864.94,20338.07,13
HCPCS,27558,Treat knee dislocation,,,4234.94,4903.61,8
HCPCS,27560,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1349.5,877.1750000000001,1.1,3004.0,114
HCPCS,27562,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,2392.0,1554.8,1.1,2392.0,50
HCPCS,27562,TREAT KNEECAP DISLOCATION,,,221.64,691.37,19
HCPCS,27562,Treat kneecap dislocation,,,654.6,757.96,8
HCPCS,27566,TREAT KNEECAP DISLOCATION,,,6600.66,20338.07,19
HCPCS,27566,Treat kneecap dislocation,,,2860.13,3311.73,8
HCPCS,27570,FIXATION OF KNEE JOINT,,,1478.75,4506.96,19
HCPCS,27570,Fixation of knee joint,,,654.6,757.96,8
HCPCS,27570,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,716.0,465.4,1.1,2743.55,50
HCPCS,27580,ARTHRODESIS KNEE ANY TECHNIQUE,8440.0,5486.0,1.1,8440.0,50
HCPCS,27580,FUSION OF KNEE,,,12146.38,35984.87,13
HCPCS,27580,Fusion of knee,,,4234.94,4903.61,8
HCPCS,27590,AMPUTATE LEG AT THIGH,,,3095.56,9170.92,13
HCPCS,27590,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,5927.0,3852.55,1.1,5927.0,50
HCPCS,27590,Amputate leg at thigh,,,2435.09,2819.58,8
HCPCS,27591,AMPUTATE LEG AT THIGH,,,3095.56,9170.92,13
HCPCS,27591,Amputate leg at thigh,,,2435.09,2819.58,8
HCPCS,27592,AMPUTATE LEG AT THIGH,,,3095.56,9170.92,13
HCPCS,27592,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,4392.0,2854.8,1.1,4392.0,50
HCPCS,27592,Amputate leg at thigh,,,2435.09,2819.58,8
HCPCS,27594,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,2916.0,1895.4,1.1,5526.53,50
HCPCS,27594,AMPUTATION FOLLOW-UP SURGERY,,,2997.95,9170.92,19
HCPCS,27594,Amputation follow-up surgery,,,2435.09,2819.58,8
HCPCS,27596,AMPUTATION FOLLOW-UP SURGERY,,,3095.56,9170.92,13
HCPCS,27596,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,4516.0,2935.4,1.1,4516.0,50
HCPCS,27596,Amputation follow-up surgery,,,2435.09,2819.58,8
HCPCS,27598,AMPUTATE LOWER LEG AT KNEE,,,3095.56,9170.92,13
HCPCS,27598,Amputate lower leg at knee,,,4234.94,4903.61,8
HCPCS,27599,"ALLOGRAFT STRUT, FEMUR (COMP CODE 27472)",8050.0,5232.5,0.01,8050.0,28
HCPCS,27599,"ARTHROPLASTY FEMORAL/FEMUR/PATELLA, KNEE (COMP CODE 27446)",7365.0,4787.25,0.01,7365.0,28
HCPCS,27599,MANIPULATION KNEE JOINT NOT UNDER GENERAL ANESTHESIA (COMP CODE,769.0,499.85,0.01,769.0,28
HCPCS,27599,OPEN REPAIR OF MEDIAL RETINACULUM (COMP CODE 27424),4096.0,2662.4,0.01,4096.0,28
HCPCS,27599,PERCUTANEOUS ULTRASOUND GUIDED TENOTOMY OF LEFT KNEE (COMP TO 24,1795.0,1166.75,0.01,1795.0,28
HCPCS,27599,"REPAIR OF GLUTEUS MEDIUS INSERTION, RIGHT HIP (COMP TO 27385)",2269.0,1474.85,0.01,2269.0,28
HCPCS,27599,STAGE 1 OSSEOINTEGRATION (COMP CODE 27495),7112.0,4622.8,0.01,7112.0,28
HCPCS,27599,TREATMENT OF OSSEOUS FEMORAL HEAD & NECK METATSTATIC DISEASE W/I,769.0,499.85,0.01,769.0,28
HCPCS,27599,"UNLIST PROC, FEMUR OR KNEE COMPARED TO 27509",1190.0,773.5,0.01,1190.0,28
HCPCS,27599,"UNLIST PROC, FEMUR OR KNEE COMPARED TO 29855",1645.0,1069.25,0.01,1645.0,28
HCPCS,27599,"UNLISTED PROC, POLYETHYLENE EXCHANGE FOR A PARTIAL KNEE REPLACEM",5864.0,3811.6,0.01,5864.0,28
HCPCS,27599,"UNLISTED PROCEDURE, FEMUR OR KNEE COMPARED TO CPT 27365",8356.0,5431.4,0.01,8356.0,28
HCPCS,27599,UNLISTED PX FEMUR/KNEE,,,221.64,691.37,19
HCPCS,27599,Unlisted px femur/knee,,,234.24,271.23,8
HCPCS,27600,DECOMPRESS ANT/LAT LEG CMPART,2412.0,1567.8,1.1,5526.53,50
HCPCS,27600,DECOMPRESSION OF LOWER LEG,,,2997.95,9170.92,19
HCPCS,27600,Decompression of lower leg,,,1971.0,2282.21,8
HCPCS,27601,DECOMPRESS POST LEG COMPARTMT,2420.0,1573.0,1.1,5526.53,50
HCPCS,27601,DECOMPRESSION OF LOWER LEG,,,2997.95,9170.92,19
HCPCS,27601,Decompression of lower leg,,,1971.0,2282.21,8
HCPCS,27602,DECOMPRESS ANT/LAT+POST LEG CMPART,3128.0,2033.2,1.1,5526.53,50
HCPCS,27602,DECOMPRESSION OF LOWER LEG,,,2997.95,9170.92,19
HCPCS,27602,Decompression of lower leg,,,1971.0,2282.21,8
HCPCS,27603,DRAIN LOWER LEG LESION,,,2644.48,8141.48,19
HCPCS,27603,Drain lower leg lesion,,,1072.58,1241.93,8
HCPCS,27603,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,2092.0,1359.8,1.1,4850.94,53
HCPCS,27604,DRAIN LOWER LEG BURSA,,,2997.95,9170.92,19
HCPCS,27604,Drain lower leg bursa,,,1971.0,2282.21,8
HCPCS,27604,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,1836.0,1193.4,1.1,5526.53,53
HCPCS,27605,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,4265.0,2772.25,0.01,7362.0,114
HCPCS,27606,INCISION OF ACHILLES TENDON,,,2997.95,9170.92,19
HCPCS,27606,Incision of achilles tendon,,,1971.0,2282.21,8
HCPCS,27606,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,1672.0,1086.8,1.1,5526.53,50
HCPCS,27607,INCISION LEG/ANKLE,3448.0,2241.2,1.1,5526.53,50
HCPCS,27607,TREAT LOWER LEG BONE LESION,,,2997.95,9170.92,19
HCPCS,27607,Treat lower leg bone lesion,,,1971.0,2282.21,8
HCPCS,27610,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,3652.0,2373.8,1.1,5526.53,50
HCPCS,27610,EXPLORE/TREAT ANKLE JOINT,,,2997.95,9170.92,19
HCPCS,27610,Explore/treat ankle joint,,,1971.0,2282.21,8
HCPCS,27612,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,3260.0,2119.0,1.1,5526.53,50
HCPCS,27612,EXPLORATION OF ANKLE JOINT,,,2997.95,9170.92,19
HCPCS,27612,Exploration of ankle joint,,,1971.0,2282.21,8
HCPCS,27613,BIOPSY LOWER LEG SOFT TISSUE,,,1497.07,4629.18,19
HCPCS,27613,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,888.0,577.2,1.1,2768.64,53
HCPCS,27613,Biopsy lower leg soft tissue,,,1072.58,1241.93,8
HCPCS,27614,BIOPSY LOWER LEG SOFT TISSUE,,,2644.48,8141.48,19
HCPCS,27614,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,2320.0,1508.0,1.1,4850.94,53
HCPCS,27614,Biopsy lower leg soft tissue,,,1072.58,1241.93,8
HCPCS,27615,RESECT LEG/ANKLE TUM < 5 CM,,,2644.48,8141.48,19
HCPCS,27615,Resect leg/ankle tum < 5 cm,,,1072.58,1241.93,8
HCPCS,27616,RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5+CM,7852.0,5103.8,1.1,7852.0,50
HCPCS,27616,RESECT LEG/ANKLE TUM 5 CM/>,,,2644.48,8141.48,19
HCPCS,27616,Resect leg/ankle tum 5 cm/>,,,1072.58,1241.93,8
HCPCS,27618,EXC LEG/ANKLE TUM < 3 CM,,,1497.07,4629.18,19
HCPCS,27618,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,1584.0,1029.6,1.1,2768.64,53
HCPCS,27618,Exc leg/ankle tum < 3 cm,,,1072.58,1241.93,8
HCPCS,27619,EXC LEG/ANKLE TUM DEEP <5 CM,,,2644.48,8141.48,19
HCPCS,27619,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,2764.0,1796.6,1.1,4850.94,50
HCPCS,27619,Exc leg/ankle tum deep <5 cm,,,1072.58,1241.93,8
HCPCS,27620,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,2460.0,1599.0,1.1,5526.53,50
HCPCS,27620,EXPLORE/TREAT ANKLE JOINT,,,2997.95,9170.92,19
HCPCS,27620,Explore/treat ankle joint,,,1971.0,2282.21,8
HCPCS,27625,ARTHROTOMY W/SYNOVECTOMY ANKLE,3396.0,2207.4,1.1,5526.53,50
HCPCS,27625,REMOVE ANKLE JOINT LINING,,,2997.95,9170.92,19
HCPCS,27625,Remove ankle joint lining,,,1971.0,2282.21,8
HCPCS,27626,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,3640.0,2366.0,1.1,5526.53,50
HCPCS,27626,REMOVE ANKLE JOINT LINING,,,2997.95,9170.92,19
HCPCS,27626,Remove ankle joint lining,,,1971.0,2282.21,8
HCPCS,27630,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,1976.0,1284.4,1.1,5526.53,53
HCPCS,27630,REMOVAL OF TENDON LESION,,,2997.95,9170.92,19
HCPCS,27630,Removal of tendon lesion,,,1971.0,2282.21,8
HCPCS,27632,EXC LEG/ANKLE LES SC 3 CM/>,,,2644.48,8141.48,19
HCPCS,27632,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM,2364.0,1536.6,1.1,4850.94,50
HCPCS,27632,Exc leg/ankle les sc 3 cm/>,,,1971.0,2282.21,8
HCPCS,27634,EXC LEG/ANKLE TUM DEP 5 CM/>,,,2644.48,8141.48,19
HCPCS,27634,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,4052.0,2633.8,1.1,4850.94,50
HCPCS,27634,Exc leg/ankle tum dep 5 cm/>,,,1971.0,2282.21,8
HCPCS,27635,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,3212.0,2087.8,1.1,5526.53,50
HCPCS,27635,REMOVE LOWER LEG BONE LESION,,,2997.95,9170.92,19
HCPCS,27635,Remove lower leg bone lesion,,,1971.0,2282.21,8
HCPCS,27637,REMOVE/GRAFT LEG BONE LESION,,,6600.66,20338.07,19
HCPCS,27637,Remove/graft leg bone lesion,,,4234.94,4903.61,8
HCPCS,27638,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,4396.0,2857.4,1.1,12214.27,50
HCPCS,27638,REMOVE/GRAFT LEG BONE LESION,,,6600.66,20338.07,19
HCPCS,27638,Remove/graft leg bone lesion,,,4234.94,4903.61,8
HCPCS,27640,PARTIAL EXCISION BONE TIBIA,4896.0,3182.4,1.1,5526.53,50
HCPCS,27640,PARTIAL REMOVAL OF TIBIA,,,2997.95,9170.92,19
HCPCS,27640,Partial removal of tibia,,,4234.94,4903.61,8
HCPCS,27641,PARTIAL EXCISION BONE FIBULA,3936.0,2558.4,1.1,5526.53,50
HCPCS,27641,PARTIAL REMOVAL OF FIBULA,,,2997.95,9170.92,19
HCPCS,27641,Partial removal of fibula,,,1971.0,2282.21,8
HCPCS,27645,RESECT TIBIA TUMOR,,,3095.56,9170.92,13
HCPCS,27645,Resect tibia tumor,,,4234.94,4903.61,8
HCPCS,27646,"RAD RESEC TUMOR,FIBULA",9284.0,6034.6,1.1,9284.0,50
HCPCS,27646,RESECT FIBULA TUMOR,,,3095.56,9170.92,13
HCPCS,27646,Resect fibula tumor,,,4234.94,4903.61,8
HCPCS,27647,RESECT TALUS/CALCANEUS TUM,,,2997.95,9170.92,19
HCPCS,27647,Resect talus/calcaneus tum,,,4234.94,4903.61,8
HCPCS,27648,INJECTION ANKLE ARTHROGRAPHY,651.0,423.15,65.08,3398.0,92
HCPCS,27650,REPAIR ACHILLES TENDON,,,6600.66,20338.07,19
HCPCS,27650,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,3684.0,2394.6,1.1,12214.27,50
HCPCS,27650,Repair achilles tendon,,,1971.0,2282.21,8
HCPCS,27652,REPAIR/GRAFT ACHILLES TENDON,,,6600.66,20338.07,19
HCPCS,27652,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,4312.0,2802.8,1.1,12214.27,50
HCPCS,27652,Repair/graft achilles tendon,,,4234.94,4903.61,8
HCPCS,27654,REPAIR OF ACHILLES TENDON,,,6600.66,20338.07,19
HCPCS,27654,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,4212.0,2737.8,1.1,12214.27,50
HCPCS,27654,Repair of achilles tendon,,,4234.94,4903.61,8
HCPCS,27656,REPAIR LEG FASCIA DEFECT,,,2997.95,9170.92,19
HCPCS,27656,Repair leg fascia defect,,,2435.09,2819.58,8
HCPCS,27658,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,2048.0,1331.2,1.1,5526.53,50
HCPCS,27658,REPAIR OF LEG TENDON EACH,,,2997.95,9170.92,19
HCPCS,27658,Repair of leg tendon each,,,1971.0,2282.21,8
HCPCS,27659,REPAIR OF LEG TENDON EACH,,,6600.66,20338.07,19
HCPCS,27659,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,2840.0,1846.0,1.1,12214.27,50
HCPCS,27659,Repair of leg tendon each,,,4234.94,4903.61,8
HCPCS,27664,REPAIR OF LEG TENDON EACH,,,6600.66,20338.07,19
HCPCS,27664,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,1892.0,1229.8,1.1,12214.27,50
HCPCS,27664,Repair of leg tendon each,,,1971.0,2282.21,8
HCPCS,27665,REPAIR OF LEG TENDON EACH,,,6600.66,20338.07,19
HCPCS,27665,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,2228.0,1448.2,1.1,12214.27,50
HCPCS,27665,Repair of leg tendon each,,,4234.94,4903.61,8
HCPCS,27675,REPAIR LOWER LEG TENDONS,,,2997.95,9170.92,19
HCPCS,27675,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,2940.0,1911.0,1.1,5526.53,50
HCPCS,27675,Repair lower leg tendons,,,1971.0,2282.21,8
HCPCS,27676,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,3492.0,2269.8,1.1,12214.27,50
HCPCS,27676,REPAIR LOWER LEG TENDONS,,,6600.66,20338.07,19
HCPCS,27676,Repair lower leg tendons,,,4234.94,4903.61,8
HCPCS,27680,RELEASE OF LOWER LEG TENDON,,,2997.95,9170.92,19
HCPCS,27680,Release of lower leg tendon,,,1971.0,2282.21,8
HCPCS,27680,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,2352.0,1528.8,1.1,5526.53,50
HCPCS,27681,RELEASE OF LOWER LEG TENDONS,,,2997.95,9170.92,19
HCPCS,27681,Release of lower leg tendons,,,1971.0,2282.21,8
HCPCS,27681,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,2820.0,1833.0,1.1,5526.53,50
HCPCS,27685,"LENGTH/SHORT LEG/ANKL TENDON,SINGLE",2676.0,1739.4,1.1,5526.53,53
HCPCS,27685,REVISION OF LOWER LEG TENDON,,,2997.95,9170.92,19
HCPCS,27685,Revision of lower leg tendon,,,1971.0,2282.21,8
HCPCS,27686,REVISE LOWER LEG TENDONS,,,2997.95,9170.92,19
HCPCS,27686,Revise lower leg tendons,,,1971.0,2282.21,8
HCPCS,27687,GASTROCNEMIUS RECESSION,2564.0,1666.6,1.1,5526.53,50
HCPCS,27687,REVISION OF CALF TENDON,,,2997.95,9170.92,19
HCPCS,27687,Revision of calf tendon,,,1971.0,2282.21,8
HCPCS,27690,REVISE LOWER LEG TENDON,,,6600.66,20338.07,19
HCPCS,27690,Revise lower leg tendon,,,4234.94,4903.61,8
HCPCS,27690,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,3668.0,2384.2,1.1,12214.27,50
HCPCS,27691,REVISE LOWER LEG TENDON,,,6600.66,20338.07,19
HCPCS,27691,Revise lower leg tendon,,,4234.94,4903.61,8
HCPCS,27691,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,4196.0,2727.4,1.1,12214.27,50
HCPCS,27692,Revise additional leg tendon,,,4234.94,4903.61,8
HCPCS,27692,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,748.0,486.2,1.1,748.0,50
HCPCS,27695,REPAIR OF ANKLE LIGAMENT,,,6600.66,20338.07,19
HCPCS,27695,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,2680.0,1742.0,1.1,12214.27,50
HCPCS,27695,Repair of ankle ligament,,,4234.94,4903.61,8
HCPCS,27696,REPAIR OF ANKLE LIGAMENTS,,,6600.66,20338.07,19
HCPCS,27696,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,3432.0,2230.8,1.1,12214.27,50
HCPCS,27696,Repair of ankle ligaments,,,4234.94,4903.61,8
HCPCS,27698,REPAIR OF ANKLE LIGAMENT,,,6600.66,20338.07,20
HCPCS,27698,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,3844.0,2498.6,1.1,12214.27,50
HCPCS,27698,Repair of ankle ligament,,,4234.94,4903.61,8
HCPCS,27700,REVISION OF ANKLE JOINT,,,6600.66,20338.07,19
HCPCS,27700,Revision of ankle joint,,,1890.92,2189.48,8
HCPCS,27702,RECONSTRUCT ANKLE JOINT,,,16992.04,76052.54,19
HCPCS,27702,Reconstruct ankle joint,,,6256.68,7244.58,8
HCPCS,27703,RECONSTRUCTION ANKLE JOINT,,,16588.34,49144.62,13
HCPCS,27703,Reconstruction ankle joint,,,6256.68,7244.58,8
HCPCS,27704,REMOVAL OF ANKLE IMPLANT,3124.0,2030.6,1.1,9170.92,69
HCPCS,27704,Removal of ankle implant,,,1971.0,2282.21,8
HCPCS,27705,OSTEOTOMY TIBIA,4344.0,2823.6,1.1,20338.07,69
HCPCS,27705,Osteotomy tibia,,,4234.94,4903.61,8
HCPCS,27707,OSTEOTOMY FIBULA,1912.0,1242.8,1.1,9170.92,69
HCPCS,27707,Osteotomy fibula,,,4234.94,4903.61,8
HCPCS,27709,OSTEOTOMY TIBIA & FIBULA,6992.0,4544.8,1.1,35984.87,69
HCPCS,27709,Osteotomy tibia & fibula,,,4234.94,4903.61,8
HCPCS,27712,OSTEOT MLT RELIGNMT IMED ROD,,,12146.38,35984.87,13
HCPCS,27712,Osteot mlt relignmt imed rod,,,4234.94,4903.61,8
HCPCS,27713,OSTEOT TIBIA IMED LNGTH DEV,,,6864.94,20338.07,13
HCPCS,27713,OSTEOT TIBIA UNI INSJ XTRNL CTRLD IMED LNGTH DEV,12320.0,8008.0,1.1,12320.0,35
HCPCS,27713,Osteot tibia imed lngth dev,,,4234.94,4903.61,8
HCPCS,27715,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,6200.0,4030.0,1.1,6200.0,50
HCPCS,27715,OSTPL TIBFIB LNGTH/SHRT,,,12146.38,35984.87,13
HCPCS,27715,Ostpl tibfib lngth/shrt,,,4234.94,4903.61,8
HCPCS,27720,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,4944.0,3213.6,1.1,12214.27,50
HCPCS,27720,REPAIR OF TIBIA,,,6600.66,20338.07,19
HCPCS,27720,Repair of tibia,,,2860.13,3311.73,8
HCPCS,27722,REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT,5478.0,3560.7,1.1,12214.27,50
HCPCS,27722,REPAIR/GRAFT OF TIBIA,,,6600.66,20338.07,19
HCPCS,27722,Repair/graft of tibia,,,2860.13,3311.73,8
HCPCS,27724,REPAIR/GRAFT OF TIBIA,,,6864.94,20338.07,13
HCPCS,27724,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,7724.0,5020.6,1.1,7724.0,50
HCPCS,27724,Repair/graft of tibia,,,2860.13,3311.73,8
HCPCS,27725,REPAIR OF LOWER LEG,,,6864.94,20338.07,13
HCPCS,27725,Repair of lower leg,,,4234.94,4903.61,8
HCPCS,27726,REPAIR FIBULA NONUNION,,,6600.66,20338.07,19
HCPCS,27726,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,5736.0,3728.4,1.1,12214.27,50
HCPCS,27726,Repair fibula nonunion,,,2860.13,3311.73,8
HCPCS,27727,REPAIR OF LOWER LEG,,,3095.56,9170.92,13
HCPCS,27727,Repair of lower leg,,,4234.94,4903.61,8
HCPCS,27730,REPAIR OF TIBIA EPIPHYSIS,,,2997.95,9170.92,19
HCPCS,27730,Repair of tibia epiphysis,,,1971.0,2282.21,8
HCPCS,27732,REPAIR OF FIBULA EPIPHYSIS,,,2997.95,9170.92,19
HCPCS,27732,Repair of fibula epiphysis,,,1971.0,2282.21,8
HCPCS,27734,REPAIR LOWER LEG EPIPHYSES,,,2997.95,9170.92,19
HCPCS,27734,Repair lower leg epiphyses,,,1971.0,2282.21,8
HCPCS,27740,REPAIR OF LEG EPIPHYSES,,,2997.95,9170.92,19
HCPCS,27740,Repair of leg epiphyses,,,1971.0,2282.21,8
HCPCS,27742,REPAIR OF LEG EPIPHYSES,,,2997.95,9170.92,19
HCPCS,27742,Repair of leg epiphyses,,,1971.0,2282.21,8
HCPCS,27745,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,4196.0,2727.4,1.1,12214.27,50
HCPCS,27745,REINFORCE TIBIA,,,6600.66,20338.07,19
HCPCS,27745,Reinforce tibia,,,4234.94,4903.61,8
HCPCS,27750,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1225.5,796.575,0.01,3004.0,175
HCPCS,27752,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,4935.0,3207.75,1.1,7362.0,114
HCPCS,27756,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,2980.0,1937.0,1.1,12214.27,50
HCPCS,27756,TREATMENT OF TIBIA FRACTURE,,,6600.66,20338.07,19
HCPCS,27756,Treatment of tibia fracture,,,2860.13,3311.73,8
HCPCS,27758,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5016.0,3260.4,1.1,22471.68,50
HCPCS,27758,TREATMENT OF TIBIA FRACTURE,,,11888.68,35984.87,19
HCPCS,27758,Treatment of tibia fracture,,,2860.13,3311.73,8
HCPCS,27759,TREATMENT OF TIBIA FRACTURE,,,11888.68,35984.87,19
HCPCS,27759,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,5780.0,3757.0,1.1,22471.68,50
HCPCS,27759,Treatment of tibia fracture,,,2860.13,3311.73,8
HCPCS,27760,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1193.5,775.7750000000001,0.01,3004.0,175
HCPCS,27762,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,4775.0,3103.75,1.1,7362.0,114
HCPCS,27766,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,3156.0,2051.4,1.1,12214.27,50
HCPCS,27766,OPTX MEDIAL ANKLE FX,,,6600.66,20338.07,19
HCPCS,27766,Optx medial ankle fx,,,2860.13,3311.73,8
HCPCS,27767,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1079.5,701.675,0.01,3004.0,174
HCPCS,27768,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,4709.0,3060.8500000000004,1.1,7362.0,111
HCPCS,27769,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,4056.0,2636.4,1.1,12214.27,50
HCPCS,27769,OPTX POST ANKLE FX,,,6600.66,20338.07,19
HCPCS,27769,Optx post ankle fx,,,2860.13,3311.73,8
HCPCS,27780,CLTX PROX FIBULA/SHFT FX W/O MANJ,1117.5,726.375,0.01,3004.0,175
HCPCS,27781,CLTX PROX FIBULA/SHFT FX W/MANJ,4599.0,2989.3500000000004,1.1,7362.0,114
HCPCS,27784,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,3868.0,2514.2,1.1,12214.27,50
HCPCS,27784,TREATMENT OF FIBULA FRACTURE,,,6600.66,20338.07,19
HCPCS,27784,Treatment of fibula fracture,,,2860.13,3311.73,8
HCPCS,27786,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1155.5,751.075,0.01,3004.0,175
HCPCS,27788,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1479.5,961.6750000000001,1.1,3004.0,114
HCPCS,27792,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,3500.0,2275.0,1.1,12214.27,50
HCPCS,27792,TREATMENT OF ANKLE FRACTURE,,,6600.66,20338.07,20
HCPCS,27792,Treatment of ankle fracture,,,2860.13,3311.73,8
HCPCS,27808,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1157.5,752.375,0.01,3004.0,175
HCPCS,27810,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,4745.0,3084.25,1.1,7362.0,114
HCPCS,27814,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,4248.0,2761.2,1.1,12214.27,50
HCPCS,27814,TREATMENT OF ANKLE FRACTURE,,,6600.66,20338.07,19
HCPCS,27814,Treatment of ankle fracture,,,2860.13,3311.73,8
HCPCS,27816,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1227.0,797.55,0.01,3004.0,175
HCPCS,27818,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,4933.0,3206.45,1.1,7362.0,114
HCPCS,27822,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,4484.0,2914.6,1.1,12214.27,50
HCPCS,27822,TREATMENT OF ANKLE FRACTURE,,,6600.66,20338.07,19
HCPCS,27822,Treatment of ankle fracture,,,2860.13,3311.73,8
HCPCS,27823,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,5264.0,3421.6,1.1,12214.27,50
HCPCS,27823,TREATMENT OF ANKLE FRACTURE,,,6600.66,20338.07,20
HCPCS,27823,Treatment of ankle fracture,,,2860.13,3311.73,8
HCPCS,27824,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1213.5,788.7750000000001,0.01,3004.0,175
HCPCS,27825,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,5019.0,3262.3500000000004,1.1,7362.0,114
HCPCS,27826,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,4440.0,2886.0,1.1,12214.27,50
HCPCS,27826,TREAT LOWER LEG FRACTURE,,,6600.66,20338.07,19
HCPCS,27826,Treat lower leg fracture,,,2860.13,3311.73,8
HCPCS,27827,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,5916.0,3845.4,1.1,22471.68,50
HCPCS,27827,TREAT LOWER LEG FRACTURE,,,11888.68,35984.87,19
HCPCS,27827,Treat lower leg fracture,,,2860.13,3311.73,8
HCPCS,27828,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,7372.0,4791.8,1.1,22471.68,50
HCPCS,27828,TREAT LOWER LEG FRACTURE,,,11888.68,35984.87,19
HCPCS,27828,Treat lower leg fracture,,,2860.13,3311.73,8
HCPCS,27829,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,3520.0,2288.0,1.1,12214.27,50
HCPCS,27829,TREAT LOWER LEG JOINT,,,6600.66,20338.07,20
HCPCS,27829,Treat lower leg joint,,,2860.13,3311.73,8
HCPCS,27830,CLTX PROX TIBFIB JT DISLC W/O ANES,1584.0,1029.6,1.1,1584.0,53
HCPCS,27830,TREAT LOWER LEG DISLOCATION,,,221.64,691.37,19
HCPCS,27830,Treat lower leg dislocation,,,234.24,271.23,8
HCPCS,27831,TREAT LOWER LEG DISLOCATION,,,2997.95,9170.92,19
HCPCS,27831,Treat lower leg dislocation,,,234.24,271.23,8
HCPCS,27832,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,4475.0,2908.75,1.1,12214.27,50
HCPCS,27832,TREAT LOWER LEG DISLOCATION,,,6600.66,20338.07,19
HCPCS,27832,Treat lower leg dislocation,,,2860.13,3311.73,8
HCPCS,27840,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1505.5,978.575,1.1,3004.0,111
HCPCS,27842,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,2584.0,1679.6,1.1,2743.55,50
HCPCS,27842,TREAT ANKLE DISLOCATION,,,1478.75,4506.96,19
HCPCS,27842,Treat ankle dislocation,,,654.6,757.96,8
HCPCS,27846,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,4112.0,2672.8,1.1,12214.27,50
HCPCS,27846,TREAT ANKLE DISLOCATION,,,6600.66,20338.07,19
HCPCS,27846,Treat ankle dislocation,,,2860.13,3311.73,8
HCPCS,27848,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,4672.0,3036.8,1.1,12214.27,50
HCPCS,27848,TREAT ANKLE DISLOCATION,,,6600.66,20338.07,19
HCPCS,27848,Treat ankle dislocation,,,2860.13,3311.73,8
HCPCS,27860,FIXATION OF ANKLE JOINT,,,2997.95,9170.92,19
HCPCS,27860,Fixation of ankle joint,,,654.6,757.96,8
HCPCS,27860,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,956.0,621.4,1.1,5526.53,50
HCPCS,27870,ARTHRODESIS ANKLE OPEN,6164.0,4006.6,1.1,22471.68,50
HCPCS,27870,FUSION OF ANKLE JOINT OPEN,,,11888.68,35984.87,19
HCPCS,27870,Fusion of ankle joint open,,,4234.94,4903.61,8
HCPCS,27871,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,3816.0,2480.4,1.1,22471.68,50
HCPCS,27871,FUSION OF TIBIOFIBULAR JOINT,,,11888.68,35984.87,19
HCPCS,27871,Fusion of tibiofibular joint,,,4234.94,4903.61,8
HCPCS,27880,AMPUTATION LOW LEG THRU TIB/FIB,6148.0,3996.2,1.1,6148.0,50
HCPCS,27880,AMPUTATION OF LOWER LEG,2038.0,1324.7,1.1,20338.07,63
HCPCS,27880,Amputation of lower leg,,,4234.94,4903.61,8
HCPCS,27881,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,5388.0,3502.2,1.1,5388.0,50
HCPCS,27881,AMPUTATION OF LOWER LEG,,,3095.56,9170.92,13
HCPCS,27881,Amputation of lower leg,,,4234.94,4903.61,8
HCPCS,27882,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,3916.0,2545.4,1.1,3916.0,50
HCPCS,27882,AMPUTATION OF LOWER LEG,,,3095.56,9170.92,13
HCPCS,27882,Amputation of lower leg,,,4234.94,4903.61,8
HCPCS,27884,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,3504.0,2277.6,1.1,5526.53,50
HCPCS,27884,AMPUTATION FOLLOW-UP SURGERY,,,2997.95,9170.92,19
HCPCS,27884,Amputation follow-up surgery,,,1971.0,2282.21,8
HCPCS,27886,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,4008.0,2605.2,1.1,4008.0,50
HCPCS,27886,AMPUTATION FOLLOW-UP SURGERY,,,3095.56,9170.92,13
HCPCS,27886,Amputation follow-up surgery,,,1971.0,2282.21,8
HCPCS,27888,AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV,4148.0,2696.2,1.1,4148.0,50
HCPCS,27888,AMPUTATION OF FOOT AT ANKLE,,,3095.56,9170.92,13
HCPCS,27888,Amputation of foot at ankle,,,4234.94,4903.61,8
HCPCS,27889,ANKLE DISARTICULATION,,,6600.66,20338.07,19
HCPCS,27889,Ankle disarticulation,,,4234.94,4903.61,8
HCPCS,27892,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,3176.0,2064.4,1.1,5526.53,50
HCPCS,27892,DECOMPRESSION OF LEG,,,2997.95,9170.92,19
HCPCS,27892,Decompression of leg,,,2435.09,2819.58,8
HCPCS,27893,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,3160.0,2054.0,1.1,12214.27,50
HCPCS,27893,DECOMPRESSION OF LEG,,,6600.66,20338.07,19
HCPCS,27893,Decompression of leg,,,2435.09,2819.58,8
HCPCS,27894,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,5068.0,3294.2,1.1,5526.53,50
HCPCS,27894,DECOMPRESSION OF LEG,,,2997.95,9170.92,19
HCPCS,27894,Decompression of leg,,,2435.09,2819.58,8
HCPCS,27899,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),636.0,413.4,0.01,3004.0,89
HCPCS,27899,"EXCISION OF ACCESSORY SOLEUS MUSCLE, LEG OR ANKLE AREA (COMP COD",2972.0,1931.8,0.01,2972.0,28
HCPCS,27899,REPAIR/SUTURE MUSCLE LOWER LEG (COMP CODE 27658),1844.0,1198.6,0.01,1844.0,28
HCPCS,27899,"UNLISTED PROCEDURE, LEG OR ANKLE COMPARED TO 27860",789.0,512.85,0.01,789.0,28
HCPCS,28001,DRAINAGE OF BURSA OF FOOT,,,1497.07,4629.18,19
HCPCS,28001,Drainage of bursa of foot,,,1392.99,1612.93,8
HCPCS,28001,INCIS/DRAINAGE BURSA OF FOOT,800.0,520.0,1.1,2768.64,53
HCPCS,28002,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,1116.0,725.4,1.1,2743.55,53
HCPCS,28002,TREATMENT OF FOOT INFECTION,,,1478.75,4506.96,19
HCPCS,28002,Treatment of foot infection,,,1392.99,1612.93,8
HCPCS,28003,I&D BELOW FASCIA FOOT MULTIPLE AREAS,2112.0,1372.8,1.1,5526.53,53
HCPCS,28003,TREATMENT OF FOOT INFECTION,,,2997.95,9170.92,19
HCPCS,28003,Treatment of foot infection,,,1072.58,1241.93,8
HCPCS,28005,INCISION BONE CORTEX FOOT,3776.0,2454.4,1.1,5526.53,50
HCPCS,28005,TREAT FOOT BONE LESION,,,2997.95,9170.92,19
HCPCS,28005,Treat foot bone lesion,,,3246.83,3759.49,8
HCPCS,28008,FASCIOTOMY FOOT&/TOE,1836.0,1193.4,1.1,5526.53,53
HCPCS,28008,INCISION OF FOOT FASCIA,,,2997.95,9170.92,19
HCPCS,28008,Incision of foot fascia,,,1392.99,1612.93,8
HCPCS,28010,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,4275.0,2778.75,0.01,7362.0,114
HCPCS,28011,INCISION OF TOE TENDONS,,,1478.75,4506.96,19
HCPCS,28011,Incision of toe tendons,,,1392.99,1612.93,8
HCPCS,28020,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,2060.0,1339.0,1.1,5526.53,53
HCPCS,28020,EXPLORATION OF FOOT JOINT,,,2997.95,9170.92,19
HCPCS,28020,Exploration of foot joint,,,1392.99,1612.93,8
HCPCS,28022,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,1924.0,1250.6,1.1,5526.53,53
HCPCS,28022,EXPLORATION OF FOOT JOINT,,,2997.95,9170.92,19
HCPCS,28022,Exploration of foot joint,,,1392.99,1612.93,8
HCPCS,28024,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,1808.0,1175.2,1.1,2743.55,53
HCPCS,28024,EXPLORATION OF TOE JOINT,,,1478.75,4506.96,19
HCPCS,28024,Exploration of toe joint,,,1392.99,1612.93,8
HCPCS,28035,DECOMPRESSION OF TIBIA NERVE,,,1804.32,5473.19,19
HCPCS,28035,Decompression of tibia nerve,,,1971.0,2282.21,8
HCPCS,28035,RELEASE TARSAL TUNNEL,2092.0,1359.8,1.1,3297.28,53
HCPCS,28039,EXC FOOT/TOE TUM SC 1.5 CM/>,,,2644.48,8141.48,19
HCPCS,28039,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,2168.0,1409.2,1.1,4850.94,53
HCPCS,28039,Exc foot/toe tum sc 1.5 cm/>,,,1392.99,1612.93,8
HCPCS,28041,EXC FOOT/TOE TUM DEP 1.5CM/>,,,2644.48,8141.48,19
HCPCS,28041,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,2852.0,1853.8,1.1,4850.94,50
HCPCS,28041,Exc foot/toe tum dep 1.5cm/>,,,1392.99,1612.93,8
HCPCS,28043,EXC FOOT/TOE TUM SC < 1.5 CM,,,1497.07,4629.18,19
HCPCS,28043,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,1584.0,1029.6,1.1,2768.64,53
HCPCS,28043,Exc foot/toe tum sc < 1.5 cm,,,1072.58,1241.93,8
HCPCS,28045,EXC FOOT/TOE TUM DEEP <1.5CM,,,2644.48,8141.48,19
HCPCS,28045,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,2180.0,1417.0,1.1,4850.94,53
HCPCS,28045,Exc foot/toe tum deep <1.5cm,,,1392.99,1612.93,8
HCPCS,28046,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,4952.0,3218.8,1.1,4952.0,50
HCPCS,28046,RESECT FOOT/TOE TUMOR < 3 CM,,,2644.48,8141.48,19
HCPCS,28046,Resect foot/toe tumor < 3 cm,,,3246.83,3759.49,8
HCPCS,28047,RESECT FOOT/TOE TUMOR 3 CM/>,,,2644.48,8141.48,19
HCPCS,28047,Resect foot/toe tumor 3 cm/>,,,3246.83,3759.49,8
HCPCS,28050,BIOPSY OF FOOT JOINT LINING,,,2997.95,9170.92,19
HCPCS,28050,Biopsy of foot joint lining,,,1392.99,1612.93,8
HCPCS,28052,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,1624.0,1055.6,1.1,5526.53,53
HCPCS,28052,BIOPSY OF FOOT JOINT LINING,,,2997.95,9170.92,19
HCPCS,28052,Biopsy of foot joint lining,,,1392.99,1612.93,8
HCPCS,28054,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,1428.0,928.2,1.1,5526.53,53
HCPCS,28054,BIOPSY OF TOE JOINT LINING,,,2997.95,9170.92,19
HCPCS,28054,Biopsy of toe joint lining,,,1392.99,1612.93,8
HCPCS,28055,NEURECTOMY FOOT,,,1804.32,5473.19,19
HCPCS,28055,Neurectomy foot,,,3246.83,3759.49,8
HCPCS,28060,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,8542.5,5552.625,0.01,14925.0,114
HCPCS,28062,FASCIECTOMY PLANTAR FASCIA RADICAL SPX,2676.0,1739.4,1.1,5526.53,53
HCPCS,28062,REMOVAL OF FOOT FASCIA,,,2997.95,9170.92,19
HCPCS,28062,Removal of foot fascia,,,1392.99,1612.93,8
HCPCS,28070,REMOVAL OF FOOT JOINT LINING,,,6600.66,20338.07,19
HCPCS,28070,Removal of foot joint lining,,,1392.99,1612.93,8
HCPCS,28070,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,2096.0,1362.4,1.1,12214.27,53
HCPCS,28072,REMOVAL OF FOOT JOINT LINING,,,2997.95,9170.92,19
HCPCS,28072,Removal of foot joint lining,,,1392.99,1612.93,8
HCPCS,28072,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,1888.0,1227.2,1.1,5526.53,53
HCPCS,28080,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,1944.0,1263.6,1.1,2743.55,53
HCPCS,28080,REMOVAL OF FOOT LESION,,,1478.75,4506.96,19
HCPCS,28080,Removal of foot lesion,,,1392.99,1612.93,8
HCPCS,28086,EXCISE FOOT TENDON SHEATH,,,2997.95,9170.92,19
HCPCS,28086,Excise foot tendon sheath,,,1392.99,1612.93,8
HCPCS,28086,"SYNOVECTOMY FLEX TENDN SHEATH,FOOT",1968.0,1279.2,1.1,5526.53,53
HCPCS,28088,EXCISE FOOT TENDON SHEATH,,,2997.95,9170.92,19
HCPCS,28088,Excise foot tendon sheath,,,1392.99,1612.93,8
HCPCS,28090,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,1820.0,1183.0,1.1,2743.55,53
HCPCS,28090,REMOVAL OF FOOT LESION,,,1478.75,4506.96,19
HCPCS,28090,Removal of foot lesion,,,1392.99,1612.93,8
HCPCS,28092,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,1512.0,982.8,1.1,2743.55,53
HCPCS,28092,REMOVAL OF TOE LESIONS,,,1478.75,4506.96,19
HCPCS,28092,Removal of toe lesions,,,1392.99,1612.93,8
HCPCS,28100,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,2332.0,1515.8,1.1,5526.53,53
HCPCS,28100,REMOVAL OF ANKLE/HEEL LESION,,,2997.95,9170.92,19
HCPCS,28100,Removal of ankle/heel lesion,,,3246.83,3759.49,8
HCPCS,28102,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,3168.0,2059.2,1.1,12214.27,50
HCPCS,28102,REMOVE/GRAFT FOOT LESION,,,6600.66,20338.07,19
HCPCS,28102,Remove/graft foot lesion,,,3246.83,3759.49,8
HCPCS,28103,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,2668.0,1734.2,1.1,12214.27,50
HCPCS,28103,REMOVE/GRAFT FOOT LESION,,,6600.66,20338.07,19
HCPCS,28103,Remove/graft foot lesion,,,3246.83,3759.49,8
HCPCS,28104,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,2104.0,1367.6,1.1,5526.53,53
HCPCS,28104,REMOVAL OF FOOT LESION,,,2997.95,9170.92,19
HCPCS,28104,Removal of foot lesion,,,1392.99,1612.93,8
HCPCS,28106,REMOVE/GRAFT FOOT LESION,,,6600.66,20338.07,19
HCPCS,28106,Remove/graft foot lesion,,,3246.83,3759.49,8
HCPCS,28107,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,2292.0,1489.8,1.1,12214.27,53
HCPCS,28107,REMOVE/GRAFT FOOT LESION,,,6600.66,20338.07,19
HCPCS,28107,Remove/graft foot lesion,,,3246.83,3759.49,8
HCPCS,28108,EXC/CURTG CST/B9 TUM PHALANGES FOOT,1720.0,1118.0,1.1,2743.55,53
HCPCS,28108,REMOVAL OF TOE LESIONS,,,1478.75,4506.96,19
HCPCS,28108,Removal of toe lesions,,,1392.99,1612.93,8
HCPCS,28110,OSTECTOMY PRTL 5TH METAR HEAD SPX,1688.0,1097.2,1.1,5526.53,53
HCPCS,28110,PART REMOVAL OF METATARSAL,,,2997.95,9170.92,19
HCPCS,28110,Part removal of metatarsal,,,3246.83,3759.49,8
HCPCS,28111,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,2060.0,1339.0,1.1,5526.53,53
HCPCS,28111,PART REMOVAL OF METATARSAL,,,2997.95,9170.92,19
HCPCS,28111,Part removal of metatarsal,,,1392.99,1612.93,8
HCPCS,28112,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,1852.0,1203.8,1.1,5526.53,53
HCPCS,28112,PART REMOVAL OF METATARSAL,,,2997.95,9170.92,19
HCPCS,28112,Part removal of metatarsal,,,1392.99,1612.93,8
HCPCS,28113,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,2444.0,1588.6,1.1,5526.53,53
HCPCS,28113,PART REMOVAL OF METATARSAL,,,2997.95,9170.92,19
HCPCS,28113,Part removal of metatarsal,,,1392.99,1612.93,8
HCPCS,28114,REMOVAL OF METATARSAL HEADS,,,2997.95,9170.92,19
HCPCS,28114,Removal of metatarsal heads,,,3246.83,3759.49,8
HCPCS,28116,OSTECTOMY TARSAL COALITION,3656.0,2376.4,1.1,5526.53,53
HCPCS,28116,REVISION OF FOOT,,,2997.95,9170.92,19
HCPCS,28116,Revision of foot,,,1392.99,1612.93,8
HCPCS,28118,OSTECTOMY CALCANEUS,2452.0,1593.8,1.1,5526.53,53
HCPCS,28118,REMOVAL OF HEEL BONE,,,2997.95,9170.92,19
HCPCS,28118,Removal of heel bone,,,1392.99,1612.93,8
HCPCS,28119,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,2224.0,1445.6,1.1,5526.53,53
HCPCS,28119,REMOVAL OF HEEL SPUR,,,2997.95,9170.92,19
HCPCS,28119,Removal of heel spur,,,1392.99,1612.93,8
HCPCS,28120,PART REMOVAL OF ANKLE/HEEL,,,2997.95,9170.92,19
HCPCS,28120,PARTIAL EXCISION BONE TALUS/CALCANEUS,2924.0,1900.6,1.1,5526.53,53
HCPCS,28120,Part removal of ankle/heel,,,1392.99,1612.93,8
HCPCS,28122,PARTIAL REMOVAL OF FOOT BONE,,,2997.95,9170.92,19
HCPCS,28122,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,2704.0,1757.6,1.1,5526.53,53
HCPCS,28122,Partial removal of foot bone,,,3246.83,3759.49,8
HCPCS,28124,PARTIAL REMOVAL OF TOE,,,2997.95,9170.92,19
HCPCS,28124,PARTICAL EXCISION BONE PHALANX TOE,2000.0,1300.0,1.1,5526.53,53
HCPCS,28124,Partial removal of toe,,,1392.99,1612.93,8
HCPCS,28126,PARTIAL REMOVAL OF TOE,,,2997.95,9170.92,19
HCPCS,28126,Partial removal of toe,,,1392.99,1612.93,8
HCPCS,28126,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,1456.0,946.4,1.1,5526.53,53
HCPCS,28130,REMOVAL OF ANKLE BONE,,,6600.66,20338.07,19
HCPCS,28130,Removal of ankle bone,,,3246.83,3759.49,8
HCPCS,28130,TALECTOMY ASTRAGALECTOMY,3800.0,2470.0,1.1,12214.27,50
HCPCS,28140,METATARSECTOMY,2856.0,1856.4,1.1,5526.53,53
HCPCS,28140,REMOVAL OF METATARSAL,,,2997.95,9170.92,19
HCPCS,28140,Removal of metatarsal,,,1392.99,1612.93,8
HCPCS,28150,REMOVAL OF TOE,,,2997.95,9170.92,19
HCPCS,28150,Removal of toe,,,1392.99,1612.93,8
HCPCS,28153,PARTIAL REMOVAL OF TOE,,,2997.95,9170.92,19
HCPCS,28153,Partial removal of toe,,,1392.99,1612.93,8
HCPCS,28153,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,1520.0,988.0,1.1,5526.53,53
HCPCS,28160,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,1552.0,1008.8,1.1,5526.53,53
HCPCS,28160,PARTIAL REMOVAL OF TOE,,,2997.95,9170.92,19
HCPCS,28160,Partial removal of toe,,,1392.99,1612.93,8
HCPCS,28171,RESECT TARSAL TUMOR,,,2997.95,9170.92,19
HCPCS,28171,Resect tarsal tumor,,,3246.83,3759.49,8
HCPCS,28173,RESECT METATARSAL TUMOR,,,2997.95,9170.92,19
HCPCS,28173,Resect metatarsal tumor,,,3246.83,3759.49,8
HCPCS,28175,RESECT PHALANX OF TOE TUMOR,,,1478.75,4506.96,19
HCPCS,28175,Resect phalanx of toe tumor,,,1392.99,1612.93,8
HCPCS,28190,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,3066.5,1993.2250000000001,0.01,4001.0,122
HCPCS,28190,"REMV FOOT FOREIGN BODY,SUBCUTANEOUS",884.0,574.6,1.1,1200.64,53
HCPCS,28192,REMOVAL FOREIGN BODY FOOT DEEP,7453.0,4844.45,525.42,7453.0,61
HCPCS,28192,"REMV FOOT FOREIGN BODY,DEEP",1912.0,1242.8,1.1,2768.64,53
HCPCS,28193,REMOVAL OF FOOT FOREIGN BODY,,,1497.07,4629.18,19
HCPCS,28193,"REMV FOOT FOREIGN BODY,COMPLEX",2360.0,1534.0,1.1,2768.64,53
HCPCS,28193,Removal of foot foreign body,,,1392.99,1612.93,8
HCPCS,28200,REPAIR OF FOOT TENDON,,,2997.95,9170.92,19
HCPCS,28200,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,1896.0,1232.4,1.1,5526.53,53
HCPCS,28200,Repair of foot tendon,,,1392.99,1612.93,8
HCPCS,28202,REPAIR/GRAFT OF FOOT TENDON,,,6600.66,20338.07,19
HCPCS,28202,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,2828.0,1838.2,1.1,12214.27,53
HCPCS,28202,Repair/graft of foot tendon,,,3246.83,3759.49,8
HCPCS,28208,REPAIR OF FOOT TENDON,,,2997.95,9170.92,19
HCPCS,28208,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,1804.0,1172.6,1.1,5526.53,53
HCPCS,28208,Repair of foot tendon,,,1392.99,1612.93,8
HCPCS,28210,REPAIR/GRAFT OF FOOT TENDON,,,6600.66,20338.07,19
HCPCS,28210,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,2608.0,1695.2,1.1,12214.27,53
HCPCS,28210,Repair/graft of foot tendon,,,3246.83,3759.49,8
HCPCS,28220,RELEASE OF FOOT TENDON,,,1478.75,4506.96,19
HCPCS,28220,Release of foot tendon,,,1392.99,1612.93,8
HCPCS,28220,TENOLYSIS FLEXOR FOOT SINGLE TENDON,1868.0,1214.2,1.1,2743.55,53
HCPCS,28222,RELEASE OF FOOT TENDONS,,,2997.95,9170.92,19
HCPCS,28222,Release of foot tendons,,,1392.99,1612.93,8
HCPCS,28222,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,2304.0,1497.6,1.1,5526.53,53
HCPCS,28225,RELEASE OF FOOT TENDON,,,2997.95,9170.92,19
HCPCS,28225,Release of foot tendon,,,1392.99,1612.93,8
HCPCS,28225,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,1512.0,982.8,1.1,5526.53,53
HCPCS,28226,RELEASE OF FOOT TENDONS,,,2997.95,9170.92,19
HCPCS,28226,Release of foot tendons,,,1392.99,1612.93,8
HCPCS,28230,INCISION OF FOOT TENDON(S),,,1478.75,4506.96,19
HCPCS,28230,Incision of foot tendon(s),,,1392.99,1612.93,8
HCPCS,28230,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,1744.0,1133.6,1.1,2743.55,53
HCPCS,28232,INCISION OF TOE TENDON,,,1478.75,4506.96,19
HCPCS,28232,Incision of toe tendon,,,1392.99,1612.93,8
HCPCS,28232,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,1404.0,912.6,1.1,2743.55,53
HCPCS,28234,INCISION OF FOOT TENDON,,,1478.75,4506.96,19
HCPCS,28234,Incision of foot tendon,,,1392.99,1612.93,8
HCPCS,28234,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,1416.0,920.4,1.1,2743.55,53
HCPCS,28238,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,3184.0,2069.6,1.1,12214.27,53
HCPCS,28238,REVISION OF FOOT TENDON,,,6600.66,20338.07,19
HCPCS,28238,Revision of foot tendon,,,3246.83,3759.49,8
HCPCS,28240,RELEASE OF BIG TOE,,,2997.95,9170.92,19
HCPCS,28240,Release of big toe,,,1392.99,1612.93,8
HCPCS,28240,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,1792.0,1164.8,1.1,5526.53,53
HCPCS,28250,REVISION OF FOOT FASCIA,,,2997.95,9170.92,19
HCPCS,28250,Revision of foot fascia,,,1392.99,1612.93,8
HCPCS,28260,"CAPSULOTOMY MIDFOOT JT,MED RELEASE",3276.0,2129.4,1.1,5526.53,53
HCPCS,28260,RELEASE OF MIDFOOT JOINT,,,2997.95,9170.92,19
HCPCS,28260,Release of midfoot joint,,,3246.83,3759.49,8
HCPCS,28261,REVISION OF FOOT TENDON,,,1478.75,4506.96,19
HCPCS,28261,Revision of foot tendon,,,3246.83,3759.49,8
HCPCS,28262,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,7572.0,4921.8,1.1,12214.27,53
HCPCS,28262,REVISION OF FOOT AND ANKLE,,,6600.66,20338.07,19
HCPCS,28262,Revision of foot and ankle,,,3246.83,3759.49,8
HCPCS,28264,RELEASE OF MIDFOOT JOINT,,,1478.75,4506.96,19
HCPCS,28264,Release of midfoot joint,,,3246.83,3759.49,8
HCPCS,28270,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,1972.0,1281.8,1.1,5526.53,53
HCPCS,28270,RELEASE OF FOOT CONTRACTURE,,,2997.95,9170.92,19
HCPCS,28270,Release of foot contracture,,,1392.99,1612.93,8
HCPCS,28272,RELEASE OF TOE JOINT EACH,,,1478.75,4506.96,19
HCPCS,28272,Release of toe joint each,,,1392.99,1612.93,8
HCPCS,28280,FUSION OF TOES,,,2997.95,9170.92,19
HCPCS,28280,Fusion of toes,,,1392.99,1612.93,8
HCPCS,28285,CORRECTION HAMMERTOE,2473.0,1607.45,1.1,5526.53,53
HCPCS,28285,REPAIR OF HAMMERTOE,,,2997.95,9170.92,19
HCPCS,28285,Repair of hammertoe,,,1392.99,1612.93,8
HCPCS,28286,REPAIR OF HAMMERTOE,,,2997.95,9170.92,19
HCPCS,28286,Repair of hammertoe,,,1392.99,1612.93,8
HCPCS,28288,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,2408.0,1565.2,1.1,5526.53,53
HCPCS,28288,PARTIAL REMOVAL OF FOOT BONE,,,2997.95,9170.92,19
HCPCS,28288,Partial removal of foot bone,,,1392.99,1612.93,8
HCPCS,28289,CORRJ HALUX RIGDUS W/O IMPLT,,,2997.95,9170.92,19
HCPCS,28289,Corrj halux rigdus w/o implt,,,3246.83,3759.49,8
HCPCS,28289,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT,2760.0,1794.0,1.1,5526.53,53
HCPCS,28291,CORRJ HALUX RIGDUS W/IMPLT,,,6600.66,20338.07,19
HCPCS,28291,Corrj halux rigdus w/implt,,,3246.83,3759.49,8
HCPCS,28292,COR HLX VLGS RSC PRX PHLX BS,,,2997.95,9170.92,19
HCPCS,28292,CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE,2976.0,1934.4,1.1,5526.53,53
HCPCS,28292,Cor hlx vlgs rsc prx phlx bs,,,3246.83,3759.49,8
HCPCS,28295,COR HLX VLGS PRX MTAR OSTEOT,,,2997.95,9170.92,19
HCPCS,28295,Cor hlx vlgs prx mtar osteot,,,3246.83,3759.49,8
HCPCS,28296,COR HLX VLGS DSTL MTAR OSTEO,,,2997.95,9170.92,19
HCPCS,28296,CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT,3300.0,2145.0,1.1,5526.53,53
HCPCS,28296,Cor hlx vlgs dstl mtar osteo,,,3246.83,3759.49,8
HCPCS,28297,COR HLX VLGS JT ARTHRD,,,11888.68,35984.87,19
HCPCS,28297,CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS,3716.0,2415.4,1.1,12214.27,53
HCPCS,28297,Cor hlx vlgs jt arthrd,,,3246.83,3759.49,8
HCPCS,28298,COR HLX VLGS PRX PHLX OSTEOT,,,6600.66,20338.07,19
HCPCS,28298,CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT,3100.0,2015.0,1.1,12214.27,53
HCPCS,28298,Cor hlx vlgs prx phlx osteot,,,3246.83,3759.49,8
HCPCS,28299,COR HLX VLGS DOUBLE OSTEOT,,,6600.66,20338.07,19
HCPCS,28299,CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY,3716.0,2415.4,1.1,12214.27,53
HCPCS,28299,Cor hlx vlgs double osteot,,,3246.83,3759.49,8
HCPCS,28300,INCISION OF HEEL BONE,,,6600.66,20338.07,19
HCPCS,28300,Incision of heel bone,,,3246.83,3759.49,8
HCPCS,28300,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,3892.0,2529.8,1.1,12214.27,50
HCPCS,28302,INCISION OF ANKLE BONE,,,6600.66,20338.07,19
HCPCS,28302,Incision of ankle bone,,,3246.83,3759.49,8
HCPCS,28302,OSTEOTOMY TALUS,3896.0,2532.4,1.1,12214.27,50
HCPCS,28304,INCISION OF MIDFOOT BONES,,,6600.66,20338.07,19
HCPCS,28304,Incision of midfoot bones,,,3246.83,3759.49,8
HCPCS,28304,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,4140.0,2691.0,1.1,12214.27,53
HCPCS,28305,INCISE/GRAFT MIDFOOT BONES,,,6600.66,20338.07,19
HCPCS,28305,Incise/graft midfoot bones,,,3246.83,3759.49,8
HCPCS,28305,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,4308.0,2800.2,1.1,12214.27,50
HCPCS,28306,INCISION OF METATARSAL,,,6600.66,20338.07,19
HCPCS,28306,Incision of metatarsal,,,1392.99,1612.93,8
HCPCS,28306,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,2400.0,1560.0,1.1,12214.27,53
HCPCS,28307,INCISION OF METATARSAL,,,6600.66,20338.07,19
HCPCS,28307,Incision of metatarsal,,,3246.83,3759.49,8
HCPCS,28308,INCISION OF METATARSAL,,,2997.95,9170.92,19
HCPCS,28308,Incision of metatarsal,,,1392.99,1612.93,8
HCPCS,28308,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,2192.0,1424.8,1.1,5526.53,53
HCPCS,28309,INCISION OF METATARSALS,,,6600.66,20338.07,19
HCPCS,28309,Incision of metatarsals,,,3246.83,3759.49,8
HCPCS,28309,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,5664.0,3681.6,1.1,12214.27,50
HCPCS,28310,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,2228.0,1448.2,1.1,12214.27,53
HCPCS,28310,REVISION OF BIG TOE,,,6600.66,20338.07,19
HCPCS,28310,Revision of big toe,,,1392.99,1612.93,8
HCPCS,28312,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,1876.0,1219.4,1.1,5526.53,53
HCPCS,28312,REVISION OF TOE,,,2997.95,9170.92,19
HCPCS,28312,Revision of toe,,,1392.99,1612.93,8
HCPCS,28313,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,2266.0,1472.9,1.1,5526.53,53
HCPCS,28313,REPAIR DEFORMITY OF TOE,,,2997.95,9170.92,19
HCPCS,28313,Repair deformity of toe,,,1392.99,1612.93,8
HCPCS,28315,REMOVAL OF SESAMOID BONE,,,2997.95,9170.92,19
HCPCS,28315,Removal of sesamoid bone,,,1392.99,1612.93,8
HCPCS,28315,SESAMOIDECTOMY FIRST TOE SPX,2000.0,1300.0,1.1,5526.53,53
HCPCS,28320,REPAIR NONUNION/MALUNION TARSAL BONES,3748.0,2436.2,1.1,22471.68,50
HCPCS,28320,REPAIR OF FOOT BONES,,,9608.0,35984.87,20
HCPCS,28320,Repair of foot bones,,,3246.83,3759.49,8
HCPCS,28322,REPAIR OF METATARSALS,,,6600.66,20338.07,19
HCPCS,28322,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,3412.0,2217.8,1.1,12214.27,53
HCPCS,28322,Repair of metatarsals,,,3246.83,3759.49,8
HCPCS,28340,RESECT ENLARGED TOE TISSUE,,,2997.95,9170.92,19
HCPCS,28340,Resect enlarged toe tissue,,,1392.99,1612.93,8
HCPCS,28341,RESECT ENLARGED TOE,,,2997.95,9170.92,19
HCPCS,28341,Resect enlarged toe,,,3246.83,3759.49,8
HCPCS,28344,REPAIR EXTRA TOE(S),,,2997.95,9170.92,19
HCPCS,28344,Repair extra toe(s),,,1392.99,1612.93,8
HCPCS,28345,REPAIR WEBBED TOE(S),,,1478.75,4506.96,19
HCPCS,28345,Repair webbed toe(s),,,1392.99,1612.93,8
HCPCS,28360,RECONSTRUCT CLEFT FOOT,,,6600.66,20338.07,19
HCPCS,28360,Reconstruct cleft foot,,,3246.83,3759.49,8
HCPCS,28400,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1013.5,658.7750000000001,0.01,3004.0,175
HCPCS,28405,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1499.5,974.6750000000001,1.1,4001.0,114
HCPCS,28406,PRQ SKEL FIX CLCNL FX W/MNPJ,,,6600.66,20338.07,19
HCPCS,28406,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,2624.0,1705.6,1.1,12214.27,50
HCPCS,28406,Prq skel fix clcnl fx w/mnpj,,,2860.13,3311.73,8
HCPCS,28415,OPEN TREATMENT CALCANEAL FRACTURE,6476.0,4209.4,1.1,12214.27,50
HCPCS,28415,OPTX CALCANEAL FRACTURE,,,6600.66,20338.07,19
HCPCS,28415,Optx calcaneal fracture,,,2860.13,3311.73,8
HCPCS,28420,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,7008.0,4555.2,1.1,22471.68,50
HCPCS,28420,OPTX CALCANEAL FX W/BONE GRF,,,11888.68,35984.87,19
HCPCS,28420,Optx calcaneal fx w/bone grf,,,2860.13,3311.73,8
HCPCS,28430,CLOSED TX TALUS FRACTURE W/O MANIPULATION,995.5,647.075,0.01,3004.0,175
HCPCS,28435,CLOSED TX TALUS FRACTURE W/MANIPULATION,4389.0,2852.85,1.1,7362.0,114
HCPCS,28436,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,9936.5,6458.725,1.1,20338.07,111
HCPCS,28445,OPEN TREATMENT TALUS FRACTURE,6304.0,4097.6,1.1,12214.27,50
HCPCS,28445,OPTX TALUS FRACTURE,,,6600.66,20338.07,19
HCPCS,28445,Optx talus fracture,,,2860.13,3311.73,8
HCPCS,28446,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,7084.0,4604.6,1.1,12214.27,50
HCPCS,28446,OPN OSTEOCHONDRL AGRFT TALUS,,,6600.66,20338.07,19
HCPCS,28446,Opn osteochondrl agrft talus,,,3246.83,3759.49,8
HCPCS,28450,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,998.0,648.7,0.01,3004.0,175
HCPCS,28455,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,4394.0,2856.1,1.1,7362.0,114
HCPCS,28456,PRQ SKEL FIX TARSL FX W/MNPJ,,,6600.66,20338.07,19
HCPCS,28456,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,1144.0,743.6,1.1,12214.27,50
HCPCS,28456,Prq skel fix tarsl fx w/mnpj,,,2860.13,3311.73,8
HCPCS,28465,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,3520.0,2288.0,1.1,12214.27,50
HCPCS,28465,OPTX TARSAL BONE FX EACH,,,6600.66,20338.07,19
HCPCS,28465,Optx tarsal bone fx each,,,2860.13,3311.73,8
HCPCS,28470,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,998.0,648.7,0.01,3004.0,175
HCPCS,28475,CLTX METAR FX W/MANJ,1153.5,749.7750000000001,1.1,3004.0,114
HCPCS,28476,PRQ SKEL FIX METAR FX W/MNPJ,,,2997.95,9170.92,19
HCPCS,28476,PRQ SKEL FIXJ METAR FX W/MANJ,1440.0,936.0,1.1,5526.53,50
HCPCS,28476,Prq skel fix metar fx w/mnpj,,,2860.13,3311.73,8
HCPCS,28485,OPEN TREATMENT METATARSAL FRACTURE EACH,2976.0,1934.4,1.1,12214.27,50
HCPCS,28485,OPTX METATARSAL FX EACH,,,6600.66,20338.07,19
HCPCS,28485,Optx metatarsal fx each,,,2860.13,3311.73,8
HCPCS,28490,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,785.5,510.57500000000005,0.01,3004.0,175
HCPCS,28495,CLTX FX GRT TOE PHLX/PHLG W/MANJ,887.5,576.875,1.1,3004.0,114
HCPCS,28496,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,992.0,644.8,1.1,5526.53,53
HCPCS,28496,TREAT BIG TOE FRACTURE,,,2997.95,9170.92,19
HCPCS,28496,Treat big toe fracture,,,2860.13,3311.73,8
HCPCS,28505,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,2976.0,1934.4,1.1,5526.53,53
HCPCS,28505,TREAT BIG TOE FRACTURE,,,2997.95,9170.92,19
HCPCS,28505,Treat big toe fracture,,,2860.13,3311.73,8
HCPCS,28510,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,785.5,510.57500000000005,0.01,3004.0,175
HCPCS,28515,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,863.5,561.2750000000001,1.1,3004.0,114
HCPCS,28525,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,2248.0,1461.2,1.1,5526.53,53
HCPCS,28525,TREAT TOE FRACTURE,,,2997.95,9170.92,19
HCPCS,28525,Treat toe fracture,,,2860.13,3311.73,8
HCPCS,28530,CLOSED TREATMENT SESAMOID FRACTURE,773.5,502.77500000000003,0.01,3004.0,175
HCPCS,28531,TREAT SESAMOID BONE FRACTURE,,,6600.66,20338.07,19
HCPCS,28531,Treat sesamoid bone fracture,,,2860.13,3311.73,8
HCPCS,28540,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,989.5,643.175,1.1,3004.0,114
HCPCS,28545,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,1040.0,676.0,1.1,5526.53,53
HCPCS,28545,TREAT FOOT DISLOCATION,,,2997.95,9170.92,19
HCPCS,28545,Treat foot dislocation,,,654.6,757.96,8
HCPCS,28546,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,1360.0,884.0,1.1,2743.55,53
HCPCS,28546,TREAT FOOT DISLOCATION,,,1478.75,4506.96,19
HCPCS,28546,Treat foot dislocation,,,2860.13,3311.73,8
HCPCS,28555,OPEN TREATMENT TARSAL BONE DISLOCATION,3860.0,2509.0,1.1,12214.27,53
HCPCS,28555,REPAIR FOOT DISLOCATION,,,6600.66,20338.07,19
HCPCS,28555,Repair foot dislocation,,,2860.13,3311.73,8
HCPCS,28570,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,903.5,587.2750000000001,1.1,3004.0,114
HCPCS,28575,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,1396.0,907.4,1.1,5526.53,53
HCPCS,28575,TREAT FOOT DISLOCATION,,,2997.95,9170.92,19
HCPCS,28575,Treat foot dislocation,,,654.6,757.96,8
HCPCS,28576,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,1840.0,1196.0,1.1,12214.27,50
HCPCS,28576,TREAT FOOT DISLOCATION,,,6600.66,20338.07,19
HCPCS,28576,Treat foot dislocation,,,2860.13,3311.73,8
HCPCS,28585,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,4452.0,2893.8,1.1,12214.27,53
HCPCS,28585,REPAIR FOOT DISLOCATION,,,6600.66,20338.07,19
HCPCS,28585,Repair foot dislocation,,,2860.13,3311.73,8
HCPCS,28600,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,955.5,621.075,1.1,3004.0,114
HCPCS,28605,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,1156.0,751.4,1.1,1156.96,53
HCPCS,28605,TREAT FOOT DISLOCATION,,,221.64,691.37,19
HCPCS,28605,Treat foot dislocation,,,654.6,757.96,8
HCPCS,28606,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,2036.0,1323.4,1.1,5526.53,50
HCPCS,28606,TREAT FOOT DISLOCATION,,,2997.95,9170.92,19
HCPCS,28606,Treat foot dislocation,,,2860.13,3311.73,8
HCPCS,28615,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,4280.0,2782.0,1.1,12214.27,50
HCPCS,28615,REPAIR FOOT DISLOCATION,,,6600.66,20338.07,19
HCPCS,28615,Repair foot dislocation,,,2860.13,3311.73,8
HCPCS,28630,CLTX METATARSOPHLNGL JT DISLC W/O ANES,901.5,585.975,1.1,3004.0,114
HCPCS,28635,CLTX METATARSOPHLNGL JT DISLC REQ ANES,784.0,509.6,1.1,2743.55,53
HCPCS,28635,TREAT TOE DISLOCATION,,,1478.75,4506.96,19
HCPCS,28635,Treat toe dislocation,,,654.6,757.96,8
HCPCS,28636,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,1108.0,720.2,1.1,5526.53,53
HCPCS,28636,TREAT TOE DISLOCATION,,,2997.95,9170.92,19
HCPCS,28636,Treat toe dislocation,,,2860.13,3311.73,8
HCPCS,28645,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,2976.0,1934.4,1.1,5526.53,53
HCPCS,28645,REPAIR TOE DISLOCATION,,,2997.95,9170.92,19
HCPCS,28645,Repair toe dislocation,,,2860.13,3311.73,8
HCPCS,28660,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,807.5,524.875,1.1,3004.0,114
HCPCS,28665,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1005.0,653.25,1.1,3004.0,114
HCPCS,28666,TREAT TOE DISLOCATION,,,2997.95,9170.92,19
HCPCS,28666,Treat toe dislocation,,,2860.13,3311.73,8
HCPCS,28675,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,2248.0,1461.2,1.1,5526.53,53
HCPCS,28675,REPAIR OF TOE DISLOCATION,,,2997.95,9170.92,19
HCPCS,28675,Repair of toe dislocation,,,2860.13,3311.73,8
HCPCS,28705,ARTHRODESIS PANTALAR,,,16588.34,49144.62,19
HCPCS,28705,Arthrodesis pantalar,,,3246.83,3759.49,8
HCPCS,28715,ARTHRODESIS TRIPLE,5368.0,3489.2,1.1,35984.87,69
HCPCS,28715,Arthrodesis triple,,,3246.83,3759.49,8
HCPCS,28725,ARTHRODESIS SUBTALAR,4488.0,2917.2,1.1,35984.87,69
HCPCS,28725,Arthrodesis subtalar,,,3246.83,3759.49,8
HCPCS,28730,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,4280.0,2782.0,1.1,22471.68,50
HCPCS,28730,FUSION OF FOOT BONES,,,9608.0,35984.87,20
HCPCS,28730,Fusion of foot bones,,,3246.83,3759.49,8
HCPCS,28735,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,4892.0,3179.8,1.1,22471.68,50
HCPCS,28735,FUSION OF FOOT BONES,,,11888.68,35984.87,19
HCPCS,28735,Fusion of foot bones,,,3246.83,3759.49,8
HCPCS,28737,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,4412.0,2867.8,1.1,22471.68,50
HCPCS,28737,REVISION OF FOOT BONES,,,11888.68,35984.87,19
HCPCS,28737,Revision of foot bones,,,3246.83,3759.49,8
HCPCS,28740,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,3716.0,2415.4,1.1,12214.27,53
HCPCS,28740,FUSION OF FOOT BONES,,,6600.66,20338.07,19
HCPCS,28740,Fusion of foot bones,,,3246.83,3759.49,8
HCPCS,28750,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,3428.0,2228.2,1.1,12214.27,53
HCPCS,28750,FUSION OF BIG TOE JOINT,,,6600.66,20338.07,19
HCPCS,28750,Fusion of big toe joint,,,3246.83,3759.49,8
HCPCS,28755,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,1952.0,1268.8,1.1,12214.27,53
HCPCS,28755,FUSION OF BIG TOE JOINT,,,6600.66,20338.07,19
HCPCS,28755,Fusion of big toe joint,,,1392.99,1612.93,8
HCPCS,28760,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,3656.0,2376.4,1.1,12214.27,53
HCPCS,28760,FUSION OF BIG TOE JOINT,,,6600.66,20338.07,19
HCPCS,28760,Fusion of big toe joint,,,3246.83,3759.49,8
HCPCS,28800,"AMPUTATION FOOT,MIDTARSAL-CHOPART",3516.0,2285.4,1.1,3516.0,50
HCPCS,28800,AMPUTATION OF MIDFOOT,,,3095.56,9170.92,13
HCPCS,28800,Amputation of midfoot,,,3246.83,3759.49,8
HCPCS,28805,"AMPUTATION FOOT,TRANSMETATARSAL",5084.0,3304.6,1.1,5526.53,50
HCPCS,28805,AMPUTATION THRU METATARSAL,,,2997.95,9170.92,19
HCPCS,28805,Amputation thru metatarsal,,,3246.83,3759.49,8
HCPCS,28810,"AMPUTATION METATARSAL+TOE,SINGLE",2656.0,1726.4,1.1,5526.53,50
HCPCS,28810,AMPUTATION TOE & METATARSAL,,,2997.95,9170.92,19
HCPCS,28810,Amputation toe & metatarsal,,,3246.83,3759.49,8
HCPCS,28820,AMPUTATION OF TOE,,,2997.95,9170.92,19
HCPCS,28820,AMPUTATION TOE METATARSOPHALANGEAL JOINT,1544.0,1003.6,1.1,5526.53,53
HCPCS,28820,Amputation of toe,,,1392.99,1612.93,8
HCPCS,28825,AMPUTATION TOE INTERPHALANGEAL JOINT,8166.5,5308.225,0.01,14833.0,114
HCPCS,28890,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,1380.0,897.0,1.1,2743.55,53
HCPCS,28890,HI ENRGY ESWT PLANTAR FASCIA,,,1478.75,4506.96,19
HCPCS,28890,Hi enrgy eswt plantar fascia,,,1392.99,1612.93,8
HCPCS,28899,COMPLETE REMOVAL OF TARSAL BONE (COMP CODE 28130),4085.0,2655.25,0.01,4085.0,28
HCPCS,28899,FOOT/TOES SURGERY PROC UNLISTED,3790.0,2463.5,0.01,3790.0,28
HCPCS,28899,INTERPOSITIONAL ARTHROPLASTY AT 2ND METATARSOPHALANGEAL JOINT (C,2270.0,1475.5,0.01,2270.0,28
HCPCS,28899,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),2554.0,1660.1,0.01,4778.0,89
HCPCS,28899,REPAIR LIGAMENT FOOT (COMP CODE 27695),2413.0,1568.45,0.01,2413.0,28
HCPCS,28899,SUBTALAR JOINT?ARTHROEREISIS (COMP CODE 28725),4040.0,2626.0,0.01,4040.0,28
HCPCS,28899,TALUS DECOMPRESSION W/DRILLING (COMP CODE 28005),916.0,595.4,0.01,916.0,28
HCPCS,28899,UNLISTED PLANTAR PLATE REPAIR 2ND METATARSOPHALANGEAL JOINT OF L,1700.0,1105.0,0.01,1700.0,28
HCPCS,28899,"UNLISTED PROC, HALLUX INTERPHALANGEAL ARTHROPLASTY W/PERCUTANEOU",1100.0,715.0,0.01,1100.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES",916.0,595.4,0.01,916.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 20680)",950.0,617.5,0.01,950.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 25447)",2180.0,1417.0,0.01,2180.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 27415)",3680.0,2392.0,0.01,3680.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 28100)",1924.0,1250.6,0.01,1924.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 28302)",2080.0,1352.0,0.01,2080.0,28
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 29891)",1970.0,1280.5,0.01,1970.0,28
HCPCS,29000,APPL HALO TYPE BODY CAST,,,245.39,783.93,19
HCPCS,29000,Appl halo type body cast,,,83.58,96.78,8
HCPCS,29010,APPL RISSER JACKET BODY ONLY,,,245.39,783.93,19
HCPCS,29010,Appl risser jacket body only,,,83.58,96.78,8
HCPCS,29015,APPL RISSR JACKET BDY W/HEAD,,,245.39,783.93,19
HCPCS,29015,Appl rissr jacket bdy w/head,,,83.58,96.78,8
HCPCS,29035,APPL BODY CAST SHO TO HIPS,,,245.39,783.93,19
HCPCS,29035,Appl body cast sho to hips,,,83.58,96.78,8
HCPCS,29040,APPL BDY CST SHO TO HIP HEAD,,,245.39,783.93,19
HCPCS,29040,Appl bdy cst sho to hip head,,,83.58,96.78,8
HCPCS,29044,APPL BDY CST SHO TO HIP 1THI,,,145.79,455.46,19
HCPCS,29044,Appl bdy cst sho to hip 1thi,,,83.58,96.78,8
HCPCS,29046,APPL BDY CST SHO TO HIP B TH,,,245.39,783.93,19
HCPCS,29046,Appl bdy cst sho to hip b th,,,83.58,96.78,8
HCPCS,29049,APPL CAST FIGURE-OF-EIGHT,,,245.39,783.93,19
HCPCS,29049,Appl cast figure-of-eight,,,83.58,96.78,8
HCPCS,29055,APPL CAST SHOULDER SPICA,,,245.39,783.93,19
HCPCS,29055,Appl cast shoulder spica,,,83.58,96.78,8
HCPCS,29058,APPL CAST PLASTER VELPEAU,,,245.39,783.93,19
HCPCS,29058,Appl cast plaster velpeau,,,83.58,96.78,8
HCPCS,29065,APPLICATION CAST SHOULDER HAND LONG ARM,785.0,510.25,0.01,2453.0,236
HCPCS,29075,APPLICATION CAST ELBOW FINGER SHORT ARM,765.0,497.25,0.01,2453.0,297
HCPCS,29085,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,537.0,349.04999999999995,0.01,2453.0,175
HCPCS,29086,APPLICATION CAST FINGER,,,145.79,455.46,19
HCPCS,29086,Application cast finger,,,83.58,96.78,8
HCPCS,29105,APPLICATION LONG ARM SPLINT SHOULDER HAND,523.0,339.95,0.01,2453.0,175
HCPCS,29125,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,406.5,264.225,0.01,2453.0,236
HCPCS,29126,APPL SHORT ARM SPLINT DYN,,,119.1,372.91,19
HCPCS,29126,"APPLY FOREARM SPLINT,DYNAMIC",299.0,194.35,1.1,299.0,53
HCPCS,29126,Appl short arm splint dyn,,,44.82,51.9,8
HCPCS,29130,APPLICATION FINGER SPLINT STATIC,406.5,264.225,0.01,2453.0,175
HCPCS,29131,APPLICATION FINGER SPLINT DYNAMIC,273.0,177.45,44.82,2453.0,61
HCPCS,29131,"APPLY FINGER SPLINT,DYNAMIC",242.0,157.3,1.1,242.0,53
HCPCS,29200,STRAPPING THORAX,,,145.79,455.46,19
HCPCS,29200,Strapping thorax,,,44.82,51.9,8
HCPCS,29240,STRAPPING SHOULDER,382.5,248.625,1.1,2453.0,114
HCPCS,29260,STRAPPING ELBOW OR WRIST,172.0,111.8,1.1,172.0,53
HCPCS,29260,STRAPPING ELBOW/WRIST,273.0,177.45,32.91,2453.0,61
HCPCS,29280,STRAPPING HAND OR FINGER,172.0,111.8,1.1,172.0,53
HCPCS,29280,STRAPPING HAND/FINGER,273.0,177.45,0.01,2453.0,122
HCPCS,29305,APPL HIP SPICA CAST 1 LEG,,,245.39,783.93,19
HCPCS,29305,Appl hip spica cast 1 leg,,,83.58,96.78,8
HCPCS,29325,APPL HIP SPICA CAST1&1/2,,,245.39,783.93,19
HCPCS,29325,Appl hip spica cast1&1/2,,,83.58,96.78,8
HCPCS,29345,APPLICATION LONG LEG CAST THIGH-TOE,891.0,579.15,0.01,3004.0,114
HCPCS,29355,APPL LONG LEG CAST WALKER,,,245.39,783.93,19
HCPCS,29355,Appl long leg cast walker,,,83.58,96.78,8
HCPCS,29358,APPL LONG LEG CAST BRACE,,,245.39,783.93,19
HCPCS,29358,Appl long leg cast brace,,,83.58,96.78,8
HCPCS,29365,APPL CYLINDER CAST,,,245.39,783.93,19
HCPCS,29365,Appl cylinder cast,,,83.58,96.78,8
HCPCS,29405,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,771.0,501.15,0.01,2453.0,236
HCPCS,29425,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,771.0,501.15,0.01,1222.0,114
HCPCS,29435,APPL PATLLR TDN BEARING CAST,,,245.39,783.93,19
HCPCS,29435,Appl patllr tdn bearing cast,,,83.58,96.78,8
HCPCS,29440,ADDING WALKER TO PREV CAST,,,145.79,455.46,19
HCPCS,29440,Adding walker to prev cast,,,83.58,96.78,8
HCPCS,29445,APPLICATION RIGID TOTAL CONTACT LEG CAST,967.0,628.55,0.01,1222.0,114
HCPCS,29450,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,915.0,594.75,1.1,915.0,53
HCPCS,29450,APPLICATION CLUBFOOT CAST,,,145.79,455.46,19
HCPCS,29450,Application clubfoot cast,,,83.58,96.78,8
HCPCS,29505,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,515.0,334.75,0.01,2453.0,236
HCPCS,29515,APPLICATION SHORT LEG SPLINT CALF FOOT,523.5,340.275,0.01,2453.0,236
HCPCS,29520,STRAPPING OF HIP,,,119.1,372.91,19
HCPCS,29520,Strapping of hip,,,44.82,51.9,8
HCPCS,29530,STRAPPING KNEE,382.5,248.625,1.1,2453.0,114
HCPCS,29540,STRAPPING ANKLE &/FOOT,449.0,291.84999999999997,1.1,2453.0,114
HCPCS,29550,STRAPPING OF TOES,,,54.88,165.35,19
HCPCS,29550,Strapping of toes,,,44.82,51.9,8
HCPCS,29580,STRAPPING UNNA BOOT,484.0,314.6,0.01,726.0,114
HCPCS,29581,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,495.0,321.75,0.01,726.0,175
HCPCS,29584,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,726.0,471.9,0.01,726.0,61
HCPCS,29584,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FINGER,140.0,91.0,1.1,268.8,53
HCPCS,29700,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,725.0,471.25,1.1,2453.0,114
HCPCS,29705,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1222.0,794.3,75.3,2453.0,61
HCPCS,29710,RMVL/BIVLV SHO/HIP SPICA,,,245.39,783.93,19
HCPCS,29710,Rmvl/bivlv sho/hip spica,,,83.58,96.78,8
HCPCS,29720,REPAIR SPICA BODY CST/JACKET,,,145.79,455.46,19
HCPCS,29720,Repair spica body cst/jacket,,,83.58,96.78,8
HCPCS,29730,WINDOWING OF CAST,,,145.79,455.46,19
HCPCS,29730,Windowing of cast,,,83.58,96.78,8
HCPCS,29740,WEDGING CAST EXCEPT CLUBFOOT CASTS,448.0,291.2,1.1,458.75,53
HCPCS,29740,WEDGING OF CAST,,,245.39,783.93,19
HCPCS,29740,Wedging of cast,,,83.58,96.78,8
HCPCS,29750,WEDGING OF CLUBFOOT CAST,,,245.39,783.93,19
HCPCS,29750,Wedging of clubfoot cast,,,83.58,96.78,8
HCPCS,29799,UNLISTED PROCEDURE CASTING OR STRAPPING,300.0,195.0,44.82,2453.0,61
HCPCS,29800,JAW ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29800,Jaw arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29804,JAW ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29804,Jaw arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29805,DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX,2412.0,1567.8,1.1,5526.53,50
HCPCS,29805,SHO ARTHRS DX +- SYNOVIAL BX,,,2997.95,9170.92,19
HCPCS,29805,Sho arthrs dx +- synovial bx,,,1453.77,1683.31,8
HCPCS,29806,SHO ARTHRS SRG CAPSULORRAPHY,,,6600.66,20338.07,19
HCPCS,29806,SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY,6056.0,3936.4,1.1,12214.27,50
HCPCS,29806,Sho arthrs srg capsulorraphy,,,3451.33,3996.28,8
HCPCS,29807,SHO ARTHRS SRG RPR SLAP LES,,,6600.66,20338.07,19
HCPCS,29807,SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION,5868.0,3814.2,1.1,12214.27,50
HCPCS,29807,Sho arthrs srg rpr slap les,,,3451.33,3996.28,8
HCPCS,29819,SHO ARTHRS SRG RMVL LOOSE/FB,,,2997.95,9170.92,19
HCPCS,29819,SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB,3116.0,2025.4,1.1,5526.53,50
HCPCS,29819,Sho arthrs srg rmvl loose/fb,,,1453.77,1683.31,8
HCPCS,29820,SHO ARTHRS SRG PRTL SYNVCT,,,6600.66,20338.07,19
HCPCS,29820,SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY,2884.0,1874.6,1.1,12214.27,50
HCPCS,29820,Sho arthrs srg prtl synvct,,,1453.77,1683.31,8
HCPCS,29821,SHO ARTHRS SRG COMPL SYNVCT,,,2997.95,9170.92,19
HCPCS,29821,SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY,3156.0,2051.4,1.1,5526.53,50
HCPCS,29821,Sho arthrs srg compl synvct,,,3451.33,3996.28,8
HCPCS,29822,SHO ARTHRS SRG LMTD DBRDMT,,,2997.95,9170.92,19
HCPCS,29822,SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2,3093.0,2010.45,1.1,5526.53,50
HCPCS,29822,Sho arthrs srg lmtd dbrdmt,,,1453.77,1683.31,8
HCPCS,29823,SHO ARTHRS SRG XTNSV DBRDMT,,,2997.95,9170.92,19
HCPCS,29823,SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+,3511.0,2282.15,1.1,5526.53,50
HCPCS,29823,Sho arthrs srg xtnsv dbrdmt,,,1453.77,1683.31,8
HCPCS,29824,SHO ARTHRS SRG DSTL CLAVICLC,,,2997.95,9170.92,19
HCPCS,29824,SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC,3592.0,2334.8,1.1,5526.53,50
HCPCS,29824,Sho arthrs srg dstl claviclc,,,1453.77,1683.31,8
HCPCS,29825,SHO ARTHRS SRG LSS&RESCJ ADS,,,2997.95,9170.92,19
HCPCS,29825,SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS,3116.0,2025.4,1.1,5526.53,50
HCPCS,29825,Sho arthrs srg lss&rescj ads,,,1453.77,1683.31,8
HCPCS,29826,SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS,1320.0,858.0,1.1,1320.0,50
HCPCS,29826,Sho arthrs srg decompression,,,1453.77,1683.31,8
HCPCS,29827,SHO ARTHRS SRG RT8TR CUF RPR,,,6600.66,20338.07,19
HCPCS,29827,SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR,6236.0,4053.4,1.1,12214.27,50
HCPCS,29827,Sho arthrs srg rt8tr cuf rpr,,,3451.33,3996.28,8
HCPCS,29828,SHO ARTHRS SRG BICP TENODSIS,,,6600.66,20338.07,19
HCPCS,29828,SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS,5790.0,3763.5,1.1,12214.27,50
HCPCS,29828,Sho arthrs srg bicp tenodsis,,,3451.33,3996.28,8
HCPCS,29830,ELBOW ARTHROSCOPY,,,2997.95,9170.92,19
HCPCS,29830,Elbow arthroscopy,,,1453.77,1683.31,8
HCPCS,29834,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,2568.0,1669.2,1.1,5526.53,50
HCPCS,29834,ELBOW ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29834,Elbow arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29835,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,2648.0,1721.2,1.1,5526.53,50
HCPCS,29835,ELBOW ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29835,Elbow arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29836,ELBOW ARTHROSCOPY/SURGERY,,,6600.66,20338.07,19
HCPCS,29836,Elbow arthroscopy/surgery,,,3451.33,3996.28,8
HCPCS,29837,ELBOW ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29837,Elbow arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29838,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,3152.0,2048.8,1.1,5526.53,50
HCPCS,29838,ELBOW ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29838,Elbow arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29840,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,2272.0,1476.8,1.1,5526.53,50
HCPCS,29840,WRIST ARTHROSCOPY,,,2997.95,9170.92,19
HCPCS,29840,Wrist arthroscopy,,,1453.77,1683.31,8
HCPCS,29843,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,2460.0,1599.0,1.1,5526.53,50
HCPCS,29843,WRIST ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29843,Wrist arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29844,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,2604.0,1692.6,1.1,5526.53,50
HCPCS,29844,WRIST ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29844,Wrist arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29845,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,3076.0,1999.4,1.1,5526.53,50
HCPCS,29845,WRIST ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29845,Wrist arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29846,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,2756.0,1791.4,1.1,5526.53,50
HCPCS,29846,WRIST ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29846,Wrist arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29847,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,2888.0,1877.2,1.1,12214.27,50
HCPCS,29847,WRIST ARTHROSCOPY/SURGERY,,,6600.66,20338.07,19
HCPCS,29847,Wrist arthroscopy/surgery,,,3451.33,3996.28,8
HCPCS,29848,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,2556.0,1661.4,1.1,2743.55,50
HCPCS,29848,WRIST ENDOSCOPY/SURGERY,,,1478.75,4506.96,19
HCPCS,29848,Wrist endoscopy/surgery,,,1453.77,1683.31,8
HCPCS,29850,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,3308.0,2150.2,1.1,3308.0,50
HCPCS,29850,KNEE ARTHROSCOPY/SURGERY,,,1478.75,4506.96,19
HCPCS,29850,Knee arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29851,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,5304.0,3447.6,1.1,5304.0,50
HCPCS,29851,KNEE ARTHROSCOPY/SURGERY,,,1478.75,4506.96,19
HCPCS,29851,Knee arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29855,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,4304.0,2797.6,1.1,12214.27,50
HCPCS,29855,TIBIAL ARTHROSCOPY/SURGERY,,,6600.66,20338.07,19
HCPCS,29855,Tibial arthroscopy/surgery,,,3451.33,3996.28,8
HCPCS,29856,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,5712.0,3712.8,1.1,22471.68,50
HCPCS,29856,TIBIAL ARTHROSCOPY/SURGERY,,,11888.68,35984.87,19
HCPCS,29856,Tibial arthroscopy/surgery,,,3451.33,3996.28,8
HCPCS,29860,HIP ARTHROSCOPY DX,,,6600.66,20338.07,19
HCPCS,29860,Hip arthroscopy dx,,,3451.33,3996.28,8
HCPCS,29861,HIP ARTHRO W/FB REMOVAL,,,6600.66,20338.07,19
HCPCS,29861,Hip arthro w/fb removal,,,1453.77,1683.31,8
HCPCS,29862,HIP ARTHR0 W/DEBRIDEMENT,,,6600.66,20338.07,19
HCPCS,29862,Hip arthr0 w/debridement,,,3451.33,3996.28,8
HCPCS,29863,HIP ARTHR0 W/SYNOVECTOMY,,,2997.95,9170.92,19
HCPCS,29863,Hip arthr0 w/synovectomy,,,1453.77,1683.31,8
HCPCS,29866,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,5868.0,3814.2,1.1,12214.27,50
HCPCS,29866,AUTGRFT IMPLNT KNEE W/SCOPE,,,6600.66,20338.07,19
HCPCS,29866,Autgrft implnt knee w/scope,,,3451.33,3996.28,8
HCPCS,29867,ALLGRFT IMPLNT KNEE W/SCOPE,,,11888.68,35984.87,19
HCPCS,29867,Allgrft implnt knee w/scope,,,3451.33,3996.28,8
HCPCS,29868,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,10040.0,6526.0,1.1,12214.27,50
HCPCS,29868,MENISCAL TRNSPL KNEE W/SCPE,,,6600.66,20338.07,19
HCPCS,29868,Meniscal trnspl knee w/scpe,,,3451.33,3996.28,8
HCPCS,29870,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,2284.0,1484.6,1.1,5526.53,53
HCPCS,29870,ARTHRS KNEE DX W/WO SYN BX,,,2997.95,9170.92,19
HCPCS,29870,Arthrs knee dx w/wo syn bx,,,1453.77,1683.31,8
HCPCS,29871,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,2944.0,1913.6,1.1,5526.53,50
HCPCS,29871,ARTHRS KNEE SURG FOR INFCTJ,,,2997.95,9170.92,19
HCPCS,29871,Arthrs knee surg for infctj,,,1453.77,1683.31,8
HCPCS,29873,ARTHRS KNEE SURG W/LAT RLS,,,2997.95,9170.92,19
HCPCS,29873,ARTHRS KNEE W LAT RELEASE,2746.0,1784.9,1.1,5526.53,50
HCPCS,29873,Arthrs knee surg w/lat rls,,,1453.77,1683.31,8
HCPCS,29874,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,3164.0,2056.6,1.1,5526.53,50
HCPCS,29874,ARTHRS KNEE SURG RMV LOOS/FB,,,2997.95,9170.92,19
HCPCS,29874,Arthrs knee surg rmv loos/fb,,,1453.77,1683.31,8
HCPCS,29875,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,2838.0,1844.7,1.1,5526.53,50
HCPCS,29875,ARTHRS KNEE SURG SYNVCT LMTD,,,2997.95,9170.92,19
HCPCS,29875,Arthrs knee surg synvct lmtd,,,1453.77,1683.31,8
HCPCS,29876,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,3548.0,2306.2,1.1,5526.53,50
HCPCS,29876,ARTHRS KNEE SURG SYNVCT MAJ,,,2997.95,9170.92,20
HCPCS,29876,Arthrs knee surg synvct maj,,,1453.77,1683.31,8
HCPCS,29877,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,3652.0,2373.8,1.1,5526.53,50
HCPCS,29877,ARTHRS KNEE SURG DBRDMT/SHVG,,,2997.95,9170.92,19
HCPCS,29877,Arthrs knee surg dbrdmt/shvg,,,1453.77,1683.31,8
HCPCS,29879,ARTHRS KNE SRG ABRASJ ARTHRP,,,2997.95,9170.92,20
HCPCS,29879,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,3596.0,2337.4,1.1,5526.53,50
HCPCS,29879,Arthrs kne srg abrasj arthrp,,,1453.77,1683.31,8
HCPCS,29880,ARTHRS KNE SRG MNISECTMY M&L,,,2997.95,9170.92,19
HCPCS,29880,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,3252.0,2113.8,1.1,5526.53,50
HCPCS,29880,Arthrs kne srg mnisectmy m&l,,,1453.77,1683.31,8
HCPCS,29881,ARTHRS KNE SRG MNISECTMY M/L,,,2997.95,9170.92,20
HCPCS,29881,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,3093.0,2010.45,1.1,5526.53,50
HCPCS,29881,Arthrs kne srg mnisectmy m/l,,,1453.77,1683.31,8
HCPCS,29882,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,4224.0,2745.6,1.1,5526.53,50
HCPCS,29882,ARTHRS KNE SRG MNISC RPR M/L,,,2997.95,9170.92,19
HCPCS,29882,Arthrs kne srg mnisc rpr m/l,,,1453.77,1683.31,8
HCPCS,29883,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,4708.0,3060.2,1.1,5526.53,50
HCPCS,29883,ARTHRS KNE SRG MNISC RPR M&L,,,2997.95,9170.92,19
HCPCS,29883,Arthrs kne srg mnisc rpr m&l,,,1453.77,1683.31,8
HCPCS,29884,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,3312.0,2152.8,1.1,5526.53,50
HCPCS,29884,ARTHRS KNEE SURG LYSIS ADS,,,2997.95,9170.92,19
HCPCS,29884,Arthrs knee surg lysis ads,,,1453.77,1683.31,8
HCPCS,29885,ARTHRS KNE SRG DRLG OST DISS,,,6600.66,20338.07,19
HCPCS,29885,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,4084.0,2654.6,1.1,12214.27,50
HCPCS,29885,Arthrs kne srg drlg ost diss,,,3451.33,3996.28,8
HCPCS,29886,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,3736.0,2428.4,1.1,5526.53,50
HCPCS,29886,ARTHRS KNEE SURG DRLG OD LES,,,2997.95,9170.92,19
HCPCS,29886,Arthrs knee surg drlg od les,,,1453.77,1683.31,8
HCPCS,29887,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,4064.0,2641.6,1.1,12214.27,50
HCPCS,29887,ARTHRS KNEE SRG DRLG OD FIXJ,,,6600.66,20338.07,19
HCPCS,29887,Arthrs knee srg drlg od fixj,,,3451.33,3996.28,8
HCPCS,29888,ARTHRS AID ACL RPR/AGMNTJ,,,6600.66,20338.07,19
HCPCS,29888,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6292.0,4089.8,1.1,12214.27,50
HCPCS,29888,Arthrs aid acl rpr/agmntj,,,3451.33,3996.28,8
HCPCS,29889,ARTHRS AID PCL RPR/AGMNTJ,,,11888.68,35984.87,19
HCPCS,29889,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6964.0,4526.6,1.1,22471.68,50
HCPCS,29889,Arthrs aid pcl rpr/agmntj,,,3451.33,3996.28,8
HCPCS,29891,ARTHR ANK OSTCHN DF TAL&/TIB,,,2997.95,9170.92,19
HCPCS,29891,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,3868.0,2514.2,1.1,5526.53,50
HCPCS,29891,Arthr ank ostchn df tal&/tib,,,1453.77,1683.31,8
HCPCS,29892,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,4108.0,2670.2,1.1,12214.27,50
HCPCS,29892,ARTHRS AID RPR OD LES/TIB FX,,,6600.66,20338.07,19
HCPCS,29892,Arthrs aid rpr od les/tib fx,,,3451.33,3996.28,8
HCPCS,29893,ENDOSCOPIC PLANTAR FASCIOTOMY,2528.0,1643.2,1.1,5526.53,53
HCPCS,29893,ENDOSCOPIC PLANTR FASCIOTOMY,,,2997.95,9170.92,19
HCPCS,29893,Endoscopic plantr fasciotomy,,,1392.99,1612.93,8
HCPCS,29894,ANKLE ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29894,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,2940.0,1911.0,1.1,5526.53,50
HCPCS,29894,Ankle arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29895,ANKLE ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29895,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,2852.0,1853.8,1.1,5526.53,50
HCPCS,29895,Ankle arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29897,ANKLE ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29897,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,2928.0,1903.2,1.1,5526.53,50
HCPCS,29897,Ankle arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29898,ANKLE ARTHROSCOPY/SURGERY,,,2997.95,9170.92,19
HCPCS,29898,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,3736.0,2428.4,1.1,5526.53,50
HCPCS,29898,Ankle arthroscopy/surgery,,,1453.77,1683.31,8
HCPCS,29899,ANKLE ARTHROSCOPY/SURGERY,,,6600.66,20338.07,19
HCPCS,29899,Ankle arthroscopy/surgery,,,3451.33,3996.28,8
HCPCS,29900,MCP JOINT ARTHROSCOPY DX,,,2997.95,9170.92,19
HCPCS,29900,Mcp joint arthroscopy dx,,,1453.77,1683.31,8
HCPCS,29901,MCP JOINT ARTHROSCOPY SURG,,,2997.95,9170.92,19
HCPCS,29901,Mcp joint arthroscopy surg,,,1453.77,1683.31,8
HCPCS,29902,MCP JOINT ARTHROSCOPY SURG,,,1478.75,4506.96,19
HCPCS,29902,Mcp joint arthroscopy surg,,,1453.77,1683.31,8
HCPCS,29904,SUBTALAR ARTHRO W/FB RMVL,,,2997.95,9170.92,19
HCPCS,29904,Subtalar arthro w/fb rmvl,,,1453.77,1683.31,8
HCPCS,29905,SUBTALAR ARTHRO W/EXC,,,6600.66,20338.07,19
HCPCS,29905,Subtalar arthro w/exc,,,1453.77,1683.31,8
HCPCS,29906,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,3860.0,2509.0,1.1,5526.53,50
HCPCS,29906,SUBTALAR ARTHRO W/DEB,,,2997.95,9170.92,19
HCPCS,29906,Subtalar arthro w/deb,,,1453.77,1683.31,8
HCPCS,29907,SUBTALAR ARTHRO W/FUSION,,,11888.68,35984.87,19
HCPCS,29907,Subtalar arthro w/fusion,,,3451.33,3996.28,8
HCPCS,29914,HIP ARTHRO W/FEMOROPLASTY,,,6600.66,20338.07,19
HCPCS,29914,Hip arthro w/femoroplasty,,,3451.33,3996.28,8
HCPCS,29915,HIP ARTHRO ACETABULOPLASTY,,,6600.66,20338.07,19
HCPCS,29915,Hip arthro acetabuloplasty,,,3451.33,3996.28,8
HCPCS,29916,HIP ARTHRO W/LABRAL REPAIR,,,6600.66,20338.07,19
HCPCS,29916,Hip arthro w/labral repair,,,3451.33,3996.28,8
HCPCS,29999,ARTHROSCOPIC AC JOINT RECONSTRUCTION (COMP CODE 23462),6288.0,4087.2,0.01,6288.0,28
HCPCS,29999,ARTHROSCOPIC BONE EXCISION WITH GRAFTING (COMP CODE 27360),4584.0,2979.6,0.01,4584.0,28
HCPCS,29999,ARTHROSCOPIC CORACOPLASTY SHOULDER (COMP CODE 23182),3444.0,2238.6,0.01,3444.0,28
HCPCS,29999,ARTHROSCOPIC EXCISION OF MENISCAL CYST OF THE KNEE (COMP CODE 29,2838.0,1844.7,0.01,2838.0,28
HCPCS,29999,ARTHROSCOPIC REMOVAL OF IMPLANT (COMP CODE 20680),2622.0,1704.3,0.01,2622.0,28
HCPCS,29999,ARTHROSCOPIC REMPLISSAGE REPAIR (COMP CODE 29827),5613.0,3648.45,0.01,5613.0,28
HCPCS,29999,ARTHROSCOPIC REPAIR AND THERMAL CAPSULORRAPHY SCAPHOLUNATE LIGAM,4629.0,3008.85,0.01,4629.0,28
HCPCS,29999,ARTHROSCOPIC REPAIR GREATER TUBEROSITY FRACTURE (COMP TO 29827),5145.0,3344.25,0.01,5145.0,28
HCPCS,29999,ARTHROSCOPIC TENOTOMY (COMP CODE 23405),3416.0,2220.4,0.01,3416.0,28
HCPCS,29999,ARTHROSCOPICALLY AIDED CARPAL DECOMPRESSION/BONE DRILLING (COMP,3060.0,1989.0,0.01,3060.0,28
HCPCS,29999,ARTHROSCOPY KNEE SUBCHONDROPLAST,1350.0,877.5,0.01,1350.0,28
HCPCS,29999,ARTHROSCOPY SHOULDER - BALLOON SPACER IMPLANTATION (COMP CODE 29,3432.0,2230.8,0.01,3432.0,28
HCPCS,29999,ENDOSCOPIC GASTROCNEMIUS RECESSION (COMP CODE 27687),1089.0,707.85,0.01,1089.0,28
HCPCS,29999,ENDOSCOPIC ILIOPSOAS TENDON RELEASE (COMP CODE 29862),4468.0,2904.2,0.01,4468.0,28
HCPCS,29999,LEFT HIP CORE DECOMPRESSION WITH INTRAOSSEOUS BIOPLASTY (COMP TO,4893.0,3180.45,0.01,4893.0,28
HCPCS,29999,TENOTOMY OF HIP FLEXORS (COMP CODE 27005),4330.0,2814.5,0.01,4330.0,28
HCPCS,29999,"UNLIST PROC, ARTHROSCOPY COMPARED TO 23420",2319.0,1507.35,0.01,2319.0,28
HCPCS,29999,UNLISTED ARTHROSCOPIC I&D OF HEMATOMA (COMPARED TO 10140),521.0,338.65,0.01,521.0,28
HCPCS,29999,"UNLISTED PROC, ARTHROSCOPIC AIDED INTERNAL FIXATION OF LAT BIL F",3290.0,2138.5,0.01,3290.0,28
HCPCS,29999,"UNLISTED PROC, ARTHROSCOPIC ULNAR WAFER PROC (REMOVING APPROX 2M",1752.0,1138.8,0.01,1752.0,28
HCPCS,29999,"UNLISTED PROC; ARTHROSCOPIC REPAIR GREATER TUBEROSITY FRACTURE,",3477.0,2260.05,0.01,3477.0,28
HCPCS,29999,UNLISTED PROC; RIGHT SHOULDER ARTHROSCOPIC SUPERIOR CAPSULE RECO,10141.0,6591.65,0.01,10141.0,28
HCPCS,29999,UNLISTED PROCEDURE ARTHROSCOPY,1391.0,904.15,0.01,1391.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY",3178.5,2066.025,0.01,4712.0,56
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 23450)",4481.0,2912.65,0.01,4481.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 23465)",5379.0,3496.35,0.01,5379.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 25390)",1650.0,1072.5,0.01,1650.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 27347)",1410.0,916.5,0.01,1410.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 29806)",4934.0,3207.1,0.01,4934.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 29827)",5095.0,3311.75,0.01,5095.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY (COMPARISON CODE 29877)",1350.0,877.5,0.01,1350.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY COMPARED TO 27635",2650.0,1722.5,0.01,2650.0,28
HCPCS,29999,"UNLISTED PROCEDURE, ARTHROSCOPY COMPARED TO 29855 X 3",4935.0,3207.75,0.01,4935.0,28
HCPCS,29999,UNLISTED PX ARTHROSCOPY,,,221.64,691.37,19
HCPCS,29999,Unlisted px arthroscopy,,,1453.77,1683.31,8
HCPCS,30000,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,830.0,539.5,1.1,3004.0,114
HCPCS,30020,DRAINAGE OF NOSE LESION,,,470.54,1511.66,19
HCPCS,30020,Drainage of nose lesion,,,745.85,863.61,8
HCPCS,3006F,Cxr doc rev,,,8.48,9.82,8
HCPCS,3008F,Body mass index docd,,,8.48,9.82,8
HCPCS,30100,"BIOPSY,INTRANASAL",376.0,244.4,1.1,2603.78,53
HCPCS,30100,INTRANASAL BIOPSY,,,1368.67,4348.85,19
HCPCS,30100,Intranasal biopsy,,,745.85,863.61,8
HCPCS,30110,REMOVAL OF NOSE POLYP(S),,,1368.67,4348.85,19
HCPCS,30110,Removal of nose polyp(s),,,745.85,863.61,8
HCPCS,30115,"EXCISION NOSE POLYP(S),EXTENSIVE",1776.0,1154.4,1.1,5497.86,50
HCPCS,30115,REMOVAL OF NOSE POLYP(S),,,2996.53,9292.73,19
HCPCS,30115,Removal of nose polyp(s),,,745.85,863.61,8
HCPCS,30117,"EXCIS INTRANASAL LESN,INTERN APPRCH",1564.0,1016.6,1.1,5497.86,53
HCPCS,30117,REMOVAL OF INTRANASAL LESION,,,2996.53,9292.73,19
HCPCS,30117,Removal of intranasal lesion,,,1237.01,1432.33,8
HCPCS,30118,REMOVAL OF INTRANASAL LESION,,,2996.53,9292.73,19
HCPCS,30118,Removal of intranasal lesion,,,1237.01,1432.33,8
HCPCS,3011F,Lipid panel doc rev,,,8.48,9.82,8
HCPCS,30120,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,2156.0,1401.4,1.1,5497.86,53
HCPCS,30120,REVISION OF NOSE,,,2996.53,9292.73,19
HCPCS,30120,Revision of nose,,,1237.01,1432.33,8
HCPCS,30124,REMOVAL OF NOSE LESION,,,1368.67,4348.85,19
HCPCS,30124,Removal of nose lesion,,,745.85,863.61,8
HCPCS,30125,REMOVAL OF NOSE LESION,,,5465.95,16592.38,19
HCPCS,30125,Removal of nose lesion,,,745.85,863.61,8
HCPCS,30130,EXCISE INFERIOR TURBINATE,,,2996.53,9292.73,19
HCPCS,30130,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,1527.0,992.55,1.1,5497.86,50
HCPCS,30130,Excise inferior turbinate,,,1634.67,1892.77,8
HCPCS,30140,RESECT INFERIOR TURBINATE,,,2996.53,9292.73,20
HCPCS,30140,Resect inferior turbinate,,,1634.67,1892.77,8
HCPCS,30140,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,1320.0,858.0,1.1,5497.86,53
HCPCS,3014F,Screen mammo doc rev,,,8.48,9.82,8
HCPCS,30150,RHINECTOMY PARTIAL,,,5465.95,16592.38,19
HCPCS,30150,Rhinectomy partial,,,3594.14,4161.63,8
HCPCS,3015F,Cerv cancer screen docd,,,8.48,9.82,8
HCPCS,30160,RHINECTOMY TOTAL,,,5465.95,16592.38,19
HCPCS,30160,Rhinectomy total,,,3594.14,4161.63,8
HCPCS,3016F,Pt scrnd unhlthy oh use,,,8.48,9.82,8
HCPCS,3017F,Colorectal ca screen doc rev,,,8.48,9.82,8
HCPCS,3018F,Pre-prxd rsk et al docd,,,8.48,9.82,8
HCPCS,3019F,Lvef assess planpost dschrge,,,8.48,9.82,8
HCPCS,30200,INJECTION TREATMENT OF NOSE,,,470.54,1511.66,19
HCPCS,30200,Injection treatment of nose,,,85.44,98.93,8
HCPCS,3020F,Lvf assess,,,8.48,9.82,8
HCPCS,30210,DISPLACEMENT THERAPY PROETZ TYPE,452.0,293.8,1.1,2603.78,53
HCPCS,30210,NASAL SINUS THERAPY,,,1368.67,4348.85,19
HCPCS,30210,Nasal sinus therapy,,,85.44,98.93,8
HCPCS,3021F,Lvef mod/sever deprs syst,,,8.48,9.82,8
HCPCS,30220,INSERT NASAL SEPTAL BUTTON,,,1368.67,4348.85,19
HCPCS,30220,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,636.0,413.4,1.1,2603.78,53
HCPCS,30220,Insert nasal septal button,,,745.85,863.61,8
HCPCS,3022F,Lvef >=40% systolic,,,8.48,9.82,8
HCPCS,3023F,Spirom doc rev,,,8.48,9.82,8
HCPCS,3025F,Spirom fev/fvc <70% w/copd,,,8.48,9.82,8
HCPCS,3027F,Spirom fev/fvc>=70%/w/ocopd,,,8.48,9.82,8
HCPCS,3028F,O2 saturation doc rev,,,8.48,9.82,8
HCPCS,30300,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,536.5,348.725,1.1,2453.0,114
HCPCS,30310,REMOVE NASAL FOREIGN BODY,,,2996.53,9292.73,19
HCPCS,30310,Remove nasal foreign body,,,745.85,863.61,8
HCPCS,30320,REMOVE NASAL FOREIGN BODY,,,1368.67,4348.85,19
HCPCS,30320,Remove nasal foreign body,,,745.85,863.61,8
HCPCS,3035F,O2 saturation<=88%/pao<=55,,,8.48,9.82,8
HCPCS,3037F,O2 saturation >88%/pao>55 hg,,,8.48,9.82,8
HCPCS,3038F,Pulm fx w/in 12 mon b/4 surg,,,8.48,9.82,8
HCPCS,30400,RECONSTRUCTION OF NOSE,,,5465.95,16592.38,19
HCPCS,30400,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,4778.0,3105.7,1.1,9999.36,50
HCPCS,30400,Reconstruction of nose,,,1634.67,1892.77,8
HCPCS,3040F,Fev <40% predicted value,,,8.48,9.82,8
HCPCS,30410,RECONSTRUCTION OF NOSE,,,5465.95,16592.38,19
HCPCS,30410,RHINP PRIM COMPLETE XTRNL PARTS,5600.0,3640.0,1.1,9999.36,50
HCPCS,30410,Reconstruction of nose,,,3594.14,4161.63,8
HCPCS,30420,RECONSTRUCTION OF NOSE,,,5465.95,16592.38,19
HCPCS,30420,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,6760.0,4394.0,1.1,9999.36,50
HCPCS,30420,Reconstruction of nose,,,3594.14,4161.63,8
HCPCS,3042F,Fev >=40% predicted value,,,8.48,9.82,8
HCPCS,30430,REVISION OF NOSE,,,5465.95,16592.38,19
HCPCS,30430,RHINOPLASTY SECONDARY MINOR REVISION,3296.0,2142.4,1.1,9999.36,50
HCPCS,30430,Revision of nose,,,1237.01,1432.33,8
HCPCS,30435,REVISION OF NOSE,,,5465.95,16592.38,19
HCPCS,30435,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,5601.0,3640.65,1.1,9999.36,50
HCPCS,30435,Revision of nose,,,3594.14,4161.63,8
HCPCS,3044F,Hg a1c level lt 7.0%,,,8.48,9.82,8
HCPCS,30450,REVISION OF NOSE,,,5465.95,16592.38,19
HCPCS,30450,Revision of nose,,,3594.14,4161.63,8
HCPCS,30460,REVISION OF NOSE,,,5465.95,16592.38,19
HCPCS,30460,Revision of nose,,,3594.14,4161.63,8
HCPCS,30462,REVISION OF NOSE,,,5465.95,16592.38,19
HCPCS,30462,Revision of nose,,,3594.14,4161.63,8
HCPCS,30465,NASAL VESTIBUL STENOS REPAIR,4944.0,3213.6,1.1,9999.36,50
HCPCS,30465,REPAIR NASAL STENOSIS,,,5465.95,16592.38,19
HCPCS,30465,Repair nasal stenosis,,,1237.01,1432.33,8
HCPCS,30468,RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT,1120.0,728.0,1.1,9999.36,52
HCPCS,30468,RPR NSL VLV COLLAPSE W/IMPLT,,,5465.95,16592.38,19
HCPCS,30468,Rpr nsl vlv collapse w/implt,,,2151.73,2491.48,8
HCPCS,30469,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,14094.0,9161.1,0.01,27212.0,113
HCPCS,3046F,Hemoglobin a1c level >9.0%,,,8.48,9.82,8
HCPCS,3048F,Ldl-c <100 mg/dl,,,8.48,9.82,8
HCPCS,3049F,Ldl-c 100-129 mg/dl,,,8.48,9.82,8
HCPCS,3050F,Ldl-c >= 130 mg/dl,,,8.48,9.82,8
HCPCS,3051F,Hg a1c>equal 7.0%<8.0%,,,8.48,9.82,8
HCPCS,30520,REPAIR OF NASAL SEPTUM,,,2996.53,9292.73,20
HCPCS,30520,Repair of nasal septum,,,1634.67,1892.77,8
HCPCS,30520,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,2804.0,1822.6,1.1,5497.86,50
HCPCS,3052F,Hg a1c>equal 8.0%<equal 9.0%,,,8.48,9.82,8
HCPCS,30540,RPR CHOANAL ATRESIA NTRANASL,,,5465.95,16592.38,19
HCPCS,30540,Rpr choanal atresia ntranasl,,,2151.73,2491.48,8
HCPCS,30545,RPR CHOANAL ATRESIA TRSNPLTN,,,5465.95,16592.38,19
HCPCS,30545,Rpr choanal atresia trsnpltn,,,2630.78,3046.16,8
HCPCS,3055F,Lvef less than/equal to 35%,,,8.48,9.82,8
HCPCS,30560,LYSIS INTRANASAL SYNECHIA,524.0,340.6,1.1,1511.66,72
HCPCS,30560,Lysis intranasal synechia,,,745.85,863.61,8
HCPCS,3056F,Lvef greater than 35%,,,8.48,9.82,8
HCPCS,30580,REPAIR FISTULA OROMAXILLARY,2752.0,1788.8,1.1,9999.36,53
HCPCS,30580,REPAIR UPPER JAW FISTULA,,,5465.95,16592.38,19
HCPCS,30580,Repair upper jaw fistula,,,2151.73,2491.48,8
HCPCS,30600,REPAIR MOUTH/NOSE FISTULA,,,5465.95,16592.38,19
HCPCS,30600,Repair mouth/nose fistula,,,2151.73,2491.48,8
HCPCS,3060F,Pos microalbuminuria rev,,,8.48,9.82,8
HCPCS,3061F,Neg microalbuminuria rev,,,8.48,9.82,8
HCPCS,30620,INTRANASAL RECONSTRUCTION,,,5465.95,16592.38,19
HCPCS,30620,Intranasal reconstruction,,,2151.73,2491.48,8
HCPCS,3062F,Pos macroalbuminuria rev,,,8.48,9.82,8
HCPCS,30630,REPAIR NASAL SEPTAL PERFORATIONS,2916.0,1895.4,1.1,5497.86,50
HCPCS,30630,REPAIR NASAL SEPTUM DEFECT,,,2996.53,9292.73,19
HCPCS,30630,Repair nasal septum defect,,,2151.73,2491.48,8
HCPCS,3066F,Nephropathy doc tx,,,8.48,9.82,8
HCPCS,3072F,Low risk for retinopathy,,,8.48,9.82,8
HCPCS,3073F,Pre-surg eye measures docd,,,8.48,9.82,8
HCPCS,3074F,Syst bp lt 130 mm hg,,,8.48,9.82,8
HCPCS,3075F,Syst bp ge 130 - 139mm hg,,,8.48,9.82,8
HCPCS,3077F,Syst bp >= 140 mm hg,,,8.48,9.82,8
HCPCS,3078F,Diast bp <80 mm hg,,,8.48,9.82,8
HCPCS,3079F,Diast bp 80-89 mm hg,,,8.48,9.82,8
HCPCS,30801,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,3635.0,2362.75,0.01,6814.0,114
HCPCS,30802,ABLATE INF TURBINATE SUBMUC,,,1368.67,4348.85,19
HCPCS,30802,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,832.0,540.8,1.1,2603.78,53
HCPCS,30802,Ablate inf turbinate submuc,,,1634.67,1892.77,8
HCPCS,3080F,Diast bp >= 90 mm hg,,,8.48,9.82,8
HCPCS,3082F,Kt/v <1.2,,,8.48,9.82,8
HCPCS,3083F,Kt/v =/> 1.2 & <1.7,,,8.48,9.82,8
HCPCS,3084F,Kt/v >= 1.7,,,8.48,9.82,8
HCPCS,3085F,Suicide risk assessed,,,8.48,9.82,8
HCPCS,3088F,Mdd mild,,,8.48,9.82,8
HCPCS,3089F,Mdd moderate,,,8.48,9.82,8
HCPCS,30901,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,516.5,335.725,0.01,3004.0,175
HCPCS,30903,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,635.5,413.075,1.1,3004.0,114
HCPCS,30905,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,730.0,474.5,1.1,3004.0,114
HCPCS,30906,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1073.0,697.45,1.1,3004.0,114
HCPCS,3090F,Mdd severe w/o psych,,,8.48,9.82,8
HCPCS,30915,LIGATION NASAL SINUS ARTERY,,,2908.23,8849.94,19
HCPCS,30915,Ligation nasal sinus artery,,,987.9,1143.88,8
HCPCS,3091F,Mdd severe w/psych,,,8.48,9.82,8
HCPCS,30920,LIGATION UPPER JAW ARTERY,,,2908.23,8849.94,19
HCPCS,30920,Ligation upper jaw artery,,,987.9,1143.88,8
HCPCS,3092F,Mdd in remission,,,8.48,9.82,8
HCPCS,30930,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,524.0,340.6,1.1,5497.86,50
HCPCS,30930,THER FX NASAL INF TURBINATE,,,2996.53,9292.73,19
HCPCS,30930,Ther fx nasal inf turbinate,,,1634.67,1892.77,8
HCPCS,3093F,Doc new diag 1st/addl mdd,,,8.48,9.82,8
HCPCS,3095F,Central dexa results docd,,,8.48,9.82,8
HCPCS,3096F,Central dexa ordered,,,8.48,9.82,8
HCPCS,30999,CRYOABLATION OF NASAL NERVE,1076.0,699.4,0.01,1076.0,28
HCPCS,30999,UNLISTED PROC; CRYOABLATION THPY INTRANASAL NERVE(S) MULTIPLE (C,2152.0,1398.8,0.01,2152.0,28
HCPCS,30999,UNLISTED PROC; NASAL SURG PROC (COMP TO 30465),4079.0,2651.35,0.01,4079.0,28
HCPCS,30999,UNLISTED PROCEDURE NOSE,995.5,647.075,0.01,3004.0,89
HCPCS,31000,IRRIGATION MAXILLARY SINUS,,,214.57,663.85,19
HCPCS,31000,Irrigation maxillary sinus,,,745.85,863.61,8
HCPCS,31000,LAVAGE CANNULATION MAXILLARY SINUS,480.0,312.0,1.1,614.61,53
HCPCS,31002,IRRIGATION SPHENOID SINUS,,,1368.67,4348.85,19
HCPCS,31002,Irrigation sphenoid sinus,,,85.44,98.93,8
HCPCS,3100F,Image test ref carot diam,,,8.48,9.82,8
HCPCS,31020,EXPLORATION MAXILLARY SINUS,,,2996.53,9292.73,19
HCPCS,31020,Exploration maxillary sinus,,,745.85,863.61,8
HCPCS,31030,EXPLORATION MAXILLARY SINUS,,,5465.95,16592.38,19
HCPCS,31030,Exploration maxillary sinus,,,2151.73,2491.48,8
HCPCS,31032,EXPLORE SINUS REMOVE POLYPS,,,5465.95,16592.38,19
HCPCS,31032,Explore sinus remove polyps,,,2151.73,2491.48,8
HCPCS,31040,EXPLORATION BEHIND UPPER JAW,,,5465.95,16592.38,19
HCPCS,31040,Exploration behind upper jaw,,,3594.14,4161.63,8
HCPCS,31050,EXPLORATION SPHENOID SINUS,,,5465.95,16592.38,19
HCPCS,31050,Exploration sphenoid sinus,,,2151.73,2491.48,8
HCPCS,31051,SPHENOID SINUS SURGERY,,,5465.95,16592.38,19
HCPCS,31051,Sphenoid sinus surgery,,,2151.73,2491.48,8
HCPCS,31070,EXPLORATION OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31070,Exploration of frontal sinus,,,2151.73,2491.48,8
HCPCS,31075,EXPLORATION OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31075,Exploration of frontal sinus,,,2151.73,2491.48,8
HCPCS,31075,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,3804.0,2472.6,1.1,9999.36,50
HCPCS,31080,REMOVAL OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31080,Removal of frontal sinus,,,2695.9,3121.57,8
HCPCS,31081,REMOVAL OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31081,Removal of frontal sinus,,,3594.14,4161.63,8
HCPCS,31084,REMOVAL OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31084,Removal of frontal sinus,,,2151.73,2491.48,8
HCPCS,31085,REMOVAL OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31085,Removal of frontal sinus,,,2695.9,3121.57,8
HCPCS,31085,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,6256.0,4066.4,1.1,9999.36,50
HCPCS,31086,REMOVAL OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31086,Removal of frontal sinus,,,2695.9,3121.57,8
HCPCS,31087,REMOVAL OF FRONTAL SINUS,,,5465.95,16592.38,19
HCPCS,31087,Removal of frontal sinus,,,2151.73,2491.48,8
HCPCS,31090,EXPLORATION OF SINUSES,,,5465.95,16592.38,19
HCPCS,31090,Exploration of sinuses,,,2151.73,2491.48,8
HCPCS,3110F,Pres/absn hmrhg/lesion docd,,,8.48,9.82,8
HCPCS,3111F,Ct/mri brain done w/in 24hrs,,,8.48,9.82,8
HCPCS,3112F,Ct/mri brain done 24 hrs,,,8.48,9.82,8
HCPCS,3115F,Quant results activity &symp,,,8.48,9.82,8
HCPCS,3117F,Hf assessment tool completed,,,8.48,9.82,8
HCPCS,3118F,Ny heart assoc class docd,,,8.48,9.82,8
HCPCS,3119F,No eval activity clin symp,,,8.48,9.82,8
HCPCS,31200,REMOVAL OF ETHMOID SINUS,,,5465.95,16592.38,19
HCPCS,31200,Removal of ethmoid sinus,,,2151.73,2491.48,8
HCPCS,31201,REMOVAL OF ETHMOID SINUS,,,1368.67,4348.85,19
HCPCS,31201,Removal of ethmoid sinus,,,1237.01,1432.33,8
HCPCS,31205,REMOVAL OF ETHMOID SINUS,,,2996.53,9292.73,19
HCPCS,31205,Removal of ethmoid sinus,,,1237.01,1432.33,8
HCPCS,3120F,12-lead ecg performed,,,8.48,9.82,8
HCPCS,31225,Removal of upper jaw,,,3594.14,4161.63,8
HCPCS,31230,Removal of upper jaw,,,3594.14,4161.63,8
HCPCS,31231,"NASAL ENDOS,DIAG,UNI/ BILATERAL",484.0,314.6,1.1,623.0,53
HCPCS,31231,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,893.0,580.45,0.01,4001.0,122
HCPCS,31233,NSL/SINS NDSC DX MAX SINUSC,,,358.79,1096.25,19
HCPCS,31233,Nsl/sins ndsc dx max sinusc,,,211.85,245.3,8
HCPCS,31235,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,7933.0,5156.45,0.01,7933.0,61
HCPCS,31237,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,1144.0,743.6,1.1,2897.66,53
HCPCS,31237,NSL/SINS NDSC SURG BX POLYPC,,,1593.38,4988.78,19
HCPCS,31237,Nsl/sins ndsc surg bx polypc,,,1124.06,1301.54,8
HCPCS,31238,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,1206.0,783.9,1.1,2897.66,53
HCPCS,31238,NSL/SINS NDSC SRG NSL HEMRRG,,,1593.38,4988.78,19
HCPCS,31238,Nsl/sins ndsc srg nsl hemrrg,,,1124.06,1301.54,8
HCPCS,31239,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,3978.0,2585.7,1.1,6393.86,50
HCPCS,31239,NSL/SINUS ENDOSCOPY SURG DCR,,,3406.67,10449.99,19
HCPCS,31239,Nsl/sinus endoscopy surg dcr,,,1124.06,1301.54,8
HCPCS,31240,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,1148.0,746.2,1.1,2897.66,50
HCPCS,31240,NSL/SNS NDSC CNCH BULL RESCJ,,,1593.38,4988.78,19
HCPCS,31240,Nsl/sns ndsc cnch bull rescj,,,211.85,245.3,8
HCPCS,31241,NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY,3520.0,2288.0,1.1,3520.0,50
HCPCS,31241,NSL/SNS NDSC LIG SPHNPTN ART,,,1593.38,4988.78,19
HCPCS,31241,Nsl/sns ndsc lig sphnptn art,,,1124.06,1301.54,8
HCPCS,31242,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,1188.0,772.2,1.1,9999.36,52
HCPCS,31242,NSL/SINUS NDSC RF ABLTJ PNN,,,5465.95,16592.38,19
HCPCS,31242,Nsl/sinus ndsc rf abltj pnn,,,2151.73,2491.48,8
HCPCS,31243,NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV,1188.0,772.2,1.1,9999.36,52
HCPCS,31243,NSL/SINUS NDSC CRYOABLTJ PNN,,,5465.95,16592.38,19
HCPCS,31243,Nsl/sinus ndsc cryoabltj pnn,,,2151.73,2491.48,8
HCPCS,31253,NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL,3960.0,2574.0,1.1,11685.63,50
HCPCS,31253,NSL/SINS NDSC TOTAL,,,6396.22,19780.99,19
HCPCS,31253,Nsl/sins ndsc total,,,2695.9,3121.57,8
HCPCS,31254,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,1879.0,1221.35,1.1,11685.63,53
HCPCS,31254,NSL/SINS NDSC W/PRTL ETHMDCT,,,6396.22,19780.99,19
HCPCS,31254,Nsl/sins ndsc w/prtl ethmdct,,,1237.01,1432.33,8
HCPCS,31255,NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY,2530.0,1644.5,1.1,11685.63,50
HCPCS,31255,NSL/SINS NDSC W/TOT ETHMDCT,,,6396.22,19780.99,19
HCPCS,31255,Nsl/sins ndsc w/tot ethmdct,,,2695.9,3121.57,8
HCPCS,31256,EXPLORATION MAXILLARY SINUS,,,3406.67,10449.99,19
HCPCS,31256,Exploration maxillary sinus,,,1237.01,1432.33,8
HCPCS,31256,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,1368.0,889.2,1.1,6393.86,50
HCPCS,31257,NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY,3520.0,2288.0,1.1,11685.63,50
HCPCS,31257,NSL/SINS NDSC TOT W/SPHENDT,,,6396.22,19780.99,19
HCPCS,31257,Nsl/sins ndsc tot w/sphendt,,,2695.9,3121.57,8
HCPCS,31259,NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL,3731.0,2425.15,1.1,11685.63,50
HCPCS,31259,NSL/SINS NDSC SPHN TISS RMVL,,,6396.22,19780.99,19
HCPCS,31259,Nsl/sins ndsc sphn tiss rmvl,,,2695.9,3121.57,8
HCPCS,31267,ENDOSCOPY MAXILLARY SINUS,,,6396.22,19780.99,19
HCPCS,31267,Endoscopy maxillary sinus,,,211.85,245.3,8
HCPCS,31267,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,2059.0,1338.35,1.1,11685.63,50
HCPCS,3126F,Esoph bx rprt w/dyspl info,,,8.48,9.82,8
HCPCS,31276,NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS,2970.0,1930.5,1.1,11685.63,50
HCPCS,31276,NSL/SINS NDSC FRNT TISS RMVL,,,6396.22,19780.99,19
HCPCS,31276,Nsl/sins ndsc frnt tiss rmvl,,,211.85,245.3,8
HCPCS,31287,NASAL/SINUS ENDOSCOPY SURG,,,6396.22,19780.99,19
HCPCS,31287,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,1540.0,1001.0,1.1,11685.63,50
HCPCS,31287,Nasal/sinus endoscopy surg,,,211.85,245.3,8
HCPCS,31288,NASAL/SINUS ENDOSCOPY SURG,,,6396.22,19780.99,19
HCPCS,31288,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,1640.0,1066.0,1.1,11685.63,50
HCPCS,31288,Nasal/sinus endoscopy surg,,,211.85,245.3,8
HCPCS,31290,Nasal/sinus endoscopy surg,,,1124.06,1301.54,8
HCPCS,31291,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,7824.0,5085.6,1.1,7824.0,50
HCPCS,31291,Nasal/sinus endoscopy surg,,,1124.06,1301.54,8
HCPCS,31292,NSL/SINS NDSC MED/INF DCMPRN,,,6396.22,19780.99,19
HCPCS,31292,Nsl/sins ndsc med/inf dcmprn,,,1124.06,1301.54,8
HCPCS,31293,NSL/SINS NDSC MED&INF DCMPRN,,,6396.22,19780.99,19
HCPCS,31293,Nsl/sins ndsc med&inf dcmprn,,,1124.06,1301.54,8
HCPCS,31294,NSL/SINS NDSC SURG ON DCMPRN,,,6396.22,19780.99,19
HCPCS,31294,Nsl/sins ndsc surg on dcmprn,,,1124.06,1301.54,8
HCPCS,31295,NSL/SINS NDSC SURG MAX SINS,,,6396.22,19780.99,20
HCPCS,31295,NSL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,1080.0,702.0,1.1,11685.63,53
HCPCS,31295,Nsl/sins ndsc surg max sins,,,1124.06,1301.54,8
HCPCS,31296,NSL/SINS NDSC SURG FRNT SINS,,,6396.22,19780.99,19
HCPCS,31296,NSL/SINUS NDSC SURG W/DILAT FRONTAL SINUS,1364.0,886.6,1.1,11685.63,53
HCPCS,31296,Nsl/sins ndsc surg frnt sins,,,211.85,245.3,8
HCPCS,31297,NSL/SINS NDSC SURG SPHN SINS,,,6396.22,19780.99,19
HCPCS,31297,NSL/SINUS NDSC SURG W/DILAT SPHENOID SINUS,976.0,634.4,1.1,11685.63,53
HCPCS,31297,Nsl/sins ndsc surg sphn sins,,,211.85,245.3,8
HCPCS,31298,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,1800.0,1170.0,1.1,11685.63,53
HCPCS,31298,NSL/SINS NDSC SURG FRNT&SPHN,,,6396.22,19780.99,19
HCPCS,31298,Nsl/sins ndsc surg frnt&sphn,,,211.85,245.3,8
HCPCS,31299,MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION (COMP 31225),9613.0,6248.45,0.01,9613.0,28
HCPCS,31299,UNLISTED PX ACCESSORY SINUS,,,214.57,663.85,19
HCPCS,31299,Unlisted px accessory sinus,,,745.85,863.61,8
HCPCS,31300,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,6364.0,4136.6,1.1,6364.0,50
HCPCS,31300,REMOVAL OF LARYNX LESION,,,2996.53,9292.73,19
HCPCS,31300,Removal of larynx lesion,,,1237.01,1432.33,8
HCPCS,3130F,Upper gi endoscopy performed,,,8.48,9.82,8
HCPCS,3132F,Doc ref upper gi endoscopy,,,8.48,9.82,8
HCPCS,31360,Removal of larynx,,,2695.9,3121.57,8
HCPCS,31365,Removal of larynx,,,2695.9,3121.57,8
HCPCS,31367,Partial removal of larynx,,,2695.9,3121.57,8
HCPCS,31368,Partial removal of larynx,,,2695.9,3121.57,8
HCPCS,31370,Partial removal of larynx,,,2695.9,3121.57,8
HCPCS,31375,Partial removal of larynx,,,2695.9,3121.57,8
HCPCS,31380,Partial removal of larynx,,,2695.9,3121.57,8
HCPCS,31382,Partial removal of larynx,,,2695.9,3121.57,8
HCPCS,31390,Removal of larynx & pharynx,,,2695.9,3121.57,8
HCPCS,31395,Reconstruct larynx & pharynx,,,2695.9,3121.57,8
HCPCS,31400,REVISION OF LARYNX,,,5465.95,16592.38,19
HCPCS,31400,Revision of larynx,,,2695.9,3121.57,8
HCPCS,3140F,Upper gi endo shows barrtts,,,8.48,9.82,8
HCPCS,3141F,Upper gi endo not barrtts,,,8.48,9.82,8
HCPCS,31420,EPIGLOTTIDECTOMY,,,5465.95,16592.38,19
HCPCS,31420,Epiglottidectomy,,,2695.9,3121.57,8
HCPCS,3142F,Barium swallow test ordered,,,8.48,9.82,8
HCPCS,31500,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1134.0,737.1,0.01,3004.0,233
HCPCS,31502,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,664.0,431.6,0.01,3004.0,172
HCPCS,31505,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,893.0,580.45,82.35,2453.0,61
HCPCS,31505,"LARYNGOSCOPY,INDIRECT,DIAGNOSTIC",244.0,158.6,1.1,338.69,53
HCPCS,3150F,Forceps esoph biopsy done,,,8.48,9.82,8
HCPCS,31510,LARYNGOSCOPY WITH BIOPSY,,,3406.67,10449.99,19
HCPCS,31510,Laryngoscopy with biopsy,,,1124.06,1301.54,8
HCPCS,31511,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,893.0,580.45,85.44,4001.0,61
HCPCS,31512,REMOVAL OF LARYNX LESION,,,3406.67,10449.99,19
HCPCS,31512,Removal of larynx lesion,,,1124.06,1301.54,8
HCPCS,31513,INJECTION INTO VOCAL CORD,,,358.79,1096.25,19
HCPCS,31513,Injection into vocal cord,,,211.85,245.3,8
HCPCS,31515,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,1786.0,1160.9,185.22,3004.0,61
HCPCS,31520,DX LARYNGOSCOPY NEWBORN,,,358.79,1096.25,19
HCPCS,31520,Dx laryngoscopy newborn,,,211.85,245.3,8
HCPCS,31520,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,1024.0,665.6,1.1,1024.0,50
HCPCS,31525,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,4492.5,2920.125,1.1,7933.0,114
HCPCS,31526,DX LARYNGOSCOPY W/OPER SCOPE,,,1593.38,4988.78,19
HCPCS,31526,Dx laryngoscopy w/oper scope,,,211.85,245.3,8
HCPCS,31526,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,1028.0,668.2,1.1,2897.66,50
HCPCS,31527,LARYNGOSCOPY FOR TREATMENT,,,3406.67,10449.99,19
HCPCS,31527,Laryngoscopy for treatment,,,1124.06,1301.54,8
HCPCS,31528,LARYNGOSCOPY AND DILATION,,,3406.67,10449.99,19
HCPCS,31528,Laryngoscopy and dilation,,,1124.06,1301.54,8
HCPCS,31529,LARYNGOSCOPY AND DILATION,,,3406.67,10449.99,19
HCPCS,31529,Laryngoscopy and dilation,,,1124.06,1301.54,8
HCPCS,31530,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,4642.5,3017.625,1.1,7933.0,111
HCPCS,31531,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,1432.0,930.8,1.1,6393.86,50
HCPCS,31531,LARYNGOSCOPY W/FB & OP SCOPE,,,3406.67,10449.99,19
HCPCS,31531,Laryngoscopy w/fb & op scope,,,1124.06,1301.54,8
HCPCS,31535,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,1264.0,821.6,1.1,6393.86,50
HCPCS,31535,LARYNGOSCOPY W/BIOPSY,,,3406.67,10449.99,19
HCPCS,31535,Laryngoscopy w/biopsy,,,1124.06,1301.54,8
HCPCS,31536,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,1420.0,923.0,1.1,6393.86,50
HCPCS,31536,LARYNGOSCOPY W/BX & OP SCOPE,,,3406.67,10449.99,19
HCPCS,31536,Laryngoscopy w/bx & op scope,,,1124.06,1301.54,8
HCPCS,31540,LARYNGOSCOPY W/EXC OF TUMOR,,,3406.67,10449.99,19
HCPCS,31540,Laryngoscopy w/exc of tumor,,,1124.06,1301.54,8
HCPCS,31541,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,1808.0,1175.2,1.1,6393.86,50
HCPCS,31541,LARYNSCOP W/TUMR EXC + SCOPE,,,3406.67,10449.99,19
HCPCS,31541,Larynscop w/tumr exc + scope,,,1124.06,1301.54,8
HCPCS,31545,REMOVE VC LESION W/SCOPE,,,3406.67,10449.99,19
HCPCS,31545,Remove vc lesion w/scope,,,1124.06,1301.54,8
HCPCS,31546,REMOVE VC LESION SCOPE/GRAFT,,,6396.22,19780.99,19
HCPCS,31546,Remove vc lesion scope/graft,,,1124.06,1301.54,8
HCPCS,31551,LARYNGOPLASTY LARYNGEAL STEN,,,5465.95,16592.38,19
HCPCS,31551,Laryngoplasty laryngeal sten,,,2695.9,3121.57,8
HCPCS,31552,LARYNGOPLASTY LARYNGEAL STEN,,,5465.95,16592.38,19
HCPCS,31552,LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >,8200.0,5330.0,1.1,9999.36,50
HCPCS,31552,Laryngoplasty laryngeal sten,,,2151.73,2491.48,8
HCPCS,31553,LARYNGOPLASTY LARYNGEAL STEN,,,5465.95,16592.38,19
HCPCS,31553,Laryngoplasty laryngeal sten,,,2695.9,3121.57,8
HCPCS,31554,LARYNGOPLASTY LARYNGEAL STEN,,,5465.95,16592.38,19
HCPCS,31554,Laryngoplasty laryngeal sten,,,2151.73,2491.48,8
HCPCS,3155F,Cytogen test marrow b/4 tx,,,8.48,9.82,8
HCPCS,31560,LARYNGOSCOP W/ARYTENOIDECTOM,,,6396.22,19780.99,19
HCPCS,31560,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,2398.0,1558.7,1.1,11685.63,50
HCPCS,31560,Laryngoscop w/arytenoidectom,,,1124.06,1301.54,8
HCPCS,31561,LARYNSCOP REMVE CART + SCOP,,,6396.22,19780.99,19
HCPCS,31561,Larynscop remve cart + scop,,,1124.06,1301.54,8
HCPCS,31570,LARYNGOSCOPE W/VC INJ,,,3406.67,10449.99,19
HCPCS,31570,Laryngoscope w/vc inj,,,1124.06,1301.54,8
HCPCS,31571,LARYNGOSCOP W/VC INJ + SCOPE,,,3406.67,10449.99,19
HCPCS,31571,Laryngoscop w/vc inj + scope,,,1124.06,1301.54,8
HCPCS,31572,LARGSC W/LASER DSTRJ LES,,,3406.67,10449.99,19
HCPCS,31572,Largsc w/laser dstrj les,,,1124.06,1301.54,8
HCPCS,31573,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,4452.5,2894.125,0.01,7933.0,114
HCPCS,31574,LARGSC W/NJX AUGMENTATION,,,1593.38,4988.78,19
HCPCS,31574,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,972.0,631.8,1.1,3098.02,53
HCPCS,31574,Largsc w/njx augmentation,,,1124.06,1301.54,8
HCPCS,31575,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,653.5,424.77500000000003,0.01,4001.0,175
HCPCS,31576,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),7933.0,5156.45,0.01,7933.0,61
HCPCS,31577,LARGSC W/RMVL FOREIGN BDY(S),,,358.79,1096.25,19
HCPCS,31577,Largsc w/rmvl foreign bdy(s),,,211.85,245.3,8
HCPCS,31578,LARGSC W/REMOVAL LESION,,,3406.67,10449.99,19
HCPCS,31578,Largsc w/removal lesion,,,1124.06,1301.54,8
HCPCS,31579,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,827.0,537.55,1.1,827.0,75
HCPCS,31579,LARYNGOSCOPY TELESCOPIC,,,358.79,1096.25,19
HCPCS,31579,Laryngoscopy telescopic,,,211.85,245.3,8
HCPCS,31580,LARYNGOPLASTY LARYNGEAL WEB,,,5465.95,16592.38,19
HCPCS,31580,Laryngoplasty laryngeal web,,,2151.73,2491.48,8
HCPCS,31584,LARYNGOPLASTY FX RDCTJ FIXJ,,,5465.95,16592.38,19
HCPCS,31584,Laryngoplasty fx rdctj fixj,,,2151.73,2491.48,8
HCPCS,31587,LARYNGOPLASTY CRICOID SPLIT,,,5465.95,16592.38,19
HCPCS,31587,Laryngoplasty cricoid split,,,2695.9,3121.57,8
HCPCS,31590,REINNERVATE LARYNX,,,5465.95,16592.38,19
HCPCS,31590,Reinnervate larynx,,,2695.9,3121.57,8
HCPCS,31591,LARYNGOPLASTY MEDIALIZATION,,,5465.95,16592.38,19
HCPCS,31591,LARYNGOPLASTY MEDIALIZATION UNLIATERAL,5424.0,3525.6,1.1,9999.36,50
HCPCS,31591,Laryngoplasty medialization,,,2151.73,2491.48,8
HCPCS,31592,CRICOTRACHEAL RESECTION,,,5465.95,16592.38,19
HCPCS,31592,Cricotracheal resection,,,2519.91,2917.79,8
HCPCS,31599,UNLISTED ENDOSCOPIC LARYNGOPLASTY WITH PLACEMENT OF POSTERIOR CR,7741.0,5031.65,0.01,7741.0,28
HCPCS,31599,UNLISTED PROCEDURE LARYNX,,,214.57,663.85,19
HCPCS,31599,Unlisted procedure larynx,,,745.85,863.61,8
HCPCS,31600,INCISION OF WINDPIPE,823.0,534.95,1.1,5497.86,50
HCPCS,31600,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,14918.0,9696.7,0.01,14918.0,53
HCPCS,31600,"TRACHEOSTOMY, PLANNED",2446.0,1589.9,1.1,5497.86,50
HCPCS,31601,PLANNED TRACHEOSTOMY<2 YRS,,,5465.95,16592.38,19
HCPCS,31603,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,4607.0,2994.55,0.01,6814.0,156
HCPCS,31605,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1824.0,1185.6,0.01,3004.0,156
HCPCS,3160F,Doc fe+ stores b/4 epo thx,,,8.48,9.82,8
HCPCS,31610,TRACHEOSTOMY FENEST SKIN FLP,,,5465.95,16592.38,19
HCPCS,31610,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,4800.0,3120.0,1.1,9999.36,50
HCPCS,31611,CONSTJ TRACHESOPHGL FSTL,,,2996.53,9292.73,19
HCPCS,31612,PERQ TRCHL PNXR TTRACH ASPIR,,,2996.53,9292.73,19
HCPCS,31612,Perq trchl pnxr ttrach aspir,,,603.71,699.03,8
HCPCS,31613,TRACHEOSTOMA REVJ SIMPLE,,,2996.53,9292.73,19
HCPCS,31613,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,1884.0,1224.6,1.1,5497.86,50
HCPCS,31614,TRACHEOSTOMA REVJ COMPLEX,,,5465.95,16592.38,19
HCPCS,31615,TRACHEOBRNCHSC THRU EST TRACHS INC,1576.5,1024.725,1.1,3004.0,114
HCPCS,31622,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,4523.0,2939.95,0.01,7933.0,175
HCPCS,31623,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,4545.0,2954.25,0.01,7933.0,114
HCPCS,31624,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,4545.0,2954.25,0.01,7933.0,114
HCPCS,31625,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,4650.5,3022.825,0.01,7933.0,114
HCPCS,31626,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,31843.0,20697.95,0.01,31843.0,61
HCPCS,31627,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,800.0,520.0,1.1,3502.07,53
HCPCS,31627,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,1624.0,1055.6,0.01,3004.0,46
HCPCS,31628,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,9261.0,6019.65,0.01,16960.0,114
HCPCS,31629,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,9305.0,6048.25,0.01,16960.0,114
HCPCS,31630,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,1524.0,990.6,1.1,6393.86,50
HCPCS,31630,BRONCHOSCOPY DILATE/FX REPR,,,3406.67,10449.99,19
HCPCS,31630,Bronchoscopy dilate/fx repr,,,2079.57,2407.92,8
HCPCS,31631,BRONCHOSCOPY DILATE W/STENT,,,6396.22,19780.99,19
HCPCS,31631,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,1744.0,1133.6,1.1,11685.63,50
HCPCS,31631,Bronchoscopy dilate w/stent,,,2079.57,2407.92,8
HCPCS,31632,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,798.0,518.7,0.01,4001.0,99
HCPCS,31633,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,528.0,343.2,1.1,528.0,53
HCPCS,31633,Bronchoscopy/needle bx addl,,,884.47,1024.12,8
HCPCS,31634,BRONCH W/BALLOON OCCLUSION,,,6396.22,19780.99,19
HCPCS,31634,Bronch w/balloon occlusion,,,2079.57,2407.92,8
HCPCS,31635,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,4719.0,3067.35,0.01,7933.0,175
HCPCS,31636,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,1720.0,1118.0,1.1,11685.63,50
HCPCS,31636,BRONCHOSCOPY BRONCH STENTS,,,6396.22,19780.99,19
HCPCS,31636,Bronchoscopy bronch stents,,,2079.57,2407.92,8
HCPCS,31637,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,632.0,410.8,1.1,632.0,50
HCPCS,31637,Bronchoscopy stent add-on,,,2079.57,2407.92,8
HCPCS,31638,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,1952.0,1268.8,1.1,11685.63,50
HCPCS,31638,BRONCHOSCOPY REVISE STENT,,,6396.22,19780.99,19
HCPCS,31638,Bronchoscopy revise stent,,,2079.57,2407.92,8
HCPCS,31640,BRONCHOSCOPY W/EXCISION TUMOR,1972.0,1281.8,1.1,6393.86,50
HCPCS,31640,BRONCHOSCOPY W/TUMOR EXCISE,,,3406.67,10449.99,19
HCPCS,31640,Bronchoscopy w/tumor excise,,,2079.57,2407.92,8
HCPCS,31641,BRONCHOSCOPY TREAT BLOCKAGE,,,3406.67,10449.99,19
HCPCS,31641,Bronchoscopy treat blockage,,,2079.57,2407.92,8
HCPCS,31643,DIAG BRONCHOSCOPE/CATHETER,,,1593.38,4988.78,19
HCPCS,31643,Diag bronchoscope/catheter,,,884.47,1024.12,8
HCPCS,31645,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,4600.0,2990.0,0.01,7933.0,114
HCPCS,31646,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1504.5,977.9250000000001,0.01,3004.0,111
HCPCS,31647,BRONCHIAL VALVE INIT INSERT,,,6396.22,19780.99,19
HCPCS,31647,Bronchial valve init insert,,,2079.57,2407.92,8
HCPCS,31648,BRONCHIAL VALVE REMOV INIT,,,3406.67,10449.99,19
HCPCS,31648,Bronchial valve remov init,,,2079.57,2407.92,8
HCPCS,31649,BRONCHIAL VALVE REMOV ADDL,,,1593.38,4988.78,19
HCPCS,31649,Bronchial valve remov addl,,,2079.57,2407.92,8
HCPCS,31651,Bronchial valve addl insert,,,2079.57,2407.92,8
HCPCS,31652,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,1962.0,1275.3,1.1,6393.86,53
HCPCS,31652,BRONCH EBUS SAMPLNG 1/2 NODE,,,3406.67,10449.99,20
HCPCS,31652,Bronch ebus samplng 1/2 node,,,2079.57,2407.92,8
HCPCS,31653,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,2182.0,1418.3,1.1,6393.86,53
HCPCS,31653,BRONCH EBUS SAMPLNG 3/> NODE,,,3406.67,10449.99,19
HCPCS,31653,Bronch ebus samplng 3/> node,,,2079.57,2407.92,8
HCPCS,31654,Bronch ebus ivntj perph les,,,2079.57,2407.92,8
HCPCS,31660,BRONCH THERMOPLSTY 1 LOBE,,,6396.22,19780.99,19
HCPCS,31660,Bronch thermoplsty 1 lobe,,,2079.57,2407.92,8
HCPCS,31661,BRONCH THERMOPLSTY 2/> LOBES,,,6396.22,19780.99,19
HCPCS,31661,Bronch thermoplsty 2/> lobes,,,2079.57,2407.92,8
HCPCS,3170F,Baselin flo cytometry b/4 tx,,,8.48,9.82,8
HCPCS,31717,BRONCHIAL BRUSH BIOPSY,,,358.79,1096.25,19
HCPCS,31717,Bronchial brush biopsy,,,2079.57,2407.92,8
HCPCS,31720,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,0.01,3004.0,122
HCPCS,31725,CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX,684.0,444.6,1.1,684.0,50
HCPCS,31725,Clearance of airways,,,211.85,245.3,8
HCPCS,31730,INTRO WINDPIPE WIRE/TUBE,,,1593.38,4988.78,19
HCPCS,31730,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,1140.0,741.0,1.1,3480.34,53
HCPCS,31750,TRACHEOPLASTY CERVICAL,,,5465.95,16592.38,19
HCPCS,31755,TRACHPLSTY TRCHPHRYNGL FSTLJ,,,5465.95,16592.38,19
HCPCS,31760,Tracheoplasty intrathoracic,,,2519.91,2917.79,8
HCPCS,31766,Carinal reconstruction,,,2519.91,2917.79,8
HCPCS,31770,Repair/graft of bronchus,,,2519.91,2917.79,8
HCPCS,31775,Reconstruct bronchus,,,2519.91,2917.79,8
HCPCS,31781,Reconstruct windpipe,,,2519.91,2917.79,8
HCPCS,31785,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,6607.0,4294.55,1.1,9999.36,50
HCPCS,31785,REMOVE WINDPIPE LESION,,,5465.95,16592.38,19
HCPCS,31786,Remove windpipe lesion,,,2519.91,2917.79,8
HCPCS,31800,SUTURE TRACHEAL WOUND/INJURY CERVICAL,3272.0,2126.8,1.1,3272.0,50
HCPCS,31805,Repair of windpipe injury,,,1367.07,1582.92,8
HCPCS,31820,CLOSURE OF WINDPIPE LESION,,,2996.53,9292.73,19
HCPCS,31825,REPAIR OF WINDPIPE DEFECT,,,2996.53,9292.73,19
HCPCS,31825,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,2828.0,1838.2,1.1,5497.86,53
HCPCS,31830,REVISE TRACHEOSTOMY SCAR,1848.0,1201.2,1.1,5497.86,53
HCPCS,31830,REVISE WINDPIPE SCAR,,,2996.53,9292.73,19
HCPCS,31899,"UNLIST PROC, TRACHEA, BRONCHI COMPARED TO 31613",1554.0,1010.1,0.01,1554.0,28
HCPCS,31899,UNLISTED PROC; TRACHEOSTOMY TUBE EXCHANGE FOLLOWING ESTABLISHED,215.0,139.75,0.01,338.69,28
HCPCS,31899,UNLISTED PX TRACHEA BRONCHI,,,179.38,559.47,19
HCPCS,31899,Unlisted px trachea bronchi,,,884.47,1024.12,8
HCPCS,3200F,Barium swallow test not req,,,8.48,9.82,8
HCPCS,32035,"THORACOSTOMY,RIB RESECT,EMPYEMA",4516.0,2935.4,1.1,4516.0,50
HCPCS,32035,Thoracostomy w/rib resection,,,2519.91,2917.79,8
HCPCS,32036,"THORACOSTOMY,OPEN DRAIN/EMPYEMA",4920.0,3198.0,1.1,4920.0,50
HCPCS,32036,Thoracostomy w/flap drainage,,,2519.91,2917.79,8
HCPCS,32096,Open wedge/bx lung infiltr,,,1367.07,1582.92,8
HCPCS,32096,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,5500.0,3575.0,1.1,5500.0,50
HCPCS,32097,Open wedge/bx lung nodule,,,2519.91,2917.79,8
HCPCS,32097,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,5500.0,3575.0,1.1,5500.0,50
HCPCS,32098,Open biopsy of lung pleura,,,2519.91,2917.79,8
HCPCS,32098,THORACOTOMY W/BIOPSY OF PLEURA,5164.0,3356.6,1.1,5164.0,50
HCPCS,32100,THORACOTOMY WITH EXPLORATION,4005.0,2603.25,1.1,5500.0,96
HCPCS,3210F,Grp a strep test performed,,,8.48,9.82,8
HCPCS,32110,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10310.0,6701.5,1.1,10508.0,96
HCPCS,32120,Re-exploration of chest,,,2519.91,2917.79,8
HCPCS,32120,"THORACOTOMY,POSTOP COMPLICATNS",5756.0,3741.4,1.1,5756.0,50
HCPCS,32124,Explore chest free adhesions,,,1367.07,1582.92,8
HCPCS,32124,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,6180.0,4017.0,1.1,6180.0,50
HCPCS,32140,Removal of lung lesion(s),,,1367.07,1582.92,8
HCPCS,32140,"THORACOTOMY,CYST REMOVAL",6664.0,4331.6,1.1,6664.0,50
HCPCS,32141,Remove/treat lung lesions,,,2519.91,2917.79,8
HCPCS,32141,THORACOTOMY W/RESECTION BULLAE,10872.0,7066.8,1.1,10872.0,50
HCPCS,32150,Removal of lung lesion(s),,,2519.91,2917.79,8
HCPCS,32151,Remove lung foreign body,,,1367.07,1582.92,8
HCPCS,3215F,Pt immunity to hep a docd,,,8.48,9.82,8
HCPCS,32160,THORACOTOMY W/CARDIAC MASSAGE,5570.5,3620.825,1.1,5901.0,96
HCPCS,3216F,Pt immunity to hep b docd,,,8.48,9.82,8
HCPCS,3218F,Rna tstng hep c docd done,,,8.48,9.82,8
HCPCS,32200,Drain open lung lesion,,,2519.91,2917.79,8
HCPCS,3220F,Hep c quant rna tstng docd,,,8.48,9.82,8
HCPCS,32215,Treat chest lining,,,1367.07,1582.92,8
HCPCS,32220,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,10660.0,6929.0,1.1,10660.0,50
HCPCS,32220,Release of lung,,,2519.91,2917.79,8
HCPCS,32225,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,6700.0,4355.0,1.1,6700.0,50
HCPCS,32225,Partial release of lung,,,1367.07,1582.92,8
HCPCS,3230F,Note hring tst w/in 6 mon,,,8.48,9.82,8
HCPCS,32310,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,6112.0,3972.8,1.1,6112.0,50
HCPCS,32310,Removal of chest lining,,,1367.07,1582.92,8
HCPCS,32320,DECORTICATION & PARIETAL PLEURECTOMY,10900.0,7085.0,1.1,10900.0,50
HCPCS,32320,Free/remove chest lining,,,2519.91,2917.79,8
HCPCS,32400,BIOPSY PLEURA PERCUTANEOUS NEEDLE,4078.5,2651.025,0.01,7453.0,175
HCPCS,32405,Percut bx lung/mediastinum,,,603.71,699.03,8
HCPCS,32408,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,4426.0,2876.9,0.01,7453.0,174
HCPCS,32440,REMOVAL OF LUNG PNEUMONECTOMY,10912.0,7092.8,1.1,10912.0,50
HCPCS,32440,Remove lung pneumonectomy,,,2519.91,2917.79,8
HCPCS,32442,Sleeve pneumonectomy,,,2519.91,2917.79,8
HCPCS,32445,Removal of lung extrapleural,,,2519.91,2917.79,8
HCPCS,32480,Partial removal of lung,,,2519.91,2917.79,8
HCPCS,32480,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,10328.0,6713.2,1.1,10328.0,50
HCPCS,32482,Bilobectomy,,,2519.91,2917.79,8
HCPCS,32482,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,10976.0,7134.4,1.1,10976.0,50
HCPCS,32484,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,10152.0,6598.8,1.1,10152.0,50
HCPCS,32484,Segmentectomy,,,2519.91,2917.79,8
HCPCS,32486,RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY,17152.0,11148.8,1.1,17152.0,50
HCPCS,32486,Sleeve lobectomy,,,2519.91,2917.79,8
HCPCS,32488,Completion pneumonectomy,,,2519.91,2917.79,8
HCPCS,32491,Lung volume reduction,,,2519.91,2917.79,8
HCPCS,32501,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,1872.0,1216.8,1.1,1872.0,50
HCPCS,32501,Repair bronchus add-on,,,2519.91,2917.79,8
HCPCS,32503,Resect apical lung tumor,,,2519.91,2917.79,8
HCPCS,32504,Resect apical lung tum/chest,,,2519.91,2917.79,8
HCPCS,32505,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,6300.0,4095.0,1.1,6300.0,50
HCPCS,32505,Wedge resect of lung initial,,,2519.91,2917.79,8
HCPCS,32506,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,1.1,1200.0,50
HCPCS,32506,Wedge resect of lung add-on,,,2519.91,2917.79,8
HCPCS,32507,Wedge resect of lung diag,,,2519.91,2917.79,8
HCPCS,3250F,Nonprim loc anat bx site tum,,,8.48,9.82,8
HCPCS,32540,Removal of lung lesion,,,2519.91,2917.79,8
HCPCS,32550,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,8901.0,5785.650000000001,0.01,16234.0,175
HCPCS,32551,INSERTION OF CHEST TUBE,351.0,228.15,1.1,2734.59,50
HCPCS,32551,TUBE THORACOSTOMY INCLUDES WATER SEAL,4181.0,2717.6499999999996,0.01,7146.0,233
HCPCS,32552,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,1012.0,657.8,1.1,1073.41,53
HCPCS,32552,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,0.01,3728.0,244
HCPCS,32553,INS MARK THOR FOR RT PERQ,,,1264.24,3879.51,19
HCPCS,32553,Ins mark thor for rt perq,,,612.38,709.07,8
HCPCS,32554,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,1822.5,1184.625,0.01,3004.0,175
HCPCS,32555,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,1921.5,1248.975,0.01,3728.0,358
HCPCS,32556,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,4913.0,3193.45,0.01,8726.0,175
HCPCS,32557,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,4259.5,2768.6749999999997,0.01,7146.0,236
HCPCS,32557,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING (45016465),7146.0,4644.9,257.53,7146.0,61
HCPCS,32560,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,616.0,400.4,1.1,1073.41,53
HCPCS,32560,TREAT PLEURODESIS W/AGENT,,,571.26,1758.23,19
HCPCS,32560,Treat pleurodesis w/agent,,,603.71,699.03,8
HCPCS,32561,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,556.0,361.4,1.1,1073.41,53
HCPCS,32561,LYSE CHEST FIBRIN INIT DAY,,,571.26,1758.23,19
HCPCS,32561,Lyse chest fibrin init day,,,603.71,699.03,8
HCPCS,32562,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,496.0,322.4,1.1,1073.41,53
HCPCS,32562,LYSE CHEST FIBRIN SUBQ DAY,,,571.26,1758.23,19
HCPCS,32562,Lyse chest fibrin subq day,,,603.71,699.03,8
HCPCS,32601,THORACOSCOPY DIAGNOSTIC,,,5390.83,16944.69,19
HCPCS,32601,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,2200.0,1430.0,1.1,9852.42,50
HCPCS,32601,Thoracoscopy diagnostic,,,2519.91,2917.79,8
HCPCS,32604,THORACOSCOPY WBX SAC,,,9619.76,29793.81,19
HCPCS,32604,Thoracoscopy wbx sac,,,1367.07,1582.92,8
HCPCS,32606,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,3356.0,2181.4,1.1,9852.42,50
HCPCS,32606,THORACOSCOPY W/BX MED SPACE,,,5390.83,16944.69,19
HCPCS,32606,Thoracoscopy w/bx med space,,,2519.91,2917.79,8
HCPCS,32607,THORACOSCOPY W/BX INFILTRATE,,,9619.76,29793.81,19
HCPCS,32607,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,2200.0,1430.0,1.1,17575.94,50
HCPCS,32607,Thoracoscopy w/bx infiltrate,,,2519.91,2917.79,8
HCPCS,32608,THORACOSCOPY W/BX NODULE,,,9619.76,29793.81,19
HCPCS,32608,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,2736.0,1778.4,1.1,17575.94,50
HCPCS,32608,Thoracoscopy w/bx nodule,,,2519.91,2917.79,8
HCPCS,32609,THORACOSCOPY W/BX PLEURA,,,5390.83,16944.69,19
HCPCS,32609,THORACOSCOPY WITH BIOPSYIES OF PLEURA,1832.0,1190.8,1.1,9852.42,50
HCPCS,32609,Thoracoscopy w/bx pleura,,,1367.07,1582.92,8
HCPCS,3260F,Pt cat/pn cat/hist grd docd,,,8.48,9.82,8
HCPCS,32650,THORACOSCOPY SURG W PLEURODESIS,4332.0,2815.8,1.1,4332.0,50
HCPCS,32650,Thoracoscopy w/pleurodesis,,,2519.91,2917.79,8
HCPCS,32651,THORACOSCOPY SURG PART PULM DECORT,7512.0,4882.8,1.1,7512.0,50
HCPCS,32651,Thoracoscopy remove cortex,,,2519.91,2917.79,8
HCPCS,32652,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,11652.0,7573.8,1.1,11652.0,50
HCPCS,32652,Thoracoscopy rem totl cortex,,,2519.91,2917.79,8
HCPCS,32653,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,7268.0,4724.2,1.1,7268.0,50
HCPCS,32653,Thoracoscopy remov fb/fibrin,,,1367.07,1582.92,8
HCPCS,32654,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,8208.0,5335.2,1.1,8208.0,50
HCPCS,32654,Thoracoscopy contrl bleeding,,,2519.91,2917.79,8
HCPCS,32655,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,6468.0,4204.2,1.1,6468.0,50
HCPCS,32655,Thoracoscopy resect bullae,,,2519.91,2917.79,8
HCPCS,32656,THORACOSCOPY SURG PART PLEURECTOMY,5304.0,3447.6,1.1,5304.0,50
HCPCS,32656,Thoracoscopy w/pleurectomy,,,1367.07,1582.92,8
HCPCS,32658,Thoracoscopy w/sac fb remove,,,2519.91,2917.79,8
HCPCS,32659,Thoracoscopy w/sac drainage,,,2519.91,2917.79,8
HCPCS,3265F,Rna tstng hepc vir ord/docd,,,8.48,9.82,8
HCPCS,32661,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,5332.0,3465.8,1.1,5332.0,50
HCPCS,32661,Thoracoscopy w/pericard exc,,,2519.91,2917.79,8
HCPCS,32662,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,5996.0,3897.4,1.1,5996.0,50
HCPCS,32662,Thoracoscopy w/mediast exc,,,2519.91,2917.79,8
HCPCS,32663,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,9856.0,6406.4,1.1,9856.0,50
HCPCS,32663,Thoracoscopy w/lobectomy,,,2519.91,2917.79,8
HCPCS,32664,THORACOSCOPY W/THORACIC SYMPATHECTOMY,6283.0,4083.95,1.1,6283.0,50
HCPCS,32664,Thoracoscopy w/ th nrv exc,,,2519.91,2917.79,8
HCPCS,32665,Thoracoscop w/esoph musc exc,,,2519.91,2917.79,8
HCPCS,32666,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,5800.0,3770.0,1.1,5800.0,50
HCPCS,32666,Thoracoscopy w/wedge resect,,,2519.91,2917.79,8
HCPCS,32667,Thoracoscopy w/w resect addl,,,2519.91,2917.79,8
HCPCS,32668,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,1200.0,780.0,1.1,1200.0,50
HCPCS,32668,Thoracoscopy w/w resect diag,,,2519.91,2917.79,8
HCPCS,32669,THORACOSCOPY W/SEGMENTECTOMY,9412.0,6117.8,1.1,9412.0,50
HCPCS,32669,Thoracoscopy remove segment,,,2519.91,2917.79,8
HCPCS,3266F,Hepc gn tstng docd b/4txmnt,,,8.48,9.82,8
HCPCS,32670,Thoracoscopy bilobectomy,,,2519.91,2917.79,8
HCPCS,32671,Thoracoscopy pneumonectomy,,,2519.91,2917.79,8
HCPCS,32672,Thoracoscopy for lvrs,,,2519.91,2917.79,8
HCPCS,32673,Thoracoscopy w/thymus resect,,,2519.91,2917.79,8
HCPCS,32674,THORCOSCPY W/MEDIASTINL &REGIONL LYMPHADENECTOMY,1648.0,1071.2,1.1,1648.0,50
HCPCS,32674,Thoracoscopy lymph node exc,,,534.53,618.93,8
HCPCS,3267F,Path rprt w/ pt pn cat et al,,,8.48,9.82,8
HCPCS,3268F,Psa/t/glsc docd b/4 txmnt,,,8.48,9.82,8
HCPCS,3269F,Bone scn b/4 txmnt/aftr dx,,,8.48,9.82,8
HCPCS,32701,Thorax stereo rad targetw/tx,,,321.96,372.8,8
HCPCS,3270F,No bone scn b/4 txmnt/aftrdx,,,8.48,9.82,8
HCPCS,3271F,Low risk prostate cancer,,,8.48,9.82,8
HCPCS,3272F,Med risk prostate cancer,,,8.48,9.82,8
HCPCS,3273F,High risk prostate cancer,,,8.48,9.82,8
HCPCS,3274F,Prost cncr rsk not lw/md/hgh,,,8.48,9.82,8
HCPCS,3278F,Serum lvls ca/ipth/lpd ord,,,8.48,9.82,8
HCPCS,3279F,Hgb lvl >= 13 g/dl,,,8.48,9.82,8
HCPCS,32800,Repair lung hernia,,,2519.91,2917.79,8
HCPCS,3280F,Hgb lvl 11-12.9 g/dl,,,8.48,9.82,8
HCPCS,32810,Close chest after drainage,,,2519.91,2917.79,8
HCPCS,32815,Close bronchial fistula,,,2519.91,2917.79,8
HCPCS,32815,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,20012.0,13007.8,1.1,20012.0,50
HCPCS,3281F,Hgb lvl <11 g/dl,,,8.48,9.82,8
HCPCS,32820,Reconstruct injured chest,,,2519.91,2917.79,8
HCPCS,3284F,Iop red >=15% pre-ntrv lvl,,,8.48,9.82,8
HCPCS,32850,Donor pneumonectomy,,,2489.17,2882.2,8
HCPCS,32851,Lung transplant single,,,975.94,1130.04,8
HCPCS,32852,Lung transplant with bypass,,,2489.17,2882.2,8
HCPCS,32853,Lung transplant double,,,975.94,1130.04,8
HCPCS,32854,Lung transplant with bypass,,,2489.17,2882.2,8
HCPCS,32855,Prepare donor lung single,,,975.94,1130.04,8
HCPCS,32856,Prepare donor lung double,,,975.94,1130.04,8
HCPCS,3285F,Iop down <15% of pre-svc lvl,,,8.48,9.82,8
HCPCS,3288F,Fall risk assessment docd,,,8.48,9.82,8
HCPCS,32900,RESECTION RIBS EXTRAPLEURAL ALL STAGES,9524.0,6190.6,1.1,9524.0,50
HCPCS,32900,Removal of rib(s),,,2519.91,2917.79,8
HCPCS,32905,Revise & repair chest wall,,,2519.91,2917.79,8
HCPCS,32906,Revise & repair chest wall,,,2519.91,2917.79,8
HCPCS,3290F,Pt=d(rh)- and unsensitized,,,8.48,9.82,8
HCPCS,3291F,Pt=d(rh)+ or sensitized,,,8.48,9.82,8
HCPCS,3292F,Hiv tstng asked/docd/revwd,,,8.48,9.82,8
HCPCS,3293F,Abo rh blood typing docd,,,8.48,9.82,8
HCPCS,32940,Revision of lung,,,2519.91,2917.79,8
HCPCS,3294F,Grp b strep screening docd,,,8.48,9.82,8
HCPCS,32960,THERAPEUTIC PNEUMOTHORAX,,,571.26,1758.23,19
HCPCS,32960,Therapeutic pneumothorax,,,603.71,699.03,8
HCPCS,32994,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,15153.5,9849.775,0.01,29793.81,114
HCPCS,32997,TOTAL LUNG LAVAGE (UNILATERAL),2924.0,1900.6,1.1,2924.0,50
HCPCS,32997,Total lung lavage,,,2079.57,2407.92,8
HCPCS,32998,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,26838.0,17444.7,0.01,26838.0,61
HCPCS,32999,CT LUNG LOCALIZATION,1845.0,1199.25,0.01,1845.0,61
HCPCS,32999,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),4230.5,2749.825,0.01,9496.0,89
HCPCS,32999,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),3928.0,2553.2,0.01,9496.0,89
HCPCS,32999,UNLISTED PROC LUNG/PLEURA,1845.0,1199.25,521.77,9496.0,61
HCPCS,32999,UNLISTED PROC; VIDEO ASSISTED THORACIC SURGERY FOR CONTROL OF PE,8342.0,5422.3,0.01,8342.0,28
HCPCS,32999,UNLISTED PROCEDURE LUNGS & PLEURA,274.0,178.1,0.01,1073.41,28
HCPCS,3300F,Ajcc stage docd b/4 thxpy,,,8.48,9.82,8
HCPCS,33016,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,5346.0,3474.9,0.01,8932.0,294
HCPCS,33017,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,3723.0,2419.95,0.01,10496.0,234
HCPCS,33018,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,3737.0,2429.05,0.01,8566.0,96
HCPCS,33019,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,3601.0,2340.65,1.1,8566.0,96
HCPCS,3301F,Cancer stage docd metast,,,8.48,9.82,8
HCPCS,33020,Incision of heart sac,,,2417.07,2798.71,8
HCPCS,33020,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,5724.0,3720.6,1.1,5724.0,50
HCPCS,33025,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,7354.0,4780.1,1.1,9496.0,142
HCPCS,33030,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,14400.0,9360.0,1.1,14400.0,50
HCPCS,33030,Partial removal of heart sac,,,2417.07,2798.71,8
HCPCS,33031,Partial removal of heart sac,,,2417.07,2798.71,8
HCPCS,33050,RESECTION PERICARDIAL CYST/TUMOR,6788.0,4412.2,1.1,6788.0,50
HCPCS,33050,Resect heart sac lesion,,,2417.07,2798.71,8
HCPCS,33120,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,15380.0,9997.0,1.1,15380.0,50
HCPCS,33120,Exc icar tum resc w/card byp,,,2417.07,2798.71,8
HCPCS,33130,Rescj external cardiac tumor,,,2417.07,2798.71,8
HCPCS,33140,Heart revascularize (tmr),,,2417.07,2798.71,8
HCPCS,33141,Heart tmr w/other procedure,,,534.53,618.93,8
HCPCS,3315F,Er+ or pr+ breast cancer,,,8.48,9.82,8
HCPCS,3316F,Er- or pr- breast cancer,,,8.48,9.82,8
HCPCS,3317F,Path rpt malig cancer docd,,,8.48,9.82,8
HCPCS,3318F,Path rpt malig cancer docd,,,8.48,9.82,8
HCPCS,3319F,X-ray/ct/ultrsnd et al ord,,,8.48,9.82,8
HCPCS,33202,"INSERT EPICARDIAL ELECTRODE, OPEN",5808.0,3775.2,1.1,5808.0,50
HCPCS,33202,Insert epicard eltrd open,,,2417.07,2798.71,8
HCPCS,33203,Insert epicard eltrd endo,,,5003.75,5793.81,8
HCPCS,33206,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,15017.5,9761.375,1.1,29295.35,111
HCPCS,33207,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,15439.5,10035.675,1.1,29295.35,172
HCPCS,33208,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,14527.5,9442.875,1.1,29295.35,233
HCPCS,3320F,No xray/ct/ et al ordd,,,8.48,9.82,8
HCPCS,33210,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,24464.5,15901.925,0.01,47587.0,355
HCPCS,33211,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,24421.5,15873.975,0.01,47587.0,111
HCPCS,33212,INS PM PLS GEN W/EXIST SINGLE LEAD,22737.0,14779.05,520.99,23194.66,61
HCPCS,33213,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,14132.0,9185.8,1.1,29295.35,111
HCPCS,33214,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,14410.5,9366.825,1.1,29295.35,111
HCPCS,33215,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,10033.0,6521.450000000001,1.1,18098.0,294
HCPCS,33216,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,16482.5,10713.625,1.1,30717.0,172
HCPCS,33217,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,14513.5,9433.775000000001,1.1,26791.0,172
HCPCS,33218,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,11627.0,7557.55,1.1,20926.0,172
HCPCS,3321F,Ajcc cncr 0/ia melan docd,,,8.48,9.82,8
HCPCS,33220,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,11643.0,7567.95,1.1,20926.0,111
HCPCS,33221,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,23628.5,15358.525,1.1,53987.6,172
HCPCS,33222,RELOCATION OF SKIN POCKET FOR PACEMAKER,6229.0,4048.85,1.1,10518.0,172
HCPCS,33223,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,6519.0,4237.35,1.1,10518.0,172
HCPCS,33224,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,16563.0,10765.95,1.1,29510.0,172
HCPCS,33225,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,9973.0,6482.450000000001,1.1,16614.0,142
HCPCS,33226,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,10785.0,7010.25,1.1,18098.0,172
HCPCS,33227,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,11797.5,7668.375,1.1,23194.66,172
HCPCS,33228,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,14472.0,9406.800000000001,1.1,29295.35,172
HCPCS,33229,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,22640.0,14716.0,1.1,53987.6,172
HCPCS,3322F,Melanomaajcc stage 0 or ia,,,8.48,9.82,8
HCPCS,33230,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,42695.0,27751.75,603.67,62345.36,61
HCPCS,33231,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,65538.0,42599.7,645.24,87978.22,61
HCPCS,33233,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,24421.5,15873.975,1.1,47587.0,172
HCPCS,33234,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,11995.0,7796.75,1.1,20926.0,233
HCPCS,33235,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,12443.0,8087.95,1.1,20926.0,233
HCPCS,33236,Remove electrode/thoracotomy,,,2417.07,2798.71,8
HCPCS,33237,Remove electrode/thoracotomy,,,2417.07,2798.71,8
HCPCS,33238,Remove electrode/thoracotomy,,,2417.07,2798.71,8
HCPCS,3323F,Clin node stgng docdb/4 surg,,,8.48,9.82,8
HCPCS,33240,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,50000.0,32500.0,580.46,62345.36,122
HCPCS,33241,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,11071.0,7196.15,1.1,20926.0,172
HCPCS,33243,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,9428.0,6128.2,1.1,9428.0,50
HCPCS,33243,Remove eltrd/thoracotomy,,,2417.07,2798.71,8
HCPCS,33244,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,13211.0,8587.15,1.1,20926.0,172
HCPCS,33249,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,31304.5,20347.925,1.1,87978.22,172
HCPCS,3324F,Mri ct scan ord rvwd rqstd,,,8.48,9.82,8
HCPCS,33250,Ablate heart dysrhythm focus,,,2417.07,2798.71,8
HCPCS,33251,Ablate heart dysrhythm focus,,,2417.07,2798.71,8
HCPCS,33254,ABLATION & RECONSTRUCTION ATRIA LIMITED,9484.0,6164.6,1.1,9484.0,50
HCPCS,33254,Ablate atria lmtd,,,2417.07,2798.71,8
HCPCS,33255,Ablate atria w/o bypass ext,,,2417.07,2798.71,8
HCPCS,33256,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,13960.0,9074.0,1.1,13960.0,50
HCPCS,33256,Ablate atria w/bypass exten,,,2417.07,2798.71,8
HCPCS,33257,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,3852.0,2503.8,1.1,3852.0,50
HCPCS,33257,Ablate atria lmtd add-on,,,534.53,618.93,8
HCPCS,33258,Ablate atria x10sv add-on,,,534.53,618.93,8
HCPCS,33259,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,5656.0,3676.4,1.1,5656.0,50
HCPCS,33259,Ablate atria w/bypass add-on,,,534.53,618.93,8
HCPCS,3325F,Preop asses 4 cataract surg,,,8.48,9.82,8
HCPCS,33261,Ablate heart dysrhythm focus,,,2417.07,2798.71,8
HCPCS,33262,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEAD,2324.0,1510.6,1.1,40246.53,50
HCPCS,33262,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,42062.0,27340.3,598.47,62345.36,122
HCPCS,33263,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEAD,2432.0,1580.8,1.1,40246.53,50
HCPCS,33263,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,40488.0,26317.2,622.46,62345.36,61
HCPCS,33264,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEAD,2540.0,1651.0,1.1,56172.03,50
HCPCS,33264,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,52725.0,34271.25,648.56,87978.22,61
HCPCS,33265,Ablate atria lmtd endo,,,2417.07,2798.71,8
HCPCS,33265,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,9484.0,6164.6,1.1,9484.0,50
HCPCS,33266,Ablate atria x10sv endo,,,2417.07,2798.71,8
HCPCS,33267,EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD,7400.0,4810.0,1.1,7400.0,50
HCPCS,33267,Excl laa open any method,,,2417.07,2798.71,8
HCPCS,33268,EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD,1000.0,650.0,1.1,1000.0,50
HCPCS,33268,Excl laa opn oth px any meth,,,2417.07,2798.71,8
HCPCS,33269,EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH,5724.0,3720.6,1.1,5724.0,50
HCPCS,33269,Excl laa thrscp any method,,,11343.93,13135.08,8
HCPCS,33270,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,28116.0,18275.399999999998,1.1,87978.22,172
HCPCS,33271,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,19720.0,12818.0,639.93,23194.66,61
HCPCS,33272,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,11655.5,7576.075,1.1,20926.0,172
HCPCS,33273,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,11763.0,7645.95,1.1,20926.0,111
HCPCS,33274,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,20720.0,13468.0,1.1,53987.6,233
HCPCS,33275,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,10767.0,6998.55,1.1,18098.0,172
HCPCS,33276,INSJ PHRNC NRV STIM SYS,,,41579.56,123455.58,19
HCPCS,33276,Insj phrnc nrv stim sys,,,15220.57,17623.82,8
HCPCS,33277,Insj phrnc nrv stim transvns,,,1720.7,1992.39,8
HCPCS,33278,RMVL PHRNC NRV STIM SYS,,,3177.58,9799.05,19
HCPCS,33278,Rmvl phrnc nrv stim sys,,,1720.7,1992.39,8
HCPCS,33279,RMVL PHRNC NRV STIM TRANSVNS,,,3177.58,9799.05,19
HCPCS,33279,Rmvl phrnc nrv stim transvns,,,1720.7,1992.39,8
HCPCS,33280,RMVL PHRNC NRV STIM PG ONLY,,,3177.58,9799.05,19
HCPCS,33280,Rmvl phrnc nrv stim pg only,,,1720.7,1992.39,8
HCPCS,33281,REPOSG PHRNC NRV STIM TRNSVN,,,3177.58,9799.05,19
HCPCS,33281,Reposg phrnc nrv stim trnsvn,,,1720.7,1992.39,8
HCPCS,33285,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,7622.0,4954.3,1.1,23194.66,236
HCPCS,33286,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,2323.0,1509.95,1.1,4046.0,236
HCPCS,33287,RMV&RPLCMT PHRNC NRV STIM PG,,,28156.99,86489.44,19
HCPCS,33287,Rmv&rplcmt phrnc nrv stim pg,,,15220.57,17623.82,8
HCPCS,33288,RMV&RPLCMT PHRNC NRV STIM LD,,,10541.85,31231.28,19
HCPCS,33289,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,20513.0,13333.45,1.1,80395.08,111
HCPCS,3328F,Prfrmnc docd 2 wks b/4 surg,,,8.48,9.82,8
HCPCS,33300,REPAIR CARDIAC WOUND W/O BYPASS,17988.0,11692.2,1.1,17988.0,50
HCPCS,33300,Repair of heart wound,,,2417.07,2798.71,8
HCPCS,33305,Repair of heart wound,,,2417.07,2798.71,8
HCPCS,3330F,Imaging study ordered (bkp),,,8.48,9.82,8
HCPCS,33310,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,8136.0,5288.4,1.1,8136.0,50
HCPCS,33310,Exploratory heart surgery,,,2417.07,2798.71,8
HCPCS,33315,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,14000.0,9100.0,1.1,14000.0,50
HCPCS,33315,Exploratory heart surgery,,,2417.07,2798.71,8
HCPCS,3331F,Bk imaging tst not ordered,,,8.48,9.82,8
HCPCS,33320,Repair major blood vessel(s),,,2082.17,2410.94,8
HCPCS,33320,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,7416.0,4820.4,1.1,7416.0,50
HCPCS,33321,Repair major vessel,,,2082.17,2410.94,8
HCPCS,33322,Repair major blood vessel(s),,,2082.17,2410.94,8
HCPCS,33322,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,9768.0,6349.2,1.1,9768.0,50
HCPCS,33330,Insert major vessel graft,,,2082.17,2410.94,8
HCPCS,33335,INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS,13564.0,8816.6,1.1,13564.0,50
HCPCS,33335,Insert major vessel graft,,,2082.17,2410.94,8
HCPCS,33340,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,9610.0,6246.5,1.1,13135.08,96
HCPCS,33361,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,12502.0,8126.299999999999,1.1,15117.0,142
HCPCS,33362,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,9816.0,6380.4,1.1,9816.0,50
HCPCS,33362,TAVR OPEN FEMORAL APPROACH,28437.0,18484.05,2155.09,28437.0,46
HCPCS,33363,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,10188.0,6622.2,1.1,10188.0,50
HCPCS,33363,Replace aortic valve open,,,11343.93,13135.08,8
HCPCS,33364,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,10388.0,6752.2,1.1,10388.0,50
HCPCS,33364,Replace aortic valve open,,,11343.93,13135.08,8
HCPCS,33365,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,10636.0,6913.4,1.1,10636.0,50
HCPCS,33365,TAVR TRANSAORTIC APPROACH,40822.0,26534.3,2327.31,40822.0,46
HCPCS,33366,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,21350.5,13877.825,1.1,29787.0,96
HCPCS,33367,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,4752.0,3088.8,1.1,4752.0,50
HCPCS,33367,Replace aortic valve w/byp,,,11343.93,13135.08,8
HCPCS,33368,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,5756.0,3741.4,1.1,5756.0,50
HCPCS,33368,Replace aortic valve w/byp,,,11343.93,13135.08,8
HCPCS,33369,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,7600.0,4940.0,1.1,7600.0,50
HCPCS,33369,Replace aortic valve w/byp,,,11343.93,13135.08,8
HCPCS,33370,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,2067.0,1343.55,1.1,13135.08,142
HCPCS,33390,Valvuloplasty aortic valve,,,2417.07,2798.71,8
HCPCS,33391,Valvuloplasty aortic valve,,,2417.07,2798.71,8
HCPCS,33404,Prepare heart-aorta conduit,,,2417.07,2798.71,8
HCPCS,33405,RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT,18181.0,11817.65,1.1,18181.0,50
HCPCS,33405,Replacement aortic valve opn,,,2417.07,2798.71,8
HCPCS,33406,Replacement aortic valve opn,,,2417.07,2798.71,8
HCPCS,3340F,Mammo assess inc xray docd,,,8.48,9.82,8
HCPCS,33410,Replacement aortic valve opn,,,2417.07,2798.71,8
HCPCS,33411,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,24828.0,16138.2,1.1,24828.0,50
HCPCS,33411,Replacement of aortic valve,,,2417.07,2798.71,8
HCPCS,33412,Replacement of aortic valve,,,2417.07,2798.71,8
HCPCS,33413,Replacement of aortic valve,,,2417.07,2798.71,8
HCPCS,33414,Repair of aortic valve,,,2417.07,2798.71,8
HCPCS,33415,RESECTION/INCISION SUBVALVULAR TISSUE,14908.0,9690.2,1.1,14908.0,50
HCPCS,33415,Revision subvalvular tissue,,,2417.07,2798.71,8
HCPCS,33416,Revise ventricle muscle,,,2417.07,2798.71,8
HCPCS,33416,VENTRICULOMYOTOMY-MYECTOMY,14624.0,9505.6,1.1,14624.0,50
HCPCS,33417,Repair of aortic valve,,,2417.07,2798.71,8
HCPCS,33418,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,17007.0,11054.55,2931.02,17007.0,46
HCPCS,33419,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,7874.0,5118.1,692.16,13135.08,46
HCPCS,3341F,Mammo assess negative docd,,,8.48,9.82,8
HCPCS,33420,Revision of mitral valve,,,2417.07,2798.71,8
HCPCS,33422,Revision of mitral valve,,,2417.07,2798.71,8
HCPCS,33425,Repair of mitral valve,,,2417.07,2798.71,8
HCPCS,33425,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,19984.0,12989.6,1.1,19984.0,50
HCPCS,33426,Repair of mitral valve,,,2417.07,2798.71,8
HCPCS,33426,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,17312.0,11252.8,1.1,17312.0,50
HCPCS,33427,Repair of mitral valve,,,2417.07,2798.71,8
HCPCS,33427,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,17932.0,11655.8,1.1,17932.0,50
HCPCS,3342F,Mammo assess bengn docd,,,8.48,9.82,8
HCPCS,33430,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,20372.0,13241.8,1.1,20372.0,50
HCPCS,33430,Replacement of mitral valve,,,2417.07,2798.71,8
HCPCS,3343F,Mammo probably bengn docd,,,8.48,9.82,8
HCPCS,33440,RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE,25600.0,16640.0,1.1,25600.0,50
HCPCS,33440,Rplcmt a-valve tlcj autol pv,,,2417.07,2798.71,8
HCPCS,3344F,Mammo assess susp docd,,,8.48,9.82,8
HCPCS,3345F,Mammo assess hghlymalig doc,,,8.48,9.82,8
HCPCS,33460,Revision of tricuspid valve,,,2417.07,2798.71,8
HCPCS,33463,VALVULOPLAS TRICUS NO RING INSERT,22832.0,14840.8,1.1,22832.0,50
HCPCS,33463,Valvuloplasty tricuspid,,,2417.07,2798.71,8
HCPCS,33464,VALVULOPLAS TRICUS W RING INSERT,17848.0,11601.2,1.1,17848.0,50
HCPCS,33464,Valvuloplasty tricuspid,,,2417.07,2798.71,8
HCPCS,33465,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,20288.0,13187.2,1.1,20288.0,50
HCPCS,33465,Replace tricuspid valve,,,2417.07,2798.71,8
HCPCS,33468,Revision of tricuspid valve,,,2417.07,2798.71,8
HCPCS,33470,Revision of pulmonary valve,,,2417.07,2798.71,8
HCPCS,33471,Vlvt pv clsd hrt via p-art,,,2417.07,2798.71,8
HCPCS,33474,Revision of pulmonary valve,,,2417.07,2798.71,8
HCPCS,33475,Replacement pulmonary valve,,,2417.07,2798.71,8
HCPCS,33476,Revision of heart chamber,,,2417.07,2798.71,8
HCPCS,33477,Implant tcat pulm vlv perq,,,11343.93,13135.08,8
HCPCS,33478,Revision of heart chamber,,,2417.07,2798.71,8
HCPCS,33496,Repair prosth valve clot,,,2417.07,2798.71,8
HCPCS,33500,Repair heart vessel fistula,,,2417.07,2798.71,8
HCPCS,33501,Repair heart vessel fistula,,,2417.07,2798.71,8
HCPCS,33502,Coronary artery correction,,,3812.25,4414.18,8
HCPCS,33503,Coronary artery graft,,,3812.25,4414.18,8
HCPCS,33504,Coronary artery graft,,,3812.25,4414.18,8
HCPCS,33505,Repair artery w/tunnel,,,3812.25,4414.18,8
HCPCS,33506,Repair artery translocation,,,3812.25,4414.18,8
HCPCS,33507,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,12560.0,8164.0,1.1,12560.0,50
HCPCS,33507,Repair art intramural,,,3812.25,4414.18,8
HCPCS,33508,Endoscopic vein harvest,,,3812.25,4414.18,8
HCPCS,33508,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,124.0,80.6,1.1,124.0,50
HCPCS,33509,ENDOSCOPIC HARVEST UXTR ARTERY 1 SEGMENT CAB PX,1336.0,868.4,1.1,1336.0,50
HCPCS,33509,Ndsc hrv uxtr art 1 sgm cab,,,3812.25,4414.18,8
HCPCS,3350F,Mammo bx proven malig docd,,,8.48,9.82,8
HCPCS,33510,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,13992.0,9094.8,1.1,13992.0,50
HCPCS,33510,Cabg vein single,,,3812.25,4414.18,8
HCPCS,33511,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,15380.0,9997.0,1.1,15380.0,50
HCPCS,33511,Cabg vein two,,,3812.25,4414.18,8
HCPCS,33512,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,17592.0,11434.8,1.1,17592.0,50
HCPCS,33512,Cabg vein three,,,3812.25,4414.18,8
HCPCS,33513,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,18148.0,11796.2,1.1,18148.0,50
HCPCS,33513,Cabg vein four,,,3812.25,4414.18,8
HCPCS,33514,Cabg vein five,,,3812.25,4414.18,8
HCPCS,33516,Cabg vein six or more,,,3812.25,4414.18,8
HCPCS,33517,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,1588.0,1032.2,1.1,1588.0,50
HCPCS,33517,Cabg artery-vein single,,,3812.25,4414.18,8
HCPCS,33518,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,3489.0,2267.85,1.1,3489.0,50
HCPCS,33518,Cabg artery-vein two,,,3812.25,4414.18,8
HCPCS,33519,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,4616.0,3000.4,1.1,4616.0,50
HCPCS,33519,Cabg artery-vein three,,,3812.25,4414.18,8
HCPCS,3351F,Neg scrn dep symp by deptool,,,8.48,9.82,8
HCPCS,33521,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,5540.0,3601.0,1.1,5540.0,50
HCPCS,33521,Cabg artery-vein four,,,3812.25,4414.18,8
HCPCS,33522,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,6222.0,4044.3,1.1,6222.0,50
HCPCS,33522,Cabg artery-vein five,,,3812.25,4414.18,8
HCPCS,33523,Cabg art-vein six or more,,,3812.25,4414.18,8
HCPCS,3352F,No sig dep symp by dep tool,,,8.48,9.82,8
HCPCS,33530,Coronary artery bypass/reop,,,3812.25,4414.18,8
HCPCS,33530,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,4052.0,2633.8,1.1,4052.0,50
HCPCS,33533,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,14850.0,9652.5,1.1,14850.0,50
HCPCS,33533,Cabg arterial single,,,3812.25,4414.18,8
HCPCS,33534,"CABG, ARTERIAL, TWO",17547.0,11405.55,1.1,17547.0,50
HCPCS,33534,Cabg arterial two,,,3812.25,4414.18,8
HCPCS,33535,"CABG, ARTERIAL, THREE",19690.0,12798.5,1.1,19690.0,50
HCPCS,33535,Cabg arterial three,,,3812.25,4414.18,8
HCPCS,33536,"CABG, ARTERIAL, FOUR+",21309.0,13850.85,1.1,21309.0,50
HCPCS,33536,Cabg arterial four or more,,,3812.25,4414.18,8
HCPCS,3353F,Mild-mod dep symp by deptool,,,8.48,9.82,8
HCPCS,33542,Removal of heart lesion,,,2417.07,2798.71,8
HCPCS,33545,Repair of heart damage,,,2417.07,2798.71,8
HCPCS,33548,Restore/remodel ventricle,,,2417.07,2798.71,8
HCPCS,33548,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,21656.0,14076.4,1.1,21656.0,50
HCPCS,3354F,Clin sig dep sym by dep tool,,,8.48,9.82,8
HCPCS,33572,CORONARY ENDARTERCOMY OPEN ANY METHOD,1776.0,1154.4,1.1,1776.0,50
HCPCS,33572,Open coronary endarterectomy,,,3812.25,4414.18,8
HCPCS,33600,Closure of valve,,,2417.07,2798.71,8
HCPCS,33602,Closure of valve,,,2417.07,2798.71,8
HCPCS,33606,Anastomosis/artery-aorta,,,2417.07,2798.71,8
HCPCS,33608,Repair anomaly w/conduit,,,2417.07,2798.71,8
HCPCS,33610,Repair by enlargement,,,2417.07,2798.71,8
HCPCS,33611,Repair double ventricle,,,2417.07,2798.71,8
HCPCS,33612,RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ,14628.0,9508.2,1.1,14628.0,50
HCPCS,33612,Repair double ventricle,,,2417.07,2798.71,8
HCPCS,33615,Repair modified fontan,,,2417.07,2798.71,8
HCPCS,33617,Repair single ventricle,,,2417.07,2798.71,8
HCPCS,33619,Repair single ventricle,,,2417.07,2798.71,8
HCPCS,33620,Apply r&l pulm art bands,,,2417.07,2798.71,8
HCPCS,33621,Transthor cath for stent,,,2417.07,2798.71,8
HCPCS,33622,Redo compl cardiac anomaly,,,2417.07,2798.71,8
HCPCS,33641,REPR ASD W BYPASS,11832.0,7690.8,1.1,11832.0,50
HCPCS,33641,Repair heart septum defect,,,2417.07,2798.71,8
HCPCS,33645,Revision of heart veins,,,2417.07,2798.71,8
HCPCS,33647,Repair heart septum defects,,,2417.07,2798.71,8
HCPCS,33660,Repair of heart defects,,,2417.07,2798.71,8
HCPCS,33665,Repair of heart defects,,,2417.07,2798.71,8
HCPCS,33670,Repair of heart chambers,,,2417.07,2798.71,8
HCPCS,33675,Close mult vsd,,,2417.07,2798.71,8
HCPCS,33676,Close mult vsd w/resection,,,2417.07,2798.71,8
HCPCS,33677,Cl mult vsd w/rem pul band,,,2417.07,2798.71,8
HCPCS,33681,Closure 1 vsd w/wo patch,,,2417.07,2798.71,8
HCPCS,33684,Clsr 1 vsd w/wo patch w/vlvt,,,2417.07,2798.71,8
HCPCS,33688,Clsr 1vsd w/wo ptch rmvl bnd,,,2417.07,2798.71,8
HCPCS,33690,Banding pulmonary artery,,,2417.07,2798.71,8
HCPCS,33692,Comp rpr tof wo pulm atresia,,,2417.07,2798.71,8
HCPCS,33694,Cmp rpr tof wo plm atrs ptch,,,2417.07,2798.71,8
HCPCS,33697,Compl rpr tof w/pulm atresia,,,2417.07,2798.71,8
HCPCS,33702,Repair of heart defects,,,2417.07,2798.71,8
HCPCS,3370F,Ajcc brst cncr stage 0 docd,,,8.48,9.82,8
HCPCS,33710,Repair of heart defects,,,2417.07,2798.71,8
HCPCS,33720,Repair of heart defect,,,2417.07,2798.71,8
HCPCS,33722,Repair of heart defect,,,2417.07,2798.71,8
HCPCS,33724,Repair venous anomaly,,,2417.07,2798.71,8
HCPCS,33726,Repair pul venous stenosis,,,2417.07,2798.71,8
HCPCS,3372F,Ajcc brst cncr stage 1 docd,,,8.48,9.82,8
HCPCS,33730,Repair heart-vein defect(s),,,2417.07,2798.71,8
HCPCS,33732,Repair heart-vein defect,,,2417.07,2798.71,8
HCPCS,33735,Revision of heart chamber,,,2417.07,2798.71,8
HCPCS,33736,Revision of heart chamber,,,2417.07,2798.71,8
HCPCS,33737,Revision of heart chamber,,,2417.07,2798.71,8
HCPCS,33741,Tas congenital car anomal,,,11343.93,13135.08,8
HCPCS,33745,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,8000.0,5200.0,1.1,8000.0,50
HCPCS,33745,Tis cgen car anomal 1st shnt,,,11343.93,13135.08,8
HCPCS,33746,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3200.0,2080.0,1.1,3200.0,50
HCPCS,33746,Tis cgen car anomal ea addl,,,11343.93,13135.08,8
HCPCS,3374F,Ajcc brst cncr stage 1 docd,,,8.48,9.82,8
HCPCS,33750,Shunt subclavian to pulm art,,,2082.17,2410.94,8
HCPCS,33755,Shunt as-aort to pulm art,,,2082.17,2410.94,8
HCPCS,33762,Shunt desc aorta to pulm art,,,2082.17,2410.94,8
HCPCS,33764,Shunt central w/prostc graft,,,2082.17,2410.94,8
HCPCS,33766,Shunt supr v/c p-art 1 lung,,,2082.17,2410.94,8
HCPCS,33767,Shunt supr v/c p-art bth lng,,,2082.17,2410.94,8
HCPCS,33768,Anast cavopulm sec sup v/c,,,2417.07,2798.71,8
HCPCS,3376F,Ajcc brstcncr stage 2 docd,,,8.48,9.82,8
HCPCS,33770,Rpr tga w/o surg enlgmnt vsd,,,2417.07,2798.71,8
HCPCS,33771,Rpr tga w/surg enlgmnt vsd,,,2417.07,2798.71,8
HCPCS,33774,Rpr tga atrial baffle px,,,2417.07,2798.71,8
HCPCS,33775,Rpr tga atr bfl rmvl plm bnd,,,2417.07,2798.71,8
HCPCS,33776,Rpr tga atr bfl clsr vsd,,,2417.07,2798.71,8
HCPCS,33777,Rpr tga bfl rpr sbpulm obstr,,,2417.07,2798.71,8
HCPCS,33778,Rpr tga aortic pulm art rcns,,,2082.17,2410.94,8
HCPCS,33779,Rpr tga rcnstj rmvl plm bnd,,,2082.17,2410.94,8
HCPCS,33780,Rpr tga rcnstj clsr vsd,,,2082.17,2410.94,8
HCPCS,33781,Rpr tga rcnstj rpr sbpl obst,,,2082.17,2410.94,8
HCPCS,33782,Nikaidoh proc,,,2417.07,2798.71,8
HCPCS,33783,Nikaidoh proc w/ostia implt,,,2417.07,2798.71,8
HCPCS,33786,Repair arterial trunk,,,2417.07,2798.71,8
HCPCS,33788,Revision of pulmonary artery,,,2417.07,2798.71,8
HCPCS,3378F,Ajcc brstcncr stage 3 docd,,,8.48,9.82,8
HCPCS,33800,Aortic suspension,,,2082.17,2410.94,8
HCPCS,33802,Division aberrant vessel,,,2082.17,2410.94,8
HCPCS,33803,Div aberrant vsl w/reanast,,,2082.17,2410.94,8
HCPCS,3380F,Ajcc brstcncr stage 4 docd,,,8.48,9.82,8
HCPCS,33813,Repair septal defect,,,2082.17,2410.94,8
HCPCS,33814,Obltrj a-pulm sep def w/byp,,,2082.17,2410.94,8
HCPCS,33820,Repair pda by ligation,,,2082.17,2410.94,8
HCPCS,33822,Repair pda div<18 years,,,2082.17,2410.94,8
HCPCS,33824,Repair pda div 18 yrs&older,,,2082.17,2410.94,8
HCPCS,3382F,Ajcc cln cncr stage 0 docd,,,8.48,9.82,8
HCPCS,33840,EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS,8536.0,5548.4,1.1,8536.0,50
HCPCS,33840,Exc coa w/direct anastomosis,,,2082.17,2410.94,8
HCPCS,33845,Excision coa w/graft,,,2082.17,2410.94,8
HCPCS,3384F,Ajcc cln cncr stage 1 docd,,,8.48,9.82,8
HCPCS,33851,Exc coa rpr l subcl art/prst,,,2082.17,2410.94,8
HCPCS,33852,Rpr hypopl a-arch wo byp,,,2082.17,2410.94,8
HCPCS,33853,Rpr hypopl a-arch w/byp,,,2082.17,2410.94,8
HCPCS,33858,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,20933.0,13606.45,1.1,25360.0,96
HCPCS,33859,AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ,18052.0,11733.8,1.1,18052.0,50
HCPCS,33859,As-aort grf f/ds oth/thn dsj,,,2082.17,2410.94,8
HCPCS,33863,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,23516.0,15285.4,1.1,23516.0,50
HCPCS,33863,Ascending aortic graft,,,2082.17,2410.94,8
HCPCS,33864,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,24032.0,15620.8,1.1,24032.0,50
HCPCS,33864,Ascending aortic graft,,,2082.17,2410.94,8
HCPCS,33866,AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS,7810.0,5076.5,1.1,7810.0,50
HCPCS,33866,Aortic hemiarch graft,,,2082.17,2410.94,8
HCPCS,3386F,Ajcc cln cncr stage 2 docd,,,8.48,9.82,8
HCPCS,33871,TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA,24352.0,15828.8,1.1,24352.0,50
HCPCS,33871,Transvrs a-arch grf hypthrm,,,2082.17,2410.94,8
HCPCS,33875,Thoracic aortic graft,,,2082.17,2410.94,8
HCPCS,33877,Thoracoabdominal graft,,,2082.17,2410.94,8
HCPCS,33880,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,13211.5,8587.474999999999,1.1,13832.0,96
HCPCS,33881,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,12211.5,7937.475,1.1,12591.0,96
HCPCS,33882,EVASC RPR TA DPLMNT BRNCHD NDGFT MULTIPIECE SYS,15400.0,10010.0,1.1,15400.0,35
HCPCS,33882,Evasc rpr ta dplmt mltpc sys,,,8291.28,9600.43,8
HCPCS,33883,Delayed plmt prox xtn prosth,,,8291.28,9600.43,8
HCPCS,33884,Endovasc prosth taa add-on,,,8291.28,9600.43,8
HCPCS,33886,Delayed plmt dstl xtn prosth,,,8291.28,9600.43,8
HCPCS,33886,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,7236.0,4703.4,1.1,7236.0,50
HCPCS,33889,Artery transpose/endovas taa,,,2082.17,2410.94,8
HCPCS,3388F,Ajcc cln cncr stage 3 docd,,,8.48,9.82,8
HCPCS,33891,Car-car bp grft/endovas taa,,,3088.09,3575.68,8
HCPCS,33894,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,8039.0,5225.35,1.1,8039.0,50
HCPCS,33894,Evasc st rpr thrc/aa acrs br,,,8291.28,9600.43,8
HCPCS,33895,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,6398.0,4158.7,1.1,6398.0,50
HCPCS,33895,Evasc st rpr thrc/aa x crsg,,,8291.28,9600.43,8
HCPCS,33897,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,4324.0,2810.6,1.1,4324.0,50
HCPCS,33897,Perq trluml angp nt/recr coa,,,4659.93,5395.71,8
HCPCS,33900,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,34810.0,22626.5,0.01,65208.0,233
HCPCS,33901,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,35504.0,23077.6,0.01,65208.0,233
HCPCS,33902,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,54425.5,35376.575,0.01,103251.0,233
HCPCS,33903,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,35904.0,23337.6,0.01,65208.0,233
HCPCS,33904,PERQ P-ART REVSC ST EA ADDL VSL/SEP LES NM/ABNL,2212.0,1437.8,1.1,2212.0,50
HCPCS,33904,Perq p-art revsc each addl,,,4659.93,5395.71,8
HCPCS,3390F,Ajcc cln cncr stage 4 docd,,,8.48,9.82,8
HCPCS,33910,Remove lung artery emboli,,,2082.17,2410.94,8
HCPCS,33915,Remove lung artery emboli,,,2082.17,2410.94,8
HCPCS,33916,Surgery of great vessel,,,2082.17,2410.94,8
HCPCS,33917,Repair pulmonary artery,,,2082.17,2410.94,8
HCPCS,33920,Repair pulmonary atresia,,,2417.07,2798.71,8
HCPCS,33922,Transect pulmonary artery,,,2082.17,2410.94,8
HCPCS,33924,Remove pulmonary shunt,,,2417.07,2798.71,8
HCPCS,33925,Rpr pul art unifocal w/o cpb,,,2082.17,2410.94,8
HCPCS,33926,Repr pul art unifocal w/cpb,,,2082.17,2410.94,8
HCPCS,33927,IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY,19600.0,12740.0,1.1,19600.0,50
HCPCS,33927,Impltj tot rplcmt hrt sys,,,2417.07,2798.71,8
HCPCS,33928,REMOVAL & RPLCMT TOTAL RPLCMT HEART SYS,20031.0,13020.15,1.1,1791901.44,31
HCPCS,33928,Rmvl & rplcmt tot hrt sys,,,2417.07,2798.71,8
HCPCS,33929,REMOVAL TOTAL RPLCMT HEART SYS FOR HEART TRNSPL,27438.0,17834.7,1.1,1791901.44,31
HCPCS,33929,Rmvl rplcmt hrt sys f/trnspl,,,2417.07,2798.71,8
HCPCS,33930,Removal of donor heart/lung,,,975.94,1130.04,8
HCPCS,33933,Prepare donor heart/lung,,,975.94,1130.04,8
HCPCS,33935,Transplantation heart/lung,,,975.94,1130.04,8
HCPCS,33940,Removal of donor heart,,,975.94,1130.04,8
HCPCS,33944,Prepare donor heart,,,975.94,1130.04,8
HCPCS,33945,Transplantation of heart,,,975.94,1130.04,8
HCPCS,33946,ECMO/ECLS INITIATION VENO-VENOUS,2640.0,1716.0,1.1,2640.0,50
HCPCS,33946,Ecmo/ecls initiation venous,,,1372.66,1589.4,8
HCPCS,33947,ECMO/ECLS INITIATION VENO-ARTERIAL,2837.0,1844.05,1.1,9496.0,96
HCPCS,33948,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,2081.0,1352.65,1.1,2081.0,50
HCPCS,33948,Ecmo/ecls daily mgmt-venous,,,1372.66,1589.4,8
HCPCS,33949,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1840.0,1196.0,1.1,1840.0,50
HCPCS,33949,Ecmo/ecls daily mgmt artery,,,1372.66,1589.4,8
HCPCS,3394F,Quant her2 ihc eval brst cx,,,8.48,9.82,8
HCPCS,33951,Ecmo/ecls insj prph cannula,,,1372.66,1589.4,8
HCPCS,33952,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,2966.5,1928.225,1.1,9496.0,96
HCPCS,33953,Ecmo/ecls insj prph cannula,,,1372.66,1589.4,8
HCPCS,33954,Ecmo/ecls insj prph cannula,,,1372.66,1589.4,8
HCPCS,33955,Ecmo/ecls insj ctr cannula,,,1372.66,1589.4,8
HCPCS,33956,Ecmo/ecls insj ctr cannula,,,1372.66,1589.4,8
HCPCS,33957,Ecmo/ecls repos perph cnula,,,1372.66,1589.4,8
HCPCS,33958,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,1404.0,912.6,1.1,1404.0,50
HCPCS,33958,Ecmo/ecls repos perph cnula,,,1372.66,1589.4,8
HCPCS,33959,Ecmo/ecls repos perph cnula,,,1372.66,1589.4,8
HCPCS,3395F,Quant nonher2 ihc brst cx,,,8.48,9.82,8
HCPCS,33962,Ecmo/ecls repos perph cnula,,,1372.66,1589.4,8
HCPCS,33963,Ecmo/ecls repos perph cnula,,,1372.66,1589.4,8
HCPCS,33964,Ecmo/ecls repos perph cnula,,,1372.66,1589.4,8
HCPCS,33965,Ecmo/ecls rmvl perph cannula,,,1372.66,1589.4,8
HCPCS,33966,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,1800.0,1170.0,1.1,1800.0,50
HCPCS,33966,Ecmo/ecls rmvl prph cannula,,,1372.66,1589.4,8
HCPCS,33967,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,2537.0,1649.0500000000002,0.01,18167.0,188
HCPCS,33968,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,821.5,533.975,1.1,18167.0,96
HCPCS,33969,Ecmo/ecls rmvl perph cannula,,,1372.66,1589.4,8
HCPCS,33970,Aortic circulation assist,,,2082.17,2410.94,8
HCPCS,33970,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,2696.0,1752.4,1.1,2696.0,50
HCPCS,33971,Aortic circulation assist,,,2082.17,2410.94,8
HCPCS,33973,Insert balloon device,,,2082.17,2410.94,8
HCPCS,33974,RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA,6012.0,3907.8,1.1,6012.0,50
HCPCS,33974,Remove intra-aortic balloon,,,2082.17,2410.94,8
HCPCS,33975,Implant ventricular device,,,54134.24,62681.75,8
HCPCS,33976,Implant ventricular device,,,54134.24,62681.75,8
HCPCS,33977,Remove ventricular device,,,2386.88,2763.76,8
HCPCS,33978,Remove ventricular device,,,2386.88,2763.76,8
HCPCS,33979,Insert intracorporeal device,,,54134.24,62681.75,8
HCPCS,33980,Remove intracorporeal device,,,2386.88,2763.76,8
HCPCS,33981,Replace vad pump ext,,,54134.24,62681.75,8
HCPCS,33982,Replace vad intra w/o bp,,,54134.24,62681.75,8
HCPCS,33983,Replace vad intra w/bp,,,54134.24,62681.75,8
HCPCS,33984,Ecmo/ecls rmvl prph cannula,,,1372.66,1589.4,8
HCPCS,33985,Ecmo/ecls rmvl ctr cannula,,,1372.66,1589.4,8
HCPCS,33986,Ecmo/ecls rmvl ctr cannula,,,1372.66,1589.4,8
HCPCS,33987,Artery expos/graft artery,,,1372.66,1589.4,8
HCPCS,33988,Insertion of left heart vent,,,1372.66,1589.4,8
HCPCS,33989,Removal of left heart vent,,,1372.66,1589.4,8
HCPCS,33990,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,2970.0,1930.5,1.1,2970.0,50
HCPCS,33990,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,7901.0,5135.65,589.05,62681.75,92
HCPCS,33991,Insj perq vad l hrt artl&ven,,,54134.24,62681.75,8
HCPCS,33992,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,2938.0,1909.7,1.1,9496.0,96
HCPCS,33993,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,2064.0,1341.6,1.1,9496.0,142
HCPCS,33995,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,5182.0,3368.3,1.1,62681.75,142
HCPCS,33997,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,2869.5,1865.175,1.1,9496.0,142
HCPCS,33999,EXTRACTION/REMOVAL OF INTRA AORTIC /INTRACARDIAC MASS (COMP CODE,3953.0,2569.45,0.01,3953.0,28
HCPCS,33999,LOOP REVISION,3924.0,2550.6,571.26,9496.0,61
HCPCS,33999,SUBCLAVIAN TRANS-CAROTID TAVR,17587.0,11431.55,571.26,17587.0,61
HCPCS,33999,UNLISTED CARDIAC SURG PROCEDURE,2776.0,1804.4,0.01,2776.0,28
HCPCS,33999,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33310)",2450.0,1592.5,0.01,2450.0,28
HCPCS,33999,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33320)",3160.0,2054.0,0.01,3160.0,28
HCPCS,33999,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33330)",4250.0,2762.5,0.01,4250.0,28
HCPCS,33999,"UNLISTED PROCEDURE, CARDIAC SURGERY (COMPARISON CODE 33800)",2210.0,1436.5,0.01,2210.0,28
HCPCS,34001,Removal of artery clot,,,872.27,1010.0,8
HCPCS,34051,Removal of artery clot,,,8291.28,9600.43,8
HCPCS,34101,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,17727.0,11522.55,1.1,31082.0,111
HCPCS,34111,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,4372.0,2841.8,1.1,9382.91,50
HCPCS,34111,REMOVAL OF ARM ARTERY CLOT,,,4994.76,15596.41,19
HCPCS,34111,Removal of arm artery clot,,,2221.81,2572.63,8
HCPCS,34151,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,10608.0,6895.2,1.1,10608.0,50
HCPCS,34151,Removal of artery clot,,,2082.17,2410.94,8
HCPCS,34201,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,7792.0,5064.8,1.1,9382.91,50
HCPCS,34201,"EMBO/THROM FEM/POP, AORTAILIAC ART",31082.0,20203.3,1667.62,31082.0,61
HCPCS,34203,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,7144.0,4643.6,1.1,9382.91,50
HCPCS,34203,EMBO/THROM POP/TIBIO/PERONEAL ART,31082.0,20203.3,1547.95,31082.0,61
HCPCS,34401,Removal of vein clot,,,2082.17,2410.94,8
HCPCS,34421,REMOVAL OF VEIN CLOT,,,2908.23,8849.94,19
HCPCS,34421,Removal of vein clot,,,2221.81,2572.63,8
HCPCS,34451,Removal of vein clot,,,2082.17,2410.94,8
HCPCS,34471,REMOVAL OF VEIN CLOT,,,571.26,1758.23,19
HCPCS,34471,Removal of vein clot,,,2221.81,2572.63,8
HCPCS,34490,REMOVAL OF VEIN CLOT,,,2908.23,8849.94,19
HCPCS,34490,Removal of vein clot,,,2221.81,2572.63,8
HCPCS,34501,REPAIR VALVE FEMORAL VEIN,,,4994.76,15596.41,19
HCPCS,34501,Repair valve femoral vein,,,2221.81,2572.63,8
HCPCS,34502,RECONSTRUCTION VENA CAVA ANY METHOD,11228.0,7298.2,1.1,11228.0,50
HCPCS,34502,Reconstruct vena cava,,,2082.17,2410.94,8
HCPCS,3450F,Dyspnea scrnd no-mild dysp,,,8.48,9.82,8
HCPCS,34510,TRANSPOSITION OF VEIN VALVE,,,4994.76,15596.41,19
HCPCS,34510,Transposition of vein valve,,,2221.81,2572.63,8
HCPCS,3451F,Dyspnea scrnd mod-high dysp,,,8.48,9.82,8
HCPCS,34520,CROSS-OVER VEIN GRAFT,,,4994.76,15596.41,19
HCPCS,34520,Cross-over vein graft,,,2221.81,2572.63,8
HCPCS,3452F,Dyspnea not screened,,,8.48,9.82,8
HCPCS,34530,LEG VEIN FUSION,,,2908.23,8849.94,19
HCPCS,34530,Leg vein fusion,,,2221.81,2572.63,8
HCPCS,3455F,Tb scr pfrmd&interpd 6 mo,,,8.48,9.82,8
HCPCS,34701,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,19628.5,12758.525000000001,1.1,29773.0,96
HCPCS,34702,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,10439.0,6785.35,1.1,17865.0,96
HCPCS,34703,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,13222.5,8594.625,1.1,17865.0,96
HCPCS,34704,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,16918.5,10997.025,1.1,18000.0,96
HCPCS,34705,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,21142.0,13742.3,1.1,30452.0,142
HCPCS,34706,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,16918.5,10997.025,1.1,18000.0,96
HCPCS,34707,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,12374.5,8043.424999999999,1.1,15837.0,142
HCPCS,34708,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,15218.5,9892.025,1.1,15837.0,96
HCPCS,34709,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,6431.0,4180.15,1.1,10262.0,96
HCPCS,3470F,Ra disease activity low,,,8.48,9.82,8
HCPCS,34710,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,8131.0,5285.15,1.1,10262.0,96
HCPCS,34711,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,6331.0,4115.15,1.1,10262.0,96
HCPCS,34712,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,7531.0,4895.15,1.1,10262.0,96
HCPCS,34713,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,5320.0,3458.0,1.1,9640.0,96
HCPCS,34714,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,10380.0,6747.0,1.1,18660.0,96
HCPCS,34715,OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI,2400.0,1560.0,1.1,2400.0,50
HCPCS,34715,Opn ax/subcla art expos,,,2221.81,2572.63,8
HCPCS,34716,OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ,2876.0,1869.4,1.1,2876.0,50
HCPCS,34716,Opn ax/subcla art expos cndt,,,534.53,618.93,8
HCPCS,34717,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,19292.5,12540.125,1.1,34625.0,96
HCPCS,34718,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,21031.0,13670.15,1.1,31502.0,96
HCPCS,3471F,Ra disease activity mod,,,8.48,9.82,8
HCPCS,3472F,Ra disease activity high,,,8.48,9.82,8
HCPCS,3475F,Disease progn ra poor docd,,,8.48,9.82,8
HCPCS,3476F,Disease progn ra good docd,,,8.48,9.82,8
HCPCS,34808,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,26743.0,17382.95,332.65,26743.0,46
HCPCS,34812,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,10156.0,6601.4,1.1,18660.0,96
HCPCS,34813,Femoral endovas graft add-on,,,8291.28,9600.43,8
HCPCS,34820,Opn iliac art expos,,,8291.28,9600.43,8
HCPCS,34830,Open aortic tube prosth repr,,,2082.17,2410.94,8
HCPCS,34831,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,15192.0,9874.8,1.1,15192.0,50
HCPCS,34831,Open aortoiliac prosth repr,,,2082.17,2410.94,8
HCPCS,34832,Open aortofemor prosth repr,,,2082.17,2410.94,8
HCPCS,34833,OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP,3264.0,2121.6,1.1,3264.0,50
HCPCS,34833,Opn ilac art expos cndt crtj,,,534.53,618.93,8
HCPCS,34834,"OPN BRACH ART EXPOS PROS, UNLAT",19786.0,12860.9,212.69,19786.0,46
HCPCS,34834,OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI,1166.0,757.9,1.1,1166.0,50
HCPCS,34839,PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT,3486.0,2265.9,1.1,1791901.44,31
HCPCS,34839,Plnning pt spec fenest graft,,,321.96,372.8,8
HCPCS,34841,Endovasc visc aorta 1 graft,,,8291.28,9600.43,8
HCPCS,34842,Endovasc visc aorta 2 graft,,,8291.28,9600.43,8
HCPCS,34843,Endovasc visc aorta 3 graft,,,8291.28,9600.43,8
HCPCS,34844,Endovasc visc aorta 4 graft,,,8291.28,9600.43,8
HCPCS,34845,VISC & INFRAREN ABD 1 PROSTH,31502.0,20476.3,4687.5,31502.0,46
HCPCS,34846,VISC & INFRAREN ABD 2 PROSTH,34625.0,22506.25,4831.0,34625.0,46
HCPCS,34846,VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS,8117.0,5276.05,1.1,8157.79,38
HCPCS,34847,VISC & INFRAREN ABD 3 PROSTH,37750.0,24537.5,4831.0,37750.0,46
HCPCS,34848,VISC & INFRAREN ABD 4+ PROSTH,16400.0,10660.0,2440.32,16400.0,46
HCPCS,3490F,History aids-defining cond,,,8.48,9.82,8
HCPCS,3491F,Hiv unsure baby of hiv+moms,,,8.48,9.82,8
HCPCS,3492F,History cd4+ cell count <350,,,8.48,9.82,8
HCPCS,3493F,No hist cd4+ cell count <350,,,8.48,9.82,8
HCPCS,3494F,Cd4+cell count <200cells/mm3,,,8.48,9.82,8
HCPCS,3495F,Cd4+cell cnt 200-499 cells,,,8.48,9.82,8
HCPCS,3496F,Cd4+ cell count >= 500 cells,,,8.48,9.82,8
HCPCS,3497F,Cd4+ cell percentage <15%,,,8.48,9.82,8
HCPCS,3498F,Cd4+ cell >=15% (hiv),,,8.48,9.82,8
HCPCS,35001,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8324.0,5410.6,1.1,8324.0,50
HCPCS,35001,Repair defect of artery,,,872.27,1010.0,8
HCPCS,35002,Repair artery rupture neck,,,872.27,1010.0,8
HCPCS,35005,Repair defect of artery,,,872.27,1010.0,8
HCPCS,3500F,Cd4+cell cnt/% docd as done,,,8.48,9.82,8
HCPCS,35011,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,7432.0,4830.8,1.1,9382.91,50
HCPCS,35011,REPAIR DEFECT OF ARTERY,,,4994.76,15596.41,19
HCPCS,35011,Repair defect of artery,,,2221.81,2572.63,8
HCPCS,35013,Repair artery rupture arm,,,2221.81,2572.63,8
HCPCS,35021,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,8868.0,5764.2,1.1,8868.0,50
HCPCS,35021,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35022,Repair artery rupture chest,,,2082.17,2410.94,8
HCPCS,3502F,Hiv rna vrl ld <lmts quantif,,,8.48,9.82,8
HCPCS,3503F,Hiv rna vrl ldnot<lmts quntf,,,8.48,9.82,8
HCPCS,35045,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,7204.0,4682.6,1.1,9382.91,50
HCPCS,35045,REPAIR DEFECT OF ARM ARTERY,,,4994.76,15596.41,19
HCPCS,35045,Repair defect of arm artery,,,2221.81,2572.63,8
HCPCS,35081,DIR RPR ANEURYSM ABDOMINAL AORTA,13412.0,8717.8,1.1,13412.0,50
HCPCS,35081,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35082,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,16836.0,10943.4,1.1,16836.0,50
HCPCS,35082,Repair artery rupture aorta,,,2082.17,2410.94,8
HCPCS,35091,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,14140.0,9191.0,1.1,14140.0,50
HCPCS,35091,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35092,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,20388.0,13252.2,1.1,20388.0,50
HCPCS,35092,Repair artery rupture aorta,,,2082.17,2410.94,8
HCPCS,35102,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,14612.0,9497.8,1.1,14612.0,50
HCPCS,35102,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35103,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,17448.0,11341.2,1.1,17448.0,50
HCPCS,35103,Repair artery rupture aorta,,,2082.17,2410.94,8
HCPCS,3510F,Doc tb scrng-rslts interpd,,,8.48,9.82,8
HCPCS,35111,DIR RPR ANEURYSM SPLENIC ARTERY,10512.0,6832.8,1.1,10512.0,50
HCPCS,35111,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35112,Repair artery rupture spleen,,,2082.17,2410.94,8
HCPCS,3511F,Chlmyd/gonrh tsts docd done,,,8.48,9.82,8
HCPCS,35121,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,12608.0,8195.2,1.1,12608.0,50
HCPCS,35121,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35122,Repair artery rupture belly,,,2082.17,2410.94,8
HCPCS,3512F,Syph scrng docd as done,,,8.48,9.82,8
HCPCS,35131,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,10560.0,6864.0,1.1,10560.0,50
HCPCS,35131,Repair defect of artery,,,2082.17,2410.94,8
HCPCS,35132,Repair artery rupture groin,,,2082.17,2410.94,8
HCPCS,3513F,Hep b scrng docd as done,,,8.48,9.82,8
HCPCS,35141,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,8364.0,5436.6,1.1,8364.0,50
HCPCS,35141,Repair defect of artery,,,2221.81,2572.63,8
HCPCS,35142,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,10064.0,6541.6,1.1,10064.0,50
HCPCS,35142,Repair artery rupture thigh,,,2221.81,2572.63,8
HCPCS,3514F,Hep c scrng docd as done,,,8.48,9.82,8
HCPCS,35151,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,9488.0,6167.2,1.1,9488.0,50
HCPCS,35151,Repair defect of artery,,,2221.81,2572.63,8
HCPCS,35152,Repair ruptd popliteal art,,,2221.81,2572.63,8
HCPCS,3515F,Pt has docd immun to hep c,,,8.48,9.82,8
HCPCS,3517F,Hbv assess&results intrp 1yr,,,8.48,9.82,8
HCPCS,35180,RPR CGEN AV FISTULA HEAD&NCK,,,1435.35,4412.12,19
HCPCS,35180,Rpr cgen av fistula head&nck,,,987.9,1143.88,8
HCPCS,35182,Rpr cgen av fistula thrx&abd,,,2082.17,2410.94,8
HCPCS,35184,RPR CGEN AV FISTULA XTR,,,2908.23,8849.94,19
HCPCS,35184,Rpr cgen av fistula xtr,,,987.9,1143.88,8
HCPCS,35188,RPR ACQ AV FISTULA HEAD&NECK,,,4994.76,15596.41,19
HCPCS,35188,Rpr acq av fistula head&neck,,,987.9,1143.88,8
HCPCS,35189,Rpr acq av fistula thrx&abd,,,2082.17,2410.94,8
HCPCS,35190,REPAIR ACQ AV FISTULA XTR,,,4994.76,15596.41,19
HCPCS,35190,RPR/TRAUMATIC AV FISTULA EXTREMITIES,5368.0,3489.2,1.1,9382.91,50
HCPCS,35190,Repair acq av fistula xtr,,,987.9,1143.88,8
HCPCS,35201,REPAIR BLOOD VESSEL DIR NECK,,,4994.76,15596.41,19
HCPCS,35201,REPAIR BLOOD VESSEL DIRECT NECK,6772.0,4401.8,1.1,9382.91,50
HCPCS,35201,Repair blood vessel dir neck,,,987.9,1143.88,8
HCPCS,35206,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,5536.0,3598.4,1.1,5536.0,50
HCPCS,35206,REPAIR BLOOD VESSEL UPPER EXT,18098.0,11763.7,987.9,18098.0,61
HCPCS,35207,REPAIR BLOOD VESSEL DIRECT HAND FINGER,11237.0,7304.05,1.1,18098.0,111
HCPCS,3520F,Cdifficile testing performed,,,8.48,9.82,8
HCPCS,35211,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS,9832.0,6390.8,1.1,9832.0,50
HCPCS,35211,Rpr blvsl dir ntrathrc w/byp,,,2082.17,2410.94,8
HCPCS,35216,Rpr blvsl dir ntrthrc wo byp,,,2082.17,2410.94,8
HCPCS,35221,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,10648.0,6921.2,1.1,10648.0,50
HCPCS,35221,Rpr bld vsl dir intra-abdl,,,2082.17,2410.94,8
HCPCS,35226,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,5083.0,3303.95,1.1,7445.0,172
HCPCS,35231,REPAIR BLVSL VN GRF NECK,,,2908.23,8849.94,19
HCPCS,35231,Repair blvsl vn grf neck,,,987.9,1143.88,8
HCPCS,35236,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,7208.0,4685.2,1.1,9382.91,50
HCPCS,35236,REPAIR BLVSL VN GRF UXTR,,,4994.76,15596.41,19
HCPCS,35236,Repair blvsl vn grf uxtr,,,987.9,1143.88,8
HCPCS,35241,Rpr blvsl vn grf ntrthrc w/b,,,2082.17,2410.94,8
HCPCS,35246,Rpr blvsl vn grf ntrthrc w/o,,,2082.17,2410.94,8
HCPCS,35251,Rpr blvsl vn grf intra-abdl,,,2082.17,2410.94,8
HCPCS,35256,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,7624.0,4955.6,1.1,9382.91,50
HCPCS,35256,REPAIR BLVSL VN GRF LXTR,,,4994.76,15596.41,19
HCPCS,35256,Repair blvsl vn grf lxtr,,,2221.81,2572.63,8
HCPCS,35261,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,7584.0,4929.6,1.1,7584.0,50
HCPCS,35261,RPR BLVSL GRF OTH/THN VN NCK,,,2908.23,8849.94,19
HCPCS,35261,Rpr blvsl grf oth/thn vn nck,,,2221.81,2572.63,8
HCPCS,35266,RPR BLVSL GRF OTH/TH VN UXTR,,,4994.76,15596.41,19
HCPCS,35266,Rpr blvsl grf oth/th vn uxtr,,,987.9,1143.88,8
HCPCS,35271,Rpr blvs gr ot/th vn ntrth w,,,2082.17,2410.94,8
HCPCS,35276,Rpr blvs gr ot/t vn ntrth wo,,,2082.17,2410.94,8
HCPCS,35281,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,12024.0,7815.6,1.1,12024.0,50
HCPCS,35281,Rpr blvsl gr ot/th vn ntr-ab,,,2082.17,2410.94,8
HCPCS,35286,RPR BLVSL GRF OTH/TH VN LXTR,,,4994.76,15596.41,19
HCPCS,35286,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,6876.0,4469.4,1.1,9382.91,50
HCPCS,35286,Rpr blvsl grf oth/th vn lxtr,,,3088.09,3575.68,8
HCPCS,35301,Rechanneling of artery,,,872.27,1010.0,8
HCPCS,35301,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,8464.0,5501.6,1.1,8464.0,50
HCPCS,35302,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,17365.5,11287.575,1.1,26191.0,96
HCPCS,35303,Rechanneling of artery,,,2221.81,2572.63,8
HCPCS,35303,TEAEC W/GRAFT POPLITEAL ARTERY,9440.0,6136.0,1.1,9440.0,50
HCPCS,35304,Rechanneling of artery,,,2221.81,2572.63,8
HCPCS,35305,Rechanneling of artery,,,2221.81,2572.63,8
HCPCS,35306,Rechanneling of artery,,,2221.81,2572.63,8
HCPCS,35311,Rechanneling of artery,,,2082.17,2410.94,8
HCPCS,35321,RECHANNELING OF ARTERY,,,4994.76,15596.41,19
HCPCS,35321,Rechanneling of artery,,,2221.81,2572.63,8
HCPCS,35331,Rechanneling of artery,,,2082.17,2410.94,8
HCPCS,35341,Rechanneling of artery,,,2082.17,2410.94,8
HCPCS,35351,Rechanneling of artery,,,2082.17,2410.94,8
HCPCS,35351,TEAEC W/WO PATCH GRAFT ILIAC,9844.0,6398.6,1.1,9844.0,50
HCPCS,35355,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,7301.0,4745.65,1.1,9496.0,96
HCPCS,35361,Rechanneling of artery,,,2082.17,2410.94,8
HCPCS,35363,Rechanneling of artery,,,2082.17,2410.94,8
HCPCS,35371,Rechanneling of artery,,,2221.81,2572.63,8
HCPCS,35371,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,6124.0,3980.6,1.1,6124.0,50
HCPCS,35372,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,17626.5,11457.225,1.1,27821.0,105
HCPCS,35390,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,1276.0,829.4,1.1,1276.0,50
HCPCS,35390,Reoperation carotid add-on,,,872.27,1010.0,8
HCPCS,35400,Angioscopy,,,89.44,103.57,8
HCPCS,35500,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,2576.0,1674.4,1.1,2576.0,50
HCPCS,35500,Harvest vein for bypass,,,3088.09,3575.68,8
HCPCS,35501,Art byp grft ipsilat carotid,,,872.27,1010.0,8
HCPCS,35506,Art byp grft subclav-carotid,,,872.27,1010.0,8
HCPCS,35508,Art byp grft carotid-vertbrl,,,872.27,1010.0,8
HCPCS,35509,Art byp grft contral carotid,,,872.27,1010.0,8
HCPCS,3550F,Low rsk thromboembolism,,,8.48,9.82,8
HCPCS,35510,Art byp grft carotid-brchial,,,872.27,1010.0,8
HCPCS,35511,Art byp grft subclav-subclav,,,2082.17,2410.94,8
HCPCS,35512,Art byp grft subclav-brchial,,,3088.09,3575.68,8
HCPCS,35515,Art byp grft subclav-vertbrl,,,2082.17,2410.94,8
HCPCS,35516,Art byp grft subclav-axilary,,,3088.09,3575.68,8
HCPCS,35518,Art byp grft axillary-axilry,,,3088.09,3575.68,8
HCPCS,3551F,Intrmed rsk thromboembolism,,,8.48,9.82,8
HCPCS,35521,Art byp grft axill-femoral,,,2082.17,2410.94,8
HCPCS,35522,Art byp grft axill-brachial,,,3088.09,3575.68,8
HCPCS,35522,BYPASS W/VEIN AXILLARY-BRACHIAL,9260.0,6019.0,1.1,9260.0,50
HCPCS,35523,Art byp grft brchl-ulnr-rdl,,,3088.09,3575.68,8
HCPCS,35525,Art byp grft brachial-brchl,,,3088.09,3575.68,8
HCPCS,35526,Art byp grft aor/carot/innom,,,2082.17,2410.94,8
HCPCS,3552F,Hgh risk for thromboembolism,,,8.48,9.82,8
HCPCS,35531,Art byp grft aorcel/aormesen,,,2082.17,2410.94,8
HCPCS,35533,Art byp grft axill/fem/fem,,,2221.81,2572.63,8
HCPCS,35535,Art byp grft hepatorenal,,,2082.17,2410.94,8
HCPCS,35536,Art byp grft splenorenal,,,2082.17,2410.94,8
HCPCS,35537,Art byp grft aortoiliac,,,2082.17,2410.94,8
HCPCS,35538,Art byp grft aortobi-iliac,,,2082.17,2410.94,8
HCPCS,35539,Art byp grft aortofemoral,,,2082.17,2410.94,8
HCPCS,35540,Art byp grft aortbifemoral,,,2082.17,2410.94,8
HCPCS,35556,Art byp grft fem-popliteal,,,3088.09,3575.68,8
HCPCS,35556,BYPASS W/VEIN FEMORAL-POPLITEAL,10700.0,6955.0,1.1,10700.0,50
HCPCS,35558,Art byp grft fem-femoral,,,3088.09,3575.68,8
HCPCS,35558,BYPASS W/VEIN FEMORAL-FEMORAL,9252.0,6013.8,1.1,9252.0,50
HCPCS,3555F,Pt inr measurement performed,,,8.48,9.82,8
HCPCS,35560,Art byp grft aortorenal,,,2082.17,2410.94,8
HCPCS,35563,Art byp grft ilioiliac,,,2082.17,2410.94,8
HCPCS,35565,Art byp grft iliofemoral,,,2082.17,2410.94,8
HCPCS,35566,Art byp fem-ant-post tib/prl,,,3088.09,3575.68,8
HCPCS,35566,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,12940.0,8411.0,1.1,12940.0,50
HCPCS,35570,Art byp tibial-tib/peroneal,,,3088.09,3575.68,8
HCPCS,35571,Art byp pop-tibl-prl-other,,,3088.09,3575.68,8
HCPCS,35571,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,11229.0,7298.85,1.1,11229.0,50
HCPCS,35572,Harvest femoropopliteal vein,,,3088.09,3575.68,8
HCPCS,35583,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,11100.0,7215.0,1.1,11100.0,50
HCPCS,35583,Vein byp grft fem-popliteal,,,3088.09,3575.68,8
HCPCS,35585,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,12940.0,8411.0,1.1,12940.0,50
HCPCS,35585,Vein byp fem-tibial peroneal,,,3088.09,3575.68,8
HCPCS,35587,IN-SITU VEIN BYP POP-TIBL PRONEAL,10484.0,6814.6,1.1,10484.0,50
HCPCS,35587,Vein byp pop-tibl peroneal,,,3088.09,3575.68,8
HCPCS,35600,OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB,1580.0,1027.0,1.1,1580.0,50
HCPCS,35600,Open hrv uxtr art 1 sgm cab,,,3812.25,4414.18,8
HCPCS,35601,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,10836.0,7043.4,1.1,10836.0,50
HCPCS,35601,Bpg com crtd-ipsi int crtd,,,872.27,1010.0,8
HCPCS,35602,BPG OTH/THN VEIN CAROTID-CONTRALATERAL CAROTID,10353.0,6729.45,1.1,10353.0,35
HCPCS,35602,Bpg crtd-clat crtd,,,872.27,1010.0,8
HCPCS,35606,ART BYPASS CAROTID-SUBCLAVIAN,28437.0,18484.05,872.27,28437.0,46
HCPCS,35606,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,8984.0,5839.6,1.1,8984.0,50
HCPCS,35612,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,4718.0,3066.7,1028.52,9496.0,46
HCPCS,35616,Bpg subclavian-axillary,,,3088.09,3575.68,8
HCPCS,35621,BYP OTH/THN VEIN AXILLARY-FEMORAL,8412.0,5467.8,1.1,8412.0,50
HCPCS,35621,Bpg axillary-femoral,,,3088.09,3575.68,8
HCPCS,35623,Bpg axillary-pop/-tibial,,,3088.09,3575.68,8
HCPCS,35626,Bpg aor-subcla/innom/carotid,,,2082.17,2410.94,8
HCPCS,35631,Bpg aor-celiac-msn-renal,,,2082.17,2410.94,8
HCPCS,35632,Bpg ilio-celiac,,,2082.17,2410.94,8
HCPCS,35633,Bpg ilio-mesenteric,,,2082.17,2410.94,8
HCPCS,35634,Bpg iliorenal,,,2082.17,2410.94,8
HCPCS,35636,Bpg splenorenal,,,2082.17,2410.94,8
HCPCS,35637,Bpg aortoiliac,,,2082.17,2410.94,8
HCPCS,35638,"BYPASS GRAFT OTHR,AORTOBI-ILIAC",13440.0,8736.0,1.1,13440.0,50
HCPCS,35638,Bpg aortobi-iliac,,,2082.17,2410.94,8
HCPCS,35642,BYP OTH/THN VEIN CAROTID-VERTEBRAL,16506.0,10728.9,872.27,16506.0,46
HCPCS,35645,Bpg subclavian-vertebral,,,2082.17,2410.94,8
HCPCS,35646,BYP OTH/THN VEIN AORTOBIFEMORAL,13192.0,8574.8,1.1,13192.0,50
HCPCS,35646,Bpg aortobifemoral,,,2082.17,2410.94,8
HCPCS,35647,BYP OTH/THN VEIN AORTOFEMORAL,11892.0,7729.8,1.1,11892.0,50
HCPCS,35647,Bpg aortofemoral,,,3088.09,3575.68,8
HCPCS,35650,Bpg axillary-axillary,,,3088.09,3575.68,8
HCPCS,35654,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,10512.0,6832.8,1.1,10512.0,50
HCPCS,35654,Bpg axillary-femoral-femoral,,,2082.17,2410.94,8
HCPCS,35656,BYP OTH/THN VEIN FEMORAL-POPLITEAL,8188.0,5322.2,1.1,8188.0,50
HCPCS,35656,Bpg femoral-popliteal,,,3088.09,3575.68,8
HCPCS,35661,ART BYP FEMORAL-FEMORAL,21164.0,13756.6,1764.02,21164.0,46
HCPCS,35661,BYP OTH/THN VEIN FEMORAL-FEMORAL,8140.0,5291.0,1.1,8140.0,50
HCPCS,35663,BYP OTH/THN VEIN ILIOILIAC,9572.0,6221.8,1.1,9572.0,50
HCPCS,35663,Bpg ilioiliac,,,2082.17,2410.94,8
HCPCS,35665,BYP OTH/THN VEIN ILIOFEMORAL,8940.0,5811.0,1.1,8940.0,50
HCPCS,35665,Bpg iliofemoral,,,3088.09,3575.68,8
HCPCS,35666,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,9464.0,6151.6,1.1,9464.0,50
HCPCS,35666,Bpg fem-ant tib pst tib/prnl,,,3088.09,3575.68,8
HCPCS,35671,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,8308.0,5400.2,1.1,8308.0,50
HCPCS,35671,Bpg pop-tibl/-prnl artery,,,3088.09,3575.68,8
HCPCS,35681,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,640.0,416.0,1.1,640.0,50
HCPCS,35681,Composite byp grft pros&vein,,,3088.09,3575.68,8
HCPCS,35682,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,2876.0,1869.4,1.1,2876.0,50
HCPCS,35682,Composite byp grft 2 veins,,,3088.09,3575.68,8
HCPCS,35683,Composite byp grft 3/> segmt,,,3088.09,3575.68,8
HCPCS,35685,Bypass graft patency/patch,,,3088.09,3575.68,8
HCPCS,35685,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,1616.0,1050.4,1.1,1616.0,50
HCPCS,35686,Bypass graft/av fist patency,,,3088.09,3575.68,8
HCPCS,35691,Art trnsposj vertbrl carotid,,,872.27,1010.0,8
HCPCS,35693,Art trnsposj subclavian,,,2082.17,2410.94,8
HCPCS,35694,Art trnsposj subclav carotid,,,872.27,1010.0,8
HCPCS,35695,Art trnsposj carotid subclav,,,872.27,1010.0,8
HCPCS,35697,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,1200.0,780.0,1.1,1200.0,50
HCPCS,35697,Reimplant artery each,,,2221.81,2572.63,8
HCPCS,35700,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,1232.0,800.8,1.1,1232.0,50
HCPCS,35700,Reoperation bypass graft,,,2221.81,2572.63,8
HCPCS,35701,EXPLORATION N/FLWD SURG NECK ARTERY,3300.0,2145.0,1.1,3300.0,50
HCPCS,35701,Expl n/flwd surg neck art,,,872.27,1010.0,8
HCPCS,35702,EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY,2848.0,1851.2,1.1,2848.0,50
HCPCS,35702,Expl n/flwd surg uxtr art,,,2221.81,2572.63,8
HCPCS,35703,EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY,3000.0,1950.0,1.1,3000.0,50
HCPCS,35703,Expl n/flwd surg lxtr art,,,2221.81,2572.63,8
HCPCS,3570F,Rprt bone scint xref w xray,,,8.48,9.82,8
HCPCS,3572F,Pt consid poss risk fx,,,8.48,9.82,8
HCPCS,3573F,Pt not consid poss risk fx,,,8.48,9.82,8
HCPCS,35800,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,4800.0,3120.0,1.1,4800.0,50
HCPCS,35800,EXPLORE NECK VESSELS,,,5264.43,15596.41,13
HCPCS,35800,Explore neck vessels,,,2221.81,2572.63,8
HCPCS,35820,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,14756.0,9591.4,1.1,14756.0,50
HCPCS,35820,Explore chest vessels,,,2221.81,2572.63,8
HCPCS,35840,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,9281.0,6032.65,1.1,10262.0,96
HCPCS,35860,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,6100.0,3965.0,1.1,6100.0,50
HCPCS,35860,EXPLORE LIMB VESSELS,,,2908.23,8849.94,19
HCPCS,35860,Explore limb vessels,,,2221.81,2572.63,8
HCPCS,35870,Repair vessel graft defect,,,2082.17,2410.94,8
HCPCS,35875,REMOVAL OF CLOT IN GRAFT,,,4994.76,15596.41,19
HCPCS,35875,Removal of clot in graft,,,2221.81,2572.63,8
HCPCS,35875,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,4288.0,2787.2,1.1,9382.91,50
HCPCS,35876,REMOVAL OF CLOT IN GRAFT,,,4994.76,15596.41,19
HCPCS,35876,Removal of clot in graft,,,2221.81,2572.63,8
HCPCS,35876,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,7128.0,4633.2,1.1,9382.91,50
HCPCS,35879,REVISE GRAFT W/VEIN,,,4994.76,15596.41,19
HCPCS,35879,Revise graft w/vein,,,3088.09,3575.68,8
HCPCS,35881,REVISE GRAFT W/VEIN,,,4994.76,15596.41,19
HCPCS,35881,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,7740.0,5031.0,1.1,9382.91,50
HCPCS,35881,Revise graft w/vein,,,3088.09,3575.68,8
HCPCS,35883,REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF,9260.0,6019.0,1.1,9382.91,50
HCPCS,35883,REVJ FEM ANAST NONAUTOG GRF,,,4994.76,15596.41,19
HCPCS,35883,Revj fem anast nonautog grf,,,3088.09,3575.68,8
HCPCS,35884,REVJ FEM ANAST AUTOG VN GRF,,,4994.76,15596.41,19
HCPCS,35884,Revj fem anast autog vn grf,,,3088.09,3575.68,8
HCPCS,35901,Excision graft neck,,,2221.81,2572.63,8
HCPCS,35903,EXCISION INFECTED GRAFT EXTREMITY,18098.0,11763.7,907.81,18098.0,61
HCPCS,35903,"EXCISION, INFEC GRAFT, EXTREMITY",3812.0,2477.8,1.1,5442.3,50
HCPCS,35905,Excision graft thorax,,,2082.17,2410.94,8
HCPCS,35907,"EXCISION, INFEC GRAFT, ABDOMEN",14908.0,9690.2,1.1,14908.0,50
HCPCS,35907,Excision graft abdomen,,,2082.17,2410.94,8
HCPCS,36000,INTRODUCTION NEEDLE/INTRACATHETER VEIN,159.0,103.35,0.01,3398.0,180
HCPCS,36002,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,2169.5,1410.175,0.01,3728.0,236
HCPCS,36005,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,1312.0,852.8000000000001,0.01,3398.0,191
HCPCS,36010,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,0.01,3398.0,138
HCPCS,36010,INTRO. OF CATH SUP/INF VENA CAVA,872.0,566.8,1.1,1768.67,53
HCPCS,36011,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,2428.5,1578.525,0.01,3601.0,191
HCPCS,36012,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,2654.0,1725.1,0.01,3904.0,191
HCPCS,36013,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,1975.0,1283.75,1.1,3398.0,99
HCPCS,36014,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2052.0,1333.8,0.01,3398.0,145
HCPCS,36015,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,2314.5,1504.425,0.01,3398.0,145
HCPCS,36100,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1165.0,757.25,251.89,3398.0,46
HCPCS,36140,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,2180.5,1417.325,1.1,3657.0,145
HCPCS,36160,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1165.0,757.25,208.95,4001.0,46
HCPCS,36200,INTRODUCTION CATHETER AORTA,2091.5,1359.475,1.1,4001.0,145
HCPCS,36215,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,4670.0,3035.5,0.01,7505.0,191
HCPCS,36216,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,4873.0,3167.45,0.01,7638.0,191
HCPCS,36217,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,5320.5,3458.325,0.01,8125.0,191
HCPCS,36218,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,697.0,453.05,0.01,4001.0,191
HCPCS,36221,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,9833.0,6391.450000000001,1.1,18098.0,175
HCPCS,36222,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,10210.5,6636.825000000001,1.1,18098.0,175
HCPCS,36223,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,16806.5,10924.225,1.1,31083.0,175
HCPCS,36224,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,16916.5,10995.725,1.1,31083.0,114
HCPCS,36225,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,10314.0,6704.1,0.01,18098.0,236
HCPCS,36226,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,16916.5,10995.725,1.1,31083.0,175
HCPCS,36227,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,3693.0,2400.45,1.1,6466.0,99
HCPCS,36228,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,3773.0,2452.45,1.1,5846.0,99
HCPCS,36245,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,2936.5,1908.725,0.01,4056.8,191
HCPCS,36246,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,3266.5,2123.225,0.01,4525.0,237
HCPCS,36247,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,4063.5,2641.275,0.01,5469.0,191
HCPCS,36248,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,626.0,406.90000000000003,0.01,4001.0,191
HCPCS,36251,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,18098.0,11763.7,426.06,18098.0,122
HCPCS,36251,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UNI,2244.0,1458.6,1.1,5442.3,53
HCPCS,36252,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,18098.0,11763.7,584.96,18098.0,122
HCPCS,36252,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BILAT,2966.0,1927.9,1.1,5442.3,53
HCPCS,36253,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,31083.0,20203.95,603.72,31083.0,61
HCPCS,36253,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTERY/S&I UNI,3212.0,2087.8,1.1,9382.91,53
HCPCS,36254,INS CATH REN ART 2ND+ BILAT,,,2908.23,8849.94,19
HCPCS,36254,Ins cath ren art 2nd+ bilat,,,2270.79,2629.34,8
HCPCS,36260,INSERTION OF INFUSION PUMP,,,4994.76,15596.41,19
HCPCS,36260,Insertion of infusion pump,,,5003.75,5793.81,8
HCPCS,36261,REVISION OF INFUSION PUMP,,,3362.64,10474.13,19
HCPCS,36261,Revision of infusion pump,,,639.93,740.97,8
HCPCS,36262,REMOVAL OF INFUSION PUMP,,,3362.64,10474.13,19
HCPCS,36262,Removal of infusion pump,,,639.93,740.97,8
HCPCS,36299,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),1226.0,796.9000000000001,0.01,9496.0,74
HCPCS,36299,INJECTION FOR EGD W/ ECHO TIP (COMP CODE 36481),2232.0,1450.8,0.01,2232.0,28
HCPCS,36299,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),753.5,489.775,0.01,9496.0,74
HCPCS,36299,"UNLISTED PROCEDURE, VASCULAR INJECTION (COMPARISON CODE 36471)",330.0,214.5,0.01,330.0,28
HCPCS,36400,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,158.0,102.7,2.09,2453.0,46
HCPCS,36405,Vnpnxr<3yrs phy/qhp scalp vn,,,2.09,2.42,8
HCPCS,36406,Vnpnxr<3yrs phy/qhp other vn,,,2.09,2.42,8
HCPCS,36410,VNPNXR 3 YEARS/> PHYS/QHP SKILL,150.5,97.825,0.01,2453.0,145
HCPCS,36415,COLLECTION VENOUS BLOOD VENIPUNCTURE,40.0,26.0,1.1,40.0,33
HCPCS,36415,ROUTINE VENIPUNCTURE,63.0,40.95,2.09,63.0,60
HCPCS,36415,VENIPUNCTURE,63.0,40.95,2.09,63.0,60
HCPCS,36415,VENIPUNCTURE (ACC),63.0,40.95,2.09,63.0,60
HCPCS,36416,COLL CAP BLOOD SPECIMEN,48.0,31.2,2.09,48.0,46
HCPCS,36416,COLLECTION CAPILLARY BLOOD,31.0,20.15,1.1,31.0,38
HCPCS,36416,COLLECTION CAPILLARY BLOOD SPECIMEN,48.0,31.2,0.01,48.0,46
HCPCS,36420,VENIPUNCTURE CUTDOWN < 1 YR,,,119.1,372.91,19
HCPCS,36420,Venipuncture cutdown < 1 yr,,,28.36,32.84,8
HCPCS,36425,VENIPUNCTURE CUTDOWN 1 YR/>,,,368.71,1252.1,19
HCPCS,36425,Venipuncture cutdown 1 yr/>,,,28.36,32.84,8
HCPCS,36430,TRANSFUSION BLOOD OR BLOOD COMPONENTS,2514.0,1634.1,79.66,3004.0,61
HCPCS,36430,TRANSFUSION BLOOD/BLOOD COMPONENTS,1785.5,1160.5749999999998,1.1,3004.0,111
HCPCS,36430,TXFUS BLOOD/BLOOD COMPONENT,2514.0,1634.1,79.66,3004.0,61
HCPCS,36440,BLD PUSH TFUJ 2 YR/<,,,403.95,1236.54,19
HCPCS,36440,Bld push tfuj 2 yr/<,,,360.34,417.23,8
HCPCS,36450,BLD EXCHANGE TRUJ NEWBORN,,,403.95,1236.54,19
HCPCS,36450,Bld exchange truj newborn,,,360.34,417.23,8
HCPCS,36455,BLD EXCHANGE TRUJ OTH THN NB,,,403.95,1236.54,19
HCPCS,36455,Bld exchange truj oth thn nb,,,360.34,417.23,8
HCPCS,36456,PRTL EXCHANGE TRANSFUSE NB,,,403.95,1236.54,19
HCPCS,36456,Prtl exchange transfuse nb,,,360.34,417.23,8
HCPCS,36460,INTRAUTERINE TRANSFUSION FTL,,,403.95,1236.54,19
HCPCS,36460,Intrauterine transfusion ftl,,,360.34,417.23,8
HCPCS,36460,TRANSFUSION INTRAUTERINE FETAL,2632.0,1710.8,1.1,2632.0,50
HCPCS,36465,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,5729.0,3723.85,1.1,10518.0,114
HCPCS,36466,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,5859.0,3808.35,0.01,10518.0,114
HCPCS,36468,INJECTION(S) SPIDER VEINS,110.0,71.5,1.1,680.96,29
HCPCS,36468,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,1277.0,830.05,0.01,3004.0,151
HCPCS,36468,SCLEROTHERAPY/SPIDER VEINS-SINGLE OR MULTIPLE INJECTIONS,350.0,227.5,1.1,680.96,29
HCPCS,36470,"INJ SCLEROSING SOLUTION, SINGLE VEIN",2297.0,1493.05,64.1,3398.0,61
HCPCS,36470,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,1298.5,844.025,0.01,3004.0,114
HCPCS,36470,INJECTION THERAPY OF VEIN,114.0,74.1,1.1,680.96,53
HCPCS,36470,"SCLEROTHERAPY/VARICOSE VEINS, SINGLE VEIN",225.0,146.25,1.1,680.96,53
HCPCS,36471,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,1478.5,961.025,0.01,3004.0,114
HCPCS,36471,INJECTION THERAPY OF VEINS,114.0,74.1,1.1,680.96,53
HCPCS,36471,"SCHLEROTHERAPY/VARICOSE VEINS, MULTIPLE VEINS",500.0,325.0,1.1,680.96,53
HCPCS,36473,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,9749.0,6336.85,0.01,18098.0,114
HCPCS,36474,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,2989.5,1943.175,0.01,5279.0,99
HCPCS,36475,ENDOVENOUS RF 1ST VEIN,,,2908.23,8849.94,19
HCPCS,36475,Endovenous rf 1st vein,,,1698.96,1967.22,8
HCPCS,36476,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,1060.0,689.0,1.1,1060.0,53
HCPCS,36476,Endovenous rf vein add-on,,,1698.96,1967.22,8
HCPCS,36478,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,10215.0,6639.75,0.01,18098.0,175
HCPCS,36478,ENDOVENOUS LASER 1ST VEIN,650.0,422.5,1.1,5442.3,53
HCPCS,36479,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,3358.0,2182.7,0.01,5550.0,99
HCPCS,36479,ENDOVENOUS LASER VEIN ADDON,321.0,208.65,1.1,995.75,53
HCPCS,36481,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1367.0,888.55,0.01,3398.0,138
HCPCS,36482,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,1400.0,910.0,1.1,9382.91,53
HCPCS,36482,ENDOVEN THER CHEM ADHES 1ST,,,4994.76,15596.41,19
HCPCS,36482,Endoven ther chem adhes 1st,,,1698.96,1967.22,8
HCPCS,36483,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,700.0,455.0,1.1,700.0,53
HCPCS,36483,Endoven ther chem adhes sbsq,,,1698.96,1967.22,8
HCPCS,36500,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1660.0,1079.0,0.01,3398.0,92
HCPCS,3650F,Eeg ordered rvwd reqstd,,,8.48,9.82,8
HCPCS,36510,CATHJ UMBILICAL VEIN DX/THER NB,282.5,183.625,1.1,9496.0,99
HCPCS,36511,APHERESIS WBC,,,1473.45,4365.23,19
HCPCS,36511,Apheresis wbc,,,1254.9,1453.05,8
HCPCS,36511,THR APHERESIS WHITE BLD CELL,880.0,572.0,1.1,2619.9,50
HCPCS,36512,THERAPEUTIC APHERESIS RED BLOOD CELLS,9426.0,6126.9,181.97,9426.0,61
HCPCS,36512,THR APHERESIS RED BLOOD CELL,880.0,572.0,1.1,2619.9,50
HCPCS,36513,THERAPEU APHERESIS PLATELETS,880.0,572.0,1.1,880.0,50
HCPCS,36513,THERAPEUTIC APHERESIS PLATELETS,2514.0,1634.1,0.01,4001.0,61
HCPCS,36514,THERAPEUTIC APHERESIS PLASMA,796.0,517.4,1.1,2619.9,53
HCPCS,36514,THERAPEUTIC APHERESIS PLASMA PHERESIS,9426.0,6126.9,160.39,9426.0,61
HCPCS,36516,APHERESIS IMMUNOADS SLCTV,,,4120.64,12207.81,19
HCPCS,36516,Apheresis immunoads slctv,,,1372.76,1589.51,8
HCPCS,36516,THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION,686.0,445.9,1.1,7900.93,53
HCPCS,36522,PHOTOPHERESIS,,,4120.64,12207.81,19
HCPCS,36522,PHOTOPHERESIS EXTRACORPOREAL,770.0,500.5,1.1,7900.93,53
HCPCS,36522,Photopheresis,,,1372.76,1589.51,8
HCPCS,36555,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,9473.5,6157.775000000001,0.01,18098.0,175
HCPCS,36556,INSERTION NON TUNNEL CENT VEN CATH >5,250.0,162.5,1.1,5442.3,53
HCPCS,36556,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,9434.0,6132.1,0.01,18098.0,358
HCPCS,36557,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,31083.0,20203.95,0.01,31083.0,61
HCPCS,36558,INSERTION CATHETER TUNNEL CENTRAL VENOUS,465.0,302.25,1.1,5442.3,53
HCPCS,36558,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,10059.0,6538.35,0.01,18098.0,297
HCPCS,36560,INSERT TUNNELED CV CATH,,,2908.23,8849.94,19
HCPCS,36560,Insert tunneled cv cath,,,1289.42,1493.01,8
HCPCS,36561,INSERT TUNNELED CENT VENOUS CATH >5YRS,582.0,378.3,1.1,5442.3,53
HCPCS,36561,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,10323.0,6709.950000000001,0.01,18098.0,175
HCPCS,36563,INSERT TUNNELED CV CATH,,,4994.76,15596.41,19
HCPCS,36563,INSJ TUNNELED CTR VAD W/SUBQ PUMP,2636.0,1713.4,1.1,9382.91,53
HCPCS,36563,Insert tunneled cv cath,,,1289.42,1493.01,8
HCPCS,36565,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,10323.0,6709.950000000001,0.01,18098.0,114
HCPCS,36566,INSERT TUNNELED CV CATH,,,4994.76,15596.41,19
HCPCS,36566,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,2768.0,1799.2,1.1,13795.55,53
HCPCS,36566,Insert tunneled cv cath,,,1289.42,1493.01,8
HCPCS,36568,INSERTION PICC W/O IMG GDN < 5 YR,4930.0,3204.5,0.01,8932.0,233
HCPCS,36569,INSERTION PERIPH CENTRAL VENOUS CATH,160.0,104.0,1.1,2734.59,50
HCPCS,36569,INSERTION PICC W/O IMG GDN 5 YR/>,4884.0,3174.6,0.01,8932.0,233
HCPCS,36570,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,18098.0,11763.7,0.01,18098.0,61
HCPCS,36571,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,10169.0,6609.85,0.01,18098.0,175
HCPCS,36572,INSERTION PICC W/RS&I < 5 YR,3555.0,2310.75,0.01,3555.0,61
HCPCS,36573,INSERTION PICC W/RS&I 5 YR >,748.0,486.2,1.1,2734.59,53
HCPCS,36573,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,0.01,8932.0,122
HCPCS,36575,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,1911.5,1242.475,0.01,4001.0,114
HCPCS,36576,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,5064.0,3291.6,1.1,8932.0,175
HCPCS,36578,RPLCMT CATH CTR VAD SUBQ PORT/PMP,9707.0,6309.55,1.1,18098.0,114
HCPCS,36580,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,4754.0,3090.1,0.01,8932.0,236
HCPCS,36581,REPLACE VENOUS ACCESS DEVICE W/O PORT,330.0,214.5,1.1,5442.3,53
HCPCS,36581,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,9695.0,6301.75,0.01,18098.0,297
HCPCS,36582,COMPLETE REPLACEMENT OF CENTRALLY TUNNELED PORT.,18098.0,11763.7,475.77,18098.0,61
HCPCS,36582,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,10047.0,6530.55,0.01,18098.0,175
HCPCS,36583,REPLACE TUNNELED CV CATH,,,4994.76,15596.41,19
HCPCS,36583,Replace tunneled cv cath,,,1289.42,1493.01,8
HCPCS,36584,COMPLETE REPLACEMENT PICC RS&I,4706.0,3058.9,0.01,8932.0,236
HCPCS,36585,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,9967.0,6478.55,1.1,18098.0,114
HCPCS,36589,REMOVAL TUNNELED CENTRAL VENOUS CATH,230.0,149.5,1.1,1073.41,53
HCPCS,36589,RMVL TUN CVC W/O SUBQ PORT/PMP,2279.0,1481.35,0.01,3728.0,175
HCPCS,36590,REMOVAL OF TUNNELED CENTRAL VENOUS ACCES,335.0,217.75,1.1,2734.59,53
HCPCS,36590,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,5148.0,3346.2000000000003,0.01,8932.0,175
HCPCS,36591,BLOOD DRAW VENOUS ACCESS DEV,741.0,481.65,28.36,741.0,61
HCPCS,36591,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,388.5,252.52499999999998,0.01,2453.0,294
HCPCS,36592,COLL BLOOD OFF PICC VENOUS,741.0,481.65,28.36,741.0,61
HCPCS,36592,COLLECT BLOOD FROM CATHETER VENOUS NOS,400.0,260.0,0.01,741.0,111
HCPCS,36593,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1209.5,786.175,0.01,3398.0,294
HCPCS,36595,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,9767.0,6348.55,1.1,18098.0,114
HCPCS,36596,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,4616.0,3000.4,0.01,8932.0,175
HCPCS,36597,REPOSITIONAL  CENTRAL VENOUS CATH,110.0,71.5,1.1,2734.59,53
HCPCS,36597,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,4708.0,3060.2000000000003,0.01,8932.0,175
HCPCS,36598,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,753.5,489.775,0.01,4001.0,175
HCPCS,36600,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,434.5,282.425,0.01,2453.0,236
HCPCS,36620,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,964.5,626.925,0.01,3398.0,188
HCPCS,36625,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,1166.5,758.225,0.01,1489.0,96
HCPCS,36640,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,18098.0,11763.7,0.01,18098.0,61
HCPCS,36660,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,406.0,263.9,0.01,560.0,96
HCPCS,36680,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2294.0,1491.1,101.45,3004.0,61
HCPCS,36680,PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION,528.0,343.2,1.1,680.96,50
HCPCS,36800,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,16076.0,10449.4,0.01,31083.0,111
HCPCS,36810,INSERTION OF CANNULA,,,2908.23,8849.94,19
HCPCS,36810,Insertion of cannula,,,1289.42,1493.01,8
HCPCS,36815,INSERTION OF CANNULA,,,4994.76,15596.41,19
HCPCS,36815,Insertion of cannula,,,1289.42,1493.01,8
HCPCS,36818,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,4956.0,3221.4,1.1,9382.91,50
HCPCS,36818,AV FUSE UPPR ARM CEPHALIC,,,4994.76,15596.41,19
HCPCS,36818,Av fuse uppr arm cephalic,,,2503.09,2898.31,8
HCPCS,36818,BRACHIAL ARTERY TO CEPHALIC AV GRAFT,1640.0,1066.0,1.1,9382.91,50
HCPCS,36819,ARTVEN ANAST OPN UPR ARM BASLILIC VEN TRANS,31083.0,20203.95,1184.84,31083.0,61
HCPCS,36819,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,5316.0,3455.4,1.1,9382.91,50
HCPCS,36819,AV FUSION BY BASILIC VEIN,1344.0,873.6,1.1,9382.91,50
HCPCS,36820,AV FUSION/FOREARM VEIN,,,4994.76,15596.41,19
HCPCS,36820,Av fusion/forearm vein,,,2503.09,2898.31,8
HCPCS,36821,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,4760.0,3094.0,1.1,5442.3,50
HCPCS,36821,AV FUSION DIRECT ANY SITE,1248.0,811.2,1.1,8849.94,69
HCPCS,36821,Av fusion direct any site,,,2503.09,2898.31,8
HCPCS,36823,INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL,9192.0,5974.8,1.1,9192.0,50
HCPCS,36823,Insertion of cannula(s),,,2221.81,2572.63,8
HCPCS,36825,ARTERY-VEIN AUTOGRAFT,,,4994.76,15596.41,19
HCPCS,36825,Artery-vein autograft,,,2503.09,2898.31,8
HCPCS,36825,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,5668.0,3684.2,1.1,9382.91,50
HCPCS,36830,ARTERY-VEIN GRAFT,1202.0,781.3,1.1,9382.91,50
HCPCS,36830,ARTERY-VEIN NONAUTOGRAFT,,,4994.76,15596.41,19
HCPCS,36830,Artery-vein nonautograft,,,2503.09,2898.31,8
HCPCS,36830,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,4812.0,3127.8,1.1,9382.91,50
HCPCS,36831,ARTERY-VEIN GRAFT,777.0,505.05,1.1,9382.91,50
HCPCS,36831,OPEN THROMBECT AV FISTULA,,,4994.76,15596.41,19
HCPCS,36831,Open thrombect av fistula,,,2503.09,2898.31,8
HCPCS,36831,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,4400.0,2860.0,1.1,9382.91,50
HCPCS,36832,"AV FISTULA REVISION, OPEN",1022.0,664.3,1.1,9382.91,50
HCPCS,36832,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,18241.5,11856.975,1.1,31083.0,111
HCPCS,36833,AV FISTULA REVISION,1118.0,726.7,1.1,9382.91,50
HCPCS,36833,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,18441.5,11986.975,1.1,31083.0,111
HCPCS,36835,INSERTION THOMAS SHUNT,,,2908.23,8849.94,19
HCPCS,36835,Insertion thomas shunt,,,2503.09,2898.31,8
HCPCS,36836,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,53065.5,34492.575,1.1,103251.0,174
HCPCS,36837,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,53485.5,34765.575,1.1,103251.0,174
HCPCS,36838,DIST REVAS LIGATION HEMO,,,4994.76,15596.41,19
HCPCS,36838,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,8676.0,5639.4,1.1,9382.91,50
HCPCS,36838,Dist revas ligation hemo,,,2503.09,2898.31,8
HCPCS,36860,EXTERNAL CANNULA DECLOTTING,,,1435.35,4412.12,19
HCPCS,36860,External cannula declotting,,,220.33,255.12,8
HCPCS,36861,CANNULA DECLOTTING,,,4994.76,15596.41,19
HCPCS,36861,Cannula declotting,,,2003.13,2319.42,8
HCPCS,36901,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,5138.0,3339.7000000000003,1.1,8932.0,175
HCPCS,36902,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,17358.0,11282.699999999999,0.01,32784.0,236
HCPCS,36903,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,17397.5,11308.375,1.1,32356.61,175
HCPCS,36904,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,17892.0,11629.8,1.1,32784.0,175
HCPCS,36905,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,34404.0,22362.6,1.1,65208.0,175
HCPCS,36906,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,53185.0,34570.25,862.06,53185.0,122
HCPCS,36907,(2017) TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,1200.0,780.0,1.1,1935.14,53
HCPCS,36907,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,16227.0,10547.55,247.51,16227.0,92
HCPCS,36908,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,24406.0,15863.9,348.98,24406.0,92
HCPCS,36909,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,12209.0,7935.85,1.1,22770.0,145
HCPCS,3700F,Psych disorders assessed,,,8.48,9.82,8
HCPCS,37140,Revision of circulation,,,2082.17,2410.94,8
HCPCS,37145,Revision of circulation,,,2221.81,2572.63,8
HCPCS,37160,Revision of circulation,,,2082.17,2410.94,8
HCPCS,37180,Revision of circulation,,,2082.17,2410.94,8
HCPCS,37181,Splice spleen/kidney veins,,,2082.17,2410.94,8
HCPCS,37182,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,11959.5,7773.674999999999,1.1,51380.79,105
HCPCS,37183,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,20388.0,13252.2,0.01,20388.0,122
HCPCS,37184,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,27064.0,17591.6,0.01,51380.79,175
HCPCS,37185,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,3491.0,2269.15,0.01,5539.0,145
HCPCS,37186,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,4598.0,2988.7,1.1,7753.23,99
HCPCS,37187,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,16598.5,10789.025,0.01,32356.61,175
HCPCS,37188,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,10250.0,6662.5,0.01,18098.0,175
HCPCS,37191,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,10170.5,6610.825,0.01,18379.0,175
HCPCS,37191,INSERTION OF INTRAVASCULAR VENA CAVA,510.0,331.5,1.1,9382.91,53
HCPCS,37192,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,568.58,18098.0,61
HCPCS,37193,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,10469.0,6804.85,0.01,18098.0,175
HCPCS,37195,THROMBOLYSIS CEREBRAL IV INFUSION,1991.0,1294.15,1.1,2453.0,99
HCPCS,37197,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,10378.0,6745.700000000001,1.1,18098.0,175
HCPCS,37200,TRANSCATHETER BIOPSY,31083.0,20203.95,0.01,31083.0,122
HCPCS,37200,TRANSVASCULAR BIOPSY,1820.0,1183.0,1.1,9382.91,50
HCPCS,3720F,Cognit impairment assessed,,,8.48,9.82,8
HCPCS,37211,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,31083.0,20203.95,0.01,31083.0,122
HCPCS,37211,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,3100.0,2015.0,1.1,9382.91,50
HCPCS,37212,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,10411.0,6767.150000000001,1.1,18098.0,111
HCPCS,37213,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,9999.0,6499.35,0.01,18098.0,233
HCPCS,37214,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,0.01,18098.0,122
HCPCS,37214,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,1096.0,712.4,1.1,5442.3,50
HCPCS,37215,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,14639.0,9515.35,1.1,21468.0,142
HCPCS,37216,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,13436.0,8733.4,0.01,19680.0,171
HCPCS,37217,Stent placemt retro carotid,,,6105.24,7069.23,8
HCPCS,37217,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,8152.0,5298.8,1.1,8152.0,50
HCPCS,37218,Stent placemt ante carotid,,,6105.24,7069.23,8
HCPCS,37218,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,5900.0,3835.0,1.1,5900.0,50
HCPCS,37220,ILIAC REVASC,,,5268.09,5689.54,6
HCPCS,37220,Iliac revasc,,,3708.64,4294.21,8
HCPCS,37221,ILIAC REVASC W/STENT,,,10478.46,11316.74,6
HCPCS,37221,Iliac revasc w/stent,,,6695.97,7753.23,8
HCPCS,37222,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,7468.0,4854.2,306.45,9608.0,46
HCPCS,37223,Iliac revasc w/stent add-on,,,6695.97,7753.23,8
HCPCS,37224,FEM/POPL REVAS W/TLA,,,5268.09,5689.54,6
HCPCS,37224,Fem/popl revas w/tla,,,3708.64,4294.21,8
HCPCS,37225,FEM/POPL REVAS W/ATHER,,,16591.65,17918.98,6
HCPCS,37225,Fem/popl revas w/ather,,,6695.97,7753.23,8
HCPCS,37226,FEM/POPL REVASC W/STENT,,,10478.46,11316.74,6
HCPCS,37226,Fem/popl revasc w/stent,,,6695.97,7753.23,8
HCPCS,37227,FEM/POPL REVASC STNT & ATHER,,,16591.65,17918.98,6
HCPCS,37227,Fem/popl revasc stnt & ather,,,6695.97,7753.23,8
HCPCS,37228,TIB/PER REVASC W/TLA,,,10478.46,11316.74,6
HCPCS,37228,Tib/per revasc w/tla,,,3708.64,4294.21,8
HCPCS,37229,TIB/PER REVASC W/ATHER,,,16591.65,17918.98,6
HCPCS,37229,Tib/per revasc w/ather,,,6695.97,7753.23,8
HCPCS,37230,TIB/PER REVASC W/STENT,,,16591.65,17918.98,6
HCPCS,37230,Tib/per revasc w/stent,,,6695.97,7753.23,8
HCPCS,37231,TIB/PER REVASC STENT & ATHER,,,16591.65,17918.98,6
HCPCS,37231,Tib/per revasc stent & ather,,,6695.97,7753.23,8
HCPCS,37232,Tib/per revasc add-on,,,6695.97,7753.23,8
HCPCS,37233,Tibper revasc w/ather add-on,,,6695.97,7753.23,8
HCPCS,37234,Revsc opn/prq tib/pero stent,,,6695.97,7753.23,8
HCPCS,37235,Tib/per revasc stnt & ather,,,6695.97,7753.23,8
HCPCS,37236,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,21782.0,14158.3,1.1,40064.0,297
HCPCS,37237,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,7871.0,5116.15,1.1,14042.0,99
HCPCS,37238,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,19796.0,12867.4,1.1,36934.0,175
HCPCS,37239,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,7569.5,4920.174999999999,1.1,13832.0,99
HCPCS,37241,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,34529.0,22443.85,1.1,65208.0,175
HCPCS,37242,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,31489.5,20468.175000000003,1.1,58667.0,236
HCPCS,37243,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,35187.0,22871.55,1.1,65208.0,175
HCPCS,37244,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,25838.0,16794.7,1.1,45626.0,175
HCPCS,37246,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,17932.0,11655.8,1.1,32784.0,236
HCPCS,37247,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,4373.0,2842.45,1.1,7206.0,145
HCPCS,37248,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,17712.0,11512.8,1.1,32784.0,175
HCPCS,37249,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,3355.5,2181.075,1.1,5404.0,145
HCPCS,37252,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,3814.5,2479.425,1.1,6837.0,145
HCPCS,37253,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,2652.5,1724.125,1.1,4671.0,99
HCPCS,37254,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,18323.5,11910.275,1.1,33435.0,90
HCPCS,37255,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,17377.5,11295.375,1.1,33435.0,81
HCPCS,37256,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,19082.5,12403.625,1.1,33435.0,90
HCPCS,37257,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,17573.5,11422.775,1.1,33435.0,81
HCPCS,37258,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,35833.5,23291.775,1.1,67817.0,90
HCPCS,37259,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,34788.5,22612.525,1.1,67817.0,81
HCPCS,3725F,Screen depression performed,,,8.48,9.82,8
HCPCS,37260,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,36700.5,23855.325,1.1,67817.0,90
HCPCS,37261,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,34843.5,22648.275,1.1,67817.0,81
HCPCS,37262,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,1320.0,858.0,1.1,8704.67,35
HCPCS,37262,Iv lithotrp ivt w/in sm art,,,2003.13,2319.42,8
HCPCS,37263,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,18422.5,11974.625,1.1,33435.0,90
HCPCS,37264,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,17377.5,11295.375,1.1,33435.0,81
HCPCS,37265,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,19027.5,12367.875,1.1,33435.0,90
HCPCS,37266,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,17597.5,11438.375,1.1,33435.0,81
HCPCS,37267,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,35833.5,23291.775,1.1,67817.0,90
HCPCS,37268,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,34729.0,22573.850000000002,1.1,67817.0,81
HCPCS,37269,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,37153.5,24149.775,1.1,67817.0,90
HCPCS,37270,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,35008.5,22755.525,1.1,67817.0,81
HCPCS,37271,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,55825.0,36286.25,1.1,107690.0,90
HCPCS,37272,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,54725.0,35571.25,1.1,107690.0,81
HCPCS,37273,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,56623.5,36805.275,1.1,107690.0,90
HCPCS,37274,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,55055.0,35785.75,1.1,107690.0,81
HCPCS,37275,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,56265.0,36572.25,1.1,107690.0,90
HCPCS,37276,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,54780.0,35607.0,1.1,107690.0,81
HCPCS,37277,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,57145.0,37144.25,1.1,107690.0,90
HCPCS,37278,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,55165.0,35857.25,1.1,107690.0,81
HCPCS,37279,INTRAVASCULAR LITHOTRIPSY FPVT W/IN SAME ARTERY,1760.0,1144.0,1.1,11836.32,35
HCPCS,37279,Iv lithotrp fpvt w/in sm art,,,2003.13,2319.42,8
HCPCS,37280,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,36064.5,23441.925000000003,1.1,67817.0,90
HCPCS,37281,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,34568.5,22469.525,1.1,67817.0,81
HCPCS,37282,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,36616.5,23800.725000000002,1.1,67817.0,90
HCPCS,37283,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,34845.5,22649.575,1.1,67817.0,81
HCPCS,37284,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,56045.0,36429.25,1.1,107690.0,90
HCPCS,37285,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,54580.0,35477.0,1.1,107690.0,81
HCPCS,37286,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,56806.0,36923.9,1.1,107690.0,90
HCPCS,37287,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,54945.0,35714.25,1.1,107690.0,81
HCPCS,37288,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,56815.0,36929.75,1.1,107690.0,90
HCPCS,37289,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,54890.0,35678.5,1.1,107690.0,81
HCPCS,37290,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,57585.0,37430.25,1.1,107690.0,90
HCPCS,37291,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,55275.0,35928.75,1.1,107690.0,81
HCPCS,37292,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,57145.0,37144.25,1.1,107690.0,90
HCPCS,37293,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,55275.0,35928.75,1.1,107690.0,81
HCPCS,37294,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,57805.0,37573.25,1.1,107690.0,90
HCPCS,37295,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,55640.0,36166.0,1.1,107690.0,81
HCPCS,37296,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,36328.5,23613.525,1.1,67817.0,90
HCPCS,37297,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,34788.5,22612.525,1.1,67817.0,81
HCPCS,37298,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,36922.5,23999.625,1.1,67817.0,90
HCPCS,37299,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,35008.5,22755.525,1.1,67817.0,81
HCPCS,37500,ENDOSCOPY LIGATE PERF VEINS,,,4994.76,5394.34,6
HCPCS,37500,Endoscopy ligate perf veins,,,2221.81,2572.63,8
HCPCS,37501,UNLISTED VASC ENDOSCOPY PX,,,571.26,1758.23,19
HCPCS,37501,Unlisted vasc endoscopy px,,,534.53,618.93,8
HCPCS,3750F,Ptnotrcvngsteroid>=10mg/day,,,8.48,9.82,8
HCPCS,3751F,Electrodiag polyneuro 6 mn,,,8.48,9.82,8
HCPCS,3752F,No electrodiag polyneuro 6mn,,,8.48,9.82,8
HCPCS,3753F,Pt has symp&signs neuropathy,,,8.48,9.82,8
HCPCS,3754F,Screening tests dm done,,,8.48,9.82,8
HCPCS,3755F,Cog&behav imprmnt scrng done,,,8.48,9.82,8
HCPCS,37565,LIGATION INT JUGULAR VEIN,,,2908.23,8849.94,19
HCPCS,37565,LIGATION INTERNAL JUGULAR VEIN,4820.0,3133.0,1.1,5442.3,50
HCPCS,37565,Ligation int jugular vein,,,987.9,1143.88,8
HCPCS,3756F,Pt w/pseudobulb affect/als,,,8.48,9.82,8
HCPCS,3757F,Pt w/o pseudobulbaffect/als,,,8.48,9.82,8
HCPCS,3758F,Pt ref pulm fx test/peakflow,,,8.48,9.82,8
HCPCS,3759F,Pt scrn dysphag/wt loss/nutr,,,8.48,9.82,8
HCPCS,37600,LIGATION EXTERNAL CAROTID ARTERY,4968.0,3229.2,1.1,5442.3,50
HCPCS,37600,LIGATION XTRNL CAROTID ART,,,2908.23,8849.94,19
HCPCS,37600,Ligation xtrnl carotid art,,,872.27,1010.0,8
HCPCS,37605,LIGATION INT/COM CAROTID ART,,,2908.23,8849.94,19
HCPCS,37605,Ligation int/com carotid art,,,872.27,1010.0,8
HCPCS,37606,LIG INT/COM CAROTID ART OCCL,,,2908.23,8849.94,19
HCPCS,37606,Lig int/com carotid art occl,,,872.27,1010.0,8
HCPCS,37607,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,10299.0,6694.35,0.01,18098.0,111
HCPCS,37607,LIGATION OF A-V FISTULA,692.0,449.8,1.1,5442.3,50
HCPCS,37609,LIGATION/BIOPSY TEMPORAL ARTERY,1220.0,793.0,1.1,2768.64,53
HCPCS,37609,LIGATION/BX TEMPORAL ARTERY,,,1497.07,4629.18,19
HCPCS,37609,Ligation/bx temporal artery,,,987.9,1143.88,8
HCPCS,37609,TEMPORAL ARTERY PROCEDURE,450.0,292.5,1.1,2768.64,53
HCPCS,3760F,Pt w/dysphag/wt loss/nutr,,,8.48,9.82,8
HCPCS,37615,LIGATION MAJOR ARTERY NECK,3120.0,2028.0,1.1,8849.94,69
HCPCS,37615,Ligation major artery neck,,,987.9,1143.88,8
HCPCS,37616,LIGATION MAJOR ARTERY CHEST,7588.0,4932.2,1.1,7588.0,50
HCPCS,37616,Ligation major artery chest,,,2082.17,2410.94,8
HCPCS,37617,LIGATION MAJOR ARTERY ABD,,,5264.43,15596.41,13
HCPCS,37617,LIGATION MAJOR ARTERY ABDOMEN,9516.0,6185.4,1.1,9516.0,50
HCPCS,37617,Ligation major artery abd,,,2082.17,2410.94,8
HCPCS,37618,LIGATION MAJOR ARTERY EXTREMITY,2412.0,1567.8,1.1,2412.0,50
HCPCS,37618,Ligation major artery xtr,,,987.9,1143.88,8
HCPCS,37619,LIGATION OF INF VENA CAVA,,,4994.76,15596.41,19
HCPCS,37619,LIGATION OF INFERIOR VENA CAVA,12000.0,7800.0,1.1,12000.0,50
HCPCS,37619,Ligation of inf vena cava,,,2221.81,2572.63,8
HCPCS,3761F,Pt w/o dysphag/wt loss/nutr,,,8.48,9.82,8
HCPCS,3762F,Patient is dysarthric,,,8.48,9.82,8
HCPCS,3763F,Patient is not dysarthric,,,8.48,9.82,8
HCPCS,37650,LIGATION OF FEMORAL VEIN,3396.0,2207.4,1.1,8849.94,69
HCPCS,37650,Ligation of femoral vein,,,987.9,1143.88,8
HCPCS,37660,LIGATION OF COMMON ILIAC VEIN,8912.0,5792.8,1.1,8912.0,50
HCPCS,37660,Ligation common iliac vein,,,2082.17,2410.94,8
HCPCS,37700,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,9813.0,6378.450000000001,0.01,18098.0,111
HCPCS,37700,LIGATION AND DICISION OF LONG SAPH. VEIN,441.0,286.65,1.1,5442.3,50
HCPCS,37700,REVISE LEG VEIN,485.0,315.25,1.1,5442.3,50
HCPCS,37718,LIG DIV&STRPG SHORT SAPH VN,,,2908.23,8849.94,19
HCPCS,37718,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,2852.0,1853.8,1.1,5442.3,50
HCPCS,37718,Lig div&strpg short saph vn,,,1698.96,1967.22,8
HCPCS,37722,LIG DIV&STRPG LONG SAPH VEIN,,,2908.23,8849.94,19
HCPCS,37722,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,3590.0,2333.5,1.1,5442.3,50
HCPCS,37722,Lig div&strpg long saph vein,,,1698.96,1967.22,8
HCPCS,37735,LIG&DIV&COMPL STRPG SAPH VN,,,2908.23,8849.94,19
HCPCS,37735,Lig&div&compl strpg saph vn,,,1698.96,1967.22,8
HCPCS,3775F,Adenoma detected screening,,,8.48,9.82,8
HCPCS,37760,LIG PRFRATR VN RADICAL 1 LEG,,,2908.23,8849.94,19
HCPCS,37760,Lig prfratr vn radical 1 leg,,,1698.96,1967.22,8
HCPCS,37761,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,10875.0,7068.75,0.01,18098.0,111
HCPCS,37761,LIGATE LEG VEINS OPEN,1100.0,715.0,1.1,5442.3,50
HCPCS,37765,PHLEB VEINS - EXTREM - TO 20,2112.0,1372.8,1.1,5442.3,53
HCPCS,37765,STAB PHLEBECTOMY V/VEINS 10-20,840.0,546.0,1.1,5442.3,53
HCPCS,37765,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,10105.0,6568.25,0.01,18098.0,114
HCPCS,37766,PHLEB VEINS - EXTREM 20+,2640.0,1716.0,1.1,5442.3,53
HCPCS,37766,STAB PHLEBECTOMY OF VARICOSE VEINS,935.0,607.75,1.1,5442.3,53
HCPCS,37766,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,10369.0,6739.85,0.01,18098.0,114
HCPCS,3776F,Adenoma not detect screening,,,8.48,9.82,8
HCPCS,37780,REVISION OF LEG VEIN,,,2908.23,8849.94,19
HCPCS,37780,Revision of leg vein,,,1698.96,1967.22,8
HCPCS,37785,LIGATE/DIVIDE/EXCISE VEIN,,,2908.23,8849.94,19
HCPCS,37785,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,1729.0,1123.85,1.1,5442.3,53
HCPCS,37785,Ligate/divide/excise vein,,,1698.96,1967.22,8
HCPCS,37788,Revascularization penis,,,2232.32,2584.79,8
HCPCS,37790,PENILE VENOUS OCCLUSION,,,3186.78,9879.99,19
HCPCS,37790,Penile venous occlusion,,,946.85,1096.35,8
HCPCS,37799,AORTIC ARTERIAL JUMP GRAFT (COMP CODE 47147),2521.0,1638.65,0.01,2521.0,28
HCPCS,37799,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,5400.5,3510.325,0.01,6801.0,89
HCPCS,37799,CREATION OF MESORENAL SHUNT (SUP MESENTERIC VEIN TO RENAL VEIN),14401.0,9360.65,0.01,14401.0,28
HCPCS,37799,CRYOABLATION AVM (COMP CODE 20983),17806.5,11574.225,0.01,32861.0,89
HCPCS,37799,DISRUPTION-FIBRIN SHEATH W/BALLOON,3448.0,2241.2,571.26,4001.0,61
HCPCS,37799,EXCISION /LIGATION ABDOMINAL VEINS (COMP CODE 35221),11314.0,7354.1,0.01,11314.0,28
HCPCS,37799,EXCISION OF INTERNAL JUGULAR VEIN TUMOR THROMBUS (COMP CODE 3447,7600.0,4940.0,0.01,7600.0,28
HCPCS,37799,EXCISION OF VEIN (COMP CODE 35206),3121.0,2028.65,0.01,3121.0,28
HCPCS,37799,"EXPLORATION OF VEIN, NOT FOLLOWED BY SURGICAL REPAIR (COMP CODE",2848.0,1851.2,0.01,2848.0,28
HCPCS,37799,EXTERNAL CAROTID ART ONLY UNI,6652.0,4323.8,571.26,6652.0,61
HCPCS,37799,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),9767.0,6348.55,0.01,18098.0,89
HCPCS,37799,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,964.5,626.925,0.01,4001.0,89
HCPCS,37799,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),3693.0,2400.45,0.01,6466.0,89
HCPCS,37799,STAB INCISION UNDER 10 (COMP CODE 37765),1350.0,877.5,0.01,1350.0,28
HCPCS,37799,STAB PHLEBECTOMY VV <10 INCN,3400.0,2210.0,0.01,4001.0,61
HCPCS,37799,SURFACE LASER SPIDER VEINS,364.0,236.6,0.01,4001.0,61
HCPCS,37799,UNLISTED OPEN DILATION INTERNAL CAROTID ARTERY UTILIZIING DILATO,2378.0,1545.7,0.01,2378.0,28
HCPCS,37799,"UNLISTED PROC, VASC SURGERY COMPARED TO 37785",1297.0,843.05,0.01,1297.0,28
HCPCS,37799,UNLISTED PROCEDURE VASCULAR SURGERY,340.0,221.0,0.01,1073.41,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR COMPARED TO 26111",1785.0,1160.25,0.01,1785.0,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY",1554.0,1010.1,0.01,1554.0,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 33417)",4900.0,3185.0,0.01,4900.0,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 34490)",1840.0,1196.0,0.01,1840.0,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 34825)",4198.0,2728.7,0.01,4198.0,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 36471)",330.0,214.5,0.01,1073.41,28
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 37765)",1350.0,877.5,0.01,1350.0,28
HCPCS,37799,UNLISTED VASC PROCEDURE,3798.0,2468.7,571.26,4001.0,61
HCPCS,37799,VASCULAR SURGERY PROCEDURE,110.0,71.5,0.01,1073.41,28
HCPCS,37799,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),26498.0,17223.7,0.01,49016.0,89
HCPCS,38100,Removal of spleen total,,,1611.33,1865.75,8
HCPCS,38100,SPLENECTOMY TOTAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,50
HCPCS,38101,Removal of spleen partial,,,1611.33,1865.75,8
HCPCS,38101,SPLENECTOMY PARTIAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,50
HCPCS,38102,Removal of spleen total,,,1611.33,1865.75,8
HCPCS,38102,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,1916.0,1245.4,1.1,1916.0,50
HCPCS,38115,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,8752.0,5688.8,1.1,8752.0,50
HCPCS,38115,Repair of ruptured spleen,,,1611.33,1865.75,8
HCPCS,38120,LAPAROSCOPY SPLENECTOMY,,,9619.76,29793.81,19
HCPCS,38120,"LAPAROSCOPY, SURGICAL, SPLENECTOMY",6828.0,4438.2,1.1,17575.94,50
HCPCS,38120,Laparoscopy splenectomy,,,1611.33,1865.75,8
HCPCS,38129,LAPAROSCOPIC PARTIAL SPLENECTOMY (COMP TO 38101),6452.0,4193.8,0.01,9852.42,28
HCPCS,38129,"UNLIST LAP PROC, SPLEEN COMPARED TO 47300",5986.0,3890.9,0.01,9852.42,28
HCPCS,38129,"UNLISTED LAPAROSCOPY PROCEDURE, SPLEEN (COMPARISON CODE 38101)",2400.0,1560.0,0.01,9852.42,28
HCPCS,38129,UNLISTED LAPS PX SPLEEN,,,5390.83,16944.69,19
HCPCS,38129,Unlisted laps px spleen,,,1611.33,1865.75,8
HCPCS,38200,Injection for spleen x-ray,,,65.08,75.36,8
HCPCS,38204,Bl donor search management,,,321.96,372.8,8
HCPCS,38205,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,660.0,429.0,1.1,660.0,50
HCPCS,38205,Harvest allogeneic stem cell,,,1254.9,1453.05,8
HCPCS,38206,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,660.0,429.0,1.1,2619.9,50
HCPCS,38206,HARVEST AUTO STEM CELLS,,,1473.45,4365.23,19
HCPCS,38206,Harvest auto stem cells,,,1254.9,1453.05,8
HCPCS,38207,CRYOPRESERVE STEM CELLS,,,403.95,1236.54,19
HCPCS,38207,Cryopreserve stem cells,,,1254.9,1453.05,8
HCPCS,38208,THAW PRESERVED STEM CELLS,,,403.95,1236.54,19
HCPCS,38208,Thaw preserved stem cells,,,1254.9,1453.05,8
HCPCS,38209,WASH HARVEST STEM CELLS,,,403.95,1236.54,19
HCPCS,38209,Wash harvest stem cells,,,1254.9,1453.05,8
HCPCS,38210,T-CELL DEPLETION OF HARVEST,,,403.95,1236.54,19
HCPCS,38210,T-cell depletion of harvest,,,1254.9,1453.05,8
HCPCS,38211,TUMOR CELL DEPLETE OF HARVST,,,403.95,1236.54,19
HCPCS,38211,Tumor cell deplete of harvst,,,1254.9,1453.05,8
HCPCS,38212,RBC DEPLETION OF HARVEST,,,403.95,1236.54,19
HCPCS,38212,Rbc depletion of harvest,,,360.34,417.23,8
HCPCS,38213,PLATELET DEPLETE OF HARVEST,,,403.95,1236.54,19
HCPCS,38213,Platelet deplete of harvest,,,1254.9,1453.05,8
HCPCS,38214,VOLUME DEPLETE OF HARVEST,,,403.95,1236.54,19
HCPCS,38214,Volume deplete of harvest,,,1254.9,1453.05,8
HCPCS,38215,HARVEST STEM CELL CONCENTRTE,,,403.95,1236.54,19
HCPCS,38215,Harvest stem cell concentrte,,,1254.9,1453.05,8
HCPCS,38220,DIAGNOSTIC BONE MARROW ASPIRATIONS,3480.5,2262.325,0.01,6481.0,114
HCPCS,38221,DIAGNOSTIC BONE MARROW BIOPSIES,3496.5,2272.725,0.01,6481.0,175
HCPCS,38222,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,6041.0,3926.65,0.01,11448.0,175
HCPCS,38225,CAR-T THERAPY HRVG BLD-DRV T LYMPHCYT PR DAY,854.0,555.1,1.1,854.0,37
HCPCS,38225,Car-t hrv bld-drv t lymphcyt,,,118.45,137.15,8
HCPCS,38226,CAR-T THERAPY PREPJ BLD-DRV T LYMPHCYT F/TRNS,348.0,226.2,1.1,348.0,37
HCPCS,38226,Car-t prep t lymphcyt f/trns,,,118.45,137.15,8
HCPCS,38227,CAR-T THERAPY RECEIPT & PREPJ CAR-T CELLS F/ADMN,352.0,228.8,1.1,4330.51,37
HCPCS,38227,Car-t receipt&prepj admn,,,118.45,137.15,8
HCPCS,38228,CAR-T ADMN AUTOLOGOUS,,,306.47,925.8,19
HCPCS,38228,CAR-T THERAPY AUTOL CAR-T CELL ADMINISTRATION,1320.0,858.0,1.1,1449.2,51
HCPCS,38228,Car-t admn autologous,,,118.45,137.15,8
HCPCS,38230,BONE MARROW HARVEST ALLOGEN,,,1473.45,4365.23,19
HCPCS,38230,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,1400.0,910.0,1.1,2619.9,50
HCPCS,38230,Bone marrow harvest allogen,,,1254.9,1453.05,8
HCPCS,38232,BONE MARROW HARVEST AUTOLOG,,,4120.64,12207.81,19
HCPCS,38232,Bone marrow harvest autolog,,,1254.9,1453.05,8
HCPCS,38240,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,66490.0,43218.5,1.1,176302.27,111
HCPCS,38241,TRANSPLT AUTOL HCT/DONOR,,,1473.45,4365.23,19
HCPCS,38241,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,1320.0,858.0,1.1,2619.9,50
HCPCS,38241,Transplt autol hct/donor,,,1254.9,1453.05,8
HCPCS,38242,ALLOGENEIC LYMPHOCYTE INFUSIONS,928.0,603.2,1.1,2619.9,50
HCPCS,38242,TRANSPLT ALLO LYMPHOCYTES,,,1473.45,4365.23,19
HCPCS,38242,Transplt allo lymphocytes,,,1254.9,1453.05,8
HCPCS,38243,TRANSPLJ HEMATOPOIETIC BOOST,,,1473.45,4365.23,19
HCPCS,38243,Transplj hematopoietic boost,,,1254.9,1453.05,8
HCPCS,38300,DRAINAGE LYMPH NODE LESION,,,2644.48,8141.48,19
HCPCS,38300,"DRAINAGE OF LYMPH NODE, SIMPLE",545.0,354.25,1.1,4850.94,53
HCPCS,38300,Drainage lymph node lesion,,,1795.98,2079.56,8
HCPCS,38305,DRAINAGE LYMPH NODE LESION,,,2644.48,8141.48,19
HCPCS,38305,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,2672.0,1736.8,1.1,4850.94,50
HCPCS,38305,Drainage lymph node lesion,,,1795.98,2079.56,8
HCPCS,38308,INCISION OF LYMPH CHANNELS,,,3538.18,10974.37,19
HCPCS,38308,Incision of lymph channels,,,1795.98,2079.56,8
HCPCS,38380,Thoracic duct procedure,,,1795.98,2079.56,8
HCPCS,38381,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,5352.0,3478.8,1.1,5352.0,50
HCPCS,38381,Thoracic duct procedure,,,2519.91,2917.79,8
HCPCS,38382,Thoracic duct procedure,,,1611.33,1865.75,8
HCPCS,38500,BIOPSY/EXCISION OF LYMPH NODE OPEN,460.0,299.0,1.1,6508.54,53
HCPCS,38500,BIOPSY/REMOVAL LYMPH NODES,,,3538.18,10974.37,19
HCPCS,38500,BX/EXC LYMPH NODE OPEN SUPERFICIAL,1516.0,985.4,1.1,6508.54,53
HCPCS,38500,Biopsy/removal lymph nodes,,,1795.98,2079.56,8
HCPCS,38505,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,3558.5,2313.0249999999996,0.01,6481.0,236
HCPCS,38510,BIOPSY/REMOVAL LYMPH NODES,,,3538.18,10974.37,20
HCPCS,38510,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,2696.0,1752.4,1.1,6508.54,53
HCPCS,38510,Biopsy/removal lymph nodes,,,1795.98,2079.56,8
HCPCS,38520,BIOPSY/REMOVAL LYMPH NODES,,,3538.18,10974.37,19
HCPCS,38520,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,2812.0,1827.8,1.1,6508.54,50
HCPCS,38520,Biopsy/removal lymph nodes,,,1795.98,2079.56,8
HCPCS,38525,BIOPSY/REMOVAL LYMPH NODES,,,3538.18,10974.37,20
HCPCS,38525,"BIOPSY/REMOVAL, LYMPH NODES",811.0,527.15,1.1,6508.54,50
HCPCS,38525,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,2572.0,1671.8,1.1,6508.54,50
HCPCS,38525,Biopsy/removal lymph nodes,,,1795.98,2079.56,8
HCPCS,38530,BIOPSY/REMOVAL LYMPH NODES,,,3538.18,10974.37,19
HCPCS,38530,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,3336.0,2168.4,1.1,6508.54,50
HCPCS,38530,Biopsy/removal lymph nodes,,,1795.98,2079.56,8
HCPCS,38531,OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,2696.0,1752.4,1.1,6508.54,50
HCPCS,38531,OPEN BX/EXC INGUINOFEM NODES,,,3538.18,10974.37,19
HCPCS,38531,Open bx/exc inguinofem nodes,,,1795.98,2079.56,8
HCPCS,38542,DISSECTION DEEP JUGULAR NODE,3180.0,2067.0,1.1,9852.42,50
HCPCS,38542,EXPLORE DEEP NODE(S) NECK,,,5390.83,16944.69,19
HCPCS,38542,Explore deep node(s) neck,,,1795.98,2079.56,8
HCPCS,38550,REMOVAL NECK/ARMPIT LESION,,,3538.18,10974.37,19
HCPCS,38550,Removal neck/armpit lesion,,,1795.98,2079.56,8
HCPCS,38555,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,6236.0,4053.4,1.1,11133.7,50
HCPCS,38555,REMOVAL NECK/ARMPIT LESION,,,6025.7,18611.38,19
HCPCS,38555,Removal neck/armpit lesion,,,1795.98,2079.56,8
HCPCS,38562,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,4424.0,2875.6,1.1,4424.0,50
HCPCS,38562,REMOVAL PELVIC LYMPH NODES,,,7732.66,22908.77,13
HCPCS,38562,Removal pelvic lymph nodes,,,1611.33,1865.75,8
HCPCS,38564,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,4552.0,2958.8,1.1,4552.0,50
HCPCS,38564,Removal abdomen lymph nodes,,,1611.33,1865.75,8
HCPCS,38570,LAPAROSCOPY LYMPH NODE BIOP,,,5390.83,16944.69,20
HCPCS,38570,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,3736.0,2428.4,1.1,9852.42,50
HCPCS,38570,Laparoscopy lymph node biop,,,1611.33,1865.75,8
HCPCS,38571,LAPAROSCOPY LYMPHADENECTOMY,,,9608.0,29793.81,20
HCPCS,38571,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,5280.0,3432.0,1.1,17575.94,50
HCPCS,38571,Laparoscopy lymphadenectomy,,,1611.33,1865.75,8
HCPCS,38572,LAPAROSCOPY LYMPHADENECTOMY,,,9619.76,29793.81,19
HCPCS,38572,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,6240.0,4056.0,1.1,17575.94,50
HCPCS,38572,Laparoscopy lymphadenectomy,,,1611.33,1865.75,8
HCPCS,38573,LAPS PELVIC LYMPHADEC,,,9619.76,29793.81,19
HCPCS,38573,LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX,8000.0,5200.0,1.1,17575.94,50
HCPCS,38573,Laps pelvic lymphadec,,,1611.33,1865.75,8
HCPCS,38589,LAP ROBOTIC RETROPERITONEAL LYMPHADENECTOMY COMP 38780,7016.0,4560.4,0.01,9852.42,28
HCPCS,38589,"UNLIST LAP PROC, LYMPHATIC SYSTEM COMPARED TO 38747",1610.0,1046.5,0.01,9852.42,28
HCPCS,38589,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",1500.0,975.0,0.01,9852.42,84
HCPCS,38589,UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM,350.0,227.5,0.01,9852.42,28
HCPCS,38589,UNLISTED LAPS PX LYMPHTC SYS,,,5390.83,16944.69,19
HCPCS,38589,UNLISTED PROC; LAP INGUINAL LYMPH NODE DISSECTION (COMPARED TO 3,1360.0,884.0,0.01,9852.42,28
HCPCS,38589,Unlisted laps px lymphtc sys,,,1611.33,1865.75,8
HCPCS,38700,REMOVAL OF LYMPH NODES NECK,,,6025.7,18611.38,19
HCPCS,38700,Removal of lymph nodes neck,,,1795.98,2079.56,8
HCPCS,38700,SUPRAHYOID LYMPHADENECTOMY,5124.0,3330.6,1.1,11133.7,50
HCPCS,38720,REMOVAL OF LYMPH NODES NECK,,,6025.7,18611.38,19
HCPCS,38720,Removal of lymph nodes neck,,,1795.98,2079.56,8
HCPCS,38724,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,9580.0,6227.0,1.1,9580.0,50
HCPCS,38724,Removal of lymph nodes neck,,,1795.98,2079.56,8
HCPCS,38740,AXILLARY LYMPHADENECTOMY SUPERFICIAL,4280.0,2782.0,1.1,9852.42,50
HCPCS,38740,REMOVE ARMPIT LYMPH NODES,,,5390.83,16944.69,19
HCPCS,38740,Remove armpit lymph nodes,,,1360.39,1575.19,8
HCPCS,38745,AXILLARY LYMPHADENECTOMY COMPLETE,5548.0,3606.2,1.1,9852.42,50
HCPCS,38745,REMOVE ARMPIT LYMPH NODES,1485.0,965.25,1.1,16944.69,69
HCPCS,38745,Remove armpit lymph nodes,,,1360.39,1575.19,8
HCPCS,38746,Remove thoracic lymph nodes,,,534.53,618.93,8
HCPCS,38746,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,1648.0,1071.2,1.1,1648.0,50
HCPCS,38747,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,1952.0,1268.8,1.1,1952.0,50
HCPCS,38747,ABDOMINAL LYMPHADENECTOMY,640.0,416.0,1.1,910.82,50
HCPCS,38747,Remove abdominal lymph nodes,,,1611.33,1865.75,8
HCPCS,38760,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,5448.0,3541.2,1.1,11133.7,50
HCPCS,38760,REMOVE GROIN LYMPH NODES,,,6025.7,18611.38,19
HCPCS,38760,Remove groin lymph nodes,,,1795.98,2079.56,8
HCPCS,38765,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,8764.0,5696.6,1.1,8764.0,50
HCPCS,38765,Remove groin lymph nodes,,,1795.98,2079.56,8
HCPCS,38770,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,5624.0,3655.6,1.1,5624.0,50
HCPCS,38770,Remove pelvis lymph nodes,,,1611.33,1865.75,8
HCPCS,38780,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,7080.0,4602.0,1.1,7080.0,50
HCPCS,38780,Remove abdomen lymph nodes,,,1611.33,1865.75,8
HCPCS,38790,INJECTION PROCEDURE LYMPHANGIOGRAPHY,2162.5,1405.625,0.01,3757.0,142
HCPCS,38792,IDENTIFY SENTINEL NODE,81.0,52.65,1.1,704.26,53
HCPCS,38792,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,933.5,606.775,0.01,3004.0,175
HCPCS,38794,CANNULATION THORACIC DUCT,7147.0,4645.55,283.94,9496.0,46
HCPCS,38900,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,1000.0,650.0,1.1,1000.0,50
HCPCS,38900,INTRAPOPERATIVE MAPPING OF LYMPH NODES,360.0,234.0,1.1,469.57,50
HCPCS,38900,IO MAP OF SENT LYMPH NODE,,,3398.0,3398.0,1
HCPCS,38900,Io map of sent lymph node,,,65.08,75.36,8
HCPCS,38999,"IMMEDIATE LVA (COMP 35206, 38308, 69990)",4774.0,3103.1,0.01,4774.0,28
HCPCS,38999,"THERAPEUTIC LVA (COMP 35206, 38308, 69990)",3412.0,2217.8,0.01,3412.0,28
HCPCS,38999,UNLISTD PX HEMIC/LYMPHTC SYS,,,403.95,1236.54,19
HCPCS,38999,UNLISTED MAGTRACE INJECTION ADMINISTRATION (COMP CODE 38900),1063.0,690.95,0.01,1063.0,28
HCPCS,38999,"UNLISTED PROC, BX OF EPIGASTRIC LYMPH NODE (COMP CODE 38531)",2224.0,1445.6,0.01,2224.0,28
HCPCS,38999,UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,968.0,629.2,0.01,968.0,28
HCPCS,38999,"UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM (COMPARISON CODE 3",410.0,266.5,0.01,741.89,28
HCPCS,38999,Unlistd px hemic/lymphtc sys,,,1795.98,2079.56,8
HCPCS,39000,Exploration of chest,,,1367.07,1582.92,8
HCPCS,39010,Exploration of chest,,,2519.91,2917.79,8
HCPCS,39010,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,5276.0,3429.4,1.1,5276.0,50
HCPCS,39200,RESECTION OF MEDIASTINAL CYST,6036.0,3923.4,1.1,6036.0,50
HCPCS,39200,Resect mediastinal cyst,,,2519.91,2917.79,8
HCPCS,39220,RESECTION MEDIASTINAL TUMOR,7820.0,5083.0,1.1,7820.0,50
HCPCS,39220,Resect mediastinal tumor,,,2519.91,2917.79,8
HCPCS,39401,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,2176.0,1414.4,1.1,9852.42,50
HCPCS,39401,MEDIASTINOSCPY W/MEDSTNL BX,,,5390.83,16944.69,19
HCPCS,39401,Mediastinoscpy w/medstnl bx,,,1367.07,1582.92,8
HCPCS,39402,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,2900.0,1885.0,1.1,9852.42,50
HCPCS,39402,MEDIASTINOSCPY W/LMPH NOD BX,,,5390.83,16944.69,19
HCPCS,39402,Mediastinoscpy w/lmph nod bx,,,1367.07,1582.92,8
HCPCS,39499,Unlisted px mediastinum,,,603.71,699.03,8
HCPCS,39501,REPAIR LACERATION DIAPHRAGM ANY APPROACH,5592.0,3634.8,1.1,5592.0,50
HCPCS,39501,Repair diaphragm laceration,,,4428.42,5127.64,8
HCPCS,39503,Repair of diaphragm hernia,,,4428.42,5127.64,8
HCPCS,39540,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,5828.0,3788.2,1.1,5828.0,50
HCPCS,39540,Repair of diaphragm hernia,,,4428.42,5127.64,8
HCPCS,39541,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,6300.0,4095.0,1.1,6300.0,50
HCPCS,39541,Repair of diaphragm hernia,,,4428.42,5127.64,8
HCPCS,39545,IMBRICATION DIAPHRAGM EVENTRATION,5868.0,3814.2,1.1,5868.0,50
HCPCS,39545,Revision of diaphragm,,,4428.42,5127.64,8
HCPCS,39560,RESCJ DIAPHRAGM W/SIMPLE REPAIR,5224.0,3395.6,1.1,5224.0,50
HCPCS,39560,Resect diaphragm simple,,,4428.42,5127.64,8
HCPCS,39561,RESCJ DIAPHRAGM W/COMPLEX REPAIR,7996.0,5197.4,1.1,7996.0,50
HCPCS,39561,Resect diaphragm complex,,,4428.42,5127.64,8
HCPCS,39599,DIAPHRAGM SURG PROC UNLISTED,2657.0,1727.05,0.01,1792000.0,28
HCPCS,39599,LAP OR ROBOTIC REPAIR OF DIAPHRAGMATIC HERNIA; CHRONIC (COMP COD,5671.0,3686.15,0.01,1792000.0,28
HCPCS,39599,"UNLISTED PROC, LAPAROSCOPIC REPAIR OF DIAPHRAGMATIC HERNIA (NON-",4808.0,3125.2,0.01,1792000.0,28
HCPCS,39599,UNLISTED PROC; LAP DIAPHRAGM RESECTION (COMP TO 39560),5224.0,3395.6,0.01,1792000.0,28
HCPCS,39599,"UNLISTED PROCEDURE, DIAPHRAGM (COMPARISON CODE 39541)",5198.0,3378.7,0.01,1792000.0,28
HCPCS,39599,"UNLISTED PROCEDURE, DIAPHRAGM (COMPARISON CODE 39560)",1670.0,1085.5,0.01,1792000.0,28
HCPCS,39599,"UNLISTED PROCEDURE, DIAPHRAGM (COMPARISON CODE 39561)",2580.0,1677.0,0.01,1792000.0,28
HCPCS,39599,UNLISTED THORACOSCOPIC REPAIR CONGENITAL DIAPHRAGMATIC HERNIA-NE,43564.0,28316.6,0.01,1792000.0,28
HCPCS,39599,Unlisted px diaphragm,,,4428.42,5127.64,8
HCPCS,4000F,Tobacco use txmnt counseling,,,8.48,9.82,8
HCPCS,4001F,Tobacco use txmnt pharmacol,,,8.48,9.82,8
HCPCS,4003F,Pt ed write/oral pts w/ hf,,,8.48,9.82,8
HCPCS,4004F,Pt tobacco screen rcvd tlk,,,8.48,9.82,8
HCPCS,4005F,Pharm thx for op rxd,,,8.48,9.82,8
HCPCS,4008F,Beta-blocker therapy rxd/tkn,,,8.48,9.82,8
HCPCS,4010F,Ace/arb therapy rxd/taken,,,8.48,9.82,8
HCPCS,4011F,Oral antiplatelet therapy rx,,,8.48,9.82,8
HCPCS,4012F,Warfarin therapy rx,,,8.48,9.82,8
HCPCS,4013F,Statin therapy/currently tkn,,,8.48,9.82,8
HCPCS,4014F,Written discharge instr prvd,,,8.48,9.82,8
HCPCS,4015F,Persist asthma medicine ctrl,,,8.48,9.82,8
HCPCS,4016F,Anti-inflm/anlgsc agent rx,,,8.48,9.82,8
HCPCS,4017F,Gi prophylaxis for nsaid rx,,,8.48,9.82,8
HCPCS,4018F,Therapy exercise joint rx,,,8.48,9.82,8
HCPCS,4019F,Doc recpt counsl vit d/calc+,,,8.48,9.82,8
HCPCS,4025F,Inhaled bronchodilator rx,,,8.48,9.82,8
HCPCS,4030F,Oxygen therapy rx,,,8.48,9.82,8
HCPCS,4033F,Pulmonary rehab rec,,,8.48,9.82,8
HCPCS,4035F,Influenza imm rec,,,8.48,9.82,8
HCPCS,4037F,Influenza imm order/admin,,,8.48,9.82,8
HCPCS,4040F,Pneumoc vac/admin/rcvd,,,8.48,9.82,8
HCPCS,4041F,Doc order cefazolin/cefurox,,,8.48,9.82,8
HCPCS,4042F,Doc antibio not given,,,8.48,9.82,8
HCPCS,4043F,Doc order given stop antibio,,,8.48,9.82,8
HCPCS,4044F,Doc order given vte prophylx,,,8.48,9.82,8
HCPCS,4045F,Empiric antibiotic rx,,,8.48,9.82,8
HCPCS,4046F,Doc antibio given b/4 surg,,,8.48,9.82,8
HCPCS,4047F,Doc antibio given b/4 surg,,,8.48,9.82,8
HCPCS,4048F,Doc antibio given b/4 surg,,,8.48,9.82,8
HCPCS,40490,BIOPSY OF LIP,488.0,317.2,1.1,663.85,72
HCPCS,40490,Biopsy of lip,,,85.44,98.93,8
HCPCS,4049F,Doc order given stop antibio,,,8.48,9.82,8
HCPCS,40500,PARTIAL EXCISION OF LIP,,,2996.53,9292.73,19
HCPCS,40500,Partial excision of lip,,,745.85,863.61,8
HCPCS,40500,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,1788.0,1162.2,1.1,5497.86,53
HCPCS,4050F,Ht care plan doc,,,8.48,9.82,8
HCPCS,40510,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,1928.0,1253.2,1.1,5497.86,53
HCPCS,40510,PARTIAL EXCISION OF LIP,,,2996.53,9292.73,19
HCPCS,40510,Partial excision of lip,,,1237.01,1432.33,8
HCPCS,4051F,Referred for an av fistula,,,8.48,9.82,8
HCPCS,40520,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1916.0,1245.4,1.1,5497.86,53
HCPCS,40520,PARTIAL EXCISION OF LIP,,,2996.53,9292.73,19
HCPCS,40520,Partial excision of lip,,,745.85,863.61,8
HCPCS,40525,RECONSTRUCT LIP WITH FLAP,,,2996.53,9292.73,19
HCPCS,40525,Reconstruct lip with flap,,,1237.01,1432.33,8
HCPCS,40527,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,3728.0,2423.2,1.1,9999.36,50
HCPCS,40527,RECONSTRUCT LIP WITH FLAP,,,5465.95,16592.38,19
HCPCS,40527,Reconstruct lip with flap,,,2151.73,2491.48,8
HCPCS,4052F,Hemodialysis via av fistula,,,8.48,9.82,8
HCPCS,40530,PARTIAL REMOVAL OF LIP,,,2996.53,9292.73,19
HCPCS,40530,Partial removal of lip,,,1237.01,1432.33,8
HCPCS,4053F,Hemodialysis via av graft,,,8.48,9.82,8
HCPCS,4054F,Hemodialysis via catheter,,,8.48,9.82,8
HCPCS,4055F,Pt rcvng periton dialysis,,,8.48,9.82,8
HCPCS,4056F,Approp oral rehyd recommd,,,8.48,9.82,8
HCPCS,4058F,Ped gastro ed given caregvr,,,8.48,9.82,8
HCPCS,4060F,Psych svcs provided,,,8.48,9.82,8
HCPCS,4062F,Pt referral psych docd,,,8.48,9.82,8
HCPCS,4063F,Antidepres rxthxpy not rxd,,,8.48,9.82,8
HCPCS,4064F,Antidepressant rx,,,8.48,9.82,8
HCPCS,40650,RPR LIP FULL THICKNESS VERMILION ONLY,1927.5,1252.875,0.01,6561.0,175
HCPCS,40652,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2057.5,1337.375,1.1,6561.0,114
HCPCS,40654,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,4503.0,2926.9500000000003,1.1,6814.0,114
HCPCS,4065F,Antipsychotic rx,,,8.48,9.82,8
HCPCS,4066F,Ect provided,,,8.48,9.82,8
HCPCS,4067F,Pt referral for ect docd,,,8.48,9.82,8
HCPCS,4069F,Vte prophylaxis rcvd,,,8.48,9.82,8
HCPCS,40700,REPAIR CLEFT LIP/NASAL,,,5465.95,16592.38,19
HCPCS,40700,Repair cleft lip/nasal,,,2630.78,3046.16,8
HCPCS,40701,REPAIR CLEFT LIP/NASAL,,,5465.95,16592.38,19
HCPCS,40701,Repair cleft lip/nasal,,,2630.78,3046.16,8
HCPCS,40702,REPAIR CLEFT LIP/NASAL,,,5465.95,16592.38,19
HCPCS,40702,Repair cleft lip/nasal,,,2630.78,3046.16,8
HCPCS,4070F,Dvt prophylx recvd day 2,,,8.48,9.82,8
HCPCS,40720,REPAIR CLEFT LIP/NASAL,,,2996.53,9292.73,19
HCPCS,40720,Repair cleft lip/nasal,,,2630.78,3046.16,8
HCPCS,4073F,Oral antiplat thx rx dischrg,,,8.48,9.82,8
HCPCS,4075F,Anticoag thx rx at dischrg,,,8.48,9.82,8
HCPCS,40761,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,6336.0,4118.4,1.1,9999.36,50
HCPCS,40761,REPAIR CLEFT LIP/NASAL,,,5465.95,16592.38,19
HCPCS,40761,Repair cleft lip/nasal,,,2630.78,3046.16,8
HCPCS,4077F,Doc t-pa admin considered,,,8.48,9.82,8
HCPCS,40799,"UNLISTED PROCEDURE, LIPS",661.0,429.65,186.93,2453.0,61
HCPCS,4079F,Doc rehab svcs considered,,,8.48,9.82,8
HCPCS,40800,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,1864.5,1211.9250000000002,1.1,3237.0,114
HCPCS,40801,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,1697.5,1103.375,1.1,4001.0,114
HCPCS,40804,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,2416.5,1570.725,1.1,4313.0,114
HCPCS,40805,REMOVAL FOREIGN BODY MOUTH,,,470.54,1511.66,19
HCPCS,40805,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,1116.0,725.4,1.1,1116.0,53
HCPCS,40805,Removal foreign body mouth,,,1358.5,1573.0,8
HCPCS,40806,INCISION LABIAL FRENUM FRENOTOMY,1233.5,801.775,0.01,3004.0,114
HCPCS,40808,BIOPSY OF MOUTH LESION,,,470.54,1511.66,19
HCPCS,40808,"BIOPSY, MOUTH, VESTIBULE",420.0,273.0,1.1,939.01,53
HCPCS,40808,Biopsy of mouth lesion,,,1358.5,1573.0,8
HCPCS,40810,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,544.0,353.6,1.1,5497.86,53
HCPCS,40810,EXCISION OF MOUTH LESION,,,2996.53,9292.73,19
HCPCS,40810,Excision of mouth lesion,,,1358.5,1573.0,8
HCPCS,40812,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,948.0,616.2,1.1,2603.78,53
HCPCS,40812,EXCISE/REPAIR MOUTH LESION,,,1368.67,4348.85,19
HCPCS,40812,Excise/repair mouth lesion,,,1358.5,1573.0,8
HCPCS,40814,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,1408.0,915.2,1.1,5497.86,53
HCPCS,40814,EXCISE/REPAIR MOUTH LESION,,,2996.53,9292.73,19
HCPCS,40814,Excise/repair mouth lesion,,,1358.5,1573.0,8
HCPCS,40816,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,1508.0,980.2,1.1,5497.86,53
HCPCS,40816,EXCISION OF MOUTH LESION,,,2996.53,9292.73,19
HCPCS,40816,Excision of mouth lesion,,,1358.5,1573.0,8
HCPCS,40818,EXCISE ORAL MUCOSA FOR GRAFT,,,470.54,1511.66,19
HCPCS,40818,Excise oral mucosa for graft,,,1358.5,1573.0,8
HCPCS,40819,EXC FRENUM LABIAL/BUCCAL,1004.0,652.6,1.1,2603.78,53
HCPCS,40819,EXCISE LIP OR CHEEK FOLD,,,1368.67,4348.85,19
HCPCS,40819,Excise lip or cheek fold,,,745.85,863.61,8
HCPCS,40820,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,536.0,348.4,1.1,5497.86,53
HCPCS,40820,TREATMENT OF MOUTH LESION,,,2996.53,9292.73,19
HCPCS,40820,Treatment of mouth lesion,,,1358.5,1573.0,8
HCPCS,40830,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,898.0,583.7,1.1,2453.0,114
HCPCS,40831,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,1685.5,1095.575,1.1,3004.0,114
HCPCS,40840,RECONSTRUCTION OF MOUTH,,,5465.95,16592.38,19
HCPCS,40840,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40842,RECONSTRUCTION OF MOUTH,,,5465.95,16592.38,19
HCPCS,40842,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40843,RECONSTRUCTION OF MOUTH,,,5465.95,16592.38,19
HCPCS,40843,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40844,RECONSTRUCTION OF MOUTH,,,5465.95,16592.38,19
HCPCS,40844,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40845,RECONSTRUCTION OF MOUTH,,,5465.95,16592.38,19
HCPCS,40845,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40845,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,7744.0,5033.6,1.1,9999.36,53
HCPCS,4084F,Aspirin recvd w/in 24 hrs,,,8.48,9.82,8
HCPCS,4086F,Aspirin/clopidogrel rxd,,,8.48,9.82,8
HCPCS,40899,TRANSORAL MYECTOMY OF DEPRESSOR ANGULI ORIS MUSCLE (COMP CODE 21,2168.0,1409.2,0.01,2168.0,28
HCPCS,40899,UNLISTED PX VESTIBULE MOUTH,,,214.57,663.85,19
HCPCS,40899,Unlisted px vestibule mouth,,,1358.5,1573.0,8
HCPCS,4090F,Pt rcvng epo thxpy,,,8.48,9.82,8
HCPCS,4095F,Pt not rcvng epo thxpy,,,8.48,9.82,8
HCPCS,41000,DRAINAGE OF MOUTH LESION,,,470.54,1511.66,19
HCPCS,41000,Drainage of mouth lesion,,,745.85,863.61,8
HCPCS,41000,INTRAORAL I&D TONGUE/FLOOR LINGUAL,540.0,351.0,1.1,939.01,53
HCPCS,41005,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,796.0,517.4000000000001,1.1,3004.0,114
HCPCS,41006,DRAINAGE OF MOUTH LESION,,,1368.67,4348.85,19
HCPCS,41006,Drainage of mouth lesion,,,745.85,863.61,8
HCPCS,41007,DRAINAGE OF MOUTH LESION,,,1368.67,4348.85,19
HCPCS,41007,Drainage of mouth lesion,,,745.85,863.61,8
HCPCS,41008,DRAINAGE OF MOUTH LESION,,,2996.53,9292.73,19
HCPCS,41008,Drainage of mouth lesion,,,745.85,863.61,8
HCPCS,41008,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,1384.0,899.6,1.1,5497.86,53
HCPCS,41009,DRAINAGE OF MOUTH LESION,,,470.54,1511.66,19
HCPCS,41009,Drainage of mouth lesion,,,745.85,863.61,8
HCPCS,4100F,Biphos thxpy vein ord/recvd,,,8.48,9.82,8
HCPCS,41010,INCISION LINGUAL FRENUM FRENOTOMY,3629.0,2358.8500000000004,0.01,6814.0,114
HCPCS,41015,DRAINAGE OF MOUTH LESION,,,470.54,1511.66,19
HCPCS,41015,Drainage of mouth lesion,,,1358.5,1573.0,8
HCPCS,41016,DRAINAGE OF MOUTH LESION,,,5465.95,16592.38,19
HCPCS,41016,Drainage of mouth lesion,,,1358.5,1573.0,8
HCPCS,41016,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,1676.0,1089.4,1.1,9999.36,53
HCPCS,41017,DRAINAGE OF MOUTH LESION,,,2996.53,9292.73,19
HCPCS,41017,Drainage of mouth lesion,,,1358.5,1573.0,8
HCPCS,41018,DRAINAGE OF MOUTH LESION,,,1368.67,4348.85,19
HCPCS,41018,Drainage of mouth lesion,,,1358.5,1573.0,8
HCPCS,41019,PLACE NEEDLES H&N FOR RT,,,5465.95,16592.38,19
HCPCS,41019,Place needles h&n for rt,,,2695.9,3121.57,8
HCPCS,41100,BIOPSY OF TONGUE,,,470.54,1511.66,19
HCPCS,41100,BIOPSY TONGUE ANTERIOR 2/3,568.0,369.2,1.1,939.01,53
HCPCS,41100,Biopsy of tongue,,,85.44,98.93,8
HCPCS,41105,BIOPSY OF TONGUE,,,2996.53,9292.73,19
HCPCS,41105,"BIOPSY TONGUE,POSTER 1/3",588.0,382.2,1.1,5497.86,53
HCPCS,41105,Biopsy of tongue,,,745.85,863.61,8
HCPCS,41108,BIOPSY OF FLOOR OF MOUTH,,,1497.07,4629.18,19
HCPCS,41108,"BIOPSY, MOUTH, FLOOR",484.0,314.6,1.1,2768.64,53
HCPCS,41108,Biopsy of floor of mouth,,,745.85,863.61,8
HCPCS,4110F,Int mam art used for cabg,,,8.48,9.82,8
HCPCS,41110,EXCISION LESION TONGUE W/O CLOSURE,624.0,405.6,1.1,5497.86,53
HCPCS,41110,EXCISION OF TONGUE LESION,,,2996.53,9292.73,19
HCPCS,41110,Excision of tongue lesion,,,745.85,863.61,8
HCPCS,41112,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,1132.0,735.8,1.1,5497.86,53
HCPCS,41112,EXCISION OF TONGUE LESION,,,2996.53,9292.73,19
HCPCS,41112,Excision of tongue lesion,,,745.85,863.61,8
HCPCS,41113,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,1316.0,855.4,1.1,5497.86,53
HCPCS,41113,EXCISION OF TONGUE LESION,,,2996.53,9292.73,19
HCPCS,41113,Excision of tongue lesion,,,745.85,863.61,8
HCPCS,41114,EXCISION OF TONGUE LESION,,,2996.53,9292.73,19
HCPCS,41114,Excision of tongue lesion,,,1237.01,1432.33,8
HCPCS,41115,EXCISION OF LINGUAL FRENUM (FRENECTOMY),716.0,465.4,1.1,2603.78,53
HCPCS,41115,EXCISION OF TONGUE FOLD,,,1368.67,4348.85,19
HCPCS,41115,Excision of tongue fold,,,745.85,863.61,8
HCPCS,41116,EXCISION LESION FLOOR MOUTH,1008.0,655.2,1.1,5497.86,53
HCPCS,41116,EXCISION OF MOUTH LESION,,,2996.53,9292.73,19
HCPCS,41116,Excision of mouth lesion,,,1358.5,1573.0,8
HCPCS,41120,GLOSSECTOMY <ONE-HALF TONGUE,4902.0,3186.3,1.1,9999.36,50
HCPCS,41120,PARTIAL REMOVAL OF TONGUE,,,5465.95,16592.38,19
HCPCS,41120,Partial removal of tongue,,,2151.73,2491.48,8
HCPCS,41130,Partial removal of tongue,,,2151.73,2491.48,8
HCPCS,41135,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,12056.0,7836.4,1.1,12056.0,50
HCPCS,41135,Tongue and neck surgery,,,2695.9,3121.57,8
HCPCS,41140,Removal of tongue,,,2695.9,3121.57,8
HCPCS,41145,Tongue removal neck surgery,,,2695.9,3121.57,8
HCPCS,41150,Tongue mouth jaw surgery,,,2695.9,3121.57,8
HCPCS,41153,Tongue mouth neck surgery,,,2695.9,3121.57,8
HCPCS,41155,Tongue jaw & neck surgery,,,2695.9,3121.57,8
HCPCS,4115F,Beta blckr admin w/in 24 hrs,,,8.48,9.82,8
HCPCS,4120F,Antibiot rxd/given,,,8.48,9.82,8
HCPCS,4124F,Antibiot not rxd/given,,,8.48,9.82,8
HCPCS,41250,"REPAIR TONGUE LACER,<2.5CM",784.0,509.6,1.1,945.06,53
HCPCS,41250,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,1836.0,1193.4,85.44,4001.0,61
HCPCS,41251,"REPAIR TONGUE LACER,POST 1/3",928.0,603.2,1.1,1052.35,53
HCPCS,41251,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1068.0,694.2,85.44,4001.0,61
HCPCS,41252,"REPAIR TONGUE LACER,2.6CM+/COMPLX",1208.0,785.2,1.1,1208.0,53
HCPCS,41252,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1068.0,694.2,85.44,4001.0,61
HCPCS,4130F,Topical prep rx aoe,,,8.48,9.82,8
HCPCS,4131F,Syst antimicrobial thx rx,,,8.48,9.82,8
HCPCS,4132F,No syst antimicrobial thx rx,,,8.48,9.82,8
HCPCS,4133F,Antihist/decong rx/recom,,,8.48,9.82,8
HCPCS,4134F,No antihist/decong rx/recom,,,8.48,9.82,8
HCPCS,4135F,Systemic corticosteroids rx,,,8.48,9.82,8
HCPCS,4136F,Syst corticosteroids not rx,,,8.48,9.82,8
HCPCS,4140F,Inhaled corticosteroids rxd,,,8.48,9.82,8
HCPCS,4142F,Corticoster sparng thrpy rxd,,,8.48,9.82,8
HCPCS,4144F,Alt long-term cntrl med rxd,,,8.48,9.82,8
HCPCS,4145F,2+ anti-hyprtnsv agents tkn,,,8.48,9.82,8
HCPCS,4148F,Hep a vac injxn admin/recvd,,,8.48,9.82,8
HCPCS,4149F,Hep b vac injxn admin/recvd,,,8.48,9.82,8
HCPCS,4150F,Pt recvng antivir txmnt hepc,,,8.48,9.82,8
HCPCS,41510,TONGUE TO LIP SURGERY,,,2996.53,9292.73,19
HCPCS,41510,Tongue to lip surgery,,,745.85,863.61,8
HCPCS,41512,TONGUE SUSPENSION,,,5465.95,16592.38,19
HCPCS,41512,Tongue suspension,,,2695.9,3121.57,8
HCPCS,4151F,Pt not recvng antiv hep c,,,8.48,9.82,8
HCPCS,41520,RECONSTRUCTION TONGUE FOLD,,,2996.53,9292.73,19
HCPCS,41520,Reconstruction tongue fold,,,2151.73,2491.48,8
HCPCS,41530,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,1400.0,910.0,1.1,5497.86,53
HCPCS,41530,TONGUE BASE VOL REDUCTION,,,2996.53,9292.73,19
HCPCS,41530,Tongue base vol reduction,,,1237.01,1432.33,8
HCPCS,4153F,Combo pegintf/rib rx,,,8.48,9.82,8
HCPCS,4155F,Hep a vac series prev recvd,,,8.48,9.82,8
HCPCS,4157F,Hep b vac series prev recvd,,,8.48,9.82,8
HCPCS,4158F,Pt edu re alcoh drnkng done,,,8.48,9.82,8
HCPCS,41599,LASER DESTRUCTION/TONGUE LESION (COMP 41110),562.0,365.3,0.01,562.0,28
HCPCS,41599,"UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH (COMPARISON CODE 1557",1380.0,897.0,0.01,1380.0,28
HCPCS,41599,UNLISTED PX TONGUE FLR MOUTH,,,214.57,663.85,19
HCPCS,41599,Unlisted px tongue flr mouth,,,745.85,863.61,8
HCPCS,4159F,Contrcp talk b/4 antiv txmnt,,,8.48,9.82,8
HCPCS,4163F,Pt couns 4 txmnt opt prost,,,8.48,9.82,8
HCPCS,4164F,Adjv hrmnl thxpy rxd,,,8.48,9.82,8
HCPCS,4165F,3d-crt/imrt received,,,8.48,9.82,8
HCPCS,4167F,Hd bed tilted 1st day vent,,,8.48,9.82,8
HCPCS,4168F,Pt care icu&vent w/in 24hrs,,,8.48,9.82,8
HCPCS,4169F,No pt care icu/vent in 24hrs,,,8.48,9.82,8
HCPCS,4171F,Pt rcvng esa thxpy,,,8.48,9.82,8
HCPCS,4172F,Pt not rcvng esa thxpy,,,8.48,9.82,8
HCPCS,4174F,Couns potent glauc impct,,,8.48,9.82,8
HCPCS,4175F,Vis 20/40/> w/in 90 days,,,8.48,9.82,8
HCPCS,4176F,Talk re uv light pt/crgvr,,,8.48,9.82,8
HCPCS,4177F,Talk pt/crgvr re areds prev,,,8.48,9.82,8
HCPCS,4178F,Antid glbln rcvd w/in 26wks,,,8.48,9.82,8
HCPCS,4179F,Tamoxifen/ai prescribed,,,8.48,9.82,8
HCPCS,41800,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,550.5,357.825,1.1,3004.0,114
HCPCS,41805,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,3675.0,2388.75,1.1,6814.0,114
HCPCS,41806,REMOVAL FOREIGN BODY JAWBONE,,,1368.67,4348.85,19
HCPCS,41806,Removal foreign body jawbone,,,1358.5,1573.0,8
HCPCS,4180F,Adjv thxpyrxd/rcvd colon ca,,,8.48,9.82,8
HCPCS,4181F,Conformal radn thxpy rcvd,,,8.48,9.82,8
HCPCS,41820,EXCISION GUM EACH QUADRANT,,,2996.53,9292.73,19
HCPCS,41820,Excision gum each quadrant,,,1358.5,1573.0,8
HCPCS,41821,EXCISION OF GUM FLAP,,,1368.67,4348.85,19
HCPCS,41821,Excision of gum flap,,,45.8,53.03,8
HCPCS,41822,EXCISION OF GUM LESION,,,1368.67,4348.85,19
HCPCS,41822,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41823,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,1508.0,980.2,1.1,9999.36,53
HCPCS,41823,EXCISION OF GUM LESION,,,5465.95,16592.38,19
HCPCS,41823,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41825,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,564.0,366.6,1.1,5497.86,53
HCPCS,41825,EXCISION OF GUM LESION,,,2996.53,9292.73,19
HCPCS,41825,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41826,EXCISION OF GUM LESION,,,2996.53,9292.73,19
HCPCS,41826,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41827,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,1685.0,1095.25,1.1,9999.36,53
HCPCS,41827,EXCISION OF GUM LESION,,,5465.95,16592.38,19
HCPCS,41827,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41828,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,1256.0,816.4,1.1,2603.78,47
HCPCS,41828,EXCISION OF GUM LESION,,,1368.67,4348.85,19
HCPCS,41828,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,4182F,No conformal radn thxpy,,,8.48,9.82,8
HCPCS,41830,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,1380.0,897.0,1.1,5497.86,47
HCPCS,41830,REMOVAL OF GUM TISSUE,,,2996.53,9292.73,19
HCPCS,41830,Removal of gum tissue,,,1358.5,1573.0,8
HCPCS,41850,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,6814.0,4429.1,0.01,6814.0,61
HCPCS,4185F,Continuous ppi or h2ra rcvd,,,8.48,9.82,8
HCPCS,4186F,No cont ppi or h2ra rcvd,,,8.48,9.82,8
HCPCS,41870,PERIODONTAL MUCOSAL GRAFTING,1563.0,1015.95,1.1,4348.85,51
HCPCS,41870,Periodontal mucosal grafting,,,1358.5,1573.0,8
HCPCS,41872,GINGIVOPLASTY EACH QUADRANT,,,2996.53,9292.73,19
HCPCS,41872,Gingivoplasty each quadrant,,,1358.5,1573.0,8
HCPCS,41874,ALVEOLOPLASTY EACH QUADRANT,,,2996.53,9292.73,19
HCPCS,41874,ALVEOLOPLASTY EACH QUADRANT SPECIFY,1404.0,912.6,1.1,5497.86,47
HCPCS,41874,Alveoloplasty each quadrant,,,1358.5,1573.0,8
HCPCS,4187F,Anti rheum drugthxpyrxd/gvn,,,8.48,9.82,8
HCPCS,4188F,Approp ace/arb tstng done,,,8.48,9.82,8
HCPCS,41899,PARTIAL BONY IMPACTION EXTRACTION (COMP D7230),357.0,232.05,0.01,417.54,28
HCPCS,41899,REMOVAL RESIDUAL ROOT,302.0,196.3,0.01,3004.0,122
HCPCS,41899,REMOVE RESIDUAL ROOT (COMP D7250),273.0,177.45,0.01,417.54,28
HCPCS,41899,SCLEROTHERAPY TO THE ORAL CAVITY (COMP CODE 36470),300.0,195.0,0.01,417.54,28
HCPCS,41899,SIMPLE EXTRACTION ERUPTED TOOTH (COMP D7140),139.0,90.35,0.01,417.54,28
HCPCS,41899,SOFT TISSUE IMPACTION EXTRACTION (COMP D7220),279.0,181.35,0.01,417.54,28
HCPCS,41899,SURGICAL EXTRACTION ERUPTED TOOTH (COMP D7210),243.0,157.95,0.01,417.54,28
HCPCS,4189F,Approp digoxin tstng done,,,8.48,9.82,8
HCPCS,4190F,Approp diuretic tstng done,,,8.48,9.82,8
HCPCS,4191F,Approp anticonvuls tstng,,,8.48,9.82,8
HCPCS,4192F,Pt not rcvng glucoco thxpy,,,8.48,9.82,8
HCPCS,4193F,Pt rcv <10mg daily predniso,,,8.48,9.82,8
HCPCS,4194F,Pt rcv >=10mg daily predniso,,,8.48,9.82,8
HCPCS,4195F,Pt rcvng anti-rheum thxpy ra,,,8.48,9.82,8
HCPCS,4196F,Ptnot rcvng anti-rhm thxpyra,,,8.48,9.82,8
HCPCS,42000,DRAINAGE ABSCESS PALATE UVULA,1068.0,694.2,85.44,4001.0,61
HCPCS,42000,DRAINAGE ABSCESS PALATE/UVULA,512.0,332.8,1.1,536.59,53
HCPCS,4200F,External beam to prost only,,,8.48,9.82,8
HCPCS,4201F,Extrnl beam other than prost,,,8.48,9.82,8
HCPCS,42100,BIOPSY PALATE UVULA,598.0,388.7,1.1,2603.78,53
HCPCS,42100,BIOPSY ROOF OF MOUTH,,,1368.67,4348.85,19
HCPCS,42100,Biopsy roof of mouth,,,745.85,863.61,8
HCPCS,42104,EXC LESION PALATE UVULA W/O CLOSURE,676.0,439.4,1.1,5497.86,53
HCPCS,42104,EXCISION LESION MOUTH ROOF,,,2996.53,9292.73,19
HCPCS,42104,Excision lesion mouth roof,,,1237.01,1432.33,8
HCPCS,42106,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,860.0,559.0,1.1,5497.86,53
HCPCS,42106,EXCISION LESION MOUTH ROOF,,,2996.53,9292.73,19
HCPCS,42106,Excision lesion mouth roof,,,1237.01,1432.33,8
HCPCS,42107,EXCISION LESION MOUTH ROOF,,,5465.95,16592.38,19
HCPCS,42107,Excision lesion mouth roof,,,1237.01,1432.33,8
HCPCS,4210F,Ace/arb thxpy for mos/>,,,8.48,9.82,8
HCPCS,42120,REMOVE PALATE/LESION,,,5465.95,16592.38,19
HCPCS,42120,RESCJ PALATE/EXTENSIVE RESCJ LESION,4744.0,3083.6,1.1,9999.36,50
HCPCS,42120,Remove palate/lesion,,,1358.5,1573.0,8
HCPCS,42140,EXCISION OF UVULA,,,2996.53,9292.73,19
HCPCS,42140,Excision of uvula,,,1237.01,1432.33,8
HCPCS,42140,UVULECTOMY EXCISION UVULA,680.0,442.0,1.1,5497.86,53
HCPCS,42145,PALATOPHAYNGOPLASTY,3912.0,2542.8,1.1,9999.36,50
HCPCS,42145,REPAIR PALATE PHARYNX/UVULA,,,5465.95,16592.38,19
HCPCS,42145,Repair palate pharynx/uvula,,,2630.78,3046.16,8
HCPCS,42160,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,7829.0,5088.85,0.01,14918.0,114
HCPCS,42180,REPAIR LAC PALATE<2 CM,,,470.54,1511.66,19
HCPCS,42180,Repair lac palate<2 cm,,,1358.5,1573.0,8
HCPCS,42182,REPAIR PALATE,,,5465.95,16592.38,19
HCPCS,42182,Repair palate,,,1358.5,1573.0,8
HCPCS,42200,RECONSTRUCT CLEFT PALATE,,,5465.95,16592.38,19
HCPCS,42200,Reconstruct cleft palate,,,2630.78,3046.16,8
HCPCS,42205,RECONSTRUCT CLEFT PALATE,,,2996.53,9292.73,19
HCPCS,42205,Reconstruct cleft palate,,,2630.78,3046.16,8
HCPCS,4220F,Digoxin thxpy for 6 mos/>,,,8.48,9.82,8
HCPCS,42210,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,6012.0,3907.8,1.1,9999.36,50
HCPCS,42210,RECONSTRUCT CLEFT PALATE,,,5465.95,16592.38,19
HCPCS,42210,Reconstruct cleft palate,,,2630.78,3046.16,8
HCPCS,42215,RECONSTRUCT CLEFT PALATE,,,5465.95,16592.38,19
HCPCS,42215,Reconstruct cleft palate,,,2630.78,3046.16,8
HCPCS,4221F,Diuretic thxpy for 6 mos/>,,,8.48,9.82,8
HCPCS,42220,RECONSTRUCT CLEFT PALATE,,,5465.95,16592.38,19
HCPCS,42220,Reconstruct cleft palate,,,2630.78,3046.16,8
HCPCS,42225,RECONSTRUCT CLEFT PALATE,,,5465.95,16592.38,19
HCPCS,42225,Reconstruct cleft palate,,,2630.78,3046.16,8
HCPCS,42226,LENGTHENING OF PALATE,,,5465.95,16592.38,19
HCPCS,42226,Lengthening of palate,,,2630.78,3046.16,8
HCPCS,42227,LENGTHENING OF PALATE,,,5465.95,16592.38,19
HCPCS,42227,Lengthening of palate,,,2630.78,3046.16,8
HCPCS,42235,REPAIR PALATE,,,5465.95,16592.38,19
HCPCS,42235,Repair palate,,,2630.78,3046.16,8
HCPCS,42260,REPAIR NOSE TO LIP FISTULA,,,5465.95,16592.38,19
HCPCS,42260,Repair nose to lip fistula,,,2151.73,2491.48,8
HCPCS,42280,PREPARATION PALATE MOLD,,,470.54,1511.66,19
HCPCS,42280,Preparation palate mold,,,1358.5,1573.0,8
HCPCS,42281,INSERTION PALATE PROSTHESIS,,,5465.95,16592.38,19
HCPCS,42281,Insertion palate prosthesis,,,1358.5,1573.0,8
HCPCS,42299,UNLISTED PX PALATE UVULA,,,214.57,663.85,19
HCPCS,42299,Unlisted px palate uvula,,,1358.5,1573.0,8
HCPCS,42300,"DRAIN ABSCESS PAROTID,SIMPLE",792.0,514.8,1.1,2603.78,53
HCPCS,42300,DRAINAGE OF SALIVARY GLAND,,,1368.67,4348.85,19
HCPCS,42300,Drainage of salivary gland,,,1358.5,1573.0,8
HCPCS,42305,DRAINAGE OF SALIVARY GLAND,,,2996.53,9292.73,19
HCPCS,42305,Drainage of salivary gland,,,1237.01,1432.33,8
HCPCS,4230F,Anticonv thxpy for 6 mos/>,,,8.48,9.82,8
HCPCS,42310,DRAINAGE OF SALIVARY GLAND,,,470.54,1511.66,19
HCPCS,42310,Drainage of salivary gland,,,1358.5,1573.0,8
HCPCS,42320,DRAINAGE OF SALIVARY GLAND,,,470.54,1511.66,19
HCPCS,42320,Drainage of salivary gland,,,1358.5,1573.0,8
HCPCS,42330,REMOVAL OF SALIVARY STONE,,,2996.53,9292.73,19
HCPCS,42330,Removal of salivary stone,,,1358.5,1573.0,8
HCPCS,42330,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,904.0,587.6,1.1,5497.86,53
HCPCS,42335,REMOVAL OF SALIVARY STONE,,,2996.53,9292.73,19
HCPCS,42335,Removal of salivary stone,,,1358.5,1573.0,8
HCPCS,42335,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,1364.0,886.6,1.1,5497.86,53
HCPCS,42340,REMOVAL OF SALIVARY STONE,,,2996.53,9292.73,19
HCPCS,42340,Removal of salivary stone,,,1358.5,1573.0,8
HCPCS,42400,BIOPSY SALIVARY GLAND NEEDLE,3066.5,1993.2250000000001,0.01,3728.0,122
HCPCS,42400,"BIOPSY SALIVARY GLAND,NEEDLE",343.0,222.95,1.1,1200.64,53
HCPCS,42405,BIOPSY OF SALIVARY GLAND,,,1368.67,4348.85,19
HCPCS,42405,BIOPSY SALIVARY GLAND INCISIONAL,1336.0,868.4,1.1,2603.78,53
HCPCS,42405,Biopsy of salivary gland,,,1358.5,1573.0,8
HCPCS,42408,EXCISION OF SALIVARY CYST,,,2996.53,9292.73,19
HCPCS,42408,Excision of salivary cyst,,,1358.5,1573.0,8
HCPCS,42409,DRAINAGE OF SALIVARY CYST,,,2996.53,9292.73,19
HCPCS,42409,Drainage of salivary cyst,,,1358.5,1573.0,8
HCPCS,4240F,Instr xrcz back pain 12 wks,,,8.48,9.82,8
HCPCS,42410,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,3828.0,2488.2,1.1,9999.36,50
HCPCS,42410,EXCISE PAROTID GLAND/LESION,,,5465.95,16592.38,19
HCPCS,42410,Excise parotid gland/lesion,,,2151.73,2491.48,8
HCPCS,42415,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,6864.0,4461.6,1.1,9999.36,50
HCPCS,42415,EXCISE PAROTID GLAND/LESION,,,5465.95,16592.38,19
HCPCS,42415,Excise parotid gland/lesion,,,2695.9,3121.57,8
HCPCS,42420,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,7812.0,5077.8,1.1,9999.36,50
HCPCS,42420,EXCISE PAROTID GLAND/LESION,,,5465.95,16592.38,19
HCPCS,42420,Excise parotid gland/lesion,,,2695.9,3121.57,8
HCPCS,42425,EXCISE PAROTID GLAND/LESION,,,5465.95,16592.38,19
HCPCS,42425,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,5368.0,3489.2,1.1,9999.36,50
HCPCS,42425,Excise parotid gland/lesion,,,2695.9,3121.57,8
HCPCS,42426,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,9064.0,5891.6,1.1,9064.0,50
HCPCS,42426,Excise parotid gland/lesion,,,2695.9,3121.57,8
HCPCS,4242F,Sprvsd xrcz back pn >12 wks,,,8.48,9.82,8
HCPCS,42440,EXCISE SUBMAXILLARY GLAND,,,5465.95,16592.38,19
HCPCS,42440,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,2702.0,1756.3,1.1,9999.36,50
HCPCS,42440,Excise submaxillary gland,,,2151.73,2491.48,8
HCPCS,42450,EXCISE SUBLINGUAL GLAND,,,5465.95,16592.38,19
HCPCS,42450,Excise sublingual gland,,,2151.73,2491.48,8
HCPCS,4245F,Pt instr nrml activities,,,8.48,9.82,8
HCPCS,4248F,Pt instr no bd rest 4 days/>,,,8.48,9.82,8
HCPCS,42500,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,27212.0,17687.8,0.01,27212.0,61
HCPCS,42505,REPAIR SALIVARY DUCT,,,5465.95,16592.38,19
HCPCS,42505,Repair salivary duct,,,1358.5,1573.0,8
HCPCS,42507,PAROTID DUCT DIVERSION,,,5465.95,16592.38,19
HCPCS,42507,Parotid duct diversion,,,2151.73,2491.48,8
HCPCS,42509,PAROTID DUCT DIVERSION,,,5465.95,16592.38,19
HCPCS,42509,Parotid duct diversion,,,2695.9,3121.57,8
HCPCS,4250F,Wrmng 4 surg normothermia,,,8.48,9.82,8
HCPCS,42510,PAROTID DUCT DIVERSION,,,2996.53,9292.73,19
HCPCS,42510,Parotid duct diversion,,,2151.73,2491.48,8
HCPCS,42550,Injection for salivary x-ray,,,65.08,75.36,8
HCPCS,4255F,Anesth 60 min/> as docd,,,8.48,9.82,8
HCPCS,4256F,Anesthe <60 min as docd,,,8.48,9.82,8
HCPCS,42600,CLOSURE OF SALIVARY FISTULA,,,2996.53,9292.73,19
HCPCS,42600,Closure of salivary fistula,,,2151.73,2491.48,8
HCPCS,4260F,Wound srfc culturetech used,,,8.48,9.82,8
HCPCS,4261F,Tech other than surfc cultr,,,8.48,9.82,8
HCPCS,42650,DILATION OF SALIVARY DUCT,,,1368.67,4348.85,19
HCPCS,42650,Dilation of salivary duct,,,1358.5,1573.0,8
HCPCS,4265F,Wet-dry dressings rx recmd,,,8.48,9.82,8
HCPCS,42660,DILATION OF SALIVARY DUCT,,,470.54,1511.66,19
HCPCS,42660,Dilation of salivary duct,,,1358.5,1573.0,8
HCPCS,42665,LIGATION OF SALIVARY DUCT,,,2996.53,9292.73,19
HCPCS,42665,Ligation of salivary duct,,,1358.5,1573.0,8
HCPCS,4266F,No wet-dry drssings rx recmd,,,8.48,9.82,8
HCPCS,4267F,Comprssion thxpy prescribed,,,8.48,9.82,8
HCPCS,4268F,Pt ed re comp thxpy rcvd,,,8.48,9.82,8
HCPCS,42699,SIALOENDOSCOPY W SALIVARY DUCT STONE EXTRACTION (COMP 31255),2473.0,1607.45,0.01,2473.0,28
HCPCS,42699,UNLISTED PX SALIVRY GLND/DUX,,,214.57,663.85,19
HCPCS,42699,Unlisted px salivry glnd/dux,,,1358.5,1573.0,8
HCPCS,4269F,Appropos mthd offloading rxd,,,8.48,9.82,8
HCPCS,42700,"I & D ABSCESS, PERITONSILLAR",668.0,434.2,1.1,668.0,53
HCPCS,42700,I&D ABSCESS PERITONSILLAR,1068.0,694.2,85.44,3004.0,61
HCPCS,4270F,Pt rcvng anti r-viral thxpy,,,8.48,9.82,8
HCPCS,4271F,Pt rcvng anti r-viral thxpy,,,8.48,9.82,8
HCPCS,42720,I&D ABSC PHRNGL NTRAORL APPR,,,2996.53,9292.73,19
HCPCS,42720,I&d absc phrngl ntraorl appr,,,745.85,863.61,8
HCPCS,42725,I&D ABSC PHRNGL XTRNL APPR,,,5465.95,16592.38,19
HCPCS,42725,I&d absc phrngl xtrnl appr,,,745.85,863.61,8
HCPCS,4274F,Flu immuno admind rcvd,,,8.48,9.82,8
HCPCS,4276F,Potent antivir thxpy rxd,,,8.48,9.82,8
HCPCS,4279F,Pcp prophylaxis rxd,,,8.48,9.82,8
HCPCS,42800,BIOPSY OF THROAT,,,1368.67,4348.85,19
HCPCS,42800,BIOPSY OROPHARYNX,576.0,374.4,1.1,2603.78,53
HCPCS,42800,Biopsy of throat,,,745.85,863.61,8
HCPCS,42804,"BIOPSY NASOPHARYNX,SIMPLE",516.0,335.4,1.1,5497.86,53
HCPCS,42804,BIOPSY OF UPPER NOSE/THROAT,,,2996.53,9292.73,19
HCPCS,42804,Biopsy of upper nose/throat,,,745.85,863.61,8
HCPCS,42806,BIOPSY OF UPPER NOSE/THROAT,,,2996.53,9292.73,19
HCPCS,42806,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,652.0,423.8,1.1,5497.86,53
HCPCS,42806,Biopsy of upper nose/throat,,,745.85,863.61,8
HCPCS,42808,EXCISE PHARYNX LESION,,,2996.53,9292.73,19
HCPCS,42808,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,940.0,611.0,1.1,5497.86,53
HCPCS,42808,Excise pharynx lesion,,,1237.01,1432.33,8
HCPCS,42809,REMOVAL FOREIGN BODY PHARYNX,1836.0,1193.4,85.44,3004.0,61
HCPCS,42809,REMOVE PHARYNX FOREIGN BODY,744.0,483.6,1.1,744.0,53
HCPCS,4280F,Pcp prophylax rxd 3mon low %,,,8.48,9.82,8
HCPCS,42810,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,1352.0,878.8,1.1,5497.86,53
HCPCS,42810,EXCISION OF NECK CYST,,,2996.53,9292.73,19
HCPCS,42810,Excision of neck cyst,,,745.85,863.61,8
HCPCS,42815,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,2924.0,1900.6,1.1,9999.36,50
HCPCS,42815,EXCISION OF NECK CYST,,,5465.95,16592.38,19
HCPCS,42815,Excision of neck cyst,,,2151.73,2491.48,8
HCPCS,42820,REMOVE TONSILS AND ADENOIDS,,,5465.95,16592.38,19
HCPCS,42820,Remove tonsils and adenoids,,,1138.7,1318.49,8
HCPCS,42820,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,1688.0,1097.2,1.1,9999.36,50
HCPCS,42821,REMOVE TONSILS AND ADENOIDS,,,2996.53,9292.73,19
HCPCS,42821,Remove tonsils and adenoids,,,1138.7,1318.49,8
HCPCS,42821,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,1744.0,1133.6,1.1,5497.86,50
HCPCS,42825,REMOVAL OF TONSILS,,,5465.95,16592.38,19
HCPCS,42825,Removal of tonsils,,,1138.7,1318.49,8
HCPCS,42825,TONSILLECTOMY PRIMARY/SECONDARY <AGE 12,1404.0,912.6,1.1,9999.36,50
HCPCS,42826,REMOVAL OF TONSILS,,,2996.53,9292.73,20
HCPCS,42826,Removal of tonsils,,,1138.7,1318.49,8
HCPCS,42826,TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>,1380.0,897.0,1.1,5497.86,50
HCPCS,42830,ADENOIDECTOMY PRIMARY <AGE 12,1060.0,689.0,1.1,5497.86,50
HCPCS,42830,REMOVAL OF ADENOIDS,,,2996.53,9292.73,19
HCPCS,42830,Removal of adenoids,,,1138.7,1318.49,8
HCPCS,42831,ADENOIDECTOMY PRIMARY AGE 12/>,1124.0,730.6,1.1,5497.86,50
HCPCS,42831,REMOVAL OF ADENOIDS,,,2996.53,9292.73,19
HCPCS,42831,Removal of adenoids,,,1138.7,1318.49,8
HCPCS,42835,REMOVAL OF ADENOIDS,,,2996.53,9292.73,19
HCPCS,42835,Removal of adenoids,,,1138.7,1318.49,8
HCPCS,42836,REMOVAL OF ADENOIDS,,,2996.53,9292.73,19
HCPCS,42836,Removal of adenoids,,,1138.7,1318.49,8
HCPCS,42842,EXTENSIVE SURGERY OF THROAT,,,5465.95,16592.38,19
HCPCS,42842,Extensive surgery of throat,,,1138.7,1318.49,8
HCPCS,42844,EXTENSIVE SURGERY OF THROAT,,,5465.95,16592.38,19
HCPCS,42844,Extensive surgery of throat,,,1138.7,1318.49,8
HCPCS,42845,Extensive surgery of throat,,,1138.7,1318.49,8
HCPCS,42860,EXCISION OF TONSIL TAGS,,,2996.53,9292.73,19
HCPCS,42860,Excision of tonsil tags,,,1138.7,1318.49,8
HCPCS,42870,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,2208.0,1435.2,1.1,9999.36,50
HCPCS,42870,EXCISION OF LINGUAL TONSIL,,,5465.95,16592.38,19
HCPCS,42870,Excision of lingual tonsil,,,1138.7,1318.49,8
HCPCS,42890,LIMITED PHARYNGECTOMY,,,5465.95,16592.38,19
HCPCS,42890,Limited pharyngectomy,,,2151.73,2491.48,8
HCPCS,42892,REVISION OF PHARYNGEAL WALLS,,,5465.95,16592.38,19
HCPCS,42892,Revision of pharyngeal walls,,,2151.73,2491.48,8
HCPCS,42894,Revision of pharyngeal walls,,,2695.9,3121.57,8
HCPCS,42900,REPAIR THROAT WOUND,,,1368.67,4348.85,19
HCPCS,42900,Repair throat wound,,,745.85,863.61,8
HCPCS,42900,SUTURE PHARYNX WOUND/INJURY,2116.0,1375.4,1.1,2603.78,50
HCPCS,4290F,Pt scrned for inj drug use,,,8.48,9.82,8
HCPCS,4293F,Pt scrnd hgh-risk sex behav,,,8.48,9.82,8
HCPCS,42950,RECONSTRUCTION OF THROAT,,,5465.95,16592.38,19
HCPCS,42950,Reconstruction of throat,,,2151.73,2491.48,8
HCPCS,42953,Repair throat esophagus,,,745.85,863.61,8
HCPCS,42955,SURGICAL OPENING OF THROAT,,,1368.67,4348.85,19
HCPCS,42955,Surgical opening of throat,,,745.85,863.61,8
HCPCS,42960,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,1647.5,1070.875,1.1,3004.0,111
HCPCS,42961,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,2308.0,1500.2,1.1,2308.0,50
HCPCS,42961,Control throat bleeding,,,745.85,863.61,8
HCPCS,42962,CONTROL THROAT BLEEDING,,,2996.53,9292.73,19
HCPCS,42962,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3256.0,2116.4,1.1,5497.86,50
HCPCS,42962,Control throat bleeding,,,745.85,863.61,8
HCPCS,42970,CONTROL NOSE/THROAT BLEEDING,,,214.57,663.85,19
HCPCS,42970,Control nose/throat bleeding,,,85.44,98.93,8
HCPCS,42971,Control nose/throat bleeding,,,1237.01,1432.33,8
HCPCS,42972,CONTROL NOSE/THROAT BLEEDING,,,2996.53,9292.73,19
HCPCS,42972,Control nose/throat bleeding,,,745.85,863.61,8
HCPCS,42975,DISE EVAL SLP DO BRTH FLX DX,,,1593.38,4988.78,19
HCPCS,42975,Dise eval slp do brth flx dx,,,85.44,98.93,8
HCPCS,42999,NASPHARSCOPY INJ PHARYNX,1360.0,884.0,0.01,3004.0,122
HCPCS,4300F,Pt rcvng warf thxpy,,,8.48,9.82,8
HCPCS,4301F,Pt not rcvng warf thxpy,,,8.48,9.82,8
HCPCS,43020,INCISION OF ESOPHAGUS,,,1368.67,4348.85,19
HCPCS,43020,Incision of esophagus,,,745.85,863.61,8
HCPCS,43030,CRICOPHARYNGEAL MYOTOMY,,,5465.95,16592.38,19
HCPCS,43030,Cricopharyngeal myotomy,,,2151.73,2491.48,8
HCPCS,43045,Esophagotomy thrc rmvl fb,,,2519.91,2917.79,8
HCPCS,4305F,Pt ed re ft care inspct rcvd,,,8.48,9.82,8
HCPCS,4306F,Pt tlk psych & rx opd addic,,,8.48,9.82,8
HCPCS,43100,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,3864.0,2511.6,1.1,3864.0,50
HCPCS,43100,Excision of esophagus lesion,,,2388.82,2766.01,8
HCPCS,43101,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,6828.0,4438.2,1.1,6828.0,50
HCPCS,43101,Excision of esophagus lesion,,,2388.82,2766.01,8
HCPCS,43107,Removal of esophagus,,,2505.22,2900.78,8
HCPCS,43107,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,20820.0,13533.0,1.1,20820.0,50
HCPCS,43108,Removal of esophagus,,,2505.22,2900.78,8
HCPCS,43112,Esphg tot w/thrcm,,,2505.22,2900.78,8
HCPCS,43113,Removal of esophagus,,,2505.22,2900.78,8
HCPCS,43116,Partial removal of esophagus,,,2505.22,2900.78,8
HCPCS,43117,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,23000.0,14950.0,1.1,23000.0,50
HCPCS,43117,Partial removal of esophagus,,,2505.22,2900.78,8
HCPCS,43118,Partial removal of esophagus,,,2505.22,2900.78,8
HCPCS,43121,Partial removal of esophagus,,,2505.22,2900.78,8
HCPCS,43122,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,17672.0,11486.8,1.1,17672.0,50
HCPCS,43122,Partial removal of esophagus,,,2505.22,2900.78,8
HCPCS,43123,Partial removal of esophagus,,,2505.22,2900.78,8
HCPCS,43124,Removal of esophagus,,,2505.22,2900.78,8
HCPCS,43124,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,27636.0,17963.4,1.1,27636.0,50
HCPCS,43130,REMOVAL OF ESOPHAGUS POUCH,,,5465.95,16592.38,19
HCPCS,43130,Removal of esophagus pouch,,,2505.22,2900.78,8
HCPCS,43135,Removal of esophagus pouch,,,2505.22,2900.78,8
HCPCS,43180,ESOPHAGOSCOPY RIGID TRNSO,,,5465.95,16592.38,19
HCPCS,43180,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,3612.0,2347.8,1.1,9999.36,50
HCPCS,43180,Esophagoscopy rigid trnso,,,2504.73,2900.22,8
HCPCS,43191,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,996.0,647.4,1.1,3248.9,50
HCPCS,43191,ESOPHAGOSCOPY RIGID TRNSO DX,,,1752.78,5378.41,19
HCPCS,43191,Esophagoscopy rigid trnso dx,,,1191.17,1379.25,8
HCPCS,43192,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,1116.0,725.4,1.1,3248.9,50
HCPCS,43192,ESOPHAGOSCP RIG TRNSO INJECT,,,1752.78,5378.41,19
HCPCS,43192,Esophagoscp rig trnso inject,,,1191.17,1379.25,8
HCPCS,43193,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,1116.0,725.4,1.1,3248.9,50
HCPCS,43193,ESOPHAGOSCP RIG TRNSO BIOPSY,,,1752.78,5378.41,19
HCPCS,43193,Esophagoscp rig trnso biopsy,,,1191.17,1379.25,8
HCPCS,43194,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,1404.0,912.6,1.1,3248.9,50
HCPCS,43194,ESOPHAGOSCP RIG TRNSO REM FB,,,1752.78,5378.41,19
HCPCS,43194,Esophagoscp rig trnso rem fb,,,1191.17,1379.25,8
HCPCS,43195,ESOPHAGOSCOPY RIGID BALLOON,,,3515.31,10806.3,19
HCPCS,43195,Esophagoscopy rigid balloon,,,2504.73,2900.22,8
HCPCS,43196,ESOPHAGOSCP GUIDE WIRE DILAT,,,1752.78,5378.41,19
HCPCS,43196,Esophagoscp guide wire dilat,,,1191.17,1379.25,8
HCPCS,43197,ESOPHAGOSCOPY FLEX DX BRUSH,,,858.08,2542.14,19
HCPCS,43197,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,608.0,395.2,1.1,1548.29,53
HCPCS,43197,Esophagoscopy flex dx brush,,,619.37,717.17,8
HCPCS,43198,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,2520.5,1638.3249999999998,0.01,4313.0,114
HCPCS,43200,ESOPHAGOSCOPY FLEXIBLE BRUSH,,,858.08,2542.14,19
HCPCS,43200,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,625.0,406.25,1.1,1548.29,53
HCPCS,43200,ESOPHAGUS ENDOSCOPY,300.0,195.0,1.1,1548.29,53
HCPCS,43200,Esophagoscopy flexible brush,,,619.37,717.17,8
HCPCS,43201,ESOPH SCOPE W/SUBMUCOUS INJ,,,1752.78,5378.41,19
HCPCS,43201,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,688.0,447.2,1.1,3248.9,53
HCPCS,43201,Esoph scope w/submucous inj,,,619.37,717.17,8
HCPCS,43202,ESOPHAGOSCOPY FLEX BIOPSY,,,1752.78,5378.41,19
HCPCS,43202,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,688.0,447.2,1.1,3248.9,53
HCPCS,43202,Esophagoscopy flex biopsy,,,619.37,717.17,8
HCPCS,43204,ESOPH SCOPE W/SCLEROSIS INJ,,,1752.78,5378.41,19
HCPCS,43204,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,932.0,605.8,1.1,3248.9,50
HCPCS,43204,Esoph scope w/sclerosis inj,,,619.37,717.17,8
HCPCS,43205,ESOPHAGUS ENDOSCOPY/LIGATION,,,1752.78,5378.41,19
HCPCS,43205,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,976.0,634.4,1.1,3248.9,50
HCPCS,43205,Esophagus endoscopy/ligation,,,619.37,717.17,8
HCPCS,43206,ESOPH OPTICAL ENDOMICROSCOPY,,,1752.78,5378.41,19
HCPCS,43206,Esoph optical endomicroscopy,,,1191.17,1379.25,8
HCPCS,4320F,Pt talk psychsoc&rx oh dpnd,,,8.48,9.82,8
HCPCS,43210,EGD ESOPHAGOGASTRC FNDOPLSTY,,,9619.76,29793.81,19
HCPCS,43210,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,3100.0,2015.0,1.1,17575.94,50
HCPCS,43210,Egd esophagogastrc fndoplsty,,,2504.73,2900.22,8
HCPCS,43211,ESOPHAGOSCOP MUCOSAL RESECT,,,1752.78,5378.41,19
HCPCS,43211,Esophagoscop mucosal resect,,,619.37,717.17,8
HCPCS,43212,ESOPHAGOSCOP STENT PLACEMENT,,,5500.28,17015.8,19
HCPCS,43212,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,1360.0,884.0,1.1,9730.56,50
HCPCS,43212,Esophagoscop stent placement,,,2504.73,2900.22,8
HCPCS,43213,ESOPHAGOSCOPY RETRO BALLOON,,,1752.78,5378.41,19
HCPCS,43213,Esophagoscopy retro balloon,,,619.37,717.17,8
HCPCS,43214,ESOPHAGOSC DILATE BALLOON 30,,,1752.78,5378.41,19
HCPCS,43214,Esophagosc dilate balloon 30,,,1191.17,1379.25,8
HCPCS,43215,ESOPHAGOSCOPY FLEX REMOVE FB,,,1752.78,5378.41,19
HCPCS,43215,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,976.0,634.4,1.1,3248.9,53
HCPCS,43215,Esophagoscopy flex remove fb,,,619.37,717.17,8
HCPCS,43216,ESOPHAGOSCOPY LESION REMOVAL,,,1752.78,5378.41,19
HCPCS,43216,Esophagoscopy lesion removal,,,619.37,717.17,8
HCPCS,43217,ESOPHAGOSCOPY SNARE LES REMV,,,1752.78,5378.41,19
HCPCS,43217,Esophagoscopy snare les remv,,,619.37,717.17,8
HCPCS,43220,ESOPHAGOSCOPY BALLOON <30MM,,,1752.78,5378.41,19
HCPCS,43220,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,800.0,520.0,1.1,3248.9,53
HCPCS,43220,Esophagoscopy balloon <30mm,,,619.37,717.17,8
HCPCS,43226,ESOPH ENDOSCOPY DILATION,,,1752.78,5378.41,19
HCPCS,43226,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,896.0,582.4,1.1,3248.9,53
HCPCS,43226,Esoph endoscopy dilation,,,619.37,717.17,8
HCPCS,43227,ESOPHAGOSCOPY CONTROL BLEED,,,1752.78,5378.41,19
HCPCS,43227,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,1156.0,751.4,1.1,3248.9,53
HCPCS,43227,Esophagoscopy control bleed,,,619.37,717.17,8
HCPCS,43229,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,1396.0,907.4,1.1,6539.01,53
HCPCS,43229,ESOPHAGOSCOPY LESION ABLATE,,,3515.31,10806.3,19
HCPCS,43229,Esophagoscopy lesion ablate,,,1191.17,1379.25,8
HCPCS,4322F,Crgvr prov w/ ed addl rsrcs,,,8.48,9.82,8
HCPCS,43231,ESOPHAGOSCOP ULTRASOUND EXAM,,,1752.78,5378.41,19
HCPCS,43231,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,1120.0,728.0,1.1,3248.9,51
HCPCS,43231,Esophagoscop ultrasound exam,,,619.37,717.17,8
HCPCS,43232,ESOPHAGOSCOPY W/US NEEDLE BX,,,1752.78,5378.41,19
HCPCS,43232,Esophagoscopy w/us needle bx,,,619.37,717.17,8
HCPCS,43233,EGD BALLOON DIL ESOPH30 MM/>,,,1752.78,5378.41,19
HCPCS,43233,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,1628.0,1058.2,1.1,3248.9,50
HCPCS,43233,Egd balloon dil esoph30 mm/>,,,619.37,717.17,8
HCPCS,43235,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,2574.5,1673.425,0.01,4831.0,236
HCPCS,43235,"UPPR GI ENDOSCOPY, DIAGNOSIS",468.0,304.2,1.1,1548.29,53
HCPCS,43236,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,1052.0,683.8,1.1,1548.29,53
HCPCS,43236,UPPR GI SCOPE W/SUBMUC INJ,,,858.08,2542.14,19
HCPCS,43236,Uppr gi scope w/submuc inj,,,619.37,717.17,8
HCPCS,43237,ENDOSCOPIC US EXAM ESOPH,,,1752.78,5378.41,20
HCPCS,43237,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,1527.0,992.55,1.1,3248.9,50
HCPCS,43237,Endoscopic us exam esoph,,,619.37,717.17,8
HCPCS,43238,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,1830.0,1189.5,1.1,3248.9,50
HCPCS,43238,EGD US FINE NEEDLE BX/ASPIR,,,1752.78,5378.41,20
HCPCS,43238,Egd us fine needle bx/aspir,,,619.37,717.17,8
HCPCS,43239,EGD BIOPSY SINGLE/MULTIPLE,,,858.08,4831.0,20
HCPCS,43239,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,1052.0,683.8,1.1,1548.29,53
HCPCS,43239,Egd biopsy single/multiple,,,619.37,717.17,8
HCPCS,43239,"UPPER GI ENDOSCOPY, BIOPSY",508.0,330.2,1.1,1548.29,53
HCPCS,43240,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,3146.0,2044.9,1.1,9730.56,50
HCPCS,43240,EGD W/TRANSMURAL DRAIN CYST,,,5500.28,17015.8,19
HCPCS,43240,Egd w/transmural drain cyst,,,2504.73,2900.22,8
HCPCS,43241,EGD INTRALUMINAL TUBE/CATHETER INSERTION,1096.0,712.4,1.1,3248.9,50
HCPCS,43241,EGD TUBE/CATH INSERTION,,,1752.78,5378.41,19
HCPCS,43241,Egd tube/cath insertion,,,619.37,717.17,8
HCPCS,43242,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,2081.0,1352.65,1.1,3248.9,50
HCPCS,43242,EGD US FINE NEEDLE BX/ASPIR,,,1752.78,5378.41,19
HCPCS,43242,Egd us fine needle bx/aspir,,,619.37,717.17,8
HCPCS,43243,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,1879.0,1221.35,1.1,3248.9,50
HCPCS,43243,EGD INJECTION VARICES,,,1752.78,5378.41,19
HCPCS,43243,Egd injection varices,,,619.37,717.17,8
HCPCS,43244,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,1936.0,1258.4,1.1,3248.9,50
HCPCS,43244,EGD VARICES LIGATION,,,1752.78,5378.41,19
HCPCS,43244,Egd varices ligation,,,619.37,717.17,8
HCPCS,43245,EGD DILATE STRICTURE,,,1752.78,5378.41,19
HCPCS,43245,EGD DILATION GASTRIC/DUODENAL STRICTURE,1355.0,880.75,1.1,3248.9,53
HCPCS,43245,Egd dilate stricture,,,619.37,717.17,8
HCPCS,43246,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,1566.0,1017.9,1.1,3248.9,50
HCPCS,43246,EGD PLACE GASTROSTOMY TUBE,,,1752.78,5378.41,20
HCPCS,43246,Egd place gastrostomy tube,,,619.37,717.17,8
HCPCS,43246,PLACE GASTROSTOMY TUBE,785.0,510.25,1.1,3248.9,50
HCPCS,43247,EGD FLEXIBLE FOREIGN BODY REMOVAL,2840.5,1846.3249999999998,1.1,4313.0,114
HCPCS,43247,OPERATIVE UPPER GI ENDOSCOPY,435.0,282.75,1.1,1548.29,53
HCPCS,43248,EGD GUIDE WIRE INSERTION,,,858.08,2542.14,19
HCPCS,43248,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,1280.0,832.0,1.1,1548.29,53
HCPCS,43248,Egd guide wire insertion,,,619.37,717.17,8
HCPCS,43249,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,1175.0,763.75,1.1,3525.33,53
HCPCS,43249,ESOPH EGD DILATION <30 MM,,,1752.78,5378.41,20
HCPCS,43249,"ESOPH ENDOSCOPY, DILATION",359.0,233.35,1.1,3525.33,53
HCPCS,43249,Esoph egd dilation <30 mm,,,619.37,717.17,8
HCPCS,4324F,Pt queried prkns complic,,,8.48,9.82,8
HCPCS,43250,EGD CAUTERY TUMOR POLYP,,,1752.78,5378.41,19
HCPCS,43250,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,1307.0,849.55,1.1,3248.9,53
HCPCS,43250,Egd cautery tumor polyp,,,619.37,717.17,8
HCPCS,43251,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,1527.0,992.55,1.1,3248.9,53
HCPCS,43251,EGD REMOVE LESION SNARE,,,1752.78,5378.41,19
HCPCS,43251,Egd remove lesion snare,,,619.37,717.17,8
HCPCS,43251,OPERATIVE UPPER GI ENDOSCOPY,516.0,335.4,1.1,3248.9,53
HCPCS,43252,EGD OPTICAL ENDOMICROSCOPY,,,1752.78,5378.41,19
HCPCS,43252,Egd optical endomicroscopy,,,2504.73,2900.22,8
HCPCS,43253,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,2081.0,1352.65,1.1,3248.9,50
HCPCS,43253,EGD US TRANSMURAL INJXN/MARK,,,1752.78,5378.41,19
HCPCS,43253,Egd us transmural injxn/mark,,,619.37,717.17,8
HCPCS,43254,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,5434.5,3532.4249999999997,1.1,8726.0,111
HCPCS,43255,EGD CONTROL BLEEDING ANY,,,1752.78,5378.41,19
HCPCS,43255,"EGD WITH CONTROL OF BLEED,",1566.0,1017.9,1.1,3248.9,53
HCPCS,43255,Egd control bleeding any,,,619.37,717.17,8
HCPCS,43255,OPERATIVE UPPER GI ENDOSCOPY,632.0,410.8,1.1,3248.9,53
HCPCS,43257,EGD W/THRML TXMNT GERD,,,3515.31,10806.3,19
HCPCS,43257,Egd w/thrml txmnt gerd,,,1191.17,1379.25,8
HCPCS,43259,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,1616.0,1050.4,1.1,3248.9,50
HCPCS,43259,EGD US EXAM DUODENUM/JEJUNUM,,,1752.78,5378.41,20
HCPCS,43259,Egd us exam duodenum/jejunum,,,619.37,717.17,8
HCPCS,4325F,Med txmnt options rvwd w/pt,,,8.48,9.82,8
HCPCS,43260,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,2340.0,1521.0,1.1,6539.01,50
HCPCS,43260,ERCP W/SPECIMEN COLLECTION,,,3515.31,10806.3,19
HCPCS,43261,ENDO CHOLANGIOPANCREATOGRAPH,,,3515.31,10806.3,19
HCPCS,43261,ERCP W/BIOPSY SINGLE/MULTIPLE,2460.0,1599.0,1.1,6539.01,50
HCPCS,43262,ENDO CHOLANGIOPANCREATOGRAPH,,,3515.31,10806.3,19
HCPCS,43262,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,2600.0,1690.0,1.1,6539.01,50
HCPCS,43263,ERCP SPHINCTER PRESSURE MEAS,,,1752.78,5378.41,19
HCPCS,43264,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,2917.0,1896.05,1.1,6539.01,50
HCPCS,43264,ERCP REMOVE DUCT CALCULI,,,3515.31,10806.3,19
HCPCS,43265,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,3489.0,2267.85,1.1,9730.56,50
HCPCS,43265,ERCP LITHOTRIPSY CALCULI,,,5500.28,17015.8,19
HCPCS,43265,Ercp lithotripsy calculi,,,2272.63,2631.46,8
HCPCS,43266,EGD ENDOSCOPIC STENT PLACE,,,5500.28,17015.8,19
HCPCS,43266,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,1568.0,1019.2,1.1,9730.56,50
HCPCS,43266,Egd endoscopic stent place,,,2504.73,2900.22,8
HCPCS,4326F,Pt asked re symp auto dysfxn,,,8.48,9.82,8
HCPCS,43270,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,1604.0,1042.6,1.1,3248.9,53
HCPCS,43270,EGD LESION ABLATION,,,1752.78,5378.41,19
HCPCS,43270,Egd lesion ablation,,,1191.17,1379.25,8
HCPCS,43273,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,896.0,582.4,1.1,896.0,50
HCPCS,43273,Endoscopic pancreatoscopy,,,2272.63,2631.46,8
HCPCS,43274,ERCP DUCT STENT PLACEMENT,,,5500.28,17015.8,19
HCPCS,43274,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,3731.0,2425.15,1.1,9730.56,50
HCPCS,43274,Ercp duct stent placement,,,2272.63,2631.46,8
HCPCS,43275,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,3018.0,1961.7,1.1,3248.9,50
HCPCS,43275,ERCP REMOVE FORGN BODY DUCT,,,1752.78,5378.41,19
HCPCS,43276,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,3890.0,2528.5,1.1,9730.56,50
HCPCS,43276,ERCP STENT EXCHANGE W/DILATE,,,5500.28,17015.8,19
HCPCS,43276,Ercp stent exchange w/dilate,,,2272.63,2631.46,8
HCPCS,43277,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,2760.0,1794.0,1.1,6539.01,50
HCPCS,43277,ERCP EA DUCT/AMPULLA DILATE,,,3515.31,10806.3,19
HCPCS,43277,Ercp ea duct/ampulla dilate,,,2272.63,2631.46,8
HCPCS,43278,ERCP LESION ABLATE W/DILATE,,,3515.31,10806.3,19
HCPCS,43278,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,3168.0,2059.2,1.1,6539.01,50
HCPCS,43278,Ercp lesion ablate w/dilate,,,2272.63,2631.46,8
HCPCS,43279,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,8840.0,5746.0,1.1,8840.0,50
HCPCS,43279,Lap myotomy heller,,,3788.7,4386.91,8
HCPCS,43280,LAPAROSCOPY FUNDOPLASTY,,,9619.76,29793.81,19
HCPCS,43280,"LAPAROSCOPY, FUNDOPLASTY",2325.0,1511.25,1.1,17575.94,50
HCPCS,43280,LAPS SURG ESOPG/GSTR FUNDOPLASTY,7240.0,4706.0,1.1,17575.94,50
HCPCS,43280,Laparoscopy fundoplasty,,,3788.7,4386.91,8
HCPCS,43281,LAP PARAESOPHAG HERN REPAIR,,,9619.76,29793.81,19
HCPCS,43281,"LAPAROSCOPY, REPAIR OF  HERNIA W/O MESH",2780.0,1807.0,1.1,17575.94,50
HCPCS,43281,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,10640.0,6916.0,1.1,17575.94,50
HCPCS,43281,Lap paraesophag hern repair,,,4428.42,5127.64,8
HCPCS,43282,LAP PARAESOPH HER RPR W/MESH,,,9608.0,29793.81,20
HCPCS,43282,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,12040.0,7826.0,1.1,17575.94,50
HCPCS,43282,Lap paraesoph her rpr w/mesh,,,4428.42,5127.64,8
HCPCS,43283,LAPS ESOPHAGEAL LENGTHENING ADDL,1298.0,843.7,1.1,1298.0,50
HCPCS,43283,Lap esoph lengthening,,,4428.42,5127.64,8
HCPCS,43284,LAPS ESOPHGL SPHNCTR AGMNTJ,,,9619.76,29793.81,19
HCPCS,43284,Laps esophgl sphnctr agmntj,,,3788.7,4386.91,8
HCPCS,43285,REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE,4188.0,2722.2,1.1,9852.42,50
HCPCS,43285,RMVL ESOPHGL SPHNCTR DEV,,,5390.83,16944.69,19
HCPCS,43285,Rmvl esophgl sphnctr dev,,,3788.7,4386.91,8
HCPCS,43286,ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ,22000.0,14300.0,1.1,22000.0,50
HCPCS,43286,Esphg tot w/laps moblj,,,2505.22,2900.78,8
HCPCS,43287,ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ,25200.0,16380.0,1.1,25200.0,50
HCPCS,43287,Esphg dstl 2/3 w/laps moblj,,,2505.22,2900.78,8
HCPCS,43288,ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ,26568.0,17269.2,1.1,26568.0,50
HCPCS,43288,Esphg thrsc moblj,,,2505.22,2900.78,8
HCPCS,43289,"UNLISTED LAP RESECTION, ESOPHAGEAL DUPLICATION CYST (COMP CODE 4",7340.0,4771.0,0.01,9852.42,28
HCPCS,43289,UNLISTED LAPS PX ESOPH,,,5390.83,16944.69,19
HCPCS,43289,Unlisted laps px esoph,,,2388.82,2766.01,8
HCPCS,4328F,Pt asked re sleep disturb,,,8.48,9.82,8
HCPCS,43290,EGD FLX TRNSORL DPLMNT BALO,,,1752.78,5378.41,19
HCPCS,43290,EGD FLX TRNSORL W/DPLMNT NTRGSTR BARIATRIC BALO,1244.0,808.6,1.1,8673.03,52
HCPCS,43290,Egd flx trnsorl dplmnt balo,,,619.37,717.17,8
HCPCS,43291,EGD FLX TRNSORL RMVL BALO,,,858.08,2542.14,19
HCPCS,43291,EGD FLX TRNSORL W/RMVL NTRGSTR BARIATRIC BALO,1120.0,728.0,1.1,1548.29,52
HCPCS,43291,Egd flx trnsorl rmvl balo,,,619.37,717.17,8
HCPCS,43300,Repair of esophagus,,,2388.82,2766.01,8
HCPCS,43305,Repair esophagus and fistula,,,2505.22,2900.78,8
HCPCS,4330F,Cnslng epi spec sfty issues,,,8.48,9.82,8
HCPCS,43310,Repair of esophagus,,,3788.7,4386.91,8
HCPCS,43312,Repair esophagus and fistula,,,3788.7,4386.91,8
HCPCS,43313,Esophagoplasty congenital,,,3788.7,4386.91,8
HCPCS,43314,Tracheo-esophagoplasty cong,,,3788.7,4386.91,8
HCPCS,43320,Fuse esophagus & stomach,,,2505.22,2900.78,8
HCPCS,43325,Revise esophagus & stomach,,,3788.7,4386.91,8
HCPCS,43327,Esoph fundoplasty lap,,,3788.7,4386.91,8
HCPCS,43328,Esoph fundoplasty thor,,,3788.7,4386.91,8
HCPCS,43330,Esophagomyotomy abdominal,,,3788.7,4386.91,8
HCPCS,43330,REPAIR OF ESOPHAGUS,2683.0,1743.95,1.1,4588.66,50
HCPCS,43331,Esophagomyotomy thoracic,,,3788.7,4386.91,8
HCPCS,43332,"LAP REPAIR, PARAESOPHAGEAL HIATAL HERNIA",2170.0,1410.5,1.1,3930.45,50
HCPCS,43332,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,7848.0,5101.2,1.1,7848.0,50
HCPCS,43332,Transab esoph hiat hern rpr,,,4428.42,5127.64,8
HCPCS,43333,LAPT RPR PARAESOPH HIATAL HERNIA W/ MESH,8584.0,5579.6,1.1,8584.0,50
HCPCS,43333,Transab esoph hiat hern rpr,,,4428.42,5127.64,8
HCPCS,43334,Transthor diaphrag hern rpr,,,4428.42,5127.64,8
HCPCS,43335,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,9588.0,6232.2,1.1,9588.0,50
HCPCS,43335,Transthor diaphrag hern rpr,,,4428.42,5127.64,8
HCPCS,43336,Thorabd diaphr hern repair,,,4428.42,5127.64,8
HCPCS,43337,Thorabd diaphr hern repair,,,4428.42,5127.64,8
HCPCS,43338,Esoph lengthening,,,3788.7,4386.91,8
HCPCS,43340,Fuse esophagus & intestine,,,2388.82,2766.01,8
HCPCS,43341,Fuse esophagus & intestine,,,2388.82,2766.01,8
HCPCS,43351,Surgical opening esophagus,,,2388.82,2766.01,8
HCPCS,43352,Surgical opening esophagus,,,2505.22,2900.78,8
HCPCS,43360,Gastrointestinal repair,,,2505.22,2900.78,8
HCPCS,43361,Gastrointestinal repair,,,2505.22,2900.78,8
HCPCS,43400,Ligate esophagus veins,,,2505.22,2900.78,8
HCPCS,43405,Ligate/staple esophagus,,,2388.82,2766.01,8
HCPCS,4340F,Cnslng chldbrng women epi,,,8.48,9.82,8
HCPCS,43410,Repair esophagus wound,,,2505.22,2900.78,8
HCPCS,43415,Repair esophagus wound,,,2505.22,2900.78,8
HCPCS,43415,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,17952.0,11668.8,1.1,17952.0,50
HCPCS,43420,REPAIR ESOPHAGUS OPENING,,,2996.53,9292.73,19
HCPCS,43420,Repair esophagus opening,,,2505.22,2900.78,8
HCPCS,43425,Repair esophagus opening,,,2388.82,2766.01,8
HCPCS,43450,DILATE ESOPHAGUS 1/MULT PASS,,,858.08,2542.14,19
HCPCS,43450,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,563.0,365.95,1.1,1548.29,53
HCPCS,43450,Dilate esophagus 1/mult pass,,,237.67,275.2,8
HCPCS,43453,DILATE ESOPHAGUS,,,1752.78,5378.41,19
HCPCS,43453,DILATION ESOPHAGUS GUIDE WIRE,564.0,366.6,1.1,3248.9,53
HCPCS,43453,Dilate esophagus,,,237.67,275.2,8
HCPCS,43460,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,1516.0,985.4,1.1,1516.0,50
HCPCS,43460,Pressure treatment esophagus,,,2388.82,2766.01,8
HCPCS,43496,Free jejunum flap microvasc,,,2388.82,2766.01,8
HCPCS,43497,TRANSORAL LOWER ESOPHAGEAL MYOTOMY,5316.0,3455.4,1.1,9730.56,50
HCPCS,43497,TRANSORL LWR ESOPHGL MYOTOMY,,,5500.28,17015.8,19
HCPCS,43497,Transorl lwr esophgl myotomy,,,2388.82,2766.01,8
HCPCS,43499,ENDOSCOPIC SUBMUCOSAL DISSECTION OF  ESOPHAGUS - (COMP CODE 4304,9299.0,6044.35,0.01,9299.0,28
HCPCS,43499,"ENDOVAC, ESOPH; EGD (COMP 43235, 97605)",990.0,643.5,0.01,1548.29,28
HCPCS,43499,"ENDOVAC, ESOPH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,1548.29,28
HCPCS,43499,"ENDOVAC, ESOPH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2092.0,28
HCPCS,43499,ESOPHAGUS SURG PROCEDURE UNLISTED,4326.0,2811.9,0.01,4326.0,28
HCPCS,43499,PERORAL ENDOSCOPIC MYOTOMY,9116.0,5925.4,0.01,9116.0,28
HCPCS,43499,THORACOSCOPY W/ LIGATION OF TRACHEOESOPH FISTULA & REP OF ESOPHA,19235.0,12502.75,0.01,19235.0,28
HCPCS,43499,"UNLIST PROC, ESOPHAGUS COMPARED TO 43520",3726.0,2421.9,0.01,3726.0,28
HCPCS,43499,UNLISTED MIN INVASIVE FOKER - ANASTOMOSIS (COMP CODE 43313),20591.0,13384.15,0.01,20591.0,28
HCPCS,43499,UNLISTED MIN INVASIVE FOKER - STRETCHING (COMP CODE 43425),10642.0,6917.3,0.01,10642.0,28
HCPCS,43499,UNLISTED PROC; ENDO GASTROESOPH FISTULA PLUG PLCMT (COMP TO 4326,1296.0,842.4,0.01,1548.29,28
HCPCS,43499,UNLISTED PROC; ORAL ENDOSCOPIC MYOTOMY (COMP TO 43279),7293.0,4740.45,0.01,7293.0,28
HCPCS,43499,UNLISTED PROCEDURE ESOPHAGUS,,,858.08,2542.14,19
HCPCS,43499,Unlisted procedure esophagus,,,2388.82,2766.01,8
HCPCS,43500,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,5116.0,3325.4,1.1,5116.0,50
HCPCS,43500,Surgical opening of stomach,,,2388.82,2766.01,8
HCPCS,43501,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,9040.0,5876.0,1.1,9040.0,50
HCPCS,43501,Surgical repair of stomach,,,2505.22,2900.78,8
HCPCS,43502,Surgical repair of stomach,,,2505.22,2900.78,8
HCPCS,4350F,Cnslng provided symp mngmnt,,,8.48,9.82,8
HCPCS,43510,SURGICAL OPENING OF STOMACH,,,858.08,2542.14,19
HCPCS,43510,Surgical opening of stomach,,,2505.22,2900.78,8
HCPCS,43520,Incision of pyloric muscle,,,2388.82,2766.01,8
HCPCS,43520,PYLOROMYOTOMY CUTTING PYLORIC MUSC,4516.0,2935.4,1.1,4516.0,50
HCPCS,43605,"BIOPSY OF STOMACH,BY LAPAROTOMY",5488.0,3567.2,1.1,5488.0,50
HCPCS,43605,Biopsy of stomach,,,2388.82,2766.01,8
HCPCS,43610,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,6536.0,4248.4,1.1,6536.0,50
HCPCS,43610,Excision of stomach lesion,,,2388.82,2766.01,8
HCPCS,43611,EXC LOCAL MALIGNANT TUMOR STOMACH,8152.0,5298.8,1.1,8152.0,50
HCPCS,43611,Excision of stomach lesion,,,2505.22,2900.78,8
HCPCS,43620,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,13616.0,8850.4,1.1,13616.0,50
HCPCS,43620,Removal of stomach,,,2505.22,2900.78,8
HCPCS,43621,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,15812.0,10277.8,1.1,15812.0,50
HCPCS,43621,Removal of stomach,,,2505.22,2900.78,8
HCPCS,43622,Removal of stomach,,,2505.22,2900.78,8
HCPCS,43631,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,9804.0,6372.6,1.1,9804.0,50
HCPCS,43631,Removal of stomach partial,,,2505.22,2900.78,8
HCPCS,43632,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,14056.0,9136.4,1.1,14056.0,50
HCPCS,43632,"REMOVAL OF STOMACH, PARTIAL",3314.0,2154.1,1.1,6989.42,50
HCPCS,43632,Removal of stomach partial,,,2505.22,2900.78,8
HCPCS,43633,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,13256.0,8616.4,1.1,13256.0,50
HCPCS,43633,Removal of stomach partial,,,2505.22,2900.78,8
HCPCS,43634,Removal of stomach partial,,,2505.22,2900.78,8
HCPCS,43635,Removal of stomach partial,,,2505.22,2900.78,8
HCPCS,43635,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,824.0,535.6,1.1,824.0,50
HCPCS,43640,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,7824.0,5085.6,1.1,7824.0,50
HCPCS,43640,Vagotomy & pylorus repair,,,2388.82,2766.01,8
HCPCS,43641,Vagotomy & pylorus repair,,,2388.82,2766.01,8
HCPCS,43644,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,12936.0,8408.4,1.1,12936.0,50
HCPCS,43644,Lap gastric bypass/roux-en-y,,,3788.7,4386.91,8
HCPCS,43645,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,12612.0,8197.8,1.1,12612.0,50
HCPCS,43645,Lap gastr bypass incl smll i,,,3788.7,4386.91,8
HCPCS,43647,LAP IMPL ELECTRODE ANTRUM,,,10541.85,31231.28,19
HCPCS,43647,Lap impl electrode antrum,,,1611.33,1865.75,8
HCPCS,43648,LAP REVISE/REMOVE GASTRIC NEUROSTIM ANTRUM,1543.0,1002.95,1.1,17575.94,38
HCPCS,43648,LAP REVISE/REMV ELTRD ANTRUM,,,9619.76,29793.81,19
HCPCS,43648,Lap revise/remv eltrd antrum,,,1611.33,1865.75,8
HCPCS,43651,LAPAROSCOPY VAGUS NERVE,,,5390.83,16944.69,19
HCPCS,43651,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,4052.0,2633.8,1.1,9852.42,50
HCPCS,43651,Laparoscopy vagus nerve,,,1611.33,1865.75,8
HCPCS,43652,LAPAROSCOPY VAGUS NERVE,,,5390.83,16944.69,19
HCPCS,43652,Laparoscopy vagus nerve,,,1611.33,1865.75,8
HCPCS,43653,LAPAROSCOPY GASTROSTOMY,,,5390.83,16944.69,19
HCPCS,43653,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,3392.0,2204.8,1.1,9852.42,50
HCPCS,43653,Laparoscopy gastrostomy,,,2505.22,2900.78,8
HCPCS,43659,ESO/GASTRECTOMY W RY ESO/JEJUNOSTOMY,14637.0,9514.05,0.01,14637.0,28
HCPCS,43659,LAP DUODENAL SWITCH PROCEDURE (COMP 43845),10659.0,6928.35,0.01,10659.0,28
HCPCS,43659,LAP GASTROTOMY (COMP 43500),4221.0,2743.65,0.01,9852.42,28
HCPCS,43659,LAP PARTIAL GASTRECTOMY (COMP CODE 43611),7337.0,4769.05,0.01,9852.42,28
HCPCS,43659,LAP PARTIAL GASTRECTOMY W RNY RECONSTRUC (COMP 43633),13256.0,8616.4,0.01,13256.0,28
HCPCS,43659,LAP REPAIR GASTRIC FISTULA (COMP 43880),9000.0,5850.0,0.01,9852.42,28
HCPCS,43659,LAP REVISION GASTROJEJUNOSTOMY (COMP 43860),6423.0,4174.95,0.01,9852.42,28
HCPCS,43659,LAP TOTAL GASTRECTOMY W/RESECTION OF THE GASTROJEJUNOSTOMY (COMP,13616.0,8850.4,0.01,13616.0,28
HCPCS,43659,"LAP, GASTROJEJUNOSTOMY (COMP 43820)",6115.0,3974.75,0.01,9852.42,28
HCPCS,43659,LAP. OVERSEW GASTR ULCER,5247.0,3410.55,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC DISTAL GASTRECTOMY W/ROUX-EN-Y GASTROJEJU & LAP TRU,11616.0,7550.4,0.01,11616.0,28
HCPCS,43659,LAPAROSCOPIC EXCISION MALIGNANT TUMOR OF STOMACH (COMP 43611),3590.0,2333.5,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC EXCISION ULCER OR BENIGN TUMOR STOMACH (COMP CODE 4,5392.0,3504.8,0.01,9852.42,28
HCPCS,43659,"LAPAROSCOPIC GASTROJEJUNOSTOMY, WITHOUT VAGOTOMY (COMP 43820)",7435.0,4832.75,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC GASTROPEXY (COMP CODE 43338),950.0,617.5,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC PARTIAL GASTRECTOMY FOR EXCISION OF GASTROCUTANEOUS,8713.0,5663.45,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC PYLOROMYOTOMY (COMP 43800),3728.0,2423.2,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC PYLOROMYOTOMY (COMP CODE 43520),4854.0,3155.1,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC REVISION GASTROJEJUNAL ANASTOMOSIS W/EXCISION GASTR,9204.0,5982.6,0.01,9852.42,28
HCPCS,43659,LAPAROSCOPIC TOTAL GASTRECTOMY W/ROUX-EN Y ANASTOMOSIS (COMPARIS,13045.0,8479.25,0.01,13045.0,28
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43633",10936.0,7108.4,0.01,10936.0,28
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43820",7435.0,4832.75,0.01,9852.42,28
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43825",7181.0,4667.65,0.01,9852.42,28
HCPCS,43659,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,3888.0,2527.2,0.01,9852.42,28
HCPCS,43659,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH (COMP CODE 43843),9120.0,5928.0,0.01,9852.42,28
HCPCS,43659,UNLISTED LAPAROSCOPIC PYLOROPLASTY (COMPARED TO 43800),5092.0,3309.8,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",3775.0,2453.75,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43605)",1770.0,1150.5,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43610)",5392.0,3504.8,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43611)",3590.0,2333.5,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43631)",4260.0,2769.0,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43840)",2660.0,1729.0,0.01,9852.42,28
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 44680)",2310.0,1501.5,0.01,9852.42,28
HCPCS,43659,UNLISTED LAPS PX STOMACH,,,5390.83,16944.69,19
HCPCS,43659,"UNLISTED PROC, LAP DISTAL GASTRECTOMY W/GASTROJEJUNOSTOMY (COMP",11596.0,7537.4,0.01,11596.0,28
HCPCS,43659,"UNLISTED PROC, LAPAROSCOPIC TRUNCAL VAGOTOMY (COMP TO 43640)",6455.0,4195.75,0.01,9852.42,28
HCPCS,43659,UNLISTED PROC; LAPAROSCOPIC DISTAL GASTRECTOMY W/GASTROJEJUOSTOM,12276.0,7979.4,0.01,12276.0,28
HCPCS,43659,UNLISTED PROC; LAPAROSCOPIC REVISION OF THE GASTRIC BYPASS GASTR,9587.0,6231.55,0.01,9852.42,28
HCPCS,43659,UNLISTED PROC; LAPARSCOPIC REVISION ROUX-EN-Y GASTRIC BYPASS GAS,10808.0,7025.2,0.01,10808.0,28
HCPCS,43659,Unlisted laps px stomach,,,2388.82,2766.01,8
HCPCS,43752,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1096.0,712.4000000000001,0.01,4001.0,288
HCPCS,43753,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1432.0,930.8,36.93,3004.0,61
HCPCS,43753,GASTRIC TUBE PLMT W/ASPIR & LAVAGE,180.0,117.0,1.1,535.81,50
HCPCS,43754,DX GASTR INTUB W/ASP SPEC,,,204.28,605.2,19
HCPCS,43754,Dx gastr intub w/asp spec,,,26.64,30.84,8
HCPCS,43755,DX GASTR INTUB W/ASP SPECS,,,121.73,360.65,19
HCPCS,43755,Dx gastr intub w/asp specs,,,237.67,275.2,8
HCPCS,43756,DX DUOD INTUB W/ASP SPEC,,,858.08,2542.14,19
HCPCS,43756,Dx duod intub w/asp spec,,,237.67,275.2,8
HCPCS,43757,DX DUOD INTUB W/ASP SPECS,,,858.08,2542.14,19
HCPCS,43757,Dx duod intub w/asp specs,,,237.67,275.2,8
HCPCS,43761,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1001.5,650.975,1.1,3398.0,175
HCPCS,43762,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,724.5,470.925,0.01,3004.0,175
HCPCS,43763,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,841.5,546.975,1.1,3004.0,114
HCPCS,43770,LAP PLACE GASTR ADJ DEVICE,,,9619.76,29793.81,19
HCPCS,43770,Lap place gastr adj device,,,3788.7,4386.91,8
HCPCS,43771,Lap revise gastr adj device,,,3788.7,4386.91,8
HCPCS,43772,LAP RMVL GASTR ADJ DEVICE,,,3515.31,10806.3,19
HCPCS,43772,Lap rmvl gastr adj device,,,3788.7,4386.91,8
HCPCS,43773,LAP REPLACE GASTR ADJ DEVICE,,,5390.83,16944.69,19
HCPCS,43773,Lap replace gastr adj device,,,3788.7,4386.91,8
HCPCS,43774,LAP RMVL GASTR ADJ ALL PARTS,,,3515.31,10806.3,19
HCPCS,43774,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,6304.0,4097.6,1.1,6539.01,50
HCPCS,43774,Lap rmvl gastr adj all parts,,,3788.7,4386.91,8
HCPCS,43775,LAP SLEEVE GASTRECTOMY,,,9608.0,9608.0,1
HCPCS,43775,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,8967.0,5828.55,1.1,8967.0,50
HCPCS,43775,Lap sleeve gastrectomy,,,2388.82,2766.01,8
HCPCS,43800,PYLOROPLASTY,6172.0,4011.8,1.1,6172.0,50
HCPCS,43800,Pyloroplasty,,,2388.82,2766.01,8
HCPCS,43810,Gastroduodenostomy,,,2388.82,2766.01,8
HCPCS,43820,GASTROJEJUNOSTOMY W/O VAGOTOMY,9012.0,5857.8,1.1,9012.0,50
HCPCS,43820,Gastrojejunostomy wo vagotmy,,,2505.22,2900.78,8
HCPCS,43825,Gastrojejunostomy w/vagotomy,,,2388.82,2766.01,8
HCPCS,43830,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,4340.0,2821.0,1.1,4340.0,50
HCPCS,43830,GSTRST OPEN WO CONSTJ TUBE,,,1752.78,5378.41,19
HCPCS,43830,Gstrst open wo constj tube,,,2388.82,2766.01,8
HCPCS,43831,GASTROSTOMY OPEN NEONATAL,,,858.08,2542.14,19
HCPCS,43831,Gastrostomy open neonatal,,,2388.82,2766.01,8
HCPCS,43832,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,6936.0,4508.4,1.1,6936.0,50
HCPCS,43832,Gstrst open w/constj tube,,,2505.22,2900.78,8
HCPCS,43840,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,9132.0,5935.8,1.1,9132.0,50
HCPCS,43840,GSTRRPHY SUTR DUOL/GSTR ULCR,,,3647.57,10806.3,13
HCPCS,43840,Gstrrphy sutr duol/gstr ulcr,,,2505.22,2900.78,8
HCPCS,43842,Gstr rstcv px v-banded gstp,,,3788.7,4386.91,8
HCPCS,43843,Gstr rstcv oth/thn v-band,,,3788.7,4386.91,8
HCPCS,43845,Gastroplasty duodenal switch,,,3788.7,4386.91,8
HCPCS,43846,Gstr rstcv px shrt roux-en-y,,,3788.7,4386.91,8
HCPCS,43847,Gstr rstcv px sm int rcnstj,,,3788.7,4386.91,8
HCPCS,43848,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,13100.0,8515.0,1.1,13100.0,50
HCPCS,43848,Revj open gstr rstcv px,,,3788.7,4386.91,8
HCPCS,43850,Revise stomach-bowel fusion,,,2388.82,2766.01,8
HCPCS,43855,Revise stomach-bowel fusion,,,2388.82,2766.01,8
HCPCS,43860,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,11156.0,7251.4,1.1,11156.0,50
HCPCS,43860,Revj gstr/jj anast w/o vgtmy,,,2505.22,2900.78,8
HCPCS,43865,Revj gstr/jj anast w/vgtmy,,,2505.22,2900.78,8
HCPCS,43870,CLOSURE GASTROSTOMY SURGICAL,,,3515.31,10806.3,19
HCPCS,43870,"CLOSURE OF GASTROSTOMY,SURGICAL",4576.0,2974.4,1.1,6539.01,50
HCPCS,43870,Closure gastrostomy surgical,,,2388.82,2766.01,8
HCPCS,43880,CLOSURE GASTROCOLIC FISTULA,10872.0,7066.8,1.1,10872.0,50
HCPCS,43880,Closure gastrocolic fistula,,,2505.22,2900.78,8
HCPCS,43881,Impl/rplcmt gstr nstim eltrd,,,2505.22,2900.78,8
HCPCS,43882,REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN,1772.0,1151.8,1.1,1885.2,38
HCPCS,43882,Rev/rmvl gstr nstim eltrd,,,2388.82,2766.01,8
HCPCS,43886,GSTR RSTCV PX OPN REVJ PORT,,,3352.64,9932.52,19
HCPCS,43886,Gstr rstcv px opn revj port,,,2388.82,2766.01,8
HCPCS,43887,GSTR RSTCV PX OPN RMVL PORT,,,1690.17,5783.06,19
HCPCS,43887,Gstr rstcv px opn rmvl port,,,2388.82,2766.01,8
HCPCS,43888,GSTR RSTCV PX OPN RMVL&RPLC,,,3352.64,9932.52,19
HCPCS,43888,Gstr rstcv px opn rmvl&rplc,,,3788.7,4386.91,8
HCPCS,43889,GSTR RSTCV PX TRNSORL ESG,,,10056.64,29793.81,13
HCPCS,43889,GSTR RSTCV PX TRNSORL ESG W/ARGON PLASMA COAGJ,5526.0,3591.9,1.1,5526.0,35
HCPCS,43889,Gstr rstcv px trnsorl esg,,,3788.7,4386.91,8
HCPCS,43999,CENTRAL GASTRECTOMY WITH GASTROGASTROSTOMY (COMP 43631),8824.0,5735.6,0.01,8824.0,28
HCPCS,43999,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),1364.0,886.6,0.01,1548.29,28
HCPCS,43999,EGD W/ SUTURE REPAIR OF STOMACH (COMP CODE 43840),8219.0,5342.35,0.01,8219.0,28
HCPCS,43999,EGD/EUS GASTROJAJUNOSTOMY LAMS (COMP 43266 AND 43237),5000.0,3250.0,0.01,5000.0,28
HCPCS,43999,ENDOSCOPIC PYLOROMYOTOMY (COMP 43520),4700.0,3055.0,0.01,4700.0,28
HCPCS,43999,ENDOSCOPIC SUBMUCOSAL DISSECTION OF STOMACH - (COMP CODE 43611),8662.0,5630.3,0.01,8662.0,28
HCPCS,43999,ENDOSCOPIC WOUND VAC PLACEMENT (COMP CODE 43235 & 97605),1122.0,729.3,0.01,1548.29,28
HCPCS,43999,"ENDOVAC, STOMACH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,1548.29,28
HCPCS,43999,"ENDOVAC, STOMACH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2092.0,28
HCPCS,43999,EXC GASTROCUTANEOUS FISTULA (COMP 44640),4221.0,2743.65,0.01,4221.0,28
HCPCS,43999,GASTRIC LAP BAND ADJUSTMENT (COMP CODE 36598),56.0,36.4,0.01,1548.29,28
HCPCS,43999,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),1001.5,650.975,0.01,4831.0,89
HCPCS,43999,"LAP, REVISION NISSEN FUNDOPLASTY (COMP 43280)",7240.0,4706.0,0.01,7240.0,28
HCPCS,43999,"LIGATION OF GASTRIC VARIED, OPEN (COMP CODE 43244)",1893.0,1230.45,0.01,1893.0,28
HCPCS,43999,OPEN GASTRIC BAND REMOVAL (COMP CODE 43774),6776.0,4404.4,0.01,6776.0,28
HCPCS,43999,OPEN GASTROPEXY (COMP TO 44680),5927.0,3852.55,0.01,5927.0,28
HCPCS,43999,PARTIAL GASTRECTOMY (COMP CODE 43610),2880.0,1872.0,0.01,2880.0,28
HCPCS,43999,"PARTIAL GATRECTOMY, PROXIMAL (COMP 43610)",8533.0,5546.45,0.01,8533.0,28
HCPCS,43999,SLEEVE GASTRECTOMY TO SINGLE ANASTOMOSIS DUODENAL SWITCH (SADIS),13320.0,8658.0,0.01,13320.0,28
HCPCS,43999,STOMACH SURGERY PROCEDURE UNLISTED,3523.0,2289.95,0.01,3523.0,28
HCPCS,43999,TRANS ORAL GASTRIC OUTLET REDUCTION TORE (COMP CODE 43771),8836.0,5743.4,0.01,8836.0,28
HCPCS,43999,TRANSNASAL EGD W/REMOVAL OF FOREIGN BODY (COMP 43247),1368.0,889.2,0.01,1548.29,28
HCPCS,43999,UNLISTED PROC; PARTIAL PROXIMAL GASTRECTOMY W/ROUX-EN-Y GASTROJE,10936.0,7108.4,0.01,10936.0,28
HCPCS,43999,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43610)",2880.0,1872.0,0.01,2880.0,28
HCPCS,43999,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",9396.5,6107.725,0.01,9866.0,56
HCPCS,43999,"UNLISTED PROCEDURE, STOMACH COMPARED TO CPT 43520",3726.0,2421.9,0.01,3726.0,28
HCPCS,44005,ENTEROLSS FRING INTSTINAL ADHESION SPX,7384.0,4799.6,1.1,7384.0,50
HCPCS,44005,FREEING OF BOWEL ADHESION,2181.0,1417.65,1.1,3741.83,50
HCPCS,44005,Freeing of bowel adhesion,,,2751.32,3185.74,8
HCPCS,4400F,Rehab thxpy options w/pt,,,8.48,9.82,8
HCPCS,44010,INCISION OF SMALL BOWEL,1586.0,1030.9,1.1,2897.0,50
HCPCS,44010,Incision of small bowel,,,1263.14,1462.58,8
HCPCS,44015,Insert needle cath bowel,,,2751.32,3185.74,8
HCPCS,44015,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,1048.0,681.2,1.1,1048.0,50
HCPCS,44020,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,6488.0,4217.2,1.1,6488.0,50
HCPCS,44020,EXPLORATION OF SMALL BOWEL,2288.0,1487.2,1.1,3338.64,50
HCPCS,44020,Explore small intestine,,,2751.32,3185.74,8
HCPCS,44021,Decompress small bowel,,,1263.14,1462.58,8
HCPCS,44021,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,6524.0,4240.6,1.1,6524.0,50
HCPCS,44025,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,6604.0,4292.6,1.1,6604.0,50
HCPCS,44025,"COLOTOMY, EXPLORATION, BIOPSY OR F.BODY",2180.0,1417.0,1.1,3356.61,50
HCPCS,44025,Incision of large bowel,,,1263.14,1462.58,8
HCPCS,44050,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,6208.0,4035.2,1.1,6208.0,50
HCPCS,44050,REDUCE BOWEL OBSTRUCTION,1580.0,1027.0,1.1,3211.54,50
HCPCS,44050,Reduce bowel obstruction,,,2751.32,3185.74,8
HCPCS,44055,CORRECT MALROTATION OF BOWEL,3826.0,2486.9,1.1,5100.99,50
HCPCS,44055,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,10252.0,6663.8,1.1,10252.0,50
HCPCS,44055,Correct malrotation of bowel,,,2751.32,3185.74,8
HCPCS,44100,BIOPSY OF BOWEL,,,858.08,2542.14,19
HCPCS,44100,Biopsy of bowel,,,706.64,818.21,8
HCPCS,44110,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,5616.0,3650.4,1.1,5616.0,50
HCPCS,44110,EXCISION LESION(S) OF SM / LG INTESTINE,1763.0,1145.95,1.1,2894.51,50
HCPCS,44110,EXCISION OF BOWEL LESION(S),1763.0,1145.95,1.1,2894.51,50
HCPCS,44110,Excise intestine lesion(s),,,1263.14,1462.58,8
HCPCS,44111,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,6608.0,4295.2,1.1,6608.0,50
HCPCS,44111,Excision of bowel lesion(s),,,1263.14,1462.58,8
HCPCS,44120,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,8328.0,5413.2,1.1,8328.0,50
HCPCS,44120,REMOVAL OF SMALL INTESTINE,2466.0,1602.9,1.1,4187.16,50
HCPCS,44120,Removal of small intestine,,,2751.32,3185.74,8
HCPCS,44121,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,1776.0,1154.4,1.1,1776.0,50
HCPCS,44121,REMOVAL OF SMALL INTESTINE,455.0,295.75,1.1,825.31,50
HCPCS,44121,Removal of small intestine,,,2751.32,3185.74,8
HCPCS,44125,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,8813.0,5728.45,1.1,8813.0,50
HCPCS,44125,Removal of small intestine,,,2751.32,3185.74,8
HCPCS,44126,Enterectomy w/o taper cong,,,2751.32,3185.74,8
HCPCS,44127,Enterectomy w/taper cong,,,2751.32,3185.74,8
HCPCS,44128,Enterectomy cong add-on,,,2751.32,3185.74,8
HCPCS,44130,Bowel to bowel fusion,,,1263.14,1462.58,8
HCPCS,44130,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,8844.0,5748.6,1.1,8844.0,50
HCPCS,44132,Enterectomy cadaver donor,,,975.94,1130.04,8
HCPCS,44133,Enterectomy live donor,,,975.94,1130.04,8
HCPCS,44135,Intestine transplnt cadaver,,,975.94,1130.04,8
HCPCS,44136,Intestine transplant live,,,975.94,1130.04,8
HCPCS,44137,Remove intestinal allograft,,,975.94,1130.04,8
HCPCS,44139,MOBILIZATION OF COLON,280.0,182.0,1.1,411.8,50
HCPCS,44139,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,892.0,579.8,1.1,892.0,50
HCPCS,44139,Mobilization of colon,,,2751.32,3185.74,8
HCPCS,44140,COLECTOMY PARTIAL W/ANASTOMOSIS,9036.0,5873.4,1.1,9036.0,50
HCPCS,44140,PARTIAL REMOVAL OF COLON,2688.0,1747.2,1.1,4592.08,50
HCPCS,44140,Partial removal of colon,,,1263.14,1462.58,8
HCPCS,44141,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,11964.0,7776.6,1.1,11964.0,50
HCPCS,44141,Partial removal of colon,,,2751.32,3185.74,8
HCPCS,44143,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,11116.0,7225.4,1.1,11116.0,50
HCPCS,44143,PARTIAL REMOVAL OF COLON,3249.0,2111.85,1.1,5654.26,50
HCPCS,44143,Partial removal of colon,,,2751.32,3185.74,8
HCPCS,44144,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,11964.0,7776.6,1.1,11964.0,50
HCPCS,44144,PARTIAL REMOVAL OF COLON,3418.0,2221.7,1.1,6035.04,50
HCPCS,44144,Partial removal of colon,,,1263.14,1462.58,8
HCPCS,44145,COLECTOMY PRTL W/COLOPROCTOSTOMY,11432.0,7430.8,1.1,11432.0,50
HCPCS,44145,PARTIAL REMOVAL OF COLON,3306.0,2148.9,1.1,5632.91,50
HCPCS,44145,Partial removal of colon,,,2751.32,3185.74,8
HCPCS,44146,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,14120.0,9178.0,1.1,14120.0,50
HCPCS,44146,PARTIAL REMOVAL OF COLON,4219.0,2742.35,1.1,7145.52,50
HCPCS,44146,Partial removal of colon,,,2751.32,3185.74,8
HCPCS,44147,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,13476.0,8759.4,1.1,13476.0,50
HCPCS,44147,Partial removal of colon,,,1263.14,1462.58,8
HCPCS,44150,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,12072.0,7846.8,1.1,12072.0,50
HCPCS,44150,REMOVAL OF COLON,3093.0,2010.45,1.1,6312.11,50
HCPCS,44150,Removal of colon,,,2751.32,3185.74,8
HCPCS,44151,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,13968.0,9079.2,1.1,13968.0,50
HCPCS,44151,Removal of colon/ileostomy,,,2751.32,3185.74,8
HCPCS,44155,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,13768.0,8949.2,1.1,13768.0,50
HCPCS,44155,Removal of colon/ileostomy,,,2751.32,3185.74,8
HCPCS,44156,Removal of colon/ileostomy,,,2751.32,3185.74,8
HCPCS,44157,Colectomy w/ileoanal anast,,,2751.32,3185.74,8
HCPCS,44158,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,14680.0,9542.0,1.1,14680.0,50
HCPCS,44158,Colectomy w/neo-rectum pouch,,,2751.32,3185.74,8
HCPCS,44160,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,8356.0,5431.4,1.1,8356.0,50
HCPCS,44160,REMOVAL OF COLON,2096.0,1362.4,1.1,4247.71,50
HCPCS,44160,Removal of colon,,,1263.14,1462.58,8
HCPCS,44180,LAP ENTEROLYSIS,,,5390.83,16944.69,19
HCPCS,44180,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,6108.0,3970.2,1.1,9852.42,50
HCPCS,44180,"LAPAROSCOPY,ENTEROLYSIS",1759.0,1143.35,1.1,9852.42,50
HCPCS,44180,Lap enterolysis,,,2751.32,3185.74,8
HCPCS,44186,LAP JEJUNOSTOMY,,,5390.83,16944.69,20
HCPCS,44186,LAPAROSCOPY SURGICAL JEJUNOSTOMY,4152.0,2698.8,1.1,9852.42,50
HCPCS,44186,Lap jejunostomy,,,2751.32,3185.74,8
HCPCS,44187,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,6960.0,4524.0,1.1,6960.0,50
HCPCS,44187,Lap ileo/jejuno-stomy,,,1263.14,1462.58,8
HCPCS,44188,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,7740.0,5031.0,1.1,7740.0,50
HCPCS,44188,Lap colostomy,,,2751.32,3185.74,8
HCPCS,44202,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,9356.0,6081.4,1.1,9356.0,50
HCPCS,44202,Lap enterectomy,,,2751.32,3185.74,8
HCPCS,44203,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,1776.0,1154.4,1.1,1776.0,50
HCPCS,44203,Lap resect s/intestine addl,,,2751.32,3185.74,8
HCPCS,44204,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,10568.0,6869.2,1.1,10568.0,50
HCPCS,44204,Laparo partial colectomy,,,2751.32,3185.74,8
HCPCS,44205,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,10098.0,6563.7,1.1,10098.0,50
HCPCS,44205,Lap colectomy part w/ileum,,,1263.14,1462.58,8
HCPCS,44206,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,11916.0,7745.4,1.1,11916.0,50
HCPCS,44206,Lap part colectomy w/stoma,,,2751.32,3185.74,8
HCPCS,44207,"ENTERECTOMY,SMALL INT, SINGLE RESECT",3120.0,2028.0,1.1,6167.95,50
HCPCS,44207,L colectomy/coloproctostomy,,,2751.32,3185.74,8
HCPCS,44207,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,14045.0,9129.25,1.1,14045.0,50
HCPCS,44208,L colectomy/coloproctostomy,,,2751.32,3185.74,8
HCPCS,44208,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,14956.0,9721.4,1.1,14956.0,50
HCPCS,44210,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,12036.0,7823.4,1.1,12036.0,50
HCPCS,44210,Laparo total proctocolectomy,,,2751.32,3185.74,8
HCPCS,44211,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,14832.0,9640.8,1.1,14832.0,50
HCPCS,44211,Lap colectomy w/proctectomy,,,2751.32,3185.74,8
HCPCS,44212,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,13832.0,8990.8,1.1,13832.0,50
HCPCS,44212,Laparo total proctocolectomy,,,2751.32,3185.74,8
HCPCS,44213,"LAP, MOBIL SPLENIC FL ADD-ON",310.0,201.5,1.1,634.51,50
HCPCS,44213,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,1400.0,910.0,1.1,1400.0,50
HCPCS,44213,Lap mobil splenic fl add-on,,,2751.32,3185.74,8
HCPCS,44227,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,11448.0,7441.2,1.1,11448.0,50
HCPCS,44227,Lap close enterostomy,,,2751.32,3185.74,8
HCPCS,44238,LAP CLOSURE OF ILEOSIGMOID FISTULA (COMP 44650),5656.0,3676.4,0.01,9852.42,34
HCPCS,44238,LAP COLECTOMY W/REMOVAL OF TI; NO ANASTOMOSIS W/ STOMA (COMP 442,10725.0,6971.25,0.01,10725.0,34
HCPCS,44238,LAP EXCISION OF CECUM W/O ANASTOMOSIS (COMP 44110),6037.0,3924.05,0.01,9852.42,34
HCPCS,44238,LAP EXCISION OF LARGE BOWEL LESION(S) (COMP 44110),3791.0,2464.15,0.01,9852.42,34
HCPCS,44238,LAP EXCISION SM BOWEL LESION,2500.0,1625.0,0.01,9852.42,34
HCPCS,44238,LAP GRAHAM PATCH INTESTINE (COMP 43840),8219.0,5342.35,0.01,9852.42,34
HCPCS,44238,"LAP REDUCE VOLVULUS,INTUSS,INTERNAL HERNIA (COMP 44050)",5588.0,3632.2,0.01,9852.42,34
HCPCS,44238,LAP REPAIR ENTEROCUTANEOUS FISTULA (COMP 44640),9684.0,6294.6,0.01,9852.42,34
HCPCS,44238,LAP REVISION COLOSTOMY W/RPR PARACOLOSTOMY HERNIA (COMP 44346),5035.0,3272.75,0.01,9852.42,34
HCPCS,44238,LAP REVISION OF ILEAL POUCH W/ RESECTION (COMP 46712),13123.0,8529.95,0.01,13123.0,34
HCPCS,44238,"LAP SUTURE OF LG INTESTINE, SINGLE/MULT (COMP 44604)",5857.0,3807.05,0.01,9852.42,34
HCPCS,44238,"LAP SUTURE OF SM INTESTINE, SINGLE (COMP 44602)",4495.0,2921.75,0.01,9852.42,34
HCPCS,44238,LAPAROSCOPIC BRAUN ENTEROENTEROSTOMY (COMP 44130),9507.0,6179.55,0.01,9852.42,34
HCPCS,44238,LAPAROSCOPIC CECOPEXY (COMP CODE 44680),6466.0,4202.9,0.01,9852.42,34
HCPCS,44238,LAPAROSCOPIC EXCISION SMALL BOWEL LESION/S (COMP 44110),6037.0,3924.05,0.01,9852.42,34
HCPCS,44238,LAPAROSCOPIC ILEOCOLOSTOMY PEXY (COMP 44312),3395.0,2206.75,0.01,9852.42,34
HCPCS,44238,LAPAROSCOPIC PARTIAL COLECTOMY WITHOUT ANASTOMOSIS (COMP CODE 44,11360.0,7384.0,0.01,11360.0,34
HCPCS,44238,LAPAROSCOPIC REMOVAL OF FOREIGN BODY; SMALL INTESTINE (COMP 4402,5840.0,3796.0,0.01,9852.42,34
HCPCS,44238,LAPAROSCOPIC STRICTUROPLASTY (COMP 44615),6538.0,4249.7,0.01,9852.42,34
HCPCS,44238,LAPARSCOPIC CLOSURE ENTEROCOLIC FISTULA (COMP 44650),10096.0,6562.4,0.01,10096.0,34
HCPCS,44238,LX EXCISION OF MECKEL'S DIVERTICULUM (COMP CODE 44800),4226.0,2746.9,0.01,9852.42,34
HCPCS,44238,"LX PROCTOSIGMOID, CAA, ILEOSTOMY",7104.0,4617.6,0.01,9852.42,34
HCPCS,44238,LX TAKEDOWN OF COLOVESICLE FIST W/RESECT (COMP CODE 44661),10664.0,6931.6,0.01,10664.0,34
HCPCS,44238,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",5122.0,3329.3,0.01,9852.42,34
HCPCS,44238,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) (COMP CODE 44144)",9870.0,6415.5,0.01,9870.0,34
HCPCS,44238,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) COMPARED TO 44144",9870.0,6415.5,0.01,9870.0,34
HCPCS,44238,UNLISTED LAP LADDS PROCEDURE (COMP CODE 44055),9227.0,5997.55,0.01,9852.42,34
HCPCS,44238,UNLISTED LAPAROSCOPIC COMPLETION PROCTECTOMY WITH ILEOANAL POUCH,14118.5,9177.03,0.01,14118.5,34
HCPCS,44238,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",2120.0,1378.0,0.01,9852.42,102
HCPCS,44238,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,2575.0,1673.75,0.01,9852.42,34
HCPCS,44238,UNLISTED LAPS PX INTESTINE,,,5390.83,16944.69,19
HCPCS,44238,"UNLISTED PROC, LAP REPAIR OF DUODENAL PERFORATION (COMP TO 44602",8158.0,5302.7,0.01,9852.42,34
HCPCS,44238,UNLISTED PROC; LAP REVISION OF ILEOSTOMY; COMPLICATED (COMP TO 4,17632.0,11460.8,0.01,17632.0,34
HCPCS,44238,Unlisted laps px intestine,,,1263.14,1462.58,8
HCPCS,44300,OPEN BOWEL TO SKIN,1361.0,884.65,1.1,5378.41,63
HCPCS,44300,Open bowel to skin,,,1263.14,1462.58,8
HCPCS,44300,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,5500.0,3575.0,1.1,5500.0,50
HCPCS,44310,ILEOSTOMY/JEJUNOSTOMY,2123.0,1379.95,1.1,3551.93,50
HCPCS,44310,"ILEOSTOMY/JEJUNOSTOMY,NONTUBE",7740.0,5031.0,1.1,7740.0,50
HCPCS,44310,Ileostomy/jejunostomy,,,1263.14,1462.58,8
HCPCS,44312,REVISION OF ILEOSTOMY,,,3352.64,9932.52,19
HCPCS,44312,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,3772.0,2451.8,1.1,6125.06,50
HCPCS,44312,Revision of ileostomy,,,1263.14,1462.58,8
HCPCS,44314,REVISION OF ILEOSTOMY,,,3352.64,9932.52,13
HCPCS,44314,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,6696.0,4352.4,1.1,6696.0,50
HCPCS,44314,Revision of ileostomy,,,1263.14,1462.58,8
HCPCS,44316,Devise bowel pouch,,,1263.14,1462.58,8
HCPCS,44320,COLOSTOMY/SKIN LEVEL CECOSTOMY,7964.0,5176.6,1.1,7964.0,50
HCPCS,44320,Colostomy,,,2751.32,3185.74,8
HCPCS,44322,Colostomy with biopsies,,,1263.14,1462.58,8
HCPCS,44340,REVISION OF COLOSTOMY,,,3352.64,9932.52,19
HCPCS,44340,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,3712.0,2412.8,1.1,6125.06,50
HCPCS,44340,Revision of colostomy,,,1263.14,1462.58,8
HCPCS,44345,REVISION OF COLOSTOMY,,,3352.64,9932.52,13
HCPCS,44345,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,6888.0,4477.2,1.1,6888.0,50
HCPCS,44345,Revision of colostomy,,,1263.14,1462.58,8
HCPCS,44346,REVISION OF COLOSTOMY,,,3352.64,9932.52,13
HCPCS,44346,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,7852.0,5103.8,1.1,7852.0,50
HCPCS,44346,Revision of colostomy,,,2751.32,3185.74,8
HCPCS,44360,ENDOSCOPY UPPER SMALL INTESTINE,996.0,647.4,1.1,3248.9,50
HCPCS,44360,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44360,Small bowel endoscopy,,,619.37,717.17,8
HCPCS,44361,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,1108.0,720.2,1.1,3248.9,50
HCPCS,44361,SMALL BOWEL ENDOSCOPY/BIOPSY,,,1752.78,5378.41,19
HCPCS,44361,Small bowel endoscopy/biopsy,,,619.37,717.17,8
HCPCS,44363,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,1356.0,881.4,1.1,3248.9,50
HCPCS,44363,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44363,Small bowel endoscopy,,,1191.17,1379.25,8
HCPCS,44364,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,1452.0,943.8,1.1,3248.9,50
HCPCS,44364,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44364,Small bowel endoscopy,,,1191.17,1379.25,8
HCPCS,44365,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,1284.0,834.6,1.1,3248.9,50
HCPCS,44365,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44365,Small bowel endoscopy,,,1191.17,1379.25,8
HCPCS,44366,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,1720.0,1118.0,1.1,3248.9,50
HCPCS,44366,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44366,Small bowel endoscopy,,,1191.17,1379.25,8
HCPCS,44369,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,1764.0,1146.6,1.1,3248.9,50
HCPCS,44369,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44369,Small bowel endoscopy,,,619.37,717.17,8
HCPCS,44370,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,1876.0,1219.4,1.1,9730.56,50
HCPCS,44370,SMALL BOWEL ENDOSCOPY/STENT,,,5500.28,17015.8,19
HCPCS,44370,Small bowel endoscopy/stent,,,1191.17,1379.25,8
HCPCS,44372,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,1720.0,1118.0,1.1,3248.9,50
HCPCS,44372,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44372,Small bowel endoscopy,,,619.37,717.17,8
HCPCS,44373,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,1356.0,881.4,1.1,3248.9,50
HCPCS,44373,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44373,Small bowel endoscopy,,,619.37,717.17,8
HCPCS,44376,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,2060.0,1339.0,1.1,3248.9,50
HCPCS,44376,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44376,Small bowel endoscopy,,,619.37,717.17,8
HCPCS,44377,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,2168.0,1409.2,1.1,3248.9,50
HCPCS,44377,SMALL BOWEL ENDOSCOPY/BIOPSY,,,1752.78,5378.41,19
HCPCS,44377,Small bowel endoscopy/biopsy,,,619.37,717.17,8
HCPCS,44378,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,2808.0,1825.2,1.1,3248.9,50
HCPCS,44378,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44378,Small bowel endoscopy,,,1191.17,1379.25,8
HCPCS,44379,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,2944.0,1913.6,1.1,9730.56,50
HCPCS,44379,S BOWEL ENDOSCOPE W/STENT,,,5500.28,17015.8,19
HCPCS,44379,S bowel endoscope w/stent,,,1191.17,1379.25,8
HCPCS,44380,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,348.0,226.2,1.1,1548.29,53
HCPCS,44380,SMALL BOWEL ENDOSCOPY BR/WA,,,858.08,2542.14,19
HCPCS,44380,Small bowel endoscopy br/wa,,,706.64,818.21,8
HCPCS,44381,ILEOSCOPY STOMA W/BALLOON DILATION,552.0,358.8,1.1,3248.9,47
HCPCS,44381,SMALL BOWEL ENDOSCOPY BR/WA,,,1752.78,5378.41,19
HCPCS,44381,Small bowel endoscopy br/wa,,,706.64,818.21,8
HCPCS,44382,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,468.0,304.2,1.1,1548.29,53
HCPCS,44382,SMALL BOWEL ENDOSCOPY,,,858.08,2542.14,19
HCPCS,44382,Small bowel endoscopy,,,706.64,818.21,8
HCPCS,44384,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,1140.0,741.0,1.1,3248.9,44
HCPCS,44384,SMALL BOWEL ENDOSCOPY,,,1752.78,5378.41,19
HCPCS,44385,ENDOSCOPY OF BOWEL POUCH,,,842.4,2606.53,19
HCPCS,44385,Endoscopy of bowel pouch,,,706.64,818.21,8
HCPCS,44385,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,528.0,343.2,1.1,1560.83,53
HCPCS,44386,ENDOSCOPY BOWEL POUCH/BIOP,,,842.4,2606.53,19
HCPCS,44386,Endoscopy bowel pouch/biop,,,706.64,818.21,8
HCPCS,44386,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,660.0,429.0,1.1,1560.83,53
HCPCS,44388,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,1088.0,707.2,1.1,1560.83,53
HCPCS,44388,COLONOSCOPY THRU STOMA SPX,,,842.4,2606.53,19
HCPCS,44388,Colonoscopy thru stoma spx,,,706.64,818.21,8
HCPCS,44389,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,1329.0,863.85,1.1,2014.21,53
HCPCS,44389,COLONOSCOPY WITH BIOPSY,,,1089.45,3354.0,19
HCPCS,44389,Colonoscopy with biopsy,,,706.64,818.21,8
HCPCS,44390,COLONOSCOPY FOR FOREIGN BODY,,,842.4,2606.53,19
HCPCS,44390,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,1496.0,972.4,1.1,1560.83,53
HCPCS,44390,Colonoscopy for foreign body,,,706.64,818.21,8
HCPCS,44391,COLONOSCOPY FOR BLEEDING,,,1089.45,3354.0,19
HCPCS,44391,COLONOSCOPY STOMA CONTROL BLEEDING,1648.0,1071.2,1.1,2109.19,53
HCPCS,44391,Colonoscopy for bleeding,,,706.64,818.21,8
HCPCS,44392,COLONOSCOPY & POLYPECTOMY,,,1089.45,3354.0,19
HCPCS,44392,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,1412.0,917.8,1.1,2014.21,53
HCPCS,44392,Colonoscopy & polypectomy,,,706.64,818.21,8
HCPCS,44394,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,1612.0,1047.8,1.1,2014.21,53
HCPCS,44394,COLONOSCOPY W/SNARE,590.0,383.5,1.1,3354.0,72
HCPCS,44394,Colonoscopy w/snare,,,706.64,818.21,8
HCPCS,44401,COLONOSCOPY WITH ABLATION,,,1089.45,3354.0,19
HCPCS,44401,Colonoscopy with ablation,,,706.64,818.21,8
HCPCS,44402,COLONOSCOPY W/STENT PLCMT,,,5500.28,17015.8,19
HCPCS,44403,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,2200.0,1430.0,1.1,2200.0,44
HCPCS,44403,COLONOSCOPY W/RESECTION,,,1089.45,3354.0,19
HCPCS,44403,Colonoscopy w/resection,,,706.64,818.21,8
HCPCS,44404,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,1208.0,785.2,1.1,2014.21,47
HCPCS,44404,COLONOSCOPY W/INJECTION,,,1089.45,3354.0,19
HCPCS,44404,Colonoscopy w/injection,,,706.64,818.21,8
HCPCS,44405,COLONOSCOPY STOMA W/BALLOON DILATION,1292.0,839.8,1.1,2014.21,47
HCPCS,44405,COLONOSCOPY W/DILATION,,,1089.45,3354.0,19
HCPCS,44405,Colonoscopy w/dilation,,,706.64,818.21,8
HCPCS,44406,COLONOSCOPY W/ULTRASOUND,,,1089.45,3354.0,19
HCPCS,44406,Colonoscopy w/ultrasound,,,706.64,818.21,8
HCPCS,44407,COLONOSCOPY W/NDL ASPIR/BX,,,1089.45,3354.0,19
HCPCS,44407,Colonoscopy w/ndl aspir/bx,,,706.64,818.21,8
HCPCS,44408,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,1656.0,1076.4,1.1,1656.0,50
HCPCS,44408,COLONOSCOPY W/DECOMPRESSION,,,842.4,2606.53,19
HCPCS,44408,Colonoscopy w/decompression,,,706.64,818.21,8
HCPCS,44500,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,2242.5,1457.625,0.01,9496.0,233
HCPCS,4450F,Self-care ed provided to pt,,,8.48,9.82,8
HCPCS,44602,ENTERORRHAPHY SINGLE PERFORATION,9888.0,6427.2,1.1,9888.0,50
HCPCS,44602,SUTURE SMALL INTESTINE,,,3647.57,10806.3,13
HCPCS,44602,"SUTURE, SMALL INTESTINE",2254.0,1465.1,1.1,4828.42,50
HCPCS,44602,Suture small intestine,,,2751.32,3185.74,8
HCPCS,44603,ENTERORRHAPHY MULTIPLE PERFORATIONS,11264.0,7321.6,1.1,11264.0,50
HCPCS,44603,"SUTURE, SMALL INTESTINE",3088.0,2007.2,1.1,5534.76,50
HCPCS,44603,Suture small intestine,,,1263.14,1462.58,8
HCPCS,44604,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,7264.0,4721.6,1.1,7264.0,50
HCPCS,44604,SUTURE OF LG INTESTINE W/O COLOSTOMY,2230.0,1449.5,1.1,3614.19,50
HCPCS,44604,Suture large intestine,,,2751.32,3185.74,8
HCPCS,44605,Repair of bowel lesion,,,1263.14,1462.58,8
HCPCS,44605,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,8832.0,5740.8,1.1,8832.0,50
HCPCS,44615,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,7264.0,4721.6,1.1,7264.0,50
HCPCS,44615,Intestinal stricturoplasty,,,2751.32,3185.74,8
HCPCS,44620,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,6349.0,4126.85,1.1,6349.0,50
HCPCS,44620,LAPAROSCOPIC OVERSEW OF SMALL BOWEL ANASTOMOSIS (COMP 44620),6204.0,4032.6,1.1,6204.0,50
HCPCS,44620,REPAIR BOWEL OPENING,1910.0,1241.5,1.1,2952.97,50
HCPCS,44620,Repair bowel opening,,,1263.14,1462.58,8
HCPCS,44625,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,6912.0,4492.8,1.1,6912.0,50
HCPCS,44625,Repair bowel opening,,,1263.14,1462.58,8
HCPCS,44626,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,11160.0,7254.0,1.1,11160.0,50
HCPCS,44626,Repair bowel opening,,,2751.32,3185.74,8
HCPCS,44640,CLOSURE INTESTINAL CUTANEOUS FISTULA,9680.0,6292.0,1.1,9680.0,50
HCPCS,44640,Repair bowel-skin fistula,,,2751.32,3185.74,8
HCPCS,44650,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,10048.0,6531.2,1.1,10048.0,50
HCPCS,44650,REPAIR BOWEL FISTULA,3738.0,2429.7,1.1,4919.8,50
HCPCS,44650,Repair bowel fistula,,,1263.14,1462.58,8
HCPCS,44660,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,9564.0,6216.6,1.1,9564.0,50
HCPCS,44660,LAP CLOSURE OF ENTEROVESICAL FISTULA W/O RESECTION (COMP 44660),10281.0,6682.65,1.1,10281.0,50
HCPCS,44660,Repair bowel-bladder fistula,,,1263.14,1462.58,8
HCPCS,44661,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,10940.0,7111.0,1.1,10940.0,50
HCPCS,44661,Repair bowel-bladder fistula,,,1263.14,1462.58,8
HCPCS,44680,INTESTINAL PLICATION SEPARATE PROCEDURE,7184.0,4669.6,1.1,7184.0,50
HCPCS,44680,Surgical revision intestine,,,1263.14,1462.58,8
HCPCS,44700,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,6992.0,4544.8,1.1,6992.0,50
HCPCS,44700,Suspend bowel w/prosthesis,,,1263.14,1462.58,8
HCPCS,44701,INTRAOPERATIVE COLONIC LAVAGE,1240.0,806.0,1.1,1240.0,50
HCPCS,44701,Intraop colon lavage add-on,,,2751.32,3185.74,8
HCPCS,44705,PREPARE FECAL MICROBIOTA FOR INSTILLATION,568.0,369.2,1.1,568.0,42
HCPCS,44705,Prepare fecal microbiota,,,237.67,275.2,8
HCPCS,4470F,Icd counseling provided,,,8.48,9.82,8
HCPCS,44715,Prepare donor intestine,,,975.94,1130.04,8
HCPCS,44720,Prep donor intestine/venous,,,975.94,1130.04,8
HCPCS,44721,Prep donor intestine/artery,,,975.94,1130.04,8
HCPCS,44799,CORRECTION OF GUT MALROTATION (EG. KAREEM'S PROCEDURE) - (COMP C,11020.0,7163.0,0.01,11020.0,28
HCPCS,44799,EGD THROUGH ARTIFICIAL STOMA (COMP 44369),1588.0,1032.2,0.01,1588.0,28
HCPCS,44799,EGD W/ CLIPPING OF INTESTINAL FISTULA (COMP 43255),1566.0,1017.9,0.01,1566.0,28
HCPCS,44799,ENDOSCOPIC SUBMUCOSAL DISSECTION OF SMALL INSTESTINE - (COMP COD,9941.0,6461.65,0.01,9941.0,28
HCPCS,44799,"ENDOVAC, SMALL INT; EGD (COMP 43235, 97605)",990.0,643.5,0.01,1548.29,28
HCPCS,44799,"ENDOVAC, SMALL INT; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,1548.29,28
HCPCS,44799,"ENDOVAC, SMALL INT; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2092.0,28
HCPCS,44799,"ENDOVAC, SMALL INT; POUCHOSCOPY (COMP 44385, 97605)",2203.0,1431.95,0.01,2203.0,28
HCPCS,44799,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),881.0,572.65,0.01,1548.29,28
HCPCS,44799,ILEOSCOPY W/ CONTROL OF BLEEDING THROUGH THE STOMA (COMP 44378),3018.0,1961.7,0.01,3018.0,28
HCPCS,44799,ILEOSCOPY WITH ABLATION VIA STOMA (COMP CODE 44401),1833.0,1191.45,0.01,1833.0,28
HCPCS,44799,POUCHOSCOPY W/ STENT PLACEMENT (COMP 44402),1693.0,1100.45,0.01,1693.0,28
HCPCS,44799,POUCHOSCOPY W/DECOMPRESSION (COMP 45393),2059.0,1338.35,0.01,2059.0,28
HCPCS,44799,POUCHOSCOPY W/SNARE (COMP 44386),645.0,419.25,0.01,1548.29,28
HCPCS,44799,REPAIR DUODENAL FISTULA (COMP 44650),4409.0,2865.85,0.01,4409.0,28
HCPCS,44799,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),2346.0,1524.9,0.01,2346.0,28
HCPCS,44799,RETROGRADE ENTEROSCOPY W/DILATION (COMP 45386),1659.0,1078.35,0.01,1659.0,28
HCPCS,44799,REVISION OF ANASTOMOSIS (COMP 44125),8813.0,5728.45,0.01,8813.0,28
HCPCS,44799,REVISION OF JEJUNOSTOMY (COMP 44314),6696.0,4352.4,0.01,6696.0,28
HCPCS,44799,SMALL INTESTINE MYRIAD COLLAGEN MATRIX IMPLANT (COMP 15777),1315.0,854.75,0.01,1548.29,28
HCPCS,44799,"UNLIST PROC, SMALL INTESTINE COMPARED TO 43265",3105.0,2018.25,0.01,3105.0,28
HCPCS,44799,"UNLIST PROC, SMALL INTESTINE COMPARED TO 44110",4633.0,3011.45,0.01,4633.0,28
HCPCS,44799,"UNLISTED PROC, OPEN ISOPERISTALTIC GASTROJEJNOSTOMY (COMP CODE 4",10025.0,6516.25,0.01,10025.0,28
HCPCS,44799,UNLISTED PROC; DUODENUM EXCLUS W/GASTROTOMY & GASTROJEJUNOSTOMY,10025.0,6516.25,0.01,10025.0,28
HCPCS,44799,UNLISTED PROCEDURE SMALL INTESTINE,335.0,217.75,0.01,1548.29,28
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE (COMPARISON CODE 15860)",325.0,211.25,0.01,1548.29,28
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 43236",935.0,607.75,0.01,1548.29,28
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44394",1373.0,892.45,0.01,1548.29,28
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44705",469.0,304.85,0.01,1548.29,28
HCPCS,44799,UNLISTED PX SMALL INTESTINE,,,858.08,2542.14,19
HCPCS,44799,Unlisted px small intestine,,,1263.14,1462.58,8
HCPCS,44800,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,4820.0,3133.0,1.1,4820.0,50
HCPCS,44800,Excision of bowel pouch,,,1263.14,1462.58,8
HCPCS,4480F,Pt rcvng ace/arb b-blockertx,,,8.48,9.82,8
HCPCS,4481F,Pt rcvng ace/arb blker <3mos,,,8.48,9.82,8
HCPCS,44820,EXCISION LESION MESENTERY SEPARATE PROCEDURE,5492.0,3569.8,1.1,5492.0,50
HCPCS,44820,Excision of mesentery lesion,,,1263.14,1462.58,8
HCPCS,44850,Repair of mesentery,,,1263.14,1462.58,8
HCPCS,44850,SUTURE MESENTERY SEPARATE PROCEDURE,4844.0,3148.6,1.1,4844.0,50
HCPCS,44899,"UNLISTED PROC, MECKEL'S DIVERTICULUM & THE MESENTERY COMPARED TO",3977.0,2585.05,0.01,1792000.0,28
HCPCS,44899,UNLISTED PROC; LAPAROSCOPIC CORE NEEDLE BIOPSY(IES) MESENTERY PR,2224.0,1445.6,0.01,1792000.0,28
HCPCS,44899,"UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY (COM",1790.0,1163.5,0.01,1792000.0,28
HCPCS,44899,UNLISTED PX MECKEL'S DIVERTICULUM & MESENTERY,1844.0,1198.6,0.01,1792000.0,28
HCPCS,44899,Unlisted px meckel's dvrtclm,,,1263.14,1462.58,8
HCPCS,44900,"DRAIN APP ABSCESS, OPEN",1833.0,1191.45,1.1,2696.01,50
HCPCS,44900,I&d appendix abscess open,,,1263.14,1462.58,8
HCPCS,44950,APPENDECTOMY,2663.0,1730.95,1.1,18145.13,119
HCPCS,44950,Appendectomy,,,2751.32,3185.74,8
HCPCS,44955,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,612.0,397.8,1.1,612.0,50
HCPCS,44955,APPENDECTOMY ADD-ON,163.0,105.95,1.1,286.61,50
HCPCS,44955,Appendectomy add-on,,,1611.33,1865.75,8
HCPCS,44960,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,5800.0,3770.0,1.1,5800.0,50
HCPCS,44960,APPENDECTOMY,1438.0,934.7,1.1,3011.67,50
HCPCS,44960,Appendectomy,,,2751.32,3185.74,8
HCPCS,44970,LAPAROSCOPIC APPENDECTOMY,3780.0,2457.0,1.1,9852.42,50
HCPCS,44970,LAPAROSCOPY APPENDECTOMY,,,5390.83,16944.69,20
HCPCS,44970,"LAPAROSCOPY, APPENDECTOMY",1129.0,733.85,1.1,9852.42,50
HCPCS,44970,Laparoscopy appendectomy,,,2751.32,3185.74,8
HCPCS,44979,LAP APPENDECTOMY AT TIME OTHER SURGERY (COMP CODE 44955),519.0,337.35,0.01,9852.42,28
HCPCS,44979,"UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX",4148.0,2696.2,0.01,9852.42,28
HCPCS,44979,UNLISTED LAPS PX APPENDIX,,,5390.83,16944.69,19
HCPCS,44979,UNLISTED PROC; LAP DRAINAGE OF APPENDICEAL ABSCESS W/DEBRIDEMENT,4148.0,2696.2,0.01,9852.42,28
HCPCS,44979,Unlisted laps px appendix,,,1263.14,1462.58,8
HCPCS,45000,DRAINAGE OF PELVIC ABSCESS,,,1089.45,3354.0,19
HCPCS,45000,Drainage of pelvic abscess,,,1457.88,1688.07,8
HCPCS,45000,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,2520.0,1638.0,1.1,2520.0,50
HCPCS,45005,DRAINAGE OF RECTAL ABSCESS,,,1089.45,3354.0,19
HCPCS,45005,Drainage of rectal abscess,,,863.18,999.47,8
HCPCS,45005,I&D SUBMUCOSAL ABSCESS RECTUM,808.0,525.2,1.1,2014.21,53
HCPCS,4500F,Ref to outpt card rehab prog,,,8.48,9.82,8
HCPCS,45020,DRAINAGE OF RECTAL ABSCESS,,,2533.91,7779.76,19
HCPCS,45020,Drainage of rectal abscess,,,1457.88,1688.07,8
HCPCS,45020,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,3424.0,2225.6,1.1,4793.6,50
HCPCS,45100,BIOPSY OF RECTUM,540.0,351.0,1.1,7779.76,69
HCPCS,45100,BX ANORECTAL WALL ANAL APPROACH,1616.0,1050.4,1.1,4793.6,50
HCPCS,45100,Biopsy of rectum,,,863.18,999.47,8
HCPCS,45108,ANORECTAL MYOMECTOMY,,,2533.91,7779.76,19
HCPCS,45108,Anorectal myomectomy,,,1457.88,1688.07,8
HCPCS,4510F,Prev cardrehab qualcardevent,,,8.48,9.82,8
HCPCS,45110,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,12304.0,7997.6,1.1,12304.0,50
HCPCS,45110,Removal of rectum,,,1457.88,1688.07,8
HCPCS,45111,PRCTECT PRTL RESCJ RECTUM TABDL APPR,7204.0,4682.6,1.1,7204.0,50
HCPCS,45111,Partial removal of rectum,,,1457.88,1688.07,8
HCPCS,45112,Removal of rectum,,,1457.88,1688.07,8
HCPCS,45113,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,13288.0,8637.2,1.1,13288.0,50
HCPCS,45113,Partial proctectomy,,,1457.88,1688.07,8
HCPCS,45114,Partial removal of rectum,,,1457.88,1688.07,8
HCPCS,45116,Partial removal of rectum,,,1457.88,1688.07,8
HCPCS,45119,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,13392.0,8704.8,1.1,13392.0,50
HCPCS,45119,Remove rectum w/reservoir,,,1457.88,1688.07,8
HCPCS,45120,Removal of rectum,,,1457.88,1688.07,8
HCPCS,45121,Removal of rectum and colon,,,1457.88,1688.07,8
HCPCS,45123,PRCTECT PRTL W/O ANAST PRNL APPR,7544.0,4903.6,1.1,7544.0,50
HCPCS,45123,Partial proctectomy,,,1457.88,1688.07,8
HCPCS,45126,PELVIC EXENTERATION COLORECTAL MALIGNANCY,19640.0,12766.0,1.1,19640.0,50
HCPCS,45126,Pelvic exenteration,,,1611.33,1865.75,8
HCPCS,45130,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,7400.0,4810.0,1.1,7400.0,50
HCPCS,45130,Excision of rectal prolapse,,,1457.88,1688.07,8
HCPCS,45135,EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH,8944.0,5813.6,1.1,8944.0,50
HCPCS,45135,Excision of rectal prolapse,,,1457.88,1688.07,8
HCPCS,45136,Excise ileoanal reservior,,,1457.88,1688.07,8
HCPCS,45150,EXCISION OF RECTAL STRICTURE,,,1089.45,3354.0,19
HCPCS,45150,Excision of rectal stricture,,,1457.88,1688.07,8
HCPCS,45160,EXCISION OF RECTAL LESION,,,2533.91,7779.76,19
HCPCS,45160,Excision of rectal lesion,,,1457.88,1688.07,8
HCPCS,45171,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,3252.0,2113.8,1.1,4793.6,50
HCPCS,45171,EXC RECT TUM TRANSANAL PART,,,2533.91,7779.76,19
HCPCS,45171,Exc rect tum transanal part,,,1457.88,1688.07,8
HCPCS,45172,EXC RCT TUM INCL MUSCULARIS PROPRIA,4852.0,3153.8,1.1,4852.0,50
HCPCS,45172,EXC RECT TUM TRANSANAL FULL,,,2533.91,7779.76,19
HCPCS,45172,"EXCISION OF RECTAL TUMOR, TRANSANAL",1800.0,1170.0,1.1,4793.6,50
HCPCS,45172,Exc rect tum transanal full,,,1457.88,1688.07,8
HCPCS,45190,DESTRUCTION RECTAL TUMOR,,,2533.91,7779.76,19
HCPCS,45190,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,4168.0,2709.2,1.1,4793.6,50
HCPCS,45190,Destruction rectal tumor,,,1457.88,1688.07,8
HCPCS,4525F,Neuropsychia interven order,,,8.48,9.82,8
HCPCS,4526F,Neuropsychia interven rcvd,,,8.48,9.82,8
HCPCS,45300,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,320.0,208.0,1.1,1560.83,53
HCPCS,45300,PROCTOSIGMOIDOSCOPY DX,,,842.4,2606.53,19
HCPCS,45300,Proctosigmoidoscopy dx,,,706.64,818.21,8
HCPCS,45303,PROCTOSGMDSC RIGID W/DILATION,560.0,364.0,1.1,3111.98,53
HCPCS,45303,PROCTOSIGMOIDOSCOPY DILATE,,,1089.45,3354.0,19
HCPCS,45305,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,460.0,299.0,1.1,2014.21,53
HCPCS,45305,PROCTOSIGMOIDOSCOPY W/BX,,,1089.45,3354.0,19
HCPCS,45305,Proctosigmoidoscopy w/bx,,,706.64,818.21,8
HCPCS,45307,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,640.0,416.0,1.1,4793.6,53
HCPCS,45307,PROCTOSIGMOIDOSCOPY FB,,,2533.91,7779.76,19
HCPCS,45307,Proctosigmoidoscopy fb,,,706.64,818.21,8
HCPCS,45308,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,520.0,338.0,1.1,4793.6,53
HCPCS,45308,PROCTOSIGMOIDOSCOPY REMOVAL,,,2533.91,7779.76,19
HCPCS,45309,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,560.0,364.0,1.1,2014.21,53
HCPCS,45309,PROCTOSIGMOIDOSCOPY REMOVAL,,,1089.45,3354.0,19
HCPCS,45309,Proctosigmoidoscopy removal,,,706.64,818.21,8
HCPCS,45315,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,680.0,442.0,1.1,2014.21,53
HCPCS,45315,PROCTOSIGMOIDOSCOPY REMOVAL,,,1089.45,3354.0,19
HCPCS,45315,Proctosigmoidoscopy removal,,,706.64,818.21,8
HCPCS,45317,PROCTOSGMDSC RIGID CONTROL BLEEDING,760.0,494.0,1.1,2014.21,53
HCPCS,45317,PROCTOSIGMOIDOSCOPY BLEED,,,1089.45,3354.0,19
HCPCS,45320,PROCTOSGMDSC RIGID ABLATION LESION,672.0,436.8,1.1,4793.6,53
HCPCS,45320,PROCTOSIGMOIDOSCOPY ABLATE,,,2533.91,7779.76,19
HCPCS,45321,PROCTOSIGMOIDOSCOPY VOLVUL,,,2533.91,7779.76,19
HCPCS,45327,PROCTOSIGMOIDOSCOPY W/STENT,,,5500.28,17015.8,19
HCPCS,45330,DIAGNOSTIC SIGMOIDOSCOPY,172.0,111.8,1.1,3728.0,73
HCPCS,45330,Diagnostic sigmoidoscopy,,,706.64,818.21,8
HCPCS,45330,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,370.0,240.5,1.1,1560.83,53
HCPCS,45331,SIGMOIDOSCOPY AND BIOPSY,216.0,140.4,1.1,2606.53,72
HCPCS,45331,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,502.0,326.3,1.1,1560.83,53
HCPCS,45331,Sigmoidoscopy and biopsy,,,706.64,818.21,8
HCPCS,45332,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,774.0,503.1,1.1,2014.21,53
HCPCS,45332,SIGMOIDOSCOPY W/FB REMOVAL,,,1089.45,3354.0,19
HCPCS,45332,Sigmoidoscopy w/fb removal,,,706.64,818.21,8
HCPCS,45333,SIGMOIDOSCOPY & POLYPECTOMY,315.0,204.75,1.1,2606.53,72
HCPCS,45333,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,682.0,443.3,1.1,1560.83,53
HCPCS,45333,Sigmoidoscopy & polypectomy,,,706.64,818.21,8
HCPCS,45334,SIGMOIDOSCOPY FLX CONTROL BLEEDING,880.0,572.0,1.1,2014.21,53
HCPCS,45334,SIGMOIDOSCOPY FOR BLEEDING,450.0,292.5,1.1,3354.0,72
HCPCS,45334,Sigmoidoscopy for bleeding,,,706.64,818.21,8
HCPCS,45335,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,458.0,297.7,1.1,1560.83,53
HCPCS,45335,SIGMOIDOSCOPY W/SUBMUC INJ,,,842.4,3728.0,20
HCPCS,45335,Sigmoidoscopy w/submuc inj,,,706.64,818.21,8
HCPCS,45337,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,924.0,600.6,1.1,1560.83,50
HCPCS,45337,SIGMOIDOSCOPY & DECOMPRESS,,,842.4,2606.53,19
HCPCS,45337,Sigmoidoscopy & decompress,,,706.64,818.21,8
HCPCS,45338,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,902.0,586.3,1.1,2014.21,53
HCPCS,45338,SIGMOIDOSCOPY REMOVAL LESION BY SNARE,317.0,206.05,1.1,2014.21,53
HCPCS,45338,SIGMOIDOSCOPY W/TUMR REMOVE,,,1089.45,4831.0,20
HCPCS,45338,SIGMOIDOSCPY W/TUMR REMOVE,317.0,206.05,1.1,2014.21,53
HCPCS,45338,Sigmoidoscopy w/tumr remove,,,706.64,818.21,8
HCPCS,45340,SIG W/TNDSC BALLOON DILATION,,,1089.45,3354.0,19
HCPCS,45340,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,550.0,357.5,1.1,2014.21,53
HCPCS,45340,Sig w/tndsc balloon dilation,,,706.64,818.21,8
HCPCS,45341,SIGMOIDOSCOPY FLX NDSC US XM,933.0,606.45,1.1,1560.83,50
HCPCS,45341,SIGMOIDOSCOPY W/ULTRASOUND,,,842.4,2606.53,19
HCPCS,45341,Sigmoidoscopy w/ultrasound,,,706.64,818.21,8
HCPCS,45342,SIGMOIDOSCOPY W/US GUIDE BX,,,1089.45,3354.0,19
HCPCS,45342,Sigmoidoscopy w/us guide bx,,,706.64,818.21,8
HCPCS,45346,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,1236.0,803.4,1.1,7452.28,53
HCPCS,45346,SIGMOIDOSCOPY W/ABLATION,,,1089.45,3354.0,19
HCPCS,45346,Sigmoidoscopy w/ablation,,,706.64,818.21,8
HCPCS,45347,SIGMOIDOSCOPY W/PLACEMENT OF STENT,1197.0,778.05,1.1,9730.56,50
HCPCS,45347,SIGMOIDOSCOPY W/PLCMT STENT,,,5500.28,17015.8,19
HCPCS,45349,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,1549.0,1006.85,1.1,4793.6,44
HCPCS,45349,SIGMOIDOSCOPY W/RESECTION,,,2533.91,7779.76,19
HCPCS,45350,SGMDSC W/BAND LIGATION,,,1089.45,3354.0,19
HCPCS,45350,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),739.0,480.35,1.1,2186.75,47
HCPCS,45350,Sgmdsc w/band ligation,,,706.64,818.21,8
HCPCS,45378,COLONOSCOPY,630.0,409.5,1.1,1560.83,53
HCPCS,45378,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,1434.0,932.1,1.1,1560.83,53
HCPCS,45378,DIAGNOSTIC COLONOSCOPY,,,842.4,4831.0,20
HCPCS,45378,Diagnostic colonoscopy,,,706.64,818.21,8
HCPCS,45379,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),1883.0,1223.95,1.1,2014.21,53
HCPCS,45379,COLONOSCOPY W/FB REMOVAL,,,1089.45,3354.0,19
HCPCS,45379,Colonoscopy w/fb removal,,,706.64,818.21,8
HCPCS,45380,COLONOSCOPY AND BIOPSY,706.0,458.9,1.1,4831.0,73
HCPCS,45380,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,1566.0,1017.9,1.1,2014.21,53
HCPCS,45380,Colonoscopy and biopsy,,,706.64,818.21,8
HCPCS,45381,COLONOSCOPY SUBMUCOUS NJX,,,1089.45,3354.0,19
HCPCS,45381,"COLONOSCOPY, SUBMUCOUS INJ",703.0,456.95,1.1,2014.21,53
HCPCS,45381,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,1566.0,1017.9,1.1,2014.21,53
HCPCS,45381,Colonoscopy submucous njx,,,706.64,818.21,8
HCPCS,45382,COLONOSCOPY W/CONTROL BLEED,,,1089.45,3354.0,19
HCPCS,45382,COLONOSCOPY/CONTROL BLEEDING,755.0,490.75,1.1,2197.68,53
HCPCS,45382,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,1864.0,1211.6,1.1,2197.68,53
HCPCS,45382,Colonoscopy w/control bleed,,,706.64,818.21,8
HCPCS,45384,COLONOSCOPY W/LESION REMOVAL,,,1089.45,3354.0,19
HCPCS,45384,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,1628.0,1058.2,1.1,2014.21,53
HCPCS,45384,Colonoscopy w/lesion removal,,,706.64,818.21,8
HCPCS,45385,COLONOSCOPY W/LESION REMOVAL,,,1089.45,4831.0,20
HCPCS,45385,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,2011.0,1307.15,1.1,2014.21,53
HCPCS,45385,Colonoscopy w/lesion removal,,,706.64,818.21,8
HCPCS,45385,LESION REMOVAL COLONOSCOPY,970.0,630.5,1.1,2014.21,53
HCPCS,45386,COLONOSCOPY DILATE STRICTURE,490.0,318.5,1.1,2014.21,53
HCPCS,45386,COLONOSCOPY W/BALLOON DILAT,,,1089.45,3354.0,19
HCPCS,45386,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,1659.0,1078.35,1.1,2014.21,53
HCPCS,45386,Colonoscopy w/balloon dilat,,,706.64,818.21,8
HCPCS,45388,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,2147.0,1395.55,1.1,7989.15,53
HCPCS,45388,COLONOSCOPY W/ABLATION,,,1089.45,3354.0,19
HCPCS,45388,Colonoscopy w/ablation,,,706.64,818.21,8
HCPCS,45389,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,2096.0,1362.4,1.1,9730.56,50
HCPCS,45389,COLONOSCOPY W/STENT PLCMT,,,5500.28,17015.8,19
HCPCS,45390,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,2416.0,1570.4,1.1,4793.6,50
HCPCS,45390,COLONOSCOPY W/RESECTION,,,2533.91,7779.76,20
HCPCS,45391,COLONOSCOPY W/ENDOSCOPE US,,,1089.45,3354.0,19
HCPCS,45391,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,1856.0,1206.4,1.1,2014.21,50
HCPCS,45391,Colonoscopy w/endoscope us,,,706.64,818.21,8
HCPCS,45392,COLONOSCOPY W/ENDOSCOPIC FNB,,,1089.45,3354.0,19
HCPCS,45392,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,2200.0,1430.0,1.1,2200.0,50
HCPCS,45393,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,2059.0,1338.35,1.1,2059.0,50
HCPCS,45393,COLONOSCOPY W/DECOMPRESSION,600.0,390.0,1.1,3354.0,69
HCPCS,45393,Colonoscopy w/decompression,,,706.64,818.21,8
HCPCS,45395,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,13200.0,8580.0,1.1,13200.0,50
HCPCS,45395,Lap removal of rectum,,,1457.88,1688.07,8
HCPCS,45397,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,14600.0,9490.0,1.1,14600.0,50
HCPCS,45397,Lap remove rectum w/pouch,,,1457.88,1688.07,8
HCPCS,45398,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),1680.0,1092.0,1.1,2718.82,53
HCPCS,45398,COLONOSCOPY W/BAND LIGATION,,,1089.45,3354.0,19
HCPCS,45398,Colonoscopy w/band ligation,,,706.64,818.21,8
HCPCS,45399,EDOSCOPIC STRICTUROTOMY (COMP 46700),4218.0,2741.7,0.01,4218.0,29
HCPCS,45399,ENDOSCOPIC DEFECT CLOSURE (COMP CODE 44604),7808.0,5075.2,0.01,7808.0,29
HCPCS,45399,ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLON - (COMP CODE 44204),11229.0,7298.85,0.01,11229.0,29
HCPCS,45399,"ENDOVAC, COLON; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,4167.77,29
HCPCS,45399,"ENDOVAC, COLON; COLONOSCOPY VIA STOMA (COMP 45388, 97605)",2336.0,1518.4,0.01,4167.77,29
HCPCS,45399,"ENDOVAC, COLON; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,4167.77,29
HCPCS,45399,OPEN RESECTION OF CECUM W/O ANASTOMOSIS (COMP 44110),5055.0,3285.75,0.01,5055.0,29
HCPCS,45399,SERIAL TRANVERSE COLOPLASTY (COMP 44604),6538.0,4249.7,0.01,6538.0,29
HCPCS,45399,"UNLISTED PROC, COLON COMPARED TO 44158",12111.0,7872.15,0.01,12111.0,29
HCPCS,45399,UNLISTED PROCEDURE COLON,247.0,160.55,0.01,4167.77,48
HCPCS,45399,"UNLISTED PROCEDURE, COLON (COMPARISON CODE 15860)",240.0,156.0,0.01,4167.77,29
HCPCS,45399,"UNLISTED PROCEDURE, RECTUM (COMPARISON CODE 44604)",2230.0,1449.5,0.01,4167.77,29
HCPCS,45399,Unlisted procedure colon,,,706.64,818.21,8
HCPCS,45400,LAPAROSCOPY PROCTOPEXY PROLAPSE,7776.0,5054.4,1.1,7776.0,50
HCPCS,45400,Laparoscopic proc,,,1457.88,1688.07,8
HCPCS,45402,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,10604.0,6892.6,1.1,10604.0,50
HCPCS,45402,Lap proctopexy w/sig resect,,,1457.88,1688.07,8
HCPCS,4540F,Disease modif pharmacothxpy,,,8.48,9.82,8
HCPCS,4541F,Pt offered tx for pseudobulb,,,8.48,9.82,8
HCPCS,45499,LAP COMPLETE PROCTECTOMY W/WO COLOANAL ANASTOMOSIS (COMP 45112),14267.0,9273.55,0.01,14267.0,28
HCPCS,45499,LAP EXCISION  RETRORECTAL MASS/TUMOR (COMP 45172),6239.0,4055.35,0.01,9852.42,28
HCPCS,45499,LAP PARTIAL PROCTECTOMY (COMP 45111),7744.0,5033.6,0.01,9852.42,28
HCPCS,45499,LAPAROSCOPE PROC RECTUM,,,5390.83,16944.69,19
HCPCS,45499,LAPAROSCOPIC ABDOMINAL PERINEAL EXCISION OF ILEAL J POUCH (COMP,13099.0,8514.35,0.01,13099.0,28
HCPCS,45499,LX COMP. PROC. IPAA +-ILEOSTOMY (COMP CODE 44211),9768.0,6349.2,0.01,9852.42,28
HCPCS,45499,Laparoscope proc rectum,,,863.18,999.47,8
HCPCS,45499,UNLISTED LAP SWENSON PROCEDURE (COMP CODE 45120),11220.0,7293.0,0.01,11220.0,28
HCPCS,45500,REPAIR OF RECTUM,,,2533.91,7779.76,19
HCPCS,45500,Repair of rectum,,,1457.88,1688.07,8
HCPCS,45505,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,3344.0,2173.6,1.1,4793.6,50
HCPCS,45505,REPAIR OF RECTUM,,,2533.91,7779.76,19
HCPCS,45505,Repair of rectum,,,1457.88,1688.07,8
HCPCS,4550F,Noninvas resp support talk,,,8.48,9.82,8
HCPCS,4551F,Nutritional support offered,,,8.48,9.82,8
HCPCS,45520,TREATMENT OF RECTAL PROLAPSE,,,842.4,2606.53,19
HCPCS,45520,Treatment of rectal prolapse,,,863.18,999.47,8
HCPCS,4552F,Pt ref for speech lang path,,,8.48,9.82,8
HCPCS,4553F,Pt asst re end life issues,,,8.48,9.82,8
HCPCS,45540,Correct rectal prolapse,,,1457.88,1688.07,8
HCPCS,45540,PROCTOPEXY ABDOMINAL APPROACH,7248.0,4711.2,1.1,7248.0,50
HCPCS,45541,CORRECT RECTAL PROLAPSE,,,2533.91,7779.76,19
HCPCS,45541,Correct rectal prolapse,,,1457.88,1688.07,8
HCPCS,45541,PROCTOPEXY PERINEAL APPROACH,5940.0,3861.0,1.1,5940.0,50
HCPCS,4554F,Pt recvd inhal anesthetic,,,8.48,9.82,8
HCPCS,45550,Repair rectum/remove sigmoid,,,1457.88,1688.07,8
HCPCS,4555F,Pt recvd no inhal anesthic,,,8.48,9.82,8
HCPCS,45560,REPAIR OF RECTOCELE,,,2533.91,7779.76,19
HCPCS,45560,REPAIR RECTOCELE SEPARATE PROCEDURE,4600.0,2990.0,1.1,4793.6,50
HCPCS,45560,Repair of rectocele,,,1457.88,1688.07,8
HCPCS,45562,EXPL RPR & PRESACRAL DRG RECTAL INJURY,7192.0,4674.8,1.1,7192.0,50
HCPCS,45562,Exploration/repair of rectum,,,1457.88,1688.07,8
HCPCS,45563,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,10552.0,6858.8,1.1,10552.0,50
HCPCS,45563,Exploration/repair of rectum,,,1457.88,1688.07,8
HCPCS,4556F,Pt w/3+ post-op nausea&vom,,,8.48,9.82,8
HCPCS,4557F,Pt w/o 3+ post-opnausea&vom,,,8.48,9.82,8
HCPCS,4558F,Pt recvd 2 rx anti-emet agt,,,8.48,9.82,8
HCPCS,4559F,1 bodytemp >=35.5cw/in 30min,,,8.48,9.82,8
HCPCS,4560F,Anesth w/o gen/neurax anesth,,,8.48,9.82,8
HCPCS,4561F,Pt w/ coronary artery stent,,,8.48,9.82,8
HCPCS,4562F,Pt w/o coronary artery stent,,,8.48,9.82,8
HCPCS,4563F,Pt recvd aspirin w/in 24 hrs,,,8.48,9.82,8
HCPCS,45800,CLOSURE RECTOVESICAL FISTULA,8124.0,5280.6,1.1,8124.0,50
HCPCS,45800,Repair rect/bladder fistula,,,1457.88,1688.07,8
HCPCS,45805,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,9328.0,6063.2,1.1,9328.0,50
HCPCS,45805,Repair fistula w/colostomy,,,1457.88,1688.07,8
HCPCS,45820,Repair rectourethral fistula,,,1457.88,1688.07,8
HCPCS,45825,Repair fistula w/colostomy,,,1457.88,1688.07,8
HCPCS,45900,REDUCTION OF RECTAL PROLAPSE,,,842.4,2606.53,19
HCPCS,45900,Reduction of rectal prolapse,,,863.18,999.47,8
HCPCS,45905,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,940.0,611.0,1.1,2014.21,50
HCPCS,45905,DILATION OF ANAL SPHINCTER,,,1089.45,3354.0,19
HCPCS,45905,Dilation of anal sphincter,,,863.18,999.47,8
HCPCS,45910,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,1140.0,741.0,1.1,2014.21,50
HCPCS,45910,DILATION OF RECTAL NARROWING,,,1089.45,3354.0,19
HCPCS,45910,Dilation of rectal narrowing,,,863.18,999.47,8
HCPCS,45915,REMOVE RECTAL OBSTRUCTION,,,1089.45,3354.0,19
HCPCS,45915,RMVL FECAL IMPACTION/FB SPX UNDER ANES,1276.0,829.4,1.1,2014.21,53
HCPCS,45915,Remove rectal obstruction,,,863.18,999.47,8
HCPCS,45990,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,720.0,468.0,1.1,4793.6,50
HCPCS,45990,SURG DX EXAM ANORECTAL,,,2533.91,7779.76,19
HCPCS,45990,"SURG DX EXAM, ANORECTAL",172.0,111.8,1.1,4793.6,50
HCPCS,45990,Surg dx exam anorectal,,,863.18,999.47,8
HCPCS,45999,"ENDOVAC, RECTUM; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,1639.0,28
HCPCS,45999,"ENDOVAC, RECTUM; COLONOSCOPY VIA STOMA (COMP 44388, 97605)",1217.0,791.05,0.01,1560.83,28
HCPCS,45999,"ENDOVAC, RECTUM; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,1560.83,28
HCPCS,45999,"OPEN REPAIR OF RECTAL FISTULA WO ANASTOMOSIS, TRANS-PERINEAL APP",6484.0,4214.6,0.01,6484.0,28
HCPCS,45999,RECTUM SURGERY PROCEDURE UNLISTED,2297.0,1493.05,0.01,2297.0,28
HCPCS,45999,REV ILEOANAL RES W/W/O ST (COMP 45113),14000.0,9100.0,0.01,14000.0,28
HCPCS,45999,REVISION/REDO POUCH AP APPROACH W/W/O STOMA (COMP 46712),13123.0,8529.95,0.01,13123.0,28
HCPCS,45999,TRANSANAL RPR COLOANAL ANASTOMOSIS (COMP 45505),2397.0,1558.05,0.01,2397.0,28
HCPCS,45999,UNLISTED PROCEDURE RECTUM,1714.0,1114.1,484.72,2606.53,61
HCPCS,46020,PLACEMENT OF SETON,678.0,440.70000000000005,1.1,7779.76,121
HCPCS,46020,Placement of seton,,,863.18,999.47,8
HCPCS,46030,REMOVAL ANAL SETON OTH MRK,,,1089.45,3354.0,19
HCPCS,46030,REMOVAL ANAL SETON OTHER MARKER,592.0,384.8,1.1,2014.21,53
HCPCS,46030,Removal anal seton oth mrk,,,863.18,999.47,8
HCPCS,46040,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,3786.0,2460.9,1.1,6561.0,175
HCPCS,46040,INCISION OF RECTAL ABSCESS,650.0,422.5,1.1,2014.21,53
HCPCS,46045,I&D ABSC TRANAL UNDER ANES,,,2533.91,7779.76,19
HCPCS,46045,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,2348.0,1526.2,1.1,4793.6,50
HCPCS,46045,I&d absc tranal under anes,,,1457.88,1688.07,8
HCPCS,46050,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,0.01,4194.0,183
HCPCS,46050,"I/D PERIANAL ABSCESS, SUPERFICIAL",546.0,354.9,1.1,1560.83,53
HCPCS,46050,INCISION OF ANAL ABSCESS,300.0,195.0,1.1,1560.83,53
HCPCS,46060,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,2548.0,1656.2,1.1,4793.6,50
HCPCS,46060,I&D ISCHIORECTAL/NTRMRL ABSC,,,2533.91,7779.76,19
HCPCS,46060,I&d ischiorectal/ntrmrl absc,,,1457.88,1688.07,8
HCPCS,46070,INCISION ANAL SEPTUM INFANT,,,2533.91,7779.76,19
HCPCS,46070,Incision anal septum infant,,,863.18,999.47,8
HCPCS,46080,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,1008.0,655.2,1.1,4793.6,53
HCPCS,46080,SPHNCTROTMY ANAL DIV SPHNCTR,,,2533.91,7779.76,19
HCPCS,46080,Sphnctrotmy anal div sphnctr,,,863.18,999.47,8
HCPCS,46083,INCISION THROMBOSED HEMORRHOID EXTERNAL,849.5,552.175,1.1,3004.0,114
HCPCS,46200,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,1436.0,933.4,1.1,4793.6,53
HCPCS,46200,REMOVAL OF ANAL FISSURE,744.0,483.6,1.1,7779.76,73
HCPCS,46200,Removal of anal fissure,,,863.18,999.47,8
HCPCS,46220,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,3034.0,1972.1,0.01,5424.0,175
HCPCS,46221,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,2569.0,1669.85,1.1,4194.0,114
HCPCS,46221,LIGATION OF HEMORRHOID(S),313.0,203.45,1.1,1560.83,53
HCPCS,46230,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,1048.0,681.2,1.1,4793.6,53
HCPCS,46230,REMOVAL OF ANAL TABS,340.0,221.0,1.1,4793.6,53
HCPCS,46230,REMOVAL OF ANAL TAGS,,,2533.91,7779.76,20
HCPCS,46230,Removal of anal tags,,,863.18,999.47,8
HCPCS,46250,HEMORRHOIDECTOMY 2 OR MORE COLUMNS,613.0,398.45,1.1,4793.6,53
HCPCS,46250,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,1700.0,1105.0,1.1,4793.6,53
HCPCS,46250,REMOVE EXT HEM GROUPS 2+,,,2533.91,7779.76,19
HCPCS,46250,Remove ext hem groups 2+,,,1457.88,1688.07,8
HCPCS,46255,HEMORRHOIDECTOMY,627.0,407.55,1.1,4793.6,53
HCPCS,46255,HEMORRHOIDECTOMY (COMP CODE 46255),627.0,407.55,1.1,4793.6,53
HCPCS,46255,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,1984.0,1289.6,1.1,4793.6,53
HCPCS,46255,REMOVE INT/EXT HEM 1 GROUP,,,2533.91,7779.76,19
HCPCS,46255,Remove int/ext hem 1 group,,,1457.88,1688.07,8
HCPCS,46257,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,2304.0,1497.6,1.1,4793.6,50
HCPCS,46257,REMOVE IN/EX HEM GRP & FISS,,,2533.91,7779.76,19
HCPCS,46257,Remove in/ex hem grp & fiss,,,1457.88,1688.07,8
HCPCS,46258,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,2564.0,1666.6,1.1,4793.6,50
HCPCS,46258,REMOVE IN/EX HEM GRP W/FISTU,,,2533.91,7779.76,19
HCPCS,46258,Remove in/ex hem grp w/fistu,,,1457.88,1688.07,8
HCPCS,46260,HEMORRHOIDECTOMY,1063.0,690.95,1.1,4793.6,50
HCPCS,46260,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,2692.0,1749.8,1.1,4793.6,50
HCPCS,46260,REMOVE IN/EX HEM GROUPS 2+,,,2533.91,7779.76,19
HCPCS,46260,Remove in/ex hem groups 2+,,,1457.88,1688.07,8
HCPCS,46261,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,3104.0,2017.6,1.1,4793.6,50
HCPCS,46261,REMOVE IN/EX HEM GRPS & FISS,,,2533.91,7779.76,19
HCPCS,46261,Remove in/ex hem grps & fiss,,,1457.88,1688.07,8
HCPCS,46262,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,2848.0,1851.2,1.1,4793.6,50
HCPCS,46262,REMOVE IN/EX HEM GRPS W/FIST,,,2533.91,7779.76,19
HCPCS,46262,Remove in/ex hem grps w/fist,,,1457.88,1688.07,8
HCPCS,46270,REMOVAL OF ANAL FISTULA,644.0,418.6,1.1,4793.6,53
HCPCS,46270,REMOVE ANAL FIST SUBQ,,,2533.91,7779.76,19
HCPCS,46270,Remove anal fist subq,,,1457.88,1688.07,8
HCPCS,46270,SURG TX ANAL FISTULA SUBQ,1968.0,1279.2,1.1,4793.6,53
HCPCS,46275,REMOVE ANAL FIST INTER,,,2533.91,7779.76,19
HCPCS,46275,Remove anal fist inter,,,1457.88,1688.07,8
HCPCS,46275,SURG TX ANAL FISTULA INTERSPHINCTERIC,2168.0,1409.2,1.1,4793.6,53
HCPCS,46280,REMOVAL OF ANAL FISTULA,802.0,521.3,1.1,4793.6,50
HCPCS,46280,REMOVE ANAL FIST COMPLEX,,,2533.91,7779.76,19
HCPCS,46280,Remove anal fist complex,,,1457.88,1688.07,8
HCPCS,46280,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,2556.0,1661.4,1.1,4793.6,50
HCPCS,46285,REMOVE ANAL FIST 2 STAGE,,,2533.91,7779.76,19
HCPCS,46285,Remove anal fist 2 stage,,,863.18,999.47,8
HCPCS,46285,SURG TX ANAL FISTULA 2ND STAGE,2168.0,1409.2,1.1,4793.6,53
HCPCS,46288,CLSR ANAL FSTL W/RCT ADVMNT FLAP,3124.0,2030.6,1.1,4793.6,50
HCPCS,46288,REPAIR ANAL FISTULA,,,2533.91,7779.76,19
HCPCS,46288,Repair anal fistula,,,1457.88,1688.07,8
HCPCS,46320,EXC THROMBOSED HEMORRHOID XTRNL,3040.0,1976.0,0.01,5424.0,297
HCPCS,46320,REMOVAL OF HEMORRHOID CLOT,235.0,152.75,1.1,2014.21,53
HCPCS,46500,INJECTION INTO HEMORRHOID(S),,,842.4,2606.53,19
HCPCS,46500,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,696.0,452.4,1.1,1560.83,53
HCPCS,46500,Injection into hemorrhoid(s),,,863.18,999.47,8
HCPCS,46505,CHEMODENERVATION ANAL MUSC,,,1089.45,4831.0,20
HCPCS,46505,CHEMODENERVATION INTERNAL ANAL SPHINCTER,1272.0,826.8,1.1,2014.21,53
HCPCS,46505,Chemodenervation anal musc,,,863.18,999.47,8
HCPCS,46600,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,417.5,271.375,1.1,3398.0,175
HCPCS,46601,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,640.0,416.0,1.1,640.0,47
HCPCS,46601,DIAGNOSTIC ANOSCOPY,,,368.71,1252.1,19
HCPCS,46601,Diagnostic anoscopy,,,237.67,275.2,8
HCPCS,46604,ANOSCOPY AND DILATION,,,1089.45,3354.0,19
HCPCS,46604,ANOSCOPY W/DILATION,412.0,267.8,1.1,2128.09,53
HCPCS,46604,Anoscopy and dilation,,,706.64,818.21,8
HCPCS,46606,ANOSCOPY AND BIOPSY,,,1089.45,3354.0,19
HCPCS,46606,ANOSCOPY W/BX SINGLE/MULTIPLE,528.0,343.2,1.1,2014.21,53
HCPCS,46606,ANOSCOPY WITH BIOPSY SINGLE OR MULTI,285.0,185.25,1.1,2014.21,53
HCPCS,46606,Anoscopy and biopsy,,,706.64,818.21,8
HCPCS,46607,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,968.0,629.2,1.1,2014.21,47
HCPCS,46607,DIAGNOSTIC ANOSCOPY & BIOPSY,,,1089.45,3354.0,19
HCPCS,46607,Diagnostic anoscopy & biopsy,,,706.64,818.21,8
HCPCS,46608,ANOSCOPY W/RMVL FOREIGN BODY,4194.0,2726.1,137.31,4194.0,61
HCPCS,46608,"ANOSCOPY,REMOVE FOREIGN BODY",520.0,338.0,1.1,1560.83,53
HCPCS,46610,ANOSCOPY REMOVE LESION,,,2533.91,7779.76,19
HCPCS,46610,ANOSCOPY W/RMVL LESION CAUTERY,512.0,332.8,1.1,4793.6,53
HCPCS,46611,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,520.0,338.0,1.1,1560.83,53
HCPCS,46611,ANOSCOPY,,,842.4,2606.53,19
HCPCS,46611,Anoscopy,,,706.64,818.21,8
HCPCS,46612,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,600.0,390.0,1.1,4793.6,53
HCPCS,46612,ANOSCOPY REMOVE LESIONS,,,2533.91,7779.76,19
HCPCS,46612,ANOSCOPY/ REMOVE LESIONS,3709.0,2410.85,1.1,4793.6,53
HCPCS,46614,ANOSCOPY CONTROL BLEEDING,,,1089.45,3354.0,19
HCPCS,46614,"ANOSCOPY,CONTROL BLEEDING",400.0,260.0,1.1,2014.21,53
HCPCS,46614,Anoscopy control bleeding,,,706.64,818.21,8
HCPCS,46615,ANOSCOPY,,,2533.91,7779.76,19
HCPCS,46615,"ANOSCOPY,ABLATE LESION",600.0,390.0,1.1,4793.6,53
HCPCS,46700,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,3924.0,2550.6,1.1,4793.6,50
HCPCS,46700,REPAIR OF ANAL STRICTURE,,,2533.91,7779.76,19
HCPCS,46700,Repair of anal stricture,,,1457.88,1688.07,8
HCPCS,46705,Repair of anal stricture,,,1457.88,1688.07,8
HCPCS,46706,REPR OF ANAL FISTULA W/GLUE,,,2533.91,7779.76,19
HCPCS,46706,Repr of anal fistula w/glue,,,863.18,999.47,8
HCPCS,46707,REPAIR ANORECTAL FIST W/PLUG,,,2533.91,7779.76,19
HCPCS,46707,RPR ANORECTAL FISTULA W/ PLUG,2556.0,1661.4,1.1,4793.6,50
HCPCS,46707,Repair anorectal fist w/plug,,,863.18,999.47,8
HCPCS,46710,Repr per/vag pouch sngl proc,,,1457.88,1688.07,8
HCPCS,46712,Repr per/vag pouch dbl proc,,,1457.88,1688.07,8
HCPCS,46715,Rep perf anoper fistu,,,1457.88,1688.07,8
HCPCS,46716,Rep perf anoper/vestib fistu,,,1457.88,1688.07,8
HCPCS,46730,Construction of absent anus,,,1457.88,1688.07,8
HCPCS,46735,Construction of absent anus,,,1457.88,1688.07,8
HCPCS,46740,Construction of absent anus,,,1457.88,1688.07,8
HCPCS,46742,Repair of imperforated anus,,,1457.88,1688.07,8
HCPCS,46744,Repair of cloacal anomaly,,,1457.88,1688.07,8
HCPCS,46746,Repair of cloacal anomaly,,,1457.88,1688.07,8
HCPCS,46748,Repair of cloacal anomaly,,,1457.88,1688.07,8
HCPCS,46750,REPAIR OF ANAL SPHINCTER,,,2533.91,7779.76,19
HCPCS,46750,Repair of anal sphincter,,,1457.88,1688.07,8
HCPCS,46750,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,4860.0,3159.0,1.1,4860.0,50
HCPCS,46751,Repair of anal sphincter,,,1457.88,1688.07,8
HCPCS,46753,RECONSTRUCTION OF ANUS,,,2533.91,7779.76,19
HCPCS,46753,Reconstruction of anus,,,1457.88,1688.07,8
HCPCS,46754,REMOVAL OF SUTURE FROM ANUS,,,2533.91,7779.76,19
HCPCS,46754,Removal of suture from anus,,,863.18,999.47,8
HCPCS,46760,REPAIR OF ANAL SPHINCTER,,,2533.91,7779.76,19
HCPCS,46760,Repair of anal sphincter,,,1457.88,1688.07,8
HCPCS,46761,REPAIR OF ANAL SPHINCTER,,,2533.91,7779.76,19
HCPCS,46761,Repair of anal sphincter,,,1457.88,1688.07,8
HCPCS,46761,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,6116.0,3975.4,1.1,6116.0,50
HCPCS,46900,DESTRUCTION ANAL LESION(S),,,369.16,1139.4,19
HCPCS,46900,DSTRJ LESION ANUS SIMPLE CHEMICAL,764.0,496.6,1.1,792.03,53
HCPCS,46900,Destruction anal lesion(s),,,863.18,999.47,8
HCPCS,46910,DESTRUCTION ANAL LESION(S),,,1690.17,5783.06,19
HCPCS,46910,DSTRJ LESION ANUS SMPL ELTRDSICCATION,764.0,496.6,1.1,3114.5,53
HCPCS,46910,Destruction anal lesion(s),,,863.18,999.47,8
HCPCS,46916,CRYOSURGERY ANAL LESION(S),,,183.59,562.35,19
HCPCS,46916,Cryosurgery anal lesion(s),,,863.18,999.47,8
HCPCS,46917,DSTRJ LESION ANUS SIMPLE LASER SURG,764.0,496.6,1.1,4793.6,53
HCPCS,46917,LASER SURGERY ANAL LESIONS,,,2533.91,7779.76,19
HCPCS,46917,Laser surgery anal lesions,,,863.18,999.47,8
HCPCS,46922,DSTRJ LESION ANUS SIMPLE SURG EXCISION,6689.5,4348.175,1.1,12615.0,114
HCPCS,46922,EXCISION OF ANAL LESION(S),351.0,228.15,1.1,4793.6,53
HCPCS,46924,DESTRUCTION ANAL LESION(S),,,2533.91,7779.76,19
HCPCS,46924,DESTRUCTION OF LESION(S) ANUS EXTENSIVE,354.0,230.1,1.1,4793.6,53
HCPCS,46924,DSTRJ LESION ANUS EXTENSIVE,1124.0,730.6,1.1,4793.6,53
HCPCS,46924,Destruction anal lesion(s),,,863.18,999.47,8
HCPCS,46930,DESTROY INTERNAL HEMORRHOIDS,,,1089.45,3354.0,19
HCPCS,46930,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,644.0,418.6,1.1,2014.21,53
HCPCS,46930,Destroy internal hemorrhoids,,,863.18,999.47,8
HCPCS,46940,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,940.0,611.0,1.1,4793.6,53
HCPCS,46940,TREATMENT OF ANAL FISSURE,,,2533.91,7779.76,19
HCPCS,46940,Treatment of anal fissure,,,863.18,999.47,8
HCPCS,46942,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,828.0,538.2,1.1,1560.83,53
HCPCS,46942,TREATMENT OF ANAL FISSURE,,,842.4,2606.53,19
HCPCS,46942,Treatment of anal fissure,,,863.18,999.47,8
HCPCS,46945,"HEMORRHOIDECTOMY, INTERNAL BY LIGATION S",431.0,280.15,1.1,4793.6,51
HCPCS,46945,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,1476.0,959.4,1.1,4793.6,51
HCPCS,46945,INT HRHC LIG 1 HROID W/O IMG,,,2533.91,7779.76,19
HCPCS,46945,Int hrhc lig 1 hroid w/o img,,,863.18,999.47,8
HCPCS,46946,HEMORRHOIDECTOMY INT LIGATION 2 OR MORE,500.0,325.0,1.1,4793.6,51
HCPCS,46946,HEMORRHOIDECTOMY INT RUBBERBAND 2 OR MOR,500.0,325.0,1.1,4793.6,51
HCPCS,46946,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,1800.0,1170.0,1.1,4793.6,51
HCPCS,46946,INT HRHC LIG 2+HROID W/O IMG,,,2533.91,7779.76,19
HCPCS,46946,Int hrhc lig 2+hroid w/o img,,,863.18,999.47,8
HCPCS,46947,HEMORRHOIDOPEXY BY STAPLING,2228.0,1448.2,1.1,7779.76,69
HCPCS,46947,Hemorrhoidopexy by stapling,,,1457.88,1688.07,8
HCPCS,46948,INT HRHC TRANAL DARTLZJ 2+,,,2533.91,7779.76,19
HCPCS,46948,INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN,2228.0,1448.2,1.1,4793.6,50
HCPCS,46948,Int hrhc tranal dartlzj 2+,,,1457.88,1688.07,8
HCPCS,46999,ANAL BIOPSY (COMP 45100),363.0,235.95,0.01,1560.83,28
HCPCS,46999,"ANOSCOPY W/SUBMUCOSAL INJECTION, ANY SUBSTANCE (COMP 45381)",1566.0,1017.9,0.01,1566.0,28
HCPCS,46999,ANUS SURGERY PROCEDURE,760.0,494.0,0.01,1560.83,28
HCPCS,46999,ANUS SURGERY PROCEDURE UNLISTED,783.0,508.95,0.01,1560.83,28
HCPCS,46999,EXPLANATION OF ARTIFICIAL BOWEL SPHINCTER (COMP 53446),3968.0,2579.2,0.01,3968.0,28
HCPCS,46999,"HEMORRHOIDECTOMY, EXTERNAL, SINGLE COLUMN (COMP 46255)",1786.0,1160.9,0.01,1786.0,28
HCPCS,46999,"HEMORROIDECTOMY, EXTERNAL, SINGLE (COMP CODE 46220)",1403.0,911.95,0.01,1560.83,28
HCPCS,46999,LAP ASSISTED CLOACA REPAIR (COMP 46748),27852.0,18103.8,0.01,27852.0,28
HCPCS,46999,POST OP CONTROL OF BLEEDING ANUS (COMP 46945),746.0,484.9,0.01,1560.83,28
HCPCS,46999,POST OP CONTROL OF BLEEDING-ANUS (COMP CODE 46614),361.0,234.65,0.01,1560.83,28
HCPCS,46999,"REPAIR, CLOSURE OF ANAL FISTULA-OTHER THAN GLUE (COMP 46706)",1049.0,681.85,0.01,1560.83,28
HCPCS,46999,SUBMUCOSAL ANAL INJECTION FOR INFLAMMATION/PAIN (COMP CODE 46505,1367.0,888.55,0.01,1560.83,28
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 45100",1333.0,866.45,0.01,1560.83,28
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 46945",746.0,484.9,0.01,1560.83,28
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 46947",1838.0,1194.7,0.01,1838.0,28
HCPCS,46999,"UNLISTED PROC; TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, SINGLE",1838.0,1194.7,0.01,1838.0,28
HCPCS,46999,UNLISTED PROCEDURE ANUS,1714.0,1114.1,484.72,3728.0,61
HCPCS,46999,"UNLISTED PROCEDURE, ANUS",1360.0,884.0,0.01,3004.0,117
HCPCS,47000,BIOPSY LIVER NEEDLE PERCUTANEOUS,4056.5,2636.725,0.01,7453.0,297
HCPCS,47000,NEEDLE BIOPSY OF LIVER,260.0,169.0,1.1,2768.64,53
HCPCS,47001,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,836.0,543.4,1.1,836.0,50
HCPCS,47001,Ndl biopsy lvr tm oth maj px,,,366.62,424.51,8
HCPCS,47010,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,7760.0,5044.0,1.1,7760.0,50
HCPCS,47010,Hepatot opn drg absc/cst 1/2,,,2755.97,3191.12,8
HCPCS,47015,Lapt aspir&/njx hep prst cst,,,2755.97,3191.12,8
HCPCS,47100,WEDGE BIOPSY OF LIVER,3266.0,2122.9,1.1,5164.0,100
HCPCS,47100,Wedge biopsy of liver,,,2755.97,3191.12,8
HCPCS,47120,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,15604.0,10142.6,1.1,15604.0,50
HCPCS,47120,Partial removal of liver,,,2755.97,3191.12,8
HCPCS,47122,Extensive removal of liver,,,2755.97,3191.12,8
HCPCS,47122,HEPATECTOMY RESCJ TRISEGMENTECTOMY,23792.0,15464.8,1.1,23792.0,50
HCPCS,47125,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,21216.0,13790.4,1.1,21216.0,50
HCPCS,47125,Partial removal of liver,,,2755.97,3191.12,8
HCPCS,47130,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,22876.0,14869.4,1.1,22876.0,50
HCPCS,47130,Partial removal of liver,,,2755.97,3191.12,8
HCPCS,47133,Removal of donor liver,,,975.94,1130.04,8
HCPCS,47135,Transplantation of liver,,,975.94,1130.04,8
HCPCS,47140,Partial removal donor liver,,,975.94,1130.04,8
HCPCS,47141,Partial removal donor liver,,,975.94,1130.04,8
HCPCS,47142,Partial removal donor liver,,,975.94,1130.04,8
HCPCS,47143,Prep donor liver whole,,,975.94,1130.04,8
HCPCS,47144,Prep donor liver 3-segment,,,975.94,1130.04,8
HCPCS,47145,Prep donor liver lobe split,,,975.94,1130.04,8
HCPCS,47146,Prep donor liver/venous,,,975.94,1130.04,8
HCPCS,47147,Prep donor liver/arterial,,,975.94,1130.04,8
HCPCS,47300,Surgery for liver lesion,,,2755.97,3191.12,8
HCPCS,47350,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,8996.0,5847.4,1.1,8996.0,50
HCPCS,47350,Repair liver wound,,,1082.41,1253.32,8
HCPCS,47360,MGMT LVR HEMRRG CPLX SUTR WND/INJ,12524.0,8140.6,1.1,12524.0,50
HCPCS,47360,Repair liver wound,,,1082.41,1253.32,8
HCPCS,47361,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,21040.0,13676.0,1.1,21040.0,50
HCPCS,47361,Repair liver wound,,,2755.97,3191.12,8
HCPCS,47362,MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING,9416.0,6120.4,1.1,9416.0,50
HCPCS,47362,Repair liver wound,,,1082.41,1253.32,8
HCPCS,47370,LAPARO ABLATE LIVER TUMOR RF,,,9619.76,29793.81,19
HCPCS,47370,LAPS SURG ABLTJ 1/> LVR TUM RF,8320.0,5408.0,1.1,17575.94,50
HCPCS,47370,Laparo ablate liver tumor rf,,,2755.97,3191.12,8
HCPCS,47371,LAPARO ABLATE LIVER CRYOSURG,,,9619.76,29793.81,19
HCPCS,47371,Laparo ablate liver cryosurg,,,2755.97,3191.12,8
HCPCS,47379,LAP EXCISION LIVER CYST (COMP 47010),6985.0,4540.25,0.01,9852.42,28
HCPCS,47379,LAP LT LOBECTOMY LIVER (COMP 47125),17503.0,11376.95,0.01,17503.0,28
HCPCS,47379,LAP MARSUPIALIZATION HEPATIC CYST (COMP CODE 47300),5896.0,3832.4,0.01,9852.42,28
HCPCS,47379,"LAPAROSCOPE PROCEDURE, LI",5610.0,3646.5,0.01,9852.42,28
HCPCS,47379,LAPAROSCOPIC LIVER BIOPSY (COMP 47001),2765.0,1797.25,0.01,9852.42,28
HCPCS,47379,LAPAROSCOPIC PARTIAL HEPATIC LOBECTOMY W/ PARTIAL HEPATIC LOBECT,25747.0,16735.55,0.01,25747.0,28
HCPCS,47379,LAPAROSCOPIC POSTOPERATIVE LIVER HEMORRHAGE(COMP CODE 47361),22618.0,14701.7,0.01,22618.0,28
HCPCS,47379,LAPRO DONOR HEPATECTOMY LIVING DONOR LT SEG II & III (47140),25542.0,16602.3,0.01,25542.0,28
HCPCS,47379,SURGERY PERFORMED LAPAROSCOPY TOTAL RIGHT HEPATIC LOBECTOMY (COM,18873.0,12267.45,0.01,18873.0,28
HCPCS,47379,UNLIST LAP LIVER PROC COMPARED TO 47300,5896.0,3832.4,0.01,9852.42,28
HCPCS,47379,UNLISTED LAPAROSCOPIC PROCEDURE LIVER,6356.0,4131.4,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47000)",310.0,201.5,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47001)",312.0,202.8,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47010)",6402.0,4161.3,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47100)",1660.0,1079.0,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47120)",5610.0,3646.5,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47125)",9040.0,5876.0,0.01,9852.42,28
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER COMPARED TO 47015",4821.0,3133.65,0.01,9852.42,28
HCPCS,47379,UNLISTED LAPS PX LIVER,,,5390.83,16944.69,19
HCPCS,47379,Unlisted laps px liver,,,1082.41,1253.32,8
HCPCS,47380,ABLTJ OPN 1/> LVR TUM RF,9824.0,6385.6,1.1,9824.0,50
HCPCS,47380,Open ablate liver tumor rf,,,2755.97,3191.12,8
HCPCS,47381,Open ablate liver tumor cryo,,,1082.41,1253.32,8
HCPCS,47382,ABLTJ 1/> LVR TUM PRQ RF,16413.0,10668.45,1.1,26838.0,175
HCPCS,47383,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,25722.0,16719.3,1.1,47892.0,175
HCPCS,47384,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,26500.5,17225.325,1.1,49956.0,90
HCPCS,47399,DESTRUCTION/FULGURATION LIVER LESION(S) (COMP 44005),6718.0,4366.7,0.01,6718.0,28
HCPCS,47399,FLUSHING OF LIVER IN SITU (COMP 47146),2400.0,1560.0,0.01,2400.0,28
HCPCS,47399,UNLISTED PROCEDURE LIVER,,,650.1,1984.79,19
HCPCS,47399,Unlisted procedure liver,,,1082.41,1253.32,8
HCPCS,47400,HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1,14544.0,9453.6,1.1,14544.0,50
HCPCS,47400,Incision of liver duct,,,1082.41,1253.32,8
HCPCS,47420,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,9693.0,6300.45,1.1,9693.0,50
HCPCS,47420,Incision of bile duct,,,2755.97,3191.12,8
HCPCS,47425,Incision of bile duct,,,2399.58,2778.46,8
HCPCS,47460,Incise bile duct sphincter,,,1082.41,1253.32,8
HCPCS,47460,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,8208.0,5335.2,1.1,8208.0,50
HCPCS,47480,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,5300.0,3445.0,1.1,5300.0,50
HCPCS,47480,Incision of gallbladder,,,2755.97,3191.12,8
HCPCS,47490,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,9164.0,5956.6,0.01,16234.0,233
HCPCS,47531,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,8403.0,5461.95,0.01,16234.0,236
HCPCS,47532,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,9052.0,5883.8,1.1,16234.0,114
HCPCS,47533,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,9300.5,6045.325,1.1,16234.0,175
HCPCS,47534,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,9789.0,6362.85,1.1,16234.0,175
HCPCS,47535,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,8986.0,5840.900000000001,1.1,16234.0,175
HCPCS,47536,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,8691.0,5649.150000000001,1.1,16234.0,175
HCPCS,47537,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,2561.5,1664.975,1.1,4831.0,175
HCPCS,47538,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,26838.0,17444.7,400.35,26838.0,122
HCPCS,47539,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,26838.0,17444.7,724.05,26838.0,61
HCPCS,47540,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,26838.0,17444.7,749.2,26838.0,61
HCPCS,47541,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,28703.0,18656.95,571.0,28703.0,61
HCPCS,47542,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,4129.0,2683.85,232.78,4129.0,92
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,3810.0,2476.5,245.43,3810.0,92
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,1200.0,780.0,1.1,1298.39,53
HCPCS,47544,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,4661.0,3029.65,268.15,4661.0,92
HCPCS,47550,BILIARY NDSC INTRAOPERATIVE,1208.0,785.2,1.1,1208.0,50
HCPCS,47550,Bile duct endoscopy add-on,,,2272.63,2631.46,8
HCPCS,47552,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,15557.5,10112.375,0.01,28703.0,172
HCPCS,47553,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,15619.5,10152.675000000001,0.01,28703.0,111
HCPCS,47554,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,16234.0,10552.1,764.23,29793.81,61
HCPCS,47555,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,16234.0,10552.1,0.01,18145.13,122
HCPCS,47556,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,47892.0,31129.8,0.01,47892.0,122
HCPCS,47562,LAPAROSCOPIC CHOLECYSTECTOMY,1406.0,913.9,1.1,16944.69,70
HCPCS,47562,LAPAROSCOPY SURG CHOLECYSTECTOMY,4188.0,2722.2,1.1,9852.42,50
HCPCS,47562,Laparoscopic cholecystectomy,,,2399.58,2778.46,8
HCPCS,47563,LAPARO CHOLECYSTECTOMY/GRAPH,1433.0,931.45,1.1,16944.69,70
HCPCS,47563,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,4588.0,2982.2,1.1,9852.42,50
HCPCS,47563,Laparo cholecystectomy/graph,,,2399.58,2778.46,8
HCPCS,47564,LAPARO CHOLECYSTECTOMY/EXPLR,,,9619.76,29793.81,19
HCPCS,47564,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,7200.0,4680.0,1.1,17575.94,50
HCPCS,47564,Laparo cholecystectomy/explr,,,2399.58,2778.46,8
HCPCS,47570,Laparo cholecystoenterostomy,,,2399.58,2778.46,8
HCPCS,47579,LAP PORTOENTEROSTOMY (COMP CODE 47701),11492.0,7469.8,0.01,11492.0,28
HCPCS,47579,LAP RESECTION EXTRA BILE DUCT,8547.0,5555.55,0.01,9852.42,28
HCPCS,47579,LAPAROSCOPIC CHOLECYSTOSTOMY TUBE PLACEMENT (COMP CODE 47480),4373.0,2842.45,0.01,9852.42,28
HCPCS,47579,OPEN ANASTOMOSIS EXTRAHEPATIC BILIARY DUCTS & GASTROINTESTIONAL,19758.0,12842.7,0.01,19758.0,28
HCPCS,47579,UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT,3039.0,1975.35,0.01,9852.42,28
HCPCS,47579,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT (COMPARISON CODE 4",3900.0,2535.0,0.01,9852.42,84
HCPCS,47579,UNLISTED LAPS PX BILIARY TRC,,,5390.83,16944.69,19
HCPCS,47579,"UNLISTED PROC, LAP COMMON BILE DUCT EXPLORATION (COMP CODE 47420",7270.0,4725.5,0.01,9852.42,28
HCPCS,47579,UNLISTED PROC; LAP CHOLECYSTECTOMY W/EXPLORATION OF COMMON DUCT;,6999.0,4549.35,0.01,9852.42,28
HCPCS,47579,UNLISTED PROC; LAP REPAIR OF COMMON BILE DUCT INJURY. (COMP TO 4,2950.0,1917.5,0.01,9852.42,28
HCPCS,47579,UNLISTED PROC; LAPAROSCOPIC CHOLEDOCHODUODENOSTOMY (COMP TO 4776,12646.0,8219.9,0.01,12646.0,28
HCPCS,47579,Unlisted laps px biliary trc,,,1082.41,1253.32,8
HCPCS,47600,CHOLECYSTECTOMY,6992.0,4544.8,1.1,6992.0,50
HCPCS,47600,Cholecystectomy,,,2755.97,3191.12,8
HCPCS,47600,REMOVAL OF GALLBLADDER,2125.0,1381.25,1.1,3669.65,50
HCPCS,47605,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,7392.0,4804.8,1.1,7392.0,50
HCPCS,47605,CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY,1669.0,1084.85,1.1,3872.47,50
HCPCS,47605,Cholecystectomy w/cholang,,,2755.97,3191.12,8
HCPCS,47610,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,8368.0,5439.2,1.1,8368.0,50
HCPCS,47610,Removal of gallbladder,,,2755.97,3191.12,8
HCPCS,47612,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,8484.0,5514.6,1.1,8484.0,50
HCPCS,47612,Removal of gallbladder,,,2399.58,2778.46,8
HCPCS,47620,Removal of gallbladder,,,2399.58,2778.46,8
HCPCS,47700,EXPLOR CONG ATRESIA BILE DUCTS,6600.0,4290.0,1.1,6600.0,50
HCPCS,47700,Exploration of bile ducts,,,1082.41,1253.32,8
HCPCS,47701,Bile duct revision,,,1082.41,1253.32,8
HCPCS,47711,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,10360.0,6734.0,1.1,10360.0,50
HCPCS,47711,Excision of bile duct tumor,,,1082.41,1253.32,8
HCPCS,47712,Excision of bile duct tumor,,,1082.41,1253.32,8
HCPCS,47715,EXCISION OF CHOLEDOCHAL CYST,8620.0,5603.0,1.1,8620.0,50
HCPCS,47715,Excision of bile duct cyst,,,1082.41,1253.32,8
HCPCS,47720,CHOLECYSTOENTEROSTOMY; DIRECT,7336.0,4768.4,1.1,7336.0,50
HCPCS,47720,Fuse gallbladder & bowel,,,2399.58,2778.46,8
HCPCS,47721,Fuse upper gi structures,,,2399.58,2778.46,8
HCPCS,47740,Fuse gallbladder & bowel,,,2399.58,2778.46,8
HCPCS,47741,Fuse gallbladder & bowel,,,2399.58,2778.46,8
HCPCS,47760,ANAST EXTRAHEP DUCT TO GI TRACT,15328.0,9963.2,1.1,15328.0,50
HCPCS,47760,Fuse bile ducts and bowel,,,2755.97,3191.12,8
HCPCS,47765,ANAST INTRAHEP DUCT TO GI TRACT,20876.0,13569.4,1.1,20876.0,50
HCPCS,47765,Fuse liver ducts & bowel,,,2755.97,3191.12,8
HCPCS,47780,"ANAST,ROUX-EN-Y,EXTRAHEP TO GI TRCT",16928.0,11003.2,1.1,16928.0,50
HCPCS,47780,Fuse bile ducts and bowel,,,2755.97,3191.12,8
HCPCS,47785,"ANAST,ROUX-EN-Y,INTRAHEP TO GI TRCT",22476.0,14609.4,1.1,22476.0,50
HCPCS,47785,Fuse bile ducts and bowel,,,2755.97,3191.12,8
HCPCS,47800,Reconstruction of bile ducts,,,1082.41,1253.32,8
HCPCS,47801,PLACEMENT CHOLEDOCHAL STENT,7040.0,4576.0,1.1,7040.0,50
HCPCS,47801,Placement bile duct support,,,2755.97,3191.12,8
HCPCS,47802,Fuse liver duct & intestine,,,1082.41,1253.32,8
HCPCS,47900,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,8976.0,5834.4,1.1,8976.0,50
HCPCS,47900,Suture bile duct injury,,,1082.41,1253.32,8
HCPCS,47999,BILE DUCT RECONSTRUCTION (COMP CODE 47760),16477.0,10710.05,0.01,16477.0,28
HCPCS,47999,"BILE TRACT SURG PROC, UNLISTED",4161.0,2704.65,0.01,4161.0,28
HCPCS,47999,ERCP W/ SUBMUCOSAL INJECTION (TATTOOING) (COMP 43236),1028.0,668.2,0.01,1548.29,28
HCPCS,47999,ERCP W/CONTROL OF BLEED (COMP CODE 44378),2278.0,1480.7,0.01,2278.0,28
HCPCS,47999,RF ABLATION BILIARY TRACT (COMP CODE 47556),22724.5,14770.925,0.01,42370.0,89
HCPCS,47999,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT",8547.0,5555.55,0.01,8547.0,28
HCPCS,47999,"UNLISTED PROCEDURE, BILIARY TRACT (COMPARISON CODE 47900)",4040.0,2626.0,0.01,4040.0,28
HCPCS,48000,Drainage of abdomen,,,2755.97,3191.12,8
HCPCS,48001,Placement of drain pancreas,,,2755.97,3191.12,8
HCPCS,48020,REMOVAL OF PANCREATIC STONE,7636.0,4963.4,1.1,7636.0,50
HCPCS,48020,Removal of pancreatic stone,,,1082.41,1253.32,8
HCPCS,48100,Biopsy of pancreas open,,,2755.97,3191.12,8
HCPCS,48100,OPEN BIOPSY OF PANCREAS,5784.0,3759.6,1.1,5784.0,50
HCPCS,48102,BIOPSY PANCREA PERCUTANEOUS NEEDLE,7453.0,4844.45,366.62,7453.0,183
HCPCS,48105,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,19704.0,12807.6,1.1,19704.0,50
HCPCS,48105,Resect/debride pancreas,,,2755.97,3191.12,8
HCPCS,48120,EXCISION OF PANCREAS LESION,7364.0,4786.6,1.1,7364.0,50
HCPCS,48120,Removal of pancreas lesion,,,2755.97,3191.12,8
HCPCS,48140,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,10528.0,6843.2,1.1,10528.0,50
HCPCS,48140,Partial removal of pancreas,,,2755.97,3191.12,8
HCPCS,48145,Partial removal of pancreas,,,2755.97,3191.12,8
HCPCS,48146,PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX,12240.0,7956.0,1.1,12240.0,50
HCPCS,48146,Pancreatectomy,,,2755.97,3191.12,8
HCPCS,48148,EXCISION AMPULLA VATER,8156.0,5301.4,1.1,8156.0,50
HCPCS,48148,Removal of pancreatic duct,,,1082.41,1253.32,8
HCPCS,48150,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,21136.0,13738.4,1.1,21136.0,50
HCPCS,48150,Partial removal of pancreas,,,2755.97,3191.12,8
HCPCS,48152,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,19460.0,12649.0,1.1,19460.0,50
HCPCS,48152,Pancreatectomy,,,2755.97,3191.12,8
HCPCS,48153,PNCRTECT W/PANCREATOJEJUNOSTOMY,21116.0,13725.4,1.1,21116.0,50
HCPCS,48153,Pancreatectomy,,,2755.97,3191.12,8
HCPCS,48154,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,19552.0,12708.8,1.1,19552.0,50
HCPCS,48154,Pancreatectomy,,,2755.97,3191.12,8
HCPCS,48155,PANCREATECTOMY TOTAL,11780.0,7657.0,1.1,11780.0,50
HCPCS,48155,Removal of pancreas,,,2755.97,3191.12,8
HCPCS,48160,Pancreas removal/transplant,,,2755.97,3191.12,8
HCPCS,48400,Injection intraop add-on,,,65.08,75.36,8
HCPCS,48500,Surgery of pancreatic cyst,,,1082.41,1253.32,8
HCPCS,48510,Drain pancreatic pseudocyst,,,2755.97,3191.12,8
HCPCS,48520,Fuse pancreas cyst and bowel,,,1082.41,1253.32,8
HCPCS,48520,INT ANAST PANCREATIC CYST GI TRACT DIRECT,7260.0,4719.0,1.1,7260.0,50
HCPCS,48540,Fuse pancreas cyst and bowel,,,1082.41,1253.32,8
HCPCS,48540,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,8776.0,5704.4,1.1,8776.0,50
HCPCS,48545,PANCREATORRHAPHY INJURY,8892.0,5779.8,1.1,8892.0,50
HCPCS,48545,Pancreatorrhaphy,,,1082.41,1253.32,8
HCPCS,48547,DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ,12152.0,7898.8,1.1,12152.0,50
HCPCS,48547,Duodenal exclusion,,,1082.41,1253.32,8
HCPCS,48548,Fuse pancreas and bowel,,,1082.41,1253.32,8
HCPCS,48548,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,11236.0,7303.4,1.1,11236.0,50
HCPCS,48550,Donor pancreatectomy,,,975.94,1130.04,8
HCPCS,48551,Prep donor pancreas,,,975.94,1130.04,8
HCPCS,48552,Prep donor pancreas/venous,,,975.94,1130.04,8
HCPCS,48554,Transpl allograft pancreas,,,975.94,1130.04,8
HCPCS,48556,Removal allograft pancreas,,,1082.41,1253.32,8
HCPCS,48999,EGD-PSEUDOCYST NECROSECTOMY (COMP 48105),21189.0,13772.85,0.01,21189.0,28
HCPCS,48999,LAP PANCREAS DEBRIDEMENT (COMP 48105),16256.0,10566.4,0.01,16256.0,28
HCPCS,48999,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM,3330.0,2164.5,0.01,3330.0,28
HCPCS,48999,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM (COMP CODE 48140),9476.0,6159.4,0.01,9476.0,28
HCPCS,48999,LAPAROSCOPIC PYLORUS PRESERVING PANCREATICODUODENECTOMY (COMP CO,22699.0,14754.35,0.01,22699.0,28
HCPCS,48999,LAPAROSCOPIC WHIPPLE,17421.0,11323.65,0.01,17421.0,28
HCPCS,48999,PANCREAS SURGERY PROC UNLISTED,2215.0,1439.75,0.01,2215.0,28
HCPCS,48999,PANCREATECTOMY CENTRAL,9064.0,5891.6,0.01,9064.0,28
HCPCS,48999,"UNLIST PROC, PANCREAS COMPARED TO 48100",4772.0,3101.8,0.01,4772.0,28
HCPCS,48999,UNLISTED LAP DEBRIDEMENT OF PANCREATIC CYST (COMP CODE 48105),16256.0,10566.4,0.01,16256.0,28
HCPCS,48999,"UNLISTED PROC, LAP PANCREATICODUODENECTOMY W/DISTAL GASTRECTOMY",5037.0,3274.05,0.01,5037.0,28
HCPCS,48999,UNLISTED PROC; DUNKING PANCREATIC JEJUNAL ANASTOMOSIS (COMP CODE,9270.0,6025.5,0.01,9270.0,28
HCPCS,48999,UNLISTED PROC; ENDOSCOPIC DEBRIDEMENT OF PANCREATIC PSEUDOCYST (,2327.0,1512.55,0.01,2327.0,28
HCPCS,48999,UNLISTED PROC; LAP PANCREATIC CYST GASTROSTOMY (COMP TO 48520),5990.0,3893.5,0.01,5990.0,28
HCPCS,48999,UNLISTED PROCEDURE PANCREAS,,,650.1,1984.79,19
HCPCS,48999,"UNLISTED PROCEDURE, PANCREAS",5673.0,3687.45,0.01,5673.0,28
HCPCS,48999,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48120)",2180.0,1417.0,0.01,2180.0,28
HCPCS,48999,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48140)",3330.0,2164.5,0.01,3330.0,28
HCPCS,48999,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48153)",17421.0,11323.65,0.01,17421.0,28
HCPCS,48999,"UNLISTED PROCEDURE, PANCREAS (COMPARISON CODE 48520)",2150.0,1397.5,0.01,2150.0,28
HCPCS,48999,Unlisted procedure pancreas,,,1082.41,1253.32,8
HCPCS,49000,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,3293.0,2140.45,1.1,7821.0,96
HCPCS,49002,REOPENING RECENT LAPAROTOMY,7052.0,4583.8,1.1,7052.0,50
HCPCS,49002,Reopening of abdomen,,,1611.33,1865.75,8
HCPCS,49010,EXPL RETROPERITONEUM W/WO BX SPX,6424.0,4175.6,1.1,6424.0,50
HCPCS,49010,EXPLORATION BEHIND ABDOMEN,,,6124.73,18145.13,13
HCPCS,49010,Exploration behind abdomen,,,1611.33,1865.75,8
HCPCS,49013,PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA,3340.0,2171.0,1.1,3340.0,50
HCPCS,49013,Prpertl pel pack hemrrg trma,,,1611.33,1865.75,8
HCPCS,49014,REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING,2692.0,1749.8,1.1,2692.0,50
HCPCS,49014,Reexploration pelvic wound,,,1611.33,1865.75,8
HCPCS,49020,DRAIN ABDOMINAL ABSCESS,2489.0,1617.85,1.1,5452.69,50
HCPCS,49020,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS OPEN,10668.0,6934.2,1.1,10668.0,50
HCPCS,49020,Drainage abdom abscess open,,,1611.33,1865.75,8
HCPCS,49040,Drain open abdom abscess,,,4428.42,5127.64,8
HCPCS,49060,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,7412.0,4817.8,1.1,7412.0,50
HCPCS,49060,Drain open retroperi abscess,,,1611.33,1865.75,8
HCPCS,49062,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,4888.0,3177.2,1.1,4888.0,50
HCPCS,49062,Drain to peritoneal cavity,,,1611.33,1865.75,8
HCPCS,49082,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,2429.5,1579.175,0.01,4313.0,175
HCPCS,49083,ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,880.0,572.0,1.1,1548.29,53
HCPCS,49083,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,0.01,4831.0,305
HCPCS,49084,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,2596.5,1687.725,1.1,4313.0,111
HCPCS,49180,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,0.01,7453.0,244
HCPCS,49180,BX ABDL/RPR MASS PRQ NDL,761.0,494.65,1.1,2768.64,53
HCPCS,49185,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,4196.5,2727.725,0.01,7453.0,236
HCPCS,49186,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS,9680.0,6292.0,1.1,9680.0,49
HCPCS,49186,Opn exc/dstr ntra-abd 5 cm/<,,,1611.33,1865.75,8
HCPCS,49187,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5.1-10 CM,12606.0,8193.9,1.1,12606.0,49
HCPCS,49187,Opn exc/dstr ntra-abd 5.1-10,,,1611.33,1865.75,8
HCPCS,49188,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM,14960.0,9724.0,1.1,14960.0,49
HCPCS,49188,Opn exc/dst ntra-abd 10.1-20,,,1611.33,1865.75,8
HCPCS,49189,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 20.1-30 CM,17600.0,11440.0,1.1,17600.0,49
HCPCS,49189,Opn exc/dst ntra-abd 20.1-30,,,1611.33,1865.75,8
HCPCS,49190,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CYST >30 CM,22000.0,14300.0,1.1,22000.0,49
HCPCS,49190,Opn exc/dstr ntra-abd >30 cm,,,1611.33,1865.75,8
HCPCS,49203,Exc abd tum 5 cm or less,,,1611.33,1865.75,8
HCPCS,49204,Exc abd tum over 5 cm,,,1611.33,1865.75,8
HCPCS,49205,Exc abd tum over 10 cm,,,1611.33,1865.75,8
HCPCS,49215,EXCISE PRESACRAL/SACRAL TUMOR,13612.0,8847.8,1.1,13612.0,50
HCPCS,49215,Excise sacral spine tumor,,,1457.88,1688.07,8
HCPCS,49220,Multiple surgery abdomen,,,1611.33,1865.75,8
HCPCS,49250,EXCISION OF UMBILICUS,,,3260.78,10035.32,19
HCPCS,49250,Excision of umbilicus,,,1934.06,2239.44,8
HCPCS,49250,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,3604.0,2342.6,1.1,5906.43,50
HCPCS,49255,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,5024.0,3265.6,1.1,5024.0,50
HCPCS,49255,REMOVAL OF OMENTUM,,,6124.73,18145.13,13
HCPCS,49255,Removal of omentum,,,1611.33,1865.75,8
HCPCS,49320,DIAG LAPARO SEPARATE PROC,,,5390.83,16944.69,20
HCPCS,49320,Diag laparo separate proc,,,1611.33,1865.75,8
HCPCS,49320,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,2262.0,1470.3,1.1,9852.42,50
HCPCS,49321,L'SCOPE W/BIOPSY SINGLE/MULTIPLE,2176.0,1414.4,1.1,9852.42,50
HCPCS,49321,LAPAROSCOPY BIOPSY,,,5390.83,16944.69,19
HCPCS,49321,"LAPARSOCOPY, SURGICAL WITH BIOPSY",557.0,362.05,1.1,9852.42,50
HCPCS,49321,Laparoscopy biopsy,,,1611.33,1865.75,8
HCPCS,49322,L'SCOPE CAVITY/CYST SINGLE/MULTIPLE,2404.0,1562.6,1.1,9852.42,50
HCPCS,49322,LAPAROSCOPY ASPIRATION,,,5390.83,16944.69,19
HCPCS,49322,Laparoscopy aspiration,,,1611.33,1865.75,8
HCPCS,49323,L'SCOPE W/DRNG  LYMPHOCELE TO PERIT,4092.0,2659.8,1.1,9852.42,50
HCPCS,49323,LAPARO DRAIN LYMPHOCELE,,,5390.83,16944.69,19
HCPCS,49323,Laparo drain lymphocele,,,1611.33,1865.75,8
HCPCS,49324,LAP INSERT TUNNEL IP CATH,,,5390.83,16944.69,19
HCPCS,49324,LAP INSERTION PERM IP CATH,635.0,412.75,1.1,9852.42,50
HCPCS,49324,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,2528.0,1643.2,1.1,9852.42,50
HCPCS,49324,Lap insert tunnel ip cath,,,1611.33,1865.75,8
HCPCS,49325,LAP REVISION PERM IP CATH,,,5390.83,16944.69,19
HCPCS,49325,LAPS W/REVISION INTRAPERITONEAL CATHETER,2728.0,1773.2,1.1,9852.42,50
HCPCS,49325,Lap revision perm ip cath,,,1611.33,1865.75,8
HCPCS,49326,Lap w/omentopexy add-on,,,1611.33,1865.75,8
HCPCS,49327,Lap ins device for rt,,,159.5,184.68,8
HCPCS,49329,LAP DRAINAGE OF ABD ABSCESS (COMP 49020),4670.0,3035.5,0.01,9852.42,28
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 10.1-20CM (COMP 49188)",14620.0,9503.0,0.01,14620.0,28
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 20.1-30CM (COMP 49189)",17200.0,11180.0,0.01,17200.0,28
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 5CM OR LESS (COMP 49186)",9460.0,6149.0,0.01,9852.42,28
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM GREATER THAN 30CM (COMP 49",21500.0,13975.0,0.01,21500.0,28
HCPCS,49329,LAP EXCISION OF A PRESACRAL SINUS(FISTULA) TRACT/ABSCESS (COMP 4,15124.0,9830.6,0.01,15124.0,28
HCPCS,49329,"LAP LYSIS ADHESIONS,PERITONEAL (COMP CODE 44180)",5013.0,3258.45,0.01,9852.42,28
HCPCS,49329,LAP RELEASE MEDIAN ARCUATE LIGAMENT (COMP 49320),2927.0,1902.55,0.01,9852.42,28
HCPCS,49329,"LAP,EXCISION ABD, PERITONEUM, OMENTUM 5.1-10CM (COMP 49187)",12320.0,8008.0,0.01,12320.0,28
HCPCS,49329,LAPAROSCOPIC ABDOMINAL MESH REMOVAL (COMP TO 20680),1967.0,1278.55,0.01,9852.42,28
HCPCS,49329,LAPAROSCOPIC CREATION OF MYOFASCIAL CUTANEOUS MUSCLE FLAPS (COMP,6999.0,4549.35,0.01,9852.42,28
HCPCS,49329,LAPAROSCOPIC EVACUATION HEMATOMA (COMP 49002),1967.0,1278.55,0.01,9852.42,28
HCPCS,49329,LAPAROSCOPIC EXCISION OMENTUM (49255),3501.0,2275.65,0.01,9852.42,28
HCPCS,49329,LAPAROSCOPIC PERITONEAL DIALYSIS CATH REMOVAL (COMP TO 49422),2016.0,1310.4,0.01,9852.42,28
HCPCS,49329,LAPAROSCOPIC RELEASE OF MEDIAN ARCUATE LIGAMENT (MALS PROC) (COM,5973.0,3882.45,0.01,9852.42,28
HCPCS,49329,LAPROSCOPIC OMENTAL FLAP INTRA-ABDOMINAL (COMP CODE 49905),711.0,462.15,0.01,9852.42,28
HCPCS,49329,LX EXCISION OF RETROPERITONEAL TUMOR (COMP 49203),8655.0,5625.75,0.01,9852.42,28
HCPCS,49329,POST OP LAP EXPLOR & CONTROL HEMORRHAGE ABD (COMP TO 35840),4557.0,2962.05,0.01,9852.42,28
HCPCS,49329,"UNLIST LAP PROC, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 57107",8105.0,5268.25,0.01,9852.42,28
HCPCS,49329,"UNLISTED LAP REMOVAL FOREIGN BODY , ABD (COMP CODE 49402)",3018.0,1961.7,0.01,9852.42,28
HCPCS,49329,UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM,2549.0,1656.85,0.01,9852.42,28
HCPCS,49329,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",4010.0,2606.5,0.01,9943.0,280
HCPCS,49329,"UNLISTED LAPAROSCOPY, ABDOMEN, PERITONEUM AND OMENTUM (COMP CODE",9943.0,6462.95,0.01,9943.0,28
HCPCS,49329,"UNLISTED PROC; I&D OF APPENDICEAL ABSCESS, OPEN (COMP CODE 44900",4148.0,2696.2,0.01,9852.42,28
HCPCS,49329,UNLSTD LAPS PX ABD PERTM&OMN,,,5390.83,16944.69,20
HCPCS,49329,Unlstd laps px abd pertm&omn,,,1611.33,1865.75,8
HCPCS,49400,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,325.0,211.25,65.08,3398.0,92
HCPCS,49402,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,5636.0,3663.4,1.1,5906.43,50
HCPCS,49402,REMOVE FOREIGN BODY ADBOMEN,,,3260.78,10035.32,19
HCPCS,49402,Remove foreign body adbomen,,,1611.33,1865.75,8
HCPCS,49405,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,4526.5,2942.225,0.01,7453.0,297
HCPCS,49406,CT GD DRAIN PERI/RETROPERI PER,7453.0,4844.45,0.01,7453.0,61
HCPCS,49406,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,4606.5,2994.225,1.1,7453.0,297
HCPCS,49407,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,7453.0,4844.45,353.68,7453.0,183
HCPCS,49411,INS MARK ABD/PEL FOR RT PERQ,,,1264.24,3879.51,19
HCPCS,49411,Ins mark abd/pel for rt perq,,,612.38,709.07,8
HCPCS,49412,Ins device for rt guide open,,,159.5,184.68,8
HCPCS,49418,INSJ INTRAPERITONEAL CATHETER W/IMG GID,1584.0,1029.6,1.1,5906.43,53
HCPCS,49418,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,16234.0,10552.1,0.01,16234.0,122
HCPCS,49419,INSERT TUN IP CATH W/PORT,,,4994.76,15596.41,19
HCPCS,49419,Insert tun ip cath w/port,,,1611.33,1865.75,8
HCPCS,49421,INS TUN IP CATH FOR DIAL OPN,,,3260.78,10035.32,19
HCPCS,49421,INSERTION PERITONEAL CATH DIALYSIS OPEN,576.0,374.4,1.1,5906.43,50
HCPCS,49421,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,1684.0,1094.6,1.1,5906.43,50
HCPCS,49421,Ins tun ip cath for dial opn,,,1611.33,1865.75,8
HCPCS,49422,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,8119.0,5277.35,0.01,14478.0,233
HCPCS,49423,EXCHNG ABSC/CST DRG CATH RAD GID SPX,4684.0,3044.6,0.01,8726.0,175
HCPCS,49424,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,482.5,313.625,0.01,3398.0,145
HCPCS,49425,INSERTION PERITONEAL-VENOUS SHUNT,8296.5,5392.725,1.1,11705.0,96
HCPCS,49426,REVIS PERITONEAL-VENOUS SHUNT,4164.0,2706.6,1.1,5906.43,50
HCPCS,49426,REVISE ABDOMEN-VENOUS SHUNT,,,3260.78,10035.32,19
HCPCS,49426,Revise abdomen-venous shunt,,,1611.33,1865.75,8
HCPCS,49427,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,392.0,254.8,1.1,392.0,50
HCPCS,49427,Injection abdominal shunt,,,65.08,75.36,8
HCPCS,49428,Ligation of shunt,,,1611.33,1865.75,8
HCPCS,49429,RMVL PERITONEAL-VENOUS SHUNT,8727.0,5672.55,1.1,14478.0,111
HCPCS,49435,Insert subq exten to ip cath,,,366.62,424.51,8
HCPCS,49436,EMBEDDED IP CATH EXIT-SITE,,,1752.78,5378.41,19
HCPCS,49436,Embedded ip cath exit-site,,,366.62,424.51,8
HCPCS,49440,INSERT GASTROSTOMY TUBE PERCUTANEOUS,5227.5,3397.875,1.1,8726.0,175
HCPCS,49441,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,5267.0,3423.5499999999997,1.1,8726.0,114
HCPCS,49442,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,3462.0,2250.3,1.1,5424.0,114
HCPCS,49446,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,4975.0,3233.75,1.1,8726.0,175
HCPCS,49450,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,2428.5,1578.5249999999999,0.01,4831.0,236
HCPCS,49451,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,2524.5,1640.925,0.01,4831.0,236
HCPCS,49452,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,2728.5,1773.5249999999999,1.1,4831.0,175
HCPCS,49460,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,2348.5,1526.5249999999999,1.1,4831.0,175
HCPCS,49465,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,680.0,442.0,0.01,3398.0,236
HCPCS,49491,RPR HERN PREEMIE REDUC,,,5390.83,16944.69,19
HCPCS,49491,Rpr hern preemie reduc,,,1934.06,2239.44,8
HCPCS,49492,RPR ING HERN PREMIE BLOCKED,,,3260.78,10035.32,19
HCPCS,49492,Rpr ing hern premie blocked,,,1934.06,2239.44,8
HCPCS,49495,RPR ING HERNIA BABY REDUC,,,3260.78,10035.32,19
HCPCS,49495,Rpr ing hernia baby reduc,,,1934.06,2239.44,8
HCPCS,49496,RPR ING HERNIA BABY BLOCKED,,,3260.78,10035.32,19
HCPCS,49496,Rpr ing hernia baby blocked,,,1934.06,2239.44,8
HCPCS,49500,RPR ING HERNIA INIT REDUCE,,,5765.4,18145.13,19
HCPCS,49500,Rpr ing hernia init reduce,,,1934.06,2239.44,8
HCPCS,49501,RPR ING HERNIA INIT BLOCKED,,,3260.78,10035.32,19
HCPCS,49501,Rpr ing hernia init blocked,,,1934.06,2239.44,8
HCPCS,49505,PRP I/HERN INIT REDUC >5 YR,,,3260.78,10035.32,20
HCPCS,49505,Prp i/hern init reduc >5 yr,,,1934.06,2239.44,8
HCPCS,49505,REPAIR INGUINAL HERNIA,1050.0,682.5,1.1,5906.43,50
HCPCS,49505,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,3184.0,2069.6,1.1,5906.43,50
HCPCS,49507,PRP I/HERN INIT BLOCK >5 YR,,,3260.78,10035.32,19
HCPCS,49507,Prp i/hern init block >5 yr,,,1934.06,2239.44,8
HCPCS,49507,REPAIR INGUINAL HERNIA,1354.0,880.1,1.1,5906.43,50
HCPCS,49507,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,3636.0,2363.4,1.1,5906.43,50
HCPCS,49520,REREPAIR ING HERNIA REDUCE,,,3260.78,10035.32,19
HCPCS,49520,REREPAIR INGUINAL HERNIA,1296.0,842.4,1.1,5906.43,50
HCPCS,49520,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,3996.0,2597.4,1.1,5906.43,50
HCPCS,49520,Rerepair ing hernia reduce,,,1934.06,2239.44,8
HCPCS,49521,REREPAIR ING HERNIA BLOCKED,,,5765.4,18145.13,19
HCPCS,49521,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,4592.0,2984.8,1.1,12916.74,50
HCPCS,49521,Rerepair ing hernia blocked,,,1934.06,2239.44,8
HCPCS,49525,REPAIR ING HERNIA SLIDING,,,3260.78,10035.32,19
HCPCS,49525,RPR INGUN HERNIA SLIDING ANY AGE,3572.0,2321.8,1.1,5906.43,50
HCPCS,49525,Repair ing hernia sliding,,,1934.06,2239.44,8
HCPCS,49540,REPAIR LUMBAR HERNIA,4296.0,2792.4,1.1,16944.69,69
HCPCS,49540,Repair lumbar hernia,,,2692.69,3117.85,8
HCPCS,49550,REPAIR FEMORAL HERNIA,980.0,637.0,1.1,5906.43,50
HCPCS,49550,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,3596.0,2337.4,1.1,5906.43,50
HCPCS,49550,RPR REM HERNIA INIT REDUCE,,,3260.78,10035.32,19
HCPCS,49550,Rpr rem hernia init reduce,,,1934.06,2239.44,8
HCPCS,49553,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,3968.0,2579.2,1.1,5906.43,50
HCPCS,49553,RPR FEM HERNIA INIT BLOCKED,,,3260.78,10035.32,19
HCPCS,49553,Rpr fem hernia init blocked,,,1934.06,2239.44,8
HCPCS,49555,REREPAIR FEM HERNIA REDUCE,,,3260.78,10035.32,19
HCPCS,49555,RPR RECRT FEM HERNIA REDUCIBLE,3756.0,2441.4,1.1,5906.43,50
HCPCS,49555,Rerepair fem hernia reduce,,,1934.06,2239.44,8
HCPCS,49557,REREPAIR FEM HERNIA BLOCKED,,,3260.78,10035.32,19
HCPCS,49557,RPR RECRT FEM HRNA INCARCERATED,4648.0,3021.2,1.1,5906.43,50
HCPCS,49557,Rerepair fem hernia blocked,,,1934.06,2239.44,8
HCPCS,49560,Rpr ventral hern init reduc,,,2692.69,3117.85,8
HCPCS,49561,Rpr ventral hern init block,,,2692.69,3117.85,8
HCPCS,49565,Rerepair ventrl hern reduce,,,2692.69,3117.85,8
HCPCS,49566,Rerepair ventrl hern block,,,2692.69,3117.85,8
HCPCS,49568,Hernia repair w/mesh,,,2692.69,3117.85,8
HCPCS,49570,Rpr epigastric hern reduce,,,2692.69,3117.85,8
HCPCS,49572,Rpr epigastric hern blocked,,,2692.69,3117.85,8
HCPCS,49580,Rpr umbil hern reduc < 5 yr,,,1934.06,2239.44,8
HCPCS,49582,Rpr umbil hern block < 5 yr,,,1934.06,2239.44,8
HCPCS,49585,Rpr umbil hern reduc > 5 yr,,,1934.06,2239.44,8
HCPCS,49587,Rpr umbil hern block > 5 yr,,,1934.06,2239.44,8
HCPCS,49590,Repair spigelian hernia,,,2692.69,3117.85,8
HCPCS,49591,RPR AA HERNIA 1ST < 3 CM REDUCIBLE,2622.0,1704.3,1.1,5906.43,50
HCPCS,49591,RPR AA HRN 1ST < 3 CM RDC,,,3260.78,10035.32,20
HCPCS,49591,Rpr aa hrn 1st < 3 cm rdc,,,2692.69,3117.85,8
HCPCS,49592,RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,3722.0,2419.3,1.1,9852.42,50
HCPCS,49592,RPR AA HRN 1ST < 3 NCR/STRN,,,5390.83,16944.69,19
HCPCS,49592,Rpr aa hrn 1st < 3 ncr/strn,,,2692.69,3117.85,8
HCPCS,49593,RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,4514.0,2934.1,1.1,5906.43,50
HCPCS,49593,RPR AA HRN 1ST 3-10 RDC,,,5765.4,18145.13,20
HCPCS,49593,Rpr aa hrn 1st 3-10 rdc,,,2692.69,3117.85,8
HCPCS,49594,RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,5922.0,3849.3,1.1,9852.42,50
HCPCS,49594,RPR AA HRN 1ST 3-10 NCR/STRN,,,5390.83,16944.69,19
HCPCS,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,2692.69,3117.85,8
HCPCS,49595,RPR AA HERNIA 1ST > 10 CM REDUCIBLE,6134.0,3987.1,1.1,6134.0,50
HCPCS,49595,RPR AA HRN 1ST > 10 RDC,,,5765.4,18145.13,19
HCPCS,49595,Rpr aa hrn 1st > 10 rdc,,,2692.69,3117.85,8
HCPCS,49596,RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED,8215.0,5339.75,1.1,8215.0,50
HCPCS,49596,Rpr aa hrn 1st > 10 ncr/strn,,,2692.69,3117.85,8
HCPCS,49600,REPAIR UMBILICAL LESION,,,3260.78,10035.32,19
HCPCS,49600,Repair umbilical lesion,,,2692.69,3117.85,8
HCPCS,49605,Repair umbilical lesion,,,2692.69,3117.85,8
HCPCS,49606,Repair umbilical lesion,,,2692.69,3117.85,8
HCPCS,49610,Repair umbilical lesion,,,2692.69,3117.85,8
HCPCS,49611,Repair umbilical lesion,,,2692.69,3117.85,8
HCPCS,49613,RPR AA HERNIA RECR < 3 CM REDUCIBLE,2968.0,1929.2,1.1,5906.43,50
HCPCS,49613,RPR AA HRN RCR < 3 RDC,,,3260.78,10035.32,19
HCPCS,49613,Rpr aa hrn rcr < 3 rdc,,,2692.69,3117.85,8
HCPCS,49614,RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,4100.0,2665.0,1.1,9852.42,50
HCPCS,49614,RPR AA HRN RCR < 3 NCR/STRN,,,5390.83,16944.69,19
HCPCS,49614,Rpr aa hrn rcr < 3 ncr/strn,,,2692.69,3117.85,8
HCPCS,49615,RPR AA HERNIA RECR 3-10 CM REDUCIBLE,4584.0,2979.6,1.1,5906.43,50
HCPCS,49615,RPR AA HRN RCR 3-10 RDC,,,5765.4,18145.13,19
HCPCS,49615,Rpr aa hrn rcr 3-10 rdc,,,2692.69,3117.85,8
HCPCS,49616,RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,6842.0,4447.3,1.1,6842.0,50
HCPCS,49616,Rpr aa hrn rcr 3-10 ncr/strn,,,2692.69,3117.85,8
HCPCS,49617,RPR AA HERNIA RECR > 10 CM REDUCIBLE,6412.0,4167.8,1.1,6412.0,50
HCPCS,49617,Rpr aa hrn rcr > 10 rdc,,,2692.69,3117.85,8
HCPCS,49618,RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,9068.0,5894.2,1.1,9068.0,50
HCPCS,49618,Rpr aa hrn rcr > 10 ncr/strn,,,2692.69,3117.85,8
HCPCS,49621,RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,5480.0,3562.0,1.1,5480.0,50
HCPCS,49621,Rpr parastomal hernia rdc,,,2692.69,3117.85,8
HCPCS,49622,RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED,6824.0,4435.6,1.1,6824.0,50
HCPCS,49622,Rpr parastomal hrna ncr/strn,,,2692.69,3117.85,8
HCPCS,49623,RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,1500.0,975.0,1.1,1500.0,50
HCPCS,49623,Rmvl ninfct mesh hernia rpr,,,2692.69,3117.85,8
HCPCS,49650,LAP ING HERNIA REPAIR INIT,,,5390.83,16944.69,20
HCPCS,49650,LAPARO HERNIA REPAIR INITIAL,682.0,443.3,1.1,9852.42,50
HCPCS,49650,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,2544.0,1653.6,1.1,9852.42,50
HCPCS,49650,Lap ing hernia repair init,,,1934.06,2239.44,8
HCPCS,49651,LAP ING HERNIA REPAIR RECUR,,,5390.83,16944.69,19
HCPCS,49651,LAPS SURG RPR RECURRENT INGUINAL HERNIA,3352.0,2178.8,1.1,9852.42,50
HCPCS,49651,Lap ing hernia repair recur,,,1934.06,2239.44,8
HCPCS,49652,Lap vent/abd hernia repair,,,2692.69,3117.85,8
HCPCS,49653,Lap vent/abd hern proc comp,,,2692.69,3117.85,8
HCPCS,49654,Lap inc hernia repair,,,2692.69,3117.85,8
HCPCS,49655,Lap inc hern repair comp,,,2692.69,3117.85,8
HCPCS,49656,Lap inc hernia repair recur,,,2692.69,3117.85,8
HCPCS,49657,Lap inc hern recur comp,,,2692.69,3117.85,8
HCPCS,49659,LAP REPAIR INITIAL FEMORAL HERNIA; INCAR OR STRANG (COMP CODE 49,3572.0,2321.8,0.01,9852.42,28
HCPCS,49659,LAP REPAIR OF ACUTE TRAUMATIC DIAPHRAGMATIC HERNIA (COMP 39540),6265.0,4072.25,0.01,9852.42,28
HCPCS,49659,LAP REPAIR OF FEMORAL HERNIA (COMP 49550),3827.0,2487.55,0.01,9852.42,28
HCPCS,49659,LAP. PERISTOMAL HERNIA REPAIR,6478.0,4210.7,0.01,9852.42,28
HCPCS,49659,LAPAROSCOPIC CONGENITAL HERNIA REPAIR W/ MESH (COMP 43282),10837.0,7044.05,0.01,10837.0,28
HCPCS,49659,LAPAROSCOPIC REPAIR RECURRENT FEMORAL HERNIA (COMP CODE 49555),3381.0,2197.65,0.01,9852.42,28
HCPCS,49659,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HER",1680.0,1092.0,0.01,9852.42,28
HCPCS,49659,UNLISTED LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,1250.0,812.5,0.01,9852.42,28
HCPCS,49659,UNLSTD LAPS PX HRNAP HRNRPHY,,,5390.83,16944.69,19
HCPCS,49659,Unlstd laps px hrnap hrnrphy,,,2692.69,3117.85,8
HCPCS,49900,Repair of abdominal wall,,,1611.33,1865.75,8
HCPCS,49900,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,4964.0,3226.6,1.1,4964.0,50
HCPCS,49904,Omental flap extra-abdom,,,1611.33,1865.75,8
HCPCS,49905,OMENTAL FLAP INTRA-ABDOMINAL,2616.0,1700.4,1.1,2616.0,50
HCPCS,49905,Omental flap intra-abdom,,,1611.33,1865.75,8
HCPCS,49906,Free omental flap microvasc,,,1611.33,1865.75,8
HCPCS,49999,CORE NEEDLE BIOPSY ABDOMEN/PERITONEUM/OMENTUM AT TIME OF OTHER P,818.0,531.7,0.01,1548.29,28
HCPCS,49999,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),14601.5,9490.975,0.01,25651.0,89
HCPCS,49999,EXPL OF GROIN WOUND W/ RELEASE OF SCAR FORMATION (COMP CODE 3584,7471.0,4856.15,0.01,7471.0,28
HCPCS,49999,MANUAL REDUCTION OF INGUINAL HERNIA (COMP CODE 49505),2866.0,1862.9,0.01,3004.0,61
HCPCS,49999,MESENTERIC OR OMENTUM BIOPSY (COMP 49000),3111.0,2022.15,0.01,3111.0,28
HCPCS,49999,"OMENTAL FLAP, LAPARCOCOPIC (COMP CODE 49905)",2812.0,1827.8,0.01,2812.0,28
HCPCS,49999,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),3861.0,2509.65,0.01,6294.0,89
HCPCS,49999,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),14729.0,9573.85,0.01,26838.0,89
HCPCS,49999,"REMOVAL FOREIGN BODY, ABD WALL (COMP CODE 11008)",3152.0,2048.8,0.01,3152.0,28
HCPCS,49999,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),4708.0,3060.2000000000003,0.01,8932.0,89
HCPCS,49999,"UNLIST PROC, ABD, PERITONEUM AND OMENUM COMPARED TO 49000",4138.0,2689.7,0.01,4138.0,28
HCPCS,49999,"UNLIST PROC, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 49082",409.0,265.85,0.01,1548.29,28
HCPCS,49999,UNLISTED PROCEDURE ABDOMEN PERITONEUM & OMENTUM,1607.0,1044.55,0.01,1607.0,28
HCPCS,49999,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 44",5122.0,3329.3,0.01,5122.0,28
HCPCS,49999,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM (COMPARISON",1560.0,1014.0,0.01,1560.0,28
HCPCS,50010,Renal exploration,,,4503.79,5214.91,8
HCPCS,50020,DRG PERIRNL/RENAL ABSC OPEN,,,1892.78,5859.03,19
HCPCS,50020,Drg perirnl/renal absc open,,,4503.79,5214.91,8
HCPCS,50040,Nfros nfrot w/drg,,,4503.79,5214.91,8
HCPCS,50045,Nephrotomy w/exploration,,,4503.79,5214.91,8
HCPCS,5005F,Pt counsld on exam for moles,,,8.48,9.82,8
HCPCS,50060,Nl removal calculus,,,4503.79,5214.91,8
HCPCS,50065,Nl sec surg operj calculus,,,4503.79,5214.91,8
HCPCS,50070,Nl comp cgen kdn abnormality,,,4503.79,5214.91,8
HCPCS,50075,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,10836.0,7043.4,1.1,10836.0,50
HCPCS,50075,Nl rmvl lg staghorn calculus,,,4503.79,5214.91,8
HCPCS,50080,PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION,5460.0,3549.0,1.1,15728.38,50
HCPCS,50080,PERQ NL/PL LITHOTRP SMPL<2CM,,,8544.18,26533.05,19
HCPCS,50080,Perq nl/pl lithotrp smpl<2cm,,,4503.79,5214.91,8
HCPCS,50081,PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS,9200.0,5980.0,1.1,15728.38,50
HCPCS,50081,PERQ NL/PL LITHOTRP CPLX>2CM,,,8544.18,26533.05,19
HCPCS,50081,Perq nl/pl lithotrp cplx>2cm,,,4503.79,5214.91,8
HCPCS,50100,Trnsxj/repos abrrnt rnl vsls,,,4503.79,5214.91,8
HCPCS,5010F,Macul result phy/qhp mng dm,,,8.48,9.82,8
HCPCS,50120,Pyelotomy w/exploration,,,4503.79,5214.91,8
HCPCS,50125,Pyelotomy w/drg pyelostomy,,,4503.79,5214.91,8
HCPCS,50130,Pyelotomy w/removal calculus,,,1680.64,1946.0,8
HCPCS,50135,Pyelotomy complicated,,,4503.79,5214.91,8
HCPCS,5015F,Doc fx & test/txmnt for op,,,8.48,9.82,8
HCPCS,50200,RENAL BIOPSY PRQ TROCAR/NEEDLE,4250.0,2762.5,0.01,7453.0,236
HCPCS,50205,Renal bx surg exposure kdn,,,4503.79,5214.91,8
HCPCS,5020F,Txmnts 2 phys/qhp by 1 mon,,,8.48,9.82,8
HCPCS,50220,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,7472.0,4856.8,1.1,7472.0,50
HCPCS,50220,Remove kidney open,,,4503.79,5214.91,8
HCPCS,50225,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,8752.0,5688.8,1.1,8752.0,50
HCPCS,50225,Removal kidney open complex,,,4503.79,5214.91,8
HCPCS,50230,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,9524.0,6190.6,1.1,9524.0,50
HCPCS,50230,Removal kidney open radical,,,4503.79,5214.91,8
HCPCS,50234,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,10582.0,6878.3,1.1,10582.0,50
HCPCS,50234,Removal of kidney & ureter,,,4503.79,5214.91,8
HCPCS,50236,Removal of kidney & ureter,,,4503.79,5214.91,8
HCPCS,50240,NEPHRECTOMY PARTIAL,9684.0,6294.6,1.1,9684.0,50
HCPCS,50240,Nephrectomy partial,,,4503.79,5214.91,8
HCPCS,50250,Opn abltj 1/> rnl mas crysrg,,,4503.79,5214.91,8
HCPCS,50280,EXCIS/UNROOF RENAL CYST,6836.0,4443.4,1.1,6836.0,50
HCPCS,50280,Exc/unroofing cyst kidney,,,4503.79,5214.91,8
HCPCS,50290,Excision perinephric cyst,,,4503.79,5214.91,8
HCPCS,50300,Remove cadaver donor kidney,,,1422.38,1646.96,8
HCPCS,50320,Remove kidney living donor,,,1422.38,1646.96,8
HCPCS,50323,Prep cadaver renal allograft,,,975.94,1130.04,8
HCPCS,50325,Prep donor renal graft,,,975.94,1130.04,8
HCPCS,50327,Prep renal graft/venous,,,975.94,1130.04,8
HCPCS,50328,Prep renal graft/arterial,,,975.94,1130.04,8
HCPCS,50329,Prep renal graft/ureteral,,,975.94,1130.04,8
HCPCS,50340,Recipient nephrectomy,,,4503.79,5214.91,8
HCPCS,50360,Rnl altrnsplj w/o rcp nfrct,,,1422.38,1646.96,8
HCPCS,50365,Rnl altrnsplj w/rcp nfrct,,,1422.38,1646.96,8
HCPCS,50370,Rmvl transplanted rnl algrft,,,4503.79,5214.91,8
HCPCS,50380,Rnl autotrnsplj rimpltj kdn,,,1422.38,1646.96,8
HCPCS,50382,RMV/RPLC INDW URET BI-S,9423.0,6124.95,0.01,9423.0,61
HCPCS,50382,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,5761.5,3744.975,1.1,9423.0,236
HCPCS,50384,REMOVAL INDWELLING URETERAL STENT PRQ,5661.5,3679.975,1.1,9423.0,175
HCPCS,50384,RMV ONLY INDW URET BI-S,9423.0,6124.95,0.01,9423.0,61
HCPCS,50385,CHANGE STENT VIA TRANSURETH,,,1892.78,5859.03,19
HCPCS,50385,Change stent via transureth,,,797.19,923.07,8
HCPCS,50386,REMOVE STENT VIA TRANSURETH,,,1892.78,5859.03,19
HCPCS,50386,Remove stent via transureth,,,797.19,923.07,8
HCPCS,50387,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,5061.5,3289.975,0.01,9423.0,297
HCPCS,50389,RMVL NFROS TUBE REQ FLUORO GUIDANCE,1777.0,1155.05,0.01,3728.0,297
HCPCS,50390,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,2010.5,1306.825,0.01,3728.0,233
HCPCS,50391,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,784.0,509.6,1.1,784.0,53
HCPCS,50391,INSTLL RX AGNT INTO RNAL TUB,,,224.72,700.29,19
HCPCS,50391,Instll rx agnt into rnal tub,,,226.03,261.72,8
HCPCS,50396,MEASURE KIDNEY PRESSURE,,,616.73,1954.42,19
HCPCS,50396,Measure kidney pressure,,,226.03,261.72,8
HCPCS,50400,Revision of kidney/ureter,,,4503.79,5214.91,8
HCPCS,50405,Revision of kidney/ureter,,,4503.79,5214.91,8
HCPCS,50430,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,2115.0,1374.75,0.01,3728.0,236
HCPCS,50431,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,1755.0,1140.75,0.01,3728.0,236
HCPCS,50432,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,5511.5,3582.475,0.01,9423.0,236
HCPCS,50433,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,8942.5,5812.625,1.1,15865.0,175
HCPCS,50434,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,5461.5,3549.975,1.1,9423.0,175
HCPCS,50435,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,5112.0,3322.7999999999997,0.01,9423.0,236
HCPCS,50436,DILAT XST TRC NDURLGC PX,,,3186.78,9879.99,19
HCPCS,50436,Dilat xst trc ndurlgc px,,,797.19,923.07,8
HCPCS,50436,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,1112.0,722.8,1.1,5953.02,50
HCPCS,50437,DILAT XST TRC NEW ACCESS RCS,,,3186.78,9879.99,19
HCPCS,50437,Dilat xst trc new access rcs,,,797.19,923.07,8
HCPCS,50437,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,1940.0,1261.0,1.1,5953.02,50
HCPCS,50500,Repair of kidney wound,,,4503.79,5214.91,8
HCPCS,5050F,Plan 2 main dr by 1 month,,,8.48,9.82,8
HCPCS,50520,Close kidney-skin fistula,,,1680.64,1946.0,8
HCPCS,50525,Close nephrovisceral fistula,,,4503.79,5214.91,8
HCPCS,50526,Close nephrovisceral fistula,,,4503.79,5214.91,8
HCPCS,50540,Revision of horseshoe kidney,,,4503.79,5214.91,8
HCPCS,50541,LAPARO ABLATE RENAL CYST,,,9619.76,29793.81,19
HCPCS,50541,LAPAROSCOPY SURG ABLATION RENAL CYSTS,6744.0,4383.6,1.1,17575.94,50
HCPCS,50541,Laparo ablate renal cyst,,,1680.64,1946.0,8
HCPCS,50542,LAPARO ABLATE RENAL MASS,,,9619.76,29793.81,19
HCPCS,50542,Laparo ablate renal mass,,,4503.79,5214.91,8
HCPCS,50543,LAPARO PARTIAL NEPHRECTOMY,,,9619.76,29793.81,19
HCPCS,50543,LAPAROSC PARTIAL NEPHRECTOMY,10964.0,7126.6,1.1,17575.94,50
HCPCS,50543,Laparo partial nephrectomy,,,4503.79,5214.91,8
HCPCS,50544,LAPAROSCOPY PYELOPLASTY,,,9619.76,29793.81,19
HCPCS,50544,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",9348.0,6076.2,1.1,17575.94,50
HCPCS,50544,Laparoscopy pyeloplasty,,,4503.79,5214.91,8
HCPCS,50545,LAPAROSCOPY RADICAL NEPHRECTOMY,10024.0,6515.6,1.1,10024.0,50
HCPCS,50545,Laparo radical nephrectomy,,,4503.79,5214.91,8
HCPCS,50546,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,8748.0,5686.2,1.1,8748.0,50
HCPCS,50546,Laparoscopic nephrectomy,,,4503.79,5214.91,8
HCPCS,50547,Laparo removal donor kidney,,,4503.79,5214.91,8
HCPCS,50548,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,10144.0,6593.6,1.1,10144.0,50
HCPCS,50548,Laparo remove w/ureter,,,4503.79,5214.91,8
HCPCS,50549,LAPAROSCOPIC RENAL AUTOTRANSPLANTATION (COMP CODE 50380),10840.0,7046.0,0.01,10840.0,28
HCPCS,50549,LAPAROSCOPIC RENAL CYST EXCISION (COMP CODE 50280),6836.0,4443.4,0.01,9852.42,28
HCPCS,50549,LAPAROSCOPIC URETEROPLASTY (COMP CODE 50700),6009.0,3905.85,0.01,9852.42,28
HCPCS,50549,"UNLISTED LAPAROSCOPY PROCEDURE, RENAL (COMP CODE 50234)",10341.0,6721.65,0.01,10341.0,28
HCPCS,50549,UNLISTED LAPS PX RENAL,,,5390.83,16944.69,19
HCPCS,50549,Unlisted laps px renal,,,797.19,923.07,8
HCPCS,50551,KIDNEY ENDOSCOPY,,,4697.16,15028.3,19
HCPCS,50551,Kidney endoscopy,,,1680.64,1946.0,8
HCPCS,50551,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,2236.0,1453.4,1.1,8834.56,53
HCPCS,50553,KIDNEY ENDOSCOPY,,,4697.16,15028.3,19
HCPCS,50553,Kidney endoscopy,,,1680.64,1946.0,8
HCPCS,50555,KIDNEY ENDOSCOPY & BIOPSY,,,8544.18,26533.05,19
HCPCS,50555,Kidney endoscopy & biopsy,,,1680.64,1946.0,8
HCPCS,50555,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,2608.0,1695.2,1.1,15728.38,53
HCPCS,50557,KIDNEY ENDOSCOPY & TREATMENT,,,8544.18,26533.05,19
HCPCS,50557,Kidney endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50561,KIDNEY ENDOSCOPY & TREATMENT,,,4697.16,15028.3,19
HCPCS,50561,Kidney endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50561,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,3032.0,1970.8,1.1,8834.56,53
HCPCS,50562,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,4360.0,2834.0,1.1,15728.38,50
HCPCS,50562,RENAL SCOPE W/TUMOR RESECT,,,8544.18,26533.05,19
HCPCS,50562,Renal scope w/tumor resect,,,1680.64,1946.0,8
HCPCS,50570,KIDNEY ENDOSCOPY,,,3186.78,9879.99,19
HCPCS,50570,Kidney endoscopy,,,1680.64,1946.0,8
HCPCS,50572,KIDNEY ENDOSCOPY,,,616.73,1954.42,19
HCPCS,50572,Kidney endoscopy,,,797.19,923.07,8
HCPCS,50574,KIDNEY ENDOSCOPY & BIOPSY,,,3186.78,9879.99,19
HCPCS,50574,Kidney endoscopy & biopsy,,,1680.64,1946.0,8
HCPCS,50574,RENAL NDSC NEPHROTOMY W/BIOPSY,4400.0,2860.0,1.1,5953.02,50
HCPCS,50575,KIDNEY ENDOSCOPY,,,4697.16,15028.3,19
HCPCS,50575,Kidney endoscopy,,,1680.64,1946.0,8
HCPCS,50575,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,5584.0,3629.6,1.1,8834.56,50
HCPCS,50576,KIDNEY ENDOSCOPY & TREATMENT,,,8544.18,26533.05,19
HCPCS,50576,Kidney endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50580,KIDNEY ENDOSCOPY & TREATMENT,,,4697.16,15028.3,19
HCPCS,50580,Kidney endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50580,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,4736.0,3078.4,1.1,8834.56,50
HCPCS,50590,FRAGMENTING OF KIDNEY STONE,,,3186.78,9879.99,20
HCPCS,50590,Fragmenting of kidney stone,,,1680.64,1946.0,8
HCPCS,50590,LITHOTRIPSY XTRCORP SHOCK WAVE,3908.0,2540.2,1.1,5953.02,53
HCPCS,50592,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,14729.0,9573.85,0.01,26838.0,114
HCPCS,50593,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,14601.5,9490.975,0.01,29793.81,175
HCPCS,50600,EXPLORATION OF URETER,,,9619.76,10389.34,6
HCPCS,50600,Exploration of ureter,,,1680.64,1946.0,8
HCPCS,50605,Insert ureteral support,,,1680.64,1946.0,8
HCPCS,50605,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,6716.0,4365.4,1.1,6716.0,50
HCPCS,50606,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,604.0,392.6,131.67,5214.91,46
HCPCS,5060F,Fndngs mammo 2pt w/in 3 days,,,8.48,9.82,8
HCPCS,50610,Removal of ureter stone,,,1680.64,1946.0,8
HCPCS,50620,Removal of ureter stone,,,1680.64,1946.0,8
HCPCS,5062F,Mammo result com to pt 5 day,,,8.48,9.82,8
HCPCS,50630,Removal of ureter stone,,,1680.64,1946.0,8
HCPCS,50650,Removal of ureter,,,2248.18,2603.15,8
HCPCS,50650,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,8281.0,5382.65,1.1,8281.0,50
HCPCS,50660,Removal of ureter,,,4503.79,5214.91,8
HCPCS,50684,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,415.0,269.75,1.1,3398.0,99
HCPCS,50686,MEASURE URETER PRESSURE,,,121.73,360.65,19
HCPCS,50686,Measure ureter pressure,,,39.43,45.66,8
HCPCS,50688,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,4951.5,3218.475,0.01,9423.0,294
HCPCS,50690,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,999.0,649.35,0.01,9903.0,213
HCPCS,50693,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,8724.5,5670.925,0.01,15865.0,236
HCPCS,50694,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,8982.5,5838.625,0.01,15865.0,175
HCPCS,50695,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,9292.5,6040.125,0.01,15865.0,236
HCPCS,50700,Revision of ureter,,,4503.79,5214.91,8
HCPCS,50705,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,604.0,392.6,131.67,5214.91,46
HCPCS,50706,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1413.0,918.45,1.1,5214.91,99
HCPCS,50715,Release of ureter,,,1680.64,1946.0,8
HCPCS,50715,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,8256.0,5366.4,1.1,8256.0,50
HCPCS,50722,Release of ureter,,,1680.64,1946.0,8
HCPCS,50725,Release/revise ureter,,,4503.79,5214.91,8
HCPCS,50727,REVISE URETER,,,3186.78,9879.99,19
HCPCS,50727,REVJ URINARY-CUTANEOUS ANASTAMOSIS,3312.0,2152.8,1.1,5953.02,50
HCPCS,50727,Revise ureter,,,846.52,980.18,8
HCPCS,50728,Revise ureter,,,2248.18,2603.15,8
HCPCS,50740,Fusion of ureter & kidney,,,4503.79,5214.91,8
HCPCS,50750,Fusion of ureter & kidney,,,4503.79,5214.91,8
HCPCS,50760,URETEROURETEROSTOMY,8028.0,5218.2,1.1,8028.0,50
HCPCS,50760,Ureteroureterostomy,,,4503.79,5214.91,8
HCPCS,50770,Splicing of ureters,,,4503.79,5214.91,8
HCPCS,50780,Reimplant ureter in bladder,,,2248.18,2603.15,8
HCPCS,50780,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,8778.0,5705.7,1.1,8778.0,50
HCPCS,50782,Reimplant ureter in bladder,,,4503.79,5214.91,8
HCPCS,50783,Reimplant ureter in bladder,,,4503.79,5214.91,8
HCPCS,50785,Reimplant ureter in bladder,,,2248.18,2603.15,8
HCPCS,50785,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,8892.0,5779.8,1.1,8892.0,50
HCPCS,50800,Implant ureter in bowel,,,4503.79,5214.91,8
HCPCS,50800,URETEROENTEROSTOMY ANAST URETER INTESTINE,7220.0,4693.0,1.1,7220.0,50
HCPCS,50810,Fusion of ureter & bowel,,,4503.79,5214.91,8
HCPCS,50815,Urine shunt to intestine,,,4503.79,5214.91,8
HCPCS,50820,Construct bowel bladder,,,2248.18,2603.15,8
HCPCS,50820,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,9628.0,6258.2,1.1,9628.0,50
HCPCS,50825,Construct bowel bladder,,,2248.18,2603.15,8
HCPCS,50830,Revise urine flow,,,4503.79,5214.91,8
HCPCS,50840,Replace ureter by bowel,,,4503.79,5214.91,8
HCPCS,50845,Appendico-vesicostomy,,,2248.18,2603.15,8
HCPCS,50860,Transplant ureter to skin,,,4503.79,5214.91,8
HCPCS,50900,Repair of ureter,,,1680.64,1946.0,8
HCPCS,50900,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,6016.0,3910.4,1.1,6016.0,50
HCPCS,50920,CLOSURE URETEROCUTANEOUS FISTULA,6324.0,4110.6,1.1,6324.0,50
HCPCS,50920,Closure ureter/skin fistula,,,1680.64,1946.0,8
HCPCS,50930,Closure ureter/bowel fistula,,,2248.18,2603.15,8
HCPCS,50940,Release of ureter,,,1680.64,1946.0,8
HCPCS,50945,LAPAROSCOPY URETEROLITHOTOMY,,,5390.83,16944.69,19
HCPCS,50945,Laparoscopy ureterolithotomy,,,1680.64,1946.0,8
HCPCS,50947,LAPARO NEW URETER/BLADDER,,,9619.76,29793.81,19
HCPCS,50947,Laparo new ureter/bladder,,,4503.79,5214.91,8
HCPCS,50948,LAPARO NEW URETER/BLADDER,,,9619.76,29793.81,19
HCPCS,50948,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,10481.0,6812.65,1.1,17575.94,50
HCPCS,50948,Laparo new ureter/bladder,,,1680.64,1946.0,8
HCPCS,50949,LAP URETEROURETEROSTOMY (COMP 50760),7226.0,4696.9,0.01,9852.42,28
HCPCS,50949,LAPAROSCOPIC URETERECTOMY WITH BLADDER CUFF (COMP CODE 50650),8093.0,5260.45,0.01,9852.42,28
HCPCS,50949,LAPAROSCOPIC URETEROCALICOSTOMY (COMP CODE 50750),8488.0,5517.2,0.01,9852.42,28
HCPCS,50949,LAPAROSCOPIC URETEROLYSIS (COMP 50715),7431.0,4830.15,0.01,9852.42,28
HCPCS,50949,"UNLISTED LAPAROSCOPY PROCEDURE, URETER (COMPARISON CODE 50760)",6623.0,4304.95,0.01,9852.42,28
HCPCS,50949,UNLISTED LAPS PX URETER,,,5390.83,16944.69,19
HCPCS,50949,Unlisted laps px ureter,,,797.19,923.07,8
HCPCS,50951,ENDOSCOPY OF URETER,,,3186.78,9879.99,19
HCPCS,50951,Endoscopy of ureter,,,797.19,923.07,8
HCPCS,50951,URETERAL ENDOSCOPY VIA URETEROSTOMY,2332.0,1515.8,1.1,5953.02,53
HCPCS,50953,ENDOSCOPY OF URETER,,,3186.78,9879.99,19
HCPCS,50953,Endoscopy of ureter,,,797.19,923.07,8
HCPCS,50955,URETER ENDOSCOPY & BIOPSY,,,4697.16,15028.3,19
HCPCS,50955,Ureter endoscopy & biopsy,,,1680.64,1946.0,8
HCPCS,50957,URETER ENDOSCOPY & TREATMENT,,,4697.16,15028.3,19
HCPCS,50957,Ureter endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50961,URETER ENDOSCOPY & TREATMENT,,,4697.16,15028.3,19
HCPCS,50961,Ureter endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50970,URETER ENDOSCOPY,,,3186.78,9879.99,19
HCPCS,50970,Ureter endoscopy,,,797.19,923.07,8
HCPCS,50972,URETER ENDOSCOPY & CATHETER,,,3186.78,9879.99,19
HCPCS,50972,Ureter endoscopy & catheter,,,797.19,923.07,8
HCPCS,50974,URETER ENDOSCOPY & BIOPSY,,,4697.16,15028.3,19
HCPCS,50974,Ureter endoscopy & biopsy,,,1680.64,1946.0,8
HCPCS,50976,URETER ENDOSCOPY & TREATMENT,,,4697.16,15028.3,19
HCPCS,50976,Ureter endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,50980,URETER ENDOSCOPY & TREATMENT,,,4697.16,15028.3,19
HCPCS,50980,Ureter endoscopy & treatment,,,1680.64,1946.0,8
HCPCS,5100F,Rsk fx ref w/n 24 hrs xray,,,8.48,9.82,8
HCPCS,51020,CYSTOTOMY/CYSTOSTOMY W/FULG,,,3186.78,9879.99,19
HCPCS,51020,Cystotomy/cystostomy w/fulg,,,846.52,980.18,8
HCPCS,51030,Incise & treat bladder,,,846.52,980.18,8
HCPCS,51040,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,1796.0,1167.4,1.1,3478.27,50
HCPCS,51040,CYSTOSTOMY WITH DRAINAGE,802.0,521.3,1.1,3478.27,50
HCPCS,51040,INCISE & DRAIN BLADDER,,,1892.78,5859.03,19
HCPCS,51040,Incise & drain bladder,,,846.52,980.18,8
HCPCS,51045,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,3124.0,2030.6,1.1,3478.27,50
HCPCS,51045,INCISE BLADDER/DRAIN URETER,,,1892.78,5859.03,19
HCPCS,51045,Incise bladder/drain ureter,,,846.52,980.18,8
HCPCS,51050,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,3188.0,2072.2,1.1,8834.56,50
HCPCS,51050,REMOVAL OF BLADDER STONE,,,4697.16,15028.3,19
HCPCS,51050,Removal of bladder stone,,,2248.18,2603.15,8
HCPCS,51060,REMOVAL OF URETER STONE,,,1892.78,5859.03,19
HCPCS,51060,Removal of ureter stone,,,797.19,923.07,8
HCPCS,51065,REMOVE URETER CALCULUS,,,3186.78,9879.99,19
HCPCS,51065,Remove ureter calculus,,,846.52,980.18,8
HCPCS,51080,DRAINAGE OF BLADDER ABSCESS,,,2644.48,8141.48,19
HCPCS,51080,Drainage of bladder abscess,,,846.52,980.18,8
HCPCS,51100,ASPIRATION BLADDER NEEDLE,1119.0,727.35,66.86,3004.0,61
HCPCS,51101,DRAIN BLADDER BY TROCAR/CATH,,,812.43,2406.92,19
HCPCS,51101,Drain bladder by trocar/cath,,,226.03,261.72,8
HCPCS,51102,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,5251.5,3413.475,0.01,9423.0,297
HCPCS,51500,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,4420.0,2873.0,1.1,9852.42,50
HCPCS,51500,REMOVAL OF BLADDER CYST,,,5390.83,16944.69,19
HCPCS,51500,Removal of bladder cyst,,,1934.06,2239.44,8
HCPCS,51520,REMOVAL OF BLADDER LESION,,,3186.78,9879.99,19
HCPCS,51520,Removal of bladder lesion,,,846.52,980.18,8
HCPCS,51525,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,6168.0,4009.2,1.1,6168.0,50
HCPCS,51525,Removal of bladder lesion,,,2248.18,2603.15,8
HCPCS,51530,"CYSTOTOMY,EXCIS BLADDER TUMOR",5484.0,3564.6,1.1,5484.0,50
HCPCS,51530,Removal of bladder lesion,,,2248.18,2603.15,8
HCPCS,51535,REPAIR OF URETER LESION,,,3186.78,9879.99,19
HCPCS,51535,Repair of ureter lesion,,,846.52,980.18,8
HCPCS,51550,CYSTECTOMY PARTIAL SIMPLE,6892.0,4479.8,1.1,6892.0,50
HCPCS,51550,Partial removal of bladder,,,2248.18,2603.15,8
HCPCS,51555,CYSTECTOMY PARTIAL COMPLICATED,9272.0,6026.8,1.1,9272.0,50
HCPCS,51555,Partial removal of bladder,,,2248.18,2603.15,8
HCPCS,51565,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,9472.0,6156.8,1.1,9472.0,50
HCPCS,51565,Revise bladder & ureter(s),,,2248.18,2603.15,8
HCPCS,51570,Removal of bladder,,,2248.18,2603.15,8
HCPCS,51575,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,13672.0,8886.8,1.1,13672.0,50
HCPCS,51575,Removal of bladder & nodes,,,2248.18,2603.15,8
HCPCS,51590,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,14532.0,9445.8,1.1,14532.0,50
HCPCS,51590,Remove bladder/revise tract,,,2248.18,2603.15,8
HCPCS,51595,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,16528.0,10743.2,1.1,16528.0,50
HCPCS,51595,Remove bladder/revise tract,,,2248.18,2603.15,8
HCPCS,51596,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,17704.0,11507.6,1.1,17704.0,50
HCPCS,51597,PELVIC EXENTERATION COMPLETE MALIGNANCY,17144.0,11143.6,1.1,17144.0,50
HCPCS,51600,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,700.0,455.0,0.01,9496.0,145
HCPCS,51605,Preparation for bladder xray,,,65.08,75.36,8
HCPCS,51610,NJX RETROGRADE URETHROCSTOGRAPY,877.5,570.375,0.01,9496.0,145
HCPCS,51700,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,691.5,449.475,0.01,3004.0,175
HCPCS,51701,INSJ NON-NDWELLG BLADDER CATHETER,406.5,264.225,0.01,3004.0,297
HCPCS,51702,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,406.5,264.225,0.01,3004.0,236
HCPCS,51703,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,0.01,3004.0,258
HCPCS,51705,CHANGE CYSTOSTOMY TUBE SIMPLE,739.5,480.675,0.01,3398.0,236
HCPCS,51710,CHANGE CYSTOSTOMY TUBE COMPLICATED,1805.0,1173.25,0.01,3728.0,175
HCPCS,51715,ENDOSCOPIC INJECTION/IMPLANT,3498.0,2273.7,1.1,5953.02,53
HCPCS,51715,NDSC NJX IMPLT MATRL URT&/BLDR NCK,8678.5,5641.025,0.01,15865.0,114
HCPCS,51720,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,1726.5,1122.225,0.01,3070.0,114
HCPCS,51721,INSJ TRURL ABLTJ TRNSDCR DLVR THRM US PRST8 TISS,1782.0,1158.3,1.1,1782.0,51
HCPCS,51721,Ins trurl ablt trnsdc thr us,,,895.32,1036.68,8
HCPCS,51725,"CYSTOMETROGRAM, SIMPLE",664.0,431.6,1.1,751.43,50
HCPCS,51725,SIMPLE CYSTOMETROGRAM,1119.0,727.35,0.01,3004.0,61
HCPCS,51726,BLADDER PRESSURE MEASUREMENT DURING FILLING,1119.0,727.35,0.01,3004.0,155
HCPCS,51727,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,1957.0,1272.05,1.1,3070.0,111
HCPCS,51728,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,1999.0,1299.35,0.01,3070.0,111
HCPCS,51728,CYSTOMETROGRAM W/VP,794.0,516.1,1.1,1193.67,50
HCPCS,51729,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3070.0,1995.5,0.01,3070.0,122
HCPCS,51729,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,1104.0,717.6,1.1,1267.37,50
HCPCS,51729,CYSTOMETROGRAM W/VP&UP,834.0,542.1,1.1,1267.37,50
HCPCS,51736,SIMPLE UROFLOMETRY,68.0,44.2,1.1,218.62,50
HCPCS,51736,URINE FLOW MEASUREMENT,,,119.1,372.91,19
HCPCS,51736,Urine flow measurement,,,39.43,45.66,8
HCPCS,51741,COMPLEX UROFLOMETRY,1432.0,930.8,1.1,1500.0,155
HCPCS,51741,ELECTRO-UROFLOWMETRY- FIRST,364.0,236.6,1.1,535.81,50
HCPCS,51784,ANAL/URINARY MUSCLE STUDY,397.0,258.05,1.1,397.0,50
HCPCS,51784,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,1.1,1050.0,262
HCPCS,51785,ANAL/URINARY MUSCLE STUDY,,,224.72,700.29,19
HCPCS,51785,Anal/urinary muscle study,,,310.96,360.06,8
HCPCS,51785,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,673.0,437.45,1.1,1426.12,50
HCPCS,51792,URINARY REFLEX STUDY,,,54.88,165.35,19
HCPCS,51792,Urinary reflex study,,,310.96,360.06,8
HCPCS,51797,INTRAABDOMINAL PRESSURE TES,350.0,227.5,1.1,626.88,50
HCPCS,51797,VOID PRESSURE STUDIES INTRAABDOMINAL,1135.0,737.75,0.01,3004.0,140
HCPCS,51798,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,157.5,102.375,0.01,2453.0,233
HCPCS,51800,Revision of bladder/urethra,,,2248.18,2603.15,8
HCPCS,51820,Revision of urinary tract,,,2248.18,2603.15,8
HCPCS,51840,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,4544.0,2953.6,1.1,4544.0,50
HCPCS,51840,ATTACH BLADDER/URETHRA,,,4732.7,14021.11,13
HCPCS,51840,Attach bladder/urethra,,,2248.18,2603.15,8
HCPCS,51841,ANT VESICOURETHROPEXY/URETHROPEXY COMP,5472.0,3556.8,1.1,5472.0,50
HCPCS,51841,Attach bladder/urethra,,,2248.18,2603.15,8
HCPCS,51845,REPAIR BLADDER NECK,,,4561.18,14021.11,19
HCPCS,51845,Repair bladder neck,,,2248.18,2603.15,8
HCPCS,51860,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,5040.0,3276.0,1.1,15728.38,50
HCPCS,51860,REPAIR OF BLADDER WOUND,1380.0,897.0,1.1,26533.05,69
HCPCS,51860,Repair of bladder wound,,,2248.18,2603.15,8
HCPCS,51865,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,6320.0,4108.0,1.1,6320.0,50
HCPCS,51865,REPAIR OF BLADDER WOUND,1555.0,1010.75,1.1,3029.3,50
HCPCS,51865,Repair of bladder wound,,,2248.18,2603.15,8
HCPCS,51880,CLOSE CYSTOSTOMY,3148.0,2046.2,1.1,5953.02,50
HCPCS,51880,REPAIR OF BLADDER OPENING,,,3186.78,9879.99,19
HCPCS,51880,Repair of bladder opening,,,846.52,980.18,8
HCPCS,51900,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,5852.0,3803.8,1.1,5852.0,50
HCPCS,51900,Repair bladder/vagina lesion,,,3197.33,3702.17,8
HCPCS,51920,Close bladder-uterus fistula,,,1352.51,1566.06,8
HCPCS,51925,Hysterectomy/bladder repair,,,2525.01,2923.69,8
HCPCS,51960,Revision of bladder & bowel,,,2248.18,2603.15,8
HCPCS,51980,Construct bladder opening,,,2248.18,2603.15,8
HCPCS,51990,LAPARO URETHRAL SUSPENSION,,,5390.83,16944.69,19
HCPCS,51990,Laparo urethral suspension,,,1676.36,1941.05,8
HCPCS,51992,LAPARO SLING OPERATION,,,5390.83,16944.69,19
HCPCS,51992,Laparo sling operation,,,1676.36,1941.05,8
HCPCS,51999,"EXCISION OF URACHAL CYST OR SINUS, W/WO UMBILICAL HERNIA REPAIR",4420.0,2873.0,0.01,9852.42,28
HCPCS,51999,"LAP PROCEDURE, UNLISTED, BLADDER",2245.0,1459.25,0.01,9852.42,28
HCPCS,51999,LAPAROSCOPIC ANTERIOR VAGINECTOMY (COMP CODE 57106),3225.0,2096.25,0.01,9852.42,28
HCPCS,51999,"LAPAROSCOPIC CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROAC",6290.0,4088.5,0.01,9852.42,28
HCPCS,51999,LAPAROSCOPY PARTIAL CYSTECTOMY (COMP 51555),14126.0,9181.9,0.01,14126.0,28
HCPCS,51999,ROBOTIC (LAP) PELVIC EXENTERATION (COMP 51597),14144.0,9193.6,0.01,14144.0,28
HCPCS,51999,ROBOTIC CYSTECTOMY W/ CONDUIT & PELVIC LYMPHADENECTOMY (COMP 515,37762.0,24545.3,0.01,37762.0,28
HCPCS,51999,"STONE REMOVAL FROM BLADDER, LAPAROSCOPIC APPROACH WITH ROBOTIC A",3427.0,2227.55,0.01,9852.42,28
HCPCS,51999,"UNLIST LAP PROC, BLADDER COMPARED TO 51900",1940.0,1261.0,0.01,9852.42,28
HCPCS,51999,UNLISTED LAPAROSCOPIC PROCEDURE BLADDER (COMP CODE 51590),15621.0,10153.65,0.01,15621.0,28
HCPCS,51999,"UNLISTED LAPAROSCOPY PROCDURE, BLADDER (COMPARISON CODE 51860)",2180.0,1417.0,0.01,9852.42,28
HCPCS,51999,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",10684.0,6944.6,0.01,16279.0,56
HCPCS,51999,UNLISTED LAPS PX BLADDER,,,5390.83,16944.69,19
HCPCS,51999,UNLISTED PROC; LAPAROSCOPIC PARTICAL CYSTECTOMY (COMP TO 51550),2280.0,1482.0,0.01,9852.42,28
HCPCS,51999,Unlisted laps px bladder,,,846.52,980.18,8
HCPCS,52000,CYSTOSCOPY,1614.0,1049.1,1.1,1614.0,53
HCPCS,52000,CYSTOURETHROSCOPY,1871.5,1216.475,0.01,3070.0,175
HCPCS,52001,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,9020.5,5863.325,0.01,15865.0,175
HCPCS,52005,CYSTO BLADDER W/URETERAL CATHETERIZATION,5233.0,3401.45,1.1,9423.0,114
HCPCS,52007,CYSTO URTRL CATHJ BRUSH BX,,,3186.78,9879.99,19
HCPCS,52007,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,1208.0,785.2,1.1,5953.02,53
HCPCS,52007,Cysto urtrl cathj brush bx,,,797.19,923.07,8
HCPCS,5200F,Eval appros surg thxpy epi,,,8.48,9.82,8
HCPCS,52010,CYSTOSCOPY & DUCT CATHETER,,,616.73,1954.42,19
HCPCS,52010,Cystoscopy & duct catheter,,,1676.36,1941.05,8
HCPCS,52204,CYSTOSCOPY W/BIOPSY(S),3543.0,2302.95,1.1,3543.0,53
HCPCS,52204,CYSTOURETHROSCOPY WITH BIOPSY,9423.0,6124.95,0.01,9423.0,61
HCPCS,52204,"CYSTOURETHROSCOPY,BIOPSY",1036.0,673.4,1.1,3478.27,53
HCPCS,52214,CYSTO W/DESTRUCTION OF LESIONS,8632.5,5611.125,0.01,15865.0,114
HCPCS,52214,CYSTOSCOPY AND TREATMENT,4396.0,2857.4,1.1,5953.02,53
HCPCS,52224,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,8742.5,5682.625,0.01,15865.0,114
HCPCS,52224,CYSTOSCOPY AND TREATMENT,4436.0,2883.4,1.1,5953.02,53
HCPCS,52234,CYSTO W/REMOVAL OF TUMORS SMALL,8856.5,5756.725,0.01,15865.0,111
HCPCS,52235,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,19
HCPCS,52235,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,2176.0,1414.4,1.1,5953.02,50
HCPCS,52235,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52240,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,13342.5,8672.625,0.01,23385.0,111
HCPCS,52250,CYSTOSCOPY AND RADIOTRACER,,,3186.78,9879.99,19
HCPCS,52250,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,1796.0,1167.4,1.1,5953.02,50
HCPCS,52250,Cystoscopy and radiotracer,,,846.52,980.18,8
HCPCS,52260,CYSTOSCOPY AND TREATMENT,,,1892.78,5859.03,20
HCPCS,52260,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,1564.0,1016.6,1.1,3478.27,50
HCPCS,52260,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52265,CYSTOSCOPY AND TREATMENT,,,1892.78,5859.03,19
HCPCS,52265,"CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH",1176.0,764.4,1.1,3478.27,53
HCPCS,52265,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52270,CYSTOSCOPY & REVISE URETHRA,,,1892.78,5859.03,19
HCPCS,52270,"CYSTOSCOPY,INTERN URETHROTOMY,FEMALE",1344.0,873.6,1.1,3478.27,53
HCPCS,52270,Cystoscopy & revise urethra,,,1676.36,1941.05,8
HCPCS,52275,CYSTOSCOPY & REVISE URETHRA,,,1892.78,5859.03,19
HCPCS,52275,"CYSTOSCOPY,INTERN URETHROTOMY,MALE",1876.0,1219.4,1.1,3478.27,53
HCPCS,52275,Cystoscopy & revise urethra,,,1676.36,1941.05,8
HCPCS,52276,CYSTOSCOPY AND TREATMENT,,,1892.78,5859.03,19
HCPCS,52276,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,1996.0,1297.4,1.1,3478.27,50
HCPCS,52276,Cystoscopy and treatment,,,1676.36,1941.05,8
HCPCS,52277,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,19
HCPCS,52277,Cystoscopy and treatment,,,1676.36,1941.05,8
HCPCS,52281,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,5316.5,3455.725,0.01,9423.0,114
HCPCS,52281,CYSTOSCOPY AND TREATMENT,3573.0,2322.45,1.1,3573.0,53
HCPCS,52282,CYSTOSCOPY IMPLANT STENT,,,3186.78,9879.99,19
HCPCS,52282,Cystoscopy implant stent,,,1676.36,1941.05,8
HCPCS,52283,CYSTOSCOPY AND TREATMENT,,,1892.78,5859.03,19
HCPCS,52283,"CYSTOSCOPY,STEROID INJ,STRICTURE",1492.0,969.8,1.1,3478.27,53
HCPCS,52283,Cystoscopy and treatment,,,1676.36,1941.05,8
HCPCS,52284,CYSTO RX BALO CATH URTL STRX,,,4697.16,15028.3,19
HCPCS,52284,CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE,1364.0,886.6,1.1,8834.56,52
HCPCS,52284,Cysto rx balo cath urtl strx,,,1676.36,1941.05,8
HCPCS,52285,CYSTOSCOPY AND TREATMENT,1859.0,1208.35,1.1,1859.0,53
HCPCS,52285,"CYSTOSCOPY,RX FEMALE URETHRAL SYND",1440.0,936.0,1.1,1440.0,53
HCPCS,52285,CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME,3070.0,1995.5,0.01,4001.0,61
HCPCS,52287,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,5351.5,3478.475,0.01,9423.0,114
HCPCS,52287,CYSTOURETHROSCOPY W/INJ CHEMO,1866.0,1212.9,1.1,3478.27,53
HCPCS,52290,CYSTOSCOPY AND TREATMENT,,,1892.78,5859.03,19
HCPCS,52290,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,1832.0,1190.8,1.1,3478.27,50
HCPCS,52290,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52300,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,2120.0,1378.0,1.1,5953.02,50
HCPCS,52300,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,19
HCPCS,52300,Cystoscopy and treatment,,,2248.18,2603.15,8
HCPCS,52301,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,2200.0,1430.0,1.1,5953.02,50
HCPCS,52301,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,19
HCPCS,52301,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52305,CYSTOSCOPY AND TREATMENT,,,4697.16,15028.3,19
HCPCS,52305,Cystoscopy and treatment,,,2248.18,2603.15,8
HCPCS,52310,CYSTO W/SIMPLE REMOVAL STONE & STENT,5273.5,3427.775,0.01,9423.0,175
HCPCS,52310,CYSTOSCOPY AND TREATMENT,3573.0,2322.45,1.1,3573.0,53
HCPCS,52315,CYSTO W/COMPLEX REMOVAL STONE & STENT,5751.5,3738.475,0.01,9423.0,114
HCPCS,52315,CYSTOSCOPY AND TREATMENT,2943.0,1912.95,1.1,3478.27,53
HCPCS,52317,LITHOLAPAXY SMPL/SM <2.5 CM,2684.0,1744.6,1.1,5953.02,53
HCPCS,52317,REMOVE BLADDER STONE,,,3186.78,9879.99,19
HCPCS,52317,Remove bladder stone,,,846.52,980.18,8
HCPCS,52318,LITHOLAPAXY COMP/LG > 2.5 CM,3672.0,2386.8,1.1,5953.02,50
HCPCS,52318,REMOVE BLADDER STONE,,,3186.78,9879.99,20
HCPCS,52318,Remove bladder stone,,,846.52,980.18,8
HCPCS,52320,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,19
HCPCS,52320,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,1876.0,1219.4,1.1,5953.02,50
HCPCS,52320,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52325,CYSTOSCOPY STONE REMOVAL,,,4697.16,15028.3,19
HCPCS,52325,Cystoscopy stone removal,,,2248.18,2603.15,8
HCPCS,52327,CYSTO W/SUBURTRIC NJX IMPLT MATRL,2072.0,1346.8,1.1,8834.56,50
HCPCS,52327,CYSTOSCOPY INJECT MATERIAL,,,4697.16,15028.3,19
HCPCS,52327,Cystoscopy inject material,,,2248.18,2603.15,8
HCPCS,52330,CYSTO MANJ W/O RMVL URETERAL STONE,2012.0,1307.8,1.1,5953.02,53
HCPCS,52330,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,19
HCPCS,52330,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52332,CYSTO W/INSERT URETERAL STENT,1128.0,733.2,1.1,5953.02,53
HCPCS,52332,CYSTOSCOPY AND TREATMENT,,,3186.78,9879.99,20
HCPCS,52332,Cystoscopy and treatment,,,846.52,980.18,8
HCPCS,52334,CREATE PASSAGE TO KIDNEY,,,3186.78,9879.99,19
HCPCS,52334,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,1483.0,963.95,1.1,5953.02,50
HCPCS,52334,Create passage to kidney,,,797.19,923.07,8
HCPCS,52341,CYSTO W/URETER STRICTURE TX,2140.0,1391.0,1.1,9879.99,69
HCPCS,52341,Cysto w/ureter stricture tx,,,846.52,980.18,8
HCPCS,52342,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,2340.0,1521.0,1.1,5953.02,50
HCPCS,52342,CYSTO W/UP STRICTURE TX,,,3186.78,9879.99,19
HCPCS,52342,Cysto w/up stricture tx,,,797.19,923.07,8
HCPCS,52343,CYSTO W/RENAL STRICTURE TX,,,3186.78,9879.99,19
HCPCS,52343,Cysto w/renal stricture tx,,,797.19,923.07,8
HCPCS,52344,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,2820.0,1833.0,1.1,5953.02,50
HCPCS,52344,CYSTO/URETERO STRICTURE TX,,,3186.78,9879.99,19
HCPCS,52344,Cysto/uretero stricture tx,,,846.52,980.18,8
HCPCS,52345,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,3020.0,1963.0,1.1,5953.02,50
HCPCS,52345,CYSTO/URETERO W/UP STRICTURE,,,3186.78,9879.99,19
HCPCS,52345,Cysto/uretero w/up stricture,,,2248.18,2603.15,8
HCPCS,52346,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,3432.0,2230.8,1.1,8834.56,50
HCPCS,52346,CYSTOURETERO W/RENAL STRICT,,,4697.16,15028.3,19
HCPCS,52346,Cystouretero w/renal strict,,,1680.64,1946.0,8
HCPCS,52351,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,2530.0,1644.5,1.1,5953.02,50
HCPCS,52351,CYSTOURETERO & OR PYELOSCOPE,,,3186.78,9879.99,20
HCPCS,52351,Cystouretero & or pyeloscope,,,846.52,980.18,8
HCPCS,52352,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,2700.0,1755.0,1.1,5953.02,50
HCPCS,52352,CYSTOURETERO W/STONE REMOVE,,,3186.78,9879.99,20
HCPCS,52352,Cystouretero w/stone remove,,,846.52,980.18,8
HCPCS,52353,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,3000.0,1950.0,1.1,8834.56,50
HCPCS,52353,CYSTOURETERO W/LITHOTRIPSY,,,4697.16,15028.3,20
HCPCS,52353,Cystouretero w/lithotripsy,,,1680.64,1946.0,8
HCPCS,52354,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,3200.0,2080.0,1.1,8834.56,50
HCPCS,52354,CYSTOURETERO W/BIOPSY,,,4697.16,15028.3,19
HCPCS,52354,Cystouretero w/biopsy,,,1680.64,1946.0,8
HCPCS,52355,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,3600.0,2340.0,1.1,8834.56,50
HCPCS,52355,CYSTOURETERO W/EXCISE TUMOR,,,4697.16,15028.3,19
HCPCS,52355,Cystouretero w/excise tumor,,,1680.64,1946.0,8
HCPCS,52356,CYSTO/URETERO W/LITHOTRIPSY,,,4697.16,15028.3,20
HCPCS,52356,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,3200.0,2080.0,1.1,8834.56,50
HCPCS,52356,Cysto/uretero w/lithotripsy,,,2248.18,2603.15,8
HCPCS,52400,CYSTO CGEN POST URTL VALVES,,,3186.78,9879.99,19
HCPCS,52400,Cysto cgen post urtl valves,,,1676.36,1941.05,8
HCPCS,52402,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,2108.0,1370.2,1.1,5953.02,50
HCPCS,52402,CYSTO TRURL RESCJ EJACUL DUX,,,3186.78,9879.99,19
HCPCS,52402,Cysto trurl rescj ejacul dux,,,1676.36,1941.05,8
HCPCS,52441,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,1760.0,1144.0,1.1,4128.64,53
HCPCS,52441,Cysto insj trnsprstc 1 implt,,,895.32,1036.68,8
HCPCS,52442,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,444.0,288.6,1.1,2801.71,53
HCPCS,52442,Cysto ins trnsprstc implt ea,,,2607.32,3019.01,8
HCPCS,52443,CYSTO 1ST TRURL ANT PRST8 COMIS NONRX BALO CATH,1593.0,1035.45,1.1,15055.51,35
HCPCS,52443,CYSTO 1ST TRURL PRST8 COMIS,,,8956.0,26533.05,13
HCPCS,52443,Cysto 1st trurl prst8 comis,,,2607.32,3019.01,8
HCPCS,52450,TRANSURETHRAL INC PROSTATE,,,3186.78,9879.99,19
HCPCS,52450,TRANSURETHRAL INCISION OF PROSTATE,3112.0,2022.8,1.1,5953.02,50
HCPCS,52450,Transurethral inc prostate,,,895.32,1036.68,8
HCPCS,52500,TRANSURETHRAL RESEC BLADDER NECK,3256.0,2116.4,1.1,5953.02,50
HCPCS,52500,TRURL RESECTION BLADDER NECK,,,3186.78,9879.99,19
HCPCS,52500,Trurl resection bladder neck,,,846.52,980.18,8
HCPCS,5250F,Asthma discharge plan presnt,,,8.48,9.82,8
HCPCS,52597,TRURL RBTC WTRJT RESCJ PRST8,,,8956.0,26533.05,13
HCPCS,52597,TRURL ROBOTIC-ASSISTED WATERJET RESECTION PRST8,4510.0,2931.5,1.1,4510.0,35
HCPCS,52597,Trurl rbtc wtrjt rescj prst8,,,2607.32,3019.01,8
HCPCS,52601,PROSTATECTOMY (TURP),,,4697.16,15028.3,20
HCPCS,52601,Prostatectomy (turp),,,2607.32,3019.01,8
HCPCS,52601,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,5790.0,3763.5,1.1,8834.56,50
HCPCS,52630,REMOVE PROSTATE REGROWTH,,,4697.16,15028.3,19
HCPCS,52630,Remove prostate regrowth,,,2607.32,3019.01,8
HCPCS,52630,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,2620.0,1703.0,1.1,8834.56,50
HCPCS,52640,RELIEVE BLADDER CONTRACTURE,,,3186.78,9879.99,19
HCPCS,52640,Relieve bladder contracture,,,846.52,980.18,8
HCPCS,52640,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,1916.0,1245.4,1.1,5953.02,50
HCPCS,52647,LASER SURGERY OF PROSTATE,,,4697.16,5072.94,6
HCPCS,52647,Laser surgery of prostate,,,2607.32,3019.01,8
HCPCS,52648,LASER SURGERY OF PROSTATE,9651.0,6273.15,1.1,9651.0,53
HCPCS,52648,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,23385.0,15200.25,0.01,28245.0,136
HCPCS,52649,LASER ENUCLEATION PROSTATE W/MORCELLATION,5824.0,3785.6,1.1,8834.56,50
HCPCS,52649,PROSTATE LASER ENUCLEATION,,,4697.16,15028.3,19
HCPCS,52649,Prostate laser enucleation,,,2607.32,3019.01,8
HCPCS,52700,DRAINAGE OF PROSTATE ABSCESS,,,3186.78,9879.99,19
HCPCS,52700,Drainage of prostate abscess,,,895.32,1036.68,8
HCPCS,52700,TRURL DRAINAGE PROSTATIC ABSCESS,2996.0,1947.4,1.1,5953.02,50
HCPCS,53000,INCISION OF URETHRA,,,1892.78,5859.03,19
HCPCS,53000,Incision of urethra,,,1676.36,1941.05,8
HCPCS,53000,URTT/URTS XTRNL SPX PENDULOUS URETHRA,932.0,605.8,1.1,3478.27,50
HCPCS,53010,INCISION OF URETHRA,,,4697.16,15028.3,19
HCPCS,53010,Incision of urethra,,,2885.48,3341.09,8
HCPCS,53010,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,1780.0,1157.0,1.1,8834.56,50
HCPCS,53020,INCISION OF URETHRA,,,1892.78,5859.03,19
HCPCS,53020,Incision of urethra,,,1676.36,1941.05,8
HCPCS,53020,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,708.0,460.2,1.1,3478.27,50
HCPCS,53025,INCISION OF URETHRA,,,1892.78,5859.03,19
HCPCS,53025,Incision of urethra,,,1676.36,1941.05,8
HCPCS,53025,MEATOTOMY CUTTING MEATUS SPX INFANT,452.0,293.8,1.1,3478.27,50
HCPCS,53040,DRAINAGE OF URETHRA ABSCESS,,,3186.78,9879.99,19
HCPCS,53040,Drainage of urethra abscess,,,1676.36,1941.05,8
HCPCS,53060,DRG OF SKENE'S GLAND ABSCESS OR CYST,1072.0,696.8,0.01,9423.0,175
HCPCS,53080,DRAINAGE OF URINARY LEAKAGE,,,616.73,1954.42,19
HCPCS,53080,Drainage of urinary leakage,,,226.03,261.72,8
HCPCS,53085,DRAINAGE OF URINARY LEAKAGE,,,1892.78,5859.03,19
HCPCS,53085,Drainage of urinary leakage,,,1676.36,1941.05,8
HCPCS,53200,BIOPSY OF URETHRA,1036.0,673.4,1.1,5859.03,72
HCPCS,53200,Biopsy of urethra,,,1676.36,1941.05,8
HCPCS,53210,REMOVAL OF URETHRA,,,3186.78,9879.99,19
HCPCS,53210,Removal of urethra,,,1676.36,1941.05,8
HCPCS,53210,URETHRECTOMY TOT W/CYSTOST FEMALE,5488.0,3567.2,1.1,5953.02,50
HCPCS,53215,REMOVAL OF URETHRA,,,4697.16,15028.3,19
HCPCS,53215,Removal of urethra,,,2885.48,3341.09,8
HCPCS,53220,TREATMENT OF URETHRA LESION,,,3186.78,9879.99,19
HCPCS,53220,Treatment of urethra lesion,,,1676.36,1941.05,8
HCPCS,53230,EXC URETHRAL DIVERTICULUM SPX FEMALE,4176.0,2714.4,1.1,8834.56,50
HCPCS,53230,REMOVAL OF URETHRA LESION,,,4697.16,15028.3,19
HCPCS,53230,Removal of urethra lesion,,,2885.48,3341.09,8
HCPCS,53235,REMOVAL OF URETHRA LESION,,,4697.16,15028.3,19
HCPCS,53235,Removal of urethra lesion,,,2885.48,3341.09,8
HCPCS,53240,SURGERY FOR URETHRA POUCH,,,3186.78,9879.99,19
HCPCS,53240,Surgery for urethra pouch,,,1676.36,1941.05,8
HCPCS,53250,REMOVAL OF URETHRA GLAND,,,3186.78,9879.99,19
HCPCS,53250,Removal of urethra gland,,,1676.36,1941.05,8
HCPCS,53260,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,1212.0,787.8,1.1,5953.02,53
HCPCS,53260,TREATMENT OF URETHRA LESION,,,3186.78,9879.99,19
HCPCS,53260,Treatment of urethra lesion,,,1676.36,1941.05,8
HCPCS,53265,EXC/FULGURATION URETHRAL CARUNCLE,5345.5,3474.575,0.01,9423.0,114
HCPCS,53270,EXCISION OR FULGURATION SKENES GLANDS,1256.0,816.4,1.1,5953.02,53
HCPCS,53270,REMOVAL OF URETHRA GLAND,,,3186.78,9879.99,19
HCPCS,53270,Removal of urethra gland,,,1676.36,1941.05,8
HCPCS,53275,EXCISION/FULGURATION URETHRAL PROLAPSE,1828.0,1188.2,1.1,5953.02,50
HCPCS,53275,REPAIR OF URETHRA DEFECT,,,3186.78,9879.99,19
HCPCS,53275,Repair of urethra defect,,,1676.36,1941.05,8
HCPCS,53400,REVISE URETHRA STAGE 1,,,4697.16,15028.3,19
HCPCS,53400,Revise urethra stage 1,,,2885.48,3341.09,8
HCPCS,53400,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,5652.0,3673.8,1.1,8834.56,50
HCPCS,53405,REVISE URETHRA STAGE 2,,,4697.16,15028.3,19
HCPCS,53405,Revise urethra stage 2,,,2885.48,3341.09,8
HCPCS,53410,RECONSTRUCTION OF URETHRA,,,4697.16,15028.3,19
HCPCS,53410,Reconstruction of urethra,,,2885.48,3341.09,8
HCPCS,53410,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,7072.0,4596.8,1.1,8834.56,50
HCPCS,53415,Reconstruction of urethra,,,2885.48,3341.09,8
HCPCS,53420,RECONSTRUCT URETHRA STAGE 1,,,4697.16,15028.3,19
HCPCS,53420,Reconstruct urethra stage 1,,,2885.48,3341.09,8
HCPCS,53425,RECONSTRUCT URETHRA STAGE 2,,,4697.16,15028.3,19
HCPCS,53425,Reconstruct urethra stage 2,,,2885.48,3341.09,8
HCPCS,53430,RECONSTRUCTION OF URETHRA,,,4697.16,15028.3,19
HCPCS,53430,Reconstruction of urethra,,,2885.48,3341.09,8
HCPCS,53430,URETHROPLASTY RCNSTJ FEMALE URETHRA,6972.0,4531.8,1.1,8834.56,50
HCPCS,53431,RECONSTRUCT URETHRA/BLADDER,,,4697.16,15028.3,19
HCPCS,53431,Reconstruct urethra/bladder,,,2885.48,3341.09,8
HCPCS,53431,URTP W/TUBULARIZATION POST URT&/LWR BLDR,8472.0,5506.8,1.1,8834.56,50
HCPCS,53440,MALE SLING PROCEDURE,,,12004.74,36979.25,19
HCPCS,53440,Male sling procedure,,,2885.48,3341.09,8
HCPCS,53440,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,5344.0,3473.6,1.1,21917.95,50
HCPCS,53442,REMOVE/REVISE MALE SLING,,,4697.16,15028.3,19
HCPCS,53442,Remove/revise male sling,,,2885.48,3341.09,8
HCPCS,53444,INSERT TANDEM CUFF,,,18598.39,58092.17,19
HCPCS,53444,Insert tandem cuff,,,2885.48,3341.09,8
HCPCS,53445,INSERT URO/VES NCK SPHINCTER,,,18598.39,58092.17,19
HCPCS,53445,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,5200.0,3380.0,1.1,34442.24,50
HCPCS,53445,Insert uro/ves nck sphincter,,,2248.18,2603.15,8
HCPCS,53446,REMOVE URO SPHINCTER,,,4697.16,15028.3,19
HCPCS,53446,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,4408.0,2865.2,1.1,8834.56,50
HCPCS,53446,Remove uro sphincter,,,2885.48,3341.09,8
HCPCS,53447,REMOVE/REPLACE UR SPHINCTER,,,18598.39,58092.17,19
HCPCS,53447,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,5712.0,3712.8,1.1,34442.24,50
HCPCS,53447,Remove/replace ur sphincter,,,2248.18,2603.15,8
HCPCS,53448,Remov/replc ur sphinctr comp,,,2885.48,3341.09,8
HCPCS,53449,REPAIR URO SPHINCTER,,,8544.18,26533.05,19
HCPCS,53449,Repair uro sphincter,,,2885.48,3341.09,8
HCPCS,53450,REVISION OF URETHRA,,,3186.78,9879.99,19
HCPCS,53450,Revision of urethra,,,1676.36,1941.05,8
HCPCS,53451,TPRNL BALO CNTNC DEV BI,,,12004.74,36979.25,19
HCPCS,53451,Tprnl balo cntnc dev bi,,,2885.48,3341.09,8
HCPCS,53452,TPRNL BALO CNTNC DEV UNI,,,8544.18,26533.05,19
HCPCS,53452,Tprnl balo cntnc dev uni,,,1676.36,1941.05,8
HCPCS,53453,TPRNL BALO CNTNC DEV RMVL EA,,,3186.78,9879.99,19
HCPCS,53453,Tprnl balo cntnc dev rmvl ea,,,1676.36,1941.05,8
HCPCS,53454,TPRNL BALO CNTNC DEV ADJMT,,,224.72,700.29,19
HCPCS,53454,Tprnl balo cntnc dev adjmt,,,226.03,261.72,8
HCPCS,53460,REVISION OF URETHRA,,,3186.78,9879.99,19
HCPCS,53460,Revision of urethra,,,1676.36,1941.05,8
HCPCS,53500,URETHRLYS TRANSVAG W/ SCOPE,,,3186.78,9879.99,19
HCPCS,53500,URETHROLSS TRVG SEC OPN W/CSTO,5200.0,3380.0,1.1,5953.02,50
HCPCS,53500,Urethrlys transvag w/ scope,,,1676.36,1941.05,8
HCPCS,53502,REPAIR OF URETHRA INJURY,,,3186.78,9879.99,19
HCPCS,53502,Repair of urethra injury,,,1676.36,1941.05,8
HCPCS,53505,REPAIR OF URETHRA INJURY,,,4697.16,15028.3,19
HCPCS,53505,Repair of urethra injury,,,1676.36,1941.05,8
HCPCS,53505,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,3304.0,2147.6,1.1,8834.56,50
HCPCS,53510,REPAIR OF URETHRA INJURY,,,4697.16,15028.3,19
HCPCS,53510,Repair of urethra injury,,,2885.48,3341.09,8
HCPCS,53515,REPAIR OF URETHRA INJURY,,,4697.16,15028.3,19
HCPCS,53515,Repair of urethra injury,,,2885.48,3341.09,8
HCPCS,53520,REPAIR OF URETHRA DEFECT,,,4697.16,15028.3,19
HCPCS,53520,Repair of urethra defect,,,2885.48,3341.09,8
HCPCS,53600,DILAT URETHRAL STRIX DILATOR MALE 1ST,801.5,520.975,0.01,3004.0,175
HCPCS,53601,DILAT URETHRAL STRIX DILATOR MALE SBSQ,492.5,320.125,0.01,3004.0,114
HCPCS,53605,DILATE URETHRA STRICTURE,,,3186.78,9879.99,19
HCPCS,53605,Dilate urethra stricture,,,226.03,261.72,8
HCPCS,53620,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,1859.0,1208.35,0.01,3070.0,114
HCPCS,53621,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,829.5,539.175,0.01,3004.0,114
HCPCS,53660,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,502.0,326.3,0.01,3004.0,114
HCPCS,53661,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,440.5,286.325,0.01,593.0,114
HCPCS,53665,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,304.0,197.6,1.1,3478.27,50
HCPCS,53665,DILATION OF URETHRA,,,1892.78,5859.03,19
HCPCS,53665,Dilation of urethra,,,226.03,261.72,8
HCPCS,53850,PROSTATIC MICROWAVE THERMOTX,,,3186.78,9879.99,19
HCPCS,53850,Prostatic microwave thermotx,,,895.32,1036.68,8
HCPCS,53850,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,2168.0,1409.2,1.1,5953.02,53
HCPCS,53852,PROSTATIC RF THERMOTX,,,3186.78,9879.99,19
HCPCS,53852,Prostatic rf thermotx,,,895.32,1036.68,8
HCPCS,53854,TRURL DSTRJ PRST8 TISS RF WV,,,3186.78,9879.99,19
HCPCS,53854,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,2609.0,1695.85,1.1,5953.02,53
HCPCS,53854,Trurl dstrj prst8 tiss rf wv,,,895.32,1036.68,8
HCPCS,53855,INSERT PROST URETHRAL STENT,,,1892.78,5859.03,19
HCPCS,53855,Insert prost urethral stent,,,1676.36,1941.05,8
HCPCS,53860,TRANSURETHRAL RF TREATMENT,,,1892.78,5859.03,19
HCPCS,53860,Transurethral rf treatment,,,1676.36,1941.05,8
HCPCS,53865,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,17442.5,11337.625,0.01,33521.0,112
HCPCS,53866,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,885.0,575.25,0.01,3004.0,112
HCPCS,53899,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT (COMP CODE 5235,3440.0,2236.0,0.01,3440.0,28
HCPCS,53899,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,5351.5,3478.475,0.01,9423.0,89
HCPCS,53899,ITIND DEVICE INSERTION (COMP CODE 52441),1539.0,1000.35,0.01,1539.0,28
HCPCS,53899,ITIND DEVICE REMOVAL COMPLICATED (COMP CODE 52315 COMPLICATED),1888.0,1227.2,0.01,1888.0,28
HCPCS,53899,ITIND DEVICE REMOVAL SIMPLE (COMP CODE 52310 SIMPLE),1020.0,663.0,0.01,1020.0,28
HCPCS,53899,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),4951.5,3218.475,0.01,9423.0,89
HCPCS,53899,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),4708.0,3060.2000000000003,0.01,8932.0,89
HCPCS,53899,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",3887.0,2526.55,0.01,3887.0,28
HCPCS,53899,"UNLISTED PROCEDURE, URINARY SYSTEM (COMPARISON CODE 51530)",2280.0,1482.0,0.01,2280.0,28
HCPCS,53899,UROLOGY SURGERY PROCEDURE UNLISTED,2348.0,1526.2,0.01,2348.0,28
HCPCS,54000,SLITTING OF PREPUCE,,,3186.78,9879.99,19
HCPCS,54000,Slitting of prepuce,,,226.03,261.72,8
HCPCS,54001,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,5159.5,3353.6749999999997,0.01,9423.0,114
HCPCS,54015,I&D PENIS DEEP,,,1497.07,4629.18,19
HCPCS,54015,I&d penis deep,,,946.85,1096.35,8
HCPCS,54015,"INCIS/DRAIN PENIS,DEEP",2144.0,1393.6,1.1,2768.64,50
HCPCS,54050,DESTRUCTION PENIS LESION(S),,,369.16,1139.4,19
HCPCS,54050,DSTRJ LESION PENIS SIMPLE CHEMICAL,568.0,369.2,1.1,680.96,53
HCPCS,54050,Destruction penis lesion(s),,,226.03,261.72,8
HCPCS,54055,DESTRUCTION- PENIS LESION(S,2545.0,1654.25,1.1,3114.5,53
HCPCS,54055,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,4457.0,2897.05,0.01,8414.0,114
HCPCS,54056,CRYOSURGERY PENIS LESION(S),,,183.59,562.35,19
HCPCS,54056,Cryosurgery penis lesion(s),,,226.03,261.72,8
HCPCS,54056,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,568.0,369.2,1.1,568.0,53
HCPCS,54057,DSTRJ LESION PENIS SIMPLE LASER,4723.0,3069.95,1.1,8930.0,75
HCPCS,54057,LASER SURG PENIS LESION(S),,,1690.17,5783.06,19
HCPCS,54057,Laser surg penis lesion(s),,,946.85,1096.35,8
HCPCS,54060,DSTRJ LESION PENIS SIMPLE SURG EXCISION,4603.0,2991.9500000000003,0.01,8414.0,114
HCPCS,54065,DESTRUCTION PENIS LESION(S),,,1690.17,5783.06,19
HCPCS,54065,DSTRJ LESION PENIS EXTENSIVE,988.0,642.2,1.1,3114.5,53
HCPCS,54065,Destruction penis lesion(s),,,946.85,1096.35,8
HCPCS,54100,BIOPSY PENIS SEPARATE PROCEDURE,4106.5,2669.225,0.01,7453.0,114
HCPCS,54105,BIOPSY OF PENIS,,,2644.48,8141.48,19
HCPCS,54105,"BIOPSY OF PENIS,DEEP STRUCT",1416.0,920.4,1.1,4850.94,53
HCPCS,54105,Biopsy of penis,,,946.85,1096.35,8
HCPCS,54110,TREATMENT OF PENIS LESION,,,3186.78,9879.99,19
HCPCS,54110,Treatment of penis lesion,,,946.85,1096.35,8
HCPCS,54111,TREAT PENIS LESION GRAFT,,,4697.16,15028.3,19
HCPCS,54111,Treat penis lesion graft,,,2232.32,2584.79,8
HCPCS,54112,TREAT PENIS LESION GRAFT,,,8544.18,26533.05,19
HCPCS,54112,Treat penis lesion graft,,,2232.32,2584.79,8
HCPCS,54115,TREATMENT OF PENIS LESION,,,2644.48,8141.48,19
HCPCS,54115,Treatment of penis lesion,,,946.85,1096.35,8
HCPCS,54120,PARTIAL REMOVAL OF PENIS,,,3186.78,9879.99,19
HCPCS,54120,Partial removal of penis,,,2232.32,2584.79,8
HCPCS,54120,"REMOVAL PENIS,PARTIAL",4404.0,2862.6,1.1,5953.02,50
HCPCS,54125,"REMOVAL PENIS,TOTAL",5824.0,3785.6,1.1,5824.0,50
HCPCS,54125,Removal of penis,,,2232.32,2584.79,8
HCPCS,54130,Remove penis & nodes,,,2232.32,2584.79,8
HCPCS,54135,Remove penis & nodes,,,2232.32,2584.79,8
HCPCS,54150,CIRCUMCISION SCN,9423.0,6124.95,165.05,9423.0,61
HCPCS,54150,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,5091.5,3309.475,0.01,9423.0,114
HCPCS,54160,CIRCUMCISION NEONATE,2041.0,1326.65,0.01,4001.0,175
HCPCS,54161,CIRCUM 28 DAYS OR OLDER,,,1892.78,5859.03,19
HCPCS,54161,CIRCUMCISION AGE >28 DAYS,1328.0,863.2,1.1,3478.27,50
HCPCS,54161,Circum 28 days or older,,,946.85,1096.35,8
HCPCS,54162,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,5375.5,3494.075,0.01,9423.0,114
HCPCS,54163,REP INCOMPLETE CIRCUMCISION,1328.0,863.2,1.1,3478.27,50
HCPCS,54163,REPAIR OF CIRCUMCISION,,,1892.78,5859.03,19
HCPCS,54163,Repair of circumcision,,,946.85,1096.35,8
HCPCS,54164,FRENULOTOMY OF PENIS,1128.0,733.2,1.1,5859.03,69
HCPCS,54164,Frenulotomy of penis,,,946.85,1096.35,8
HCPCS,54200,INJECTION PEYRONIE DISEASE,781.5,507.975,0.01,1119.0,114
HCPCS,54205,NJX PX PEYRONIE DS EXPS PLAQ,,,4697.16,15028.3,19
HCPCS,54205,Njx px peyronie ds exps plaq,,,2232.32,2584.79,8
HCPCS,54220,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1043.5,678.2750000000001,0.01,3004.0,175
HCPCS,54230,Njx corpora cavernosograpy,,,946.85,1096.35,8
HCPCS,54231,DYNAMIC CAVERNOSOMETRY,,,224.72,700.29,19
HCPCS,54231,Dynamic cavernosometry,,,946.85,1096.35,8
HCPCS,54235,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,797.5,518.375,0.01,2453.0,175
HCPCS,54240,PENILE PLETHYSMOGRAPHY,,,204.28,605.2,19
HCPCS,54240,Penile plethysmography,,,39.43,45.66,8
HCPCS,54250,NCTRNL PEN TMSCN&/RGDITY TST,,,224.72,700.29,19
HCPCS,54250,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,1447.5,940.875,1.1,2007.0,94
HCPCS,54250,Nctrnl pen tmscn&/rgdity tst,,,39.43,45.66,8
HCPCS,54300,PENIS STRAIGHTENING CHORDEE,4480.0,2912.0,1.1,5953.02,50
HCPCS,54300,REVISION OF PENIS,,,3186.78,9879.99,19
HCPCS,54300,Revision of penis,,,946.85,1096.35,8
HCPCS,54304,REVISION OF PENIS,,,3186.78,9879.99,19
HCPCS,54304,Revision of penis,,,946.85,1096.35,8
HCPCS,54308,RECONSTRUCTION OF URETHRA,,,4697.16,15028.3,19
HCPCS,54308,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54312,RECONSTRUCTION OF URETHRA,,,3186.78,9879.99,19
HCPCS,54312,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54316,RECONSTRUCTION OF URETHRA,,,8544.18,26533.05,19
HCPCS,54316,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54318,RECONSTRUCTION OF URETHRA,,,3186.78,9879.99,19
HCPCS,54318,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54322,RECONSTRUCTION OF URETHRA,,,3186.78,9879.99,19
HCPCS,54322,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54324,RECONSTRUCTION OF URETHRA,,,3186.78,9879.99,19
HCPCS,54324,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54326,RECONSTRUCTION OF URETHRA,,,3186.78,9879.99,19
HCPCS,54326,Reconstruction of urethra,,,2232.32,2584.79,8
HCPCS,54328,REVISE PENIS/URETHRA,,,3186.78,9879.99,19
HCPCS,54328,Revise penis/urethra,,,2232.32,2584.79,8
HCPCS,54332,REVISE PENIS/URETHRA,,,3186.78,9879.99,19
HCPCS,54332,Revise penis/urethra,,,2232.32,2584.79,8
HCPCS,54336,REVISE PENIS/URETHRA,,,3186.78,9879.99,19
HCPCS,54336,Revise penis/urethra,,,2232.32,2584.79,8
HCPCS,54340,RPR HYPSPAD COMP SIMPLE,,,3186.78,9879.99,19
HCPCS,54340,Rpr hypspad comp simple,,,946.85,1096.35,8
HCPCS,54344,RRP HYPSPAD COMP MOBLJ&URTP,,,8544.18,26533.05,19
HCPCS,54344,Rrp hypspad comp moblj&urtp,,,2232.32,2584.79,8
HCPCS,54348,RPR HYPSPAD COMP DSJ & URTP,,,4697.16,15028.3,19
HCPCS,54348,Rpr hypspad comp dsj & urtp,,,2232.32,2584.79,8
HCPCS,54352,REVJ PRIOR HYPSPAD REPAIR,,,4697.16,15028.3,19
HCPCS,54352,Revj prior hypspad repair,,,2232.32,2584.79,8
HCPCS,54360,PENIS PLASTIC SURGERY,,,3186.78,9879.99,19
HCPCS,54360,PLASTIC RPR PENIS CORRECT ANGULATION,5112.0,3322.8,1.1,5953.02,50
HCPCS,54360,Penis plastic surgery,,,946.85,1096.35,8
HCPCS,54380,REPAIR PENIS,,,1892.78,5859.03,19
HCPCS,54380,Repair penis,,,946.85,1096.35,8
HCPCS,54385,REPAIR PENIS,,,1892.78,5859.03,19
HCPCS,54385,Repair penis,,,946.85,1096.35,8
HCPCS,54390,Repair penis and bladder,,,2232.32,2584.79,8
HCPCS,54400,INSERT SEMI-RIGID PROSTHESIS,,,12004.74,36979.25,19
HCPCS,54400,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,3668.0,2384.2,1.1,21917.95,50
HCPCS,54400,Insert semi-rigid prosthesis,,,9966.42,11540.07,8
HCPCS,54401,INSERT SELF-CONTD PROSTHESIS,,,18598.39,58092.17,19
HCPCS,54401,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,4176.0,2714.4,1.1,34442.24,50
HCPCS,54401,Insert self-contd prosthesis,,,9966.42,11540.07,8
HCPCS,54405,INSERT MULTI-COMP PENIS PROS,,,18598.39,58092.17,19
HCPCS,54405,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,5808.0,3775.2,1.1,34442.24,50
HCPCS,54405,Insert multi-comp penis pros,,,9966.42,11540.07,8
HCPCS,54405,PENILE IMPLANT,42000.0,27300.0,1.1,42000.0,50
HCPCS,54406,REMOVE MUTI-COMP PENIS PROS,,,3186.78,9879.99,19
HCPCS,54406,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,5156.0,3351.4,1.1,5953.02,50
HCPCS,54406,Remove muti-comp penis pros,,,946.85,1096.35,8
HCPCS,54408,REPAIR MULTI-COMP PENIS PROS,,,4697.16,15028.3,19
HCPCS,54408,Repair multi-comp penis pros,,,946.85,1096.35,8
HCPCS,54410,REMOVE/REPLACE PENIS PROSTH,,,18598.39,58092.17,19
HCPCS,54410,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,6072.0,3946.8,1.1,34442.24,50
HCPCS,54410,Remove/replace penis prosth,,,9966.42,11540.07,8
HCPCS,54411,REMOV/REPLC PENIS PROS COMP,,,18598.39,58092.17,19
HCPCS,54411,Remov/replc penis pros comp,,,9966.42,11540.07,8
HCPCS,54415,REMOVE SELF-CONTD PENIS PROS,,,3186.78,9879.99,19
HCPCS,54415,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,3552.0,2308.8,1.1,5953.02,50
HCPCS,54415,Remove self-contd penis pros,,,946.85,1096.35,8
HCPCS,54416,REMV/REPL PENIS CONTAIN PROS,,,18598.39,58092.17,19
HCPCS,54416,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,4832.0,3140.8,1.1,34442.24,50
HCPCS,54416,Remv/repl penis contain pros,,,9966.42,11540.07,8
HCPCS,54417,REMV/REPLC PENIS PROS COMPL,,,12004.74,58092.17,19
HCPCS,54417,Remv/replc penis pros compl,,,9966.42,11540.07,8
HCPCS,54420,REVISION OF PENIS,,,3186.78,9879.99,19
HCPCS,54420,Revision of penis,,,946.85,1096.35,8
HCPCS,54430,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,4424.0,2875.6,1.1,4424.0,50
HCPCS,54430,Revision of penis,,,946.85,1096.35,8
HCPCS,54435,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,2724.0,1770.6,1.1,5953.02,50
HCPCS,54435,REVISION OF PENIS,,,3186.78,9879.99,19
HCPCS,54435,Revision of penis,,,946.85,1096.35,8
HCPCS,54437,REPAIR CORPOREAL TEAR,,,3186.78,9879.99,19
HCPCS,54437,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),4600.0,2990.0,1.1,5953.02,50
HCPCS,54437,Repair corporeal tear,,,2232.32,2584.79,8
HCPCS,54438,Replantation of penis,,,2885.48,3341.09,8
HCPCS,54440,PLASTIC OPERATION PENIS INJURY,5550.0,3607.5,1.1,5953.02,32
HCPCS,54440,REPAIR OF PENIS,,,3186.78,9879.99,19
HCPCS,54440,Repair of penis,,,946.85,1096.35,8
HCPCS,54450,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,783.5,509.275,1.1,3004.0,114
HCPCS,54500,BIOPSY OF TESTIS,,,2644.48,8141.48,19
HCPCS,54500,Biopsy of testis,,,226.03,261.72,8
HCPCS,54505,BIOPSY OF TESTIS,,,3186.78,9879.99,19
HCPCS,54505,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,1400.0,910.0,1.1,5953.02,50
HCPCS,54505,Biopsy of testis,,,946.85,1096.35,8
HCPCS,54512,EXC XTRPARENCHYMAL LESION TESTIS,3732.0,2425.8,1.1,5953.02,50
HCPCS,54512,EXCISE LESION TESTIS,,,3186.78,9879.99,19
HCPCS,54512,Excise lesion testis,,,1186.5,1373.85,8
HCPCS,54520,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,2332.0,1515.8,1.1,5953.02,50
HCPCS,54520,REMOVAL OF TESTIS,,,3186.78,9879.99,19
HCPCS,54520,Removal of testis,,,1186.5,1373.85,8
HCPCS,54522,ORCHIECTOMY PARTIAL,,,3186.78,9879.99,19
HCPCS,54522,Orchiectomy partial,,,946.85,1096.35,8
HCPCS,54522,PARTIAL ORCHIECTOMY,4100.0,2665.0,1.1,5953.02,50
HCPCS,54530,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,3384.0,2199.6,1.1,5906.43,50
HCPCS,54530,REMOVAL OF TESTIS,,,3260.78,10035.32,19
HCPCS,54530,Removal of testis,,,946.85,1096.35,8
HCPCS,54535,EXTENSIVE TESTIS SURGERY,,,3186.78,9879.99,19
HCPCS,54535,Extensive testis surgery,,,946.85,1096.35,8
HCPCS,54535,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,5276.0,3429.4,1.1,5953.02,50
HCPCS,54550,EXPLORATION FOR TESTIS,,,3260.78,10035.32,19
HCPCS,54550,Exploration for testis,,,1186.5,1373.85,8
HCPCS,54560,EXPLORATION FOR TESTIS,,,1892.78,5859.03,19
HCPCS,54560,Exploration for testis,,,946.85,1096.35,8
HCPCS,54600,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,3056.0,1986.4,1.1,5953.02,50
HCPCS,54600,REDUCE TESTIS TORSION,,,3186.78,9879.99,19
HCPCS,54600,Reduce testis torsion,,,1186.5,1373.85,8
HCPCS,54620,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,2084.0,1354.6,1.1,5953.02,50
HCPCS,54620,SUSPENSION OF TESTIS,,,3186.78,9879.99,19
HCPCS,54620,Suspension of testis,,,1186.5,1373.85,8
HCPCS,54640,ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,3401.0,2210.65,1.1,5906.43,50
HCPCS,54640,ORCHIOPEXY INGUN/SCROT APPR,,,3260.78,10035.32,20
HCPCS,54640,Orchiopexy ingun/scrot appr,,,1186.5,1373.85,8
HCPCS,54650,ORCHIOPEXY (FOWLER-STEPHENS),,,3260.78,10035.32,19
HCPCS,54650,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,5452.0,3543.8,1.1,5906.43,50
HCPCS,54650,Orchiopexy (fowler-stephens),,,946.85,1096.35,8
HCPCS,54660,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,2296.0,1492.4,1.1,8834.56,50
HCPCS,54660,REVISION OF TESTIS,,,4697.16,15028.3,19
HCPCS,54660,Revision of testis,,,946.85,1096.35,8
HCPCS,54670,REPAIR TESTIS INJURY,,,3186.78,9879.99,19
HCPCS,54670,Repair testis injury,,,1186.5,1373.85,8
HCPCS,54670,SUTURE/REPAIR TESTICULAR INJURY,2660.0,1729.0,1.1,5953.02,50
HCPCS,54680,RELOCATION OF TESTIS(ES),,,3186.78,9879.99,19
HCPCS,54680,Relocation of testis(es),,,946.85,1096.35,8
HCPCS,54680,TRANSPLANTATION TESTIS TO THIGH,5616.0,3650.4,1.1,5953.02,50
HCPCS,54690,LAPAROSCOPY ORCHIECTOMY,,,5390.83,16944.69,19
HCPCS,54690,Laparoscopy orchiectomy,,,946.85,1096.35,8
HCPCS,54692,LAPAROSCOPY ORCHIOPEXY,,,5390.83,16944.69,19
HCPCS,54692,Laparoscopy orchiopexy,,,946.85,1096.35,8
HCPCS,54699,UNLISTED LAPS PX TESTIS,,,5390.83,16944.69,19
HCPCS,54699,Unlisted laps px testis,,,1186.5,1373.85,8
HCPCS,54700,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,5405.5,3513.575,0.01,9423.0,172
HCPCS,54800,BIOPSY OF EPIDIDYMIS,,,1497.07,4629.18,19
HCPCS,54800,Biopsy of epididymis,,,1186.5,1373.85,8
HCPCS,54830,EXCISION LOCAL LESION EPIDIDYMIS,2404.0,1562.6,1.1,5953.02,50
HCPCS,54830,REMOVE EPIDIDYMIS LESION,,,3186.78,9879.99,19
HCPCS,54830,Remove epididymis lesion,,,1186.5,1373.85,8
HCPCS,54840,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,2108.0,1370.2,1.1,3478.27,50
HCPCS,54840,REMOVE EPIDIDYMIS LESION,,,1892.78,5859.03,19
HCPCS,54840,Remove epididymis lesion,,,1186.5,1373.85,8
HCPCS,54860,EPIDIDYMECTOMY UNILATERAL,2780.0,1807.0,1.1,5953.02,50
HCPCS,54860,REMOVAL OF EPIDIDYMIS,,,3186.78,9879.99,19
HCPCS,54860,Removal of epididymis,,,1186.5,1373.85,8
HCPCS,54861,REMOVAL OF EPIDIDYMIS,,,3186.78,9879.99,19
HCPCS,54861,Removal of epididymis,,,946.85,1096.35,8
HCPCS,54865,EXPLORATION OF EPIDIDYMIS W/WO BIOPSY,2539.0,1650.35,1.1,5953.02,50
HCPCS,54865,EXPLORE EPIDIDYMIS,,,3186.78,9879.99,19
HCPCS,54865,Explore epididymis,,,1186.5,1373.85,8
HCPCS,54900,FUSION OF SPERMATIC DUCTS,,,1892.78,5859.03,19
HCPCS,54900,Fusion of spermatic ducts,,,1186.5,1373.85,8
HCPCS,54901,FUSION OF SPERMATIC DUCTS,,,3186.78,9879.99,19
HCPCS,54901,Fusion of spermatic ducts,,,946.85,1096.35,8
HCPCS,55000,DRAINAGE OF HYDROCELE,1033.0,671.45,1.1,1200.64,53
HCPCS,55000,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,1904.5,1237.9250000000002,0.01,3237.0,114
HCPCS,55040,EXCISION HYDROCELE UNILATERAL,2180.0,1417.0,1.1,5906.43,50
HCPCS,55040,REMOVAL OF HYDROCELE,639.0,415.35,1.1,10035.32,69
HCPCS,55040,Removal of hydrocele,,,946.85,1096.35,8
HCPCS,55041,EXCISION HYDROCELE BILATERAL,3758.0,2442.7,1.1,5906.43,50
HCPCS,55041,REMOVAL OF HYDROCELES,,,3260.78,10035.32,19
HCPCS,55041,Removal of hydroceles,,,946.85,1096.35,8
HCPCS,55060,REPAIR OF HYDROCELE,,,3186.78,9879.99,19
HCPCS,55060,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,2460.0,1599.0,1.1,5953.02,50
HCPCS,55060,Repair of hydrocele,,,1186.5,1373.85,8
HCPCS,55100,DRAINAGE SCROTAL WALL ABSCESS,4216.5,2740.725,0.01,7453.0,236
HCPCS,55110,EXPLORE SCROTUM,1585.0,1030.25,1.1,9879.99,119
HCPCS,55110,Explore scrotum,,,946.85,1096.35,8
HCPCS,55120,REMOVAL FOREIGN BODY SCROTUM,2288.0,1487.2,1.1,3478.27,50
HCPCS,55120,REMOVAL OF SCROTUM LESION,,,1892.78,5859.03,19
HCPCS,55120,Removal of scrotum lesion,,,1186.5,1373.85,8
HCPCS,55150,REMOVAL OF SCROTUM,,,3186.78,9879.99,19
HCPCS,55150,RESECTION SCROTUM,3256.0,2116.4,1.1,5953.02,50
HCPCS,55150,Removal of scrotum,,,1186.5,1373.85,8
HCPCS,55175,REVISION OF SCROTUM,,,3186.78,9879.99,19
HCPCS,55175,Revision of scrotum,,,1186.5,1373.85,8
HCPCS,55180,REVISION OF SCROTUM,,,4697.16,15028.3,19
HCPCS,55180,Revision of scrotum,,,946.85,1096.35,8
HCPCS,55180,SCROTOPLASTY COMPLICATED,4712.0,3062.8,1.1,8834.56,50
HCPCS,55200,INCISION OF SPERM DUCT,,,3186.78,9879.99,19
HCPCS,55200,Incision of sperm duct,,,1186.5,1373.85,8
HCPCS,55250,REMOVAL OF SPERM DUCT(S),800.0,520.0,1.1,3478.27,106
HCPCS,55250,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,5385.5,3500.575,0.01,9423.0,114
HCPCS,55300,Prepare sperm duct x-ray,,,39.43,45.66,8
HCPCS,55400,REPAIR OF SPERM DUCT,,,3186.78,9879.99,19
HCPCS,55400,Repair of sperm duct,,,946.85,1096.35,8
HCPCS,55400,VASOVASOSTOMY VASOVASORRHAPHY,3788.0,2462.2,1.1,5953.02,50
HCPCS,55500,EXC HYDROCELE SPRMATIC CORD UNI SPX,2488.0,1617.2,1.1,5953.02,50
HCPCS,55500,REMOVAL OF HYDROCELE,,,3186.78,9879.99,19
HCPCS,55500,Removal of hydrocele,,,1186.5,1373.85,8
HCPCS,55520,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,2664.0,1731.6,1.1,5953.02,50
HCPCS,55520,REMOVAL OF SPERM CORD LESION,790.0,513.5,1.1,9879.99,69
HCPCS,55520,Removal of sperm cord lesion,,,1186.5,1373.85,8
HCPCS,55530,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,2300.0,1495.0,1.1,5953.02,50
HCPCS,55530,REVISE SPERMATIC CORD VEINS,670.0,435.5,1.1,9879.99,69
HCPCS,55530,Revise spermatic cord veins,,,946.85,1096.35,8
HCPCS,55535,REVISE SPERMATIC CORD VEINS,,,5765.4,18145.13,19
HCPCS,55535,Revise spermatic cord veins,,,1186.5,1373.85,8
HCPCS,55540,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,3320.0,2158.0,1.1,5906.43,50
HCPCS,55540,REVISE HERNIA & SPERM VEINS,,,3260.78,10035.32,19
HCPCS,55540,Revise hernia & sperm veins,,,946.85,1096.35,8
HCPCS,55550,LAPARO LIGATE SPERMATIC VEIN,,,5390.83,16944.69,19
HCPCS,55550,LAPS LIGATION SPERMATIC VEINS VARICOCELE,2880.0,1872.0,1.1,9852.42,50
HCPCS,55550,Laparo ligate spermatic vein,,,946.85,1096.35,8
HCPCS,55559,LAPAROSCOPIC EXCISION OF SPERMATIC CORD LESION (COMP 55520),2664.0,1731.6,0.01,9852.42,28
HCPCS,55559,"UNLISTED LAPAROSCOY PROCEDURE, SPERMATIC CORD (COMPARISON CODE 5",2664.0,1731.6,0.01,9852.42,28
HCPCS,55559,UNLSTD LAPS PX SPRMATIC CORD,,,5390.83,16944.69,19
HCPCS,55559,Unlstd laps px sprmatic cord,,,1186.5,1373.85,8
HCPCS,55600,VESICULOTOMY,,,1892.78,5859.03,19
HCPCS,55600,Vesiculotomy,,,1186.5,1373.85,8
HCPCS,55605,Vesiculotomy complicated,,,946.85,1096.35,8
HCPCS,55650,Remove sperm duct pouch,,,946.85,1096.35,8
HCPCS,55650,VESICULECTOMY ANY APPROACH,5060.0,3289.0,1.1,5060.0,50
HCPCS,55680,REMOVE SPERM POUCH LESION,,,3186.78,9879.99,19
HCPCS,55680,Remove sperm pouch lesion,,,946.85,1096.35,8
HCPCS,55700,BIOPSY OF PROSTATE,,,1892.78,4831.0,7
HCPCS,55700,Biopsy of prostate,,,895.32,1036.68,8
HCPCS,55705,BIOPSY PROSTATE INCISIONAL ANY APPROACH,1844.0,1198.6,1.1,5953.02,50
HCPCS,55705,BX PRST8 ANY APPROACH NONIMG,,,3186.78,9879.99,19
HCPCS,55705,Bx prst8 any approach nonimg,,,895.32,1036.68,8
HCPCS,55706,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,2512.0,1632.8,1.1,5953.02,50
HCPCS,55706,BX PRST8 NDL SAT SAMPLING,,,3186.78,9879.99,19
HCPCS,55706,Bx prst8 ndl sat sampling,,,895.32,1036.68,8
HCPCS,55707,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,8861.5,5759.974999999999,0.01,16566.0,145
HCPCS,55708,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,9029.0,5868.849999999999,0.01,16566.0,145
HCPCS,55709,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,8993.5,5845.775,0.01,16566.0,145
HCPCS,55710,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,9121.0,5928.65,0.01,16566.0,145
HCPCS,55711,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,8857.0,5757.05,0.01,16566.0,145
HCPCS,55712,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,8965.0,5827.25,0.01,16566.0,145
HCPCS,55713,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,13479.0,8761.35,0.01,25198.0,145
HCPCS,55714,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,13395.5,8707.075,0.01,25198.0,145
HCPCS,55715,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,12830.0,8339.5,0.01,25198.0,127
HCPCS,55720,DRAINAGE OF PROSTATE ABSCESS,,,3186.78,9879.99,19
HCPCS,55720,Drainage of prostate abscess,,,895.32,1036.68,8
HCPCS,55720,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,3092.0,2009.8,1.1,5953.02,50
HCPCS,55725,DRAINAGE OF PROSTATE ABSCESS,,,3186.78,9879.99,19
HCPCS,55725,Drainage of prostate abscess,,,895.32,1036.68,8
HCPCS,55801,Removal of prostate,,,2607.32,3019.01,8
HCPCS,55810,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55812,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55815,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55821,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,6072.0,3946.8,1.1,6072.0,50
HCPCS,55821,Removal of prostate,,,2607.32,3019.01,8
HCPCS,55831,Removal of prostate,,,2607.32,3019.01,8
HCPCS,55840,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55840,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,8544.0,5553.6,1.1,8544.0,50
HCPCS,55842,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55845,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55845,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,11079.0,7201.35,1.1,11079.0,50
HCPCS,55860,SURGICAL EXPOSURE PROSTATE,,,4697.16,15028.3,19
HCPCS,55860,Surgical exposure prostate,,,2607.32,3019.01,8
HCPCS,55862,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55865,Extensive prostate surgery,,,2607.32,3019.01,8
HCPCS,55866,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,9882.0,6423.3,1.1,17575.94,50
HCPCS,55866,LAPS SURG PRST8ECT RPBIC RAD,,,9619.76,29793.81,20
HCPCS,55866,Laps surg prst8ect rpbic rad,,,2607.32,3019.01,8
HCPCS,55867,LAPS SURG PRST8ECT SMPL STOT,,,9619.76,29793.81,19
HCPCS,55867,LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE,7812.0,5077.8,1.1,17575.94,50
HCPCS,55867,Laps surg prst8ect smpl stot,,,2607.32,3019.01,8
HCPCS,55868,LAP SRG PRST8CT LYMPH NOD BX,,,10056.64,29793.81,13
HCPCS,55868,LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX,9882.0,6423.3,1.1,9882.0,35
HCPCS,55868,Lap srg prst8ct lymph nod bx,,,2607.32,3019.01,8
HCPCS,55869,LAP SRG PRST8CT BI PL LMPHAD,,,10056.64,29793.81,13
HCPCS,55869,LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC,12060.0,7839.0,1.1,12060.0,35
HCPCS,55869,Lap srg prst8ct bi pl lmphad,,,2607.32,3019.01,8
HCPCS,55870,ELECTROEJACULATION,1032.0,670.8,1.1,2581.56,66
HCPCS,55870,Electroejaculation,,,226.03,261.72,8
HCPCS,55873,CRYOABLATE PROSTATE,,,8544.18,26533.05,19
HCPCS,55873,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,5440.0,3536.0,1.1,18631.36,53
HCPCS,55873,Cryoablate prostate,,,2607.32,3019.01,8
HCPCS,55874,TPRNL PLMT BIODEGRDABL MATRL,,,4697.16,15028.3,19
HCPCS,55874,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,1212.0,787.8,1.1,9331.98,53
HCPCS,55874,Tprnl plmt biodegrdabl matrl,,,2607.32,3019.01,8
HCPCS,55875,TRANSPERI NEEDLE PLACE PROS,,,4697.16,15028.3,19
HCPCS,55875,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,5384.0,3499.6,1.1,8834.56,50
HCPCS,55875,Transperi needle place pros,,,2607.32,3019.01,8
HCPCS,55876,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,3493.0,2270.45,0.01,6294.0,114
HCPCS,55877,ABLATION IRE PRST8 1 OR MORE TUMORS PERCUTANEOUS,5940.0,3861.0,1.1,5940.0,35
HCPCS,55877,ABLTJ IRE PRST8 1+ TUM PERQ,,,10056.64,29793.81,13
HCPCS,55877,Abltj ire prst8 1+ tum perq,,,2607.32,3019.01,8
HCPCS,55880,ABLTJ MAL PRST8 TISS HIFU,,,8544.18,26533.05,19
HCPCS,55880,Abltj mal prst8 tiss hifu,,,2607.32,3019.01,8
HCPCS,55880,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,7092.0,4609.8,1.1,15728.38,50
HCPCS,55881,ABLATION TRANSURETHRAL PRST8 TISSUE W/THERMAL US,4312.0,2802.8,1.1,26896.12,51
HCPCS,55881,Ablt trurl prst8 tis thrm us,,,895.32,1036.68,8
HCPCS,55882,ABLT TRURL PRST8 TIS THRM US INS TRURL US TRNSDC,5060.0,3289.0,1.1,27850.59,51
HCPCS,55882,ABLT TRURL PRST8 TIS TRNSDCR,,,12004.74,36979.25,19
HCPCS,55882,Ablt trurl prst8 tis trnsdcr,,,2607.32,3019.01,8
HCPCS,55899,DENERVATION MICROSURGICAL SPERM CORD (COMP 55530 & 55520),950.0,617.5,0.01,950.0,28
HCPCS,55899,FREE FLAP PHALLOPLASTY (COMP CODE 15757),15975.0,10383.75,0.01,15975.0,28
HCPCS,55899,LAPAROSCOPIC VESICULECTOMY (COMP CODE 55650),5060.0,3289.0,0.01,5060.0,28
HCPCS,55899,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),8489.0,5517.849999999999,0.01,13287.0,89
HCPCS,55899,MICROSCOPIC CREMASTERIC LYSIS (COMP CODE 64722),3434.0,2232.1,0.01,3434.0,28
HCPCS,55899,"UNLIST PROC, MALE GENITAL SYSTEM COMPARED TO 55821",1654.0,1075.1,0.01,1654.0,28
HCPCS,55899,"UNLISTED PROCEDURE, MALE GENITAL SYSTEM (COMPARISON CODE 55520)",950.0,617.5,0.01,950.0,28
HCPCS,55899,"UNLISTED PROCEDURE, MALE GENITAL SYSTEM (COMPARISON CODE 55821)",5201.0,3380.65,0.01,5201.0,28
HCPCS,55899,"UNLISTED PROCEDURE, MALE GENITAL SYSTEM (COMPARISON CODE 55842)",8169.0,5309.85,0.01,8169.0,28
HCPCS,55920,PLACE NEEDLES PELVIC FOR RT,,,4561.18,14021.11,19
HCPCS,55920,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,3324.0,2160.6,1.1,8492.29,50
HCPCS,55920,Place needles pelvic for rt,,,2248.18,2603.15,8
HCPCS,55970,SEX TRANSFORMATION M TO F,,,4561.18,14021.11,19
HCPCS,55970,Sex transformation m to f,,,2232.32,2584.79,8
HCPCS,55980,SEX TRANSFORMATION F TO M,,,3186.78,9879.99,19
HCPCS,55980,Sex transformation f to m,,,3197.33,3702.17,8
HCPCS,56405,I&D VULVA/PERINEAL ABSCESS,997.5,648.375,0.01,4001.0,175
HCPCS,56420,I&D OF BARTHOLINS GLAND ABSCESS,750.5,487.825,0.01,3004.0,175
HCPCS,56440,MARSUP BARTHOLIN GLAND CYST,1156.0,751.4,1.1,5338.37,50
HCPCS,56440,MRSPLZATN BRTHLNS GLND CST,,,2937.82,9073.17,19
HCPCS,56440,Mrsplzatn brthlns glnd cst,,,1166.34,1350.5,8
HCPCS,56441,LYSIS LABIAL ADHESIONS,808.0,525.2,1.1,5338.37,53
HCPCS,56441,LYSIS OF LABIAL ADHESIONS,,,2937.82,9073.17,19
HCPCS,56441,Lysis of labial adhesions,,,1166.34,1350.5,8
HCPCS,56442,HYMENOTOMY SIMPLE INCISION,14626.0,9506.9,78.08,14626.0,61
HCPCS,56442,"HYMENOTOMY, SIMPLE INCISION",272.0,176.8,1.1,5338.37,50
HCPCS,56501,DESTROY VULVA LESIONS SIM,,,1690.17,5783.06,19
HCPCS,56501,DESTRUCTION LESIONS VULVA SIMPLE,632.0,410.8,1.1,3114.5,53
HCPCS,56501,Destroy vulva lesions sim,,,1166.34,1350.5,8
HCPCS,56515,DESTROY VULVA LESION/S COMPL,,,1690.17,5783.06,19
HCPCS,56515,DESTRUCTION LESIONS VULVA EXTENSIVE,1355.0,880.75,1.1,3114.5,53
HCPCS,56515,Destroy vulva lesion/s compl,,,1166.34,1350.5,8
HCPCS,56605,BIOPSY VULVA/PERINEUM 1 LESION SPX,2222.5,1444.625,0.01,4005.0,114
HCPCS,56606,BIOPSY VULVA/PERINEUM EACH ADDL LESION,502.0,326.3,0.01,3004.0,99
HCPCS,56620,VULVECTOMY SIMPLE PARTIAL,3313.0,2153.45,1.1,9073.17,69
HCPCS,56620,Vulvectomy simple partial,,,1166.34,1350.5,8
HCPCS,56625,VULVECTOMY SIMPLE COMPLETE,4259.0,2768.35,1.1,9073.17,69
HCPCS,56625,Vulvectomy simple complete,,,3197.33,3702.17,8
HCPCS,56630,VULVECTOMY RADICAL PARTIAL,6512.0,4232.8,1.1,14021.11,63
HCPCS,56630,Vulvectomy radical partial,,,3197.33,3702.17,8
HCPCS,56631,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,7596.0,4937.4,1.1,7596.0,50
HCPCS,56631,Vlvctmy rad prtl uni lymphad,,,3197.33,3702.17,8
HCPCS,56632,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,8744.0,5683.6,1.1,8744.0,50
HCPCS,56632,Vlvctmy rad prtl bi lymphad,,,3197.33,3702.17,8
HCPCS,56633,VULVECTOMY RADICAL COMPLETE,7848.0,5101.2,1.1,7848.0,50
HCPCS,56633,Vulvectomy radical complete,,,3197.33,3702.17,8
HCPCS,56634,Vlvctmy rad comp uni lymphad,,,3197.33,3702.17,8
HCPCS,56637,Vlvctmy rad comp bi lymphad,,,3197.33,3702.17,8
HCPCS,56640,Vlvctmy rad comp w/lymphadec,,,3197.33,3702.17,8
HCPCS,56700,PRTL HYMENECTOMY/REVJ HYMENAL RING,1136.0,738.4,1.1,5338.37,50
HCPCS,56700,PRTL HYMNCTMY/REVJ HYMNL RNG,,,2937.82,9073.17,19
HCPCS,56700,Prtl hymnctmy/revj hymnl rng,,,1166.34,1350.5,8
HCPCS,56740,EXC BARTHOLINS GLAND/CYST,1952.0,1268.8,1.1,9073.17,69
HCPCS,56740,Exc bartholins gland/cyst,,,1166.34,1350.5,8
HCPCS,56800,PLASTIC REPAIR INTROITUS,1572.0,1021.8,1.1,9073.17,69
HCPCS,56800,Plastic repair introitus,,,1166.34,1350.5,8
HCPCS,56805,CLITOROPLASTY INTERSEX STATE,,,2937.82,9073.17,19
HCPCS,56805,Clitoroplasty intersex state,,,1166.34,1350.5,8
HCPCS,56810,PERINEOPLASTY RPR PER NONOB,,,2937.82,9073.17,19
HCPCS,56810,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,1716.0,1115.4,1.1,5338.37,50
HCPCS,56810,Perineoplasty rpr per nonob,,,1166.34,1350.5,8
HCPCS,56820,COLPOSCOPY VULVA,925.0,601.25,0.01,3004.0,61
HCPCS,56820,"COLPOSCOPY, VULVA",600.0,390.0,1.1,600.0,53
HCPCS,56821,COLPOSCOPY VULVA W/BIOPSY,1109.5,721.175,0.01,3004.0,114
HCPCS,57000,COLPOTOMY W/EXPLORATION,1208.0,785.2,1.1,9073.17,69
HCPCS,57000,Colpotomy w/exploration,,,1166.34,1350.5,8
HCPCS,57010,COLPOTOMY DRG PEL ABSCESS,,,2937.82,9073.17,19
HCPCS,57010,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,2736.0,1778.4,1.1,5338.37,50
HCPCS,57010,Colpotomy drg pel abscess,,,1166.34,1350.5,8
HCPCS,57020,COLPOCENTESIS SEPARATE PROCEDURE,22708.0,14760.2,133.93,22708.0,61
HCPCS,57022,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,1092.0,709.8,1.1,4850.94,50
HCPCS,57022,"INCISION AND DRAINAGE HEMATOMA, VAGINAL OB/POSTPARTUM",3866.0,2512.9,298.24,8141.48,61
HCPCS,57023,I&D VAGINAL HEMATOMA NON-OB,,,2644.48,8141.48,19
HCPCS,57023,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,2072.0,1346.8,1.1,4850.94,50
HCPCS,57023,I&d vaginal hematoma non-ob,,,1166.34,1350.5,8
HCPCS,57061,DESTRUCTION VAG LESIONS SMPL,,,2937.82,9073.17,19
HCPCS,57061,DESTRUCTION VAGINAL LESIONS SIMPLE,572.0,371.8,1.1,5338.37,53
HCPCS,57061,Destruction vag lesions smpl,,,1166.34,1350.5,8
HCPCS,57065,DESTRUCTION VAG LESION XTNSV,,,2937.82,9073.17,19
HCPCS,57065,DESTRUCTION VAGINAL LESIONS EXTENSIVE,1170.0,760.5,1.1,5338.37,53
HCPCS,57065,Destruction vag lesion xtnsv,,,1166.34,1350.5,8
HCPCS,57100,BIOPSY VAGINAL MUCOSA SIMPLE,2242.5,1457.625,0.01,4005.0,114
HCPCS,57105,BIOPSY VAGINAL MUCOSA EXTENSIVE,696.0,452.4,1.1,5338.37,53
HCPCS,57105,BIOPSY VAGINAL MUCOSA XTNSV,,,2937.82,9073.17,19
HCPCS,57105,Biopsy vaginal mucosa xtnsv,,,1166.34,1350.5,8
HCPCS,57106,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,3000.0,1950.0,1.1,5338.37,50
HCPCS,57106,VAGNC PRTL RMVL VAG WALL,,,2937.82,9073.17,19
HCPCS,57106,Vagnc prtl rmvl vag wall,,,1166.34,1350.5,8
HCPCS,57107,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,9824.0,6385.6,1.1,9824.0,50
HCPCS,57107,VAGNC COMPL RMVL PARAVAG TIS,,,2937.82,9073.17,19
HCPCS,57107,Vagnc compl rmvl paravag tis,,,3197.33,3702.17,8
HCPCS,57109,VAGNC BI TOTAL PEL LYMPHADEC,,,2937.82,9073.17,19
HCPCS,57109,Vagnc bi total pel lymphadec,,,3197.33,3702.17,8
HCPCS,57110,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,6192.0,4024.8,1.1,6192.0,50
HCPCS,57110,Vagnc compl rmvl vag wall,,,3197.33,3702.17,8
HCPCS,57111,Vagnc compl rmvl paravag tis,,,3197.33,3702.17,8
HCPCS,57112,Vaginectomy w/nodes compl,,,3197.33,3702.17,8
HCPCS,57120,COLPOCLEISIS LE FORT TYPE,3312.0,2152.8,1.1,14021.11,69
HCPCS,57120,Colpocleisis le fort type,,,3197.33,3702.17,8
HCPCS,57130,EXCIS VAGINAL SEPTUM,984.0,639.6,1.1,5338.37,53
HCPCS,57130,EXCISION VAGINAL SEPTUM,,,2937.82,9073.17,19
HCPCS,57130,Excision vaginal septum,,,1166.34,1350.5,8
HCPCS,57135,EXCIS VAGINAL CYST/TUMOR,1080.0,702.0,1.1,5338.37,53
HCPCS,57135,EXCISION VAGINAL CYST/TUMOR,,,2937.82,9073.17,19
HCPCS,57135,Excision vaginal cyst/tumor,,,1166.34,1350.5,8
HCPCS,57150,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,200.0,130.0,1.1,200.0,53
HCPCS,57150,TREAT VAGINA INFECTION,,,54.88,165.35,19
HCPCS,57150,Treat vagina infection,,,54.44,63.04,8
HCPCS,57155,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,12487.0,8116.55,1.1,22708.0,114
HCPCS,57156,INSERTION VAGINAL RADIATION DEVICE,1184.0,769.6,0.01,4001.0,175
HCPCS,57160,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,640.5,416.325,0.01,925.0,114
HCPCS,57170,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,364.0,236.6,1.1,364.0,53
HCPCS,57170,FITTING OF DIAPHRAGM/CAP,,,185.88,566.65,19
HCPCS,57170,Fitting of diaphragm/cap,,,54.44,63.04,8
HCPCS,57180,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,788.5,512.525,1.1,2453.0,114
HCPCS,57200,COLPORRHAPHY SUTURE INJURY VAGINA,8197.0,5328.05,1.1,14626.0,111
HCPCS,57210,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,2284.0,1484.6,1.1,5338.37,50
HCPCS,57210,REPAIR VAGINA/PERINEUM,,,2937.82,9073.17,19
HCPCS,57210,Repair vagina/perineum,,,1166.34,1350.5,8
HCPCS,57220,REVISION OF URETHRA,,,4561.18,14021.11,19
HCPCS,57220,Revision of urethra,,,1676.36,1941.05,8
HCPCS,57230,REPAIR OF URETHRAL LESION,,,2937.82,9073.17,19
HCPCS,57230,Repair of urethral lesion,,,1676.36,1941.05,8
HCPCS,57240,ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO,4032.0,2620.8,1.1,8492.29,50
HCPCS,57240,ANTERIOR COLPORRHAPHY,,,4561.18,14021.11,19
HCPCS,57240,Anterior colporrhaphy,,,1676.36,1941.05,8
HCPCS,57250,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,4435.0,2882.75,1.1,8492.29,50
HCPCS,57250,REPAIR RECTUM & VAGINA,,,4561.18,14021.11,19
HCPCS,57250,Repair rectum & vagina,,,863.18,999.47,8
HCPCS,57260,CMBN ANT PST COLPRHY,,,4561.18,14021.11,20
HCPCS,57260,CMBND ANTERPOST COLPORRAPHY W/CYSTO,5830.0,3789.5,1.1,8492.29,50
HCPCS,57260,Cmbn ant pst colprhy,,,1676.36,1941.05,8
HCPCS,57265,CMBN AP COLPRHY W/NTRCL RPR,,,4561.18,14021.11,19
HCPCS,57265,CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR,6000.0,3900.0,1.1,8492.29,50
HCPCS,57265,Cmbn ap colprhy w/ntrcl rpr,,,863.18,999.47,8
HCPCS,57267,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,1952.0,1268.8,1.1,1952.0,50
HCPCS,57267,Insert mesh/pelvic flr addon,,,2885.48,3341.09,8
HCPCS,57268,REPAIR ENTEROCELE VAGINAL APPROACH SPX,3028.0,1968.2,1.1,8492.29,50
HCPCS,57268,REPAIR OF BOWEL BULGE,,,4561.18,14021.11,19
HCPCS,57268,Repair of bowel bulge,,,863.18,999.47,8
HCPCS,57270,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,5468.0,3554.2,1.1,5468.0,50
HCPCS,57270,Repair of bowel pouch,,,863.18,999.47,8
HCPCS,57280,COLPOPEXY ABDOMINAL APPROACH,6688.0,4347.2,1.1,6688.0,50
HCPCS,57280,Suspension of vagina,,,3197.33,3702.17,8
HCPCS,57282,COLPOPEXY EXTRAPERITONEAL,,,6832.66,20784.34,19
HCPCS,57282,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,4652.0,3023.8,1.1,12902.4,50
HCPCS,57282,Colpopexy extraperitoneal,,,1166.34,1350.5,8
HCPCS,57283,COLPOPEXY INTRAPERITONEAL,,,6832.66,20784.34,19
HCPCS,57283,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,4664.0,3031.6,1.1,12902.4,50
HCPCS,57283,Colpopexy intraperitoneal,,,1166.34,1350.5,8
HCPCS,57284,REPAIR PARAVAG DEFECT OPEN,,,4561.18,14021.11,19
HCPCS,57284,Repair paravag defect open,,,3197.33,3702.17,8
HCPCS,57285,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,4640.0,3016.0,1.1,12902.4,50
HCPCS,57285,REPAIR PARAVAG DEFECT VAG,,,6832.66,20784.34,19
HCPCS,57285,Repair paravag defect vag,,,1166.34,1350.5,8
HCPCS,57287,REVISE/REMOVE SLING REPAIR,,,2937.82,9073.17,19
HCPCS,57287,RMVL/REVJ SLING STRESS INCONTINENCE,4460.0,2899.0,1.1,5338.37,50
HCPCS,57287,Revise/remove sling repair,,,1676.36,1941.05,8
HCPCS,57288,REPAIR BLADDER DEFECT,,,4561.18,14021.11,20
HCPCS,57288,Repair bladder defect,,,1676.36,1941.05,8
HCPCS,57288,SLING OPER STRES INCONTINENCE,5337.0,3469.05,1.1,8492.29,50
HCPCS,57289,REPAIR BLADDER & VAGINA,,,6832.66,20784.34,19
HCPCS,57289,Repair bladder & vagina,,,1676.36,1941.05,8
HCPCS,57291,CONSTRUCTION OF VAGINA,,,4561.18,14021.11,19
HCPCS,57291,Construction of vagina,,,3197.33,3702.17,8
HCPCS,57292,CONSTRUCT VAGINA WITH GRAFT,,,4561.18,14021.11,19
HCPCS,57292,Construct vagina with graft,,,3197.33,3702.17,8
HCPCS,57295,REVISE VAG GRAFT VIA VAGINA,,,2937.82,9073.17,19
HCPCS,57295,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,3128.0,2033.2,1.1,5338.37,50
HCPCS,57295,Revise vag graft via vagina,,,1166.34,1350.5,8
HCPCS,57296,Revise vag graft open abd,,,3197.33,3702.17,8
HCPCS,57300,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,3484.0,2264.6,1.1,5338.37,50
HCPCS,57300,REPAIR RECTUM-VAGINA FISTULA,,,2937.82,9073.17,19
HCPCS,57300,Repair rectum-vagina fistula,,,3197.33,3702.17,8
HCPCS,57305,CLOSURE RECTOVAGINAL FISTUAL ABD APPROAC,1640.0,1066.0,1.1,3364.69,50
HCPCS,57305,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,6140.0,3991.0,1.1,6140.0,50
HCPCS,57305,Repair rectum-vagina fistula,,,1457.88,1688.07,8
HCPCS,57305,"STENT NON-CORONARY, TEMP",1640.0,1066.0,1.1,3364.69,50
HCPCS,57307,Fistula repair & colostomy,,,3197.33,3702.17,8
HCPCS,57308,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,4236.0,2753.4,1.1,4236.0,50
HCPCS,57308,Fistula repair transperine,,,1166.34,1350.5,8
HCPCS,57310,CLOSE URETHROVAGINAL FISTULA,3060.0,1989.0,1.1,12902.4,50
HCPCS,57310,REPAIR URETHROVAGINAL LESION,,,6832.66,20784.34,19
HCPCS,57310,Repair urethrovaginal lesion,,,3197.33,3702.17,8
HCPCS,57311,Repair urethrovaginal lesion,,,3197.33,3702.17,8
HCPCS,57320,REPAIR BLADDER-VAGINA LESION,,,4561.18,14021.11,19
HCPCS,57320,Repair bladder-vagina lesion,,,3197.33,3702.17,8
HCPCS,57330,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,5284.0,3434.6,1.1,12902.4,50
HCPCS,57330,REPAIR BLADDER-VAGINA LESION,,,6832.66,20784.34,19
HCPCS,57330,Repair bladder-vagina lesion,,,3197.33,3702.17,8
HCPCS,57335,REPAIR VAGINA,,,4561.18,14021.11,19
HCPCS,57335,Repair vagina,,,3197.33,3702.17,8
HCPCS,57400,DILATION OF VAGINA,,,2937.82,9073.17,19
HCPCS,57400,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,908.0,590.2,1.1,5338.37,50
HCPCS,57400,Dilation of vagina,,,1166.34,1350.5,8
HCPCS,57410,PELVIC EXAMINATION,,,2937.82,9073.17,19
HCPCS,57410,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,700.0,455.0,1.1,5338.37,50
HCPCS,57410,Pelvic examination,,,54.44,63.04,8
HCPCS,57415,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,996.0,647.4,1.1,5338.37,50
HCPCS,57415,REMOVE VAGINAL FOREIGN BODY,,,2937.82,9073.17,19
HCPCS,57415,Remove vaginal foreign body,,,1166.34,1350.5,8
HCPCS,57420,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1019.5,662.675,0.01,3004.0,114
HCPCS,57421,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,2442.5,1587.625,0.01,4005.0,114
HCPCS,57423,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,6432.0,4180.8,1.1,17575.94,50
HCPCS,57423,REPAIR PARAVAG DEFECT LAP,,,9619.76,29793.81,19
HCPCS,57423,Repair paravag defect lap,,,3197.33,3702.17,8
HCPCS,57425,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,6812.0,4427.8,1.1,17575.94,50
HCPCS,57425,LAPAROSCOPY SURG COLPOPEXY,,,9608.0,29793.81,20
HCPCS,57425,Laparoscopy surg colpopexy,,,3197.33,3702.17,8
HCPCS,57426,REVISE PROSTH VAG GRAFT LAP,,,6832.66,20784.34,19
HCPCS,57426,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,5720.0,3718.0,1.1,12902.4,50
HCPCS,57426,Revise prosth vag graft lap,,,3197.33,3702.17,8
HCPCS,57452,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,762.5,495.625,0.01,4001.0,114
HCPCS,57454,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,1165.5,757.575,0.01,4001.0,114
HCPCS,57455,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,1097.5,713.375,0.01,3004.0,114
HCPCS,57456,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,1069.5,695.175,0.01,3004.0,114
HCPCS,57460,BX OF CERVIX W/SCOPE LEEP,,,2937.82,9073.17,19
HCPCS,57460,Bx of cervix w/scope leep,,,1352.51,1566.06,8
HCPCS,57460,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,1132.0,735.8,1.1,5338.37,53
HCPCS,57461,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,7999.0,5199.349999999999,0.01,14626.0,114
HCPCS,57465,COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY,324.0,210.6,1.1,324.0,52
HCPCS,57465,Cam cervix uteri drg colp,,,162.64,188.32,8
HCPCS,57500,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,2266.5,1473.225,0.01,4005.0,114
HCPCS,57505,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,2240.5,1456.325,0.01,4005.0,114
HCPCS,57510,CAUTERIZATION OF CERVIX,,,2937.82,9073.17,19
HCPCS,57510,CAUTERY CERVIX ELECTRO/THERMAL,760.0,494.0,1.1,5338.37,53
HCPCS,57510,Cauterization of cervix,,,1352.51,1566.06,8
HCPCS,57511,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,780.0,507.0,1.1,780.0,53
HCPCS,57511,CRYOCAUTERY OF CERVIX,,,281.07,854.11,19
HCPCS,57511,Cryocautery of cervix,,,162.64,188.32,8
HCPCS,57513,CAUTERY CERVIX LASER ABLATION,780.0,507.0,1.1,5338.37,53
HCPCS,57513,LASER SURGERY OF CERVIX,,,2937.82,9073.17,19
HCPCS,57513,Laser surgery of cervix,,,1352.51,1566.06,8
HCPCS,57520,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,1644.0,1068.6,1.1,5338.37,53
HCPCS,57520,CONIZATION OF CERVIX,,,2937.82,9073.17,20
HCPCS,57520,Conization of cervix,,,1352.51,1566.06,8
HCPCS,57522,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,1468.0,954.2,1.1,5338.37,53
HCPCS,57522,CONIZATION OF CERVIX,,,2937.82,9073.17,20
HCPCS,57522,Conization of cervix,,,1352.51,1566.06,8
HCPCS,57530,REMOVAL OF CERVIX,,,4561.18,14021.11,19
HCPCS,57530,Removal of cervix,,,1352.51,1566.06,8
HCPCS,57530,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,2108.0,1370.2,1.1,8492.29,50
HCPCS,57531,Removal of cervix radical,,,2211.17,2560.31,8
HCPCS,57540,Removal of residual cervix,,,2211.17,2560.31,8
HCPCS,57545,Remove cervix/repair pelvis,,,2211.17,2560.31,8
HCPCS,57550,REMOVAL OF RESIDUAL CERVIX,,,4561.18,14021.11,19
HCPCS,57550,Removal of residual cervix,,,1352.51,1566.06,8
HCPCS,57555,REMOVE CERVIX/REPAIR VAGINA,,,4561.18,14021.11,19
HCPCS,57555,Remove cervix/repair vagina,,,1352.51,1566.06,8
HCPCS,57556,REMOVE CERVIX REPAIR BOWEL,,,4561.18,14021.11,19
HCPCS,57556,Remove cervix repair bowel,,,2211.17,2560.31,8
HCPCS,57558,D&C OF CERVICAL STUMP,,,2937.82,9073.17,19
HCPCS,57558,D&c of cervical stump,,,1352.51,1566.06,8
HCPCS,57558,DILATION & CURETTAGE CERVICAL STUMP,688.0,447.2,1.1,5338.37,53
HCPCS,57700,REVISION OF CERVIX,,,2937.82,9073.17,19
HCPCS,57700,Revision of cervix,,,1352.51,1566.06,8
HCPCS,57720,REVISION OF CERVIX,,,2937.82,9073.17,19
HCPCS,57720,Revision of cervix,,,1352.51,1566.06,8
HCPCS,57720,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,1844.0,1198.6,1.1,5338.37,50
HCPCS,57800,DILATION CERVICAL CANAL INSTRUMENTAL SPX,7467.0,4853.55,0.01,14626.0,114
HCPCS,58100,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,728.5,473.525,0.01,3004.0,236
HCPCS,58110,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,377.5,245.375,0.01,3004.0,99
HCPCS,58120,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,1436.0,933.4,1.1,5338.37,53
HCPCS,58120,DILATION AND CURETTAGE,,,2937.82,9073.17,20
HCPCS,58120,Dilation and curettage,,,1352.51,1566.06,8
HCPCS,58140,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,6316.0,4105.4,1.1,6316.0,50
HCPCS,58140,Myomectomy abdom method,,,4365.95,5055.31,8
HCPCS,58145,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,9095.0,5911.75,1.1,14626.0,111
HCPCS,58146,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,8136.0,5288.4,1.1,8136.0,50
HCPCS,58146,Myomectomy abdom complex,,,4365.95,5055.31,8
HCPCS,58150,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,5771.0,3751.15,1.1,9329.0,96
HCPCS,58152,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,8744.0,5683.6,1.1,8744.0,50
HCPCS,58152,Total hysterectomy,,,4365.95,5055.31,8
HCPCS,58180,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,5329.5,3464.175,1.1,9329.0,96
HCPCS,58200,Extensive hysterectomy,,,4365.95,5055.31,8
HCPCS,58200,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,9240.0,6006.0,1.1,9240.0,50
HCPCS,58210,Extensive hysterectomy,,,4365.95,5055.31,8
HCPCS,58210,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,12364.0,8036.6,1.1,12364.0,50
HCPCS,58240,PEL EXNTJ GYNECOLOGIC MAL,19732.0,12825.8,1.1,19732.0,50
HCPCS,58240,Removal of pelvis contents,,,4365.95,5055.31,8
HCPCS,58260,VAGINAL HYSTERECTOMY,,,4561.18,14021.11,19
HCPCS,58260,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,5660.0,3679.0,1.1,8492.29,50
HCPCS,58260,Vaginal hysterectomy,,,2525.01,2923.69,8
HCPCS,58262,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,6376.0,4144.4,1.1,8492.29,50
HCPCS,58262,VAG HYST INCLUDING T/O,,,4561.18,14021.11,20
HCPCS,58262,Vag hyst including t/o,,,2525.01,2923.69,8
HCPCS,58263,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,6892.0,4479.8,1.1,8492.29,50
HCPCS,58263,VAG HYST W/T/O & VAG REPAIR,,,4561.18,14021.11,19
HCPCS,58263,Vag hyst w/t/o & vag repair,,,2525.01,2923.69,8
HCPCS,58267,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,7344.0,4773.6,1.1,7344.0,50
HCPCS,58267,Vag hyst w/urinary repair,,,2525.01,2923.69,8
HCPCS,58270,VAG HYST W/ENTEROCELE REPAIR,,,4561.18,14021.11,19
HCPCS,58270,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,6120.0,3978.0,1.1,8492.29,50
HCPCS,58270,Vag hyst w/enterocele repair,,,2525.01,2923.69,8
HCPCS,58275,Hysterectomy/revise vagina,,,2525.01,2923.69,8
HCPCS,58275,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,6812.0,4427.8,1.1,6812.0,50
HCPCS,58280,Hysterectomy/revise vagina,,,2525.01,2923.69,8
HCPCS,58280,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,7332.0,4765.8,1.1,7332.0,50
HCPCS,58285,Extensive hysterectomy,,,2525.01,2923.69,8
HCPCS,58290,VAG HYST COMPLEX,,,6832.66,20784.34,19
HCPCS,58290,VAGINAL HYSTERECTOMY UTERUS > 250 GM,8108.0,5270.2,1.1,12902.4,50
HCPCS,58290,Vag hyst complex,,,4365.95,5055.31,8
HCPCS,58291,VAG HYST > 250 GM RMVL TUBE&/OVARY,8824.0,5735.6,1.1,8824.0,50
HCPCS,58291,VAG HYST INCL T/O COMPLEX,,,4561.18,14021.11,19
HCPCS,58291,Vag hyst incl t/o complex,,,4365.95,5055.31,8
HCPCS,58292,VAG HYST T/O & REPAIR COMPL,,,6832.66,20784.34,19
HCPCS,58292,Vag hyst t/o & repair compl,,,4365.95,5055.31,8
HCPCS,58293,Vag hyst w/uro repair compl,,,2525.01,2923.69,8
HCPCS,58294,VAG HYST W/ENTEROCELE COMPL,,,4561.18,14021.11,19
HCPCS,58294,Vag hyst w/enterocele compl,,,4365.95,5055.31,8
HCPCS,58300,INSERT INTRAUTERINE DEVICE,444.0,288.6,1.1,444.0,42
HCPCS,58300,INSERTION INTRAUTERINE DEVICE IUD,502.0,326.3,0.01,3398.0,92
HCPCS,58301,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,0.01,3004.0,122
HCPCS,58301,REMOVE INTRAUTERINE DEVICE,559.0,363.35,1.1,559.0,53
HCPCS,58321,ARTIFICIAL INSEMINATION,,,281.07,854.11,19
HCPCS,58321,Artificial insemination,,,120.06,139.02,8
HCPCS,58322,ARTIFIC INSEMINATION INTRAUTERIN,440.0,286.0,1.1,440.0,47
HCPCS,58322,ARTIFICIAL INSEMINATION INTRA-UTERINE,925.0,601.25,0.01,925.0,61
HCPCS,58323,SPERM WASHING,,,185.88,566.65,19
HCPCS,58323,SPERM WASHING FOR ARTIF INSEM,92.0,59.8,1.1,340.48,47
HCPCS,58323,Sperm washing,,,120.06,139.02,8
HCPCS,58340,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,609.0,395.85,0.01,3398.0,145
HCPCS,58345,REOPEN FALLOPIAN TUBE,,,2937.82,9073.17,19
HCPCS,58345,Reopen fallopian tube,,,1352.51,1566.06,8
HCPCS,58346,INSERT HEYMAN UTERI CAPSULE,,,4561.18,14021.11,19
HCPCS,58346,Insert heyman uteri capsule,,,1352.51,1566.06,8
HCPCS,58350,CHROMOTUBATION OVIDUCT W/MATERIALS,424.0,275.6,1.1,8492.29,47
HCPCS,58350,REOPEN FALLOPIAN TUBE,,,4561.18,14021.11,19
HCPCS,58350,Reopen fallopian tube,,,1352.51,1566.06,8
HCPCS,58353,ENDOMETR ABLATE THERMAL,,,4561.18,14021.11,19
HCPCS,58353,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,1440.0,936.0,1.1,8492.29,53
HCPCS,58353,Endometr ablate thermal,,,1352.51,1566.06,8
HCPCS,58356,ENDOMETRIAL CRYOABLATION,,,4561.18,14021.11,19
HCPCS,58356,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,2564.0,1666.6,1.1,8492.29,53
HCPCS,58356,Endometrial cryoablation,,,2211.17,2560.31,8
HCPCS,58400,Suspension of uterus,,,1352.51,1566.06,8
HCPCS,58400,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,2856.0,1856.4,1.1,2856.0,50
HCPCS,58410,Suspension of uterus,,,2211.17,2560.31,8
HCPCS,58520,Repair of ruptured uterus,,,2211.17,2560.31,8
HCPCS,58540,Revision of uterus,,,2211.17,2560.31,8
HCPCS,58541,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,4916.0,3195.4,1.1,17575.94,50
HCPCS,58541,LSH UTERUS 250 G OR LESS,,,9619.76,29793.81,19
HCPCS,58541,Lsh uterus 250 g or less,,,4365.95,5055.31,8
HCPCS,58542,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,6230.0,4049.5,1.1,17575.94,50
HCPCS,58542,LSH W/T/O UT 250 G OR LESS,,,9619.76,29793.81,19
HCPCS,58542,Lsh w/t/o ut 250 g or less,,,4365.95,5055.31,8
HCPCS,58543,"LAP, SUPRACERVIAL HYSTERECTOMY, >250G",6332.0,4115.8,1.1,17575.94,50
HCPCS,58543,LSH UTERUS ABOVE 250 G,,,9619.76,29793.81,19
HCPCS,58543,Lsh uterus above 250 g,,,4365.95,5055.31,8
HCPCS,58544,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,6240.0,4056.0,1.1,17575.94,50
HCPCS,58544,LSH W/T/O UTERUS ABOVE 250 G,,,9619.76,29793.81,19
HCPCS,58544,Lsh w/t/o uterus above 250 g,,,4365.95,5055.31,8
HCPCS,58545,LAPAROSCOPIC MYOMECTOMY,,,5390.83,16944.69,19
HCPCS,58545,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,6220.0,4043.0,1.1,9852.42,50
HCPCS,58545,Laparoscopic myomectomy,,,4365.95,5055.31,8
HCPCS,58546,LAPARO-MYOMECTOMY COMPLEX,,,9619.76,29793.81,19
HCPCS,58546,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,7976.0,5184.4,1.1,17575.94,50
HCPCS,58546,Laparo-myomectomy complex,,,4365.95,5055.31,8
HCPCS,58548,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,12652.0,8223.8,1.1,12652.0,50
HCPCS,58548,Lap radical hyst,,,4365.95,5055.31,8
HCPCS,58550,LAPARO-ASST VAG HYSTERECTOMY,,,5390.83,16944.69,19
HCPCS,58550,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,6040.0,3926.0,1.1,9852.42,50
HCPCS,58550,Laparo-asst vag hysterectomy,,,4365.95,5055.31,8
HCPCS,58552,LAPARO-VAG HYST INCL T/O,,,9608.0,29793.81,20
HCPCS,58552,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,6764.0,4396.6,1.1,17575.94,50
HCPCS,58552,Laparo-vag hyst incl t/o,,,4365.95,5055.31,8
HCPCS,58553,LAPARO-VAG HYST COMPLEX,,,9619.76,29793.81,19
HCPCS,58553,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,8024.0,5215.6,1.1,17575.94,50
HCPCS,58553,Laparo-vag hyst complex,,,4365.95,5055.31,8
HCPCS,58554,LAPARO-VAG HYST W/T/O COMPL,,,9608.0,29793.81,20
HCPCS,58554,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,9244.0,6008.6,1.1,17575.94,50
HCPCS,58554,Laparo-vag hyst w/t/o compl,,,4365.95,5055.31,8
HCPCS,58555,HYSTEROSCOPY DX SEP PROC,,,2937.82,9073.17,19
HCPCS,58555,"HYSTEROSCOPY, DIAGNOSTIC (SEPARATE",1166.0,757.9,1.1,5338.37,53
HCPCS,58555,Hysteroscopy dx sep proc,,,1352.51,1566.06,8
HCPCS,58558,HYSTEROSCOPY BIOPSY,,,2937.82,9073.17,20
HCPCS,58558,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,1835.0,1192.75,1.1,5338.37,53
HCPCS,58558,Hysteroscopy biopsy,,,1352.51,1566.06,8
HCPCS,58559,HYSTEROSCOPY LYSIS,,,4561.18,14021.11,19
HCPCS,58559,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,2080.0,1352.0,1.1,8492.29,50
HCPCS,58559,Hysteroscopy lysis,,,1352.51,1566.06,8
HCPCS,58560,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,2300.0,1495.0,1.1,8492.29,50
HCPCS,58560,HYSTEROSCOPY RESECT SEPTUM,,,4561.18,14021.11,19
HCPCS,58560,Hysteroscopy resect septum,,,1352.51,1566.06,8
HCPCS,58561,HYSTEROSCOPY REMOVAL LEIOMYOMATA,12806.0,8323.9,0.01,22708.0,111
HCPCS,58562,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,1600.0,1040.0,1.1,5338.37,53
HCPCS,58562,HYSTEROSCOPY REMOVE FB,,,2937.82,9073.17,20
HCPCS,58562,Hysteroscopy remove fb,,,1352.51,1566.06,8
HCPCS,58563,HYSTEROSCOPY ABLATION,,,4561.18,14021.11,20
HCPCS,58563,HYSTEROSCOPY ENDOMETRIAL ABLATION,1967.0,1278.55,1.1,8492.29,53
HCPCS,58563,Hysteroscopy ablation,,,1352.51,1566.06,8
HCPCS,58565,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,2848.0,1851.2,1.1,8492.29,53
HCPCS,58565,HYSTEROSCOPY STERILIZATION,,,4561.18,14021.11,19
HCPCS,58565,Hysteroscopy sterilization,,,2211.17,2560.31,8
HCPCS,58570,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,5344.0,3473.6,1.1,17575.94,50
HCPCS,58570,TLH UTERUS 250 G OR LESS,,,9619.76,29793.81,19
HCPCS,58570,Tlh uterus 250 g or less,,,4365.95,5055.31,8
HCPCS,58571,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,6600.0,4290.0,1.1,17575.94,50
HCPCS,58571,TLH W/T/O 250 G OR LESS,,,9608.0,29793.81,20
HCPCS,58571,Tlh w/t/o 250 g or less,,,4365.95,5055.31,8
HCPCS,58572,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,7792.0,5064.8,1.1,17575.94,50
HCPCS,58572,TLH UTERUS OVER 250 G,,,9619.76,29793.81,19
HCPCS,58572,Tlh uterus over 250 g,,,4365.95,5055.31,8
HCPCS,58573,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,8316.0,5405.4,1.1,17575.94,50
HCPCS,58573,TLH W/T/O UTERUS OVER 250 G,,,9619.76,29793.81,19
HCPCS,58573,Tlh w/t/o uterus over 250 g,,,4365.95,5055.31,8
HCPCS,58575,LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC,13040.0,8476.0,1.1,13040.0,50
HCPCS,58575,Laps tot hyst resj mal,,,4365.95,5055.31,8
HCPCS,58578,LAPAROSCOPIC CERVICAL STOMA CREATION (COMP CODE 44187),6960.0,4524.0,0.01,9852.42,28
HCPCS,58578,LAPAROSCOPIC ISTHMOCELE REPAIR (COMP CODE 58520),5392.0,3504.8,0.01,9852.42,28
HCPCS,58578,"UNLISTED LAP, PROC, UTERUS COMPARED TO 58100",144.0,93.6,0.01,9852.42,28
HCPCS,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTE",1040.0,676.0,0.01,9852.42,28
HCPCS,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 57530)",1010.0,656.5,0.01,9852.42,28
HCPCS,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 58400)",920.0,598.0,0.01,9852.42,28
HCPCS,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 59325)",720.0,468.0,0.01,9852.42,28
HCPCS,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 59350)",1630.0,1059.5,0.01,9852.42,28
HCPCS,58578,UNLISTED LAPS PX UTERUS,,,5390.83,16944.69,19
HCPCS,58578,UNLISTED PROC; LAP RADICAL TRACHELECTOMY AND BIL OOPHORECTOMY (C,9884.0,6424.6,0.01,9884.0,28
HCPCS,58578,UNLISTED PROC; ROBOTIC LAPAROSCOPIC TRACHELECTOMY AMPUTATION OF,1739.0,1130.35,0.01,9852.42,28
HCPCS,58578,Unlisted laps px uterus,,,1352.51,1566.06,8
HCPCS,58579,UNLISTED HYSTSC PX UTERUS,,,185.88,566.65,19
HCPCS,58579,Unlisted hystsc px uterus,,,162.64,188.32,8
HCPCS,58580,TRANSCERVICAL ABLATION UTERINE FIBROID RF,18594.0,12086.1,1.1,34016.0,113
HCPCS,58600,DIVISION OF FALLOPIAN TUBE,,,2937.82,9073.17,19
HCPCS,58600,Division of fallopian tube,,,1352.51,1566.06,8
HCPCS,58600,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,2364.0,1536.6,1.1,5338.37,50
HCPCS,58605,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,1384.0,899.5999999999999,1.1,4831.0,96
HCPCS,58611,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,1291.5,839.475,1.1,4831.0,96
HCPCS,58615,OCCLUDE FALLOPIAN TUBE(S),,,2937.82,9073.17,19
HCPCS,58615,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,1576.0,1024.4,1.1,5338.37,50
HCPCS,58615,Occlude fallopian tube(s),,,1352.51,1566.06,8
HCPCS,58660,LAPAROSCOPY LYSIS,,,5390.83,16944.69,19
HCPCS,58660,LAPAROSCOPY W/LYSIS OF ADHESION,4636.0,3013.4,1.1,9852.42,50
HCPCS,58660,Laparoscopy lysis,,,2211.17,2560.31,8
HCPCS,58661,LAPAROSCOPY REMOVE ADNEXA,,,5390.83,16944.69,20
HCPCS,58661,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,4994.0,3246.1,1.1,9852.42,50
HCPCS,58661,Laparoscopy remove adnexa,,,2211.17,2560.31,8
HCPCS,58662,LAPAROSCOPY EXCISE LESIONS,,,5390.83,16944.69,20
HCPCS,58662,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,4860.0,3159.0,1.1,9852.42,50
HCPCS,58662,Laparoscopy excise lesions,,,2211.17,2560.31,8
HCPCS,58670,LAPAROSCOPY FULGURATION OVIDUCTS,2364.0,1536.6,1.1,9852.42,50
HCPCS,58670,LAPAROSCOPY TUBAL CAUTERY,,,5390.83,16944.69,19
HCPCS,58670,Laparoscopy tubal cautery,,,2211.17,2560.31,8
HCPCS,58671,LAPAROSCOPY TUBAL BLOCK,,,5390.83,16944.69,19
HCPCS,58671,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,2364.0,1536.6,1.1,9852.42,50
HCPCS,58671,Laparoscopy tubal block,,,2211.17,2560.31,8
HCPCS,58672,LAPAROSCOPY FIMBRIOPLASTY,,,5390.83,16944.69,19
HCPCS,58672,Laparoscopy fimbrioplasty,,,2211.17,2560.31,8
HCPCS,58673,LAPAROSCOPY SALPINGOSTOMY,,,9619.76,29793.81,19
HCPCS,58673,Laparoscopy salpingostomy,,,2211.17,2560.31,8
HCPCS,58674,LAPS ABLTJ UTERINE FIBROIDS,,,9619.76,29793.81,19
HCPCS,58674,Laps abltj uterine fibroids,,,4365.95,5055.31,8
HCPCS,58679,LAPAROSCOPIC UTERINE AND OVARIAN TRANSPOSITION (COMP CODE 58571),6600.0,4290.0,0.01,9852.42,28
HCPCS,58679,UNLISTED LAPAROSCOPIC DETORSION OF OVARY (COMP CODE 49322),2584.0,1679.6,0.01,9852.42,28
HCPCS,58679,"UNLISTED LAPAROSCOPY PROCEDURE, OVI",1401.0,910.65,0.01,9852.42,28
HCPCS,58679,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",1035.0,672.75,0.01,9852.42,56
HCPCS,58679,UNLISTED LAPS PX OVIDCT OVRY,,,5390.83,16944.69,19
HCPCS,58679,"UNLISTED PROC, LAPAROSCOPIC BIL OVARIAN TRANSPOSITION (COMP CODE",3887.0,2526.55,0.01,9852.42,28
HCPCS,58679,Unlisted laps px ovidct ovry,,,1352.51,1566.06,8
HCPCS,58700,Removal of fallopian tube,,,2211.17,2560.31,8
HCPCS,58700,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,5180.0,3367.0,1.1,5180.0,50
HCPCS,58720,Removal of ovary/tube(s),,,2211.17,2560.31,8
HCPCS,58720,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,4864.0,3161.6,1.1,4864.0,50
HCPCS,58740,Adhesiolysis tube ovary,,,2211.17,2560.31,8
HCPCS,58740,LYSIS OF ADHESIONS SALPINX/OVARY,5960.0,3874.0,1.1,5960.0,50
HCPCS,58750,Repair oviduct,,,2211.17,2560.31,8
HCPCS,58752,Revise ovarian tube(s),,,1352.51,1566.06,8
HCPCS,58760,Fimbrioplasty,,,1352.51,1566.06,8
HCPCS,58770,CREATE NEW TUBAL OPENING,,,2937.82,9073.17,19
HCPCS,58770,Create new tubal opening,,,1352.51,1566.06,8
HCPCS,58800,DRAINAGE OF OVARIAN CYST(S),,,2937.82,9073.17,19
HCPCS,58800,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,1848.0,1201.2,1.1,5338.37,53
HCPCS,58800,Drainage of ovarian cyst(s),,,1352.51,1566.06,8
HCPCS,58805,DRAINAGE OF OVARIAN CYST(S),,,2937.82,9073.17,19
HCPCS,58805,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,2568.0,1669.2,1.1,5338.37,50
HCPCS,58805,Drainage of ovarian cyst(s),,,1352.51,1566.06,8
HCPCS,58820,DRAIN OVARY ABSCESS OPEN,,,2937.82,9073.17,19
HCPCS,58820,Drain ovary abscess open,,,1352.51,1566.06,8
HCPCS,58822,Drain ovary abscess percut,,,1352.51,1566.06,8
HCPCS,58825,"TRANSPOSITION, OVARY(S)",4712.0,3062.8,1.1,4712.0,50
HCPCS,58825,Transposition ovary(s),,,2211.17,2560.31,8
HCPCS,58900,BIOPSY OF OVARY(S),,,2937.82,9073.17,19
HCPCS,58900,Biopsy of ovary(s),,,1352.51,1566.06,8
HCPCS,58920,PARTIAL REMOVAL OF OVARY(S),,,6832.66,20784.34,19
HCPCS,58920,Partial removal of ovary(s),,,2211.17,2560.31,8
HCPCS,58925,OVARIAN CYSTECTOMY UNI/BI,13840.0,8996.0,1.1,22708.0,111
HCPCS,58940,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,13162.5,8555.625,1.1,22708.0,96
HCPCS,58940,REMOVAL OF OVARY(S),921.0,598.65,1.1,1899.67,50
HCPCS,58943,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,7808.0,5075.2,1.1,7808.0,50
HCPCS,58943,Removal of ovary(s),,,2211.17,2560.31,8
HCPCS,58950,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,7348.0,4776.2,1.1,7348.0,50
HCPCS,58950,Resect ovarian malignancy,,,2211.17,2560.31,8
HCPCS,58951,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,9704.0,6307.6,1.1,9704.0,50
HCPCS,58951,Resect ovarian malignancy,,,4365.95,5055.31,8
HCPCS,58952,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,10916.0,7095.4,1.1,10916.0,50
HCPCS,58952,Resect ovarian malignancy,,,2211.17,2560.31,8
HCPCS,58953,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,13652.0,8873.8,1.1,13652.0,50
HCPCS,58953,Tah rad dissect for debulk,,,4365.95,5055.31,8
HCPCS,58954,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,14852.0,9653.8,1.1,14852.0,50
HCPCS,58954,Tah rad debulk/lymph remove,,,4365.95,5055.31,8
HCPCS,58956,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,9120.0,5928.0,1.1,9120.0,50
HCPCS,58956,Bso omentectomy w/tah,,,4365.95,5055.31,8
HCPCS,58957,Resect recurrent gyn mal,,,4365.95,5055.31,8
HCPCS,58958,RESCJ RECR OVR TBL PP UTR MAL OMNTC PEL LMPHADEC,11688.0,7597.2,1.1,11688.0,50
HCPCS,58958,Resc recr ovr tbl pp utr mal,,,4365.95,5055.31,8
HCPCS,58960,Exploration of abdomen,,,2211.17,2560.31,8
HCPCS,58960,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,6316.0,4105.4,1.1,6316.0,50
HCPCS,58970,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,1549.0,1006.85,1.1,1549.0,47
HCPCS,58970,RETRIEVAL OF OOCYTE,,,804.55,2581.56,19
HCPCS,58970,Retrieval of oocyte,,,120.06,139.02,8
HCPCS,58974,EMBRYO TRANSFER INTRAUTERINE,,,804.55,2581.56,19
HCPCS,58974,Embryo transfer intrauterine,,,120.06,139.02,8
HCPCS,58974,"TRANSFER OF EMBRYO,INTRAUTERINE",1163.0,755.95,1.1,1372.67,32
HCPCS,58976,TRANSFER OF EMBRYO,,,281.07,854.11,19
HCPCS,58976,Transfer of embryo,,,120.06,139.02,8
HCPCS,58999,LAPAROSCOPIC REPAIR COLOVAGINAL FISTULA (COMP 57305),3655.0,2375.75,0.01,3655.0,28
HCPCS,58999,LAPAROSCOPIC RESECTION OF NEOVAGINA (COMP 57110),6656.0,4326.4,0.01,6656.0,28
HCPCS,58999,LAPAROSCOPIC UTEROSACRAL LIGAMENT SUSPENSION (COMP CODE 57283),4664.0,3031.6,0.01,4664.0,28
HCPCS,58999,"UNLISTED PROC, EXCISION OF VAGINAL CUFF LESION (COMP TO 57135)",891.0,579.15,0.01,891.0,28
HCPCS,58999,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL) (COMP",870.0,565.5,0.01,2160.0,84
HCPCS,58999,UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL,556.0,361.4,0.01,556.0,28
HCPCS,58999,UNLISTED VAGINAL CUFF REPAIR (COMP CODE 57200),870.0,565.5,0.01,870.0,28
HCPCS,58999,VAGINAL CUFF BIOPSY (COMP CODE 57100),2242.5,1457.625,0.01,4005.0,89
HCPCS,59000,AMNIOCENTESIS DIAGNOSIC,2001.5,1300.975,0.01,3483.0,114
HCPCS,59001,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,1208.5,785.525,0.01,3004.0,111
HCPCS,59012,CORDOCENTESIS(INTRAUTERINE),1376.0,894.4,1.1,1376.0,50
HCPCS,59012,FETAL CORD PUNCTURE PRENATAL,,,281.07,854.11,19
HCPCS,59012,Fetal cord puncture prenatal,,,524.26,607.04,8
HCPCS,59015,CHORIONIC VILLUS SAMPLING,2181.5,1417.975,0.01,3483.0,114
HCPCS,59020,FETAL CONTRACTION STRESS TEST,805.0,523.25,0.01,2453.0,122
HCPCS,59025,FETAL NON-STRESS TEST,805.0,523.25,1.1,1038.0,140
HCPCS,59025,FETAL NONSTRESS TEST,805.0,523.25,79.6,2453.0,183
HCPCS,59025,FETAL NST TEST,805.0,523.25,79.6,805.0,122
HCPCS,59030,FETAL SCALP BLOOD SAMPLING,,,281.07,854.11,19
HCPCS,59030,Fetal scalp blood sampling,,,204.11,236.34,8
HCPCS,59050,FETAL MONITORING LABOR PHYS WRITTEN REPORT,380.0,247.0,82.84,380.0,46
HCPCS,59051,Fetal monitor/interpret only,,,321.96,372.8,8
HCPCS,59070,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,1217.0,791.05,281.07,3004.0,61
HCPCS,59072,UMBILICAL CORD OCCLUD W/US,,,281.07,854.11,19
HCPCS,59072,Umbilical cord occlud w/us,,,1875.34,2171.44,8
HCPCS,59074,FETAL FLUID DRAINAGE W/US,,,281.07,854.11,19
HCPCS,59074,Fetal fluid drainage w/us,,,204.11,236.34,8
HCPCS,59076,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,1217.0,791.05,281.07,3398.0,61
HCPCS,59100,REMOVE UTERUS LESION,,,4561.18,14021.11,19
HCPCS,59100,Remove uterus lesion,,,3003.06,3477.23,8
HCPCS,59120,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,5068.0,3294.2,1.1,5068.0,50
HCPCS,59120,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59121,TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY,5096.0,3312.4,1.1,5096.0,50
HCPCS,59121,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59130,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59135,Treat ectopic pregnancy,,,2525.01,2923.69,8
HCPCS,59136,TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER,5700.0,3705.0,1.1,5700.0,50
HCPCS,59136,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59140,TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION,2376.0,1544.4,1.1,2376.0,50
HCPCS,59140,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59150,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,4916.0,3195.4,1.1,9852.42,50
HCPCS,59150,TREAT ECTOPIC PREGNANCY,,,5390.83,16944.69,19
HCPCS,59150,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59151,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,4844.0,3148.6,1.1,9852.42,50
HCPCS,59151,TREAT ECTOPIC PREGNANCY,,,5390.83,16944.69,19
HCPCS,59151,Treat ectopic pregnancy,,,3003.06,3477.23,8
HCPCS,59160,CURETTAGE POSTPARTUM,2392.5,1555.125,1.1,9073.17,114
HCPCS,59200,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,872.5,567.125,0.01,3004.0,236
HCPCS,59300,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,6841.0,4446.650000000001,1.1,12718.0,114
HCPCS,59320,CERCLAGE CERVIX PREGNANCY VAGINAL,992.0,644.8,1.1,5338.37,50
HCPCS,59320,REVISION OF CERVIX,,,2937.82,9073.17,19
HCPCS,59320,Revision of cervix,,,1458.54,1688.83,8
HCPCS,59325,CERCLAGE CERVIX PREGNANCY ABDOMINAL,1624.0,1055.6,1.1,1624.0,50
HCPCS,59325,Revision of cervix,,,1458.54,1688.83,8
HCPCS,59350,Repair of uterus,,,1458.54,1688.83,8
HCPCS,59400,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,14800.0,9620.0,1.1,14800.0,50
HCPCS,59400,Obstetrical care,,,1825.19,2113.38,8
HCPCS,59409,VAGINAL DELIVERY ONLY,9520.5,6188.325000000001,1.1,12718.0,172
HCPCS,59410,Obstetrical care,,,1825.19,2113.38,8
HCPCS,59410,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,8254.0,5365.1,1.1,8254.0,50
HCPCS,59412,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,6701.0,4355.650000000001,0.01,12718.0,172
HCPCS,59414,DELIVER PLACENTA,644.0,418.6,1.1,5338.37,50
HCPCS,59414,DELIVERY OF PLACENTA,12718.0,8266.7,151.5,12718.0,61
HCPCS,59414,DELIVERY OF PLACENTA ONLY,12718.0,8266.7,151.5,12718.0,61
HCPCS,59414,DELIVERY PLACENTA SEPARATE PROCEDURE,12718.0,8266.7,151.5,12718.0,61
HCPCS,59425,ANTEPARTUM CARE 4-6 VISIT MIDWIFE,3120.0,2028.0,1.1,3120.0,53
HCPCS,59425,Antepartum care only,,,101.63,117.68,8
HCPCS,59426,ANTEPARTUM CARE ONLY 7 OR > VISITS.,5720.0,3718.0,1.1,5720.0,53
HCPCS,59426,Antepartum care only,,,101.63,117.68,8
HCPCS,59430,Care after delivery,,,101.63,117.68,8
HCPCS,59430,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,1288.0,837.2,1.1,1288.0,53
HCPCS,59510,Cesarean delivery,,,1267.71,1467.87,8
HCPCS,59510,OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM,16420.0,10673.0,1.1,16420.0,44
HCPCS,59514,CESAREAN DELIVERY ONLY,7097.0,4613.05,1.1,7097.0,50
HCPCS,59514,Cesarean delivery only,,,1267.71,1467.87,8
HCPCS,59515,CESAREAN DELIVERY+POSTPARTUM CARE,10028.0,6518.2,1.1,10028.0,50
HCPCS,59515,Cesarean delivery,,,1267.71,1467.87,8
HCPCS,59525,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,3801.0,2470.65,1.1,9496.0,96
HCPCS,59610,ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB,15484.0,10064.6,1.1,15484.0,44
HCPCS,59610,Vbac delivery,,,1825.19,2113.38,8
HCPCS,59612,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,6436.0,4183.4,1.1,6436.0,50
HCPCS,59612,VBAC DELIVERY ONLY,,,2937.82,9073.17,19
HCPCS,59612,Vbac delivery only,,,1825.19,2113.38,8
HCPCS,59614,VAGINAL DELIVERY & POSTPARTUM CARE VBAC,8192.0,5324.8,1.1,8192.0,50
HCPCS,59614,Vbac care after delivery,,,1825.19,2113.38,8
HCPCS,59618,Attempted vbac delivery,,,1267.71,1467.87,8
HCPCS,59618,ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC,16628.0,10808.2,1.1,16628.0,44
HCPCS,59620,Attempted vbac delivery only,,,1267.71,1467.87,8
HCPCS,59620,CESAREAN DELIVERY ATTEMPTED VBAC,6664.0,4331.6,1.1,6664.0,50
HCPCS,59622,Attempted vbac after care,,,1267.71,1467.87,8
HCPCS,59622,CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA,9328.0,6063.2,1.1,9328.0,50
HCPCS,59812,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,7247.0,4710.55,0.01,12718.0,175
HCPCS,59820,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,7327.0,4762.55,1.1,12718.0,114
HCPCS,59821,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,7377.0,4795.05,0.01,12718.0,175
HCPCS,59830,Treat uterus infection,,,1625.04,1881.63,8
HCPCS,59840,INDUCED ABORTION D&C,,,2937.82,9073.17,19
HCPCS,59840,INDUCED ABORTION DILATION AND CURETTAGE,1204.0,782.6,1.1,5338.37,53
HCPCS,59840,Induced abortion d&c,,,1625.04,1881.63,8
HCPCS,59841,INDUCED ABORTION DILAT&EVAC,,,2937.82,9073.17,19
HCPCS,59841,INDUCED ABORTION DILATION & EVACUATION,2260.0,1469.0,1.1,5338.37,53
HCPCS,59841,Induced abortion dilat&evac,,,1625.04,1881.63,8
HCPCS,59850,INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ,2360.0,1534.0,1.1,2360.0,50
HCPCS,59850,Induced abortion 1+ njx,,,1625.04,1881.63,8
HCPCS,59851,Induced abortion 1+njx d&c,,,1625.04,1881.63,8
HCPCS,59852,Induced abortion 1+njx hyst,,,1625.04,1881.63,8
HCPCS,59855,INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS,2572.0,1671.8,1.1,2572.0,50
HCPCS,59855,Induced abortion 1+vag supp,,,1625.04,1881.63,8
HCPCS,59856,INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC,3116.0,2025.4,1.1,3116.0,50
HCPCS,59856,Induced ab 1+vag supp d&c,,,1625.04,1881.63,8
HCPCS,59857,Induced ab 1+vag supp hyst,,,1625.04,1881.63,8
HCPCS,59866,ABORTION (MPR),,,281.07,854.11,19
HCPCS,59866,Abortion (mpr),,,1625.04,1881.63,8
HCPCS,59866,MULTIFETAL PREGNANCY REDUCTION(S),1596.0,1037.4,1.1,1596.0,44
HCPCS,59870,EVACUATE MOLE OF UTERUS,,,2937.82,9073.17,19
HCPCS,59870,Evacuate mole of uterus,,,3003.06,3477.23,8
HCPCS,59870,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,2628.0,1708.2,1.1,5338.37,50
HCPCS,59871,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,6785.0,4410.25,1.1,12718.0,111
HCPCS,59897,FETAL INVAS PROC W/US GUIDANCE,630.0,409.5,0.01,3004.0,61
HCPCS,59897,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,1049.0,681.85,0.01,1392.64,29
HCPCS,59898,UNLSTD LAPS PX MAT CARE&DLVR,,,5390.83,16944.69,19
HCPCS,59898,Unlstd laps px mat care&dlvr,,,1458.54,1688.83,8
HCPCS,59899,JADA PROCEDURE (COMP CODE43460),1629.0,1058.85,0.01,1629.0,28
HCPCS,59899,PROC MATERNITY CARE UNLISTD - IUPC,351.0,228.15,99.26,4001.0,61
HCPCS,59899,PROC MATERNITY CARE UNLISTED,379.0,246.35,0.01,4001.0,61
HCPCS,59899,UNLISTED PROC; POST PARTUM LAPAROTOMY WITH UTERINE INVERSION RED,1630.0,1059.5,0.01,1630.0,28
HCPCS,59899,UNLISTED PROCEDURE MATERNITY CARE & DELIVERY,803.0,521.95,0.01,803.0,28
HCPCS,59899,"UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY (COMPARISON CODE",500.0,325.0,0.01,780.0,56
HCPCS,60000,I&D THYROGLOSSAL DUCT CYST INFECTED,5925.0,3851.25,266.37,5925.0,61
HCPCS,6005F,Care level rationale doc,,,8.48,9.82,8
HCPCS,60100,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,1719.0,1117.35,0.01,3004.0,114
HCPCS,6010F,Dysphag test done b/4 eating,,,8.48,9.82,8
HCPCS,6015F,Dysphag test done b/4 eating,,,8.48,9.82,8
HCPCS,60200,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,4008.0,2605.2,1.1,9852.42,50
HCPCS,60200,REMOVE THYROID LESION,,,5390.83,16944.69,19
HCPCS,60200,Remove thyroid lesion,,,3424.1,3964.75,8
HCPCS,6020F,Npo (nothing-mouth) ordered,,,8.48,9.82,8
HCPCS,60210,PARTIAL THYROID EXCISION,1570.0,1020.5,1.1,16944.69,69
HCPCS,60210,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4492.0,2919.8,1.1,9852.42,50
HCPCS,60210,Partial thyroid excision,,,3424.1,3964.75,8
HCPCS,60212,PARTIAL THYROID EXCISION,,,5390.83,16944.69,19
HCPCS,60212,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,6572.0,4271.8,1.1,9852.42,50
HCPCS,60212,Partial thyroid excision,,,3424.1,3964.75,8
HCPCS,60220,PARTIAL REMOVAL OF THYROID,,,5390.83,16944.69,20
HCPCS,60220,Partial removal of thyroid,,,3424.1,3964.75,8
HCPCS,60220,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4924.0,3200.6,1.1,9852.42,50
HCPCS,60225,PARTIAL REMOVAL OF THYROID,,,5390.83,16944.69,19
HCPCS,60225,Partial removal of thyroid,,,3424.1,3964.75,8
HCPCS,60225,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,6508.0,4230.2,1.1,9852.42,50
HCPCS,60240,REMOVAL OF THYROID,,,5390.83,16944.69,20
HCPCS,60240,Removal of thyroid,,,3424.1,3964.75,8
HCPCS,60240,THYROIDECTOMY TOTAL/COMPLETE,6618.0,4301.7,1.1,9852.42,50
HCPCS,60252,REMOVAL OF THYROID,,,5465.95,16592.38,19
HCPCS,60252,Removal of thyroid,,,3424.1,3964.75,8
HCPCS,60252,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,8804.0,5722.6,1.1,9999.36,50
HCPCS,60254,Extensive thyroid surgery,,,3424.1,3964.75,8
HCPCS,60254,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,11368.0,7389.2,1.1,11368.0,50
HCPCS,60260,REPEAT THYROID SURGERY,,,5465.95,16592.38,19
HCPCS,60260,Repeat thyroid surgery,,,3424.1,3964.75,8
HCPCS,60260,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,7304.0,4747.6,1.1,9999.36,50
HCPCS,60270,Removal of thyroid,,,3424.1,3964.75,8
HCPCS,60270,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,9280.0,6032.0,1.1,9280.0,50
HCPCS,60271,REMOVAL OF THYROID,,,5465.95,16592.38,19
HCPCS,60271,Removal of thyroid,,,3424.1,3964.75,8
HCPCS,60271,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,7048.0,4581.2,1.1,9999.36,50
HCPCS,60280,EXCISION THYROGLOSSAL DUCT CYST/SINUS,2464.0,1601.6,1.1,9852.42,50
HCPCS,60280,REMOVE THYROID DUCT LESION,,,5390.83,16944.69,19
HCPCS,60280,Remove thyroid duct lesion,,,3424.1,3964.75,8
HCPCS,60281,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,3528.0,2293.2,1.1,9852.42,50
HCPCS,60281,REMOVE THYROID DUCT LESION,,,5390.83,16944.69,19
HCPCS,60281,Remove thyroid duct lesion,,,3424.1,3964.75,8
HCPCS,60300,ASPIRATION AND/OR INJECTION THYROID CYST,1601.0,1040.6499999999999,0.01,3004.0,114
HCPCS,6030F,Max sterile barriers flwd,,,8.48,9.82,8
HCPCS,6040F,Appro rad ds dvcs techs docd,,,8.48,9.82,8
HCPCS,6045F,Radxps in end rprt4fluro pxd,,,8.48,9.82,8
HCPCS,60500,EXPLORE PARATHYROID GLANDS,,,5465.95,16592.38,20
HCPCS,60500,Explore parathyroid glands,,,3424.1,3964.75,8
HCPCS,60500,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,6864.0,4461.6,1.1,9999.36,50
HCPCS,60502,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,8460.0,5499.0,1.1,9999.36,50
HCPCS,60502,RE-EXPLORE PARATHYROIDS,,,5465.95,16592.38,20
HCPCS,60502,Re-explore parathyroids,,,3424.1,3964.75,8
HCPCS,60505,Explore parathyroid glands,,,3424.1,3964.75,8
HCPCS,60505,PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC,9224.0,5995.6,1.1,9224.0,50
HCPCS,60512,Autotransplant parathyroid,,,3424.1,3964.75,8
HCPCS,60512,PARATHYROID AUTOTRANSPLANTATION ADD-ON,1776.0,1154.4,1.1,1776.0,50
HCPCS,60520,REMOVAL OF THYMUS GLAND,,,5465.95,16592.38,19
HCPCS,60520,Removal of thymus gland,,,2519.91,2917.79,8
HCPCS,60520,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,6864.0,4461.6,1.1,9999.36,50
HCPCS,60521,Removal of thymus gland,,,2519.91,2917.79,8
HCPCS,60521,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,7672.0,4986.8,1.1,7672.0,50
HCPCS,60522,Removal of thymus gland,,,2519.91,2917.79,8
HCPCS,60522,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,9392.0,6104.8,1.1,9392.0,50
HCPCS,60540,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,7929.0,5153.85,1.1,7929.0,50
HCPCS,60540,Explore adrenal gland,,,1611.33,1865.75,8
HCPCS,60545,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,8372.0,5441.8,1.1,8372.0,50
HCPCS,60545,Explore adrenal gland,,,1611.33,1865.75,8
HCPCS,60600,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,10036.0,6523.4,1.1,10036.0,50
HCPCS,60600,Remove carotid body lesion,,,872.27,1010.0,8
HCPCS,60605,Remove carotid body lesion,,,872.27,1010.0,8
HCPCS,60650,LAPAROSCOPY ADRENALECTOMY PARTIAL OR COM,8292.0,5389.8,1.1,8292.0,50
HCPCS,60650,Laparoscopy adrenalectomy,,,1611.33,1865.75,8
HCPCS,60659,UNLISTED LAPS PX ENDOC SYS,,,5390.83,16944.69,19
HCPCS,60659,UNLISTED PROC; TRANSORAL ENDOSCOPIC PARATHYROIDETOMY VESTIBULAR,6286.0,4085.9,0.01,9852.42,28
HCPCS,60659,"UNLISTED PROC; TRANSORAL ENDOSCOPIC THYROID LOBECTOMY, VESTIBULA",3702.0,2406.3,0.01,9852.42,28
HCPCS,60659,Unlisted laps px endoc sys,,,1611.33,1865.75,8
HCPCS,60660,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,4505.5,2928.575,1.1,7597.35,112
HCPCS,60661,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,3560.0,2314.0,1.1,5250.0,97
HCPCS,60699,AUTOTRANS OF CRYO TISSUE (COMP CODE 60512),1599.0,1039.35,0.01,9852.42,28
HCPCS,60699,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),21214.5,13789.425,0.01,39232.0,89
HCPCS,60699,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),14729.0,9573.85,0.01,26838.0,89
HCPCS,60699,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,89
HCPCS,60699,UNLISTED PROC; TRANSORAL ENDOSCOPIC SUBTOTAL THYROIDECTOMY VESTI,5815.0,3779.75,0.01,9852.42,28
HCPCS,60699,"UNLISTED PROC; TRANSORAL ENDOSCOPIC THYROID LOCECTOMY, VESTIBULA",3699.0,2404.35,0.01,9852.42,28
HCPCS,6070F,Pt asked/cnsld aed effects,,,8.48,9.82,8
HCPCS,6080F,Pt/caregiver queried falls,,,8.48,9.82,8
HCPCS,6090F,Pt/caregiver counsel safety,,,8.48,9.82,8
HCPCS,61000,REMOVE CRANIAL CAVITY FLUID,,,639.87,1978.48,19
HCPCS,61000,Remove cranial cavity fluid,,,229.66,265.93,8
HCPCS,61001,REMOVE CRANIAL CAVITY FLUID,,,639.87,1978.48,19
HCPCS,61001,Remove cranial cavity fluid,,,229.66,265.93,8
HCPCS,6100F,Verify pt site pxd docd,,,8.48,9.82,8
HCPCS,6101F,Safety counseling dementia,,,8.48,9.82,8
HCPCS,61020,REMOVE BRAIN CAVITY FLUID,,,822.61,2479.04,19
HCPCS,61020,Remove brain cavity fluid,,,558.63,646.83,8
HCPCS,61026,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,4778.0,3105.7,0.01,4778.0,61
HCPCS,6102F,Safety counseling dem order,,,8.48,9.82,8
HCPCS,61050,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,2037.0,1324.05,0.01,3004.0,61
HCPCS,61055,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2037.0,1324.05,0.01,3004.0,61
HCPCS,61070,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,2585.0,1680.25,0.01,4778.0,111
HCPCS,61105,Tdh sdrl/ventr pnxr,,,3997.78,4629.01,8
HCPCS,61107,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,5331.5,3465.4750000000004,0.01,8667.0,96
HCPCS,61108,Tdh pnxr evac&/drg sdrl hmta,,,3997.78,4629.01,8
HCPCS,6110F,Counsel prov driving risks,,,8.48,9.82,8
HCPCS,61120,BURR HOLE VENTRICULAR PUNCTURE,3840.0,2496.0,1.1,3840.0,50
HCPCS,61120,Burr hole for ventr puncture,,,3997.78,4629.01,8
HCPCS,61140,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,6892.0,4479.8,1.1,6892.0,50
HCPCS,61140,Burr hole/treph bx brain/les,,,3997.78,4629.01,8
HCPCS,61150,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,7560.0,4914.0,1.1,7560.0,50
HCPCS,61150,Bur hol/trph drg brn abs/cst,,,3997.78,4629.01,8
HCPCS,61151,Burr hole/treph sbsq tapping,,,3997.78,4629.01,8
HCPCS,61154,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,6828.0,4438.2,1.1,6828.0,50
HCPCS,61154,Burr hole w/evac&/drg hmtma,,,3997.78,4629.01,8
HCPCS,61156,Burr hol aspir hmtm/cst icer,,,3997.78,4629.01,8
HCPCS,61210,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,3446.5,2240.225,1.1,4629.01,96
HCPCS,61215,INS SUBQ RSVR PMP/NFS SYS,,,5917.23,24597.37,19
HCPCS,61215,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,2340.0,1521.0,1.1,11373.82,50
HCPCS,61215,Ins subq rsvr pmp/nfs sys,,,3026.0,3503.79,8
HCPCS,61250,Burr hole/treph sttl expl,,,3997.78,4629.01,8
HCPCS,61253,Burr hole treph ittl uni/bi,,,3997.78,4629.01,8
HCPCS,61304,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,9364.0,6086.6,1.1,9364.0,50
HCPCS,61304,Crnec/crnot expl supratntorl,,,2142.24,2480.49,8
HCPCS,61305,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,12602.0,8191.3,1.1,12602.0,50
HCPCS,61305,Crnec/crnot expl infratntorl,,,2142.24,2480.49,8
HCPCS,61312,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,12068.0,7844.2,1.1,12068.0,50
HCPCS,61312,Crnec/crnot sttl xdrl/sdrl,,,2142.24,2480.49,8
HCPCS,61313,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11236.0,7303.4,1.1,11236.0,50
HCPCS,61313,Crnec/crnot sttl icere,,,2142.24,2480.49,8
HCPCS,61314,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,10360.0,6734.0,1.1,10360.0,50
HCPCS,61314,Crnec/crnot ittl xdrl/sdrl,,,2142.24,2480.49,8
HCPCS,61315,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11860.0,7709.0,1.1,11860.0,50
HCPCS,61315,Crnec/crnot ittl ntracereblr,,,2142.24,2480.49,8
HCPCS,61316,Inc&subq plmt crnl bone grf,,,2142.24,2480.49,8
HCPCS,61320,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,10968.0,7129.2,1.1,10968.0,50
HCPCS,61320,Crnec/crnot drg icr abs sttl,,,2142.24,2480.49,8
HCPCS,61321,Crnec/crnot drg icr abs ittl,,,2142.24,2480.49,8
HCPCS,61322,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,13704.0,8907.6,1.1,13704.0,50
HCPCS,61322,Crnec/crnot dcmprv w/o lobec,,,2142.24,2480.49,8
HCPCS,61323,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,14024.0,9115.6,1.1,14024.0,50
HCPCS,61323,Crnec/crnot dcmprv w/lobec,,,2142.24,2480.49,8
HCPCS,61330,DCMPRN ORBIT ONLY TRANSCRNL,,,2996.53,9292.73,19
HCPCS,61330,Dcmprn orbit only transcrnl,,,2142.24,2480.49,8
HCPCS,61333,Expl orbit w/removal lesion,,,2142.24,2480.49,8
HCPCS,61340,SUBTEMPORAL CRANIAL DECOMPRESSION,8044.0,5228.6,1.1,8044.0,50
HCPCS,61340,Subtemporal cranial dcmprn,,,2142.24,2480.49,8
HCPCS,61343,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,12744.0,8283.6,1.1,12744.0,50
HCPCS,61343,Crnec sopl crv lam dcmprn,,,2142.24,2480.49,8
HCPCS,61345,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,11692.0,7599.8,1.1,11692.0,50
HCPCS,61345,Oth cranial dcmprn pst fossa,,,2142.24,2480.49,8
HCPCS,61450,Crnec stpl sctj cmprn/dcmprn,,,2142.24,2480.49,8
HCPCS,61458,CRNEC SOPL EXPL/DCMPRN CRNL NRV,11536.0,7498.4,1.1,11536.0,50
HCPCS,61458,Crnec sopl xpl/dcmpr crl nrv,,,2142.24,2480.49,8
HCPCS,61460,Crnec sopl sctj 1+crnl nrv,,,2142.24,2480.49,8
HCPCS,61500,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,7672.0,4986.8,1.1,7672.0,50
HCPCS,61500,Crnec exc tum/bone les skull,,,2142.24,2480.49,8
HCPCS,61501,Craniectomy f/osteomyelitis,,,2142.24,2480.49,8
HCPCS,6150F,Pt notrcvng1st antitnf txmnt,,,8.48,9.82,8
HCPCS,61510,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,13565.0,8817.25,1.1,13565.0,50
HCPCS,61510,Crnec treph exc brn tum sttl,,,2142.24,2480.49,8
HCPCS,61512,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,14856.0,9656.4,1.1,14856.0,50
HCPCS,61512,Crnec treph exc mngioma sttl,,,2142.24,2480.49,8
HCPCS,61514,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,10892.0,7079.8,1.1,10892.0,50
HCPCS,61514,Crnec treph exc brn abs sttl,,,2142.24,2480.49,8
HCPCS,61516,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,10632.0,6910.8,1.1,10632.0,50
HCPCS,61516,Crnec treph exc cyst sttl,,,2142.24,2480.49,8
HCPCS,61517,Implt brn intrcv chemotx agt,,,3997.78,4629.01,8
HCPCS,61518,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,15956.0,10371.4,1.1,15956.0,50
HCPCS,61518,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61519,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,17372.0,11291.8,1.1,17372.0,50
HCPCS,61519,Remove brain lining lesion,,,2142.24,2480.49,8
HCPCS,61520,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,22836.0,14843.4,1.1,22836.0,50
HCPCS,61520,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61521,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61522,Removal of brain abscess,,,2142.24,2480.49,8
HCPCS,61524,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,13152.0,8548.8,1.1,13152.0,50
HCPCS,61524,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61526,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61530,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61531,Implant brain electrodes,,,3997.78,4629.01,8
HCPCS,61533,Implant brain electrodes,,,2142.24,2480.49,8
HCPCS,61534,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61535,Remove brain electrodes,,,2142.24,2480.49,8
HCPCS,61536,Removal of brain lesion,,,2142.24,2480.49,8
HCPCS,61537,Removal of brain tissue,,,2142.24,2480.49,8
HCPCS,61538,Removal of brain tissue,,,2142.24,2480.49,8
HCPCS,61539,Removal of brain tissue,,,2142.24,2480.49,8
HCPCS,61540,Removal of brain tissue,,,2142.24,2480.49,8
HCPCS,61541,Incision of brain tissue,,,2142.24,2480.49,8
HCPCS,61543,Removal of brain tissue,,,2142.24,2480.49,8
HCPCS,61544,Remove & treat brain lesion,,,2142.24,2480.49,8
HCPCS,61545,Excision of brain tumor,,,2142.24,2480.49,8
HCPCS,61546,Removal of pituitary gland,,,2142.24,2480.49,8
HCPCS,61548,Removal of pituitary gland,,,3594.14,4161.63,8
HCPCS,61550,Release of skull seams,,,2142.24,2480.49,8
HCPCS,61552,Release of skull seams,,,2142.24,2480.49,8
HCPCS,61556,Incise skull/sutures,,,2142.24,2480.49,8
HCPCS,61557,Incise skull/sutures,,,2142.24,2480.49,8
HCPCS,61558,Excision of skull/sutures,,,2142.24,2480.49,8
HCPCS,61559,Excision of skull/sutures,,,2142.24,2480.49,8
HCPCS,61563,Excision of skull tumor,,,2142.24,2480.49,8
HCPCS,61564,Excision of skull tumor,,,2142.24,2480.49,8
HCPCS,61566,Removal of brain tissue,,,2142.24,2480.49,8
HCPCS,61567,Incision of brain tissue,,,2142.24,2480.49,8
HCPCS,61570,CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN,10604.0,6892.6,1.1,10604.0,50
HCPCS,61570,Remove foreign body brain,,,2142.24,2480.49,8
HCPCS,61571,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,11368.0,7389.2,1.1,11368.0,50
HCPCS,61571,Incise skull for brain wound,,,2142.24,2480.49,8
HCPCS,61575,Skull base/brainstem surgery,,,3594.14,4161.63,8
HCPCS,61575,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,14624.0,9505.6,1.1,14624.0,50
HCPCS,61576,Skull base/brainstem surgery,,,3594.14,4161.63,8
HCPCS,61580,Craniofacial approach skull,,,3594.14,4161.63,8
HCPCS,61581,Craniofacial approach skull,,,3594.14,4161.63,8
HCPCS,61582,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,14056.0,9136.4,1.1,14056.0,50
HCPCS,61582,Craniofacial approach skull,,,3594.14,4161.63,8
HCPCS,61583,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,15400.0,10010.0,1.1,15400.0,50
HCPCS,61583,Craniofacial approach skull,,,3594.14,4161.63,8
HCPCS,61584,Orbitocranial approach/skull,,,3594.14,4161.63,8
HCPCS,61585,Orbitocranial approach/skull,,,3594.14,4161.63,8
HCPCS,61586,Resect nasopharynx skull,,,3594.14,4161.63,8
HCPCS,61590,Infratemporal approach/skull,,,3594.14,4161.63,8
HCPCS,61591,Infratemporal approach/skull,,,3594.14,4161.63,8
HCPCS,61592,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,17232.0,11200.8,1.1,17232.0,50
HCPCS,61592,Orbitocranial approach/skull,,,3594.14,4161.63,8
HCPCS,61595,Transtemporal approach/skull,,,3594.14,4161.63,8
HCPCS,61596,Transcochlear approach/skull,,,3594.14,4161.63,8
HCPCS,61597,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,16328.0,10613.2,1.1,16328.0,50
HCPCS,61597,Transcondylar approach/skull,,,3594.14,4161.63,8
HCPCS,61598,Transpetrosal approach/skull,,,3594.14,4161.63,8
HCPCS,61600,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,12004.0,7802.6,1.1,12004.0,50
HCPCS,61600,Resect/excise cranial lesion,,,2142.24,2480.49,8
HCPCS,61601,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,13702.0,8906.3,1.1,13702.0,50
HCPCS,61601,Resect/excise cranial lesion,,,2142.24,2480.49,8
HCPCS,61605,Resect/excise cranial lesion,,,2142.24,2480.49,8
HCPCS,61606,Resect/excise cranial lesion,,,2142.24,2480.49,8
HCPCS,61607,Resect/excise cranial lesion,,,2142.24,2480.49,8
HCPCS,61608,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,18216.0,11840.4,1.1,18216.0,50
HCPCS,61608,Resect/excise cranial lesion,,,2142.24,2480.49,8
HCPCS,61611,Transect artery sinus,,,872.27,1010.0,8
HCPCS,61613,Remove aneurysm sinus,,,872.27,1010.0,8
HCPCS,61615,Resect/excise lesion skull,,,2142.24,2480.49,8
HCPCS,61616,Resect/excise lesion skull,,,2142.24,2480.49,8
HCPCS,61618,Repair dura,,,2142.24,2480.49,8
HCPCS,61619,Repair dura,,,2142.24,2480.49,8
HCPCS,61623,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,26498.0,17223.7,0.01,49016.0,172
HCPCS,61624,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,11278.5,7331.025,1.1,51380.79,105
HCPCS,61626,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,29440.0,19136.0,0.01,52240.0,172
HCPCS,61630,BALLON ANGIOPLASTY  INTRACRANIAL PERCUTANEOUS,8828.0,5738.2,1.1,8828.0,44
HCPCS,61630,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,26324.0,17110.6,2229.71,26324.0,46
HCPCS,61635,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,23802.0,15471.3,1.1,37892.0,90
HCPCS,61640,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,15626.0,10156.9,1.1,26324.0,79
HCPCS,61641,PERQ BALO DILA IC VSPSM EA VSL SM VASC TER,8352.0,5428.8,1242.78,9496.0,46
HCPCS,61642,PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER,10269.5,6675.175,1.1,17075.0,79
HCPCS,61645,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,9297.0,6043.05,1.1,17865.0,96
HCPCS,61650,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,5400.5,3510.325,1.1,9496.0,96
HCPCS,61651,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,3970.5,2580.825,1.1,9496.0,96
HCPCS,61680,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,13020.0,8463.0,1.1,13020.0,50
HCPCS,61680,Intracranial vessel surgery,,,872.27,1010.0,8
HCPCS,61682,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,25364.0,16486.6,1.1,25364.0,50
HCPCS,61682,Intracranial vessel surgery,,,872.27,1010.0,8
HCPCS,61684,Intracranial vessel surgery,,,872.27,1010.0,8
HCPCS,61686,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,27000.0,17550.0,1.1,27000.0,50
HCPCS,61686,Intracranial vessel surgery,,,872.27,1010.0,8
HCPCS,61690,Intracranial vessel surgery,,,872.27,1010.0,8
HCPCS,61692,Intracranial vessel surgery,,,872.27,1010.0,8
HCPCS,61697,Brain aneurysm repr complx,,,872.27,1010.0,8
HCPCS,61697,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,25360.0,16484.0,1.1,25360.0,50
HCPCS,61698,Brain aneurysm repr complx,,,872.27,1010.0,8
HCPCS,61700,Brain aneurysm repr simple,,,872.27,1010.0,8
HCPCS,61700,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,20248.0,13161.2,1.1,20248.0,50
HCPCS,61702,Inner skull vessel surgery,,,872.27,1010.0,8
HCPCS,61702,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,24016.0,15610.4,1.1,24016.0,50
HCPCS,61703,Clamp neck artery,,,872.27,1010.0,8
HCPCS,61705,Revise circulation to head,,,872.27,1010.0,8
HCPCS,61708,Revise circulation to head,,,872.27,1010.0,8
HCPCS,61710,Revise circulation to head,,,872.27,1010.0,8
HCPCS,61711,Fusion of skull arteries,,,872.27,1010.0,8
HCPCS,61715,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,47423.0,30824.95,1.1,86045.0,89
HCPCS,61720,INCISE SKULL/BRAIN SURGERY,,,5917.23,24597.37,19
HCPCS,61720,Incise skull/brain surgery,,,3997.78,4629.01,8
HCPCS,61735,Incise skull/brain surgery,,,3997.78,4629.01,8
HCPCS,61736,LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION,7624.0,4955.6,1.1,7624.0,50
HCPCS,61736,Litt icr 1 traj 1 smpl les,,,3997.78,4629.01,8
HCPCS,61737,LITT LES ICR MLT TRAJECTORIES MLT/CPLX LESIONS,9068.0,5894.2,1.1,9068.0,50
HCPCS,61737,Litt icr mlt trj mlt/cplx ls,,,3997.78,4629.01,8
HCPCS,61750,Incise skull/brain biopsy,,,3997.78,4629.01,8
HCPCS,61750,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,7932.0,5155.8,1.1,7932.0,50
HCPCS,61751,Brain biopsy w/ct/mr guide,,,3997.78,4629.01,8
HCPCS,61751,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,7516.0,4885.4,1.1,7516.0,50
HCPCS,61760,Implant brain electrodes,,,3997.78,4629.01,8
HCPCS,61770,INCISE SKULL FOR TREATMENT,,,3231.94,9574.94,19
HCPCS,61770,Incise skull for treatment,,,3997.78,4629.01,8
HCPCS,61781,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,1500.0,975.0,1.1,1500.0,50
HCPCS,61781,Scan proc cranial intra,,,1352.32,1565.84,8
HCPCS,61782,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,1399.0,909.35,1.1,1399.0,50
HCPCS,61782,Scan proc cranial extra,,,1352.32,1565.84,8
HCPCS,61783,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,1500.0,975.0,1.1,1500.0,50
HCPCS,61783,Scan proc spinal,,,3026.0,3503.79,8
HCPCS,61790,TREAT TRIGEMINAL NERVE,,,1804.32,5473.19,19
HCPCS,61790,Treat trigeminal nerve,,,1352.32,1565.84,8
HCPCS,61791,TREAT TRIGEMINAL TRACT,,,1804.32,5473.19,19
HCPCS,61791,Treat trigeminal tract,,,1352.32,1565.84,8
HCPCS,61796,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,5572.0,3621.8,1.1,5572.0,50
HCPCS,61796,Srs cranial lesion simple,,,3184.72,3687.57,8
HCPCS,61797,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,1392.0,904.8,1.1,1392.0,50
HCPCS,61797,Srs cran les simple addl,,,3184.72,3687.57,8
HCPCS,61798,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,7940.0,5161.0,1.1,7940.0,50
HCPCS,61798,Srs cranial lesion complex,,,3184.72,3687.57,8
HCPCS,61799,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,1924.0,1250.6,1.1,1924.0,50
HCPCS,61799,Srs cran les complex addl,,,3184.72,3687.57,8
HCPCS,61800,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,900.0,585.0,1.1,900.0,50
HCPCS,61800,Apply srs headframe add-on,,,3184.72,3687.57,8
HCPCS,61850,Implant neuroelectrodes,,,15220.57,17623.82,8
HCPCS,61860,Implant neuroelectrodes,,,15220.57,17623.82,8
HCPCS,61863,Implant neuroelectrode,,,15220.57,17623.82,8
HCPCS,61864,Implant neuroelectrde addl,,,15220.57,17623.82,8
HCPCS,61867,Implant neuroelectrode,,,15220.57,17623.82,8
HCPCS,61868,Implant neuroelectrde addl,,,15220.57,17623.82,8
HCPCS,61870,Implant neuroelectrodes,,,15220.57,17623.82,8
HCPCS,61880,REVISE/REMOVE NEUROELECTRODE,,,3177.58,9799.05,19
HCPCS,61880,Revise/remove neuroelectrode,,,1720.7,1992.39,8
HCPCS,61885,INSRT/REDO NEUROSTIM 1 ARRAY,,,19814.19,86489.44,19
HCPCS,61885,Insrt/redo neurostim 1 array,,,15220.57,17623.82,8
HCPCS,61886,IMPLANT NEUROSTIM ARRAYS,,,28156.99,86489.44,19
HCPCS,61886,Implant neurostim arrays,,,15220.57,17623.82,8
HCPCS,61888,REVISE/REMOVE NEURORECEIVER,,,10541.85,31231.28,19
HCPCS,61888,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,2092.0,1359.8,1.1,23258.37,50
HCPCS,61888,Revise/remove neuroreceiver,,,1720.7,1992.39,8
HCPCS,61889,INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,11330.0,7364.5,1.1,11330.0,50
HCPCS,61889,Ins sk-mnt crnl nstm pg/rcvr,,,15220.57,17623.82,8
HCPCS,61891,REV/RPLCMT SK-MNT CRNL NSTM,,,19814.19,86489.44,19
HCPCS,61891,REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,4950.0,3217.5,1.1,37350.66,50
HCPCS,61892,REMOVAL SKULL-MNTD CRANIAL NSTIM PG/RCVR W/CRNOP,6600.0,4290.0,1.1,6600.0,50
HCPCS,61892,RMV SK-MNT CRNL NSTM PG/RCVR,,,2997.95,9170.92,19
HCPCS,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,1720.7,1992.39,8
HCPCS,62000,TREAT SKULL FRACTURE,,,2996.53,9292.73,19
HCPCS,62000,Treat skull fracture,,,3997.78,4629.01,8
HCPCS,62005,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,7052.0,4583.8,1.1,7052.0,50
HCPCS,62005,Treat skull fracture,,,2142.24,2480.49,8
HCPCS,62010,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,8572.0,5571.8,1.1,8572.0,50
HCPCS,62010,Treatment of head injury,,,2142.24,2480.49,8
HCPCS,62100,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,10353.0,6729.45,1.1,10353.0,50
HCPCS,62100,Repair brain fluid leakage,,,2142.24,2480.49,8
HCPCS,62115,Reduction of skull defect,,,3997.78,4629.01,8
HCPCS,62117,Reduction of skull defect,,,3997.78,4629.01,8
HCPCS,62120,Repair skull cavity lesion,,,3997.78,4629.01,8
HCPCS,62121,Incise skull repair,,,3997.78,4629.01,8
HCPCS,62140,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,5820.0,3783.0,1.1,5820.0,50
HCPCS,62140,Crnop skull defect<5 cm diam,,,3997.78,4629.01,8
HCPCS,62141,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,6428.0,4178.2,1.1,6428.0,50
HCPCS,62141,Crnop skull defect>5 cm diam,,,3997.78,4629.01,8
HCPCS,62142,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,4732.0,3075.8,1.1,4732.0,50
HCPCS,62142,Rmvl b1 flp/prostc plate skl,,,3997.78,4629.01,8
HCPCS,62143,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,5660.0,3679.0,1.1,5660.0,50
HCPCS,62143,Rpl b1 flp/prostc plate skl,,,3997.78,4629.01,8
HCPCS,62145,CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG,8036.0,5223.4,1.1,8036.0,50
HCPCS,62145,Repair of skull & brain,,,3997.78,4629.01,8
HCPCS,62146,Crnop w/autograft<5 cm diam,,,3997.78,4629.01,8
HCPCS,62147,Crnop w/autograft>5 cm diam,,,3997.78,4629.01,8
HCPCS,62148,Retr bone flap to fix skull,,,3997.78,4629.01,8
HCPCS,62160,Neuroendoscopy add-on,,,3997.78,4629.01,8
HCPCS,62161,Dissect brain w/scope,,,3997.78,4629.01,8
HCPCS,62161,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,8492.0,5519.8,1.1,8492.0,50
HCPCS,62162,NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG,10720.0,6968.0,1.1,10720.0,50
HCPCS,62162,Remove colloid cyst w/scope,,,3997.78,4629.01,8
HCPCS,62163,Zneuroendoscopy w/fb removal,,,3997.78,4629.01,8
HCPCS,62164,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,11772.0,7651.8,1.1,11772.0,50
HCPCS,62164,Remove brain tumor w/scope,,,3997.78,4629.01,8
HCPCS,62165,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,9292.0,6039.8,1.1,9292.0,50
HCPCS,62165,Remove pituit tumor w/scope,,,3997.78,4629.01,8
HCPCS,62180,Establish brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62190,Establish brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62192,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,5340.0,3471.0,1.1,5340.0,50
HCPCS,62192,Establish brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62194,REPLACE/IRRIGATE CATHETER,,,1804.32,5473.19,19
HCPCS,62194,Replace/irrigate catheter,,,448.9,519.78,8
HCPCS,62200,Establish brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62200,"VENTRICULO-CISTERNOSTOMY,3RD VENT",7716.0,5015.4,1.1,7716.0,50
HCPCS,62201,Brain cavity shunt w/scope,,,4252.42,4923.85,8
HCPCS,62220,CREATE SHUNT; VENTRIC-ATR JUGUL AURICL,5640.0,3666.0,1.1,5640.0,50
HCPCS,62220,Establish brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62223,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,6182.0,4018.3,1.1,6182.0,50
HCPCS,62223,Establish brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62225,REPLACE/IRRIGATE CATHETER,,,3231.94,9574.94,19
HCPCS,62225,RPLCMT/IRRIGATION VENTRICULAR CATHETER,2724.0,1770.6,1.1,11373.82,50
HCPCS,62225,Replace/irrigate catheter,,,4252.42,4923.85,8
HCPCS,62230,REPLACE/REVISE BRAIN SHUNT,,,5917.23,24597.37,19
HCPCS,62230,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,4572.0,2971.8,1.1,11373.82,50
HCPCS,62230,Replace/revise brain shunt,,,4252.42,4923.85,8
HCPCS,62252,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2069.0,1344.85,0.01,2395.0,155
HCPCS,62256,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,2952.0,1918.8,1.1,2952.0,50
HCPCS,62256,Remove brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62258,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,6256.0,4066.4,1.1,6256.0,50
HCPCS,62258,Replace brain cavity shunt,,,4252.42,4923.85,8
HCPCS,62263,EPIDURAL LYSIS MULT SESSIONS,,,822.61,2479.04,19
HCPCS,62263,Epidural lysis mult sessions,,,448.9,519.78,8
HCPCS,62263,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,2000.0,1300.0,1.1,2100.44,53
HCPCS,62264,EPIDURAL LYSIS ON SINGLE DAY,,,822.61,2479.04,19
HCPCS,62264,Epidural lysis on single day,,,448.9,519.78,8
HCPCS,62267,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,3027.5,1967.875,0.01,4855.0,236
HCPCS,62268,DRAIN SPINAL CORD CYST,,,822.61,2479.04,19
HCPCS,62268,Drain spinal cord cyst,,,448.9,519.78,8
HCPCS,62269,NEEDLE BIOPSY SPINAL CORD,,,1497.07,4629.18,19
HCPCS,62269,Needle biopsy spinal cord,,,448.9,519.78,8
HCPCS,62270,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,2657.5,1727.375,0.01,4778.0,358
HCPCS,62272,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,2705.0,1758.25,0.01,4778.0,297
HCPCS,62273,INJECTION EPIDURAL BLOOD/CLOT PATCH,2862.0,1860.3,0.01,4778.0,297
HCPCS,62280,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,1052.0,683.8,1.1,1555.46,53
HCPCS,62280,TREAT SPINAL CORD LESION,,,822.61,2479.04,19
HCPCS,62280,Treat spinal cord lesion,,,448.9,519.78,8
HCPCS,62281,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,3603.5,2342.275,0.01,6143.0,114
HCPCS,62282,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,1025.0,666.25,1.1,1555.46,53
HCPCS,62282,TREAT SPINAL CANAL LESION,,,822.61,2479.04,19
HCPCS,62282,Treat spinal canal lesion,,,448.9,519.78,8
HCPCS,62284,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1097.5,713.375,0.01,3398.0,145
HCPCS,62287,DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR,13474.0,8758.1,0.01,13474.0,61
HCPCS,62290,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,1651.5,1073.475,0.01,3398.0,145
HCPCS,62291,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1346.0,874.9000000000001,0.01,3398.0,145
HCPCS,62292,NJX CHEMONUCLEOLYSIS LMBR,,,1804.32,5473.19,19
HCPCS,62292,Njx chemonucleolysis lmbr,,,448.9,519.78,8
HCPCS,62294,INJECTION INTO SPINAL ARTERY,,,822.61,2479.04,19
HCPCS,62294,Injection into spinal artery,,,448.9,519.78,8
HCPCS,62302,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,5451.0,3543.15,0.01,5451.0,61
HCPCS,62303,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,5451.0,3543.15,0.01,5451.0,122
HCPCS,62304,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,3175.5,2064.075,0.01,5451.0,175
HCPCS,62305,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,4944.0,3213.6,0.01,5451.0,175
HCPCS,62320,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,2785.0,1810.25,1.1,4778.0,114
HCPCS,62321,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,2818.0,1831.6999999999998,0.01,4778.0,236
HCPCS,62322,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,3412.5,2218.125,1.1,6143.0,114
HCPCS,62323,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,2785.0,1810.25,0.01,4778.0,358
HCPCS,62324,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,832.0,540.8,1.1,1555.46,53
HCPCS,62324,NJX INTERLAMINAR CRV/THRC,,,822.61,2479.04,19
HCPCS,62324,Njx interlaminar crv/thrc,,,448.9,519.78,8
HCPCS,62325,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,968.0,629.2,1.1,1555.46,53
HCPCS,62325,NJX INTERLAMINAR CRV/THRC,,,822.61,2479.04,19
HCPCS,62325,Njx interlaminar crv/thrc,,,448.9,519.78,8
HCPCS,62326,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,783.0,508.95,1.1,1555.46,53
HCPCS,62326,NJX INTERLAMINAR LMBR/SAC,,,822.61,2479.04,19
HCPCS,62326,Njx interlaminar lmbr/sac,,,448.9,519.78,8
HCPCS,62327,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,3489.5,2268.1749999999997,0.01,6143.0,175
HCPCS,62328,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,2735.0,1777.75,0.01,4778.0,235
HCPCS,62329,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,2795.0,1816.75,0.01,4778.0,235
HCPCS,62330,DCMPRN PERQ PRTL RMVL LIGA FLAVM BI 1NTRSPC LMBR,3520.0,2288.0,1.1,3520.0,35
HCPCS,62330,DCMPRN PRQ RMV LIG FLV 1LMBR,,,6864.94,20338.07,13
HCPCS,62330,Dcmprn prq rmv lig flv 1lmbr,,,3026.0,3503.79,8
HCPCS,62331,DCMPRN PRQ PRT RMV LIGA FLAVM BI ADD NTRSPC LMBR,1870.0,1215.5,1.1,1870.0,35
HCPCS,62331,Dcmprn prq rmv lig flv addl,,,3026.0,3503.79,8
HCPCS,62350,IMPLANT SPINAL CANAL CATH,,,5917.23,24597.37,19
HCPCS,62350,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,2662.0,1730.3,1.1,11373.82,50
HCPCS,62350,Implant spinal canal cath,,,3026.0,3503.79,8
HCPCS,62351,IMPLANT SPINAL CANAL CATH,,,6600.66,20338.07,19
HCPCS,62351,Implant spinal canal cath,,,7403.35,8572.3,8
HCPCS,62355,REMOVE SPINAL CANAL CATHETER,,,1804.32,5473.19,19
HCPCS,62355,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,1420.0,923.0,1.1,3297.28,50
HCPCS,62355,Remove spinal canal catheter,,,448.9,519.78,8
HCPCS,62360,INSERT SPINE INFUSION DEVICE,,,16330.53,50518.12,19
HCPCS,62360,Insert spine infusion device,,,10130.69,11730.27,8
HCPCS,62361,IMPLANT SPINE INFUSION PUMP,,,16330.53,50518.12,19
HCPCS,62361,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,2000.0,1300.0,1.1,30449.66,50
HCPCS,62361,Implant spine infusion pump,,,10130.69,11730.27,8
HCPCS,62362,IMPLANT SPINE INFUSION PUMP,,,16330.53,50518.12,19
HCPCS,62362,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,2464.0,1601.6,1.1,30449.66,50
HCPCS,62362,Implant spine infusion pump,,,10130.69,11730.27,8
HCPCS,62365,REMOVE SPINE INFUSION DEVICE,,,3231.94,9574.94,19
HCPCS,62365,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,1572.0,1021.8,1.1,11373.82,50
HCPCS,62365,Remove spine infusion device,,,3026.0,3503.79,8
HCPCS,62367,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,1140.0,741.0,1.1,4001.0,114
HCPCS,62368,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,1182.0,768.3,1.1,4001.0,114
HCPCS,62369,ANAL SP INF PMP W/REPRG&FILL,295.0,191.75,1.1,860.86,72
HCPCS,62369,Anal sp inf pmp w/reprg&fill,,,73.53,85.14,8
HCPCS,62370,ANL SP INF PMP W/MDREPRG&FIL,,,277.11,860.86,19
HCPCS,62370,Anl sp inf pmp w/mdreprg&fil,,,73.53,85.14,8
HCPCS,62370,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR&REF PHYS,396.0,257.4,1.1,510.72,53
HCPCS,62380,NDSC DCMPRN 1 NTRSPC LUMBAR,,,6600.66,20338.07,19
HCPCS,62380,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,5916.0,3845.4,1.1,12214.27,31
HCPCS,62380,Ndsc dcmprn 1 ntrspc lumbar,,,3026.0,3503.79,8
HCPCS,63001,LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV,7044.0,4578.6,1.1,12214.27,50
HCPCS,63001,REMOVE SPINE LAMINA 1/2 CRVL,,,6600.66,20338.07,19
HCPCS,63001,Remove spine lamina 1/2 crvl,,,3026.0,3503.79,8
HCPCS,63003,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,7096.0,4612.4,1.1,12214.27,50
HCPCS,63003,REMOVE SPINE LAMINA 1/2 THRC,,,6600.66,20338.07,19
HCPCS,63003,Remove spine lamina 1/2 thrc,,,3026.0,3503.79,8
HCPCS,63005,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,6572.0,4271.8,1.1,12214.27,50
HCPCS,63005,REMOVE SPINE LAMINA 1/2 LMBR,,,6600.66,20338.07,19
HCPCS,63005,Remove spine lamina 1/2 lmbr,,,3026.0,3503.79,8
HCPCS,63011,REMOVE SPINE LAMINA 1/2 SCRL,,,6600.66,20338.07,19
HCPCS,63011,Remove spine lamina 1/2 scrl,,,3026.0,3503.79,8
HCPCS,63012,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,6740.0,4381.0,1.1,12214.27,50
HCPCS,63012,REMOVE LAMINA/FACETS LUMBAR,,,6600.66,20338.07,19
HCPCS,63012,Remove lamina/facets lumbar,,,3026.0,3503.79,8
HCPCS,63015,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,8340.0,5421.0,1.1,12214.27,50
HCPCS,63015,REMOVE SPINE LAMINA >2 CRVCL,,,6600.66,20338.07,19
HCPCS,63015,Remove spine lamina >2 crvcl,,,3026.0,3503.79,8
HCPCS,63016,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,8812.0,5727.8,1.1,12214.27,50
HCPCS,63016,REMOVE SPINE LAMINA >2 THRC,,,6600.66,20338.07,19
HCPCS,63016,Remove spine lamina >2 thrc,,,3026.0,3503.79,8
HCPCS,63017,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,6932.0,4505.8,1.1,12214.27,50
HCPCS,63017,REMOVE SPINE LAMINA >2 LMBR,,,6600.66,20338.07,19
HCPCS,63017,Remove spine lamina >2 lmbr,,,3026.0,3503.79,8
HCPCS,63020,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,5964.0,3876.6,1.1,12214.27,50
HCPCS,63020,LAMOT DCMPRN NRV RT 1 CERV,,,6600.66,20338.07,19
HCPCS,63020,Lamot dcmprn nrv rt 1 cerv,,,3026.0,3503.79,8
HCPCS,63030,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,4800.0,3120.0,1.1,12214.27,50
HCPCS,63030,LAMOT DCMPRN NRV RT 1 LMBR,,,6600.66,20338.07,20
HCPCS,63030,Lamot dcmprn nrv rt 1 lmbr,,,3026.0,3503.79,8
HCPCS,63032,LAMOT DCMPRN NRV RT RPR ANULR DFCT 1NTRSPC LMBR,1100.0,715.0,1.1,1100.0,35
HCPCS,63032,Lamot rpr anulr dfct 1 lmbr,,,3026.0,3503.79,8
HCPCS,63035,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,1544.0,1003.6,1.1,1544.0,50
HCPCS,63035,Lamot dcmprn nrv rt ea addl,,,3026.0,3503.79,8
HCPCS,63040,LAMINOTOMY SINGLE CERVICAL,,,6600.66,20338.07,19
HCPCS,63040,Laminotomy single cervical,,,3026.0,3503.79,8
HCPCS,63042,LAMINOTOMY SINGLE LUMBAR,,,6600.66,20338.07,19
HCPCS,63042,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,7504.0,4877.6,1.1,12214.27,50
HCPCS,63042,Laminotomy single lumbar,,,3026.0,3503.79,8
HCPCS,63043,Laminotomy addl cervical,,,3026.0,3503.79,8
HCPCS,63044,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,3744.0,2433.6,1.1,3744.0,38
HCPCS,63044,Laminotomy addl lumbar,,,7403.35,8572.3,8
HCPCS,63045,LAM FACETEC & FORAMOT CRV,,,6600.66,20338.07,19
HCPCS,63045,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL,7180.0,4667.0,1.1,12214.27,50
HCPCS,63045,Lam facetec & foramot crv,,,3026.0,3503.79,8
HCPCS,63046,LAM FACETEC & FORAMOT THRC,,,6600.66,20338.07,19
HCPCS,63046,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC,7590.0,4933.5,1.1,12214.27,50
HCPCS,63046,Lam facetec & foramot thrc,,,3026.0,3503.79,8
HCPCS,63047,LAM FACETEC & FORAMOT LUMBAR,,,6600.66,20338.07,19
HCPCS,63047,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR,6763.0,4395.95,1.1,12214.27,50
HCPCS,63047,Lam facetec & foramot lumbar,,,3026.0,3503.79,8
HCPCS,63048,LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM,1527.0,992.55,1.1,1527.0,50
HCPCS,63048,Lam facetec &foramot ea addl,,,3026.0,3503.79,8
HCPCS,63050,Cervical laminoplsty 2/> seg,,,7403.35,8572.3,8
HCPCS,63050,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,9684.0,6294.6,1.1,9684.0,50
HCPCS,63051,C-laminoplasty w/graft/plate,,,7403.35,8572.3,8
HCPCS,63051,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,11224.0,7295.6,1.1,11224.0,50
HCPCS,63052,LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM,1700.0,1105.0,1.1,1700.0,50
HCPCS,63052,Lam facetc/frmt arthrd lum 1,,,7403.35,8572.3,8
HCPCS,63053,LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM,1512.0,982.8,1.1,1512.0,50
HCPCS,63053,Lam factc/frmt arthrd lum ea,,,7403.35,8572.3,8
HCPCS,63055,DECOMPRESS SPINAL CORD THRC,,,6600.66,20338.07,19
HCPCS,63055,Decompress spinal cord thrc,,,3026.0,3503.79,8
HCPCS,63055,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,9420.0,6123.0,1.1,12214.27,50
HCPCS,63056,DECOMPRESS SPINAL CORD LMBR,,,6600.66,20338.07,19
HCPCS,63056,Decompress spinal cord lmbr,,,3026.0,3503.79,8
HCPCS,63056,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,8744.0,5683.6,1.1,12214.27,50
HCPCS,63057,Decompress spine cord add-on,,,3026.0,3503.79,8
HCPCS,63057,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,2100.0,1365.0,1.1,2100.0,50
HCPCS,63064,DECOMPRESS SPINAL CORD THRC,,,6600.66,20338.07,19
HCPCS,63064,Decompress spinal cord thrc,,,3026.0,3503.79,8
HCPCS,63066,Decompress spine cord add-on,,,3026.0,3503.79,8
HCPCS,63075,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,7840.0,5096.0,1.1,12214.27,50
HCPCS,63075,NECK SPINE DISK SURGERY,,,6600.66,20338.07,19
HCPCS,63075,Neck spine disk surgery,,,7403.35,8572.3,8
HCPCS,63076,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,1616.0,1050.4,1.1,1616.0,50
HCPCS,63076,Neck spine disk surgery,,,7403.35,8572.3,8
HCPCS,63077,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,9152.0,5948.8,1.1,9152.0,50
HCPCS,63077,Spine disk surgery thorax,,,3026.0,3503.79,8
HCPCS,63078,Spine disk surgery thorax,,,7403.35,8572.3,8
HCPCS,63081,Remove vert body dcmprn crvl,,,7403.35,8572.3,8
HCPCS,63081,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,10440.0,6786.0,1.1,10440.0,50
HCPCS,63082,Remove vertebral body add-on,,,11158.03,12919.82,8
HCPCS,63082,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,1744.0,1133.6,1.1,1744.0,50
HCPCS,63085,Remove vert body dcmprn thrc,,,11158.03,12919.82,8
HCPCS,63085,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1.1,11788.0,72
HCPCS,63086,Remove vertebral body add-on,,,11158.03,12919.82,8
HCPCS,63086,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG,1276.0,829.4,1.1,1276.0,72
HCPCS,63087,Remov vertbr dcmprn thrclmbr,,,11158.03,12919.82,8
HCPCS,63087,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,15012.0,9757.8,1.1,15012.0,50
HCPCS,63088,Remove vertebral body add-on,,,11158.03,12919.82,8
HCPCS,63088,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,1728.0,1123.2,1.1,1728.0,50
HCPCS,63090,Remove vert body dcmprn lmbr,,,11158.03,12919.82,8
HCPCS,63090,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,12372.0,8041.8,1.1,12372.0,50
HCPCS,63091,Remove vertebral body add-on,,,11158.03,12919.82,8
HCPCS,63091,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,1212.0,787.8,1.1,1212.0,50
HCPCS,63101,Remove vert body dcmprn thrc,,,11158.03,12919.82,8
HCPCS,63101,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,13640.0,8866.0,1.1,13640.0,50
HCPCS,63102,Remove vert body dcmprn lmbr,,,11158.03,12919.82,8
HCPCS,63102,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,15004.0,9752.6,1.1,15004.0,50
HCPCS,63103,Remove vertebral body add-on,,,11158.03,12919.82,8
HCPCS,63103,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,2121.0,1378.65,1.1,2121.0,50
HCPCS,63170,Incise spinal cord tract(s),,,11158.03,12919.82,8
HCPCS,63172,Drainage of spinal cyst,,,3026.0,3503.79,8
HCPCS,63172,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,7904.0,5137.6,1.1,7904.0,50
HCPCS,63173,Drainage of spinal cyst,,,11158.03,12919.82,8
HCPCS,63180,Revise spinal cord ligaments,,,11158.03,12919.82,8
HCPCS,63182,Revise spinal cord ligaments,,,11158.03,12919.82,8
HCPCS,63185,Incise spine nrv half segmnt,,,3026.0,3503.79,8
HCPCS,63190,Incise spine nrv >2 segmnts,,,3026.0,3503.79,8
HCPCS,63191,Incise spine accessory nerve,,,3026.0,3503.79,8
HCPCS,63194,Incise spine & cord cervical,,,11158.03,12919.82,8
HCPCS,63195,Incise spine & cord thoracic,,,11158.03,12919.82,8
HCPCS,63196,Incise spine&cord 2 trx crvl,,,11158.03,12919.82,8
HCPCS,63197,Lam w/cordotomy 1stg thrc,,,11158.03,12919.82,8
HCPCS,63198,Incise spin&cord 2 stgs crvl,,,11158.03,12919.82,8
HCPCS,63199,Incise spin&cord 2 stgs thrc,,,11158.03,12919.82,8
HCPCS,63200,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,9434.0,6132.1,1.1,9434.0,50
HCPCS,63200,Release spinal cord lumbar,,,7403.35,8572.3,8
HCPCS,63250,Revise spinal cord vsls crvl,,,11158.03,12919.82,8
HCPCS,63251,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,17856.0,11606.4,1.1,17856.0,50
HCPCS,63251,Revise spinal cord vsls thrc,,,11158.03,12919.82,8
HCPCS,63252,Revise spine cord vsl thrlmb,,,11158.03,12919.82,8
HCPCS,63265,EXCISE INTRASPINL LESION CRV,,,6600.66,20338.07,19
HCPCS,63265,Excise intraspinl lesion crv,,,3026.0,3503.79,8
HCPCS,63265,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,9528.0,6193.2,1.1,12214.27,50
HCPCS,63266,EXCISE INTRSPINL LESION THRC,,,6600.66,20338.07,19
HCPCS,63266,Excise intrspinl lesion thrc,,,3026.0,3503.79,8
HCPCS,63266,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,9872.0,6416.8,1.1,12214.27,50
HCPCS,63267,EXCISE INTRSPINL LESION LMBR,,,6600.66,20338.07,19
HCPCS,63267,Excise intrspinl lesion lmbr,,,3026.0,3503.79,8
HCPCS,63267,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,7780.0,5057.0,1.1,12214.27,50
HCPCS,63268,EXCISE INTRSPINL LESION SCRL,,,6600.66,20338.07,19
HCPCS,63268,Excise intrspinl lesion scrl,,,3026.0,3503.79,8
HCPCS,63270,Excise intrspinl lesion crvl,,,7403.35,8572.3,8
HCPCS,63270,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,11920.0,7748.0,1.1,11920.0,50
HCPCS,63271,Excise intrspinl lesion thrc,,,11158.03,12919.82,8
HCPCS,63271,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,11968.0,7779.2,1.1,11968.0,50
HCPCS,63272,Excise intrspinl lesion lmbr,,,7403.35,8572.3,8
HCPCS,63272,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,11000.0,7150.0,1.1,11000.0,50
HCPCS,63273,Excise intrspinl lesion scrl,,,7403.35,8572.3,8
HCPCS,63275,Bx/exc xdrl spine lesn crvl,,,11158.03,12919.82,8
HCPCS,63275,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,10344.0,6723.6,1.1,10344.0,50
HCPCS,63276,Bx/exc xdrl spine lesn thrc,,,11158.03,12919.82,8
HCPCS,63276,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,10276.0,6679.4,1.1,10276.0,50
HCPCS,63277,Bx/exc xdrl spine lesn lmbr,,,11158.03,12919.82,8
HCPCS,63277,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,8956.0,5821.4,1.1,8956.0,50
HCPCS,63278,Bx/exc xdrl spine lesn scrl,,,11158.03,12919.82,8
HCPCS,63280,Bx/exc idrl spine lesn crvl,,,11158.03,12919.82,8
HCPCS,63280,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,12116.0,7875.4,1.1,12116.0,50
HCPCS,63281,Bx/exc idrl spine lesn thrc,,,11158.03,12919.82,8
HCPCS,63281,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,11996.0,7797.4,1.1,11996.0,50
HCPCS,63282,Bx/exc idrl spine lesn lmbr,,,7403.35,8572.3,8
HCPCS,63282,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,11260.0,7319.0,1.1,11260.0,50
HCPCS,63283,Bx/exc idrl spine lesn scrl,,,11158.03,12919.82,8
HCPCS,63285,Bx/exc idrl imed lesn cervl,,,11158.03,12919.82,8
HCPCS,63285,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,15220.0,9893.0,1.1,15220.0,50
HCPCS,63286,Bx/exc idrl imed lesn thrc,,,11158.03,12919.82,8
HCPCS,63286,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,15048.0,9781.2,1.1,15048.0,50
HCPCS,63287,Bx/exc idrl imed lesn thrlmb,,,11158.03,12919.82,8
HCPCS,63290,Bx/exc xdrl/idrl lsn any lvl,,,11158.03,12919.82,8
HCPCS,63290,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,16328.0,10613.2,1.1,16328.0,50
HCPCS,63295,Repair laminectomy defect,,,7403.35,8572.3,8
HCPCS,63300,Remove vert xdrl body crvcl,,,11158.03,12919.82,8
HCPCS,63300,VCRPEC LES 1 SGM XDRL CERVICAL,10720.0,6968.0,1.1,10720.0,50
HCPCS,63301,Remove vert xdrl body thrc,,,11158.03,12919.82,8
HCPCS,63302,Remove vert xdrl body thrlmb,,,11158.03,12919.82,8
HCPCS,63302,VCRPEC LES 1 SEG XDRL THRC THORACOLMBR,12460.0,8099.0,1.1,12460.0,50
HCPCS,63303,Remov vert xdrl bdy lmbr/sac,,,11158.03,12919.82,8
HCPCS,63304,Remove vert idrl body crvcl,,,11158.03,12919.82,8
HCPCS,63305,Remove vert idrl body thrc,,,11158.03,12919.82,8
HCPCS,63306,Remov vert idrl bdy thrclmbr,,,11158.03,12919.82,8
HCPCS,63307,Remov vert idrl bdy lmbr/sac,,,11158.03,12919.82,8
HCPCS,63308,Remove vertebral body add-on,,,11158.03,12919.82,8
HCPCS,63600,REMOVE SPINAL CORD LESION,,,1804.32,5473.19,19
HCPCS,63600,Remove spinal cord lesion,,,3026.0,3503.79,8
HCPCS,63610,STIMULATION OF SPINAL CORD,,,1804.32,5473.19,19
HCPCS,63610,Stimulation of spinal cord,,,3026.0,3503.79,8
HCPCS,63620,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,6864.0,4461.6,1.1,6864.0,50
HCPCS,63620,Srs spinal lesion,,,3184.72,3687.57,8
HCPCS,63621,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,1760.0,1144.0,1.1,1760.0,50
HCPCS,63621,Srs spinal lesion addl,,,3184.72,3687.57,8
HCPCS,63650,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,14277.5,9280.375,0.01,25409.0,159
HCPCS,63655,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,28681.5,18642.975,1.1,54375.57,111
HCPCS,63661,REMOVE SPINE ELTRD PERQ ARAY,,,1804.32,5473.19,19
HCPCS,63661,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,2235.0,1452.75,1.1,3297.28,53
HCPCS,63661,Remove spine eltrd perq aray,,,1720.7,1992.39,8
HCPCS,63662,REMOVE SPINE ELTRD PLATE,,,3177.58,9799.05,19
HCPCS,63662,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,4840.0,3146.0,1.1,5809.66,50
HCPCS,63662,Remove spine eltrd plate,,,1720.7,1992.39,8
HCPCS,63663,REVISE SPINE ELTRD PERQ ARAY,,,6029.34,17862.53,19
HCPCS,63663,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,3410.0,2216.5,1.1,11676.67,53
HCPCS,63664,REVISE SPINE ELTRD PLATE,,,10541.85,31231.28,19
HCPCS,63664,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,5069.0,3294.85,1.1,23258.37,50
HCPCS,63664,Revise spine eltrd plate,,,15220.57,17623.82,8
HCPCS,63685,INS/RPLC SPI NPG/RCVR POCKET,,,28156.99,86489.44,19
HCPCS,63685,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,2284.0,1484.6,1.1,53018.11,50
HCPCS,63685,Ins/rplc spi npg/rcvr pocket,,,15220.57,17623.82,8
HCPCS,63688,REV/RMV IMP SP NPG/R DTCH CN,,,3177.58,9799.05,19
HCPCS,63688,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,1914.0,1244.1,1.1,5809.66,50
HCPCS,63688,Rev/rmv imp sp npg/r dtch cn,,,1720.7,1992.39,8
HCPCS,63700,Repair of spinal herniation,,,3026.0,3503.79,8
HCPCS,63702,Repair of spinal herniation,,,3026.0,3503.79,8
HCPCS,63704,Repair of spinal herniation,,,3026.0,3503.79,8
HCPCS,63706,Repair of spinal herniation,,,3026.0,3503.79,8
HCPCS,63707,REPR DURAL/CSF LEAK,5060.0,3289.0,1.1,5060.0,50
HCPCS,63707,Repair spinal fluid leakage,,,3026.0,3503.79,8
HCPCS,63709,REPR DURAL/CSF LEAK W LAMINECTOMY,6260.0,4069.0,1.1,6260.0,50
HCPCS,63709,Repair spinal fluid leakage,,,7403.35,8572.3,8
HCPCS,63710,"DURAL GRAFT REPAIR,SPINE DEFECT",6160.0,4004.0,1.1,6160.0,50
HCPCS,63710,Graft repair of spine defect,,,7403.35,8572.3,8
HCPCS,63740,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM,5052.0,3283.8,1.1,5052.0,50
HCPCS,63740,Install spinal shunt,,,4252.42,4923.85,8
HCPCS,63741,INSTALL SPINAL SHUNT,,,5917.23,24597.37,19
HCPCS,63741,Install spinal shunt,,,4252.42,4923.85,8
HCPCS,63744,REVISION OF SPINAL SHUNT,,,3231.94,9574.94,19
HCPCS,63744,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,3576.0,2324.4,1.1,11373.82,50
HCPCS,63744,Revision of spinal shunt,,,4252.42,4923.85,8
HCPCS,63746,REMOVAL OF SPINAL SHUNT,,,1804.32,5473.19,19
HCPCS,63746,Removal of spinal shunt,,,865.36,1002.0,8
HCPCS,64400,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,1183.5,769.275,0.01,3398.0,297
HCPCS,64405,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,1225.5,796.575,0.01,3004.0,358
HCPCS,64408,INJECTION AA&/STRD VAGUS NERVE,330.0,214.5,1.1,505.34,53
HCPCS,64408,NJX AA&/STRD VAGUS NRV,,,272.75,860.34,19
HCPCS,64408,Njx aa&/strd vagus nrv,,,229.66,265.93,8
HCPCS,64415,INJECTION AA&/STRD BRACHIAL PLEXUS,6143.0,3992.95,122.8,6143.0,61
HCPCS,64415,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,3401.5,2210.975,0.01,6143.0,114
HCPCS,64416,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,792.0,514.8,1.1,1555.46,50
HCPCS,64416,NJX AA&/STRD BRCH PL NFS IMG,,,822.61,2479.04,19
HCPCS,64416,Njx aa&/strd brch pl nfs img,,,558.63,646.83,8
HCPCS,64417,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,3359.5,2183.6749999999997,0.01,6143.0,114
HCPCS,64418,INJECTION AA&/STRD SUPRASCAPULAR NERVE,2631.0,1710.1499999999999,0.01,4778.0,236
HCPCS,64420,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,2626.5,1707.225,0.01,4778.0,236
HCPCS,64421,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,3181.5,2067.975,0.01,6143.0,175
HCPCS,64425,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,2609.0,1695.85,0.01,4778.0,114
HCPCS,64430,INJECTION AA&/STRD PUDENDAL NERVE,6143.0,3992.95,0.01,6583.0,197
HCPCS,64435,INJECTION AA&/STRD PARACERVICAL NERVE,330.0,214.5,1.1,1180.93,53
HCPCS,64435,NJX AA&/STRD PARACRV NRV,,,639.87,1978.48,19
HCPCS,64435,Njx aa&/strd paracrv nrv,,,229.66,265.93,8
HCPCS,64445,INJECTION AA&/STRD SCIATIC NERVE,4778.0,3105.7,123.93,4778.0,61
HCPCS,64445,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,2695.0,1751.75,0.01,4778.0,114
HCPCS,64446,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,770.0,500.5,1.1,1555.46,50
HCPCS,64446,NJX AA&/STRD SC NRV NFS IMG,,,822.61,2479.04,19
HCPCS,64446,Njx aa&/strd sc nrv nfs img,,,558.63,646.83,8
HCPCS,64447,INJECTION AA&/STRD FEMORAL NERVE,4778.0,3105.7,111.38,4778.0,61
HCPCS,64447,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,2684.0,1744.6,0.01,4778.0,114
HCPCS,64448,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,739.0,480.35,1.1,1555.46,50
HCPCS,64448,NJX AA&/STRD FEM NRV NFS IMG,,,822.61,2479.04,19
HCPCS,64448,Njx aa&/strd fem nrv nfs img,,,558.63,646.83,8
HCPCS,64449,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,3351.0,2178.15,0.01,6143.0,111
HCPCS,64450,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,2554.0,1660.1,0.01,4778.0,480
HCPCS,64451,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,2723.5,1770.2749999999999,0.01,4778.0,113
HCPCS,64454,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,2723.5,1770.2749999999999,0.01,4778.0,174
HCPCS,64455,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,1183.5,769.275,0.01,3004.0,114
HCPCS,64461,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,2774.0,1803.1,0.01,4778.0,175
HCPCS,64462,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,903.0,586.95,0.01,3004.0,99
HCPCS,64463,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,2807.0,1824.55,1.1,4778.0,114
HCPCS,64466,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,2498.0,1623.7,1.1,4336.0,97
HCPCS,64467,THORACIC FASCIAL PLANE BLOCK UNI CONT INFUSION,766.0,497.9,1.1,766.0,51
HCPCS,64467,Thrc fascial pln blk uni nfs,,,229.66,265.93,8
HCPCS,64468,THORACIC FASCIAL PLANE BLOCK BI INJECTION,2535.5,1648.075,1.1,4336.0,97
HCPCS,64469,THORACIC FASCIAL PLANE BLOCK BI CONT INFUSION,805.0,523.25,1.1,1086.42,51
HCPCS,64469,Thrc fascial pln blk bi nfs,,,558.63,646.83,8
HCPCS,64473,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,671.5,436.475,1.1,3004.0,97
HCPCS,64474,LOWER XTR FASCIAL PLANE BLOCK UNI CONT INFUSION,735.0,477.75,1.1,735.0,51
HCPCS,64474,Lwr xtr fscl pln blk uni nfs,,,229.66,265.93,8
HCPCS,64479,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,3575.5,2324.075,0.01,6143.0,236
HCPCS,64480,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,944.5,613.925,0.01,3398.0,145
HCPCS,64483,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,3489.5,2268.1749999999997,0.01,6143.0,358
HCPCS,64484,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,961.0,624.65,0.01,3398.0,191
HCPCS,64486,TAP BLOCK UNILATERAL BY INJECTION(S),967.5,628.875,0.01,4001.0,145
HCPCS,64487,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),612.0,397.8,1.1,712.53,53
HCPCS,64487,Tap block uni by infusion,,,229.66,265.93,8
HCPCS,64488,TAP BLOCK BILATERAL BY INJECTION(S),616.0,400.4,1.1,616.0,53
HCPCS,64488,Tap block bi injection,,,558.63,646.83,8
HCPCS,64489,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),770.0,500.5,1.1,1157.73,53
HCPCS,64489,Tap block bi by infusion,,,558.63,646.83,8
HCPCS,64490,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,3472.0,2256.7999999999997,0.01,6143.0,175
HCPCS,64491,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,583.0,378.95,0.01,3004.0,145
HCPCS,64492,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,583.0,378.95,0.01,3004.0,145
HCPCS,64493,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,3406.0,2213.9,0.01,6143.0,358
HCPCS,64494,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1088.5,707.525,0.01,3398.0,283
HCPCS,64495,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,850.0,552.5,0.01,3398.0,237
HCPCS,64505,INJECTION ANES AGENT SPHENOPALATINE GANGLION,1317.5,856.375,0.01,3004.0,175
HCPCS,64510,"INJECTION, ANESTHETIC AGENT; STELLATE GANGLION",6143.0,3992.95,127.8,6143.0,61
HCPCS,64510,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,3340.0,2171.0,0.01,6143.0,175
HCPCS,64517,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,5628.0,3658.2,0.01,6143.0,175
HCPCS,64520,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,3368.5,2189.525,0.01,6143.0,236
HCPCS,64530,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,3419.0,2222.35,0.01,6143.0,114
HCPCS,64553,IMPLANT NEUROELECTRODES,,,10541.85,31231.28,19
HCPCS,64553,Implant neuroelectrodes,,,15220.57,17623.82,8
HCPCS,64555,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,13689.0,8897.85,0.01,17862.53,181
HCPCS,64561,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,13410.0,8716.5,0.01,24426.0,106
HCPCS,64566,PERC TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,264.0,171.6,1.1,505.34,53
HCPCS,64566,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2037.0,1324.05,0.01,3004.0,61
HCPCS,64567,PERQ ELEC NRV FIELD STIMJ CN,,,858.08,2542.14,13
HCPCS,64567,PERQ ELEC NRV FIELD STIMJ CRANIAL NRV W/O IMPLTJ,660.0,429.0,1.1,2941.43,35
HCPCS,64567,Perq elec nrv field stimj cn,,,427.56,495.07,8
HCPCS,64568,OPN IMPLTJ CRNL NRV NEA&PG,,,28156.99,123455.58,19
HCPCS,64568,Opn impltj crnl nrv nea&pg,,,15220.57,17623.82,8
HCPCS,64569,REVISE/REPL VAGUS N ELTRD,,,10541.85,31231.28,19
HCPCS,64569,Revise/repl vagus n eltrd,,,15220.57,17623.82,8
HCPCS,64570,REMOVE VAGUS N ELTRD,,,3231.94,9574.94,19
HCPCS,64570,Remove vagus n eltrd,,,1720.7,1992.39,8
HCPCS,64575,OPEN IMPLANTATION NEA PERIPHERAL NERVE,1768.0,1149.2,1.1,23258.37,50
HCPCS,64575,OPN IMPLTJ NEA PERPH NERVE,,,10541.85,31231.28,19
HCPCS,64575,Opn impltj nea perph nerve,,,15220.57,17623.82,8
HCPCS,64580,OPEN IMPLANTATION NEA NEUROMUSCULAR,1676.0,1089.4,1.1,37350.66,50
HCPCS,64580,OPN IMPLTJ NEA NEUROMUSCULAR,,,18354.0,54375.57,19
HCPCS,64580,Opn impltj nea neuromuscular,,,15220.57,17623.82,8
HCPCS,64581,OPEN IMPLANTATION NEA SACRAL NERVE,5368.0,3489.2,1.1,11676.67,50
HCPCS,64581,OPN IMPLTJ NEA SACRAL NERVE,,,6029.34,17862.53,19
HCPCS,64582,OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR,5600.0,3640.0,1.1,53018.11,50
HCPCS,64582,OPN MPLTJ HPGLSL NSTM ARY PG,,,28156.99,86489.44,19
HCPCS,64582,Opn mpltj hpglsl nstm ary pg,,,15220.57,17623.82,8
HCPCS,64583,REV/RPLCT HPGLSL NSTM ARY PG,,,10541.85,31231.28,19
HCPCS,64583,REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR,5800.0,3770.0,1.1,23258.37,50
HCPCS,64584,REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR,4800.0,3120.0,1.1,11373.82,50
HCPCS,64584,RMVL HPGLSL NSTIM ARY PG,,,3231.94,9574.94,19
HCPCS,64584,Rmvl hpglsl nstim ary pg,,,1720.7,1992.39,8
HCPCS,64585,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,12286.5,7986.225,0.01,23729.0,236
HCPCS,64590,INS/RPL PRPH SAC/GSTR NPG/R,,,18354.0,54375.57,19
HCPCS,64590,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,2244.0,1458.6,1.1,37350.66,53
HCPCS,64590,Ins/rpl prph sac/gstr npg/r,,,15220.57,17623.82,8
HCPCS,64595,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,12622.5,8204.625,1.1,23729.0,114
HCPCS,64595,REVISION/RMVL PERIPHERAL/GASTRIC NPGR,23729.0,15423.85,0.01,23729.0,61
HCPCS,64596,INS/RPLCMT PRQ ELTRD RA PN 1,,,10541.85,31231.28,19
HCPCS,64596,INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA,2856.0,1856.4,1.1,23258.37,31
HCPCS,64597,INSJ/RPLCMT PERQ ELTRD RA PN INT NSTIM EA ADD RA,2856.0,1856.4,1.1,2856.0,31
HCPCS,64598,REVISION/REMOVAL NSTIM ELTRD ARRAY PN INT NSTIM,1047.0,680.55,1.1,5809.66,31
HCPCS,64598,REVJ/RMVL NEA PN W/INT NSTIM,,,3177.58,9799.05,19
HCPCS,64598,Revj/rmvl nea pn w/int nstim,,,1720.7,1992.39,8
HCPCS,64600,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,3769.5,2450.1749999999997,0.01,6143.0,114
HCPCS,64605,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,2260.0,1469.0,1.1,3297.28,53
HCPCS,64605,INJECTION TREATMENT OF NERVE,,,1804.32,5473.19,19
HCPCS,64605,Injection treatment of nerve,,,558.63,646.83,8
HCPCS,64610,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,2880.0,1872.0,1.1,3297.28,53
HCPCS,64610,INJECTION TREATMENT OF NERVE,,,1804.32,5473.19,19
HCPCS,64610,Injection treatment of nerve,,,558.63,646.83,8
HCPCS,64611,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BI,412.0,267.8,1.1,505.34,53
HCPCS,64611,CHEMODENERV SALIV GLANDS,,,272.75,860.34,19
HCPCS,64611,Chemodenerv saliv glands,,,229.66,265.93,8
HCPCS,64612,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,1328.5,863.525,0.01,3004.0,114
HCPCS,64615,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,1425.5,926.575,0.01,3004.0,114
HCPCS,64616,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,1355.0,880.75,0.01,3004.0,114
HCPCS,64617,CHEMODENER MUSCLE LARYNX EMG,,,639.87,1978.48,19
HCPCS,64617,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,836.0,543.4,1.1,1180.93,53
HCPCS,64617,Chemodener muscle larynx emg,,,229.66,265.93,8
HCPCS,64620,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,3707.5,2409.875,0.01,6143.0,114
HCPCS,64624,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,7237.0,4704.05,0.01,13474.0,174
HCPCS,64625,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,7415.0,4819.75,0.01,13474.0,174
HCPCS,64628,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,2860.0,1859.0,1.1,22471.68,50
HCPCS,64628,TRML DSTRJ IOS BVN 1ST 2 L/S,,,11888.68,35984.87,19
HCPCS,64628,Trml dstrj ios bvn 1st 2 l/s,,,7403.35,8572.3,8
HCPCS,64629,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,1508.0,980.2,1.1,1508.0,50
HCPCS,64629,Trml dstrj ios bvn ea addl,,,7403.35,8572.3,8
HCPCS,64630,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,3742.5,2432.625,0.01,6143.0,114
HCPCS,64632,DEST BY NEUROLYTIC AGENT; PLANTAR COMM DIG NERVE,541.0,351.65,1.1,541.0,53
HCPCS,64632,N BLOCK INJ COMMON DIGIT,,,272.75,860.34,19
HCPCS,64632,N block inj common digit,,,229.66,265.93,8
HCPCS,64633,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,7467.5,4853.875,0.01,13474.0,236
HCPCS,64634,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,747.5,485.875,0.01,3398.0,191
HCPCS,64635,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,7467.5,4853.875,0.01,13474.0,236
HCPCS,64636,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,1888.5,1227.525,0.01,3398.0,191
HCPCS,64640,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,3507.0,2279.5499999999997,0.01,6143.0,175
HCPCS,64642,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,2752.0,1788.8,0.01,4778.0,114
HCPCS,64643,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,1651.5,1073.4750000000001,0.01,3004.0,99
HCPCS,64644,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,2789.5,1813.175,0.01,4778.0,114
HCPCS,64645,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,1420.5,923.3249999999999,0.01,3004.0,99
HCPCS,64646,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,2785.0,1810.25,0.01,4778.0,114
HCPCS,64647,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,2811.0,1827.1499999999999,0.01,4778.0,114
HCPCS,64650,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,1158.5,753.025,0.01,3004.0,114
HCPCS,64653,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,1194.5,776.425,0.01,3004.0,114
HCPCS,64654,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,92421.0,60073.65,1.1,180002.0,90
HCPCS,64655,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,9629.5,6259.174999999999,1.1,14287.0,90
HCPCS,64656,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,17525.0,11391.25,1.1,86489.44,90
HCPCS,64657,REMOVAL BAT MODULATION SYSTEM TOTAL SYSTEM,5337.0,3469.05,1.1,5337.0,35
HCPCS,64657,RMVL BAT MODULJ SYS TOT SYS,,,3231.94,9574.94,13
HCPCS,64657,Rmvl bat modulj sys tot sys,,,1720.7,1992.39,8
HCPCS,64658,REMOVAL BAT MODULATION SYSTEM LEAD ONLY,3938.0,2559.7,1.1,3938.0,35
HCPCS,64658,RMVL BAT MODUL SYS LEAD ONLY,,,3307.59,9799.05,13
HCPCS,64658,Rmvl bat modul sys lead only,,,1720.7,1992.39,8
HCPCS,64659,REMOVAL BAT MODULATION SYSTEM PG ONLY,3621.0,2353.65,1.1,3621.0,35
HCPCS,64659,RMVL BAT MODULJ SYS PG ONLY,,,3307.59,9799.05,13
HCPCS,64659,Rmvl bat modulj sys pg only,,,1720.7,1992.39,8
HCPCS,64680,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,3659.0,2378.35,0.01,6143.0,114
HCPCS,64681,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,1512.0,982.8,1.1,1555.46,53
HCPCS,64681,INJECTION TREATMENT OF NERVE,,,822.61,2479.04,19
HCPCS,64681,Injection treatment of nerve,,,558.63,646.83,8
HCPCS,64702,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,2504.0,1627.6,1.1,3297.28,50
HCPCS,64702,REVISE FINGER/TOE NERVE,,,1804.32,5473.19,19
HCPCS,64702,Revise finger/toe nerve,,,865.36,1002.0,8
HCPCS,64704,NEUROPLASTY NERVE HAND/FOOT,1876.0,1219.4,1.1,3297.28,50
HCPCS,64704,REVISE HAND/FOOT NERVE,,,1804.32,5473.19,19
HCPCS,64704,Revise hand/foot nerve,,,865.36,1002.0,8
HCPCS,64708,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,2544.0,1653.6,1.1,3297.28,50
HCPCS,64708,REVISE ARM/LEG NERVE,,,1804.32,5473.19,19
HCPCS,64708,Revise arm/leg nerve,,,865.36,1002.0,8
HCPCS,64712,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,3228.0,2098.2,1.1,3297.28,50
HCPCS,64712,REVISION OF SCIATIC NERVE,,,1804.32,5473.19,19
HCPCS,64712,Revision of sciatic nerve,,,2822.5,3268.16,8
HCPCS,64713,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,4560.0,2964.0,1.1,4560.0,50
HCPCS,64713,REVISION OF ARM NERVE(S),,,1804.32,5473.19,19
HCPCS,64713,Revision of arm nerve(s),,,2822.5,3268.16,8
HCPCS,64714,REVISE LOW BACK NERVE(S),,,1804.32,5473.19,19
HCPCS,64714,Revise low back nerve(s),,,2822.5,3268.16,8
HCPCS,64716,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,3076.0,1999.4,1.1,3297.28,50
HCPCS,64716,REVISION OF CRANIAL NERVE,,,1804.32,5473.19,19
HCPCS,64716,Revision of cranial nerve,,,2822.5,3268.16,8
HCPCS,64718,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,2904.0,1887.6,1.1,3297.28,50
HCPCS,64718,REVISE ULNAR NERVE AT ELBOW,,,1804.32,5473.19,19
HCPCS,64718,Revise ulnar nerve at elbow,,,865.36,1002.0,8
HCPCS,64719,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,1988.0,1292.2,1.1,3297.28,50
HCPCS,64719,REVISE ULNAR NERVE AT WRIST,,,1804.32,5473.19,19
HCPCS,64719,Revise ulnar nerve at wrist,,,865.36,1002.0,8
HCPCS,64721,CARPAL TUNNEL SURGERY,,,1804.32,5473.19,19
HCPCS,64721,Carpal tunnel surgery,,,865.36,1002.0,8
HCPCS,64721,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,1988.0,1292.2,1.1,3297.28,53
HCPCS,64722,DECOMPRESSION UNSPEC NERVE,,,1804.32,5473.19,19
HCPCS,64722,Decompression unspec nerve,,,865.36,1002.0,8
HCPCS,64726,DCMPRN PLANTAR DIGITAL NERVE,,,1804.32,5473.19,19
HCPCS,64726,Dcmprn plantar digital nerve,,,865.36,1002.0,8
HCPCS,64727,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,1240.0,806.0,1.1,1240.0,50
HCPCS,64727,Internal neurolysis,,,2822.5,3268.16,8
HCPCS,64728,DCMPRN MEDIAN NRV AT CARPL TUNL PERQ BALO DILAT,1188.0,772.2,1.1,3441.81,35
HCPCS,64728,DCMPRN MEDIAN NRV CARPL TUNL,,,1847.43,5473.19,13
HCPCS,64728,Dcmprn median nrv carpl tunl,,,865.36,1002.0,8
HCPCS,64732,INCISION OF BROW NERVE,,,1804.32,5473.19,19
HCPCS,64732,Incision of brow nerve,,,865.36,1002.0,8
HCPCS,64734,INCISION OF CHEEK NERVE,,,1804.32,5473.19,19
HCPCS,64734,Incision of cheek nerve,,,865.36,1002.0,8
HCPCS,64736,INCISION OF CHIN NERVE,,,1804.32,5473.19,19
HCPCS,64736,Incision of chin nerve,,,865.36,1002.0,8
HCPCS,64738,INCISION OF JAW NERVE,,,1804.32,5473.19,19
HCPCS,64738,Incision of jaw nerve,,,865.36,1002.0,8
HCPCS,64740,INCISION OF TONGUE NERVE,,,1804.32,5473.19,19
HCPCS,64740,Incision of tongue nerve,,,865.36,1002.0,8
HCPCS,64742,INCISION OF FACIAL NERVE,,,1804.32,5473.19,19
HCPCS,64742,Incision of facial nerve,,,865.36,1002.0,8
HCPCS,64744,INCISE NERVE BACK OF HEAD,,,1804.32,5473.19,19
HCPCS,64744,Incise nerve back of head,,,2822.5,3268.16,8
HCPCS,64746,INCISE DIAPHRAGM NERVE,,,1804.32,5473.19,19
HCPCS,64746,Incise diaphragm nerve,,,2822.5,3268.16,8
HCPCS,64755,Incision of stomach nerves,,,1611.33,1865.75,8
HCPCS,64760,Incision of vagus nerve,,,1611.33,1865.75,8
HCPCS,64763,INCISE HIP/THIGH NERVE,,,1804.32,5473.19,19
HCPCS,64763,Incise hip/thigh nerve,,,865.36,1002.0,8
HCPCS,64766,INCISE HIP/THIGH NERVE,,,1804.32,5473.19,19
HCPCS,64766,Incise hip/thigh nerve,,,865.36,1002.0,8
HCPCS,64771,SEVER CRANIAL NERVE,,,1804.32,5473.19,19
HCPCS,64771,Sever cranial nerve,,,2822.5,3268.16,8
HCPCS,64772,INCISION OF SPINAL NERVE,,,1804.32,5473.19,19
HCPCS,64772,Incision of spinal nerve,,,865.36,1002.0,8
HCPCS,64772,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,3136.0,2038.4,1.1,3297.28,50
HCPCS,64774,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,2320.0,1508.0,1.1,3297.28,50
HCPCS,64774,REMOVE SKIN NERVE LESION,,,1804.32,5473.19,19
HCPCS,64774,Remove skin nerve lesion,,,865.36,1002.0,8
HCPCS,64776,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,2240.0,1456.0,1.1,3297.28,50
HCPCS,64776,REMOVE DIGIT NERVE LESION,,,1804.32,5473.19,19
HCPCS,64776,Remove digit nerve lesion,,,865.36,1002.0,8
HCPCS,64778,Digit nerve surgery add-on,,,865.36,1002.0,8
HCPCS,64782,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,2744.0,1783.6,1.1,3297.28,50
HCPCS,64782,REMOVE LIMB NERVE LESION,,,1804.32,5473.19,19
HCPCS,64782,Remove limb nerve lesion,,,865.36,1002.0,8
HCPCS,64783,Limb nerve surgery add-on,,,865.36,1002.0,8
HCPCS,64784,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,4248.0,2761.2,1.1,4248.0,50
HCPCS,64784,REMOVE NERVE LESION,,,1804.32,5473.19,19
HCPCS,64784,Remove nerve lesion,,,865.36,1002.0,8
HCPCS,64786,REMOVE SCIATIC NERVE LESION,,,3231.94,9574.94,19
HCPCS,64786,Remove sciatic nerve lesion,,,2822.5,3268.16,8
HCPCS,64787,IMPLANT NERVE END TO BONE/MUSC,1716.0,1115.4,1.1,1716.0,50
HCPCS,64787,Implant nerve end,,,2822.5,3268.16,8
HCPCS,64788,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,2096.0,1362.4,1.1,3297.28,50
HCPCS,64788,REMOVE SKIN NERVE LESION,,,1804.32,5473.19,19
HCPCS,64788,Remove skin nerve lesion,,,865.36,1002.0,8
HCPCS,64790,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,4840.0,3146.0,1.1,4840.0,50
HCPCS,64790,REMOVAL OF NERVE LESION,,,1804.32,5473.19,19
HCPCS,64790,Removal of nerve lesion,,,2822.5,3268.16,8
HCPCS,64792,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,6344.0,4123.6,1.1,11373.82,50
HCPCS,64792,REMOVAL OF NERVE LESION,,,3231.94,9574.94,19
HCPCS,64792,Removal of nerve lesion,,,2822.5,3268.16,8
HCPCS,64795,BIOPSY OF NERVE,1204.0,782.6,1.1,5473.19,69
HCPCS,64795,Biopsy of nerve,,,865.36,1002.0,8
HCPCS,64802,SYMPATHECTOMY CERVICAL,,,1804.32,5473.19,19
HCPCS,64802,Sympathectomy cervical,,,865.36,1002.0,8
HCPCS,64804,SYMPATHECTOMY CERVICOTHORAC,,,1804.32,5473.19,19
HCPCS,64804,Sympathectomy cervicothorac,,,2822.5,3268.16,8
HCPCS,64809,Sympathectomy thoracolumbar,,,2822.5,3268.16,8
HCPCS,64818,Sympathectomy lumbar,,,2822.5,3268.16,8
HCPCS,64820,SYMPATHECTOMY DIGITAL ARTERY,,,1804.32,5473.19,19
HCPCS,64820,"SYMPATHECTOMY,DIGITAL ARTERIES",4296.0,2792.4,1.1,4296.0,50
HCPCS,64820,Sympathectomy digital artery,,,865.36,1002.0,8
HCPCS,64821,SYMPATHECTOMY RADIAL ARTERY,3732.0,2425.8,1.1,9170.92,69
HCPCS,64821,Sympathectomy radial artery,,,865.36,1002.0,8
HCPCS,64822,SYMPATHECTOMY ULNAR ARTERY,3732.0,2425.8,1.1,9170.92,69
HCPCS,64822,Sympathectomy ulnar artery,,,865.36,1002.0,8
HCPCS,64823,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,4376.0,2844.4,1.1,5526.53,50
HCPCS,64823,SYMPATHECTOMY SUPFC PALMAR,,,2997.95,9170.92,19
HCPCS,64823,Sympathectomy supfc palmar,,,865.36,1002.0,8
HCPCS,64831,REPAIR OF DIGIT NERVE,,,1804.32,5473.19,19
HCPCS,64831,Repair of digit nerve,,,865.36,1002.0,8
HCPCS,64831,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,3664.0,2381.6,1.1,3664.0,50
HCPCS,64832,Repair nerve add-on,,,2822.5,3268.16,8
HCPCS,64832,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,2260.0,1469.0,1.1,2260.0,50
HCPCS,64834,REPAIR OF HAND OR FOOT NERVE,,,3231.94,9574.94,19
HCPCS,64834,Repair of hand or foot nerve,,,2822.5,3268.16,8
HCPCS,64834,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,4324.0,2810.6,1.1,11373.82,50
HCPCS,64835,REPAIR OF HAND OR FOOT NERVE,,,3231.94,9574.94,19
HCPCS,64835,Repair of hand or foot nerve,,,2822.5,3268.16,8
HCPCS,64835,SUTURE 1 NERVE MEDIAN MOTOR THENAR,5161.0,3354.65,1.1,11373.82,50
HCPCS,64836,REPAIR OF HAND OR FOOT NERVE,,,3231.94,9574.94,19
HCPCS,64836,Repair of hand or foot nerve,,,2822.5,3268.16,8
HCPCS,64836,SUTURE 1 NERVE ULNAR MOTOR,4692.0,3049.8,1.1,11373.82,50
HCPCS,64837,Repair nerve add-on,,,2822.5,3268.16,8
HCPCS,64837,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,2500.0,1625.0,1.1,2500.0,50
HCPCS,64840,REPAIR OF LEG NERVE,,,5917.23,24597.37,19
HCPCS,64840,Repair of leg nerve,,,2822.5,3268.16,8
HCPCS,64856,REPAIR/TRANSPOSE NERVE,,,5917.23,24597.37,19
HCPCS,64856,Repair/transpose nerve,,,2822.5,3268.16,8
HCPCS,64856,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,6028.0,3918.2,1.1,11373.82,50
HCPCS,64857,REPAIR ARM/LEG NERVE,,,3231.94,9574.94,19
HCPCS,64857,Repair arm/leg nerve,,,2822.5,3268.16,8
HCPCS,64857,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,6328.0,4113.2,1.1,11373.82,50
HCPCS,64858,REPAIR SCIATIC NERVE,,,1804.32,5473.19,19
HCPCS,64858,Repair sciatic nerve,,,2822.5,3268.16,8
HCPCS,64859,Nerve surgery,,,2822.5,3268.16,8
HCPCS,64859,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,1700.0,1105.0,1.1,1700.0,50
HCPCS,64861,REPAIR OF ARM NERVES,,,1804.32,5473.19,19
HCPCS,64861,Repair of arm nerves,,,2822.5,3268.16,8
HCPCS,64862,REPAIR OF LOW BACK NERVES,,,3231.94,9574.94,19
HCPCS,64862,Repair of low back nerves,,,2822.5,3268.16,8
HCPCS,64864,REPAIR OF FACIAL NERVE,,,5917.23,24597.37,19
HCPCS,64864,Repair of facial nerve,,,2822.5,3268.16,8
HCPCS,64864,SUTURE FACIAL NERVE EXTRACRANIAL,5900.0,3835.0,1.1,11373.82,50
HCPCS,64865,REPAIR OF FACIAL NERVE,,,3231.94,9574.94,19
HCPCS,64865,Repair of facial nerve,,,2822.5,3268.16,8
HCPCS,64866,Fusion of facial/other nerve,,,2822.5,3268.16,8
HCPCS,64868,ANAST FACIAL-HYPOGLOSSAL NERVE,5960.0,3874.0,1.1,5960.0,50
HCPCS,64868,Fusion of facial/other nerve,,,2822.5,3268.16,8
HCPCS,64872,Subsequent repair of nerve,,,2822.5,3268.16,8
HCPCS,64874,Repair & revise nerve add-on,,,2822.5,3268.16,8
HCPCS,64876,"REPAIR NERVE DELAY,SHORTEN BONE",1348.0,876.2,1.1,1348.0,50
HCPCS,64876,Repair nerve/shorten bone,,,2822.5,3268.16,8
HCPCS,64885,NERVE GRAFT HEAD/NECK <4 CM,,,5917.23,24597.37,19
HCPCS,64885,Nerve graft head/neck <4 cm,,,2822.5,3268.16,8
HCPCS,64886,NERVE GRAFT HEAD/NECK >4 CM,,,5917.23,24597.37,19
HCPCS,64886,Nerve graft head/neck >4 cm,,,2822.5,3268.16,8
HCPCS,64890,NRV GRF 1STRND HND/FOOT <4CM,,,5917.23,24597.37,19
HCPCS,64890,Nrv grf 1strnd hnd/foot <4cm,,,2822.5,3268.16,8
HCPCS,64891,NRV GRF 1STRND HND/FOOT >4CM,,,5917.23,24597.37,19
HCPCS,64891,Nrv grf 1strnd hnd/foot >4cm,,,2822.5,3268.16,8
HCPCS,64892,"NERVE GRAFT,ARM/LEG,ONE,UP TO 4CM",6296.0,4092.4,1.1,11373.82,50
HCPCS,64892,NRV GRF 1STRND ARM/LEG <4CM,,,5917.23,24597.37,19
HCPCS,64892,Nrv grf 1strnd arm/leg <4cm,,,2822.5,3268.16,8
HCPCS,64893,NRV GRF 1STRND ARM/LEG >4 CM,,,3231.94,9574.94,19
HCPCS,64893,Nrv grf 1strnd arm/leg >4 cm,,,2822.5,3268.16,8
HCPCS,64895,NRV GRF MLTST HND/FOOT <4 CM,,,5917.23,24597.37,19
HCPCS,64895,Nrv grf mltst hnd/foot <4 cm,,,2822.5,3268.16,8
HCPCS,64896,NRV GRF MLTST HND/FOOT >4 CM,,,5917.23,24597.37,19
HCPCS,64896,Nrv grf mltst hnd/foot >4 cm,,,2822.5,3268.16,8
HCPCS,64897,NRV GRF MLTST ARM/LEG <4 CM,,,5917.23,24597.37,19
HCPCS,64897,Nrv grf mltst arm/leg <4 cm,,,2822.5,3268.16,8
HCPCS,64898,NERVE GRAFT MULTI STR ARM/LEG; > 4 CM,8388.0,5452.2,1.1,11373.82,50
HCPCS,64898,NRV GRF MLTST ARM/LEG >4 CM,,,5917.23,24597.37,19
HCPCS,64898,Nrv grf mltst arm/leg >4 cm,,,2822.5,3268.16,8
HCPCS,64901,Nerve graft add-on,,,2822.5,3268.16,8
HCPCS,64902,Nerve graft add-on,,,2822.5,3268.16,8
HCPCS,64905,NERVE PEDICLE TRANSFER,,,5917.23,24597.37,19
HCPCS,64905,"NERVE PEDICLE XFER,FIRST STAGE",6044.0,3928.6,1.1,11373.82,50
HCPCS,64905,Nerve pedicle transfer,,,2822.5,3268.16,8
HCPCS,64907,NERVE PEDICLE TRANSFER,,,5917.23,24597.37,19
HCPCS,64907,Nerve pedicle transfer,,,2822.5,3268.16,8
HCPCS,64910,NERVE REPAIR W/ALLOGRAFT,,,5917.23,24597.37,19
HCPCS,64910,NERVE REPAIR W/CONDUIT EACH NERVE,4629.0,3008.85,1.1,11373.82,50
HCPCS,64910,Nerve repair w/allograft,,,2822.5,3268.16,8
HCPCS,64911,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,5600.0,3640.0,1.1,11373.82,50
HCPCS,64911,NEURORRAPHY W/VEIN AUTOGRAFT,,,5917.23,24597.37,19
HCPCS,64911,Neurorraphy w/vein autograft,,,2822.5,3268.16,8
HCPCS,64912,NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND,4800.0,3120.0,1.1,11373.82,50
HCPCS,64912,NRV RPR W/NRV ALGRFT 1ST,,,5917.23,24597.37,19
HCPCS,64912,Nrv rpr w/nrv algrft 1st,,,2822.5,3268.16,8
HCPCS,64913,NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND,1200.0,780.0,1.1,1200.0,50
HCPCS,64913,Nrv rpr w/nrv algrft ea addl,,,2822.5,3268.16,8
HCPCS,64999,APPLICATION OF QUTENZA (CAPSAICIN 8% TOPICAL SYSTEM) (COMP CODE,488.0,317.2,0.01,505.34,28
HCPCS,64999,ENDOS TRANSNASAL INTRACRANIAL BIOPSY (COMP CODE 61570),8526.0,5541.9,0.01,8526.0,28
HCPCS,64999,"ERECTOR SPINAE BLOCKAGE, RIGHT T7 UNDER FLUOROSCOPIC GUIDANCE (C",569.0,369.85,0.01,569.0,28
HCPCS,64999,GANGLION IMPAR BLOCK INJ,419.0,272.35,0.01,505.34,28
HCPCS,64999,GANGLION OF IMPAR BLOCKADE UNDER FLUOROSCOPIC GUIDANCE (COMP COD,171.0,111.15,0.01,505.34,28
HCPCS,64999,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),3659.0,2378.35,0.01,6143.0,89
HCPCS,64999,INJ ANES AGENT FAC NERVE,817.0,531.05,229.66,3004.0,61
HCPCS,64999,"INJ, ANESTHETIC AGENT; CERVICAL PLEXUS (COMP 64425)",578.0,375.7,0.01,578.0,28
HCPCS,64999,LARYNGEAL REINNERVATION USING CERVICAL NERVE BRANCHES (COMP CODE,6059.0,3938.35,0.01,6059.0,28
HCPCS,64999,LASER INTERSTITIAL THERMAL THERAPY(LITT,10174.0,6613.1,0.01,10174.0,28
HCPCS,64999,MASSETER NRV TO FAC NRV ANASTOMOSIS (COMP 64865),4917.0,3196.05,0.01,4917.0,28
HCPCS,64999,NERVE WRAPPING (COMP CODE 15271),646.0,419.9,0.01,646.0,28
HCPCS,64999,PECS 1 & PECS 2 UNILAT CONTINUOUS INFUSION CATH (COMP CODE 64487,629.0,408.85,0.01,629.0,28
HCPCS,64999,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),566.0,367.9,0.01,566.0,28
HCPCS,64999,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),1225.5,796.575,0.01,3398.0,89
HCPCS,64999,TRANSPALATAL APPROACH FOR REMOVAL OF FOREIGN BODY (61575),14624.0,9505.6,0.01,14624.0,28
HCPCS,64999,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 15271",160.0,104.0,0.01,505.34,28
HCPCS,64999,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 62223",2410.0,1566.5,0.01,2410.0,28
HCPCS,64999,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",474.0,308.1,0.01,505.34,28
HCPCS,64999,"UNLISTED PROC, INJECTION, ANESTHETIC AGENT, CERVICAL PLEXUS (COM",488.0,317.2,0.01,505.34,28
HCPCS,64999,"UNLISTED PROC, NERVOUS SYSTEM COMPARED TO 64905",4986.0,3240.9,0.01,4986.0,28
HCPCS,65091,REVISE EYE,,,3484.33,11019.11,19
HCPCS,65091,Revise eye,,,1684.99,1951.04,8
HCPCS,65093,REVISE EYE WITH IMPLANT,,,3484.33,11019.11,19
HCPCS,65093,Revise eye with implant,,,1684.99,1951.04,8
HCPCS,65101,REMOVAL OF EYE,,,3484.33,11019.11,19
HCPCS,65101,Removal of eye,,,1684.99,1951.04,8
HCPCS,65103,REMOVE EYE/INSERT IMPLANT,,,3484.33,11019.11,19
HCPCS,65103,Remove eye/insert implant,,,1684.99,1951.04,8
HCPCS,65105,REMOVE EYE/ATTACH IMPLANT,,,3484.33,11019.11,19
HCPCS,65105,Remove eye/attach implant,,,1684.99,1951.04,8
HCPCS,65110,REMOVAL OF EYE,,,3484.33,11019.11,19
HCPCS,65110,Removal of eye,,,1684.99,1951.04,8
HCPCS,65112,REMOVE EYE/REVISE SOCKET,,,3484.33,11019.11,19
HCPCS,65112,Remove eye/revise socket,,,1684.99,1951.04,8
HCPCS,65114,REMOVE EYE/REVISE SOCKET,,,3484.33,11019.11,19
HCPCS,65114,Remove eye/revise socket,,,1684.99,1951.04,8
HCPCS,65125,REVISE OCULAR IMPLANT,,,2155.61,6663.73,19
HCPCS,65125,Revise ocular implant,,,1684.99,1951.04,8
HCPCS,65130,INSERT OCULAR IMPLANT,,,3484.33,11019.11,19
HCPCS,65130,Insert ocular implant,,,1684.99,1951.04,8
HCPCS,65135,INSERT OCULAR IMPLANT,,,3484.33,11019.11,19
HCPCS,65135,Insert ocular implant,,,1684.99,1951.04,8
HCPCS,65140,ATTACH OCULAR IMPLANT,,,3484.33,11019.11,19
HCPCS,65140,Attach ocular implant,,,1684.99,1951.04,8
HCPCS,65150,REVISE OCULAR IMPLANT,,,3484.33,11019.11,19
HCPCS,65150,Revise ocular implant,,,1684.99,1951.04,8
HCPCS,65155,REINSERT OCULAR IMPLANT,,,3484.33,11019.11,19
HCPCS,65155,Reinsert ocular implant,,,1684.99,1951.04,8
HCPCS,65175,REMOVAL OF OCULAR IMPLANT,,,3484.33,11019.11,19
HCPCS,65175,Removal of ocular implant,,,1684.99,1951.04,8
HCPCS,65205,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,404.5,262.925,1.1,2453.0,112
HCPCS,65210,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,1052.0,683.8000000000001,1.1,2453.0,114
HCPCS,65220,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1074.0,698.1,1.1,2453.0,114
HCPCS,65222,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,481.5,312.975,1.1,2453.0,114
HCPCS,65235,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,10491.0,6819.15,302.55,10491.0,61
HCPCS,65260,REMOVE FOREIGN BODY FROM EYE,,,2107.35,6468.48,19
HCPCS,65260,Remove foreign body from eye,,,319.13,369.52,8
HCPCS,65265,REMOVE FOREIGN BODY FROM EYE,,,2107.35,6468.48,19
HCPCS,65265,Remove foreign body from eye,,,319.13,369.52,8
HCPCS,65270,REPAIR OF EYE WOUND,,,2155.61,6663.73,19
HCPCS,65270,Repair of eye wound,,,1214.97,1406.81,8
HCPCS,65272,REPAIR OF EYE WOUND,,,2155.61,6663.73,19
HCPCS,65272,Repair of eye wound,,,915.87,1060.48,8
HCPCS,65273,Repair of eye wound,,,915.87,1060.48,8
HCPCS,65275,REPAIR OF EYE WOUND,,,3484.33,11019.11,19
HCPCS,65275,Repair of eye wound,,,2202.53,2550.3,8
HCPCS,65280,REPAIR OF EYE WOUND,,,4767.47,14914.8,19
HCPCS,65280,Repair of eye wound,,,2202.53,2550.3,8
HCPCS,65285,REPAIR OF EYE WOUND,,,4767.47,14914.8,19
HCPCS,65285,Repair of eye wound,,,2202.53,2550.3,8
HCPCS,65286,REPAIR OF EYE WOUND,,,2107.35,6468.48,19
HCPCS,65286,Repair of eye wound,,,252.71,292.61,8
HCPCS,65290,REPAIR OF EYE SOCKET WOUND,,,3484.33,11019.11,19
HCPCS,65290,Repair of eye socket wound,,,1684.99,1951.04,8
HCPCS,65400,REMOVAL OF EYE LESION,,,894.91,2794.1,19
HCPCS,65400,Removal of eye lesion,,,252.71,292.61,8
HCPCS,65410,BIOPSY OF CORNEA,,,2155.61,6663.73,19
HCPCS,65410,Biopsy of cornea,,,252.71,292.61,8
HCPCS,65420,REMOVAL OF EYE LESION,,,2155.61,6663.73,19
HCPCS,65420,Removal of eye lesion,,,252.71,292.61,8
HCPCS,65426,REMOVAL OF EYE LESION,,,2155.61,6663.73,19
HCPCS,65426,Removal of eye lesion,,,2202.53,2550.3,8
HCPCS,65430,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,588.0,382.2,1.1,680.96,53
HCPCS,65430,CORNEAL SMEAR,,,368.71,1252.1,19
HCPCS,65430,Corneal smear,,,157.33,182.17,8
HCPCS,65435,CURETTE/TREAT CORNEA,,,894.91,2794.1,19
HCPCS,65435,Curette/treat cornea,,,252.71,292.61,8
HCPCS,65436,CURETTE/TREAT CORNEA,,,2155.61,6663.73,19
HCPCS,65436,Curette/treat cornea,,,252.71,292.61,8
HCPCS,65450,TREATMENT OF CORNEAL LESION,,,276.21,889.64,19
HCPCS,65450,Treatment of corneal lesion,,,252.71,292.61,8
HCPCS,65600,REVISION OF CORNEA,,,2155.61,6663.73,19
HCPCS,65600,Revision of cornea,,,252.71,292.61,8
HCPCS,65710,CORNEAL TRANSPLANT,,,4767.47,14914.8,19
HCPCS,65710,Corneal transplant,,,2202.53,2550.3,8
HCPCS,65730,CORNEAL TRANSPLANT,,,3717.04,11585.35,19
HCPCS,65730,Corneal transplant,,,2202.53,2550.3,8
HCPCS,65750,CORNEAL TRANSPLANT,,,4767.47,14914.8,19
HCPCS,65750,Corneal transplant,,,2202.53,2550.3,8
HCPCS,65755,CORNEAL TRANSPLANT,,,3717.04,11585.35,19
HCPCS,65755,Corneal transplant,,,2202.53,2550.3,8
HCPCS,65756,CORNEAL TRNSPL ENDOTHELIAL,,,3717.04,11585.35,19
HCPCS,65756,Corneal trnspl endothelial,,,2202.53,2550.3,8
HCPCS,65757,Prep corneal endo allograft,,,2202.53,2550.3,8
HCPCS,65760,Keratomileusis,,,252.71,292.61,8
HCPCS,65765,Keratophakia,,,252.71,292.61,8
HCPCS,65767,Epikeratoplasty,,,252.71,292.61,8
HCPCS,65770,KERATOPROSTHESIS,,,13203.04,40658.41,19
HCPCS,65770,Keratoprosthesis,,,2202.53,2550.3,8
HCPCS,65771,Radial keratotomy,,,252.71,292.61,8
HCPCS,65772,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,4455.0,2895.75,0.01,7445.0,61
HCPCS,65775,CORRECTION OF ASTIGMATISM,,,2155.61,6663.73,19
HCPCS,65775,Correction of astigmatism,,,252.71,292.61,8
HCPCS,65778,COVER EYE W/MEMBRANE,,,894.91,2794.1,19
HCPCS,65778,Cover eye w/membrane,,,252.71,292.61,8
HCPCS,65779,COVER EYE W/MEMBRANE SUTURE,,,3484.33,11019.11,19
HCPCS,65779,Cover eye w/membrane suture,,,252.71,292.61,8
HCPCS,65780,OCULAR RECONST TRANSPLANT,,,3484.33,11019.11,19
HCPCS,65780,Ocular reconst transplant,,,2202.53,2550.3,8
HCPCS,65781,OCULAR RECONST TRANSPLANT,,,4767.47,14914.8,19
HCPCS,65781,Ocular reconst transplant,,,2202.53,2550.3,8
HCPCS,65782,OCULAR RECONST TRANSPLANT,,,3484.33,11019.11,19
HCPCS,65782,Ocular reconst transplant,,,2202.53,2550.3,8
HCPCS,65785,IMPLTJ NTRSTRML CRNL RNG SEG,,,3717.04,11585.35,19
HCPCS,65785,Impltj ntrstrml crnl rng seg,,,2202.53,2550.3,8
HCPCS,65800,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,10491.0,6819.15,0.01,10491.0,122
HCPCS,65810,DRAINAGE OF EYE,,,2107.35,6468.48,19
HCPCS,65810,Drainage of eye,,,302.55,350.32,8
HCPCS,65815,DRAINAGE OF EYE,,,2107.35,6468.48,19
HCPCS,65815,Drainage of eye,,,302.55,350.32,8
HCPCS,65820,GONIOTOMY,,,3717.04,11585.35,19
HCPCS,65820,Goniotomy,,,302.55,350.32,8
HCPCS,65850,TRABECULOTOMY AB EXTERNO,,,2107.35,6468.48,19
HCPCS,65850,Trabeculotomy ab externo,,,1921.59,2225.0,8
HCPCS,65855,TRABECULOPLASTY LASER SURG,,,506.9,1541.56,19
HCPCS,65855,Trabeculoplasty laser surg,,,302.55,350.32,8
HCPCS,65860,SEVERING ADS ANT SGM LASER,,,506.9,1541.56,19
HCPCS,65860,Severing ads ant sgm laser,,,302.55,350.32,8
HCPCS,65865,INCISE INNER EYE ADHESIONS,,,2107.35,6468.48,19
HCPCS,65865,Incise inner eye adhesions,,,302.55,350.32,8
HCPCS,65870,INCISE INNER EYE ADHESIONS,,,2107.35,6468.48,19
HCPCS,65870,Incise inner eye adhesions,,,302.55,350.32,8
HCPCS,65875,INCISE INNER EYE ADHESIONS,,,2107.35,6468.48,19
HCPCS,65875,Incise inner eye adhesions,,,302.55,350.32,8
HCPCS,65880,INCISE INNER EYE ADHESIONS,,,3717.04,11585.35,19
HCPCS,65880,Incise inner eye adhesions,,,1921.59,2225.0,8
HCPCS,65900,REMOVE EYE LESION,,,2107.35,6468.48,19
HCPCS,65900,Remove eye lesion,,,1921.59,2225.0,8
HCPCS,65920,REMOVE IMPLANT OF EYE,,,2107.35,6468.48,19
HCPCS,65920,Remove implant of eye,,,302.55,350.32,8
HCPCS,65930,REMOVE BLOOD CLOT FROM EYE,,,2107.35,6468.48,19
HCPCS,65930,Remove blood clot from eye,,,302.55,350.32,8
HCPCS,66020,INJECTION TREATMENT OF EYE,,,2107.35,6468.48,19
HCPCS,66020,Injection treatment of eye,,,302.55,350.32,8
HCPCS,66030,INJECTION TREATMENT OF EYE,,,2107.35,6468.48,19
HCPCS,66030,Injection treatment of eye,,,302.55,350.32,8
HCPCS,66130,REMOVE EYE LESION,,,2155.61,6663.73,19
HCPCS,66130,Remove eye lesion,,,302.55,350.32,8
HCPCS,66150,GLAUCOMA SURGERY,,,3717.04,11585.35,19
HCPCS,66150,Glaucoma surgery,,,1921.59,2225.0,8
HCPCS,66155,GLAUCOMA SURGERY,,,3717.04,11585.35,19
HCPCS,66155,Glaucoma surgery,,,1921.59,2225.0,8
HCPCS,66160,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,5452.0,3543.8,1.1,5452.0,50
HCPCS,66160,GLAUCOMA SURGERY,,,2107.35,6468.48,19
HCPCS,66160,Glaucoma surgery,,,1921.59,2225.0,8
HCPCS,66170,GLAUCOMA SURGERY,,,2107.35,6468.48,19
HCPCS,66170,Glaucoma surgery,,,1921.59,2225.0,8
HCPCS,66172,INCISION OF EYE,,,2107.35,6468.48,19
HCPCS,66172,Incision of eye,,,1921.59,2225.0,8
HCPCS,66174,TRLUML DIL AQ O/F CAN W/O ST,,,3717.04,11585.35,19
HCPCS,66174,TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST,3353.0,2179.45,1.1,6942.21,50
HCPCS,66174,Trluml dil aq o/f can w/o st,,,1921.59,2225.0,8
HCPCS,66175,TRLUML DIL AQ O/F CAN W/ST,,,4767.47,14914.8,19
HCPCS,66175,Trluml dil aq o/f can w/st,,,1921.59,2225.0,8
HCPCS,66179,AQUEOUS SHUNT EYE W/O GRAFT,,,4767.47,14914.8,19
HCPCS,66179,Aqueous shunt eye w/o graft,,,1921.59,2225.0,8
HCPCS,66180,AQUEOUS SHUNT EYE W/GRAFT,,,4767.47,14914.8,19
HCPCS,66180,Aqueous shunt eye w/graft,,,1921.59,2225.0,8
HCPCS,66183,INSERT ANT DRAINAGE DEVICE,,,3717.04,11585.35,19
HCPCS,66183,Insert ant drainage device,,,1921.59,2225.0,8
HCPCS,66184,REVISION OF AQUEOUS SHUNT,,,2107.35,6468.48,19
HCPCS,66184,Revision of aqueous shunt,,,302.55,350.32,8
HCPCS,66185,REVISE AQUEOUS SHUNT EYE,,,2107.35,6468.48,19
HCPCS,66185,Revise aqueous shunt eye,,,302.55,350.32,8
HCPCS,66225,REPAIR/GRAFT EYE LESION,,,4767.47,14914.8,19
HCPCS,66225,Repair/graft eye lesion,,,1921.59,2225.0,8
HCPCS,66250,FOLLOW-UP SURGERY OF EYE,,,2155.61,6663.73,19
HCPCS,66250,Follow-up surgery of eye,,,302.55,350.32,8
HCPCS,66500,INCISION OF IRIS,,,2107.35,6468.48,19
HCPCS,66500,Incision of iris,,,302.55,350.32,8
HCPCS,66505,INCISION OF IRIS,,,2107.35,6468.48,19
HCPCS,66505,Incision of iris,,,302.55,350.32,8
HCPCS,66600,REMOVE IRIS AND LESION,,,3717.04,11585.35,19
HCPCS,66600,Remove iris and lesion,,,1921.59,2225.0,8
HCPCS,66605,REMOVAL OF IRIS,,,2107.35,6468.48,19
HCPCS,66605,Removal of iris,,,1921.59,2225.0,8
HCPCS,66625,REMOVAL OF IRIS,,,2107.35,6468.48,19
HCPCS,66625,Removal of iris,,,302.55,350.32,8
HCPCS,66630,REMOVAL OF IRIS,,,2107.35,6468.48,19
HCPCS,66630,Removal of iris,,,302.55,350.32,8
HCPCS,66635,REMOVAL OF IRIS,,,2107.35,6468.48,19
HCPCS,66635,Removal of iris,,,302.55,350.32,8
HCPCS,66680,REPAIR IRIS & CILIARY BODY,,,2107.35,6468.48,19
HCPCS,66680,Repair iris & ciliary body,,,302.55,350.32,8
HCPCS,66682,REPAIR IRIS & CILIARY BODY,,,2107.35,6468.48,19
HCPCS,66682,Repair iris & ciliary body,,,302.55,350.32,8
HCPCS,66683,IMPLANTATION IRIS PROSTHESIS,,,15168.46,46137.2,19
HCPCS,66683,IMPLTJ IRIS PROSTHESIS W/SUTR FIXJ&RPR/RMVL IRIS,4695.0,3051.75,1.1,4695.0,49
HCPCS,66683,Implantation iris prosthesis,,,1921.59,2225.0,8
HCPCS,66700,DESTRUCTION CILIARY BODY,,,2107.35,6468.48,19
HCPCS,66700,Destruction ciliary body,,,302.55,350.32,8
HCPCS,66710,CILIARY TRANSSLERAL THERAPY,,,2155.61,6663.73,19
HCPCS,66710,Ciliary transsleral therapy,,,302.55,350.32,8
HCPCS,66711,ECP CILIARY BODY DESTRUCTION,,,2107.35,6468.48,19
HCPCS,66711,Ecp ciliary body destruction,,,302.55,350.32,8
HCPCS,66720,DESTRUCTION CILIARY BODY,,,2155.61,6663.73,19
HCPCS,66720,Destruction ciliary body,,,302.55,350.32,8
HCPCS,66740,DESTRUCTION CILIARY BODY,,,2155.61,6663.73,19
HCPCS,66740,Destruction ciliary body,,,302.55,350.32,8
HCPCS,66761,REVISION OF IRIS,,,506.9,1541.56,19
HCPCS,66761,Revision of iris,,,302.55,350.32,8
HCPCS,66762,REVISION OF IRIS,,,506.9,1541.56,19
HCPCS,66762,Revision of iris,,,302.55,350.32,8
HCPCS,66770,REMOVAL OF INNER EYE LESION,,,506.9,1541.56,19
HCPCS,66770,Removal of inner eye lesion,,,302.55,350.32,8
HCPCS,66820,INCISION SECONDARY CATARACT,,,2107.35,6468.48,19
HCPCS,66820,Incision secondary cataract,,,252.71,292.61,8
HCPCS,66821,AFTER CATARACT LASER SURGERY,,,506.9,1541.56,19
HCPCS,66821,After cataract laser surgery,,,252.71,292.61,8
HCPCS,66825,REPOSITION INTRAOCULAR LENS,,,2107.35,6468.48,19
HCPCS,66825,Reposition intraocular lens,,,1047.84,1213.29,8
HCPCS,66830,REMOVAL OF LENS LESION,,,2107.35,6468.48,19
HCPCS,66830,Removal of lens lesion,,,252.71,292.61,8
HCPCS,66840,REMOVAL OF LENS MATERIAL,,,2107.35,6468.48,19
HCPCS,66840,Removal of lens material,,,1047.84,1213.29,8
HCPCS,66850,REMOVAL OF LENS MATERIAL,,,2107.35,6468.48,19
HCPCS,66850,Removal of lens material,,,1047.84,1213.29,8
HCPCS,66852,REMOVAL OF LENS MATERIAL,,,3717.04,11585.35,19
HCPCS,66852,Removal of lens material,,,1047.84,1213.29,8
HCPCS,66920,EXTRACTION OF LENS,,,2107.35,6468.48,19
HCPCS,66920,Extraction of lens,,,1047.84,1213.29,8
HCPCS,66930,EXTRACTION OF LENS,,,3717.04,11585.35,19
HCPCS,66930,Extraction of lens,,,1047.84,1213.29,8
HCPCS,66940,EXTRACTION OF LENS,,,2107.35,6468.48,19
HCPCS,66940,Extraction of lens,,,1047.84,1213.29,8
HCPCS,66982,XCAPSL CTRC RMVL CPLX WO ECP,,,2107.35,6468.48,19
HCPCS,66982,Xcapsl ctrc rmvl cplx wo ecp,,,1047.84,1213.29,8
HCPCS,66983,CATARACT SURG W/IOL 1 STAGE,,,2107.35,6468.48,19
HCPCS,66983,Cataract surg w/iol 1 stage,,,1047.84,1213.29,8
HCPCS,66984,XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP,3234.0,2102.1,1.1,3978.24,50
HCPCS,66984,XCAPSL CTRC RMVL W/O ECP,,,2107.35,6468.48,19
HCPCS,66984,Xcapsl ctrc rmvl w/o ecp,,,1047.84,1213.29,8
HCPCS,66985,INSERT LENS PROSTHESIS,,,2107.35,6468.48,19
HCPCS,66985,Insert lens prosthesis,,,1047.84,1213.29,8
HCPCS,66986,EXCHANGE LENS PROSTHESIS,,,2107.35,6468.48,19
HCPCS,66986,Exchange lens prosthesis,,,1047.84,1213.29,8
HCPCS,66987,XCAPSL CTRC RMVL CPLX W/ECP,,,3717.04,11585.35,19
HCPCS,66987,Xcapsl ctrc rmvl cplx w/ecp,,,1047.84,1213.29,8
HCPCS,66988,XCAPSL CTRC RMVL W/ECP,,,3717.04,11585.35,19
HCPCS,66988,Xcapsl ctrc rmvl w/ecp,,,1047.84,1213.29,8
HCPCS,66989,XCAPSL CTRC RMVL INSJ IO LENS PRSTH CPLX INSJ 1+,4852.0,3153.8,1.1,8924.16,50
HCPCS,66989,XCPSL CTRC RMVL CPLX INSJ 1+,,,4767.47,14914.8,19
HCPCS,66989,Xcpsl ctrc rmvl cplx insj 1+,,,1921.59,2225.0,8
HCPCS,66990,Ophthalmic endoscope add-on,,,321.96,372.8,8
HCPCS,66991,XCAPSL CTRC RMVL INSJ 1+,,,4767.47,14914.8,19
HCPCS,66991,XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+,4061.0,2639.65,1.1,8924.16,50
HCPCS,66991,Xcapsl ctrc rmvl insj 1+,,,1921.59,2225.0,8
HCPCS,66999,UNLISTED PX ANT SEGMENT EYE,,,2107.35,6468.48,19
HCPCS,66999,Unlisted px ant segment eye,,,302.55,350.32,8
HCPCS,67005,PARTIAL REMOVAL OF EYE FLUID,,,2107.35,6468.48,19
HCPCS,67005,Partial removal of eye fluid,,,319.13,369.52,8
HCPCS,67010,PARTIAL REMOVAL OF EYE FLUID,,,2107.35,6468.48,19
HCPCS,67010,Partial removal of eye fluid,,,319.13,369.52,8
HCPCS,67015,RELEASE OF EYE FLUID,,,2107.35,6468.48,19
HCPCS,67015,Release of eye fluid,,,2290.15,2651.75,8
HCPCS,67025,REPLACE EYE FLUID,,,2107.35,6468.48,19
HCPCS,67025,Replace eye fluid,,,319.13,369.52,8
HCPCS,67027,IMPLANT EYE DRUG SYSTEM,,,13200.57,39108.02,19
HCPCS,67027,Implant eye drug system,,,2290.15,2651.75,8
HCPCS,67028,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,1080.0,702.0,0.01,3004.0,114
HCPCS,67030,INCISE INNER EYE STRANDS,,,2107.35,6468.48,19
HCPCS,67030,Incise inner eye strands,,,319.13,369.52,8
HCPCS,67031,LASER SURGERY EYE STRANDS,,,506.9,1541.56,19
HCPCS,67031,Laser surgery eye strands,,,319.13,369.52,8
HCPCS,67036,REMOVAL OF INNER EYE FLUID,,,3717.04,11585.35,19
HCPCS,67036,Removal of inner eye fluid,,,2290.15,2651.75,8
HCPCS,67039,LASER TREATMENT OF RETINA,,,3717.04,11585.35,19
HCPCS,67039,Laser treatment of retina,,,2290.15,2651.75,8
HCPCS,67040,LASER TREATMENT OF RETINA,,,3717.04,11585.35,19
HCPCS,67040,Laser treatment of retina,,,2290.15,2651.75,8
HCPCS,67041,VIT FOR MACULAR PUCKER,,,3717.04,11585.35,19
HCPCS,67041,Vit for macular pucker,,,2290.15,2651.75,8
HCPCS,67042,VIT FOR MACULAR HOLE,,,3717.04,11585.35,19
HCPCS,67042,Vit for macular hole,,,2290.15,2651.75,8
HCPCS,67043,VIT FOR MEMBRANE DISSECT,,,3717.04,11585.35,19
HCPCS,67043,Vit for membrane dissect,,,2290.15,2651.75,8
HCPCS,67101,REPAIR DETACHED RETINA CRTX,,,2107.35,6468.48,19
HCPCS,67101,Repair detached retina crtx,,,2290.15,2651.75,8
HCPCS,67105,REPAIR DETACHED RETINA PC,,,506.9,1541.56,19
HCPCS,67105,Repair detached retina pc,,,319.13,369.52,8
HCPCS,67107,REPAIR DETACHED RETINA,,,3717.04,11585.35,19
HCPCS,67107,Repair detached retina,,,2290.15,2651.75,8
HCPCS,67108,REPAIR DETACHED RETINA,,,3717.04,11585.35,19
HCPCS,67108,Repair detached retina,,,2290.15,2651.75,8
HCPCS,67110,REPAIR DETACHED RETINA,,,2107.35,6468.48,19
HCPCS,67110,Repair detached retina,,,319.13,369.52,8
HCPCS,67113,REPAIR RETINAL DETACH CPLX,,,4767.47,14914.8,19
HCPCS,67113,Repair retinal detach cplx,,,2290.15,2651.75,8
HCPCS,67115,RELEASE ENCIRCLING MATERIAL,,,3717.04,11585.35,19
HCPCS,67115,Release encircling material,,,319.13,369.52,8
HCPCS,67120,REMOVE EYE IMPLANT MATERIAL,,,2107.35,6468.48,19
HCPCS,67120,Remove eye implant material,,,319.13,369.52,8
HCPCS,67121,REMOVE EYE IMPLANT MATERIAL,,,2107.35,6468.48,19
HCPCS,67121,Remove eye implant material,,,319.13,369.52,8
HCPCS,67141,PROPH RTA DTCHMNT CRTX DTHRM,,,276.21,889.64,19
HCPCS,67141,Proph rta dtchmnt crtx dthrm,,,157.33,182.17,8
HCPCS,67145,PROPH RTA DTCHMNT PC,,,506.9,1541.56,19
HCPCS,67145,Proph rta dtchmnt pc,,,319.13,369.52,8
HCPCS,67208,TREATMENT OF RETINAL LESION,,,276.21,889.64,19
HCPCS,67208,Treatment of retinal lesion,,,157.33,182.17,8
HCPCS,67210,TREATMENT OF RETINAL LESION,,,506.9,1541.56,19
HCPCS,67210,Treatment of retinal lesion,,,319.13,369.52,8
HCPCS,67218,TREATMENT OF RETINAL LESION,,,3484.33,11019.11,19
HCPCS,67218,Treatment of retinal lesion,,,2290.15,2651.75,8
HCPCS,67220,TREATMENT OF CHOROID LESION,,,506.9,1541.56,19
HCPCS,67220,Treatment of choroid lesion,,,319.13,369.52,8
HCPCS,67221,OCULAR PHOTODYNAMIC THER,,,506.9,1541.56,19
HCPCS,67221,Ocular photodynamic ther,,,319.13,369.52,8
HCPCS,67225,Eye photodynamic ther add-on,,,319.13,369.52,8
HCPCS,67227,DSTRJ EXTENSIVE RETINOPATHY,,,3484.33,11019.11,19
HCPCS,67227,Dstrj extensive retinopathy,,,2290.15,2651.75,8
HCPCS,67228,TREATMENT X10SV RETINOPATHY,,,506.9,1541.56,19
HCPCS,67228,Treatment x10sv retinopathy,,,319.13,369.52,8
HCPCS,67229,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,7172.0,4661.8,1.1,7172.0,50
HCPCS,67229,TR RETINAL LES PRETERM INF,,,506.9,1541.56,19
HCPCS,67229,Tr retinal les preterm inf,,,319.13,369.52,8
HCPCS,67250,REINFORCE EYE WALL,,,2155.61,6663.73,19
HCPCS,67250,Reinforce eye wall,,,319.13,369.52,8
HCPCS,67255,REINFORCE/GRAFT EYE WALL,,,3717.04,11585.35,19
HCPCS,67255,Reinforce/graft eye wall,,,319.13,369.52,8
HCPCS,67299,AUTOLOGOUS RETINAL GRAFT (COMP 67042),6532.0,4245.8,0.01,6532.0,28
HCPCS,67299,UNLISTED PX POSTERIOR SEGMNT,,,2107.35,6468.48,19
HCPCS,67299,Unlisted px posterior segmnt,,,319.13,369.52,8
HCPCS,67311,REVISE EYE MUSCLE,,,2155.61,6663.73,19
HCPCS,67311,Revise eye muscle,,,1536.92,1779.59,8
HCPCS,67312,REVISE TWO EYE MUSCLES,,,3484.33,11019.11,19
HCPCS,67312,Revise two eye muscles,,,1536.92,1779.59,8
HCPCS,67314,REVISE EYE MUSCLE,,,2155.61,6663.73,19
HCPCS,67314,Revise eye muscle,,,1536.92,1779.59,8
HCPCS,67316,REVISE TWO EYE MUSCLES,,,2155.61,6663.73,19
HCPCS,67316,Revise two eye muscles,,,1536.92,1779.59,8
HCPCS,67318,REVISE EYE MUSCLE(S),,,2155.61,6663.73,19
HCPCS,67318,Revise eye muscle(s),,,1536.92,1779.59,8
HCPCS,67320,Revise eye muscle(s) add-on,,,1536.92,1779.59,8
HCPCS,67331,Eye surgery follow-up add-on,,,1536.92,1779.59,8
HCPCS,67332,Rerevise eye muscles add-on,,,1536.92,1779.59,8
HCPCS,67334,Revise eye muscle w/suture,,,1536.92,1779.59,8
HCPCS,67335,Eye suture during surgery,,,1536.92,1779.59,8
HCPCS,67340,Revise eye muscle add-on,,,1536.92,1779.59,8
HCPCS,67343,RELEASE EYE TISSUE,,,2155.61,6663.73,19
HCPCS,67343,Release eye tissue,,,1536.92,1779.59,8
HCPCS,67345,DESTROY NERVE OF EYE MUSCLE,,,276.21,889.64,19
HCPCS,67345,Destroy nerve of eye muscle,,,157.33,182.17,8
HCPCS,67346,BIOPSY EYE MUSCLE,,,3484.33,11019.11,19
HCPCS,67346,Biopsy eye muscle,,,1536.92,1779.59,8
HCPCS,67399,UNLISTED PX EXTRAOCULAR MUSC,,,276.21,889.64,19
HCPCS,67399,Unlisted px extraocular musc,,,157.33,182.17,8
HCPCS,67400,EXPLORE/BIOPSY EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67400,Explore/biopsy eye socket,,,1684.99,1951.04,8
HCPCS,67405,EXPLORE/DRAIN EYE SOCKET,,,2155.61,6663.73,19
HCPCS,67405,Explore/drain eye socket,,,1684.99,1951.04,8
HCPCS,67412,EXPLORE/TREAT EYE SOCKET,,,2155.61,6663.73,19
HCPCS,67412,Explore/treat eye socket,,,1684.99,1951.04,8
HCPCS,67412,ORBITTMY W/O BN FLP W REM LESION,4120.0,2678.0,1.1,4120.0,50
HCPCS,67413,EXPLORE/TREAT EYE SOCKET,,,2155.61,6663.73,19
HCPCS,67413,Explore/treat eye socket,,,1684.99,1951.04,8
HCPCS,67414,EXPLR/DECOMPRESS EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67414,Explr/decompress eye socket,,,1684.99,1951.04,8
HCPCS,67415,ASPIRATION ORBITAL CONTENTS,,,2155.61,6663.73,19
HCPCS,67415,Aspiration orbital contents,,,319.13,369.52,8
HCPCS,67420,EXPLORE/TREAT EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67420,Explore/treat eye socket,,,3594.14,4161.63,8
HCPCS,67430,EXPLORE/TREAT EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67430,Explore/treat eye socket,,,1634.67,1892.77,8
HCPCS,67440,EXPLORE/DRAIN EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67440,Explore/drain eye socket,,,3594.14,4161.63,8
HCPCS,67445,EXPLR/DECOMPRESS EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67445,Explr/decompress eye socket,,,3594.14,4161.63,8
HCPCS,67450,EXPLORE/BIOPSY EYE SOCKET,,,3484.33,11019.11,19
HCPCS,67450,Explore/biopsy eye socket,,,3594.14,4161.63,8
HCPCS,67500,INJECT/TREAT EYE SOCKET,,,276.21,889.64,19
HCPCS,67500,Inject/treat eye socket,,,157.33,182.17,8
HCPCS,67505,INJECT/TREAT EYE SOCKET,,,276.21,889.64,19
HCPCS,67505,Inject/treat eye socket,,,157.33,182.17,8
HCPCS,67515,INJECT/TREAT EYE SOCKET,,,276.21,889.64,19
HCPCS,67515,Inject/treat eye socket,,,157.33,182.17,8
HCPCS,67516,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,1099.5,714.675,0.01,1526.0,113
HCPCS,67550,INSERT EYE SOCKET IMPLANT,,,3484.33,11019.11,19
HCPCS,67550,Insert eye socket implant,,,1684.99,1951.04,8
HCPCS,67560,REVISE EYE SOCKET IMPLANT,,,3484.33,11019.11,19
HCPCS,67560,Revise eye socket implant,,,1684.99,1951.04,8
HCPCS,67570,DECOMPRESS OPTIC NERVE,,,3484.33,11019.11,19
HCPCS,67570,Decompress optic nerve,,,1684.99,1951.04,8
HCPCS,67599,UNLISTED PROCEDURE ORBIT,,,276.21,889.64,19
HCPCS,67599,Unlisted procedure orbit,,,157.33,182.17,8
HCPCS,67700,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,967.5,628.875,1.1,3004.0,114
HCPCS,67710,SEVERING TARSORRHAPHY,,,894.91,2794.1,19
HCPCS,67710,Severing tarsorrhaphy,,,915.87,1060.48,8
HCPCS,67715,CANTHOTOMY SEPARATE PROCEDURE,5620.0,3653.0,1.1,10732.0,114
HCPCS,67800,"EXCIS CHALAZION,SINGLE",564.0,366.6,1.1,564.0,53
HCPCS,67800,REMOVE EYELID LESION,,,276.21,889.64,19
HCPCS,67800,Remove eyelid lesion,,,157.33,182.17,8
HCPCS,67801,REMOVE EYELID LESIONS,,,894.91,2794.1,19
HCPCS,67801,Remove eyelid lesions,,,915.87,1060.48,8
HCPCS,67805,REMOVE EYELID LESIONS,,,276.21,889.64,19
HCPCS,67805,Remove eyelid lesions,,,157.33,182.17,8
HCPCS,67808,REMOVE EYELID LESION(S),,,2155.61,6663.73,19
HCPCS,67808,Remove eyelid lesion(s),,,915.87,1060.48,8
HCPCS,67810,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,947.0,615.55,0.01,3004.0,114
HCPCS,67820,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,141.0,91.65,1.1,218.62,53
HCPCS,67820,REVISE EYELASHES,,,119.1,372.91,19
HCPCS,67820,Revise eyelashes,,,38.61,44.7,8
HCPCS,67825,REVISE EYELASHES,,,276.21,889.64,19
HCPCS,67825,Revise eyelashes,,,157.33,182.17,8
HCPCS,67830,REVISE EYELASHES,,,894.91,2794.1,19
HCPCS,67830,Revise eyelashes,,,157.33,182.17,8
HCPCS,67835,REVISE EYELASHES,,,2155.61,6663.73,19
HCPCS,67835,Revise eyelashes,,,1214.97,1406.81,8
HCPCS,67840,REMOVE EYELID LESION,,,894.91,2794.1,19
HCPCS,67840,Remove eyelid lesion,,,915.87,1060.48,8
HCPCS,67850,DSTRJ LESION LID MARGIN <1CM,,,894.91,2794.1,19
HCPCS,67850,Dstrj lesion lid margin <1cm,,,157.33,182.17,8
HCPCS,67875,CLOSURE OF EYELID BY SUTURE,,,894.91,2794.1,19
HCPCS,67875,Closure of eyelid by suture,,,915.87,1060.48,8
HCPCS,67875,TEMP CLOSURE EYELID BY SUTURE,540.0,351.0,1.1,1729.28,53
HCPCS,67880,REVISION OF EYELID,,,2155.61,6663.73,19
HCPCS,67880,Revision of eyelid,,,915.87,1060.48,8
HCPCS,67882,REVISION OF EYELID,,,2155.61,6663.73,19
HCPCS,67882,Revision of eyelid,,,1214.97,1406.81,8
HCPCS,67900,REPAIR BROW DEFECT,,,2155.61,6663.73,19
HCPCS,67900,REPAIR BROW PTOSIS,3001.0,1950.65,1.1,3988.99,53
HCPCS,67900,Repair brow defect,,,1214.97,1406.81,8
HCPCS,67901,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67901,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67902,REPAIR EYELID DEFECT,,,3484.33,11019.11,19
HCPCS,67902,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67903,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67903,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67904,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67904,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,3507.0,2279.55,1.1,3988.99,53
HCPCS,67904,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67906,REPAIR EYELID DEFECT,,,3484.33,11019.11,19
HCPCS,67906,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67908,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67908,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67909,REVISE EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67909,Revise eyelid defect,,,1214.97,1406.81,8
HCPCS,67911,REVISE EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67911,Revise eyelid defect,,,915.87,1060.48,8
HCPCS,67912,CORRECTION EYELID W/IMPLANT,,,2155.61,6663.73,19
HCPCS,67912,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,2544.0,1653.6,1.1,3988.99,53
HCPCS,67912,Correction eyelid w/implant,,,915.87,1060.48,8
HCPCS,67914,"FIX ECTROPION,SUTURE",1500.0,975.0,1.1,3988.99,53
HCPCS,67914,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67914,Repair eyelid defect,,,915.87,1060.48,8
HCPCS,67915,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67915,Repair eyelid defect,,,915.87,1060.48,8
HCPCS,67916,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67916,Repair eyelid defect,,,915.87,1060.48,8
HCPCS,67917,REPAIR ECTROPION EXTENSIVE,2372.0,1541.8,1.1,3988.99,53
HCPCS,67917,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67917,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67921,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67921,Repair eyelid defect,,,915.87,1060.48,8
HCPCS,67922,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67922,Repair eyelid defect,,,915.87,1060.48,8
HCPCS,67923,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67923,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67924,REPAIR EYELID DEFECT,,,2155.61,6663.73,19
HCPCS,67924,Repair eyelid defect,,,1214.97,1406.81,8
HCPCS,67930,REPAIR EYELID WOUND,,,2155.61,6663.73,19
HCPCS,67930,Repair eyelid wound,,,915.87,1060.48,8
HCPCS,67935,REPAIR EYELID WOUND,,,2155.61,6663.73,19
HCPCS,67935,Repair eyelid wound,,,915.87,1060.48,8
HCPCS,67935,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,2544.0,1653.6,1.1,3988.99,53
HCPCS,67938,REMOVAL EMBEDDED FOREIGN BODY EYELID,1375.0,893.75,157.33,3004.0,61
HCPCS,67938,"REMOVE EYELID FOREIGN BODY,EMBEDDED",552.0,358.8,1.1,889.47,53
HCPCS,67950,CANTHOPLASTY LATERAL,2636.0,1713.4,1.1,3988.99,53
HCPCS,67950,REVISION OF EYELID,,,2155.61,6663.73,19
HCPCS,67950,Revision of eyelid,,,915.87,1060.48,8
HCPCS,67961,REVISION OF EYELID,,,2155.61,6663.73,19
HCPCS,67961,Revision of eyelid,,,1214.97,1406.81,8
HCPCS,67966,REVISION OF EYELID,,,2155.61,6663.73,19
HCPCS,67966,Revision of eyelid,,,1214.97,1406.81,8
HCPCS,67971,RECONSTRUCTION OF EYELID,,,2155.61,6663.73,19
HCPCS,67971,Reconstruction of eyelid,,,1214.97,1406.81,8
HCPCS,67973,RECONSTRUCTION OF EYELID,,,2155.61,6663.73,19
HCPCS,67973,Reconstruction of eyelid,,,1214.97,1406.81,8
HCPCS,67974,RECONSTRUCTION OF EYELID,,,3484.33,11019.11,19
HCPCS,67974,Reconstruction of eyelid,,,1214.97,1406.81,8
HCPCS,67975,RECONSTRUCTION OF EYELID,,,2155.61,6663.73,19
HCPCS,67975,Reconstruction of eyelid,,,1214.97,1406.81,8
HCPCS,67999,FACELIFT - ENDOSCOPIC,2760.0,1794.0,0.01,2760.0,28
HCPCS,67999,FOREHEAD LIFT - ENDOSCOPIC,3346.0,2174.9,0.01,3346.0,28
HCPCS,67999,"ORBICULARIS OCULI LATERAL MYECTOMY, UNILATERAL (COMP CODE 15823)",2996.0,1947.4,0.01,2996.0,28
HCPCS,67999,UNLISTED PROCEDURE EYELIDS,,,276.21,889.64,19
HCPCS,67999,Unlisted procedure eyelids,,,157.33,182.17,8
HCPCS,68020,INCISE/DRAIN EYELID LINING,,,894.91,2794.1,19
HCPCS,68020,Incise/drain eyelid lining,,,915.87,1060.48,8
HCPCS,68040,TREATMENT OF EYELID LESIONS,,,276.21,889.64,19
HCPCS,68040,Treatment of eyelid lesions,,,157.33,182.17,8
HCPCS,68100,BIOPSY CONJUNCTIVA,,,2155.61,6663.73,19
HCPCS,68100,Biopsy conjunctiva,,,915.87,1060.48,8
HCPCS,68110,EXC LES CONJUNCTIVA <1 CM,,,2155.61,6663.73,19
HCPCS,68110,Exc les conjunctiva <1 cm,,,302.55,350.32,8
HCPCS,68115,EXC LES CONJUNCTIVA >1 CM,,,2155.61,6663.73,19
HCPCS,68115,Exc les conjunctiva >1 cm,,,1214.97,1406.81,8
HCPCS,68130,EXC LES CONJUNCTIVA ADJ SCL,,,2155.61,6663.73,19
HCPCS,68130,Exc les conjunctiva adj scl,,,1214.97,1406.81,8
HCPCS,68135,DESTRUCTION LES CONJUNCTIVA,,,2155.61,6663.73,19
HCPCS,68135,Destruction les conjunctiva,,,915.87,1060.48,8
HCPCS,68200,TREAT EYELID BY INJECTION,,,368.71,1252.1,19
HCPCS,68200,Treat eyelid by injection,,,38.61,44.7,8
HCPCS,68320,REVISE/GRAFT EYELID LINING,,,2155.61,6663.73,19
HCPCS,68320,Revise/graft eyelid lining,,,915.87,1060.48,8
HCPCS,68325,REVISE/GRAFT EYELID LINING,,,3484.33,11019.11,19
HCPCS,68325,Revise/graft eyelid lining,,,1214.97,1406.81,8
HCPCS,68326,REVISE/GRAFT EYELID LINING,,,3484.33,11019.11,19
HCPCS,68326,Revise/graft eyelid lining,,,1214.97,1406.81,8
HCPCS,68328,REVISE/GRAFT EYELID LINING,,,2155.61,6663.73,19
HCPCS,68328,Revise/graft eyelid lining,,,1214.97,1406.81,8
HCPCS,68330,REVISE EYELID LINING,,,2107.35,6468.48,19
HCPCS,68330,Revise eyelid lining,,,915.87,1060.48,8
HCPCS,68335,REVISE/GRAFT EYELID LINING,,,3484.33,11019.11,19
HCPCS,68335,Revise/graft eyelid lining,,,1214.97,1406.81,8
HCPCS,68340,SEPARATE EYELID ADHESIONS,,,2155.61,6663.73,19
HCPCS,68340,Separate eyelid adhesions,,,915.87,1060.48,8
HCPCS,68360,REVISE EYELID LINING,,,3484.33,11019.11,19
HCPCS,68360,Revise eyelid lining,,,1214.97,1406.81,8
HCPCS,68362,REVISE EYELID LINING,,,2155.61,6663.73,19
HCPCS,68362,Revise eyelid lining,,,1214.97,1406.81,8
HCPCS,68371,HARVEST EYE TISSUE ALOGRAFT,,,2155.61,6663.73,19
HCPCS,68371,Harvest eye tissue alograft,,,915.87,1060.48,8
HCPCS,68399,UNLISTED PX CONJUNCTIVA,,,276.21,889.64,19
HCPCS,68399,Unlisted px conjunctiva,,,157.33,182.17,8
HCPCS,68400,I&D LACRIMAL GLAND,,,894.91,2794.1,19
HCPCS,68400,I&d lacrimal gland,,,915.87,1060.48,8
HCPCS,68420,I&D LACRIMAL SAC,,,2155.61,6663.73,19
HCPCS,68420,I&d lacrimal sac,,,1214.97,1406.81,8
HCPCS,68440,SNIP INC LACRIMAL PUNCTUM,,,276.21,889.64,19
HCPCS,68440,Snip inc lacrimal punctum,,,157.33,182.17,8
HCPCS,68500,REMOVAL OF TEAR GLAND,,,3484.33,11019.11,19
HCPCS,68500,Removal of tear gland,,,1214.97,1406.81,8
HCPCS,68505,PARTIAL REMOVAL TEAR GLAND,,,3484.33,11019.11,19
HCPCS,68505,Partial removal tear gland,,,1214.97,1406.81,8
HCPCS,68510,BIOPSY OF TEAR GLAND,,,2155.61,6663.73,19
HCPCS,68510,Biopsy of tear gland,,,1214.97,1406.81,8
HCPCS,68520,REMOVAL OF TEAR SAC,,,3484.33,11019.11,19
HCPCS,68520,Removal of tear sac,,,1214.97,1406.81,8
HCPCS,68525,BIOPSY OF TEAR SAC,,,2155.61,6663.73,19
HCPCS,68525,Biopsy of tear sac,,,915.87,1060.48,8
HCPCS,68530,CLEARANCE OF TEAR DUCT,,,276.21,889.64,19
HCPCS,68530,Clearance of tear duct,,,157.33,182.17,8
HCPCS,68540,REMOVE TEAR GLAND LESION,,,2155.61,6663.73,19
HCPCS,68540,Remove tear gland lesion,,,1214.97,1406.81,8
HCPCS,68550,REMOVE TEAR GLAND LESION,,,3484.33,11019.11,19
HCPCS,68550,Remove tear gland lesion,,,1214.97,1406.81,8
HCPCS,68700,REPAIR TEAR DUCTS,,,2155.61,6663.73,19
HCPCS,68700,Repair tear ducts,,,915.87,1060.48,8
HCPCS,68705,REVISE TEAR DUCT OPENING,,,276.21,889.64,19
HCPCS,68705,Revise tear duct opening,,,157.33,182.17,8
HCPCS,68720,CREATE TEAR SAC DRAIN,,,3484.33,11019.11,19
HCPCS,68720,Create tear sac drain,,,1214.97,1406.81,8
HCPCS,68745,CREATE TEAR DUCT DRAIN,,,3484.33,11019.11,19
HCPCS,68745,Create tear duct drain,,,1214.97,1406.81,8
HCPCS,68750,CREATE TEAR DUCT DRAIN,,,3484.33,11019.11,19
HCPCS,68750,Create tear duct drain,,,1214.97,1406.81,8
HCPCS,68760,CLOSE TEAR DUCT OPENING,,,276.21,889.64,19
HCPCS,68760,Close tear duct opening,,,157.33,182.17,8
HCPCS,68761,CLOSE TEAR DUCT OPENING,,,276.21,889.64,19
HCPCS,68761,Close tear duct opening,,,157.33,182.17,8
HCPCS,68770,CLOSE TEAR SYSTEM FISTULA,,,2155.61,6663.73,19
HCPCS,68770,Close tear system fistula,,,1214.97,1406.81,8
HCPCS,68801,DILATE TEAR DUCT OPENING,,,368.71,1252.1,19
HCPCS,68801,Dilate tear duct opening,,,157.33,182.17,8
HCPCS,68810,PROBE NASOLACRIMAL DUCT,,,276.21,889.64,19
HCPCS,68810,Probe nasolacrimal duct,,,157.33,182.17,8
HCPCS,68811,PROBE NASOLACRIMAL DUCT,,,2155.61,6663.73,19
HCPCS,68811,Probe nasolacrimal duct,,,915.87,1060.48,8
HCPCS,68815,PROBE NASOLACRIMAL DUCT,,,2155.61,6663.73,19
HCPCS,68815,Probe nasolacrimal duct,,,915.87,1060.48,8
HCPCS,68816,PROBE NL DUCT W/BALLOON,,,2155.61,6663.73,19
HCPCS,68816,Probe nl duct w/balloon,,,915.87,1060.48,8
HCPCS,68840,EXPLORE/IRRIGATE TEAR DUCTS,,,276.21,889.64,19
HCPCS,68840,Explore/irrigate tear ducts,,,157.33,182.17,8
HCPCS,68841,INSJ RX ELUT IMPLT LAC CANAL,,,2155.61,6663.73,19
HCPCS,68841,INSJ RX ELUTING IMPLT PUNCTAL DILAT LAC CANAL EA,216.0,140.4,1.1,3988.99,52
HCPCS,68841,Insj rx elut implt lac canal,,,38.61,44.7,8
HCPCS,68850,Injection for tear sac x-ray,,,65.08,75.36,8
HCPCS,68899,UNLISTED PX LACRIMAL SYSTEM,,,276.21,889.64,19
HCPCS,68899,Unlisted px lacrimal system,,,157.33,182.17,8
HCPCS,69000,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,1737.0,1129.05,1.1,3004.0,114
HCPCS,69005,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,3672.5,2387.125,1.1,6481.0,114
HCPCS,69020,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,1713.0,1113.45,1.1,3004.0,114
HCPCS,69090,EAR PIERCING,67.0,43.55,1.1,176.73,32
HCPCS,69090,"EAR PIERCING, BOTH EARS W/EARRINGS",50.0,32.5,1.1,176.73,32
HCPCS,69090,Ear piercing,,,50.62,58.61,8
HCPCS,69100,BIOPSY EXTERNAL EAR,626.5,407.225,0.01,929.0,114
HCPCS,69100,BIOPSY OF EXTERNAL EAR,167.0,108.55,1.1,417.54,53
HCPCS,69105,BIOPSY OF EXTERNAL EAR CANAL,,,1368.67,4348.85,19
HCPCS,69105,Biopsy of external ear canal,,,745.85,863.61,8
HCPCS,69110,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,6430.0,4179.5,0.01,11448.0,114
HCPCS,69120,REMOVAL OF EXTERNAL EAR,,,5465.95,16592.38,19
HCPCS,69120,Removal of external ear,,,2151.73,2491.48,8
HCPCS,69140,REMOVE EAR CANAL LESION(S),,,5465.95,16592.38,19
HCPCS,69140,Remove ear canal lesion(s),,,2151.73,2491.48,8
HCPCS,69145,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,1080.0,702.0,1.1,4850.94,53
HCPCS,69145,REMOVE EAR CANAL LESION(S),,,2644.48,8141.48,19
HCPCS,69145,Remove ear canal lesion(s),,,1237.01,1432.33,8
HCPCS,69150,EXTENSIVE EAR CANAL SURGERY,,,5465.95,16592.38,19
HCPCS,69150,Extensive ear canal surgery,,,2151.73,2491.48,8
HCPCS,69155,Extensive ear/neck surgery,,,2695.9,3121.57,8
HCPCS,69200,RMVL FB XTRNL AUDITORY CANAL W/O ANES,427.5,277.875,0.01,2453.0,175
HCPCS,69205,CLEAR OUTER EAR CANAL,,,1497.07,4629.18,19
HCPCS,69205,Clear outer ear canal,,,745.85,863.61,8
HCPCS,69205,RMVL FB XTRNL AUDITORY CANAL ANES,532.0,345.8,1.1,2768.64,50
HCPCS,69209,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,248.0,161.2,0.01,3004.0,172
HCPCS,69210,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,253.0,164.45,0.01,3004.0,175
HCPCS,69220,CLEAN OUT MASTOID CAVITY,,,183.59,562.35,19
HCPCS,69220,Clean out mastoid cavity,,,85.44,98.93,8
HCPCS,69220,"DEBRID MASTOIDECTOM CAVITY,SIMP",332.0,215.8,1.1,342.27,53
HCPCS,69222,CLEAN OUT MASTOID CAVITY,,,470.54,1511.66,19
HCPCS,69222,Clean out mastoid cavity,,,745.85,863.61,8
HCPCS,69300,REVISE EXTERNAL EAR,,,2996.53,9292.73,19
HCPCS,69300,Revise external ear,,,2151.73,2491.48,8
HCPCS,69310,REBUILD OUTER EAR CANAL,,,5465.95,16592.38,19
HCPCS,69310,Rebuild outer ear canal,,,2695.9,3121.57,8
HCPCS,69320,REBUILD OUTER EAR CANAL,,,5465.95,16592.38,19
HCPCS,69320,Rebuild outer ear canal,,,2151.73,2491.48,8
HCPCS,69399,ENDOSCOPIC EXTERNAL AUDITORY CANAL (COMP CODE 69200),339.0,220.35,0.01,417.54,28
HCPCS,69399,REVISION OF OSSEOINTEGRATED BONE ANCHORED IMPANT ABUTMENT (COMP,3164.0,2056.6,0.01,3164.0,28
HCPCS,69399,UNLISTED PX EXTERNAL EAR,,,214.57,663.85,19
HCPCS,69399,Unlisted px external ear,,,85.44,98.93,8
HCPCS,69420,INCISION OF EARDRUM,,,214.57,663.85,19
HCPCS,69420,Incision of eardrum,,,85.44,98.93,8
HCPCS,69420,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,552.0,358.8,1.1,634.79,53
HCPCS,69421,INCISION OF EARDRUM,,,2996.53,9292.73,19
HCPCS,69421,Incision of eardrum,,,745.85,863.61,8
HCPCS,69421,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,783.0,508.95,1.1,5497.86,50
HCPCS,69424,REMOVE VENTILATING TUBE,,,2996.53,9292.73,19
HCPCS,69424,Remove ventilating tube,,,745.85,863.61,8
HCPCS,69433,CREATE EARDRUM OPENING,,,470.54,1511.66,19
HCPCS,69433,Create eardrum opening,,,85.44,98.93,8
HCPCS,69433,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,628.0,408.2,1.1,939.01,53
HCPCS,69436,CREATE EARDRUM OPENING,,,1368.67,4348.85,19
HCPCS,69436,Create eardrum opening,,,745.85,863.61,8
HCPCS,69436,TYMPANOSTOMY GENERAL ANESTHESIA,884.0,574.6,1.1,2603.78,50
HCPCS,69440,EXPLORATION OF MIDDLE EAR,,,2996.53,9292.73,19
HCPCS,69440,Exploration of middle ear,,,1237.01,1432.33,8
HCPCS,69450,EARDRUM REVISION,,,2996.53,9292.73,19
HCPCS,69450,Eardrum revision,,,1237.01,1432.33,8
HCPCS,69501,MASTOIDECTOMY,,,5465.95,16592.38,19
HCPCS,69501,Mastoidectomy,,,2695.9,3121.57,8
HCPCS,69501,TRANSMASTOID ANTROTOMY,3684.0,2394.6,1.1,9999.36,50
HCPCS,69502,MASTOIDECTOMY,,,5465.95,16592.38,19
HCPCS,69502,Mastoidectomy,,,2695.9,3121.57,8
HCPCS,69505,REMOVE MASTOID STRUCTURES,,,5465.95,16592.38,19
HCPCS,69505,Remove mastoid structures,,,2151.73,2491.48,8
HCPCS,69511,EXTENSIVE MASTOID SURGERY,,,5465.95,16592.38,19
HCPCS,69511,Extensive mastoid surgery,,,2695.9,3121.57,8
HCPCS,69530,EXTENSIVE MASTOID SURGERY,,,5465.95,16592.38,19
HCPCS,69530,Extensive mastoid surgery,,,2695.9,3121.57,8
HCPCS,69535,Remove part of temporal bone,,,3594.14,4161.63,8
HCPCS,69540,EXCISION AURAL POLYP,500.0,325.0,1.1,4348.85,72
HCPCS,69540,Excision aural polyp,,,745.85,863.61,8
HCPCS,69550,EXC AURL GLOMUS TUM TRNSCANL,,,5465.95,16592.38,19
HCPCS,69550,Exc aurl glomus tum trnscanl,,,2151.73,2491.48,8
HCPCS,69552,EXC AURL GLOMUS TUM TRNSMSTD,,,5465.95,16592.38,19
HCPCS,69552,Exc aurl glomus tum trnsmstd,,,2695.9,3121.57,8
HCPCS,69554,Exc aurl glomus tum extended,,,1237.01,1432.33,8
HCPCS,69601,REVJ MSTDC RSLTG COMPL MSTDC,,,5465.95,16592.38,19
HCPCS,69601,Revj mstdc rsltg compl mstdc,,,2695.9,3121.57,8
HCPCS,69602,REV MSTDC RSLT MOD RAD MSTDC,,,5465.95,16592.38,19
HCPCS,69602,Rev mstdc rslt mod rad mstdc,,,2695.9,3121.57,8
HCPCS,69603,REVJ MSTDC RSLTG RAD MSTDC,,,5465.95,16592.38,19
HCPCS,69603,Revj mstdc rsltg rad mstdc,,,2695.9,3121.57,8
HCPCS,69604,REVJ MSTDC RSLTG TYMPANPLSTY,,,5465.95,16592.38,19
HCPCS,69604,Revj mstdc rsltg tympanplsty,,,2695.9,3121.57,8
HCPCS,69605,Mastoid surgery revision,,,2695.9,3121.57,8
HCPCS,69610,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,1967.0,1278.55,1.1,2603.78,53
HCPCS,69610,TYMPANIC MEMBRANE REPAIR,,,1368.67,4348.85,19
HCPCS,69610,Tympanic membrane repair,,,745.85,863.61,8
HCPCS,69620,MYRINGOPLASTY,2653.0,1724.45,1.1,9292.73,72
HCPCS,69620,Myringoplasty,,,1237.01,1432.33,8
HCPCS,69631,REPAIR EARDRUM STRUCTURES,,,5465.95,16592.38,19
HCPCS,69631,Repair eardrum structures,,,2151.73,2491.48,8
HCPCS,69631,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,4020.0,2613.0,1.1,9999.36,50
HCPCS,69632,REBUILD EARDRUM STRUCTURES,,,5465.95,16592.38,19
HCPCS,69632,Rebuild eardrum structures,,,2695.9,3121.57,8
HCPCS,69633,REBUILD EARDRUM STRUCTURES,,,5465.95,16592.38,19
HCPCS,69633,Rebuild eardrum structures,,,2695.9,3121.57,8
HCPCS,69635,REPAIR EARDRUM STRUCTURES,,,5465.95,16592.38,19
HCPCS,69635,Repair eardrum structures,,,2151.73,2491.48,8
HCPCS,69636,REBUILD EARDRUM STRUCTURES,,,5465.95,16592.38,19
HCPCS,69636,Rebuild eardrum structures,,,2695.9,3121.57,8
HCPCS,69636,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,6172.0,4011.8,1.1,9999.36,50
HCPCS,69637,REBUILD EARDRUM STRUCTURES,,,5465.95,16592.38,19
HCPCS,69637,Rebuild eardrum structures,,,2695.9,3121.57,8
HCPCS,69641,REVISE MIDDLE EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69641,Revise middle ear & mastoid,,,2695.9,3121.57,8
HCPCS,69642,REVISE MIDDLE EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69642,Revise middle ear & mastoid,,,2695.9,3121.57,8
HCPCS,69643,REVISE MIDDLE EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69643,Revise middle ear & mastoid,,,2695.9,3121.57,8
HCPCS,69643,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,6860.0,4459.0,1.1,9999.36,50
HCPCS,69644,REVISE MIDDLE EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69644,Revise middle ear & mastoid,,,2695.9,3121.57,8
HCPCS,69644,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,6892.0,4479.8,1.1,9999.36,50
HCPCS,69645,REVISE MIDDLE EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69645,Revise middle ear & mastoid,,,2695.9,3121.57,8
HCPCS,69645,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,6684.0,4344.6,1.1,9999.36,50
HCPCS,69646,REVISE MIDDLE EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69646,Revise middle ear & mastoid,,,2695.9,3121.57,8
HCPCS,69650,STAPES MOBILIZATION,,,2996.53,9292.73,19
HCPCS,69650,Stapes mobilization,,,2151.73,2491.48,8
HCPCS,69660,REVISE MIDDLE EAR BONE,,,5465.95,16592.38,19
HCPCS,69660,Revise middle ear bone,,,2151.73,2491.48,8
HCPCS,69661,REVISE MIDDLE EAR BONE,,,5465.95,16592.38,19
HCPCS,69661,Revise middle ear bone,,,2151.73,2491.48,8
HCPCS,69662,REVISE MIDDLE EAR BONE,,,5465.95,16592.38,19
HCPCS,69662,Revise middle ear bone,,,2151.73,2491.48,8
HCPCS,69666,REPAIR MIDDLE EAR STRUCTURES,,,2996.53,9292.73,19
HCPCS,69666,Repair middle ear structures,,,1237.01,1432.33,8
HCPCS,69667,REPAIR MIDDLE EAR STRUCTURES,,,2996.53,9292.73,19
HCPCS,69667,Repair middle ear structures,,,1237.01,1432.33,8
HCPCS,69670,REMOVE MASTOID AIR CELLS,,,5465.95,16592.38,19
HCPCS,69670,Remove mastoid air cells,,,2695.9,3121.57,8
HCPCS,69676,REMOVE MIDDLE EAR NERVE,,,2996.53,9292.73,19
HCPCS,69676,Remove middle ear nerve,,,2151.73,2491.48,8
HCPCS,69700,CLOSE MASTOID FISTULA,,,1368.67,4348.85,19
HCPCS,69700,Close mastoid fistula,,,1237.01,1432.33,8
HCPCS,69705,NPS SURG DILAT EUST TUBE UNI,,,5465.95,16592.38,19
HCPCS,69705,Nps surg dilat eust tube uni,,,1124.06,1301.54,8
HCPCS,69705,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,1200.0,780.0,1.1,9999.36,52
HCPCS,69706,NPS SURG DILAT EUST TUBE BI,,,5465.95,16592.38,19
HCPCS,69706,Nps surg dilat eust tube bi,,,1124.06,1301.54,8
HCPCS,69706,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,1708.0,1110.2,1.1,9999.36,52
HCPCS,69710,Implant/replace hearing aid,,,3604.79,4173.97,8
HCPCS,69711,REMOVE/REPAIR HEARING AID,,,2996.53,9292.73,19
HCPCS,69711,Remove/repair hearing aid,,,2151.73,2491.48,8
HCPCS,69714,IMPL OI IMPLT SKULL PERQ ESP,,,11888.68,35984.87,19
HCPCS,69714,Impl oi implt skull perq esp,,,3604.79,4173.97,8
HCPCS,69715,Temple bne implnt w/stimulat,,,3604.79,4173.97,8
HCPCS,69716,IMPL OI IMPLT SK TC ESP<100,,,11888.68,35984.87,19
HCPCS,69716,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,3612.0,2347.8,1.1,22471.68,50
HCPCS,69716,Impl oi implt sk tc esp<100,,,3604.79,4173.97,8
HCPCS,69717,RPLCMT OI IMPLT SKL PRQ ESP,,,6600.66,20338.07,19
HCPCS,69717,Rplcmt oi implt skl prq esp,,,2695.9,3121.57,8
HCPCS,69718,Revise temple bone implant,,,3604.79,4173.97,8
HCPCS,69719,RPLCM OI IMPLT SK TC ESP<100,,,11888.68,35984.87,19
HCPCS,69719,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,4162.0,2705.3,1.1,22471.68,50
HCPCS,69719,Rplcm oi implt sk tc esp<100,,,3604.79,4173.97,8
HCPCS,69720,RELEASE FACIAL NERVE,,,5465.95,16592.38,19
HCPCS,69720,Release facial nerve,,,1352.32,1565.84,8
HCPCS,69725,RELEASE FACIAL NERVE,,,5465.95,16592.38,19
HCPCS,69725,Release facial nerve,,,1352.32,1565.84,8
HCPCS,69726,REMOVAL OI IMPLT SKULL PERQ ATTACHMENT ESP,2544.0,1653.6,1.1,5526.53,50
HCPCS,69726,RMV NTR OI IMPLT SKL PRQ ESP,,,2997.95,9170.92,19
HCPCS,69726,Rmv ntr oi implt skl prq esp,,,1237.01,1432.33,8
HCPCS,69727,REMOVAL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP<100,2952.0,1918.8,1.1,5526.53,50
HCPCS,69727,RMV NTR OI IMP SK TC ESP<100,,,2997.95,9170.92,19
HCPCS,69727,Rmv ntr oi imp sk tc esp<100,,,1237.01,1432.33,8
HCPCS,69728,RMV NTR OI IMP SK TC>=100,,,2997.95,9170.92,19
HCPCS,69728,RMVL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP>=100,3400.0,2210.0,1.1,5526.53,50
HCPCS,69728,Rmv ntr oi imp sk tc>=100,,,1237.01,1432.33,8
HCPCS,69729,IMPL OI IMPLT SK TC ESP>=100,,,11888.68,35984.87,19
HCPCS,69729,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,3988.0,2592.2,1.1,22471.68,50
HCPCS,69729,Impl oi implt sk tc esp>=100,,,3604.79,4173.97,8
HCPCS,69730,RPLC OI IMPLT SK TC ESP>=100,,,11888.68,35984.87,19
HCPCS,69730,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,4100.0,2665.0,1.1,22471.68,50
HCPCS,69730,Rplc oi implt sk tc esp>=100,,,3604.79,4173.97,8
HCPCS,69740,REPAIR FACIAL NERVE,,,5465.95,16592.38,19
HCPCS,69740,Repair facial nerve,,,1352.32,1565.84,8
HCPCS,69745,REPAIR FACIAL NERVE,,,5465.95,16592.38,19
HCPCS,69745,Repair facial nerve,,,1352.32,1565.84,8
HCPCS,69799,DEBRID PURULENT MID EAR,302.0,196.3,0.01,3004.0,61
HCPCS,69801,INCISE INNER EAR,,,1368.67,4348.85,19
HCPCS,69801,Incise inner ear,,,745.85,863.61,8
HCPCS,69801,LABYRINTHOTOMY TRANSCANAL,906.0,588.9,1.1,2603.78,53
HCPCS,69805,EXPLORE INNER EAR,,,5465.95,16592.38,19
HCPCS,69805,Explore inner ear,,,2695.9,3121.57,8
HCPCS,69806,EXPLORE INNER EAR,,,5465.95,16592.38,19
HCPCS,69806,Explore inner ear,,,2151.73,2491.48,8
HCPCS,69905,"EXCIS LABYRINTH,TRANSCANAL",4954.0,3220.1,1.1,9999.36,50
HCPCS,69905,REMOVE INNER EAR,,,5465.95,16592.38,19
HCPCS,69905,Remove inner ear,,,2151.73,2491.48,8
HCPCS,69910,REMOVE INNER EAR & MASTOID,,,5465.95,16592.38,19
HCPCS,69910,Remove inner ear & mastoid,,,2695.9,3121.57,8
HCPCS,69915,INCISE INNER EAR NERVE,,,2996.53,9292.73,19
HCPCS,69915,Incise inner ear nerve,,,2151.73,2491.48,8
HCPCS,69930,IMPLANT COCHLEAR DEVICE,,,29389.79,92415.85,19
HCPCS,69930,Implant cochlear device,,,7765.06,8991.13,8
HCPCS,69949,UNLISTED PX INNER EAR,,,214.57,663.85,19
HCPCS,69949,Unlisted px inner ear,,,745.85,863.61,8
HCPCS,69950,Incise inner ear nerve,,,3997.78,4629.01,8
HCPCS,69955,RELEASE FACIAL NERVE,,,5465.95,16592.38,19
HCPCS,69955,Release facial nerve,,,3997.78,4629.01,8
HCPCS,69960,RELEASE INNER EAR CANAL,,,5465.95,16592.38,19
HCPCS,69960,Release inner ear canal,,,3997.78,4629.01,8
HCPCS,69970,REMOVE INNER EAR LESION,,,5465.95,16592.38,19
HCPCS,69970,Remove inner ear lesion,,,3594.14,4161.63,8
HCPCS,69979,UNLISTED PX TEMPORAL BONE,,,214.57,663.85,19
HCPCS,69979,Unlisted px temporal bone,,,1634.67,1892.77,8
HCPCS,69990,MICROSURG TQS REQ USE OPERATING MICROSCOPE,1384.0,899.6,1.1,1384.0,50
HCPCS,69990,Microsurgery add-on,,,321.96,372.8,8
HCPCS,70010,CONTRAST X-RAY OF BRAIN,,,329.98,1863.61,21
HCPCS,70010,Contrast x-ray of brain,,,302.11,349.81,8
HCPCS,70015,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,5451.0,3543.15,0.87,5451.0,61
HCPCS,70030,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,0.87,687.0,279
HCPCS,70100,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,608.0,395.2,0.87,680.0,157
HCPCS,7010F,Pt info into recall system,,,8.48,9.82,8
HCPCS,70110,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,734.0,477.1,0.87,834.0,157
HCPCS,70120,X-RAY EXAM OF MASTOIDS,,,98.26,551.66,21
HCPCS,70120,X-ray exam of mastoids,,,45.07,52.18,8
HCPCS,70130,X-RAY EXAM OF MASTOIDS,,,98.26,551.66,21
HCPCS,70130,X-ray exam of mastoids,,,45.07,52.18,8
HCPCS,70134,X-RAY EXAM OF MIDDLE EAR,,,506.62,2444.63,21
HCPCS,70134,X-ray exam of middle ear,,,45.07,52.18,8
HCPCS,70140,RADEX FACIAL BONES < 3 VIEWS,608.0,395.2,0.87,684.0,157
HCPCS,70150,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,734.0,477.1,0.87,838.0,157
HCPCS,70160,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,676.0,157
HCPCS,70170,X-RAY EXAM OF TEAR DUCT,,,223.34,1165.03,21
HCPCS,70170,X-ray exam of tear duct,,,113.2,131.08,8
HCPCS,70190,X-RAY EXAM OF EYE SOCKETS,,,81.36,409.57,21
HCPCS,70190,X-ray exam of eye sockets,,,45.07,52.18,8
HCPCS,70200,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,734.0,477.1,0.87,846.0,157
HCPCS,7020F,Mammo assess cat in dbase,,,8.48,9.82,8
HCPCS,70210,RADEX SINUSES PARANASAL <3 VIEWS,608.0,395.2,0.87,676.0,157
HCPCS,70220,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,608.0,395.2,0.87,705.0,157
HCPCS,70240,X-RAY EXAM PITUITARY SADDLE,,,81.36,409.57,21
HCPCS,70240,X-ray exam pituitary saddle,,,45.07,52.18,8
HCPCS,70250,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,734.0,477.1,0.87,813.0,157
HCPCS,7025F,Pt infosys alarm 4 nxt mammo,,,8.48,9.82,8
HCPCS,70260,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,734.0,477.1,0.87,846.0,157
HCPCS,70300,RADIOLOGIC EXAMINATION TEETH 1 VIEW,344.0,223.6,1.1,648.0,96
HCPCS,70300,X-RAY EXAM OF TEETH,,,81.36,409.57,21
HCPCS,70300,X-ray exam of teeth,,,45.07,52.18,8
HCPCS,70310,X-RAY EXAM OF TEETH,,,223.34,1165.03,21
HCPCS,70310,X-ray exam of teeth,,,45.07,52.18,8
HCPCS,70320,FULL MOUTH X-RAY OF TEETH,,,223.34,1165.03,21
HCPCS,70320,Full mouth x-ray of teeth,,,45.07,52.18,8
HCPCS,70320,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,922.0,599.3000000000001,1.1,1756.0,96
HCPCS,70328,X-RAY EXAM OF JAW JOINT,,,81.36,409.57,21
HCPCS,70328,X-ray exam of jaw joint,,,45.07,52.18,8
HCPCS,70330,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,608.0,395.2,0.87,704.0,157
HCPCS,70332,X-RAY EXAM OF JAW JOINT,,,223.34,1165.03,21
HCPCS,70332,X-ray exam of jaw joint,,,113.2,131.08,8
HCPCS,70336,MRI TEMPOROMANDIBULAR JOINT,1130.0,734.5,0.87,1668.0,106
HCPCS,70350,CEPHALOGRAM ORTHODONTIC,372.0,241.79999999999998,1.1,676.0,96
HCPCS,70350,X-RAY HEAD FOR ORTHODONTIA,,,81.36,409.57,21
HCPCS,70350,X-ray head for orthodontia,,,45.07,52.18,8
HCPCS,70355,ORTHOPANTOGRAM,608.0,395.2,0.87,696.0,157
HCPCS,70360,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,647.5,420.875,0.87,687.0,158
HCPCS,70370,THROAT X-RAY & FLUOROSCOPY,,,81.36,409.57,21
HCPCS,70370,Throat x-ray & fluoroscopy,,,45.07,52.18,8
HCPCS,70371,SPEECH EVALUATION COMPLEX,,,223.34,1165.03,21
HCPCS,70371,Speech evaluation complex,,,113.2,131.08,8
HCPCS,70380,X-RAY EXAM OF SALIVARY GLAND,,,81.36,409.57,21
HCPCS,70380,X-ray exam of salivary gland,,,45.07,52.18,8
HCPCS,70390,X-RAY EXAM OF SALIVARY DUCT,,,223.34,1165.03,21
HCPCS,70390,X-ray exam of salivary duct,,,113.2,131.08,8
HCPCS,70450,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,0.87,1108.0,264
HCPCS,70460,CT HEAD/BRAIN W/CONTRAST MATERIAL,862.5,560.625,0.87,1228.0,106
HCPCS,70470,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1787.0,203
HCPCS,70471,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,2459.0,1598.35,0.87,3559.0,164
HCPCS,70472,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1228.0,798.2,0.87,1567.0,155
HCPCS,70473,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1236.0,803.4,0.87,1676.0,164
HCPCS,70480,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,734.0,477.1,0.87,1297.0,203
HCPCS,70481,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,862.5,560.625,0.87,1228.0,106
HCPCS,70482,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,893.5,580.7750000000001,0.87,1228.0,106
HCPCS,70486,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,734.0,477.1,0.87,1108.0,157
HCPCS,70487,CT MAXILLOFACIAL W/CONTRAST MATERIAL,862.5,560.625,0.87,1228.0,106
HCPCS,70488,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,893.5,580.7750000000001,0.87,1228.0,106
HCPCS,70490,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,648.5,421.525,0.87,734.0,106
HCPCS,70491,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1228.0,798.2,0.87,1835.0,203
HCPCS,70492,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,970.5,630.825,0.87,1228.0,106
HCPCS,70496,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1998.0,203
HCPCS,70498,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,1998.0,203
HCPCS,70540,MRI ORBIT FACE &/NECK W/O CONTRAST,1131.0,735.1500000000001,0.87,1668.0,106
HCPCS,70542,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,2464.0,1601.6,0.87,3112.0,203
HCPCS,70543,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,2464.0,1601.6,0.87,3324.0,203
HCPCS,70544,MRA HEAD W/O CONTRST MATERIAL,1668.0,1084.2,0.87,1668.0,61
HCPCS,70544,"MRA, HEAD W/O CONTRAST",1668.0,1084.2,1.1,2148.0,142
HCPCS,70545,MRA HEAD W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
HCPCS,70546,MRA HEAD W/O & W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
HCPCS,70546,MRA; HEAD W & WO CONTRAST,651.0,423.15,1.1,651.0,45
HCPCS,70547,MRA NECK W/O CONTRST MATERIAL,1668.0,1084.2,0.87,1668.0,61
HCPCS,70547,"MRA, NECK; W/O CONTRAST",1668.0,1084.2,1.1,2196.0,142
HCPCS,70548,MRA NECK W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
HCPCS,70549,MRA NECK W/O &W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
HCPCS,70549,"MRA,NECK; W/WO CONTRAST",1952.0,1268.8,1.1,3184.0,96
HCPCS,70551,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,2319.0,203
HCPCS,70552,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,1623.5,1055.2749999999999,0.87,2464.0,106
HCPCS,70553,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,2419.5,1572.675,0.87,3360.0,203
HCPCS,70554,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,1668.0,1084.2,0.87,1668.0,61
HCPCS,70555,FMRI BRAIN BY PHYS/PSYCH,,,223.34,1165.03,21
HCPCS,70555,Fmri brain by phys/psych,,,202.79,234.81,8
HCPCS,70557,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,3783.0,2458.95,0.87,3783.0,61
HCPCS,70558,MRI BRAIN W/DYE,,,164.49,903.92,21
HCPCS,70558,Mri brain w/dye,,,306.46,354.85,8
HCPCS,70559,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1228.0,798.2,0.87,1228.0,61
HCPCS,71045,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,0.87,687.0,218
HCPCS,71046,RADIOLOGIC EXAM CHEST 2 VIEWS,585.0,380.25,0.87,705.0,264
HCPCS,71047,RADIOLOGIC EXAM CHEST 3 VIEWS,608.0,395.2,0.87,727.0,157
HCPCS,71048,RADIOLOGIC EXAM CHEST 4+ VIEWS,734.0,477.1,0.87,870.0,157
HCPCS,71100,RADEX RIBS UNILATERAL 2 VIEWS,608.0,395.2,0.87,696.0,157
HCPCS,71101,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,734.0,477.1,0.87,842.0,157
HCPCS,71110,RADEX RIBS BILATERAL 3 VIEWS,734.0,477.1,0.87,862.0,157
HCPCS,71111,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,734.0,477.1,0.87,862.0,157
HCPCS,71120,RADEX STERNUM MINIMUM 2 VIEWS,608.0,395.2,0.87,696.0,157
HCPCS,71130,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,608.0,395.2,0.87,705.0,157
HCPCS,71250,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,706.5,459.225,0.87,1144.0,264
HCPCS,71260,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1181.5,767.975,0.87,1634.0,264
HCPCS,71270,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,889.0,577.85,0.87,1228.0,106
HCPCS,71271,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,734.0,477.1,0.87,1209.0,157
HCPCS,71275,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1228.0,798.2,0.87,2029.0,203
HCPCS,71550,MRI CHEST W/O CONTRAST MATERIAL,1126.0,731.9000000000001,0.87,1668.0,106
HCPCS,71551,MRI CHEST W/CONTRAST MATERIAL,5451.0,3543.15,0.87,5451.0,61
HCPCS,71552,MRI CHEST W/O & W/CONTRAST MATERIAL,1684.0,1094.6,0.87,2464.0,106
HCPCS,71555,MR ANGIO CHEST (MRA),6274.0,4078.1,1.1,7070.0,142
HCPCS,71555,MRA CHEST W CON,6274.0,4078.1,0.87,6274.0,46
HCPCS,71555,MRA CHEST W CONTRAST,6274.0,4078.1,0.87,7070.0,188
HCPCS,71555,MRA CHEST W/O & W/CONTRAST MATERIAL,6274.0,4078.1,1.1,7070.0,142
HCPCS,71555,MRA CHEST WITH OR W/O CONT,3933.0,2556.45,1.1,7070.0,96
HCPCS,71555,MRA CHEST WO,6274.0,4078.1,0.87,6274.0,46
HCPCS,71555,MRA CHEST WO CONTR,6274.0,4078.1,0.87,6274.0,46
HCPCS,71555,MRA CHEST WO/W,6274.0,4078.1,0.87,6274.0,46
HCPCS,71555,MRA CHEST WO/W CONTR,6274.0,4078.1,0.87,6274.0,46
HCPCS,72020,RADEX SPINE 1 VIEW SPECIFY LEVEL,608.0,395.2,0.87,672.0,157
HCPCS,72040,RADEX SPINE CERVICAL 2 OR 3 VIEWS,608.0,395.2,0.87,705.0,157
HCPCS,72050,RADEX SPINE CERVICAL 4 OR 5 VIEWS,734.0,477.1,0.87,853.0,157
HCPCS,72052,RADEX SPINE CERVICAL 6 OR MORE VIEWS,734.0,477.1,0.87,866.0,157
HCPCS,72070,RADEX SPINE THORACIC 2 VIEWS,734.0,477.1,0.87,822.0,157
HCPCS,72072,RADEX SPINE THORACIC 3 VIEWS,734.0,477.1,0.87,835.0,157
HCPCS,72074,RADEX SPINE THORACIC MINIMUM 4 VIEWS,422.0,274.3,0.87,734.0,106
HCPCS,72080,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,608.0,395.2,0.87,692.0,157
HCPCS,72081,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,0.87,722.0,203
HCPCS,72082,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,0.87,870.0,203
HCPCS,72083,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,734.0,477.1,0.87,888.0,203
HCPCS,72084,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,734.0,477.1,0.87,914.0,203
HCPCS,72100,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,734.0,477.1,0.87,831.0,157
HCPCS,72110,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,734.0,477.1,0.87,848.0,157
HCPCS,72114,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,734.0,477.1,0.87,866.0,157
HCPCS,72120,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,734.0,477.1,0.87,831.0,203
HCPCS,72125,CT CERVICAL SPINE W/O CONTRAST MATERIAL,587.0,381.55,0.87,734.0,167
HCPCS,72126,CT CERVICAL SPINE W/CONTRAST MATERIAL,1476.0,959.4,0.87,2464.0,106
HCPCS,72127,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,868.0,564.2,0.87,1228.0,106
HCPCS,72128,CT THORACIC SPINE W/O CONTRAST MATERIAL,734.0,477.1,0.87,1134.0,203
HCPCS,72129,CT THORACIC SPINE W/CONTRAST MATERIAL,1228.0,798.2,0.87,1716.0,203
HCPCS,72130,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1736.0,203
HCPCS,72131,CT LUMBAR SPINE W/O CONTRAST MATERIAL,587.0,381.55,0.87,734.0,106
HCPCS,72132,CT LUMBAR SPINE W/CONTRAST MATERIAL,2464.0,1601.6,0.87,3001.0,203
HCPCS,72133,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1787.0,203
HCPCS,72141,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,1668.0,1084.2,0.87,2319.0,203
HCPCS,72142,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,2464.0,1601.6,0.87,3247.0,203
HCPCS,72146,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,1668.0,1084.2,0.87,2319.0,203
HCPCS,72147,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,2464.0,1601.6,0.87,3247.0,203
HCPCS,72148,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,2260.0,157
HCPCS,72149,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,1588.0,1032.2,0.87,2464.0,106
HCPCS,72156,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,2464.0,1601.6,0.87,3472.0,203
HCPCS,72157,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,2464.0,1601.6,0.87,3380.0,203
HCPCS,72158,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,2464.0,1601.6,0.87,3380.0,203
HCPCS,72159,MR ANGIO SPINE (MRA),3068.0,1994.2,1.1,3788.0,142
HCPCS,72159,MRA SPINAL CANAL WO/W,3068.0,1994.2,0.87,3068.0,46
HCPCS,72159,MRA SPINE WITH OR W/O CONT,3068.0,1994.2,1.1,3788.0,142
HCPCS,72159,MRA W/CONTRAST SPINAL CANAL,3068.0,1994.2,0.87,3068.0,46
HCPCS,72159,MRA W/O CONTRAST SPINAL CANAL,3068.0,1994.2,0.87,3068.0,46
HCPCS,72159,MRA WO/W CONTRAST SPINAL CANAL,3068.0,1994.2,1.1,3788.0,142
HCPCS,72170,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,734.0,477.1,0.87,809.0,157
HCPCS,72190,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,734.0,477.1,0.87,844.0,157
HCPCS,72191,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,976.0,634.4000000000001,0.87,1228.0,106
HCPCS,72192,CT PELVIS W/O CONTRAST MATERIAL,585.0,380.25,0.87,734.0,106
HCPCS,72193,CT PELVIS W/CONTRAST MATERIAL,1228.0,798.2,0.87,1738.0,203
HCPCS,72194,CT PELVIS W/O & W/CONTRAST MATERIAL,882.5,573.625,0.87,1228.0,106
HCPCS,72195,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,2310.0,264
HCPCS,72196,MRI PELVIS W/CONTRAST MATERIAL,1612.5,1048.125,0.87,2464.0,106
HCPCS,72197,MRI PELVIS W/O & W/CONTRAST MATERIAL,2464.0,1601.6,0.87,3432.0,203
HCPCS,72198,MRA PELV W CONTRL,6296.0,4092.4,0.87,7088.0,188
HCPCS,72198,MRA PELV WO CONTRL,6296.0,4092.4,0.87,7088.0,188
HCPCS,72198,MRA PELV WO/W CONTR,6296.0,4092.4,0.87,6296.0,92
HCPCS,72198,MRA PELVIS W/WO CONTRAST MATERIAL,6296.0,4092.4,1.1,7088.0,142
HCPCS,72198,MRA PELVIS WITH OR W/O CONT,792.0,514.8,1.1,792.0,45
HCPCS,72200,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,734.0,477.1,0.87,809.0,157
HCPCS,72202,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,734.0,477.1,0.87,835.0,157
HCPCS,72220,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,608.0,395.2,0.87,676.0,157
HCPCS,72240,MYELOGRAPHY CERVICAL RS&I,5451.0,3543.15,0.87,5815.0,203
HCPCS,72255,MYELOGRAPHY THORACIC RS&I,5451.0,3543.15,0.87,5451.0,61
HCPCS,72265,MYELOGRAPY LUMBOSACRAL RS&I,5451.0,3543.15,0.87,5783.0,203
HCPCS,72270,MYELOGRAPY 2/MORE REGIONS RS&I,5451.0,3543.15,0.87,5983.0,203
HCPCS,72275,Epidurography,,,89.44,103.57,8
HCPCS,72285,DISKOGRAPY CERVICAL/THORACIC RS&I,13474.0,8758.1,0.87,13474.0,61
HCPCS,72295,DISKOGRAPY LUMBAR RS&I,6903.0,4486.95,0.87,13474.0,203
HCPCS,73000,RADEX CLAVICLE COMPLETE,608.0,395.2,0.87,672.0,401
HCPCS,73010,RADEX SCAPULA COMPLETE,734.0,477.1,0.87,809.0,401
HCPCS,73020,RADEX SHOULDER 1 VIEW,608.0,395.2,0.87,674.0,218
HCPCS,73030,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,585.0,380.25,0.87,687.0,691
HCPCS,73040,RADEX SHOULDER ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2702.0,157
HCPCS,73050,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,608.0,395.2,0.87,687.0,157
HCPCS,73060,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,0.87,672.0,340
HCPCS,73070,RADEX ELBOW 2 VIEWS,608.0,395.2,0.87,672.0,401
HCPCS,73080,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,676.0,462
HCPCS,73085,RADEX ELBOW ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,122
HCPCS,73090,RADEX FOREARM 2 VIEWS,608.0,395.2,0.87,672.0,401
HCPCS,73092,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,734.0,477.1,0.87,798.0,218
HCPCS,73100,RADEX WRIST 2 VIEWS,608.0,395.2,0.87,672.0,462
HCPCS,73110,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,683.0,706
HCPCS,73115,RADEX WRIST ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
HCPCS,73120,RADEX HAND 2 VIEWS,734.0,477.1,0.87,798.0,706
HCPCS,73130,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,0.87,683.0,645
HCPCS,73140,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,0.87,660.0,218
HCPCS,73200,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,0.87,1174.0,264
HCPCS,73201,CT UPPER EXTREMITY W/CONTRAST MATERIAL,1487.0,966.55,0.87,2464.0,106
HCPCS,73202,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
HCPCS,73206,CT ANGIOGRAPHY UPPER EXTREMITY,976.0,634.4000000000001,0.87,1228.0,106
HCPCS,73218,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,1104.0,717.6,0.87,1668.0,167
HCPCS,73219,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,2464.0,1601.6,0.87,2464.0,61
HCPCS,73220,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,1662.0,1080.3,0.87,2464.0,106
HCPCS,73221,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,1104.0,717.6,0.87,1668.0,167
HCPCS,73222,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,3049.5,1982.175,0.87,5451.0,106
HCPCS,73223,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,1662.0,1080.3,0.87,2464.0,106
HCPCS,73225,MR ANGIO UPPER EXTREM,6296.0,4092.4,1.1,7088.0,142
HCPCS,73225,MRA UPPER EXT W CONT,6296.0,4092.4,0.87,6296.0,46
HCPCS,73225,MRA UPPER EXT WO CONT,4288.0,2787.2,0.87,4980.0,188
HCPCS,73225,MRA UPPER EXT WO/W CONT,4288.0,2787.2,0.87,4288.0,46
HCPCS,73225,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,4288.0,2787.2,1.1,4980.0,142
HCPCS,73501,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,343.5,223.275,0.87,608.0,264
HCPCS,73502,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,0.87,705.0,203
HCPCS,73503,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,734.0,477.1,0.87,853.0,157
HCPCS,73521,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,734.0,477.1,0.87,822.0,203
HCPCS,73522,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,0.87,862.0,264
HCPCS,73523,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,0.87,858.0,264
HCPCS,73525,RADEX HIP ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2680.0,157
HCPCS,73551,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,0.87,672.0,264
HCPCS,73552,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,0.87,687.0,569
HCPCS,73560,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,0.87,678.0,767
HCPCS,73562,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,0.87,687.0,523
HCPCS,73564,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,0.87,831.0,645
HCPCS,73565,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,608.0,395.2,0.87,672.0,157
HCPCS,73580,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,2464.0,1601.6,0.87,2464.0,61
HCPCS,73590,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,0.87,672.0,523
HCPCS,73592,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,608.0,395.2,0.87,678.0,218
HCPCS,73600,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,0.87,672.0,462
HCPCS,73610,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,0.87,683.0,645
HCPCS,73615,CONTRAST X-RAY OF ANKLE,,,329.98,1863.61,21
HCPCS,73615,Contrast x-ray of ankle,,,113.2,131.08,8
HCPCS,73620,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,0.87,672.0,462
HCPCS,73630,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,585.0,380.25,0.87,683.0,691
HCPCS,73650,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,0.87,672.0,523
HCPCS,73660,RADEX TOE MINIMUM 2 VIEWS,608.0,395.2,0.87,660.0,157
HCPCS,73700,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,587.0,381.55,0.87,734.0,167
HCPCS,73701,CT LOWER EXTREMITY W/CONTRAST MATERIAL,869.0,564.85,0.87,1228.0,167
HCPCS,73702,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,882.5,573.625,0.87,1228.0,106
HCPCS,73706,CT ANGIOGRAPHY LOWER EXTREMITY,994.0,646.1,0.87,1228.0,167
HCPCS,73718,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,1131.0,735.1500000000001,0.87,1668.0,167
HCPCS,73719,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,1588.5,1032.5249999999999,0.87,2464.0,106
HCPCS,73720,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,1705.0,1108.25,0.87,2464.0,106
HCPCS,73721,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,1131.0,735.1500000000001,0.87,1668.0,167
HCPCS,73722,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,3082.0,2003.3,0.87,5451.0,167
HCPCS,73723,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,1705.0,1108.25,0.87,2464.0,167
HCPCS,73725,MR ANGIO LOWER EXTREM (MRA),6006.0,3903.9,1.1,6734.0,142
HCPCS,73725,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,6006.0,3903.9,1.1,6734.0,142
HCPCS,73725,MRA LWR EX WO/W,6006.0,3903.9,0.87,6006.0,46
HCPCS,73725,MRA LWR EXT W CONTR,6006.0,3903.9,0.87,6006.0,46
HCPCS,73725,MRA LWR EXT W CONTRL,6006.0,3903.9,1.1,6734.0,142
HCPCS,73725,MRA LWR EXT WO CONTR,6006.0,3903.9,0.87,6006.0,46
HCPCS,73725,MRA LWR EXT WO/W CONTR,6006.0,3903.9,0.87,6006.0,46
HCPCS,74018,RADIOLOGIC EXAM ABDOMEN 1 VIEW,608.0,395.2,0.87,687.0,157
HCPCS,74019,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,0.87,835.0,218
HCPCS,74021,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,734.0,477.1,0.87,853.0,157
HCPCS,74022,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,734.0,477.1,0.87,875.0,157
HCPCS,74150,CT ABDOMEN W/O CONTRAST,734.0,477.1,1.1,1258.0,142
HCPCS,74150,CT ABDOMEN W/O CONTRAST MATERIAL,734.0,477.1,0.87,734.0,61
HCPCS,74160,CT ABDOMEN W/CONTRAST,1228.0,798.2,1.1,1787.0,142
HCPCS,74160,CT ABDOMEN W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
HCPCS,74170,CT ABDOMEN W & W/O CONTRAST,1228.0,798.2,1.1,1844.0,142
HCPCS,74170,CT ABDOMEN W/O & W/CONTRAST MATERIAL,1228.0,798.2,0.87,1228.0,61
HCPCS,74174,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,2464.0,1601.6,0.87,2464.0,61
HCPCS,74174,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,968.0,629.2,1.1,968.0,45
HCPCS,74175,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,978.0,635.7,0.87,1228.0,106
HCPCS,74176,CT ABD & PELVIS W/O CONTRAST,766.0,497.9,1.1,766.0,45
HCPCS,74176,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
HCPCS,74177,CT ABD & PELVIS W/CONTRAST,2375.0,1543.75,1.1,3265.0,142
HCPCS,74177,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,0.87,2464.0,61
HCPCS,74178,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,2464.0,1601.6,1.1,3268.0,142
HCPCS,74178,CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE,2464.0,1601.6,0.87,2464.0,61
HCPCS,74181,MRI ABDOMEN W/O CONTRAST MATERIAL,1668.0,1084.2,0.87,1668.0,61
HCPCS,74181,"MRI, ABDOMEN (MRI)",1668.0,1084.2,1.1,2252.0,142
HCPCS,74182,MRI ABDOMEN W/CONTRAST MATERIAL,1612.5,1048.125,0.87,2464.0,106
HCPCS,74183,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,1716.0,1115.4,0.87,2464.0,106
HCPCS,74185,MR ABDOMINAL AORTA ANGIOGRAM,2579.0,1676.35,1.1,3299.0,142
HCPCS,74185,MRA ABD W CONT,2579.0,1676.35,0.87,2579.0,46
HCPCS,74185,MRA ABD W CONTR,2579.0,1676.35,0.87,3299.0,188
HCPCS,74185,MRA ABD WITH OR W/O CONT,2579.0,1676.35,1.1,3299.0,142
HCPCS,74185,MRA ABD WO CONT,2579.0,1676.35,0.87,2579.0,46
HCPCS,74185,MRA ABD WO CONTR,2579.0,1676.35,0.87,2579.0,46
HCPCS,74185,MRA ABD WO/W CONTR,2579.0,1676.35,0.87,2579.0,46
HCPCS,74185,MRA ABDOMEN WO/W CONT,2579.0,1676.35,0.87,2579.0,46
HCPCS,74190,PERITONEOGRAM RS&I,3783.0,2458.95,0.87,3783.0,61
HCPCS,74210,X-RAY XM PHRNX&/CRV ESOPH C+,,,164.49,903.92,21
HCPCS,74210,X-ray xm phrnx&/crv esoph c+,,,45.07,52.18,8
HCPCS,74220,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,734.0,477.1,0.87,1228.0,106
HCPCS,74221,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1228.0,798.2,0.87,1508.0,157
HCPCS,74230,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,720.0,468.0,0.87,1228.0,106
HCPCS,74235,Remove esophagus obstruction,,,89.44,103.57,8
HCPCS,74240,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,774.0,503.1,0.87,1228.0,106
HCPCS,74246,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,794.0,516.1,0.87,1228.0,106
HCPCS,74248,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,795.0,516.75,0.87,1075.0,142
HCPCS,74250,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,776.0,504.40000000000003,0.87,1228.0,106
HCPCS,74251,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,848.0,551.2,0.87,1228.0,106
HCPCS,74261,CT COLONOGRAPHY DX,,,98.26,551.66,21
HCPCS,74261,Ct colonography dx,,,145.8,168.82,8
HCPCS,74262,CT COLONOGRAPHY DX W/DYE,,,164.49,903.92,21
HCPCS,74262,Ct colonography dx w/dye,,,312.54,361.89,8
HCPCS,74263,CT COLONOGRAPHY SCREENING,,,223.34,3345.71,20
HCPCS,74263,Ct colonography screening,,,145.8,168.82,8
HCPCS,74270,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,822.0,534.3,0.87,1228.0,106
HCPCS,74280,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,866.0,562.9000000000001,0.87,1228.0,106
HCPCS,74283,THER NMA RDCTJ INTUS/OBSTRCJ,,,164.49,903.92,21
HCPCS,74283,Ther nma rdctj intus/obstrcj,,,113.2,131.08,8
HCPCS,74290,CONTRAST X-RAY GALLBLADDER,,,164.49,903.92,21
HCPCS,74290,Contrast x-ray gallbladder,,,113.2,131.08,8
HCPCS,74300,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1101.0,715.65,0.87,1227.0,164
HCPCS,74301,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,148.0,96.19999999999999,0.87,214.0,91
HCPCS,74328,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,0.87,620.0,210
HCPCS,74329,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,488.0,317.2,0.87,757.0,91
HCPCS,74330,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,593.5,385.775,0.87,927.0,91
HCPCS,74340,INTRO LONG GI TUBE W/FLUORO/FILMS,211.0,137.15,1.1,211.0,45
HCPCS,74340,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,632.0,410.8,0.87,632.0,46
HCPCS,74355,X-ray guide intestinal tube,,,89.44,103.57,8
HCPCS,74360,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,552.5,359.125,0.87,894.0,91
HCPCS,74363,X-ray bile duct dilation,,,89.44,103.57,8
HCPCS,74400,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1228.0,798.2,0.87,1444.0,157
HCPCS,74410,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1228.0,798.2,0.87,1228.0,61
HCPCS,74415,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1228.0,798.2,0.87,1228.0,61
HCPCS,74420,UROGRAPHY RETROGRADE WITH/WO KUB,2464.0,1601.6,0.87,2672.0,203
HCPCS,74425,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2464.0,1601.6,0.87,2668.0,157
HCPCS,74430,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2464.0,1601.6,0.87,2605.0,203
HCPCS,74440,X-RAY MALE GENITAL TRACT,,,223.34,1165.03,21
HCPCS,74440,X-ray male genital tract,,,113.2,131.08,8
HCPCS,74445,X-RAY EXAM OF PENIS,,,98.26,551.66,21
HCPCS,74445,X-ray exam of penis,,,113.2,131.08,8
HCPCS,74450,URETHROCYSTOGRAPHY RETROGRADE RS&I,1668.0,1084.2,0.87,1800.0,179
HCPCS,74455,URETHROCYSTOGRAPHY VOIDING RS&I,1668.0,1084.2,0.87,1800.0,203
HCPCS,74470,X-RAY EXAM OF KIDNEY LESION,,,506.62,2444.63,21
HCPCS,74470,X-ray exam of kidney lesion,,,113.2,131.08,8
HCPCS,74485,DILATION URETERS/URETHRA RS&I,14135.0,9187.75,0.87,14135.0,61
HCPCS,74710,X-RAY MEASUREMENT OF PELVIS,,,205.96,205.96,1
HCPCS,74710,X-ray measurement of pelvis,,,45.07,52.18,8
HCPCS,74712,MRI FETAL SNGL/1ST GESTATION,,,223.34,1165.03,21
HCPCS,74712,Mri fetal sngl/1st gestation,,,202.79,234.81,8
HCPCS,74713,MRI FETAL EA ADDL GESTATION,,,390.01,390.01,1
HCPCS,74713,Mri fetal ea addl gestation,,,202.79,234.81,8
HCPCS,74740,HYSTEROSALPINGOGRAPHY RS&I,910.0,591.5,0.87,1668.0,106
HCPCS,74742,X-ray fallopian tube,,,89.44,103.57,8
HCPCS,74775,X-RAY EXAM OF PERINEUM,,,223.34,1165.03,21
HCPCS,74775,X-ray exam of perineum,,,113.2,131.08,8
HCPCS,75557,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,1668.0,1084.2,0.87,2608.0,157
HCPCS,75559,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,3783.0,2458.95,0.87,3783.0,61
HCPCS,75561,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,2464.0,1601.6,0.87,3608.0,157
HCPCS,75563,CARDIAC MRI W/W/O CONTRAST W/STRESS,5451.0,3543.15,0.87,5451.0,61
HCPCS,75565,CARDIAC MRI FOR VELOCITY FLOW MAPPING,566.0,367.9,0.87,676.0,142
HCPCS,75571,CT CALCIUM SCORING - SELF PAY,608.0,395.2,0.87,840.0,203
HCPCS,75571,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,608.0,395.2,0.87,840.0,157
HCPCS,75571,CT HRT W/O DYE W/CA TEST,608.0,395.2,0.87,608.0,61
HCPCS,75572,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,1582.0,1028.3,0.87,2464.0,106
HCPCS,75573,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,1742.0,1132.3,0.87,2464.0,106
HCPCS,75574,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,2464.0,1601.6,0.87,3424.0,157
HCPCS,75577,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6558.0,4262.7,0.87,6932.0,164
HCPCS,75580,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7020.0,4563.0,0.87,7350.0,203
HCPCS,75600,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,21914.0,142
HCPCS,75600,CONTRAST EXAM THORACIC AORTA,,,2908.23,14487.17,20
HCPCS,75600,Contrast exam thoracic aorta,,,787.47,911.81,8
HCPCS,75605,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37299.0,24244.35,0.87,37801.0,157
HCPCS,75625,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,21718.0,14116.7,0.87,22294.0,157
HCPCS,75630,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,21718.0,14116.7,0.87,22518.0,203
HCPCS,75635,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1094.0,711.1,0.87,1228.0,157
HCPCS,75705,ANGIOGRAPHY SPINAL SELECTIVE RS&I,37299.0,24244.35,0.87,38171.0,157
HCPCS,75710,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,21718.0,14116.7,0.87,22418.0,203
HCPCS,75716,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,21718.0,14116.7,0.87,22506.0,157
HCPCS,75726,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,0.87,38119.0,157
HCPCS,75731,ARTERY X-RAYS ADRENAL GLAND,,,2908.23,14487.17,20
HCPCS,75731,Artery x-rays adrenal gland,,,787.47,911.81,8
HCPCS,75733,ARTERY X-RAYS ADRENALS,,,2908.23,14487.17,20
HCPCS,75733,Artery x-rays adrenals,,,787.47,911.81,8
HCPCS,75736,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,18877.5,12270.375,0.87,37299.0,106
HCPCS,75741,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,11121.0,7228.650000000001,0.87,21718.0,106
HCPCS,75743,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,21718.0,14116.7,0.87,22382.0,157
HCPCS,75746,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,11110.0,7221.5,0.87,21718.0,167
HCPCS,75756,ANGIOGRAPHY INTERNAL MAMMARY RS&I,456.0,296.4,1.1,456.0,45
HCPCS,75756,ARTERY X-RAYS CHEST,,,2908.23,14487.17,20
HCPCS,75756,Artery x-rays chest,,,787.47,911.81,8
HCPCS,75774,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4182.0,2718.3,0.87,4586.0,142
HCPCS,75801,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILAT RS&I,4266.0,2772.9,0.87,4266.0,61
HCPCS,75803,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,10719.0,6967.35,0.87,10719.0,61
HCPCS,75805,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,21718.0,14116.7,0.87,21718.0,61
HCPCS,75807,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,21718.0,14116.7,0.87,21718.0,61
HCPCS,75809,NONVASCULAR SHUNT X-RAY,,,98.26,551.66,21
HCPCS,75809,Nonvascular shunt x-ray,,,113.2,131.08,8
HCPCS,75809,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,207.0,134.55,1.1,207.0,45
HCPCS,75810,SPLENOPORTOGRAPY RS&I,21718.0,14116.7,0.87,21718.0,61
HCPCS,75820,VENOGRAPHY EXTREMITY UNILATERAL RS&I,10719.0,6967.35,0.87,11139.0,157
HCPCS,75822,VENOGRAPHY EXTREMITY BILATERAL RS&I,10719.0,6967.35,0.87,11311.0,157
HCPCS,75825,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,21718.0,14116.7,0.87,22220.0,157
HCPCS,75827,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,10719.0,6967.35,0.87,11175.0,157
HCPCS,75831,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,11087.0,7206.55,0.87,21718.0,106
HCPCS,75833,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,21718.0,14116.7,0.87,21718.0,61
HCPCS,75840,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,0.87,22174.0,157
HCPCS,75842,VEIN X-RAY ADRENAL GLANDS,,,4994.76,5394.34,6
HCPCS,75842,Vein x-ray adrenal glands,,,2270.79,2629.34,8
HCPCS,75860,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,21718.0,14116.7,0.87,22174.0,157
HCPCS,75870,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,11110.0,7221.5,0.87,21718.0,106
HCPCS,75872,VEIN X-RAY SKULL EPIDURAL,,,571.26,2741.96,20
HCPCS,75872,VENOGRAM EPIDURAL,4266.0,2772.9,1.1,4768.0,142
HCPCS,75872,Vein x-ray skull epidural,,,519.65,601.7,8
HCPCS,75880,VEIN X-RAY EYE SOCKET,,,571.26,2741.96,20
HCPCS,75880,Vein x-ray eye socket,,,519.65,601.7,8
HCPCS,75885,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,21718.0,14116.7,0.87,21718.0,61
HCPCS,75887,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,21718.0,14116.7,0.87,21718.0,61
HCPCS,75889,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,11087.0,7206.55,0.87,21718.0,106
HCPCS,75891,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,21718.0,14116.7,0.87,21718.0,61
HCPCS,75893,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,37299.0,24244.35,0.87,37299.0,61
HCPCS,75894,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,0.87,3637.0,187
HCPCS,75898,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,0.87,22378.0,201
HCPCS,75901,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,720.0,468.0,0.87,916.0,142
HCPCS,75902,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,419.0,272.35,0.87,419.0,46
HCPCS,75956,Xray endovasc thor ao repr,,,89.44,103.57,8
HCPCS,75957,Xray endovasc thor ao repr,,,89.44,103.57,8
HCPCS,75958,Xray place prox ext thor ao,,,89.44,103.57,8
HCPCS,75959,Xray place dist ext thor ao,,,89.44,103.57,8
HCPCS,75970,TRANSCATHETER BIOPSY RS&I,3670.0,2385.5,0.87,3670.0,46
HCPCS,75970,TRANSVASCULAR BIOPSY,2167.0,1408.5500000000002,1.1,4002.0,84
HCPCS,75984,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,691.5,449.475,0.87,1051.0,91
HCPCS,75989,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,0.87,2603.0,234
HCPCS,76000,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1668.0,1084.2,0.87,1788.0,157
HCPCS,76010,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,608.0,395.2,0.87,680.0,157
HCPCS,76014,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,169.0,109.85,0.87,322.0,157
HCPCS,76015,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,716.0,465.4,0.87,1059.0,142
HCPCS,76016,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,608.0,395.2,0.87,872.0,200
HCPCS,76017,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,1668.0,1084.2,0.87,2002.0,200
HCPCS,76018,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,633.0,411.45,0.87,963.0,200
HCPCS,76019,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,410.0,266.5,0.87,674.0,200
HCPCS,76080,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3783.0,2458.95,0.87,3999.0,157
HCPCS,76098,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,1953.5,1269.7749999999999,0.87,3783.0,167
HCPCS,76100,X-RAY EXAM OF BODY SECTION,,,98.26,551.66,21
HCPCS,76100,X-ray exam of body section,,,45.07,52.18,8
HCPCS,76101,Complex body section x-ray,,,45.07,52.18,8
HCPCS,76102,Complex body section x-rays,,,45.07,52.18,8
HCPCS,76120,CINE/VIDEO X-RAYS,,,98.26,551.66,21
HCPCS,76120,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,152.0,98.8,1.1,152.0,45
HCPCS,76120,Cine/video x-rays,,,45.07,52.18,8
HCPCS,76125,Cine/video x-rays add-on,,,45.07,52.18,8
HCPCS,76140,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,1732.0,1125.8,1.1,1873.0,76
HCPCS,76140,X-ray consultation,,,68.91,79.79,8
HCPCS,76145,MEDICAL PHYSICS DOSE EVAL RADIATION EXPOS W/RPRT,3661.0,2379.65,0.87,3661.0,61
HCPCS,76376,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,0.87,654.0,234
HCPCS,76377,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,0.87,1752.0,418
HCPCS,76380,CT LIMITED/LOCALIZED FOLLOW UP STUDY,608.0,395.2,0.87,1000.0,157
HCPCS,76390,MR SPECTROSCOPY,,,81.36,409.57,21
HCPCS,76390,Mr spectroscopy,,,202.79,234.81,8
HCPCS,76391,MAGNETIC RESONANCE ELASTOGRAPHY,1318.0,856.7,1.1,2152.0,96
HCPCS,76391,MR ELASTOGRAPHY,,,223.34,1165.03,21
HCPCS,76391,Mr elastography,,,202.79,234.81,8
HCPCS,76496,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),19680.0,12792.0,0.01,20311.0,143
HCPCS,76496,BRONCHOGRAPHY,780.0,507.0,0.87,1162.0,122
HCPCS,76496,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),21718.0,14116.7,0.01,22174.0,143
HCPCS,76496,VENOGRAM AZYGOS VEIN (COMP CODE 75705),33929.0,22053.85,0.01,34714.0,82
HCPCS,76496,VENOGRAM AZYGOS VEIN (COMP COMP CODE 75705),33929.0,22053.85,0.87,33929.0,61
HCPCS,76496,VENOGRAM CARDINAL VARIX (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,143
HCPCS,76496,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),21718.0,14116.7,0.01,22174.0,143
HCPCS,76496,VENOGRAM GASTRIC VEIN (COMP CODE 75891),19680.0,12792.0,0.01,20091.0,143
HCPCS,76496,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,143
HCPCS,76496,VENOGRAM GONADAL VEIN (COMP CODE 75831),19680.0,12792.0,0.01,20091.0,143
HCPCS,76496,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),37264.0,24221.6,0.01,38171.0,143
HCPCS,76496,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),19680.0,12792.0,0.01,20091.0,143
HCPCS,76496,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),33929.0,22053.85,0.01,34714.0,143
HCPCS,76496,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,0.01,38171.0,143
HCPCS,76496,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),33929.0,22053.85,0.01,34340.0,143
HCPCS,76496,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),10719.0,6967.35,0.01,11139.0,143
HCPCS,76496,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),37299.0,24244.35,0.01,38171.0,143
HCPCS,76496,VENOGRAM SPLENIC VEIN (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,143
HCPCS,76496,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,143
HCPCS,76496,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4182.0,2718.3,0.01,4586.0,143
HCPCS,76496,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),3872.0,2516.8,0.01,4236.0,143
HCPCS,76496,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,0.01,38171.0,143
HCPCS,76496,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",21718.0,14116.7,0.01,22220.0,143
HCPCS,76497,CT CALCIUM SCORING,65.0,42.25,0.87,409.57,61
HCPCS,76497,CT CONE BEAM,622.0,404.3,0.87,622.0,61
HCPCS,76497,LOW DOSE WHOLE BODY CT,10064.0,6541.6,0.87,10064.0,61
HCPCS,76497,LOW DOSE WHOLE BODY CT (COMP CODE 78813),10064.0,6541.6,0.01,10864.0,82
HCPCS,76497,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,55.0,35.75,1.1,55.0,23
HCPCS,76498,MMR BRAIN WITH PC,2464.0,1601.6,0.01,3051.0,143
HCPCS,76498,MRI 3D CAD,1231.0,800.15,0.87,1231.0,61
HCPCS,76498,MRI 3D CAD (COMP CODE 76377),1359.5,883.675,0.01,1488.0,59
HCPCS,76498,MRI BRAIN LOCALIZATION W IVCON,2651.0,1723.15,0.87,2651.0,61
HCPCS,76498,MRI BRAIN LOCALIZATION WO CONT,2319.0,1507.35,0.01,4018.0,143
HCPCS,76498,MRI BRAIN LOCALIZATION WWO CONT,1929.0,1253.85,0.01,2685.0,143
HCPCS,76498,MRI BRAIN W/WO CONTAST PC,2464.0,1601.6,0.87,2464.0,61
HCPCS,76498,MRI BRAIN W/WO CONTRAST PC,2464.0,1601.6,0.01,3243.0,82
HCPCS,76498,MRI BREAST LIMITED,225.0,146.25,0.01,409.57,143
HCPCS,76498,MRI CERVICAL LOCALIZATION W IVCON,2651.0,1723.15,0.01,3230.0,143
HCPCS,76498,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,0.01,3042.0,143
HCPCS,76498,MRI LUMBAR LOCALIZATION W IVCON,1619.0,1052.3500000000001,0.01,3238.0,143
HCPCS,76498,MRI PRE- OP MAPPING W/WO CONTR,608.0,395.2,0.87,608.0,61
HCPCS,76498,MRI PRE-OP MAPPING W/CONTRAST,629.0,408.85,0.01,1237.0,143
HCPCS,76498,MRI PRE-OP MAPPING W/O CONTRAST,608.0,395.2,0.87,608.0,61
HCPCS,76498,MRI PRE-OP MAPPING W/O CONTRST,608.0,395.2,0.01,1131.0,82
HCPCS,76498,MRI PRE-OP MAPPING W/WO CNTRST,835.0,542.75,0.01,1443.0,82
HCPCS,76498,MRI PROSTATE LIMITED WO IVCON,280.0,182.0,0.01,350.0,82
HCPCS,76498,MRI THORACIC LOCALIZATION W IVCON,2651.0,1723.15,0.01,3230.0,143
HCPCS,76498,UNLISTED MAGNETIC RESONANCE PROCED,66.0,42.9,1.1,66.0,23
HCPCS,76498,WHOLE BODY MRI,10064.0,6541.6,0.87,10064.0,61
HCPCS,76498,WHOLE BODY MRI (COMP CODE 78816),10064.0,6541.6,0.01,10965.0,82
HCPCS,76499,3D RENDERING LIVER (DONOR) S&I,1436.0,933.4,0.01,2535.0,148
HCPCS,76499,BD WHOLE BODY COMPOSITION,734.0,477.1,0.01,819.0,87
HCPCS,76499,BREAST TOMO,122.0,79.3,0.87,409.57,61
HCPCS,76499,CT ABDOMEN W/O SCREENING,734.0,477.1,0.01,1258.0,148
HCPCS,76499,LYMPHANGIOGRAPHY OF FACE & NECK,10719.0,6967.35,0.87,10719.0,61
HCPCS,76499,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),10719.0,6967.35,0.01,11223.0,87
HCPCS,76499,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,577.0,375.05,0.01,577.0,29
HCPCS,76499,UNLISTED DXA BODY COMPOSITION STUDY,734.0,477.1,0.87,734.0,61
HCPCS,76499,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),734.0,477.1,0.01,819.0,87
HCPCS,76499,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE,2773.0,1802.45,0.87,2773.0,61
HCPCS,76499,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),2773.0,1802.45,0.01,2935.0,87
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP",21718.0,14116.7,0.87,21718.0,61
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",21718.0,14116.7,0.01,21750.0,87
HCPCS,76499,XR DEXA WHOLE BODY COMPOSITION,734.0,477.1,0.87,734.0,61
HCPCS,76506,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,493.0,320.45000000000005,0.87,734.0,106
HCPCS,76510,OPH US DX B-SCAN&QUAN A-SCAN,,,119.1,566.75,21
HCPCS,76510,Oph us dx b-scan&quan a-scan,,,77.56,89.8,8
HCPCS,76511,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,734.0,477.1,0.87,1016.0,157
HCPCS,76512,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,0.87,980.0,157
HCPCS,76513,OPH US DX ANT SGM US UNI/BI,,,98.26,551.66,21
HCPCS,76513,Oph us dx ant sgm us uni/bi,,,77.56,89.8,8
HCPCS,76514,ECHO EXAM OF EYE THICKNESS,,,22.63,124.9,21
HCPCS,76514,Echo exam of eye thickness,,,37.89,43.87,8
HCPCS,76514,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,146.5,95.225,1.1,231.0,96
HCPCS,76516,ECHO EXAM OF EYE,,,98.26,551.66,21
HCPCS,76516,Echo exam of eye,,,77.56,89.8,8
HCPCS,76519,ECHO EXAM OF EYE,,,98.26,551.66,21
HCPCS,76519,Echo exam of eye,,,77.56,89.8,8
HCPCS,76529,ECHO EXAM OF EYE,,,81.36,409.57,21
HCPCS,76529,Echo exam of eye,,,37.89,43.87,8
HCPCS,76529,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,228.0,148.2,1.1,279.6,51
HCPCS,76536,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,734.0,477.1,0.87,980.0,157
HCPCS,76604,US CHEST REAL TIME W/IMAGE DOCUMENTATION,706.5,459.225,0.87,970.0,203
HCPCS,76641,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,0.87,1055.0,218
HCPCS,76642,US BREAST UNI REAL TIME WITH IMAGE LIMITED,608.0,395.2,0.87,907.0,157
HCPCS,76700,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,545.0,354.25,0.87,734.0,106
HCPCS,76705,US ABDOMINAL REAL TIME W/IMAGE LIMITED,706.5,459.225,0.87,994.0,264
HCPCS,76706,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,477.0,310.05,0.87,734.0,161
HCPCS,76770,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,706.5,459.225,0.87,998.0,203
HCPCS,76775,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,734.0,477.1,0.87,966.0,203
HCPCS,76776,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,734.0,477.1,0.87,1038.0,157
HCPCS,76800,ULTRASOUND SPINAL CANAL & CONTENTS,593.0,385.45000000000005,0.87,734.0,106
HCPCS,76801,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,734.0,477.1,0.87,1170.0,203
HCPCS,76802,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,711.0,462.15,0.87,1076.0,188
HCPCS,76805,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,734.0,477.1,0.87,1130.0,203
HCPCS,76810,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,711.0,462.15,0.87,1103.0,188
HCPCS,76811,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,1668.0,1084.2,0.87,2428.0,203
HCPCS,76812,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,712.0,462.8,0.87,1366.0,188
HCPCS,76813,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,734.0,477.1,0.87,1206.0,203
HCPCS,76814,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,426.0,276.9,0.87,822.0,188
HCPCS,76815,US PREGNANT UTERUS LIMITED 1/> FETUSES,734.0,477.1,0.87,1020.0,203
HCPCS,76816,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,734.0,477.1,0.87,1108.0,203
HCPCS,76817,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,734.0,477.1,0.87,1034.0,203
HCPCS,76818,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,734.0,477.1,0.87,1154.0,203
HCPCS,76819,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,734.0,477.1,0.87,1073.0,203
HCPCS,76820,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,734.0,477.1,0.87,954.0,203
HCPCS,76821,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,734.0,477.1,0.87,1014.0,203
HCPCS,76825,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,3783.0,2458.95,0.87,4451.0,157
HCPCS,76826,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,1668.0,1084.2,0.87,2033.0,157
HCPCS,76827,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,734.0,477.1,0.87,966.0,157
HCPCS,76828,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,734.0,477.1,0.87,958.0,157
HCPCS,76830,US TRANSVAGINAL,734.0,477.1,0.87,1038.0,157
HCPCS,76831,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1668.0,1084.2,0.87,1956.0,157
HCPCS,76856,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,734.0,477.1,0.87,1038.0,203
HCPCS,76857,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,0.87,2453.0,218
HCPCS,76870,US SCROTUM & CONTENTS,734.0,477.1,0.87,990.0,157
HCPCS,76872,US TRANSRECTAL,734.0,477.1,0.87,734.0,61
HCPCS,76872,"US, TRANSRECTAL",643.0,417.95,1.1,1010.0,96
HCPCS,76872,US- TRANSRECTAL,354.0,230.1,1.1,528.3,51
HCPCS,76873,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,734.0,477.1,0.87,1416.0,157
HCPCS,76881,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,734.0,477.1,0.87,1130.0,157
HCPCS,76882,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,734.0,477.1,0.87,1038.0,157
HCPCS,76883,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,734.0,477.1,0.87,734.0,61
HCPCS,76885,US EXAM INFANT HIPS DYNAMIC,,,81.36,409.57,21
HCPCS,76885,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,296.0,192.4,1.1,296.0,45
HCPCS,76885,Us exam infant hips dynamic,,,77.56,89.8,8
HCPCS,76886,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,428.0,278.2,0.87,608.0,106
HCPCS,76932,Echo guide for heart biopsy,,,74.0,85.68,8
HCPCS,76936,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2149.0,1396.85,0.87,2945.0,157
HCPCS,76937,US GUIDE VASCULAR ACCESS,29.0,18.85,1.1,129.82,51
HCPCS,76937,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,0.87,2453.0,234
HCPCS,76940,US &MNTR PARENCHYMAL TISSUE ABLATION,800.0,520.0,0.87,1498.0,130
HCPCS,76941,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,724.0,470.6,0.87,1260.0,164
HCPCS,76942,ECHO GUIDE FOR BIOPSY,509.0,330.84999999999997,1.1,952.0,102
HCPCS,76942,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.87,1158.0,372
HCPCS,76945,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,268.0,174.2,0.87,507.0,130
HCPCS,76946,US GUIDANCE AMNIOCENTESIS IMG S&I,366.0,237.9,0.87,518.0,188
HCPCS,76948,ECHO GUIDE OVA ASPIRATION,,,154.65,154.65,1
HCPCS,76948,Echo guide ova aspiration,,,74.0,85.68,8
HCPCS,76965,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1192.0,774.8,0.87,1728.0,142
HCPCS,76970,Ultrasound exam follow-up,,,77.56,89.8,8
HCPCS,76975,GI ENDOSCOPIC ULTRASOUND,,,223.34,1165.03,20
HCPCS,76975,GI ENDOSCOPIC US S&I,324.0,210.6,1.1,775.75,39
HCPCS,76975,Gi endoscopic ultrasound,,,74.0,85.68,8
HCPCS,76977,US BONE DENSITY MEASURE,,,98.26,551.66,21
HCPCS,76978,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1262.0,820.3000000000001,1.1,1876.0,96
HCPCS,76978,US TRGT DYN MBUBB 1ST LES,,,164.49,977.84,21
HCPCS,76978,Us trgt dyn mbubb 1st les,,,119.27,138.11,8
HCPCS,76979,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,723.0,469.95,1.1,1106.0,96
HCPCS,76979,US TRGT DYN MBUBB EA ADDL,,,502.89,502.89,1
HCPCS,76979,Us trgt dyn mbubb ea addl,,,119.27,138.11,8
HCPCS,76981,ULTRASOUND ELASTOGRAPHY PARENCHYMA,734.0,477.1,0.87,994.0,157
HCPCS,76982,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,734.0,477.1,0.87,970.0,157
HCPCS,76983,ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION,1030.0,669.5,0.87,1030.0,46
HCPCS,76983,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,703.0,456.95000000000005,1.1,1218.0,96
HCPCS,76984,Dx intraop thoracic aorta us,,,534.53,618.93,8
HCPCS,76987,Dx intraop epicar car us chd,,,534.53,618.93,8
HCPCS,76988,Dx ntrop epcr us chd img acq,,,534.53,618.93,8
HCPCS,76989,Dx intraop epcar us chd i&r,,,534.53,618.93,8
HCPCS,76998,INTRA OP ULTRASONIC GUIDANCE,821.5,533.975,1.1,1243.0,84
HCPCS,76998,ULTRASONIC GUIDANCE INTRAOPERATIVE,843.0,547.95,0.87,843.0,46
HCPCS,76999,US UNLISTED SOFT TISSUE,333.0,216.45,0.87,409.57,61
HCPCS,77001,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,823.0,534.95,0.87,990.0,142
HCPCS,77002,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,838.0,544.7,0.87,1076.0,142
HCPCS,77003,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,996.0,647.4,0.87,1260.0,188
HCPCS,77011,CT GUIDANCE STEREOTACTIC LOCALIZATION,1527.0,992.55,0.87,2011.0,188
HCPCS,77012,CT GUIDANCE NEEDLE PLACEMENT,2193.0,1425.45,0.87,2793.0,142
HCPCS,77013,CT GUIDANCE &MONITORING VISC TISS ABLATION,2593.0,1685.45,0.87,4189.0,164
HCPCS,77014,CT SCAN FOR THERAPY GUIDE,,,241.96,241.96,1
HCPCS,77014,Ct scan for therapy guide,,,88.43,102.39,8
HCPCS,77021,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2053.0,1334.45,0.87,2053.0,46
HCPCS,77022,Mri gdn parnchyma tiss abltj,,,41.36,47.89,8
HCPCS,77046,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,1668.0,1084.2,0.87,2306.0,157
HCPCS,77047,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,1668.0,1084.2,0.87,2372.0,157
HCPCS,77048,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,0.87,4970.0,46
HCPCS,77048,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,3325.0,2161.25,1.1,5810.0,96
HCPCS,77049,MRI BREAST BIL W/ CONTR,5984.0,3889.6,0.87,5984.0,46
HCPCS,77049,MRI BREAST BILAT W CONTR,5984.0,3889.6,1.1,6904.0,142
HCPCS,77049,MRI BREAST BILAT WO/W CONTR,5984.0,3889.6,0.87,6904.0,188
HCPCS,77049,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,3912.0,2542.8,1.1,6904.0,96
HCPCS,77053,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,1668.0,1084.2,0.87,1668.0,61
HCPCS,77054,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,1668.0,1084.2,0.87,1668.0,61
HCPCS,77061,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,0.87,462.83,180
HCPCS,77062,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,106.0,68.9,0.87,591.75,147
HCPCS,77063,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,240.0,156.0,0.87,380.0,262
HCPCS,77065,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,563.0,365.95,0.87,887.0,202
HCPCS,77066,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,553.0,359.45,0.87,706.0,151
HCPCS,77067,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,609.0,395.85,0.87,913.0,202
HCPCS,77071,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,180.0,117.0,1.1,180.6,51
HCPCS,77071,MNL APPL STRS JT RADIOGRAPHY,,,81.36,409.57,21
HCPCS,77071,Mnl appl strs jt radiography,,,68.91,79.79,8
HCPCS,77072,BONE AGE STUDIES,734.0,477.1,0.87,810.0,157
HCPCS,77073,BONE LENGTH STUDIES,734.0,477.1,0.87,838.0,203
HCPCS,77074,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,734.0,477.1,0.87,928.0,157
HCPCS,77075,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,488.0,317.20000000000005,0.87,734.0,106
HCPCS,77076,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,507.0,329.55,0.87,734.0,106
HCPCS,77077,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,433.0,281.45,0.87,734.0,106
HCPCS,77078,CT BONE DENSITY AXIAL,,,81.36,409.57,21
HCPCS,77080,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,734.0,477.1,0.87,822.0,195
HCPCS,77081,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,608.0,395.2,0.87,696.0,195
HCPCS,77084,MRI BONE MARROW BLOOD SUPPLY,,,223.34,1165.03,21
HCPCS,77084,Mri bone marrow blood supply,,,202.79,234.81,8
HCPCS,77085,DXA BONE DENSITY STUDY AXIAL SKELETON,433.0,281.45,0.87,734.0,144
HCPCS,77086,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,341.5,221.975,0.87,608.0,98
HCPCS,77089,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,198.5,129.025,0.87,309.0,89
HCPCS,77090,TBS TECHL PREP&TRANSMIS DATA,,,81.36,418.21,20
HCPCS,77090,TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,474.0,308.1,1.1,474.0,51
HCPCS,77091,TBS TECHNICAL CALCULATION ONLY,383.0,248.95,0.87,608.0,104
HCPCS,77092,TBS I&R FX RSK QHP,,,52.56,52.56,1
HCPCS,77092,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,88.0,57.2,1.1,88.0,51
HCPCS,77092,Tbs i&r fx rsk qhp,,,321.96,372.8,8
HCPCS,77261,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,572.0,371.8,1.1,572.0,51
HCPCS,77261,Ther radiology tx plng smpl,,,83.9,97.15,8
HCPCS,77262,Ther radiology tx plng intrm,,,83.9,97.15,8
HCPCS,77263,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1258.5,818.025,0.87,1382.0,97
HCPCS,77280,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,916.0,595.4,0.87,1224.0,218
HCPCS,77285,THER RAD SIMULAJ FIELD INTRM,,,338.24,1049.47,19
HCPCS,77285,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,462.0,300.3,1.1,462.0,45
HCPCS,77285,Ther rad simulaj field intrm,,,388.13,449.42,8
HCPCS,77290,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,0.87,3212.0,279
HCPCS,77293,RESPIRATORY MOTION MANAGEMENT SIMULATION,2981.0,1937.65,0.87,3861.0,142
HCPCS,77295,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,9441.0,6136.65,0.87,11329.0,157
HCPCS,77299,UNLISTED PX THER RAD TX PLNG,,,122.68,376.73,19
HCPCS,77299,Unlisted px ther rad tx plng,,,83.9,97.15,8
HCPCS,77300,BASIC RAD DOSIMETRY CALCULATION,731.0,475.15,1.1,1189.0,96
HCPCS,77300,BASIC RADIATION DOSIMETRY CALCULATION,916.0,595.4,0.87,916.0,61
HCPCS,77301,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,9441.0,6136.65,0.87,12957.0,157
HCPCS,77306,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,2526.0,1641.9,0.87,3142.0,157
HCPCS,77307,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,2526.0,1641.9,0.87,3802.0,218
HCPCS,77316,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,122
HCPCS,77317,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2526.0,1641.9,0.87,2526.0,122
HCPCS,77318,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,2526.0,1641.9,0.87,3802.0,218
HCPCS,77321,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2526.0,1641.9,0.87,2944.0,157
HCPCS,77331,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,916.0,595.4,0.87,1299.0,157
HCPCS,77332,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,916.0,595.4,0.87,916.0,61
HCPCS,77332,TX DEVICES DESIGN/CONSTR SIMPLE,656.0,426.4,1.1,1114.0,96
HCPCS,77333,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,916.0,595.4,0.87,916.0,61
HCPCS,77333,TX DEVICES DESIGN/CONSTR INTERMED,330.0,214.5,1.1,330.0,45
HCPCS,77334,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,2526.0,1641.9,0.87,2526.0,122
HCPCS,77334,TX DEVICES DESIGN/CONSTR COMPLEX,1769.0,1149.85,1.1,3032.0,96
HCPCS,77336,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1003.5,652.275,0.87,1091.0,112
HCPCS,77338,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,2526.0,1641.9,0.87,4414.0,157
HCPCS,77370,SPEC MEDICAL RADJ PHYSICS CONSLTJ,916.0,595.4,0.87,916.0,61
HCPCS,77370,SPECIAL RADIATION PHYSICS CONSULT,1131.0,735.15,1.1,1131.0,51
HCPCS,77371,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,52747.0,34285.55,0.87,52747.0,61
HCPCS,77372,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,52747.0,34285.55,0.87,52747.0,61
HCPCS,77373,STEREOTACTIC BODY RADIATION DELIVERY,13083.0,8503.95,0.87,14050.0,173
HCPCS,77385,NTSTY MODUL RAD TX DLVR SMPL,,,534.49,577.25,6
HCPCS,77385,Ntsty modul rad tx dlvr smpl,,,284.58,329.52,8
HCPCS,77386,NTSTY MODUL RAD TX DLVR CPLX,,,534.49,577.25,6
HCPCS,77386,Ntsty modul rad tx dlvr cplx,,,284.58,329.52,8
HCPCS,77387,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,1.1,336.36,91
HCPCS,77387,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,392.0,254.8,0.87,392.0,46
HCPCS,77399,UNLISTED PX MED RADJ PHYSICS,,,122.68,376.73,19
HCPCS,77399,Unlisted px med radj physics,,,83.9,97.15,8
HCPCS,77401,RADIATION TX DELIVERY SUPFC,,,101.18,109.27,6
HCPCS,77401,Radiation tx delivery supfc,,,108.37,125.48,8
HCPCS,77402,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,0.87,897.0,172
HCPCS,77407,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,0.87,3388.0,172
HCPCS,77412,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,4855.0,3155.75,0.87,4855.0,111
HCPCS,77417,THERAPEUTIC RADIOLOGY PORT IMAGES(S),534.5,347.42499999999995,0.87,586.0,86
HCPCS,77423,NEUTRON BEAM TX COMPLEX,,,522.75,1548.69,19
HCPCS,77423,Neutron beam tx complex,,,284.58,329.52,8
HCPCS,77424,IO RAD TX DELIVERY BY X-RAY,,,6968.13,20643.79,19
HCPCS,77424,Io rad tx delivery by x-ray,,,785.65,909.7,8
HCPCS,77425,IO RAD TX DELIVER BY ELCTRNS,,,6968.13,20643.79,19
HCPCS,77425,Io rad tx deliver by elctrns,,,785.65,909.7,8
HCPCS,77427,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,1483.0,963.95,1.1,1483.0,51
HCPCS,77427,Radiation tx management x5,,,134.87,156.17,8
HCPCS,77431,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,796.0,517.4,1.1,796.0,51
HCPCS,77431,Radiation therapy management,,,134.87,156.17,8
HCPCS,77432,Stereotactic radiation trmt,,,134.87,156.17,8
HCPCS,77435,STEREOTACTIC BODY RADIATION MANAGEMENT,5223.0,3394.95,1.1,5223.0,51
HCPCS,77435,Sbrt management,,,134.87,156.17,8
HCPCS,77436,SURF RADJ THER TX PLANNING,,,35.34,104.69,13
HCPCS,77436,Surf radj ther tx planning,,,83.9,97.15,8
HCPCS,77437,SURF RADJ THER SUPFC<=150KV,,,96.53,285.97,13
HCPCS,77437,Surf radj ther supfc<=150kv,,,108.37,125.48,8
HCPCS,77438,SURF RAD THR ORTHVLT>150-500,,,96.53,285.97,13
HCPCS,77438,Surf rad thr orthvlt>150-500,,,108.37,125.48,8
HCPCS,77439,Surf rad thr img gdn us plmt,,,74.0,85.68,8
HCPCS,77469,Io radiation tx management,,,134.87,156.17,8
HCPCS,77470,SPECIAL TREATMENT PROCEDURE,3991.0,2594.15,0.87,4884.0,157
HCPCS,77499,Unlisted px ther rad tx mgmt,,,134.87,156.17,8
HCPCS,77520,PROTON TRMT SIMPLE W/O COMP,,,522.75,1548.69,19
HCPCS,77520,Proton trmt simple w/o comp,,,284.58,329.52,8
HCPCS,77522,PROTON TRMT SIMPLE W/COMP,,,1178.55,3502.83,19
HCPCS,77522,Proton trmt simple w/comp,,,785.65,909.7,8
HCPCS,77523,PROTON TRMT INTERMEDIATE,,,1178.55,3502.83,19
HCPCS,77523,Proton trmt intermediate,,,785.65,909.7,8
HCPCS,77525,PROTON TREATMENT COMPLEX,,,1178.55,3502.83,19
HCPCS,77525,Proton treatment complex,,,785.65,909.7,8
HCPCS,77600,HYPERTHERMIA EXT GEN SUPFC,,,242.99,1081.05,19
HCPCS,77600,Hyperthermia ext gen supfc,,,108.37,125.48,8
HCPCS,77605,HYPERTHERMIA EXT GEN DEEP,,,641.07,1952.11,19
HCPCS,77605,HYPERTHERMIA EXTERNAL GENERATED DEEP,736.0,478.4,1.1,3103.51,51
HCPCS,77605,Hyperthermia ext gen deep,,,284.58,329.52,8
HCPCS,77610,HYPERTHERMIA NTRSTL PRB 5/<,,,522.75,1548.69,19
HCPCS,77610,Hyperthermia ntrstl prb 5/<,,,284.58,329.52,8
HCPCS,77615,HYPERTHERMIA NTRSTL PRB>5,,,522.75,1548.69,19
HCPCS,77615,Hyperthermia ntrstl prb>5,,,284.58,329.52,8
HCPCS,77620,HYPERTHERMIA GEN INTRCV PRB,,,522.75,1548.69,19
HCPCS,77620,Hyperthermia gen intrcv prb,,,284.58,329.52,8
HCPCS,77750,INFUSE RADIOACTIVE MATERIALS,,,242.99,1081.05,19
HCPCS,77750,Infuse radioactive materials,,,108.37,125.48,8
HCPCS,77761,APPLY INTRCAV RADIAT SIMPLE,,,522.75,1548.69,19
HCPCS,77761,Apply intrcav radiat simple,,,284.58,329.52,8
HCPCS,77761,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,1540.0,1001.0,1.1,1540.0,45
HCPCS,77762,APPLY INTRCAV RADIAT INTERM,,,522.75,1548.69,19
HCPCS,77762,Apply intrcav radiat interm,,,785.65,909.7,8
HCPCS,77763,APPLY INTRCAV RADIAT COMPL,,,641.07,1952.11,19
HCPCS,77763,Apply intrcav radiat compl,,,785.65,909.7,8
HCPCS,77763,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,3464.0,2251.6,1.1,3464.0,45
HCPCS,77767,HDR RDNCL SKN SURF BRACHYTX,,,242.99,1081.05,19
HCPCS,77767,Hdr rdncl skn surf brachytx,,,284.58,329.52,8
HCPCS,77768,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,1815.0,1179.75,0.87,1815.0,61
HCPCS,77770,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,4787.0,3111.55,0.87,4787.0,61
HCPCS,77771,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,5291.5,3439.4750000000004,0.87,5796.0,112
HCPCS,77772,HDR RDNCL NTRSTL/ICAV BRCHTX,,,641.07,1952.11,19
HCPCS,77772,Hdr rdncl ntrstl/icav brchtx,,,785.65,909.7,8
HCPCS,77778,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,0.87,8650.0,157
HCPCS,77789,APPLY SURF LDR RADIONUCLIDE,,,96.53,285.97,19
HCPCS,77789,Apply surf ldr radionuclide,,,108.37,125.48,8
HCPCS,77790,SUPERVISION HANDLING LOADING RADIATION SOURCE,961.0,624.65,0.87,1407.0,126
HCPCS,77799,UNLISTED PX CLIN BRACHYTX,,,96.53,285.97,19
HCPCS,77799,Unlisted px clin brachytx,,,108.37,125.48,8
HCPCS,78012,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,2773.0,1802.45,0.87,2773.0,61
HCPCS,78013,THYROID IMAGING WITH VASCULAR FLOW,2773.0,1802.45,0.87,2773.0,61
HCPCS,78014,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2773.0,1802.45,0.87,2993.0,203
HCPCS,78015,THYROID MET IMAGING,,,371.28,1909.17,21
HCPCS,78015,Thyroid met imaging,,,247.14,286.17,8
HCPCS,78016,THYROID MET IMAGING/STUDIES,,,371.28,1909.17,21
HCPCS,78016,Thyroid met imaging/studies,,,247.14,286.17,8
HCPCS,78018,THYROID CARCINOMA METASTASES IMG WHOLE BODY,2029.0,1318.85,0.87,3714.0,106
HCPCS,78020,THYROID CARCINOMA METASTASES UPTAKE,883.0,573.95,0.87,1123.0,188
HCPCS,78070,PARATHYROID PLANAR IMAGING,2773.0,1802.45,0.87,2773.0,61
HCPCS,78071,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,1626.5,1057.225,0.87,2773.0,106
HCPCS,78072,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,3714.0,2414.1,0.87,4354.0,203
HCPCS,78075,ADRENAL IMAGING CORTEX &/MEDULLA,9008.0,5855.2,0.87,9008.0,61
HCPCS,78099,UNLISTED ENDOCRINE PX DX NUC,,,371.28,1909.17,20
HCPCS,78099,Unlisted endocrine px dx nuc,,,247.14,286.17,8
HCPCS,78102,BONE MARROW IMAGING LIMITED AREA,2773.0,1802.45,0.87,2773.0,61
HCPCS,78102,"BONE MARROW IMAGING, LTD",2773.0,1802.45,1.1,2993.0,142
HCPCS,78103,BONE MARROW IMAGING MULT,,,371.28,1909.17,21
HCPCS,78103,Bone marrow imaging mult,,,247.14,286.17,8
HCPCS,78104,BONE MARROW IMAGING WHOLE BODY,2773.0,1802.45,0.87,2773.0,61
HCPCS,78110,PLASMA VOLUME SINGLE,,,1206.24,6611.33,21
HCPCS,78110,Plasma volume single,,,705.42,816.81,8
HCPCS,78111,PLASMA VOLUME MULTIPLE,,,1206.24,6611.33,21
HCPCS,78111,Plasma volume multiple,,,705.42,816.81,8
HCPCS,78120,RED CELL MASS SINGLE,,,371.28,1909.17,21
HCPCS,78120,Red cell mass single,,,247.14,286.17,8
HCPCS,78121,RED CELL MASS MULTIPLE,,,497.35,2477.59,21
HCPCS,78121,Red cell mass multiple,,,247.14,286.17,8
HCPCS,78122,WHL BLD VOLUME DETERMINATION,,,497.35,2477.59,21
HCPCS,78122,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,180.0,117.0,1.1,180.0,45
HCPCS,78122,Whl bld volume determination,,,705.42,816.81,8
HCPCS,78130,RED CELL SURVIVAL STUDY,,,371.28,1909.17,21
HCPCS,78130,Red cell survival study,,,247.14,286.17,8
HCPCS,78135,Red cell survival kinetics,,,247.14,286.17,8
HCPCS,78140,RED CELL SEQUESTRATION,,,371.28,1909.17,21
HCPCS,78140,Red cell sequestration,,,247.14,286.17,8
HCPCS,78185,SPLEEN IMAGING,,,371.28,1909.17,21
HCPCS,78185,Spleen imaging,,,247.14,286.17,8
HCPCS,78191,PLATELET SURVIVAL STUDY,,,371.28,1909.17,21
HCPCS,78191,Platelet survival study,,,247.14,286.17,8
HCPCS,78195,LYMPHATICS & LYMPH NODES IMAGING,2097.0,1363.05,0.87,3714.0,106
HCPCS,78199,UNLSTD HEMATOP RET/ENDO LYMP,,,371.28,1909.17,20
HCPCS,78199,Unlstd hematop ret/endo lymp,,,247.14,286.17,8
HCPCS,78201,LIVER IMAGING STATIC ONLY,,,497.35,2477.59,21
HCPCS,78201,Liver imaging static only,,,705.42,816.81,8
HCPCS,78202,LIVER IMAGING WITH VASC FLOW,,,497.35,2477.59,21
HCPCS,78202,Liver imaging with vasc flow,,,705.42,816.81,8
HCPCS,78215,LIVER & SPLEEN IMAGING STATIC ONLY,2773.0,1802.45,0.87,2773.0,61
HCPCS,78216,LVR&SPLEEN IMG W/VASC FLOW,,,371.28,1909.17,21
HCPCS,78216,Lvr&spleen img w/vasc flow,,,705.42,816.81,8
HCPCS,78226,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,2773.0,1802.45,0.87,3069.0,157
HCPCS,78227,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,3714.0,2414.1,0.87,4110.0,157
HCPCS,78230,SALIVARY GLAND IMAGING,,,371.28,1909.17,21
HCPCS,78230,Salivary gland imaging,,,247.14,286.17,8
HCPCS,78231,SALIVARY GLND IMG SERIAL IMG,,,371.28,1909.17,21
HCPCS,78231,Salivary glnd img serial img,,,247.14,286.17,8
HCPCS,78232,SALIVARY GLAND FUNCTION STD,,,371.28,1909.17,21
HCPCS,78232,Salivary gland function std,,,247.14,286.17,8
HCPCS,78258,ESOPHAGEAL MOTILITY,,,371.28,1909.17,21
HCPCS,78258,Esophageal motility,,,247.14,286.17,8
HCPCS,78261,GASTRIC MUCOSA IMAGING,,,371.28,1909.17,21
HCPCS,78261,Gastric mucosa imaging,,,247.14,286.17,8
HCPCS,78262,GASTROESOPHAGEAL REFLUX STUDY,2773.0,1802.45,0.87,2773.0,61
HCPCS,78264,GASTRIC EMPTYING IMAGING STUDY,2773.0,1802.45,0.87,2773.0,61
HCPCS,78264,GASTRIC EMPTYING STUDY,1734.5,1127.425,1.1,3121.0,96
HCPCS,78265,GSTR EMPTG IMG SM BWL TRNST,,,371.28,1909.17,21
HCPCS,78265,Gstr emptg img sm bwl trnst,,,247.14,286.17,8
HCPCS,78266,GSTR EMPT IMG SM BWL&COLON,,,497.35,2477.59,21
HCPCS,78266,Gstr empt img sm bwl&colon,,,247.14,286.17,8
HCPCS,78267,UREA BREATH TST C-14 ACQUISJ,,,11.06,71.48,20
HCPCS,78267,Urea breath tst c-14 acquisj,,,14.4,16.68,8
HCPCS,78268,UREA BREATH TEST C-14 ALYS,,,94.41,477.95,20
HCPCS,78268,Urea breath test c-14 alys,,,29.28,33.9,8
HCPCS,78278,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,2773.0,1802.45,0.87,2773.0,61
HCPCS,78278,ACUTE GI BLOOD LOSS IMAGING,1782.5,1158.625,1.1,3169.0,96
HCPCS,78282,GI PROTEIN LOSS,,,371.28,1909.17,21
HCPCS,78282,Gi protein loss,,,247.14,286.17,8
HCPCS,78290,INTESTINE IMAGING,2773.0,1802.45,0.87,3072.0,203
HCPCS,78291,PERITONEAL-VENOUS SHUNT PATENCY TEST,2773.0,1802.45,0.87,2773.0,61
HCPCS,78299,UNLISTED GI PX DX NUC MED,,,371.28,1909.17,20
HCPCS,78299,Unlisted gi px dx nuc med,,,247.14,286.17,8
HCPCS,78300,BONE &/JOINT IMAGING LIMITED AREA,2773.0,1802.45,0.87,3021.0,203
HCPCS,78305,BONE &/JOINT IMAGING MULTIPLE AREAS,2773.0,1802.45,0.87,2773.0,61
HCPCS,78306,BONE &/JOINT IMAGING WHOLE BODY,2773.0,1802.45,0.87,3151.0,157
HCPCS,78315,BONE &/JOINT IMAGING 3 PHASE STUDY,2773.0,1802.45,0.87,3181.0,157
HCPCS,78350,BONE MINERAL SINGLE PHOTON,,,109.51,109.51,1
HCPCS,78350,Bone mineral single photon,,,247.14,286.17,8
HCPCS,78351,BONE MINERAL DUAL PHOTON,,,77.72,77.72,1
HCPCS,78351,Bone mineral dual photon,,,247.14,286.17,8
HCPCS,78399,UNLISTED MUSCSKEL PX DX NUC,,,371.28,1909.17,20
HCPCS,78399,Unlisted muscskel px dx nuc,,,247.14,286.17,8
HCPCS,78414,NON-IMAGING HEART FUNCTION,,,497.35,2477.59,21
HCPCS,78414,Non-imaging heart function,,,247.14,286.17,8
HCPCS,78428,CARDIAC SHUNT DETECTION,2773.0,1802.45,0.87,3085.0,203
HCPCS,78429,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10064.0,6541.6,0.87,10768.0,125
HCPCS,78430,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10064.0,6541.6,0.87,10732.0,125
HCPCS,78431,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,14584.0,9479.6,1.1,16288.0,106
HCPCS,78431,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,15528.0,10093.2,0.87,15528.0,53
HCPCS,78432,MYOCRD IMG PET 2RTRACER,,,1435.79,13924.42,21
HCPCS,78433,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,13049.0,8481.85,0.87,14362.0,153
HCPCS,78434,AQMBF PET REST AND PHARMACOLOGIC STRESS,3209.0,2085.85,0.87,3461.0,110
HCPCS,78445,VASCULAR FLOW IMAGING,,,371.28,1909.17,21
HCPCS,78445,Vascular flow imaging,,,247.14,286.17,8
HCPCS,78451,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,4807.5,3124.875,0.87,9008.0,106
HCPCS,78452,MYOCARDIAL SPECT MULTIPLE STUDIES,9008.0,5855.2,0.87,9721.0,203
HCPCS,78453,HT MUSCLE IMAGE PLANAR SING,,,1206.24,6611.33,21
HCPCS,78453,Ht muscle image planar sing,,,705.42,816.81,8
HCPCS,78454,HT MUSC IMAGE PLANAR MULT,,,1206.24,6611.33,21
HCPCS,78454,Ht musc image planar mult,,,705.42,816.81,8
HCPCS,78454,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,536.0,348.4,1.1,536.0,45
HCPCS,78456,ACUTE VENOUS THROMBUS IMAGE,,,1206.24,6611.33,21
HCPCS,78456,Acute venous thrombus image,,,247.14,286.17,8
HCPCS,78457,VENOUS THROMBOSIS IMAGING,,,497.35,2477.59,21
HCPCS,78457,Venous thrombosis imaging,,,705.42,816.81,8
HCPCS,78458,VEN THROMBOSIS IMAGES BILAT,,,371.28,1909.17,21
HCPCS,78458,Ven thrombosis images bilat,,,247.14,286.17,8
HCPCS,78459,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9008.0,5855.2,0.87,9008.0,106
HCPCS,78466,HEART INFARCT IMAGE,,,371.28,1909.17,21
HCPCS,78466,Heart infarct image,,,247.14,286.17,8
HCPCS,78468,HEART INFARCT IMAGE (EF),,,497.35,2477.59,21
HCPCS,78468,Heart infarct image (ef),,,247.14,286.17,8
HCPCS,78469,HEART INFARCT IMAGE (3D),,,497.35,2477.59,21
HCPCS,78469,Heart infarct image (3d),,,705.42,816.81,8
HCPCS,78472,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,1582.5,1028.625,0.87,2773.0,106
HCPCS,78473,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,1680.5,1092.325,0.87,2773.0,106
HCPCS,78481,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,392.0,254.8,1.1,392.0,45
HCPCS,78481,HEART FIRST PASS SINGLE,,,497.35,2477.59,21
HCPCS,78481,Heart first pass single,,,247.14,286.17,8
HCPCS,78483,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,2445.0,1589.25,1.1,4302.0,96
HCPCS,78483,HEART FIRST PASS MULTIPLE,,,497.35,2477.59,21
HCPCS,78483,Heart first pass multiple,,,705.42,816.81,8
HCPCS,78491,MYOCRD IMG PET 1STD RST/STRS,,,1347.71,7494.23,21
HCPCS,78492,MYOCRD IMG PET MLT RST&STRS,,,1347.71,7494.23,21
HCPCS,78494,HEART IMAGE SPECT,,,371.28,1909.17,21
HCPCS,78494,Heart image spect,,,247.14,286.17,8
HCPCS,78496,HEART FIRST PASS ADD-ON,,,59.87,59.87,1
HCPCS,78496,Heart first pass add-on,,,247.14,286.17,8
HCPCS,78499,UNLISTED CV PX DX NUC MED,,,371.28,1909.17,20
HCPCS,78499,Unlisted cv px dx nuc med,,,247.14,286.17,8
HCPCS,78579,PULMONARY VENTILATION IMAGING,2773.0,1802.45,0.87,2773.0,61
HCPCS,78580,PULMONARY PERFUSION IMAGING PARTICULATE,2773.0,1802.45,0.87,3069.0,157
HCPCS,78582,PULMONARY VENTILATION & PERFUSION IMAGING,3714.0,2414.1,0.87,4142.0,157
HCPCS,78597,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,1536.5,998.725,0.87,2773.0,106
HCPCS,78598,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,3714.0,2414.1,0.87,3714.0,61
HCPCS,78599,UNLISTED RESP PX DX NUC MED,,,371.28,1909.17,20
HCPCS,78599,Unlisted resp px dx nuc med,,,247.14,286.17,8
HCPCS,78600,BRAIN IMAGE < 4 VIEWS,,,371.28,1909.17,21
HCPCS,78600,Brain image < 4 views,,,247.14,286.17,8
HCPCS,78601,BRAIN IMAGE W/FLOW < 4 VIEWS,,,371.28,1909.17,21
HCPCS,78601,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,204.0,132.6,1.1,204.0,45
HCPCS,78601,Brain image w/flow < 4 views,,,247.14,286.17,8
HCPCS,78605,BRAIN IMAGE 4+ VIEWS,,,497.35,2477.59,21
HCPCS,78605,Brain image 4+ views,,,247.14,286.17,8
HCPCS,78606,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,3714.0,2414.1,0.87,3714.0,61
HCPCS,78608,BRAIN IMAGING PET METABOLIC EVALUATION,10064.0,6541.6,0.87,10064.0,106
HCPCS,78610,BRAIN FLOW IMAGING ONLY,,,497.35,2477.59,21
HCPCS,78610,"BRAIN IMAGING, VASC FLOW ONLY",3714.0,2414.1,1.1,3834.0,142
HCPCS,78610,Brain flow imaging only,,,247.14,286.17,8
HCPCS,78630,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,3714.0,2414.1,0.87,3714.0,61
HCPCS,78635,CSF VENTRICULOGRAPHY,,,497.35,2477.59,21
HCPCS,78635,Csf ventriculography,,,247.14,286.17,8
HCPCS,78645,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,3714.0,2414.1,0.87,3714.0,61
HCPCS,78650,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,9008.0,5855.2,0.87,9008.0,61
HCPCS,78660,NUCLEAR EXAM OF TEAR FLOW,,,371.28,1909.17,21
HCPCS,78660,Nuclear exam of tear flow,,,247.14,286.17,8
HCPCS,78699,UNLISTED NRVS SYS PX DX NUC,,,371.28,1909.17,20
HCPCS,78699,Unlisted nrvs sys px dx nuc,,,247.14,286.17,8
HCPCS,78700,KIDNEY IMAGING MORPHOL,,,371.28,1909.17,21
HCPCS,78700,Kidney imaging morphol,,,247.14,286.17,8
HCPCS,78701,KIDNEY IMAGING WITH FLOW,,,371.28,1909.17,21
HCPCS,78701,Kidney imaging with flow,,,247.14,286.17,8
HCPCS,78707,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,2049.0,1331.85,0.87,3714.0,106
HCPCS,78708,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,3714.0,2414.1,0.87,4198.0,157
HCPCS,78709,K FLOW/FUNCT IMAGE MULTIPLE,,,497.35,2477.59,21
HCPCS,78709,K flow/funct image multiple,,,247.14,286.17,8
HCPCS,78709,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,2421.0,1573.6499999999999,1.1,4278.0,96
HCPCS,78725,KIDNEY FUNCTION STUDY,,,371.28,1909.17,20
HCPCS,78725,Kidney function study,,,247.14,286.17,8
HCPCS,78730,URINARY BLADDER RETENTION,,,204.71,204.71,1
HCPCS,78730,Urinary bladder retention,,,247.14,286.17,8
HCPCS,78740,URETERAL REFLUX STUDY,,,371.28,1909.17,21
HCPCS,78740,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,1614.5,1049.425,1.1,3001.0,96
HCPCS,78740,Ureteral reflux study,,,247.14,286.17,8
HCPCS,78761,TESTICULAR IMAGING WITH VASCULAR FLOW,2773.0,1802.45,0.87,2773.0,61
HCPCS,78799,UNLISTED GU PX DX NUC MED,,,371.28,1909.17,20
HCPCS,78799,Unlisted gu px dx nuc med,,,247.14,286.17,8
HCPCS,78800,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,2773.0,1802.45,0.87,3029.0,203
HCPCS,78801,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,2773.0,1802.45,0.87,2773.0,61
HCPCS,78802,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9008.0,5855.2,0.87,9360.0,203
HCPCS,78803,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,0.87,9488.0,218
HCPCS,78804,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,9008.0,5855.2,0.87,9008.0,61
HCPCS,78808,IV INJ RA DRUG DX STUDY,,,371.28,1909.17,21
HCPCS,78808,Iv inj ra drug dx study,,,65.08,75.36,8
HCPCS,78811,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9008.0,5855.2,0.87,9008.0,53
HCPCS,78812,PET IMAGE SKULL-THIGH,,,1347.71,7494.23,21
HCPCS,78813,PET IMAGE FULL BODY,,,1347.71,7494.23,21
HCPCS,78814,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,0.87,10064.0,53
HCPCS,78815,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,0.87,11040.0,224
HCPCS,78816,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,0.87,11064.0,277
HCPCS,78830,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9008.0,5855.2,0.87,9604.0,157
HCPCS,78831,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9008.0,5855.2,0.87,9008.0,61
HCPCS,78832,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10064.0,6541.6,0.87,10912.0,157
HCPCS,78835,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,410.0,266.5,0.87,598.0,188
HCPCS,78999,MRI FUSION TO PET (COMP CODE 76376),656.0,426.4,0.01,1909.17,148
HCPCS,79005,RP THERAPY ORAL ADMINISTRATION,1546.0,1004.9,0.87,2266.0,203
HCPCS,79101,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,0.87,2330.0,203
HCPCS,79200,NUCLEAR RX INTRACAV ADMIN,,,207.09,1263.71,21
HCPCS,79200,Nuclear rx intracav admin,,,215.84,249.92,8
HCPCS,79300,NUCLR RX INTERSTIT COLLOID,,,207.09,1263.71,21
HCPCS,79300,Nuclr rx interstit colloid,,,215.84,249.92,8
HCPCS,79403,HEMATOPOIETIC NUCLEAR TX,,,207.09,1263.71,20
HCPCS,79403,Hematopoietic nuclear tx,,,215.84,249.92,8
HCPCS,79440,NUCLEAR RX INTRA-ARTICULAR,,,207.09,1263.71,21
HCPCS,79440,Nuclear rx intra-articular,,,215.84,249.92,8
HCPCS,79445,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,0.87,2506.0,240
HCPCS,79999,RP THERAPY UNLISTED PX,,,207.09,1263.71,20
HCPCS,79999,Rp therapy unlisted px,,,215.84,249.92,8
HCPCS,80047,BASIC METABLC PNL IONIZED CA,,,15.38,15.38,1
HCPCS,80047,BMP I STAT ANALYZER,95.0,61.75,0.95,95.0,60
HCPCS,80047,BMP I STAT ANALYZER (POINT OF CARE LAB),95.0,61.75,0.95,95.0,60
HCPCS,80047QW,BASIC METABLC PNL IONIZED CA,,,15.38,15.38,1
HCPCS,80048,BASIC METABOLIC PANEL,58.0,37.7,0.95,58.0,60
HCPCS,80048,BASIC METABOLIC PNL TOTAL CA,,,9.48,9.48,1
HCPCS,80048QW,BASIC METABOLIC PNL TOTAL CA,,,9.48,9.48,1
HCPCS,80050,GENERAL HEALTH PANEL,497.0,323.05,0.95,497.0,46
HCPCS,80051,ELECTROLYTE PANEL,48.0,31.2,0.95,48.0,61
HCPCS,80051QW,ELECTROLYTE PANEL,,,7.85,7.85,1
HCPCS,80053,COMPRE META PANL,73.0,47.45,0.95,73.0,60
HCPCS,80053,COMPREHEN METABOLIC PANEL,,,11.84,11.84,1
HCPCS,80053,COMPREHENSIVE METABOLIC PANEL,73.0,47.45,1.1,73.0,32
HCPCS,80053QW,COMPREHEN METABOLIC PANEL,,,11.84,11.84,1
HCPCS,80055,OB PANEL,330.0,214.5,0.95,381.89,60
HCPCS,80055,OBSTETRIC PANEL,330.0,214.5,0.95,381.89,60
HCPCS,80061,%NMRLIP CHOLESTEROL,92.0,59.8,0.95,92.0,60
HCPCS,80061,*LIPID PANEL,92.0,59.8,0.95,92.0,60
HCPCS,80061,LIPID,92.0,59.8,0.95,92.0,60
HCPCS,80061,LIPID PANEL,92.0,59.8,1.1,92.0,33
HCPCS,80061,LIPID-LIPO PANEL 1,92.0,59.8,0.95,92.0,60
HCPCS,80061,LIPID-LIPO PANEL 1 (POINT OF CARE LAB),92.0,59.8,0.95,92.0,60
HCPCS,80061QW,LIPID PANEL,,,15.0,15.0,1
HCPCS,80069,RENAL FUNC PANL,60.0,39.0,0.95,60.0,60
HCPCS,80069,RENAL FUNCTION PANEL,,,9.72,9.72,1
HCPCS,80069QW,RENAL FUNCTION PANEL,,,9.72,9.72,1
HCPCS,80074,HEPATITIS ACUTE PANEL,329.0,213.85,0.95,329.0,60
HCPCS,80076,HEP FUNC PANL,56.0,36.4,0.95,56.0,60
HCPCS,80076,HEPATIC FUNCTION PNL,56.0,36.4,1.1,56.0,32
HCPCS,80081,OBSTETRIC PANEL INC HIV TSTG,,,74.86,306.76,21
HCPCS,80081,Obstetric panel inc hiv tstg,,,15.61,18.07,8
HCPCS,80100,DRUG SCREEN QUALITATE/MULTI,,,276.01,276.01,1
HCPCS,80101,DRUG SCREEN SINGLE,,,160.67,160.67,1
HCPCS,80102,DRUG CONFIRMATION,,,63.89,63.89,1
HCPCS,80103,DRUG ANALYSIS TISSUE PREP,,,13.42,13.42,1
HCPCS,80143,ACETAMINOPHEN BL TEST,129.0,83.85,0.95,129.0,60
HCPCS,80145,ADALIMUMAB ACT NEUT AB,266.0,172.9,0.95,266.0,60
HCPCS,80145,ANSADA MEAS SER ADA,266.0,172.9,0.95,266.0,60
HCPCS,80150,AMIKACIN ASSAY,104.0,67.6,0.95,104.0,60
HCPCS,80151,AMIODARONE,129.0,83.85,0.95,129.0,60
HCPCS,80152,ASSAY OF AMITRIPTYLINE,,,137.86,137.86,1
HCPCS,80154,ASSAY OF BENZODIAZEPINES,,,31.34,31.34,1
HCPCS,80155,CAFFEINE,266.0,172.9,0.95,266.0,60
HCPCS,80156,CARBAZEPINE TEGRETOL,101.0,65.65,0.95,101.0,60
HCPCS,80157,CARBAMAZEPINE FREE,91.0,59.15,0.95,91.0,60
HCPCS,80158,CYCLOSPORINE ASSAY,125.0,81.25,0.95,125.0,60
HCPCS,80159,CLOZAPINE,139.0,90.35,0.95,139.0,60
HCPCS,80159,DRUG SCREEN QUANT CLOZAPINE,139.0,90.35,0.95,139.0,60
HCPCS,80160,ASSAY OF DESIPRAMINE,,,132.53,132.53,1
HCPCS,80161,CARBAMAZEPINE-10-11-EPOXI,129.0,83.85,0.95,129.0,60
HCPCS,80162,DIGOXIN ASSAY,92.0,59.8,0.95,92.0,60
HCPCS,80163,DIGOXIN FREE,92.0,59.8,0.95,92.0,60
HCPCS,80164,VALPROIC ACID ASSAY,93.0,60.45,0.95,93.0,60
HCPCS,80164,VALPROIC ACID-DEPAKENE,93.0,60.45,0.95,93.0,60
HCPCS,80165,VALPROIC ACID FREE,93.0,60.45,0.95,93.0,120
HCPCS,80166,ASSAY OF DOXEPIN,,,105.07,105.07,1
HCPCS,80167,FELBAMATE,129.0,83.85,0.95,129.0,60
HCPCS,80168,ETHOSUXIMIDE LEVEL,113.0,73.45,0.95,113.0,60
HCPCS,80168,ETHOSUXIMIDE ZARONTIN,113.0,73.45,0.95,113.0,60
HCPCS,80169,EVEROLIMUS,95.0,61.75,0.95,95.0,60
HCPCS,80170,GENTAMICIN ASSAY,113.0,73.45,0.95,113.0,60
HCPCS,80171,GABAPENTIN,150.0,97.5,0.95,150.0,60
HCPCS,80172,ASSAY OF GOLD,,,71.92,71.92,1
HCPCS,80173,ASSAY OF HALOPERIDOL,,,15.78,96.22,21
HCPCS,80173,Assay of haloperidol,,,14.54,16.83,8
HCPCS,80174,ASSAY OF IMIPRAMINE,,,53.02,53.02,1
HCPCS,80175,DRUG SCREEN QUAN LAMOTRIGINE,,,13.25,54.3,21
HCPCS,80175,Drug screen quan lamotrigine,,,14.54,16.83,8
HCPCS,80176,LIDOCAINE PLASMA,101.0,65.65,0.95,101.0,60
HCPCS,80177,LEVETIRACETAM/KEPPRA,91.0,59.15,0.95,91.0,60
HCPCS,80178,ASSAY OF LITHIUM,,,7.41,7.41,1
HCPCS,80178,LITHIUM ASSAY,46.0,29.9,0.95,46.0,60
HCPCS,80178QW,ASSAY OF LITHIUM,,,7.41,7.41,1
HCPCS,80179,SALICYLATE,129.0,83.85,0.95,129.0,60
HCPCS,80180,MYCOPHENOLIC ACID,125.0,81.25,0.95,125.0,60
HCPCS,80181,FLECAINIDE,129.0,83.85,0.95,129.0,60
HCPCS,80182,ASSAY OF NORTRIPTYLINE,,,73.83,73.83,1
HCPCS,80183,OXCARBAZEPINE,91.0,59.15,0.95,91.0,60
HCPCS,80184,PHENOBARBITAL ASSAY,106.0,68.9,0.95,106.0,60
HCPCS,80184,PHENOBARBITAL FREE (UNBOUND),106.0,68.9,0.95,106.0,60
HCPCS,80185,PHENYTOIN-DILANTIN,91.0,59.15,0.95,91.0,60
HCPCS,80186,PHENYTOIN FREE,95.0,61.75,0.95,95.0,60
HCPCS,80186,PHENYTOIN FREE PLASMA,95.0,61.75,0.95,95.0,60
HCPCS,80187,POSACONAZOLE,187.0,121.55,0.95,187.0,60
HCPCS,80188,%FREE PRIMIDONE PLASMA,114.0,74.1,0.95,127.78,60
HCPCS,80188,*PRIMIDONE ASSAY,114.0,74.1,0.95,127.78,60
HCPCS,80189,ITRACONAZOLE,187.0,121.55,0.95,187.0,60
HCPCS,80190,ASSAY OF PROCAINAMIDE,,,60.0,245.87,21
HCPCS,80190,Assay of procainamide,,,14.54,16.83,8
HCPCS,80192,PROCAINAMIDE/NAPA,116.0,75.4,0.95,116.0,60
HCPCS,80193,DRUG ASSAY LEFLUNOMIDE,,,38.57,158.05,20
HCPCS,80193,Drug assay leflunomide,,,14.54,16.83,8
HCPCS,80194,QUINIDINE,101.0,65.65,0.95,101.0,60
HCPCS,80195,SIROLIMUS ASSAY,95.0,61.75,0.95,95.0,60
HCPCS,80196,ASSAY OF SALICYLATE,,,22.12,22.12,1
HCPCS,80197,TACROLIMUS ASSAY,95.0,61.75,0.95,95.0,60
HCPCS,80198,THEOPHYLLINE ASSAY,98.0,63.7,0.95,98.0,60
HCPCS,80199,DRUG SCREEN QUANT TIAGABINE,,,27.11,111.09,21
HCPCS,80199,Drug screen quant tiagabine,,,14.54,16.83,8
HCPCS,80200,TOBRAMYCIN ASSAY,111.0,72.15,0.95,111.0,60
HCPCS,80201,TOPIRAMATE,82.0,53.3,0.95,82.0,60
HCPCS,80202,VANCOMYCIN,93.0,60.45,0.95,93.0,60
HCPCS,80202,VANCOMYCIN ASSAY,93.0,60.45,0.95,93.0,60
HCPCS,80203,ZONISAMIDE,91.0,59.15,0.95,91.0,60
HCPCS,80204,METHOTREXATE,266.0,172.9,0.95,266.0,60
HCPCS,80210,RUFINAMIDE,187.0,121.55,0.95,187.0,60
HCPCS,80220,"HYDROXYCHLOROQUINE, BLOOD",129.0,83.85,0.95,129.0,60
HCPCS,80230,ANSIFX MEAS SER ADA,266.0,172.9,0.95,266.0,60
HCPCS,80230,"INFLIXIMAB, SERUM",266.0,172.9,0.95,266.0,60
HCPCS,80230,INFLIXIMAB/BIOSIMILAR ACT NEUT AB,266.0,172.9,0.95,266.0,60
HCPCS,80235,LACOSAMIDE,187.0,121.55,0.95,187.0,60
HCPCS,80280,ANSVDZ MEAS SER VDZ,266.0,172.9,0.95,266.0,60
HCPCS,80280,"VEDOLIZUMAB QN, S",266.0,172.9,0.95,266.0,60
HCPCS,80285,VORICONAZOLE,187.0,121.55,0.95,187.0,60
HCPCS,80299,"5-FLUCYTOSINE, S",129.0,83.85,0.95,129.0,60
HCPCS,80299,ACETAZOLAMIDE,129.0,83.85,0.95,129.0,60
HCPCS,80299,ADANEU THEARP DRG QNT,129.0,83.85,0.95,129.0,60
HCPCS,80299,ANSUST MEAS SER UST,129.0,83.85,0.95,129.0,60
HCPCS,80299,BRIVARACETAM - QUANTITATIVE ASSAY DRUG,129.0,83.85,0.95,129.0,60
HCPCS,80299,"CENOBAMATE (XCOPRI), PLASMA",129.0,83.85,0.95,129.0,60
HCPCS,80299,DEXAMETHASONE SERUM,129.0,83.85,0.95,129.0,60
HCPCS,80299,DIGITOXIN,129.0,83.85,0.95,129.0,60
HCPCS,80299,DRUG QUANT NOS ASSAY,129.0,83.85,0.95,129.0,60
HCPCS,80299,FLECAINIDE BLOOD,129.0,83.85,0.95,129.0,60
HCPCS,80299,FLUCONAZOLE SERUM,129.0,83.85,0.95,129.0,60
HCPCS,80299,IFXNEU THEARP DRG QNT,129.0,83.85,0.95,129.0,60
HCPCS,80299,ITRACONAZOLE,129.0,83.85,0.95,129.0,60
HCPCS,80299,LEFLUNOMIDE METABOLITE,129.0,83.85,0.95,129.0,60
HCPCS,80299,METHOTREXATE,129.0,83.85,0.95,129.0,60
HCPCS,80299,PERAMPANEL - QUANTITATIVE ASSAY DRUG,129.0,83.85,0.95,129.0,60
HCPCS,80299,POSACONAZOLE,129.0,83.85,0.95,129.0,60
HCPCS,80299,QUETIAPINE,129.0,83.85,0.95,129.0,60
HCPCS,80299,SULFONAMIDES,129.0,83.85,0.95,129.0,60
HCPCS,80299,"SYNTHETIC GLUCOCORTICOID SCREEN, URINE",129.0,83.85,0.95,129.0,60
HCPCS,80299,THERAPEUTIC DRUG LEVEL,129.0,83.85,0.95,129.0,60
HCPCS,80299,THIOPURINE METAB LC-MS/MS,129.0,83.85,0.95,129.0,60
HCPCS,80299,TRILEPTAL,129.0,83.85,0.95,129.0,60
HCPCS,80299,"USTEKINUMAB QN, S",129.0,83.85,0.95,129.0,60
HCPCS,80299,VORICONAZOLE,129.0,83.85,0.95,129.0,60
HCPCS,80305,"ALCOHOL, ETHYL, QUAL(IN-HOUSE)",87.0,56.55,0.95,87.0,60
HCPCS,80305,DOT 5 PANEL URINE DRUG SCREEN,35.0,22.75,1.1,35.0,32
HCPCS,80305,DRUG TEST PRSMV DIR OPT OBS,,,14.12,14.12,1
HCPCS,80305,DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY,87.0,56.55,1.1,87.0,32
HCPCS,80305,DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE,16.0,10.4,1.1,30.52,32
HCPCS,80305,TOX CUP SCREEN 14 (IN-HOUSE),87.0,56.55,0.95,87.0,60
HCPCS,80305QW,DRUG TEST PRSMV DIR OPT OBS,,,14.12,14.12,1
HCPCS,80306,"DRUG SCREEN,PRESUMPTIVE MEDTOX",118.0,76.7,0.95,118.0,60
HCPCS,80306,"DRUG SCREEN,PRESUMPTIVE SCREEN",118.0,76.7,0.95,118.0,60
HCPCS,80306,DRUG TEST PRSMV INSTRMNT (POINT OF CARE LAB),118.0,76.7,0.95,118.0,60
HCPCS,80306,DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS,118.0,76.7,1.1,118.0,32
HCPCS,80307,ALCOHOL,429.0,278.85,0.95,429.0,60
HCPCS,80307,ASSAY OF ACETAMINOPHEN,429.0,278.85,0.95,429.0,60
HCPCS,80307,DRG SCRN 9 PANEL SER OR PL,429.0,278.85,0.95,429.0,60
HCPCS,80307,DRUG ANALYSIS UR,429.0,278.85,0.95,429.0,60
HCPCS,80307,"DRUG PAN9, SER/PLA W/ RFLX TO CONF",429.0,278.85,0.95,429.0,60
HCPCS,80307,"DRUG SCRN, BLD",429.0,278.85,0.95,429.0,60
HCPCS,80307,DRUG TEST PRSMV CHEM ANLYZR,429.0,278.85,0.95,429.0,120
HCPCS,80307,DRUG TEST PRSMV INSTRMT CHEMISTRY ANALYZER,56.0,36.4,1.1,150.51,32
HCPCS,80307,DRUG TESTS PRESUMPTIVE,429.0,278.85,0.95,429.0,60
HCPCS,80307,DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE,429.0,278.85,1.1,429.0,32
HCPCS,80307,DRUGS OF ABUSE 9A SCRN UR,429.0,278.85,0.95,429.0,60
HCPCS,80307,ETHYL GLUC UR SCRN,429.0,278.85,0.95,429.0,60
HCPCS,80307,LSD SCREEN (SEND OUT),429.0,278.85,0.95,429.0,60
HCPCS,80307,MATERNAL 8PC DRUG SCREEN,429.0,278.85,0.95,429.0,60
HCPCS,80307,"MITRAGYNINE (KRATOM), URINE",429.0,278.85,0.95,429.0,60
HCPCS,80307,"OXYCODONE SCRN, UR",429.0,278.85,0.95,429.0,60
HCPCS,80307,"SALICYLATE, S",429.0,278.85,0.95,429.0,120
HCPCS,80307,TRAMADOL SCREEN (SEND OUT),429.0,278.85,0.95,429.0,60
HCPCS,80307,"UR DRUG SCRN, MULTI (PT ENCTR)",429.0,278.85,0.95,429.0,60
HCPCS,80307,URINE OPIATE,429.0,278.85,0.95,429.0,60
HCPCS,80320,Drug screen quantalcohols,,,23.91,27.69,8
HCPCS,80321,Alcohols biomarkers 1or 2,,,23.91,27.69,8
HCPCS,80322,Alcohols biomarkers 3/more,,,23.91,27.69,8
HCPCS,80323,KRATOM (MITRAGYNINE) CONFIRMATION,334.0,217.1,0.95,334.0,46
HCPCS,80324,Drug screen amphetamines 1/2,,,23.91,27.69,8
HCPCS,80325,Amphetamines 3or 4,,,23.91,27.69,8
HCPCS,80326,Amphetamines 5 or more,,,23.91,27.69,8
HCPCS,80327,Anabolic steroid 1 or 2,,,23.91,27.69,8
HCPCS,80328,Anabolic steroid 3 or more,,,23.91,27.69,8
HCPCS,80329,Analgesics non-opioid 1 or 2,,,23.91,27.69,8
HCPCS,80330,Analgesics non-opioid 3-5,,,23.91,27.69,8
HCPCS,80331,Analgesics non-opioid 6/more,,,23.91,27.69,8
HCPCS,80332,Antidepressants class 1 or 2,,,27.64,32.0,8
HCPCS,80333,Antidepressants class 3-5,,,23.91,27.69,8
HCPCS,80334,Antidepressants class 6/more,,,23.91,27.69,8
HCPCS,80335,Antidepressant tricyclic 1/2,,,23.91,27.69,8
HCPCS,80336,Antidepressant tricyclic 3-5,,,23.91,27.69,8
HCPCS,80337,Tricyclic & cyclicals 6/more,,,23.91,27.69,8
HCPCS,80338,VENLAFAXINE SERUM/PLASMA - ARUP,36.0,23.4,0.95,36.0,46
HCPCS,80339,Antiepileptics nos 1-3,,,27.64,32.0,8
HCPCS,80340,Antiepileptics nos 4-6,,,23.91,27.69,8
HCPCS,80341,Antiepileptics nos 7/more,,,23.91,27.69,8
HCPCS,80342,Antipsychotics nos 1-3,,,23.91,27.69,8
HCPCS,80343,Antipsychotics nos 4-6,,,23.91,27.69,8
HCPCS,80344,Antipsychotics nos 7/more,,,23.91,27.69,8
HCPCS,80345,Drug screening barbiturates,,,23.91,27.69,8
HCPCS,80346,Benzodiazepines1-12,,,23.91,27.69,8
HCPCS,80347,Benzodiazepines 13 or more,,,23.91,27.69,8
HCPCS,80348,Drug screening buprenorphine,,,23.91,27.69,8
HCPCS,80349,CANNABINOIDS NATURAL,53.0,34.45,0.95,53.0,46
HCPCS,80350,Cannabinoids synthetic 1-3,,,23.91,27.69,8
HCPCS,80351,Cannabinoids synthetic 4-6,,,23.91,27.69,8
HCPCS,80352,Cannabinoid synthetic 7/more,,,23.91,27.69,8
HCPCS,80353,Drug screening cocaine,,,23.91,27.69,8
HCPCS,80354,Drug screening fentanyl,,,23.91,27.69,8
HCPCS,80355,Gabapentin non-blood,,,23.91,27.69,8
HCPCS,80356,Heroin metabolite,,,23.91,27.69,8
HCPCS,80357,Ketamine and norketamine,,,23.91,27.69,8
HCPCS,80358,Drug screening methadone,,,23.91,27.69,8
HCPCS,80359,Methylenedioxyamphetamines,,,23.91,27.69,8
HCPCS,80360,Methylphenidate,,,23.91,27.69,8
HCPCS,80361,Opiates 1 or more,,,23.91,27.69,8
HCPCS,80362,Opioids & opiate analogs 1/2,,,23.91,27.69,8
HCPCS,80363,Opioids & opiate analogs 3/4,,,23.91,27.69,8
HCPCS,80364,Opioid &opiate analog 5/more,,,23.91,27.69,8
HCPCS,80365,Drug screening oxycodone,,,23.91,27.69,8
HCPCS,80366,"PREGABALIN, URINE",32.0,20.8,0.95,32.0,46
HCPCS,80367,Drug screening propoxyphene,,,23.91,27.69,8
HCPCS,80368,Sedative hypnotics,,,23.91,27.69,8
HCPCS,80369,Skeletal muscle relaxant 1/2,,,23.91,27.69,8
HCPCS,80370,Skel musc relaxant 3 or more,,,23.91,27.69,8
HCPCS,80371,Stimulants synthetic,,,23.91,27.69,8
HCPCS,80372,Drug screening tapentadol,,,23.91,27.69,8
HCPCS,80373,Drug screening tramadol,,,23.91,27.69,8
HCPCS,80374,Stereoisomer analysis,,,23.91,27.69,8
HCPCS,80375,Drug/substance nos 1-3,,,27.64,32.0,8
HCPCS,80376,Drug/substance nos 4-6,,,23.91,27.69,8
HCPCS,80377,Drug/substance nos 7/more,,,23.91,27.69,8
HCPCS,80400,%ACTH STIMULATION PANEL,225.0,146.25,0.95,225.0,60
HCPCS,80400,ACTH STIM W/2 TIME PTS,225.0,146.25,0.95,225.0,60
HCPCS,80402,ACTH STIMULATION PANEL,,,86.96,356.34,21
HCPCS,80402,Acth stimulation panel,,,21.97,25.44,8
HCPCS,80406,ACTH STIMULATION PANEL,,,78.26,345.62,21
HCPCS,80406,Acth stimulation panel,,,21.97,25.44,8
HCPCS,80408,ALDOSTERONE SUPPRESSION EVAL,,,125.5,515.32,21
HCPCS,80408,Aldosterone suppression eval,,,21.97,25.44,8
HCPCS,80410,CALCITONIN STIMUL PANEL,,,80.37,354.83,21
HCPCS,80410,Calcitonin stimul panel,,,21.97,25.44,8
HCPCS,80412,CRH STIMULATION PANEL,,,801.62,3284.88,21
HCPCS,80412,Crh stimulation panel,,,137.41,159.1,8
HCPCS,80414,TESTOSTERONE RESPONSE PANEL,,,51.64,211.61,21
HCPCS,80414,Testosterone response panel,,,21.97,25.44,8
HCPCS,80415,TOT ESTRADIOL RESPONSE PANEL,,,55.89,246.83,21
HCPCS,80415,Tot estradiol response panel,,,21.97,25.44,8
HCPCS,80416,RENIN STIMULATION PANEL,,,209.32,857.75,21
HCPCS,80416,Renin stimulation panel,,,92.46,107.06,8
HCPCS,80417,RENIN STIMULATION PANEL,,,43.99,180.26,21
HCPCS,80417,Renin stimulation panel,,,21.97,25.44,8
HCPCS,80418,PITUITARY EVALUATION PANEL,,,579.48,2560.61,21
HCPCS,80418,Pituitary evaluation panel,,,87.06,100.8,8
HCPCS,80420,DEXAMETHASONE PANEL,,,135.94,663.35,21
HCPCS,80420,Dexamethasone panel,,,92.46,107.06,8
HCPCS,80422,GLUCAGON TOLERANCE PANEL,,,46.07,188.79,21
HCPCS,80422,Glucagon tolerance panel,,,21.97,25.44,8
HCPCS,80424,GLUCAGON TOLERANCE PANEL,,,50.5,223.11,21
HCPCS,80424,Glucagon tolerance panel,,,21.97,25.44,8
HCPCS,80426,GONADOTROPIN HORMONE PANEL,,,148.41,608.15,21
HCPCS,80426,Gonadotropin hormone panel,,,92.46,107.06,8
HCPCS,80428,GROWTH HORMONE PANEL,,,66.7,273.32,21
HCPCS,80428,Growth hormone panel,,,21.97,25.44,8
HCPCS,80430,GROWTH HORMONE PANEL,,,129.33,529.97,21
HCPCS,80430,Growth hormone panel,,,21.97,25.44,8
HCPCS,80432,CPEPSP INSULIN SUPPRESSION PANEL,1143.0,742.95,0.95,1143.0,60
HCPCS,80434,INSULIN TOLERANCE PANEL,,,285.03,1168.0,21
HCPCS,80434,Insulin tolerance panel,,,92.46,107.06,8
HCPCS,80435,INSULIN TOLERANCE PANEL,,,103.0,967.46,21
HCPCS,80435,Insulin tolerance panel,,,21.97,25.44,8
HCPCS,80436,METYRAPONE PANEL,,,91.16,402.64,21
HCPCS,80436,Metyrapone panel,,,21.97,25.44,8
HCPCS,80438,TRH STIMULATION PANEL,,,50.41,222.46,21
HCPCS,80438,Trh stimulation panel,,,21.97,25.44,8
HCPCS,80439,TRH STIMULATION PANEL,,,67.21,296.67,21
HCPCS,80439,Trh stimulation panel,,,21.97,25.44,8
HCPCS,80440,TRH STIMULATION PANEL,,,256.66,256.66,1
HCPCS,80500,LAB PATHOLOGY CONSULTATION,,,100.55,100.55,1
HCPCS,80500,Lab pathology consultation,,,27.56,31.91,8
HCPCS,80502,LAB PATHOLOGY CONSULTATION,,,349.55,349.55,1
HCPCS,80502,Lab pathology consultation,,,27.56,31.91,8
HCPCS,80503,PATH CLIN CONSLTJ SF 5-20,,,49.3,146.06,20
HCPCS,80503,Path clin consltj sf 5-20,,,27.56,31.91,8
HCPCS,80504,PATH CLIN CONSLTJ MOD 21-40,,,158.33,477.52,20
HCPCS,80504,Path clin consltj mod 21-40,,,27.56,31.91,8
HCPCS,80505,PATH CLIN CONSLTJ HIGH 41-60,,,158.33,477.52,20
HCPCS,80505,Path clin consltj high 41-60,,,27.56,31.91,8
HCPCS,80506,PATH CLIN CONSLTJ PROLNG SVC,,,97.34,97.34,1
HCPCS,80506,Path clin consltj prolng svc,,,27.56,31.91,8
HCPCS,81000,URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB),28.0,18.2,0.95,28.0,60
HCPCS,81000,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,28.0,18.2,1.1,28.0,32
HCPCS,81001,URINALYSIS AUTO W SCPE,22.0,14.3,0.95,22.0,60
HCPCS,81001,URINALYSIS WITH MICRO (POINT OF CARE LAB),22.0,14.3,0.95,22.0,60
HCPCS,81001,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,22.0,14.3,1.1,22.0,32
HCPCS,81002,N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB),24.0,15.6,0.95,24.0,60
HCPCS,81002,UA NON-AUTO W/O MICRO (POINT OF CARE LAB),24.0,15.6,0.95,24.0,60
HCPCS,81002,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,24.0,15.6,1.1,24.0,32
HCPCS,81003,URINALYSIS (POINT OF CARE LAB),16.0,10.4,0.95,17.31,60
HCPCS,81003,URINALYSIS AUTO W/O SCOPE,,,2.52,2.52,1
HCPCS,81003,URINALYSIS AUTO WO SCPE,16.0,10.4,0.95,17.31,60
HCPCS,81003,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),16.0,10.4,0.95,17.31,120
HCPCS,81003,URINALYSIS ONLY,16.0,10.4,0.95,17.31,60
HCPCS,81003,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,16.0,10.4,1.1,16.0,32
HCPCS,81003QW,URINALYSIS AUTO W/O SCOPE,,,2.52,2.52,1
HCPCS,81005,"URINANALYSIS, QUAL OR SEMI-QUANT",15.0,9.75,0.95,15.0,60
HCPCS,81007,URINE SCREEN FOR BACTERIA,,,11.24,122.85,22
HCPCS,81007,Urine screen for bacteria,,,5.06,5.86,8
HCPCS,81007QW,URINE SCREEN FOR BACTERIA,,,33.59,33.59,1
HCPCS,81015,URINALYSIS MICROSCOP ONLY,21.0,13.65,0.95,21.0,60
HCPCS,81015,URINALYSIS MICROSCOP ONLY (POINT OF CARE LAB),21.0,13.65,0.95,21.0,60
HCPCS,81020,URINALYSIS GLASS TEST,,,4.7,19.26,21
HCPCS,81020,Urinalysis glass test,,,5.06,5.86,8
HCPCS,81025,HCG QUAL FLUID/URINE,59.0,38.35,0.95,59.0,60
HCPCS,81025,HCG URINE (POINT OF CARE LAB),59.0,38.35,0.95,59.0,60
HCPCS,81025,PREGNANCY TEST URINE (POINT OF CARE LAB),59.0,38.35,0.95,59.0,120
HCPCS,81025,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,59.0,38.35,1.1,59.0,32
HCPCS,81050,VOL MEASURE TIMED UR OUT,25.0,16.25,0.95,25.0,60
HCPCS,81099,"REDUCING SUBSTANCE, URINE",11.0,7.15,0.95,11.0,46
HCPCS,81105,HPA-1 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81106,HPA-2 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81107,HPA-3 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81108,HPA-4 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81109,HPA-5 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81110,HPA-6 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81111,HPA-9 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81112,HPA-15 GENOTYPING,843.0,547.95,0.95,843.0,120
HCPCS,81120,%IDHI12 GENE ANALYSIS IDH1,1333.0,866.45,0.95,1333.0,60
HCPCS,81120,IDH1 COMMON VARIANTS,1333.0,866.45,0.95,1333.0,60
HCPCS,81120,IDH1 HOTSPOT VARIANT BM,1333.0,866.45,0.95,1333.0,60
HCPCS,81120,IDH1 HOTSPOT VARIANT PB,1333.0,866.45,0.95,1333.0,60
HCPCS,81121,%IDHI12 GENE ANALYSIS IDH2,2041.0,1326.65,0.95,2041.0,60
HCPCS,81121,IDH2 COMMON VARIANTS,2041.0,1326.65,0.95,2041.0,60
HCPCS,81121,IDH2 HOTSPOT VARIANT PB,2041.0,1326.65,0.95,2041.0,60
HCPCS,81121,IHD2 HOTSPOT VARIANT BM,2041.0,1326.65,0.95,2041.0,60
HCPCS,81161,DMD DUP/DELET ANALYSIS,,,279.0,1143.29,21
HCPCS,81161,Dmd dup/delet analysis,,,92.46,107.06,8
HCPCS,81162,BRCA1&2 GEN FULL SEQ DUP/DEL,,,1824.88,7477.99,21
HCPCS,81162,Brca1&2 gen full seq dup/del,,,533.45,617.68,8
HCPCS,81163,BRCA1&2 GENE FULL SEQ ALYS,,,468.0,1917.77,21
HCPCS,81163,Brca1&2 gene full seq alys,,,87.06,100.8,8
HCPCS,81164,BRCA1&2 GEN FUL DUP/DEL ALYS,,,584.23,2394.06,21
HCPCS,81164,Brca1&2 gen ful dup/del alys,,,87.06,100.8,8
HCPCS,81165,BRCA1 GENE FULL SEQ ALYS,,,282.88,1159.19,21
HCPCS,81165,Brca1 gene full seq alys,,,92.46,107.06,8
HCPCS,81166,BRCA1 GENE FULL DUP/DEL ALYS,,,301.35,1234.87,21
HCPCS,81166,Brca1 gene full dup/del alys,,,92.46,107.06,8
HCPCS,81167,BRCA2 GENE FULL DUP/DEL ALYS,,,282.88,1159.19,21
HCPCS,81167,Brca2 gene full dup/del alys,,,92.46,107.06,8
HCPCS,81168,CCND1/IGH TRANSLOCATION ALYS,,,207.31,849.51,21
HCPCS,81168,Ccnd1/igh translocation alys,,,92.46,107.06,8
HCPCS,81170,BCR-ABL1 KINASE MUT DET BY SANGER SEQ BM,2070.0,1345.5,0.95,2070.0,60
HCPCS,81170,BCR-ABL1 KINASE MUT DET SANGER BLD,2070.0,1345.5,0.95,2070.0,60
HCPCS,81170,KINASE TEST,2070.0,1345.5,0.95,2070.0,60
HCPCS,81171,AFF2 GEN ALY DETC ABNL ALLEL,,,137.0,561.4,21
HCPCS,81171,Aff2 gen aly detc abnl allel,,,92.46,107.06,8
HCPCS,81172,AFF2 GEN ALYS CHARAC ALLELES,,,274.83,1126.2,21
HCPCS,81172,Aff2 gen alys charac alleles,,,92.46,107.06,8
HCPCS,81173,AR GENE FULL GENE SEQUENCE,,,301.35,1234.87,21
HCPCS,81173,Ar gene full gene sequence,,,92.46,107.06,8
HCPCS,81174,AR GENE KNOWN FAMIL VARIANT,,,185.2,758.91,21
HCPCS,81174,Ar gene known famil variant,,,92.46,107.06,8
HCPCS,81175,ASXL1 FULL GENE SEQUENCE,,,676.5,2772.16,21
HCPCS,81175,Asxl1 full gene sequence,,,137.41,159.1,8
HCPCS,81176,ASXL1 GENE TARGET SEQ ALYS,,,241.9,991.26,21
HCPCS,81176,Asxl1 gene target seq alys,,,92.46,107.06,8
HCPCS,81177,ATN1 GENE DETC ABNOR ALLELES,,,137.0,561.4,21
HCPCS,81177,Atn1 gene detc abnor alleles,,,92.46,107.06,8
HCPCS,81178,ATXN1 GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81178,Atxn1 gene detc abnor allele,,,92.46,107.06,8
HCPCS,81179,ATXN2 GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81179,Atxn2 gene detc abnor allele,,,92.46,107.06,8
HCPCS,81180,ATXN3 GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81180,Atxn3 gene detc abnor allele,,,92.46,107.06,8
HCPCS,81181,ATXN7 GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81181,Atxn7 gene detc abnor allele,,,92.46,107.06,8
HCPCS,81182,ATXN8OS GEN DETC ABNOR ALLEL,,,137.0,561.4,21
HCPCS,81182,Atxn8os gen detc abnor allel,,,92.46,107.06,8
HCPCS,81183,ATXN10 GENE DETC ABNOR ALLEL,,,137.0,561.4,21
HCPCS,81183,Atxn10 gene detc abnor allel,,,92.46,107.06,8
HCPCS,81184,CACNA1A GEN DETC ABNOR ALLEL,,,137.0,561.4,21
HCPCS,81184,Cacna1a gen detc abnor allel,,,92.46,107.06,8
HCPCS,81185,CACNA1A GENE FULL GENE SEQ,,,846.27,3467.85,21
HCPCS,81185,Cacna1a gene full gene seq,,,137.41,159.1,8
HCPCS,81186,CACNA1A GEN KNOWN FAMIL VRNT,,,185.2,758.91,21
HCPCS,81186,Cacna1a gen known famil vrnt,,,92.46,107.06,8
HCPCS,81187,CNBP GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81187,Cnbp gene detc abnor allele,,,92.46,107.06,8
HCPCS,81188,CSTB GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81188,Cstb gene detc abnor allele,,,92.46,107.06,8
HCPCS,81189,CSTB GENE FULL GENE SEQUENCE,,,274.83,1126.2,21
HCPCS,81189,Cstb gene full gene sequence,,,92.46,107.06,8
HCPCS,81190,CSTB GENE KNOWN FAMIL VRNT,,,185.2,758.91,21
HCPCS,81190,Cstb gene known famil vrnt,,,92.46,107.06,8
HCPCS,81191,NTRK1 TRANSLOCATION ANALYSIS,,,207.31,849.51,21
HCPCS,81191,Ntrk1 translocation analysis,,,92.46,107.06,8
HCPCS,81192,NTRK2 TRANSLOCATION ANALYSIS,,,207.31,849.51,21
HCPCS,81192,Ntrk2 translocation analysis,,,92.46,107.06,8
HCPCS,81193,NTRK3 TRANSLOCATION ANALYSIS,,,207.31,849.51,21
HCPCS,81193,Ntrk3 translocation analysis,,,92.46,107.06,8
HCPCS,81194,NTRK NGS,3359.0,2183.35,0.95,3359.0,60
HCPCS,81195,CYTOG GENOM-WID ALYS HEM MAL,,,1263.53,7635.1,19
HCPCS,81195,Cytog genom-wid alys hem mal,,,533.45,617.68,8
HCPCS,81200,ASPA GENE,,,47.25,193.62,20
HCPCS,81200,Aspa gene,,,66.63,77.15,8
HCPCS,81201,APC GENE FULL SEQUENCE,,,780.0,3196.28,21
HCPCS,81201,Apc gene full sequence,,,137.41,159.1,8
HCPCS,81202,APC GENE KNOWN FAM VARIANTS,,,280.0,1147.38,21
HCPCS,81202,Apc gene known fam variants,,,92.46,107.06,8
HCPCS,81203,APC GENE DUP/DELET VARIANTS,,,200.0,819.56,21
HCPCS,81203,Apc gene dup/delet variants,,,92.46,107.06,8
HCPCS,81204,AR GENE CHARAC ALLELES,,,137.0,561.4,21
HCPCS,81204,Ar gene charac alleles,,,92.46,107.06,8
HCPCS,81205,BCKDHB GENE ANALYSIS COMMON VARIANTS,655.0,425.75,1.1,655.0,32
HCPCS,81205,CSPNL BCKDHB GENE,655.0,425.75,0.95,655.0,60
HCPCS,81206,%ABLQUL BCR/ABL1 MAJ,1131.0,735.15,0.95,1262.54,60
HCPCS,81206,%BCRQL BCR/ABL1 MAJ BRKPT,1131.0,735.15,0.95,1262.54,60
HCPCS,81206,BCR P210 (CML),1131.0,735.15,0.95,1262.54,60
HCPCS,81206,BCR/ABL QUANT BLOOD TEST,1131.0,735.15,0.95,1262.54,60
HCPCS,81206,BCRBM BCR/ABL1 GENE MAJOR BP,1131.0,735.15,0.95,1262.54,60
HCPCS,81206,BCRPB BCR/ABL1 GENE MAJOR BP,1131.0,735.15,0.95,1262.54,60
HCPCS,81207,%ABLQUL BCR/ABL1 MIN,999.0,649.35,0.95,1115.21,60
HCPCS,81207,%BCRQL BCR/ABL1 MIN BRKPT,999.0,649.35,0.95,1115.21,60
HCPCS,81207,190PCR BONE MARROW TEST,999.0,649.35,0.95,1115.21,60
HCPCS,81207,BCR P190 (ALL),999.0,649.35,0.95,1115.21,60
HCPCS,81207,BCRBM BCR/ABL1 GENE MINOR BP,999.0,649.35,0.95,1115.21,60
HCPCS,81207,BCRPB BCR/ABL1 GENE MINOR BP,999.0,649.35,0.95,1115.21,60
HCPCS,81207,P190PCR BLOOD,999.0,649.35,0.95,1115.21,60
HCPCS,81208,%ABLQUL BCR/ABL1 OTH,1481.0,962.65,0.95,1481.0,60
HCPCS,81208,%BCRQL BCR/ABL1 OTH BRKPT,1481.0,962.65,0.95,1481.0,60
HCPCS,81209,BLM GENE,,,39.31,161.08,20
HCPCS,81209,Blm gene,,,66.63,77.15,8
HCPCS,81210,%BRAFGN BRAF GENE AN,1210.0,786.5,0.95,1210.0,60
HCPCS,81210,%NGSCOL BRAF,1210.0,786.5,0.95,1210.0,60
HCPCS,81210,%NGSMEL BRAF,1210.0,786.5,0.95,1210.0,60
HCPCS,81210,BRAF V600E/D AND V600K/R MUTATION DETECTION CIRCULATING TUMOR DN,1335.0,867.75,0.95,1335.0,60
HCPCS,81210,GIST BRAF GENE,1210.0,786.5,0.95,1210.0,60
HCPCS,81212,BRCA1&2 185&5385&6174 VRNT,,,440.0,1803.03,21
HCPCS,81212,Brca1&2 185&5385&6174 vrnt,,,87.06,100.8,8
HCPCS,81215,BRCA1 GENE KNOWN FAMIL VRNT,,,375.25,1537.7,21
HCPCS,81215,Brca1 gene known famil vrnt,,,87.06,100.8,8
HCPCS,81216,BRCA2 GENE FULL SEQ ALYS,,,185.12,758.58,21
HCPCS,81216,Brca2 gene full seq alys,,,92.46,107.06,8
HCPCS,81217,BRCA2 GENE KNOWN FAMIL VRNT,,,375.25,1537.7,21
HCPCS,81217,Brca2 gene known famil vrnt,,,87.06,100.8,8
HCPCS,81218,CEBPA MUT ANALYSIS,1669.0,1084.85,0.95,1669.0,60
HCPCS,81219,CALR EXON 9 MUTATION,839.0,545.35,0.95,839.0,60
HCPCS,81219,CALR GENE ANALYSIS,839.0,545.35,0.95,839.0,60
HCPCS,81220,CF PATHOGENIC VARIANT,3841.0,2496.65,0.95,4289.05,60
HCPCS,81220,CFNGS 139 VAR,3841.0,2496.65,0.95,4289.05,60
HCPCS,81220,CFTR GENE COM VARIANTS,3841.0,2496.65,0.95,4289.05,60
HCPCS,81220,CSPNL CFTR GENE COM VARS,3841.0,2496.65,0.95,4289.05,60
HCPCS,81221,CFTR GENE KNOWN FAM VARIANTS,,,97.22,398.39,21
HCPCS,81221,Cftr gene known fam variants,,,66.63,77.15,8
HCPCS,81222,CFTR GENE DUP/DELET VARIANTS,,,435.07,1782.83,21
HCPCS,81222,Cftr gene dup/delet variants,,,87.06,100.8,8
HCPCS,81223,*CFTR GENE FULL SEQUENCE,3443.0,2237.95,0.95,3443.0,60
HCPCS,81224,CFTR GENE INTRON POLY T,,,168.75,691.5,21
HCPCS,81224,Cftr gene intron poly t,,,92.46,107.06,8
HCPCS,81225,CYTOCHROME P450 2C19,2010.0,1306.5,0.95,2010.0,60
HCPCS,81226,CYTOCHROME P450 2D6,3111.0,2022.15,0.95,3111.0,60
HCPCS,81226,PGPAIN CYP2D6 GENE COM VAR,3111.0,2022.15,0.95,3111.0,60
HCPCS,81227,CYP2C9 GENE COM VARIANTS,,,174.81,988.16,21
HCPCS,81227,Cyp2c9 gene com variants,,,92.46,107.06,8
HCPCS,81228,CYTOG ALYS CHRML ABNR CGH,,,900.0,3688.02,21
HCPCS,81228,Cytog alys chrml abnr cgh,,,137.41,159.1,8
HCPCS,81229,CRMSNP TEST,4500.0,2925.0,0.95,4753.45,60
HCPCS,81229,CYTOGENOMIC SNP MICROARRAY - FETAL,4500.0,2925.0,0.95,4753.45,60
HCPCS,81229,"MICROARRAY ANALYSIS, POC FFPE",1335.0,867.75,0.95,4753.45,60
HCPCS,81229,"MICROARRAY ANALYSIS, SNP, FORMALIN FIXED PARAFFIN EMBEDDED TISSU",1335.0,867.75,0.95,4753.45,60
HCPCS,81229,POCHF PROD CONCEPT+SNP,4500.0,2925.0,0.95,4753.45,60
HCPCS,81229,"PRENATAL SNP MICROARRAY, AMNIOTIC FLUID, CVS",4500.0,2925.0,0.95,4753.45,60
HCPCS,81229,PROD OF CONCEPTION + SNP,4500.0,2925.0,0.95,4753.45,60
HCPCS,81230,CYP3A4 GENE COMMON VARIANTS,,,174.81,716.34,21
HCPCS,81230,Cyp3a4 gene common variants,,,92.46,107.06,8
HCPCS,81231,CYP3A5 GENE COMMON VARIANTS,,,174.81,716.34,21
HCPCS,81231,Cyp3a5 gene common variants,,,92.46,107.06,8
HCPCS,81232,5FUDPD DPYD GENE COMMON VARS,1206.0,783.9,0.95,1206.0,60
HCPCS,81232,DUPNL DPYD GENE COMMON VARIANTS,1206.0,783.9,0.95,1206.0,60
HCPCS,81233,BTK GENE ANALYISIS,1210.0,786.5,0.95,1210.0,60
HCPCS,81234,DMPK GENE DETC ABNOR ALLELE,,,137.0,561.4,21
HCPCS,81234,Dmpk gene detc abnor allele,,,92.46,107.06,8
HCPCS,81235,%NGSLUNG EGFR,2240.0,1456.0,0.95,2240.0,60
HCPCS,81235,EGFR GENETIC ANALYSIS,2240.0,1456.0,0.95,2240.0,60
HCPCS,81236,EZH2 GENE FULL GENE SEQUENCE,,,282.88,1159.19,21
HCPCS,81236,Ezh2 gene full gene sequence,,,92.46,107.06,8
HCPCS,81237,EZH2 GENE COMMON VARIANTS,,,175.4,718.75,21
HCPCS,81237,Ezh2 gene common variants,,,92.46,107.06,8
HCPCS,81238,F9 FULL GENE SEQUENCE,,,600.0,2458.68,21
HCPCS,81238,F9 full gene sequence,,,137.41,159.1,8
HCPCS,81239,DMPK GENE CHARAC ALLELES,,,274.83,1126.2,21
HCPCS,81239,Dmpk gene charac alleles,,,92.46,107.06,8
HCPCS,81240,MISC SENDOUT CPT 81240,438.0,284.7,0.95,438.0,60
HCPCS,81240,PTGENEO TEST,453.0,294.45,0.95,453.0,60
HCPCS,81241,FACT V LEIDEN TEST,506.0,328.9,0.95,506.0,60
HCPCS,81241,FACTOR V LEIDEN MUTATION,506.0,328.9,0.95,506.0,60
HCPCS,81242,CSPNL FANCC GENE,253.0,164.45,0.95,253.0,60
HCPCS,81243,%FRAX FMR 1 TEST,394.0,256.1,0.95,930.61,60
HCPCS,81243,CSPNL FMR1 GENE DETECTION,394.0,256.1,0.95,930.61,60
HCPCS,81244,FMR1 GEN ALYS CHARAC ALLELES,,,44.89,183.95,21
HCPCS,81244,Fmr1 gen alys charac alleles,,,66.63,77.15,8
HCPCS,81245,%FLT3 ITD TEST,1142.0,742.3,0.95,1142.0,60
HCPCS,81246,%FLT3 TKD TEST,573.0,372.45,0.95,573.0,60
HCPCS,81246,FLT3 TKDM BONE MARROW,573.0,372.45,0.95,573.0,60
HCPCS,81247,G6PD GENE ALYS CMN VARIANT,,,174.81,716.34,21
HCPCS,81247,G6pd gene alys cmn variant,,,92.46,107.06,8
HCPCS,81248,G6PD KNOWN FAMILIAL VARIANT,,,375.25,1537.7,21
HCPCS,81248,G6pd known familial variant,,,87.06,100.8,8
HCPCS,81249,G6PD FULL GENE SEQUENCE,,,600.0,2458.68,21
HCPCS,81249,G6pd full gene sequence,,,137.41,159.1,8
HCPCS,81250,%AJPWO G6PC,404.0,262.6,0.95,404.0,60
HCPCS,81250,CSPNL G6PC GENE,404.0,262.6,0.95,404.0,60
HCPCS,81251,CSPNL GBA GENE,326.0,211.9,0.95,326.0,60
HCPCS,81252,GJB2 GENE FULL SEQUENCE,,,101.12,414.37,21
HCPCS,81252,Gjb2 gene full sequence,,,66.63,77.15,8
HCPCS,81253,GJB2 GENE KNOWN FAM VARIANTS,,,61.52,252.1,21
HCPCS,81253,Gjb2 gene known fam variants,,,66.63,77.15,8
HCPCS,81254,GJB6 GENE COM VARIANTS,,,35.0,143.42,21
HCPCS,81254,Gjb6 gene com variants,,,66.63,77.15,8
HCPCS,81255,CSPNL HEXA GENE,355.0,230.75,0.95,355.0,60
HCPCS,81256,HEMDNA TEST,451.0,293.15,0.95,503.27,60
HCPCS,81256,HEREDITARY HEMOCHROM,451.0,293.15,0.95,503.27,60
HCPCS,81256,HFE TARGETED MUT BY SANGER SEQ,451.0,293.15,0.95,503.27,60
HCPCS,81257,ALPHA THALASSEMIA TEST,706.0,458.9,0.95,1397.77,60
HCPCS,81258,HBA1/HBA2 GENE FAM VRNT,,,375.25,1537.7,21
HCPCS,81258,Hba1/hba2 gene fam vrnt,,,87.06,100.8,8
HCPCS,81259,HBA1/HBA2 FULL GENE SEQUENCE,,,600.0,2458.68,21
HCPCS,81259,Hba1/hba2 full gene sequence,,,137.41,159.1,8
HCPCS,81260,CSPNL IKBKAP GENE,271.0,176.15,0.95,271.0,60
HCPCS,81261,BCBMDO LGH REARR HCL,1366.0,887.9,0.95,1524.53,60
HCPCS,81262,IGH GENE REARRANG DIR PROBE,,,68.55,280.9,21
HCPCS,81262,Igh gene rearrang dir probe,,,66.63,77.15,8
HCPCS,81263,IGH VARI REGIONAL MUTATION,2032.0,1320.8,0.95,2032.0,60
HCPCS,81264,BCBMDO LGK REARR KLCL,1192.0,774.8,0.95,1192.0,60
HCPCS,81265,FETAL CELL CONTAMINATION (FCC),1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,MATERNAL CELL CONTAMINATION,1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,MATRNL TEST,1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,RECIPIENT TYPING FOR ENGRAFTMENT MONITORING,1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, BLOOD",1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,"STR ANALYSIS FOR MOL PREG, BLD",1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,"STR ANALYSIS FOR MOL PREG, OTHER",1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,STR GENOTYPING,1608.0,1045.2,0.95,1608.0,60
HCPCS,81265,TISSUE DNA FP FOR MOLAR PREG - IHC SENDOUT,1608.0,1045.2,0.95,1608.0,60
HCPCS,81266,STR MARKERS SPEC ANAL ADDL,,,304.81,1249.05,21
HCPCS,81266,Str markers spec anal addl,,,92.46,107.06,8
HCPCS,81267,CHIMERISM/ENGRAFTMENT ANALY W/COMP TO BASLINE,1431.0,930.15,0.95,1431.0,60
HCPCS,81267,POST-TX FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,0.95,1431.0,60
HCPCS,81267,POST-TX NO-T-CELL FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,0.95,1431.0,60
HCPCS,81268,BMFUNG CHIMERISM ANAL W/CELL SELECT,1799.0,1169.35,0.95,1799.0,60
HCPCS,81269,HBA1 HBA2 DEL/DUP,1397.0,908.05,0.95,1397.0,60
HCPCS,81270,"JAK2 GENE ANALYSIS, VAL617PHE VARIANT",632.0,410.8,0.95,632.0,60
HCPCS,81270,JAK2 MUTATION,632.0,410.8,0.95,632.0,60
HCPCS,81270,JAK2 TEST,632.0,410.8,0.95,632.0,120
HCPCS,81271,HTT GENE DETC ABNOR ALLELES,,,137.0,561.4,21
HCPCS,81271,Htt gene detc abnor alleles,,,92.46,107.06,8
HCPCS,81272,%NGSMEL KIT,2274.0,1478.1,0.95,2274.0,60
HCPCS,81272,GIST KIT GENE,2274.0,1478.1,0.95,2274.0,60
HCPCS,81273,KIT D816V MUT DETECT,862.0,560.3,0.95,862.0,60
HCPCS,81273,KIT D816V MUT DETECT BLD,862.0,560.3,0.95,862.0,60
HCPCS,81273,KIT D816V MUT DETECT BM,862.0,560.3,0.95,862.0,60
HCPCS,81273,KIT D816V MUTATION PCR,862.0,560.3,0.95,862.0,60
HCPCS,81274,HTT GENE CHARAC ALLELES,,,274.83,1126.2,21
HCPCS,81274,Htt gene charac alleles,,,92.46,107.06,8
HCPCS,81275,%KRASGN KRAS EXON2,1333.0,866.45,0.95,1333.0,60
HCPCS,81275,"%NGSCOL KRAS 12,13",1333.0,866.45,0.95,1333.0,60
HCPCS,81275,KRAS GENE,1333.0,866.45,0.95,1333.0,60
HCPCS,81275,KRAS GENETIC ANALYSIS,1333.0,866.45,0.95,1333.0,60
HCPCS,81276,%NGSCOL KRAS 61,1333.0,866.45,0.95,1333.0,60
HCPCS,81276,%NGSLUNG KRAS 61,1333.0,866.45,0.95,1333.0,60
HCPCS,81276,KRAS ADDITIONAL VARIANTS,1333.0,866.45,0.95,1333.0,60
HCPCS,81277,MICORARRAY SNP FFPET,8004.0,5202.6,0.95,8004.0,60
HCPCS,81278,IGH@/BCL2 TRANSLOCATION ALYS,,,207.31,849.51,21
HCPCS,81278,Igh@/bcl2 translocation alys,,,92.46,107.06,8
HCPCS,81279,"JAK2 GENE ANALYSIS, EXONS 12 AND 13",1278.0,830.7,0.95,1278.0,60
HCPCS,81279,JAKNON EX 12-16 SEQ BLD,1278.0,830.7,0.95,1278.0,60
HCPCS,81283,IFNL3 GENE,,,73.37,300.66,21
HCPCS,81283,Ifnl3 gene,,,66.63,77.15,8
HCPCS,81284,FXN GENE DETC ABNOR ALLELES,,,137.0,561.4,21
HCPCS,81284,Fxn gene detc abnor alleles,,,92.46,107.06,8
HCPCS,81285,FXN GENE CHARAC ALLELES,,,274.83,1126.2,21
HCPCS,81285,Fxn gene charac alleles,,,92.46,107.06,8
HCPCS,81286,FXN GENE FULL GENE SEQUENCE,,,274.83,1126.2,21
HCPCS,81286,Fxn gene full gene sequence,,,92.46,107.06,8
HCPCS,81287,MGMT TEST,860.0,559.0,0.95,860.0,60
HCPCS,81288,MLH1 PROMOTER HYPERMETH,1327.0,862.55,0.95,1327.0,60
HCPCS,81289,FXN GENE KNOWN FAMIL VARIANT,,,185.2,758.91,21
HCPCS,81289,Fxn gene known famil variant,,,92.46,107.06,8
HCPCS,81290,CSPNL MCOLN1 GENE,271.0,176.15,0.95,271.0,60
HCPCS,81291,MTHFR 1298 & MTHFR 677,451.0,293.15,0.95,451.0,60
HCPCS,81291,MTHFR BY PCR TEST,451.0,293.15,0.95,451.0,60
HCPCS,81291,MTHRF 2 VARIANTS,451.0,293.15,0.95,451.0,60
HCPCS,81292,MLH1 GENE FULL SEQ,,,675.4,2767.65,21
HCPCS,81292,Mlh1 gene full seq,,,137.41,159.1,8
HCPCS,81293,MLH1 GENE KNOWN VARIANTS,,,331.0,1356.37,21
HCPCS,81293,Mlh1 gene known variants,,,92.46,107.06,8
HCPCS,81294,MLH1 GENE DUP/DELETE VARIANT,,,202.4,829.39,21
HCPCS,81294,Mlh1 gene dup/delete variant,,,92.46,107.06,8
HCPCS,81295,MSH2 GENE FULL SEQ,,,381.7,1564.13,21
HCPCS,81295,Msh2 gene full seq,,,87.06,100.8,8
HCPCS,81296,MSH2 GENE KNOWN VARIANTS,,,337.73,1383.95,21
HCPCS,81296,Msh2 gene known variants,,,92.46,107.06,8
HCPCS,81297,MSH2 GENE DUP/DELETE VARIANT,,,213.3,874.06,21
HCPCS,81297,Msh2 gene dup/delete variant,,,92.46,107.06,8
HCPCS,81298,MSH6 GENE FULL SEQ,,,641.85,2630.17,21
HCPCS,81298,Msh6 gene full seq,,,137.41,159.1,8
HCPCS,81299,MSH6 GENE KNOWN VARIANTS,,,308.0,1262.12,21
HCPCS,81299,Msh6 gene known variants,,,92.46,107.06,8
HCPCS,81300,MSH6 GENE DUP/DELETE VARIANT,,,238.0,975.28,21
HCPCS,81300,Msh6 gene dup/delete variant,,,92.46,107.06,8
HCPCS,81301,MICROSATELLITE INSTABILITY DET (MSIID),2405.0,1563.25,0.95,2405.0,60
HCPCS,81302,RETTFG MECP2 GENE FULL SEQ,3642.0,2367.3,0.95,3642.0,60
HCPCS,81303,MECP2 GENE KNOWN VARIANT,,,120.0,491.74,21
HCPCS,81303,Mecp2 gene known variant,,,66.63,77.15,8
HCPCS,81304,RETTFG MECP2 GENE DUP/DELET VARIANT,1035.0,672.75,0.95,1035.0,60
HCPCS,81305,MYD88 L265P MUT ANLS,1210.0,786.5,0.95,1210.0,60
HCPCS,81305,MYD88 L265P MUT ANLS BM,1210.0,786.5,0.95,1210.0,60
HCPCS,81305,MYD88 L265P MUT ANLS OTH,1210.0,786.5,0.95,1210.0,60
HCPCS,81306,NUDT15 GENE COMMON VARIANTS,,,291.36,1193.94,21
HCPCS,81306,Nudt15 gene common variants,,,92.46,107.06,8
HCPCS,81307,PALB2 GENE FULL GENE SEQ,,,676.5,2772.16,21
HCPCS,81307,Palb2 gene full gene seq,,,137.41,159.1,8
HCPCS,81308,PALB2 GENE KNOWN FAMIL VRNT,,,301.35,1234.87,21
HCPCS,81308,Palb2 gene known famil vrnt,,,92.46,107.06,8
HCPCS,81309,PIK3CA GENE TRGT SEQ ALYS,,,274.83,1126.2,21
HCPCS,81309,Pik3ca gene trgt seq alys,,,92.46,107.06,8
HCPCS,81310,NMP1 MUTATION DETECTION BY RT-PCR,1701.0,1105.65,0.95,1701.0,60
HCPCS,81310,NPM1 GENE ANALYSIS BM,1701.0,1105.65,0.95,1701.0,60
HCPCS,81310,NPM1 GENE ANALYSIS OTHER,1701.0,1105.65,0.95,1701.0,60
HCPCS,81310,NPM1 GENE ANALYSIS PB,1701.0,1105.65,0.95,1701.0,60
HCPCS,81311,%NGSCOL NRAS,2041.0,1326.65,0.95,2041.0,60
HCPCS,81311,%NGSMEL NRAS,2041.0,1326.65,0.95,2041.0,60
HCPCS,81312,PABPN1 GENE DETC ABNOR ALLEL,,,137.0,561.4,21
HCPCS,81312,Pabpn1 gene detc abnor allel,,,92.46,107.06,8
HCPCS,81313,PCA3/KLK3 ANTIGEN,,,255.05,1045.14,21
HCPCS,81313,Pca3/klk3 antigen,,,92.46,107.06,8
HCPCS,81314,GIST PDGFRA GENE,2274.0,1478.1,0.95,2274.0,60
HCPCS,81315,APLPCR RTPCR TEST,1430.0,929.5,0.95,1596.35,60
HCPCS,81316,PML/RARALPHA 1 BREAKPOINT,,,207.31,849.51,21
HCPCS,81316,Pml/raralpha 1 breakpoint,,,92.46,107.06,8
HCPCS,81317,PMS2 GENE FULL SEQ ANALYSIS,,,676.5,2772.16,21
HCPCS,81317,Pms2 gene full seq analysis,,,137.41,159.1,8
HCPCS,81318,PMS2 KNOWN FAMILIAL VARIANTS,,,331.0,1356.37,21
HCPCS,81318,Pms2 known familial variants,,,92.46,107.06,8
HCPCS,81319,PMS2 GENE DUP/DELET VARIANTS,,,203.5,833.9,21
HCPCS,81319,Pms2 gene dup/delet variants,,,92.46,107.06,8
HCPCS,81320,PLCG2 GENE ANALYSIS,2010.0,1306.5,0.95,2010.0,60
HCPCS,81321,PTEN GENE FULL SEQUENCE,,,600.0,2458.68,21
HCPCS,81321,Pten gene full sequence,,,137.41,159.1,8
HCPCS,81322,PTEN GENE KNOWN FAM VARIANT,,,46.6,190.96,21
HCPCS,81322,Pten gene known fam variant,,,66.63,77.15,8
HCPCS,81323,PTEN GENE DUP/DELET VARIANT,,,300.0,1229.34,21
HCPCS,81323,Pten gene dup/delet variant,,,92.46,107.06,8
HCPCS,81324,PMP22 GENE DUP/DELET,,,758.36,3107.61,21
HCPCS,81324,Pmp22 gene dup/delet,,,137.41,159.1,8
HCPCS,81325,PMP22 GENE FULL SEQUENCE,,,769.58,3153.58,21
HCPCS,81325,Pmp22 gene full sequence,,,137.41,159.1,8
HCPCS,81326,PMP22 GENE KNOWN FAM VARIANT,,,46.6,190.96,21
HCPCS,81326,Pmp22 gene known fam variant,,,66.63,77.15,8
HCPCS,81327,SEPT9 GEN PRMTR MTHYLTN ALYS,,,192.0,786.78,21
HCPCS,81327,Sept9 gen prmtr mthyltn alys,,,92.46,107.06,8
HCPCS,81328,SLCO1B1 GENE COM VARIANTS,,,174.81,716.34,21
HCPCS,81328,Slco1b1 gene com variants,,,92.46,107.06,8
HCPCS,81329,CSPNL SMN1 GENE DOS/DEL,945.0,614.25,0.95,945.0,60
HCPCS,81329,SMA CARRIER SCRN DIAG,945.0,614.25,0.95,945.0,60
HCPCS,81330,CSPNL SMPD1 GENE COMMON VARS,324.0,210.6,0.95,324.0,60
HCPCS,81331,PRADER-WILLI METH,352.0,228.8,0.95,352.0,60
HCPCS,81332,%HA1AT SERPINA1 GENE ANLY,301.0,195.65,0.95,301.0,60
HCPCS,81332,%SERPINA1 GENE ANALYSIS,301.0,195.65,0.95,301.0,60
HCPCS,81332,SERPINA1 GENE,301.0,195.65,0.95,301.0,60
HCPCS,81332,SERPINA1 TARG MUT BY SANGER SEQ,301.0,195.65,0.95,301.0,60
HCPCS,81333,TGFBI GENE COMMON VARIANTS,,,137.0,561.4,21
HCPCS,81333,Tgfbi gene common variants,,,92.46,107.06,8
HCPCS,81334,RUNX1 GENE TARGETED SEQ ALYS,,,329.51,1350.27,21
HCPCS,81334,Runx1 gene targeted seq alys,,,92.46,107.06,8
HCPCS,81335,TPMT GENOTYPE ASSAY,1206.0,783.9,0.95,1206.0,60
HCPCS,81336,SMN1 GENE FULL GENE SEQUENCE,,,301.35,1234.87,21
HCPCS,81336,Smn1 gene full gene sequence,,,92.46,107.06,8
HCPCS,81337,SMN1 GEN NOWN FAMIL SEQ VRNT,,,185.2,758.91,21
HCPCS,81337,Smn1 gen nown famil seq vrnt,,,92.46,107.06,8
HCPCS,81338,MPL MUTATION ANSYS BLD,1037.0,674.05,0.95,1037.0,60
HCPCS,81339,MPL GENE ANALYSIS,1278.0,830.7,0.95,1278.0,60
HCPCS,81340,TCBMD II TEST,1442.0,937.3,0.95,1442.0,60
HCPCS,81340,TCBMDM GENE REARRANGE AMP,1442.0,937.3,0.95,1442.0,60
HCPCS,81340,TCBMDO GENE REARRANGE AMP,1442.0,937.3,0.95,1442.0,60
HCPCS,81340,TCRB TEST,1442.0,937.3,0.95,1442.0,60
HCPCS,81340,TCRBO GENE REARRANGE AMP,1442.0,937.3,0.95,1442.0,60
HCPCS,81341,TRB@ GENE REARRANGE DIRPROBE,,,49.59,203.21,21
HCPCS,81341,Trb@ gene rearrange dirprobe,,,66.63,77.15,8
HCPCS,81342,T GAMMA TEST,1390.0,903.5,0.95,1390.0,120
HCPCS,81342,TCBMDM GENE REARRANGE ANAL,1390.0,903.5,0.95,1390.0,60
HCPCS,81342,TCBMDO GENE REARRANGE ANAL,1390.0,903.5,0.95,1390.0,60
HCPCS,81343,PPP2R2B GEN DETC ABNOR ALLEL,,,137.0,561.4,21
HCPCS,81343,Ppp2r2b gen detc abnor allel,,,92.46,107.06,8
HCPCS,81344,TBP GENE DETC ABNOR ALLELES,,,137.0,561.4,21
HCPCS,81344,Tbp gene detc abnor alleles,,,92.46,107.06,8
HCPCS,81345,TERT GENE TARGETED SEQ ALYS,,,185.2,758.91,21
HCPCS,81345,Tert gene targeted seq alys,,,92.46,107.06,8
HCPCS,81346,TYMS GENE COM VARIANTS,,,174.81,716.34,21
HCPCS,81346,Tyms gene com variants,,,92.46,107.06,8
HCPCS,81347,SF3B1 GENE COMMON VARIANTS,,,193.25,791.9,21
HCPCS,81347,Sf3b1 gene common variants,,,92.46,107.06,8
HCPCS,81348,SRSF2 GENE COMMON VARIANTS,,,175.4,718.75,21
HCPCS,81348,Srsf2 gene common variants,,,92.46,107.06,8
HCPCS,81349,CYTOG ALYS CHRML ABNR LW-PS,,,1197.94,4908.92,19
HCPCS,81349,Cytog alys chrml abnr lw-ps,,,533.45,617.68,8
HCPCS,81350,DUPNL UGT1A1 GENE COMMON VARIANTS,1615.0,1049.75,0.95,1615.0,60
HCPCS,81350,UGT1A1 TARG MUT DET BY SANGER,1615.0,1049.75,0.95,1615.0,60
HCPCS,81351,FULL GENE SEQUENCE ANALYSIS OF THE TP53 (TUMOR PROTEIN 53) GENE,4429.0,2878.85,0.95,4429.0,60
HCPCS,81352,"TP53 SOMATIC MUT, PROGNOSTIC",2274.0,1478.1,0.95,2274.0,60
HCPCS,81353,TP53 GENE KNOWN FAMIL VRNT,,,308.0,1262.12,21
HCPCS,81353,Tp53 gene known famil vrnt,,,92.46,107.06,8
HCPCS,81354,CYTOG ALYS CHRML ABNOR OGM,,,1263.53,5177.69,14
HCPCS,81354,Cytog alys chrml abnor ogm,,,66.63,77.15,8
HCPCS,81355,VKORC1 GENE,,,88.2,361.43,21
HCPCS,81355,Vkorc1 gene,,,66.63,77.15,8
HCPCS,81357,U2AF1 GENE COMMON VARIANTS,,,193.25,791.9,21
HCPCS,81357,U2af1 gene common variants,,,92.46,107.06,8
HCPCS,81360,ZRSR2 GENE COMMON VARIANTS,,,193.25,791.9,21
HCPCS,81360,Zrsr2 gene common variants,,,92.46,107.06,8
HCPCS,81361,HBB GENE COM VARIANTS,,,174.81,716.34,21
HCPCS,81361,Hbb gene com variants,,,92.46,107.06,8
HCPCS,81362,HBB GENE KNOWN FAM VARIANT,,,375.25,1537.7,21
HCPCS,81362,Hbb gene known fam variant,,,87.06,100.8,8
HCPCS,81363,HBB GENE DUP/DEL VARIANTS,,,202.4,829.39,21
HCPCS,81363,Hbb gene dup/del variants,,,92.46,107.06,8
HCPCS,81364,HBB FULL GENE SEQUENCE,,,324.58,1330.06,21
HCPCS,81364,Hbb full gene sequence,,,92.46,107.06,8
HCPCS,81370,"HLA-A,B,C,DR,DQ,DRB345_RT-PCR",2775.0,1803.75,0.95,2775.0,60
HCPCS,81370,"HLA-A,B,CW,DR,DQ,DRB345-RSSOP",2775.0,1803.75,0.95,2775.0,60
HCPCS,81370,SOLID ORGAN NGS FEE,2775.0,1803.75,0.95,2775.0,60
HCPCS,81371,"HLA-A-B,CW,DR,DQ,DRB345-RSSOP-Q9 VERIF",2791.0,1814.15,0.95,2791.0,60
HCPCS,81372,HLA I TYPING COMPLETE LR,,,403.59,1653.83,21
HCPCS,81372,Hla i typing complete lr,,,87.06,100.8,8
HCPCS,81373,HLA-B51,879.0,571.35,0.95,879.0,60
HCPCS,81374,%HLAA29 TEST,513.0,333.45,0.95,513.0,60
HCPCS,81374,B27PCR TEST,513.0,333.45,0.95,513.0,60
HCPCS,81374,HLA-B58,513.0,333.45,0.95,513.0,60
HCPCS,81375,HLA II TYPING AG EQUIV LR,,,220.74,904.55,21
HCPCS,81375,Hla ii typing ag equiv lr,,,92.46,107.06,8
HCPCS,81376,HLADR TEST,843.0,547.95,0.95,843.0,60
HCPCS,81377,HLA II TYPE 1 AG EQUIV LR,,,94.74,388.23,21
HCPCS,81377,Hla ii type 1 ag equiv lr,,,66.63,77.15,8
HCPCS,81378,"HLA-A,B,CW,DR,DQ,DP-NGS-BMT",2384.0,1549.6,0.95,2384.0,60
HCPCS,81379,HLA I TYPING COMPLETE HR,,,335.38,1374.32,21
HCPCS,81379,Hla i typing complete hr,,,92.46,107.06,8
HCPCS,81380,HLA I TYPING 1 LOCUS HR,,,177.25,726.34,21
HCPCS,81380,Hla i typing 1 locus hr,,,92.46,107.06,8
HCPCS,81381,HLA B5701,1172.0,761.8,0.95,1172.0,60
HCPCS,81381,HLA-B*57:01,1172.0,761.8,0.95,1172.0,120
HCPCS,81382,%CELCMP HLADQ2 TEST,853.0,554.45,0.95,853.0,60
HCPCS,81382,%CELCMP HLADQ8 TEST,853.0,554.45,0.95,853.0,60
HCPCS,81382,HLADQ2 TEST,853.0,554.45,0.95,853.0,60
HCPCS,81382,HLADQ8 TEST,853.0,554.45,0.95,853.0,60
HCPCS,81382,NARCOLEPSY GENOTYPING (HLADQB1* 06:02),853.0,554.45,0.95,853.0,60
HCPCS,81383,NARCOLEPSY ASSOC AG,753.0,489.45,0.95,753.0,60
HCPCS,81383,PROSTATIC ACID PHOS,753.0,489.45,0.95,753.0,60
HCPCS,81400,CSPNL MOPATH PROC LVL 1,441.0,286.65,0.95,1608.07,60
HCPCS,81400,MOPATH PROCEDURE LEVEL 1,441.0,286.65,0.95,1608.07,60
HCPCS,81400,PAIGEN TEST,441.0,286.65,0.95,1608.07,60
HCPCS,81400,PLASMINOGEN ACTIVATOR INHIB 1,441.0,286.65,0.95,1608.07,60
HCPCS,81400,XIIIVL TEST,441.0,286.65,0.95,1608.07,60
HCPCS,81401,CBFB-MYH11 INV(16),945.0,614.25,0.95,2297.92,60
HCPCS,81401,CSPNL MOPATH PROC LVL 2,945.0,614.25,0.95,2297.92,60
HCPCS,81401,RUNX1-RUNX1T1,945.0,614.25,0.95,2297.92,60
HCPCS,81401,SMN1 SMN2 SCRN DIAG,945.0,614.25,0.95,2297.92,60
HCPCS,81402,MOPATH PROCEDURE LEVEL 3,,,150.33,1728.34,21
HCPCS,81402,Mopath procedure level 3,,,92.46,107.06,8
HCPCS,81403,JAKNON TEST,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,MPL MUTATION ANLYS BLD,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,MPL TEST,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,MPLDNA TEST,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,PARD UNLISTED MOL PATH,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,SANGER SEQ DNA BLD,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,SANGER SEQ DNA OTHER,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,SANGER SEQ RNA BLD,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,SANGER SEQ RNA BONE MARROW,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,SANGER SQ DNA BONE MARROW,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UBA1 MUT DET BY DDPCR BLOOD,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UBA1 MUT DET BY DDPCR BONE MARROW,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UBA1 MUT DET BY DDPCR OTHER,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UBA1 MUTATION TESTING FOR VEXAS SYNDROME,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UBA1 TARG MUT DET BY SANGER BM,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UBA1 TARG MUT DET BY SANGER OTHER,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,UGTA1 TARG MUT DET BY SANGER BLD,1278.0,830.7,0.95,1988.72,60
HCPCS,81403,YCMICR TEST,1278.0,830.7,0.95,1988.72,60
HCPCS,81404,%PANCPL PRSS1,1896.0,1232.4,0.95,1896.0,60
HCPCS,81404,%PANCPL SPINK1,1896.0,1232.4,0.95,1896.0,60
HCPCS,81404,FAMILAL MEDITER FEVER SEQ,1896.0,1232.4,0.95,1896.0,60
HCPCS,81404,TTR GENE FULL ANALYSIS,1896.0,1232.4,0.95,1896.0,60
HCPCS,81405,%PANCPL MOPATH LVL 6,2079.0,1351.35,0.95,2079.0,60
HCPCS,81405,VWF2A SEQ 9 EXON REFLEX,2079.0,1351.35,0.95,2079.0,60
HCPCS,81406,MOPATH PROCEDURE LEVEL 7,,,282.88,3582.53,21
HCPCS,81406,Mopath procedure level 7,,,92.46,107.06,8
HCPCS,81407,MOPATH PROCEDURE LEVEL 8,,,846.27,3467.85,21
HCPCS,81407,Mopath procedure level 8,,,137.41,159.1,8
HCPCS,81408,MOPATH PROCEDURE LEVEL 9,,,1980.67,8195.6,21
HCPCS,81408,Mopath procedure level 9,,,533.45,617.68,8
HCPCS,81410,AORTIC DYSFUNCTION/DILATION,,,504.0,2065.29,21
HCPCS,81410,Aortic dysfunction/dilation,,,87.06,100.8,8
HCPCS,81411,AORTIC DYSFUNCTION/DILATION,,,1350.19,5532.81,21
HCPCS,81411,Aortic dysfunction/dilation,,,533.45,617.68,8
HCPCS,81412,ASHKENAZI JEWISH ASSOC DIS,,,2448.56,10033.71,21
HCPCS,81412,Ashkenazi jewish assoc dis,,,533.45,617.68,8
HCPCS,81413,CAR ION CHNNLPATH INC 10 GNS,,,584.9,2396.8,21
HCPCS,81413,Car ion chnnlpath inc 10 gns,,,87.06,100.8,8
HCPCS,81414,CAR ION CHNNLPATH INC 2 GNS,,,584.9,2396.8,21
HCPCS,81414,Car ion chnnlpath inc 2 gns,,,87.06,100.8,8
HCPCS,81415,EXOME SEQUENCING AHUS1,11950.0,7767.5,0.95,19587.48,60
HCPCS,81416,EXOME SEQUENCE ANALYSIS,,,12000.0,49173.6,20
HCPCS,81416,Exome sequence analysis,,,533.45,617.68,8
HCPCS,81417,EXOME RE-EVALUATION,,,320.0,1311.3,21
HCPCS,81417,Exome re-evaluation,,,92.46,107.06,8
HCPCS,81418,RX METAB GEN SEQ ALYS PNL 6,,,917.08,3758.01,19
HCPCS,81418,Rx metab gen seq alys pnl 6,,,137.41,159.1,8
HCPCS,81419,EPILEPSY GEN SEQ ALYS PANEL,,,2448.56,10033.71,21
HCPCS,81419,Epilepsy gen seq alys panel,,,533.45,617.68,8
HCPCS,81420,MATERNIT21 PLUS,5237.0,3404.05,0.95,5237.0,60
HCPCS,81422,FETAL CHRMOML MICRODELTJ,,,759.05,3110.44,21
HCPCS,81422,Fetal chrmoml microdeltj,,,137.41,159.1,8
HCPCS,81425,GENOME SEQUENCE ANALYSIS,,,5031.2,20616.85,21
HCPCS,81425,Genome sequence analysis,,,533.45,617.68,8
HCPCS,81426,GENOME SEQUENCE ANALYSIS,,,2709.95,11104.83,21
HCPCS,81426,Genome sequence analysis,,,533.45,617.68,8
HCPCS,81427,GENOME RE-EVALUATION,,,2337.65,9579.22,21
HCPCS,81427,Genome re-evaluation,,,533.45,617.68,8
HCPCS,81430,HEARING LOSS SEQUENCE ANALYS,,,1625.0,6658.93,21
HCPCS,81430,Hearing loss sequence analys,,,533.45,617.68,8
HCPCS,81431,HEARING LOSS DUP/DEL ANALYS,,,679.57,2784.74,21
HCPCS,81431,Hearing loss dup/del analys,,,137.41,159.1,8
HCPCS,81432,HRDTRY BRST CA-RLATD DO 5+,,,760.78,5343.33,21
HCPCS,81432,Hrdtry brst ca-rlatd do 5+,,,137.41,159.1,8
HCPCS,81433,HRDTRY BRST CA-RLATD DSORDRS,,,491.76,925.41,2
HCPCS,81433,Hrdtry brst ca-rlatd dsordrs,,,87.06,100.8,8
HCPCS,81434,HERED RTA DO GEN SEQ 15,,,597.91,2450.12,21
HCPCS,81434,Hered rta do gen seq 15,,,87.06,100.8,8
HCPCS,81435,HERED COLON CA-RLATD DO 5+,,,655.3,5343.33,21
HCPCS,81435,Hered colon ca-rlatd do 5+,,,87.06,100.8,8
HCPCS,81436,HEREDITARY COLON CA DSORDRS,,,655.3,1233.17,2
HCPCS,81436,Hereditary colon ca dsordrs,,,87.06,100.8,8
HCPCS,81437,HERED NEUROEND TUM-RLT DO 5+,,,491.76,5343.33,21
HCPCS,81437,Hered neuroend tum-rlt do 5+,,,87.06,100.8,8
HCPCS,81438,HEREDTRY NURONDCRN TUM DSRDR,,,491.76,925.41,2
HCPCS,81438,Heredtry nurondcrn tum dsrdr,,,87.06,100.8,8
HCPCS,81439,HRDTRY CARDMYPY GENE PANEL,,,584.9,2396.8,21
HCPCS,81439,Hrdtry cardmypy gene panel,,,87.06,100.8,8
HCPCS,81440,MITOCHONDRIAL GENE,,,3324.0,13621.09,21
HCPCS,81440,Mitochondrial gene,,,533.45,617.68,8
HCPCS,81441,IBMFS SEQ ALYS PNL 30 GENES,,,2448.56,10033.71,19
HCPCS,81441,Ibmfs seq alys pnl 30 genes,,,533.45,617.68,8
HCPCS,81442,NOONAN SPECTRUM DISORDERS,,,2143.6,8784.04,21
HCPCS,81442,Noonan spectrum disorders,,,533.45,617.68,8
HCPCS,81443,GENOMIC SEQUENCING AHUS1,6121.0,3978.65,0.95,10033.71,60
HCPCS,81445,HEAD AND NECK NGS,1737.0,1129.05,0.95,2450.12,60
HCPCS,81445,LNG550 LUNG CANCER GENE PNL,2409.0,1565.85,0.95,2450.12,60
HCPCS,81445,LUNG CANCER HOTSPOT CYTO,1992.0,1294.8,0.95,2450.12,60
HCPCS,81448,HRDTRY PERPH NEURPHY PANEL,,,584.9,2396.8,21
HCPCS,81448,Hrdtry perph neurphy panel,,,87.06,100.8,8
HCPCS,81449,SO NEO GSAP 5-50 RNA ALYS,,,597.91,2450.12,19
HCPCS,81449,So neo gsap 5-50 rna alys,,,533.45,617.68,8
HCPCS,81450,"B-CELL LYMPHOMA, NGS",5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,GBL MYL NGS 5-50 GENE,5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,"HISTIOCYTIC NEOPLASMS, NGS",5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,LPMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,MYELOID NGS 5-50 GENE,5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,MYMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,ONKOSIGHT ADVANCED CHRONIC LYMPHOID NGS PANEL,5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,"T-CELL LYMPHOMA, NGS",5241.0,3406.65,0.95,5241.0,60
HCPCS,81450,TARGETED B-ALL FUS ANLYS,5241.0,3406.65,0.95,5241.0,60
HCPCS,81451,HL NEO GSAP 5-50 RNA ALYS,,,759.53,3112.4,19
HCPCS,81451,Hl neo gsap 5-50 rna alys,,,137.41,159.1,8
HCPCS,81455,"ACUTE LEUKEMIA RAPID NGS PANEL, BLOOD",4922.0,3199.3,0.95,11963.94,60
HCPCS,81455,"ACUTE LEUKEMIA RAPID NGS PANEL, BONE MARROW",4922.0,3199.3,0.95,11963.94,60
HCPCS,81455,HDMNGS ACUTE LEUK NGS PNL BM,3000.0,1950.0,0.95,11963.94,60
HCPCS,81455,HDONGS ACUTE LEUK NGS PNL OTHER,3000.0,1950.0,0.95,11963.94,60
HCPCS,81455,HDPNGS ACUTE LEUK NGS PNL BLD,3000.0,1950.0,0.95,11963.94,60
HCPCS,81455,HFMNGS HN FUSION NGS PNL BLD,1616.0,1050.4,0.95,11963.94,60
HCPCS,81455,HNCPPB NGS,1616.0,1050.4,0.95,11963.94,60
HCPCS,81455,HNMNGS HN NGS SEQ PANEL BM,1616.0,1050.4,0.95,11963.94,60
HCPCS,81455,MYNGSM MYELOID PANEL NGS BM,1616.0,1050.4,0.95,11963.94,60
HCPCS,81455,MYNGSP MYELOID PANEL NGS P BLD,1616.0,1050.4,0.95,11963.94,60
HCPCS,81455,SARCOMA FUSION NGS,1737.0,1129.05,0.95,11963.94,60
HCPCS,81455,TARGETED ONCOLOGY PANEL - FINE NEEDLE ASPIRATE,4400.0,2860.0,0.95,11963.94,60
HCPCS,81455,TARGETED ONCOLOGY PANEL LOW PURITY,4400.0,2860.0,0.95,11963.94,60
HCPCS,81455,"TOPBM TGT ONC NGS, BM",4400.0,2860.0,0.95,11963.94,60
HCPCS,81455,"TOPCY TGT ONC NGS, CYTO",4400.0,2860.0,0.95,11963.94,60
HCPCS,81455,"TOPPB TGT ONC NGS, PER BLD",4400.0,2860.0,0.95,11963.94,60
HCPCS,81455,"TOPTO TGT ONC NGS, OTH",4400.0,2860.0,0.95,11963.94,60
HCPCS,81456,SO/HL 51/>GSAP RNA ALYS,,,2919.6,11963.94,19
HCPCS,81456,So/hl 51/>gsap rna alys,,,533.45,617.68,8
HCPCS,81457,SO NEO GSAP DNA MCRSTL INS,,,896.87,3675.19,19
HCPCS,81457,So neo gsap dna mcrstl ins,,,87.06,100.8,8
HCPCS,81458,SO GSAP DNA CPY NMBR&MCRSTL,,,1046.35,4287.73,19
HCPCS,81458,So gsap dna cpy nmbr&mcrstl,,,87.06,100.8,8
HCPCS,81459,SO NEO GSAP DNA/DNA&RNA,,,2989.55,12250.58,19
HCPCS,81459,So neo gsap dna/dna&rna,,,87.06,100.8,8
HCPCS,81460,WHOLE MITOCHONDRIAL GENOME,,,1287.0,5273.87,21
HCPCS,81460,Whole mitochondrial genome,,,533.45,617.68,8
HCPCS,81462,SO GSAP CLL FR DNA/DNA&RNA,,,1195.83,4900.27,19
HCPCS,81462,So gsap cll fr dna/dna&rna,,,87.06,100.8,8
HCPCS,81463,SO GSAP CL FR CPY NMBR&MCRST,,,1345.31,5512.81,19
HCPCS,81463,So gsap cl fr cpy nmbr&mcrst,,,87.06,100.8,8
HCPCS,81464,SO GSAP CLL FR MCRSTL INS,,,3288.51,13475.66,19
HCPCS,81464,So gsap cll fr mcrstl ins,,,87.06,100.8,8
HCPCS,81465,WHOLE MITOCHONDRIAL GENOME,,,936.0,3835.54,21
HCPCS,81465,Whole mitochondrial genome,,,137.41,159.1,8
HCPCS,81470,X-LINKED INTELLECTUAL DBLT,,,914.0,3745.39,21
HCPCS,81470,X-linked intellectual dblt,,,137.41,159.1,8
HCPCS,81471,X-LINKED INTELLECTUAL DBLT,,,914.0,3745.39,21
HCPCS,81471,X-linked intellectual dblt,,,137.41,159.1,8
HCPCS,81479,*UNLISTED MOLECULAR PATHOLOGY,1124.0,730.6,0.95,1124.0,46
HCPCS,81479,CSPNL UNLISTED MOPATH,72.0,46.8,0.95,837.52,46
HCPCS,81479,"CXCR4 MUTATION ANALYSIS, SOMATIC",891.0,579.15,0.95,891.0,46
HCPCS,81479,DNA FINGERPRNT TEST-NGS-FOLLOW UP,4128.0,2683.2,0.95,4128.0,46
HCPCS,81479,DNA FINGERPRNT TEST-NGS-GENOTYPING,4128.0,2683.2,0.95,4128.0,46
HCPCS,81479,GIST NGS GIST,189.0,122.85,0.95,837.52,46
HCPCS,81479,IBDSGI ATG16L1 TEST,146.0,94.9,0.95,837.52,46
HCPCS,81479,IBDSGI NKX23 TEST,146.0,94.9,0.95,837.52,46
HCPCS,81479,IBDSGI STAT3 TEST,146.0,94.9,0.95,837.52,46
HCPCS,81479,IBDSGI UNLISTED MOL PATH,144.0,93.6,0.95,837.52,46
HCPCS,81479,IDH1&2-COMMON VARIANTS,1160.0,754.0,0.95,1160.0,46
HCPCS,81479,MNGS PATHOGEN DX,7250.0,4712.5,0.95,7250.0,46
HCPCS,81479,MOLECULAR PATH PROC,218.0,141.7,0.95,837.52,46
HCPCS,81479,MYD88 L265P MUT ANLYS,599.0,389.35,0.95,837.52,46
HCPCS,81479,MYD88 L265P MUTATION,2070.0,1345.5,0.95,2070.0,46
HCPCS,81479,MYELOPROLIF NEOPL PNL BLD,896.0,582.4,0.95,896.0,46
HCPCS,81479,MYELOPROLIF NEOPL PNL BM,830.0,539.5,0.95,837.52,46
HCPCS,81479,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2727.0,1772.55,0.95,2964.0,138
HCPCS,81479,POLE DROPLET DIGITAL PCR,378.0,245.7,0.95,837.52,46
HCPCS,81479,POLE TARG MUT DET BY SANGER,378.0,245.7,0.95,837.52,46
HCPCS,81479,SHOX DNA DIAGNOSTIC,161.0,104.65,0.95,837.52,46
HCPCS,81490,AUTOIMMUNE RA ALYS 12 BMRK,,,840.65,3444.82,21
HCPCS,81490,Autoimmune ra alys 12 bmrk,,,137.41,159.1,8
HCPCS,81493,COR ARTERY DISEASE MRNA,,,1050.0,4302.69,21
HCPCS,81493,Cor artery disease mrna,,,533.45,617.68,8
HCPCS,81500,ONCO (OVAR) TWO PROTEINS,,,260.5,1067.48,21
HCPCS,81500,Onco (ovar) two proteins,,,92.46,107.06,8
HCPCS,81503,ONCO (OVAR) FIVE PROTEINS,,,897.0,3675.73,20
HCPCS,81503,Onco (ovar) five proteins,,,137.41,159.1,8
HCPCS,81504,ONCOLOGY TISSUE OF ORIGIN,,,520.0,2130.86,21
HCPCS,81504,Oncology tissue of origin,,,87.06,100.8,8
HCPCS,81506,ENDO ASSAY SEVEN ANAL,,,68.92,282.42,21
HCPCS,81506,Endo assay seven anal,,,66.63,77.15,8
HCPCS,81507,FETAL ANEUPLOIDY TRISOM RISK,,,795.0,3257.75,20
HCPCS,81507,Fetal aneuploidy trisom risk,,,137.41,159.1,8
HCPCS,81508,FTL CGEN ABNOR TWO PROTEINS,,,54.3,222.51,21
HCPCS,81508,Ftl cgen abnor two proteins,,,66.63,77.15,8
HCPCS,81509,FTL CGEN ABNOR 3 PROTEINS,,,1487.37,6094.94,21
HCPCS,81509,Ftl cgen abnor 3 proteins,,,533.45,617.68,8
HCPCS,81510,FTL CGEN ABNOR THREE ANAL,,,55.54,227.59,21
HCPCS,81510,Ftl cgen abnor three anal,,,66.63,77.15,8
HCPCS,81511,PRENATAL QUAD SCREEN,1059.0,688.35,0.95,1059.0,60
HCPCS,81511,QUAD SCREEN 2014,1059.0,688.35,0.95,1059.0,60
HCPCS,81511,SEQUENTIAL SCR 2,1059.0,688.35,0.95,1059.0,120
HCPCS,81512,FTL CGEN ABNOR FIVE ANAL,,,69.52,284.88,21
HCPCS,81512,Ftl cgen abnor five anal,,,66.63,77.15,8
HCPCS,81513,BACTERIAL VAGINOSIS AMPLIFICATION,984.0,639.6,0.95,984.0,60
HCPCS,81514,NFCT DS BV&VAGINITIS DNA ALG,,,262.99,1077.68,21
HCPCS,81514,Nfct ds bv&vaginitis dna alg,,,92.46,107.06,8
HCPCS,81515,NFCT DS BV&VAGINITIS DNA ALG,,,262.99,1077.68,19
HCPCS,81515,Nfct ds bv&vaginitis dna alg,,,92.46,107.06,8
HCPCS,81517,ENHANCED LIVER FIBROSIS (ELF) SCORE,1216.0,790.4,0.95,1216.0,60
HCPCS,81518,ONC BRST MRNA 11 GENES,,,3873.0,15870.78,21
HCPCS,81518,Onc brst mrna 11 genes,,,533.45,617.68,8
HCPCS,81519,ONCOLOGY BREAST MRNA,,,3873.0,15870.78,21
HCPCS,81519,Oncology breast mrna,,,533.45,617.68,8
HCPCS,81520,ONC BREAST MRNA 58 GENES,,,2510.21,10286.34,21
HCPCS,81520,Onc breast mrna 58 genes,,,533.45,617.68,8
HCPCS,81521,ONC BREAST MRNA 70 GENES,,,3873.0,15870.78,21
HCPCS,81521,Onc breast mrna 70 genes,,,533.45,617.68,8
HCPCS,81522,ONC BREAST MRNA 12 GENES,,,3873.0,15870.78,21
HCPCS,81522,Onc breast mrna 12 genes,,,533.45,617.68,8
HCPCS,81523,ONC BRST MRNA 70 CNT 31 GENE,,,3873.0,15870.78,20
HCPCS,81523,Onc brst mrna 70 cnt 31 gene,,,533.45,617.68,8
HCPCS,81524,"Onc cns tum dna mthyl 10,000",,,66.63,77.15,8
HCPCS,81525,ONCOLOGY COLON MRNA,,,3116.0,12768.74,21
HCPCS,81525,Oncology colon mrna,,,533.45,617.68,8
HCPCS,81528,ONCOLOGY COLORECTAL SCR,,,508.87,2085.25,21
HCPCS,81528,Oncology colorectal scr,,,87.06,100.8,8
HCPCS,81529,ONC CUTAN MLNMA MRNA 31 GENE,,,7193.0,29475.48,20
HCPCS,81529,Onc cutan mlnma mrna 31 gene,,,533.45,617.68,8
HCPCS,81535,ONCOLOGY GYNECOLOGIC,,,579.46,2374.51,21
HCPCS,81535,Oncology gynecologic,,,87.06,100.8,8
HCPCS,81536,ONCOLOGY GYNECOLOGIC,,,177.56,727.61,21
HCPCS,81536,Oncology gynecologic,,,92.46,107.06,8
HCPCS,81538,ONCOLOGY LUNG,,,2871.0,11764.78,21
HCPCS,81538,Oncology lung,,,533.45,617.68,8
HCPCS,81539,ONCOLOGY PROSTATE PROB SCORE,,,760.0,3114.33,21
HCPCS,81539,Oncology prostate prob score,,,137.41,159.1,8
HCPCS,81540,ONCOLOGY TUM UNKNOWN ORIGIN,,,3750.0,15366.75,21
HCPCS,81540,Oncology tum unknown origin,,,533.45,617.68,8
HCPCS,81541,ONC PROSTATE MRNA 46 GENES,,,3873.0,15870.78,21
HCPCS,81541,Onc prostate mrna 46 genes,,,533.45,617.68,8
HCPCS,81542,ONC PROSTATE MRNA 22 CNT GEN,,,3873.0,15870.78,21
HCPCS,81542,Onc prostate mrna 22 cnt gen,,,533.45,617.68,8
HCPCS,81545,Oncology thyroid,,,533.45,617.68,8
HCPCS,81546,"ONC THYR MRNA 10,196 GEN ALG",,,3600.0,14752.08,21
HCPCS,81546,"Onc thyr mrna 10,196 gen alg",,,533.45,617.68,8
HCPCS,81551,ONC PROSTATE 3 GENES,,,2030.0,8318.53,21
HCPCS,81551,Onc prostate 3 genes,,,533.45,617.68,8
HCPCS,81552,ONC UVEAL MLNMA MRNA 15 GENE,,,7776.0,31864.49,20
HCPCS,81552,Onc uveal mlnma mrna 15 gene,,,533.45,617.68,8
HCPCS,81554,PULM DS IPF MRNA 190 GEN ALG,,,5409.6,22167.46,21
HCPCS,81554,Pulm ds ipf mrna 190 gen alg,,,533.45,617.68,8
HCPCS,81558,TRNSPL REJ KDN MRNA QPCR 139,,,3240.0,13276.87,19
HCPCS,81558,Trnspl rej kdn mrna qpcr 139,,,533.45,617.68,8
HCPCS,81560,INTESTINAL TRANSPLANT REJECTION RISK EVALUATION (PLEXIMMUNE),4421.0,2873.65,0.95,4421.0,60
HCPCS,81595,CARDIOLOGY HRT TRNSPL MRNA,,,3240.0,13276.87,21
HCPCS,81595,Cardiology hrt trnspl mrna,,,533.45,617.68,8
HCPCS,81596,LIVER FIBRO AND ACTI,498.0,323.7,0.95,498.0,60
HCPCS,81599,LIVER FIBROSIS (FIBROSURE),710.0,461.5,0.95,710.0,46
HCPCS,81599,"LIVER FIBROSIS, CHRONIC VIRAL HEPATITIS (ARUP)",106.0,68.9,0.95,106.0,46
HCPCS,82000,ASSAY OF BLOOD ACETALDEHYDE,,,54.67,54.67,1
HCPCS,82003,ASSAY OF ACETAMINOPHEN,,,62.33,62.33,1
HCPCS,82009,ACETONE/KETONE SERUM QUAL,31.0,20.15,0.95,31.0,60
HCPCS,82010,KETONE BODYS QUAN,,,9.15,9.15,1
HCPCS,82010,QUANT SERUM ACETONES/KETONES,56.0,36.4,0.95,56.0,60
HCPCS,82010QW,KETONE BODYS QUAN,,,9.15,9.15,1
HCPCS,82013,ACETYLCHOLINESTERASE ASSAY,,,12.29,56.01,21
HCPCS,82013,Acetylcholinesterase assay,,,14.4,16.68,8
HCPCS,82016,ACYLCARNITINES QUAL,,,16.49,67.57,21
HCPCS,82016,Acylcarnitines qual,,,14.4,16.68,8
HCPCS,82017,ACYLCARN PRO1 QT PLASMA,116.0,75.4,0.95,129.85,60
HCPCS,82017,"ACYLCARNITINES, QUANTIT, P-MAYO",116.0,75.4,0.95,129.85,60
HCPCS,82017,UC5DC ACYLCARNITINES QUANT,116.0,75.4,0.95,129.85,60
HCPCS,82024,ACTH,266.0,172.9,0.95,266.0,120
HCPCS,82030,ASSAY OF ADP & AMP,,,25.8,113.86,21
HCPCS,82030,Assay of adp & amp,,,17.46,20.22,8
HCPCS,82040,*ALBUMIN SERUM ASSAY,34.0,22.1,0.95,34.0,60
HCPCS,82040,ALBUMIN SERUM ASSAY,34.0,22.1,0.95,34.0,60
HCPCS,82040,ASSAY OF SERUM ALBUMIN,,,5.54,5.54,1
HCPCS,82040,LYMRFX SERUM ALBUMIN,34.0,22.1,0.95,34.0,60
HCPCS,82040QW,ASSAY OF SERUM ALBUMIN,,,5.54,5.54,1
HCPCS,82042,ALBUMIN URINE/OTHER QUANT,54.0,35.1,0.95,54.0,60
HCPCS,82042,LYMRFX CSF ALBUMIN,54.0,35.1,0.95,54.0,60
HCPCS,82042,OTHER SOURCE ALBUMIN QUAN EA,,,8.72,8.72,1
HCPCS,82042QW,OTHER SOURCE ALBUMIN QUAN EA,,,8.72,8.72,1
HCPCS,82043,*MICROALBUMIN URINE QUANT,40.0,26.0,0.95,40.0,60
HCPCS,82043,UR ALBUMIN QUANTITATIVE,,,6.48,6.48,1
HCPCS,82043,URINE ALBUMIN QUANTITATIVE,40.0,26.0,1.1,40.0,32
HCPCS,82043QW,UR ALBUMIN QUANTITATIVE,,,6.48,6.48,1
HCPCS,82044,MICROALBUMIN UR SEMI QNT (POINT OF CARE LAB),43.0,27.95,0.95,43.0,60
HCPCS,82044,UR ALBUMIN SEMIQUANTITATIVE,,,6.98,6.98,1
HCPCS,82044,URINE ALBUMIN SEMIQUANTITATIVE,43.0,27.95,1.1,43.0,32
HCPCS,82044QW,UR ALBUMIN SEMIQUANTITATIVE,,,6.98,6.98,1
HCPCS,82045,ALBUMIN ISCHEMIA MODIFIED,,,33.94,190.33,21
HCPCS,82045,Albumin ischemia modified,,,16.56,19.17,8
HCPCS,82055,ASSAY OF ETHANOL,,,33.27,33.27,1
HCPCS,82075,ASSAY OF ALCOHOL (ETHANOL) BREATH,207.0,134.55,1.1,207.0,32
HCPCS,82075,ASSAY OF BREATH ETHANOL,,,30.0,122.93,21
HCPCS,82075,Assay of breath ethanol,,,23.91,27.69,8
HCPCS,82077,ETHANOL PLASMA,119.0,77.35,0.95,119.0,60
HCPCS,82085,ALDOLASE,67.0,43.55,0.95,67.0,120
HCPCS,82088,ALDOSTERONE,281.0,182.65,0.95,281.0,60
HCPCS,82088,ALDOSTERONE ASSAY,281.0,182.65,0.95,281.0,60
HCPCS,82088,"ALDOSTERONE, URINE",281.0,182.65,0.95,281.0,60
HCPCS,82101,ASSAY OF URINE ALKALOIDS,,,35.65,35.65,1
HCPCS,82103,%A1APHE A1A TOTAL,93.0,60.45,0.95,93.0,60
HCPCS,82103,%PHA1A TOTAL,93.0,60.45,0.95,93.0,60
HCPCS,82103,%SERPINA1 A1A,93.0,60.45,0.95,93.0,60
HCPCS,82103,*ALPHA-1-ANTITRYPSIN; TOTAL,93.0,60.45,0.95,93.0,60
HCPCS,82103,ALPHA 1 ANTRY STOOL,93.0,60.45,0.95,93.0,60
HCPCS,82103,ALPHA-1 ANTITRYPSIN TOTAL,93.0,60.45,0.95,93.0,60
HCPCS,82103,"ALPHA-1 ANTITRYPSIN, TOTAL",93.0,60.45,0.95,93.0,60
HCPCS,82103,"ALPHA-1-ANTITRYPSIN,STOOL",93.0,60.45,0.95,93.0,60
HCPCS,82104,%A1APHE A1A PHENOTYPE,100.0,65.0,0.95,100.0,60
HCPCS,82104,*ALPHA-1-ANTITRYPSIN PHENOTYPE,100.0,65.0,0.95,100.0,60
HCPCS,82105,%2ND TRI AFP,116.0,75.4,0.95,116.0,60
HCPCS,82105,%SEQ2 ALPHA FETOPROTEIN,116.0,75.4,0.95,116.0,60
HCPCS,82105,ALPHA FETO TUMOR MARKER,116.0,75.4,0.95,116.0,60
HCPCS,82105,ALPHA-FETOPROTEIN SERUM,116.0,75.4,0.95,116.0,60
HCPCS,82106,AFP AMNIOTIC FLUID,117.0,76.05,0.95,129.17,60
HCPCS,82107,ALPHA-FETOPROTEIN L3,444.0,288.6,0.95,444.0,60
HCPCS,82108,ALUM ASSAY,176.0,114.4,0.95,176.0,60
HCPCS,82120,AMINES VAGINAL FLUID QUAL,,,5.99,28.96,22
HCPCS,82120,Amines vaginal fluid qual,,,9.33,10.8,8
HCPCS,82120QW,AMINES VAGINAL FLUID QUAL,,,6.71,6.71,1
HCPCS,82127,AMINO ACID SINGLE QUAL,,,14.18,96.14,21
HCPCS,82127,Amino acid single qual,,,14.4,16.68,8
HCPCS,82128,%NEO AMINO ACIDS X3,96.0,62.4,0.95,96.0,60
HCPCS,82131,AMINO ACID SINGL QUANT,159.0,103.35,0.95,159.0,60
HCPCS,82131,HOMOCYSTINE UR QNT,159.0,103.35,0.95,159.0,60
HCPCS,82135,AMINOLEVULINIC ACID (ALA) URINE,114.0,74.1,0.95,114.0,60
HCPCS,82136,UCYS24 AMINO ACIDS QUANT 2-5,135.0,87.75,0.95,135.0,60
HCPCS,82139,AMINO ACID>=6 QUANT EA,116.0,75.4,0.95,129.85,60
HCPCS,82140,AMMONIA,101.0,65.65,0.95,101.0,60
HCPCS,82140,"AMMONIUM, 24 HOUR, URINE",101.0,65.65,0.95,101.0,60
HCPCS,82140,"AMMONIUM, RANDOM, URINE",101.0,65.65,0.95,101.0,60
HCPCS,82143,AMNIOTIC FLUID SCAN,,,9.35,38.31,21
HCPCS,82143,Amniotic fluid scan,,,9.33,10.8,8
HCPCS,82145,ASSAY OF AMPHETAMINES,,,47.86,47.86,1
HCPCS,82150,*AMYLASE ASSAY,45.0,29.25,0.95,45.0,60
HCPCS,82150,AMYLASE,45.0,29.25,0.95,45.0,120
HCPCS,82150,ASSAY OF AMYLASE,,,7.25,7.25,1
HCPCS,82150QW,ASSAY OF AMYLASE,,,7.25,7.25,1
HCPCS,82154,ANDROSTANEDIOL GLUCURONIDE,,,28.83,127.31,21
HCPCS,82154,Androstanediol glucuronide,,,17.46,20.22,8
HCPCS,82157,ANDROSTENEDIONE,202.0,131.3,0.95,202.0,60
HCPCS,82157,CAHSP ASSAY OF ANDROSTENEDIONE,202.0,131.3,0.95,202.0,60
HCPCS,82160,ASSAY OF ANDROSTERONE,,,25.55,110.39,21
HCPCS,82160,Assay of androsterone,,,17.46,20.22,8
HCPCS,82163,ANGIOTENSIN II,142.0,92.3,0.95,158.03,60
HCPCS,82164,ANGIOTENSIN CONV ENZYM,101.0,65.65,0.95,101.0,60
HCPCS,82166,ASSAY OF ANTI-MULLERIAN HORMONE,266.0,172.9,0.95,266.0,60
HCPCS,82166,HVIIVF ANTI MULLERIAN,266.0,172.9,0.95,266.0,60
HCPCS,82172,%LIVFIB APOLIPOPROTEIN,146.0,94.9,0.95,146.0,60
HCPCS,82172,APOLIPOPROTEIN A1+B X2,146.0,94.9,0.95,146.0,60
HCPCS,82172,LIPOPROTEIN,146.0,94.9,0.95,146.0,60
HCPCS,82175,%UTXM3 ARSENIC,131.0,85.15,0.95,131.0,60
HCPCS,82175,ARSENIC,131.0,85.15,0.95,131.0,60
HCPCS,82175,ARSENIC ASSAY,131.0,85.15,0.95,131.0,60
HCPCS,82175,ARSENIC URINE,131.0,85.15,0.95,131.0,60
HCPCS,82180,ASSAY OF ASCORBIC ACID,68.0,44.2,0.95,68.0,60
HCPCS,82190,ATOMIC ABSORP SPECTROSCOPY EA,110.0,71.5,0.95,110.0,60
HCPCS,82205,ASSAY OF BARBITURATES,,,75.67,75.67,1
HCPCS,82232,BETA 2 MICROGLOBULIN ASSAY,112.0,72.8,0.95,112.0,60
HCPCS,82232,BETA 2 MICROGLOBULIN BLD,112.0,72.8,0.95,112.0,60
HCPCS,82233,BETA-AMYLOID 1-40 (ABETA 40),,,128.92,528.29,14
HCPCS,82233,Beta-amyloid 1-40 (abeta 40),,,92.46,107.06,8
HCPCS,82234,BETA-AMYLOID; 1-42 (ABETA 42),121.0,78.65,0.95,528.29,55
HCPCS,82239,BILE ACIDS TOTAL,118.0,76.7,0.95,118.0,60
HCPCS,82240,BILE ACIDS CHOLYLGLYCINE,,,26.58,117.31,21
HCPCS,82240,Bile acids cholylglycine,,,16.56,19.17,8
HCPCS,82247,%LIVFIB BILIRUBIN,35.0,22.75,0.95,35.0,60
HCPCS,82247,BILIRUBIN TOTAL,35.0,22.75,0.95,35.0,61
HCPCS,82247,BILIRUBIN TOTAL (BACK OFFICE),35.0,22.75,0.95,35.0,60
HCPCS,82247,TOTAL BILIRUBIN,35.0,22.75,0.95,35.0,60
HCPCS,82247QW,BILIRUBIN TOTAL,,,5.63,5.63,1
HCPCS,82248,BILIRUBIN DIR,35.0,22.75,0.95,35.0,60
HCPCS,82252,FECAL BILIRUBIN TEST,,,4.56,19.95,21
HCPCS,82252,Fecal bilirubin test,,,9.33,10.8,8
HCPCS,82261,BIOTINIDASE ASSAY EA,116.0,75.4,0.95,116.0,60
HCPCS,82270,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,30.0,19.5,1.1,30.0,32
HCPCS,82270,HEMOCULT FECES SCREEN (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
HCPCS,82270,OCCULT BLOOD FECES COLORECT,30.0,19.5,0.95,30.0,60
HCPCS,82271,%FGSTRO GSTRC OCCULT BLD,37.0,24.05,0.95,37.0,60
HCPCS,82271,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,37.0,24.05,1.1,37.0,32
HCPCS,82271,OCCLT BLD GST (POINT OF CARE LAB),37.0,24.05,0.95,37.0,60
HCPCS,82271,OCCULT BLOOD OTHER SOURCES,,,5.96,5.96,1
HCPCS,82271QW,OCCULT BLOOD OTHER SOURCES,,,5.96,5.96,1
HCPCS,82272,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,29.0,18.85,1.1,29.0,33
HCPCS,82272,OCCULT BLOOD FECES 1-3 TEST,29.0,18.85,0.95,29.0,120
HCPCS,82272,OCCULT BLOOD FECES 1-3 TEST (POINT OF CARE LAB),29.0,18.85,0.95,29.0,60
HCPCS,82274,ASSAY TEST FOR BLOOD FECAL,,,17.84,17.84,1
HCPCS,82274,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,110.0,71.5,1.1,110.0,32
HCPCS,82274,"IMMUNOASSAY, FECAL OCCULT BLOOD",110.0,71.5,0.95,110.0,60
HCPCS,82274,OCCULT BLD IA SCRN,110.0,71.5,0.95,110.0,60
HCPCS,82274QW,ASSAY TEST FOR BLOOD FECAL,,,17.84,17.84,1
HCPCS,82286,ASSAY OF BRADYKININ,,,5.16,30.29,21
HCPCS,82286,Assay of bradykinin,,,9.33,10.8,8
HCPCS,82300,%UTXM4 CADMIUM,163.0,105.95,0.95,163.0,60
HCPCS,82300,"CADMIUM, WHOLE BLOOD",163.0,105.95,0.95,163.0,60
HCPCS,82306,D2D3 25-OH VITAMIN,204.0,132.6,0.95,204.0,60
HCPCS,82306,VITAMIN D 25 HYDROXY,204.0,132.6,0.95,204.0,60
HCPCS,82308,CALCITONIN,185.0,120.25,0.95,185.0,60
HCPCS,82308,CALCITONIN FNA LYMPH ND,185.0,120.25,0.95,185.0,60
HCPCS,82308,UREA CLEARANCE 24 HR UR,185.0,120.25,0.95,185.0,60
HCPCS,82310,ASSAY OF CALCIUM,,,5.78,5.78,1
HCPCS,82310,CALCIUM,36.0,23.4,0.95,36.0,60
HCPCS,82310QW,ASSAY OF CALCIUM,,,5.78,5.78,1
HCPCS,82330,*CALCIUM IONIZED,94.0,61.1,0.95,94.0,60
HCPCS,82330,ASSAY IONIZED CA,94.0,61.1,0.95,94.0,60
HCPCS,82330,ASSAY IONIZED CA (POINT OF CARE LAB),94.0,61.1,0.95,94.0,60
HCPCS,82330,ASSAY OF CALCIUM,,,15.33,15.33,1
HCPCS,82330,CALCIUM IONIZED BLD,94.0,61.1,1.1,94.0,32
HCPCS,82330QW,ASSAY OF CALCIUM,,,15.33,15.33,1
HCPCS,82331,CALCIUM INFUSION TEST,,,13.34,54.66,21
HCPCS,82331,Calcium infusion test,,,14.4,16.68,8
HCPCS,82340,CA URINE QUANT TIMED,42.0,27.3,0.95,42.0,60
HCPCS,82355,CALCULUS ANALYSIS QUAL,,,11.58,47.45,21
HCPCS,82355,Calculus analysis qual,,,14.4,16.68,8
HCPCS,82360,CALCULUS ASSAY QUANT,,,12.87,52.74,21
HCPCS,82360,Calculus assay quant,,,14.4,16.68,8
HCPCS,82365,CALCULI (STONE) ANALYSIS,89.0,57.85,0.95,89.0,60
HCPCS,82370,X-RAY ASSAY CALCULUS,,,12.52,51.3,21
HCPCS,82370,X-ray assay calculus,,,14.4,16.68,8
HCPCS,82373,CARBOHYDRATE DEF TRANSFER,125.0,81.25,0.95,139.04,60
HCPCS,82374,ASSAY BLOOD CARBON DIOXIDE,,,5.47,5.47,1
HCPCS,82374,CO2 BLOOD ASSAY,34.0,22.1,0.95,34.0,60
HCPCS,82374QW,ASSAY BLOOD CARBON DIOXIDE,,,5.47,5.47,1
HCPCS,82375,CARBOXYHEMOGLOBIN,85.0,55.25,0.95,85.0,60
HCPCS,82375,CARBOXYHEMOGLOBIN (POINT OF CARE LAB),85.0,55.25,0.95,85.0,60
HCPCS,82376,ASSAY CARBOXYHB QUAL,,,14.07,57.66,21
HCPCS,82376,Assay carboxyhb qual,,,14.4,16.68,8
HCPCS,82378,CEA AG,131.0,85.15,0.95,131.0,60
HCPCS,82379,%GMAPS CARNITINE,116.0,75.4,0.95,129.85,60
HCPCS,82379,CARNITINE FR & TOT PLASMA,116.0,75.4,0.95,129.85,60
HCPCS,82379,CARNITINE TOTAL & FREE QUANT,116.0,75.4,0.95,129.85,60
HCPCS,82379,"CARNITINE, P",116.0,75.4,0.95,129.85,60
HCPCS,82380,CAROTENE,64.0,41.6,0.95,64.0,60
HCPCS,82382,ASSAY URINE CATECHOLAMINES,,,27.3,111.87,21
HCPCS,82382,Assay urine catecholamines,,,17.46,20.22,8
HCPCS,82383,%GMAPS CATECHOLAMINES,201.0,130.65,0.95,201.0,60
HCPCS,82384,*CATECHOLAMINE FRACT ASSAY,174.0,113.1,0.95,174.0,60
HCPCS,82384,CATECHOLAMINE FRAC UR,174.0,113.1,0.95,174.0,60
HCPCS,82384,CATECHOLAMINE FRACT PL,174.0,113.1,0.95,174.0,60
HCPCS,82387,ASSAY OF CATHEPSIN-D,,,18.06,91.8,21
HCPCS,82387,Assay of cathepsin-d,,,14.4,16.68,8
HCPCS,82390,CERULOPLASMIN LEVEL,74.0,48.1,0.95,74.0,60
HCPCS,82397,%FSII CHEMILUMINESCENT,97.0,63.05,0.95,104.92,60
HCPCS,82397,ADANEU CHEMILUMINESCENT,97.0,63.05,0.95,104.92,60
HCPCS,82397,ALPHA SUBUNIT,97.0,63.05,0.95,104.92,60
HCPCS,82397,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,0.95,104.92,120
HCPCS,82397,CHEMILUMINESCENT ASSAY,97.0,63.05,0.95,104.92,60
HCPCS,82397,IBDSGI CHEMILUM X4,97.0,63.05,0.95,104.92,60
HCPCS,82397,IFXNEU CHEMILUMINESCENT,97.0,63.05,0.95,104.92,60
HCPCS,82397,IGFBP-3 INSULIN,97.0,63.05,0.95,104.92,60
HCPCS,82397,MCROHN SAA CHEMILUM,97.0,63.05,0.95,104.92,60
HCPCS,82397,PTH RELATED PEPTIDE,97.0,63.05,0.95,104.92,120
HCPCS,82397,"VEDOLIZUMAB AB, S",97.0,63.05,0.95,104.92,60
HCPCS,82415,ASSAY OF CHLORAMPHENICOL,,,12.67,55.83,21
HCPCS,82415,Assay of chloramphenicol,,,14.54,16.83,8
HCPCS,82435,*CHLORIDE,32.0,20.8,0.95,32.0,60
HCPCS,82435,ASSAY BLOOD CHLORIDE,32.0,20.8,0.95,32.0,60
HCPCS,82435,ASSAY OF BLOOD CHLORIDE,,,5.15,5.15,1
HCPCS,82435,CHLORIDE,32.0,20.8,0.95,32.0,60
HCPCS,82435,CHLORIDE (POINT OF CARE LAB),32.0,20.8,0.95,32.0,60
HCPCS,82435,CHLORIDE BLD,32.0,20.8,1.1,32.0,32
HCPCS,82435QW,ASSAY OF BLOOD CHLORIDE,,,5.15,5.15,1
HCPCS,82436,CHLORIDE UR 24HR,40.0,26.0,0.95,40.0,60
HCPCS,82436,CL URINE ASSAY,40.0,26.0,0.95,40.0,60
HCPCS,82438,CL OTHER SOURCE ASSAY,35.0,22.75,0.95,37.65,60
HCPCS,82438,NONENDOCRINE RECEPTOR ASSAY,35.0,22.75,0.95,37.65,60
HCPCS,82441,TEST FOR CHLOROHYDROCARBONS,,,6.01,26.44,21
HCPCS,82441,Test for chlorohydrocarbons,,,12.86,14.89,8
HCPCS,82465,ASSAY BLD/SERUM CHOLESTEROL,,,4.88,4.88,1
HCPCS,82465,CHOLESTEROL BLOOD TOTAL,30.0,19.5,0.95,30.0,60
HCPCS,82465,CHOLESTEROL FLUID,30.0,19.5,0.95,30.0,60
HCPCS,82465QW,ASSAY BLD/SERUM CHOLESTEROL,,,4.88,4.88,1
HCPCS,82480,PSEUDOCHOLINESTERASE TOTAL,54.0,35.1,0.95,54.0,60
HCPCS,82482,ASSAY RBC CHOLINESTERASE,,,9.81,40.2,21
HCPCS,82482,Assay rbc cholinesterase,,,9.33,10.8,8
HCPCS,82485,ASSAY CHONDROITIN SULFATE,,,20.65,159.03,21
HCPCS,82485,Assay chondroitin sulfate,,,17.46,20.22,8
HCPCS,82486,GAS/LIQUID CHROMATOGRAPHY,,,139.04,139.04,1
HCPCS,82487,PAPER CHROMATOGRAPHY,,,70.37,70.37,1
HCPCS,82488,PAPER CHROMATOGRAPHY,,,94.29,94.29,1
HCPCS,82489,THIN LAYER CHROMATOGRAPHY,,,122.08,122.08,1
HCPCS,82491,CHROMOTOGRAPHY QUANT SING,,,134.47,134.47,1
HCPCS,82492,CHROMOTOGRAPHY QUANT MULT,,,139.04,139.04,1
HCPCS,82495,CHROMIUM BLOOD,140.0,91.0,0.95,142.17,60
HCPCS,82495,CHROMIUM URINE,140.0,91.0,0.95,142.17,60
HCPCS,82495,CHSER,140.0,91.0,0.95,142.17,60
HCPCS,82507,*CITRATE ASSAY,192.0,124.8,0.95,192.0,60
HCPCS,82507,CITRIC ACID URINE,192.0,124.8,0.95,192.0,60
HCPCS,82520,ASSAY OF COCAINE,,,46.67,46.67,1
HCPCS,82523,COLLAGEN CROSS LINKS,129.0,83.85,0.95,129.0,60
HCPCS,82523,COLLAGEN CROSSLINKS,,,20.92,20.92,1
HCPCS,82523,CROSS-LINK N-TELOPEPTIDES,129.0,83.85,0.95,129.0,60
HCPCS,82523QW,COLLAGEN CROSSLINKS,,,20.92,20.92,1
HCPCS,82525,COPPER,86.0,55.9,0.95,95.56,60
HCPCS,82525,COPPER BLOOD,86.0,55.9,0.95,95.56,60
HCPCS,82525,COPPER URINE,86.0,55.9,0.95,95.56,60
HCPCS,82525,"COPPER, FREE, SERUM OR PLASMA",86.0,55.9,0.95,95.56,60
HCPCS,82525,"COPPER, TISSUE",86.0,55.9,0.95,95.56,60
HCPCS,82528,ASSAY OF CORTICOSTERONE,,,22.52,99.29,21
HCPCS,82528,Assay of corticosterone,,,17.46,20.22,8
HCPCS,82530,CORTISOL FREE,115.0,74.75,0.95,115.0,60
HCPCS,82530,FREE CORTISOL UR LCM X3,115.0,74.75,0.95,115.0,60
HCPCS,82530,FREE CORTISOL URINE LCM,115.0,74.75,0.95,115.0,60
HCPCS,82533,CAHSP TOTAL CORTISOL,112.0,72.8,0.95,112.0,60
HCPCS,82533,CORTISOL,112.0,72.8,0.95,112.0,60
HCPCS,82533,CORTISOL TOTAL,112.0,72.8,0.95,112.0,120
HCPCS,82540,%PCA3 INTERP REPORT PC,32.0,20.8,0.95,35.18,60
HCPCS,82540,"CREATINE, URINE",32.0,20.8,0.95,35.18,60
HCPCS,82541,COLUMN CHROMOTOGRAPHY QUAL,,,79.59,79.59,1
HCPCS,82542,%F2 MS/MS QUANTITATIVE,166.0,107.9,0.95,166.0,60
HCPCS,82542,7ALPHAC4,166.0,107.9,0.95,166.0,60
HCPCS,82542,ACYLGLYCINES QNT UR,166.0,107.9,0.95,166.0,60
HCPCS,82542,AMIODARONE,166.0,107.9,0.95,166.0,60
HCPCS,82542,ANSADA MEAS AB ATI,166.0,107.9,0.95,166.0,60
HCPCS,82542,ANSIFX MEAS AB ATI,166.0,107.9,0.95,166.0,60
HCPCS,82542,ANSUST MEAS AB ATI,166.0,107.9,0.95,166.0,60
HCPCS,82542,ANSVDZ MEAS AB ATI,166.0,107.9,0.95,166.0,60
HCPCS,82542,COENZYME Q10,166.0,107.9,0.95,166.0,60
HCPCS,82542,HEX4 GLC4,166.0,107.9,0.95,166.0,60
HCPCS,82542,HYPEROXALURIA,166.0,107.9,0.95,166.0,60
HCPCS,82542,"IOHEXOL GLOMERULAR FILTRATION RATE (GFR), PLASMA",166.0,107.9,0.95,166.0,60
HCPCS,82542,N-METHYLHISTAMINE UR,166.0,107.9,0.95,166.0,60
HCPCS,82542,OMEGACHECK,166.0,107.9,0.95,166.0,60
HCPCS,82542,OXYSTEROLS,166.0,107.9,0.95,166.0,60
HCPCS,82542,PLASMA THYMIDINE DETERMINATION,166.0,107.9,0.95,166.0,60
HCPCS,82542,PTH RELATED PEPTIDE,166.0,107.9,0.95,166.0,60
HCPCS,82542,PURINE&PYRIMIDINE,166.0,107.9,0.95,166.0,60
HCPCS,82542,TRIMETHYLAMINE N-OXIDE,166.0,107.9,0.95,166.0,60
HCPCS,82542,UMHISR COL CHROMOTOGRAPHY,166.0,107.9,0.95,166.0,60
HCPCS,82543,COLUMN CHROMOTOGRAPH/ISOTOPE,,,139.04,139.04,1
HCPCS,82544,COLUMN CHROMOTOGRAPH/ISOTOPE,,,139.04,139.04,1
HCPCS,82550,*CREATINE KINASE TOTAL ASSAY,45.0,29.25,0.95,45.0,120
HCPCS,82550,ASSAY OF CK (CPK),,,7.3,7.3,1
HCPCS,82550,CREATINE KINASE TOTAL,45.0,29.25,1.1,45.0,32
HCPCS,82550QW,ASSAY OF CK (CPK),,,7.3,7.3,1
HCPCS,82552,*CREATINE KINASE ISOENZYME,92.0,59.8,0.95,92.0,60
HCPCS,82553,*CREATINE KINASE MB FRACT,80.0,52.0,0.95,80.0,60
HCPCS,82554,CREATINE ISOFORMS,,,11.87,52.29,21
HCPCS,82554,Creatine isoforms,,,14.4,16.68,8
HCPCS,82565,*CREATININE BLOOD,35.0,22.75,0.95,35.0,60
HCPCS,82565,ASSAY OF CREATININE,,,5.74,5.74,1
HCPCS,82565,CREATININE BLOOD (POINT OF CARE LAB),35.0,22.75,0.95,35.0,60
HCPCS,82565,CREATININE BLOOD ASSAY,35.0,22.75,0.95,35.0,60
HCPCS,82565,CREATININE SERUM (TRPHOS),35.0,22.75,0.95,35.0,60
HCPCS,82565,CREATININE; BLOOD,35.0,22.75,1.1,35.0,32
HCPCS,82565QW,ASSAY OF CREATININE,,,5.74,5.74,1
HCPCS,82570,%F2 CREATININE,36.0,23.4,0.95,36.0,60
HCPCS,82570,%UCAT24 CREATININE,36.0,23.4,0.95,36.0,60
HCPCS,82570,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,0.95,36.0,240
HCPCS,82570,ASSAY OF URINE CREATININE,,,5.8,5.8,1
HCPCS,82570,CREATININE OTHER SOURCE,36.0,23.4,0.95,36.0,92
HCPCS,82570,CREATININE UR/FLUID,36.0,23.4,0.95,36.0,60
HCPCS,82570,CREATININE URINE (TRPHOS),36.0,23.4,0.95,36.0,60
HCPCS,82570,"CREATININE, UR (LABCORP PORPHOBILINOGEN, QN, RANDOM UR)",36.0,23.4,0.95,36.0,60
HCPCS,82570,"CREATININE, URINE RANDOM",36.0,23.4,0.95,36.0,60
HCPCS,82570,HEX4 CREATININE,36.0,23.4,0.95,36.0,60
HCPCS,82570,UMHISR UR CREATININE,36.0,23.4,0.95,36.0,60
HCPCS,82570QW,ASSAY OF URINE CREATININE,,,5.8,5.8,1
HCPCS,82575,CREATININE CLEARANCE TEST,65.0,42.25,0.95,65.0,60
HCPCS,82585,CRYOFIBRINOGEN,98.0,63.7,0.95,98.0,60
HCPCS,82595,CRYOGLOBULIN QL,45.0,29.25,0.95,49.8,120
HCPCS,82600,CYANIDE BLOOD,134.0,87.1,0.95,134.0,60
HCPCS,82607,VIT B-12,104.0,67.6,0.95,104.0,60
HCPCS,82607,VITAMIN B12 BLOOD,104.0,67.6,0.95,104.0,60
HCPCS,82608,HALOPERIDOL,99.0,64.35,0.95,99.0,60
HCPCS,82610,CYSTATIN C,128.0,83.2,0.95,128.0,60
HCPCS,82610,CYSTATIN C WITH GFR,128.0,83.2,0.95,128.0,60
HCPCS,82615,TEST FOR URINE CYSTINES,,,9.55,39.13,21
HCPCS,82615,Test for urine cystines,,,9.33,10.8,8
HCPCS,82626,CAHSP DEHYDROEPIANDROSTERONE,174.0,113.1,0.95,174.0,60
HCPCS,82626,DEHYDROEPIANDROSTERONE,174.0,113.1,0.95,174.0,60
HCPCS,82627,DHEA-S,153.0,99.45,0.95,153.0,60
HCPCS,82633,11 DEOXYCORTICOSTERONE,214.0,139.1,0.95,214.0,60
HCPCS,82633,CAHSP DESOXYCORTICOSTERONE,214.0,139.1,0.95,214.0,60
HCPCS,82634,11-DEOXYCORTISOL,202.0,131.3,0.95,202.0,60
HCPCS,82634,CAHSP DEOXYCORTISOL,202.0,131.3,0.95,202.0,60
HCPCS,82638,%PSEUDOCHOL PHENOTYPE,85.0,55.25,0.95,85.0,60
HCPCS,82642,DIHYDROTESTOSTERONE,202.0,131.3,0.95,202.0,60
HCPCS,82646,ASSAY OF DIHYDROCODEINONE,,,63.61,63.61,1
HCPCS,82649,ASSAY OF DIHYDROMORPHINONE,,,113.42,113.42,1
HCPCS,82651,ASSAY OF DIHYDROTESTOSTERONE,,,79.51,79.51,1
HCPCS,82652,VIT D 1 25 DIHYDROXY,266.0,172.9,0.95,266.0,60
HCPCS,82653,ELASTASE PANCREATIC FECAL,158.0,102.7,0.95,158.0,60
HCPCS,82654,ASSAY OF DIMETHADIONE,,,61.01,61.01,1
HCPCS,82656,PANC ELASTASE FECAL QUAL/SEMI,80.0,52.0,0.95,88.84,60
HCPCS,82657,ALPHA GALACTOS SERUM,153.0,99.45,0.95,153.0,60
HCPCS,82657,AMINOLEV ACID DEHYD,153.0,99.45,0.95,153.0,60
HCPCS,82657,ASPARAGINASE ENZYME ACTIVITY,153.0,99.45,0.95,153.0,60
HCPCS,82657,CPALMT ENZYME CELL ACTIVITY,153.0,99.45,0.95,153.0,60
HCPCS,82657,DISACCHARIDASE IN TISSUE,153.0,99.45,0.95,153.0,60
HCPCS,82657,FAOACM ENZYME CELL ACTIVITY X8,153.0,99.45,0.95,153.0,60
HCPCS,82657,FAOSCM ENZYME CELL ACTIVITY X4,153.0,99.45,0.95,153.0,60
HCPCS,82657,GAUCHER GBA ACTIVITY LEUKOCYTES,153.0,99.45,0.95,153.0,60
HCPCS,82657,THIOPURINE METHYLT TPMT,153.0,99.45,0.95,153.0,60
HCPCS,82658,CPALMT ENZYME CELL ACTIVITY RA X2,304.0,197.6,0.95,304.0,60
HCPCS,82664,CHYLOMICRON SCREEN,424.0,275.6,0.95,424.0,60
HCPCS,82664,"CHYLOSCREEN, BF ELECTROPHORESIS, REFLEX",424.0,275.6,0.95,424.0,60
HCPCS,82664,ELECTROPHORESIS NON-SPEC,424.0,275.6,0.95,424.0,60
HCPCS,82664,ISOELECTRIC FOCUSING HB,424.0,275.6,0.95,424.0,60
HCPCS,82664,MPS ELECTROPHORESIS,424.0,275.6,0.95,424.0,60
HCPCS,82666,ASSAY OF EPIANDROSTERONE,,,84.51,84.51,1
HCPCS,82668,ERYTHROPOIETIN,130.0,84.5,0.95,130.0,60
HCPCS,82670,ESTRADIOL TANDEM MASS SP,193.0,125.45,0.95,193.0,60
HCPCS,82670,ESTRADIOL-17B,193.0,125.45,0.95,193.0,60
HCPCS,82671,ESTROGENS; FRACTIONATED,223.0,144.95,0.95,223.0,60
HCPCS,82672,ESTROGENS TOTAL,150.0,97.5,0.95,150.0,60
HCPCS,82677,%QUAD4 MARKERS  ESTRIOL,167.0,108.55,0.95,167.0,60
HCPCS,82677,%SEQ2 ESTRIOL,167.0,108.55,0.95,167.0,60
HCPCS,82677,ESTRIOL,167.0,108.55,0.95,167.0,60
HCPCS,82677,ESTRIOL SERUM,167.0,108.55,0.95,167.0,60
HCPCS,82679,ASSAY OF ESTRONE,,,27.95,27.95,1
HCPCS,82679,ESTRONE SERUM,172.0,111.8,0.95,172.0,60
HCPCS,82679QW,ASSAY OF ESTRONE,,,27.95,27.95,1
HCPCS,82681,ASSAY DIR MEAS FR ESTRADIOL,,,27.94,114.49,21
HCPCS,82681,Assay dir meas fr estradiol,,,17.46,20.22,8
HCPCS,82690,ASSAY OF ETHCHLORVYNOL,,,71.52,71.52,1
HCPCS,82693,ETHYLENE GLYCOL,103.0,66.95,0.95,103.0,60
HCPCS,82696,ASSAY OF ETIOCHOLANOLONE,,,26.24,107.53,21
HCPCS,82696,Assay of etiocholanolone,,,17.46,20.22,8
HCPCS,82705,"FAT, FECAL QUAL",35.0,22.75,0.95,35.0,60
HCPCS,82705,FECAL FAT QUALITATIVE,35.0,22.75,0.95,35.0,60
HCPCS,82710,FECAL FAT QUANT FECES,117.0,76.05,0.95,117.0,60
HCPCS,82715,ASSAY OF FECAL FAT,,,22.97,94.13,21
HCPCS,82715,Assay of fecal fat,,,14.4,16.68,8
HCPCS,82725,FATTY ACIDS FREE,130.0,84.5,0.95,130.0,60
HCPCS,82725,FATTY ACIDS NONESTERIFIED,130.0,84.5,0.95,130.0,60
HCPCS,82726,%CFA VERY LONG CHAIN,136.0,88.4,0.95,139.04,60
HCPCS,82726,LONG CHAIN FATTY ACIDS,136.0,88.4,0.95,139.04,60
HCPCS,82728,FERRITIN ASSAY,94.0,61.1,0.95,94.0,60
HCPCS,82731,FETAL FIBRONECTIN,444.0,288.6,0.95,444.0,60
HCPCS,82735,FLUORIDE SERUM,128.0,83.2,0.95,183.29,60
HCPCS,82742,ASSAY OF FLURAZEPAM,,,87.32,87.32,1
HCPCS,82746,FOLIC ACID SERUM ASSAY,101.0,65.65,0.95,101.0,60
HCPCS,82747,FOLIC ACID RBC TEST,122.0,79.3,0.95,122.0,60
HCPCS,82747,"RBC FOLATE (REFLAB ONLY, REQUIRES HCT WITHIN 24 HRS)",122.0,79.3,0.95,122.0,60
HCPCS,82757,ASSAY OF SEMEN FRUCTOSE,,,17.34,71.06,21
HCPCS,82757,Assay of semen fructose,,,14.4,16.68,8
HCPCS,82759,ASSAY OF RBC GALACTOKINASE,,,21.48,202.1,21
HCPCS,82759,Assay of rbc galactokinase,,,14.4,16.68,8
HCPCS,82760,ASSAY OF GALACTOSE,,,11.2,45.9,21
HCPCS,82760,Assay of galactose,,,14.4,16.68,8
HCPCS,82775,ASSAY GALACTOSE TRANSFERASE,,,21.07,162.23,21
HCPCS,82775,Assay galactose transferase,,,14.4,16.68,8
HCPCS,82776,%NEO GIPO4 URIDYL TRANS,81.0,52.65,0.95,81.0,60
HCPCS,82777,GALECTIN-3 SERUM,305.0,198.25,0.95,305.0,60
HCPCS,82784,%CELCMP GAMMALOBULIN,64.0,41.6,0.95,64.0,60
HCPCS,82784,*CRYSTAL EXAM FLUID/TIS,64.0,41.6,0.95,64.0,60
HCPCS,82784,GAMMAGLOBULIN ASSAY,64.0,41.6,0.95,64.0,60
HCPCS,82784,HUMOR1 ASSAY GAMMAG X3,64.0,41.6,0.95,64.0,60
HCPCS,82784,IG-M,64.0,41.6,0.95,64.0,60
HCPCS,82784,IGA,64.0,41.6,0.95,64.0,60
HCPCS,82784,IGG SUBCLASS PANEL,64.0,41.6,0.95,64.0,60
HCPCS,82784,"IMGLB IGG, A, M X3",64.0,41.6,0.95,64.0,60
HCPCS,82784,"IMMUNOGLOB D QT, SERUM",64.0,41.6,0.95,64.0,60
HCPCS,82784,LYMRFX IGG QUANT,64.0,41.6,0.95,64.0,60
HCPCS,82785,*GAMMAGLOBULIN ASSAY IGE,114.0,74.1,0.95,114.0,60
HCPCS,82785,ATLANTIC RESPIRATORY PANEL IGE TOTAL,114.0,74.1,0.95,114.0,60
HCPCS,82785,GAMMAGLOBULIN ASSAY IGE,114.0,74.1,0.95,114.0,60
HCPCS,82787,%IGA12 IGA SUBCLASS 1&2,55.0,35.75,0.95,55.0,60
HCPCS,82787,%IGG SUBCLASSES X4,55.0,35.75,0.95,55.0,60
HCPCS,82787,*GAMMAGLOBULIN IGG SUBCLASS EA,55.0,35.75,0.95,55.0,60
HCPCS,82787,HUMOR1 IGG SUBCLASSES X4,55.0,35.75,0.95,55.0,60
HCPCS,82800,LAB VENOUS-PH,76.0,49.4,0.95,89.32,60
HCPCS,82800,"PH, BLOOD (POINT OF CARE LAB)",76.0,49.4,0.95,89.32,60
HCPCS,82803,BLOOD GAS ARTERIAL (POINT OF CARE LAB),180.0,117.0,0.95,180.0,60
HCPCS,82803,BLOOD GAS MIXED WO O2 SAT,180.0,117.0,0.95,180.0,60
HCPCS,82803,BLOOD GAS VENOUS (POINT OF CARE LAB),180.0,117.0,0.95,180.0,60
HCPCS,82803,BLOOD GAS W CALC O2 SATUR (POINT OF CARE LAB),180.0,117.0,0.95,180.0,60
HCPCS,82803,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,180.0,117.0,1.1,180.0,32
HCPCS,82805,BLD GAS PH/PO2/PCO2 W SAT (POINT OF CARE LAB),544.0,353.6,0.95,544.0,60
HCPCS,82805,BLOOD GAS,544.0,353.6,0.95,544.0,60
HCPCS,82805,BLOOD GAS (POINT OF CARE LAB),544.0,353.6,0.95,544.0,60
HCPCS,82810,BLOOD GAS O2 SATUR ONLY,67.0,43.55,0.95,67.0,60
HCPCS,82810,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),67.0,43.55,0.95,67.0,120
HCPCS,82820,HEMOGLOBIN-OXYGEN AFFINITY,,,13.34,54.66,21
HCPCS,82820,Hemoglobin-oxygen affinity,,,6.74,7.8,8
HCPCS,82926,ASSAY OF GASTRIC ACID,,,23.93,23.93,1
HCPCS,82928,ASSAY OF GASTRIC ACID,,,28.81,28.81,1
HCPCS,82930,GASTRIC ANALY W/PH EA SPEC,,,6.71,27.5,21
HCPCS,82930,Gastric analy w/ph ea spec,,,9.33,10.8,8
HCPCS,82938,GASTRIN TEST,,,17.69,174.01,21
HCPCS,82938,Gastrin test,,,17.46,20.22,8
HCPCS,82941,GASTRIN,122.0,79.3,0.95,122.0,60
HCPCS,82943,GLUCAGON,99.0,64.35,0.95,110.02,60
HCPCS,82945,GLUC BODY FLUID NOT BLOOD,27.0,17.55,0.95,27.0,60
HCPCS,82945,GLUCOSE BF,27.0,17.55,0.95,27.0,60
HCPCS,82945,"GLUCOSE RANDOM, UR",27.0,17.55,0.95,27.0,60
HCPCS,82946,GLUCAGON TOLERANCE TEST,,,17.77,72.82,21
HCPCS,82946,Glucagon tolerance test,,,14.4,16.68,8
HCPCS,82947,*GLUCOSE QUANT,27.0,17.55,0.95,27.0,60
HCPCS,82947,ASSAY GLUCOSE BLOOD QUANT,,,4.41,4.41,1
HCPCS,82947,BLOOD GLUCOSE,27.0,17.55,0.95,27.0,60
HCPCS,82947,GLUC BLOOD QUANT ASSAY,27.0,17.55,0.95,27.0,60
HCPCS,82947,"GLUC, FASTING",27.0,17.55,0.95,27.0,60
HCPCS,82947,GLUCOSE QUANT,27.0,17.55,0.95,27.0,60
HCPCS,82947,GLUCOSE QUANT (POINT OF CARE LAB),27.0,17.55,0.95,27.0,60
HCPCS,82947,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,27.0,17.55,1.1,27.0,32
HCPCS,82947,OCC.HEALTH/ BLOOD SUGAR,27.0,17.55,0.95,27.0,60
HCPCS,82947QW,ASSAY GLUCOSE BLOOD QUANT,,,4.41,4.41,1
HCPCS,82948,GLUCOSE BLOOD REAGENT STRIP,35.0,22.75,1.1,35.0,32
HCPCS,82948,GLUCOSE BLOOD REAGENT STRIP (POINT OF CARE LAB),35.0,22.75,0.95,35.0,60
HCPCS,82950,GLUC NON GEST TOLERANCE,33.0,21.45,0.95,33.0,60
HCPCS,82950,GLUCOSE SCRN POST DOSE,33.0,21.45,0.95,33.0,60
HCPCS,82950,GLUCOSE TEST,,,5.32,5.32,1
HCPCS,82950QW,GLUCOSE TEST,,,5.32,5.32,1
HCPCS,82951,GLUCOSE TOLERANCE TEST (GTT),,,14.42,14.42,1
HCPCS,82951,GTT 3SPEC,89.0,57.85,0.95,89.0,60
HCPCS,82951QW,GLUCOSE TOLERANCE TEST (GTT),,,14.42,14.42,1
HCPCS,82952,GTT EA ADD SPEC BEYOND 3,27.0,17.55,0.95,27.0,60
HCPCS,82952,GTT-ADDED SAMPLES,,,4.4,4.4,1
HCPCS,82952QW,GTT-ADDED SAMPLES,,,4.4,4.4,1
HCPCS,82953,GLUCOSE-TOLBUTAMIDE TEST,,,66.79,66.79,1
HCPCS,82955,G6PD QUANT,67.0,43.55,0.95,67.0,60
HCPCS,82955,GLUCOSE 6 PHOS DEHYD QT,67.0,43.55,0.95,67.0,60
HCPCS,82960,G6PD SCREEN,42.0,27.3,0.95,42.0,60
HCPCS,82962,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,23.0,14.95,1.1,23.0,32
HCPCS,82962,GLUC BLOOD TEST BY DVC (POINT OF CARE LAB),23.0,14.95,0.95,23.0,60
HCPCS,82962,GLUCOSE BLD BY MONIT DEV (POINT OF CARE LAB),23.0,14.95,0.95,23.0,60
HCPCS,82962,QUICK CHECK GLUCOMETER B/S,23.0,14.95,0.95,23.0,60
HCPCS,82963,ASSAY OF GLUCOSIDASE,,,19.97,88.02,21
HCPCS,82963,Assay of glucosidase,,,14.4,16.68,8
HCPCS,82965,ASSAY OF GDH ENZYME,,,13.15,53.89,21
HCPCS,82965,Assay of gdh enzyme,,,14.4,16.68,8
HCPCS,82975,ASSAY OF GLUTAMINE,,,69.8,69.8,1
HCPCS,82977,%LIVFIB GGT,50.0,32.5,0.95,50.0,60
HCPCS,82977,ASSAY OF GGT,,,8.06,8.06,1
HCPCS,82977,"GAMMA GLUTAMYL TRANSFERASE, FIBROMETER",50.0,32.5,0.95,50.0,60
HCPCS,82977,GGT ASSAY,50.0,32.5,0.95,50.0,60
HCPCS,82977QW,ASSAY OF GGT,,,8.06,8.06,1
HCPCS,82978,GLUTATHIONE TOTAL,107.0,69.55,0.95,107.0,60
HCPCS,82979,ASSAY RBC GLUTATHIONE,,,9.44,38.68,21
HCPCS,82979,Assay rbc glutathione,,,9.33,10.8,8
HCPCS,82980,ASSAY OF GLUTETHIMIDE,,,80.83,80.83,1
HCPCS,82985,ASSAY OF GLYCATED PROTEIN,116.0,75.4,0.95,116.0,61
HCPCS,82985,GLYCATED PROTEIN,116.0,75.4,0.95,116.0,60
HCPCS,82985,GLYCOPROTEINS,116.0,75.4,0.95,116.0,60
HCPCS,82985QW,ASSAY OF GLYCATED PROTEIN,,,18.77,18.77,1
HCPCS,83001,ASSAY OF GONADOTROPIN (FSH),,,20.81,20.81,1
HCPCS,83001,FSH SERUM,128.0,83.2,0.95,128.0,60
HCPCS,83001,GONADOTROPIN FSH,128.0,83.2,0.95,128.0,60
HCPCS,83001QW,ASSAY OF GONADOTROPIN (FSH),,,20.81,20.81,1
HCPCS,83002,ASSAY OF GONADOTROPIN (LH),,,20.75,20.75,1
HCPCS,83002,GONADOTROPIN LH,128.0,83.2,0.95,128.0,60
HCPCS,83002,"LH, PEDIATRIC",128.0,83.2,0.95,128.0,60
HCPCS,83002,LUTEINING HORMONE,128.0,83.2,0.95,128.0,60
HCPCS,83002QW,ASSAY OF GONADOTROPIN (LH),,,20.75,20.75,1
HCPCS,83003,GROWTH HORMONE HUMAN,115.0,74.75,0.95,115.0,60
HCPCS,83006,GROWTH STIMULATION GENE 2,,,75.6,309.79,21
HCPCS,83006,Growth stimulation gene 2,,,21.97,25.44,8
HCPCS,83008,ASSAY OF GUANOSINE,,,74.0,74.0,1
HCPCS,83009,H PYLORI (C-13) BLOOD,,,67.36,377.67,21
HCPCS,83009,H pylori (c-13) blood,,,29.28,33.9,8
HCPCS,83010,%LIVFIB HAPTOGLOBIN QNT,87.0,56.55,0.95,87.0,60
HCPCS,83010,HAPTOGLOBIN QUANT,87.0,56.55,0.95,87.0,60
HCPCS,83012,ASSAY OF HAPTOGLOBINS,,,26.89,110.19,21
HCPCS,83012,Assay of haptoglobins,,,16.56,19.17,8
HCPCS,83013,H.PYLORI BREATH TEST,465.0,302.25,0.95,465.0,60
HCPCS,83014,H PYLORI DRUG ADMIN,,,7.86,60.56,21
HCPCS,83014,H pylori drug admin,,,9.33,10.8,8
HCPCS,83015,HEAVY METAL QUAL ANY NUMBER,,,20.94,85.81,21
HCPCS,83015,Heavy metal qual any number,,,12.86,14.89,8
HCPCS,83018,*HEAVY METAL; QUAN,152.0,98.8,0.95,152.0,60
HCPCS,83018,IODIDE SERUM,152.0,98.8,0.95,152.0,60
HCPCS,83018,IODINE TOTAL URINE,152.0,98.8,0.95,152.0,60
HCPCS,83018,TITANIUM SER/PLAS,152.0,98.8,0.95,152.0,60
HCPCS,83018,"TOXIC METAL, QUANT EA",152.0,98.8,0.95,152.0,60
HCPCS,83020,HBSCN1 REFLEX,89.0,57.85,0.95,89.0,60
HCPCS,83020,HEMOGLOBIN FRACT AND QUANT,89.0,57.85,0.95,89.0,60
HCPCS,83020,HGB ELECPHRSIS FRACT/QUANT,89.0,57.85,0.95,89.0,120
HCPCS,83021,HEMOGLOBIN A2 ASCAA,125.0,81.25,0.95,125.0,60
HCPCS,83021,HGB CHROMO FRACT/QUANT,125.0,81.25,0.95,125.0,60
HCPCS,83026,HEMOGLOBIN COPPER SULFATE,,,4.01,16.43,21
HCPCS,83026,Hemoglobin copper sulfate,,,6.74,7.8,8
HCPCS,83030,HEMOGLOBIN F FETAL CHEMICAL,,,10.74,81.02,21
HCPCS,83030,Hemoglobin f fetal chemical,,,9.33,10.8,8
HCPCS,83033,F(FETAL) QUAL,55.0,35.75,0.95,55.0,60
HCPCS,83036,HEMOGLOBIN GLYCOSYLATED A1C,67.0,43.55,1.1,67.0,33
HCPCS,83036,HGB A1C GLYCOSYLATED,67.0,43.55,0.95,67.0,60
HCPCS,83036,HGB A1C GLYCOSYLATED (POINT OF CARE LAB),67.0,43.55,0.95,67.0,60
HCPCS,83036QW,HEMOGLOBIN GLYCOSYLATED A1C,,,10.88,10.88,1
HCPCS,83037,HB GLYCOSYLATED A1C HOME DEV,,,9.71,39.79,22
HCPCS,83037,HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE,67.0,43.55,1.1,67.0,32
HCPCS,83037,Hb glycosylated a1c home dev,,,9.33,10.8,8
HCPCS,83037QW,HB GLYCOSYLATED A1C HOME DEV,,,10.88,10.88,1
HCPCS,83045,HGB METHEMOGLOBIN QUAL,,,6.49,26.59,21
HCPCS,83045,Hgb methemoglobin qual,,,9.33,10.8,8
HCPCS,83050,METHEMOGLOBIN QUANT,57.0,37.05,0.95,57.0,60
HCPCS,83050,METHEMOGLOBIN QUANT (POINT OF CARE LAB),57.0,37.05,0.95,57.0,60
HCPCS,83051,HEMOGLOBIN PLASMA,50.0,32.5,0.95,51.56,60
HCPCS,83051,HEMOGLOBIN SERUM (POINT OF CARE LAB),50.0,32.5,0.95,51.56,60
HCPCS,83051,HGB; PLASMA,50.0,32.5,0.95,51.56,60
HCPCS,83055,BLOOD SULFHEMOGLOBIN TEST,,,21.62,21.62,1
HCPCS,83060,HGB SULFHEMOGLOBIN QUAN,,,8.8,36.39,21
HCPCS,83060,Hgb sulfhemoglobin quan,,,9.33,10.8,8
HCPCS,83065,HEMOGLOBIN THERMOLABILE,,,9.0,36.88,21
HCPCS,83065,Hemoglobin thermolabile,,,9.33,10.8,8
HCPCS,83068,HEMOGLOBIN UNSTABLE SCREEN,,,9.47,38.81,21
HCPCS,83068,Hemoglobin unstable screen,,,9.33,10.8,8
HCPCS,83069,HEMOGLOBIN URINE,,,3.95,16.19,21
HCPCS,83069,Hemoglobin urine,,,9.33,10.8,8
HCPCS,83070,HEMOSIDERIN URINE,33.0,21.45,0.95,33.0,60
HCPCS,83071,ASSAY OF HEMOSIDERIN QUANT,,,30.22,30.22,1
HCPCS,83080,ASSAY OF B HEXOSAMINIDASE EA,,,16.87,129.85,21
HCPCS,83080,Assay of b hexosaminidase ea,,,14.4,16.68,8
HCPCS,83088,HISTAMINE,204.0,132.6,0.95,204.0,60
HCPCS,83090,HOMOCYSTEINE ASSAY,124.0,80.6,0.95,124.0,60
HCPCS,83150,ASSAY OF HOMOVANILLIC ACID,,,22.41,91.83,21
HCPCS,83150,Assay of homovanillic acid,,,17.46,20.22,8
HCPCS,83491,ASY HYDROXYCORTICOSTEROIDS17,,,17.9,134.89,21
HCPCS,83491,Asy hydroxycorticosteroids17,,,17.46,20.22,8
HCPCS,83497,%NEUR 5-HIAA,89.0,57.85,0.95,99.26,60
HCPCS,83497,5 HIAA URINE,89.0,57.85,0.95,99.26,60
HCPCS,83497,"5-HIAA, PLASMA - LABCORP",89.0,57.85,0.95,99.26,60
HCPCS,83498,%NEO 17 OH PROGESTERONE,187.0,121.55,0.95,187.0,60
HCPCS,83498,17-HYDROXYPROG QNT TIMED X2,187.0,121.55,0.95,187.0,60
HCPCS,83498,17-HYDROXYPROGESTERONE UR,187.0,121.55,0.95,187.0,60
HCPCS,83498,17-OH PROGESTERONE,187.0,121.55,0.95,187.0,60
HCPCS,83498,CAHSP ASY HYDROXYPROGESTERONE 17-D,187.0,121.55,0.95,187.0,60
HCPCS,83499,Assay of progesterone 20-,,,111.21,111.21,1
HCPCS,83500,ASSAY FREE HYDROXYPROLINE,,,22.65,92.82,21
HCPCS,83500,Assay free hydroxyproline,,,17.46,20.22,8
HCPCS,83505,ASSAY TOTAL HYDROXYPROLINE,,,24.3,99.58,21
HCPCS,83505,Assay total hydroxyproline,,,17.46,20.22,8
HCPCS,83516,%ANCA C+P EIA X2,80.0,52.0,0.95,80.0,60
HCPCS,83516,%CELCMP TRANSGLUT IGA,80.0,52.0,0.95,80.0,60
HCPCS,83516,%RHEUMA IMMUNO X2,80.0,52.0,0.95,80.0,60
HCPCS,83516,*GLIADIN ANTIBODY,80.0,52.0,0.95,80.0,60
HCPCS,83516,*IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,120
HCPCS,83516,ACESTR IMMUNOASSAY NONANTIBODY X2,80.0,52.0,0.95,80.0,60
HCPCS,83516,ACETYLCHOL REC MOD,80.0,52.0,0.95,80.0,60
HCPCS,83516,ACETYLCHOLINE RECEPTOR MOD AB,80.0,52.0,0.95,80.0,60
HCPCS,83516,ALLOGEN AUTOANTIBODY,80.0,52.0,0.95,80.0,60
HCPCS,83516,ANTI AT1R AB DETERMINATION,80.0,52.0,0.95,80.0,60
HCPCS,83516,ANTI IGE,80.0,52.0,0.95,80.0,60
HCPCS,83516,ANTI-C1Q AB IGG,80.0,52.0,0.95,80.0,60
HCPCS,83516,ANTI-HMGCR AUTO AB,80.0,52.0,0.95,80.0,60
HCPCS,83516,"ANTI-SP100 AND ANTI-GP210 ANTIBODIES, IGG",80.0,52.0,0.95,80.0,60
HCPCS,83516,ANTIBODY IMMUNOASSAY (POLMYO),80.0,52.0,0.95,80.0,60
HCPCS,83516,AT1R-ANTIBODY-REFERENCE SAMPLE,80.0,52.0,0.95,80.0,60
HCPCS,83516,"BULLOUS PEMPHIGOID, BP180 AND BP230, IGG ANTIBODIES",80.0,52.0,0.95,80.0,60
HCPCS,83516,DERMATOMYOSITIS PANEL,80.0,52.0,0.95,80.0,60
HCPCS,83516,DERMATOMYOSITIS PANEL X6,80.0,52.0,0.95,80.0,60
HCPCS,83516,GANGLIOSIDE ABS X2,80.0,52.0,0.95,80.0,60
HCPCS,83516,GANGLIOSIDE ABS X6,80.0,52.0,0.95,80.0,60
HCPCS,83516,GBMGP IMMUNOASSAY NONANTIBODY,80.0,52.0,0.95,80.0,60
HCPCS,83516,GLOM BASE MEM AB IGG,80.0,52.0,0.95,80.0,60
HCPCS,83516,GM1 ANTIBODY PANEL X2,80.0,52.0,0.95,80.0,60
HCPCS,83516,HISTONE ANTIBODIES,80.0,52.0,0.95,80.0,60
HCPCS,83516,HSP-70 AB,80.0,52.0,0.95,80.0,60
HCPCS,83516,HYDROXYLASE-21 AB,80.0,52.0,0.95,80.0,60
HCPCS,83516,IMMUNOASSAY (MYOSPL),80.0,52.0,0.95,80.0,60
HCPCS,83516,IMMUNOASSAY NONANTIBODY,80.0,52.0,0.95,80.0,61
HCPCS,83516,IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,180
HCPCS,83516,IMMUNOASSY NONINF QUAL/SEMI,80.0,52.0,0.95,80.0,120
HCPCS,83516,MAG ANTIBODY IGM,80.0,52.0,0.95,80.0,60
HCPCS,83516,MYOSITIS ANTIBODY,80.0,52.0,0.95,80.0,60
HCPCS,83516,PARIETAL AB,80.0,52.0,0.95,80.0,60
HCPCS,83516,"PT AB, IGG",80.0,52.0,0.95,80.0,60
HCPCS,83516,RIBPRO IMMUNO NON AB,80.0,52.0,0.95,80.0,60
HCPCS,83516,RNA POLYMER III IGG,80.0,52.0,0.95,80.0,60
HCPCS,83516,SENMOT IMMUNOASSAY (ARUP),80.0,52.0,0.95,80.0,60
HCPCS,83516,SENNRO IMMUNOASSAY (ARUP),80.0,52.0,0.95,80.0,60
HCPCS,83516,TH/TO ANTIBODY,80.0,52.0,0.95,80.0,60
HCPCS,83516,TTG IGG/IGA,80.0,52.0,0.95,80.0,60
HCPCS,83516,TYSABRI ANTIBODIES,80.0,52.0,0.95,80.0,60
HCPCS,83516QW,IMMUNOASSAY NONANTIBODY,,,12.92,12.92,1
HCPCS,83518,IMMUNOASSAY DIPSTICK,,,9.64,39.5,22
HCPCS,83518,Immunoassay dipstick,,,9.33,10.8,8
HCPCS,83518QW,IMMUNOASSAY DIPSTICK,,,10.8,10.8,1
HCPCS,83519,%CEPHAL IA/RIA,127.0,82.55,0.95,127.0,60
HCPCS,83519,%LAMBRT IA;QNT RIA X4 MOD,127.0,82.55,0.95,127.0,60
HCPCS,83519,%MYGRAV ACHR ABX2,127.0,82.55,0.95,127.0,60
HCPCS,83519,%PARNEO AB BIND X2 MOD,127.0,82.55,0.95,127.0,60
HCPCS,83519,*IMMUNOASSAY NONINF QUANT RIA,127.0,82.55,0.95,127.0,60
HCPCS,83519,ACESTR RIA NONANTIBODY,127.0,82.55,0.95,127.0,60
HCPCS,83519,ACETYLCHOL REC MOD,127.0,82.55,0.95,127.0,60
HCPCS,83519,ADIPONECTIN,127.0,82.55,0.95,127.0,60
HCPCS,83519,AIDYSA RIA NONAB,127.0,82.55,0.95,127.0,60
HCPCS,83519,GANGLIONIC ACHR AUTOAB,127.0,82.55,0.95,127.0,60
HCPCS,83519,GANGLIONIC NACHR ANTIBOD,127.0,82.55,0.95,127.0,60
HCPCS,83519,IGF BINDING PROTEIN 2,127.0,82.55,0.95,127.0,60
HCPCS,83519,IGF-II INSULIN LIKE GR,127.0,82.55,0.95,127.0,60
HCPCS,83519,IMMUNOASSAY,127.0,82.55,0.95,127.0,60
HCPCS,83519,IMMUNOASSAY NONINF QUANT RIA,127.0,82.55,0.95,127.0,60
HCPCS,83519,IMMUNOASSY NONINF QUANT RIA,127.0,82.55,0.95,127.0,120
HCPCS,83519,MELANOCYTE STIM HORMONE ALP,127.0,82.55,0.95,127.0,60
HCPCS,83519,MUSCLE MODULATING AB,127.0,82.55,0.95,127.0,60
HCPCS,83519,MUSK ANTIBODY,127.0,82.55,0.95,127.0,60
HCPCS,83519,NEURO VG K CHAN ABS MOD,127.0,82.55,0.95,127.0,60
HCPCS,83519,PANCREASTATIN,127.0,82.55,0.95,127.0,60
HCPCS,83519,PANCREATIC POLYPE,127.0,82.55,0.95,127.0,60
HCPCS,83519,PROCOL TYPEL N TARMINAL,127.0,82.55,0.95,127.0,60
HCPCS,83519,TRYPSINOGEN,127.0,82.55,0.95,127.0,60
HCPCS,83519,VOLTAGE-GATED CAL IGG AB,127.0,82.55,0.95,127.0,60
HCPCS,83519,VOLTAGE-GATED KCHANNEL AB,127.0,82.55,0.95,127.0,60
HCPCS,83520,%CEPHAL IA QNTNOS NONABX4,119.0,77.35,0.95,119.0,60
HCPCS,83520,%FSII IMMUNO QUANT,119.0,77.35,0.95,119.0,60
HCPCS,83520,%INHAB IMMUNO QT,119.0,77.35,0.95,119.0,60
HCPCS,83520,%LAMBRT IMMUNASSY QNT;NOS,119.0,77.35,0.95,119.0,60
HCPCS,83520,%MYGRAV STRIATIONAL AB,119.0,77.35,0.95,119.0,60
HCPCS,83520,%PARNEO STRIATIONAL AB,119.0,77.35,0.95,119.0,60
HCPCS,83520,%SENNRO SENSRY NEU IMMX6,119.0,77.35,0.95,119.0,60
HCPCS,83520,*IMMUNOASSAY QUANT NOS,119.0,77.35,0.95,119.0,120
HCPCS,83520,"14.3.3 ETA PROTEIN, SER",119.0,77.35,0.95,119.0,60
HCPCS,83520,ADIPONECTIN,119.0,77.35,0.95,119.0,120
HCPCS,83520,ADMARK PHOS TAU CSF X3,119.0,77.35,0.95,119.0,60
HCPCS,83520,AIDYSA IMMUNO QNT NOS NONAB,119.0,77.35,0.95,119.0,60
HCPCS,83520,ANTI IGE,119.0,77.35,0.95,119.0,60
HCPCS,83520,ANTI MULLERIAN HORMONE,119.0,77.35,0.95,119.0,60
HCPCS,83520,ANTI-IGA ANTIBODY,119.0,77.35,0.95,119.0,60
HCPCS,83520,CAR AUTOANTIBODY,119.0,77.35,0.95,119.0,60
HCPCS,83520,COLLAGEN TYPE II AB,119.0,77.35,0.95,119.0,60
HCPCS,83520,"CV2 AB IGG CBA-IFA SCREEN, SERUM",119.0,77.35,0.95,119.0,60
HCPCS,83520,"CXCL9 QUANTITATION, SERUM",119.0,77.35,0.95,119.0,60
HCPCS,83520,CYTOKINE PANEL,119.0,77.35,0.95,119.0,60
HCPCS,83520,GANGLIOSIDE ABS MAYO X6,119.0,77.35,0.95,119.0,60
HCPCS,83520,GQ1B AUTOANTIBODY,119.0,77.35,0.95,119.0,60
HCPCS,83520,GROWTH DIFF FACTOR 15,119.0,77.35,0.95,119.0,60
HCPCS,83520,HU AUTOANTIBODY,119.0,77.35,0.95,119.0,60
HCPCS,83520,HUMAN ANTI-MOUSE AB (HAMA),119.0,77.35,0.95,119.0,120
HCPCS,83520,IBDSGI ELISA X6,119.0,77.35,0.95,119.0,60
HCPCS,83520,IMMUNOASSAY QUANT NOS,119.0,77.35,0.95,119.0,60
HCPCS,83520,IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,0.95,119.0,121
HCPCS,83520,INHIBIN B,119.0,77.35,0.95,119.0,120
HCPCS,83520,INTERLEUKIN 2,119.0,77.35,0.95,119.0,60
HCPCS,83520,INTERLEUKIN 2 RECEPTOR,119.0,77.35,0.95,119.0,60
HCPCS,83520,INTERLEUKIN 4,119.0,77.35,0.95,119.0,60
HCPCS,83520,INTERLEUKIN 5,119.0,77.35,0.95,119.0,60
HCPCS,83520,INTERLEUKIN 6,119.0,77.35,0.95,119.0,60
HCPCS,83520,LEPTIN,119.0,77.35,0.95,119.0,60
HCPCS,83520,MANNOSE BINDING PROTEIN,119.0,77.35,0.95,119.0,60
HCPCS,83520,MATRIX METALLOPRO-9 MMP-9,119.0,77.35,0.95,119.0,60
HCPCS,83520,MELATONIN,119.0,77.35,0.95,119.0,60
HCPCS,83520,NEOPTERIN BLD/CSF,119.0,77.35,0.95,119.0,60
HCPCS,83520,NEOSEN NEURO PARANEO X3,119.0,77.35,0.95,119.0,60
HCPCS,83520,"NERUON SPEC ENOLASE, SER",119.0,77.35,0.95,119.0,60
HCPCS,83520,NEUROFILAMENT LIGHT (NFL),119.0,77.35,0.95,119.0,60
HCPCS,83520,NEURON SPECIFIC ENO CSF,119.0,77.35,0.95,119.0,60
HCPCS,83520,"NITROGEN, URINE 24 HR",119.0,77.35,0.95,119.0,60
HCPCS,83520,OXIDIZED LDL,119.0,77.35,0.95,119.0,60
HCPCS,83520,"PAN.ELASTASE, FECAL",119.0,77.35,0.95,119.0,60
HCPCS,83520,"PHOSPHOLIPASE A2 RECEPTOR AB, ELISA, SERUM",119.0,77.35,0.95,119.0,60
HCPCS,83520,PHOSPHOLIPASE A2 RECEPTOR IGG ANTIBODY ELISA,119.0,77.35,0.95,119.0,60
HCPCS,83520,PLASMIN ACT INHIBITOR AG,119.0,77.35,0.95,119.0,60
HCPCS,83520,"PRIMARY MEMBRANOUS NEPHROPATHY DIAG CASCADE, SER",119.0,77.35,0.95,119.0,60
HCPCS,83520,RECOMBX MA TA AUTOAB,119.0,77.35,0.95,119.0,60
HCPCS,83520,RI AUTOANTIBODY,119.0,77.35,0.95,119.0,60
HCPCS,83520,RIBOSOMAL P PROTEIN IGG,119.0,77.35,0.95,119.0,60
HCPCS,83520,S. CEREVISIAE IGA AND IGG,119.0,77.35,0.95,119.0,60
HCPCS,83520,SENMOT IMMUNOASSAY X11,119.0,77.35,0.95,119.0,60
HCPCS,83520,TRYPSINOGEN,119.0,77.35,0.95,119.0,60
HCPCS,83520,TUMOR NECROSIS SERUM,119.0,77.35,0.95,119.0,60
HCPCS,83520,UFLCKL IMMUNO QNT NOS NAB,119.0,77.35,0.95,119.0,60
HCPCS,83520,"USTEKINUMAB AB, S",119.0,77.35,0.95,119.0,60
HCPCS,83520,VASC ENDO GROWTH FACT,119.0,77.35,0.95,119.0,60
HCPCS,83520,YO AUTOANTIBODY,119.0,77.35,0.95,119.0,60
HCPCS,83520QW,IMMUNOASSAY QUANT NOS NONAB,,,19.35,19.35,1
HCPCS,83521,IMMUNOGL LT CHNS FR EA,119.0,77.35,0.95,119.0,60
HCPCS,83525,INSULIN ASSAY,79.0,51.35,0.95,79.0,60
HCPCS,83527,INSULIN FREE,89.0,57.85,0.95,99.71,60
HCPCS,83528,ASSAY OF INTRINSIC FACTOR,,,19.82,81.22,21
HCPCS,83528,Assay of intrinsic factor,,,14.4,16.68,8
HCPCS,83529,"ADALIMUMAB, SERUM",119.0,77.35,0.95,119.0,60
HCPCS,83540,*FE ASSAY,45.0,29.25,0.95,45.0,60
HCPCS,83540,FE ASSAY,45.0,29.25,0.95,45.0,60
HCPCS,83540,IRON TEST,45.0,29.25,0.95,45.0,60
HCPCS,83550,*FE BINDING CAPACITY,60.0,39.0,0.95,60.0,60
HCPCS,83550,FE BINDING CAPACITY,60.0,39.0,0.95,60.0,60
HCPCS,83570,ASSAY OF IDH ENZYME,,,8.85,38.95,21
HCPCS,83570,Assay of idh enzyme,,,9.33,10.8,8
HCPCS,83582,ASSAY OF KETOGENIC STEROIDS,,,15.47,63.39,21
HCPCS,83582,Assay of ketogenic steroids,,,17.46,20.22,8
HCPCS,83586,%U17K 17KETOSTEROIDS 24UR,88.0,57.2,0.95,88.0,60
HCPCS,83593,FRACTIONATION KETOSTEROIDS,,,28.5,116.79,21
HCPCS,83593,Fractionation ketosteroids,,,17.46,20.22,8
HCPCS,83605,ASSAY LACTIC ACID,80.0,52.0,0.95,80.0,60
HCPCS,83605,ASSAY LACTIC ACID (POINT OF CARE LAB),80.0,52.0,0.95,80.0,60
HCPCS,83605,ASSAY OF LACTATE,80.0,52.0,1.1,80.0,32
HCPCS,83605,ASSAY OF LACTIC ACID,80.0,52.0,0.95,80.0,61
HCPCS,83605,LACTATE (LACTIC ACID),80.0,52.0,0.95,80.0,60
HCPCS,83605,LACTATE(LACTIC ACID),80.0,52.0,0.95,80.0,60
HCPCS,83605QW,ASSAY OF LACTIC ACID,,,12.96,12.96,1
HCPCS,83615,LAC (LD)(LDH),42.0,27.3,0.95,42.0,120
HCPCS,83615,LDH,42.0,27.3,0.95,42.0,60
HCPCS,83625,%LDISO LD ISOENZYMES,88.0,57.2,0.95,88.0,60
HCPCS,83625,*LAC (LD)(LDH) ASSAY ENZYME,88.0,57.2,0.95,88.0,60
HCPCS,83630,"IMMUNOASSAY, LACTOFERRIN, FECAL, QUALITATIVE",136.0,88.4,0.95,136.0,60
HCPCS,83630,"LACTOFERRIN, FECAL",136.0,88.4,0.95,136.0,60
HCPCS,83631,LACTOFERRIN FECAL (QUANT),,,19.63,100.72,21
HCPCS,83631,Lactoferrin fecal (quant),,,14.4,16.68,8
HCPCS,83632,HUMAN PLACENTAL LACTOGEN,140.0,91.0,0.95,140.0,60
HCPCS,83633,TEST URINE FOR LACTOSE,,,11.25,46.1,21
HCPCS,83633,Test urine for lactose,,,14.4,16.68,8
HCPCS,83634,ASSAY OF URINE FOR LACTOSE,,,32.77,32.77,1
HCPCS,83655,%OSHA LEAD,84.0,54.6,0.95,84.0,60
HCPCS,83655,%UTXM3 LEAD,84.0,54.6,0.95,84.0,60
HCPCS,83655,%UTXM4 LEAD,84.0,54.6,0.95,84.0,60
HCPCS,83655,ASSAY OF LEAD,,,13.57,13.57,1
HCPCS,83655,LEAD ASSAY,84.0,54.6,0.95,84.0,60
HCPCS,83655,LEAD CONCENTRATION,84.0,54.6,0.95,84.0,60
HCPCS,83655,LEAD UR 24HR,84.0,54.6,0.95,84.0,60
HCPCS,83655QW,ASSAY OF LEAD,,,13.57,13.57,1
HCPCS,83661,L/S RATIO FETAL LUNG,,,21.99,90.11,21
HCPCS,83661,L/s ratio fetal lung,,,14.4,16.68,8
HCPCS,83662,FOAM STABILITY FETAL LUNG,,,18.91,77.49,21
HCPCS,83662,Foam stability fetal lung,,,14.4,16.68,8
HCPCS,83663,FLUORO POLARIZE FETAL LUNG,,,18.91,77.49,21
HCPCS,83663,Fluoro polarize fetal lung,,,14.4,16.68,8
HCPCS,83664,LAMELLAR BODY COUNT,133.0,86.45,0.95,133.0,60
HCPCS,83670,ASSAY OF LAP ENZYME,,,9.81,43.35,21
HCPCS,83670,Assay of lap enzyme,,,9.33,10.8,8
HCPCS,83690,LIPASE ASSAY,48.0,31.2,0.95,48.0,60
HCPCS,83695,LIPOPROTEIN (A),99.0,64.35,0.95,99.0,60
HCPCS,83695,LP (A),99.0,64.35,0.95,99.0,60
HCPCS,83698,LP-PLA2 ACTIVITY,320.0,208.0,0.95,320.0,60
HCPCS,83700,LIPOPROTEIN ELECTROPHOR,78.0,50.7,0.95,78.0,60
HCPCS,83701,HDL CHOL SUBFRACTIONS,234.0,152.1,0.95,234.0,60
HCPCS,83704,*LIPOPROTEIN MR SPECTROSCOPY,236.0,153.4,0.95,236.0,60
HCPCS,83704,NMRLIPO PARTICLE QT,236.0,153.4,0.95,236.0,60
HCPCS,83718,ASSAY OF LIPOPROTEIN,,,9.17,9.17,1
HCPCS,83718,HDL CHOLESTEROL DIR ASSAY,57.0,37.05,0.95,57.0,60
HCPCS,83718QW,ASSAY OF LIPOPROTEIN,,,9.17,9.17,1
HCPCS,83719,ASSAY OF BLOOD LIPOPROTEIN,,,12.75,52.25,21
HCPCS,83719,Assay of blood lipoprotein,,,14.4,16.68,8
HCPCS,83721,ASSAY OF BLOOD LIPOPROTEIN,,,11.76,11.76,1
HCPCS,83721,LDL CHOLESTE,72.0,46.8,0.95,72.0,60
HCPCS,83721,LDL CHOLESTEROL DIR ASSAY,72.0,46.8,0.95,72.0,60
HCPCS,83721,OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL),72.0,46.8,0.95,72.0,60
HCPCS,83721QW,ASSAY OF BLOOD LIPOPROTEIN,,,11.76,11.76,1
HCPCS,83722,LIPOPRTN DIR MEAS SD LDL CHL,,,34.19,140.1,21
HCPCS,83722,Lipoprtn dir meas sd ldl chl,,,16.56,19.17,8
HCPCS,83727,ASSAY OF LRH HORMONE,,,17.19,75.88,21
HCPCS,83727,Assay of lrh hormone,,,17.46,20.22,8
HCPCS,83735,%STCATH MAGNESIUM,46.0,29.9,0.95,46.0,60
HCPCS,83735,MAG ASSAY,46.0,29.9,0.95,46.0,60
HCPCS,83735,MAGNESIUM,46.0,29.9,0.95,46.0,120
HCPCS,83735,MAGNESIUM RBC,46.0,29.9,0.95,46.0,60
HCPCS,83775,ASSAY MALATE DEHYDROGENASE,,,7.37,32.44,21
HCPCS,83775,Assay malate dehydrogenase,,,9.33,10.8,8
HCPCS,83785,MANGANESE,184.0,119.6,0.95,184.0,60
HCPCS,83785,MANGANESE BLOOD,184.0,119.6,0.95,184.0,60
HCPCS,83785,MANGANESE URINE,184.0,119.6,0.95,184.0,60
HCPCS,83788,MASS SPECTROMETRY QUAL,,,139.04,139.04,1
HCPCS,83789,ATMS MASS SPEC QUAL,166.0,107.9,0.95,166.0,60
HCPCS,83789,BILE ACIDS FRACTIONATED,166.0,107.9,0.95,166.0,60
HCPCS,83789,"GFR, RENAL FUNCTION",166.0,107.9,0.95,166.0,60
HCPCS,83789,PLTHY MASS SPEC QUANT,166.0,107.9,0.95,166.0,60
HCPCS,83789,SILVER UR QUANT,166.0,107.9,0.95,166.0,60
HCPCS,83805,ASSAY OF MEPROBAMATE,,,77.72,77.72,1
HCPCS,83825,%UTXM3 MERCURY,112.0,72.8,0.95,112.0,60
HCPCS,83825,MERCURY QUANT,112.0,72.8,0.95,112.0,60
HCPCS,83825,MERCURY QUANT ASSAY,112.0,72.8,0.95,112.0,60
HCPCS,83825,MERCURY URINE,112.0,72.8,0.95,112.0,60
HCPCS,83835,METANEPHRINES ASSAY,117.0,76.05,0.95,130.46,60
HCPCS,83835,METANEPHRINES URINE,117.0,76.05,0.95,130.46,60
HCPCS,83840,ASSAY OF METHADONE,,,28.71,28.71,1
HCPCS,83857,ASSAY OF METHEMALBUMIN,,,10.74,179.72,21
HCPCS,83857,Assay of methemalbumin,,,9.33,10.8,8
HCPCS,83858,ASSAY OF METHSUXIMIDE,,,65.27,65.27,1
HCPCS,83861,MICROFLUID ANALY TEARS,,,22.48,92.12,22
HCPCS,83861,Microfluid analy tears,,,14.4,16.68,8
HCPCS,83861QW,MICROFLUID ANALY TEARS,,,25.19,25.19,1
HCPCS,83864,MUCOPOLYSACCHARIDES MG/MMOL CRT,197.0,128.05,0.95,197.0,60
HCPCS,83866,MUCOPOLYSACCHARIDES SCREEN,,,43.39,43.39,1
HCPCS,83872,ASSAY SYNOVIAL FLUID MUCIN,,,5.86,24.01,21
HCPCS,83872,Assay synovial fluid mucin,,,9.33,10.8,8
HCPCS,83873,MYELIN BASIC PROTEIN,119.0,77.35,0.95,119.0,60
HCPCS,83874,MYOGLOBIN ASSAY,89.0,57.85,0.95,89.0,60
HCPCS,83874,MYOGLOBIN BLOOD,89.0,57.85,0.95,89.0,60
HCPCS,83874,MYOGLOBIN URINE,89.0,57.85,0.95,89.0,60
HCPCS,83876,MYELOPEROXIDASE (MPO),351.0,228.15,0.95,351.0,60
HCPCS,83880,ASSAY OF NATRIURETIC PEPTIDE,,,43.99,43.99,1
HCPCS,83880,B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB),271.0,176.15,0.95,271.0,60
HCPCS,83880,NATRIURETIC PEPTIDE,271.0,176.15,1.1,271.0,32
HCPCS,83880,NATRIURETIC PEPTIDE ASSAY,271.0,176.15,0.95,271.0,60
HCPCS,83880,NT PRO BNP,271.0,176.15,0.95,271.0,60
HCPCS,83880QW,ASSAY OF NATRIURETIC PEPTIDE,,,43.99,43.99,1
HCPCS,83883,%FSII NEPHELOMETRY EA,94.0,61.1,0.95,94.0,60
HCPCS,83883,%LIVFIB NEPHELOMETRY,94.0,61.1,0.95,94.0,60
HCPCS,83883,CHRONIC VIRAL HEPATITIS NEPHELOMETRY (ARUP),94.0,61.1,0.95,94.0,60
HCPCS,83883,KAPPA & LAMBDA SERUM X2,94.0,61.1,0.95,94.0,60
HCPCS,83883,"KAPPA FREE, URINE",94.0,61.1,0.95,94.0,60
HCPCS,83883,KAPPA/LAMDA FR LT CH UR,94.0,61.1,0.95,94.0,60
HCPCS,83883,"LAMBDA FREE, URINE",94.0,61.1,0.95,94.0,60
HCPCS,83883,RETINOL BINDING PROTEIN,94.0,61.1,0.95,94.0,60
HCPCS,83884,NEUROFILAMENT LIGHT (NFL),119.0,77.35,0.95,476.29,55
HCPCS,83885,NICKEL SERUM,169.0,109.85,0.95,169.0,60
HCPCS,83887,ASSAY OF NICOTINE,,,53.0,53.0,1
HCPCS,83890,MOLECULE ISOLATE,,,110.4,110.4,1
HCPCS,83891,MOLECULE ISOLATE NUCLEIC,,,125.96,125.96,1
HCPCS,83892,MOLECULAR DIAGNOSTICS,,,42.16,42.16,1
HCPCS,83893,MOLECULE DOT/SLOT/BLOT,,,89.14,89.14,1
HCPCS,83894,MOLECULE GEL ELECTROPHOR,,,77.32,77.32,1
HCPCS,83896,MOLECULAR DIAGNOSTICS,,,33.27,33.27,1
HCPCS,83897,MOLECULE NUCLEIC TRANSFER,,,128.08,128.08,1
HCPCS,83898,MOLECULE NUCLEIC AMPLI EACH,,,175.82,175.82,1
HCPCS,83900,MOLECULE NUCLEIC AMPLI 2 SEQ,,,216.58,216.58,1
HCPCS,83901,MOLECULE NUCLEIC AMPLI ADDON,,,58.33,58.33,1
HCPCS,83902,MOLECULAR DIAGNOSTICS,,,121.09,121.09,1
HCPCS,83903,MOLECULE MUTATION SCAN,,,178.99,178.99,1
HCPCS,83904,MOLECULE MUTATION IDENTIFY,,,73.29,73.29,1
HCPCS,83905,MOLECULE MUTATION IDENTIFY,,,14.77,14.77,1
HCPCS,83906,MOLECULE MUTATION IDENTIFY,,,188.8,188.8,1
HCPCS,83907,LYSE CELLS FOR NUCLEIC EXT,,,80.4,80.4,1
HCPCS,83908,NUCLEIC ACID SIGNAL AMPLI,,,85.99,85.99,1
HCPCS,83909,NUCLEIC ACID HIGH RESOLUTE,,,554.03,554.03,1
HCPCS,83912,GENETIC EXAMINATION,,,134.73,134.73,1
HCPCS,83913,MOLECULAR RNA STABILIZATION,,,77.2,77.2,1
HCPCS,83914,MUTATION IDENT OLA/SBCE/ASPE,,,41.01,41.01,1
HCPCS,83915,NUCLEOTIDASE-5,77.0,50.05,0.95,77.0,60
HCPCS,83916,OLIGOCLONAL BAND TEST,189.0,122.85,0.95,189.0,60
HCPCS,83918,%UORA ORG ACIDS UR QNT,163.0,105.95,0.95,163.0,60
HCPCS,83918,ORGANIC ACIDS QUANT EA,163.0,105.95,0.95,163.0,60
HCPCS,83919,%GMAPS ORGANIC ACIDS QL,114.0,74.1,0.95,126.71,60
HCPCS,83921,3-METHYLGLUTACONIC ACID,146.0,94.9,0.95,146.0,60
HCPCS,83921,METHYLMALONIC ACID BL,146.0,94.9,0.95,146.0,60
HCPCS,83921,METHYLMALONIC ACID URINE,146.0,94.9,0.95,146.0,60
HCPCS,83921,ORGANIC ACID SNGL QUANT,146.0,94.9,0.95,146.0,60
HCPCS,83921,ORGANIC ACID SNGL QUANT-LABCORP,146.0,94.9,0.95,146.0,60
HCPCS,83925,ASSAY OF OPIATES,,,48.79,48.79,1
HCPCS,83930,OSMOLALITY BLOOD ASSAY,46.0,29.9,0.95,46.0,60
HCPCS,83930,"OSMOLALITY, BODY FLUID",46.0,29.9,0.95,46.0,60
HCPCS,83935,OSMOLALITY URINE ASSAY,47.0,30.55,0.95,47.0,60
HCPCS,83937,OSTEOCALCIN,206.0,133.9,0.95,206.0,60
HCPCS,83945,%GMAPS OXALATE,100.0,65.0,0.95,100.0,60
HCPCS,83945,*OXALATE ASSAY,100.0,65.0,0.95,100.0,60
HCPCS,83945,OXALATE URINE,100.0,65.0,0.95,100.0,60
HCPCS,83950,HER-2/NEU SERUM,444.0,288.6,0.95,444.0,60
HCPCS,83951,PIVKA II,444.0,288.6,0.95,444.0,60
HCPCS,83970,PARATHYROID HORMONE ASSAY,285.0,185.25,0.95,285.0,120
HCPCS,83970,PARATHYROID HORMONE INTACT,285.0,185.25,0.95,285.0,60
HCPCS,83986,"%SSAT24 PH, UR",25.0,16.25,0.95,27.56,60
HCPCS,83986,ASSAY PH BODY FLUID NOS,,,4.01,4.01,1
HCPCS,83986,PH BODY FLUID EXCEPT BLD (POINT OF CARE),25.0,16.25,0.95,27.56,60
HCPCS,83986,PH BODY FLUID NOT ELSEWHERE SPECIFIED,25.0,16.25,1.1,25.0,32
HCPCS,83986,"PH BODY FLUID, NES",25.0,16.25,0.95,27.56,60
HCPCS,83986,"PH BODY FLUID, NES (POINT OF CARE LAB)",25.0,16.25,0.95,27.56,60
HCPCS,83986QW,ASSAY PH BODY FLUID NOS,,,4.01,4.01,1
HCPCS,83987,EXHALED BREATH CONDENSATE,,,3.58,71.37,21
HCPCS,83987,Exhaled breath condensate,,,9.33,10.8,8
HCPCS,83992,ASSAY FOR PHENCYCLIDINE,,,93.42,95.51,2
HCPCS,83992,Assay for phencyclidine,,,12.86,14.89,8
HCPCS,83993,ASSAY FOR CALPROTECTIN FECAL,135.0,87.75,0.95,151.13,60
HCPCS,84022,ASSAY OF PHENOTHIAZINE,,,68.69,68.69,1
HCPCS,84030,%NEO PHENYLALANINE,38.0,24.7,0.95,39.14,60
HCPCS,84030,PHENYLALANINE (PKU) EA,38.0,24.7,0.95,39.14,60
HCPCS,84035,%GMAPS PHENYLKETONES,27.0,17.55,0.95,27.0,60
HCPCS,84060,ACID PHOSPHATASE TOTL,53.0,34.45,0.95,53.0,60
HCPCS,84061,Phosphatase forensic exam,,,34.8,34.8,1
HCPCS,84066,PROSTATIC ACID PHOS,67.0,43.55,0.95,67.0,60
HCPCS,84075,*ALKA PHOSPHTAS ASSAY,36.0,23.4,0.95,36.0,60
HCPCS,84075,ALKA PHOSPHTA,36.0,23.4,0.95,36.0,60
HCPCS,84075,ASSAY ALKALINE PHOSPHATASE,,,5.8,5.8,1
HCPCS,84075QW,ASSAY ALKALINE PHOSPHATASE,,,5.8,5.8,1
HCPCS,84078,ASSAY ALKALINE PHOSPHATASE,,,8.26,67.19,21
HCPCS,84078,Assay alkaline phosphatase,,,9.33,10.8,8
HCPCS,84080,ALK-P BONE SPECIFIC,102.0,66.3,0.95,102.0,60
HCPCS,84080,ALKA PHOSPHTAS ISOENZYME,102.0,66.3,0.95,102.0,60
HCPCS,84081,ASSAY PHOSPHATIDYLGLYCEROL,,,16.52,77.56,21
HCPCS,84081,Assay phosphatidylglycerol,,,14.4,16.68,8
HCPCS,84085,ASSAY OF RBC PG6D ENZYME,,,9.44,38.68,21
HCPCS,84085,Assay of rbc pg6d enzyme,,,9.33,10.8,8
HCPCS,84087,ASSAY PHOSPHOHEXOSE ENZYMES,,,10.73,45.51,21
HCPCS,84087,Assay phosphohexose enzymes,,,9.33,10.8,8
HCPCS,84100,%STCATH PHOSPOROUS,33.0,21.45,0.95,33.0,60
HCPCS,84100,"INORGANIC PHOSPHATE, SERUM (TRPHOS)",33.0,21.45,0.95,33.0,60
HCPCS,84100,PHOSPHOROUS ASSAY,33.0,21.45,0.95,33.0,60
HCPCS,84105,"INORGANIC PHOSPHATE, URINE (TRPHOS)",40.0,26.0,0.95,40.0,60
HCPCS,84105,PHOSPHOROUS URINE ASSAY,40.0,26.0,0.95,40.0,60
HCPCS,84106,PORPHOBILINOGEN UR SCN,40.0,26.0,0.95,40.0,60
HCPCS,84110,"PORPHOBILINOGEN, QN, RANDOM UR",58.0,37.7,0.95,58.09,60
HCPCS,84112,ACTIM*ACTIM PROM,677.0,440.05,0.95,677.0,60
HCPCS,84112,PREMATURE RUPTURE MEMBRANES,677.0,440.05,0.95,677.0,60
HCPCS,84112,ROM RUPTURE OF FETAL MEMBRANES,677.0,440.05,0.95,677.0,60
HCPCS,84119,%PORPHYRIN SCREEN,92.0,59.8,0.95,92.0,60
HCPCS,84120,PORPHYRINS URINE,101.0,65.65,0.95,113.27,60
HCPCS,84126,HEMOQUANT FECAL,270.0,175.5,0.95,270.0,60
HCPCS,84126,PORPHYRINS STOOL,270.0,175.5,0.95,270.0,60
HCPCS,84126,STFRTP ASSAY OF FECES PORPHYRINS,270.0,175.5,0.95,270.0,60
HCPCS,84127,ASSAY OF FECES PORPHYRINS,,,51.32,51.32,1
HCPCS,84132,*POTASSIUM SERUM,33.0,21.45,0.95,33.0,60
HCPCS,84132,ASSAY OF SERUM POTASSIUM,,,5.33,5.33,1
HCPCS,84132,POTASSIUM,33.0,21.45,0.95,33.0,60
HCPCS,84132,POTASSIUM (POINT OF CARE LAB),33.0,21.45,0.95,33.0,60
HCPCS,84132,POTASSIUM SERUM PLASMA/WHOLE BLOOD,33.0,21.45,1.1,33.0,32
HCPCS,84132QW,ASSAY OF SERUM POTASSIUM,,,5.33,5.33,1
HCPCS,84133,K URINE ASSAY,33.0,21.45,0.95,33.0,120
HCPCS,84134,PREALBUMIN ASSAY,101.0,65.65,0.95,101.0,60
HCPCS,84135,ASSAY OF PREGNANEDIOL,,,21.27,87.16,21
HCPCS,84135,Assay of pregnanediol,,,17.46,20.22,8
HCPCS,84138,ASSAY OF PREGNANETRIOL,,,21.05,86.26,21
HCPCS,84138,Assay of pregnanetriol,,,17.46,20.22,8
HCPCS,84140,PREGNENOLONE SERUM,143.0,92.95,0.95,143.0,60
HCPCS,84143,CAHSP ASSAY OF 17-HYDROXYPREGNENO,157.0,102.05,0.95,157.0,60
HCPCS,84143,HYDROXYPREGNENELONE-17,157.0,102.05,0.95,157.0,60
HCPCS,84144,CAHSP ASSAY OF PROGESTERONE,144.0,93.6,0.95,144.0,60
HCPCS,84144,PROGESTERONE,144.0,93.6,0.95,144.0,60
HCPCS,84145,PROCALCITONIN,188.0,122.2,0.95,188.0,60
HCPCS,84146,*PROLACTIN ASSAY,134.0,87.1,0.95,134.0,60
HCPCS,84146,PROLACTIN,134.0,87.1,0.95,134.0,60
HCPCS,84146,PROLACTIN MACROADENOMA,134.0,87.1,0.95,134.0,60
HCPCS,84150,ASSAY OF PROSTAGLANDIN,,,41.77,171.17,21
HCPCS,84150,Assay of prostaglandin,,,21.97,25.44,8
HCPCS,84152,ASSAY OF PSA COMPLEXED,,,18.39,81.13,21
HCPCS,84152,Assay of psa complexed,,,14.4,16.68,8
HCPCS,84153,%PHI PROST SPEC AG TOT,127.0,82.55,0.95,127.0,60
HCPCS,84153,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,127.0,82.55,1.1,127.0,32
HCPCS,84153,PHI PROST SPEC AG TOT,127.0,82.55,0.95,127.0,60
HCPCS,84153,PROSTATIC SPECIFIC AG,127.0,82.55,0.95,127.0,60
HCPCS,84153,PSA (SEND OUT),127.0,82.55,0.95,127.0,60
HCPCS,84153,PSA DIAGNOSTIC,127.0,82.55,0.95,127.0,60
HCPCS,84153,PSA SCREEN,127.0,82.55,0.95,127.0,60
HCPCS,84153,PSA SCREENING,127.0,82.55,0.95,127.0,60
HCPCS,84154,%PHI PROST SPEC AG FREE,127.0,82.55,0.95,127.0,60
HCPCS,84154,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,127.0,82.55,1.1,127.0,32
HCPCS,84154,PSA FREE,127.0,82.55,0.95,127.0,120
HCPCS,84155,ASSAY OF PROTEIN SERUM,,,4.11,4.11,1
HCPCS,84155,PROTEIN TOTAL SERUM ASSAY,25.0,16.25,0.95,25.0,60
HCPCS,84155QW,ASSAY OF PROTEIN SERUM,,,4.11,4.11,1
HCPCS,84156,*PROTEIN TOTAL URINE ASSAY,25.0,16.25,0.95,25.0,120
HCPCS,84156,UFLCKL PROTEIN UR,25.0,16.25,0.95,25.0,60
HCPCS,84157,%CSFPE PROTEIN TOTAL CSF,28.0,18.2,0.95,28.0,60
HCPCS,84157,ASSAY OF PROTEIN OTHER,,,4.48,4.48,1
HCPCS,84157,CPALMT ASSAY OF PROTEIN OTHER,28.0,18.2,0.95,28.0,60
HCPCS,84157,FAOACM ASSAY OF PROTEIN OTHER,28.0,18.2,0.95,28.0,60
HCPCS,84157,FAOSCM ASSAY OF PROTEIN OTHER,28.0,18.2,0.95,28.0,60
HCPCS,84157,PROTEIN TOTAL OTHER ASSAY,28.0,18.2,0.95,28.0,60
HCPCS,84157,"PROTEIN TOTAL, OTHER SOURCE",28.0,18.2,0.95,28.0,60
HCPCS,84157QW,ASSAY OF PROTEIN OTHER,,,4.48,4.48,1
HCPCS,84160,ASSAY OF PROTEIN ANY SOURCE,,,5.61,22.99,21
HCPCS,84160,Assay of protein any source,,,9.33,10.8,8
HCPCS,84163,%1ST TRI PAPP-A,104.0,67.6,0.95,115.95,60
HCPCS,84163,PAPP-A,104.0,67.6,0.95,115.95,60
HCPCS,84165,PROTEIN ELECPHRSIS SERUM,74.0,48.1,0.95,74.0,60
HCPCS,84166,%CSFPE PROT ELEC SCF QT,123.0,79.95,0.95,123.0,60
HCPCS,84166,*PROTEIN ELECPHRSIS OTHER,123.0,79.95,0.95,123.0,60
HCPCS,84166,PROTEIN E-PHORESIS/URINE/CSF,123.0,79.95,0.95,123.0,60
HCPCS,84166,PROTEIN ELECTRO.FLUID QT,123.0,79.95,0.95,123.0,60
HCPCS,84181,GBM ANTIBODY,118.0,76.7,0.95,118.0,60
HCPCS,84181,HUWB WESTERN BLOT TEST,118.0,76.7,0.95,118.0,60
HCPCS,84181,INNER EAR 68KD ANTIBODY,118.0,76.7,0.95,118.0,60
HCPCS,84181,WESTERN BLOT BLOOD OR BODY FL,118.0,76.7,0.95,118.0,60
HCPCS,84182,%CJD WESTERN BLOT,202.0,131.3,0.95,202.0,60
HCPCS,84182,CRMP 5 IGG WEST BLOT CSF,202.0,131.3,0.95,202.0,60
HCPCS,84182,CRMP-5 WB BAND ID,202.0,131.3,0.95,202.0,60
HCPCS,84182,IMMUNOBLOT (POLMYO),202.0,131.3,0.95,202.0,60
HCPCS,84182,"MA2/TA ANTIBODY, IGG CSF",202.0,131.3,0.95,202.0,60
HCPCS,84182,"MA2/TA ANTIBODY, IGG SERUM",202.0,131.3,0.95,202.0,60
HCPCS,84182,MLPTHY CRMP-5 WB,202.0,131.3,0.95,202.0,60
HCPCS,84182,"NEURONAL AB (TR/DNER) IGG, CSF",202.0,131.3,0.95,202.0,60
HCPCS,84182,"NEURONAL AB (TR/DNER) IGG, SER",202.0,131.3,0.95,202.0,60
HCPCS,84182,"NEURONAL NUCLEAR AB (HU) IGG, IB, CSF",202.0,131.3,0.95,202.0,60
HCPCS,84182,"NEURONAL NUCLEAR AB (HU) IGG, IB, SERUM",202.0,131.3,0.95,202.0,60
HCPCS,84182,PARA AB WB BND ID,202.0,131.3,0.95,202.0,60
HCPCS,84182,PARA AB WB CSF,202.0,131.3,0.95,202.0,60
HCPCS,84182,PROT WB IMMUNO (MYOSPL),202.0,131.3,0.95,202.0,60
HCPCS,84182,RFLX IMBLOT PARNEO AIDYSA,202.0,131.3,0.95,202.0,60
HCPCS,84202,%OSHA ZPP,99.0,64.35,0.95,110.47,60
HCPCS,84202,PROTOPORPHYRIN RBC QUANT,99.0,64.35,0.95,110.47,60
HCPCS,84202,ZINC PROTOPORPHYRINS,99.0,64.35,0.95,110.47,60
HCPCS,84203,TEST RBC PROTOPORPHYRIN,,,9.74,39.91,21
HCPCS,84203,Test rbc protoporphyrin,,,9.33,10.8,8
HCPCS,84206,PROINSULIN,184.0,119.6,0.95,184.0,60
HCPCS,84206,PROINSULIN SERUM,184.0,119.6,0.95,184.0,60
HCPCS,84207,%GMAPS VIT B-6,194.0,126.1,0.95,194.0,60
HCPCS,84207,VITAMIN B6 PLASMA,194.0,126.1,0.95,194.0,60
HCPCS,84210,%GMAPS PYRUVATE,100.0,65.0,0.95,100.0,60
HCPCS,84210,PYRUVIC ACID CSF,100.0,65.0,0.95,100.0,60
HCPCS,84220,PYRUVATE KINASE,65.0,42.25,0.95,65.0,60
HCPCS,84228,ASSAY OF QUININE,,,11.63,47.66,21
HCPCS,84228,Assay of quinine,,,14.54,16.83,8
HCPCS,84233,ASSAY OF ESTROGEN,,,87.88,360.11,21
HCPCS,84233,Assay of estrogen,,,21.97,25.44,8
HCPCS,84234,ASSAY OF PROGESTERONE,,,64.88,286.43,21
HCPCS,84234,Assay of progesterone,,,21.97,25.44,8
HCPCS,84235,ASSAY OF ENDOCRINE HORMONE,,,71.23,291.89,21
HCPCS,84235,Assay of endocrine hormone,,,21.97,25.44,8
HCPCS,84238,ASSAY NONENDOCRINE RECEPTOR,252.0,163.8,0.95,252.0,60
HCPCS,84238,NONENDOCRINE RECEPTOR ASSAY,252.0,163.8,0.95,252.0,60
HCPCS,84238,SOLUBLE TRANSFERRINE RECEPTOR,252.0,163.8,0.95,252.0,60
HCPCS,84244,RENIN PLASMA,152.0,98.8,0.95,152.0,60
HCPCS,84252,%GMAPS VITAMIN B-2,140.0,91.0,0.95,140.0,60
HCPCS,84252,VIT B-2 ASSAY,140.0,91.0,0.95,140.0,60
HCPCS,84255,SELENIUM BLOOD,176.0,114.4,0.95,176.0,60
HCPCS,84260,%GMAPS SEROTONIN,214.0,139.1,0.95,214.0,60
HCPCS,84260,SEROTONIN SERUM,214.0,139.1,0.95,214.0,60
HCPCS,84260,SEROTONIN WHOLE BLOOD,214.0,139.1,0.95,214.0,60
HCPCS,84270,*SEX HORMONE BINDING GLOBULIN,150.0,97.5,0.95,150.0,60
HCPCS,84270,BTSTFC ASSAY OF SEX HORMONE GLOBUL,150.0,97.5,0.95,150.0,60
HCPCS,84270,SEX-HORMONE BIND GLOBULIN,150.0,97.5,0.95,150.0,60
HCPCS,84275,LIPID ASSOC SIALIC ACID,93.0,60.45,0.95,103.46,60
HCPCS,84285,SILICON SERUM,174.0,113.1,0.95,174.0,60
HCPCS,84295,*SODIUM BLOOD,33.0,21.45,0.95,33.0,60
HCPCS,84295,ASSAY OF SERUM SODIUM,,,5.39,5.39,1
HCPCS,84295,SODIUM,33.0,21.45,0.95,33.0,60
HCPCS,84295,SODIUM BLOOD (POINT OF CARE LAB),33.0,21.45,0.95,33.0,60
HCPCS,84295,SODIUM SERUM PLASMA OR WHOLE BLOOD,33.0,21.45,1.1,33.0,32
HCPCS,84295QW,ASSAY OF SERUM SODIUM,,,5.39,5.39,1
HCPCS,84300,*NA URINE ASSAY,35.0,22.75,0.95,35.0,60
HCPCS,84300,NA URINE ASSAY,35.0,22.75,0.95,35.0,60
HCPCS,84302,SODIUM FLUID,34.0,22.1,0.95,34.0,60
HCPCS,84305,INSULIN LIK GR FAC 1,147.0,95.55,0.95,147.0,60
HCPCS,84307,SOMATOSTATIN,126.0,81.9,0.95,140.77,60
HCPCS,84311,"ADENOSINE DEAMINASE, PF",56.0,36.4,0.95,56.0,60
HCPCS,84311,"ADENOSINE DEAMINASE, RBC",56.0,36.4,0.95,56.0,60
HCPCS,84311,"ADENOSINE DEAMINASE, SER",56.0,36.4,0.95,56.0,60
HCPCS,84311,"CHYMOTRYPSIN, STOOL",56.0,36.4,0.95,56.0,60
HCPCS,84311,FAOACM SPECTROPHOTOMETRY X8,56.0,36.4,0.95,56.0,60
HCPCS,84311,FAOSCM SPECTROPHOTOMETRY X4,56.0,36.4,0.95,56.0,60
HCPCS,84311,PBG DEAMINASE,56.0,36.4,0.95,56.0,60
HCPCS,84311,PHOSPHOLIPIDS,56.0,36.4,0.95,56.0,60
HCPCS,84311,PORPHYRINS PLASMA,56.0,36.4,0.95,56.0,60
HCPCS,84311,PORPHYRINS SERUM TOTAL,56.0,36.4,0.95,56.0,60
HCPCS,84315,SPECIFIC GRAVITY BDY FLD,23.0,14.95,0.95,23.0,60
HCPCS,84375,%CDG SUGAR CHROMATOGR,269.0,174.85,0.95,269.0,60
HCPCS,84375,%NCDG SUGAR CHROMATOGR,269.0,174.85,0.95,269.0,60
HCPCS,84376,SUGARS SINGLE QUAL,,,5.5,42.35,21
HCPCS,84376,Sugars single qual,,,9.33,10.8,8
HCPCS,84377,%GMAPS SUGARS QL,38.0,24.7,0.95,38.0,60
HCPCS,84377,"CARBOHYDRATE, UR",38.0,24.7,0.95,38.0,60
HCPCS,84377,SUGARS MULT QL EA,38.0,24.7,0.95,38.0,60
HCPCS,84378,"15AGTL - 1,5 ANHYDROGLUCITOL",80.0,52.0,0.95,80.0,60
HCPCS,84378,GALACTOSE-1-PHOSPHATE,80.0,52.0,0.95,80.0,60
HCPCS,84378,GLYCOMARK,80.0,52.0,0.95,80.0,60
HCPCS,84379,"CARBOHYDRATE, UR",80.0,52.0,0.95,80.0,60
HCPCS,84392,USO4 ASSAY OF URINE SULFATE,38.0,24.7,0.95,38.0,60
HCPCS,84393,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",121.0,78.65,0.95,528.29,110
HCPCS,84394,"TAU, TOTAL (TTAU)",121.0,78.65,0.95,528.29,55
HCPCS,84402,BTSTFC TESTOSTERONE FR,176.0,114.4,0.95,176.0,60
HCPCS,84402,FTTESM TESTO FR AD MALE,176.0,114.4,0.95,176.0,60
HCPCS,84402,TESTOSTERONE FR AD MALE,176.0,114.4,0.95,176.0,60
HCPCS,84402,TESTOSTERONE FREE,176.0,114.4,0.95,176.0,60
HCPCS,84402,"TESTOSTERONE, FREE, SERUM",176.0,114.4,0.95,176.0,60
HCPCS,84403,*TESTOSTERONE TOTAL ASSAY,178.0,115.7,0.95,178.0,60
HCPCS,84403,ASSAY OF TESTOSTERONE TOTAL,178.0,115.7,1.1,178.0,32
HCPCS,84403,CAHSP ASSAY OF TOTAL TESTOSTERONE,178.0,115.7,0.95,178.0,60
HCPCS,84403,FTTESM TESTOSTERONE,178.0,115.7,0.95,178.0,60
HCPCS,84403,TESTOSTERONE TOTAL ASSAY,178.0,115.7,0.95,178.0,120
HCPCS,84403,"TESTOSTERONE, TOTAL, SERUM",178.0,115.7,0.95,178.0,60
HCPCS,84410,TESTOSTERONE BIOAVAILABLE,,,51.28,210.14,21
HCPCS,84410,Testosterone bioavailable,,,21.97,25.44,8
HCPCS,84425,%GMAPS VIT B-1,146.0,94.9,0.95,146.0,60
HCPCS,84425,VIT B-1 ASSAY,146.0,94.9,0.95,146.0,60
HCPCS,84425,VITAMIN B WHOLE BLOOD,146.0,94.9,0.95,146.0,60
HCPCS,84425,VITAMIN B1 PLASMA,146.0,94.9,0.95,146.0,60
HCPCS,84430,THIOCYANATE,80.0,52.0,0.95,80.0,60
HCPCS,84431,THROMBOXANE URINE,,,35.11,143.87,21
HCPCS,84431,Thromboxane urine,,,16.56,19.17,8
HCPCS,84432,THYROGLOB AB INTERFERENCE,111.0,72.15,0.95,111.0,60
HCPCS,84432,THYROGLOBULIN,111.0,72.15,0.95,111.0,120
HCPCS,84432,THYROGLOBULIN FLUID,111.0,72.15,0.95,111.0,60
HCPCS,84433,ASY THIOPURIN S-MTHYLTRNSFRS,,,22.17,90.85,19
HCPCS,84433,Asy thiopurin s-mthyltrnsfrs,,,14.4,16.68,8
HCPCS,84436,*THYROXINE TOTAL ASSAY,47.0,30.55,0.95,47.0,60
HCPCS,84436,T4,47.0,30.55,0.95,47.0,60
HCPCS,84436,THYROXINE TOTAL ASSAY,47.0,30.55,0.95,47.0,60
HCPCS,84437,ASSAY OF NEONATAL THYROXINE,,,6.47,28.49,21
HCPCS,84437,Assay of neonatal thyroxine,,,17.46,20.22,8
HCPCS,84439,THYROXIN FREE,62.0,40.3,0.95,62.0,60
HCPCS,84439,THYROXINE FREE ASSAY,62.0,40.3,0.95,62.0,60
HCPCS,84442,THYROXINE BIND GLOBULIN,102.0,66.3,0.95,102.0,60
HCPCS,84443,%NEO TSH,116.0,75.4,0.95,116.0,60
HCPCS,84443,ASSAY THYROID STIM HORMONE,,,18.82,18.82,1
HCPCS,84443,THYROID STIMULATING HORMONE (TSH),116.0,75.4,0.95,116.0,60
HCPCS,84443,TSH,116.0,75.4,0.95,116.0,120
HCPCS,84443QW,ASSAY THYROID STIM HORMONE,,,18.82,18.82,1
HCPCS,84445,%TRAB THYROID STIM IMMUN,351.0,228.15,0.95,351.0,60
HCPCS,84445,*TSI ASSAY,351.0,228.15,0.95,351.0,60
HCPCS,84446,%GMAPS VIT E,98.0,63.7,0.95,102.87,60
HCPCS,84446,VIT E ALPHA-TOCO TEST,98.0,63.7,0.95,102.87,60
HCPCS,84446,VITAMIN E,98.0,63.7,0.95,102.87,60
HCPCS,84449,CORTICOSTEROID-BINDING GLOGULIN,124.0,80.6,0.95,124.0,60
HCPCS,84450,"ASPARTATE AMINOTRANSFERASE, FIBROMETER",36.0,23.4,0.95,36.0,60
HCPCS,84450,AST/SGOT,36.0,23.4,0.95,36.0,60
HCPCS,84450,TRANSFERASE (AST) (SGOT),,,5.8,5.8,1
HCPCS,84450QW,TRANSFERASE (AST) (SGOT),,,5.8,5.8,1
HCPCS,84460,%LIVFIB ALANINE AMINO,37.0,24.05,0.95,37.0,60
HCPCS,84460,ALANINE AMINO (ALT) (SGPT),,,5.93,5.93,1
HCPCS,84460,"ALANINE AMINOTRANSFERASE, FIBROMETER",37.0,24.05,0.95,37.0,60
HCPCS,84460,ALT/SGPT,37.0,24.05,0.95,37.0,60
HCPCS,84460QW,ALANINE AMINO (ALT) (SGPT),,,5.93,5.93,1
HCPCS,84466,TRANSFERRIN,88.0,57.2,0.95,88.0,60
HCPCS,84478,ASSAY OF TRIGLYCERIDES,,,6.43,6.43,1
HCPCS,84478,TRIGLYCERIDES ASSAY,40.0,26.0,0.95,40.0,60
HCPCS,84478,TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH,40.0,26.0,0.95,40.0,60
HCPCS,84478QW,ASSAY OF TRIGLYCERIDES,,,6.43,6.43,1
HCPCS,84479,%T4TFI T4 UPTAKE,45.0,29.25,0.95,45.0,60
HCPCS,84479,T3 UPTAKE,45.0,29.25,0.95,45.0,60
HCPCS,84479,T3/T4 UPTAKE,45.0,29.25,0.95,45.0,60
HCPCS,84480,TRIIODOTHYRONINE TOTAL(TT-3),98.0,63.7,0.95,98.0,60
HCPCS,84481,T3 DIAL FREE,117.0,76.05,0.95,117.0,60
HCPCS,84481,T3 FREE,117.0,76.05,0.95,117.0,60
HCPCS,84481,TRIIODOTHYRONINE FREE(FT-3),117.0,76.05,0.95,117.0,60
HCPCS,84482,REVERSE T3,109.0,70.85,0.95,109.0,60
HCPCS,84484,TROPONIN I,86.0,55.9,0.95,86.0,60
HCPCS,84484,TROPONIN T,86.0,55.9,0.95,86.0,60
HCPCS,84485,ASSAY DUODENAL FLUID TRYPSIN,,,7.2,33.1,21
HCPCS,84485,Assay duodenal fluid trypsin,,,9.33,10.8,8
HCPCS,84488,TEST FECES FOR TRYPSIN,,,7.3,29.91,21
HCPCS,84488,Test feces for trypsin,,,9.33,10.8,8
HCPCS,84490,ASSAY OF FECES FOR TRYPSIN,,,9.93,40.69,21
HCPCS,84490,Assay of feces for trypsin,,,9.33,10.8,8
HCPCS,84510,%GMAPS TYROSINE,73.0,47.45,0.95,73.0,60
HCPCS,84510,"TYROSINE, PLASMA, EA",73.0,47.45,0.95,73.0,60
HCPCS,84512,ASSAY OF TROPONIN QUAL,,,10.09,41.35,21
HCPCS,84512,Assay of troponin qual,,,9.33,10.8,8
HCPCS,84520,ASSAY OF UREA NITROGEN,,,4.43,4.43,1
HCPCS,84520,ASSAY OF UREA NITROGEN QUANTITATIVE,27.0,17.55,1.1,27.0,32
HCPCS,84520,BUN,27.0,17.55,0.95,27.0,60
HCPCS,84520,I STAT BUN DETERMINATION (POINT OF CARE LAB),27.0,17.55,0.95,27.0,60
HCPCS,84520,"UREA NITROGEN, SERUM, FIBROMETER",27.0,17.55,0.95,27.0,60
HCPCS,84520,UREA NITROGEN; QUAN,27.0,17.55,0.95,27.0,60
HCPCS,84520QW,ASSAY OF UREA NITROGEN,,,4.43,4.43,1
HCPCS,84525,%GMAPS UREA NITROGEN,35.0,22.75,0.95,35.0,60
HCPCS,84540,UREA NITROGEN URINE ASSAY,38.0,24.7,0.95,38.0,60
HCPCS,84540,"UREA NITROGEN, U 24HR",38.0,24.7,0.95,38.0,60
HCPCS,84545,UREA-N CLEARANCE TEST,,,7.2,43.75,21
HCPCS,84545,Urea-n clearance test,,,9.33,10.8,8
HCPCS,84550,%GMAPS URIC ACID BLD,31.0,20.15,0.95,31.0,60
HCPCS,84550,ASSAY OF BLOOD/URIC ACID,,,5.06,5.06,1
HCPCS,84550,URIC ACID BLOOD ASSAY,31.0,20.15,0.95,31.0,60
HCPCS,84550QW,ASSAY OF BLOOD/URIC ACID,,,5.06,5.06,1
HCPCS,84560,URIC ACID BODY FLUID,35.0,22.75,0.95,35.0,60
HCPCS,84560,URIC ACID OTHER SOURCE ASSAY,35.0,22.75,0.95,35.0,60
HCPCS,84577,ASSAY OF FECES/UROBILINOGEN,,,7.59,68.84,21
HCPCS,84577,Assay of feces/urobilinogen,,,14.4,16.68,8
HCPCS,84578,TEST URINE UROBILINOGEN,,,4.47,52.94,21
HCPCS,84578,Test urine urobilinogen,,,9.33,10.8,8
HCPCS,84580,ASSAY OF URINE UROBILINOGEN,,,9.55,39.13,21
HCPCS,84580,Assay of urine urobilinogen,,,9.33,10.8,8
HCPCS,84583,ASSAY OF URINE UROBILINOGEN,,,6.05,24.79,21
HCPCS,84583,Assay of urine urobilinogen,,,9.33,10.8,8
HCPCS,84585,VMA URINE,107.0,69.55,0.95,119.32,60
HCPCS,84586,VIP,244.0,158.6,0.95,272.08,60
HCPCS,84588,"COPEPTIN PROAVP, PLASMA",234.0,152.1,0.95,234.0,60
HCPCS,84590,%GMAPS VIT A,80.0,52.0,0.95,89.35,60
HCPCS,84590,VIT A (RETINAL) TEST,80.0,52.0,0.95,89.35,60
HCPCS,84590,VITAMIN A LEVEL,80.0,52.0,0.95,89.35,60
HCPCS,84591,VITAMIN B3 (NIACIN AND METABOLITES),118.0,76.7,0.95,118.0,60
HCPCS,84591,VITAMIN B5,118.0,76.7,0.95,118.0,60
HCPCS,84591,VITAMIN B7 (BIOTIN),118.0,76.7,0.95,118.0,60
HCPCS,84591,VITAMIN NOS,118.0,76.7,0.95,118.0,60
HCPCS,84597,VITAMIN K,95.0,61.75,0.95,104.38,60
HCPCS,84600,METHYL ETHYL KETONE URIN,118.0,76.7,0.95,118.0,60
HCPCS,84600,PROPYLENE GLYCOL,118.0,76.7,0.95,118.0,60
HCPCS,84600,TOLUENE BLOOD,118.0,76.7,0.95,118.0,60
HCPCS,84600,VOLATILES ASSAY,118.0,76.7,0.95,118.0,60
HCPCS,84620,XYLOSE TOLERANCE TEST,,,12.91,52.9,21
HCPCS,84620,Xylose tolerance test,,,14.4,16.68,8
HCPCS,84630,ZINC BLOOD,79.0,51.35,0.95,87.67,60
HCPCS,84630,ZINC WHOL BLOOD,79.0,51.35,0.95,87.67,60
HCPCS,84630,"ZINC, URINE QUANTITATIVE",79.0,51.35,0.95,87.67,60
HCPCS,84681,C-PEPTIDE SERUM,144.0,93.6,0.95,144.0,60
HCPCS,84681,UCPEP C PEPTIDE URINE,144.0,93.6,0.95,144.0,60
HCPCS,84702,%1ST TRI HCG QUANT,104.0,67.6,0.95,104.0,60
HCPCS,84702,%SEQ1 HCG,104.0,67.6,0.95,104.0,60
HCPCS,84702,%SEQ2 HCG QUANT,104.0,67.6,0.95,104.0,60
HCPCS,84702,BETA HCG QUANT SERUM,104.0,67.6,0.95,104.0,60
HCPCS,84702,BETA HCG QUANT TUMOR MARKER,104.0,67.6,0.95,104.0,60
HCPCS,84702,HCG QUANT SERUM,104.0,67.6,0.95,104.0,60
HCPCS,84702,"QUAD-HCG,QUANT",104.0,67.6,0.95,104.0,60
HCPCS,84703,CHORIONIC GONADOTROPIN ASSAY,,,8.42,8.42,1
HCPCS,84703,GONADOTROPIN CHORIONIC QUALITATIVE,52.0,33.8,1.1,52.0,32
HCPCS,84703,HCG QUAL URI,52.0,33.8,0.95,52.0,60
HCPCS,84703,HCG TEST QUAL,52.0,33.8,0.95,52.0,60
HCPCS,84703,HCG TEST QUAL (POINT OF CARE LAB),52.0,33.8,0.95,52.0,60
HCPCS,84703,UA DIP URINE HCG (POINT OF CARE LAB),52.0,33.8,0.95,52.0,60
HCPCS,84703QW,CHORIONIC GONADOTROPIN ASSAY,,,8.42,8.42,1
HCPCS,84704,BETA HCG QNT TUMOR MKR,106.0,68.9,0.95,106.0,60
HCPCS,84830,OVULATION TESTS,,,12.7,52.04,21
HCPCS,84830,Ovulation tests,,,17.46,20.22,8
HCPCS,84999,ALLIED GENERIC LAB CODE,5.0,3.25,0.01,1612801.79,28
HCPCS,84999,CHITOTRIOSIDASE,288.0,187.2,0.95,1005.62,46
HCPCS,84999,FECAL WT 24HR WET WEIGHT,20.0,13.0,0.95,1005.62,46
HCPCS,84999,"NITROGEN, TOTAL, FECES",761.0,494.65,0.95,1005.62,46
HCPCS,84999,"OSMOLALITY, STOOL",75.0,48.75,0.95,1005.62,46
HCPCS,84999,"POTASSIUM, BODY FLUID",56.0,36.4,0.95,1005.62,46
HCPCS,84999,"POTASSIUM, STOOL",62.0,40.3,0.95,1005.62,46
HCPCS,84999,UNLISTED CHEMISTRY TEST,268.0,174.2,0.95,1005.62,46
HCPCS,85002,BLEEDING TIME TEST,,,4.82,66.48,21
HCPCS,85002,Bleeding time test,,,7.7,8.92,8
HCPCS,85004,AUTOMATED DIFFERENTIAL,45.0,29.25,0.95,45.0,120
HCPCS,85007,WBC COUNT MANUAL DIFF,26.0,16.9,0.95,26.0,60
HCPCS,85008,SCHISTOCYT SCAN,24.0,15.6,0.95,24.0,60
HCPCS,85009,BUFFY COAT SEZARY CELL,35.0,22.75,0.95,35.0,60
HCPCS,85013,BLOOD COUNT SPUN MICRO HCT,48.0,31.2,0.95,48.0,60
HCPCS,85014,*BLOOD COUNT HCT,16.0,10.4,0.95,16.0,60
HCPCS,85014,BLOOD COUNT HCT (POINT OF CARE LAB),16.0,10.4,0.95,16.0,60
HCPCS,85014,BLOOD COUNT HEMATOCRIT,16.0,10.4,1.1,16.0,32
HCPCS,85014,HEMATOCRIT,16.0,10.4,0.95,16.0,61
HCPCS,85014,HEMATOCRIT (POINT OF CARE LAB),16.0,10.4,0.95,16.0,60
HCPCS,85014QW,HEMATOCRIT,,,2.65,2.65,1
HCPCS,85018,*BLOOD COUNT HGB,16.0,10.4,0.95,16.0,60
HCPCS,85018,BLOOD COUNT HEMOGLOBIN,16.0,10.4,1.1,16.0,32
HCPCS,85018,BLOOD COUNT HGB,16.0,10.4,0.95,16.0,60
HCPCS,85018,BLOOD COUNT HGB (POINT OF CARE LAB),16.0,10.4,0.95,16.0,60
HCPCS,85018,HEMOGLOBIN,16.0,10.4,0.95,16.0,61
HCPCS,85018QW,HEMOGLOBIN,,,2.65,2.65,1
HCPCS,85025,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,54.0,35.1,1.1,54.0,32
HCPCS,85025,CBC AUTO W AUTO DIFF,54.0,35.1,0.95,54.0,60
HCPCS,85025,CBC W/DIFF,54.0,35.1,0.95,54.0,60
HCPCS,85025,COMPLETE CBC W/AUTO DIFF WBC,,,8.71,8.71,1
HCPCS,85025QW,COMPLETE CBC W/AUTO DIFF WBC,,,8.71,8.71,1
HCPCS,85027,BLOOD COUNT COMPLETE AUTOMATED,45.0,29.25,1.1,45.0,32
HCPCS,85027,CBC AUTO WO DIFF,45.0,29.25,0.95,45.0,60
HCPCS,85032,MANUAL CELL COUNT EA,30.0,19.5,0.95,30.0,60
HCPCS,85032,"SMEAR, PARASITEMIA CELL COUNT",30.0,19.5,0.95,30.0,60
HCPCS,85041,AUTOMATED RBC COUNT,21.0,13.65,0.95,21.0,60
HCPCS,85041,CSPNL AUTO RBC COUNT,21.0,13.65,0.95,21.0,60
HCPCS,85044,MANUAL RETICULOCYTE COUNT,,,4.31,32.59,21
HCPCS,85044,Manual reticulocyte count,,,6.74,7.8,8
HCPCS,85045,BLOOD COUNT RETICULOCYTE AUTOMATED,28.0,18.2,1.1,28.0,32
HCPCS,85045,RETICULOCYTE COUNT AUTO,28.0,18.2,0.95,28.0,60
HCPCS,85046,RETICULOCYTE HEMOGLOBIN,38.0,24.7,0.95,38.0,60
HCPCS,85048,*LEUKO (WBC) COUNT AUTO,18.0,11.7,0.95,18.0,60
HCPCS,85048,LEUKO (WBC) COUNT AUTO,18.0,11.7,0.95,18.0,60
HCPCS,85049,BLOOD COUNT PLATELET AUTOMATED,31.0,20.15,1.1,31.0,32
HCPCS,85049,PLATELETS,31.0,20.15,0.95,31.0,60
HCPCS,85049,PLT COUNT AUTO,31.0,20.15,0.95,31.0,60
HCPCS,85055,IMMATURE PLATELET FRACT,247.0,160.55,0.95,247.0,60
HCPCS,85060,BLOOD SMEAR INTERPRETATION,,,53.4,55.74,2
HCPCS,85060,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,198.0,128.7,1.1,198.0,44
HCPCS,85060,Blood smear interpretation,,,6.74,7.8,8
HCPCS,85097,BONE MARROW ROUTINE,5637.0,3664.05,0.95,5637.0,61
HCPCS,85097,BONE MARROW SMEAR INTERPRETATION,414.0,269.1,1.1,1467.65,47
HCPCS,85130,CHROMOGENIC SUBSTRATE ASSAY,,,11.89,52.42,21
HCPCS,85130,Chromogenic substrate assay,,,6.74,7.8,8
HCPCS,85170,BLOOD CLOT RETRACTION,,,6.87,66.79,21
HCPCS,85170,Blood clot retraction,,,7.7,8.92,8
HCPCS,85175,BLOOD CLOT LYSIS TIME,,,19.95,83.47,21
HCPCS,85175,Blood clot lysis time,,,37.33,43.22,8
HCPCS,85210,COAG FACT ASSAY 2,90.0,58.5,0.95,90.0,60
HCPCS,85220,COAG FACT ASSAY 5,122.0,79.3,0.95,122.0,60
HCPCS,85230,COAG FACT ASSAY 7,124.0,80.6,0.95,124.0,60
HCPCS,85240,COAG FACT ASSAY 8,124.0,80.6,0.95,124.0,60
HCPCS,85240,FACTOR VIII TEST 1 STAGE,124.0,80.6,0.95,124.0,60
HCPCS,85244,CLOT FACTOR VIII RELTD ANTGN,,,19.97,83.68,21
HCPCS,85244,Clot factor viii reltd antgn,,,37.33,43.22,8
HCPCS,85245,CLOT FACTOR VIII VW RISTOCTN,158.0,102.7,0.95,158.0,60
HCPCS,85245,FACTOR VIII TEST VW FACTOR,158.0,102.7,0.95,158.0,60
HCPCS,85246,%VWD2N FACTOR ANTIGEN,158.0,102.7,0.95,158.0,60
HCPCS,85246,VON WILLEBRAND ANTIGEN,158.0,102.7,0.95,158.0,60
HCPCS,85247,FACTOR VIII TEST VW MULT,158.0,102.7,0.95,176.68,60
HCPCS,85247,VWF MULTIMER,158.0,102.7,0.95,176.68,60
HCPCS,85250,COAG FACT ASSAY 9,131.0,85.15,0.95,131.0,60
HCPCS,85260,COAG FACT ASSAY 10,124.0,80.6,0.95,124.0,60
HCPCS,85270,COAG FACT ASSAY 11,124.0,80.6,0.95,124.0,60
HCPCS,85280,COAG FACT ASSAY 12,134.0,87.1,0.95,134.0,60
HCPCS,85290,COAG FACTOR ASSAY 13,113.0,73.45,0.95,113.0,60
HCPCS,85291,CLOT FACTOR XIII FIBRIN SCRN,,,9.11,39.12,21
HCPCS,85291,Clot factor xiii fibrin scrn,,,7.7,8.92,8
HCPCS,85292,PREKALLIKREIN FLETCHER,131.0,85.15,0.95,131.0,60
HCPCS,85293,CLOT FACTOR WGHT KININOGEN,,,18.93,145.81,21
HCPCS,85293,Clot factor wght kininogen,,,7.7,8.92,8
HCPCS,85300,ANTITHROMBIN 3,82.0,53.3,0.95,82.0,60
HCPCS,85301,ANTITHROMBIN III AG ASSAY,75.0,48.75,0.95,75.0,60
HCPCS,85302,PROTEIN C AG,83.0,53.95,0.95,87.58,60
HCPCS,85302,PROTEIN C IMMUNO,83.0,53.95,0.95,87.58,60
HCPCS,85303,PROTEIN C ACTIVITY,95.0,61.75,0.95,95.0,60
HCPCS,85303,PROTEIN C FUNCTIONAL,95.0,61.75,0.95,95.0,60
HCPCS,85305,PROTEIN S TOTAL,80.0,52.0,0.95,89.35,60
HCPCS,85306,PROTEIN S FREE,106.0,68.9,0.95,106.0,60
HCPCS,85307,APC RESISTANCE,106.0,68.9,0.95,106.0,60
HCPCS,85335,%AD13IN FACTR INHIB TEST,89.0,57.85,0.95,99.1,60
HCPCS,85337,THROMBOMODULIN,,,17.27,70.77,21
HCPCS,85337,Thrombomodulin,,,7.7,8.92,8
HCPCS,85345,COAGULATION TIME LEE & WHITE,,,4.69,19.22,21
HCPCS,85345,Coagulation time lee & white,,,7.7,8.92,8
HCPCS,85347,ACTIVATED COAGULATION,30.0,19.5,0.95,32.77,120
HCPCS,85347,COAG TIME ACTIVATED (POINT OF CARE LAB),30.0,19.5,0.95,32.77,60
HCPCS,85347,"OCCULT BLOOD, SGL DIGTL EXAM",30.0,19.5,0.95,32.77,60
HCPCS,85348,COAGULATION TIME OTR METHOD,,,4.49,18.4,21
HCPCS,85348,Coagulation time otr method,,,7.7,8.92,8
HCPCS,85360,EUGLOBULIN LYSIS TIME,58.0,37.7,0.95,58.82,60
HCPCS,85362,DEGRADATION PRODUCTS,48.0,31.2,0.95,53.05,60
HCPCS,85366,FIBRINOGEN TEST,,,37.93,329.71,21
HCPCS,85366,Fibrinogen test,,,37.33,43.22,8
HCPCS,85370,FIBRINOGEN TEST,,,12.43,50.94,21
HCPCS,85370,Fibrinogen test,,,7.7,8.92,8
HCPCS,85378,FIBRIN DEGRADE SEMIQUANT,,,9.72,49.89,21
HCPCS,85378,Fibrin degrade semiquant,,,7.7,8.92,8
HCPCS,85379,D-DIMER (POINT OF CARE LAB),70.0,45.5,0.95,70.0,60
HCPCS,85379,D-DIMER QUANT,70.0,45.5,0.95,70.0,60
HCPCS,85380,FIBRIN DEGRADJ D-DIMER,,,10.18,42.41,21
HCPCS,85380,Fibrin degradj d-dimer,,,6.74,7.8,8
HCPCS,85384,FIBRINOGEN,67.0,43.55,0.95,67.0,120
HCPCS,85384,MANUAL HEME - FIBRINOGEN,67.0,43.55,0.95,67.0,60
HCPCS,85384,MANUAL HEME- FIBRINOGEN,67.0,43.55,0.95,67.0,60
HCPCS,85385,FIBRIN AG,100.0,65.0,0.95,100.0,60
HCPCS,85390,*FIBRINOLYSINS SCREEN I&R,107.0,69.55,0.95,107.0,60
HCPCS,85390,COAGULOPATHY INTERPRET,107.0,69.55,0.95,107.0,60
HCPCS,85390,FIBRINOLYSINS SCREEN I&R,107.0,69.55,0.95,107.0,60
HCPCS,85396,COAGULATION/FIBRINOLYSIS,163.0,105.95,0.95,163.0,46
HCPCS,85397,%AD13AC COAG/FIBFUNC ACT,213.0,138.45,0.95,213.0,60
HCPCS,85397,*CLOTTING FUNCT ACTIVITY,213.0,138.45,0.95,213.0,60
HCPCS,85400,FIBRINOLYTIC PLASMIN,,,7.71,33.62,21
HCPCS,85400,Fibrinolytic plasmin,,,7.7,8.92,8
HCPCS,85410,ALPHA 2 ANTIPLASMIN,53.0,34.45,0.95,58.82,60
HCPCS,85415,FIBRIN PLASMINOGEN ACTIVATOR,119.0,77.35,0.95,119.0,60
HCPCS,85420,PLASMINOGEN FUNCTIONAL,45.0,29.25,0.95,46.35,60
HCPCS,85421,FIBRINOLYTIC PLASMINOGEN,,,10.18,41.72,21
HCPCS,85421,Fibrinolytic plasminogen,,,7.7,8.92,8
HCPCS,85441,HEINZ BODY STAIN,29.0,18.85,0.95,29.0,60
HCPCS,85445,HEINZ BODIES INDUCED,,,6.82,29.97,21
HCPCS,85445,Heinz bodies induced,,,6.74,7.8,8
HCPCS,85460,KLEIHAUER BETKE ST,53.0,34.45,0.95,59.61,60
HCPCS,85461,HGB FETAL ROS,65.0,42.25,0.95,90.26,60
HCPCS,85475,HEMOLYSIN ACID,,,8.87,39.71,21
HCPCS,85475,Hemolysin acid,,,7.7,8.92,8
HCPCS,85520,ANTIXA,90.0,58.5,0.95,90.0,60
HCPCS,85520,HEPARIN ASSAY,90.0,58.5,0.95,90.0,60
HCPCS,85525,HEPARIN NEUTRALIZATION,,,11.84,48.52,21
HCPCS,85525,Heparin neutralization,,,7.7,8.92,8
HCPCS,85530,HEPARIN-PROTAMINE TOLERANCE,,,13.09,62.52,21
HCPCS,85530,Heparin-protamine tolerance,,,7.7,8.92,8
HCPCS,85536,IRON STAIN MISC,47.0,30.55,0.95,115.77,60
HCPCS,85540,WBC ALKA PHOSPHTAS W COUNT,59.0,38.35,0.95,66.27,60
HCPCS,85547,RBC MECHANICAL FRAGILITY,,,8.6,37.88,21
HCPCS,85547,Rbc mechanical fragility,,,6.74,7.8,8
HCPCS,85549,MURAMIDASE,129.0,83.85,0.95,129.0,60
HCPCS,85555,OSMOTIC FRAG ERYTHRO,52.0,33.8,0.95,52.0,60
HCPCS,85557,RBC OSMOTIC FRAGILITY,,,13.36,88.9,21
HCPCS,85557,Rbc osmotic fragility,,,6.74,7.8,8
HCPCS,85576,*BLOOD PLT AGGREGATION EA,172.0,111.8,0.95,172.0,120
HCPCS,85576,BLOOD PLATELET AGGREGATION,,,27.91,27.91,1
HCPCS,85576,PLATELET AGGREGATION IN VITRO EACH AGENT,163.0,105.95,1.1,163.0,77
HCPCS,85576QW,BLOOD PLATELET AGGREGATION,,,27.91,27.91,1
HCPCS,85597,PLATELET NEUTRALIZATION,124.0,80.6,0.95,124.0,120
HCPCS,85598,HEXAGOAL PHASE PHOSPHOLIPID NEUTRALIZATION,124.0,80.6,0.95,124.0,60
HCPCS,85598,LUPUS ANTICOAG INTERP PANEL,124.0,80.6,0.95,124.0,60
HCPCS,85610,*PRO TIME,30.0,19.5,0.95,30.0,120
HCPCS,85610,CLOTTING TEST,30.0,19.5,0.95,30.0,60
HCPCS,85610,CLOTTING TEST (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
HCPCS,85610,MANUAL HEME - PRO TIME,30.0,19.5,0.95,30.0,60
HCPCS,85610,PRO TIME (POINT OF CARE LAB),30.0,19.5,0.95,30.0,120
HCPCS,85610,PROTHROMBIN TIME,27.5,17.875,1.1,30.0,65
HCPCS,85610,PROTHROMBIN TIME AND INR (POINT OF CARE LAB),30.0,19.5,0.95,30.0,60
HCPCS,85610QW,PROTHROMBIN TIME,,,4.81,4.81,1
HCPCS,85611,*PRO TIME TEST PLASMA FRACT EA,27.0,17.55,0.95,30.36,60
HCPCS,85612,VIPER VENOM PROTHROMBIN TIME,,,17.49,71.67,21
HCPCS,85612,Viper venom prothrombin time,,,7.7,8.92,8
HCPCS,85613,DILUTE RVVT X2,66.0,42.9,0.95,66.0,60
HCPCS,85613,RUSSELL VIPER VENOM TIME DILUT,66.0,42.9,0.95,66.0,60
HCPCS,85635,REPTILASE R TIME,68.0,44.2,0.95,68.0,60
HCPCS,85651,SED RATE WESTERGREN,29.0,18.85,0.95,29.0,60
HCPCS,85652,SEDIMENTATION RATE AUTO,19.0,12.35,0.95,19.0,60
HCPCS,85660,RBC SICKLING REDUC,38.0,24.7,0.95,38.0,60
HCPCS,85670,THROMBIN TIME,40.0,26.0,0.95,40.0,60
HCPCS,85675,THROMBIN TIME TITER,,,6.85,30.14,21
HCPCS,85675,Thrombin time titer,,,7.7,8.92,8
HCPCS,85705,THROMBOPLASTIN INHIBITION,,,9.63,42.37,21
HCPCS,85705,Thromboplastin inhibition,,,7.7,8.92,8
HCPCS,85730,*PTT PLASMA/WHOLE BLOOD,41.0,26.65,0.95,41.0,120
HCPCS,85730,MANUAL HEME - PTT PLASMA/WHOLE BLOOD,41.0,26.65,0.95,41.0,60
HCPCS,85732,*PTT PLASMA FRACT EA,45.0,29.25,0.95,45.0,60
HCPCS,85810,VISCOSITY BLOOD,81.0,52.65,0.95,81.0,60
HCPCS,85810,VISCOSITY SERUM,81.0,52.65,0.95,81.0,60
HCPCS,85999,Unlisted hematology&coagj px,,,6.74,7.8,8
HCPCS,86000,AGGLUTININS FEBRILE ANTIGEN,,,6.98,30.69,21
HCPCS,86000,Agglutinins febrile antigen,,,18.32,21.21,8
HCPCS,86001,%ABPA2 IGG TOTAL,54.0,35.1,0.95,54.0,60
HCPCS,86001,*ALLERGEN IGG QUANT/SEMI EA,54.0,35.1,0.95,54.0,60
HCPCS,86001,ALGN FOOD PANEL IGG X19,54.0,35.1,0.95,54.0,60
HCPCS,86001,ALLERGEN IGG EACH,54.0,35.1,0.95,54.0,60
HCPCS,86003,%PNUTCP ALLG SPEC IGE,36.0,23.4,0.95,36.0,60
HCPCS,86003,*ALLERG SP IGE;QT OR QUAL,36.0,23.4,0.95,36.0,60
HCPCS,86003,*ALLERGEN IGE QUANT/SEMI,36.0,23.4,0.95,36.0,60
HCPCS,86003,ALGN CHAETOMIUM GLOB IGE,36.0,23.4,0.95,36.0,60
HCPCS,86003,ALGN ORRIS ROOT IGE,36.0,23.4,0.95,36.0,60
HCPCS,86003,ALLERGEN IGE EACH,36.0,23.4,0.95,36.0,60
HCPCS,86003,ALLERGEN IGE QUANT/SEMI EA,36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, EGG IGE X2",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, ANCHOVY IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, ANNATTO SEED IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, APRICOT",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, ASPARAGUS IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, BLACK OLIVE IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, CAROB GUM IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, CAULIFLOWER IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, EGGPLANT",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, GINGER IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, GOAT MILK IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, LAMB",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, NAVY BEAN IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, NUTMEG IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, SARDINE IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, SPINACH",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, SUMMER SQUASH IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, TEA IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FOOD, TURMERIC IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, INSECT, BUMBLE BEE VENOM IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, INSECT, FIRE ANT, IMPORTED",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, INSECT, MOSQUITO, IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, MILK IGE X4",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, SESAME SEED WITH COMPONENT REFLEX",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, TREE, PALM/QUEEN TREE IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, WHEAT WITH COMPONENT REFLEX",36.0,23.4,0.95,36.0,60
HCPCS,86003,"ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE",36.0,23.4,0.95,36.0,60
HCPCS,86003,CHEESE MOZZARELLA IGE,36.0,23.4,0.95,36.0,60
HCPCS,86003,CHEESE PARMESAN IGE,36.0,23.4,0.95,36.0,60
HCPCS,86003,CHEESE SWISS IGE,36.0,23.4,0.95,36.0,60
HCPCS,86003,F324-IGE HOP (FOOD),36.0,23.4,0.95,36.0,60
HCPCS,86003,"HOPS, IGE ALLERGEN",36.0,23.4,0.95,36.0,60
HCPCS,86003,HYPERSENSITIVITY PNEUMO IGE QUANT,36.0,23.4,0.95,36.0,60
HCPCS,86003,LUPINE SEED (LUPINUS ALBUS) IGE,36.0,23.4,0.95,36.0,60
HCPCS,86005,HYPERSENSITIVITY PNEUMO IGE QUAL,55.0,35.75,0.95,55.0,60
HCPCS,86008,%PNUTCP ALLG IGE RECOMBX5,124.0,80.6,0.95,124.0,60
HCPCS,86008,"ALGN FOOD, ALPHA-GAL IGE",124.0,80.6,0.95,124.0,60
HCPCS,86008,"ALLERGEN, BROMELAIN IGE",124.0,80.6,0.95,124.0,60
HCPCS,86008,"ALLERGEN, PAPER WASP COMPONENT IGE",124.0,80.6,0.95,124.0,60
HCPCS,86008,"ALLERGEN, SESAME SEED RSES I 1 COMPONENT",124.0,80.6,0.95,124.0,60
HCPCS,86008,"ALLERGEN, WHEAT, RTRI A OMEGA-5-GLIADIN COMPONENT",124.0,80.6,0.95,124.0,60
HCPCS,86008,"ALLERGEN, YELLOW JACKET (COMMON WASP) COMPONENTS IGE",124.0,80.6,0.95,124.0,60
HCPCS,86008,ALLG SPEC IGE IN HOUSE,124.0,80.6,0.95,124.0,60
HCPCS,86008,ALLG SPEC IGE RECOMB EA,124.0,80.6,0.95,124.0,120
HCPCS,86008,"GALAC-ALPHA 1,3-GALAC IGE",124.0,80.6,0.95,124.0,60
HCPCS,86015,ACTIN SMOOTH MUSCLE AB EA,83.0,53.95,0.95,83.0,60
HCPCS,86021,AB ID LEUKO AB,104.0,67.6,0.95,104.0,60
HCPCS,86022,*AB ID PLT AB,127.0,82.55,0.95,127.0,120
HCPCS,86022,*PLATELET AB SCREEN,127.0,82.55,0.95,127.0,60
HCPCS,86022,ANTI PLATELET FACT 4 X2,127.0,82.55,0.95,127.0,60
HCPCS,86022,PLATELET AB DETECTION,127.0,82.55,0.95,127.0,60
HCPCS,86022,PLATELET ANTIBODIES,127.0,82.55,0.95,127.0,120
HCPCS,86022,PLATELET SURFACE GLYCOPROTEIN EXPRESSION,127.0,82.55,0.95,127.0,60
HCPCS,86022,SEROTONIN RELEASE LMWH,127.0,82.55,0.95,127.0,60
HCPCS,86023,*AB ID PLT IG ASSAY,86.0,55.9,0.95,95.9,120
HCPCS,86036,ANTINEUT CYT AB SCR EA,83.0,53.95,0.95,83.0,60
HCPCS,86036,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,83.0,53.95,1.1,83.0,31
HCPCS,86036,IBDSER ANTINEUT CYT AB SCR EA,83.0,53.95,0.95,83.0,60
HCPCS,86037,ANCA TITER EACH ANTIBODY,,,12.05,49.38,20
HCPCS,86037,Anca titer each antibody,,,18.32,21.21,8
HCPCS,86038,%FANA ANA AB,83.0,53.95,0.95,83.0,60
HCPCS,86038,ANTINUCLEAR,83.0,53.95,0.95,83.0,60
HCPCS,86038,ANTINUCLEAR AB(ANA),83.0,53.95,0.95,83.0,60
HCPCS,86039,*%ANA,77.0,50.05,0.95,77.0,60
HCPCS,86039,ANA (POLMYO),77.0,50.05,0.95,77.0,60
HCPCS,86039,ANTINUCLEAR AB(ANA) TITER,77.0,50.05,0.95,77.0,120
HCPCS,86039,SEMIQUANTITATIVE ANA (DERMYO),77.0,50.05,0.95,77.0,60
HCPCS,86039,SEMIQUANTITATIVE ANA (MYOSPL),77.0,50.05,0.95,77.0,60
HCPCS,86041,ACETYLCHOLINE RECEPTOR (ACHR) BINDING ANTIBODY,127.0,82.55,0.95,127.0,60
HCPCS,86041,ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,127.0,82.55,0.95,127.0,60
HCPCS,86042,ACETYLCHOLINE RECEPTOR (ACHR) BLOCKING ANTIBODY,127.0,82.55,0.95,127.0,60
HCPCS,86042,ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,127.0,82.55,0.95,127.0,60
HCPCS,86043,ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,83.0,53.95,0.95,83.0,60
HCPCS,86051,AQUAPORIN-4 ANTB ELISA,,,11.53,47.25,20
HCPCS,86051,Aquaporin-4 antb elisa,,,18.32,21.21,8
HCPCS,86052,"NMO/AQP4 AB IGG CBA-IFA SCREEN, CSF",83.0,53.95,0.95,83.0,60
HCPCS,86052,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,0.95,83.0,120
HCPCS,86052,NMOIFA AQ-4 AB EA,83.0,53.95,0.95,83.0,60
HCPCS,86053,CDS1SE AQ4 AB FL CYT EA,260.0,169.0,0.95,260.0,60
HCPCS,86053,MLPTHY NMO/AQP4 FACS,260.0,169.0,0.95,260.0,60
HCPCS,86060,*ANTISTREPTOLYSIN 0 TITER,50.0,32.5,0.95,50.0,60
HCPCS,86060,ANTI-STREPTOLYSIN O,50.0,32.5,0.95,50.0,60
HCPCS,86063,ANTISTREPTOLYSIN O SCREEN,,,5.77,23.64,21
HCPCS,86063,Antistreptolysin o screen,,,18.32,21.21,8
HCPCS,86077,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,414.0,269.1,1.1,414.0,47
HCPCS,86077,PHYS BLOOD BANK SERV XMATCH,,,22.63,109.59,21
HCPCS,86077,Phys blood bank serv xmatch,,,27.56,31.91,8
HCPCS,86078,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,414.0,269.1,1.1,414.0,47
HCPCS,86078,PHYS BLOOD BANK SERV REACTJ,,,158.33,477.52,21
HCPCS,86078,Phys blood bank serv reactj,,,27.56,31.91,8
HCPCS,86079,PHYS BLOOD BANK SERV AUTHRJ,,,49.3,162.07,21
HCPCS,86079,Phys blood bank serv authrj,,,27.56,31.91,8
HCPCS,86140,%IBDSGI C REAC PROTEIN,36.0,23.4,0.95,36.0,60
HCPCS,86140,C-REACTIVE PROTEIN,36.0,23.4,0.95,36.0,60
HCPCS,86141,C-REACTIVE PROTEIN HIGH SENSE,89.0,57.85,0.95,89.0,60
HCPCS,86146,*BETA 2 GLYCOPROTEIN I AB EA,176.0,114.4,0.95,176.0,60
HCPCS,86146,BETA2 GLYCOPROT IGG/MX2,176.0,114.4,0.95,176.0,60
HCPCS,86147,CARDIOLIPIN AB SCREEN,176.0,114.4,0.95,176.0,60
HCPCS,86147,PHOEV - CARDIOLIPIN,176.0,114.4,0.95,176.0,60
HCPCS,86148,*PHOSPHOLIPID AB,111.0,72.15,0.95,111.0,120
HCPCS,86152,CELL ENUMERATION & ID,,,250.78,1027.65,21
HCPCS,86152,Cell enumeration & id,,,92.46,107.06,8
HCPCS,86153,Cell enumeration phys interp,,,22.75,26.35,8
HCPCS,86155,CHEMOTAXIS ASSAY,,,15.99,123.08,21
HCPCS,86155,Chemotaxis assay,,,18.32,21.21,8
HCPCS,86156,COLD AGGLUTININ SCREEN,,,8.07,33.07,21
HCPCS,86156,Cold agglutinin screen,,,18.32,21.21,8
HCPCS,86157,COLD AGGLUTININS,56.0,36.4,0.95,56.0,60
HCPCS,86160,C1 ESTERASE INHIBITOR,83.0,53.95,0.95,83.0,60
HCPCS,86160,C2 COMPLEMENT AG,83.0,53.95,0.95,83.0,60
HCPCS,86160,C3 COMPLEMENT B1C/B1A,83.0,53.95,0.95,83.0,60
HCPCS,86160,C3 NEPHRITIC FACTOR,83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT AG EA,83.0,53.95,0.95,83.0,60
HCPCS,86160,"COMPLEMENT AG, EA",83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT C2,83.0,53.95,0.95,83.0,60
HCPCS,86160,"COMPLEMENT C3, SER",83.0,53.95,0.95,83.0,60
HCPCS,86160,"COMPLEMENT C4, SER",83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT COMP3A,83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT COMP4A,83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT FACTOR B,83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT FACTOR H,83.0,53.95,0.95,83.0,60
HCPCS,86160,COMPLEMENT FACTOR I,83.0,53.95,0.95,83.0,60
HCPCS,86160,SC5B-9 LEVEL MAC COMPLEX,83.0,53.95,0.95,83.0,60
HCPCS,86161,C5COMF COMPLEMENT/FUNCTION ACTIVITY,83.0,53.95,0.95,83.0,60
HCPCS,86161,COMPLEMENT AH50 FUNC,83.0,53.95,0.95,83.0,60
HCPCS,86161,"COMPLEMENT C7, FUNC",83.0,53.95,0.95,83.0,60
HCPCS,86161,COMPLEMENT C9 FUNCTIONAL,83.0,53.95,0.95,83.0,60
HCPCS,86161,COMPLEMENT FUNCT ACT C8,83.0,53.95,0.95,83.0,60
HCPCS,86161,COMPLEMENT/FUNC ACTIVITY EA,83.0,53.95,0.95,83.0,60
HCPCS,86162,COMPLEMENT DEFICIENCY,140.0,91.0,0.95,140.0,60
HCPCS,86162,COMPLEMENT TOTAL(CH50),140.0,91.0,0.95,140.0,60
HCPCS,86171,COMPLEMENT FIXATION EACH,,,10.01,48.87,21
HCPCS,86171,Complement fixation each,,,18.32,21.21,8
HCPCS,86185,Counterimmunoelectrophoresis,,,41.24,41.24,1
HCPCS,86200,CYCLIC CITRU PEPT ANTI IG,89.0,57.85,0.95,89.0,60
HCPCS,86215,*DEOXYRIBONUCLEASE AB,91.0,59.15,0.95,91.0,60
HCPCS,86225,DNA AB DOUBLE STRANDED,95.0,61.75,0.95,95.0,60
HCPCS,86225,DNA ANTIBODY,95.0,61.75,0.95,95.0,60
HCPCS,86226,SS DNA ANTIBODY IGG,84.0,54.6,0.95,84.0,60
HCPCS,86231,EMA EACH IG CLASS,,,12.09,49.54,20
HCPCS,86231,Ema each ig class,,,18.32,21.21,8
HCPCS,86235,*EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,60
HCPCS,86235,ENA (MYOSPL),124.0,80.6,0.95,124.0,60
HCPCS,86235,ENA ANY METHOD,124.0,80.6,0.95,124.0,60
HCPCS,86235,EXTRACT NUC AG EA AB,124.0,80.6,0.95,124.0,300
HCPCS,86235,IMMUNOASSAY ENA (POLMYO),124.0,80.6,0.95,124.0,60
HCPCS,86235,PM - 1 ANTIBODY,124.0,80.6,0.95,124.0,60
HCPCS,86235,U3 RNP AB,124.0,80.6,0.95,124.0,60
HCPCS,86243,Fc receptor,,,77.51,77.51,1
HCPCS,86255,%CEPHAL FLOUR AB X3,83.0,53.95,0.95,83.0,60
HCPCS,86255,%IBDSER NEUTROPH SP ABS,83.0,53.95,0.95,83.0,60
HCPCS,86255,%PARNEO FLUORESCENT X9,83.0,53.95,0.95,83.0,60
HCPCS,86255,ACESTR FLUORESCENT ANTIBODY SCREEN,83.0,53.95,0.95,83.0,60
HCPCS,86255,ADRENAL ANTIBODY,83.0,53.95,0.95,83.0,60
HCPCS,86255,AIDYSA FLUOR AB SCRN,83.0,53.95,0.95,83.0,60
HCPCS,86255,AMPA RECEPTOR AB CBA,83.0,53.95,0.95,83.0,60
HCPCS,86255,ANTI NEUT CY AB,83.0,53.95,0.95,83.0,60
HCPCS,86255,AQUAPORIN4 REC AB IGG CSF,83.0,53.95,0.95,83.0,60
HCPCS,86255,CASPR2 IGG REFLEX,83.0,53.95,0.95,83.0,60
HCPCS,86255,DNA CRITHIDIA ANTIBODY,83.0,53.95,0.95,83.0,60
HCPCS,86255,ENCCSF FLUORESCENT AB X21,83.0,53.95,0.95,83.0,60
HCPCS,86255,ENCSER FLUORESCENT AB SCRN,83.0,53.95,0.95,83.0,60
HCPCS,86255,ENDOMYSIAL IGA,83.0,53.95,0.95,83.0,60
HCPCS,86255,EPIDERMAL ABS & REFLEXX2,83.0,53.95,0.95,83.0,60
HCPCS,86255,FAB SCREEN E,83.0,53.95,0.95,83.0,60
HCPCS,86255,FAB SCREEN EA AB,83.0,53.95,0.95,83.0,60
HCPCS,86255,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, CSF",83.0,53.95,0.95,83.0,60
HCPCS,86255,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, SERUM",83.0,53.95,0.95,83.0,60
HCPCS,86255,GABA-B RECEPTOR AB CBA,83.0,53.95,0.95,83.0,60
HCPCS,86255,GBMGP FLUORESCENT ANTIBODY SCREEN,83.0,53.95,0.95,83.0,60
HCPCS,86255,"GLOM BASE AB, IGG IFA",83.0,53.95,0.95,83.0,60
HCPCS,86255,HUANT FLUORESCENT ANTIBODY SCREEN,83.0,53.95,0.95,83.0,60
HCPCS,86255,LGI1 IGG,83.0,53.95,0.95,83.0,60
HCPCS,86255,LRP4 AB TEST,83.0,53.95,0.95,83.0,60
HCPCS,86255,MITOCHONDR AB,83.0,53.95,0.95,83.0,60
HCPCS,86255,MLPTHY FLUORESCENT AB SCREEN,83.0,53.95,0.95,83.0,60
HCPCS,86255,MOG-IGG1 FACS,83.0,53.95,0.95,83.0,60
HCPCS,86255,MYELIN ANTIBODY IGG,83.0,53.95,0.95,83.0,60
HCPCS,86255,NEUTROPHIL SPECIFIC ABS,83.0,53.95,0.95,83.0,60
HCPCS,86255,NMDA IGG,83.0,53.95,0.95,83.0,60
HCPCS,86255,NMO AQUAPORIN4 IGG,83.0,53.95,0.95,83.0,60
HCPCS,86255,NMO AQUAPORIN4 IGG CSF,83.0,53.95,0.95,83.0,60
HCPCS,86255,NMOA4 AQUAPORIN4 IGG,83.0,53.95,0.95,83.0,60
HCPCS,86255,PARANEOPLAST ABS CSF X9,83.0,53.95,0.95,83.0,60
HCPCS,86255,PARIETAL CELL AB SCR,83.0,53.95,0.95,83.0,60
HCPCS,86255,"PCCA/ANNA BY IFA, SERUM",83.0,53.95,0.95,83.0,60
HCPCS,86255,PHOSPHOLIP A2-R AB IGG,83.0,53.95,0.95,83.0,60
HCPCS,86255,"PLA2R, IMMUNOFLUORESCENCE, S (REFLEX ONLY)",83.0,53.95,0.95,83.0,60
HCPCS,86255,RETICULIN IGA IGG ABS,83.0,53.95,0.95,83.0,60
HCPCS,86255,"SEND-OUT PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODY, IGG BY IMMU",83.0,53.95,0.95,83.0,60
HCPCS,86255,SENMOT FLUORESCENT ANTIBODY (ARUP),83.0,53.95,0.95,83.0,60
HCPCS,86255,SENNRO FLUORESCENT AB (ARUP),83.0,53.95,0.95,83.0,60
HCPCS,86255,SKELETAL MUSCLE AB SCREEN,83.0,53.95,0.95,83.0,60
HCPCS,86255,SMOOTH MUSCLE AB SCR,83.0,53.95,0.95,83.0,60
HCPCS,86255,SPSDEV FLUORESCENT AB SCREEN,83.0,53.95,0.95,83.0,60
HCPCS,86255,"THSD7A AB, S",83.0,53.95,0.95,83.0,60
HCPCS,86255,"TRIM46 AB CBA, CSF",83.0,53.95,0.95,83.0,60
HCPCS,86255,"TRIM46 AB CBA, S",83.0,53.95,0.95,83.0,60
HCPCS,86256,*FAB TITER EA AB,83.0,53.95,0.95,104.69,60
HCPCS,86256,ADRENAL AB TITER RFLX,83.0,53.95,0.95,104.69,60
HCPCS,86256,"AMPA RECEPTOR AB IGG TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"AMPA RECEPTOR AB IGG TITER, SERUM - REFLEX",83.0,53.95,0.95,104.69,60
HCPCS,86256,AMPIFC FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,ANCA TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,ANCA TITER BILL,83.0,53.95,0.95,104.69,60
HCPCS,86256,BM2 ABS TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,"CASPR2 AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"CASPR2 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
HCPCS,86256,"CV2 ANTIBODY TITER, IGG",83.0,53.95,0.95,104.69,60
HCPCS,86256,"DPPX AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"DPPX AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
HCPCS,86256,ENDOMYSTAL AB IGG,83.0,53.95,0.95,104.69,60
HCPCS,86256,FAB TITER EA AB,83.0,53.95,0.95,104.69,60
HCPCS,86256,FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,"GABA-A RECE$TOR IGG CBA-IFA TITER, SERUM",83.0,53.95,0.95,104.69,60
HCPCS,86256,"GABA-AR AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"GABA-BR AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"GABA-BR AB IGG CBA-IFA TITER, SER",83.0,53.95,0.95,104.69,60
HCPCS,86256,GABTTR FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,HUTIT FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,INTERCELL SUB AB TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,"LGI1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"LGI1 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
HCPCS,86256,"MGLUR1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"MOG AB IGG TITER BY CBA-IFA, SER",83.0,53.95,0.95,104.69,60
HCPCS,86256,"MOG FACS TITER, S REF",83.0,53.95,0.95,104.69,60
HCPCS,86256,NANNTR FLUORESCENT ANTIBODY TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,NEUROMYELITIS OPT AQP4IGG,83.0,53.95,0.95,104.69,60
HCPCS,86256,"NEURONAL NUCLEAR AB (ANNA) IFA TITER, IGG",83.0,53.95,0.95,104.69,60
HCPCS,86256,"NEURONAL NUCLEAR ANTIBODY (ANNA) IFA TITER, IGG, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,NMDAG TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,NMO/AQP4 FACS TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,"PDE10A AB IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"PDE10A AB IFA TITER, S",83.0,53.95,0.95,104.69,60
HCPCS,86256,"PHOSPHOLIPASE RECEPTOR A2 ANTIBODY, IGG TITER",83.0,53.95,0.95,104.69,60
HCPCS,86256,PLA2R AB IGG TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,"PURKINJE CELL ANTIBODY, TITER",83.0,53.95,0.95,104.69,60
HCPCS,86256,"PURKINJE CELL ANTIBODY, TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"REFLEX MGLUR1 AB IGG CBA-IFA TITER, SERUM",83.0,53.95,0.95,104.69,60
HCPCS,86256,STRIATED MUSCLE TITER,83.0,53.95,0.95,104.69,60
HCPCS,86256,"TRIM46 AB IFA TITER, CSF",83.0,53.95,0.95,104.69,60
HCPCS,86256,"TRIM46 AB IFA TITER, S",83.0,53.95,0.95,104.69,60
HCPCS,86258,GLIADIN ANTIBODY EACH,83.0,53.95,0.95,83.0,60
HCPCS,86277,GROWTH HORMONE ANTIBODY,,,15.74,69.43,21
HCPCS,86277,Growth hormone antibody,,,18.32,21.21,8
HCPCS,86280,HEMAGGLUTINATION INHIBITION,,,8.19,36.04,21
HCPCS,86280,Hemagglutination inhibition,,,18.32,21.21,8
HCPCS,86294,IMMUNOASSAY TUMOR QUAL,,,25.57,104.78,22
HCPCS,86294,Immunoassay tumor qual,,,18.32,21.21,8
HCPCS,86294QW,IMMUNOASSAY TUMOR QUAL,,,28.65,28.65,1
HCPCS,86300,IMMUNOASSY TUMOR CA 15-3,144.0,93.6,0.95,144.0,120
HCPCS,86301,IMMUNOASSY TUMOR CA 19-9,144.0,93.6,0.95,144.0,60
HCPCS,86304,IMMUNOASSY TUMOR CA 125,144.0,93.6,0.95,144.0,60
HCPCS,86305,HE4,144.0,93.6,0.95,144.0,60
HCPCS,86308,HETEROPHILE ANTIBODIES SCREEN,36.0,23.4,1.1,36.0,32
HCPCS,86308,HETEROPHILE ANTIBODY SCREEN,,,5.8,5.8,1
HCPCS,86308,HETRPHL AB SCRN,36.0,23.4,0.95,36.0,60
HCPCS,86308,HTEROPHIL AB SCREEN,36.0,23.4,0.95,36.0,60
HCPCS,86308,HTEROPHIL AB SCREEN (POINT OF CARE LAB),36.0,23.4,0.95,36.0,60
HCPCS,86308QW,HETEROPHILE ANTIBODY SCREEN,,,5.8,5.8,1
HCPCS,86309,HETEROPHILE AB TITER,45.0,29.25,0.95,45.0,60
HCPCS,86310,HETEROPHILE ANTIBODY ABSRBJ,,,7.37,32.44,21
HCPCS,86310,Heterophile antibody absrbj,,,18.32,21.21,8
HCPCS,86316,%CJD IMMUNO QT,144.0,93.6,0.95,144.0,60
HCPCS,86316,%PHI IMMUNO TUMOR AG,144.0,93.6,0.95,144.0,60
HCPCS,86316,AFP CSF TUMOR MARKER,144.0,93.6,0.95,144.0,60
HCPCS,86316,CHROMOGRANIN A,144.0,93.6,0.95,144.0,120
HCPCS,86316,IMMUNOASSY TUMOR AG QUANT,144.0,93.6,0.95,144.0,60
HCPCS,86316,S-100B PROTEIN,144.0,93.6,0.95,144.0,60
HCPCS,86317,%HUMOR DIPHTHERIA TOX AB,103.0,66.95,0.95,103.0,60
HCPCS,86317,%HUMOR PNEUMO IGG X14,103.0,66.95,0.95,103.0,60
HCPCS,86317,%HUMOR TETANUS TOX AB,103.0,66.95,0.95,103.0,60
HCPCS,86317,ASPERGILLUS FUMIGATUS ANTIBODY IGG,103.0,66.95,0.95,103.0,60
HCPCS,86317,CJD IMASSAY IA AB QNT,103.0,66.95,0.95,103.0,60
HCPCS,86317,DIPHTHERIA TOXOID IGG,103.0,66.95,0.95,103.0,60
HCPCS,86317,DIPTHERIA TETANUS AB,103.0,66.95,0.95,103.0,60
HCPCS,86317,HAEMOPHILUS INFLU B IGG,103.0,66.95,0.95,103.0,60
HCPCS,86317,HEPATITIS B SUR AB QUANT,103.0,66.95,0.95,103.0,60
HCPCS,86317,HUMOR1 IMMUNASSY INF AG X4,103.0,66.95,0.95,103.0,60
HCPCS,86317,HUMOR1 IMMUNASSY INF AG1 X6,103.0,66.95,0.95,103.0,60
HCPCS,86317,HUMOR1 IMMUNASSY INF AG2 X6,103.0,66.95,0.95,103.0,60
HCPCS,86317,HUMORAL IMMUNITY PANELS 1/2,103.0,66.95,0.95,103.0,60
HCPCS,86317,N MENINGITIIDIS IGG X4,103.0,66.95,0.95,103.0,60
HCPCS,86317,STREP PNEUMO ABS X14,103.0,66.95,0.95,103.0,60
HCPCS,86317,TETANUS TOXOID IGG,103.0,66.95,0.95,103.0,60
HCPCS,86318,IA INFECTIOUS AGENT ANTIBODY,,,18.09,74.13,22
HCPCS,86318,IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH,125.0,81.25,1.1,125.0,32
HCPCS,86318,Ia infectious agent antibody,,,18.32,21.21,8
HCPCS,86318QW,IA INFECTIOUS AGENT ANTIBODY,,,20.27,20.27,1
HCPCS,86320,SERUM IMMUNOELECTROPHORESIS,,,29.92,122.61,21
HCPCS,86320,Serum immunoelectrophoresis,,,22.75,26.35,8
HCPCS,86325,OTHER IMMUNOELECTROPHORESIS,,,23.13,94.78,21
HCPCS,86325,Other immunoelectrophoresis,,,18.32,21.21,8
HCPCS,86327,IMMUNOELECTROPHORESIS ASSAY,,,90.91,100.11,2
HCPCS,86327,Immunoelectrophoresis assay,,,22.75,26.35,8
HCPCS,86328,IA NFCT AB SARSCOV2 COVID19,,,45.23,185.55,23
HCPCS,86328,Ia nfct ab sarscov2 covid19,,,18.32,21.21,8
HCPCS,86328QW,IA NFCT AB SARSCOV2 COVID19,,,50.73,50.73,1
HCPCS,86329,IMMUNODIFFUSION NOS,97.0,63.05,0.95,97.0,60
HCPCS,86329,TEICHOIC ACID ANTIBODIES,97.0,63.05,0.95,97.0,60
HCPCS,86331,%ABPA2 ASPERG QUAL OUCHT,83.0,53.95,0.95,83.0,60
HCPCS,86331,*IMMUNODIF QUAL EA AB/AG,83.0,53.95,0.95,83.0,60
HCPCS,86331,*IMMUNODIFFUSION QUAL EA AB/AG,83.0,53.95,0.95,83.0,60
HCPCS,86331,BIRD FANCIERS PRECIPITIN,83.0,53.95,0.95,83.0,60
HCPCS,86331,HYPERSENSITIVITY PNEUMO ID QUAL,83.0,53.95,0.95,83.0,60
HCPCS,86331,"TEICHOIC ACID, QUAL",83.0,53.95,0.95,83.0,60
HCPCS,86332,C1Q BINDING ASSAY,168.0,109.2,0.95,168.0,60
HCPCS,86334,%IMMUNOFIXATION,154.0,100.1,0.95,154.0,60
HCPCS,86334,*IMMUNOFIX ELECPHRSIS SERUM,154.0,100.1,0.95,154.0,60
HCPCS,86334,IMMUNOFIX E-PHORESIS SERUM,163.0,105.95,1.1,163.0,44
HCPCS,86334,IMMUNOFIX ELEC GEL,154.0,100.1,0.95,154.0,60
HCPCS,86335,*IMMUNOFIX ELECPHRSIS OTHER,203.0,131.95,0.95,203.0,60
HCPCS,86335,"MONOCLONAL PROTEIN,FLUID",203.0,131.95,0.95,203.0,60
HCPCS,86336,%QUAD4 MARKERS INHIBIN,108.0,70.2,0.95,108.0,60
HCPCS,86336,INHIBIN A,108.0,70.2,0.95,108.0,120
HCPCS,86337,INSULIN ANTIBODY,148.0,96.2,0.95,148.0,60
HCPCS,86340,INT FAC AB,104.0,67.6,0.95,104.0,60
HCPCS,86341,%CEPHAL ISLET CELL AB,163.0,105.95,0.95,163.0,60
HCPCS,86341,AIDYSA ISLET CELL AB,163.0,105.95,0.95,163.0,60
HCPCS,86341,ENCCSF ISLET CELL AB,163.0,105.95,0.95,163.0,60
HCPCS,86341,ENCSER ISLET CELL AB,163.0,105.95,0.95,163.0,60
HCPCS,86341,GAD65 ANTIBODY,163.0,105.95,0.95,163.0,120
HCPCS,86341,GLUTAMIC ACID DECARBOXYLASE ANTIBODY,163.0,105.95,0.95,163.0,60
HCPCS,86341,GLUTAMIC ACID DECARBOXYLASE ANTIBODY CSF,163.0,105.95,0.95,163.0,60
HCPCS,86341,ISLET CELL AB,163.0,105.95,0.95,163.0,120
HCPCS,86341,ISLET CELL ANTIBODY,163.0,105.95,0.95,163.0,60
HCPCS,86341,MLPTHY GAD65 AB,163.0,105.95,0.95,163.0,60
HCPCS,86341,SPSDEV GAD65 AB,163.0,105.95,0.95,163.0,60
HCPCS,86341,ZINC TRANSPORTER 8 ANTIBODY,163.0,105.95,0.95,163.0,60
HCPCS,86343,LEUKOCYTE HISTAMINE RELEASE,,,12.46,54.93,21
HCPCS,86343,Leukocyte histamine release,,,18.32,21.21,8
HCPCS,86344,LEUKOCYTE PHAGOCYTOSIS,,,10.39,42.58,21
HCPCS,86344,Leukocyte phagocytosis,,,18.32,21.21,8
HCPCS,86352,FLOW CD107A CELL FUNCTION,937.0,609.05,0.95,937.0,60
HCPCS,86352,IMMUNE FUN ASSY ATP,937.0,609.05,0.95,937.0,60
HCPCS,86352,NABFERON AB,937.0,609.05,0.95,937.0,60
HCPCS,86352,NEUTROPHIL OX BURST BLD,937.0,609.05,0.95,937.0,60
HCPCS,86352,PSTAT5 CELL FUNCTION,937.0,609.05,0.95,937.0,60
HCPCS,86353,%RETROVIR LYMPH TRANSF,338.0,219.7,0.95,358.7,60
HCPCS,86353,LPT TO BERYLLIUM,338.0,219.7,0.95,358.7,60
HCPCS,86353,LYMPH TRANS TEST,338.0,219.7,0.95,358.7,60
HCPCS,86353,LYMPHOCYTE ANTIGEN PROLIFERATION,338.0,219.7,0.95,358.7,60
HCPCS,86355,*B CELL TOTAL COUNT,260.0,169.0,0.95,260.0,60
HCPCS,86355,B CELL TOTAL-ARUP,260.0,169.0,0.95,260.0,60
HCPCS,86355,B CELLS TOTAL COUNT,260.0,169.0,0.95,260.0,60
HCPCS,86355,"B CELLS, TOTAL COUNT",260.0,169.0,0.95,260.0,60
HCPCS,86356,%PNH CELL AG,185.0,120.25,0.95,185.0,60
HCPCS,86356,BAL FCM MARKERS,185.0,120.25,0.95,185.0,60
HCPCS,86356,BPHENO MONONUCLEAR AG,185.0,120.25,0.95,185.0,60
HCPCS,86356,BPHENO MONONUCLEAR AG - ARUP,185.0,120.25,0.95,185.0,60
HCPCS,86356,"CD20 MONONUCLEAR CELL ANTIGEN, QUANT",185.0,120.25,0.95,185.0,60
HCPCS,86357,*NATURAL KILLER TOTAL COUNT,260.0,169.0,0.95,260.0,60
HCPCS,86357,NK CELLS TOTAL COUNT,260.0,169.0,0.95,260.0,60
HCPCS,86359,*T CELL TOTAL COUNT,260.0,169.0,0.95,260.0,60
HCPCS,86359,T CELLS TOTAL COUNT,260.0,169.0,0.95,260.0,60
HCPCS,86360,*T CELL ABSOLUTE COUNT W RATIO,324.0,210.6,0.95,324.0,60
HCPCS,86360,T CELL ABSOLUTE COUNT/RATIO,324.0,210.6,0.95,324.0,60
HCPCS,86361,%CD4ABS ABSOLUTE COUNT,185.0,120.25,0.95,185.0,60
HCPCS,86361,"LYMPHOCYTE SUBSET 2, CD4 PCT. AND ABSL",185.0,120.25,0.95,185.0,60
HCPCS,86362,"MOG AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,0.95,83.0,120
HCPCS,86363,CDS1SE MOG-IGG1 AB FL EA,260.0,169.0,0.95,260.0,60
HCPCS,86363,MLPTHY MOG FACS,260.0,169.0,0.95,260.0,60
HCPCS,86363,"MOG AB IGG CBA-IFA SCREEN, SERUM",260.0,169.0,0.95,260.0,60
HCPCS,86363,"MOG FACS TITNER, SERUM RFLX",260.0,169.0,0.95,260.0,60
HCPCS,86364,TISSUE TRANSGLUTAMINASE EA,80.0,52.0,0.95,80.0,60
HCPCS,86366,"MUSCLE-SPECIFIC KINASE (MUSK) AUTOANTIBODY, SERUM",127.0,82.55,0.95,127.0,60
HCPCS,86367,STEM CELLS TOTAL COUNT,,,77.78,318.73,21
HCPCS,86367,Stem cells total count,,,22.75,26.35,8
HCPCS,86376,MICROSOMAL ANTIBODIES EA,100.0,65.0,0.95,100.0,60
HCPCS,86376,THYROID PEROXIDASE AB,100.0,65.0,0.95,100.0,60
HCPCS,86378,Migration inhibitory factor,,,58.61,58.61,1
HCPCS,86381,MITOCHONDRIAL ANTIBODY EACH,176.0,114.4,0.95,176.0,60
HCPCS,86382,*VIRUS AB NOS,117.0,76.05,0.95,117.0,60
HCPCS,86384,NITROBLUE TETRAZOLIUM DYE,,,13.61,87.67,21
HCPCS,86384,Nitroblue tetrazolium dye,,,18.32,21.21,8
HCPCS,86386,NUCLEAR MATRIX PROTEIN 22,,,21.78,89.25,22
HCPCS,86386,Nuclear matrix protein 22,,,18.32,21.21,8
HCPCS,86386QW,NUCLEAR MATRIX PROTEIN 22,,,24.4,24.4,1
HCPCS,86403,%CANDA PART AGG,80.0,52.0,0.95,80.0,60
HCPCS,86403,*PARTCL AGGLUT SCREEN EA,80.0,52.0,0.95,80.0,60
HCPCS,86403,CRYPTOCOCCAL ANTIGEN,80.0,52.0,0.95,80.0,60
HCPCS,86403,PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY,80.0,52.0,1.1,80.0,32
HCPCS,86406,PARTICLE AGGLUT ANTBDY TITR,,,10.64,46.55,21
HCPCS,86406,Particle agglut antbdy titr,,,18.32,21.21,8
HCPCS,86408,NEUTRLZG ANTB SARSCOV2 SCR,,,42.13,172.64,21
HCPCS,86408,Neutrlzg antb sarscov2 scr,,,18.32,21.21,8
HCPCS,86409,NEUTRLZG ANTB SARSCOV2 TITER,,,79.61,326.23,21
HCPCS,86409,Neutrlzg antb sarscov2 titer,,,18.32,21.21,8
HCPCS,86413,SARS-COV-2 ANTB QUANTITATIVE,,,47.2,210.75,21
HCPCS,86413,Sars-cov-2 antb quantitative,,,22.75,26.35,8
HCPCS,86430,RHEUMATOID FACTOR TEST QUAL,,,6.14,25.16,21
HCPCS,86430,Rheumatoid factor test qual,,,18.32,21.21,8
HCPCS,86431,RHEUMATOID FACTOR QUANT,39.0,25.35,0.95,39.0,60
HCPCS,86431,RHEUMATOID FACTOR TEST QUANT,39.0,25.35,0.95,39.0,60
HCPCS,86480,"QUANTIFERON-TB GOLD PLUS, BLOOD",428.0,278.2,0.95,428.0,60
HCPCS,86480,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON,428.0,278.2,1.1,428.0,32
HCPCS,86480,TB GOLD PLUS,428.0,278.2,0.95,428.0,60
HCPCS,86480,TB TEST CELL IMMUNITY MEAS,428.0,278.2,0.95,428.0,60
HCPCS,86481,TB AG RESPONSE T-CELL SUSP,,,100.0,409.78,21
HCPCS,86481,Tb ag response t-cell susp,,,22.75,26.35,8
HCPCS,86485,TEST SKIN CANDIDA,169.0,109.85,0.95,169.0,61
HCPCS,86486,"SKIN TEST, UNLISTED ANTIGEN EA",169.0,109.85,0.95,169.0,61
HCPCS,86490,COCCIDIOIDOMYCOSIS SKIN TEST,,,35.72,35.72,1
HCPCS,86490,Coccidioidomycosis skin test,,,22.75,26.35,8
HCPCS,86510,HISTOPLASMOSIS SKIN TEST,,,35.34,125.24,21
HCPCS,86510,Histoplasmosis skin test,,,22.75,26.35,8
HCPCS,86580,SKIN TEST TUBERCULOSIS INTRADERMAL,46.0,29.9,1.1,50.18,44
HCPCS,86580,TB SKIN TEST,15.0,9.75,1.1,50.18,44
HCPCS,86580,TB SKIN TEST 2,15.0,9.75,1.1,50.18,44
HCPCS,86580,TUBERCULOSIS INTRADERMAL (POINT OF CARE LAB),169.0,109.85,0.95,169.0,61
HCPCS,86581,PNEUMO ABS SEROTYPES X23,106.0,68.9,0.95,377.12,55
HCPCS,86581,STREP PNEUMO ABS X14,106.0,68.9,0.95,377.12,55
HCPCS,86590,STREPTOKINASE ANTIBODY,,,12.66,51.88,21
HCPCS,86590,Streptokinase antibody,,,18.32,21.21,8
HCPCS,86592,SYPHILIS TEST QUAL,29.0,18.85,0.95,29.0,180
HCPCS,86592,VDRL-CSF QUAL,29.0,18.85,0.95,29.0,60
HCPCS,86592,VDRL/RPR QUAL,29.0,18.85,0.95,29.0,60
HCPCS,86592,WHIIVF SYPHILIS TEST,29.0,18.85,0.95,29.0,60
HCPCS,86593,SYPHILIS TEST QUANT,30.0,19.5,0.95,31.66,60
HCPCS,86593,VDRL/RPR QUAN,30.0,19.5,0.95,31.66,60
HCPCS,86596,%PARNEO VOLTAGE-GTD CA CHNL ANTB EA,83.0,53.95,0.95,83.0,60
HCPCS,86596,VOLTAGE-GATED NA CH AB EA,83.0,53.95,0.95,83.0,60
HCPCS,86602,ANTINOMYCES ANTIBODY,,,10.18,44.81,21
HCPCS,86602,Antinomyces antibody,,,18.32,21.21,8
HCPCS,86603,ADENOVIRUS ANTIBODY,89.0,57.85,0.95,89.0,60
HCPCS,86606,%ABPA IMMDIFF QUAL,104.0,67.6,0.95,105.93,60
HCPCS,86606,"A FUMIGATUS AB, IGG",104.0,67.6,0.95,105.93,60
HCPCS,86606,ASPERGILLUS AB,104.0,67.6,0.95,105.93,120
HCPCS,86606,ASPERGILLUS AB IMDIFF,104.0,67.6,0.95,105.93,60
HCPCS,86606,ASPERGILLUS ID,104.0,67.6,0.95,105.93,120
HCPCS,86606,ASPERGILLUS QUAL OR SEMI-QUANT,104.0,67.6,0.95,105.93,60
HCPCS,86606,FUNCF ASPERGILLUS ID,104.0,67.6,0.95,105.93,60
HCPCS,86606,HYPERSENSITIVITY PNEUMO IA QUAL,104.0,67.6,0.95,105.93,60
HCPCS,86609,DNA CRITHIDIA ANTIBODY,89.0,57.85,0.95,89.0,60
HCPCS,86609,LISTERIA ANTIBODY,89.0,57.85,0.95,89.0,60
HCPCS,86609,STREPTO.PNEUM.X14,89.0,57.85,0.95,89.0,60
HCPCS,86611,*BARTONELLA AB,70.0,45.5,0.95,78.37,60
HCPCS,86611,BARTONELLA,70.0,45.5,0.95,78.37,60
HCPCS,86612,%FABCSF BLASTOMYCES,89.0,57.85,0.95,99.37,60
HCPCS,86612,BLASOMYCES DERMATITIDIS AB,89.0,57.85,0.95,99.37,60
HCPCS,86612,BLASTOMYCES ID,89.0,57.85,0.95,99.37,60
HCPCS,86612,FUNCF BLASOMYCES DERMATITIDIS AB,89.0,57.85,0.95,99.37,60
HCPCS,86615,B PERTUSSIS AB IGA IB,91.0,59.15,0.95,91.0,60
HCPCS,86615,B PERTUSSIS AB IGG IB,91.0,59.15,0.95,91.0,60
HCPCS,86615,B PERTUSSIS AB IGM IB,91.0,59.15,0.95,91.0,60
HCPCS,86615,BORDETELLA QUAL OR SEMI-QUANT,91.0,59.15,0.95,91.0,60
HCPCS,86615,PERTUSSIS/PARAPERT GAM X3,91.0,59.15,0.95,91.0,60
HCPCS,86617,*LYME WESTERN BLOT,107.0,69.55,0.95,107.0,60
HCPCS,86617,B BURGDO AB IGG IGM X2,107.0,69.55,0.95,107.0,60
HCPCS,86617,LYME DISEASE AB RFLX,107.0,69.55,0.95,107.0,60
HCPCS,86617,LYME IGG/IGM IB CSF X2,107.0,69.55,0.95,107.0,60
HCPCS,86617,LYME WESTERN BLOT,107.0,69.55,0.95,107.0,60
HCPCS,86618,BORELIA BURGDORFERI LYME,118.0,76.7,0.95,118.0,60
HCPCS,86618,LYME DISEASE ANTIBODY,,,19.08,19.08,1
HCPCS,86618,LYME IGG & IGM SERUM,118.0,76.7,0.95,118.0,60
HCPCS,86618,LYME IGG CSF,118.0,76.7,0.95,118.0,60
HCPCS,86618,"LYME REFLEX PNL, CSF",118.0,76.7,0.95,118.0,60
HCPCS,86618,LYMRFX BORRELIA ANTIBODY,118.0,76.7,0.95,118.0,60
HCPCS,86618QW,LYME DISEASE ANTIBODY,,,19.08,19.08,1
HCPCS,86619,BORRELIA ANTIBODY,,,13.38,59.0,21
HCPCS,86619,Borrelia antibody,,,18.32,21.21,8
HCPCS,86622,*BRUCELLA AB,62.0,40.3,0.95,68.79,60
HCPCS,86622,BRUCELLA AB TOTAL,62.0,40.3,0.95,68.79,60
HCPCS,86622,BRUCELLA CONFIRM,62.0,40.3,0.95,68.79,60
HCPCS,86625,CAMPY JEJUNI AB IGG,91.0,59.15,0.95,91.0,60
HCPCS,86628,%CANDA ALBICAN AB X3,83.0,53.95,0.95,92.43,60
HCPCS,86628,*CANDIDA AB,83.0,53.95,0.95,92.43,60
HCPCS,86628,"CANDIDA ABS IGA,G,M X3",83.0,53.95,0.95,92.43,60
HCPCS,86628,CANDIDA IMMUNE COMPLEX,83.0,53.95,0.95,92.43,60
HCPCS,86631,%CIGIM ABS X3,82.0,53.3,0.95,82.0,60
HCPCS,86631,*CHLAMYDIA AB,82.0,53.3,0.95,82.0,60
HCPCS,86631,CHLAMYDIA,82.0,53.3,0.95,82.0,60
HCPCS,86631,CHLAMYDIA AB PANEL X3,82.0,53.3,0.95,82.0,60
HCPCS,86632,%CIGIM IGM ABS X3,87.0,56.55,0.95,87.0,60
HCPCS,86632,*CHLAMYDIA IGM,87.0,56.55,0.95,87.0,60
HCPCS,86632,CHLAMYDIA IGM,87.0,56.55,0.95,87.0,60
HCPCS,86632,CHLAMYDIA IGM PANEL X3,87.0,56.55,0.95,87.0,60
HCPCS,86635,%FABCSF COCCIDIODE IGG/M ABS,79.0,51.35,0.95,88.34,60
HCPCS,86635,COCCIDIODES IGG/M ABS X2,79.0,51.35,0.95,88.34,60
HCPCS,86635,COCCIDIOIDES ID,79.0,51.35,0.95,88.34,60
HCPCS,86635,FUNCF COCCIDOIDES AB,79.0,51.35,0.95,88.34,60
HCPCS,86638,*Q FEVER (COXIELLA) AB,84.0,54.6,0.95,84.0,60
HCPCS,86638,COXIELLA BURNETII IGG X2,84.0,54.6,0.95,84.0,60
HCPCS,86638,COXIELLA IGG IGM IGA X6,84.0,54.6,0.95,84.0,60
HCPCS,86638,QFEVER AB IGG IGM PH I&II,84.0,54.6,0.95,84.0,60
HCPCS,86641,CRYPTOCOCCUS ANTIBODY,,,14.41,60.64,21
HCPCS,86641,Cryptococcus antibody,,,18.32,21.21,8
HCPCS,86644,%IDM CMV,99.0,64.35,0.95,99.0,60
HCPCS,86644,%TORCH AB CMV IGG,99.0,64.35,0.95,99.0,60
HCPCS,86644,CMV AB,99.0,64.35,0.95,99.0,120
HCPCS,86644,CMV IGG ANTIBODY,99.0,64.35,0.95,99.0,60
HCPCS,86644,CMV IGG AVIDITY,99.0,64.35,0.95,99.0,60
HCPCS,86644,WHIIVF2 CMV IGG AB,99.0,64.35,0.95,99.0,60
HCPCS,86645,%TORCHM AB CMV IGM,116.0,75.4,0.95,116.0,60
HCPCS,86645,CMV IGM EIA AB,116.0,75.4,0.95,116.0,60
HCPCS,86645,WHIIVF2 CMV IGM EIA AB,116.0,75.4,0.95,116.0,60
HCPCS,86648,*DIPHTHERIA ABMA,105.0,68.25,0.95,105.0,60
HCPCS,86651,ENCEPHALITIS CALIFORN ANTBDY,,,13.19,55.18,21
HCPCS,86651,Encephalitis californ antbdy,,,18.32,21.21,8
HCPCS,86652,ENCEPHALTIS EAST EQNE ANBDY,,,13.19,89.32,21
HCPCS,86652,Encephaltis east eqne anbdy,,,18.32,21.21,8
HCPCS,86653,ENCEPHALTIS ST LOUIS ANTBODY,,,13.19,89.32,21
HCPCS,86653,Encephaltis st louis antbody,,,18.32,21.21,8
HCPCS,86654,ENCEPHALTIS WEST EQNE ANTBDY,,,13.19,89.32,21
HCPCS,86654,Encephaltis west eqne antbdy,,,18.32,21.21,8
HCPCS,86658,*ENTEROVIRUS AB,90.0,58.5,0.95,100.33,120
HCPCS,86658,COXSACKIE A ABS,90.0,58.5,0.95,100.33,60
HCPCS,86658,COXSACKIE A DIFF AB X6,90.0,58.5,0.95,100.33,60
HCPCS,86658,ECHOVIRUS ANTIBODIES X5,90.0,58.5,0.95,100.33,60
HCPCS,86658,POLIOVIRUS ABS NEUTRAL X2,90.0,58.5,0.95,100.33,60
HCPCS,86658,POLIOVIRUS ANTIBODIES X3,90.0,58.5,0.95,100.33,60
HCPCS,86663,EBV-EA IFA,91.0,59.15,0.95,91.0,60
HCPCS,86664,EBV EBNA,106.0,68.9,0.95,106.0,60
HCPCS,86664,EBV IGG AB,106.0,68.9,0.95,106.0,60
HCPCS,86664,EBV-NA IFA,106.0,68.9,0.95,106.0,60
HCPCS,86665,EBV CAPSID AG IGM,125.0,81.25,0.95,125.0,60
HCPCS,86665,EBV-VCA IFA IGG,125.0,81.25,0.95,125.0,60
HCPCS,86666,"A PHAGO AB, IGG/IGM X2",70.0,45.5,0.95,78.37,60
HCPCS,86666,EHRLICHIA,70.0,45.5,0.95,78.37,60
HCPCS,86666,EHRLICHIA CHAF IGG/IGMX2,70.0,45.5,0.95,78.37,60
HCPCS,86668,FRANCISELLA TULARENSIS AB,98.0,63.7,0.95,98.0,60
HCPCS,86671,%IBDSER SACCH CEREV X2,85.0,55.25,0.95,85.0,60
HCPCS,86671,*FUNGI AB NOS,85.0,55.25,0.95,85.0,120
HCPCS,86671,FUNGI AB NOS,85.0,55.25,0.95,85.0,60
HCPCS,86674,GIARDIA LAMBLIA IG/GAM X3,102.0,66.3,0.95,103.03,60
HCPCS,86677,*H PYLORI AB,116.0,75.4,0.95,116.0,60
HCPCS,86677,H PYLORI AB,116.0,75.4,0.95,116.0,60
HCPCS,86677,H PYLORI AB (BACK OFFICE),116.0,75.4,0.95,116.0,60
HCPCS,86682,FILARIASIS ABS IGG4,90.0,58.5,0.95,90.0,60
HCPCS,86682,SCHISTOSOMA IGG AB,90.0,58.5,0.95,90.0,60
HCPCS,86682,STRONGYLOIDES IGG AB,90.0,58.5,0.95,90.0,60
HCPCS,86682,STRONGYLOIDES IGG ABS,90.0,58.5,0.95,90.0,60
HCPCS,86682,TOXOCARA ANTIBODIES,90.0,58.5,0.95,90.0,60
HCPCS,86684,HEMOPHILUS INFLUENZA ANTIBDY,,,15.84,64.91,21
HCPCS,86684,Hemophilus influenza antibdy,,,18.32,21.21,8
HCPCS,86687,%IDM ANTI HTLV I,63.0,40.95,0.95,63.0,60
HCPCS,86688,HTLV-II ANTIBODY,,,14.0,61.78,21
HCPCS,86688,Htlv-ii antibody,,,18.32,21.21,8
HCPCS,86689,HIV  CONFIRMATION,134.0,87.1,0.95,134.0,60
HCPCS,86689,HIV AB CONFIRM/WESTERN BLOT,134.0,87.1,0.95,134.0,60
HCPCS,86689,HIV2 AB CONF SERUM,134.0,87.1,0.95,134.0,60
HCPCS,86692,HEPATITIS DELTA AB,118.0,76.7,0.95,118.0,60
HCPCS,86694,%TORCHM HSV 1/2 IGM,99.0,64.35,0.95,99.0,60
HCPCS,86694,HERPES IGM,99.0,64.35,0.95,99.0,60
HCPCS,86694,HERPES SIMPLEX IGM ABS,99.0,64.35,0.95,99.0,60
HCPCS,86695,%HIVIFA HSV 1 IGM,91.0,59.15,0.95,91.0,60
HCPCS,86695,%HSVG12 IGG 1,91.0,59.15,0.95,91.0,60
HCPCS,86695,%HSVIFA HSV 2 IGM,91.0,59.15,0.95,91.0,60
HCPCS,86695,HERPES SIMPLEX TYPE I,91.0,59.15,0.95,91.0,60
HCPCS,86696,%HSVG12 IGG 2,134.0,87.1,0.95,134.0,60
HCPCS,86696,*AB; HSV II,134.0,87.1,0.95,134.0,60
HCPCS,86696,*HERPES SIMPLEX TYPE 2 AB,134.0,87.1,0.95,134.0,60
HCPCS,86696,HSV 2 IGM TITER REFLEX,134.0,87.1,0.95,134.0,60
HCPCS,86698,*HISTOPLASMA AB,95.0,61.75,0.95,96.24,60
HCPCS,86698,FUNCF HISTOPLASMA AB X2,95.0,61.75,0.95,96.24,60
HCPCS,86698,HISTO ID,95.0,61.75,0.95,96.24,60
HCPCS,86698,HISTOPLASMA,95.0,61.75,0.95,96.24,60
HCPCS,86698,"HISTOPLASMA AB, CF X2",95.0,61.75,0.95,96.24,60
HCPCS,86701,HIV ANTIBODY,61.0,39.65,0.95,61.0,60
HCPCS,86701,HIV I AB,61.0,39.65,0.95,61.0,60
HCPCS,86701,HIV-1ANTIBODY,,,9.96,9.96,1
HCPCS,86701QW,HIV-1ANTIBODY,,,9.96,9.96,1
HCPCS,86702,HIV-2 AB,93.0,60.45,0.95,93.0,60
HCPCS,86703,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,0.95,95.0,120
HCPCS,86703,HIV 1&2 ANTIBODY SCREEN,95.0,61.75,0.95,95.0,60
HCPCS,86703,HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB),95.0,61.75,0.95,95.0,60
HCPCS,86703,HIV1 HIV2 SNGL ASSAY AB,95.0,61.75,0.95,95.0,60
HCPCS,86704,*HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,60
HCPCS,86704,HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,120
HCPCS,86704,IDM HEP B CORE AB TOTAL,83.0,53.95,0.95,83.0,60
HCPCS,86704,WHIIVF HEP B CORE AB TOTA,83.0,53.95,0.95,83.0,60
HCPCS,86705,HEP B CORE IGM AB,81.0,52.65,0.95,81.0,60
HCPCS,86706,*HEP B SURFACE AB,74.0,48.1,0.95,74.0,60
HCPCS,86706,HEPATITIS B SURF ANTIBODY HBSAB,74.0,48.1,1.1,74.0,32
HCPCS,86707,HEPATITIS BE ANTIBODY,80.0,52.0,0.95,80.0,60
HCPCS,86708,HEP A AB TOTAL,85.0,55.25,0.95,85.0,60
HCPCS,86708,HEPATITIS A ANTIBODY HAAB,85.0,55.25,1.1,85.0,32
HCPCS,86709,"HEP A, HEP A AB IGM",78.0,50.7,0.95,78.0,60
HCPCS,86710,INFLUENZA A+B CF X2,93.0,60.45,0.95,93.0,60
HCPCS,86711,JOHN CUNNINGHAM ANTIBODY,,,16.89,69.21,21
HCPCS,86711,John cunningham antibody,,,18.32,21.21,8
HCPCS,86713,LEGIONELLA ANTIBODY,106.0,68.9,0.95,106.0,60
HCPCS,86713,LEGIONELLA IGM ABS,106.0,68.9,0.95,106.0,60
HCPCS,86713,LEGIONELLA PNEUMOPHILA AB,106.0,68.9,0.95,106.0,60
HCPCS,86717,LEISHMANIASIS,85.0,55.25,0.95,85.0,60
HCPCS,86720,LEPTOSPIRA ANTIBODY,112.0,72.8,0.95,112.0,60
HCPCS,86723,LISTERIA MONOCYTOGENES,,,13.19,101.56,21
HCPCS,86723,Listeria monocytogenes,,,18.32,21.21,8
HCPCS,86727,*LYMPH CHORIOMENINGITIS AB,89.0,57.85,0.95,89.0,60
HCPCS,86729,Lympho venereum antibody,,,52.64,52.64,1
HCPCS,86732,MUCORMYCOSIS ANTIBODY,,,15.0,61.47,21
HCPCS,86732,Mucormycosis antibody,,,18.32,21.21,8
HCPCS,86735,ANTIBODY MUMPS,90.0,58.5,1.1,90.0,32
HCPCS,86735,MUMPS IGG ANTIBODY,90.0,58.5,0.95,90.0,60
HCPCS,86735,MUMPS VIRUS AB IGM,90.0,58.5,0.95,90.0,60
HCPCS,86738,MYCOPLASMA AB,91.0,59.15,0.95,91.0,60
HCPCS,86738,MYCOPLASMA IGM AB,91.0,59.15,0.95,91.0,60
HCPCS,86741,"N. MENINGITIDIS A, C, W-135 AND Y IGG",91.0,59.15,0.95,91.0,60
HCPCS,86744,NOCARDIA ANTIBODY,,,15.99,65.52,21
HCPCS,86744,Nocardia antibody,,,18.32,21.21,8
HCPCS,86747,PARVO B19 AB IGG & IGMX2,104.0,67.6,0.95,104.0,60
HCPCS,86750,MALARIA ANTIBODY,,,13.19,101.56,21
HCPCS,86750,Malaria antibody,,,18.32,21.21,8
HCPCS,86753,%IDM CHAGAS,85.0,55.25,0.95,90.01,60
HCPCS,86753,BABESIA MICROTI G+M X2,85.0,55.25,0.95,90.01,60
HCPCS,86753,ENTAMOEBA HISTO IGG,85.0,55.25,0.95,90.01,60
HCPCS,86753,TRYPANOSOMA CRUZI AB IGG,85.0,55.25,0.95,90.01,60
HCPCS,86753,TRYPANOSOMA CRUZI AB IGM,85.0,55.25,0.95,90.01,60
HCPCS,86756,RESPIRATORY VIRUS ANTIBODY,,,15.89,66.69,21
HCPCS,86756,Respiratory virus antibody,,,18.32,21.21,8
HCPCS,86757,*RICKETTSIA AB,134.0,87.1,0.95,134.0,60
HCPCS,86759,ROTAVIRUS ANTIBODY,,,18.23,74.7,21
HCPCS,86759,Rotavirus antibody,,,18.32,21.21,8
HCPCS,86762,%TORC AB RUBELLA IGM,99.0,64.35,0.95,99.0,60
HCPCS,86762,ANTIBODY RUBELLA,99.0,64.35,1.1,99.0,32
HCPCS,86762,RUBELLA IGG SEMI-QUANT,99.0,64.35,0.95,99.0,60
HCPCS,86762,RUBELLA IGM IFA,99.0,64.35,0.95,99.0,60
HCPCS,86762,WHIIVF2 RUBELLA IGG SEMI-QUANT,99.0,64.35,0.95,99.0,60
HCPCS,86762,WHIIVF2 RUBELLA IGM IFA,99.0,64.35,0.95,99.0,60
HCPCS,86765,ANTIBODY RUBEOLA,89.0,57.85,1.1,89.0,32
HCPCS,86765,MEASLES-RUBEOLA IGG AB,89.0,57.85,0.95,89.0,60
HCPCS,86765,MEASLES-RUBEOLA IGM AB,89.0,57.85,0.95,89.0,60
HCPCS,86768,*AB; SALMONELLA,91.0,59.15,0.95,91.0,60
HCPCS,86769,SARS-COV-2 COVID-19 ANTIBODY,,,42.13,172.64,22
HCPCS,86769,Sars-cov-2 covid-19 antibody,,,18.32,21.21,8
HCPCS,86771,SHIGELLA ANTIBODY,,,24.48,100.31,21
HCPCS,86771,Shigella antibody,,,18.32,21.21,8
HCPCS,86774,TETANUS AB,102.0,66.3,0.95,102.0,60
HCPCS,86777,%CSFTOX TOXOPLAS IGG,99.0,64.35,0.95,99.0,60
HCPCS,86777,%TORCH AB TOXOPLS IGG,99.0,64.35,0.95,99.0,60
HCPCS,86777,TOXOPLAS IGG,99.0,64.35,0.95,99.0,60
HCPCS,86778,%CSFTOX TOXOPLAS IGM,99.0,64.35,0.95,99.0,60
HCPCS,86778,%TORCHM AB TOXOPLS IGM,99.0,64.35,0.95,99.0,60
HCPCS,86778,TOXOPLASMOSIS IGM AB,99.0,64.35,0.95,99.0,60
HCPCS,86780,SYPHILIS T PALLIDUM IGG,91.0,59.15,0.95,91.0,60
HCPCS,86780,TREPONEMA PALLIDUM,91.0,59.15,0.95,91.0,61
HCPCS,86780,WHIIVF SYPHILIS,91.0,59.15,0.95,91.0,60
HCPCS,86780QW,TREPONEMA PALLIDUM,,,14.84,14.84,1
HCPCS,86784,TRICHINELLA IGG AB,87.0,56.55,0.95,87.0,60
HCPCS,86787,ANTIBODY VARICELLA-ZOSTER,89.0,57.85,1.1,89.0,32
HCPCS,86787,VARICELLA ZOSTER IGG AB,89.0,57.85,0.95,89.0,60
HCPCS,86787,VARICELLA ZOSTER IGM,89.0,57.85,0.95,89.0,60
HCPCS,86787,"VZV IGG AB, CSF",89.0,57.85,0.95,89.0,60
HCPCS,86788,%CNILE WEST NILE VRS IGM,116.0,75.4,0.95,116.0,60
HCPCS,86788,WEST NILE VIRUS IGM,116.0,75.4,0.95,116.0,60
HCPCS,86789,%ARBOVIRUS W NILE AB IGG,99.0,64.35,0.95,110.69,60
HCPCS,86789,%CNILE WEST NILE VRS IGG,99.0,64.35,0.95,110.69,60
HCPCS,86789,*WEST NILE VIRUS AB,99.0,64.35,0.95,110.69,60
HCPCS,86790,AB; VIRUS NES,89.0,57.85,0.95,89.0,60
HCPCS,86790,CHIKUNGUNYA AB IGG IGM X2,89.0,57.85,0.95,89.0,60
HCPCS,86790,CHIKUNGUNYA AB W/ REFLEX,89.0,57.85,0.95,89.0,60
HCPCS,86790,CHIKUNGUNYA IGG TITER,89.0,57.85,0.95,89.0,60
HCPCS,86790,CHIKUNGUNYA IGM TITER,89.0,57.85,0.95,89.0,60
HCPCS,86790,DENGUE FEVER ABS IGG/M X2,89.0,57.85,0.95,89.0,60
HCPCS,86790,DENGUE VIRUS IGG AB,89.0,57.85,0.95,89.0,60
HCPCS,86790,DENGUE VIRUS IGM AB,89.0,57.85,0.95,89.0,60
HCPCS,86790,HATAVIRUS IGG & IGM,89.0,57.85,0.95,89.0,60
HCPCS,86790,HEPATITIS E IGG,89.0,57.85,0.95,89.0,60
HCPCS,86790,HEPATITIS E IGG/IGM ABX2,89.0,57.85,0.95,89.0,60
HCPCS,86790,HEPATITIS E IGM,89.0,57.85,0.95,89.0,60
HCPCS,86790,HERPES VIRUS 6 IGG AB,89.0,57.85,0.95,89.0,60
HCPCS,86790,HERPESVIR 6 AB IGM TITER,89.0,57.85,0.95,89.0,60
HCPCS,86790,HERPESVIRUS 6 IGM AB,89.0,57.85,0.95,89.0,60
HCPCS,86790,HERPESVIRUS-7 IGG/M X2,89.0,57.85,0.95,89.0,60
HCPCS,86790,HTLV I/II ANTIBODY EIA,89.0,57.85,0.95,89.0,60
HCPCS,86790,HV6 HUMAN IGG/IGM ABSX2,89.0,57.85,0.95,89.0,60
HCPCS,86790,PARAINFLU 123ABS IGG/MX3,89.0,57.85,0.95,89.0,60
HCPCS,86793,YERSINIA ANTIBODY,,,13.19,58.17,21
HCPCS,86793,Yersinia antibody,,,18.32,21.21,8
HCPCS,86794,ZIKA VIRUS IGM,116.0,75.4,0.95,116.0,60
HCPCS,86800,THRYOGLOB ANTIBODY,110.0,71.5,0.95,110.0,60
HCPCS,86800,THYROGLOBULIN AB,110.0,71.5,0.95,110.0,60
HCPCS,86803,*HEP C AB,98.0,63.7,0.95,98.0,60
HCPCS,86803,HEP C AB,98.0,63.7,0.95,98.0,120
HCPCS,86803,HEPATITIS C AB TEST,98.0,63.7,1.1,98.0,33
HCPCS,86803,IDM HEP C AB,98.0,63.7,0.95,98.0,60
HCPCS,86803,WHIIVF HEP C AB,98.0,63.7,0.95,98.0,60
HCPCS,86803QW,HEPATITIS C AB TEST,,,15.99,15.99,1
HCPCS,86804,HEP C AB TEST CONFIRM,,,15.49,270.35,21
HCPCS,86804,Hep c ab test confirm,,,18.32,21.21,8
HCPCS,86805,LYMPHOCYTOTOXICITY ASSAY,,,189.51,776.57,21
HCPCS,86805,Lymphocytotoxicity assay,,,41.47,48.02,8
HCPCS,86806,LYMPHOCYTOTOXICITY ASSAY,,,47.59,210.14,21
HCPCS,86806,Lymphocytotoxicity assay,,,53.63,62.1,8
HCPCS,86807,CYTOTOXIC ANTIBODY SCREENING,,,78.65,322.29,21
HCPCS,86807,Cytotoxic antibody screening,,,53.63,62.1,8
HCPCS,86808,CYTOTOXIC ANTIBODY SCREENING,,,29.68,228.56,21
HCPCS,86808,Cytotoxic antibody screening,,,22.11,25.6,8
HCPCS,86812,HLA B27 FLOW,178.0,115.7,0.95,178.0,60
HCPCS,86813,HLA TYPING A/B/C MULT AG,400.0,260.0,0.95,409.49,60
HCPCS,86813,"HLA-A,B TYPING",400.0,260.0,0.95,409.49,60
HCPCS,86813,"HLA-A,B TYPING VERIFICATION",400.0,260.0,0.95,409.49,60
HCPCS,86813,"HLA-A,B,CW - TYPING DECEASED DONOR",400.0,260.0,0.95,409.49,60
HCPCS,86816,HLA TYPING DR/DQ,,,30.17,1008.15,21
HCPCS,86816,Hla typing dr/dq,,,53.63,62.1,8
HCPCS,86817,"HLA-DR,DQ,DR51,52,53 -TYPING DECEASED DONOR",732.0,475.8,0.95,732.0,60
HCPCS,86817,"HLA-DR,DQ,DRW TYPING",732.0,475.8,0.95,732.0,60
HCPCS,86821,LYMPHOCYTE CULTURE MIXED,,,36.56,149.82,21
HCPCS,86821,Lymphocyte culture mixed,,,53.63,62.1,8
HCPCS,86822,Lymphocyte culture primed,,,142.53,142.53,1
HCPCS,86825,XM T & B FLOW ALLO,755.0,490.75,0.95,755.0,60
HCPCS,86825,XM T & B FLOW AUTO,755.0,490.75,0.95,755.0,60
HCPCS,86825,XM T&B FLOW ALLO DECEASED DONOR,755.0,490.75,0.95,755.0,60
HCPCS,86826,XM T & B FLOW ALLO- ADD SERUM SAMPLE,252.0,163.8,0.95,252.0,60
HCPCS,86828,AB PRA FLOW,443.0,287.95,0.95,443.0,60
HCPCS,86828,AB PRA FLOW REPEAT,443.0,287.95,0.95,443.0,60
HCPCS,86829,HLA CLASS I/II ANTIBODY QUAL,,,64.19,263.04,21
HCPCS,86829,Hla class i/ii antibody qual,,,53.63,62.1,8
HCPCS,86830,HLA CLASS I PHENOTYPE QUAL,,,95.52,391.42,21
HCPCS,86830,Hla class i phenotype qual,,,53.63,62.1,8
HCPCS,86831,HLA CLASS II PHENOTYPE QUAL,,,81.88,335.53,21
HCPCS,86831,Hla class ii phenotype qual,,,53.63,62.1,8
HCPCS,86832,AB ID & VPRA -CLASS I C1Q,2234.0,1452.1,0.95,2234.0,60
HCPCS,86832,AB ID & VPRA -CLASS I LUMINEX,2234.0,1452.1,0.95,2234.0,60
HCPCS,86832,AB ID & VPRA -CLASS I LUMINEX REPEAT,2234.0,1452.1,0.95,2234.0,60
HCPCS,86832,AB ID CLASS I PHENO BEADS,2234.0,1452.1,0.95,2234.0,60
HCPCS,86832,AB ID CLASS I PHENO BEADS REPEAT,2234.0,1452.1,0.95,2234.0,60
HCPCS,86832,AB ID DILUTION - CLASS I LUMINEX,2234.0,1452.1,0.95,2234.0,60
HCPCS,86832,XM POST-TX DSA MONITORING  CLASS I,2234.0,1452.1,0.95,2234.0,60
HCPCS,86833,AB ID & VPRA -CLASS II LUMINEX,2248.0,1461.2,0.95,2248.0,60
HCPCS,86833,AB ID & VPRA -CLASS II LUMINEX REPEAT,2248.0,1461.2,0.95,2248.0,60
HCPCS,86833,AB ID & VPRA-CLAS II LUMINEX-C1Q,2248.0,1461.2,0.95,2248.0,60
HCPCS,86833,AB ID CLASS II PHENO BEADS,2248.0,1461.2,0.95,2248.0,60
HCPCS,86833,AB ID CLASS II PHENO BEADS REPEAT,2248.0,1461.2,0.95,2248.0,60
HCPCS,86833,AB ID DILUTION - CLASS II LUMINEX,2248.0,1461.2,0.95,2248.0,60
HCPCS,86833,XM POST-TX DSA MONITORING  CLASS II,2248.0,1461.2,0.95,2248.0,60
HCPCS,86834,HLA CLASS I SEMIQUANT PANEL,,,357.56,1465.21,21
HCPCS,86834,Hla class i semiquant panel,,,41.47,48.02,8
HCPCS,86835,HLA CLASS II SEMIQUANT PANEL,,,322.96,1323.43,21
HCPCS,86835,Hla class ii semiquant panel,,,41.47,48.02,8
HCPCS,86849,"PT AB, IGG & IGM X2",326.0,211.9,0.95,326.0,46
HCPCS,86850,*RBC AB SCREEN EA SERUM,67.0,43.55,0.95,168.05,61
HCPCS,86850,WHIVF RBC AB ACRN,67.0,43.55,0.95,168.05,61
HCPCS,86860,RBC AB ELUTION EA ELUTION,1182.0,768.3,0.95,1182.0,61
HCPCS,86860,RBC ANTIB ELUTION,1182.0,768.3,0.95,1182.0,61
HCPCS,86870,AB ID RULE OUT,2482.0,1613.3,0.95,2482.0,61
HCPCS,86870,CRC AB ID PANEL,2482.0,1613.3,0.95,2482.0,61
HCPCS,86870,RBC AB ID EA PANL,2482.0,1613.3,0.95,2482.0,122
HCPCS,86880,AGT DIR MONOSPECIF C3,37.0,24.05,0.95,165.35,61
HCPCS,86880,COOMBS TEST DIR EA ANTISERUM,37.0,24.05,0.95,165.35,61
HCPCS,86880,COOMBS; DIRECT,37.0,24.05,0.95,165.35,61
HCPCS,86885,COOMBS TEST INDIRECT QUAL,39.0,25.35,0.95,477.52,61
HCPCS,86885,"CRC AB ID, EACH CELL",39.0,25.35,0.95,477.52,61
HCPCS,86886,ANTIBODY TITER,36.0,23.4,0.95,477.52,61
HCPCS,86886,COOMBS TEST INDIRECT TITER,36.0,23.4,0.95,477.52,61
HCPCS,86890,COLL/STORE AUTOLOGOUS BLOOD,1182.0,768.3,0.95,1182.0,61
HCPCS,86891,AUTOLOGOUS BLOOD OP SALVAGE,,,308.73,2258.2,21
HCPCS,86891,Autologous blood op salvage,,,50.92,58.96,8
HCPCS,86900,ABO BLOOD TYPING,21.0,13.65,0.95,372.91,61
HCPCS,86900,WHIVF BLD BYPE ABO,21.0,13.65,0.95,372.91,61
HCPCS,86901,*BLOOD TYPING RH(D),21.0,13.65,0.95,104.69,122
HCPCS,86901,PAT BLOOD TYPING RH(D),21.0,13.65,0.95,104.69,61
HCPCS,86901,WHIVF BLD TYPE RHD,21.0,13.65,0.95,104.69,61
HCPCS,86901,WKD D AG TYPING,21.0,13.65,0.95,104.69,61
HCPCS,86902,BLOOD TYPE AN,44.0,28.6,0.95,1004.67,61
HCPCS,86902,BLOOD TYPE ANTIGEN DONOR EA,44.0,28.6,0.95,1004.67,61
HCPCS,86902,SPECIAL ANTIGEN SCREEN,44.0,28.6,0.95,1004.67,61
HCPCS,86903,"BLOOD TYPING, ANTIGEN SCREEN",,,61.04,61.04,1
HCPCS,86904,BLOOD TYPING PATIENT SERUM,,,36.77,153.48,22
HCPCS,86904,Blood typing patient serum,,,22.11,25.6,8
HCPCS,86905,RBC AG NOT AB,26.0,16.9,0.95,1004.67,61
HCPCS,86905,RBC ANTIGEN TYPING,26.0,16.9,0.95,1004.67,61
HCPCS,86906,BLD TYPING SEROLOGIC RH PHNT,,,17.45,97.18,22
HCPCS,86906,Bld typing serologic rh phnt,,,22.11,25.6,8
HCPCS,86910,BLOOD TYPING PATERNITY TEST,,,44.66,59.67,2
HCPCS,86910,Blood typing paternity test,,,22.11,25.6,8
HCPCS,86911,BLOOD TYPING ANTIGEN SYSTEM,,,39.31,51.83,2
HCPCS,86911,Blood typing antigen system,,,22.11,25.6,8
HCPCS,86920,COMPATIBILITY TEST SPIN,1182.0,768.3,0.95,1182.0,61
HCPCS,86921,COMPATIBILITY TEST INCUBATE,1182.0,768.3,0.95,1182.0,61
HCPCS,86921,INCUBATION CROSSMATCH,1182.0,768.3,0.95,1182.0,61
HCPCS,86922,COMPATIBILITY TEST ANTIGLOB,1182.0,768.3,0.95,1182.0,61
HCPCS,86922,"CROSSMATCH, ANTIGLOBULIN",1182.0,768.3,0.95,1182.0,61
HCPCS,86923,ELECTRONIC CROSSMATCH,1182.0,768.3,0.95,1182.0,61
HCPCS,86927,THAW FFP EA UNIT,1182.0,768.3,0.95,1182.0,61
HCPCS,86930,FROZEN BLOOD PREP,,,76.04,655.34,21
HCPCS,86930,Frozen blood prep,,,50.92,58.96,8
HCPCS,86931,FROZEN BLOOD THAW,,,48.87,655.34,21
HCPCS,86931,Frozen blood thaw,,,50.92,58.96,8
HCPCS,86932,FROZEN BLOOD FREEZE/THAW,,,35.34,152.2,21
HCPCS,86932,Frozen blood freeze/thaw,,,50.92,58.96,8
HCPCS,86940,HEMOLYSINS/AGGLUTININS AUTO,,,8.77,36.11,21
HCPCS,86940,Hemolysins/agglutinins auto,,,22.11,25.6,8
HCPCS,86941,HEMOLYSINS/AGGLUTININS,,,12.11,49.62,21
HCPCS,86941,Hemolysins/agglutinins,,,22.11,25.6,8
HCPCS,86945,IRRADIATION BLOOD PRODUCT,271.0,176.15,0.95,271.0,61
HCPCS,86950,LEUKACYTE TRANSFUSION,,,101.41,477.52,21
HCPCS,86950,Leukacyte transfusion,,,50.92,58.96,8
HCPCS,86960,VOL REDUCTION OF BLOOD/PROD,,,158.33,477.52,20
HCPCS,86960,Vol reduction of blood/prod,,,50.92,58.96,8
HCPCS,86965,POOLING BLOOD PLT OR OTHER BLD PRD,1182.0,768.3,0.95,1182.0,61
HCPCS,86970,DTT TREATMENT,410.0,266.5,0.95,410.0,61
HCPCS,86970,PRETREAT RBC AB ID DRUG,410.0,266.5,0.95,410.0,61
HCPCS,86971,AB ID ENZYMES,1182.0,768.3,0.95,1182.0,61
HCPCS,86971,PRETREATMENT W/ENZYME,1182.0,768.3,0.95,1182.0,61
HCPCS,86972,PRETREAT RBC AB ID DENSITYSEP,1182.0,768.3,0.95,1182.0,61
HCPCS,86975,RBC SERUM PRETX INCUBJ DRUGS,,,51.1,1252.1,21
HCPCS,86975,Rbc serum pretx incubj drugs,,,50.92,58.96,8
HCPCS,86976,PREWARM MODIFICATION,169.0,109.85,0.95,169.0,61
HCPCS,86977,PRETREAT SERUM AB ID INCUBATE,1182.0,768.3,0.95,1182.0,61
HCPCS,86977,R E S ABSORP TEST,1182.0,768.3,0.95,1182.0,61
HCPCS,86978,AB ABSORPTION,410.0,266.5,0.95,410.0,61
HCPCS,86978,PRETREAT SERUM AB ID ABSORP,410.0,266.5,0.95,410.0,61
HCPCS,86978,TRIPLE ABSORPTION X3,410.0,266.5,0.95,410.0,61
HCPCS,86985,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,1182.0,768.3,0.95,1182.0,61
HCPCS,86999,UNLISTED TRANSFUSION MED PX,,,22.63,81.07,20
HCPCS,86999,Unlisted transfusion med px,,,22.11,25.6,8
HCPCS,87001,SMALL ANIMAL INOCULATION,,,58.28,58.28,1
HCPCS,87003,SMALL ANIMAL INOCULATION,,,16.84,74.24,21
HCPCS,87003,Small animal inoculation,,,13.21,15.29,8
HCPCS,87015,*CONC FOR INFECTIOUS AGENT,46.0,29.9,0.95,46.0,60
HCPCS,87015,*CONCENTRATION FOR INFECT AGNT,46.0,29.9,0.95,46.0,60
HCPCS,87015,PROCESSING AFB REDIGESTION,46.0,29.9,0.95,46.0,60
HCPCS,87015,"PROCESSING, AFB CONCENTRATION",46.0,29.9,0.95,46.0,60
HCPCS,87015,"PROCESSING, CYTOSPIN",46.0,29.9,0.95,46.0,60
HCPCS,87015,"PROCESSING, FLUID CONCENTRATION",46.0,29.9,0.95,46.0,60
HCPCS,87015,"PROCESSING, THICK SMEAR PREPARATION",46.0,29.9,0.95,46.0,60
HCPCS,87040,CULTURE FOR BLOOD,71.0,46.15,0.95,71.0,60
HCPCS,87040,"CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC",71.0,46.15,0.95,71.0,60
HCPCS,87045,CULTURE FOR STOOL PANEL,65.0,42.25,0.95,65.0,60
HCPCS,87045,"CULTURE, BACTERIAL, STOOL, SALMONELLA SHIGELLA",65.0,42.25,0.95,65.0,60
HCPCS,87046,"CULTURE, BACTERIAL, STOOL, EACH PLATE",65.0,42.25,0.95,65.0,60
HCPCS,87070,%IOHWC CULTURE,59.0,38.35,0.95,59.0,60
HCPCS,87070,*BACTERIAL CULTURE-OTHR SOURCE,59.0,38.35,0.95,59.0,60
HCPCS,87070,BACTERIAL CULTURE OTHR SOURCE,59.0,38.35,0.95,59.0,120
HCPCS,87070,"CULTURE, BACTERIAL, AEROBIC",59.0,38.35,0.95,59.0,60
HCPCS,87071,"CULTURE, BACTERIAL, AEROBIC, QUANTITATIVE",68.0,44.2,0.95,68.0,60
HCPCS,87073,"CULTURE, BACTERIAL, ANAEROBIC, QUANTITATIVE",67.0,43.55,0.95,67.0,60
HCPCS,87075,"CULTURE, BACTERIAL, ANAEROBIC",65.0,42.25,0.95,65.0,60
HCPCS,87076,"IDENTIFICATION, ANAEROBIC ISOLATE",56.0,36.4,0.95,62.24,60
HCPCS,87077,CULTURE AEROBIC IDENTIFY,,,9.05,9.05,1
HCPCS,87077,"IDENTIFICATION, AEROBIC ISOLATE",56.0,36.4,0.95,62.24,60
HCPCS,87077,"IDENTIFICATION, AEROBIC ISOLATE (POINT OF CARE LAB)",56.0,36.4,0.95,62.24,60
HCPCS,87077QW,CULTURE AEROBIC IDENTIFY,,,9.05,9.05,1
HCPCS,87081,CULT SCREEN ONLY,46.0,29.9,0.95,46.0,60
HCPCS,87081,"CULTURE, PRESUMPTIVE SCREENING",46.0,29.9,0.95,46.0,60
HCPCS,87081,LEGIONELLA CULTURE,46.0,29.9,0.95,46.0,60
HCPCS,87081,MRSA,46.0,29.9,0.95,46.0,60
HCPCS,87081,VRE SCREEN,46.0,29.9,0.95,46.0,60
HCPCS,87084,CULTURE OF SPECIMEN BY KIT,,,27.07,110.93,21
HCPCS,87084,Culture of specimen by kit,,,13.21,15.29,8
HCPCS,87086,CULT/COLONY COUNT QUANT URINE,56.0,36.4,0.95,56.0,60
HCPCS,87086,"CULTURE,  BACTERIAL, URINE, QUANTITATIVE",56.0,36.4,0.95,56.0,60
HCPCS,87088,"IDENTIFICATION, URINE, PRESUMPTIVE",56.0,36.4,0.95,56.0,60
HCPCS,87101,CULT FUNGI SKIN HAIR NAIL,53.0,34.45,0.95,59.38,60
HCPCS,87101,"CULTURE, FUNGAL ISOLATION, HAIR, SKIN, NAIL",53.0,34.45,0.95,59.38,60
HCPCS,87102,"CULTURE, FUNGAL ISOLATION",58.0,37.7,0.95,58.0,60
HCPCS,87103,*CULT FUNGI PRES ID BLOOD,141.0,91.65,0.95,141.0,60
HCPCS,87103,"CULTURE, FUNGAL ISOLATION, BLOOD",141.0,91.65,0.95,141.0,60
HCPCS,87106,"IDENTIFICATION, YEAST",71.0,46.15,0.95,71.0,60
HCPCS,87107,"IDENTIFICATION, MOLD",71.0,46.15,0.95,71.0,60
HCPCS,87109,CULT MYCOPLASMA ANY SOURCE,106.0,68.9,0.95,106.0,120
HCPCS,87109,"CULTURE, MYCOPLASMA",106.0,68.9,0.95,106.0,60
HCPCS,87110,*CULT CHLAMYDIA ANY SOURCE,135.0,87.75,0.95,135.0,60
HCPCS,87116,*CULT TUBERCLE PRES ID,75.0,48.75,0.95,75.0,60
HCPCS,87116,"CULTURE, ACID FAST",75.0,48.75,0.95,75.0,60
HCPCS,87118,"IDENTIFICATION, MYCOBACTERIAL",101.0,65.65,0.95,101.0,60
HCPCS,87140,*CULT TYPE IF EA ANTISERUM,38.0,24.7,0.95,38.0,60
HCPCS,87140,CULT TYPE IF EA ANTISERUM,38.0,24.7,0.95,38.0,60
HCPCS,87140,HERPES TYPING,38.0,24.7,0.95,38.0,60
HCPCS,87143,CULTURE TYPING GLC/HPLC,,,12.52,55.19,21
HCPCS,87143,Culture typing glc/hplc,,,13.21,15.29,8
HCPCS,87147,CULTURE TYPE IMMUNOLOGIC,36.0,23.4,0.95,36.0,60
HCPCS,87147,E COLI AGGL,36.0,23.4,0.95,36.0,60
HCPCS,87147,TYPING BY IMMUNOLOGIC METHOD,36.0,23.4,0.95,36.0,60
HCPCS,87149,GPC BLD CULT ID VERIGENE,138.0,89.7,0.95,138.0,60
HCPCS,87149,MICRO ID BY PNA FISH,138.0,89.7,0.95,138.0,60
HCPCS,87150,"AMPLIFICATION, STREPTOCOCCUS, GROUP B WITH LIM BROTH",242.0,157.3,0.95,242.0,60
HCPCS,87150,BCID DNA/RNA AMP PROBE,242.0,157.3,0.95,242.0,60
HCPCS,87152,CULTURE TYPE PULSE FIELD GEL,,,7.74,31.72,21
HCPCS,87152,Culture type pulse field gel,,,13.21,15.29,8
HCPCS,87153,"IDENTIFICATION, NUCLEIC ACID SEQUENCING",796.0,517.4,0.95,796.0,60
HCPCS,87154,"IDENTIFICATION, BLOOD PATHOGEN PANEL",1505.0,978.25,0.95,1505.0,60
HCPCS,87158,ID BY PYROSEQUENCING,53.0,34.45,0.95,53.0,60
HCPCS,87158,"IDENTIFICATION, OTHER METHODS",53.0,34.45,0.95,53.0,60
HCPCS,87164,DARK FIELD EXAM SPEC COLLJ,,,10.74,47.26,21
HCPCS,87164,Dark field exam spec collj,,,13.21,15.29,8
HCPCS,87166,DARK FIELD EXAM W/O COLLJ,,,11.3,49.81,21
HCPCS,87166,Dark field exam w/o collj,,,13.21,15.29,8
HCPCS,87168,"MACROSCOPIC EXAM, ARTHROPOD",29.0,18.85,0.95,39.45,60
HCPCS,87169,"MACROSCOPIC EXAM, PARASITE",30.0,19.5,0.95,32.88,60
HCPCS,87172,PINWORM PREP PERIANAL,29.0,18.85,0.95,29.0,60
HCPCS,87172,PINWORM PREP PERIANAL (POINT OF CARE LAB),29.0,18.85,0.95,29.0,60
HCPCS,87176,"PROCESSING, TISSUE HOMOGENIZATION",41.0,26.65,0.95,45.32,60
HCPCS,87177,"CONCENTRATION AND ID, OVA AND PARASITE",61.0,39.65,0.95,61.0,60
HCPCS,87181,SUSCEPTIBILITY AGAR DIL,33.0,21.45,0.95,33.0,60
HCPCS,87181,"SUSCEPTIBILITY, AGAR DILUTION, PER AGENT",33.0,21.45,0.95,33.0,60
HCPCS,87182,"SUSCEPTIBILITY, CARBAPENAMASE ENZYME DETECTION, PER ISOLATE",260.0,169.0,0.95,260.0,46
HCPCS,87183,SC STD CARBAPENEM RESIST GEN,,,35.09,143.79,14
HCPCS,87183,Sc std carbapenem resist gen,,,26.69,30.9,8
HCPCS,87184,SENSITIVITY - DISK PER PLATE,52.0,33.8,0.95,53.16,60
HCPCS,87184,"SUSCEPTIBILITY, DISK METHOD, PER PLATE",52.0,33.8,0.95,53.16,60
HCPCS,87185,"SUSCEPTIBILITY, ENZYME DETECTION, PER ENZYME",33.0,21.45,0.95,33.0,60
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL",60.0,39.0,0.95,60.0,60
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL AFB",60.0,39.0,0.95,60.0,60
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL PHOENIX",60.0,39.0,0.95,60.0,60
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL SENSITITRE",60.0,39.0,0.95,60.0,60
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL VITEK",60.0,39.0,0.95,60.0,60
HCPCS,87187,SC STD MICRODIL/AGAR MLC,,,40.17,164.61,21
HCPCS,87187,Sc std microdil/agar mlc,,,26.69,30.9,8
HCPCS,87188,AMBCAN AMPHOTERICIN B/CANDIN SUSCEPTIBILITY PANEL X4,46.0,29.9,0.95,51.09,60
HCPCS,87188,AZOLE PANEL X4,46.0,29.9,0.95,51.09,60
HCPCS,87188,MOLD SUSCEPT 2 DRUG X2,46.0,29.9,0.95,51.09,60
HCPCS,87188,MOLD SUSCEPT 3 DRUGS X3,46.0,29.9,0.95,51.09,60
HCPCS,87190,SC STD MYOBACTERIA PROP METH,,,7.31,29.95,21
HCPCS,87190,Sc std myobacteria prop meth,,,13.21,15.29,8
HCPCS,87197,SERUM BACTERICIDAL TITER,,,15.02,66.26,21
HCPCS,87197,Serum bactericidal titer,,,13.21,15.29,8
HCPCS,87205,%IOHWC GRAM STAIN,29.0,18.85,0.95,29.0,60
HCPCS,87205,*SMEAR GRAM STAIN,29.0,18.85,0.95,29.0,60
HCPCS,87205,KRUGER'S TEST,29.0,18.85,0.95,29.0,60
HCPCS,87205,"SMEAR, GRAM STAIN",29.0,18.85,0.95,29.0,60
HCPCS,87206,*SMEAR FLUORESCENT/ACID STAIN,37.0,24.05,0.95,37.0,60
HCPCS,87206,"SMEAR, ACID FAST FLUORESCENT",37.0,24.05,0.95,37.0,60
HCPCS,87206,"SMEAR, FUNGAL FLUORESCENT",37.0,24.05,0.95,37.0,60
HCPCS,87207,SMEAR SPECIAL STAIN,41.0,26.65,0.95,58.34,60
HCPCS,87207,"SMEAR, BLOOD PARASITE",41.0,26.65,0.95,58.34,60
HCPCS,87207,"SMEAR, PARASITE SPECIAL STAIN",41.0,26.65,0.95,58.34,60
HCPCS,87209,PARASITE STAIN,124.0,80.6,0.95,124.0,60
HCPCS,87209,"SMEAR, TRICHROME STAIN",124.0,80.6,0.95,124.0,60
HCPCS,87210,SMEAR - INFECTIOUS WET MOUNT,40.0,26.0,0.95,40.0,60
HCPCS,87210,SMEAR WET MOUNT,40.0,26.0,0.95,40.0,120
HCPCS,87210,SMEAR WET MOUNT SALINE/INK,,,6.52,6.52,1
HCPCS,87210,SMR PRIM SRC WET MOUNT NFCT AGT,40.0,26.0,1.1,40.0,32
HCPCS,87210QW,SMEAR WET MOUNT SALINE/INK,,,6.52,6.52,1
HCPCS,87220,KOH EXAM (POINT OF CARE LAB),29.0,18.85,0.95,29.0,60
HCPCS,87220,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,29.0,18.85,1.1,29.0,32
HCPCS,87220,TISSUE EXAM FOR FUNGI,23.0,14.95,1.1,23.0,32
HCPCS,87220,TISSUE EXAM KOH,29.0,18.85,0.95,29.0,60
HCPCS,87230,TOXIN/ANTITOXIN ASY TISS CUL,,,19.74,87.11,21
HCPCS,87230,Toxin/antitoxin asy tiss cul,,,13.21,15.29,8
HCPCS,87250,VIRUS INOCULATE EGGS/ANIMAL,,,19.56,86.24,21
HCPCS,87250,Virus inoculate eggs/animal,,,13.21,15.29,8
HCPCS,87252,%HSVCUL VIR INNOC TISSUE,180.0,117.0,0.95,180.0,60
HCPCS,87252,ENTEROVIRUS CULTURE,180.0,117.0,0.95,180.0,60
HCPCS,87252,TISSUE CULTURE,180.0,117.0,0.95,180.0,60
HCPCS,87253,%HSVCUL VIR INNOC TIS ADD,139.0,90.35,0.95,155.51,60
HCPCS,87253,VIRUS CULTURE W/STAIN,139.0,90.35,0.95,155.51,60
HCPCS,87254,*VIRUS INOCULATION SHELL VIAL,135.0,87.75,0.95,135.0,60
HCPCS,87254,CULTURE ANTIGEN DFA,135.0,87.75,0.95,135.0,60
HCPCS,87254,CYTOMEGALOVIRUS,135.0,87.75,0.95,135.0,60
HCPCS,87254,IN HOUSE CULT ANTIGEN DFA,135.0,87.75,0.95,135.0,60
HCPCS,87255,HERPES SIMPLEX CULTURE,234.0,152.1,0.95,234.0,60
HCPCS,87255,HSVCUL GENETIC VIRUS ISOLATION HSV,234.0,152.1,0.95,234.0,60
HCPCS,87260,*%DFA ADENO,100.0,65.0,0.95,100.0,60
HCPCS,87265,BORDETELLA PERTUSS DFA X2,83.0,53.95,0.95,83.0,60
HCPCS,87267,ENTEROVIRUS ANTIBODY DFA,,,13.42,54.99,21
HCPCS,87267,Enterovirus antibody dfa,,,13.21,15.29,8
HCPCS,87269,GIARDIA AG IF,,,13.61,55.77,21
HCPCS,87269,Giardia ag if,,,13.21,15.29,8
HCPCS,87270,CHLAMYDIA TRACHOMATIS AG IF,,,11.98,52.85,21
HCPCS,87270,Chlamydia trachomatis ag if,,,13.21,15.29,8
HCPCS,87271,CYTOMEGALOVIRUS DFA,,,13.42,54.99,21
HCPCS,87271,Cytomegalovirus dfa,,,13.21,15.29,8
HCPCS,87272,CRYPTOSPORIDIUM AG IF,,,11.98,52.85,21
HCPCS,87272,Cryptosporidium ag if,,,13.21,15.29,8
HCPCS,87273,HERPES SIMPLEX 2 AG IF,,,11.98,52.85,21
HCPCS,87273,Herpes simplex 2 ag if,,,13.21,15.29,8
HCPCS,87274,HERPES SIMPLEX 1 AG IF,,,11.98,52.85,21
HCPCS,87274,Herpes simplex 1 ag if,,,13.21,15.29,8
HCPCS,87275,INFLUENZA B AG IF,,,12.25,107.02,21
HCPCS,87275,Influenza b ag if,,,13.21,15.29,8
HCPCS,87276,INFLUENZA A AG IF,,,16.07,116.37,21
HCPCS,87276,Influenza a ag if,,,13.21,15.29,8
HCPCS,87277,Legionella micdadei ag if,,,52.85,52.85,1
HCPCS,87278,LEGION PNEUMOPHILIA AG IF,,,15.6,63.93,21
HCPCS,87278,Legion pneumophilia ag if,,,13.21,15.29,8
HCPCS,87279,PARAINFLUENZA AG IF,,,16.43,92.38,21
HCPCS,87279,Parainfluenza ag if,,,13.21,15.29,8
HCPCS,87280,RESPIRATORY SYNCYTIAL AG IF,,,13.42,72.56,21
HCPCS,87280,Respiratory syncytial ag if,,,13.21,15.29,8
HCPCS,87281,PNEUMOCYSTIS CARINII AG IF,,,11.98,52.85,21
HCPCS,87281,Pneumocystis carinii ag if,,,13.21,15.29,8
HCPCS,87283,RUBEOLA AG IF,,,52.85,249.15,21
HCPCS,87283,Rubeola ag if,,,26.69,30.9,8
HCPCS,87285,TREPONEMA PALLIDUM AG IF,,,12.18,52.85,21
HCPCS,87285,Treponema pallidum ag if,,,13.21,15.29,8
HCPCS,87290,VARICELLA ZOSTER DFA,93.0,60.45,0.95,93.0,60
HCPCS,87299,ANTIBODY DETECTION NOS IF,,,16.1,65.97,21
HCPCS,87299,Antibody detection nos if,,,13.21,15.29,8
HCPCS,87300,HERPES SIMPLEX DFA,83.0,53.95,0.95,83.0,60
HCPCS,87301,%ROTAD ADENOV 40-41,83.0,53.95,0.95,83.0,60
HCPCS,87301,ROTAD ADENOV 40-41,83.0,53.95,0.95,83.0,60
HCPCS,87305,"ASPER GALACTOMAN, BAL",83.0,53.95,0.95,92.38,60
HCPCS,87305,ASPERGILLUS AG EIA,83.0,53.95,0.95,92.38,60
HCPCS,87305,ASPERGILLUS GALACT SERUM,83.0,53.95,0.95,92.38,60
HCPCS,87320,CHLMYD TRACH AG IA,,,15.0,61.47,21
HCPCS,87320,Chlmyd trach ag ia,,,13.21,15.29,8
HCPCS,87324,"IMMUNOASSAY, CLOSTRIDIUM DIFFICILE TOXIN",83.0,53.95,0.95,83.0,60
HCPCS,87327,CRYPTOCOCCUS NEOFORMANS ANTGN,93.0,60.45,0.95,93.0,60
HCPCS,87328,"IMMUNOASSAY, CRYPTOSPORIDIUM",95.0,61.75,0.95,95.0,60
HCPCS,87329,GIARDIA AG EIA,83.0,53.95,0.95,83.0,60
HCPCS,87329,"GIARDIA ANTIGEN, STOOL",83.0,53.95,0.95,83.0,60
HCPCS,87329,"IMMUNOASSAY, GIARDIA",83.0,53.95,0.95,83.0,60
HCPCS,87332,CYTOMEGALOVIRUS AG IA,,,11.98,52.85,21
HCPCS,87332,Cytomegalovirus ag ia,,,13.21,15.29,8
HCPCS,87335,E COLI 0157 AG IA,,,12.66,52.85,21
HCPCS,87335,E coli 0157 ag ia,,,13.21,15.29,8
HCPCS,87336,ENTAMOEB HIST DISPR AG IA,,,16.0,65.56,21
HCPCS,87336,Entamoeb hist dispr ag ia,,,13.21,15.29,8
HCPCS,87337,ENTAMOEBA HISTOLYT AG,83.0,53.95,0.95,83.0,60
HCPCS,87338,H. PYLORI QUALITATIVE,99.0,64.35,0.95,99.0,60
HCPCS,87338,HPYLORI STOOL AG IA,,,16.11,16.11,1
HCPCS,87338,"IMMUNOASSAY, H. PYLORI",99.0,64.35,0.95,99.0,60
HCPCS,87338QW,HPYLORI STOOL AG IA,,,16.11,16.11,1
HCPCS,87339,H PYLORI AG IA,,,16.0,65.56,21
HCPCS,87339,H pylori ag ia,,,13.21,15.29,8
HCPCS,87340,*%HEP HBSAG,71.0,46.15,0.95,71.0,60
HCPCS,87340,*HEP B SURFACE AG EIA,71.0,46.15,0.95,71.0,60
HCPCS,87340,HEP B SURFACE AG EIA,71.0,46.15,0.95,71.0,120
HCPCS,87340,WHIIVF *%HEP HBSAG,71.0,46.15,0.95,71.0,60
HCPCS,87341,HEP B SURFACE AG NEUTRAL,71.0,46.15,0.95,71.0,60
HCPCS,87341,HEPATITIS HBSAG CONF,71.0,46.15,0.95,71.0,60
HCPCS,87350,HEPATITIS BE ANTIGEN,80.0,52.0,0.95,80.0,60
HCPCS,87380,HEPATITIS DELTA AGENT AG IA,,,18.36,75.24,21
HCPCS,87380,Hepatitis delta agent ag ia,,,13.21,15.29,8
HCPCS,87385,HISTOPLASMA ANTIGEN SERUM,91.0,59.15,0.95,92.38,60
HCPCS,87385,HISTOPLASMA ANTIGEN UR,91.0,59.15,0.95,92.38,60
HCPCS,87385,HISTOPLASMA CAPSULA AG,91.0,59.15,0.95,92.38,60
HCPCS,87385,"HISTOPLASMA GALACTOMANNAN EIA, BAL",91.0,59.15,0.95,92.38,60
HCPCS,87385,"HISTOPLASMA GALACTOMANNAN EIA, CSF",91.0,59.15,0.95,92.38,60
HCPCS,87389,%HEXP HIV 1&2 AG/AB,166.0,107.9,0.95,166.0,60
HCPCS,87389,HIV 1&2 ANTIGEN/ANTIBODY,166.0,107.9,0.95,166.0,60
HCPCS,87389,HIV-1 AG W/HIV-1&-2 AB AG IA,,,26.98,26.98,1
HCPCS,87389,WHIIVF HIV 1&2 AG/AB,166.0,107.9,0.95,166.0,60
HCPCS,87389QW,HIV-1 AG W/HIV-1&-2 AB AG IA,,,26.98,26.98,1
HCPCS,87390,HIV-1 AG IA,,,24.06,98.59,21
HCPCS,87390,Hiv-1 ag ia,,,13.21,15.29,8
HCPCS,87391,HIV-2 AG IA,,,21.9,89.74,21
HCPCS,87391,Hiv-2 ag ia,,,13.21,15.29,8
HCPCS,87400,INFLUENZA A/B EACH AG IA,,,15.83,15.83,1
HCPCS,87400,RAPID INFLUENZA AG TRGR,97.0,63.05,0.95,97.0,120
HCPCS,87400,"RAPID INFLUENZA AG, PER AG",97.0,63.05,0.95,97.0,60
HCPCS,87400QW,INFLUENZA A/B EACH AG IA,,,15.83,15.83,1
HCPCS,87420,RESP SYNCYTIAL VIRUS AG IA,,,15.59,15.59,1
HCPCS,87420,RSV ANTIGEN,96.0,62.4,0.95,96.0,60
HCPCS,87420,RSV EIA,96.0,62.4,0.95,96.0,60
HCPCS,87420QW,RESP SYNCYTIAL VIRUS AG IA,,,15.59,15.59,1
HCPCS,87425,%ROTAD ROTAVIRUS,83.0,53.95,0.95,83.0,60
HCPCS,87425,"IMMUNOASSAY, ROTAVIRUS",83.0,53.95,0.95,83.0,60
HCPCS,87426,SARSCOV CORONAVIRUS AG IA,,,35.33,144.78,22
HCPCS,87426,Sarscov coronavirus ag ia,,,13.21,15.29,8
HCPCS,87426QW,SARSCOV CORONAVIRUS AG IA,,,50.67,50.67,1
HCPCS,87427,%STOOL SHIGA LIKE TOX X2,83.0,53.95,0.95,83.0,60
HCPCS,87428,SARSCOV & INF VIR A&B AG IA,,,34.67,288.03,23
HCPCS,87428,Sarscov & inf vir a&b ag ia,,,26.69,30.9,8
HCPCS,87428QW,SARSCOV & INF VIR A&B AG IA,,,34.67,34.67,1
HCPCS,87430,STREP A AG IA,,,18.83,18.83,1
HCPCS,87430,STREP SCREEN,116.0,75.4,0.95,116.0,60
HCPCS,87430QW,STREP A AG IA,,,18.83,18.83,1
HCPCS,87449,*INFECT AGENT NOS EIA MULT,83.0,53.95,0.95,83.0,120
HCPCS,87449,AG DETECT NOS IA MULT,83.0,53.95,0.95,83.0,120
HCPCS,87449,BLASTOMYCES ANTIGEN,83.0,53.95,0.95,83.0,60
HCPCS,87449,FUNGI ASSAY FOR B-D GLUC,83.0,53.95,0.95,83.0,60
HCPCS,87449,INFECT AGENT NOS EIA MULT,83.0,53.95,0.95,83.0,60
HCPCS,87449,NORWALK-LIKE VIRUS AG,83.0,53.95,0.95,83.0,60
HCPCS,87449,NOS EACH ORGANISM AG IA,,,13.42,13.42,1
HCPCS,87449QW,NOS EACH ORGANISM AG IA,,,13.42,13.42,1
HCPCS,87450,Ag detect nos ia single,,,13.21,22.4,9
HCPCS,87451,POLYVALENT MULT ORG EA AG IA,,,10.51,43.07,21
HCPCS,87451,Polyvalent mult org ea ag ia,,,13.21,15.29,8
HCPCS,87467,HEPATITIS B SURFACE AG QUAN,,,25.32,103.76,19
HCPCS,87467,Hepatitis b surface ag quan,,,13.21,15.29,8
HCPCS,87468,ANAPLSMA PHGCYTOPHLM AMP PRB,,,35.09,143.79,19
HCPCS,87468,Anaplsma phgcytophlm amp prb,,,26.69,30.9,8
HCPCS,87469,BABESIA MICROTI AMP PRB,,,35.09,143.79,19
HCPCS,87469,Babesia microti amp prb,,,26.69,30.9,8
HCPCS,87470,Bartonella dna dir probe,,,88.47,88.47,1
HCPCS,87471,*INFECT AGENT NOS AMPL PROBE,242.0,157.3,0.95,242.0,60
HCPCS,87472,BARTONELLA DNA QUANT,,,42.84,189.09,21
HCPCS,87472,Bartonella dna quant,,,26.69,30.9,8
HCPCS,87475,LYME DIS DNA DIR PROBE,,,20.05,88.47,21
HCPCS,87475,Lyme dis dna dir probe,,,13.21,15.29,8
HCPCS,87476,LYME DISEASE DNA AMPL PROBE,242.0,157.3,0.95,247.11,60
HCPCS,87477,Lyme dis dna quant,,,189.09,189.09,1
HCPCS,87478,BORRELIA MIYAMOTOI AMP PRB,,,35.09,143.79,19
HCPCS,87478,Borrelia miyamotoi amp prb,,,26.69,30.9,8
HCPCS,87480,%VAGONA CANDIDA,138.0,89.7,0.95,138.0,60
HCPCS,87481,CANDIDA DNA AMP PROBE,242.0,157.3,0.95,242.0,60
HCPCS,87482,CANDIDA DNA QUANT,,,55.74,228.41,21
HCPCS,87482,Candida dna quant,,,26.69,30.9,8
HCPCS,87483,CNS DNA AMP PROBE TYPE 12-25,2876.0,1869.4,0.95,2876.0,60
HCPCS,87483,"FILM ARRAY, MENINGITIS/ENCEPHALITIS",2876.0,1869.4,0.95,2876.0,60
HCPCS,87484,EHRLICHA CHAFFEENSIS AMP PRB,,,35.09,143.79,19
HCPCS,87484,Ehrlicha chaffeensis amp prb,,,26.69,30.9,8
HCPCS,87485,CHLMYD PNEUM DNA DIR PROBE,,,20.05,88.47,21
HCPCS,87485,Chlmyd pneum dna dir probe,,,13.21,15.29,8
HCPCS,87486,%E18RP CHLAMYDIA PNEU AMP,242.0,157.3,0.95,789.1,60
HCPCS,87486,CHLAMYDIA PNEUM DNA AMPL PROB,242.0,157.3,0.95,789.1,60
HCPCS,87486,RPRAPD CHLAMYDIA PNEU AMP,242.0,157.3,0.95,789.1,60
HCPCS,87487,CHLMYD PNEUM DNA QUANT,,,42.84,189.09,21
HCPCS,87487,Chlmyd pneum dna quant,,,26.69,30.9,8
HCPCS,87490,CHLMYD TRACH DNA DIR PROBE,,,22.75,93.22,21
HCPCS,87490,Chlmyd trach dna dir probe,,,13.21,15.29,8
HCPCS,87491,%CTNGAO CHLAMYDIA OCULAR,242.0,157.3,0.95,242.0,60
HCPCS,87491,CHLAMYDIA TRACH AMPLIFY,242.0,157.3,0.95,242.0,60
HCPCS,87491,CHLAMYDIATRACH AMP OCULAR,242.0,157.3,0.95,242.0,60
HCPCS,87491,WHIIVF CHLAMYDIA TRACH AM,242.0,157.3,0.95,242.0,60
HCPCS,87492,CHLMYD TRACH DNA QUANT,,,53.47,219.11,21
HCPCS,87492,Chlmyd trach dna quant,,,26.69,30.9,8
HCPCS,87493,"AMPLIFICATION, CLOSTRIDIUM DIFFICILE",257.0,167.05,0.95,257.0,60
HCPCS,87494,"AMPLIFIED PROBE, GC/CT",484.0,314.6,0.95,484.0,55
HCPCS,87494,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",484.0,314.6,0.95,484.0,55
HCPCS,87495,CYTOMEG DNA DIR PROBE,,,30.03,123.06,21
HCPCS,87495,Cytomeg dna dir probe,,,26.69,30.9,8
HCPCS,87496,CMV DNA AMPL PROB,242.0,157.3,0.95,242.0,60
HCPCS,87496,CMV PCR M4,242.0,157.3,0.95,242.0,60
HCPCS,87496,"CYTOMEGALOVIRUS (CMV) PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
HCPCS,87496,CYTOMEGALOVIRUS CMV,242.0,157.3,0.95,242.0,60
HCPCS,87497,CMV DNA QUANT,296.0,192.4,0.95,296.0,60
HCPCS,87497,"QUANTIFICATION, CYTOMEGALOVIRUS",296.0,192.4,0.95,296.0,60
HCPCS,87498,ENTEROVIRUS BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87498,ENTEROVIRUS PCR,242.0,157.3,0.95,242.0,60
HCPCS,87498,ENTEROVIRUS PCR PLASMA,242.0,157.3,0.95,242.0,60
HCPCS,87498,"ENTEROVIRUS, REAL-TIME PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
HCPCS,87500,VANOMYCIN DNA AMP PROBE,,,35.09,166.48,21
HCPCS,87500,Vanomycin dna amp probe,,,26.69,30.9,8
HCPCS,87501,INFLUENZA DNA AMP PROB 1+,,,51.31,210.26,21
HCPCS,87501,Influenza dna amp prob 1+,,,26.69,30.9,8
HCPCS,87502,FLUPCR RAPID PCR FLU,661.0,429.65,0.95,661.0,60
HCPCS,87502,FLUPCR RAPID PCR FLU (POINT OF CARE LAB),661.0,429.65,0.95,661.0,60
HCPCS,87502,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,661.0,429.65,1.1,661.0,32
HCPCS,87502,INFLUENZA A&B MOLECULAR (POINT OF CARE LAB),661.0,429.65,0.95,661.0,60
HCPCS,87502,INFLUENZA DNA AMP PROBE,,,107.33,107.33,1
HCPCS,87502,"SEQUENCING, INFLUENZA",661.0,429.65,0.95,661.0,60
HCPCS,87502QW,INFLUENZA DNA AMP PROBE,,,107.33,107.33,1
HCPCS,87503,"SEQUENCING, INFLUENZA PLUS",202.0,131.3,0.95,202.0,60
HCPCS,87505,"GASTROINTESTINAL PANEL, 5 VIRAL TARGETS",885.0,575.25,0.95,885.0,60
HCPCS,87505,NFCT AGENT DETECTION GI,885.0,575.25,0.95,885.0,60
HCPCS,87506,IADNA-DNA/RNA PROBE TQ 6-11,,,262.99,1077.68,21
HCPCS,87506,Iadna-dna/rna probe tq 6-11,,,39.01,45.17,8
HCPCS,87507,STOOL GASTROINT PNL PCR,2876.0,1869.4,0.95,2876.0,60
HCPCS,87510,%VAGDNA GARDNERELLA,138.0,89.7,0.95,138.0,60
HCPCS,87511,GARDNER VAG DNA AMP PROBE,,,35.09,154.93,21
HCPCS,87511,Gardner vag dna amp probe,,,26.69,30.9,8
HCPCS,87512,GARDNER VAG DNA QUANT,,,41.76,184.33,21
HCPCS,87512,Gardner vag dna quant,,,26.69,30.9,8
HCPCS,87513,H PYLRI CLRTHMCN RST AMP PRB,,,35.09,143.79,19
HCPCS,87513,H pylri clrthmcn rst amp prb,,,26.69,30.9,8
HCPCS,87515,Hepatitis b dna dir probe,,,88.47,88.47,1
HCPCS,87516,%IDM HBVNAT,242.0,157.3,0.95,242.0,60
HCPCS,87517,"QUANTIFICATION, HEPATITIS B VIRUS",296.0,192.4,0.95,296.0,60
HCPCS,87520,HEPATITIS C RNA DIR PROBE,,,31.22,127.93,21
HCPCS,87520,Hepatitis c rna dir probe,,,26.69,30.9,8
HCPCS,87521,HEPATITIS C AMPLIFIED PROBE,242.0,157.3,0.95,270.23,60
HCPCS,87522,"QUANTIFICATION, HEPATITIS C VIRUS",296.0,192.4,0.95,296.0,60
HCPCS,87523,HEPATITIS DELTA VIRUS BY QUANTITATIVE PCR,296.0,192.4,0.95,296.0,60
HCPCS,87525,HEPATITIS G DNA DIR PROBE,,,29.8,122.11,21
HCPCS,87525,Hepatitis g dna dir probe,,,13.21,15.29,8
HCPCS,87526,HEPATITIS G DNA AMP PROBE,,,39.26,160.88,21
HCPCS,87526,Hepatitis g dna amp probe,,,26.69,30.9,8
HCPCS,87527,HEPATITIS G DNA QUANT,,,41.76,184.33,21
HCPCS,87527,Hepatitis g dna quant,,,26.69,30.9,8
HCPCS,87528,HSV DNA DIR PROBE,,,20.05,88.47,21
HCPCS,87528,Hsv dna dir probe,,,13.21,15.29,8
HCPCS,87529,*HERPES SIMPLEX DNA AMPL PROBE,242.0,157.3,0.95,270.23,60
HCPCS,87529,"AMPLIFIED PROBE, HERPES SIMPLEX VIRUS",242.0,157.3,0.95,270.23,60
HCPCS,87529,HSV DNA AMP PROBE X2,242.0,157.3,0.95,270.23,60
HCPCS,87529,HSV PCR MISC SPEC,242.0,157.3,0.95,270.23,60
HCPCS,87529,HSV PCR OCULAR FLD,242.0,157.3,0.95,270.23,60
HCPCS,87529,PCRHSV HSV DNA AMP PROBE X2,242.0,157.3,0.95,270.23,60
HCPCS,87530,HSV DNA QUANT,,,42.84,458.88,21
HCPCS,87530,Hsv dna quant,,,26.69,30.9,8
HCPCS,87531,HHV-6 DNA DIR PROBE,,,58.0,237.67,21
HCPCS,87531,Hhv-6 dna dir probe,,,26.69,30.9,8
HCPCS,87532,HHV-6 PCR,242.0,157.3,0.95,242.0,60
HCPCS,87533,HHV-6A HHV-6B QT PCR,288.0,187.2,0.95,321.49,60
HCPCS,87534,HIV-1 DNA DIR PROBE,,,21.92,89.82,21
HCPCS,87534,Hiv-1 dna dir probe,,,13.21,15.29,8
HCPCS,87535,HIV-1 RNA,242.0,157.3,0.95,242.0,60
HCPCS,87535,IDM HIV-1 DNA BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87536,"QUANTIFICATION, HIV-1",587.0,381.55,0.95,587.0,60
HCPCS,87537,HIV-2 DNA DIR PROBE,,,21.92,89.82,21
HCPCS,87537,Hiv-2 dna dir probe,,,13.21,15.29,8
HCPCS,87538,HIV-2 DNA AMPL PROBE,242.0,157.3,0.95,270.23,60
HCPCS,87538,HIV-2 RNA,242.0,157.3,0.95,270.23,60
HCPCS,87539,HIV-2 QUANT&REVRSE TRNSCRIPJ,,,58.62,240.21,21
HCPCS,87539,Hiv-2 quant&revrse trnscripj,,,26.69,30.9,8
HCPCS,87540,LEGION PNEUMO DNA DIR PROB,,,20.05,88.47,21
HCPCS,87540,Legion pneumo dna dir prob,,,13.21,15.29,8
HCPCS,87541,LEGIONELLA PNEUM PCR,242.0,157.3,0.95,242.0,60
HCPCS,87542,LEGION PNEUMO DNA QUANT,,,41.76,184.33,21
HCPCS,87542,Legion pneumo dna quant,,,26.69,30.9,8
HCPCS,87550,MYCOBACTERIA DNA DIR PROBE,,,20.05,124.53,21
HCPCS,87550,Mycobacteria dna dir probe,,,13.21,15.29,8
HCPCS,87551,%AFBPCR MYCOBACT PROBE,333.0,216.45,0.95,333.0,60
HCPCS,87551,ID MTB COMPLEX VS NTM,333.0,216.45,0.95,333.0,60
HCPCS,87552,MYCOBACTERIA DNA QUANT,,,42.84,189.09,21
HCPCS,87552,Mycobacteria dna quant,,,26.69,30.9,8
HCPCS,87555,M.TUBERCULO DNA DIR PROBE,,,26.88,110.15,21
HCPCS,87555,M.tuberculo dna dir probe,,,13.21,15.29,8
HCPCS,87556,"AMPLIFICATION, MYCOBACTERIA TUBERCULOSIS",288.0,187.2,0.95,288.0,60
HCPCS,87556,MYCOBACTERIA TB AMPLIFIED PROBE,288.0,187.2,0.95,288.0,60
HCPCS,87557,M.TUBERCULO DNA QUANT,,,42.84,189.09,21
HCPCS,87557,M.tuberculo dna quant,,,26.69,30.9,8
HCPCS,87560,M.AVIUM-INTRA DNA DIR PROB,,,27.29,111.83,21
HCPCS,87560,M.avium-intra dna dir prob,,,13.21,15.29,8
HCPCS,87561,M.AVIUM-INTRA DNA AMP PROB,,,35.09,143.79,21
HCPCS,87561,M.avium-intra dna amp prob,,,26.69,30.9,8
HCPCS,87562,M.AVIUM-INTRA DNA QUANT,,,42.84,189.09,21
HCPCS,87562,M.avium-intra dna quant,,,26.69,30.9,8
HCPCS,87563,MYCOPLASMA GENITALIUM PCR,242.0,157.3,0.95,242.0,60
HCPCS,87563,URMPCR MYCOPLAS GENITALIUM AMP,242.0,157.3,0.95,242.0,60
HCPCS,87564,"AMPLIFICATION, MYCOBACTERIUM TUBERCULOSIS",530.0,344.5,0.95,530.0,60
HCPCS,87564,MTB RIF RES,530.0,344.5,0.95,530.0,60
HCPCS,87580,M.PNEUMON DNA DIR PROBE,,,20.05,88.47,21
HCPCS,87580,M.pneumon dna dir probe,,,13.21,15.29,8
HCPCS,87581,%E18RP MYCOPLAS PNEU AMP,242.0,157.3,0.95,242.0,60
HCPCS,87581,MYCOPLASMA PNEUM DNA AMPL,242.0,157.3,0.95,242.0,60
HCPCS,87581,RPRAPD M.PNEUM AMP PRB,242.0,157.3,0.95,242.0,60
HCPCS,87582,M.PNEUMON DNA QUANT,,,184.33,1240.08,21
HCPCS,87582,M.pneumon dna quant,,,39.01,45.17,8
HCPCS,87590,N.GONORRHOEAE DNA DIR PROB,,,26.88,110.15,21
HCPCS,87590,N.gonorrhoeae dna dir prob,,,13.21,15.29,8
HCPCS,87591,*NEISSERIA GONORR DNA AMPL,242.0,157.3,0.95,242.0,60
HCPCS,87591,GC AMPLIFICATION,242.0,157.3,0.95,242.0,60
HCPCS,87591,WHIIVF GC AMP,242.0,157.3,0.95,242.0,60
HCPCS,87592,N.GONORRHOEAE DNA QUANT,,,42.84,175.55,21
HCPCS,87592,N.gonorrhoeae dna quant,,,26.69,30.9,8
HCPCS,87593,"AMPLIFICATION, ORTHOPOX VIRUS",354.0,230.1,0.95,354.0,60
HCPCS,87593,MONKEYPOX VIRUS QUAL PCR,354.0,230.1,0.95,354.0,60
HCPCS,87594,"AMPLIFIED PROBE, PNEUMOCYSTIS JIROVECII",242.0,157.3,0.95,242.0,60
HCPCS,87620,HPV DNA DIR PROBE,,,88.47,88.47,1
HCPCS,87621,HPV DNA AMP PROBE,,,108.09,108.09,1
HCPCS,87622,HPV DNA QUANT,,,184.33,184.33,1
HCPCS,87623,HPV LOW-RISK TYPES,242.0,157.3,0.95,242.0,60
HCPCS,87624,HPV DNA 16 18 PCR,242.0,157.3,0.95,242.0,60
HCPCS,87624,HPV DNA HI RISK ANL RECT,242.0,157.3,0.95,242.0,60
HCPCS,87624,HPV DNA PROBE REFLEX,242.0,157.3,0.95,242.0,60
HCPCS,87624,HPV HIGH-RISK TYPES,242.0,157.3,0.95,242.0,60
HCPCS,87624,HPV SCREEN BY TMA (ARUP),242.0,157.3,0.95,242.0,60
HCPCS,87624,HPVSFX HPV HIGH-RISK TYPE,242.0,157.3,0.95,242.0,60
HCPCS,87625,HPV GENOTYPE BY TMA (ARUP REFLEX),280.0,182.0,0.95,280.0,60
HCPCS,87626,IADNA HPV SEP RPRT HI-RSK TYP&HI-RSK POOLD RSLTS,484.0,314.6,0.95,484.0,60
HCPCS,87627,JT SPC PTHGN&RX RSIST GEN26+,,,679.77,2785.56,14
HCPCS,87627,Jt spc pthgn&rx rsist gen26+,,,66.63,77.15,8
HCPCS,87631,INFLUENZA RAPID PCR,984.0,639.6,0.95,984.0,60
HCPCS,87631,INFLUENZA RSV DETECT,984.0,639.6,0.95,984.0,60
HCPCS,87631,RESP VIRUS 3-5 TARGETS,984.0,639.6,0.95,984.0,61
HCPCS,87631,RPRAPD INFLUENZA RAPID PCR,984.0,639.6,0.95,984.0,60
HCPCS,87631QW,RESP VIRUS 3-5 TARGETS,,,159.8,159.8,1
HCPCS,87632,RESP VIRUS 6-11 TARGETS,,,218.06,893.57,21
HCPCS,87632,Resp virus 6-11 targets,,,39.01,45.17,8
HCPCS,87633,RESP VIRUS 12-25 TARGETS,,,466.94,466.94,1
HCPCS,87633,RVP BY PCR,2876.0,1869.4,0.95,2876.0,60
HCPCS,87633QW,RESP VIRUS 12-25 TARGETS,,,466.94,466.94,1
HCPCS,87634,RSV DNA/RNA AMP PROBE,,,78.65,78.65,1
HCPCS,87634,RSV RAPID PCR,484.0,314.6,0.95,484.0,60
HCPCS,87634,RSV RAPID PCR (POINT OF CARE LAB),484.0,314.6,0.95,484.0,60
HCPCS,87634QW,RSV DNA/RNA AMP PROBE,,,78.65,78.65,1
HCPCS,87635,COVID-19 MOLECULAR (POINT OF CARE LAB),354.0,230.1,0.95,354.0,61
HCPCS,87635,COVID19 INHOUSE,354.0,230.1,0.95,354.0,61
HCPCS,87635,COVID19 INHOUSE (POINT OF CARE LAB),354.0,230.1,0.95,354.0,61
HCPCS,87635,COVID19 SENDOUT,354.0,230.1,0.95,354.0,61
HCPCS,87635,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,354.0,230.1,1.1,354.0,32
HCPCS,87635,SARS-COV-2 COVID-19 AMP PRB,,,57.49,57.49,1
HCPCS,87635QW,SARS-COV-2 COVID-19 AMP PRB,,,57.49,57.49,1
HCPCS,87636,COVID-19 MOLECULAR (POC) & INFLUENZA A&B MOLECULAR (POC),984.0,639.6,0.95,984.0,61
HCPCS,87636,SARSCOV2 & INF A&B AMP PRB,984.0,639.6,0.95,984.0,62
HCPCS,87636QW,SARSCOV2 & INF A&B AMP PRB,,,159.8,159.8,1
HCPCS,87637,"AMPLIFICATION, EXPEDITED, COVID, FLU A/B, RSV",925.0,601.25,0.95,925.0,61
HCPCS,87637,"COVID & INFLUENZA A/B & RSV NAAT, ROUTINE",984.0,639.6,0.95,984.0,61
HCPCS,87637,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,560.0,364.0,1.1,560.0,32
HCPCS,87637,SARSCOV2&INF A&B&RSV AMP PRB,,,159.8,159.8,1
HCPCS,87637QW,SARSCOV2&INF A&B&RSV AMP PRB,,,159.8,159.8,1
HCPCS,87640,"AMPLIFICATION, STAPHYLOCOCCUS AUREUS",242.0,157.3,0.95,242.0,60
HCPCS,87641,"AMPLIFICATION, METHICILLIN RESISTANCE",242.0,157.3,0.95,242.0,60
HCPCS,87650,STREP A DNA DIR PROBE,,,20.05,82.16,22
HCPCS,87650,Strep a dna dir probe,,,13.21,15.29,8
HCPCS,87650QW,STREP A DNA DIR PROBE,,,22.46,22.46,1
HCPCS,87651,"AMPLIFICATION, STREPTOCOCCUS, GROUP A",242.0,157.3,0.95,242.0,60
HCPCS,87651,GROUP A STREP PCR (POINT OF CARE LAB),242.0,157.3,0.95,242.0,60
HCPCS,87651,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,32
HCPCS,87651,STREP A (MOLECULAR),217.0,141.05,1.1,217.0,32
HCPCS,87651,STREP A DNA AMP PROBE,,,39.32,39.32,1
HCPCS,87651QW,STREP A DNA AMP PROBE,,,39.32,39.32,1
HCPCS,87652,STREP A DNA QUANT,,,41.76,184.33,21
HCPCS,87652,Strep a dna quant,,,26.69,30.9,8
HCPCS,87653,"AMPLIFICATION, STREPTOCOCCUS, GROUP B",242.0,157.3,0.95,242.0,60
HCPCS,87660,%VAGDNA TRICHOMONAS,138.0,89.7,0.95,138.0,60
HCPCS,87661,TRICHOMONAS VAG AMP,242.0,157.3,0.95,242.0,60
HCPCS,87661,TRICHOMONAS VAGINALIS AMPLIF,242.0,157.3,0.95,242.0,60
HCPCS,87662,ZIKA VIRUS RT-PCR,354.0,230.1,0.95,354.0,60
HCPCS,87797,DETECT AGENT NOS DNA DIR,,,30.03,123.06,20
HCPCS,87797,Detect agent nos dna dir,,,26.69,30.9,8
HCPCS,87798,%IDM W NILE RNA PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,%MTBAM1 PROBE PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,"ACANTHAMOEBA SPECIES DETECTION, PCR",242.0,157.3,0.95,242.0,60
HCPCS,87798,ADENOVIRUS PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,"AMPLIFICATION, RIFAMPIN RESISTANCE",242.0,157.3,0.95,242.0,120
HCPCS,87798,"AMPLIFIED PROBE, VARICELLA ZOSTER VIRUS",242.0,157.3,0.95,242.0,60
HCPCS,87798,BK VIRUS PCR QUAL BLD,242.0,157.3,0.95,242.0,60
HCPCS,87798,BK VIRUS QUAL URINE,242.0,157.3,0.95,242.0,60
HCPCS,87798,BORDETELLA PERTUSSIS,242.0,157.3,0.95,242.0,60
HCPCS,87798,CARBAPENEM RESISTANCE GENE PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,CHIKUNGUNYA BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,EHRLICHIA/ANAPLASMA PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,EPSTEIN BARR VIRUS PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,"EPSTEIN-BARR VIRUS BY QUALITATIVE PCR, CSF",242.0,157.3,0.95,242.0,60
HCPCS,87798,HEP D VIRUS PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,HTLV I/II DNA PCR X2,242.0,157.3,0.95,242.0,60
HCPCS,87798,HUMAN METAPNEUM RT-PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,INFECT AGENT NOS AMPL PROBE,242.0,157.3,0.95,242.0,120
HCPCS,87798,JC VIRUS BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,JC VIRUS DNA PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,M HOMINTS PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,MEASLES VIRUS QUAL NAAT,242.0,157.3,0.95,242.0,60
HCPCS,87798,MONKEYPOX VIRUS QUAL PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,MTBAM1 AMPLIFICATION,242.0,157.3,0.95,242.0,60
HCPCS,87798,MUCORALES BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,MUMPS VIRUS BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,NOROVIR 1 & 2 DETECT X2,242.0,157.3,0.95,242.0,60
HCPCS,87798,P JIROVECI PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,PARVO B19 PLASMA PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,"PARVOVIRUS B19 PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
HCPCS,87798,PLASMODIUM SP DIFF PCR X5,242.0,157.3,0.95,242.0,60
HCPCS,87798,RPRAPD INFECT AGENT NOS AMP,242.0,157.3,0.95,242.0,60
HCPCS,87798,RT-QULC ANALYSIS CSF,242.0,157.3,0.95,242.0,60
HCPCS,87798,STAPH AUREUS AMPLIFICATION,242.0,157.3,0.95,242.0,60
HCPCS,87798,"TOXOPLASMA GONDII, PCR, AMNIOTIC FLUID",242.0,157.3,0.95,242.0,60
HCPCS,87798,TOXOPLASMA PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,UREAPLASMA SPECIES BY PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,URMPCR DETECT AGENT NOS DNA AMP,242.0,157.3,0.95,242.0,60
HCPCS,87798,VARICELLA ZOSTER PCR,242.0,157.3,0.95,242.0,60
HCPCS,87798,WEST NILE VIRUS PCR PLS,242.0,157.3,0.95,242.0,60
HCPCS,87798,WHIPPLE DNA WHOLE BLD,242.0,157.3,0.95,242.0,60
HCPCS,87799,ADENOVIRUS PCR QUANT,296.0,192.4,0.95,309.32,60
HCPCS,87799,"BK VIRUS QUANT PCR, PLASMA",296.0,192.4,0.95,309.32,60
HCPCS,87799,BK VIRUS QUANT URINE,296.0,192.4,0.95,309.32,60
HCPCS,87799,EBV BY PCR QUANT CSF,296.0,192.4,0.95,309.32,60
HCPCS,87799,HERPESVIRUS 7 PCR QUANT,296.0,192.4,0.95,309.32,60
HCPCS,87799,HHV8 BY QUANTITATIVE PCR,296.0,192.4,0.95,309.32,60
HCPCS,87799,INFECT AGENT NOS QUANT,296.0,192.4,0.95,309.32,60
HCPCS,87799,JC VIRUS QUANT PCR,296.0,192.4,0.95,309.32,60
HCPCS,87799,NY BK VIRUS QNT PCR BLD,296.0,192.4,0.95,309.32,60
HCPCS,87799,"QUANTIFICATION, BK VIRUS",296.0,192.4,0.95,309.32,60
HCPCS,87799,"QUANTIFICATION, EPSTEIN-BARR VIRUS",296.0,192.4,0.95,309.32,60
HCPCS,87800,DETECT AGNT MULT DNA DIREC,,,43.67,178.95,21
HCPCS,87800,Detect agnt mult dna direc,,,26.69,30.9,8
HCPCS,87801,*DNA/RNA;MULTI ORG-AMP PR,484.0,314.6,0.95,484.0,60
HCPCS,87801,"BACTERIAL PCR, DIRECT SPEC",484.0,314.6,0.95,484.0,60
HCPCS,87801,DETECT AGNT MULT DNA AMPLI,,,78.65,78.65,1
HCPCS,87801,UNIVERSAL FUNGAL PCR,484.0,314.6,0.95,484.0,60
HCPCS,87801QW,DETECT AGNT MULT DNA AMPLI,,,78.65,78.65,1
HCPCS,87802,STREP B ASSAY W/OPTIC,,,12.73,52.16,21
HCPCS,87802,Strep b assay w/optic,,,13.21,15.29,8
HCPCS,87803,CLOSTRIDIUM TOXIN A W/OPTIC,,,16.0,65.56,21
HCPCS,87803,Clostridium toxin a w/optic,,,13.21,15.29,8
HCPCS,87804,*INFLUENZA A,114.0,74.1,0.95,114.0,60
HCPCS,87804,IAADIADOO INFLUENZA,114.0,74.1,1.1,114.0,32
HCPCS,87804,INFLUENZA ASSAY W/OPTIC,,,18.55,18.55,1
HCPCS,87804,INFLUENZA OIA (POINT OF CARE LAB),114.0,74.1,0.95,114.0,60
HCPCS,87804QW,INFLUENZA ASSAY W/OPTIC,,,18.55,18.55,1
HCPCS,87806,HIV AG W/HIV1&2 ANTB W/OPTIC,,,32.77,134.28,22
HCPCS,87806,Hiv ag w/hiv1&2 antb w/optic,,,26.69,30.9,8
HCPCS,87806QW,HIV AG W/HIV1&2 ANTB W/OPTIC,,,36.71,36.71,1
HCPCS,87807,IAADIADOO RESPIRATORY SYNCTIAL VIRUS,90.0,58.5,1.1,90.0,32
HCPCS,87807,RSV ASSAY W/OPTIC,,,14.67,14.67,1
HCPCS,87807,RSV IA W DIR OBSERV,90.0,58.5,0.95,90.0,60
HCPCS,87807,RSV IA W DIR OBSERV (POINT OF CARE LAB),90.0,58.5,0.95,90.0,60
HCPCS,87807QW,RSV ASSAY W/OPTIC,,,14.67,14.67,1
HCPCS,87808,TRICHOMONAS ANTIGEN,106.0,68.9,0.95,106.0,60
HCPCS,87808,TRICHOMONAS ASSAY W/OPTIC,,,17.13,17.13,1
HCPCS,87808QW,TRICHOMONAS ASSAY W/OPTIC,,,17.13,17.13,1
HCPCS,87809,ADENOVIRUS ASSAY W/OPTIC,,,21.76,89.17,22
HCPCS,87809,Adenovirus assay w/optic,,,13.21,15.29,8
HCPCS,87809QW,ADENOVIRUS ASSAY W/OPTIC,,,24.38,24.38,1
HCPCS,87810,CHLMYD TRACH ASSAY W/OPTIC,,,35.29,144.61,21
HCPCS,87810,Chlmyd trach assay w/optic,,,26.69,30.9,8
HCPCS,87811,SARS-COV-2 COVID19 W/OPTIC,,,41.38,169.57,21
HCPCS,87811,Sars-cov-2 covid19 w/optic,,,13.21,15.29,8
HCPCS,87812,SARSCOV2&INF TYP A&B W/OPTIC,,,74.48,305.2,14
HCPCS,87812,Sarscov2&inf typ a&b w/optic,,,13.21,15.29,8
HCPCS,87850,N. GONORRHOEAE ASSAY W/OPTIC,,,24.56,100.64,21
HCPCS,87850,N. gonorrhoeae assay w/optic,,,13.21,15.29,8
HCPCS,87880,IAADIADOO STREPTOCOCCUS GROUP A,114.0,74.1,1.1,114.0,32
HCPCS,87880,STREP A ASSAY W/OPTIC,114.0,74.1,0.95,2453.0,121
HCPCS,87880,STREP ASSAY (POINT OF CARE LAB),114.0,74.1,0.95,114.0,60
HCPCS,87880QW,STREP A ASSAY W/OPTIC,,,18.52,18.52,1
HCPCS,87899,AGENT NOS ASSAY W/OPTIC,,,18.0,18.0,1
HCPCS,87899,HIV I/II POST EXP AG SRN,111.0,72.15,0.95,111.0,60
HCPCS,87899,HIV-1/2 AG/AB COMBO,111.0,72.15,0.95,111.0,60
HCPCS,87899,"IMMUNOASSAY, CAD",111.0,72.15,0.95,111.0,60
HCPCS,87899,"IMMUNOASSAY, CAD TITER",111.0,72.15,0.95,111.0,60
HCPCS,87899,"IMMUNOASSAY, MALARIA P. FALCIPARUM",111.0,72.15,0.95,111.0,60
HCPCS,87899,"IMMUNOASSAY, PAN-MALARIAL",111.0,72.15,0.95,111.0,60
HCPCS,87899,"IMMUNOASSAY, STREP PNEUMONIAE ANTIGEN",111.0,72.15,0.95,111.0,60
HCPCS,87899,LIMULUS AMEBOCYTE LT,111.0,72.15,0.95,111.0,60
HCPCS,87899QW,AGENT NOS ASSAY W/OPTIC,,,18.0,18.0,1
HCPCS,87900,%HIVGEN PHENOTYPE,899.0,584.35,0.95,899.0,60
HCPCS,87900,%HIVPHS PHENOTYPE,899.0,584.35,0.95,899.0,60
HCPCS,87900,CYTSEQ PHENOTYPE INFECT AGENT DRUG,899.0,584.35,0.95,899.0,60
HCPCS,87900,HIVNGS PHENOTYPE INFECT AGENT DRUG,899.0,584.35,0.95,899.0,60
HCPCS,87901,%HIVGEN HIV GENOTYPING,1776.0,1154.4,0.95,1776.0,60
HCPCS,87901,%HIVPHS GENOTYPE,1776.0,1154.4,0.95,1776.0,60
HCPCS,87901,HIVNGS GENOTYPE DNA HIV REVERSE T,1776.0,1154.4,0.95,1776.0,60
HCPCS,87902,"GENOTYPE, HEPATITIS C VIRUS",1776.0,1154.4,0.95,1776.0,60
HCPCS,87902,HCV NS5A DRG RES SEQ,1776.0,1154.4,0.95,1776.0,60
HCPCS,87903,%HIVPHS PHENO 1-10 DRUGS,3372.0,2191.8,0.95,3372.0,60
HCPCS,87904,%HIVPHS PHENO EA ADD X12,180.0,117.0,0.95,180.0,60
HCPCS,87905,IA NZMTC ACTV OTH/THN VIRUS,,,13.69,13.69,1
HCPCS,87905,RAPID BACTERIAL VAGINOSIS,84.0,54.6,0.95,84.0,120
HCPCS,87905QW,IA NZMTC ACTV OTH/THN VIRUS,,,13.69,13.69,1
HCPCS,87906,GENOSURE INTEGRASE,888.0,577.2,0.95,888.0,60
HCPCS,87906,HIV GENO (INTEGRASE),888.0,577.2,0.95,888.0,60
HCPCS,87906,HIVNGS GENOTYPE DNA/RNA HIV,888.0,577.2,0.95,888.0,60
HCPCS,87910,CYTSEQ NFCT AGT GNTYP ALYS CMV,1776.0,1154.4,0.95,1776.0,60
HCPCS,87912,HBV DRUG RESISTANCE SEQ,1776.0,1154.4,0.95,1776.0,60
HCPCS,87912,HEPATITIS B GENOTYPING,1776.0,1154.4,0.95,1776.0,60
HCPCS,87913,NFCT AGT GNTYP ALYS SARSCOV2,,,257.45,1054.98,19
HCPCS,87913,Nfct agt gntyp alys sarscov2,,,39.01,45.17,8
HCPCS,87999,Unlisted microbiology px,,,13.21,15.29,8
HCPCS,88000,AUTOPSY (NECROPSY) GROSS,,,473.43,477.8,2
HCPCS,88005,AUTOPSY (NECROPSY) GROSS,,,477.8,552.72,2
HCPCS,88007,AUTOPSY (NECROPSY) GROSS,,,507.33,578.61,2
HCPCS,88012,AUTOPSY (NECROPSY) GROSS,,,297.1,473.43,2
HCPCS,88014,AUTOPSY (NECROPSY) GROSS,,,434.16,581.37,2
HCPCS,88016,"B. PERTUSSIS IGG, BLOT",189.0,122.85,0.95,605.33,38
HCPCS,88020,AUTOPSY (NECROPSY) COMPLETE,,,53.79,815.72,2
HCPCS,88025,AUTOPSY (NECROPSY) COMPLETE,,,53.79,789.03,2
HCPCS,88027,AUTOPSY (NECROPSY) COMPLETE,,,604.66,841.62,2
HCPCS,88028,AUTOPSY (NECROPSY) COMPLETE,,,418.73,473.43,2
HCPCS,88029,AUTOPSY (NECROPSY) COMPLETE,,,418.73,473.43,2
HCPCS,88036,LIMITED AUTOPSY,,,237.11,282.48,2
HCPCS,88037,LIMITED AUTOPSY,,,149.39,210.41,2
HCPCS,88040,FORENSIC AUTOPSY (NECROPSY),,,608.16,1315.04,2
HCPCS,88045,CORONERS AUTOPSY (NECROPSY),,,90.29,131.9,2
HCPCS,88099,UNLISTED NECROPSY (AUTOPSY),,,53.79,53.79,1
HCPCS,88104,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,246.0,159.9,1.1,246.0,44
HCPCS,88104,CYTPATH NONGYN SMEAR INTERP,271.0,176.15,0.95,271.0,122
HCPCS,88106,CYTOPATH FL NONGYN FILTER,,,22.63,81.07,21
HCPCS,88106,Cytopath fl nongyn filter,,,36.09,41.79,8
HCPCS,88107,CYTOPATH FL NONGYN SM/FLTR,,,102.1,102.1,1
HCPCS,88108,CYTOLOGY FLUID,271.0,176.15,0.95,271.0,61
HCPCS,88108,CYTP CONCENTRATION SMEARS & INTERPRETATION,194.0,126.1,1.1,194.0,44
HCPCS,88108,CYTPATH SACCOMENNO SMEAR,271.0,176.15,0.95,271.0,61
HCPCS,88112,BILIARY TRACT MALIG,369.0,239.85,0.95,369.0,61
HCPCS,88112,CYTO BRONCH BR CONC TECH,369.0,239.85,0.95,369.0,61
HCPCS,88112,CYTOLOGY FLUID TP,369.0,239.85,0.95,369.0,61
HCPCS,88112,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,246.0,159.9,1.1,246.0,44
HCPCS,88112,FNA CONCENTRATION,369.0,239.85,0.95,369.0,61
HCPCS,88120,FISH FOR BLADDER CANCER W/URINARY CYTO,1182.0,768.3,0.95,1182.0,61
HCPCS,88121,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,440.0,286.0,1.1,944.8,44
HCPCS,88121,CYTP URINE 3-5 PROBES CMPTR,1182.0,768.3,0.95,1182.0,61
HCPCS,88125,FORENSIC CYTOPATHOLOGY,,,35.26,146.06,21
HCPCS,88125,Forensic cytopathology,,,36.09,41.79,8
HCPCS,88130,SEX CHROMATIN IDENTIFICATION,,,17.98,73.68,21
HCPCS,88130,Sex chromatin identification,,,7.12,8.24,8
HCPCS,88140,SEX CHROMATIN IDENTIFICATION,,,7.99,32.74,21
HCPCS,88140,Sex chromatin identification,,,7.12,8.24,8
HCPCS,88141,CYTOPATH C/V INTERPRET,,,49.46,68.77,2
HCPCS,88141,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,114.0,74.1,1.1,114.0,44
HCPCS,88141,Cytopath c/v interpret,,,12.13,14.05,8
HCPCS,88142,CYTOLOGY GYN SC THIN PREP,140.0,91.0,0.95,140.0,60
HCPCS,88142,PAP AND REFLEX HPV SCREEN- ARUP,140.0,91.0,0.95,140.0,60
HCPCS,88142,PAP SMR THN PRP,140.0,91.0,0.95,140.0,60
HCPCS,88142,PAP WITH REFLEX HPV SCREEN-ARUP,140.0,91.0,0.95,140.0,60
HCPCS,88143,"PAP, THIN PREP RESCREEN",159.0,103.35,0.95,159.0,60
HCPCS,88147,CYTOPATH C/V AUTOMATED,,,46.57,207.18,21
HCPCS,88147,Cytopath c/v automated,,,12.13,14.05,8
HCPCS,88148,CYTOPATH C/V AUTO RESCREEN,,,18.19,75.97,21
HCPCS,88148,Cytopath c/v auto rescreen,,,12.13,14.05,8
HCPCS,88150,CYTOPATH C/V MANUAL,,,12.81,75.97,21
HCPCS,88150,Cytopath c/v manual,,,12.13,14.05,8
HCPCS,88152,CYTOPATH C/V AUTO REDO,,,27.64,113.26,21
HCPCS,88152,Cytopath c/v auto redo,,,12.13,14.05,8
HCPCS,88153,CYTOPATH C/V REDO,,,24.03,98.47,21
HCPCS,88153,Cytopath c/v redo,,,12.13,14.05,8
HCPCS,88154,Cytopath c/v select,,,25.3,25.3,1
HCPCS,88155,CYTOPATH C/V INDEX ADD-ON,,,14.65,60.03,21
HCPCS,88155,Cytopath c/v index add-on,,,12.13,14.05,8
HCPCS,88160,CYTP SMRS ANY OTH SRC SCR&INTERPJ,220.0,143.0,1.1,220.0,44
HCPCS,88160,CYTPATH SMEAR OTHER,169.0,109.85,0.95,169.0,61
HCPCS,88161,PATH TOUCH PREP INIT,169.0,109.85,0.95,169.0,61
HCPCS,88162,CYTOPATH SMEAR OTHER SOURCE,,,49.3,146.06,21
HCPCS,88162,Cytopath smear other source,,,36.09,41.79,8
HCPCS,88164,CYTOPATH TBS C/V MANUAL,,,18.19,75.97,21
HCPCS,88164,Cytopath tbs c/v manual,,,12.13,14.05,8
HCPCS,88165,CYTOPATH TBS C/V REDO,,,25.3,173.01,21
HCPCS,88165,Cytopath tbs c/v redo,,,12.13,14.05,8
HCPCS,88166,CYTOPATH TBS C/V AUTO REDO,,,18.19,75.97,21
HCPCS,88166,Cytopath tbs c/v auto redo,,,12.13,14.05,8
HCPCS,88167,CYTOPATH TBS C/V SELECT,,,18.19,75.97,21
HCPCS,88167,Cytopath tbs c/v select,,,12.13,14.05,8
HCPCS,88172,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,304.0,197.6,1.1,304.0,44
HCPCS,88172,CYTPATH FNA IMMEDIATE EVAL,259.0,168.35,0.95,477.52,61
HCPCS,88173,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,612.0,397.8,1.1,612.0,44
HCPCS,88173,CYTPATH FNA I&R,369.0,239.85,0.95,369.0,61
HCPCS,88174,CYTOPATH C/V AUTO IN FLUID,,,25.37,103.96,21
HCPCS,88174,Cytopath c/v auto in fluid,,,12.13,14.05,8
HCPCS,88175,CYTO IMAGER GYN TP DIAG,184.0,119.6,0.95,184.0,60
HCPCS,88175,CYTO IMAGER GYN TP SCREEN,184.0,119.6,0.95,184.0,60
HCPCS,88175,PAP WITH REFLEX HPV SCREEN-ARUP,184.0,119.6,0.95,184.0,60
HCPCS,88177,CYTO SECOND PASS ADEQ,147.0,95.55,0.95,147.0,46
HCPCS,88177,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,185.0,120.25,1.1,185.0,44
HCPCS,88177,CYTP FNA EVAL EA ADDL,147.0,95.55,0.95,147.0,46
HCPCS,88182,TELOMERE LENGTH MEASUREMENT,369.0,239.85,0.95,369.0,61
HCPCS,88184,%ACLUK2 1ST MARK,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%CVID FLOW FIRST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%LGLYM 1ST MRK,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%MYELOMA 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%NKFUNC FIRST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%NUCLEAR TDT BY FCM 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%PLAFLW FLOW 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%PNH BY FCM 1ST MARK X2,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%PNH PANEL 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%RLLLIP 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,%T CELL VBETA 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,*FLOW CYTOMETRY TC 1ST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,ALPS FLOW CYTOMETRY,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,CD52EX FIRST MARKER,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,FLOW CD107A,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,"FLOW CYTO, 1ST MARKER",2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,"FLOW CYTOMETRY TC, 1ST MARKER",2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,FLOW PERFORIN/GRANZYME B,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,FLOW PSTAT5,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,FLOW SAP (XLP1) AND XIAP (XLP2),2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,FLOW SCRN TUBE 1ST MKR,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,FLOW TH17,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,INDIVIDUAL FCM MARKER X1,2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,"KIRFLW FLOW CYTOMETRY; FIRST CELL SURFACE, CYTOPLASMIC OR NUCLEA",2482.0,1613.3,0.95,2482.0,61
HCPCS,88184,RBCB3 PROTEIN RED,2482.0,1613.3,0.95,2482.0,61
HCPCS,88185,%CVID FLW EA ADD MARK X2,149.0,96.85,0.95,149.0,46
HCPCS,88185,%NKFUNC ADDTL MARKERS X2,149.0,96.85,0.95,149.0,46
HCPCS,88185,%PLAFLW FLW ADD MARKER X5,149.0,96.85,0.95,149.0,46
HCPCS,88185,%PNH BY FCM ADD MARK X7,149.0,96.85,0.95,149.0,46
HCPCS,88185,ADDITIONAL MARKERS,149.0,96.85,0.95,149.0,46
HCPCS,88185,ALPS FLOW MARKERS,149.0,96.85,0.95,149.0,46
HCPCS,88185,CD52EX ADDITIONAL MARKERS,149.0,96.85,0.95,149.0,46
HCPCS,88185,FLOW CD107A ADDITIONAL,149.0,96.85,0.95,149.0,46
HCPCS,88185,"FLOW CYTO, EA ADD MARKER",149.0,96.85,0.95,149.0,46
HCPCS,88185,FLOW EA ADD MARK 10,149.0,96.85,0.95,149.0,46
HCPCS,88185,FLOW PERFORIN/GRANZYME B ADDITIONAL,149.0,96.85,0.95,149.0,46
HCPCS,88185,FLOW PSTAT5 ADDITIONAL,149.0,96.85,0.95,149.0,46
HCPCS,88185,FLOW SAP (XLP1) AND XIAP (XLP2) ADDITIONAL,149.0,96.85,0.95,149.0,46
HCPCS,88185,FLOW TH17 ADDITIONAL,149.0,96.85,0.95,149.0,46
HCPCS,88185,"KIRFLW FLOW CYTOMETRY; ADDITIONAL CELL SURFACE, CYTOPLASMIC OR N",149.0,96.85,0.95,149.0,46
HCPCS,88187,FLOWCYTOMETRY/READ 2-8,,,82.44,182.03,2
HCPCS,88187,Flowcytometry/read 2-8,,,36.09,41.79,8
HCPCS,88188,ALPS FLOW INTERP,1947.0,1265.55,0.95,1947.0,46
HCPCS,88189,FLOWCYTOMETRY/READ 16 & >,,,191.57,236.47,2
HCPCS,88189,Flowcytometry/read 16 & >,,,36.09,41.79,8
HCPCS,88199,UNLISTED CYTOPATHOLOGY PX,,,45.96,146.06,21
HCPCS,88199,Unlisted cytopathology px,,,36.09,41.79,8
HCPCS,88230,%CHROMO BLD TISSUE CULT,804.0,522.6,0.95,804.0,60
HCPCS,88230,*TIS CULT LYMPHOCYTE,804.0,522.6,0.95,804.0,60
HCPCS,88233,CHROM TISSUE CULT PROCESS,971.0,631.15,0.95,1083.61,60
HCPCS,88233,POCHF CHROM TIS CUL PROC,971.0,631.15,0.95,1083.61,60
HCPCS,88235,%CHROMO CULT AMNIOTIC,1037.0,674.05,0.95,1037.0,60
HCPCS,88235,AMNIOTIC FLUID FETAL CELL CULTURE,1037.0,674.05,0.95,1037.0,60
HCPCS,88235,CHROMOSOME AMNIOTIC FLUID,1037.0,674.05,0.95,1037.0,60
HCPCS,88235,CVS FETAL CELL CULTURE,1037.0,674.05,0.95,1037.0,60
HCPCS,88235,"LABCORP CMBP CHROMOSOME ANALYSIS, CHORIONIC VILLUS",1037.0,674.05,0.95,1037.0,60
HCPCS,88235,REFLEX AMNIOTIC FLUID CULTURE,1037.0,674.05,0.95,1037.0,60
HCPCS,88235,REFLEX AMNIOTIC FLUID CULTURE PROCESSING FEE,1037.0,674.05,0.95,1037.0,60
HCPCS,88237,%CHRMDS CULT PROC,992.0,644.8,0.95,992.0,60
HCPCS,88237,APLFBM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,APLFSH TISSUE CULT BLOOD,992.0,644.8,0.95,992.0,60
HCPCS,88237,CHROM BM CULT PROC,992.0,644.8,0.95,992.0,60
HCPCS,88237,CHROM LEUK BLD CULT PROC,992.0,644.8,0.95,992.0,60
HCPCS,88237,CLLFSH TISSUE CULT BLD,992.0,644.8,0.95,992.0,60
HCPCS,88237,CLLFSM TISSUE CULT BLD,992.0,644.8,0.95,992.0,60
HCPCS,88237,FABCBM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,FAMLPN TISSUE CULT BLOOD,992.0,644.8,0.95,992.0,60
HCPCS,88237,FISH 3Q26 TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,FISH3Q36 TISSUE CULT BLOOD,992.0,644.8,0.95,992.0,60
HCPCS,88237,FSBLLM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,FSMDSM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,MPNFSM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,PDGFAM TISSUE CULT BM,992.0,644.8,0.95,992.0,60
HCPCS,88237,TISS CULT BONE MARROW,992.0,644.8,0.95,992.0,60
HCPCS,88239,%CHROMO SOL TUMOR CULTURE,1018.0,661.7,0.95,1026.15,60
HCPCS,88240,CELL PROCESSING AND STORAGE,90.0,58.5,0.95,90.0,60
HCPCS,88241,FROZEN CELL PREPARATION,,,12.09,77.75,21
HCPCS,88241,Frozen cell preparation,,,7.12,8.24,8
HCPCS,88245,CHROMOSOME ANALYSIS 20-25,,,173.17,709.62,21
HCPCS,88245,Chromosome analysis 20-25,,,92.46,107.06,8
HCPCS,88248,CHROMOSOME ANALYSIS 50-100,,,173.17,709.62,21
HCPCS,88248,Chromosome analysis 50-100,,,92.46,107.06,8
HCPCS,88249,CHROMOSOME ANALYSIS 100,,,173.17,709.62,21
HCPCS,88249,Chromosome analysis 100,,,92.46,107.06,8
HCPCS,88261,"REFLEX COUNT 5, 1 KARYOTYPE",1824.0,1185.6,0.95,1824.0,120
HCPCS,88262,%CHROMO HEM KAROTYPES,866.0,562.9,0.95,866.0,60
HCPCS,88262,%CHROMO POC KARY 15-20,866.0,562.9,0.95,866.0,60
HCPCS,88262,CHRMSM ANAL 2 KARYO BAND,866.0,562.9,0.95,866.0,60
HCPCS,88262,CHROMO ANALYSIS 15-20CELL BAND,866.0,562.9,0.95,866.0,120
HCPCS,88262,POCHF CHR ANLS KARY 15-20,866.0,562.9,0.95,866.0,60
HCPCS,88263,CHROMOSOME ANALYSIS 45,,,150.29,615.86,21
HCPCS,88263,Chromosome analysis 45,,,92.46,107.06,8
HCPCS,88264,CHRBMH CHROM ANLY 20-25,998.0,648.7,0.95,998.0,60
HCPCS,88264,CHRMDS CHROM ANLY 20-25,998.0,648.7,0.95,998.0,60
HCPCS,88267,%CHROMO AMNIOTIC FL,1301.0,845.65,0.95,1301.0,60
HCPCS,88267,%CVC CHROMOSOME ANALYSIS,1301.0,845.65,0.95,1301.0,60
HCPCS,88267,CHROMOSOME ANALYSIS CVS,1301.0,845.65,0.95,1301.0,60
HCPCS,88269,"CHROMOSOME ANALYSIS 6-12 COLONIES, 1 KARYOTYPE",1198.0,778.7,0.95,1198.0,60
HCPCS,88269,CHROMOSOME ANALYSIS AMNIOTIC FLUID,1198.0,778.7,0.95,1198.0,60
HCPCS,88271,%CLLFSH PROBE X7,148.0,96.2,0.95,164.91,60
HCPCS,88271,%DGEORG DNA PROBEX2,148.0,96.2,0.95,164.91,60
HCPCS,88271,%FAMLPN PROBE,148.0,96.2,0.95,164.91,60
HCPCS,88271,%FSHMDS PROBE X6,148.0,96.2,0.95,164.91,60
HCPCS,88271,%FSHPCM DNA PROBE,148.0,96.2,0.95,164.91,60
HCPCS,88271,%UROFISH MOLE GEN DNA X4,148.0,96.2,0.95,164.91,60
HCPCS,88271,"13, 21 AMNIO ANEUPLOID FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,"18, XY AMNIO ANEUPLOID FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,240
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-I(12P), GERM CELL",148.0,96.2,0.95,164.91,60
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FI",148.0,96.2,0.95,164.91,60
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-NR4A3, REARRANGEM",148.0,96.2,0.95,164.91,60
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PDGFB (22Q13), FI",148.0,96.2,0.95,164.91,60
HCPCS,88271,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PLASMA CELL PROLI,148.0,96.2,0.95,164.91,60
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PRKACA, REARRANGE",148.0,96.2,0.95,164.91,60
HCPCS,88271,"ALK, (2P23), IMT, FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,APLFBM BM PROBE X2,148.0,96.2,0.95,164.91,60
HCPCS,88271,APLFSH PROBE X2,148.0,96.2,0.95,164.91,60
HCPCS,88271,CHROMOSOME FISH PRENATAL,148.0,96.2,0.95,164.91,60
HCPCS,88271,CLLFSM PROBE X7,148.0,96.2,0.95,164.91,60
HCPCS,88271,CYTOGEN DNA PROBE EA,148.0,96.2,0.95,164.91,60
HCPCS,88271,DDIT3 PROBE X2,148.0,96.2,0.95,164.91,60
HCPCS,88271,FABCBM BM PROBE X8,148.0,96.2,0.95,164.91,60
HCPCS,88271,FISH 3Q26 BLD PROBE,148.0,96.2,0.95,164.91,60
HCPCS,88271,FISH 3Q36 BM PROBE,148.0,96.2,0.95,164.91,60
HCPCS,88271,FISH FOR BCR/ABL 1 PROBE X2,148.0,96.2,0.95,164.91,60
HCPCS,88271,FSBLLM BM PROBE X12,148.0,96.2,0.95,164.91,60
HCPCS,88271,FSMDSM BM PROBE X6,148.0,96.2,0.95,164.91,60
HCPCS,88271,"FUS (16P11.2), FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,"I(12P), GERM CELL TUMOR, FISH, TS",148.0,96.2,0.95,164.91,60
HCPCS,88271,ISIGHT DNA PROBE,148.0,96.2,0.95,164.91,60
HCPCS,88271,"JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,MAML2 FISH DNA PROBES,148.0,96.2,0.95,164.91,60
HCPCS,88271,MOLECULAR CYTOGENETIC TEST,148.0,96.2,0.95,164.91,60
HCPCS,88271,MOLECULAR CYTOGENETICS DNA PROBE EACH,148.0,96.2,1.1,148.0,32
HCPCS,88271,MPNFSM BM PROBE X9,148.0,96.2,0.95,164.91,60
HCPCS,88271,"NR4A3, REARRANGEMENT, FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,PDGFAM BM PROBE X2,148.0,96.2,0.95,164.91,60
HCPCS,88271,"PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
HCPCS,88271,"PLASMA CELL PROLIFERATIVE DISORDER, FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,"PRKACA, REARRANGEMENT, FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,240
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
HCPCS,88271,SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,0.95,164.91,60
HCPCS,88271,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,240
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
HCPCS,88271,SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,0.95,164.91,60
HCPCS,88271,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,0.95,164.91,240
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,0.95,164.91,60
HCPCS,88271,SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,0.95,164.91,60
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,0.95,164.91,60
HCPCS,88271,T-CELL ALL FISH 10 PROBE SETS,148.0,96.2,0.95,164.91,60
HCPCS,88271,T-CELL ALL FISH ADDITIONAL PROBE SET,148.0,96.2,0.95,164.91,60
HCPCS,88271,"T-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA, FISH",148.0,96.2,0.95,164.91,60
HCPCS,88272,CYTOGENETICS 3-5,,,40.7,166.78,21
HCPCS,88272,Cytogenetics 3-5,,,66.63,77.15,8
HCPCS,88273,CYTOGENETICS 10-30,,,34.81,142.64,21
HCPCS,88273,Cytogenetics 10-30,,,66.63,77.15,8
HCPCS,88274,%FSHPCM ANALY 25-99,292.0,189.8,0.95,292.0,60
HCPCS,88274,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,240
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-I(12P), GERM CELL TUMO",292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMENT,",292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FISH, T",292.0,189.8,0.95,292.0,60
HCPCS,88274,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFERAT,292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEMENT,",292.0,189.8,0.95,292.0,60
HCPCS,88274,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,0.95,292.0,240
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-I(12P), GERM CELL",292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FIS",292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEME",292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FIS",292.0,189.8,0.95,292.0,60
HCPCS,88274,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIF,292.0,189.8,0.95,292.0,60
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEM",292.0,189.8,0.95,292.0,60
HCPCS,88274,INTER FISH ANALYSIS 25-99 CELLS,292.0,189.8,0.95,292.0,60
HCPCS,88275,%APLFSH ANALY 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,%BCRFSH ANALY 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,%CLLFSH ANALY 100-300 X3,353.0,229.45,0.95,353.0,60
HCPCS,88275,%FAMLPN ANALY 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,%FSHMDS ANALY 100-300 X3,353.0,229.45,0.95,353.0,60
HCPCS,88275,%FSHPCM ANALY 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,%ISIGHT MOL CY 100 - 300,353.0,229.45,0.95,353.0,60
HCPCS,88275,APLFBM BM 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,CHROMOSOME ANALYSIS AMNIOTIC FLUID,353.0,229.45,0.95,353.0,60
HCPCS,88275,CLLFSM ANALY 100-300 X3,353.0,229.45,0.95,353.0,60
HCPCS,88275,CYTOGEN INTERPHASE 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,DDIT3 ANALY 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,FABCBM BM 100-300 X4,353.0,229.45,0.95,353.0,60
HCPCS,88275,FHT410 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,FISH 3Q26 BLD ANALYSIS,353.0,229.45,0.95,353.0,60
HCPCS,88275,FISH 3Q26 BM ANALYSIS,353.0,229.45,0.95,353.0,60
HCPCS,88275,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE),353.0,229.45,0.95,353.0,60
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",353.0,229.45,0.95,353.0,60
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMEN",353.0,229.45,0.95,353.0,60
HCPCS,88275,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFE,353.0,229.45,0.95,353.0,60
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PRKACA, REARRANGEME",353.0,229.45,0.95,353.0,60
HCPCS,88275,FISH MAYO GREATER THAN 100 CELLS (IF APPROPRIATE),353.0,229.45,0.95,353.0,60
HCPCS,88275,FSBLLM BM 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,FSMDSM BM 100-300 X3,353.0,229.45,0.95,353.0,60
HCPCS,88275,INTERPHASE IN SITU HYBRIDIZATION,353.0,229.45,0.95,353.0,60
HCPCS,88275,MPNFSM BM 100-300 X4,353.0,229.45,0.95,353.0,60
HCPCS,88275,PDGFAM BM 100-300,353.0,229.45,0.95,353.0,60
HCPCS,88275,T-CELL ALL FISH 100-300 CELLS ADDITIONAL PROBE SET,353.0,229.45,0.95,353.0,60
HCPCS,88275,TALLAF FISH 100-300 CELLS,353.0,229.45,0.95,353.0,60
HCPCS,88280,"CHROMOSOME ANAL, KAROTYPE EA",231.0,150.15,0.95,231.0,60
HCPCS,88280,CHROMOSOME ANALYSIS ADDITIONAL KARYOTYPE,231.0,150.15,0.95,231.0,60
HCPCS,88280,CVCYTO CHROMOSOME KARYOTYPE,231.0,150.15,0.95,231.0,60
HCPCS,88283,CHROMOSOME BANDING STUDY,,,68.6,281.11,21
HCPCS,88283,Chromosome banding study,,,66.63,77.15,8
HCPCS,88285,ADDITIONAL CELLS COUNTED,186.0,120.9,0.95,186.0,60
HCPCS,88285,CHROMO COUNT ADD,186.0,120.9,0.95,186.0,60
HCPCS,88285,CVCYTO CHROMOSOME COUNT ADDITIONAL,186.0,120.9,0.95,186.0,60
HCPCS,88289,CHRBLD CHROMO STDY ADD,238.0,154.7,0.95,238.0,60
HCPCS,88291,MOL CYTOGEN I&R,229.0,148.85,0.95,229.0,46
HCPCS,88299,UNLISTED CYTOGENETIC STUDY,,,49.3,146.06,20
HCPCS,88299,Unlisted cytogenetic study,,,66.63,77.15,8
HCPCS,88300,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,1.1,35.0,44
HCPCS,88300,SURG PATH GROSS ONLY LVL I,169.0,109.85,0.95,169.0,61
HCPCS,88302,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,126.5,82.225,1.1,196.0,134
HCPCS,88302,SURG PATH GROSS MICRO LVL II,271.0,176.15,0.95,271.0,61
HCPCS,88304,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,97.0,63.05,1.1,97.0,44
HCPCS,88304,SURG PATH GROSS MICRO LVL III,369.0,239.85,0.95,369.0,61
HCPCS,88305,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,349.5,227.175,1.1,369.0,134
HCPCS,88305,SP BIOPSY PROSTATE,369.0,239.85,0.95,369.0,61
HCPCS,88305,SURG PATH GROSS MICRO LVL IV,369.0,239.85,0.95,369.0,61
HCPCS,88305,SURGERY PATH GROSS MICRO LEVEL 4,369.0,239.85,0.95,369.0,61
HCPCS,88307,%AHTBX PATH LVL V,2482.0,1613.3,0.95,2482.0,61
HCPCS,88307,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,700.0,455.0,1.1,700.0,44
HCPCS,88307,SURG PATH GROSS MICRO LVL V MOD,2482.0,1613.3,0.95,2482.0,61
HCPCS,88307,TISSUE EXAM BY PATH LVL V,2482.0,1613.3,0.95,2482.0,61
HCPCS,88309,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1232.0,800.8,1.1,1232.0,44
HCPCS,88309,SURG PATH GROSS MICRO LVL VI MOD,5637.0,3664.05,0.95,5637.0,61
HCPCS,88309,TISSUE EXAM BY PATH LVL VI,5637.0,3664.05,0.95,5637.0,61
HCPCS,88311,DECALCIFICATION MOD,106.0,68.9,0.95,106.0,46
HCPCS,88311,DECALCIFICATION PROC,106.0,68.9,0.95,106.0,46
HCPCS,88311,DECALCIFICATION PROCEDURE,106.0,68.9,1.1,106.0,44
HCPCS,88312,SPEC STN GRP I,207.0,134.55,0.95,207.0,61
HCPCS,88312,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,238.0,154.7,1.1,238.0,44
HCPCS,88312,"SPECIAL STAIN GRP I EA, SEMEN",207.0,134.55,0.95,207.0,61
HCPCS,88313,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,106.0,68.9,1.1,106.0,44
HCPCS,88313,SPEC STN GRP II,126.0,81.9,0.95,372.91,183
HCPCS,88313,"SPECIAL STAIN GRP II EA, SEMEN",126.0,81.9,0.95,372.91,61
HCPCS,88314,HISTOCHEMICAL STAIN,184.0,119.6,0.95,184.0,46
HCPCS,88314,SPECIAL STAIN ON FS,184.0,119.6,0.95,184.0,46
HCPCS,88318,CHEMICAL HISTOCHEMISTRY,,,113.97,113.97,1
HCPCS,88319,HISTOCHEMISTRY FOR ENZYME,5637.0,3664.05,0.95,5637.0,61
HCPCS,88321,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,717.0,466.05,1.1,717.0,22
HCPCS,88321,CONSULT SLIDE PREP ELSEWHERE,271.0,176.15,0.95,271.0,61
HCPCS,88323,CONSULT SLIDE W PREP,369.0,239.85,0.95,369.0,61
HCPCS,88325,CONSLTJ COMPRE RVW REC REPRT,,,135.12,477.52,21
HCPCS,88325,Consltj compre rvw rec reprt,,,27.56,31.91,8
HCPCS,88329,PATH CONSLTJ DRG SURG,,,54.88,165.35,21
HCPCS,88329,Path consltj drg surg,,,27.56,31.91,8
HCPCS,88331,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,524.0,340.6,1.1,524.0,44
HCPCS,88331,PATH CONSULT OR 1ST BLOCK,1182.0,768.3,0.95,1182.0,61
HCPCS,88332,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,260.0,169.0,1.1,260.0,44
HCPCS,88332,PATH CONSULT OR ADD TIS BLOCK,183.0,118.95,0.95,183.0,46
HCPCS,88333,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,528.0,343.2,1.1,528.0,44
HCPCS,88333,PATH CONSULT CYTO EXAM INIT,5637.0,3664.05,0.95,5637.0,61
HCPCS,88333,PATH TOUCH PREP INIT,5637.0,3664.05,0.95,5637.0,61
HCPCS,88334,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,321.0,208.65,1.1,321.0,44
HCPCS,88334,PATH TOUCH PREP EA ADD,183.0,118.95,0.95,183.0,46
HCPCS,88341,IHC /SPC EA ADD AB STN,247.0,160.55,0.95,247.0,46
HCPCS,88341,IHC EA ADDTL AB/BLOCK,247.0,160.55,0.95,247.0,46
HCPCS,88341,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,246.0,159.9,1.1,246.0,44
HCPCS,88341,IMMUNO H/C EA ADDTL AB STAIN,247.0,160.55,0.95,247.0,46
HCPCS,88342,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,308.0,200.2,1.1,308.0,44
HCPCS,88342,IMMUNOHISTOCHEM EA AB,1182.0,768.3,0.95,1182.0,122
HCPCS,88344,IHC EA MULTIPLEX AB,2482.0,1613.3,0.95,2482.0,61
HCPCS,88344,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,339.0,220.35,1.1,339.0,44
HCPCS,88346,%IBDSGI IFA FIRST,1182.0,768.3,0.95,1182.0,61
HCPCS,88346,*IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,0.95,1182.0,122
HCPCS,88346,CIFAB AB IGG FIRST,1182.0,768.3,0.95,1182.0,61
HCPCS,88346,DIRECT IMMUNOFLUOR-EACH,1182.0,768.3,0.95,1182.0,61
HCPCS,88347,IMMUNOFLUORESCENT STUDY,,,198.6,198.6,1
HCPCS,88348,CILIARY MOTILITY - EM DIAG,5637.0,3664.05,0.95,5637.0,61
HCPCS,88348,ELECTRON MICRO DX,5637.0,3664.05,0.95,5637.0,61
HCPCS,88349,SCANNING ELECTRON MICROSCOPY,,,446.27,446.27,1
HCPCS,88350,%ENTERO AB ADDTL X2,249.0,161.85,0.95,249.0,46
HCPCS,88350,%IBDSGI IFA ADDTL,249.0,161.85,0.95,249.0,46
HCPCS,88350,%PEMGUS IFL ADDTL,249.0,161.85,0.95,249.0,46
HCPCS,88350,CIFAB AB IGG ADDTL,249.0,161.85,0.95,249.0,46
HCPCS,88350,IMMUNOFLUOR ADDTL,249.0,161.85,0.95,249.0,46
HCPCS,88355,M/PHMTRC ALYS SKELETAL MUSC,,,158.33,477.52,21
HCPCS,88355,M/phmtrc alys skeletal musc,,,54.37,62.95,8
HCPCS,88356,ANALYSIS NERVE,,,49.3,462.03,21
HCPCS,88356,Analysis nerve,,,29.68,34.36,8
HCPCS,88358,ANALYSIS TUMOR,,,158.33,477.52,21
HCPCS,88358,Analysis tumor,,,54.37,62.95,8
HCPCS,88360,ER PARAFFIN BLOCK,1182.0,768.3,0.95,1182.0,61
HCPCS,88360,IMMUNOHISTOCHEM QT,1182.0,768.3,0.95,1182.0,61
HCPCS,88360,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,374.0,243.1,1.1,374.0,44
HCPCS,88360,"PD-L1 (28-8), SEMIQUANT IHC, MANUAL",1182.0,768.3,0.95,1182.0,61
HCPCS,88360,"PD-L1 (SP142) SEMIQUANT IHC, MANUAL",1182.0,768.3,0.95,1182.0,61
HCPCS,88360,"PD-L1 (SP263) SEMIQUANT IHC, MANUAL",1182.0,768.3,0.95,1182.0,61
HCPCS,88360,PD-L1 22C3 IHC WITH TPS,1182.0,768.3,0.95,1182.0,61
HCPCS,88360,PR PARAFFIN BLOCK,1182.0,768.3,0.95,1182.0,61
HCPCS,88361,TUMOR IMMUNOHISTOCHEM/COMPUT,,,126.24,1004.67,21
HCPCS,88361,Tumor immunohistochem/comput,,,54.37,62.95,8
HCPCS,88362,NERVE TEASING PREPARATIONS,,,311.5,2258.2,21
HCPCS,88362,Nerve teasing preparations,,,54.37,62.95,8
HCPCS,88363,RETRVL/SELECT SPCM MOLEC TEST,169.0,109.85,0.95,169.0,61
HCPCS,88364,CISH ADDTL,935.0,607.75,0.95,935.0,46
HCPCS,88364,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,308.0,200.2,1.1,308.0,44
HCPCS,88365,CISH EA PROBE,673.0,437.45,0.95,673.0,61
HCPCS,88365,CISH EA PROBE MOD,673.0,437.45,0.95,673.0,61
HCPCS,88365,CISH EACH PROBE,673.0,437.45,0.95,673.0,122
HCPCS,88365,CISH FOR EPSTEIN BARR,673.0,437.45,0.95,673.0,61
HCPCS,88365,CISH KAPPA,673.0,437.45,0.95,673.0,61
HCPCS,88365,CISH LAMDA,673.0,437.45,0.95,673.0,61
HCPCS,88365,IN SITU HYBRIDIZATION 1ST PROBE STAIN,387.0,251.55,1.1,387.0,44
HCPCS,88366,INSITU HYBRIDIZATION DUAL,1182.0,768.3,0.95,1182.0,61
HCPCS,88366,"RET GENE REARRANGEMENTS, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88366,"SEND OUT ALK GENE REARRANGEMENTS BY FISH, LUNG",1182.0,768.3,0.95,1182.0,61
HCPCS,88366,SEND OUT ROS1 BY FISH,1182.0,768.3,0.95,1182.0,61
HCPCS,88367,INSITU HYBRIDIZATION AUTO,,,332.02,1004.67,21
HCPCS,88367,Insitu hybridization auto,,,54.37,62.95,8
HCPCS,88368,QFEVER ABS IGG PH2 RFLX,2482.0,1613.3,0.95,2482.0,61
HCPCS,88369,M/PHMTRC ALYSISHQUANT/SEMIQ,,,193.14,193.14,1
HCPCS,88369,M/phmtrc alysishquant/semiq,,,29.68,34.36,8
HCPCS,88371,PROTEIN WESTERN BLOT TISSUE,,,46.87,170.55,5
HCPCS,88371,Protein western blot tissue,,,36.09,41.79,8
HCPCS,88372,PROTEIN ANALYSIS W/PROBE,,,54.53,107.44,5
HCPCS,88372,Protein analysis w/probe,,,36.09,41.79,8
HCPCS,88373,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,106.01,106.01,1
HCPCS,88373,M/phmtrc alys ishquant/semiq,,,29.68,34.36,8
HCPCS,88374,M/PHMTRC ALYS ISHQUANT/SEMIQ,1182.0,768.3,0.95,1182.0,61
HCPCS,88375,OPTICAL ENDOMICROSCPY INTERP,,,110.7,110.7,1
HCPCS,88375,Optical endomicroscpy interp,,,27.56,31.91,8
HCPCS,88377,1P19Q FISH FOR 1P/19Q,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,ALK FISH LUNG NSCLC,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"B-CELL LYMPHOMA, FISH, TISSUE",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,BTM FISH REFLEX 1,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH ALK NSCLC,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH CUTANE MELANOMA,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR 19Q,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR AGG B CL LYM,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR ANGIO MYC AMP,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR BCL2,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR CHOP GENE,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR EGFR,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR MDM2,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR RET CYTO BLOCK,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR RET PRFN,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR ROS1 CYTO BLOCK,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH FOR ROS1 PRFN,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH HER-2,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH RENAL CELL CARCINOMA PNL,1182.0,768.3,0.95,1182.0,61
HCPCS,88377,FISH SYT GENE(18Q11),1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"HER-2 MORPH ANLYS MULTI, MAN",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"HER2 AMPLIFICATION, MISCELLANEOUS TUMOR, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"ISH, QUANT/SEMI QUANT, MULTIPLEX PROBE STAIN",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,616.0,400.4,1.1,616.0,44
HCPCS,88377,"MDM2, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"MORPHOMETRIC ANALYSIS, IN SITU HYBRID (HER2FGAST)",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"MYCN (N-MYC), FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"SLL, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88377,"T-CELL LYMPHOMA, FISH",1182.0,768.3,0.95,1182.0,61
HCPCS,88380,ATMS MICRODISECTION,519.0,337.35,0.95,519.0,46
HCPCS,88381,%MSI3 MICRO DELETION X3,519.0,337.35,0.95,519.0,46
HCPCS,88381,*MICRODISECTION MANUAL,519.0,337.35,0.95,519.0,46
HCPCS,88384,EVAL MOLECULAR PROBES 11-50,,,141.45,141.45,1
HCPCS,88385,EVAL MOLECUL PROBES 51-250,,,623.85,623.85,1
HCPCS,88386,EVAL MOLECUL PROBES 251-500,,,854.51,854.51,1
HCPCS,88387,MACROSCOPIC XM DSJ&PREP TISS,,,18.08,65.09,2
HCPCS,88387,Macroscopic xm dsj&prep tiss,,,29.68,34.36,8
HCPCS,88388,TISS EX MOLECUL STUDY ADD-ON,,,39.28,39.28,1
HCPCS,88388,Tiss ex molecul study add-on,,,27.56,31.91,8
HCPCS,88399,PARATHYROID GLAND CRYOPRESERVA,335.0,217.75,0.95,335.0,61
HCPCS,88720,BILIRUBIN TOTAL TRANSCUT (POINT OF CARE LAB),35.0,22.75,0.95,35.0,60
HCPCS,88738,HGB QUANT TRANSCUTANEOUS,,,5.02,20.57,21
HCPCS,88738,Hgb quant transcutaneous,,,6.74,7.8,8
HCPCS,88740,TRANSCUTANEOUS CARBOXYHB,,,9.37,38.4,21
HCPCS,88740,Transcutaneous carboxyhb,,,6.74,7.8,8
HCPCS,88741,TRANSCUTANEOUS METHB,,,9.37,38.4,21
HCPCS,88741,Transcutaneous methb,,,6.74,7.8,8
HCPCS,88749,Unlisted in vivo lab service,,,7.12,8.24,8
HCPCS,89049,CHCT FOR MAL HYPERTHERMIA,,,158.33,477.52,21
HCPCS,89049,Chct for mal hyperthermia,,,48.21,55.83,8
HCPCS,89050,CSF COUNT BILL (NO DIFF),33.0,21.45,0.95,33.0,60
HCPCS,89051,CELL COUNT & DIFF,39.0,25.35,0.95,42.4,60
HCPCS,89051,CELL COUNT FLUID DIFF COUNT,39.0,25.35,0.95,42.4,60
HCPCS,89051,CELL COUNT/DIFF BODY FLD,39.0,25.35,0.95,42.4,60
HCPCS,89055,LEUKOCYTE ASSESSMENT FECAL,,,4.27,32.88,21
HCPCS,89055,Leukocyte assessment fecal,,,7.12,8.24,8
HCPCS,89060,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,163.0,105.95,1.1,163.0,33
HCPCS,89060,EXAM SYNOVIAL FLUID CRYSTALS,51.0,33.15,0.95,51.0,120
HCPCS,89100,SAMPLE INTESTINAL CONTENTS,,,42.37,42.37,1
HCPCS,89105,SAMPLE INTESTINAL CONTENTS,,,36.58,36.58,1
HCPCS,89125,SPECIMEN FAT STAIN,,,5.88,24.1,21
HCPCS,89125,Specimen fat stain,,,7.12,8.24,8
HCPCS,89130,SAMPLE STOMACH CONTENTS,,,31.25,31.25,1
HCPCS,89132,SAMPLE STOMACH CONTENTS,,,14.61,14.61,1
HCPCS,89135,SAMPLE STOMACH CONTENTS,,,51.64,51.64,1
HCPCS,89136,SAMPLE STOMACH CONTENTS,,,13.43,13.43,1
HCPCS,89140,SAMPLE STOMACH CONTENTS,,,76.48,76.48,1
HCPCS,89141,SAMPLE STOMACH CONTENTS,,,75.38,75.38,1
HCPCS,89160,EXAM FECES FOR MEAT FIBERS,,,4.85,19.87,21
HCPCS,89160,Exam feces for meat fibers,,,7.12,8.24,8
HCPCS,89190,EOSINOPHIL SMEAR MISC,40.0,26.0,0.95,40.0,60
HCPCS,89220,SPUTUM SPECIMEN COLLECTION,,,36.99,477.52,22
HCPCS,89220,Sputum specimen collection,,,48.21,55.83,8
HCPCS,89225,"STARCH GRANULES, FECES",,,6.0,6.0,1
HCPCS,89230,COLLECT SWEAT FOR TEST,,,12.94,146.06,21
HCPCS,89230,Collect sweat for test,,,36.09,41.79,8
HCPCS,89235,WATER LOAD TEST,,,21.2,21.2,1
HCPCS,89240,UNLISTED MISC PATH TEST,,,49.3,209.3,21
HCPCS,89240,Unlisted misc path test,,,36.09,41.79,8
HCPCS,89250,CULTR OOCYTE/EMBRYO <4 DAYS,,,158.33,2102.98,22
HCPCS,89250,Cultr oocyte/embryo <4 days,,,19.72,22.84,8
HCPCS,89251,CULTR OOCYTE/EMBRYO <4 DAYS,,,158.33,9188.2,21
HCPCS,89251,Cultr oocyte/embryo <4 days,,,19.72,22.84,8
HCPCS,89253,EMBRYO HATCHING,,,158.33,1046.16,22
HCPCS,89253,Embryo hatching,,,19.72,22.84,8
HCPCS,89254,OOCYTE IDENTIFICATION,,,158.33,1470.1,21
HCPCS,89254,Oocyte identification,,,19.72,22.84,8
HCPCS,89255,PREPARE EMBRYO FOR TRANSFER,,,49.3,692.88,22
HCPCS,89255,Prepare embryo for transfer,,,19.72,22.84,8
HCPCS,89257,SPERM IDENTIFICATION,,,49.3,977.25,22
HCPCS,89257,Sperm identification,,,19.72,22.84,8
HCPCS,89258,CRYOPRESERVATION EMBRYO(S),,,22.63,2258.2,22
HCPCS,89258,Cryopreservation embryo(s),,,19.72,22.84,8
HCPCS,89259,CRYOPRESERVATION SPERM,540.0,351.0,0.95,540.0,61
HCPCS,89260,SPERM WASH FOR INSEMINATI,268.0,174.2,0.95,397.39,61
HCPCS,89261,SPERM WASH SECOND INSEM,500.0,325.0,0.95,500.0,61
HCPCS,89264,IDENTIFY SPERM TISSUE,,,49.3,471.11,22
HCPCS,89264,Identify sperm tissue,,,19.72,22.84,8
HCPCS,89268,INSEMINATION OF OOCYTES,,,158.33,477.52,20
HCPCS,89268,Insemination of oocytes,,,19.72,22.84,8
HCPCS,89272,EXTENDED CULTURE OF OOCYTES,,,754.8,2258.2,20
HCPCS,89272,Extended culture of oocytes,,,19.72,22.84,8
HCPCS,89280,ASSIST OOCYTE FERTILIZATION,,,545.27,2258.2,21
HCPCS,89280,Assist oocyte fertilization,,,19.72,22.84,8
HCPCS,89281,ASSIST OOCYTE FERTILIZATION,,,158.33,2014.66,21
HCPCS,89281,Assist oocyte fertilization,,,19.72,22.84,8
HCPCS,89290,BIOPSY OOCYTE POLAR BODY <=5,,,158.33,3374.41,22
HCPCS,89290,Biopsy oocyte polar body <=5,,,19.72,22.84,8
HCPCS,89291,BIOPSY OOCYTE POLAR BODY,,,158.33,3572.39,22
HCPCS,89291,Biopsy oocyte polar body,,,19.72,22.84,8
HCPCS,89300,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,68.0,44.2,1.1,68.0,32
HCPCS,89300,SEMEN ANALYSIS W/HUHNER,,,9.84,68.68,22
HCPCS,89300,Semen analysis w/huhner,,,7.12,8.24,8
HCPCS,89300QW,SEMEN ANALYSIS W/HUHNER,,,11.03,11.03,1
HCPCS,89310,SPERM COUNT/MOTILITY SEMEN,59.0,38.35,0.95,60.05,60
HCPCS,89320,CASA,205.0,133.25,0.95,205.0,60
HCPCS,89321,SEMEN ANAL POST VASEC,191.0,124.15,0.95,191.0,60
HCPCS,89321,SEMEN ANAL SPERM DETECTION,,,13.51,13.51,1
HCPCS,89321QW,SEMEN ANAL SPERM DETECTION,,,13.51,13.51,1
HCPCS,89322,SEMEN ANAL STRICT CRITERIA,,,15.5,63.52,21
HCPCS,89322,Semen anal strict criteria,,,7.12,8.24,8
HCPCS,89325,ANTI SPERM AB TYPING,210.0,136.5,0.95,210.0,60
HCPCS,89329,EVAL SPERM HAMSTER TEST,135.0,87.75,0.95,135.0,60
HCPCS,89330,EVALUATION CERVICAL MUCUS,,,10.38,43.6,21
HCPCS,89330,Evaluation cervical mucus,,,7.12,8.24,8
HCPCS,89331,RETRO AN SPERM COUNT,135.0,87.75,0.95,135.0,60
HCPCS,89335,CRYOPRESERVE TESTICULAR TISS,,,49.3,146.06,20
HCPCS,89335,Cryopreserve testicular tiss,,,19.72,22.84,8
HCPCS,89337,CRYOPRESERVATION OOCYTE(S),,,158.33,477.52,20
HCPCS,89337,Cryopreservation oocyte(s),,,19.72,22.84,8
HCPCS,89342,STORAGE EMBRYO EA YR,700.0,455.0,0.95,700.0,61
HCPCS,89343,STORAGE/YEAR SPERM/SEMEN,,,158.33,477.52,22
HCPCS,89343,Storage/year sperm/semen,,,19.72,22.84,8
HCPCS,89344,STORAGE/YEAR REPROD TISSUE,,,158.33,477.52,20
HCPCS,89344,Storage/year reprod tissue,,,19.72,22.84,8
HCPCS,89346,STORAGE/YEAR OOCYTE(S),500.0,325.0,0.95,655.34,61
HCPCS,89352,THAWING CRYOPRESRVED EMBRYO,,,158.33,1449.71,22
HCPCS,89352,Thawing cryopresrved embryo,,,19.72,22.84,8
HCPCS,89353,THAW CRYOPRESERVE SPERM/SEMEN,250.0,162.5,0.95,250.0,61
HCPCS,89354,THAW CRYOPRSVRD REPROD TISS,,,158.33,477.52,20
HCPCS,89354,Thaw cryoprsvrd reprod tiss,,,19.72,22.84,8
HCPCS,89356,THAWING CRYOPRESRVED OOCYTE,,,158.33,477.52,20
HCPCS,89356,Thawing cryopresrved oocyte,,,19.72,22.84,8
HCPCS,89398,UNLISTED REPROD MED LAB PROC,,,49.3,146.06,20
HCPCS,89398,Unlisted reprod med lab proc,,,36.09,41.79,8
HCPCS,9001F,Aortic aneurysm<5cm diam ct,,,8.48,9.82,8
HCPCS,9002F,Aortic aneurysm 5-5.4cm diam,,,8.48,9.82,8
HCPCS,9003F,Aortic anrysm5.5-5.9cm diam,,,8.48,9.82,8
HCPCS,9004F,Aortic anrysm 6/> cm diam,,,8.48,9.82,8
HCPCS,9005F,Asympt carot/vrtbrbas sten,,,8.48,9.82,8
HCPCS,9006F,Sympt sten-tia/strk<120days,,,8.48,9.82,8
HCPCS,9007F,Other carot sten 120 days/>,,,8.48,9.82,8
HCPCS,90281,HUMAN IG IM,,,128.44,221.11,3
HCPCS,90281,Human ig im,,,41.42,47.96,8
HCPCS,9028100,HUMAN IG IM,,,172.62,172.62,1
HCPCS,90283,HUMAN IG IV,,,123.12,196.68,3
HCPCS,90283,Human ig iv,,,41.42,47.96,8
HCPCS,9028300,HUMAN IG IV,,,135.01,135.01,1
HCPCS,90284,HUMAN IG SC,,,27.0,49.45,3
HCPCS,90284,Human ig sc,,,41.42,47.96,8
HCPCS,9028400,HUMAN IG SC,,,27.0,27.0,1
HCPCS,90287,Botulinum antitoxin,,,112.58,130.36,8
HCPCS,90288,BOTULISM IG IV,,,104850.9,111047.4,2
HCPCS,90288,Botulism ig iv,,,11321.23,13108.79,8
HCPCS,9028800,BOTULISM IG IV,,,104850.9,104850.9,1
HCPCS,90291,CMV IG IV,,,3189.74,4532.67,3
HCPCS,90291,Cmv ig iv,,,3875.72,4487.68,8
HCPCS,9029100,CMV IG IV,,,3189.74,3189.74,1
HCPCS,90296,Diphtheria antitoxin,,,41.42,47.96,8
HCPCS,90371,HEP B IG IM,,,245.34,245.34,1
HCPCS,90371,HYPERHEP B 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,593.46,385.75,131.15,1287.79,65
HCPCS,90371,HYPERHEP B 220 UNIT/ML INTRAMUSCULAR SOLUTION,618.45,401.99,136.68,1287.79,65
HCPCS,90371,HYPERHEP B NEONATAL 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,655.92,426.35,137.82,1287.79,65
HCPCS,90371,NABI-HB GREATER THAN 1560 UNIT/5 ML INTRAMUSCULAR SOLUTION,569.07,369.9,125.76,1287.79,65
HCPCS,9037100,HEP B IG IM,,,245.34,245.34,1
HCPCS,90375,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,279.94,2642.72,195
HCPCS,90375,RABIES IG IM/SC,,,498.31,498.31,1
HCPCS,9037500,RABIES IG IM/SC,,,498.31,498.31,1
HCPCS,90376,IMOGAM RABIES-HT (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,1629.24,1059.01,352.44,2642.72,65
HCPCS,90376,RABIES IG HEAT TREATED,,,821.68,821.68,1
HCPCS,9037600,RABIES IG HEAT TREATED,,,821.68,821.68,1
HCPCS,90377,RABIES IG HT&SOL HUMAN IM/SC,,,232.05,660.36,25
HCPCS,90377,Rabies ig ht&sol human im/sc,,,2282.35,2642.72,8
HCPCS,9037700,RABIES IG HT&SOL HUMAN IM/SC,,,427.43,427.43,1
HCPCS,90378,RSV MAB IM 50MG,,,436.75,4234.12,22
HCPCS,90378,Rsv mab im 50mg,,,1112.18,1287.79,8
HCPCS,9037800,RSV MAB IM 50MG,,,3305.58,3305.58,1
HCPCS,90380,BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,4284.4349999999995,2784.88,637.52,4284.45,102
HCPCS,90380,RSV MONOC ANTB SEASN .5ML IM,,,1009.72,1009.72,1
HCPCS,90380,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,1.1,2681.91,79
HCPCS,9038000,RSV MONOC ANTB SEASN .5ML IM,,,1009.72,1009.72,1
HCPCS,90381,BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE,2142.21,1392.44,318.76,2142.21,102
HCPCS,90381,RSV MONOC ANTB SEASN 1 ML IM,,,1009.72,1009.72,1
HCPCS,90381,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,1.1,2080.0,79
HCPCS,9038100,RSV MONOC ANTB SEASN 1 ML IM,,,1009.72,1009.72,1
HCPCS,90382,RSV MONOC ANTB SEASN .7ML IM,,,1187.62,1187.62,1
HCPCS,90382,Rsv monoc antb seasn .7ml im,,,1112.18,1287.79,8
HCPCS,9038200,RSV MONOC ANTB SEASN .7ML IM,,,1187.62,1187.62,1
HCPCS,90384,RH IG FULL-DOSE IM,,,150.39,257.57,3
HCPCS,90384,Rh ig full-dose im,,,112.58,130.36,8
HCPCS,9038400,RH IG FULL-DOSE IM,,,150.39,150.39,1
HCPCS,90385,RH IG MINIDOSE IM,,,54.18,220.0,16
HCPCS,90385,Rh ig minidose im,,,41.42,47.96,8
HCPCS,9038500,RH IG MINIDOSE IM,,,54.18,54.18,1
HCPCS,90386,RH IG IV,,,18.71,1424.87,3
HCPCS,90386,Rh ig iv,,,2813.05,3257.22,8
HCPCS,9038600,RH IG IV,,,18.71,18.71,1
HCPCS,90389,TETANUS IG IM,,,1178.63,1674.85,3
HCPCS,90389,Tetanus ig im,,,112.58,130.36,8
HCPCS,9038900,TETANUS IG IM,,,1178.63,1178.63,1
HCPCS,90393,Vaccina ig im,,,112.58,130.36,8
HCPCS,90396,VARICELLA-ZOSTER IG IM,,,2250.71,6499.32,22
HCPCS,90396,Varicella-zoster ig im,,,576.07,667.03,8
HCPCS,9039600,VARICELLA-ZOSTER IG IM,,,4140.94,4140.94,1
HCPCS,90399,UNLISTED IMMUNE GLOBULIN,,,919.96,919.96,1
HCPCS,90399,Unlisted immune globulin,,,41.42,47.96,8
HCPCS,90460,IM ADMIN 1ST/ONLY COMPONENT,70.0,45.5,13.56,70.0,46
HCPCS,90460,IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID,96.0,62.4,1.1,96.0,50
HCPCS,90460,VFC IM ADMIN 1ST/ONLY THRU 18,21.25,13.81,4.63,48.52,46
HCPCS,90460,VFC IM ADMIN/ONLY THRU 18,21.25,13.81,1.1,74.35,50
HCPCS,90461,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,27.0,17.55,5.89,27.0,46
HCPCS,90461,IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID,72.0,46.8,1.1,72.0,44
HCPCS,90471,ADMIN FLU VIRUS VACCINE,68.0,44.2,1.1,120.06,50
HCPCS,90471,ADMIN VACCINE FLU,214.0,139.1,13.56,214.0,61
HCPCS,90471,ADMIN VACCINE PNEUMONIA,214.0,139.1,13.56,214.0,61
HCPCS,90471,ADMIN VACCINE SNGL,214.0,139.1,13.56,214.0,61
HCPCS,90471,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,68.0,44.2,1.1,120.06,50
HCPCS,90471,IMMUNIZ INJ-HEP B VACC ONLY,214.0,139.1,13.56,214.0,61
HCPCS,90471,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,33.0,21.45,9.33,201.81,61
HCPCS,90472,ADMIN VACCINE EA ADD,64.0,41.6,13.56,64.0,46
HCPCS,90472,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,60.0,39.0,1.1,60.0,50
HCPCS,90473,IM ADM INTRANSL/ORAL 1 VACCINE,68.0,44.2,1.1,120.06,50
HCPCS,90473,IMMUNE ADMIN ORAL/NAS 1ST,214.0,139.1,13.56,214.0,61
HCPCS,90474,IM ADM INTRANSL/ORAL EA VACCINE,60.0,39.0,1.1,60.0,50
HCPCS,90474,IMM ADMIN ORAL/NASAL ADDL,190.0,123.5,13.56,190.0,46
HCPCS,90476,Adenovirus vaccine type 4,,,7.93,9.19,8
HCPCS,90477,Adenovirus vaccine type 7,,,7.93,9.19,8
HCPCS,90480,ADMINISTRATION COVID VACCINE,286.0,185.9,1.0,286.0,60
HCPCS,90480,ADMINISTRATION COVID VACCINE (2023-2024),293.0,190.45,1.1,293.0,32
HCPCS,90480,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,1.0,138.2,92
HCPCS,90481,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,286.0,185.9,1.1,286.0,68
HCPCS,90482,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,88.0,57.2,1.1,106.0,69
HCPCS,90483,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,145.0,94.25,1.1,220.0,69
HCPCS,90484,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,200.0,130.0,1.1,330.0,69
HCPCS,90581,ANTHRAX VACCINE SC OR IM,,,179.74,249.53,3
HCPCS,90581,Anthrax vaccine sc or im,,,13.37,15.48,8
HCPCS,9058100,ANTHRAX VACCINE SC OR IM,,,179.74,179.74,1
HCPCS,90584,Dengue vacc quad 2 dose subq,,,13.37,15.48,8
HCPCS,90585,BCG VACCINE PERCUT,,,147.34,438.3,4
HCPCS,90585,Bcg vaccine percut,,,7.93,9.19,8
HCPCS,9058500,BCG VACCINE PERCUT,,,330.39,330.39,1
HCPCS,90586,BCG VACCINE INTRAVESICAL,,,146.56,341.89,6
HCPCS,90586,Bcg vaccine intravesical,,,13.37,15.48,8
HCPCS,9058600,BCG VACCINE INTRAVESICAL,,,291.87,291.87,1
HCPCS,90587,DENGUE VACC QUAD 3 DOSE SUBQ,,,50.0,170.28,4
HCPCS,90587,Dengue vacc quad 3 dose subq,,,13.37,15.48,8
HCPCS,9058700,DENGUE VACC QUAD 3 DOSE SUBQ,,,119.83,119.83,1
HCPCS,90589,CHIKUNGUNYA VACCINE LIVE IM,,,587.4,587.4,1
HCPCS,90589,"CHIKUNGUNYA VACCINE, LIVE",990.0,643.5,13.37,990.0,51
HCPCS,90589,CHIKUNGUNYA VIRUS VACCINE LIVE FOR IM USE,990.0,643.5,1.1,1791901.44,27
HCPCS,9058900,CHIKUNGUNYA VACCINE LIVE IM,,,587.4,587.4,1
HCPCS,90593,CHIKUNGUNYA VACC RECOMB IM,,,587.4,587.4,1
HCPCS,90593,"CHIKUNGUNYA VACCINE, RECOMBINANT (VIMKUNYA)",991.0,644.15,1.1,991.0,75
HCPCS,9059300,CHIKUNGUNYA VACC RECOMB IM,,,587.4,587.4,1
HCPCS,90611,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,0.01,785.7,92
HCPCS,90611,SMALLPOX&MONKEYPOX VAC 0.5ML,,,490.21,490.21,1
HCPCS,9061100,SMALLPOX&MONKEYPOX VAC 0.5ML,,,490.21,490.21,1
HCPCS,90612,Inf&sarscov2 vacc 31.7/.32im,,,7.93,9.19,8
HCPCS,90613,Inf&sarscov2 vacc 40/0.4 im,,,7.93,9.19,8
HCPCS,90619,MENACWY-TT VACCINE IM,,,321.33,321.33,1
HCPCS,90619,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,1.1,617.0,77
HCPCS,90619,MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1269.78,825.36,13.37,1269.78,102
HCPCS,9061900,MENACWY-TT VACCINE IM,,,321.33,321.33,1
HCPCS,90620,BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1804.02,1172.61,13.37,1804.02,102
HCPCS,90620,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,852.0,553.8,1.1,852.0,28
HCPCS,90620,MENB RP W/OMV VACCINE IM,852.0,553.8,13.37,852.0,51
HCPCS,90620,MENB-4C VACCINE IM,,,430.3,430.3,1
HCPCS,9062000,MENB-4C VACCINE IM,,,430.3,430.3,1
HCPCS,90621,MENB RLP VACCINE IM,604.0,392.6,13.37,604.0,51
HCPCS,90621,MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM,604.0,392.6,1.1,604.0,28
HCPCS,90621,MENB-FHBP VACC 2/3 DOSE IM,,,376.19,376.19,1
HCPCS,90621,TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1621.14,1053.74,13.37,1621.14,102
HCPCS,9062100,MENB-FHBP VACC 2/3 DOSE IM,,,376.19,376.19,1
HCPCS,90622,VACCINIA VRS VAC 0.3 ML PERQ,,,0.01,0.03,20
HCPCS,90622,Vaccinia vrs vac 0.3 ml perq,,,7.93,9.19,8
HCPCS,90623,MENACWY-TT MENB-FHBP VACC IM,,,430.12,593.4,3
HCPCS,90623,Menacwy-tt menb-fhbp vacc im,,,13.37,15.48,8
HCPCS,9062300,MENACWY-TT MENB-FHBP VACC IM,,,430.12,430.12,1
HCPCS,90624,MENB-4C&MENACWY VACC IM,,,455.04,455.04,1
HCPCS,90624,Menb-4c&menacwy vacc im,,,13.37,15.48,8
HCPCS,9062400,MENB-4C&MENACWY VACC IM,,,455.04,455.04,1
HCPCS,90625,CHOLERA VACCINE LIVE ORAL,,,529.25,639.54,2
HCPCS,90625,Cholera vaccine live oral,,,7.93,9.19,8
HCPCS,9062500,CHOLERA VACCINE LIVE ORAL,,,529.25,529.25,1
HCPCS,90626,TIC-BRN ENCEPH VAC 0.25ML IM,,,551.76,673.1,2
HCPCS,90626,Tic-brn enceph vac 0.25ml im,,,13.37,15.48,8
HCPCS,9062600,TIC-BRN ENCEPH VAC 0.25ML IM,,,551.76,551.76,1
HCPCS,90627,TIC-BRN ENCEPH VAC 0.5ML IM,,,551.76,673.1,2
HCPCS,90627,Tic-brn enceph vac 0.5ml im,,,13.37,15.48,8
HCPCS,9062700,TIC-BRN ENCEPH VAC 0.5ML IM,,,551.76,551.76,1
HCPCS,90630,FLU VACC IIV4 NO PRESERV ID,,,21.11,41.5,3
HCPCS,90630,Flu vacc iiv4 no preserv id,,,7.93,9.19,8
HCPCS,9063000,FLU VACC IIV4 NO PRESERV ID,,,32.4,32.4,1
HCPCS,90631,H5 vaccine pandemic im use,,,7.93,9.19,8
HCPCS,90632,HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE,319.74,207.83,7.93,319.74,51
HCPCS,90632,HEP A/ADULT,308.0,200.2,7.93,308.0,51
HCPCS,90632,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,308.0,200.2,1.1,308.0,28
HCPCS,90632,HEPA VACCINE ADULT IM,,,130.9,130.9,1
HCPCS,90632,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,298.74,194.18,7.93,298.74,51
HCPCS,90632,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,298.74,194.18,7.93,298.74,102
HCPCS,9063200,HEPA VACCINE ADULT IM,,,130.9,130.9,1
HCPCS,90633,HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE,284.61,185.0,7.93,284.61,51
HCPCS,90633,HEP A/PEDIATRIC ADOLESEN,138.0,89.7,7.93,138.0,51
HCPCS,90633,HEPA VACC PED/ADOL 2 DOSE IM,,,72.48,72.48,1
HCPCS,90633,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,138.0,89.7,1.1,138.0,28
HCPCS,90633,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,282.51,183.63,7.93,282.51,51
HCPCS,90633,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,282.51,183.63,7.93,282.51,51
HCPCS,9063300,HEPA VACC PED/ADOL 2 DOSE IM,,,72.48,72.48,1
HCPCS,90634,HEPA VACC PED/ADOL 3 DOSE,,,54.74,70.11,3
HCPCS,90634,Hepa vacc ped/adol 3 dose,,,7.93,9.19,8
HCPCS,9063400,HEPA VACC PED/ADOL 3 DOSE,,,54.74,54.74,1
HCPCS,90635,H5n1 vacc drv cll cul adj im,,,7.93,9.19,8
HCPCS,90636,HEP A/HEP B VACC ADULT IM,,,240.0,240.0,1
HCPCS,90636,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,472.0,306.8,1.1,472.0,28
HCPCS,90636,IM ADULT HEPA-HEPB,472.0,306.8,13.37,472.0,51
HCPCS,90636,TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE,504.36,327.83,13.37,504.36,51
HCPCS,9063600,HEP A/HEP B VACC ADULT IM,,,240.0,240.0,1
HCPCS,90637,Vacc qirv mrna 30mcg/.5ml im,,,7.93,9.19,8
HCPCS,90638,Vacc qirv mrna 60mcg/.5ml im,,,7.93,9.19,8
HCPCS,90644,HIB-MENCY VACC 6WK-18M0 IM,,,44.41,56.89,3
HCPCS,90644,Hib-mency vacc 6wk-18m0 im,,,13.37,15.48,8
HCPCS,9064400,HIB-MENCY VACC 6WK-18M0 IM,,,44.41,44.41,1
HCPCS,90647,HIB PRP-OMP VACC 3 DOSE IM,,,57.58,57.58,1
HCPCS,90647,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,108.0,70.2,1.1,108.0,28
HCPCS,90647,"IM 3 DOSE HIB, PRP-OMP",108.0,70.2,7.93,108.0,51
HCPCS,90647,PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION,221.22,143.79,7.93,221.22,51
HCPCS,9064700,HIB PRP-OMP VACC 3 DOSE IM,,,57.58,57.58,1
HCPCS,90648,ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,47.37,30.79,7.05,47.37,102
HCPCS,90648,HIB PRP-T VACCINE 4 DOSE IM,,,25.01,25.01,1
HCPCS,90648,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,47.0,30.55,1.1,47.0,28
HCPCS,90648,"HIB, PRP-T",47.0,30.55,6.99,47.0,51
HCPCS,9064800,HIB PRP-T VACCINE 4 DOSE IM,,,25.01,25.01,1
HCPCS,90649,4VHPV VACCINE 3 DOSE IM,,,290.57,290.57,1
HCPCS,90649,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,442.0,287.3,1.1,442.0,28
HCPCS,90649,H PAPILLOMA VACC 3 DOSE IM,442.0,287.3,13.37,442.0,51
HCPCS,9064900,4VHPV VACCINE 3 DOSE IM,,,290.57,290.57,1
HCPCS,90650,2VHPV VACCINE 3 DOSE IM,,,251.43,322.05,2
HCPCS,90650,2vhpv vaccine 3 dose im,,,7.93,9.19,8
HCPCS,9065000,2VHPV VACCINE 3 DOSE IM,,,251.43,251.43,1
HCPCS,90651,9VHPV VACC 2/3 DOSE SCHED IM USE,1106.0,718.9,1.1,1106.0,28
HCPCS,90651,9VHPV VACCINE 2/3 DOSE IM,,,597.28,597.28,1
HCPCS,90651,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION,2364.06,1536.64,13.37,2364.06,51
HCPCS,90651,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2364.06,1536.64,13.37,2364.06,102
HCPCS,90651,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,13.37,1106.0,102
HCPCS,9065100,9VHPV VACCINE 2/3 DOSE IM,,,597.28,597.28,1
HCPCS,90653,IIV ADJUVANT VACCINE IM,,,56.25,207.12,8
HCPCS,90653,Iiv adjuvant vaccine im,,,7.93,9.19,8
HCPCS,9065300,IIV ADJUVANT VACCINE IM,,,174.72,174.72,1
HCPCS,90654,FLU VACC IIV3 NO PRESERV ID,,,19.63,38.58,3
HCPCS,90654,Flu vacc iiv3 no preserv id,,,7.93,9.19,8
HCPCS,9065400,FLU VACC IIV3 NO PRESERV ID,,,30.12,30.12,1
HCPCS,90655,IIV3 VACC NO PRSV 0.25 ML IM,,,27.69,37.16,3
HCPCS,90655,Iiv3 vacc no prsv 0.25 ml im,,,7.93,9.19,8
HCPCS,9065500,IIV3 VACC NO PRSV 0.25 ML IM,,,29.01,29.01,1
HCPCS,90656,FLU VACCINE NO PRESERV 0.25 ML,74.7,48.56,7.93,74.7,51
HCPCS,90656,FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE,149.4,97.11,7.93,149.4,51
HCPCS,90656,IIV3 VACC NO PRSV 0.5 ML IM,,,41.33,41.33,1
HCPCS,90656,IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE,74.7,48.56,1.1,74.7,28
HCPCS,90656,INFLUENZA VACCINE,74.7,48.56,7.93,74.7,51
HCPCS,9065600,IIV3 VACC NO PRSV 0.5 ML IM,,,41.33,41.33,1
HCPCS,90657,IIV3 VACCINE SPLT 0.25 ML IM,,,6.25,24.92,8
HCPCS,90657,Iiv3 vaccine splt 0.25 ml im,,,7.93,9.19,8
HCPCS,9065700,IIV3 VACCINE SPLT 0.25 ML IM,,,19.63,19.63,1
HCPCS,90658,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,1.1,69.7,130
HCPCS,90658,IIV3 VACCINE SPLT 0.5 ML IM,,,39.28,39.28,1
HCPCS,9065800,IIV3 VACCINE SPLT 0.5 ML IM,,,39.28,39.28,1
HCPCS,90660,FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE,61.06,39.69,7.93,62.69,51
HCPCS,90660,FLUMIST VACC NSPR 0.2ML,62.9,40.89,7.93,62.9,51
HCPCS,90660,LAIV3 VACCINE INTRANASAL,,,52.88,52.88,1
HCPCS,90660,LAIV3 VACCINE LIVE FOR INTRANASAL USE,62.9,40.89,1.1,62.9,28
HCPCS,9066000,LAIV3 VACCINE INTRANASAL,,,52.88,52.88,1
HCPCS,90661,CCIIV3 VAC ABX FR 0.5 ML IM,,,23.13,104.45,8
HCPCS,90661,Cciiv3 vac abx fr 0.5 ml im,,,7.93,9.19,8
HCPCS,9066100,CCIIV3 VAC ABX FR 0.5 ML IM,,,88.11,88.11,1
HCPCS,90662,FLU VACC PRSV FREE INC ANTIG,203.3,132.15,7.93,207.12,51
HCPCS,90662,FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,406.53,264.24,7.93,406.53,51
HCPCS,90662,IIV NO PRSV INCREASED AG IM,,,174.72,174.72,1
HCPCS,90662,IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM,203.3,132.15,1.1,203.3,28
HCPCS,9066200,IIV NO PRSV INCREASED AG IM,,,174.72,174.72,1
HCPCS,90664,Laiv vacc pandemic intranasl,,,7.93,9.19,8
HCPCS,90666,Flu vac pandem prsrv free im,,,7.93,9.19,8
HCPCS,90667,Iiv vacc pandemic adjuvt im,,,7.93,9.19,8
HCPCS,90668,Iiv vaccine pandemic im,,,7.93,9.19,8
HCPCS,90670,PCV13 VACCINE FOR INTRAMUSCULAR USE,814.0,529.1,1.1,814.0,28
HCPCS,90670,PCV13 VACCINE IM,,,410.88,410.88,1
HCPCS,90670,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1650.375,1072.745,13.37,1675.86,153
HCPCS,90670,PREVNAR13 PNEUMOCOCCAL VACC IM,814.0,529.1,13.37,814.0,51
HCPCS,9067000,PCV13 VACCINE IM,,,410.88,410.88,1
HCPCS,90671,PCV15 VACCINE IM,,,232.65,578.12,8
HCPCS,90671,Pcv15 vaccine im,,,13.37,15.48,8
HCPCS,9067100,PCV15 VACCINE IM,,,479.37,479.37,1
HCPCS,90672,FLU VACCINE 4 VALENT NASAL,57.0,37.05,7.93,65.34,51
HCPCS,90672,LAIV4 VACCINE FOR INTRANASAL USE,57.0,37.05,1.1,57.0,28
HCPCS,90672,LAIV4 VACCINE INTRANASAL,,,44.25,44.25,1
HCPCS,9067200,LAIV4 VACCINE INTRANASAL,,,44.25,44.25,1
HCPCS,90673,FLUBLOK TRIVALENT,284.6,184.99,7.93,284.6,51
HCPCS,90673,RIV3 VACCINE NO PRESERV IM,,,174.72,174.72,1
HCPCS,90673,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,284.6,184.99,1.1,284.6,28
HCPCS,9067300,RIV3 VACCINE NO PRESERV IM,,,174.72,174.72,1
HCPCS,90674,CCIIV4 VAC NO PRSV 0.5 ML IM,,,54.41,54.41,1
HCPCS,90674,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,1.1,109.0,79
HCPCS,9067400,CCIIV4 VAC NO PRSV 0.5 ML IM,,,54.41,54.41,1
HCPCS,90675,IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION,1561.71,1015.11,13.37,1561.71,130
HCPCS,90675,RABAVERT (PF) 2.5 UNIT IM SUSPENSION,1564.59,1016.98,13.37,1564.59,130
HCPCS,90675,RABIES VACCINE IM,,,569.16,569.16,1
HCPCS,90675,"RABIES VACCINE, IM",1491.0,969.15,1.1,1491.0,93
HCPCS,9067500,RABIES VACCINE IM,,,569.16,569.16,1
HCPCS,90676,RABIES VACCINE ID,,,140.62,651.37,22
HCPCS,90676,Rabies vaccine id,,,13.37,15.48,8
HCPCS,9067600,RABIES VACCINE ID,,,140.62,140.62,1
HCPCS,90677,PCV20 VACCINE FOR INTRAMUSCULAR USE,1018.0,661.7,1.1,1018.0,28
HCPCS,90677,PCV20 VACCINE IM,,,556.96,556.96,1
HCPCS,90677,PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677,1018.0,661.7,13.37,1018.0,51
HCPCS,90677,PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2182.965,1418.925,13.37,2216.73,102
HCPCS,9067700,PCV20 VACCINE IM,,,556.96,556.96,1
HCPCS,90678,ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1148.64,746.62,7.93,1148.64,51
HCPCS,90678,RSV VACC PREF BIVALENT IM,,,557.03,557.03,1
HCPCS,90678,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,1106.0,718.9,1.1,1106.0,28
HCPCS,90678,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,1.1,1106.0,79
HCPCS,9067800,RSV VACC PREF BIVALENT IM,,,557.03,557.03,1
HCPCS,90679,RSV VACC PREF RECOMB ADJT IM,,,556.21,556.21,1
HCPCS,90679,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,1.1,758.52,79
HCPCS,9067900,RSV VACC PREF RECOMB ADJT IM,,,556.21,556.21,1
HCPCS,90680,ROTATEQ VACCINE 2 ML ORAL SOLUTION,153.0,99.45,13.37,254.62,51
HCPCS,90680,ROTOVIRUS VAC ORAL USE,309.0,200.85,13.37,309.0,51
HCPCS,90680,RV5 VACC 3 DOSE LIVE ORAL,,,186.31,186.31,1
HCPCS,90680,RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,309.0,200.85,1.1,309.0,28
HCPCS,9068000,RV5 VACC 3 DOSE LIVE ORAL,,,186.31,186.31,1
HCPCS,90681,ROTAVIRUS VAC 2 DOSE ORAL,402.0,261.3,7.93,402.0,51
HCPCS,90681,RV1 VACC 2 DOSE LIVE ORAL,,,266.7,266.7,1
HCPCS,90681,RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE,402.0,261.3,1.1,402.0,28
HCPCS,9068100,RV1 VACC 2 DOSE LIVE ORAL,,,266.7,266.7,1
HCPCS,90682,FLUBLOK QUADRIVALENT PFS,233.0,151.45,7.93,233.0,51
HCPCS,90682,RIV4 VACC RECOMBINANT DNA IM,,,116.89,116.89,1
HCPCS,90682,RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM,233.0,151.45,1.1,233.0,28
HCPCS,9068200,RIV4 VACC RECOMBINANT DNA IM,,,116.89,116.89,1
HCPCS,90683,RSV VACC MRNA LIPID NANO IM,,,526.52,748.2,3
HCPCS,90683,Rsv vacc mrna lipid nano im,,,7.93,9.19,8
HCPCS,9068300,RSV VACC MRNA LIPID NANO IM,,,526.52,526.52,1
HCPCS,90684,PCV21 VACCINE IM,,,612.77,747.59,7
HCPCS,90684,Pcv21 vaccine im,,,13.37,15.48,8
HCPCS,9068400,PCV21 VACCINE IM,,,612.77,612.77,1
HCPCS,90685,IIV4 VACC NO PRSV 0.25 ML IM,,,20.45,44.14,2
HCPCS,90685,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,34.0,22.1,1.1,41.22,27
HCPCS,90685,Iiv4 vacc no prsv 0.25 ml im,,,7.93,9.19,8
HCPCS,90686,FLU VAC NO PRSV 4 VAL,70.0,45.5,7.93,70.0,51
HCPCS,90686,IIV4 VACC NO PRSV 0.5 ML IM,,,35.6,35.6,1
HCPCS,90686,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,70.0,45.5,1.1,70.0,28
HCPCS,9068600,IIV4 VACC NO PRSV 0.5 ML IM,,,35.6,35.6,1
HCPCS,90687,IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE,33.0,21.45,1.1,33.0,28
HCPCS,90687,IIV4 VACCINE SPLT 0.25 ML IM,,,9.41,21.3,5
HCPCS,90687,Iiv4 vaccine splt 0.25 ml im,,,7.93,9.19,8
HCPCS,9068700,IIV4 VACCINE SPLT 0.25 ML IM,,,16.63,16.63,1
HCPCS,90688,FLUZONE QUADRIVALENT MDV,67.0,43.55,7.93,67.0,51
HCPCS,90688,IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE,67.0,43.55,1.1,67.0,28
HCPCS,90688,IIV4 VACCINE SPLT 0.5 ML IM,,,33.25,33.25,1
HCPCS,9068800,IIV4 VACCINE SPLT 0.5 ML IM,,,33.25,33.25,1
HCPCS,90689,IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE,44.0,28.6,1.1,44.0,23
HCPCS,90689,Vacc iiv4 no prsrv 0.25ml im,,,7.93,9.19,8
HCPCS,90690,TYPHOID VACCINE ORAL,,,212.91,212.91,1
HCPCS,90690,VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE,70.38,45.75,7.93,194.04,51
HCPCS,9069000,TYPHOID VACCINE ORAL,,,212.91,212.91,1
HCPCS,90691,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,802.41,521.57,7.93,802.41,51
HCPCS,90691,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1163.52,756.29,7.93,1163.52,51
HCPCS,90691,TYPHOID VACCINE IM,,,293.4,293.4,1
HCPCS,90691,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,441.0,286.65,1.1,441.0,28
HCPCS,90691,TYPHOID VI 25MCG/0.5ML SYG,441.0,286.65,7.93,441.0,51
HCPCS,9069100,TYPHOID VACCINE IM,,,293.4,293.4,1
HCPCS,90694,AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE,243.0,157.95,1.1,243.0,79
HCPCS,90694,VACC AIIV4 NO PRSRV 0.5ML IM,,,123.21,123.21,1
HCPCS,9069400,VACC AIIV4 NO PRSRV 0.5ML IM,,,123.21,123.21,1
HCPCS,90695,H5n8 vacc drv cll cul adj im,,,7.93,9.19,8
HCPCS,90696,DTAP-IPV VACC 4-6 YR IM,210.0,136.5,7.93,328.03,51
HCPCS,90696,DTAP-IPV VACCINE 4-6 YRS IM,,,118.48,118.48,1
HCPCS,90696,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,210.0,136.5,1.1,210.0,28
HCPCS,90696,KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,447.93,291.15,7.93,447.93,51
HCPCS,90696,QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,443.34,288.17,7.93,443.34,51
HCPCS,9069600,DTAP-IPV VACCINE 4-6 YRS IM,,,118.48,118.48,1
HCPCS,90697,DTAP-IPV-HIB-HEPB VACCINE IM,526.05,341.93,7.93,804.51,52
HCPCS,90697,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,526.05,341.93,1.1,526.05,28
HCPCS,90697,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,1172.58,762.18,7.93,1172.58,51
HCPCS,90697,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1172.58,762.18,7.93,1172.58,51
HCPCS,9069700,DTAP-IPV-HIB-HEPB VACCINE IM,,,292.99,292.99,1
HCPCS,90698,"DTAP-HIB-IP VACCINE, IM",370.0,240.5,7.93,370.0,51
HCPCS,90698,DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE,370.0,240.5,1.1,370.0,28
HCPCS,90698,DTAP-IPV/HIB VACCINE IM,,,227.04,227.04,1
HCPCS,90698,PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT,467.67,303.99,7.93,467.67,51
HCPCS,9069800,DTAP-IPV/HIB VACCINE IM,,,227.04,227.04,1
HCPCS,90700,DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP,210.75,136.99,7.93,210.75,102
HCPCS,90700,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,102.0,66.3,1.1,102.0,28
HCPCS,90700,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,1.1,102.0,79
HCPCS,90700,DTAP IMMUNIZATION,102.0,66.3,7.93,102.0,51
HCPCS,90700,DTAP VACCINE < 7 YRS IM,,,55.54,55.54,1
HCPCS,90700,INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE,204.72,133.07,7.93,204.72,51
HCPCS,9070000,DTAP VACCINE < 7 YRS IM,,,55.54,55.54,1
HCPCS,90702,DT VACCINE UNDER 7 YRS IM,,,119.54,119.54,1
HCPCS,90702,TETANUS-DIPHTHERIA TOXOID PED,222.0,144.3,7.93,222.0,51
HCPCS,90702,TETANUSDIPHTHERIA TOXOID PED (PF) 5 LF UNIT-25 LF UNIT/0.5 ML IM SUSP,442.89,287.88,7.93,442.89,51
HCPCS,9070200,DT VACCINE UNDER 7 YRS IM,,,119.54,119.54,1
HCPCS,90707,M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION,344.67,224.04,7.93,344.67,102
HCPCS,90707,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,336.0,218.4,1.1,336.0,28
HCPCS,90707,MMR VACCINE SC,,,178.25,178.25,1
HCPCS,90707,MUMPS RUBELLA MEA,336.0,218.4,7.93,336.0,51
HCPCS,9070700,MMR VACCINE SC,,,178.25,178.25,1
HCPCS,90710,"MMR+VARICELLA,SQ-COMBINED VACCINE",992.0,644.8,1.1,992.0,28
HCPCS,90710,MMRV VACCINE,992.0,644.8,7.93,992.0,51
HCPCS,90710,MMRV VACCINE SC,,,524.1,524.1,1
HCPCS,90710,PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION,1030.2,669.63,7.93,1030.2,51
HCPCS,9071000,MMRV VACCINE SC,,,524.1,524.1,1
HCPCS,90713,INACTIVE POLIO VACCINE,151.0,98.15,7.93,151.0,51
HCPCS,90713,IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION,338.85,220.25,7.93,338.85,51
HCPCS,90713,POLIOVIRUS IPV SC/IM,,,90.66,90.66,1
HCPCS,90713,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,151.0,98.15,1.1,151.0,28
HCPCS,9071300,POLIOVIRUS IPV SC/IM,,,90.66,90.66,1
HCPCS,90714,DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,141.48,91.96,7.93,141.48,51
HCPCS,90714,TD VACC NO PRESV 7 YRS+ IM,,,69.37,69.37,1
HCPCS,90714,TD VACCINE NO PRSRV >= 7 IM,141.0,91.65,7.93,141.0,51
HCPCS,90714,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,141.0,91.65,1.1,141.0,28
HCPCS,90714,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,319.77,207.85,7.93,319.77,51
HCPCS,90714,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,319.755,207.84,7.93,319.77,102
HCPCS,9071400,TD VACC NO PRESV 7 YRS+ IM,,,69.37,69.37,1
HCPCS,90715,ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE,351.57,228.52,7.93,351.57,102
HCPCS,90715,ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP,351.57,228.52,7.93,351.57,102
HCPCS,90715,BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE,344.82,224.13,7.93,344.82,51
HCPCS,90715,TDAP VACCINE 7 YRS/> IM,170.0,110.5,1.1,170.0,29
HCPCS,90715,TDAP VACCINE >7 IM,170.0,110.5,7.93,170.0,51
HCPCS,9071500,TDAP VACCINE 7 YRS/> IM,,,70.65,70.65,1
HCPCS,90716,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,657.0,427.05,1.1,657.0,28
HCPCS,90716,VAR VACCINE LIVE SUBQ,,,348.58,348.58,1
HCPCS,90716,VARICELLA VIRUS VACCINE LIVE,657.0,427.05,13.37,657.0,51
HCPCS,90716,VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION,688.92,447.8,13.37,688.92,51
HCPCS,9071600,VAR VACCINE LIVE SUBQ,,,348.58,348.58,1
HCPCS,90717,YELLOW FEVER VACCINE SUBQ,,,465.38,465.38,1
HCPCS,90717,"YELLOW FEVER VACCINE, SQ LIVE",648.0,421.2,13.37,648.0,51
HCPCS,9071700,YELLOW FEVER VACCINE SUBQ,,,465.38,465.38,1
HCPCS,90723,DTAP-HEP B-IPV VACCINE IM,,,195.8,195.8,1
HCPCS,90723,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,312.0,202.8,1.1,312.0,28
HCPCS,90723,PEDIARIX,312.0,202.8,7.93,312.0,51
HCPCS,90723,PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,773.7,502.91,7.93,773.7,51
HCPCS,9072300,DTAP-HEP B-IPV VACCINE IM,,,195.8,195.8,1
HCPCS,90732,PNEUMOCOCCAL VACCINE 23V,423.0,274.95,7.93,423.0,51
HCPCS,90732,PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE,842.97,547.93,7.93,842.97,102
HCPCS,90732,PPSV23 VACC 2 YRS+ SUBQ/IM,,,237.58,237.58,1
HCPCS,90732,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,423.0,274.95,1.1,423.0,28
HCPCS,9073200,PPSV23 VACC 2 YRS+ SUBQ/IM,,,237.58,237.58,1
HCPCS,90733,MENOMUNE VAC,344.0,223.6,13.37,344.0,51
HCPCS,90733,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,344.0,223.6,1.1,344.0,28
HCPCS,90733,MPSV4 VACCINE SUBQ,,,223.39,223.39,1
HCPCS,9073300,MPSV4 VACCINE SUBQ,,,223.39,223.39,1
HCPCS,90734,MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,565.0,367.25,1.1,565.0,28
HCPCS,90734,MENACWYD/MENACWYCRM VACC IM,,,302.53,302.53,1
HCPCS,90734,"MENINGOCOCCAL VACCINE, IM",565.0,367.25,13.37,565.0,51
HCPCS,90734,MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS),633.45,411.74,13.37,633.45,51
HCPCS,9073400,MENACWYD/MENACWYCRM VACC IM,,,302.53,302.53,1
HCPCS,90736,HZV VACCINE LIVE SUBQ,,,386.12,386.12,1
HCPCS,90736,ZOSTAVAX VACC INJ,804.0,522.6,13.37,804.0,51
HCPCS,90736,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,804.0,522.6,1.1,804.0,28
HCPCS,9073600,HZV VACCINE LIVE SUBQ,,,386.12,386.12,1
HCPCS,90738,INACTIVATED JE VACC IM,,,535.76,535.76,1
HCPCS,90738,IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,2124.57,1380.97,13.37,2124.57,51
HCPCS,9073800,INACTIVATED JE VACC IM,,,535.76,535.76,1
HCPCS,90739,HEPB VACC 2 DOSE ADULT IM,562.0,365.3,7.93,562.0,51
HCPCS,90739,HEPB VACC 2/4 DOSE ADULT IM,,,316.06,316.06,1
HCPCS,90739,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,562.0,365.3,1.1,562.0,28
HCPCS,90739,HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1121.4,728.91,7.93,1121.4,51
HCPCS,9073900,HEPB VACC 2/4 DOSE ADULT IM,,,316.06,316.06,1
HCPCS,90740,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SUSPENSION,267.66,173.98,13.37,346.93,51
HCPCS,90740,HEPB VACC 3 DOSE IMMUNSUP IM,,,292.67,292.67,1
HCPCS,90740,RECOMBIVAX HB (PF) 40 MCG/ML INTRAMUSCULAR SUSPENSION,703.23,457.1,13.37,703.23,51
HCPCS,9074000,HEPB VACC 3 DOSE IMMUNSUP IM,,,292.67,292.67,1
HCPCS,90743,HEPB VACC 2 DOSE ADOLESC IM,,,24.7,171.34,8
HCPCS,90743,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,139.0,90.35,1.1,139.0,28
HCPCS,90743,Hepb vacc 2 dose adolesc im,,,7.93,9.19,8
HCPCS,9074300,HEPB VACC 2 DOSE ADOLESC IM,,,133.77,133.77,1
HCPCS,90744,ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,211.38,137.4,7.93,211.38,102
HCPCS,90744,HEP B/PEDIATRIC/ADOLESCEN,104.0,67.6,7.93,104.0,51
HCPCS,90744,HEPB VACC 3 DOSE PED/ADOL IM,,,59.1,59.1,1
HCPCS,90744,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,104.0,67.6,1.1,104.0,28
HCPCS,90744,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,205.32,133.46,7.93,205.32,102
HCPCS,90744,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,205.32,133.46,7.93,205.32,51
HCPCS,9074400,HEPB VACC 3 DOSE PED/ADOL IM,,,59.1,59.1,1
HCPCS,90746,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,267.66,173.98,7.93,267.66,51
HCPCS,90746,HEPB VACCINE 3 DOSE ADULT IM,,,133.77,133.77,1
HCPCS,90746,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,258.0,167.7,1.1,258.0,28
HCPCS,90746,IMMUNIZATION HEPATITIS,258.0,167.7,7.93,258.0,51
HCPCS,90746,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION,257.28,167.23,7.93,257.28,51
HCPCS,90746,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE,257.28,167.23,7.93,257.28,51
HCPCS,9074600,HEPB VACCINE 3 DOSE ADULT IM,,,133.77,133.77,1
HCPCS,90747,"HEPATITIS B VACCINE, IMMUNOSUP",230.0,149.5,13.37,346.93,51
HCPCS,90747,HEPB VACC 4 DOSE IMMUNSUP IM,,,292.67,292.67,1
HCPCS,90747,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,230.0,149.5,1.1,287.74,28
HCPCS,9074700,HEPB VACC 4 DOSE IMMUNSUP IM,,,292.67,292.67,1
HCPCS,90748,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,132.0,85.8,1.1,132.0,28
HCPCS,90748,HIB-HEPB VACCINE IM,,,76.36,76.36,1
HCPCS,90748,IM HEPB-HIB VACCINE,132.0,85.8,7.93,132.0,51
HCPCS,9074800,HIB-HEPB VACCINE IM,,,76.36,76.36,1
HCPCS,90749,Unlisted vaccine/toxoid,,,7.93,9.19,8
HCPCS,90750,HZV VACC RECOMBINANT IM,,,391.28,391.28,1
HCPCS,90750,HZV VACC RECOMBINANT IM NJX,777.0,505.05,13.37,777.0,51
HCPCS,90750,HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,777.0,505.05,1.1,777.0,28
HCPCS,90750,SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT,810.36,526.735,13.37,844.89,102
HCPCS,90750,SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION,810.36,526.735,13.37,844.89,102
HCPCS,9075000,HZV VACC RECOMBINANT IM,,,391.28,391.28,1
HCPCS,90756,CCIIV4 VACC ABX FREE IM,,,26.81,66.05,5
HCPCS,90756,Cciiv4 vacc abx free im,,,7.93,9.19,8
HCPCS,9075600,CCIIV4 VACC ABX FREE IM,,,51.57,51.57,1
HCPCS,90758,Zaire ebolavirus vac live im,,,13.37,15.48,8
HCPCS,90759,HEP B VAC 3AG 10MCG 3 DOS IM,,,131.4,131.4,1
HCPCS,90759,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,83.0,53.95,1.1,158.71,78
HCPCS,9075900,HEP B VAC 3AG 10MCG 3 DOS IM,,,131.4,131.4,1
HCPCS,90785,PSYCHOTHERAPY COMPLEX INTERACTIVE,149.0,96.85,1.1,153.0,191
HCPCS,90791,CD ASSESSMENT (UPDATE),482.0,313.3,136.31,497.49,61
HCPCS,90791,PSYCHIATRIC DIAGNOSTIC EVALUATION,1009.0,655.85,1.1,1536.0,114
HCPCS,90791,VIRTUAL VISIT PSYCH DIAGNOSTIC EVAL,1536.0,998.4,1.1,1536.0,53
HCPCS,90792,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,1073.0,697.4499999999999,1.1,1664.0,114
HCPCS,90792,VIRTUAL VISIT DIAGNOSTIC EVAL W/MEDICAL  (PSYCHIATRISTS/MID LEVE,1664.0,1081.6,1.1,1664.0,53
HCPCS,90832,PSYCHOTHERAPY 30 MINUTES PATIENT,744.0,483.6,1.1,744.0,53
HCPCS,90832,PSYCHOTHERAPY W/PATIENT 30 MINUTES,482.0,313.3,75.49,497.49,122
HCPCS,90832,VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS,744.0,483.6,1.1,744.0,53
HCPCS,90833,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,656.0,426.4,1.1,656.0,53
HCPCS,90833,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN,162.0,105.3,35.32,162.0,46
HCPCS,90833,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (30 MIN),656.0,426.4,1.1,656.0,53
HCPCS,90834,PSYCHOTHERAPY 45 MINUTES WITH PATIENT,980.0,637.0,1.1,980.0,53
HCPCS,90834,PSYCHOTHERAPY W/PATIENT 45 MINUTES,482.0,313.3,94.44,497.49,122
HCPCS,90834,VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS,980.0,637.0,1.1,980.0,53
HCPCS,90836,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,832.0,540.8,1.1,832.0,53
HCPCS,90836,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN,189.0,122.85,41.2,189.0,46
HCPCS,90836,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (45 MIN),832.0,540.8,1.1,832.0,53
HCPCS,90837,PSYCHOTHERAPY 60 MINUTES WITH PATIENT,1452.0,943.8,1.1,1452.0,53
HCPCS,90837,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,94.44,497.49,122
HCPCS,90837,VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS,1452.0,943.8,1.1,1452.0,53
HCPCS,90838,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,1096.0,712.4,1.1,1096.0,53
HCPCS,90838,PSYTX W PT W E/M 60 MIN,,,153.47,153.47,1
HCPCS,90838,Psytx w pt w e/m 60 min,,,94.44,109.35,8
HCPCS,90838,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (60 MIN),1096.0,712.4,1.1,1096.0,53
HCPCS,90839,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINS,1509.0,980.85,1.1,1509.0,53
HCPCS,90839,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,94.44,497.49,61
HCPCS,90839,VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,94.44,497.49,61
HCPCS,90840,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,659.5,428.675,1.1,722.0,99
HCPCS,90840,VIRTUAL PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,597.0,388.05,91.67,597.0,46
HCPCS,90845,PSYCHOANALYSIS,,,148.46,497.49,19
HCPCS,90845,Psychoanalysis,,,94.44,109.35,8
HCPCS,90846,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,767.0,498.54999999999995,1.1,1052.0,114
HCPCS,90846,PSYTX FAMILY W/O PT,482.0,313.3,126.06,497.49,61
HCPCS,90846,VIRTUAL VISIT FAMILY PSYCHOTHERAPY W/O PATIENT,1052.0,683.8,1.1,1052.0,53
HCPCS,90847,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,789.0,512.85,1.1,1096.0,114
HCPCS,90847,VIRTUAL VISIT FAMILY PSYTX W/PATIENT,1096.0,712.4,1.1,1096.0,53
HCPCS,90849,MULTI FAMILY GROUP THERAPY,482.0,313.3,52.53,497.49,61
HCPCS,90849,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,260.0,169.0,1.1,272.38,53
HCPCS,90853,CD IOP DAY,834.0,542.1,36.05,834.0,63
HCPCS,90853,EXT AFTERCARE THPY GRP OP ONLY,278.0,180.7,36.05,284.74,61
HCPCS,90853,GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.0,53
HCPCS,90853,GROUP THERAPY,278.0,180.7,36.05,284.74,61
HCPCS,90853,GROUP THERAPY (OP),278.0,180.7,36.05,284.74,61
HCPCS,90853,GROUP THERAPY IP 6100,278.0,180.7,36.05,284.74,61
HCPCS,90853,GROUP THERAPY W/O PHY PHP,278.0,180.7,36.05,284.74,61
HCPCS,90853,GROUP THPY-DBT SKILLS OP ONLY,278.0,180.7,36.05,284.74,61
HCPCS,90853,GRP TX DBT SKILL,278.0,180.7,36.05,284.74,61
HCPCS,90853,IOP HALF DAY RATE,834.0,542.1,36.05,834.0,63
HCPCS,90853,VIRTUAL VISIT AFTERCARE GROUP,278.0,180.7,36.05,284.74,61
HCPCS,90853,VIRTUAL VISIT CD IOP DAY,834.0,542.1,36.05,834.0,63
HCPCS,90853,VIRTUAL VISIT GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.0,53
HCPCS,90853,VIRTUAL VISIT GROUP THERAPY,278.0,180.7,36.05,284.74,61
HCPCS,90853,VIRTUAL VISIT IOP HALF DAY RATE,834.0,542.1,36.05,834.0,63
HCPCS,90853,VIRTUAL VISIT MH IOP GROUP THERAPY,278.0,180.7,36.05,284.74,61
HCPCS,90863,Pharmacologic mgmt w/psytx,,,8.4,9.72,8
HCPCS,90865,NARCOSYNTHESIS,,,148.46,497.49,19
HCPCS,90865,Narcosynthesis,,,156.65,181.38,8
HCPCS,90867,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,534.5,347.425,1.1,1239.34,76
HCPCS,90867,TCRANIAL MAGN STIM TX PLAN,934.0,607.1,204.28,934.0,61
HCPCS,90868,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,584.0,379.6,1.1,934.0,137
HCPCS,90869,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,724.5,470.925,1.1,1517.59,99
HCPCS,90869,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MNGT,584.0,379.6,1.1,1517.59,38
HCPCS,90870,ELECTROCONVULSIVE THERAPY,1296.0,842.4,1.1,2406.92,127
HCPCS,90875,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,480.0,312.0,1.1,480.0,36
HCPCS,90875,PSYCHOPHYSIOLOGICAL THERAPY,,,81.37,81.37,1
HCPCS,90875,Psychophysiological therapy,,,96.9,112.2,8
HCPCS,90876,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,760.0,494.0,1.1,760.0,36
HCPCS,90876,PSYCHOPHYSIOLOGICAL THERAPY,,,138.02,138.02,1
HCPCS,90876,Psychophysiological therapy,,,96.9,112.2,8
HCPCS,90880,HYPNOTHERAPY,,,85.47,284.74,20
HCPCS,90880,Hypnotherapy,,,75.49,87.41,8
HCPCS,90882,Envrn ivntj med mgmt psyc pt,,,32.9,38.09,8
HCPCS,90885,Psy evaluation of records,,,32.9,38.09,8
HCPCS,90887,CD CASE MGMT,60.0,39.0,8.93,145.96,46
HCPCS,90889,Preparation of report,,,32.9,38.09,8
HCPCS,90899,UNLISTED PSYC SVC/THERAPY,,,27.53,105.02,19
HCPCS,90899,Unlisted psyc svc/therapy,,,75.49,87.41,8
HCPCS,90901,BIOFDBK TRAIN ANY METHOD GO,319.0,207.35,23.22,319.0,60
HCPCS,90901,BIOFDBK TRAIN ANY METHOD GP,319.0,207.35,23.22,319.0,60
HCPCS,90901,"BIOFEEDBACK TRAINING,ANY MODALITY",180.0,117.0,1.1,180.0,47
HCPCS,90912,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,267.0,173.55,52.06,267.0,60
HCPCS,90912,BFB TRAING W/EMG &AMP;/MANOMETRY 1ST 15 MIN CNTCT,396.0,257.4,1.1,396.0,46
HCPCS,90913,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,267.0,173.55,29.16,267.0,60
HCPCS,90913,BFB TRAING W/EMG&AMP;/MANOMETRY EA ADDL 15 MIN CNTCT,220.0,143.0,1.1,220.0,46
HCPCS,90935,HEMO 1 EVAL IP,4828.0,3138.2,124.44,4828.0,61
HCPCS,90935,HEMODIALYSIS,4828.0,3138.2,124.44,4828.0,61
HCPCS,90935,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,651.0,423.15,1.1,1193.47,50
HCPCS,90937,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,928.0,603.2,1.1,928.0,50
HCPCS,90937,Hemodialysis repeated eval,,,296.15,342.91,8
HCPCS,90940,Hemodialysis access study,,,283.94,328.77,8
HCPCS,90945,CRRT - SINGLE EVALUATION,2938.0,1909.7,147.66,2938.0,61
HCPCS,90945,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,686.0,445.9,1.1,756.22,50
HCPCS,90945,PERITONEAL DIALYSIS CAPD,2938.0,1909.7,147.66,2938.0,61
HCPCS,90945,PERITONEAL DIALYSIS CCPD,2938.0,1909.7,147.66,2938.0,61
HCPCS,90945,PERITONEAL DIALYSIS NON-CAPD,2938.0,1909.7,147.66,2938.0,61
HCPCS,90947,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,1008.0,655.2,1.1,1008.0,50
HCPCS,90947,Dialysis repeated eval,,,296.15,342.91,8
HCPCS,90951,Esrd serv 4 visits p mo <2yr,,,283.64,328.43,8
HCPCS,90952,Esrd serv 2-3 vsts p mo <2yr,,,283.64,328.43,8
HCPCS,90953,Esrd serv 1 visit p mo <2yrs,,,283.64,328.43,8
HCPCS,90954,Esrd serv 4 vsts p mo 2-11,,,283.64,328.43,8
HCPCS,90955,Esrd srv 2-3 vsts p mo 2-11,,,283.64,328.43,8
HCPCS,90956,Esrd srv 1 visit p mo 2-11,,,283.64,328.43,8
HCPCS,90957,Esrd srv 4 vsts p mo 12-19,,,283.64,328.43,8
HCPCS,90958,Esrd srv 2-3 vsts p mo 12-19,,,283.64,328.43,8
HCPCS,90959,Esrd serv 1 vst p mo 12-19,,,283.64,328.43,8
HCPCS,90960,Esrd srv 4 visits p mo 20+,,,283.64,328.43,8
HCPCS,90961,Esrd srv 2-3 vsts p mo 20+,,,283.64,328.43,8
HCPCS,90962,Esrd serv 1 visit p mo 20+,,,283.64,328.43,8
HCPCS,90963,Esrd home pt serv p mo <2yrs,,,283.64,328.43,8
HCPCS,90964,Esrd home pt serv p mo 2-11,,,283.64,328.43,8
HCPCS,90965,Esrd home pt serv p mo 12-19,,,283.64,328.43,8
HCPCS,90966,Esrd home pt serv p mo 20+,,,283.64,328.43,8
HCPCS,90967,Esrd svc pr day pt <2,,,296.15,342.91,8
HCPCS,90968,Esrd svc pr day pt 2-11,,,296.15,342.91,8
HCPCS,90969,Esrd svc pr day pt 12-19,,,296.15,342.91,8
HCPCS,90970,Esrd svc pr day pt 20+,,,296.15,342.91,8
HCPCS,90989,Dialysis training complete,,,31.04,35.94,8
HCPCS,90993,Dialysis training incompl,,,31.04,35.94,8
HCPCS,90997,Hemoperfusion,,,296.15,342.91,8
HCPCS,90999,Unlisted dialysis procedure,,,296.15,342.91,8
HCPCS,91010,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,2441.0,1586.65,1.1,3398.0,155
HCPCS,91013,Esophgl motil w/stim/perfus,,,237.67,275.2,8
HCPCS,91020,GASTRIC MOTILITY STUDIES,,,353.04,1045.9,19
HCPCS,91020,Gastric motility studies,,,237.67,275.2,8
HCPCS,91022,DUODENAL MOTILITY STUDY,,,353.04,1045.9,19
HCPCS,91022,Duodenal motility study,,,237.67,275.2,8
HCPCS,91030,ACID PERFUSION OF ESOPHAGUS,,,353.04,1045.9,19
HCPCS,91030,Acid perfusion of esophagus,,,237.67,275.2,8
HCPCS,91034,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,1608.5,1045.5249999999999,1.1,2829.0,94
HCPCS,91034,GASTROESOPHAGEAL REFLUX TEST,,,353.04,1045.9,19
HCPCS,91034,Gastroesophageal reflux test,,,237.67,275.2,8
HCPCS,91035,G-ESOPH REFLX TST W/ELECTROD,,,490.26,2406.92,19
HCPCS,91035,G-esoph reflx tst w/electrod,,,237.67,275.2,8
HCPCS,91035,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,700.0,455.0,1.1,1498.68,50
HCPCS,91037,ESOPH IMPED FUNCTION TEST,,,204.28,605.2,19
HCPCS,91037,Esoph imped function test,,,237.67,275.2,8
HCPCS,91037,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1432.0,930.8,1.1,1820.0,140
HCPCS,91038,ESOPH IMPED FUNCT TEST > 1HR,,,353.04,1045.9,19
HCPCS,91038,Esoph imped funct test > 1hr,,,237.67,275.2,8
HCPCS,91040,ESOPH BALLOON DISTENSION TST,,,353.04,1045.9,19
HCPCS,91040,Esoph balloon distension tst,,,237.67,275.2,8
HCPCS,91065,BREATH HYDROGEN/METHANE TEST,,,144.57,605.2,19
HCPCS,91065,Breath hydrogen/methane test,,,29.28,33.9,8
HCPCS,91110,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,1.1,5299.0,201
HCPCS,91111,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,4313.0,2803.45,237.67,4831.0,61
HCPCS,91112,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,4313.0,2803.45,237.67,4831.0,61
HCPCS,91113,GI TRACT IMAGING INTRALUMINAL COLON I&R,964.0,626.6,1.1,2948.17,50
HCPCS,91113,GI TRC IMG INTRAL COLON I&R,,,842.4,2606.53,19
HCPCS,91113,Gi trc img intral colon i&r,,,237.67,275.2,8
HCPCS,91117,COLON MOTILITY 6 HR STUDY,,,204.28,605.2,19
HCPCS,91117,Colon motility 6 hr study,,,237.67,275.2,8
HCPCS,91120,RECTAL SENSATION TEST,,,287.73,310.75,6
HCPCS,91120,Rectal sensation test,,,310.96,360.06,8
HCPCS,91122,ANORECTAL MANOMETRY,,,287.73,310.75,6
HCPCS,91122,Anorectal manometry,,,310.96,360.06,8
HCPCS,91124,RECTAL SENSATION TONE&COMPLIANCE STUDY,1522.0,989.3,1.1,2864.0,162
HCPCS,91125,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1754.0,1140.1,1.1,2942.0,162
HCPCS,91132,ELECTROGASTROGRAPHY,,,204.28,605.2,19
HCPCS,91132,Electrogastrography,,,310.96,360.06,8
HCPCS,91133,ELECTROGASTROGRAPHY W/TEST,,,119.1,372.91,19
HCPCS,91133,Electrogastrography w/test,,,310.96,360.06,8
HCPCS,91200,LIVER ELASTOGRAPHY,,,121.73,706.48,20
HCPCS,91200,Liver elastography,,,77.56,89.8,8
HCPCS,91299,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,1916.0,1245.4,0.01,1916.0,28
HCPCS,91299,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE (COMPARISON CODE,1860.0,1209.0,0.01,1860.0,28
HCPCS,91299,UNLISTED DX GI PROCEDURE,,,121.73,360.65,19
HCPCS,91299,Unlisted dx gi procedure,,,237.67,275.2,8
HCPCS,91300,SARSCOV2 VAC 30MCG/0.3ML IM,,,0.01,0.01,1
HCPCS,91300,Sarscov2 vac 30mcg/0.3ml im,,,7.93,9.19,8
HCPCS,91301,SARSCOV2 VAC 100MCG/0.5ML IM,,,0.01,0.01,1
HCPCS,91301,Sarscov2 vac 100mcg/0.5ml im,,,7.93,9.19,8
HCPCS,91302,Sarscov2 vac 5x1010vp/.5mlim,,,7.93,9.19,8
HCPCS,91303,Sarscov2 vac ad26 .5ml im,,,7.93,9.19,8
HCPCS,91304,SARSCOV2 VAC 5MCG/0.5ML IM,,,341.62,404.95,7
HCPCS,91304,Sarscov2 vac 5mcg/0.5ml im,,,7.93,9.19,8
HCPCS,9130400,SARSCOV2 VAC 5MCG/0.5ML IM,,,341.62,341.62,1
HCPCS,91305,Sarscov2 vac 30 mcg trs-sucr,,,7.93,9.19,8
HCPCS,91306,Sarscov2 vac 50mcg/0.25ml im,,,7.93,9.19,8
HCPCS,91307,Sarscov2 vac 10 mcg trs-sucr,,,7.93,9.19,8
HCPCS,91308,Sarscov2 vac 3 mcg trs-sucr,,,7.93,9.19,8
HCPCS,91309,Sarscov2 vac 50mcg/0.5ml im,,,7.93,9.19,8
HCPCS,91310,Sarscov2 vac 5mcg/0.5ml as03,,,7.93,9.19,8
HCPCS,91311,Sarscov2 vac 25mcg/0.25ml im,,,7.93,9.19,8
HCPCS,91312,Sarscov2 vac bvl 30mcg/0.3ml,,,7.93,9.19,8
HCPCS,91313,Sarscov2 vac bvl 50mcg/0.5ml,,,7.93,9.19,8
HCPCS,91314,Sarscov2 vac bvl 25mcg/.25ml,,,7.93,9.19,8
HCPCS,91315,Sarscov2 vac bvl 10mcg/0.2ml,,,7.93,9.19,8
HCPCS,91316,Sarscov2 vac bvl 10mcg/0.2ml,,,7.93,9.19,8
HCPCS,91317,Sarscov2 vac bvl 3mcg/0.2ml,,,7.93,9.19,8
HCPCS,91318,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,1.1,140.93,79
HCPCS,91318,SARSCOV2 VAC 3MCG TRS-SUC IM,,,104.4,104.4,1
HCPCS,9131800,SARSCOV2 VAC 3MCG TRS-SUC IM,,,104.4,104.4,1
HCPCS,91319,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,1.1,278.0,79
HCPCS,91319,SARSCV2 VAC 10MCG TRS-SUC IM,,,168.74,168.74,1
HCPCS,9131900,SARSCV2 VAC 10MCG TRS-SUC IM,,,168.74,168.74,1
HCPCS,91320,COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE,2038.14,1324.79,7.93,2038.14,51
HCPCS,91320,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,512.85,333.355,1.1,532.7,79
HCPCS,91320,SARSCV2 VAC 30MCG TRS-SUC IM,,,299.7,299.7,1
HCPCS,9132000,SARSCV2 VAC 30MCG TRS-SUC IM,,,299.7,299.7,1
HCPCS,91321,SARSCOV2 VAC 25 MCG/.25ML IM,,,261.77,261.77,1
HCPCS,91321,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,1.1,465.4,79
HCPCS,91321,SPIKEVAX 2025-26 (6M-11Y) (PF) 25 MCG/0.25 ML INTRAMUSCULAR SYRINGE,1857.6,1207.44,7.93,1857.6,51
HCPCS,9132100,SARSCOV2 VAC 25 MCG/.25ML IM,,,261.77,261.77,1
HCPCS,91322,SARSCOV2 VAC 50 MCG/0.5ML IM,,,287.74,368.56,7
HCPCS,91322,Sarscov2 vac 50 mcg/0.5ml im,,,7.93,9.19,8
HCPCS,9132200,SARSCOV2 VAC 50 MCG/0.5ML IM,,,287.74,287.74,1
HCPCS,91323,SARSCOV2 VAC 10 MCG/0.2ML IM,,,359.4,426.03,5
HCPCS,91323,Sarscov2 vac 10 mcg/0.2ml im,,,7.93,9.19,8
HCPCS,9132300,SARSCOV2 VAC 10 MCG/0.2ML IM,,,359.4,359.4,1
HCPCS,92002,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,593.0,385.45,0.01,593.0,61
HCPCS,92004,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,593.0,385.45,0.01,593.0,61
HCPCS,92012,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,593.0,385.45,0.01,593.0,61
HCPCS,92014,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,593.0,385.45,0.01,593.0,61
HCPCS,92015,Determine refractive state,,,50.62,58.61,8
HCPCS,92018,COMPL OPH EXAM GENERAL ANES,,,2155.61,6663.73,19
HCPCS,92018,Compl oph exam general anes,,,157.33,182.17,8
HCPCS,92019,LMTD OPH EXAM GENERAL ANES,,,2155.61,6663.73,19
HCPCS,92019,Lmtd oph exam general anes,,,157.33,182.17,8
HCPCS,92020,GONIOSCOPY,,,119.1,372.91,19
HCPCS,92020,Gonioscopy,,,38.61,44.7,8
HCPCS,92025,CPTRIZED CORNEAL TOPOGRAPHY,,,54.88,165.35,19
HCPCS,92025,Cptrized corneal topography,,,37.89,43.87,8
HCPCS,92060,SENSORIMOTOR EXAMINATION,,,54.88,165.35,19
HCPCS,92060,Sensorimotor examination,,,38.61,44.7,8
HCPCS,92065,Orthop traing pfrmd phys/qhp,,,96.9,112.2,8
HCPCS,92066,ORTHOP TRAING SUPVJ PHYS/QHP,,,54.88,165.35,19
HCPCS,92066,Orthop traing supvj phys/qhp,,,96.9,112.2,8
HCPCS,92071,Contact lens fitting for tx,,,38.61,44.7,8
HCPCS,92072,Fitg c-lens keratoconus 1st,,,38.61,44.7,8
HCPCS,92081,LIMITED VISUAL FIELD XM,,,54.88,165.35,19
HCPCS,92081,Limited visual field xm,,,38.61,44.7,8
HCPCS,92082,INTERMEDIATE VISUAL FIELD XM,,,54.88,165.35,19
HCPCS,92082,Intermediate visual field xm,,,38.61,44.7,8
HCPCS,92083,EXTENDED VISUAL FIELD XM,,,119.1,372.91,19
HCPCS,92083,Extended visual field xm,,,38.61,44.7,8
HCPCS,92083,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,516.5,335.725,1.1,813.0,94
HCPCS,92100,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,268.0,174.2,1.1,277.87,53
HCPCS,92100,Serial tonometry,,,38.61,44.7,8
HCPCS,92132,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,264.5,171.92499999999998,1.1,401.0,94
HCPCS,92132,CPTRZD OPH DX IMG ANT SGM,,,54.88,165.35,19
HCPCS,92132,Cptrzd oph dx img ant sgm,,,37.89,43.87,8
HCPCS,92133,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,272.5,177.125,1.1,409.0,94
HCPCS,92133,CPTRZD OPH DX IMG PST SGM ON,,,54.88,165.35,19
HCPCS,92133,Cptrzd oph dx img pst sgm on,,,37.89,43.87,8
HCPCS,92134,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,273.0,177.45,1.1,414.0,155
HCPCS,92136,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,238.0,154.7,1.1,238.0,44
HCPCS,92136,OPHTHALMIC BIOMETRY,,,119.1,372.91,19
HCPCS,92136,Ophthalmic biometry,,,37.89,43.87,8
HCPCS,92137,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,857.0,557.05,1.1,1432.0,104
HCPCS,92145,CORNEAL HYSTERESIS DETER,,,54.88,165.35,19
HCPCS,92145,Corneal hysteresis deter,,,38.61,44.7,8
HCPCS,92201,OPSCPY EXTND RTA DRAW UNI/BI,,,54.88,165.35,19
HCPCS,92201,OPSCPY EXTND RTA DRAWING &AMP; SCL DEPRSN I&AMP;R UNI/BI,176.0,114.4,1.1,176.0,52
HCPCS,92201,Opscpy extnd rta draw uni/bi,,,37.89,43.87,8
HCPCS,92202,OPSCPY EXTND ON/MAC DRAW,,,54.88,165.35,19
HCPCS,92202,OPSCPY EXTND OPTIC NRV/MACULA DRAWING I&AMP;R UNI/BI,114.0,74.1,1.1,114.0,52
HCPCS,92202,Opscpy extnd on/mac draw,,,37.89,43.87,8
HCPCS,92227,IMG RTA DETCJ/MNTR DS STAFF,,,54.88,165.35,19
HCPCS,92227,Img rta detcj/mntr ds staff,,,37.89,43.87,8
HCPCS,92227,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/BI,21.0,13.65,1.1,103.94,50
HCPCS,92228,IMG RTA DETC/MNTR DS PHY/QHP,,,35.34,104.69,19
HCPCS,92228,Img rta detc/mntr ds phy/qhp,,,37.89,43.87,8
HCPCS,92229,IMG RTA DETC/MNTR DS POC ALY,,,54.88,165.35,19
HCPCS,92229,Img rta detc/mntr ds poc aly,,,37.89,43.87,8
HCPCS,92230,FLUORESCEIN ANGIOSCOPY I&R,,,353.04,1045.9,19
HCPCS,92230,Fluorescein angioscopy i&r,,,157.33,182.17,8
HCPCS,92235,FLUORESCEIN ANGRPH MLTIFRAME,,,204.28,605.2,19
HCPCS,92235,Fluorescein angrph mltiframe,,,157.33,182.17,8
HCPCS,92240,ICG ANGIOGRAPHY I&R UNI/BI,,,204.28,605.2,19
HCPCS,92240,Icg angiography i&r uni/bi,,,157.33,182.17,8
HCPCS,92242,FLUORESCEIN&ICG ANGIOGRAPHY,,,204.28,605.2,19
HCPCS,92242,Fluorescein&icg angiography,,,157.33,182.17,8
HCPCS,92250,FUNDUS PHOTOGRAPHY W/I&R,,,119.1,372.91,19
HCPCS,92250,Fundus photography w/i&r,,,37.89,43.87,8
HCPCS,92260,OPHTHALMODYNAMOMETRY,,,35.34,104.69,19
HCPCS,92260,Ophthalmodynamometry,,,37.89,43.87,8
HCPCS,92265,NDL OCULOELECTROMYOGRAPHY 1+,,,54.88,165.35,19
HCPCS,92265,Ndl oculoelectromyography 1+,,,38.61,44.7,8
HCPCS,92270,ELECTRO-OCULOGRAPHY W/I&R,,,119.1,372.91,19
HCPCS,92270,Electro-oculography w/i&r,,,38.61,44.7,8
HCPCS,92273,FULL FIELD ERG W/I&R,,,204.28,605.2,19
HCPCS,92273,Full field erg w/i&r,,,38.61,44.7,8
HCPCS,92274,MULTIFOCAL ERG W/I&R,,,121.73,360.65,19
HCPCS,92274,Multifocal erg w/i&r,,,38.61,44.7,8
HCPCS,92283,EXTND COLOR VISION XM,,,54.88,165.35,19
HCPCS,92283,Extnd color vision xm,,,38.61,44.7,8
HCPCS,92284,DARK ADAPTATION XM W/INTERPRETATION & REPORT,1020.0,663.0,1.1,1938.0,90
HCPCS,92284,DX DARK ADAPTATION EXAM I&R,,,368.71,1252.1,19
HCPCS,92284,Dx dark adaptation exam i&r,,,38.61,44.7,8
HCPCS,92285,EXTERNAL OCULAR PHOTOGRAPHY,,,35.34,104.69,19
HCPCS,92285,External ocular photography,,,37.89,43.87,8
HCPCS,92286,ANT SGM IMG I&R SPECLR MIC,,,119.1,372.91,19
HCPCS,92286,Ant sgm img i&r speclr mic,,,37.89,43.87,8
HCPCS,92287,ANT SGM IMG IR FLRSCN ANGRPH,,,119.1,372.91,19
HCPCS,92287,Ant sgm img ir flrscn angrph,,,37.89,43.87,8
HCPCS,92288,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,955.5,621.075,0.01,1836.0,69
HCPCS,92310,Contact lens fitting ou,,,38.61,44.7,8
HCPCS,92310,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,468.0,304.2,1.1,468.0,42
HCPCS,92311,CONTACT LENS FITG APHAKIA 1,,,368.71,1252.1,19
HCPCS,92311,Contact lens fitg aphakia 1,,,38.61,44.7,8
HCPCS,92311,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,432.0,280.8,1.1,680.96,53
HCPCS,92312,CONTACT LENS FITG APHAKIA OU,,,119.1,372.91,19
HCPCS,92312,Contact lens fitg aphakia ou,,,38.61,44.7,8
HCPCS,92313,C-LENS FITG CORNEOSCLRL LENS,,,119.1,372.91,19
HCPCS,92313,C-lens fitg corneosclrl lens,,,38.61,44.7,8
HCPCS,92314,C-lens fitg tech ou,,,38.61,44.7,8
HCPCS,92315,C-LENS FITG TECH APHAKIA 1,,,119.1,372.91,19
HCPCS,92315,C-lens fitg tech aphakia 1,,,38.61,44.7,8
HCPCS,92316,C-LENS FITG TECH APHAKIA OU,,,119.1,372.91,19
HCPCS,92316,C-lens fitg tech aphakia ou,,,38.61,44.7,8
HCPCS,92317,C-LENS FITG TECH CORNEOSCLRL,,,35.34,104.69,19
HCPCS,92317,C-lens fitg tech corneosclrl,,,38.61,44.7,8
HCPCS,92325,MODIFICATION OF CONTACT LENS,,,119.1,372.91,19
HCPCS,92325,Modification of contact lens,,,38.61,44.7,8
HCPCS,92326,REPLACEMENT OF CONTACT LENS,,,54.88,165.35,19
HCPCS,92326,Replacement of contact lens,,,38.61,44.7,8
HCPCS,92340,Fit spectacles monofocal,,,38.61,44.7,8
HCPCS,92341,Fit spectacles bifocal,,,38.61,44.7,8
HCPCS,92342,Fit spectacles multifocal,,,38.61,44.7,8
HCPCS,92352,FIT APHAKIA SPECTCL MONOFOCL,,,54.88,165.35,19
HCPCS,92352,Fit aphakia spectcl monofocl,,,38.61,44.7,8
HCPCS,92353,FIT APHAKIA SPECTCL MULTIFOC,,,54.88,165.35,19
HCPCS,92353,Fit aphakia spectcl multifoc,,,38.61,44.7,8
HCPCS,92354,FITG SPECT LOW VIS 1SYSTEM,,,35.34,104.69,19
HCPCS,92354,Fitg spect low vis 1system,,,38.61,44.7,8
HCPCS,92355,FITG SPECT LW VIS CMPND LENS,,,35.34,104.69,19
HCPCS,92355,Fitg spect lw vis cmpnd lens,,,38.61,44.7,8
HCPCS,92358,APHAKIA PROSTH SERVICE TEMP,,,54.88,165.35,19
HCPCS,92358,Aphakia prosth service temp,,,38.61,44.7,8
HCPCS,92370,Rpr&refitg spect xcp aphakia,,,50.62,58.61,8
HCPCS,92371,RPR&REFIT SPCT PRSTH APHAKIA,,,54.88,165.35,19
HCPCS,92371,Rpr&refit spct prsth aphakia,,,38.61,44.7,8
HCPCS,92499,UNLISTED OPH SVC/PROCEDURE,,,22.63,81.07,19
HCPCS,92499,Unlisted oph svc/procedure,,,38.61,44.7,8
HCPCS,92502,EAR AND THROAT EXAMINATION,,,470.54,1511.66,19
HCPCS,92502,Ear and throat examination,,,85.44,98.93,8
HCPCS,92502,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,604.0,392.6,1.1,939.01,50
HCPCS,92504,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,79.0,51.35,1.1,94.94,53
HCPCS,92504,Ear microscopy examination,,,50.62,58.61,8
HCPCS,92507,SPEECH/HEARING THERAPY INDIV,473.0,307.45,56.15,473.0,60
HCPCS,92507,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,496.5,322.725,1.1,520.0,110
HCPCS,92507,VV SPEECH THERAPY (92507),473.0,307.45,56.15,473.0,60
HCPCS,92508,SLT-SPEECH/LANGUAG THERAPY GRP,283.0,183.95,30.03,283.0,60
HCPCS,92508,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,132.0,85.8,1.1,132.0,50
HCPCS,92511,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,522.5,339.625,1.1,3004.0,114
HCPCS,92512,NASAL FUNCTION STUDIES,,,204.28,605.2,19
HCPCS,92512,Nasal function studies,,,194.75,225.5,8
HCPCS,92516,FACIAL NERVE FUNCTION TEST,,,204.28,605.2,19
HCPCS,92516,Facial nerve function test,,,194.75,225.5,8
HCPCS,92517,VEMP TEST I&R CERVICAL,,,121.73,360.65,19
HCPCS,92517,Vemp test i&r cervical,,,194.75,225.5,8
HCPCS,92518,VEMP TEST I&R OCULAR,,,121.73,360.65,19
HCPCS,92518,Vemp test i&r ocular,,,194.75,225.5,8
HCPCS,92519,VEMP TST I&R CERVICAL&OCULAR,,,204.28,605.2,19
HCPCS,92519,Vemp tst i&r cervical&ocular,,,194.75,225.5,8
HCPCS,92520,LARYNGEAL FUNCTION STUDIES,516.0,335.4,69.7,516.0,61
HCPCS,92520,LARYNGEAL FUNCTION STUDY,300.0,195.0,1.1,300.0,53
HCPCS,92521,EVAL OF SPEECH FLUENCY,593.0,385.45,56.15,593.0,60
HCPCS,92521,"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)",896.0,582.4,1.1,896.0,50
HCPCS,92521,VV FLUENCY EVAL (92521),593.0,385.45,56.15,593.0,60
HCPCS,92522,EVAL OF SPEECH PRODUCTION,573.0,372.45,56.15,573.0,60
HCPCS,92522,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,670.5,435.825,1.1,768.0,110
HCPCS,92522,VV SOUND PRODUCTION EVALUATION (92522),573.0,372.45,56.15,573.0,60
HCPCS,92523,EVAL SPEECH SOUND LANG COMPREH,1002.0,651.3,56.15,1002.0,60
HCPCS,92523,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1269.0,824.8499999999999,1.1,1536.0,110
HCPCS,92523,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523),1002.0,651.3,56.15,1002.0,60
HCPCS,92524,BEHAV QUAL ANLYS VOICE MO,544.0,353.6,56.15,544.0,60
HCPCS,92524,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,544.0,353.6,56.15,544.0,120
HCPCS,92524,BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE,768.0,499.2,1.1,768.0,50
HCPCS,92524,VV VOICE EVAL (92524),544.0,353.6,56.15,544.0,60
HCPCS,92526,TREAT SWALLOWING DYSFUNCTION,664.0,431.6,67.54,664.0,60
HCPCS,92526,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,536.0,348.4,1.1,536.0,50
HCPCS,92531,SPONTANEOUS NYSTAGMUS STUDY,1048.0,681.2,31.75,1048.0,46
HCPCS,92532,POSITIONAL NYSTAGMUS STUDY,215.0,139.75,1.1,215.0,32
HCPCS,92532,Positional nystagmus test,,,31.75,36.76,8
HCPCS,92533,Caloric vestibular test,,,31.75,36.76,8
HCPCS,92534,Optokinetic nystagmus test,,,194.75,225.5,8
HCPCS,92537,CALORIC VEST TEST BITHERMAL,626.0,406.9,65.76,626.0,61
HCPCS,92537,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,577.0,375.05,1.1,890.0,94
HCPCS,92538,CALORIC VEST TEST MONOTHERMAL,626.0,406.9,36.2,626.0,61
HCPCS,92540,BASIC VESTIBULAR EVAL,626.0,406.9,144.57,626.0,61
HCPCS,92540,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,973.0,632.45,1.1,1286.0,94
HCPCS,92541,SPONTANEOUS NYSTAGMUS TEST,516.0,335.4,1.1,692.0,155
HCPCS,92542,POSITIONAL NYSTAGMUS TEST,516.0,335.4,1.1,727.0,155
HCPCS,92544,OPTOKINETIC NYSTAGMUS TEST,720.0,468.0,29.98,720.0,61
HCPCS,92545,OSCILLATING TRACKING TEST,1432.0,930.8,28.2,1432.0,61
HCPCS,92546,SINUSOIDAL ROTATIONAL TEST,,,121.73,360.65,19
HCPCS,92546,Sinusoidal rotational test,,,194.75,225.5,8
HCPCS,92547,Supplemental electrical test,,,194.75,225.5,8
HCPCS,92547,USE VERTICAL ELECTRODES,187.0,121.55,1.1,187.0,50
HCPCS,92548,CDP-SOT 6 COND W/I&R,,,119.1,372.91,19
HCPCS,92548,Cdp-sot 6 cond w/i&r,,,194.75,225.5,8
HCPCS,92549,CDP-SOT 6 COND W/I&R MCT&ADT,,,119.1,372.91,19
HCPCS,92549,Cdp-sot 6 cond w/i&r mct&adt,,,194.75,225.5,8
HCPCS,92550,TYMP & REFLEX THRESH,626.0,406.9,36.85,626.0,61
HCPCS,92550,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,154.0,100.1,1.1,267.01,50
HCPCS,92551,SCREENING TEST PURE TONE AIR ONLY,63.0,40.95,1.1,64.0,85
HCPCS,92552,AUDIOMETRY THRESHOLD TEST,516.0,335.4,31.75,516.0,61
HCPCS,92552,PURE TONE AUDIOMETRY AIR ONLY,127.0,82.55,1.1,218.62,50
HCPCS,92553,AUDIOMETRY AIR AND BONE,626.0,406.9,90.44,626.0,61
HCPCS,92553,PURE TONE AUDIOMETRY AIR & BONE,166.0,107.9,1.1,267.01,50
HCPCS,92555,SPEECH AUDIOMETRY THRESHOLD,161.0,104.64999999999999,1.1,238.0,111
HCPCS,92556,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,147.0,95.55,1.1,147.0,50
HCPCS,92556,SPEECH RECEPTION THRESHOLD,238.0,154.7,31.75,238.0,61
HCPCS,92557,AUDIOMETRY EVAL & SPEECH RECOG,626.0,406.9,55.37,626.0,61
HCPCS,92557,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,264.0,171.6,1.1,267.01,53
HCPCS,92558,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,186.0,120.9,27.68,186.0,46
HCPCS,92559,Group audiometric testing,,,31.75,36.76,8
HCPCS,92560,Bekesy audiometry screen,,,31.75,36.76,8
HCPCS,92561,Bekesy audiometry diagnosis,,,31.75,36.76,8
HCPCS,92562,LOUDNESS BALANCE TEST,,,204.28,605.2,19
HCPCS,92562,Loudness balance test,,,31.75,36.76,8
HCPCS,92563,TONE DECAY,98.0,63.7,1.1,105.89,50
HCPCS,92563,TONE DECAY HEARING TEST,,,35.34,104.69,19
HCPCS,92563,Tone decay hearing test,,,31.75,36.76,8
HCPCS,92564,Sisi hearing test,,,31.75,36.76,8
HCPCS,92565,STENGER TEST PURE TONE,,,54.88,165.35,19
HCPCS,92565,Stenger test pure tone,,,31.75,36.76,8
HCPCS,92567,TYMPANOMETRY,122.5,79.625,1.1,157.0,114
HCPCS,92568,ACOUSTIC REFLEX,116.0,75.4,1.1,116.0,53
HCPCS,92568,ACOUSTIC REFLEX THRESHOLD,157.0,102.05,26.33,157.0,61
HCPCS,92570,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,242.0,157.3,1.1,267.01,53
HCPCS,92570,ACOUSTIC IMMITANCE TESTING,,,121.73,360.65,19
HCPCS,92570,Acoustic immitance testing,,,106.87,123.74,8
HCPCS,92571,FILTERED SPEECH TEST,,,35.34,104.69,19
HCPCS,92571,Filtered speech test,,,31.75,36.76,8
HCPCS,92572,STAGGERED SPONDAIC WORD TEST,,,121.73,360.65,19
HCPCS,92572,Staggered spondaic word test,,,106.87,123.74,8
HCPCS,92575,SENSORINEURAL ACUITY LVL TST,,,35.34,104.69,19
HCPCS,92575,Sensorineural acuity lvl tst,,,31.75,36.76,8
HCPCS,92576,SYNTHETIC SENTENCE ID TEST,,,35.34,104.69,19
HCPCS,92576,Synthetic sentence id test,,,31.75,36.76,8
HCPCS,92577,SPEECH STENGER,144.0,93.6,1.1,915.71,50
HCPCS,92577,STENGER TEST SPEECH,,,353.04,1045.9,19
HCPCS,92577,Stenger test speech,,,106.87,123.74,8
HCPCS,92579,VISUAL AUDIOMETRY (VRA),,,144.57,605.2,19
HCPCS,92579,Visual audiometry (vra),,,106.87,123.74,8
HCPCS,92582,AUDIOMETRY CONDITION PLAY,626.0,406.9,106.87,626.0,61
HCPCS,92582,CONDITIONING PLAY AUDIOMETRY,168.0,109.2,1.1,267.01,50
HCPCS,92583,SELECT PICTURE AUDIOMETRY,,,54.88,165.35,19
HCPCS,92583,Select picture audiometry,,,31.75,36.76,8
HCPCS,92584,ELECTROCOCHLEOGRAPHY,,,121.73,360.65,19
HCPCS,92584,Electrocochleography,,,106.87,123.74,8
HCPCS,92585,Auditor evoke potent compre,,,106.87,123.74,8
HCPCS,92586,Auditor evoke potent limit,,,106.87,123.74,8
HCPCS,92587,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,777.0,505.05,1.1,1400.0,94
HCPCS,92587,TEST EVOKED AUDITORY LTD,1246.0,809.9,36.65,1246.0,61
HCPCS,92588,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,865.0,562.25,1.1,1488.0,94
HCPCS,92588,TEST EVOKED AUDITORY COMPR,1246.0,809.9,56.81,1246.0,61
HCPCS,92590,Hearing aid xm&slctn monaurl,,,31.75,36.76,8
HCPCS,92591,Hearing aid xm&slctn binaurl,,,31.75,36.76,8
HCPCS,92592,Hearing aid check monaural,,,31.75,36.76,8
HCPCS,92593,Hearing aid check binaural,,,31.75,36.76,8
HCPCS,92594,Electro hearng aid test one,,,31.75,36.76,8
HCPCS,92595,Electro hearng aid tst both,,,31.75,36.76,8
HCPCS,92596,EAR PROTECTOR EVALUATION,,,35.34,104.69,19
HCPCS,92596,Ear protector evaluation,,,31.75,36.76,8
HCPCS,92597,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,504.0,327.6,1.1,504.0,50
HCPCS,92597,FIT PROSTHTIC VOICE DVC 440,636.0,413.4,56.15,636.0,60
HCPCS,92601,COCHLEAR IMPLT F/UP EXAM <7,,,121.73,360.65,19
HCPCS,92601,Cochlear implt f/up exam <7,,,18.13,20.99,8
HCPCS,92602,REPROGRAM COCHLEAR IMPLT <7,,,121.73,360.65,19
HCPCS,92602,Reprogram cochlear implt <7,,,18.13,20.99,8
HCPCS,92603,COCHLEAR IMPLT F/UP EXAM 7/>,,,121.73,360.65,19
HCPCS,92603,Cochlear implt f/up exam 7/>,,,18.13,20.99,8
HCPCS,92604,REPROGRAM COCHLEAR IMPLT 7/>,,,121.73,360.65,19
HCPCS,92604,Reprogram cochlear implt 7/>,,,18.13,20.99,8
HCPCS,92605,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR,775.0,503.75,56.15,775.0,46
HCPCS,92606,THER SVC N-SP-GENRATJ DEV PRGRMG&MODIFICAJ,207.0,134.55,24.68,239.0,46
HCPCS,92607,EVAL SPCH - GEN DEV 1 HR,1420.0,923.0,56.15,1420.0,60
HCPCS,92607,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,1080.0,702.0,1.1,1420.0,110
HCPCS,92608,EVAL SPCH - GEN DEV 30 MN,172.0,111.8,48.64,239.0,60
HCPCS,92608,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,280.0,182.0,1.1,280.0,50
HCPCS,92609,SLT-THERA SVC COM DEV PRG MOD,629.0,408.85,67.54,629.0,60
HCPCS,92609,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,600.0,390.0,1.1,600.0,50
HCPCS,92610,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,545.0,354.25,1.1,570.0,173
HCPCS,92610,EVALUATE SWALLOWING FUNCTION,570.0,370.5,56.15,570.0,60
HCPCS,92611,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,682.5,443.625,1.1,829.0,110
HCPCS,92611,SWALLOW EVAL FUNC FLUORO GN,829.0,538.85,113.2,829.0,60
HCPCS,92612,FEES W CINE OR VIDEO,1084.0,704.6,74.78,1084.0,60
HCPCS,92613,Endoscopy swallow (fees) i&r,,,85.44,98.93,8
HCPCS,92614,LARYNGOSCOPIC SENSORY VID,,,74.61,205.18,21
HCPCS,92614,Laryngoscopic sensory vid,,,85.44,98.93,8
HCPCS,92615,Laryngoscopic sensory i&r,,,85.44,98.93,8
HCPCS,92616,FEES W/LARYNGEAL SENSE TEST,,,110.4,303.6,21
HCPCS,92616,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,752.0,488.8,1.1,752.0,53
HCPCS,92616,Fees w/laryngeal sense test,,,85.44,98.93,8
HCPCS,92617,Fees w/laryngeal sense i&r,,,85.44,98.93,8
HCPCS,92618,Ex for nonspeech dev rx add,,,56.15,65.01,8
HCPCS,92620,AUDITORY FUNCTION 60 MIN,,,121.73,360.65,19
HCPCS,92620,Auditory function 60 min,,,56.15,65.01,8
HCPCS,92621,Auditory function + 15 min,,,56.15,65.01,8
HCPCS,92622,DX ALY AUD OI SND PRCSR 1ST,,,121.73,360.65,19
HCPCS,92622,Dx aly aud oi snd prcsr 1st,,,18.13,20.99,8
HCPCS,92623,Dx aly aud oi snd prcsr each,,,18.13,20.99,8
HCPCS,92625,ASSESSMENT TINNITUS,626.0,406.9,105.58,626.0,61
HCPCS,92626,EVAL AUD REHAB STATUS,626.0,406.9,56.15,626.0,61
HCPCS,92627,Eval aud funcj ea addl 15,,,56.15,65.01,8
HCPCS,92628,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,206.5,134.225,1.1,313.0,68
HCPCS,92629,EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN,157.0,102.05,23.36,157.0,46
HCPCS,92630,Aud rehab pre-ling hear loss,,,24.68,28.58,8
HCPCS,92631,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,206.5,134.225,1.1,313.0,68
HCPCS,92632,HEARING AID SELECTION SERVICES EA ADDL 15 MIN,157.0,102.05,23.36,157.0,46
HCPCS,92633,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,329.0,213.85,24.68,329.0,46
HCPCS,92634,HEARING AID FITTING SERVICES 1ST 60 MINUTES,463.0,300.95,1.1,626.0,68
HCPCS,92635,HEARING AID FITTING SERVICES EA ADDL 15 MINUTES,157.0,102.05,23.36,157.0,46
HCPCS,92636,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,181.5,117.975,1.1,313.0,68
HCPCS,92637,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,91.0,59.15,1.1,157.0,68
HCPCS,92638,BEHAVIORAL VERIFICATION OF AMPLIFICATION,626.0,406.9,31.75,626.0,46
HCPCS,92639,HEARING AID MEAS VERIF W/PROBE MICROPHONE,626.0,406.9,31.75,626.0,46
HCPCS,92640,AUD BRAINSTEM IMPLT PROGRAMG,,,121.73,360.65,19
HCPCS,92640,Aud brainstem implt programg,,,67.54,78.2,8
HCPCS,92641,HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS,626.0,406.9,31.75,626.0,46
HCPCS,92642,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,363.0,235.95,1.1,626.0,68
HCPCS,92650,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,370.5,240.825,1.1,631.0,85
HCPCS,92651,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,400.0,260.0,1.1,535.81,50
HCPCS,92651,AEP HEARING STATUS DETER I&R,,,204.28,605.2,19
HCPCS,92651,Aep hearing status deter i&r,,,106.87,123.74,8
HCPCS,92652,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,600.0,390.0,1.1,600.0,50
HCPCS,92652,AEP THRSHLD EST MLT FREQ I&R,,,204.28,605.2,19
HCPCS,92652,Aep thrshld est mlt freq i&r,,,106.87,123.74,8
HCPCS,92653,AEP NEURODIAGNOSTIC I&R,,,204.28,605.2,19
HCPCS,92653,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,420.0,273.0,1.1,535.81,50
HCPCS,92653,Aep neurodiagnostic i&r,,,106.87,123.74,8
HCPCS,92700,UNLISTED ORL SERVICE/PX,,,22.63,81.07,19
HCPCS,92700,Unlisted orl service/px,,,85.44,98.93,8
HCPCS,92920,PRQ CARD ANGIOPLAST 1 ART LC,32784.0,21309.6,863.64,32784.0,61
HCPCS,92920,PRQ CARDIAC ANGIOPLAST 1 ART,32784.0,21309.6,863.64,32784.0,61
HCPCS,92920,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,18559.0,12063.349999999999,1.1,32784.0,111
HCPCS,92921,Prq cardiac angio addl art,,,4659.93,5395.71,8
HCPCS,92924,PRQ CARDIAC ANGIO/ARTHRECT 1 ART,30204.0,19632.6,1028.9,32356.61,61
HCPCS,92924,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,17450.0,11342.5,1.1,32356.61,111
HCPCS,92925,Prq card angio/athrect addl,,,4659.93,5395.71,8
HCPCS,92928,PRQ CARDIAC STENT W/ANGIO 1 VSL,42281.0,27482.65,960.18,42281.0,61
HCPCS,92928,PRQ PLC BM STNT W/ANG 1 VSL LC,42281.0,27482.65,960.18,42281.0,61
HCPCS,92928,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,4822.0,3134.3,1.1,18783.74,50
HCPCS,92929,Prq card stent w/angio addl,,,4659.93,5395.71,8
HCPCS,92930,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,67254.0,43715.1,1.1,129228.0,90
HCPCS,92933,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,25311.0,16452.149999999998,1.1,51380.79,172
HCPCS,92934,Prq card stent/ath/angio,,,4659.93,5395.71,8
HCPCS,92937,PRQ BM REVASC CABG 1 VSL,44674.0,29038.1,959.53,44674.0,61
HCPCS,92937,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,4818.0,3131.7,1.1,18783.74,50
HCPCS,92938,Prq revasc byp graft addl,,,4659.93,5395.71,8
HCPCS,92941,PRQ CARD REVASC MI 1 VSL,33050.0,21482.5,1078.76,33050.0,46
HCPCS,92941,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,4924.0,3200.6,1.1,4924.0,50
HCPCS,92943,PRQ DES REVASC CHRONIC 1VSL,38342.0,24922.3,1078.55,38342.0,61
HCPCS,92943,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,5416.0,3520.4,1.1,18783.74,50
HCPCS,92944,Prq card revasc chronic addl,,,4659.93,5395.71,8
HCPCS,92945,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,43990.0,28593.5,1.1,81380.0,90
HCPCS,92950,CARDIO-PULMONARY RESUSCITATION,1760.0,1144.0,1.1,1760.0,53
HCPCS,92950,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,0.01,2453.0,244
HCPCS,92953,TEMPORARY TRANSCUTANEOUS PACING,3763.0,2445.95,1.97,3763.0,122
HCPCS,92960,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,2321.5,1508.975,1.1,3763.0,236
HCPCS,92961,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,1736.0,1128.4,1.1,1736.0,50
HCPCS,92961,"CARDIOVERSION, INTERNAL",3763.0,2445.95,315.57,3763.0,61
HCPCS,92970,Cardioassist internal,,,2003.13,2319.42,8
HCPCS,92971,Cardioassist external,,,315.57,365.4,8
HCPCS,92972,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,3184.5,2069.925,1.1,5395.71,96
HCPCS,92973,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,2566.5,1668.225,1.1,5395.71,96
HCPCS,92974,Cath place cardio brachytx,,,159.5,184.68,8
HCPCS,92975,Dissolve clot heart vessel,,,2270.79,2629.34,8
HCPCS,92977,DISSOLVE CLOT HEART VESSEL,,,306.47,330.99,6
HCPCS,92977,Dissolve clot heart vessel,,,310.37,359.38,8
HCPCS,92978,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5062.0,3290.3,1.1,5854.0,128
HCPCS,92979,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,2240.5,1456.325,1.1,3905.0,90
HCPCS,92986,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,14999.5,9749.675,1.1,20959.0,111
HCPCS,92987,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,36015.0,23409.75,2217.04,36015.0,61
HCPCS,92990,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,65208.0,42385.2,1768.23,65208.0,61
HCPCS,92992,Revision of heart chamber,,,4659.93,5395.71,8
HCPCS,92993,Revision of heart chamber,,,4659.93,5395.71,8
HCPCS,92997,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,35000.0,22750.0,1.1,65208.0,111
HCPCS,92998,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,5794.0,3766.1,522.24,9608.0,46
HCPCS,93000,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,245.0,159.25,1.1,415.0,96
HCPCS,93005,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,318.5,207.025,1.1,342.0,111
HCPCS,93010,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,75.0,48.75,1.1,75.0,50
HCPCS,93010,Electrocardiogram report,,,18.66,21.6,8
HCPCS,93010,PRO FEE - EKG,15.0,9.75,1.1,27.57,50
HCPCS,93015,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,330.0,214.5,1.1,330.0,50
HCPCS,93015,Cv stress test supvj i&r,,,86.16,99.76,8
HCPCS,93016,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,198.0,128.7,1.1,198.0,50
HCPCS,93016,Cv stress test supvj only,,,86.16,99.76,8
HCPCS,93016,PF CARDIAC STRESS TEST SUPERV,39.0,25.35,1.1,71.01,50
HCPCS,93017,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,1791.0,1164.15,71.26,1791.0,61
HCPCS,93018,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,469.5,305.17499999999995,1.1,807.0,96
HCPCS,93018,PRO FEE - CARDIAC STRESS TEST,26.0,16.9,1.1,47.05,50
HCPCS,93024,ERGONOVINE PROVOCATION TEST,,,368.71,1252.1,19
HCPCS,93024,Ergonovine provocation test,,,86.16,99.76,8
HCPCS,93025,MICROVOLT T-WAVE ASSESS,,,121.73,360.65,19
HCPCS,93025,Microvolt t-wave assess,,,68.77,79.63,8
HCPCS,93040,Rhythm ecg with report,,,18.66,21.6,8
HCPCS,93041,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,207.0,134.55,1.1,342.0,111
HCPCS,93041,TRANS-TELEPHONIC ARRHYTHMIA MONITORING,342.0,222.3,12.14,342.0,61
HCPCS,93042,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,66.0,42.9,1.1,66.0,50
HCPCS,93042,Rhythm ecg report,,,18.66,21.6,8
HCPCS,93042,TRANS-TELEPHONIC ARRHYTHMIA MONITORING,20.0,13.0,1.1,23.09,50
HCPCS,93050,ART PRESSURE WAVEFORM ANALYS,,,22.63,81.07,19
HCPCS,93050,Art pressure waveform analys,,,68.77,79.63,8
HCPCS,93145,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,596.5,387.72499999999997,1.1,907.0,90
HCPCS,93146,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,651.5,423.47499999999997,1.1,907.0,90
HCPCS,93150,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,503.5,327.275,1.1,633.0,113
HCPCS,93151,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,492.5,320.125,1.1,633.0,113
HCPCS,93152,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,1435.0,932.75,1.1,2069.0,113
HCPCS,93153,INTERROGATION WITHOUT PROGRAMMING IPNSS,411.0,267.15,1.1,633.0,113
HCPCS,93224,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,172.0,111.8,1.1,236.26,50
HCPCS,93224,Xtrnl ecg rec up to 48 hrs,,,68.77,79.63,8
HCPCS,93225,XTRNL ECG & 48 HR RECORDING,549.0,356.85,1.1,741.0,111
HCPCS,93226,EXTERNAL ECG SCANNING ANALYSIS REPORT,546.0,354.9,1.1,750.0,111
HCPCS,93227,PRO FEE - HOLTER MONITOR,46.25,30.06,1.1,61.85,50
HCPCS,93227,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,172.0,111.8,1.1,172.0,50
HCPCS,93227,Xtrnl ecg rec<48 hr r&i,,,68.77,79.63,8
HCPCS,93228,PF - MOBILE CARDIAC TELEMETRY,47.0,30.55,1.1,85.72,50
HCPCS,93228,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,211.0,137.15,1.1,211.0,50
HCPCS,93229,REMOTE 30 DAY ECG TECH SUPP,,,287.73,1045.9,19
HCPCS,93241,Xtrnl ecg rec>48hr<7d,,,68.77,79.63,8
HCPCS,93242,EXTERNAL ECG REC>48HR<7D RECORDING,277.0,180.05,1.1,328.0,111
HCPCS,93243,EXT ECG>48HR<7D SCAN A/R,,,119.1,372.91,19
HCPCS,93243,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,370.0,240.5,1.1,730.57,50
HCPCS,93243,Ext ecg>48hr<7d scan a/r,,,68.77,79.63,8
HCPCS,93244,EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION,200.0,130.0,1.1,200.0,50
HCPCS,93244,Ext ecg>48hr<7d rev&interpj,,,68.77,79.63,8
HCPCS,93245,EXTERNAL ECG REC>7D<15D SCAN ALYS REPORT R&I,220.0,143.0,1.1,893.75,50
HCPCS,93245,Ext ecg>7d<15d rec scan a/r,,,68.77,79.63,8
HCPCS,93246,EXTERNAL ECG REC>7D<15D RECORDING,277.0,180.05,1.1,328.0,111
HCPCS,93247,EXT ECG>7D<15D SCAN A/R,,,119.1,372.91,19
HCPCS,93247,EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT,370.0,240.5,1.1,767.95,50
HCPCS,93247,Ext ecg>7d<15d scan a/r,,,68.77,79.63,8
HCPCS,93248,EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION,242.0,157.3,1.1,242.0,50
HCPCS,93248,Ext ecg>7d<15d rev&interpj,,,68.77,79.63,8
HCPCS,93260,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,374.0,243.1,1.1,588.0,155
HCPCS,93261,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,326.0,211.9,1.1,540.0,201
HCPCS,93264,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,261.0,169.64999999999998,1.1,308.0,106
HCPCS,93268,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,208.0,135.2,1.1,575.22,50
HCPCS,93270,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,375.5,244.075,1.1,537.0,103
HCPCS,93271,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,528.0,343.2,84.81,528.0,53
HCPCS,93272,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,208.0,135.2,1.1,208.0,50
HCPCS,93278,ECG/SIGNAL-AVERAGED,,,54.88,165.35,19
HCPCS,93278,Ecg/signal-averaged,,,18.66,21.6,8
HCPCS,93279,PACEMAKER PROGRAMMING SINGLE,237.0,154.05,1.1,260.0,111
HCPCS,93279,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,260.0,169.0,1.1,474.0,155
HCPCS,93280,PACEMAKER PROGRAMMING DUAL,261.0,169.64999999999998,1.1,308.0,111
HCPCS,93280,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,308.0,200.2,1.1,522.0,216
HCPCS,93281,PACEMAKER PROGRAMMING MULT,294.0,191.1,1.1,374.0,111
HCPCS,93281,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,374.0,243.1,1.1,588.0,155
HCPCS,93282,DEFIBRILLATOR PROGRAMMING SINGLE,294.0,191.1,1.1,374.0,111
HCPCS,93282,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,374.0,243.1,1.1,588.0,216
HCPCS,93283,DEFIBRILLATOR PROGRAMMING DUAL,360.0,234.0,1.1,506.0,111
HCPCS,93283,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,506.0,328.9,1.1,720.0,216
HCPCS,93284,DEFIBRILLATOR PROGRAMMING MULT,382.0,248.3,1.1,550.0,111
HCPCS,93284,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,550.0,357.5,1.1,764.0,216
HCPCS,93285,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,214.0,139.1,1.1,422.0,155
HCPCS,93286,PACEMAKER PERI PROCEDURAL,217.0,141.05,1.1,302.0,96
HCPCS,93286,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,302.0,196.3,1.1,434.0,140
HCPCS,93287,DEFIBRILLATOR PERI PROCEDURAL,268.5,174.52499999999998,1.1,339.0,96
HCPCS,93287,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,339.0,220.35,1.1,537.0,140
HCPCS,93288,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,1.1,2453.0,216
HCPCS,93288,PACEMAKER INTERROGATION,193.0,125.44999999999999,1.1,214.0,111
HCPCS,93289,DEFIBRILLATOR INTERROGATION,330.0,214.5,1.1,544.0,155
HCPCS,93289,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,330.0,214.5,1.1,544.0,155
HCPCS,93290,INTERROG DEV EVAL ICPMS IP,,,34.46,104.61,19
HCPCS,93290,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,296.0,192.39999999999998,1.1,403.0,94
HCPCS,93290,Interrog dev eval icpms ip,,,18.13,20.99,8
HCPCS,93290,PHYSIOLOGICAL MONITOR INTERROGATION,189.0,122.85,1.1,189.0,50
HCPCS,93291,IMPLANTABLE LOOP RECORDER INTERROGATION,152.0,98.80000000000001,1.1,163.26,111
HCPCS,93291,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,163.0,105.95,1.1,304.0,155
HCPCS,93292,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,193.0,125.44999999999999,1.1,214.0,111
HCPCS,93292,WEARABLE DEFIBRILLATOR INTERROGATION,172.0,111.8,1.1,172.0,50
HCPCS,93293,TELEPHONIC MONITORING,175.0,113.75,1.1,214.0,111
HCPCS,93293,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,214.0,139.1,1.1,350.0,216
HCPCS,93294,REM INTERROG PM/LDLS PM <90 D PHYS/QHP,240.0,156.0,1.1,240.0,50
HCPCS,93294,Rem interrog evl pm/ldls pm,,,18.13,20.99,8
HCPCS,93295,Dev interrog remote 1/2/mlt,,,18.13,20.99,8
HCPCS,93295,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,326.0,211.9,1.1,326.0,50
HCPCS,93296,DEFIBRILLATOR HEART RHYTHM DATA PRO CODE,151.5,98.475,1.1,214.0,111
HCPCS,93296,PACEMAKER HEART RHYTHM DATA PRO CODE,214.0,139.1,18.13,214.0,61
HCPCS,93296,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,156.5,101.725,1.1,214.0,172
HCPCS,93297,REM INTERROG ICPMS <30 D PHYS/QHP,214.0,139.1,1.1,422.0,141
HCPCS,93298,REM INTERROG SCRMS <30 D PHYS /QHP (LOOP REMOTE),214.0,139.1,34.46,214.0,53
HCPCS,93298,REM INTERROG SCRMS <30 D PHYS/QHP,214.0,139.1,1.1,422.0,141
HCPCS,93303,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,1862.5,1210.625,1.1,3153.0,105
HCPCS,93304,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,1741.5,1131.975,1.1,3153.0,105
HCPCS,93306,ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST,3153.0,2049.45,280.48,3153.0,61
HCPCS,93306,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3153.0,2049.45,1.1,3795.0,216
HCPCS,93306,PRO FEE - ECHO COMPLETE,138.5,90.03,1.1,942.59,50
HCPCS,93307,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1390.0,903.5,1.1,1795.0,201
HCPCS,93308,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,1.1,1623.0,338
HCPCS,93308,PRO FEE - LIMITED 2D,45.0,29.25,1.1,417.54,50
HCPCS,93312,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,1.1,4165.0,262
HCPCS,93313,ECHO R-T 2D W/PROBE PLACEMENT ONLY,114.0,74.1,1.1,942.59,50
HCPCS,93313,ECHO TRANSESOPHAGEAL,,,506.62,1531.52,19
HCPCS,93313,Echo transesophageal,,,280.48,324.76,8
HCPCS,93314,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,814.0,529.1,1.1,814.0,50
HCPCS,93314,Echo transesophageal,,,280.48,324.76,8
HCPCS,93314,PRO FEE - TEE,160.0,104.0,1.1,749.78,50
HCPCS,93315,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,2168.5,1409.5249999999999,1.1,3153.0,99
HCPCS,93316,ECHO TRANSESOPHAGEAL,,,506.62,1531.52,19
HCPCS,93316,Echo transesophageal,,,280.48,324.76,8
HCPCS,93317,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,1.1,894.56,38
HCPCS,93317,Echo transesophageal,,,280.48,324.76,8
HCPCS,93318,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,2522.5,1639.625,1.1,4099.0,82
HCPCS,93318,ECHO TRANSESOPHAGEAL INTRAOP,,,506.62,1531.52,19
HCPCS,93318,Echo transesophageal intraop,,,280.48,324.76,8
HCPCS,93319,3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,518.0,336.7,40.85,518.0,46
HCPCS,93319,ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,220.0,143.0,1.1,220.0,52
HCPCS,93320,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,750.0,487.5,1.1,1333.0,90
HCPCS,93321,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,600.0,390.0,1.1,666.0,186
HCPCS,93325,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1066.0,692.9,1.1,1097.0,140
HCPCS,93350,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,1.1,3795.0,277
HCPCS,93351,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,1961.5,1274.975,1.1,3153.0,166
HCPCS,93352,Admin ecg contrast agent,,,280.48,324.76,8
HCPCS,93355,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,3049.0,1981.85,1.1,4048.0,142
HCPCS,93356,HOSPITAL MYOCRD STRAIN,69.0,44.85,15.04,324.76,46
HCPCS,93356,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,87.5,56.875,1.1,324.76,98
HCPCS,93451,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,18494.0,12021.1,1.1,19581.0,195
HCPCS,93452,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,10237.0,6654.05,1.1,18494.0,105
HCPCS,93453,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,18494.0,12021.1,1.1,21130.0,155
HCPCS,93454,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1518.51,18494.0,61
HCPCS,93454,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1.1,20492.0,134
HCPCS,93455,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,18494.0,12021.1,1.1,20822.0,155
HCPCS,93456,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,21090.0,155
HCPCS,93457,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,18494.0,12021.1,1546.13,18494.0,61
HCPCS,93457,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,12169.0,7909.849999999999,1.1,21416.0,94
HCPCS,93458,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,20958.0,195
HCPCS,93459,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,18494.0,12021.1,1.1,21288.0,155
HCPCS,93460,R & L HRT CATH WINJX HRT ART& L VENTR IMG,18494.0,12021.1,1.1,21618.0,195
HCPCS,93461,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,18494.0,12021.1,1.1,21948.0,155
HCPCS,93462,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,5567.0,3618.55,1.1,9996.0,96
HCPCS,93463,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,2705.0,1758.25,1.1,4530.0,142
HCPCS,93464,Exercise w/hemodynamic meas,,,86.16,99.76,8
HCPCS,93503,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,4906.0,3188.9,0.01,9996.0,172
HCPCS,93505,ENDOMYOCARDIAL BIOPSY,18098.0,11763.7,1.1,19911.0,155
HCPCS,93530,Rt heart cath congenital,,,1546.13,1790.26,8
HCPCS,93531,R & l heart cath congenital,,,1546.13,1790.26,8
HCPCS,93532,R & l heart cath congenital,,,1546.13,1790.26,8
HCPCS,93533,R & l heart cath congenital,,,1546.13,1790.26,8
HCPCS,93561,Cardiac output measurement,,,65.08,75.36,8
HCPCS,93562,Card output measure subsq,,,65.08,75.36,8
HCPCS,93563,Njx cgen car cth slctv c ang,,,65.08,75.36,8
HCPCS,93564,Njx cgen car cath slctv opac,,,65.08,75.36,8
HCPCS,93565,Njx car cth slctv lv/la ang,,,65.08,75.36,8
HCPCS,93566,Njx car cth slctv rv/ra ang,,,65.08,75.36,8
HCPCS,93567,NJX SUPRAVALV AORTOG HRT CATH W/S&I,2447.0,1590.55,1.1,10496.0,97
HCPCS,93568,Njx car cth nslc p-art angrp,,,65.08,75.36,8
HCPCS,93569,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,6622.5,4304.625,1.1,12902.0,96
HCPCS,93571,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,4625.0,3006.25,1.1,7735.57,128
HCPCS,93572,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,4750.0,3087.5,1.1,7719.15,128
HCPCS,93573,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,8880.5,5772.325,1.1,17189.0,96
HCPCS,93574,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,1000.5,650.325,1.1,3398.0,96
HCPCS,93575,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,2734.0,1777.1,1.1,4623.0,96
HCPCS,93580,CLSR ASD TX CATH W IMP,33856.0,22006.4,1590.58,51380.79,61
HCPCS,93580,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,20881.5,13572.975,1.1,51380.79,111
HCPCS,93581,TRANSCATH CLOSURE OF VSD,,,16591.65,51380.79,19
HCPCS,93581,Transcath closure of vsd,,,11343.93,13135.08,8
HCPCS,93582,PERQ TRANSCATH CLOSURE PDA,,,16591.65,51380.79,19
HCPCS,93582,Perq transcath closure pda,,,11343.93,13135.08,8
HCPCS,93583,Perq transcath septal reduxn,,,11343.93,13135.08,8
HCPCS,93584,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,30034.5,19522.425,1.1,59541.0,96
HCPCS,93585,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,30019.0,19512.350000000002,1.1,59541.0,96
HCPCS,93586,VENOGRAPHY CHD CORONARY SINUS,30085.0,19555.25,1.1,59541.0,96
HCPCS,93587,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,30234.5,19652.425,1.1,59541.0,96
HCPCS,93588,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,30239.0,19655.350000000002,1.1,59541.0,96
HCPCS,93590,PERQ TRANSCATH CLS MITRAL,,,16591.65,51380.79,19
HCPCS,93590,Perq transcath cls mitral,,,11343.93,13135.08,8
HCPCS,93591,PERQ TRANSCATH CLS AORTIC,,,16591.65,51380.79,19
HCPCS,93591,Perq transcath cls aortic,,,11343.93,13135.08,8
HCPCS,93592,Perq transcath closure each,,,11343.93,13135.08,8
HCPCS,93593,R HRT CATH CHD NML NT CNJ,,,2971.9,9086.64,19
HCPCS,93593,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,1596.0,1037.4,1.1,5564.16,26
HCPCS,93593,R hrt cath chd nml nt cnj,,,1546.13,1790.26,8
HCPCS,93594,R HRT CATH CHD ABNL NT CNJ,,,2971.9,9086.64,19
HCPCS,93594,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,2440.0,1586.0,1.1,5564.16,26
HCPCS,93594,R hrt cath chd abnl nt cnj,,,1546.13,1790.26,8
HCPCS,93595,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,2541.0,1651.65,1.1,5564.16,26
HCPCS,93595,L HRT CATH CHD NM/ABN NT CNJ,,,2971.9,9086.64,19
HCPCS,93595,L hrt cath chd nm/abn nt cnj,,,1546.13,1790.26,8
HCPCS,93596,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,2736.0,1778.4,1.1,5564.16,26
HCPCS,93596,R&L HRT CATH CHD NML NT CNJ,,,2971.9,9086.64,19
HCPCS,93596,R&l hrt cath chd nml nt cnj,,,1546.13,1790.26,8
HCPCS,93597,R&L HRT CATH CHD ABNL NT CNJ,,,2971.9,9086.64,19
HCPCS,93597,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,3552.0,2308.8,1.1,6276.37,26
HCPCS,93597,R&l hrt cath chd abnl nt cnj,,,1546.13,1790.26,8
HCPCS,93598,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,634.0,412.1,1.1,634.0,26
HCPCS,93598,Car outp meas drg cath chd,,,65.08,75.36,8
HCPCS,93600,BUNDLE OF HIS RECORDING,20747.0,13485.55,1.1,21861.27,143
HCPCS,93602,INTRA-ATRIAL RECORDING,43632.0,28360.8,1.1,44565.0,143
HCPCS,93603,RIGHT VENTRICULAR RECORDING,6980.0,4537.0,1.1,7913.0,143
HCPCS,93609,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,5963.0,3875.95,1.1,11141.72,128
HCPCS,93610,INTRA-ATRIAL PACING,43632.0,28360.8,1.1,44961.0,143
HCPCS,93612,INTRAVENTRICULAR PACING,43632.0,28360.8,1.1,44961.0,143
HCPCS,93613,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,7717.0,5016.049999999999,1.1,13342.0,142
HCPCS,93615,ESOPHAGEAL RECORDING,,,1121.7,3412.58,19
HCPCS,93615,Esophageal recording,,,1238.33,1433.86,8
HCPCS,93616,ESOPHAGEAL RECORDING W/PACG,,,1121.7,3412.58,19
HCPCS,93616,Esophageal recording w/pacg,,,1238.33,1433.86,8
HCPCS,93618,INDUCTION ARRHYTHMIA ELECTRICAL PACING,6980.0,4537.0,1.1,9329.0,143
HCPCS,93619,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,43632.0,28360.8,1.1,46632.0,143
HCPCS,93620,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,43632.0,28360.8,1.1,48613.0,143
HCPCS,93621,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,14588.0,9482.2,1.1,15248.0,128
HCPCS,93622,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,5913.5,3843.775,1.1,10514.0,90
HCPCS,93623,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,9664.0,6281.6,1.1,10095.0,128
HCPCS,93624,EP F-UP STUDY PACG&REC,,,7011.25,21861.27,19
HCPCS,93624,Ep f-up study pacg&rec,,,1238.33,1433.86,8
HCPCS,93631,INTRAOP EPICAR& ENDOCAR PACG& MAPG,3340.0,2171.0,1.1,3340.0,38
HCPCS,93631,Ntraop epicar&endcar pac&map,,,1238.33,1433.86,8
HCPCS,93640,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,3549.0,2306.85,528.09,9329.0,46
HCPCS,93641,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,1.1,9329.0,174
HCPCS,93642,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,6980.0,4537.0,1.1,9329.0,155
HCPCS,93644,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,1338.0,869.7,1.1,1338.0,44
HCPCS,93644,Ep eval subq impl dfb,,,1238.33,1433.86,8
HCPCS,93650,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,13093.5,8510.775,1.1,22091.0,111
HCPCS,93653,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,42613.5,27698.775,1.1,78627.0,111
HCPCS,93654,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,41384.5,26899.925,1.1,74805.0,111
HCPCS,93655,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,4648.5,3021.525,1.1,11141.72,96
HCPCS,93656,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,38554.0,25060.1,1.1,73260.44,111
HCPCS,93657,ABLATE L/R ATRIAL FIBRIL W/ ISOLATED PULM VEIN,2420.0,1573.0,1.1,2420.0,50
HCPCS,93657,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,6667.0,4333.55,498.09,11141.72,46
HCPCS,93660,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3051.0,1983.15,1.1,3883.0,155
HCPCS,93662,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,1.1,7507.0,174
HCPCS,93668,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,342.0,222.3,27.18,342.0,61
HCPCS,93701,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,741.0,481.65,49.1,741.0,61
HCPCS,93702,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,900.0,585.0,0.01,900.0,122
HCPCS,93724,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,1935.5,1258.0749999999998,1.1,2147.0,105
HCPCS,93740,TEMPERATURE GRADIENT STUDIES,,,121.73,360.65,19
HCPCS,93740,Temperature gradient studies,,,68.91,79.79,8
HCPCS,93745,SET-UP CARDIOVERT-DEFIBRILL,,,277.11,860.86,19
HCPCS,93745,Set-up cardiovert-defibrill,,,68.77,79.63,8
HCPCS,93750,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,528.0,343.2,18.13,528.0,61
HCPCS,93750,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,330.0,214.5,1.1,330.0,53
HCPCS,93770,Determination venous press,,,68.77,79.63,8
HCPCS,93784,AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R,167.0,108.55,1.1,167.0,44
HCPCS,93784,Ambl bp mntr w/software,,,68.77,79.63,8
HCPCS,93786,AMBL BP MNTR W/SW REC ONLY,,,119.1,372.91,19
HCPCS,93786,Ambl bp mntr w/sw rec only,,,68.77,79.63,8
HCPCS,93788,AMBL BP MNTR W/SW A/R,,,119.1,372.91,19
HCPCS,93788,Ambl bp mntr w/sw a/r,,,68.77,79.63,8
HCPCS,93790,Ambl bp mntr w/sw i&r,,,68.77,79.63,8
HCPCS,93792,PT/CAREGIVER TRAINJ FOR INITIATION HOME INR MNTR,535.0,347.75,1.1,535.0,50
HCPCS,93792,Pt/caregiver traing home inr,,,31.04,35.94,8
HCPCS,93793,ANTICOAGULANT MGMT FOR PT TAKING WARFARIN,79.0,51.35,1.1,79.0,50
HCPCS,93793,Anticoag mgmt pt warfarin,,,17.35,20.09,8
HCPCS,93797,REHAB CARD PHASE II,724.0,470.6,14.87,724.0,61
HCPCS,93798,FOLLOWUP REASSSESSMENT,724.0,470.6,23.57,724.0,61
HCPCS,93798,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,112.0,72.8,1.1,225.79,53
HCPCS,93798,REHAB CARD OP DEPT W ECG,724.0,470.6,23.57,724.0,61
HCPCS,93799,CARD PHASE III TO 3/WK,72.0,46.8,18.66,360.65,61
HCPCS,93799,CARDIOVASCULAR PROCEDURE,1145.0,744.25,18.66,3398.0,61
HCPCS,93799,ISOPROTERENOL CHALLENGE FOR PVC INDUCTION ONLY (COMP CODE 93623),9664.0,6281.6,18.66,9664.0,61
HCPCS,93799,PROCAINAMIDE INFUSION CHALLENGE,3823.0,2484.95,18.66,3823.0,61
HCPCS,93799,SMARTPHONE MONITORING 30 DAY,50.0,32.5,0.01,267.01,28
HCPCS,93799,SMARTPHONE MONITORING CHRONIC,20.0,13.0,0.01,267.01,28
HCPCS,93799,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",465.0,302.25,18.66,3398.0,61
HCPCS,93799,TELEMETRY,289.0,187.85,18.66,360.65,61
HCPCS,93799,UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE  (COMPARISON CODE 9,680.0,442.0,0.01,680.0,28
HCPCS,93799,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,700.0,455.0,0.01,700.0,28
HCPCS,93880,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1390.0,903.5,1.1,1742.0,155
HCPCS,93880,EXTRACRANIAL STUDY,53.0,34.45,1.1,622.04,50
HCPCS,93882,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,1.1,811.0,201
HCPCS,93886,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1390.0,903.5,1.1,1750.0,201
HCPCS,93888,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,466.0,302.9,1.1,611.0,105
HCPCS,93890,Tcd vasoreactivity study,,,77.56,89.8,8
HCPCS,93892,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,611.0,397.15,98.26,611.0,61
HCPCS,93893,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,611.0,397.15,77.56,611.0,61
HCPCS,93895,Carotid intima atheroma eval,,,77.56,89.8,8
HCPCS,93896,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,995.0,646.75,1.1,1634.0,89
HCPCS,93897,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,533.0,346.45,1.1,745.0,89
HCPCS,93898,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,559.5,363.675,1.1,745.0,89
HCPCS,93922,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,1.1,2453.0,384
HCPCS,93923,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,900.0,585.0,1.1,1098.0,155
HCPCS,93924,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,900.0,585.0,1.1,1100.0,201
HCPCS,93925,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,1.1,1710.0,155
HCPCS,93926,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,1.1,811.0,155
HCPCS,93930,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,1.1,1710.0,155
HCPCS,93931,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,1.1,811.0,155
HCPCS,93931,UPPER EXTREMITY STUDY,200.0,130.0,1.1,401.32,50
HCPCS,93970,DUP SCAN EXT VEIN BILAT,1390.0,903.5,119.27,1390.0,61
HCPCS,93970,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,975.0,633.75,1.1,1670.0,94
HCPCS,93970,EXTREMITY STUDY,57.0,37.05,1.1,612.29,50
HCPCS,93971,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,611.0,397.15,1.1,809.0,155
HCPCS,93971,EXTREMITY STUDY,36.0,23.4,1.1,387.98,50
HCPCS,93975,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1325.5,861.575,1.1,1900.0,262
HCPCS,93976,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,588.5,382.525,1.1,963.0,262
HCPCS,93978,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1390.0,903.5,1.1,1742.0,155
HCPCS,93979,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,611.0,397.15,1.1,831.0,155
HCPCS,93980,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,805.5,523.575,1.1,1111.0,94
HCPCS,93980,PENILE VASCULAR STUDY,,,98.26,293.03,19
HCPCS,93980,Penile vascular study,,,119.27,138.11,8
HCPCS,93981,PENILE VASCULAR STUDY,,,98.26,293.03,19
HCPCS,93981,Penile vascular study,,,77.56,89.8,8
HCPCS,93985,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1390.0,903.5,1.1,1710.0,140
HCPCS,93985,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1390.0,903.5,77.56,1390.0,61
HCPCS,93986,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,611.0,397.15,1.1,811.0,140
HCPCS,93986,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,611.0,397.15,77.56,611.0,61
HCPCS,93990,DOPPLER FLOW TESTING,228.0,148.2,1.1,418.04,50
HCPCS,93990,DUPLEX SCAN HEMODIALYSIS ACCESS,611.0,397.15,1.1,811.0,201
HCPCS,93998,PHLEBOTEST EXTREMITY STUDY,154.0,100.1,22.63,154.0,61
HCPCS,93998,US TEMPORAL ARTERIES (COMP CODE 93880),803.0,521.95,0.01,1261.0,90
HCPCS,94002,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,1958.5,1273.025,1.1,3041.0,111
HCPCS,94003,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,1822.0,1184.3,1.1,3041.0,111
HCPCS,94004,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,400.0,260.0,1.1,400.0,44
HCPCS,94004,Vent mgmt nf per day,,,540.38,625.7,8
HCPCS,94010,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,720.0,468.0,1.1,795.0,155
HCPCS,94011,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT-2 YR,700.0,455.0,1.1,700.0,50
HCPCS,94011,SPIROMETRY UP TO 2 YRS OLD,,,121.73,360.65,19
HCPCS,94011,Spirometry up to 2 yrs old,,,51.58,59.72,8
HCPCS,94012,SPIRMTRY W/BRNCHDIL INF-2 YR,,,204.28,605.2,19
HCPCS,94012,Spirmtry w/brnchdil inf-2 yr,,,101.57,117.61,8
HCPCS,94013,MEAS LUNG VOL THRU 2 YRS,,,353.04,1045.9,19
HCPCS,94013,Meas lung vol thru 2 yrs,,,101.57,117.61,8
HCPCS,94014,PATIENT RECORDED SPIROMETRY,,,368.71,1252.1,19
HCPCS,94014,Patient recorded spirometry,,,101.57,117.61,8
HCPCS,94015,PATIENT-INITIATED SPIROMETRIC RECORDING,1432.0,930.8,59.75,1432.0,61
HCPCS,94016,REVIEW PATIENT SPIROMETRY,,,31.91,91.82,22
HCPCS,94016,Review patient spirometry,,,51.58,59.72,8
HCPCS,94060,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1432.0,930.8,1.1,1529.0,155
HCPCS,94070,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1432.0,930.8,1.1,1672.0,155
HCPCS,94150,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,720.0,468.0,1.1,748.0,133
HCPCS,94200,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,273.0,177.45,26.69,273.0,61
HCPCS,94250,Expired gas collection,,,51.58,59.72,8
HCPCS,94375,RESPIRATORY FLOW VOLUME LOOP,124.0,80.6,1.1,605.2,69
HCPCS,94375,Respiratory flow volume loop,,,101.57,117.61,8
HCPCS,94400,Co2 breathing response curve,,,51.58,59.72,8
HCPCS,94450,BREATHING RESPONSE HYPOXIA,,,121.73,360.65,19
HCPCS,94450,BREATHING RESPONSE TO HYPOXIA,720.0,468.0,1.1,844.0,140
HCPCS,94450,Breathing response hypoxia,,,51.58,59.72,8
HCPCS,94452,HAST W/I&R PHYS/QHP,,,119.1,372.91,19
HCPCS,94452,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,432.5,281.125,1.1,729.0,94
HCPCS,94452,Hast w/i&r phys/qhp,,,51.58,59.72,8
HCPCS,94453,HAST W/SUPPL OXYGEN TITRJ,,,119.1,372.91,19
HCPCS,94453,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,472.5,307.125,1.1,769.0,94
HCPCS,94453,Hast w/suppl oxygen titrj,,,51.58,59.72,8
HCPCS,94610,INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP,498.0,323.7,51.58,613.76,61
HCPCS,94617,EXERCISE TST BRNCSPSM W/ECG,,,119.1,372.91,19
HCPCS,94617,Exercise tst brncspsm w/ecg,,,51.58,59.72,8
HCPCS,94617,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,604.5,392.92499999999995,1.1,901.0,94
HCPCS,94618,PULMONARY STRESS TEST (6-MINUTE WALK) INTERP ONLY,192.0,124.8,1.1,218.62,50
HCPCS,94618,PULMONARY STRESS TESTING,593.0,385.45,1.1,785.0,155
HCPCS,94619,EXERCISE TST BRNCSPSM WO ECG,,,54.88,165.35,19
HCPCS,94619,Exercise tst brncspsm wo ecg,,,51.58,59.72,8
HCPCS,94619,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,332.5,216.125,1.1,469.0,94
HCPCS,94621,CARDIOPULMONARY EXERCISE TESTING,1432.0,930.8,1.1,2000.0,201
HCPCS,94625,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,215.5,140.075,1.1,273.0,113
HCPCS,94626,PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,273.0,177.45,27.26,273.0,61
HCPCS,94640,DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,2901.0,1885.65,14.65,2901.0,61
HCPCS,94640,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,545.0,354.25,1.1,936.0,172
HCPCS,94642,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,647.5,420.875,1.1,936.0,93
HCPCS,94644,CONTINUOUS INHALATION TREATMENT 1ST HR,593.0,385.45,51.58,593.0,61
HCPCS,94645,CONTINUOUS INHALATION TREATMENT EA ADDL HR,162.0,105.3,31.56,162.0,46
HCPCS,94660,CPAP VENTILATION CPAP INITIATION&MGMT,936.0,608.4,64.26,936.0,61
HCPCS,94662,NEG PRESS VENTILATION CNP,,,610.84,659.71,6
HCPCS,94662,Neg press ventilation cnp,,,540.38,625.7,8
HCPCS,94664,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,530.0,344.5,1.1,936.0,172
HCPCS,94667,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,593.0,385.45,46.84,593.0,61
HCPCS,94668,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,593.0,385.45,51.58,593.0,61
HCPCS,94669,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,936.0,608.4,38.7,936.0,61
HCPCS,94680,O2 UPTK RST&XERS DIR SIMPLE,,,121.73,360.65,19
HCPCS,94680,O2 uptk rst&xers dir simple,,,51.58,59.72,8
HCPCS,94681,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1432.0,930.8,1.1,1520.0,155
HCPCS,94690,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,28.0,18.2,1.1,152.71,50
HCPCS,94690,O2 UPTK REST INDIRECT,,,54.88,165.35,19
HCPCS,94690,O2 uptk rest indirect,,,51.58,59.72,8
HCPCS,94726,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1432.0,930.8,1.1,1546.0,155
HCPCS,94727,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,720.0,468.0,51.58,720.0,61
HCPCS,94727,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,474.0,308.1,1.1,834.0,94
HCPCS,94728,AIRWY RESIST BY OSCILLOMETRY,,,121.73,360.65,19
HCPCS,94728,Airwy resist by oscillometry,,,101.57,117.61,8
HCPCS,94729,CO DIFFUSING CAPACITY,605.0,393.25,51.58,605.0,46
HCPCS,94729,DIFFUSING CAPACITY,378.5,246.02499999999998,1.1,681.0,94
HCPCS,94750,Pulmonary compliance study,,,51.58,59.72,8
HCPCS,94760,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,234.0,152.1,1.1,348.0,136
HCPCS,94761,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,273.0,177.45,1.1,348.0,136
HCPCS,94762,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,720.0,468.0,45.97,720.0,122
HCPCS,94770,Exhaled carbon dioxide test,,,51.58,59.72,8
HCPCS,94772,CIRCADIAN RESPIR PATTERN REC,,,353.04,1045.9,19
HCPCS,94772,Circadian respir pattern rec,,,101.57,117.61,8
HCPCS,94774,Ped home apnea mntr evnt rec,,,51.58,59.72,8
HCPCS,94775,PED HOME APNEA MNTR ATT ONLY,,,121.73,360.65,19
HCPCS,94775,Ped home apnea mntr att only,,,51.58,59.72,8
HCPCS,94776,PED HOME APNEA MNTR DL&ALYS,,,121.73,360.65,19
HCPCS,94776,Ped home apnea mntr dl&alys,,,51.58,59.72,8
HCPCS,94777,Ped home apnea mntr rvw i&r,,,51.58,59.72,8
HCPCS,94780,CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN,181.0,117.65,35.34,181.0,61
HCPCS,94781,CAR SEAT/BED TEST INFT THRU 12 MO EA ADDL 30 MIN,141.0,91.65,14.22,141.0,46
HCPCS,94799,CAR SEAT CHALLENGE,110.0,71.5,31.11,360.65,61
HCPCS,94799,MINI-BAL RT,432.0,280.8,51.58,432.0,61
HCPCS,94799,PEP THERAPY,113.0,73.45,31.96,360.65,61
HCPCS,94799,RESPIRATORY THERAPY EVAL-HOSP,314.0,204.1,51.58,360.65,61
HCPCS,94799,RT DAILY ASSESSMENT,483.0,313.95,51.58,483.0,61
HCPCS,94799,RT MONITORING TRANSPORT,486.0,315.9,51.58,486.0,61
HCPCS,95004,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,1.1,2406.92,103
HCPCS,95012,NITRIC OXIDE EXPIRED GAS DETERMINATION,94.5,61.425,1.1,118.0,111
HCPCS,95017,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,28.0,18.2,1.1,50.18,53
HCPCS,95017,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,73.0,47.45,6.26,141.96,61
HCPCS,95018,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,165.0,107.25,1.1,165.0,53
HCPCS,95018,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,165.0,107.25,12.25,165.0,61
HCPCS,95024,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,0.62,165.35,114
HCPCS,95027,IQ TSTS SEQL&INCRL AIRBORNE,,,22.63,81.07,19
HCPCS,95027,Iq tsts seql&incrl airborne,,,122.6,141.96,8
HCPCS,95028,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,48.0,31.2,1.1,68.1,50
HCPCS,95028,IQ TSTS ALLERGY DELAYED RXN,,,35.34,104.69,19
HCPCS,95028,Iq tsts allergy delayed rxn,,,122.6,141.96,8
HCPCS,95044,PATCH TEST(S) SPECIFY NUMBER,408.0,265.2,1.1,1784.83,50
HCPCS,95044,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,408.0,265.2,9.01,2406.92,53
HCPCS,95052,PHOTO PATCH TESTS,,,54.88,165.35,19
HCPCS,95052,Photo patch tests,,,122.6,141.96,8
HCPCS,95056,PHOTO TESTS,,,119.1,372.91,19
HCPCS,95060,OPH MUCOUS MEMBRANE TESTS,,,119.1,372.91,19
HCPCS,95065,DIR NSL MUCOUS MEMBRANE TEST,,,35.34,104.69,19
HCPCS,95065,Dir nsl mucous membrane test,,,122.6,141.96,8
HCPCS,95070,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1592.0,1034.8,65.24,1592.0,106
HCPCS,95071,Bronchial allergy tests,,,122.6,141.96,8
HCPCS,95076,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,1126.0,731.9,1.1,1592.0,114
HCPCS,95079,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,441.5,286.975,1.1,607.0,99
HCPCS,95115,IMMUNOTHERAPY 1 INJ,138.0,89.7,15.75,138.0,61
HCPCS,95115,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,60.0,39.0,1.1,80.64,50
HCPCS,95117,IMMUNOTHERAPY>=2 INJ,198.0,128.7,15.75,198.0,61
HCPCS,95117,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,198.0,128.7,1.1,198.0,50
HCPCS,95120,Immunotherapy one injection,,,15.75,18.24,8
HCPCS,95125,Immunotherapy 2/> injections,,,15.75,18.24,8
HCPCS,95130,Immntx 1 sting insect,,,15.75,18.24,8
HCPCS,95131,Immntx 2 sting insects,,,15.75,18.24,8
HCPCS,95132,Immntx 3 sting insects,,,15.75,18.24,8
HCPCS,95133,Immntx 4 sting insects,,,15.75,18.24,8
HCPCS,95134,Immntx 5 sting insects,,,15.75,18.24,8
HCPCS,95144,ANTIGEN THERAPY SERVICES,,,42.63,131.25,19
HCPCS,95144,Antigen therapy services,,,15.75,18.24,8
HCPCS,95145,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,24.0,15.6,1.1,106.53,53
HCPCS,95145,VENOM INSECT 1 VIAL,138.0,89.7,5.6,138.0,61
HCPCS,95146,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,24.0,15.6,1.1,195.15,53
HCPCS,95146,VENOM MULTIDOSE 2 VIAL,138.0,89.7,5.6,138.0,61
HCPCS,95147,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,24.0,15.6,1.1,188.72,53
HCPCS,95147,VENOM MULTIDOSE 3 VIAL,214.0,139.1,5.6,214.0,61
HCPCS,95148,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,24.0,15.6,1.1,278.42,53
HCPCS,95148,VENOM MULTIDOSE 4 VIAL,214.0,139.1,5.6,214.0,61
HCPCS,95149,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,24.0,15.6,1.1,368.12,53
HCPCS,95149,VENOM MULTIDOSE 5 VIAL,214.0,139.1,5.6,214.0,61
HCPCS,95165,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,1.1,131.25,114
HCPCS,95170,ANTIGEN THERAPY SERVICES,,,42.63,131.25,19
HCPCS,95170,Antigen therapy services,,,15.75,18.24,8
HCPCS,95180,RAPID DESENSITIZATION PROCEDURE EACH HOUR,1000.5,650.325,1.1,1252.1,106
HCPCS,95199,UNLISTED ALL/IMMLG SVC/PX,,,22.63,81.07,19
HCPCS,95199,Unlisted all/immlg svc/px,,,122.6,141.96,8
HCPCS,95249,CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT,238.0,154.7,31.04,238.0,61
HCPCS,95250,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,454.0,295.1,1.1,515.0,111
HCPCS,95251,CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,280.0,182.0,1.1,280.0,50
HCPCS,95251,Cont gluc mntr analysis i&r,,,68.77,79.63,8
HCPCS,95700,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,869.5,565.175,1.1,1080.0,99
HCPCS,95705,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,1772.5,1152.125,1.1,2149.0,99
HCPCS,95706,EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,2149.0,1396.85,167.47,2149.0,61
HCPCS,95707,EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,2149.0,1396.85,167.47,2149.0,61
HCPCS,95708,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,2528.5,1643.525,1.1,3661.0,99
HCPCS,95709,EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,3661.0,2379.65,353.04,3661.0,61
HCPCS,95710,EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,3661.0,2379.65,353.04,3661.0,61
HCPCS,95711,VEEG BY TECH 2-12 HOURS UNMONITORED,2381.5,1547.975,1.1,2614.0,99
HCPCS,95712,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2381.5,1547.975,1.1,2614.0,99
HCPCS,95713,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,3137.5,2039.375,1.1,3661.0,99
HCPCS,95714,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,3137.5,2039.375,1.1,3661.0,99
HCPCS,95715,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,3137.5,2039.375,1.1,3661.0,99
HCPCS,95716,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,4817.0,3131.05,1.1,7020.0,99
HCPCS,95717,EEG PHYS/QHP 2-12 HR WITHOUT VIDEO,880.0,572.0,1.1,880.0,52
HCPCS,95717,Eeg phys/qhp 2-12 hr w/o vid,,,167.47,193.91,8
HCPCS,95718,EEG PHYS/QHP 2-12 HR WITH VEEG,1100.0,715.0,1.1,1100.0,52
HCPCS,95718,Eeg phys/qhp 2-12 hr w/veeg,,,167.47,193.91,8
HCPCS,95719,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID,1320.0,858.0,1.1,1320.0,52
HCPCS,95719,Eeg phys/qhp ea incr w/o vid,,,167.47,193.91,8
HCPCS,95720,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG,1698.0,1103.7,1.1,1698.0,52
HCPCS,95720,Eeg phy/qhp ea incr w/veeg,,,167.47,193.91,8
HCPCS,95721,Eeg phy/qhp>36<60 hr w/o vid,,,167.47,193.91,8
HCPCS,95722,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG,2068.0,1344.2,1.1,2068.0,52
HCPCS,95722,Eeg phy/qhp>36<60 hr w/veeg,,,552.3,639.51,8
HCPCS,95723,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO,2090.0,1358.5,1.1,2090.0,52
HCPCS,95723,Eeg phy/qhp>60<84 hr w/o vid,,,552.3,639.51,8
HCPCS,95724,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG,2640.0,1716.0,1.1,2640.0,52
HCPCS,95724,Eeg phy/qhp>60<84 hr w/veeg,,,552.3,639.51,8
HCPCS,95725,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/O VID,2376.0,1544.4,1.1,2376.0,52
HCPCS,95725,Eeg phy/qhp>84 hr w/o vid,,,552.3,639.51,8
HCPCS,95726,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/VEEG,3335.0,2167.75,1.1,3335.0,52
HCPCS,95726,Eeg phy/qhp>84 hr w/veeg,,,552.3,639.51,8
HCPCS,95782,POLYSOM <6 YRS 4/> PARAMTRS,,,812.43,2406.92,19
HCPCS,95783,POLYSOM <6 YRS CPAP/BILVL,,,812.43,2406.92,19
HCPCS,95800,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,340.0,221.0,1.1,485.0,50
HCPCS,95800,SLP STDY UNATTENDED,,,144.57,605.2,19
HCPCS,95800,Slp stdy unattended,,,68.51,79.33,8
HCPCS,95801,SLP STDY UNATND W/ANAL,,,54.88,165.35,19
HCPCS,95801,Slp stdy unatnd w/anal,,,68.51,79.33,8
HCPCS,95803,ACTIGRAPHY TESTING,,,54.88,165.35,19
HCPCS,95803,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,360.0,234.0,1.1,452.94,50
HCPCS,95803,Actigraphy testing,,,68.77,79.63,8
HCPCS,95805,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,3661.0,2379.65,1.1,4189.0,147
HCPCS,95806,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,1.1,1489.0,323
HCPCS,95807,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,3661.0,2379.65,1.1,4224.0,147
HCPCS,95808,POLYSOM ANY AGE 1-3> PARAM,,,812.43,2406.92,19
HCPCS,95808,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,766.0,497.9,1.1,766.0,44
HCPCS,95810,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,8120.0,200
HCPCS,95811,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,8164.0,200
HCPCS,95812,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2149.0,1396.85,1.1,2581.0,201
HCPCS,95813,EEG EXTENDED MONITORING 61-119 MINUTES,2149.0,1396.85,1.1,2801.0,201
HCPCS,95816,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2149.0,1396.85,1.1,2624.0,201
HCPCS,95819,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2149.0,1396.85,1.1,2624.0,155
HCPCS,95822,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2149.0,1396.85,1.1,2624.0,201
HCPCS,95824,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,1978.5,1286.025,1.1,3661.0,105
HCPCS,95829,Surgery electrocorticogram,,,167.47,193.91,8
HCPCS,95830,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,868.0,564.2,0.01,868.0,46
HCPCS,95836,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,792.0,514.8,1.1,792.0,50
HCPCS,95836,ECOG IMPLTD BRN NPGT <30 D,,,34.46,104.61,19
HCPCS,95851,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI,67.0,43.55,9.27,239.0,120
HCPCS,95852,ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID,63.0,40.95,6.76,239.0,120
HCPCS,95857,CHOLINESTERASE CHALLENGE,,,204.28,605.2,19
HCPCS,95857,CHOLINESTERASE INHIBITOR CHALLENGE TEST,212.0,137.8,1.1,535.81,53
HCPCS,95857,Cholinesterase challenge,,,310.96,360.06,8
HCPCS,95860,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,1.1,1273.0,155
HCPCS,95861,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,1.1,1505.0,155
HCPCS,95863,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,748.0,486.2,1.1,748.0,50
HCPCS,95863,NEEDLE EMG 3 EXTREMITIES,,,121.73,360.65,19
HCPCS,95863,Needle emg 3 extremities,,,310.96,360.06,8
HCPCS,95864,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,1.1,1876.0,155
HCPCS,95865,NEEDLE ELECTROMYOGRAPHY LARYNX,1072.5,697.125,1.1,1517.0,94
HCPCS,95865,NEEDLE EMG LARYNX,,,119.1,372.91,19
HCPCS,95865,Needle emg larynx,,,310.96,360.06,8
HCPCS,95866,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1040.0,676.0,1.1,1580.0,94
HCPCS,95866,NEEDLE EMG HEMIDIAPHRAGM,,,121.73,360.65,19
HCPCS,95866,Needle emg hemidiaphragm,,,310.96,360.06,8
HCPCS,95867,NDL EMG CRANIAL NRV MUSC UNI,,,204.28,605.2,19
HCPCS,95867,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,1390.5,903.825,1.1,2465.0,94
HCPCS,95867,Ndl emg cranial nrv musc uni,,,310.96,360.06,8
HCPCS,95868,NDL EMG CRANIAL NRV MUSC BI,,,204.28,605.2,19
HCPCS,95868,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,1546.5,1005.225,1.1,2621.0,94
HCPCS,95868,Ndl emg cranial nrv musc bi,,,310.96,360.06,8
HCPCS,95869,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2149.0,1396.85,1.1,2297.0,155
HCPCS,95870,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,889.0,577.85,1.1,1037.0,155
HCPCS,95872,NDL EMG SINGLE FIBER ELTRD,,,144.57,605.2,19
HCPCS,95872,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1692.0,1099.8,1.1,2232.0,94
HCPCS,95872,Ndl emg single fiber eltrd,,,310.96,360.06,8
HCPCS,95873,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,200.5,130.325,1.1,238.0,94
HCPCS,95873,Guide nerv destr elec stim,,,229.66,265.93,8
HCPCS,95874,NEEDLE EMG GUID W/CHEMODENERVATION,782.0,508.3,132.01,782.0,46
HCPCS,95874,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,554.0,360.1,1.1,945.0,94
HCPCS,95875,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,440.0,286.0,1.1,447.9,50
HCPCS,95875,LIMB EXERCISE TEST,,,121.73,360.65,19
HCPCS,95875,Limb exercise test,,,310.96,360.06,8
HCPCS,95885,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,997.0,648.05,1.1,1137.0,140
HCPCS,95886,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,922.0,599.3,1.1,1466.0,140
HCPCS,95887,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,558.0,362.7,1.1,870.0,140
HCPCS,95905,MOTOR &/ SENS NRVE CNDJ TEST,,,368.71,1252.1,19
HCPCS,95905,Motor &/ sens nrve cndj test,,,310.96,360.06,8
HCPCS,95907,NERVE CONDUCTION STUDIES 1-2 STUDIES,1080.0,702.0,1.1,1520.0,155
HCPCS,95908,NERVE CONDUCTION STUDIES 3-4 STUDIES,2149.0,1396.85,1.1,2699.0,155
HCPCS,95909,NERVE CONDUCTION STUDIES 5-6 STUDIES,2149.0,1396.85,1.1,2809.0,155
HCPCS,95910,NERVE CONDUCTION STUDIES 7-8 STUDIES,2149.0,1396.85,1.1,3029.0,155
HCPCS,95911,NERVE CONDUCTION STUDIES 9-10 STUDIES,3661.0,2379.65,1.1,4761.0,155
HCPCS,95912,NERVE CONDUCTION STUDIES 11-12 STUDIES,3661.0,2379.65,1.1,4981.0,155
HCPCS,95913,NERVE CONDUCTION STUDIES 13/> STUDIES,3661.0,2379.65,1.1,5227.0,155
HCPCS,95919,QUAN PUPLMTRY PHY/QHP UNI/BI,,,119.1,372.91,19
HCPCS,95919,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,72.0,46.8,1.1,218.62,50
HCPCS,95919,Quan puplmtry phy/qhp uni/bi,,,310.96,360.06,8
HCPCS,95921,AUTONOMIC NRV PARASYM INERVJ,,,121.73,360.65,19
HCPCS,95921,Autonomic nrv parasym inervj,,,310.96,360.06,8
HCPCS,95921,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,900.0,585.0,1.1,1440.0,94
HCPCS,95922,AUTONOMIC NRV ADRENRG INERVJ,,,119.1,372.91,19
HCPCS,95922,Autonomic nrv adrenrg inervj,,,310.96,360.06,8
HCPCS,95922,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,828.5,538.525,1.1,1273.0,94
HCPCS,95923,AUTONOMIC NRV SYST FUNJ TEST,,,119.1,372.91,19
HCPCS,95923,Autonomic nrv syst funj test,,,310.96,360.06,8
HCPCS,95924,ANS PARASYMP & SYMP W/TILT,,,204.28,605.2,19
HCPCS,95924,Ans parasymp & symp w/tilt,,,310.96,360.06,8
HCPCS,95925,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2149.0,1396.85,204.28,2149.0,61
HCPCS,95926,SOMATOSENSORY TESTING,,,204.28,605.2,19
HCPCS,95926,Somatosensory testing,,,310.96,360.06,8
HCPCS,95927,SOMATOSENSORY TESTING,,,204.28,605.2,19
HCPCS,95927,Somatosensory testing,,,310.96,360.06,8
HCPCS,95928,C MOTOR EVOKED UPPR LIMBS,,,812.43,2406.92,19
HCPCS,95928,C motor evoked uppr limbs,,,310.96,360.06,8
HCPCS,95929,C MOTOR EVOKED LWR LIMBS,,,353.04,1045.9,19
HCPCS,95929,C motor evoked lwr limbs,,,310.96,360.06,8
HCPCS,95930,VISUAL EP TEST CNS W/I&R,,,204.28,605.2,19
HCPCS,95930,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2149.0,1396.85,1.1,2289.0,140
HCPCS,95930,Visual ep test cns w/i&r,,,310.96,360.06,8
HCPCS,95933,BLINK REFLEX TEST,,,54.88,165.35,19
HCPCS,95933,Blink reflex test,,,38.61,44.7,8
HCPCS,95933,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,441.0,286.65,1.1,646.0,94
HCPCS,95937,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1080.0,702.0,1.1,1340.0,201
HCPCS,95938,SOMATOSENSORY TESTING,,,490.26,2406.92,19
HCPCS,95938,Somatosensory testing,,,310.96,360.06,8
HCPCS,95939,C MOTOR EVOKED UPR&LWR LIMBS,,,812.43,2406.92,19
HCPCS,95939,C motor evoked upr&lwr limbs,,,310.96,360.06,8
HCPCS,95940,Ionm in operatng room 15 min,,,321.96,372.8,8
HCPCS,95941,Ionm remote/>1 pt or per hr,,,321.96,372.8,8
HCPCS,95943,Parasymp&symp hrt rate test,,,310.96,360.06,8
HCPCS,95954,EEG MONITORING/GIVING DRUGS,,,353.04,1045.9,19
HCPCS,95954,Eeg monitoring/giving drugs,,,167.47,193.91,8
HCPCS,95955,EEG NONINTRACRANIAL SURGERY,1193.0,775.45,1.1,1597.0,186
HCPCS,95957,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,1.1,900.29,50
HCPCS,95957,Eeg digital analysis,,,18.13,20.99,8
HCPCS,95958,EEG MONITORING/FUNCTION TEST,,,812.43,2406.92,19
HCPCS,95958,Eeg monitoring/function test,,,167.47,193.91,8
HCPCS,95961,ELECTRODE STIMULATION BRAIN,,,812.43,2406.92,19
HCPCS,95961,Electrode stimulation brain,,,167.47,193.91,8
HCPCS,95961,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,4698.0,3053.7,1.1,8208.0,94
HCPCS,95962,Electrode stim brain add-on,,,167.47,193.91,8
HCPCS,95965,MEG SPONTANEOUS,,,812.43,2406.92,19
HCPCS,95965,Meg spontaneous,,,933.92,1081.38,8
HCPCS,95966,MEG EVOKED SINGLE,,,812.43,2406.92,19
HCPCS,95966,Meg evoked single,,,933.92,1081.38,8
HCPCS,95967,Meg evoked each addl,,,933.92,1081.38,8
HCPCS,95970,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,521.5,338.975,1.1,889.0,114
HCPCS,95971,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,488.0,317.2,1.1,633.0,114
HCPCS,95972,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,492.5,320.125,1.1,633.0,114
HCPCS,95976,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,289.0,187.85000000000002,1.1,321.0,114
HCPCS,95977,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,510.5,331.825,1.1,633.0,114
HCPCS,95980,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,320.0,208.0,1.1,320.0,50
HCPCS,95980,Io anal gast n-stim init,,,73.53,85.14,8
HCPCS,95981,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,120.0,78.0,1.1,126.95,53
HCPCS,95981,IO ANAL GAST N-STIM SUBSQ,,,54.88,165.35,19
HCPCS,95981,Io anal gast n-stim subsq,,,18.13,20.99,8
HCPCS,95982,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,260.0,169.0,1.1,260.0,53
HCPCS,95982,IO GA N-STIM SUBSQ W/REPROG,,,34.46,104.61,19
HCPCS,95982,Io ga n-stim subsq w/reprog,,,18.13,20.99,8
HCPCS,95983,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,516.5,335.725,1.1,633.0,114
HCPCS,95984,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,355.5,231.075,1.1,359.0,99
HCPCS,95990,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,217.0,141.05,1.1,578.82,50
HCPCS,95990,SPIN/BRAIN PUMP REFIL & MAIN,,,306.47,925.8,19
HCPCS,95990,Spin/brain pump refil & main,,,36.15,41.86,8
HCPCS,95991,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,339.0,220.35,1.1,505.34,53
HCPCS,95991,SPIN/BRAIN PUMP REFIL & MAIN,,,272.75,860.34,19
HCPCS,95991,Spin/brain pump refil & main,,,36.15,41.86,8
HCPCS,95992,CANALITH REPOSITIONING PROCEDURE,270.0,175.5,1.1,300.0,173
HCPCS,95999,UNLISTED NEUROLOGICAL DX PX,,,121.73,360.65,19
HCPCS,95999,Unlisted neurological dx px,,,310.96,360.06,8
HCPCS,96000,MOTION ANALYSIS VIDEO/3D,,,353.04,1045.9,19
HCPCS,96000,Motion analysis video/3d,,,310.96,360.06,8
HCPCS,96001,MOTION TEST W/FT PRESS MEAS,,,812.43,2406.92,19
HCPCS,96001,Motion test w/ft press meas,,,310.96,360.06,8
HCPCS,96002,DYNAMIC SURFACE EMG,,,204.28,605.2,19
HCPCS,96002,Dynamic surface emg,,,310.96,360.06,8
HCPCS,96003,Dynamic fine wire emg,,,310.96,360.06,8
HCPCS,96004,Phys review of motion tests,,,321.96,372.8,8
HCPCS,96020,Functional brain mapping,,,163.81,189.67,8
HCPCS,96040,Genetic counseling 30 min,,,54.56,63.17,8
HCPCS,96041,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,465.0,302.25,0.01,650.0,77
HCPCS,96105,ASSESS APHASIA PER HR,480.0,312.0,124.17,480.0,60
HCPCS,96105,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,700.0,455.0,1.1,700.0,50
HCPCS,96110,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,176.0,114.4,1.1,316.0,131
HCPCS,96110,DEVELOPMENTAL TEST LIMITED,316.0,205.4,47.02,316.0,46
HCPCS,96110,"SLT-DEVELOPMENTAL TEST,LIM",316.0,205.4,47.02,316.0,46
HCPCS,96112,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,122
HCPCS,96112,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1052.0,683.8,1.1,1080.0,114
HCPCS,96113,DEVEL TST PHYS/QHP EA ADDL,291.5,189.47500000000002,1.1,302.0,99
HCPCS,96113,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,383.0,248.95000000000002,1.1,464.0,99
HCPCS,96116,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,1446.5,940.2249999999999,1.1,2149.0,114
HCPCS,96121,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,571.0,371.15,1.1,752.0,99
HCPCS,96125,COGNITIVE TEST BY HC PRO,662.0,430.3,129.95,662.0,60
HCPCS,96125,COGNITIVE TEST BY HCPRO GN,662.0,430.3,129.95,662.0,60
HCPCS,96125,STANDARDIZED COGNITIVE PERFORMANCE TESTING,671.0,436.15,1.1,680.0,110
HCPCS,96127,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,66.0,42.9,1.1,104.69,111
HCPCS,96127,DEPRESSION SCREENING AUTO BILLING,66.0,42.9,1.1,68.1,50
HCPCS,96127,VIRTUAL BRIEF EMOTIONAL/BEHAV ASSMT,66.0,42.9,6.18,104.69,61
HCPCS,96130,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1030.0,669.5,1.1,1126.0,114
HCPCS,96131,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,626.0,406.9,1.1,862.0,99
HCPCS,96132,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1359.0,883.3499999999999,1.1,1592.0,114
HCPCS,96133,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,626.0,406.9,1.1,862.0,99
HCPCS,96136,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,314.5,204.425,1.1,387.0,114
HCPCS,96137,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,296.0,192.4,1.1,390.0,99
HCPCS,96138,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,992.5,645.125,1.1,1252.1,105
HCPCS,96139,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,589.0,382.85,1.1,788.0,90
HCPCS,96146,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,138.0,89.69999999999999,1.1,203.0,111
HCPCS,96156,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,46
HCPCS,96156,HLTH BHV ASSMT/REASSESSMENT,,,85.47,284.74,19
HCPCS,96156,Hlth bhv assmt/reassessment,,,156.65,181.38,8
HCPCS,96156,VV HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,46
HCPCS,96158,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,46
HCPCS,96158,HLTH BHV IVNTJ INDIV 1ST 30,,,148.46,497.49,19
HCPCS,96158,Hlth bhv ivntj indiv 1st 30,,,75.49,87.41,8
HCPCS,96158,VV HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,46
HCPCS,96159,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,46
HCPCS,96159,Hlth bhv ivntj indiv ea addl,,,50.62,58.61,8
HCPCS,96159,VV HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,46
HCPCS,96160,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,67.5,43.875,0.01,105.02,111
HCPCS,96160,VV PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,1.1,46.0,50
HCPCS,96161,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,0.01,105.02,111
HCPCS,96161,VV CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,1.1,89.0,50
HCPCS,96164,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,46
HCPCS,96164,HLTH BHV IVNTJ GRP 1ST 30,,,27.53,105.02,19
HCPCS,96164,Hlth bhv ivntj grp 1st 30,,,104.59,121.1,8
HCPCS,96164,VV HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,46
HCPCS,96165,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,44.0,46
HCPCS,96165,Hlth bhv ivntj grp ea addl,,,50.62,58.61,8
HCPCS,96165,VV HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,44.0,46
HCPCS,96167,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,46
HCPCS,96167,HLTH BHV IVNTJ FAM 1ST 30,,,27.53,105.02,19
HCPCS,96167,Hlth bhv ivntj fam 1st 30,,,126.06,145.96,8
HCPCS,96167,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,46
HCPCS,96168,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,46
HCPCS,96168,Hlth bhv ivntj fam ea addl,,,50.62,58.61,8
HCPCS,96168,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,46
HCPCS,96170,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,35
HCPCS,96170,Hlth bhv ivntj fam wo pt 1st,,,126.06,145.96,8
HCPCS,96170,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,35
HCPCS,96171,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,35
HCPCS,96171,Hlth bhv ivntj fam w/o pt ea,,,50.62,58.61,8
HCPCS,96171,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,35
HCPCS,96202,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,208.5,135.525,0.01,245.0,106
HCPCS,96203,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,53.5,34.775,0.01,121.1,104
HCPCS,96360,IV HYDRATE INIT 31-60MIN,1454.0,945.1,55.38,1454.0,61
HCPCS,96360,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,75.0,48.75,1.1,365.57,50
HCPCS,96361,IV HYDRATE EA ADD HR,318.0,206.7,20.85,359.38,61
HCPCS,96361,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,40.0,26.0,1.1,80.64,50
HCPCS,96365,IV INF INIT UP TO 1 HR,1454.0,945.1,107.52,1454.0,61
HCPCS,96365,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,92.0,59.8,1.1,365.57,50
HCPCS,96365,THERAPEUTIC IV INFUSION 1ST HR,1454.0,945.1,107.52,1454.0,61
HCPCS,96366,IV INF SEQ EA ADD HR,318.0,206.7,34.57,359.38,61
HCPCS,96366,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,79.0,51.35,1.1,80.64,50
HCPCS,96366,THERAP IV INFUSION EA ADDL HR,318.0,206.7,34.57,359.38,61
HCPCS,96367,IV INF SEQ UP TO 1HR,491.0,319.15,48.2,491.0,61
HCPCS,96367,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,84.0,54.6,1.1,120.06,50
HCPCS,96368,IV INF CONCUR THERAPY,762.0,495.3,32.83,762.0,46
HCPCS,96368,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,75.0,48.75,1.1,75.0,50
HCPCS,96369,SC THER INFUSION UP TO 1 HR,,,194.67,596.17,19
HCPCS,96369,Sc ther infusion up to 1 hr,,,220.33,255.12,8
HCPCS,96370,SC THER INFUSION ADDL HR,,,42.63,131.25,19
HCPCS,96370,Sc ther infusion addl hr,,,310.37,359.38,8
HCPCS,96371,SC THER INFUSION RESET PUMP,,,65.76,201.81,19
HCPCS,96371,Sc ther infusion reset pump,,,220.33,255.12,8
HCPCS,96372,INJ SQ/IM,491.0,319.15,17.51,491.0,61
HCPCS,96372,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,491.0,319.15,1.1,491.0,111
HCPCS,96373,THER/PROPH/DIAG INJ IA,1454.0,945.1,32.83,1454.0,61
HCPCS,96374,INJ IVPUSH INIT DRUG,1454.0,945.1,36.15,1454.0,61
HCPCS,96374,INJECTION IV PUSH INIT,1454.0,945.1,36.15,1454.0,61
HCPCS,96374,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,79.0,51.35,1.1,365.57,50
HCPCS,96375,INJ IV PUSH SEQ NEW DRUG,318.0,206.7,25.72,318.0,61
HCPCS,96375,INJ IVPUSH SEQ NEW DRUG,318.0,206.7,25.72,318.0,61
HCPCS,96375,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,44.0,28.6,1.1,80.64,50
HCPCS,96376,INJ IV PUSH SEQ SAME DRUG,488.0,317.2,36.15,488.0,46
HCPCS,96376,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,390.0,253.5,1.1,390.0,38
HCPCS,96377,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,196.5,127.725,1.1,3004.0,111
HCPCS,96379,UNL THER/PROP/DIAG INJ/INF,,,42.63,131.25,19
HCPCS,96379,Unl ther/prop/diag inj/inf,,,36.15,41.86,8
HCPCS,96380,"ADMIN BEYFORTUS IM INJ, W/ COUNSELING",158.0,102.7,13.56,158.0,46
HCPCS,96380,"ADMIN BEYFORTUS IM INJ,W/ COUNSELING",158.0,102.7,1.1,158.0,44
HCPCS,96380,"VFC ADMIN BEYFORTUS IM INJ,W/ COUNSELING",21.25,13.81,1.1,71.19,44
HCPCS,96380,"VFC ADMIN BEYFORTUS, W/COUNSELING",21.25,13.81,4.63,62.93,46
HCPCS,96381,ADMIN BEYFORTUS IM INJ,158.0,102.7,1.1,158.0,90
HCPCS,96401,"CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM",92.0,59.8,1.1,234.61,50
HCPCS,96401,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,36.15,2453.0,122
HCPCS,96402,CHEMOTHER HORMON ANTINEOPL SUB-Q/IM,84.0,54.6,1.1,120.06,50
HCPCS,96402,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,491.0,319.15,36.15,491.0,61
HCPCS,96405,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,360.0,234.0,1.1,491.0,114
HCPCS,96406,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,903.0,586.95,1.1,1454.0,114
HCPCS,96409,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2289.0,1487.85,36.15,2289.0,61
HCPCS,96411,"CHEMOTHER, IV PUSH,EA ADD DRUG",88.0,57.2,1.1,178.95,50
HCPCS,96411,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,491.0,319.15,36.15,491.0,61
HCPCS,96413,"CHEMOTHER, IV INFUSION, 1 HR",123.0,79.95,1.1,578.82,50
HCPCS,96413,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,220.33,2289.0,61
HCPCS,96415,"CHEMOTHER, IV INFUSION, EA ADD HR",84.0,54.6,1.1,120.06,50
HCPCS,96415,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,491.0,319.15,46.32,491.0,61
HCPCS,96416,CHEMOTHER PROLONG INFUSE W/PUMP,92.0,59.8,1.1,578.82,50
HCPCS,96416,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2289.0,1487.85,222.38,2289.0,61
HCPCS,96417,"CHEMOTHER, IV INFUSE, EACH SEQU INFUS",92.0,59.8,1.1,207.9,50
HCPCS,96417,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,491.0,319.15,65.76,491.0,61
HCPCS,96420,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,1182.0,768.3,1.1,2289.0,111
HCPCS,96422,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,1178.5,766.025,1.1,2289.0,111
HCPCS,96423,CHEMO IA INFUSE EACH ADDL HR,,,42.63,131.25,19
HCPCS,96423,Chemo ia infuse each addl hr,,,310.37,359.38,8
HCPCS,96425,CHEMOTHERAPY ADMIN INTRA-ARTERIAL  INFUSION TECHNIQUE >8 HR PRTB,2289.0,1487.85,294.34,2289.0,61
HCPCS,96440,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2289.0,1487.85,0.01,2289.0,122
HCPCS,96446,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,1226.0,796.9,1.1,2289.0,114
HCPCS,96450,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,1450.5,942.8249999999999,0.01,2289.0,175
HCPCS,96521,FILL PORTABLE PUMP,1454.0,945.1,36.15,1454.0,61
HCPCS,96521,"REFILL/MAINT, PORTABLE PUMP",92.0,59.8,1.1,405.98,50
HCPCS,96522,FILL IMP PUMP RESVOIR IV OR IA,1454.0,945.1,36.15,1454.0,61
HCPCS,96523,IRRIG DRUG DELIVERY DEVICE,410.0,266.5,36.15,410.0,61
HCPCS,96523,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,214.0,139.1,0.01,2453.0,233
HCPCS,96542,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,1294.5,841.425,1.1,2289.0,114
HCPCS,96547,INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES,2612.0,1697.8,1.1,2612.0,44
HCPCS,96547,Intraop hipec px 1st 60 min,,,534.53,618.93,8
HCPCS,96548,INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES,1200.0,780.0,1.1,1649.73,44
HCPCS,96548,Ntraop hipec px ea add 30min,,,534.53,618.93,8
HCPCS,96549,CONCURRENT CHEMO INFUSION UNLISTED,761.0,494.65,42.63,761.0,61
HCPCS,96549,UNLISTED PROC;  HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY VIA TE,541.0,351.65,0.01,541.0,28
HCPCS,96567,PDT DSTR PRMLG LES SKN,,,183.59,562.35,19
HCPCS,96567,Pdt dstr prmlg les skn,,,133.98,155.13,8
HCPCS,96570,Photodynmc tx 30 min add-on,,,89.44,103.57,8
HCPCS,96571,Photodynamic tx addl 15 min,,,89.44,103.57,8
HCPCS,96573,PDT DSTR PRMLG LES PHYS/QHP,,,183.59,562.35,19
HCPCS,96573,Pdt dstr prmlg les phys/qhp,,,133.98,155.13,8
HCPCS,96574,DBRDMT PRMLG LES W/PDT,,,183.59,562.35,19
HCPCS,96574,Dbrdmt prmlg les w/pdt,,,133.98,155.13,8
HCPCS,96900,ACTINOTHERAPY UV LIGHT,,,35.34,104.69,19
HCPCS,96900,Actinotherapy uv light,,,24.68,28.58,8
HCPCS,96902,Mcrscp xm hair pluck/clipped,,,7.12,8.24,8
HCPCS,96904,Whole body photography,,,321.96,372.8,8
HCPCS,96910,PHOTCHMTX TAR&UVB/PTRLTM&UVB,,,54.88,165.35,19
HCPCS,96910,Photchmtx tar&uvb/ptrltm&uvb,,,67.54,78.2,8
HCPCS,96912,PHOTOCHEMOTHERAPY PUVA,,,54.88,165.35,19
HCPCS,96912,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,167.0,108.55,1.1,321.61,50
HCPCS,96912,Photochemotherapy puva,,,67.54,78.2,8
HCPCS,96913,PHOTOCHEMOTX SEV DERMATOSES,,,369.16,1139.4,19
HCPCS,96913,Photochemotx sev dermatoses,,,133.98,155.13,8
HCPCS,96920,EXCIMER LSR PSRIASIS<250SQCM,,,183.59,562.35,19
HCPCS,96920,Excimer lsr psriasis<250sqcm,,,309.06,357.86,8
HCPCS,96921,EXCIMER LSR PSRIASIS 250-500,,,183.59,562.35,19
HCPCS,96921,Excimer lsr psriasis 250-500,,,309.06,357.86,8
HCPCS,96922,EXCIMER LSR PSRIASIS>500SQCM,,,369.16,1139.4,19
HCPCS,96922,Excimer lsr psriasis>500sqcm,,,309.06,357.86,8
HCPCS,96931,Rcm img acquisj&i&r 1st les,,,7.32,8.48,8
HCPCS,96932,Rcm img acquisj only 1st les,,,7.32,8.48,8
HCPCS,96933,Rcm i&r only 1st lesion,,,7.32,8.48,8
HCPCS,96934,Rcm img acquisj&i&r ea addl,,,7.32,8.48,8
HCPCS,96935,Rcm img acquisj only ea addl,,,7.32,8.48,8
HCPCS,96936,Rcm i&r only ea addl lesion,,,7.32,8.48,8
HCPCS,96999,UNLISTED SPEC DERM SVC/PX,,,183.59,562.35,19
HCPCS,96999,Unlisted spec derm svc/px,,,133.98,155.13,8
HCPCS,96NBBCON,BODY BEAUTIFUL CONSULTS,25.0,16.25,1.1,25.0,22
HCPCS,96NCG,CLEANSING GEL,36.0,23.4,1.1,36.0,22
HCPCS,96NCL,CLENZIDERM,93.0,60.45,1.1,93.0,22
HCPCS,96NDL,DAY LOTION,50.0,32.5,1.1,50.0,22
HCPCS,96NENEC,ELASTIDERM NIGHT EYE CREAM,80.0,52.0,1.1,80.0,22
HCPCS,96NMD,MICRODERMABRASIONS,103.0,66.95,1.1,103.0,22
HCPCS,96NNC,NIGHT CREAM,81.0,52.65,1.1,81.0,22
HCPCS,96NSG,SUN GUARD,38.0,24.7,1.1,38.0,22
HCPCS,97007,MCHNL SCLP COOL CAP SPLY HEAD MEAS FITG&EDUCAJ,10008.0,6505.2,0.01,10008.0,55
HCPCS,97008,MCHNL SCLP COOL HAIR PREPJ CAP PLMT THER&PRECOOL,12078.0,7850.7,0.01,12078.0,46
HCPCS,97009,MCHNL SCLP COOL AFTER CHEMO EACH 30 MINUTES,3020.0,1963.0,0.01,3020.0,46
HCPCS,97010,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,24.0,15.6,1.1,24.0,33
HCPCS,97010,Hot or cold packs therapy,,,24.68,28.58,8
HCPCS,97012,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,100.0,65.0,1.1,100.0,50
HCPCS,97012,APPLY TRACTION MECH GP,194.0,126.1,18.61,239.0,60
HCPCS,97014,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,124.5,80.925,0.01,239.0,125
HCPCS,97014,ELEC STIM - UNAT,177.0,115.05,24.68,239.0,46
HCPCS,97014,ELECTRICAL STIM. UNATTENDED,177.0,115.05,24.68,239.0,46
HCPCS,97016,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,72.0,46.8,1.1,72.0,50
HCPCS,97016,JOBST COMPRESSION UT,203.0,131.95,14.87,239.0,60
HCPCS,97016,VASOPNEUMATIC DVC GP,203.0,131.95,14.87,239.0,60
HCPCS,97018,APPL MODALITY 1/> AREAS PARAFFIN BATH,24.0,15.6,1.1,24.0,50
HCPCS,97018,PARAFFIN,166.0,107.9,7.7,239.0,60
HCPCS,97018,PARAFFIN BATH GO,166.0,107.9,7.7,239.0,60
HCPCS,97022,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,68.0,44.2,1.1,68.0,50
HCPCS,97022,WHIRLPOOL GO,179.0,116.35,20.16,239.0,60
HCPCS,97022,WHIRLPOOL GP,179.0,116.35,20.16,239.0,60
HCPCS,97024,DIATHERMY EG MICROWAVE,,,9.28,26.48,22
HCPCS,97024,Diathermy eg microwave,,,24.68,28.58,8
HCPCS,97026,APPLICATION MODALITY 1/> AREAS INFRARED,26.0,16.9,1.1,26.0,44
HCPCS,97026,INFRARED THERAPY,,,8.66,23.82,22
HCPCS,97026,Infrared therapy,,,24.68,28.58,8
HCPCS,97028,ULTRAVIOLET THERAPY,,,10.45,29.84,22
HCPCS,97028,Ultraviolet therapy,,,24.68,28.58,8
HCPCS,97032,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,169.5,110.175,0.01,239.0,170
HCPCS,97032,ELECTR STIM 15MIN GP,239.0,155.35,18.62,239.0,60
HCPCS,97032,OT ELECTRICAL STIMULATION 15 M,239.0,155.35,18.62,239.0,60
HCPCS,97033,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,104.0,67.6,1.1,104.0,44
HCPCS,97033,IONTOPHORESIS 15MIN GO,189.0,122.85,23.82,239.0,60
HCPCS,97033,PT IONTOPHORESIS 15MIN GP,189.0,122.85,23.82,239.0,60
HCPCS,97034,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,105.0,68.25,1.1,239.0,110
HCPCS,97034,"CONTRAST BATH, EA 15 MIN",126.0,81.9,17.37,239.0,120
HCPCS,97035,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,129.0,83.85,1.1,239.0,110
HCPCS,97035,US 15MIN GO,174.0,113.1,17.72,239.0,60
HCPCS,97035,US 15MIN GP,174.0,113.1,17.72,239.0,60
HCPCS,97036,HUBBARD 15MIN GP,232.0,150.8,45.89,239.0,60
HCPCS,97037,APPL MODALITY 1+LLLT PO PAIN,,,35.34,104.69,19
HCPCS,97037,Appl modality 1+lllt po pain,,,24.68,28.58,8
HCPCS,97039,UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND,163.0,105.95,1.1,1792000.0,28
HCPCS,97039,Unlisted modality,,,24.68,28.58,8
HCPCS,97110,"PT THERAPEUT PROC/EXER, 15 MIN",258.0,167.7,37.06,258.0,60
HCPCS,97110,THERA EXER 1,258.0,167.7,37.06,258.0,60
HCPCS,97110,THERA EXER 15MIN,258.0,167.7,37.06,258.0,120
HCPCS,97110,"THERAPEUTIC EXERCISES RE, EA 15 MIN",45.0,29.25,1.1,98.79,50
HCPCS,97110,"THERAPEUTIC EXERCISES RE, EA 15 MIN.",198.0,128.7,1.1,198.0,50
HCPCS,97110,VV THERAPEUTIC EXERCISE  OT (97110),258.0,167.7,37.06,258.0,60
HCPCS,97110,VV THERAPEUTIC EXERCISE PT (97110),258.0,167.7,37.06,258.0,60
HCPCS,97112,NEURMSCL THERAPY 15MIN,261.0,169.65,41.24,261.0,120
HCPCS,97112,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,220.0,143.0,1.1,220.0,50
HCPCS,97112,VV NEUROMUSCULAR EDUCATION  OT (97112),261.0,169.65,41.24,261.0,60
HCPCS,97112,VV NEUROMUSCULAR EDUCATION PT (97112),261.0,169.65,41.24,261.0,60
HCPCS,97113,AQUATIC THERAPY 15MIN GP,326.0,211.9,46.97,326.0,60
HCPCS,97113,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,326.0,211.9,46.97,326.0,60
HCPCS,97116,GAIT TRAINING THERAPY 15M,228.0,148.2,24.68,239.0,60
HCPCS,97116,VV GAIT TRAINING THERAPY  (97116),228.0,148.2,24.68,239.0,60
HCPCS,97124,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,171.0,111.15,1.1,239.0,170
HCPCS,97129,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,202.5,131.625,1.1,239.0,172
HCPCS,97130,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,198.5,129.025,1.1,239.0,170
HCPCS,97139,Unlisted therapeutic px,,,24.68,28.58,8
HCPCS,97140,MANUAL THERAPY 15MIN,241.0,156.65,35.04,241.0,60
HCPCS,97140,MANUAL THERAPY 15MIN GP,241.0,156.65,35.04,241.0,60
HCPCS,97140,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,215.0,139.75,1.1,241.0,110
HCPCS,97150,ACTIVITY THERAPY PHP ONLY,234.0,152.1,22.65,234.0,60
HCPCS,97150,GROUP THERAPY GO,234.0,152.1,22.65,239.0,60
HCPCS,97150,GROUP THERAPY GP,234.0,152.1,22.65,239.0,60
HCPCS,97150,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,175.0,113.75,1.1,234.0,110
HCPCS,97151,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,119.0,77.35,1.1,294.38,32
HCPCS,97151,BHV ID ASSMT BY PHYS/QHP,,,85.47,284.74,19
HCPCS,97151,Bhv id assmt by phys/qhp,,,144.46,167.27,8
HCPCS,97152,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,293.0,190.45,1.1,293.0,32
HCPCS,97152,BHV ID SUPRT ASSMT BY 1 TECH,,,85.47,284.74,19
HCPCS,97152,Bhv id suprt assmt by 1 tech,,,144.46,167.27,8
HCPCS,97153,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,335.5,218.075,1.1,425.0,93
HCPCS,97154,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,159.0,103.35,1.1,181.0,93
HCPCS,97155,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,492.5,320.125,1.1,739.0,93
HCPCS,97156,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,117.5,76.375,1.1,294.38,93
HCPCS,97157,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,1.1,167.27,93
HCPCS,97158,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,106.0,68.9,1.1,167.27,93
HCPCS,97161,PT EVAL - LOW,605.0,393.25,73.97,605.0,60
HCPCS,97161,VV EVALUATION LOW COMPLEXITY  (97161),605.0,393.25,73.97,605.0,60
HCPCS,97162,PT EVAL - MOD,605.0,393.25,73.97,605.0,60
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY  (97162),605.0,393.25,73.97,605.0,60
HCPCS,97163,PT EVAL - HIGH,605.0,393.25,73.97,605.0,60
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY (97163),605.0,393.25,73.97,605.0,60
HCPCS,97164,PT RE-EVAL,383.0,248.95,73.97,383.0,60
HCPCS,97165,OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS,616.0,400.4,1.1,616.0,50
HCPCS,97165,OT EVAL - LOW,674.0,438.1,102.68,674.0,60
HCPCS,97165,VV EVALUATION LOW COMPLEXITY (97165),674.0,438.1,102.68,674.0,60
HCPCS,97166,OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS,616.0,400.4,1.1,616.0,50
HCPCS,97166,OT EVAL - MOD,674.0,438.1,102.68,674.0,60
HCPCS,97166,VV EVALUATION MODERATE COMPLEXITY (97166),674.0,438.1,102.68,674.0,60
HCPCS,97167,OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS,616.0,400.4,1.1,616.0,50
HCPCS,97167,OT EVAL - HIGH,674.0,438.1,102.68,674.0,60
HCPCS,97167,VV EVALUATION HIGH COMPLEXITY (97167),674.0,438.1,102.68,674.0,60
HCPCS,97168,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,383.5,249.27499999999998,1.1,384.0,110
HCPCS,97169,Athletic trn eval low cmplx,,,54.56,63.17,8
HCPCS,97170,Athletic trn eval mod cmplx,,,54.56,63.17,8
HCPCS,97171,Athletic trn eval high cmplx,,,54.56,63.17,8
HCPCS,97172,Athletic trn re-eval plan cr,,,54.56,63.17,8
HCPCS,97530,THERA ACTIVITY DIR 15MIN,274.0,178.1,44.62,274.0,60
HCPCS,97530,THERA FUNC ACTIVITIES 15M,274.0,178.1,1.1,274.0,110
HCPCS,97530,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,225.0,146.25,1.1,274.0,110
HCPCS,97530,VV THERAPEUTIC ACTIVITIES (97530),274.0,178.1,44.62,274.0,60
HCPCS,97533,PT SENSORY INTEGRATIVE TCH/15M,188.0,122.2,53.17,239.0,60
HCPCS,97533,"SENSORY INTEGRATION, EA 1",188.0,122.2,53.17,239.0,60
HCPCS,97533,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,192.0,124.8,1.1,207.99,50
HCPCS,97533,SENSORY INTEGRATN EA 15M,188.0,122.2,53.17,239.0,60
HCPCS,97535,EDUC HOME MGMT EA 15MIN GO,274.0,178.1,24.68,274.0,60
HCPCS,97535,EDUC HOME MGMT EA 15MIN GP,274.0,178.1,24.68,274.0,60
HCPCS,97535,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,227.0,147.55,1.1,274.0,170
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT  PT (97535),274.0,178.1,24.68,274.0,60
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT OT (97535),274.0,178.1,24.68,274.0,60
HCPCS,97537,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,184.0,119.6,1.1,239.0,170
HCPCS,97537,OT COMMUNITY REINTEGRATION/15M,176.0,114.4,40.61,239.0,60
HCPCS,97537,P.T. COMMUNITY REINTEG 15 MIN,176.0,114.4,40.61,239.0,60
HCPCS,97542,OT WHEELCHAIR MANAGEMENT 15 MI,254.0,165.1,1.1,254.0,110
HCPCS,97542,WHEELCHAIR MGMT EA 15 MIN,223.0,144.95,1.1,254.0,170
HCPCS,97545,PT/OT WORK CONDITION,1004.0,652.6,24.68,1004.0,46
HCPCS,97545,WORK HARDENING INIT 2HR GO,1004.0,652.6,24.68,1004.0,46
HCPCS,97546,WC/WH EA ADDTL HR,503.0,326.95,24.68,503.0,46
HCPCS,97546,WORK HARDENING (ADDL HR),503.0,326.95,24.68,503.0,46
HCPCS,97546,WORK HARDENING/CONDITIONING EACH HOUR,503.0,326.95,24.68,503.0,46
HCPCS,97550,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,663.5,431.275,0.01,887.0,112
HCPCS,97550,PT/OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,0.01,887.0,60
HCPCS,97550,SLT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,31.04,887.0,60
HCPCS,97551,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,562.5,365.625,0.01,887.0,112
HCPCS,97551,PT/OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,0.01,887.0,60
HCPCS,97551,SLT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,60
HCPCS,97552,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,494.0,321.09999999999997,0.01,887.0,112
HCPCS,97552,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,887.0,576.55,13.13,887.0,60
HCPCS,97552,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE?,887.0,576.55,0.01,887.0,60
HCPCS,97597,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,611.0,397.15,0.01,3004.0,175
HCPCS,97598,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,483.0,313.95,0.01,3004.0,191
HCPCS,97602,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,529.0,343.85,0.01,914.0,93
HCPCS,97605,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,578.0,375.70000000000005,0.01,914.0,175
HCPCS,97606,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1051.0,683.15,0.01,1838.0,175
HCPCS,97607,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1009.0,655.85,0.01,1838.0,174
HCPCS,97608,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1020.0,663.0,0.01,1838.0,113
HCPCS,97610,LOW FREQUENCY NON-THERMAL US,,,183.59,562.35,19
HCPCS,97610,Low frequency non-thermal us,,,147.83,171.17,8
HCPCS,97750,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,226.0,146.9,1.1,272.0,110
HCPCS,97750,TEST PHYSCL PERF EA 15MIN GO,272.0,176.8,42.65,272.0,60
HCPCS,97750,TEST PHYSCL PERF EA 15MIN GP,272.0,176.8,42.65,272.0,60
HCPCS,97755,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,296.0,192.4,48.65,296.0,120
HCPCS,97760,ORTHO MGMT EXT/TRUNK 15MN GO,295.0,191.75,60.21,295.0,60
HCPCS,97760,ORTHO MGMT EXT/TRUNK 15MN GP,295.0,191.75,60.21,295.0,60
HCPCS,97760,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,247.5,160.875,1.1,295.0,110
HCPCS,97761,PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,50
HCPCS,97761,PROSTHTIC TRAINING EXT 15M GO,270.0,175.5,52.32,270.0,60
HCPCS,97761,PROSTHTIC TRAINING EXT 15M GP,270.0,175.5,52.32,270.0,60
HCPCS,97763,ORTH/PROS MGMT EA 15 MIN GO,320.0,208.0,66.46,320.0,60
HCPCS,97763,ORTH/PROS MGMT EA 15 MIN GP,320.0,208.0,66.46,320.0,60
HCPCS,97763,ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,192.0,124.8,1.1,192.0,50
HCPCS,97799,DRIVER ON ROAD PER 60 MINS,100.0,65.0,14.88,239.0,46
HCPCS,97799,DRIVER'S ON ROAD,100.0,65.0,14.88,239.0,46
HCPCS,97799,GOLF PERFORMANCE,110.0,71.5,16.37,239.0,46
HCPCS,97802,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,1.1,212.0,113
HCPCS,97802,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,35.63,212.0,60
HCPCS,97802,"VIRTUAL VISIT MNT, INITIAL, EA. 15 MIN INCREMENT 97802",212.0,137.8,1.1,212.0,53
HCPCS,97803,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,1.1,180.0,113
HCPCS,97803,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,29.84,180.0,60
HCPCS,97803,"VIRTUAL VISIT MNT, RE ASSES, EA. 15 MIN INCREMENT 97803",180.0,117.0,1.1,180.0,53
HCPCS,97804,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,1.1,100.0,173
HCPCS,97804,"VV MNT GROUP, EA. 30 MIN",100.0,65.0,1.1,100.0,53
HCPCS,97810,ACUPUNCT W/O STIMUL 15 MIN,70.0,45.5,1.1,128.63,53
HCPCS,97810,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,54.5,35.425,1.1,128.63,114
HCPCS,97811,ACUPUNCTURE 1/> NDLS W/O ESTIM EACH ADDL 15 MIN,54.5,35.425,1.1,97.67,99
HCPCS,97813,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,54.5,35.425,1.1,151.55,114
HCPCS,97814,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,54.5,35.425,1.1,123.83,99
HCPCS,98000,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?SF MDM 15 MIN,372.0,241.8,1.1,372.0,39
HCPCS,98000,SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN,372.0,241.8,1.1,372.0,39
HCPCS,98000,Synch audio-video new sf 15,,,54.56,63.17,8
HCPCS,98001,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,39
HCPCS,98001,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,39
HCPCS,98001,Synch audio-video new low 30,,,54.56,63.17,8
HCPCS,98002,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,39
HCPCS,98002,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,39
HCPCS,98002,Synch audio-video new mod 45,,,54.56,63.17,8
HCPCS,98003,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,33
HCPCS,98003,SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,33
HCPCS,98003,Synch audio-video new hi 60,,,54.56,63.17,8
HCPCS,98004,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,39
HCPCS,98004,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,39
HCPCS,98004,Synch audio-video est sf 10,,,54.56,63.17,8
HCPCS,98005,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,39
HCPCS,98005,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,39
HCPCS,98005,Synch audio-video est low 20,,,54.56,63.17,8
HCPCS,98006,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,39
HCPCS,98006,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,39
HCPCS,98006,Synch audio-video est mod 30,,,54.56,63.17,8
HCPCS,98007,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,33
HCPCS,98007,SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,33
HCPCS,98007,Synch audio-video est hi 40,,,54.56,63.17,8
HCPCS,98008,SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN,360.0,234.0,1.1,360.0,39
HCPCS,98008,Synch audio-only new sf 15,,,54.56,63.17,8
HCPCS,98009,SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN,620.0,403.0,1.1,620.0,39
HCPCS,98009,Synch audio-only new low 30,,,54.56,63.17,8
HCPCS,98010,SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN,968.0,629.2,1.1,968.0,39
HCPCS,98010,Synch audio-only new mod 45,,,54.56,63.17,8
HCPCS,9801047,AUDIOGRAM,28.0,18.2,1.1,28.0,22
HCPCS,9801051,DOT PHYSICAL EXAM,110.0,71.5,1.1,110.0,22
HCPCS,9801052,EKG W/INTERPRETATION,70.0,45.5,1.1,70.0,22
HCPCS,9801057,LIFT TEST/PHYSICAL ABILITY,45.0,29.25,1.1,45.0,22
HCPCS,9801059,PRE-PLACEMENT EXAM,65.0,42.25,1.1,65.0,22
HCPCS,9801060,PHYSICAL EXAM,65.0,42.25,1.1,65.0,22
HCPCS,9801061,PULMONARY FUNCTION TEST,60.0,39.0,1.1,60.0,22
HCPCS,9801062,RESPIRATOR FIT TEST,35.0,22.75,1.1,35.0,22
HCPCS,9801063,OSHA RESPIRATOR QUESTIONNAIRE REVIEW,35.0,22.75,1.1,35.0,22
HCPCS,9801064,RESPIRATOR MEDICAL EVALUATION,35.0,22.75,1.1,35.0,22
HCPCS,9801065,RETURN TO WORK EXAM,65.0,42.25,1.1,65.0,22
HCPCS,9801068,TB SKIN TEST,30.0,19.5,1.1,30.0,22
HCPCS,9801069,TITMUS VISION,45.0,29.25,1.1,45.0,22
HCPCS,9801070,URINE COLLECTION ONLY,25.0,16.25,1.1,25.0,22
HCPCS,9801073,"X-RAY, CHEST, 2 VIEWS",105.0,68.25,1.1,105.0,22
HCPCS,9801074,RAPID URINE DRUG SCREEN 10-PANEL - MEDTOX,65.0,42.25,1.1,65.0,22
HCPCS,9801075,RAPID URINE DRUG SCREEN 5-PANEL - MEDTOX,65.0,42.25,1.1,65.0,22
HCPCS,9801077,URINE DRUG SCREEN 10-PANEL - MEDTOX,50.0,32.5,1.1,50.0,22
HCPCS,9801083,URINE DRUG SCREEN 12-PANEL - MEDTOX,95.0,61.75,1.1,95.0,22
HCPCS,9801084,URINE DRUG SCREEN 4-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,22
HCPCS,9801085,URINE DRUG SCREEN 5-PANEL - MEDTOX,50.0,32.5,1.1,50.0,22
HCPCS,9801087,URINE DRUG SCREEN 9-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,22
HCPCS,9801088,URINE DRUG SCREEN DOT - MEDTOX,50.0,32.5,1.1,50.0,22
HCPCS,9801090,URINE DRUG SCREEN CRL WS66 - CRL,95.0,61.75,1.1,95.0,22
HCPCS,9801092,HAIR DRUG SCREEN 5-PANEL - OMEGA,105.0,68.25,1.1,105.0,22
HCPCS,9801099,BREATH ALCOHOL TEST - CCAW / WW,30.0,19.5,1.1,30.0,22
HCPCS,98011,SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN,1280.0,832.0,1.1,1280.0,33
HCPCS,98011,Synch audio-only new high 60,,,54.56,63.17,8
HCPCS,98012,SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN,260.0,169.0,1.1,260.0,39
HCPCS,98012,Synch audio-only est sf 10,,,54.56,63.17,8
HCPCS,9801201,TB SKIN TESTING (2-STEP) (RETURN TO CLINIC FOR READING WITHIN 48,60.0,39.0,1.1,60.0,22
HCPCS,98013,SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN,480.0,312.0,1.1,480.0,39
HCPCS,98013,Synch audio-only est low 20,,,54.56,63.17,8
HCPCS,98014,SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN,700.0,455.0,1.1,700.0,39
HCPCS,98014,Synch audio-only est mod 30,,,54.56,63.17,8
HCPCS,98015,SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,33
HCPCS,98015,Synch audio-only est high 40,,,54.56,63.17,8
HCPCS,98016,BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN,132.0,85.8,1.1,132.0,51
HCPCS,98016,Brief comunicaj tech-bsd svc,,,8.52,9.87,8
HCPCS,98925,"OSTEOPATHIC MANIP,1-2 BODY REGN",139.0,90.35000000000001,0.01,202.0,114
HCPCS,98925,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,2453.0,122
HCPCS,98926,"OSTEOPATHIC MANIP,3-4 BODY REGN",312.0,202.8,1.1,312.0,53
HCPCS,98926,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,76.0,49.4,20.43,2453.0,122
HCPCS,98927,"OSTEOPATHIC MANIP,5-6 BODY REGN",422.0,274.3,1.1,422.0,53
HCPCS,98927,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,76.0,49.4,20.43,81.13,61
HCPCS,98928,"OSTEOPATHIC MANIP,7-8 BODY REGN",532.0,345.8,1.1,532.0,53
HCPCS,98928,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,76.0,49.4,20.43,102.47,61
HCPCS,98929,"OSTEOPATHIC MANIP,9-10 BODY REGN",642.0,417.3,1.1,642.0,53
HCPCS,98929,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,76.0,49.4,20.43,122.4,61
HCPCS,98940,"CHIROPRAC MANIP,SPINAL,1-2 REGIONS",121.0,78.65,1.1,202.0,106
HCPCS,98940,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,76.0,49.4,20.43,76.0,61
HCPCS,98941,"CHIROPRAC MANIP,SPINAL,3-4 REGIONS",186.0,120.9,1.1,312.0,106
HCPCS,98941,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,76.0,49.4,20.43,76.0,61
HCPCS,98942,"CHIROPRAC MANIP,SPINAL,5 REGIONS",422.0,274.3,1.1,422.0,53
HCPCS,98942,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,76.0,49.4,20.43,81.52,61
HCPCS,98943,"CHIROPRAC MANIP, EXTRASPINAL, 1+ REGNS",40.0,26.0,1.1,88.73,36
HCPCS,98943,"CHIROPRAC MANIP,EXTRASPINAL,1+ REGNS",184.0,119.6,1.1,184.0,36
HCPCS,98943,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,123.0,79.95,18.3,123.0,46
HCPCS,98960,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,101.5,65.975,1.1,126.0,79
HCPCS,98960,EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT,126.0,81.9,18.75,126.0,46
HCPCS,98960,VIRTUAL MGMT DIABETES SNGL 30 MIN,101.5,65.975,1.1,126.0,79
HCPCS,98961,EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS,86.0,55.9,1.1,95.0,79
HCPCS,98961,"VIRTUAL MGMT DIABETES GRP 30 MIN, 2-4 PT",77.0,50.05,1.1,77.0,33
HCPCS,98962,EDUCATION&TRAINING PT SELF-MGMT NQHP 5-8 PTS,33.0,21.45,1.1,33.28,33
HCPCS,98962,Edu&trn pt slf-mgmt nqhp 5-8,,,35.45,41.05,8
HCPCS,98962,"VIRTUAL MGMT DIABETES GRP 30 MIN, 5-8 PT",33.0,21.45,1.1,33.28,33
HCPCS,98966,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,101.0,65.65,1.1,102.0,107
HCPCS,98967,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,204.0,132.6,1.1,208.0,107
HCPCS,98968,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,306.5,199.225,1.1,313.0,107
HCPCS,98970,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,65.0,42.25,1.1,65.0,44
HCPCS,98970,NQHP OL DIG ASSMT&MGMT 5-10,,,14.49,39.85,22
HCPCS,98970,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN,65.0,42.25,1.1,65.0,44
HCPCS,98970,Nqhp ol dig assmt&mgmt 5-10,,,54.56,63.17,8
HCPCS,98971,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,80.0,52.0,1.1,80.0,46
HCPCS,98971,NQHP OL DIG ASSMT&MGMT 11-20,,,26.33,72.41,22
HCPCS,98971,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN,80.0,52.0,1.1,80.0,46
HCPCS,98971,Nqhp ol dig assmt&mgmt 11-20,,,54.56,63.17,8
HCPCS,98972,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,120.0,78.0,1.1,120.0,46
HCPCS,98972,NQHP OL DIG ASSMT&MGMT 21+,,,40.46,111.27,22
HCPCS,98972,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN,120.0,78.0,1.1,120.0,46
HCPCS,98972,Nqhp ol dig assmt&mgmt 21+,,,54.56,63.17,8
HCPCS,98975,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQ,593.0,385.45,37.45,593.0,61
HCPCS,98975,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQP,593.0,385.45,37.45,593.0,61
HCPCS,98976,RTM DEV SPLY RESP SYS 16-30D,,,34.46,104.61,19
HCPCS,98977,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,172.0,111.8,34.46,239.0,106
HCPCS,98978,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,185.0,120.25,1.1,258.0,92
HCPCS,98979,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,263.0,170.95,1.1,593.0,129
HCPCS,98980,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,160.0,104.0,1.1,248.0,193
HCPCS,98981,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,158.0,102.69999999999999,1.1,244.0,193
HCPCS,98984,RTM DEV SPLY DATA RESPIR SYS 2-15 DAYS IN 30D PD,263.0,170.95,35.31,263.0,47
HCPCS,98985,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,161.0,104.64999999999999,1.1,263.0,82
HCPCS,98986,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,260.5,169.325,0.01,263.0,69
HCPCS,9899071J,JUVEDERM ULTRA,550.0,357.5,1.1,550.0,22
HCPCS,9899071J,JUVEDERM VOLLURE,750.0,487.5,1.1,750.0,22
HCPCS,9899071K,KYBELLAINJECTION,600.0,390.0,1.1,600.0,22
HCPCS,9899071V,JUVEDERM VOLBELLA XC,400.0,260.0,1.1,400.0,22
HCPCS,9899071V,JUVEDERM VOLUMA,900.0,585.0,1.1,900.0,22
HCPCS,9899201,WORK PERMIT PHYSICAL EXAM,59.0,38.35,1.1,59.0,22
HCPCS,9899202C,COSMETIC CONSULTATION,100.0,65.0,1.1,100.0,22
HCPCS,9899456,EMPLOYMENT PHYSICAL EXAM,108.0,70.2,1.1,108.0,22
HCPCS,9899999B,BOTOX COSMETIC,525.0,341.25,1.1,525.0,22
HCPCS,9899999H,HYALURONIC ACID TX,250.0,162.5,1.1,250.0,22
HCPCS,9899999R,BOTOX RETURN,475.0,308.75,1.1,475.0,22
HCPCS,98BLUEP,BLUE PEEL,250.0,162.5,1.1,250.0,22
HCPCS,98BRA,SURGICAL BRA,31.0,20.15,1.1,31.0,22
HCPCS,98CLFG,CLENZIDERM FOAM GEL,35.0,22.75,1.1,35.0,22
HCPCS,98CLPT,CLENZIDERM PORE THERAPY,35.0,22.75,1.1,35.0,22
HCPCS,98CLSG,CLENZIDERM SERUM GEL,70.0,45.5,1.1,70.0,22
HCPCS,98COOLSC,COOL SCULPT,750.0,487.5,1.1,750.0,22
HCPCS,98DERMA,DERMAPLANE  ADDITIONAL,50.0,32.5,1.1,50.0,22
HCPCS,98DPLANE,DERMAPLANE,140.0,91.0,1.1,140.0,22
HCPCS,98EARBI,"EARLOBE REPAIR, BILAT",700.0,455.0,1.1,700.0,22
HCPCS,98EARUN,"EARLOBE REPAIR, UNILAT",500.0,325.0,1.1,500.0,22
HCPCS,98ELAST,ELASTIDERM CREAM,98.0,63.7,1.1,98.0,22
HCPCS,98ELASTG,ELASTIDERM GEL,98.0,63.7,1.1,98.0,22
HCPCS,98ELASTS,ELASTIDERM SERUM,98.0,63.7,1.1,98.0,22
HCPCS,98EXCSC,COSMETIC EXC SCAR,500.0,325.0,1.1,500.0,22
HCPCS,98FACBR,FACIAL BRA,20.0,13.0,1.1,20.0,22
HCPCS,98ILLUM,ILLUMINIZE PEEL,145.0,94.25,1.1,145.0,22
HCPCS,98LATS,LATISSE 5ML,180.0,117.0,1.1,180.0,22
HCPCS,98LATSSE,LATISSE 5ML,300.0,195.0,1.1,300.0,22
HCPCS,98LESRE,COSMETIC LESION REMOVAL,250.0,162.5,1.1,250.0,22
HCPCS,98MBARB,AGE REVERSAL BUNDLE,269.0,174.85,1.1,269.0,22
HCPCS,98MBAT,A-TEAM,92.0,59.8,1.1,92.0,22
HCPCS,98MBBC,BRIGHTAMIN-C,105.0,68.25,1.1,105.0,22
HCPCS,98MBBF,LET ME CLARIFY PROA LOTION,53.0,34.45,1.1,53.0,22
HCPCS,98MBCATS,CALM AFTER THE STORM GPH LOTION,83.0,53.95,1.1,83.0,22
HCPCS,98MBCI,SOOTHING BUNDLE,193.0,125.45,1.1,193.0,22
HCPCS,98MBCR,CLEAN ROUTINE,28.0,18.2,1.1,28.0,22
HCPCS,98MBEI,CLARIFYING BUNDLE,220.0,143.0,1.1,220.0,22
HCPCS,98MBFIB,FUTURE IS BRIGHT,75.0,48.75,1.1,75.0,22
HCPCS,98MBLMC,LET ME CLARIFY,57.0,37.05,1.1,57.0,22
HCPCS,98MBMH,MYHERO,197.0,128.05,1.1,197.0,22
HCPCS,98MBMHC,MY HERO CREAM,127.0,82.55,1.1,127.0,22
HCPCS,98MBMHL,MY HERO LOTION,101.0,65.65,1.1,101.0,22
HCPCS,98MBNC,NECK-CESSITY,110.0,71.5,1.1,110.0,22
HCPCS,98MBPS,PROTECT AND SERVEE SPF30,57.0,37.05,1.1,57.0,22
HCPCS,98MBRI,REVERSE IT KIT,265.0,172.25,1.1,265.0,22
HCPCS,98MBTC,TAKE CONTROL,27.0,17.55,1.1,27.0,22
HCPCS,98MBY,YOUTHIFEYE,87.0,56.55,1.1,87.0,22
HCPCS,98MBYO,YOUTH OVERNIGHT,97.0,63.05,1.1,97.0,22
HCPCS,98MICPRP,MICRO NEEDLING W/PRP PACKAGE 30CC (4 TX),4800.0,3120.0,1.1,4800.0,22
HCPCS,98MICPRP,MICRO NEEDLING W/PRP PACKAGE 60CC (4 TX),7400.0,4810.0,1.1,7400.0,22
HCPCS,98MICROD,MICRODERMABRASION,140.0,91.0,1.1,140.0,22
HCPCS,98MICROG,MICRO NEEDLING WITH GROWTH FACTOR,350.0,227.5,1.1,350.0,22
HCPCS,98MICROP,MICRO NEEDLING PACKAGE (4 TX),1200.0,780.0,1.1,1200.0,22
HCPCS,98Micprp,MICRO NEEDLING W/PRP 30CC,1350.0,877.5,1.1,1350.0,22
HCPCS,98Micrpr,MICRO NEEDLING W/PRP 60 CC,2050.0,1332.5,1.1,2050.0,22
HCPCS,98NBBCON,BODY BEAUTIFUL CONSULTS,25.0,16.25,1.1,25.0,22
HCPCS,98NI24CC,GENTLE CLEANSING CREAM,30.0,19.5,1.1,30.0,22
HCPCS,98NI24CS,PHYSICAL SCRUB,35.0,22.75,1.1,35.0,22
HCPCS,98NI24SC,STRENGTHENING COMPLEX,85.0,55.25,1.1,85.0,22
HCPCS,98NMD,MICRODERMABRASIONS,103.0,66.95,1.1,103.0,22
HCPCS,98NS,NO SHOW FOR APPT CHARGE,25.0,16.25,1.1,25.0,22
HCPCS,98OBBFX,BLENDER FX,79.0,51.35,1.1,79.0,22
HCPCS,98OBBL,BLENDER,91.0,59.15,1.1,91.0,22
HCPCS,98OBCBT,C-BALANCING TONER,36.0,23.4,1.1,36.0,22
HCPCS,98OBCCL,C--CLEANSING GEL,37.0,24.05,1.1,37.0,22
HCPCS,98OBCCS,C-CLARIFYING SERUM N-D,108.0,70.2,1.1,108.0,22
HCPCS,98OBCEB,PROFESSIONAL-C PEPTIDE COMPLEX,81.0,52.65,1.1,81.0,22
HCPCS,98OBCED,C-EXFOLIATING DAY CREAM,61.0,39.65,1.1,61.0,22
HCPCS,98OBCFX,CLEAR FX,83.0,53.95,1.1,83.0,22
HCPCS,98OBCLE,CLEAR,95.0,61.75,1.1,95.0,22
HCPCS,98OBCPC,PROFESSIONAL-C EYE BRIGHTENER,99.0,64.35,1.1,99.0,22
HCPCS,98OBCS,*C-CLARIFYING SERUM N-O,108.0,70.2,1.1,108.0,22
HCPCS,98OBCSU,C-SUNGUARD SPF 30,63.0,40.95,1.1,63.0,22
HCPCS,98OBCTN,*C-THERAPY NIGHT CREAM,93.0,60.45,1.1,93.0,22
HCPCS,98OBEXE,EXFODERM,65.0,42.25,1.1,65.0,22
HCPCS,98OBEXF,EXFODERM FORTE,65.0,42.25,1.1,65.0,22
HCPCS,98OBFGE,FOAMING GEL,37.0,24.05,1.1,37.0,22
HCPCS,98OBGCL,GENTLE CLEANSER,37.0,24.05,1.1,37.0,22
HCPCS,98OBHYD,OBHYD,44.0,28.6,1.1,44.0,22
HCPCS,98OBHYDL,OBAJI HYDRATE LUXE,63.0,40.95,1.1,63.0,22
HCPCS,98OBPR,BLUE PEEL RADIANCE,125.0,81.25,1.1,125.0,22
HCPCS,98OBROSC,GENTLE CLEANSER,36.0,23.4,1.1,36.0,22
HCPCS,98OBSSC,OBAGI SUNSHIELD SPF 50 COOL,46.0,29.9,1.1,46.0,22
HCPCS,98OBSSD,OBAGI SUN SHIELD SPF50,46.0,29.9,1.1,46.0,22
HCPCS,98OBSSM,OBAGI SUNSHIELD SPF 50 MATTE,46.0,29.9,1.1,46.0,22
HCPCS,98OBSSW,SUN SHIELD SPF WARM,46.0,29.9,1.1,46.0,22
HCPCS,98OBSUB,SUNBLOCK SPF 32,44.0,28.6,1.1,44.0,22
HCPCS,98OBSUC,SUNSCREEN SPF 35,46.0,29.9,1.1,46.0,22
HCPCS,98OBSUF,SUNFADER,76.0,49.4,1.1,76.0,22
HCPCS,98OBTON,TONER,37.0,24.05,1.1,37.0,22
HCPCS,98OBTR1,TRETINOIN CREAM 1%,64.0,41.6,1.1,64.0,22
HCPCS,98OBTRA,OBAGI TRAVEL SET,210.0,136.5,1.1,210.0,22
HCPCS,98OBTRAD,OBAGI TRAVEL SET N-D,215.0,139.75,1.1,215.0,22
HCPCS,98OBTRAO,OBTRA TRAVEL OBTRAO NOR TO OIL,215.0,139.75,1.1,215.0,22
HCPCS,98OBTRO2,TRETINOIN CR .025%,34.5,22.43,1.1,34.5,22
HCPCS,98OBTRS,TRETINOIN CR. .05%,57.0,37.05,1.1,57.0,22
HCPCS,98PDERP,PERFECT DERMA PEEL,250.0,162.5,1.1,250.0,22
HCPCS,98PDPBO,PERFECT DERM PEEL W/BOOST,300.0,195.0,1.1,300.0,22
HCPCS,98PL30,PLATELET RICH PLASMA 30CC,1000.0,650.0,1.1,1000.0,22
HCPCS,98PL60,PLATELET RICH PLASMA 60CC,1700.0,1105.0,1.1,1700.0,22
HCPCS,98PLPKG3,PLATELET RICH PLASMA PACKAGE 30CC,3500.0,2275.0,1.1,3500.0,22
HCPCS,98PLPKG6,PLATELET RICH PLASMA PACKAGE 60CC,6200.0,4030.0,1.1,6200.0,22
HCPCS,98PRECIS,VIPEEL W/ PRECISION,300.0,195.0,1.1,300.0,22
HCPCS,98PREVAG,PREVAGE MD,118.0,76.7,1.1,118.0,22
HCPCS,98PROC10,PROFESSIONAL-C 10%,68.0,44.2,1.1,68.0,22
HCPCS,98PROC15,PROFESSIONAL-C 15%,82.0,53.3,1.1,82.0,22
HCPCS,98PROC20,PROFESSIONAL-C 20%,102.0,66.3,1.1,102.0,22
HCPCS,98PROC5,PROFESSIONAL-C 5%,48.0,31.2,1.1,48.0,22
HCPCS,98PRP,PRP-PLATELET RICH PLASMA CONSULT,52.0,33.8,1.1,52.0,22
HCPCS,98REJUVE,REJUVENIZE PEEL,195.0,126.75,1.1,195.0,22
HCPCS,98RS,REAL SELF CONSULTATION,50.0,32.5,1.1,50.0,22
HCPCS,98SHIPPI,SHIPPING,8.0,5.2,1.1,8.0,22
HCPCS,98SPORT,SPORTS PHYSICAL,35.0,22.75,1.1,35.0,22
HCPCS,98TATRE,TATOO REMOVAL/EXCIS,750.0,487.5,1.1,750.0,22
HCPCS,98VIDAF,DAILY ANTIOXIDANT SERUM,110.0,71.5,1.1,110.0,22
HCPCS,98VIEFC,EXFOLIATING FACIAL CLEANSER,46.0,29.9,1.1,46.0,22
HCPCS,98VINRC,NIGHT RENEWAL FACIAL CREAM,83.0,53.95,1.1,83.0,22
HCPCS,98VIPEEL,VIPEEL,250.0,162.5,1.1,250.0,22
HCPCS,98VIRFC,REPLENISH FACIAL CLEANSER,25.0,16.25,1.1,25.0,22
HCPCS,98VIRHC,REPLENISH HYDRATING CREAM,50.0,32.5,1.1,50.0,22
HCPCS,98VITA,VITALIZED PEEL,165.0,107.25,1.1,165.0,22
HCPCS,98VIVT,VIBRANCE THERAPY,119.0,77.35,1.1,119.0,22
HCPCS,98XRAYS,PAT PURCH COPIES XRAY SHEETS,6.0,3.9,1.1,6.0,22
HCPCS,99000,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,42.0,27.3,1.1,42.0,32
HCPCS,99000,SPECIMEN ACQUISITION KIT- DD WAIT LIST,49.0,31.85,2.09,49.0,46
HCPCS,99001,SERUM PROCESSING AND STORAGE,59.0,38.35,2.09,59.0,46
HCPCS,99001,SPECIMEN ACQUISITION-KIT - DAILY TESTING,59.0,38.35,2.09,59.0,46
HCPCS,99002,Device handling phys/qhp,,,321.96,372.8,8
HCPCS,99024,Postop follow-up visit,,,50.62,58.61,8
HCPCS,99026,In-hospital on call service,,,321.96,372.8,8
HCPCS,99027,Out-of-hosp on call service,,,321.96,372.8,8
HCPCS,99050,STAT/AFTER-HOURS REQUEST,144.0,93.6,8.52,144.0,46
HCPCS,99051,Med serv eve/wkend/holiday,,,8.52,9.87,8
HCPCS,99053,Med serv 10pm-8am 24 hr fac,,,8.52,9.87,8
HCPCS,99056,Med service out of office,,,321.96,372.8,8
HCPCS,99058,Office emergency care,,,8.52,9.87,8
HCPCS,99060,Out of office emerg med serv,,,8.52,9.87,8
HCPCS,99070,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,49.0,31.85,0.01,49.0,29
HCPCS,99070,Special supplies phys/qhp,,,13.46,15.59,8
HCPCS,99071,Patient education materials,,,50.62,58.61,8
HCPCS,99072,Addl supl matrl&staf tm phe,,,13.46,15.59,8
HCPCS,99075,Medical testimony,,,321.96,372.8,8
HCPCS,99078,Group health education,,,35.45,41.05,8
HCPCS,99078,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,79.0,51.35,1.1,79.0,35
HCPCS,99080,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,129.0,83.85,1.1,129.0,29
HCPCS,99080,Special reports or forms,,,321.96,372.8,8
HCPCS,99082,Unusual physician travel,,,321.96,372.8,8
HCPCS,99091,COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D,484.0,314.6,1.1,484.0,44
HCPCS,99100,Anes pt exteme age<1 yr&>70,,,159.23,184.37,8
HCPCS,99116,Anes comp tot bdy hypthrm,,,159.23,184.37,8
HCPCS,99135,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,136.0,88.4,1.1,691.04,30
HCPCS,99135,Anes comp ctrld hypotension,,,159.23,184.37,8
HCPCS,99140,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,137.0,89.05,1.1,276.42,30
HCPCS,99140,Anes comp emergency cond,,,159.23,184.37,8
HCPCS,99151,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,220.0,143.0,1.1,220.0,53
HCPCS,99151,Mod sed same phys/qhp <5 yrs,,,159.23,184.37,8
HCPCS,99152,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,405.5,263.575,1.1,701.0,99
HCPCS,99152,MODERATE SEDATION FOR ENDOSCOPY,110.0,71.5,1.1,163.46,53
HCPCS,99153,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,193.0,125.45,1.1,276.0,142
HCPCS,99155,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,760.0,494.0,1.1,760.0,50
HCPCS,99155,Mod sed oth phys/qhp <5 yrs,,,159.23,184.37,8
HCPCS,99156,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,622.0,404.3,1.1,660.0,96
HCPCS,99156,PF MODERATE SEDATION INITIAL 15,137.75,89.54,1.1,259.38,50
HCPCS,99157,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,388.0,252.2,1.1,500.0,96
HCPCS,99157,PF MODERATE SEDATION EA ADDL 15,111.5,72.48,1.1,210.25,50
HCPCS,99170,ANOGENITAL EXAM CHILD W IMAG,,,185.88,566.65,19
HCPCS,99170,Anogenital exam child w imag,,,54.56,63.17,8
HCPCS,99172,Ocular function screen,,,50.62,58.61,8
HCPCS,99173,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,116.0,75.4,1.1,180.0,85
HCPCS,99174,INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL &AMP; RPT,72.0,46.8,1.1,72.0,39
HCPCS,99174,Ocular instrumnt screen bil,,,50.62,58.61,8
HCPCS,99175,Induction of vomiting,,,26.64,30.84,8
HCPCS,99177,Ocular instrumnt screen bil,,,50.62,58.61,8
HCPCS,99183,Hyperbaric oxygen therapy,,,321.96,372.8,8
HCPCS,99183,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION,844.0,548.6,1.1,844.0,50
HCPCS,99184,Hypothermia ill neonate,,,321.96,372.8,8
HCPCS,99188,APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP,80.0,52.0,1.1,80.0,42
HCPCS,99188,App topical fluoride varnish,,,802.93,929.71,8
HCPCS,99190,Special pump services,,,321.96,372.8,8
HCPCS,99191,Special pump services,,,321.96,372.8,8
HCPCS,99192,Special pump services,,,321.96,372.8,8
HCPCS,99195,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,628.5,408.525,0.01,889.0,172
HCPCS,99195,THERAPEUTIC PHLEBOTOMY,889.0,577.85,28.36,889.0,61
HCPCS,99199,SANE EVAL,700.0,455.0,104.16,700.0,46
HCPCS,99199,UNLISTED SPECIAL SERVICE OR REPORT,5.0,3.25,0.01,1792000.0,28
HCPCS,99201,Office/outpatient visit new,,,54.56,63.17,8
HCPCS,99202,NEW PATIENT VISIT LEVEL 2,25.0,16.25,1.1,152.94,53
HCPCS,99202,OD NEW ONLINE E&M LEVEL 2,372.0,241.8,1.1,372.0,53
HCPCS,99202,OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES,372.0,241.8,1.1,372.0,53
HCPCS,99202,OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES,136.0,88.4,0.01,136.0,46
HCPCS,99202,OFFICE/OUTPATIENT VISIT NEW,68.0,44.2,1.1,152.94,53
HCPCS,99203,NEW PATIENT VISIT LEVEL 3,25.0,16.25,1.1,237.5,53
HCPCS,99203,OD NEW ONLINE E&M LEVEL 3,640.0,416.0,1.1,640.0,53
HCPCS,99203,OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES,640.0,416.0,1.1,640.0,53
HCPCS,99203,OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES,139.0,90.35,0.01,153.39,46
HCPCS,99203,OFFICE/OUTPATIENT VISIT NEW,103.0,66.95,1.1,237.5,53
HCPCS,99204,NEW PATIENT VISIT LEVEL 4,25.0,16.25,1.1,357.22,53
HCPCS,99204,OD NEW ONLINE E&M LEVEL 4,1040.0,676.0,1.1,1040.0,53
HCPCS,99204,OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES,1040.0,676.0,1.1,1040.0,53
HCPCS,99204,OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES,174.0,113.1,0.01,251.09,46
HCPCS,99204,OFFICE/OUTPATIENT VISIT NEW,175.0,113.75,1.1,357.22,53
HCPCS,99205,NEW PATIENT VISIT LEVEL 5,25.0,16.25,1.1,471.66,53
HCPCS,99205,OD NEW ONLINE E&M LEVEL 5,1400.0,910.0,1.1,1400.0,53
HCPCS,99205,OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES,1400.0,910.0,1.1,1400.0,53
HCPCS,99205,OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES,235.0,152.75,0.01,342.0,46
HCPCS,99211,EST PATIENT VISIT LEVEL 1,25.0,16.25,1.1,45.66,53
HCPCS,99211,OD EST ONLINE E&M LEVEL 1,79.0,51.35,1.1,79.0,53
HCPCS,99211,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,114.5,74.425,0.01,150.0,329
HCPCS,99212,BOY SCOUT PHYSICAL,30.0,19.5,1.1,113.21,53
HCPCS,99212,COLLEGE PHYSICAL,30.0,19.5,1.1,113.21,53
HCPCS,99212,EST PATIENT VISIT LEVEL 2,25.0,16.25,1.1,113.21,53
HCPCS,99212,GENERAL PHYSICAL,30.0,19.5,1.1,113.21,53
HCPCS,99212,OD EST ONLINE E&M LEVEL 2,280.0,182.0,1.1,280.0,53
HCPCS,99212,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN,280.0,182.0,1.1,280.0,53
HCPCS,99212,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,138
HCPCS,99212,OFFICE/OUTPATIENT VISIT EST,35.0,22.75,1.1,113.21,53
HCPCS,99212,WORK PERMIT PHYSICAL,30.0,19.5,1.1,113.21,53
HCPCS,99213,EST PATIENT VISIT LEVEL 3,25.0,16.25,1.1,181.76,53
HCPCS,99213,OD EST ONLINE E&M LEVEL 3,520.0,338.0,1.1,520.0,53
HCPCS,99213,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN,520.0,338.0,1.1,520.0,53
HCPCS,99213,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,150.0,97.5,0.01,150.0,46
HCPCS,99213,OFFICE/OUTPATIENT VISIT EST,68.0,44.2,1.1,181.76,53
HCPCS,99214,EST PATIENT VISIT LEVEL 4,25.0,16.25,1.1,257.54,53
HCPCS,99214,OD EST ONLINE E&M LEVEL 4,768.0,499.2,1.1,768.0,53
HCPCS,99214,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN,768.0,499.2,1.1,768.0,53
HCPCS,99214,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,184
HCPCS,99214,OFFICE/OUTPATIENT VISIT EST,106.0,68.9,1.1,257.54,53
HCPCS,99215,EST PATIENT VISIT LEVEL 5,25.0,16.25,1.1,361.57,53
HCPCS,99215,OD EST ONLINE E&M LEVEL 5,1120.0,728.0,1.1,1120.0,53
HCPCS,99215,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,53
HCPCS,99215,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,240.0,156.0,0.01,271.21,138
HCPCS,99215,OFFICE/OUTPATIENT VISIT EST,150.0,97.5,1.1,361.57,53
HCPCS,99217,Observation care discharge,,,54.56,63.17,8
HCPCS,99218,DIRECT ADMISSION HOSP OBSERV,240.0,156.0,35.71,13224.0,47
HCPCS,99219,Initial observation care,,,54.56,63.17,8
HCPCS,99220,Initial observation care,,,54.56,63.17,8
HCPCS,99221,1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES,652.0,423.8,1.1,652.0,50
HCPCS,99221,1st hosp ip/obs sf/low 40,,,54.56,63.17,8
HCPCS,99221,"INITIAL HOSPITAL CARE, LEVEL I",652.0,423.8,1.1,652.0,50
HCPCS,99221,"VIRTUAL INITIAL HOSPITAL CARE, E&M (30 MIN)",652.0,423.8,1.1,652.0,50
HCPCS,99222,1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,50
HCPCS,99222,1st hosp ip/obs moderate 55,,,54.56,63.17,8
HCPCS,99222,VIRTUAL 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,50
HCPCS,99223,1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES,1400.0,910.0,1.1,1400.0,50
HCPCS,99223,1st hosp ip/obs high 75,,,54.56,63.17,8
HCPCS,99224,Subsequent observation care,,,54.56,63.17,8
HCPCS,99225,Subsequent observation care,,,54.56,63.17,8
HCPCS,99226,Subsequent observation care,,,54.56,63.17,8
HCPCS,99231,SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,50
HCPCS,99231,Sbsq hosp ip/obs sf/low 25,,,54.56,63.17,8
HCPCS,99231,VIRTUAL  SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,50
HCPCS,99232,SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,50
HCPCS,99232,Sbsq hosp ip/obs moderate 35,,,54.56,63.17,8
HCPCS,99232,VIRTUAL SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,50
HCPCS,99233,SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,50
HCPCS,99233,Sbsq hosp ip/obs high 50,,,54.56,63.17,8
HCPCS,99233,VIRTUAL SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,50
HCPCS,99234,HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN,800.0,520.0,1.1,800.0,50
HCPCS,99234,Hosp ip/obs sm dt sf/low 45,,,54.56,63.17,8
HCPCS,99234,VV HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN (99234),800.0,520.0,1.1,800.0,50
HCPCS,99235,HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN,1296.0,842.4,1.1,1296.0,50
HCPCS,99235,Hosp ip/obs same date mod 70,,,54.56,63.17,8
HCPCS,99235,VV HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN (99235),1296.0,842.4,1.1,1296.0,50
HCPCS,99236,HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN,1720.0,1118.0,1.1,1720.0,50
HCPCS,99236,Hosp ip/obs same date hi 85,,,54.56,63.17,8
HCPCS,99236,VV HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN (99236),1720.0,1118.0,1.1,1720.0,50
HCPCS,99238,HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<,600.0,390.0,1.1,600.0,50
HCPCS,99238,Hosp ip/obs dschrg mgmt 30/<,,,17.35,20.09,8
HCPCS,99238,VIRTUAL IP/OBS DISCHARGE =/<30 MIN,600.0,390.0,1.1,600.0,50
HCPCS,99239,HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN,860.0,559.0,1.1,860.0,50
HCPCS,99239,Hosp ip/obs dschrg mgmt >30,,,17.35,20.09,8
HCPCS,99239,VIRTUAL IP/OBS DISCHARGE DAY > 30 MIN,860.0,559.0,1.1,860.0,50
HCPCS,99241,Office consultation,,,54.56,63.17,8
HCPCS,99242,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,42
HCPCS,99242,Off/op consltj new/est sf 20,,,54.56,63.17,8
HCPCS,99242,VV OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,42
HCPCS,99243,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,147.0,95.55,0.01,720.0,130
HCPCS,99243,VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,1.1,720.0,42
HCPCS,99244,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,42
HCPCS,99244,Off/op cnsltj new/est mod 40,,,54.56,63.17,8
HCPCS,99244,VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,42
HCPCS,99245,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,42
HCPCS,99245,Off/op consltj new/est hi 55,,,54.56,63.17,8
HCPCS,99245,VV OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,42
HCPCS,99251,Inpatient consultation,,,54.56,63.17,8
HCPCS,99252,IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES,600.0,390.0,1.1,600.0,39
HCPCS,99252,Ip/obs consltj new/est sf 35,,,54.56,63.17,8
HCPCS,99253,IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES,880.0,572.0,1.1,880.0,39
HCPCS,99253,Ip/obs cnsltj new/est low 45,,,54.56,63.17,8
HCPCS,99253,VIRTUAL INPATIENT CONSULTATION SERVICES (45 MIN),880.0,572.0,1.1,880.0,39
HCPCS,99254,IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES,1197.0,778.05,1.1,1197.0,39
HCPCS,99254,Ip/obs cnsltj new/est mod 60,,,54.56,63.17,8
HCPCS,99255,IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES,1698.0,1103.7,1.1,1698.0,39
HCPCS,99255,Ip/obs consltj new/est hi 80,,,54.56,63.17,8
HCPCS,99281,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,359.0,233.35,1.1,2453.0,172
HCPCS,99282,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,751.0,488.15000000000003,1.1,2453.0,172
HCPCS,99283,EMERGENCY DEPARTMENT VISIT LOW MDM,1307.5,849.875,1.1,2453.0,172
HCPCS,99284,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2072.0,1346.8,1.1,2735.0,172
HCPCS,99285,EMERGENCY DEPARTMENT VISIT HIGH MDM,2995.0,1946.75,1.1,3807.0,172
HCPCS,99288,Direct advanced life support,,,54.56,63.17,8
HCPCS,99291,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,3897.0,2533.05,1.1,5232.6,175
HCPCS,99292,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,1738.5,1130.025,1.1,2453.0,145
HCPCS,99304,1st nf care sf/low mdm 25,,,54.56,63.17,8
HCPCS,99304,INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN,600.0,390.0,1.1,600.0,50
HCPCS,99305,1st nf care moderate mdm 35,,,54.56,63.17,8
HCPCS,99305,INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES,1000.0,650.0,1.1,1000.0,50
HCPCS,99306,1st nf care high mdm 50,,,54.56,63.17,8
HCPCS,99306,INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES,1400.0,910.0,1.1,1400.0,50
HCPCS,99307,SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES,280.0,182.0,1.1,280.0,50
HCPCS,99307,Sbsq nf care sf mdm 10,,,54.56,63.17,8
HCPCS,99308,SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES,520.0,338.0,1.1,520.0,50
HCPCS,99308,Sbsq nf care low mdm 20,,,54.56,63.17,8
HCPCS,99309,SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES,768.0,499.2,1.1,768.0,50
HCPCS,99309,Sbsq nf care moderate mdm 30,,,54.56,63.17,8
HCPCS,99310,SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES,1120.0,728.0,1.1,1120.0,50
HCPCS,99310,Sbsq nf care high mdm 45,,,54.56,63.17,8
HCPCS,99315,NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME,600.0,390.0,1.1,600.0,50
HCPCS,99315,Nf dschrg mgmt 30 min/less,,,54.56,63.17,8
HCPCS,99316,NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME,1000.0,650.0,1.1,1000.0,50
HCPCS,99316,Nf dschrg mgmt 30 min+,,,54.56,63.17,8
HCPCS,99318,Annual nursing fac assessmnt,,,54.56,63.17,8
HCPCS,99324,Domicil/r-home visit new pat,,,54.56,63.17,8
HCPCS,99325,Domicil/r-home visit new pat,,,54.56,63.17,8
HCPCS,99326,Domicil/r-home visit new pat,,,54.56,63.17,8
HCPCS,99327,Domicil/r-home visit new pat,,,54.56,63.17,8
HCPCS,99328,Domicil/r-home visit new pat,,,54.56,63.17,8
HCPCS,99334,Domicil/r-home visit est pat,,,54.56,63.17,8
HCPCS,99335,Domicil/r-home visit est pat,,,54.56,63.17,8
HCPCS,99336,Domicil/r-home visit est pat,,,54.56,63.17,8
HCPCS,99337,Domicil/r-home visit est pat,,,54.56,63.17,8
HCPCS,99339,Domicil/r-home care supervis,,,17.35,20.09,8
HCPCS,99340,Domicil/r-home care supervis,,,17.35,20.09,8
HCPCS,99341,HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES,440.0,286.0,1.1,440.0,50
HCPCS,99341,HOME/RES VST NEW SF MDM 15,,,70.04,70.04,1
HCPCS,99341,Home/res vst new sf mdm 15,,,54.56,63.17,8
HCPCS,99342,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,579.0,376.35,1.1,726.0,100
HCPCS,99342,HOME/RES VST NEW LOW MDM 30,,,99.91,99.91,1
HCPCS,99342,Home/res vst new low mdm 30,,,54.56,63.17,8
HCPCS,99343,HOME VISIT NEW PATIENT,,,164.8,164.8,1
HCPCS,99343,"HOME VISIT,NEW PATIENT,LEVEL III",679.0,441.35,1.1,679.0,22
HCPCS,99343,Home visit new patient,,,54.56,63.17,8
HCPCS,99344,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,1112.0,722.8,1.1,1263.0,100
HCPCS,99344,HOME/RES VST NEW MOD MDM 60,,,233.81,233.81,1
HCPCS,99344,Home/res vst new mod mdm 60,,,54.56,63.17,8
HCPCS,99345,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1435.0,932.75,1.1,1707.0,100
HCPCS,99345,HOME/RES VST NEW HIGH MDM 75,,,284.28,284.28,1
HCPCS,99345,Home/res vst new high mdm 75,,,54.56,63.17,8
HCPCS,99347,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,332.0,215.79999999999998,1.1,396.0,100
HCPCS,99347,HOME/RES VST EST SF MDM 20,,,70.04,70.04,1
HCPCS,99347,Home/res vst est sf mdm 20,,,54.56,63.17,8
HCPCS,99348,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,464.0,301.6,1.1,660.0,100
HCPCS,99348,HOME/RES VST EST LOW MDM 30,,,107.12,107.12,1
HCPCS,99348,Home/res vst est low mdm 30,,,54.56,63.17,8
HCPCS,99349,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,849.0,551.85,1.1,1074.0,100
HCPCS,99349,HOME/RES VST EST MOD MDM 40,,,163.77,163.77,1
HCPCS,99349,Home/res vst est mod mdm 40,,,54.56,63.17,8
HCPCS,99350,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,1232.0,800.8,1.1,1584.0,100
HCPCS,99350,HOME/RES VST EST HIGH MDM 60,,,228.66,228.66,1
HCPCS,99350,Home/res vst est high mdm 60,,,54.56,63.17,8
HCPCS,99354,PROLNG SVC O/P 1ST HOUR,,,165.83,165.83,1
HCPCS,99354,Prolng svc o/p 1st hour,,,50.62,58.61,8
HCPCS,99355,PROLNG SVC O/P EA ADDL 30,,,125.66,125.66,1
HCPCS,99355,Prolng svc o/p ea addl 30,,,50.62,58.61,8
HCPCS,99356,PROLNG SVC I/P/OBS 1ST HOUR,,,118.45,118.45,1
HCPCS,99356,Prolng svc i/p/obs 1st hour,,,50.62,58.61,8
HCPCS,99357,PROLNG SVC I/P/OBS EA ADDL,,,119.48,119.48,1
HCPCS,99357,Prolng svc i/p/obs ea addl,,,50.62,58.61,8
HCPCS,99358,PROLONGED E&M SERVICE-1ST HOUR,792.0,514.8,1.1,792.0,35
HCPCS,99358,Prolong service w/o contact,,,50.62,58.61,8
HCPCS,99359,"PROLONGED SERV,NO CONTCT,EA ADD 1/2",330.0,214.5,1.1,330.0,33
HCPCS,99359,Prolong serv w/o contact add,,,50.62,58.61,8
HCPCS,99360,"PHYSICIAN STANDBY SERV,EA 30 MIN",480.0,312.0,1.1,480.0,33
HCPCS,99360,Physician standby services,,,321.96,372.8,8
HCPCS,99366,Team conf w/pat by hc prof,,,17.35,20.09,8
HCPCS,99367,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,440.0,286.0,1.1,440.0,33
HCPCS,99367,Team conf w/o pat by phys,,,17.35,20.09,8
HCPCS,99368,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,288.0,187.2,1.1,288.0,33
HCPCS,99368,Team conf w/o pat by hc pro,,,17.35,20.09,8
HCPCS,99374,"HOME HEALTH CARE SUPERV,15-29 MIN",440.0,286.0,1.1,440.0,36
HCPCS,99379,"NURSING FAC CARE SUPERVN,15-29 MIN",440.0,286.0,1.1,440.0,36
HCPCS,99381,INIT PM E/M NEW PAT INF <1 YR,25.0,16.25,1.1,230.81,42
HCPCS,99381,Init pm e/m new pat infant,,,54.56,63.17,8
HCPCS,99381,"PREVENTIVE VISIT,NEW,INFANT",600.0,390.0,1.1,600.0,42
HCPCS,99382,INIT PM E/M NEW PAT 1-4 YRS,25.0,16.25,1.1,241.67,42
HCPCS,99382,Init pm e/m new pat 1-4 yrs,,,54.56,63.17,8
HCPCS,99382,"PREVENTIVE VISIT,NEW,AGE 1-4",640.0,416.0,1.1,640.0,42
HCPCS,99383,PREV VISIT NEW AGE 5-11,25.0,16.25,1.1,251.08,42
HCPCS,99383,"PREVENTIVE VISIT,NEW,AGE5-11",680.0,442.0,1.1,680.0,42
HCPCS,99383,Prev visit new age 5-11,,,54.56,63.17,8
HCPCS,99384,PREV VISIT NEW AGE 12-17,25.0,16.25,1.1,282.18,42
HCPCS,99384,Prev visit new age 12-17,,,54.56,63.17,8
HCPCS,99384,WELLNESS EXAMS NEW 12-17 YRS,800.0,520.0,1.1,800.0,42
HCPCS,99385,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,184.0,119.6,0.01,184.0,46
HCPCS,99385,PREV VISIT NEW AGE 18-39,25.0,16.25,1.1,274.24,42
HCPCS,99385,WELLNESS EXAM NEW 18-39 YRS,768.0,499.2,1.1,768.0,42
HCPCS,99386,PREV VISIT NEW AGE 40-64,25.0,16.25,1.1,316.84,42
HCPCS,99386,Prev visit new age 40-64,,,54.56,63.17,8
HCPCS,99386,WELLNESS EXAMS NEW 40-64 YRS,932.0,605.8,1.1,932.0,42
HCPCS,99387,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,291.0,189.15,0.01,291.0,46
HCPCS,99387,WELLNESS EXAMS NEW 65+ YRS,1000.0,650.0,1.1,1000.0,42
HCPCS,99391,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,144.0,93.6,0.01,144.0,46
HCPCS,99391,"PREVENTIVE VISIT,EST,INFANT",548.0,356.2,1.1,548.0,42
HCPCS,99392,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,153.0,99.45,0.01,153.0,46
HCPCS,99392,"PREVENTIVE VISIT,EST,AGE 1-4",600.0,390.0,1.1,600.0,42
HCPCS,99393,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,185.0,120.25,0.01,185.0,46
HCPCS,99393,"PREVENTIVE VISIT,EST,AGE5-11",600.0,390.0,1.1,600.0,42
HCPCS,99394,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,211.0,137.15,0.01,211.0,46
HCPCS,99394,"PREVENTIVE VISIT,EST,12-17",680.0,442.0,1.1,680.0,42
HCPCS,99395,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,313.0,203.45,0.01,313.0,46
HCPCS,99395,WELLNESS EXAMS EST 18-39 YRS,700.0,455.0,1.1,700.0,42
HCPCS,99396,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,230.0,149.5,0.01,230.0,46
HCPCS,99396,WELLNESS EXAMS EST 40-64 YRS,760.0,494.0,1.1,760.0,42
HCPCS,99397,PER PM REEVAL EST PAT 65+ YR,25.0,16.25,1.1,282.85,42
HCPCS,99397,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,243.0,157.95,0.01,243.0,46
HCPCS,99397,WELLNESS EXAMS EST 65+ YRS,800.0,520.0,1.1,800.0,42
HCPCS,99401,"PREVENT COUNSEL,INDIV,15 MIN",25.0,16.25,1.1,80.85,42
HCPCS,99401,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,158.0,102.69999999999999,0.01,192.0,88
HCPCS,99402,"PREVENT COUNSEL,INDIV,30 MIN",25.0,16.25,1.1,132.87,42
HCPCS,99402,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,307.0,199.55,0.01,392.0,88
HCPCS,99403,"PREVENT COUNSEL,INDIV,45 MIN",25.0,16.25,1.1,183.44,42
HCPCS,99403,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,584.0,379.6,1.1,584.0,42
HCPCS,99403,Prev med cnsl indiv apprx 45,,,68.71,79.56,8
HCPCS,99404,PREV MED CNSL INDIV APPRX 60,,,129.78,129.78,1
HCPCS,99404,"PREVENT COUNSEL,INDIV,60 MIN",25.0,16.25,1.1,234.72,42
HCPCS,99404,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,780.0,507.0,1.1,780.0,42
HCPCS,99404,Prev med cnsl indiv apprx 60,,,68.71,79.56,8
HCPCS,99406,BEHAV CHNG SMOKING 3-10,25.0,16.25,1.1,42.27,53
HCPCS,99406,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,92.5,60.125,1.1,105.02,114
HCPCS,99407,BEHAV CHNG SMOKING > 10,25.0,16.25,1.1,58.85,53
HCPCS,99407,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,144.5,93.925,1.1,200.0,114
HCPCS,99408,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,189.0,122.85,1.1,260.0,82
HCPCS,99408,"AUDIT/DAST, 15-30 MIN",25.0,16.25,1.1,73.3,36
HCPCS,99409,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,387.5,251.875,1.1,520.0,82
HCPCS,99409,"AUDIT/DAST, OVER 30 MIN",25.0,16.25,1.1,141.9,36
HCPCS,99411,Preventive counseling group,,,68.71,79.56,8
HCPCS,99412,Preventive counseling group,,,68.71,79.56,8
HCPCS,99415,PROLNG CLIN STAFF SVC 1ST HR,,,12.36,12.36,1
HCPCS,99415,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,273.0,177.45,1.1,273.0,50
HCPCS,99415,Prolng clin staff svc 1st hr,,,50.62,58.61,8
HCPCS,99416,PROLNG CLIN STAFF SVC EA ADD,,,7.21,7.21,1
HCPCS,99416,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,273.0,177.45,1.1,273.0,50
HCPCS,99416,Prolng clin staff svc ea add,,,50.62,58.61,8
HCPCS,99417,PROLNG OP E/M EACH 15 MIN,,,64.89,64.89,1
HCPCS,99417,PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,41
HCPCS,99417,Prolng op e/m each 15 min,,,50.62,58.61,8
HCPCS,99417,VIRTUAL PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,41
HCPCS,99418,PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,39
HCPCS,99418,Prolng ip/obs e/m ea 15 min,,,50.62,58.61,8
HCPCS,99418,VV?PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,39
HCPCS,99421,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,52
HCPCS,99421,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,65.0,42.25,1.1,65.0,52
HCPCS,99421,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,52
HCPCS,99421,Ol dig e/m svc 5-10 min,,,54.56,63.17,8
HCPCS,99422,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,52
HCPCS,99422,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,80.0,52.0,1.1,80.0,52
HCPCS,99422,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,52
HCPCS,99422,Ol dig e/m svc 11-20 min,,,54.56,63.17,8
HCPCS,99423,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES,120.0,78.0,1.1,120.0,52
HCPCS,99423,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,120.0,78.0,1.1,120.0,52
HCPCS,99423,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 21+ MINUTES,120.0,78.0,1.1,120.0,52
HCPCS,99423,Ol dig e/m svc 21+ min,,,54.56,63.17,8
HCPCS,99424,PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO,580.0,377.0,1.1,580.0,46
HCPCS,99425,PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO,400.0,260.0,1.1,400.0,46
HCPCS,99426,PRIN CARE MGMT STAFF 1ST 30,,,85.47,284.74,19
HCPCS,99426,PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO,400.0,260.0,1.1,400.0,46
HCPCS,99427,PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO,284.0,184.6,1.1,284.0,46
HCPCS,99429,UNLISTED PREVENTIVE MEDICINE SERVICE,94.0,61.1,0.01,1545999.98,28
HCPCS,99429,Unlisted preventive service,,,50.62,58.61,8
HCPCS,99437,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,440.0,286.0,1.1,440.0,46
HCPCS,99439,CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN,280.0,182.0,1.1,280.0,46
HCPCS,99441,PHONE E/M PHYS/QHP 5-10 MIN,,,70.04,70.04,1
HCPCS,99441,Phone e/m phys/qhp 5-10 min,,,54.56,63.17,8
HCPCS,99442,PHONE E/M PHYS/QHP 11-20 MIN,,,113.3,113.3,1
HCPCS,99442,Phone e/m phys/qhp 11-20 min,,,54.56,63.17,8
HCPCS,99443,PHONE E/M PHYS/QHP 21-30 MIN,,,160.68,160.68,1
HCPCS,99443,Phone e/m phys/qhp 21-30 min,,,54.56,63.17,8
HCPCS,99445,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,150.0,97.5,0.01,263.0,82
HCPCS,99446,NTRPROF PH1/NTRNET/EHR 5-10,,,27.81,27.81,1
HCPCS,99446,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN,154.0,100.1,1.1,154.0,50
HCPCS,99447,NTRPROF PH1/NTRNET/EHR 11-20,,,55.62,55.62,1
HCPCS,99447,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN,280.0,182.0,1.1,280.0,50
HCPCS,99448,NTRPROF PH1/NTRNET/EHR 21-30,,,83.43,83.43,1
HCPCS,99448,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN,420.0,273.0,1.1,420.0,50
HCPCS,99449,NTRPROF PH1/NTRNET/EHR 31/>,,,111.24,111.24,1
HCPCS,99449,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN,560.0,364.0,1.1,560.0,50
HCPCS,99450,Basic life disability exam,,,54.56,63.17,8
HCPCS,99450,LIFE/DISABILITY EVALUATION,651.0,423.15,1.1,651.0,29
HCPCS,99451,NTRPROF PH1/NTRNET/EHR 5/>,,,56.65,56.65,1
HCPCS,99451,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN,280.0,182.0,1.1,280.0,50
HCPCS,99452,NTRPROF PH1/NTRNET/EHR RFRL,,,56.65,56.65,1
HCPCS,99452,NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN,280.0,182.0,1.1,280.0,50
HCPCS,99453,REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP,37.0,24.05,1.1,194.72,50
HCPCS,99453,REMOTE MONITORING EDUCATION AND SET UP,889.0,577.85,37.45,889.0,61
HCPCS,99454,REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D,118.0,76.7,1.1,118.0,50
HCPCS,99454,"REMOTE MONITORING, INITIAL SUPPLY",257.0,167.05,34.46,257.0,53
HCPCS,99455,FIT FOR DUTY,63.5,41.28,1.1,187.58,29
HCPCS,99455,WORK RELATED DISABILITY EXAM,25.0,16.25,1.1,187.58,29
HCPCS,99455,WORK RELATED/MED DBLT XM TREATING PHYS,193.0,125.45,1.1,193.0,29
HCPCS,99455,Work related disability exam,,,54.56,63.17,8
HCPCS,99456,Disability examination,,,54.56,63.17,8
HCPCS,99456,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,918.0,596.7,1.1,918.0,29
HCPCS,99457,REMOTE MONITORING 20 MIN,72.0,46.8,15.7,239.0,38
HCPCS,99457,REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH,244.0,158.6,1.1,244.0,53
HCPCS,99459,PELVIC EXAMINATION,53.0,34.45,1.1,53.0,50
HCPCS,99459,Pelvic examination,,,54.56,63.17,8
HCPCS,99460,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,768.0,499.2,1.1,768.0,50
HCPCS,99460,INIT NB EM PER DAY HOSP,,,119.07,373.16,19
HCPCS,99460,Init nb em per day hosp,,,54.56,63.17,8
HCPCS,99461,Init nb em per day non-fac,,,54.56,63.17,8
HCPCS,99462,SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN,336.0,218.4,1.1,336.0,50
HCPCS,99462,Sbsq nb em per day hosp,,,54.56,63.17,8
HCPCS,99463,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,852.0,553.8,1.1,852.0,50
HCPCS,99463,SAME DAY NB DISCHARGE,,,119.07,373.16,19
HCPCS,99463,Same day nb discharge,,,54.56,63.17,8
HCPCS,99464,ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN,600.0,390.0,1.1,600.0,50
HCPCS,99464,Attendance at delivery,,,321.96,372.8,8
HCPCS,99465,DELIVERY/BIRTHING ROOM RESUSCITATION,2843.5,1848.275,1.1,4515.0,172
HCPCS,99466,Ped crit care transport,,,54.56,63.17,8
HCPCS,99467,Ped crit care transport addl,,,54.56,63.17,8
HCPCS,99468,1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<,8122.0,5279.3,1.1,8122.0,50
HCPCS,99468,Neonate crit care initial,,,54.56,63.17,8
HCPCS,99469,Neonate crit care subsq,,,54.56,63.17,8
HCPCS,99469,SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<,3516.0,2285.4,1.1,3516.0,50
HCPCS,99470,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,190.0,123.5,0.01,244.0,73
HCPCS,99471,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,7031.0,4570.15,1.1,7031.0,50
HCPCS,99471,Ped critical care initial,,,54.56,63.17,8
HCPCS,99472,Ped critical care subsq,,,54.56,63.17,8
HCPCS,99472,SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO,3516.0,2285.4,1.1,3516.0,50
HCPCS,99473,SELF-MEAS BP PT EDUCAJ/TRAIN,,,22.63,81.07,19
HCPCS,99473,SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION,221.0,143.65,1.1,221.0,50
HCPCS,99473,Self-meas bp pt educaj/train,,,68.77,79.63,8
HCPCS,99474,SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD,72.0,46.8,1.1,72.0,52
HCPCS,99475,Ped crit care age 2-5 init,,,54.56,63.17,8
HCPCS,99476,Ped crit care age 2-5 subsq,,,54.56,63.17,8
HCPCS,99477,INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL,3080.0,2002.0,1.1,3080.0,50
HCPCS,99477,Init day hosp neonate care,,,54.56,63.17,8
HCPCS,99478,SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS,1210.0,786.5,1.1,1210.0,50
HCPCS,99478,"Sbsq ic vlbw inf<1,500 gm",,,54.56,63.17,8
HCPCS,99479,SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS,1100.0,715.0,1.1,1100.0,50
HCPCS,99479,"Sbsq ic lbw inf 1,500-2,500",,,54.56,63.17,8
HCPCS,99480,SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS,1056.0,686.4,1.1,1056.0,50
HCPCS,99480,"Sbsq ic inf pbw 2,501-5,000",,,54.56,63.17,8
HCPCS,99483,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,1164.0,756.6,1.1,1690.0,114
HCPCS,99484,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,372.0,241.8,1.1,372.0,47
HCPCS,99484,CARE MGMT SVC BHVL HLTH COND,,,27.53,105.02,19
HCPCS,99485,Suprv interfacilty transport,,,54.56,63.17,8
HCPCS,99486,Suprv interfac trnsport addl,,,54.56,63.17,8
HCPCS,99487,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,724.0,470.6,1.1,724.0,47
HCPCS,99487,CPLX CHRNC CARE 1ST 60 MIN,,,148.46,497.49,19
HCPCS,99490,CHRNC CARE MGMT STAFF 1ST 20,,,85.47,284.74,19
HCPCS,99490,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,400.0,260.0,1.1,400.0,47
HCPCS,99491,CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH,600.0,390.0,1.1,600.0,46
HCPCS,99492,1ST PSYC COLLAB CARE MGMT,,,85.47,284.74,19
HCPCS,99492,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,827.0,537.55,1.1,827.0,47
HCPCS,99493,SBSQ PSYC COLLAB CARE MGMT,,,85.47,284.74,19
HCPCS,99493,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,902.0,586.3,1.1,902.0,47
HCPCS,99494,1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS,361.0,234.65,1.1,361.0,47
HCPCS,99495,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,889.0,577.85,0.01,1112.0,155
HCPCS,99496,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,889.0,577.85,0.01,1516.0,155
HCPCS,99497,ADVANCE CARE PLANNING FIRST 30 MINS,600.0,390.0,1.1,600.0,53
HCPCS,99497,ADVNCD CARE PLAN 30 MIN,,,85.47,284.74,19
HCPCS,99497,Advncd care plan 30 min,,,17.35,20.09,8
HCPCS,99498,ADVANCE CARE PLANNING EA ADDL 30 MINS,560.0,364.0,1.1,560.0,53
HCPCS,99498,Advncd care plan addl 30 min,,,17.35,20.09,8
HCPCS,99499,BUS PHYSICAL,50.0,32.5,0.01,1545999.98,28
HCPCS,99499,CLINIC VISIT LAB CHARGE,5.0,3.25,0.01,1545999.98,28
HCPCS,99499,COSMETIC ASSESSMENT,99.0,64.35,0.01,1545999.98,28
HCPCS,99499,COSMETIC ESTABLISHED,75.0,48.75,0.01,1545999.98,28
HCPCS,99499,DOT PHYSICAL,200.0,130.0,0.01,1545999.98,28
HCPCS,99499,SPORTS EXAM OR PHYSICAL,35.0,22.75,0.01,1545999.98,28
HCPCS,99499,Unlisted e&m service,,,54.56,63.17,8
HCPCS,99605,Mtms by pharm np 15 min,,,50.62,58.61,8
HCPCS,99606,Mtms by pharm est 15 min,,,50.62,58.61,8
HCPCS,99607,Mtms by pharm addl 15 min,,,50.62,58.61,8
HCPCS,99999,ONLINE BASIC REVIEW,20.0,13.0,1.1,20.0,22
HCPCS,99999,ONLINE BASIC TRTMNT PLAN,49.0,31.85,1.1,49.0,22
HCPCS,99999,ONLINE MODERATE PLAN,100.0,65.0,1.1,100.0,22
HCPCS,99999,ONLINE MODERATE REVIEW,75.0,48.75,1.1,75.0,22
HCPCS,A2001,"Innovamatrix ac, per sq cm",,,117.73,3119.04,16
HCPCS,A200100,"Innovamatrix ac, per sq cm",,,2670.0,2670.0,1
HCPCS,A2002,Mirragen adv wnd mat per sq,,,117.73,374.14,14
HCPCS,A2004,"Xcellistem, 1 mg",,,8.84,35.57,11
HCPCS,A200400,"Xcellistem, 1 mg",,,27.77,27.77,1
HCPCS,A2005,"Microlyte matrix, per sq cm",,,117.73,547.33,14
HCPCS,A2006,Novosorb synpath per sq cm,,,117.73,348.8,13
HCPCS,A2007,"Restrata, per sq cm",,,117.73,551.76,16
HCPCS,A200700,"Restrata, per sq cm",,,430.76,430.76,1
HCPCS,A2008,"Theragenesis, per sq cm",,,117.73,405.77,16
HCPCS,A200800,"Theragenesis, per sq cm",,,316.79,316.79,1
HCPCS,A2009,"Symphony, per sq cm",,,117.73,348.8,14
HCPCS,A2010,"Apis, per square centimeter",,,117.73,348.8,13
HCPCS,A2011,"Supra sdrm, per sq cm",,,117.73,1012.39,21
HCPCS,A2012,"Suprathel, per sq cm",,,117.73,1012.39,21
HCPCS,A2013,"Innovamatrix fs, per sq cm",,,117.73,3488.4,24
HCPCS,A201300,"Innovamatrix fs, per sq cm",,,2883.6,2883.6,1
HCPCS,A2014,Omeza collag compl 100 mg,,,153.19,273.68,3
HCPCS,A2014,Omeza collag per 100 mg,,,874.33,1012.39,8
HCPCS,A201400,Omeza collag compl 100 mg,,,273.68,273.68,1
HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,117.73,3093.12,22
HCPCS,A2016,"Permeaderm b, per sq cm",,,117.73,1012.39,21
HCPCS,A2017,"Permeaderm glove, each",,,874.33,1012.39,8
HCPCS,A2018,"Permeaderm c, per sq cm",,,117.73,1012.39,21
HCPCS,A2019,Kerecis marigen shld sq cm,,,117.73,1549.05,16
HCPCS,A201900,Kerecis marigen shld sq cm,,,1271.77,1271.77,1
HCPCS,A2021,Neomatrix per sq cm,,,117.73,4717.48,16
HCPCS,A202100,Neomatrix per sq cm,,,3682.94,3682.94,1
HCPCS,A2022,Innovabrn/innovamatx xl sqcm,,,117.73,3556.8,16
HCPCS,A202200,Innovabrn/innovamatx xl sqcm,,,3043.8,3043.8,1
HCPCS,A2023,"Innovamatrix pd, 1 mg",,,31.99,41.04,3
HCPCS,A202300,"Innovamatrix pd, 1 mg",,,34.71,34.71,1
HCPCS,A2024,Resolve or xenopatch sq cm,,,117.73,4172.7,14
HCPCS,A2025,Miro3d per cubic cm,,,117.73,570.0,16
HCPCS,A202500,Miro3d per cubic cm,,,445.0,445.0,1
HCPCS,A2027,Matriderm per sq cm,,,117.73,348.8,13
HCPCS,A2028,Micromatrix flex per mg,,,1671.21,2080.45,2
HCPCS,A202800,Micromatrix flex per mg,,,1671.21,1671.21,1
HCPCS,A2029,Mirotract matrix sheet,,,117.73,1140.0,15
HCPCS,A202900,Mirotract matrix sheet,,,890.0,890.0,1
HCPCS,A2030,"Miro3d fibers, per mg",,,9.79,9.79,1
HCPCS,A203000,"Miro3d fibers, per mg",,,9.79,9.79,1
HCPCS,A2031,"Mirodry, per sq cm",,,117.73,1068.0,14
HCPCS,A203100,"Mirodry, per sq cm",,,1068.0,1068.0,1
HCPCS,A2032,"Myriad matrix, per sq cm",,,36.85,36.85,1
HCPCS,A203200,"Myriad matrix, per sq cm",,,36.85,36.85,1
HCPCS,A2033,"Myriad morcells, 4 mg",,,23.5,23.5,1
HCPCS,A203300,"Myriad morcells, 4 mg",,,23.5,23.5,1
HCPCS,A2036,Cohealyx col dml mx pr sq cm,,,117.73,348.8,13
HCPCS,A2038,"Marigen pacto, per sq cm",,,117.73,348.8,13
HCPCS,A2039,"Innovamatrix fd, per sq cm",,,117.73,348.8,13
HCPCS,A4100,Nosht skin sub fda clrd nos,,,874.33,1012.39,8
HCPCS,A4206,1 cc sterile syringe&needle,,,13.46,15.59,8
HCPCS,A4207,2 cc sterile syringe&needle,,,13.46,15.59,8
HCPCS,A4208,3 cc sterile syringe&needle,,,13.46,15.59,8
HCPCS,A4209,5+ cc sterile syringe&needle,,,13.46,15.59,8
HCPCS,A4210,Nonneedle injection device,,,13.46,15.59,8
HCPCS,A4211,Supp for self-adm injections,,,13.46,15.59,8
HCPCS,A4212,Non coring needle or stylet,,,13.46,15.59,8
HCPCS,A4213,20+ cc syringe only,,,13.46,15.59,8
HCPCS,A4215,Sterile needle,,,13.46,15.59,8
HCPCS,A4216,"Sterile water/saline, 10 ml",,,1.84,15.59,10
HCPCS,A4217,"Sterile water/saline, 500 ml",,,13.46,17.87,10
HCPCS,A4218,Sterile saline or water,,,13.46,15.59,8
HCPCS,A4220,Infusion pump refill kit,,,8.84,10.24,8
HCPCS,A4221,Supp non-insulin inf cath/wk,,,8.84,103.43,10
HCPCS,A4222,Infusion supplies with pump,,,28.98,196.19,10
HCPCS,A4223,Infusion supplies w/o pump,,,13.46,15.59,8
HCPCS,A4224,Supply insulin inf cath/wk,,,13.46,103.43,10
HCPCS,A4225,Sup/ext insulin inf pump syr,,,11.79,15.59,10
HCPCS,A4226,Weekly supply maint cgs pump,,,13.46,15.59,8
HCPCS,A4230,Infus insulin pump non needl,,,672.04,778.15,8
HCPCS,A4231,Infusion insulin pump needle,,,50.71,306.12,10
HCPCS,A423100,Infusion insulin pump needle,,,50.71,50.71,1
HCPCS,A4232,Syringe w/needle insulin 3cc,,,13.46,15.59,8
HCPCS,A4233,Alkalin batt for glucose mon,,,1.73,15.59,10
HCPCS,A4234,J-cell batt for glucose mon,,,8.02,15.59,10
HCPCS,A4235,Lithium batt for glucose mon,,,3.4,15.59,10
HCPCS,A4236,Silvr oxide batt glucose mon,,,3.94,15.59,10
HCPCS,A4238,Adju cgm supply allowance,,,46.46,1122.33,10
HCPCS,A4239,Non-adju cgm supply allow,,,46.46,1092.63,10
HCPCS,A4244,Alcohol or peroxide per pint,,,13.46,15.59,8
HCPCS,A4245,Alcohol wipes per box,,,13.46,15.59,8
HCPCS,A4246,Betadine/phisohex solution,,,13.46,15.59,8
HCPCS,A4247,Betadine/iodine swabs/wipes,,,8.84,10.24,8
HCPCS,A4248,Chlorhexidine antisept,,,0.05,15.59,10
HCPCS,A424800,Chlorhexidine antisept,,,0.05,0.05,1
HCPCS,A4250,Urine reagent strips/tablets,,,13.46,15.59,8
HCPCS,A4252,Blood ketone test or strip,,,13.46,15.59,8
HCPCS,A4253,Blood glucose/reagent strips,,,13.46,33.27,10
HCPCS,A4255,Glucose monitor platforms,,,13.46,22.31,10
HCPCS,A4256,Calibrator solution/chips,,,8.84,13.51,10
HCPCS,A4257,Replace lensshield cartridge,,,8.84,72.73,10
HCPCS,A4258,Lancet device each,,,7.2,10.24,10
HCPCS,A4259,Lancets per box,,,4.83,15.59,10
HCPCS,A4261,Cervical cap contraceptive,,,8.84,10.24,8
HCPCS,A4262,Temporary tear duct plug,,,13.46,15.59,8
HCPCS,A4263,Permanent tear duct plug,,,8.84,10.24,8
HCPCS,A4264,Intratubal occlusion device,,,159.5,184.68,8
HCPCS,A4265,Paraffin,,,13.46,19.43,10
HCPCS,A4266,DIAPHRAGM,89.0,57.85,1.1,91.02,29
HCPCS,A4266,Diaphragm,,,28.98,33.56,8
HCPCS,A4267,Male condom,,,13.46,15.59,8
HCPCS,A4268,Female condom,,,13.46,15.59,8
HCPCS,A4269,Spermicide,,,13.46,15.59,8
HCPCS,A4270,Disposable endoscope sheath,,,28.98,33.56,8
HCPCS,A4271,Home lancing/test cartridges,,,13.46,136.34,10
HCPCS,A4280,Brst prsths adhsv attchmnt,,,13.46,30.35,10
HCPCS,A4281,Replacement breastpump tube,,,28.98,33.56,8
HCPCS,A4282,Replacement breastpump adpt,,,28.98,33.56,8
HCPCS,A4283,Replacement breastpump cap,,,28.98,33.56,8
HCPCS,A4284,Replcmnt breast pump shield,,,28.98,33.56,8
HCPCS,A4285,Replcmnt breast pump bottle,,,25.16,29.13,8
HCPCS,A4286,Replcmnt breastpump lok ring,,,28.98,33.56,8
HCPCS,A4287,Disp col sto bag breast milk,,,8.84,10.24,8
HCPCS,A4288,Replacement breastpump valve,,,13.46,15.59,8
HCPCS,A4290,Sacral nerve stim test lead,,,13.46,15.59,8
HCPCS,A4295,Straigh tip hydrophilic cath,,,8.26,15.59,10
HCPCS,A4296,Coude tip hydrophilic cath,,,13.46,31.11,10
HCPCS,A4297,Hydrophilic coat insert sup,,,13.46,39.86,10
HCPCS,A4300,Cath impl vasc access portal,,,8.84,10.24,8
HCPCS,A4301,Implantable access syst perc,,,8.84,10.24,8
HCPCS,A4305,Drug delivery system >=50 ml,,,8.84,10.24,8
HCPCS,A4306,Drug delivery system <=50 ml,,,8.84,10.24,8
HCPCS,A4310,Insert tray w/o bag/cath,,,13.46,44.02,10
HCPCS,A4311,Catheter w/o bag 2-way latex,,,8.84,84.4,10
HCPCS,A4312,Cath w/o bag 2-way silicone,,,8.84,102.75,10
HCPCS,A4313,Catheter w/bag 3-way,,,8.84,105.55,10
HCPCS,A4314,Cath w/drainage 2-way latex,,,28.98,144.06,10
HCPCS,A4315,Cath w/drainage 2-way silcne,,,28.98,150.29,10
HCPCS,A4316,Cath w/drainage 3-way,,,28.98,161.81,10
HCPCS,A4318,Fem urinary cup w/wo attch,,,13.46,15.59,8
HCPCS,A4320,Irrigation tray,,,13.46,27.11,10
HCPCS,A4321,Cath therapeutic irrig agent,,,13.46,15.59,8
HCPCS,A4322,Irrigation syringe,,,13.46,16.59,10
HCPCS,A4326,Male external catheter,,,8.84,59.09,10
HCPCS,A4327,Fem urinary collect dev cup,,,28.98,240.81,10
HCPCS,A4328,Fem urinary collect pouch,,,13.46,53.98,10
HCPCS,A4330,Stool collection pouch,,,13.46,34.7,10
HCPCS,A4331,Extension drainage tubing,,,13.46,18.11,10
HCPCS,A4332,Lube sterile packet,,,0.51,15.59,10
HCPCS,A4333,Urinary cath anchor device,,,10.74,15.59,10
HCPCS,A4334,Urinary cath leg strap,,,13.46,28.03,10
HCPCS,A4335,Incontinence supply,,,13.46,15.59,8
HCPCS,A4336,PR URETHRAL INSERT,148.0,96.2,1.1,148.0,33
HCPCS,A4336,Urethral insert,,,6.97,15.59,10
HCPCS,A4337,Incontinent rectal insert,,,13.46,15.59,8
HCPCS,A4338,Indwelling catheter latex,,,8.84,69.89,10
HCPCS,A4340,Indwelling catheter special,,,28.98,153.77,10
HCPCS,A4341,Iduc valve pat inst repl,,,28.98,1390.37,10
HCPCS,A4342,Iduc valve sply repl,,,8.84,3510.66,10
HCPCS,A4344,Cath indw foley 2 way silicn,,,8.84,91.2,10
HCPCS,A4346,Cath indw foley 3 way,,,13.46,111.59,10
HCPCS,A4349,Disposable male external cat,,,9.75,15.59,10
HCPCS,A4351,Straight tip urine catheter,,,8.26,15.59,10
HCPCS,A4352,Coude tip urinary catheter,,,13.46,31.11,10
HCPCS,A4353,Intermittent urinary cath,,,13.46,39.86,10
HCPCS,A4354,Cath insertion tray w/bag,,,8.84,67.29,10
HCPCS,A4355,Bladder irrigation tubing,,,13.46,50.82,10
HCPCS,A4356,Ext ureth clmp or compr dvc,,,28.98,260.0,10
HCPCS,A4357,BEDSIDE DRAINAGE BAG,18.0,11.7,1.1,44.6,33
HCPCS,A4357,Bedside drainage bag,,,13.46,55.34,10
HCPCS,A4358,URINARY LEG BAG,10.0,6.5,1.1,30.48,33
HCPCS,A4358,Urinary leg or abdomen bag,,,13.46,37.82,10
HCPCS,A4360,Disposable ext urethral dev,,,2.38,15.59,10
HCPCS,A4361,Ostomy face plate,,,8.84,104.59,10
HCPCS,A4362,Solid skin barrier,,,13.46,19.39,10
HCPCS,A4363,"Ostomy clamp, replacement",,,11.49,15.59,10
HCPCS,A4364,"Adhesive, liquid or equal",,,12.1,15.59,10
HCPCS,A4366,Ostomy vent,,,6.25,15.59,10
HCPCS,A4367,Ostomy belt,,,13.46,41.94,10
HCPCS,A4368,Ostomy filter,,,1.22,15.59,10
HCPCS,A4369,Skin barrier liquid per oz,,,11.76,15.59,10
HCPCS,A4371,Skin barrier powder per oz,,,13.46,20.79,10
HCPCS,A4372,Skin barrier solid 4x4 equiv,,,13.46,23.95,10
HCPCS,A4373,Skin barrier with flange,,,13.46,35.74,10
HCPCS,A4375,Drainable plastic pch w fcpl,,,8.84,97.84,10
HCPCS,A4376,Drainable rubber pch w fcplt,,,28.98,271.12,10
HCPCS,A4377,Drainable plstic pch w/o fp,,,13.46,24.43,10
HCPCS,A4378,Drainable rubber pch w/o fp,,,28.98,175.2,10
HCPCS,A4379,Urinary plastic pouch w fcpl,,,8.84,85.56,10
HCPCS,A4380,Urinary rubber pouch w fcplt,,,28.98,212.7,10
HCPCS,A4381,Urinary plastic pouch w/o fp,,,13.46,26.35,10
HCPCS,A4382,Urinary hvy plstc pch w/o fp,,,8.84,140.3,10
HCPCS,A4383,Urinary rubber pouch w/o fp,,,28.98,160.61,10
HCPCS,A4384,Ostomy faceplt/silicone ring,,,13.46,54.74,10
HCPCS,A4385,Ost skn barrier sld ext wear,,,13.46,29.03,10
HCPCS,A4387,Ost clsd pouch w att st barr,,,10.88,15.59,10
HCPCS,A4388,Drainable pch w ex wear barr,,,13.46,24.83,10
HCPCS,A4389,Drainable pch w st wear barr,,,13.46,35.34,10
HCPCS,A4390,Drainable pch ex wear convex,,,13.46,54.7,10
HCPCS,A4391,Urinary pouch w ex wear barr,,,13.46,40.26,10
HCPCS,A4392,Urinary pouch w st wear barr,,,13.46,46.58,10
HCPCS,A4393,Urine pch w ex wear bar conv,,,13.46,51.5,10
HCPCS,A4394,Ostomy pouch liq deodorant,,,12.54,15.59,10
HCPCS,A4395,Ostomy pouch solid deodorant,,,0.17,15.59,10
HCPCS,A4396,Peristomal hernia supprt blt,,,28.98,230.66,10
HCPCS,A4397,Irrigation supply sleeve,,,13.46,15.59,8
HCPCS,A4398,Ostomy irrigation bag,,,8.84,78.76,10
HCPCS,A4399,Ostomy irrig cone/cath w brs,,,8.84,59.41,10
HCPCS,A4400,Ostomy irrigation set,,,25.16,278.47,10
HCPCS,A4402,Lubricant per ounce,,,7.71,15.59,10
HCPCS,A4404,Ostomy ring each,,,7.44,15.59,10
HCPCS,A4405,Nonpectin based ostomy paste,,,13.46,19.47,10
HCPCS,A4406,Pectin based ostomy paste,,,13.46,32.63,10
HCPCS,A4407,"Ext wear ost skn barr <=4sq""",,,13.46,49.9,10
HCPCS,A4408,"Ext wear ost skn barr >4sq""",,,13.46,56.25,10
HCPCS,A4409,Ost skn barr convex <=4 sq i,,,13.46,35.34,10
HCPCS,A4410,Ost skn barr extnd >4 sq,,,13.46,51.5,10
HCPCS,A4411,Ost skn barr extnd =4sq,,,13.46,29.03,10
HCPCS,A4412,Ost pouch drain high output,,,13.12,15.59,10
HCPCS,A4413,2 pc drainable ost pouch,,,13.46,31.39,10
HCPCS,A4414,Ost sknbar w/o conv<=4 sq in,,,13.46,28.03,10
HCPCS,A4415,Ost skn barr w/o conv >4 sqi,,,13.46,34.18,10
HCPCS,A4416,Ost pch clsd w barrier/filtr,,,13.36,15.71,10
HCPCS,A4417,Ost pch w bar/bltinconv/fltr,,,13.46,21.23,10
HCPCS,A4418,Ost pch clsd w/o bar w filtr,,,8.77,15.59,10
HCPCS,A4419,Ost pch for bar w flange/flt,,,8.36,15.59,10
HCPCS,A4420,Ost pch clsd for bar w lk fl,,,13.46,15.59,8
HCPCS,A4421,Ostomy supply misc,,,13.46,15.59,8
HCPCS,A4422,Ost pouch absorbent material,,,0.51,15.59,10
HCPCS,A4423,Ost pch for bar w lk fl/fltr,,,8.97,15.59,10
HCPCS,A4424,Ost pch drain w bar & filter,,,13.46,27.11,10
HCPCS,A4425,Ost pch drain for barrier fl,,,13.46,20.39,10
HCPCS,A4426,Ost pch drain 2 piece system,,,13.22,15.59,10
HCPCS,A4427,Ost pch drain/barr lk flng/f,,,13.46,15.91,10
HCPCS,A4428,Urine ost pouch w faucet/tap,,,13.46,37.14,10
HCPCS,A4429,Urine ost pouch w bltinconv,,,13.46,47.02,10
HCPCS,A4430,Ost urine pch w b/bltin conv,,,13.46,48.54,10
HCPCS,A4431,Ost pch urine w barrier/tapv,,,13.46,35.34,10
HCPCS,A4432,Os pch urine w bar/fange/tap,,,13.46,20.43,10
HCPCS,A4433,Urine ost pch bar w lock fln,,,13.46,19.11,10
HCPCS,A4434,Ost pch urine w lock flng/ft,,,13.46,21.43,10
HCPCS,A4435,1pc ost pch drain hgh output,,,13.46,32.83,10
HCPCS,A4436,Irr supply sleev reus per mo,,,9.17,109.27,12
HCPCS,A443600,Irr supply sleev reus per mo,,,9.17,9.17,1
HCPCS,A4437,Irr supply sleev disp per mo,,,7.4,109.27,12
HCPCS,A443700,Irr supply sleev disp per mo,,,7.4,7.4,1
HCPCS,A4438,Adhesive clip ext ens contr,,,6.66,15.59,10
HCPCS,A4450,Non-waterproof tape,,,0.34,15.59,10
HCPCS,A4452,Waterproof tape,,,1.7,15.59,10
HCPCS,A4453,"Rec cath any transanal, each",,,8.84,56.13,10
HCPCS,A4455,Adhesive remover per ounce,,,6.9,15.59,10
HCPCS,A4456,"Adhesive remover, wipes",,,1.19,15.59,10
HCPCS,A4457,Enema tube any type repl,,,13.46,15.59,8
HCPCS,A4458,Reusable enema bag,,,13.46,15.59,8
HCPCS,A4459,"Transanal irrigation, any",,,13.46,641.39,10
HCPCS,A4461,Surgicl dress hold non-reuse,,,13.46,18.79,10
HCPCS,A4463,Surgical dress holder reuse,,,8.84,75.85,10
HCPCS,A4465,Non-elastic extremity binder,,,13.46,15.59,8
HCPCS,A4467,BELT STRAP SLEEV GRMNT COVER,48.0,31.2,1.1,111.78,29
HCPCS,A4467,Belt strap sleev grmnt cover,,,13.46,15.59,8
HCPCS,A4468,Exsuff belt incl all sup acc,,,1022.49,1183.93,8
HCPCS,A4470,Gravlee jet washer,,,13.46,15.59,8
HCPCS,A4479,"Electro pump enema, reusable",,,1022.49,1183.93,8
HCPCS,A4480,Vabra aspirator,,,13.46,15.59,8
HCPCS,A4481,Tracheostoma filter,,,1.73,15.59,10
HCPCS,A4483,Moisture exchanger,,,13.46,15.59,8
HCPCS,A4490,Above knee surgical stocking,,,8.84,10.24,8
HCPCS,A4495,Thigh length surg stocking,,,13.46,15.59,8
HCPCS,A4500,Below knee surgical stocking,,,13.46,15.59,8
HCPCS,A4510,Full length surg stocking,,,28.98,33.56,8
HCPCS,A4520,Incontinence garment anytype,,,13.46,15.59,8
HCPCS,A4540,Trans elec nerv periph nerv,,,72.46,83.9,8
HCPCS,A4541,Monthly supp use with e0733,,,28.98,164.21,10
HCPCS,A4542,Supp ext up limb tremor stim,,,28.98,2106.45,10
HCPCS,A4543,Supply trans elec nerve stim,,,25.16,29.13,8
HCPCS,A4544,Electro nerve stimulator rls,,,8.84,25.35,10
HCPCS,A4545,Suppl accessor tibial stim,,,28.98,154.09,10
HCPCS,A4550,Surgical trays,,,13.46,15.59,8
HCPCS,A4553,"Nondisp underpads, all sizes",,,13.46,15.59,8
HCPCS,A4554,Disposable underpads,,,13.46,15.59,8
HCPCS,A4555,Ca tx e-stim electr/transduc,,,28.98,33.56,8
HCPCS,A4556,"Electrodes, pair",,,8.84,69.21,10
HCPCS,A4557,"Lead wires, pair",,,8.84,52.78,10
HCPCS,A4558,Conductive gel or paste,,,13.46,31.07,10
HCPCS,A4559,Coupling gel or paste,,,0.44,15.59,10
HCPCS,A4560,Nmes disposable,,,28.98,33.56,8
HCPCS,A4561,"PESSARY RUBBER, ANY TYPE",53.0,34.45,1.1,94.19,33
HCPCS,A4561,"RUBBER PESSARY, ANY TYPE",109.0,70.85,8.84,116.79,48
HCPCS,A4562,"PESSARY, NON RUBBER",139.0,90.35,25.16,290.15,48
HCPCS,A4562,"PESSARY, NON RUBBER,ANY TYPE",89.0,57.85,1.1,233.98,33
HCPCS,A4563,Vag inser rectal control sys,,,28.98,6719.29,10
HCPCS,A4564,"Pessary, disposable any type",,,13.46,15.59,8
HCPCS,A4565,SLING PEDIATRIC MEDIUM,28.0,18.2,6.1,43.9,47
HCPCS,A4565,SLINGS,21.0,13.65,1.1,35.38,33
HCPCS,A4566,Should sling/vest/abrestrain,,,13.46,15.59,8
HCPCS,A4570,SPLINT,31.5,20.475,1.1,50.1,79
HCPCS,A4575,Hyperbaric o2 chamber disps,,,13.46,15.59,8
HCPCS,A4580,Cast supplies (plaster),,,13.46,15.59,8
HCPCS,A4590,"SHORT LEG SPLINT, FIBERGLASS",73.0,47.45,10.86,73.0,47
HCPCS,A4590,SPECIAL CASTING MATERIAL,41.0,26.65,1.1,64.51,32
HCPCS,A4593,Neuromod sti sys adj rehab,,,177.67,15554.11,10
HCPCS,A4594,Neuromod adj rehab mouthpie,,,672.04,12374.91,10
HCPCS,A4595,Tens suppl 2 lead per month,,,28.98,50.86,10
HCPCS,A4596,Ces system monthly supp,,,46.46,164.21,11
HCPCS,A4600,"Sleeve, inter limb comp dev",,,8.84,10.24,8
HCPCS,A4601,Lith ion non prosth recharge,,,13.46,15.59,8
HCPCS,A4602,Replace lithium battery 1.5v,,,13.46,21.23,10
HCPCS,A4604,Tubing with heating element,,,25.16,199.11,10
HCPCS,A4605,Trach suction cath close sys,,,8.84,93.48,10
HCPCS,A4606,Oxygen probe used w oximeter,,,13.46,15.59,8
HCPCS,A4608,Transtracheal oxygen cath,,,25.16,285.63,10
HCPCS,A4611,Heavy duty battery,,,278.93,322.97,8
HCPCS,A4612,Battery cables,,,25.16,29.13,8
HCPCS,A4613,Battery charger,,,46.46,53.79,8
HCPCS,A4614,Hand-held pefr meter,,,8.84,135.5,10
HCPCS,A4615,Cannula nasal,,,3.53,15.59,10
HCPCS,A4616,Tubing (oxygen) per foot,,,0.27,15.59,10
HCPCS,A4617,Mouth piece,,,13.46,17.67,10
HCPCS,A4618,Breathing circuits,,,4.25,15.59,10
HCPCS,A4619,Face tent,,,8.73,15.59,10
HCPCS,A4620,Variable concentration mask,,,3.09,15.59,10
HCPCS,A4623,Tracheostomy inner cannula,,,13.46,31.75,10
HCPCS,A4624,Tracheal suction tube,,,12.78,15.59,10
HCPCS,A4625,Trach care kit for new trach,,,13.46,39.46,10
HCPCS,A4626,Tracheostomy cleaning brush,,,13.46,18.15,10
HCPCS,A4627,SPACER BAG/RESERVOIR,48.0,31.2,7.14,48.0,46
HCPCS,A4628,Oropharyngeal suction cath,,,13.46,21.31,10
HCPCS,A4629,Tracheostomy care kit,,,13.46,26.51,10
HCPCS,A4630,Repl bat t.e.n.s. own by pt,,,13.46,30.19,10
HCPCS,A4633,Uvl replacement bulb,,,28.98,233.85,10
HCPCS,A4634,Replacement bulb th lightbox,,,13.46,15.59,8
HCPCS,A4635,Underarm crutch pad,,,2.85,15.59,10
HCPCS,A4636,Handgrip for cane etc,,,1.36,15.59,10
HCPCS,A4637,Repl tip cane/crutch/walker,,,0.75,15.59,10
HCPCS,A4638,Repl batt pulse gen sys,,,13.46,15.59,8
HCPCS,A4639,Infrared ht sys replcmnt pad,,,72.46,163.69,10
HCPCS,A4640,Alternating pressure pad,,,23.82,29.13,10
HCPCS,A4641,HEPTOLITE,825.0,536.25,0.01,825.0,44
HCPCS,A4642,In111 satumomab,,,8.48,3819.0,11
HCPCS,A464200,In111 satumomab,,,2981.5,2981.5,1
HCPCS,A4648,BARD US BIOPSY CLIP,200.75,130.49,29.87,200.75,48
HCPCS,A4648,GEL MARKER,825.0,536.25,77.79,825.0,48
HCPCS,A4648,HOLOGIC STEREO BIOPSY CLIP,164.25,106.76,24.44,184.68,48
HCPCS,A4648,HYDROMARK US BIOPSY CLIP,248.2,161.33,36.93,248.2,48
HCPCS,A4648,IMPLANTABLE TISSUE MARKER,1337.0,869.05,1.1,1337.0,29
HCPCS,A4648,NEEDLE LOC WIRE,60.23,39.15,8.96,184.68,48
HCPCS,A4648,SAVI SCOUT REFLECTOT,1460.0,949.0,159.5,1460.0,48
HCPCS,A4648,TISSUE MARKER,911.0,592.15,135.56,911.0,48
HCPCS,A4648,W IMP TISSUE MARKER BREAST,442.0,287.3,65.77,442.0,48
HCPCS,A4649,BARD MARQUEE US BIOPSY DEVICE,273.75,177.94,13.46,273.75,47
HCPCS,A4649,BARD MARQUEE US BIOPSY DEVICE W/GUIDE,189.8,123.37,13.46,189.8,47
HCPCS,A4649,CENTURION VASECTOMY SET,108.0,70.2,13.46,108.0,47
HCPCS,A4649,COOLED RF KIT (1 PROBE),3956.0,2571.4,13.46,3956.0,47
HCPCS,A4649,EVIVA STEREO DEVICE,657.0,427.05,13.46,657.0,47
HCPCS,A4649,STEREO BIOPSY TRAY,40.15,26.1,5.97,40.15,47
HCPCS,A4649,US BIOPSY TRAY,111.47,72.46,13.46,111.47,47
HCPCS,A4650,Implant radiation dosimeter,,,159.5,184.68,8
HCPCS,A4651,Calibrated microcap tube,,,13.46,15.59,8
HCPCS,A4652,Microcapillary tube sealant,,,13.46,15.59,8
HCPCS,A4653,Pd catheter anchor belt,,,13.46,15.59,8
HCPCS,A4657,Syringe w/wo needle,,,13.46,15.59,8
HCPCS,A4660,Sphyg/bp app w cuff and stet,,,28.98,33.56,8
HCPCS,A4663,Dialysis blood pressure cuff,,,13.46,15.59,8
HCPCS,A4670,"Automatic bp monitor, dial",,,25.16,29.13,8
HCPCS,A4671,Disposable cycler set,,,13.46,15.59,8
HCPCS,A4672,"Drainage ext line, dialysis",,,13.46,15.59,8
HCPCS,A4673,Ext line w easy lock connect,,,13.46,15.59,8
HCPCS,A4674,"Chem/antisept solution, 8oz",,,13.46,15.59,8
HCPCS,A4680,"Activated carbon filter, ea",,,13.46,15.59,8
HCPCS,A4690,"Dialyzer, each",,,8.84,10.24,8
HCPCS,A4706,Bicarbonate conc sol per gal,,,13.46,15.59,8
HCPCS,A4707,Bicarbonate conc pow per pac,,,13.46,15.59,8
HCPCS,A4708,Acetate conc sol per gallon,,,13.46,15.59,8
HCPCS,A4709,Acid conc sol per gallon,,,13.46,15.59,8
HCPCS,A4714,Treated water per gallon,,,13.46,15.59,8
HCPCS,A4719,"""y set"" tubing",,,8.84,10.24,8
HCPCS,A4720,Dialysat sol fld vol > 249cc,,,13.46,15.59,8
HCPCS,A4721,Dialysat sol fld vol > 999cc,,,13.46,15.59,8
HCPCS,A4722,Dialys sol fld vol > 1999cc,,,13.46,15.59,8
HCPCS,A4723,Dialys sol fld vol > 2999cc,,,13.46,15.59,8
HCPCS,A4724,Dialys sol fld vol > 3999cc,,,13.46,15.59,8
HCPCS,A4725,Dialys sol fld vol > 4999cc,,,13.46,15.59,8
HCPCS,A4726,Dialys sol fld vol > 5999cc,,,13.46,15.59,8
HCPCS,A4728,"Dialysate solution, non-dex",,,13.46,15.59,8
HCPCS,A4730,"Fistula cannulation set, ea",,,8.84,10.24,8
HCPCS,A4736,"Topical anesthetic, per gram",,,13.46,15.59,8
HCPCS,A4737,Inj anesthetic per 10 ml,,,13.46,15.59,8
HCPCS,A4740,Shunt accessory,,,13.46,15.59,8
HCPCS,A4750,Art or venous blood tubing,,,8.84,10.24,8
HCPCS,A4755,Comb art/venous blood tubing,,,13.46,15.59,8
HCPCS,A4760,"Dialysate sol test kit, each",,,13.46,15.59,8
HCPCS,A4765,Dialysate conc pow per pack,,,13.46,15.59,8
HCPCS,A4766,Dialysate conc sol add 10 ml,,,8.84,10.24,8
HCPCS,A4770,Blood collection tube/vacuum,,,13.46,15.59,8
HCPCS,A4771,Serum clotting time tube,,,13.46,15.59,8
HCPCS,A4772,Blood glucose test strips,,,13.46,15.59,8
HCPCS,A4773,Occult blood test strips,,,13.46,15.59,8
HCPCS,A4774,Ammonia test strips,,,13.46,15.59,8
HCPCS,A4802,Protamine sulfate per 50 mg,,,13.46,36.43,10
HCPCS,A480200,Protamine sulfate per 50 mg,,,28.44,28.44,1
HCPCS,A4860,Disposable catheter tips,,,13.46,15.59,8
HCPCS,A4870,Plumb/elec wk hm hemo equip,,,13.46,15.59,8
HCPCS,A4890,Repair/maint cont hemo equip,,,13.46,15.59,8
HCPCS,A4911,Drain bag/bottle,,,13.46,15.59,8
HCPCS,A4913,Misc dialysis supplies noc,,,13.46,15.59,8
HCPCS,A4918,Venous pressure clamp,,,13.46,15.59,8
HCPCS,A4927,Non-sterile gloves,,,13.46,15.59,8
HCPCS,A4928,Surgical mask,,,13.46,15.59,8
HCPCS,A4929,"Tourniquet for dialysis, ea",,,13.46,15.59,8
HCPCS,A4930,"Sterile, gloves per pair",,,13.46,15.59,8
HCPCS,A4931,Reusable oral thermometer,,,13.46,15.59,8
HCPCS,A4932,Reusable rectal thermometer,,,13.46,15.59,8
HCPCS,A5051,Pouch clsd w barr attached,,,9.99,15.59,10
HCPCS,A5052,Clsd ostomy pouch w/o barr,,,7.2,15.59,10
HCPCS,A5053,Clsd ostomy pouch faceplate,,,8.36,15.59,10
HCPCS,A5054,Clsd ostomy pouch w/flange,,,8.7,15.59,10
HCPCS,A5055,Stoma cap,,,6.39,15.59,10
HCPCS,A5056,1 pc ost pouch w filter,,,13.46,26.63,10
HCPCS,A5057,1 pc ost pou w built-in conv,,,13.46,54.7,10
HCPCS,A5061,Pouch drainable w barrier at,,,13.46,20.15,10
HCPCS,A5062,Drnble ostomy pouch w/o barr,,,10.06,15.59,10
HCPCS,A5063,Drain ostomy pouch w/flange,,,13.12,15.59,10
HCPCS,A5071,Urinary pouch w/barrier,,,13.46,34.26,10
HCPCS,A5072,Urinary pouch w/o barrier,,,13.46,20.15,10
HCPCS,A5073,Urinary pouch on barr w/flng,,,13.46,17.83,10
HCPCS,A5081,"Stoma plug or seal, any type",,,13.46,18.87,10
HCPCS,A5082,Continent stoma catheter,,,8.84,67.81,10
HCPCS,A5083,Stoma absorptive cover,,,3.13,15.59,10
HCPCS,A5093,Ostomy accessory convex inse,,,8.02,15.59,10
HCPCS,A5102,Bedside drain btl w/wo tube,,,8.84,127.62,10
HCPCS,A5105,Urinary suspensory,,,28.98,232.34,10
HCPCS,A5112,Urinary leg bag,,,28.98,179.52,10
HCPCS,A5113,Latex leg strap,,,13.46,22.79,10
HCPCS,A5114,Foam/fabric leg strap,,,13.46,43.34,10
HCPCS,A5120,"Skin barrier, wipe or swab",,,1.05,15.59,10
HCPCS,A5121,Solid skin barrier 6x6,,,13.46,40.66,10
HCPCS,A5122,Solid skin barrier 8x8,,,8.84,73.17,10
HCPCS,A5126,Disk/foam pad +or- adhesive,,,5.4,15.59,10
HCPCS,A5131,Appliance cleaner,,,8.84,76.77,10
HCPCS,A5200,Percutaneous catheter anchor,,,8.84,64.37,10
HCPCS,A5500,Diab shoe for density insert,,,25.16,362.36,10
HCPCS,A5501,Diabetic custom molded shoe,,,278.93,1086.71,10
HCPCS,A5503,Diabetic shoe w/roller/rockr,,,28.98,183.08,10
HCPCS,A5504,Diabetic shoe with wedge,,,28.98,183.08,10
HCPCS,A5505,Diab shoe w/metatarsal bar,,,28.98,183.08,10
HCPCS,A5506,Diabetic shoe w/off set heel,,,28.98,183.08,10
HCPCS,A5507,Modification diabetic shoe,,,28.98,183.08,10
HCPCS,A5508,Diabetic deluxe shoe,,,13.46,15.59,8
HCPCS,A5510,Compression form shoe insert,,,13.46,15.59,8
HCPCS,A5512,Multi den insert direct form,,,28.98,147.77,10
HCPCS,A5513,Multi den insert custom mold,,,28.98,220.54,10
HCPCS,A5514,Mult den insert dir carv/cam,,,28.98,220.54,10
HCPCS,A6000,Wound warming wound cover,,,13.46,15.59,8
HCPCS,A6010,Collagen based wound filler,,,28.98,176.48,10
HCPCS,A6011,Collagen gel/paste wound fil,,,11.05,15.59,10
HCPCS,A6021,Collagen dressing <=16 sq in,,,8.84,119.83,10
HCPCS,A6022,Collagen drsg>16<=48 sq in,,,8.84,119.83,10
HCPCS,A6023,Collagen dressing >48 sq in,,,46.46,1084.39,10
HCPCS,A6024,Collagen dsg wound filler,,,13.46,35.22,10
HCPCS,A6025,"Silicone gel sheet, each",,,13.46,15.59,8
HCPCS,A6154,Wound pouch each,,,8.84,79.4,10
HCPCS,A6196,ALGINATE DRSG 4X4,36.0,23.4,7.85,41.94,46
HCPCS,A6197,ALGINATE DRSG >16 <=48 SQ IN,78.0,50.7,8.84,93.72,46
HCPCS,A6198,Alginate dressing > 48 sq in,,,8.84,10.24,8
HCPCS,A6199,Alginate drsg wound filler,,,13.46,30.07,10
HCPCS,A6203,Composite drsg <= 16 sq in,,,13.46,19.19,10
HCPCS,A6204,Composite drsg >16<=48 sq in,,,13.46,35.42,10
HCPCS,A6205,Composite drsg > 48 sq in,,,13.46,15.59,8
HCPCS,A6206,Contact layer <= 16 sq in,,,13.46,15.59,8
HCPCS,A6207,Contact layer >16<= 48 sq in,,,13.46,41.86,10
HCPCS,A6208,Contact layer > 48 sq in,,,13.46,15.59,8
HCPCS,A6209,Foam drsg <=16 sq in w/o bdr,,,13.46,42.58,10
HCPCS,A6210,Foam drg >16<=48 sq in w/o b,,,8.84,113.55,10
HCPCS,A6211,Foam drg > 48 sq in w/o brdr,,,28.98,167.36,10
HCPCS,A6212,Foam drg <=16 sq in w/border,,,13.46,55.34,10
HCPCS,A6213,Foam drg >16<=48 sq in w/bdr,,,13.46,15.59,8
HCPCS,A6214,Foam drg > 48 sq in w/border,,,13.46,58.69,10
HCPCS,A6215,Foam dressing wound filler,,,13.46,15.59,8
HCPCS,A6216,Non-sterile gauze<=16 sq in,,,0.17,15.59,10
HCPCS,A6217,Non-sterile gauze>16<=48 sq,,,13.46,15.59,8
HCPCS,A6218,Non-sterile gauze > 48 sq in,,,13.46,15.59,8
HCPCS,A6219,Gauze <= 16 sq in w/border,,,4.62,15.59,10
HCPCS,A6220,Gauze >16 <=48 sq in w/bordr,,,12.54,15.59,10
HCPCS,A6221,Gauze > 48 sq in w/border,,,13.46,15.59,8
HCPCS,A6222,Gauze <=16 in no w/sal w/o b,,,10.33,15.59,10
HCPCS,A6223,Gauze >16<=48 no w/sal w/o b,,,11.76,15.59,10
HCPCS,A6224,Gauze > 48 in no w/sal w/o b,,,13.46,20.51,10
HCPCS,A6228,Gauze <= 16 sq in water/sal,,,13.46,15.59,8
HCPCS,A6229,Gauze >16<=48 sq in watr/sal,,,13.46,20.51,10
HCPCS,A6230,Gauze > 48 sq in water/salne,,,13.46,15.59,8
HCPCS,A6231,Hydrogel dsg<=16 sq in,,,13.46,26.63,10
HCPCS,A6232,Hydrogel dsg>16<=48 sq in,,,13.46,39.1,10
HCPCS,A6233,Hydrogel dressing >48 sq in,,,8.84,109.27,10
HCPCS,A6234,Hydrocolld drg <=16 w/o bdr,,,13.46,37.3,10
HCPCS,A6235,Hydrocolld drg >16<=48 w/o b,,,8.84,95.84,10
HCPCS,A6236,Hydrocolld drg > 48 in w/o b,,,28.98,155.25,10
HCPCS,A6237,Hydrocolld drg <=16 in w/bdr,,,13.46,45.06,10
HCPCS,A6238,Hydrocolld drg >16<=48 w/bdr,,,8.84,129.94,10
HCPCS,A6239,Hydrocolld drg > 48 in w/bdr,,,8.84,10.24,8
HCPCS,A6240,Hydrocolld drg filler paste,,,8.84,69.77,10
HCPCS,A6241,Hydrocolloid drg filler dry,,,12.44,15.59,10
HCPCS,A6242,Hydrogel drg <=16 in w/o bdr,,,13.46,34.5,10
HCPCS,A6243,Hydrogel drg >16<=48 w/o bdr,,,8.84,70.21,10
HCPCS,A6244,Hydrogel drg >48 in w/o bdr,,,28.98,223.86,10
HCPCS,A6245,Hydrogel drg <= 16 in w/bdr,,,13.46,41.42,10
HCPCS,A6246,Hydrogel drg >16<=48 in w/b,,,13.46,56.61,10
HCPCS,A6247,Hydrogel drg > 48 sq in w/b,,,8.84,135.5,10
HCPCS,A6248,Hydrogel drsg gel filler,,,8.84,92.56,10
HCPCS,A6250,DRSG INTERDRY AG 10X36,195.0,126.75,0.07,195.0,47
HCPCS,A6250,SILVADINE CREAM,25.75,16.74,1.1,25.75,29
HCPCS,A6250,Skin seal protect moisturizr,,,0.07,0.07,1
HCPCS,A625000,Skin seal protect moisturizr,,,0.07,0.07,1
HCPCS,A6251,Absorpt drg <=16 sq in w/o b,,,9.65,15.59,10
HCPCS,A6252,Absorpt drg >16 <=48 w/o bdr,,,13.46,18.55,10
HCPCS,A6253,Absorpt drg > 48 sq in w/o b,,,13.46,36.1,10
HCPCS,A6254,Absorpt drg <=16 sq in w/bdr,,,5.78,15.59,10
HCPCS,A6255,Absorpt drg >16<=48 in w/bdr,,,13.46,17.35,10
HCPCS,A6256,Absorpt drg > 48 sq in w/bdr,,,13.46,15.59,8
HCPCS,A6257,Transparent film <= 16 sq in,,,7.41,15.59,10
HCPCS,A6258,Transparent film >16<=48 in,,,13.46,24.55,10
HCPCS,A6259,Transparent film > 48 sq in,,,8.84,62.33,10
HCPCS,A6260,Wound cleanser any type/size,,,13.46,15.59,8
HCPCS,A6261,Wound filler gel/paste /oz,,,13.46,15.59,8
HCPCS,A6262,Wound filler dry form / gram,,,13.46,15.59,8
HCPCS,A6266,Impreg gauze no h20/sal/yard,,,9.24,15.59,10
HCPCS,A6402,Sterile gauze <= 16 sq in,,,0.51,15.59,10
HCPCS,A6403,Sterile gauze>16 <= 48 sq in,,,1.97,15.59,10
HCPCS,A6404,Sterile gauze > 48 sq in,,,13.46,15.59,8
HCPCS,A6407,"Packing strips, non-impreg",,,9.04,15.59,10
HCPCS,A6410,Sterile eye pad,,,1.8,15.59,10
HCPCS,A6411,Non-sterile eye pad,,,13.46,15.59,8
HCPCS,A6412,Occlusive eye patch,,,13.46,15.59,8
HCPCS,A6413,"Adhesive bandage, first-aid",,,13.46,15.59,8
HCPCS,A6441,"Pad band w>=3"" <5""/yd",,,3.3,15.59,10
HCPCS,A6442,"Conform band n/s w<3""/yd",,,0.78,15.59,10
HCPCS,A6443,"Conform band n/s w>=3""<5""/yd",,,1.36,15.59,10
HCPCS,A6444,"Conform band n/s w>=5""/yd",,,2.72,15.59,10
HCPCS,A6445,"Conform band s w <3""/yd",,,1.53,15.59,10
HCPCS,A6446,"Conform band s w>=3"" <5""/yd",,,1.87,15.59,10
HCPCS,A6447,"Conform band s w >=5""/yd",,,3.3,15.59,10
HCPCS,A6448,"Lt compres band <3""/yd",,,5.57,15.59,10
HCPCS,A6449,"Lt compres band >=3"" <5""/yd",,,8.5,15.59,10
HCPCS,A6450,"Lt compres band >=5""/yd",,,8.5,15.59,10
HCPCS,A6451,"Mod compres band w>=3""<5""/yd",,,8.5,15.59,10
HCPCS,A6452,"High compres band w>=3""<5""yd",,,13.46,33.58,10
HCPCS,A6453,"Self-adher band w <3""/yd",,,3.06,15.59,10
HCPCS,A6454,"Self-adher band w>=3"" <5""/yd",,,3.81,15.59,10
HCPCS,A6455,"Self-adher band >=5""/yd",,,6.76,15.59,10
HCPCS,A6456,"Zinc paste band w >=3""<5""/yd",,,6.08,15.59,10
HCPCS,A6457,Tubular dressing,,,5.51,15.59,10
HCPCS,A6460,Synthetic drsg <= 16 sq in,,,13.46,15.59,8
HCPCS,A6461,Synthetic drsg >16<=48 sq in,,,13.46,15.59,8
HCPCS,A6501,Compres burngarment bodysuit,,,28.98,33.56,8
HCPCS,A6502,Compres burngarment chinstrp,,,28.98,33.56,8
HCPCS,A6503,Compres burngarment facehood,,,28.98,33.56,8
HCPCS,A6504,Cmprsburngarment glove-wrist,,,28.98,33.56,8
HCPCS,A6505,Cmprsburngarment glove-elbow,,,28.98,33.56,8
HCPCS,A6506,Cmprsburngrmnt glove-axilla,,,28.98,33.56,8
HCPCS,A6507,Cmprs burngarment foot-knee,,,28.98,33.56,8
HCPCS,A6508,Cmprs burngarment foot-thigh,,,28.98,33.56,8
HCPCS,A6509,Compres burn garment jacket,,,28.98,33.56,8
HCPCS,A6510,Compres burn garment leotard,,,28.98,33.56,8
HCPCS,A6511,Compres burn garment panty,,,28.98,33.56,8
HCPCS,A6512,"Compres burn garment, noc",,,28.98,33.56,8
HCPCS,A6513,Compress burn mask face/neck,,,13.46,15.59,8
HCPCS,A6515,Grad com wrap w str fu le cu,,,46.46,53.79,8
HCPCS,A6516,Grad com wrap w strap foo cu,,,46.46,53.79,8
HCPCS,A6517,Grad com wrap w strap bn cus,,,25.16,29.13,8
HCPCS,A6518,Grad com wrap w strap arm cu,,,8.84,10.24,8
HCPCS,A6519,Grad com garm noc night use,,,8.84,10.24,8
HCPCS,A6520,G com garmnt glove nghttime,,,8.84,505.57,10
HCPCS,A6521,G com garmnt glove nght cust,,,8.84,2006.1,10
HCPCS,A6522,G com garment arm nighttime,,,8.84,1228.49,10
HCPCS,A6523,G com garment arm nght custm,,,8.84,2914.77,10
HCPCS,A6524,G com garmnt lwr leg/ft nght,,,8.84,1532.67,10
HCPCS,A6525,G com garm lwrleg/ft ngt cus,,,8.84,3094.21,10
HCPCS,A6526,G com garmt full leg/ft nght,,,8.84,2770.99,10
HCPCS,A6527,G garmt full leg/ft nght cus,,,8.84,5095.51,10
HCPCS,A6528,G com garment bra nighttime,,,28.98,2664.48,10
HCPCS,A6529,G com garmt bra night custm,,,28.98,4210.26,10
HCPCS,A6530,Compression stocking bk18-30,,,8.84,156.21,10
HCPCS,A6531,Compress stking bk30-40 surg,,,28.98,246.53,10
HCPCS,A6532,Compress stking bk40-50 surg,,,25.16,347.36,10
HCPCS,A6533,GC STOCKING THIGHLNGTH 18-30,57.0,37.05,1.1,155.49,33
HCPCS,A6533,Gc stocking thighlngth 18-30,,,8.84,219.34,10
HCPCS,A6534,Gc stocking thighlngth 30-40,,,46.46,250.49,10
HCPCS,A6535,Gc stocking thighlngth 40+,,,46.46,288.39,10
HCPCS,A6536,Gc stocking full lngth 18-30,,,46.46,295.67,10
HCPCS,A6537,Gc stocking full lngth 30-40,,,46.46,350.52,10
HCPCS,A6538,Gc stocking full lngth 40+,,,46.46,410.42,10
HCPCS,A6539,Gc stocking waistlngth 18-30,,,46.46,391.26,10
HCPCS,A6540,Gc stocking waistlngth 30-40,,,46.46,466.51,10
HCPCS,A6541,Gc stocking waistlngth 40+,,,46.46,552.59,10
HCPCS,A6544,Gc stocking garter belt,,,28.98,33.56,8
HCPCS,A6545,COBAN II COMPRESSION BANDAGE,74.0,48.1,16.13,485.42,48
HCPCS,A6545,COBAN II LITE COMPRSSN BANDAGE,68.0,44.2,14.82,485.42,48
HCPCS,A6545,COFLEX TLC COMPRESSION BANDAGE,68.0,44.2,14.82,485.42,48
HCPCS,A6545,PROFORE COMPRESSION BANDAGE,78.0,50.7,17.0,485.42,48
HCPCS,A6548,Acces cust grad silic band,,,8.84,10.24,8
HCPCS,A6549,Grad com garm noc day use,,,8.84,10.24,8
HCPCS,A6550,Neg pres wound ther drsg set,,,8.84,127.62,10
HCPCS,A6552,Grad com stocking bk 30-40,,,8.84,231.78,10
HCPCS,A6553,G com stcking bk 30-40 custm,,,28.98,905.11,10
HCPCS,A6554,Grad com stocking bk 40+,,,25.16,318.74,10
HCPCS,A6555,G com stcking bk 40+ custm,,,25.16,905.11,10
HCPCS,A6556,G com stcking thgh18-30 cust,,,8.84,1240.44,10
HCPCS,A6557,G com stcking thgh30-40 cust,,,46.46,1240.44,10
HCPCS,A6558,G com stcking thgh 40+ cust,,,46.46,1280.1,10
HCPCS,A6559,G stckng full/chap18-30 cust,,,46.46,53.79,8
HCPCS,A6560,G stckng full/chap30-40 cust,,,46.46,53.79,8
HCPCS,A6561,G stockng full/chap 40+ cust,,,46.46,53.79,8
HCPCS,A6562,G com stckng waist18-30 cust,,,46.46,4059.65,10
HCPCS,A6563,G com stckng waist30-40 cust,,,46.46,4059.65,10
HCPCS,A6564,G com stckng waist 40+ cust,,,46.46,4373.15,10
HCPCS,A6565,Grad comp gauntlet custom,,,8.84,701.48,10
HCPCS,A6566,Grad com garment neck/head,,,28.98,1018.54,10
HCPCS,A6567,G com garment neck/head cust,,,28.98,3200.24,10
HCPCS,A6568,G com garment torso/shldr,,,28.98,664.74,10
HCPCS,A6569,G com garmnt torso/shdr cust,,,28.98,3785.26,10
HCPCS,A6570,Grad com garment genital,,,28.98,452.92,10
HCPCS,A6571,G com garment genital custm,,,28.98,2722.13,10
HCPCS,A6572,Grad com garment toe caps,,,28.98,420.25,10
HCPCS,A6573,Grad com garmnt toe cap cust,,,28.98,997.27,10
HCPCS,A6574,Custom gradient sleev/glov,,,28.98,1271.39,10
HCPCS,A6575,Gradient comp sleev/glov,,,28.98,412.01,10
HCPCS,A6576,Custom grad com sleeve med,,,28.98,780.29,10
HCPCS,A6577,Custom grad cm sleeve heavy,,,28.98,645.83,10
HCPCS,A6578,Gradient comp sleeve,,,28.98,318.06,10
HCPCS,A6579,Custom grad com glove med,,,28.98,1252.48,10
HCPCS,A6580,Custom grad com glove heavy,,,28.98,1243.28,10
HCPCS,A6581,Gradient comp glove,,,28.98,291.83,10
HCPCS,A6582,Gradient comp gauntlet,,,28.98,194.63,10
HCPCS,A6583,Grad com wrap w straps bk,,,25.16,640.23,10
HCPCS,A6584,Grad com wrap w straps,,,8.84,10.24,8
HCPCS,A6585,Grad com wrap w straps ak,,,8.84,758.06,10
HCPCS,A6586,Grad com wrap w strap fu leg,,,46.46,2233.35,10
HCPCS,A6587,Grad com wrap w straps foot,,,25.16,292.55,10
HCPCS,A6588,Grad com wrap w strap arm,,,8.84,975.04,10
HCPCS,A6589,Grad com wrap w straps bra,,,8.84,384.91,10
HCPCS,A6590,Urinary cath disp suc pump,,,13.46,1619.27,10
HCPCS,A6591,Urinary cath suc pump,,,13.46,362.4,10
HCPCS,A6593,Grad com accessory gmt_wrap,,,13.46,15.59,8
HCPCS,A6594,G comp bandge liner lwr extr,,,13.46,140.14,10
HCPCS,A6595,G comp bandge liner upr extr,,,13.46,137.86,10
HCPCS,A6596,G comp bandge conform gauze,,,0.61,15.59,10
HCPCS,A6597,G comp bandage long stretch,,,5.27,15.59,10
HCPCS,A6598,G comp bandage med stretch,,,2.55,15.59,10
HCPCS,A6599,G comp bandage short stretch,,,5.78,15.59,10
HCPCS,A6600,G com bandge hgh dn foam sht,,,10.43,15.59,10
HCPCS,A6601,G com bandge hgh dn foam pad,,,11.72,15.59,10
HCPCS,A6602,G com bandge hgh dn foamroll,,,13.46,20.11,10
HCPCS,A6603,G com bandge low dn foamchnl,,,8.02,15.59,10
HCPCS,A6604,G com bandge low dn foam flt,,,4.69,15.59,10
HCPCS,A6605,G com bandage padded foam,,,5.34,15.59,10
HCPCS,A6606,G com bandage padded textile,,,13.46,18.67,10
HCPCS,A6607,G com bandage tub protct lyr,,,4.25,15.59,10
HCPCS,A6608,G com bandage tub protct pad,,,13.46,20.83,10
HCPCS,A6609,G compression bandaging,,,13.46,15.59,8
HCPCS,A6610,G com stcking bk 18-30 custm,,,8.84,905.11,10
HCPCS,A6611,Grad com wrap w strap ak cus,,,8.84,10.24,8
HCPCS,A7000,Disposable canister for pump,,,13.46,42.26,10
HCPCS,A7001,Nondisposable pump canister,,,28.98,188.44,10
HCPCS,A7002,Tubing used w suction pump,,,13.46,21.87,10
HCPCS,A7003,Nebulizer administration set,,,6.42,15.59,10
HCPCS,A7004,Disposable nebulizer sml vol,,,5.37,15.59,10
HCPCS,A7005,Nondisposable nebulizer set,,,28.98,64.37,10
HCPCS,A7006,Filtered nebulizer admin set,,,13.46,39.62,10
HCPCS,A7007,Lg vol nebulizer disposable,,,13.46,17.47,10
HCPCS,A7008,Disposable nebulizer prefill,,,8.84,62.65,10
HCPCS,A7009,Nebulizer reservoir bottle,,,28.98,239.65,10
HCPCS,A7010,Disposable corrugated tubing,,,8.84,80.28,10
HCPCS,A7012,Nebulizer water collec devic,,,11.86,15.59,10
HCPCS,A7013,Disposable compressor filter,,,2.48,15.59,10
HCPCS,A7014,Compressor nondispos filter,,,13.46,16.91,10
HCPCS,A7015,Aerosol mask used w nebulize,,,5.47,15.59,10
HCPCS,A7016,Nebulizer dome & mouthpiece,,,13.46,41.34,10
HCPCS,A7017,Nebulizer not used w oxygen,,,46.46,61.89,10
HCPCS,A7018,Water distilled w/nebulizer,,,1.5,15.59,10
HCPCS,A7020,"Interface, cough stim device",,,8.84,82.44,10
HCPCS,A7021,Suppl and access lung expan,,,13.46,547.95,10
HCPCS,A7023,Mech allergen parti barrier,,,278.93,322.97,8
HCPCS,A7025,Replace chest compress vest,,,210.67,778.15,10
HCPCS,A7026,Replace chst cmprss sys hose,,,28.98,163.77,10
HCPCS,A7027,Combination oral/nasal mask,,,46.46,612.44,10
HCPCS,A7028,Repl oral cushion combo mask,,,25.16,173.0,10
HCPCS,A7029,Repl nasal pillow comb mask,,,8.84,77.21,10
HCPCS,A7030,Cpap full face mask,,,46.46,443.04,10
HCPCS,A7031,Replacement facemask interfa,,,25.16,167.56,10
HCPCS,A7032,Replacement nasal cushion,,,28.98,92.32,10
HCPCS,A7033,Replacement nasal pillows,,,8.84,77.65,10
HCPCS,A7034,Nasal application device,,,46.46,280.51,10
HCPCS,A7035,Pos airway press headgear,,,28.98,92.04,10
HCPCS,A7036,Pos airway press chinstrap,,,8.84,54.3,10
HCPCS,A7037,Pos airway pressure tubing,,,28.98,59.57,10
HCPCS,A7038,Pos airway pressure filter,,,8.84,15.59,10
HCPCS,A7039,"Filter, non disposable w pap",,,8.84,31.47,10
HCPCS,A7040,One way chest drain valve,,,25.16,230.42,10
HCPCS,A7041,Water seal drain container,,,25.16,433.13,10
HCPCS,A7044,Pap oral interface,,,46.46,436.32,10
HCPCS,A7045,Repl exhalation port for pap,,,5.47,10.24,10
HCPCS,A7046,"Repl water chamber, pap dev",,,8.84,68.77,10
HCPCS,A7047,Resp suction oral interface,,,13.46,688.93,10
HCPCS,A7048,Vacuum drain bottle/tube kit,,,28.98,241.21,10
HCPCS,A7049,Epap nasal valve,,,46.46,53.79,8
HCPCS,A7501,Tracheostoma valve w diaphra,,,46.46,598.37,10
HCPCS,A7502,Replacement diaphragm/fplate,,,25.16,284.47,10
HCPCS,A7503,Hmes filter holder or cap,,,8.84,64.65,10
HCPCS,A7504,Tracheostoma hmes filter,,,3.3,15.59,10
HCPCS,A7505,Hmes or trach valve housing,,,13.46,26.71,10
HCPCS,A7506,Hmes/trachvalve adhesivedisk,,,1.56,15.59,10
HCPCS,A7507,Integrated filter & holder,,,12.1,15.59,10
HCPCS,A7508,Housing & integrated adhesiv,,,13.46,16.35,10
HCPCS,A7509,Heat & moisture exchange sys,,,6.83,15.59,10
HCPCS,A7520,Trach/laryn tube non-cuffed,,,28.98,270.52,10
HCPCS,A7521,"CUFFED TRACH TUBE 4,6,8 CUFF",198.0,128.7,28.98,268.04,48
HCPCS,A7521,"CUFFED TRACH TUBE DISTAL 5,6,7 CUFF",328.0,213.2,28.98,328.0,48
HCPCS,A7521,PEDS TRACH TUBE,284.0,184.6,28.98,284.0,48
HCPCS,A7522,Trach/laryn tube stainless,,,28.98,257.32,10
HCPCS,A7523,Tracheostomy shower protect,,,13.46,15.59,8
HCPCS,A7524,Tracheostoma stent/stud/bttn,,,25.16,441.12,10
HCPCS,A7525,Tracheostomy mask,,,9.99,15.59,10
HCPCS,A7526,Tracheostomy tube collar,,,13.46,19.31,10
HCPCS,A7527,Trach/laryn tube plug/stop,,,13.46,20.39,10
HCPCS,A8000,YB HELMET PROT SOFT PREFAB,1194.0,776.1,46.46,1194.0,47
HCPCS,A8001,Hard protect helmet prefab,,,46.46,87.4,10
HCPCS,A8002,Soft protect helmet custom,,,13.46,15.59,8
HCPCS,A8003,Hard protect helmet custom,,,13.46,15.59,8
HCPCS,A8004,"Repl soft interface, helmet",,,13.46,15.59,8
HCPCS,A8006,Grip glove replacement only,,,278.93,322.97,8
HCPCS,A9150,Misc/exper non-prescript dru,,,13.46,15.59,8
HCPCS,A9152,Single vitamin nos,,,13.46,15.59,8
HCPCS,A9153,Multi-vitamin nos,,,13.46,15.59,8
HCPCS,A9154,"Artificial saliva, 1 ml",,,0.46,15.59,9
HCPCS,A915400,"Artificial saliva, 1 ml",,,0.46,0.46,1
HCPCS,A9155,Artificial saliva,,,13.46,21.09,10
HCPCS,A915500,Artificial saliva,,,16.8,16.8,1
HCPCS,A9156,Oral mucoadhesive per 1 ml,,,5.18,15.59,10
HCPCS,A915600,Oral mucoadhesive per 1 ml,,,5.18,5.18,1
HCPCS,A9180,"Lice treatment, topical",,,1.9,15.59,10
HCPCS,A918000,"Lice treatment, topical",,,1.9,1.9,1
HCPCS,A9268,Programmer orally ingest cap,,,13.46,15.59,8
HCPCS,A9269,Programable ingest capsule,,,13.46,15.59,8
HCPCS,A9270,Non-covered item or service,,,13.46,15.59,8
HCPCS,A9270,TORIC IOL WORKUP,1127.0,732.55,0.01,1127.0,29
HCPCS,A9272,"Disp wound suct, drsg/access",,,8.84,10.24,8
HCPCS,A9273,Hot/cold botle/cap/col/wrap,,,13.46,15.59,8
HCPCS,A9274,Ext amb insulin delivery sys,,,531.62,615.56,8
HCPCS,A9275,Disp home glucose monitor,,,13.46,15.59,8
HCPCS,A9276,"Disposable sensor, cgm sys",,,13.46,15.59,8
HCPCS,A9277,"External transmitter, cgm",,,13.46,15.59,8
HCPCS,A9278,"External receiver, cgm sys",,,13.46,15.59,8
HCPCS,A9279,Monitoring feature/devicenoc,,,13.46,15.59,8
HCPCS,A9280,"Alert device, noc",,,13.46,15.59,8
HCPCS,A9281,Reaching/grabbing device,,,13.46,15.59,8
HCPCS,A9282,Wig any type,,,13.46,15.59,8
HCPCS,A9283,Foot press off load supp dev,,,13.46,15.59,8
HCPCS,A9284,Non-electronic spirometer,,,13.46,15.59,8
HCPCS,A9285,Inversion eversion cor devic,,,72.46,83.9,8
HCPCS,A9286,"Any hygienic item, device",,,13.46,15.59,8
HCPCS,A9292,Pres dig visual therapy fda,,,68.91,79.79,8
HCPCS,A9293,Fertility cycl tracking soft,,,26.64,30.84,8
HCPCS,A9300,Exercise equipment,,,13.46,15.59,8
HCPCS,A9500,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,66.0,42.9,0.01,968.75,45
HCPCS,A9500,TC99M SESTAMIBI PER DOSE,66.0,42.9,0.01,968.75,44
HCPCS,A9500,Tc99m sestamibi,,,228.02,228.02,1
HCPCS,A950000,Tc99m sestamibi,,,228.02,228.02,1
HCPCS,A9501,Technetium tc-99m teboroxime,,,102.79,119.02,8
HCPCS,A9502,MYOVIEW KIT 1.38 MG INTRAVENOUS SOLUTION,62.0,40.3,0.01,339.38,45
HCPCS,A9502,TC99M TETROFOSMIN/PER DOSE,62.0,40.3,0.01,339.38,44
HCPCS,A9502,Tc99m tetrofosmin,,,182.15,182.15,1
HCPCS,A950200,Tc99m tetrofosmin,,,182.15,182.15,1
HCPCS,A9503,DRAXIMAGE MDP-25 25 MG INTRAVENOUS SOLUTION,56.0,36.4,0.01,127.26,45
HCPCS,A9503,TC99M MEDRONATE<30MCI,56.0,36.4,0.01,127.26,44
HCPCS,A9503,Tc99m medronate,,,27.77,27.77,1
HCPCS,A950300,Tc99m medronate,,,27.77,27.77,1
HCPCS,A9504,Tc99m apcitide,,,102.79,1140.0,11
HCPCS,A950400,Tc99m apcitide,,,890.0,890.0,1
HCPCS,A9505,Tl201 thallium,,,69.76,119.02,11
HCPCS,A950500,Tl201 thallium,,,69.76,69.76,1
HCPCS,A9506,Tc-99m graphite crucible,,,102.79,903.65,30
HCPCS,A950600,Tc-99m graphite crucible,,,662.16,662.16,1
HCPCS,A9507,In111 capromab,,,102.79,12027.48,24
HCPCS,A950700,In111 capromab,,,9389.87,9389.87,1
HCPCS,A9508,"I131 iodobenguate, dx",,,102.79,2620.78,24
HCPCS,A950800,"I131 iodobenguate, dx",,,1578.79,1578.79,1
HCPCS,A9509,I-123 CAP PER 1 MCI,210.0,136.5,0.01,331.04,44
HCPCS,A9509,Iodine i-123 sod iodide mil,,,3862.96,3862.96,1
HCPCS,A950900,Iodine i-123 sod iodide mil,,,3862.96,3862.96,1
HCPCS,A9510,TC99M DISOFENIN UP TO 15MCI,202.0,131.3,0.01,202.0,44
HCPCS,A9510,Tc99m disofenin,,,149.52,149.52,1
HCPCS,A951000,Tc99m disofenin,,,149.52,149.52,1
HCPCS,A9512,TC99 PERTECHNET,34.0,22.1,0.01,119.02,44
HCPCS,A9512,Tc99m pertechnetate,,,3.61,3.61,1
HCPCS,A951200,Tc99m pertechnetate,,,3.61,3.61,1
HCPCS,A9513,"LUTETIUM LU 177 DOTATATE, TX",671.0,436.15,2.17,17165.41,61
HCPCS,A9513,Lutetium lu 177 dotatat ther,,,651.53,651.53,1
HCPCS,A951300,Lutetium lu 177 dotatat ther,,,651.53,651.53,1
HCPCS,A9515,Choline c-11,,,102.79,13680.0,30
HCPCS,A951500,Choline c-11,,,10680.0,10680.0,1
HCPCS,A9516,I-123 SODIUM CAP 200 UCI,210.0,136.5,0.01,239.94,44
HCPCS,A9516,Iodine i-123 sod iodide mic,,,226.91,226.91,1
HCPCS,A9516,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,210.0,136.5,0.01,239.94,45
HCPCS,A951600,Iodine i-123 sod iodide mic,,,226.91,226.91,1
HCPCS,A9517,I131 THERA CAPSL /MCI,180.0,117.0,2.17,310.51,61
HCPCS,A9517,"I131 iodide cap, rx",,,76.26,76.26,1
HCPCS,A951700,"I131 iodide cap, rx",,,76.26,76.26,1
HCPCS,A9520,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1190.0,773.5,0.01,1190.0,45
HCPCS,A9520,TC99 TILMANOCEPT DIAG 0.5MCI,1190.0,773.5,0.01,1190.0,44
HCPCS,A9520,Tc99 tilmanocept diag 0.5mci,,,1413.12,1413.12,1
HCPCS,A952000,Tc99 tilmanocept diag 0.5mci,,,1413.12,1413.12,1
HCPCS,A9521,CERETEC 0.5 MG INTRAVENOUS SOLUTION,3128.0,2033.2,0.01,3128.0,60
HCPCS,A9521,TC99M EXAMETAZIME<25MCI,3128.0,2033.2,0.01,3128.0,59
HCPCS,A9521,Tc99m exametazime,,,3661.03,3661.03,1
HCPCS,A952100,Tc99m exametazime,,,3661.03,3661.03,1
HCPCS,A9524,"I131 serum albumin, dx",,,102.79,798.33,11
HCPCS,A952400,"I131 serum albumin, dx",,,798.33,798.33,1
HCPCS,A9526,Nitrogen n-13 ammonia,,,102.79,1803.02,11
HCPCS,A952600,Nitrogen n-13 ammonia,,,1548.39,1548.39,1
HCPCS,A9527,Iodine i-125 sodium iodide,,,192.72,1087.27,20
HCPCS,A9528,I131 DX CAPSL /MCI,180.0,117.0,0.01,203.07,44
HCPCS,A9528,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE,180.0,117.0,0.01,203.07,45
HCPCS,A9529,"IODINE I-131 SODIUM IODID SOLUTION, DIAG, PER MCI",180.0,117.0,0.01,180.0,44
HCPCS,A9530,"I131 iodide sol, rx",,,20.77,310.51,28
HCPCS,A9531,I131 max 100uci,,,9.05,119.02,9
HCPCS,A9532,"I125 serum albumin, dx",,,46.73,1289.92,24
HCPCS,A953200,"I125 serum albumin, dx",,,46.73,46.73,1
HCPCS,A9536,Tc99m depreotide,,,102.79,3192.0,11
HCPCS,A953600,Tc99m depreotide,,,2492.0,2492.0,1
HCPCS,A9537,CHOLETEC 45 MG INTRAVENOUS SOLUTION,62.0,40.3,0.01,243.94,45
HCPCS,A9537,TC99M MEBROFENIN<15MCI,62.0,40.3,0.01,243.94,44
HCPCS,A9537,Tc99m mebrofenin,,,118.16,118.16,1
HCPCS,A953700,Tc99m mebrofenin,,,118.16,118.16,1
HCPCS,A9538,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,118.0,76.7,0.01,119.02,45
HCPCS,A9538,TC99M PYROPHOSPHATE<25MCI,118.0,76.7,0.01,119.02,44
HCPCS,A9538,Tc99m pyrophosphate,,,136.81,136.81,1
HCPCS,A953800,Tc99m pyrophosphate,,,136.81,136.81,1
HCPCS,A9539,DRAXIMAGE DTPA 20 MG INTRAVENOUS SOLUTION,426.0,276.9,0.01,426.0,45
HCPCS,A9539,TC99M PENTETATE<25MCI,240.0,156.0,0.01,240.0,44
HCPCS,A9539,Tc99m pentetate,,,66.93,66.93,1
HCPCS,A953900,Tc99m pentetate,,,66.93,66.93,1
HCPCS,A9540,DRAXIMAGE MAA 2.5 MG INTRAVENOUS SOLUTION,1092.0,709.8,0.01,1092.0,45
HCPCS,A9540,TC99M MAA<10MCI,1092.0,709.8,0.01,1092.0,44
HCPCS,A9540,Tc99m maa,,,64.08,64.08,1
HCPCS,A954000,Tc99m maa,,,64.08,64.08,1
HCPCS,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,200.0,130.0,0.01,1615.51,45
HCPCS,A9541,TC99M FILTERED SULFR COLLOID,200.0,130.0,0.01,1615.51,44
HCPCS,A9541,TC99M SULFUR COLLOID =< 20MCI,200.0,130.0,0.01,1615.51,44
HCPCS,A9541,Tc99m sulfur colloid,,,571.1,571.1,1
HCPCS,A954100,Tc99m sulfur colloid,,,571.1,571.1,1
HCPCS,A9542,"In111 ibritumomab, dx",,,102.79,9576.0,17
HCPCS,A954200,"In111 ibritumomab, dx",,,7476.0,7476.0,1
HCPCS,A9543,"Y90 ibritumomab, rx",,,144835.13,144835.13,1
HCPCS,A9543,ZEVALIN (Y-90) 3.2 MG/2 ML INTRAVENOUS KIT,148248.86,96361.76,14774.74,168348.38,65
HCPCS,A954300,"Y90 ibritumomab, rx",,,144835.13,144835.13,1
HCPCS,A9546,Co57/58,,,2.77,119.02,9
HCPCS,A9547,IN111 OXYQUINOLINE 0.5MCI,5030.0,3269.5,0.01,5030.0,59
HCPCS,A9547,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,5030.0,3269.5,0.01,5030.0,60
HCPCS,A9547,In111 oxyquinoline,,,4496.24,4496.24,1
HCPCS,A954700,In111 oxyquinoline,,,4496.24,4496.24,1
HCPCS,A9548,"IN-111 PENTETATE, PER 0.5 MCI",4518.0,2936.7,0.01,4518.0,59
HCPCS,A9548,IN111 DTPA.5MCI,4518.0,2936.7,0.01,4518.0,59
HCPCS,A9548,INDIUM IN-111 DTPA 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4518.0,2936.7,0.01,4518.0,60
HCPCS,A9548,In111 pentetate,,,1891.43,1891.43,1
HCPCS,A954800,In111 pentetate,,,1891.43,1891.43,1
HCPCS,A9550,Tc99m gluceptate,,,102.79,119.02,8
HCPCS,A9551,Tc99m succimer,,,102.79,1814.81,24
HCPCS,A955100,Tc99m succimer,,,1280.35,1280.35,1
HCPCS,A9552,F18 FDG DOSE,250.0,162.5,0.01,897.82,44
HCPCS,A9552,F18 fdg,,,672.75,672.75,1
HCPCS,A9552,FLUDEOXYGLUCOSE F-18 20 MCI TO 500 MCI/ML INTRAVENOUS SOLUTION,250.0,162.5,0.01,897.82,45
HCPCS,A9552,PET SCAN ISOTP UP TO 45MCI,250.0,162.5,0.01,897.82,44
HCPCS,A955200,F18 fdg,,,672.75,672.75,1
HCPCS,A9553,Cr51 chromate,,,102.79,5274.39,24
HCPCS,A955300,Cr51 chromate,,,1204.7,1204.7,1
HCPCS,A9554,"I125 iothalamate, dx",,,80.1,1786.51,24
HCPCS,A955400,"I125 iothalamate, dx",,,80.1,80.1,1
HCPCS,A9555,Rb82 rubidium,,,102.79,972.23,9
HCPCS,A9556,"GALLIUM GA 67, PER MCI",2626.0,1706.9,0.01,2626.0,44
HCPCS,A9556,Ga67 gallium,,,288.4,288.4,1
HCPCS,A955600,Ga67 gallium,,,288.4,288.4,1
HCPCS,A9557,NEUROLITE 0.9 MG INTRAVENOUS SOLUTION,3766.0,2447.9,0.01,3766.0,60
HCPCS,A9557,TC99M BICISATE<25MCI,3766.0,2447.9,0.01,3766.0,59
HCPCS,A9557,Tc99m bicisate,,,7831.27,7831.27,1
HCPCS,A955700,Tc99m bicisate,,,7831.27,7831.27,1
HCPCS,A9558,"XENON XE 133, PER 10 MCI",460.0,299.0,0.01,557.75,44
HCPCS,A9558,XENON XE-133  370 MBQ (10 MCI) GAS FOR INHALATION,460.0,299.0,0.01,557.75,45
HCPCS,A9558,Xe133 xenon 10mci,,,544.89,544.89,1
HCPCS,A955800,Xe133 xenon 10mci,,,544.89,544.89,1
HCPCS,A9559,Co57 cyano,,,102.79,541.76,11
HCPCS,A955900,Co57 cyano,,,156.48,156.48,1
HCPCS,A9560,TC99 RBC DOSE,350.0,227.5,0.01,350.0,44
HCPCS,A9560,Tc99m labeled rbc,,,199.5,199.5,1
HCPCS,A9560,ULTRATAG RBC INTRAVENOUS SOLUTION,350.0,227.5,0.01,350.0,45
HCPCS,A956000,Tc99m labeled rbc,,,199.5,199.5,1
HCPCS,A9561,TECHNESCAN HDP 3.15 MG INTRAVENOUS SOLUTION,82.0,53.3,0.01,119.02,45
HCPCS,A9561,Tc99m oxidronate,,,93.98,93.98,1
HCPCS,A956100,Tc99m oxidronate,,,93.98,93.98,1
HCPCS,A9562,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,568.0,369.2,0.01,1651.69,45
HCPCS,A9562,TC99M MERTIATIDE<15MCI,568.0,369.2,0.01,1651.69,44
HCPCS,A9562,Tc99m mertiatide,,,1654.92,1654.92,1
HCPCS,A956200,Tc99m mertiatide,,,1654.92,1654.92,1
HCPCS,A9563,P32 na phosphate,,,179.12,834.14,30
HCPCS,A956300,P32 na phosphate,,,651.21,651.21,1
HCPCS,A9564,P32 chromic phosphate,,,268.17,794.72,11
HCPCS,A956400,P32 chromic phosphate,,,620.44,620.44,1
HCPCS,A9566,Tc99m fanolesomab,,,102.79,119.02,8
HCPCS,A9567,TC99M AERO<75MCI,240.0,156.0,0.01,240.0,44
HCPCS,A9568,Technetium tc99m arcitumomab,,,102.79,2964.0,17
HCPCS,A956800,Technetium tc99m arcitumomab,,,2314.0,2314.0,1
HCPCS,A9569,Technetium tc-99m auto wbc,,,102.79,4689.41,30
HCPCS,A956900,Technetium tc-99m auto wbc,,,3661.03,3661.03,1
HCPCS,A9570,IN111 AUTO WBC DIAG/PER DOSE,4928.0,3203.2,0.01,4928.0,59
HCPCS,A9570,Indium in-111 auto wbc,,,8992.47,8992.47,1
HCPCS,A957000,Indium in-111 auto wbc,,,8992.47,8992.47,1
HCPCS,A9571,Indium in-111 auto platelet,,,102.79,11518.45,11
HCPCS,A957100,Indium in-111 auto platelet,,,8992.47,8992.47,1
HCPCS,A9572,IND111 PENTETREOTIDE DOSE,10558.0,6862.7,0.01,10558.0,59
HCPCS,A9572,Indium in-111 pentetreotide,,,8266.32,8266.32,1
HCPCS,A9572,OCTREOSCAN 3 MCI/ML-10 MCG INTRAVENOUS KIT,10558.0,6862.7,0.01,10558.0,60
HCPCS,A957200,Indium in-111 pentetreotide,,,8266.32,8266.32,1
HCPCS,A9573,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,0.01,39.75,196
HCPCS,A9573,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,0.01,22.96,74
HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,5.87,5.87,1
HCPCS,A957300,"Inj, gadopiclenol, 1 ml",,,5.87,5.87,1
HCPCS,A9575,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.01,22.96,147
HCPCS,A9575,CLARISCAN 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.8,12.87,0.01,22.96,49
HCPCS,A9575,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,11.88,7.72,0.01,22.96,196
HCPCS,A9575,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.740000000000002,12.83,0.01,22.96,196
HCPCS,A9575,DOTAREM 7.5 MMOL SYRING 15ML,2.27,1.48,0.01,22.96,49
HCPCS,A9575,"DOTAREM INJ 0.1 ML, 10 ML",2.27,1.48,0.01,22.96,49
HCPCS,A9575,"DOTAREM INJ 0.1ML, 20 ML",2.27,1.48,0.01,22.96,49
HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.18,0.18,1
HCPCS,A957500,Inj gadoterate meglumi 0.1ml,,,0.18,0.18,1
HCPCS,A9576,"GAD-BASE MR CONTRAST NOS,1ML",33.0,21.45,0.01,33.0,49
HCPCS,A9576,Inj prohance multipack,,,2.53,2.53,1
HCPCS,A957600,Inj prohance multipack,,,2.53,2.53,1
HCPCS,A9577,"INJ MULTIHANCE 20 ML, PER 1ML",22.0,14.3,0.01,22.96,49
HCPCS,A9577,Inj multihance,,,3.2,3.2,1
HCPCS,A9577,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,20.43,13.28,0.01,22.96,147
HCPCS,A957700,Inj multihance,,,3.2,3.2,1
HCPCS,A9578,Inj multihance multipack,,,1.82,22.96,14
HCPCS,A957800,Inj multihance multipack,,,3.13,3.13,1
HCPCS,A9579,"GAD-BASE MR CONTRAST NOS,1ML",32.0,20.8,0.01,32.0,49
HCPCS,A9579,"Gad-base mr contrast nos,1ml",,,2.6,2.6,1
HCPCS,A9579,OMNISCAN 10 MMOL/20 ML (287 MG/ML) INTRAVENOUS SOLUTION,17.34,11.27,0.01,22.96,49
HCPCS,A957900,"Gad-base mr contrast nos,1ml",,,2.6,2.6,1
HCPCS,A9580,SODIUM FLUORIDE F-18 10-200 MCI/ML (370-7400 MBQ/ML) INTRAVENOUS SOLN,500.0,325.0,0.01,563.32,45
HCPCS,A9580,Sodium fluoride f-18,,,640.8,640.8,1
HCPCS,A958000,Sodium fluoride f-18,,,640.8,640.8,1
HCPCS,A9581,EOVIST 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,51.12,33.23,0.01,51.12,49
HCPCS,A9581,Gadoxetate disodium inj,,,26.26,26.26,1
HCPCS,A9581,"INJ EOVIST GADOXETATE DISODIUM, PER 1ML",147.0,95.55,0.01,147.0,49
HCPCS,A958100,Gadoxetate disodium inj,,,26.26,26.26,1
HCPCS,A9582,I-123 MIBG DOSE UP TO 15MCI,8816.0,5730.4,102.79,8816.0,61
HCPCS,A9582,Iodine i-123 iobenguane,,,10911.56,10911.56,1
HCPCS,A958200,Iodine i-123 iobenguane,,,10911.56,10911.56,1
HCPCS,A9583,Gadofosveset trisodium inj,,,37.4,37.4,1
HCPCS,A9583,INJ GADOFOSVESET TRISODIUM ML,118.0,76.7,0.01,118.0,49
HCPCS,A958300,Gadofosveset trisodium inj,,,37.4,37.4,1
HCPCS,A9584,GENERIC IOFLUPANE1-123 UP TO 5 MCI,4537.0,2949.05,0.01,4537.0,59
HCPCS,A9584,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3150.0,2047.5,0.01,4111.32,60
HCPCS,A9584,IOFLUPANE I-123 UP TO 5 MCI,4537.0,2949.05,0.01,4537.0,59
HCPCS,A9584,Iodine i-123 ioflupane,,,5536.51,5536.51,1
HCPCS,A958400,Iodine i-123 ioflupane,,,5536.51,5536.51,1
HCPCS,A9585,GADAVIST GADOBUTROL INJ 0.1ML,2.99,1.94,0.01,22.96,49
HCPCS,A9585,Gadobutrol injection,,,0.5,0.5,1
HCPCS,A958500,Gadobutrol injection,,,0.5,0.5,1
HCPCS,A9586,AMYVID 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,5720.0,3718.0,0.01,5720.0,60
HCPCS,A9586,Florbetapir f18,,,6103.41,6103.41,1
HCPCS,A958600,Florbetapir f18,,,6103.41,6103.41,1
HCPCS,A9587,Gallium ga-68,,,123.41,123.41,1
HCPCS,A9587,NETSPOT (GA-68 DOTATATE),152.0,98.8,0.01,152.0,59
HCPCS,A958700,Gallium ga-68,,,123.41,123.41,1
HCPCS,A9588,AXUMIN 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,9888.0,6427.2,0.01,9888.0,60
HCPCS,A9588,Fluciclovine f-18,,,1172.88,1172.88,1
HCPCS,A958800,Fluciclovine f-18,,,1172.88,1172.88,1
HCPCS,A9589,CYSVIEW 100 MG INTRAVESICAL SOLUTION,97.2,63.18,14.46,2964.23,51
HCPCS,A9589,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,64.8,42.12,9.64,2964.23,51
HCPCS,A9589,Insti hexaminolevulinate hcl,,,2536.09,2536.09,1
HCPCS,A958900,Insti hexaminolevulinate hcl,,,2536.09,2536.09,1
HCPCS,A9590,Iodine i-131 iobenguane 1mci,,,102.79,876.59,11
HCPCS,A959000,Iodine i-131 iobenguane 1mci,,,684.36,684.36,1
HCPCS,A9591,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,1534.0,997.1,0.01,1534.0,59
HCPCS,A9591,Fluoroestradiol f 18,,,1642.94,1642.94,1
HCPCS,A959100,Fluoroestradiol f 18,,,1642.94,1642.94,1
HCPCS,A9592,"COPPER CU-64, DOTATATE, DIAGNOSTIC, 1 MILLICURIE",2081.0,1352.65,0.01,2081.0,59
HCPCS,A9592,Copper cu 64 dotatate diag,,,2055.9,2055.9,1
HCPCS,A9592,DETECTNET 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,7700.0,5005.0,0.01,7700.0,60
HCPCS,A959200,Copper cu 64 dotatate diag,,,2055.9,2055.9,1
HCPCS,A9593,Gallium ga-68 psma-11 ucsf,,,102.79,2128.22,30
HCPCS,A959300,Gallium ga-68 psma-11 ucsf,,,1661.51,1661.51,1
HCPCS,A9594,GALLIUM GA-68 GOZETOTIDE 18.5 MBQ TO 185 MBQ/ML (0.5-5 MCI/ML) IV SOLN,16335.0,10617.75,0.01,16335.0,60
HCPCS,A9594,"Gallium ga-68 psma-11, ucla",,,1626.8,1626.8,1
HCPCS,A959400,"Gallium ga-68 psma-11, ucla",,,1626.8,1626.8,1
HCPCS,A9595,F-18 PSMA PYLARIFY,745.0,484.25,0.01,1026.51,59
HCPCS,A9595,"Piflu f-18, dia 1 millicurie",,,1313.76,1313.76,1
HCPCS,A959500,"Piflu f-18, dia 1 millicurie",,,1313.76,1313.76,1
HCPCS,A9596,Gallium illuccix 1 millicure,,,102.79,2692.22,30
HCPCS,A959600,Gallium illuccix 1 millicure,,,2206.92,2206.92,1
HCPCS,A9597,"Pet, dx, for tumor id, noc",,,102.79,119.02,8
HCPCS,A9598,"Pet dx for non-tumor id, noc",,,102.79,119.02,8
HCPCS,A9600,Sr89 strontium,,,1740.72,11402.41,30
HCPCS,A960000,Sr89 strontium,,,8010.0,8010.0,1
HCPCS,A9601,Flortaucipir inj 1 millicuri,,,102.79,7976.5,30
HCPCS,A960100,Flortaucipir inj 1 millicuri,,,747.6,747.6,1
HCPCS,A9602,Fluorodopa f-18 diag per mci,,,102.79,2693.88,31
HCPCS,A960200,Fluorodopa f-18 diag per mci,,,1065.58,1065.58,1
HCPCS,A9603,CYTALUX 3.2 MG/1.6 ML INTRAVENOUS SOLUTION,9562.5,6215.63,0.01,9562.5,49
HCPCS,A9603,"Inj, pafolacianine, 0.1 mg",,,283.7,283.7,1
HCPCS,A960300,"Inj, pafolacianine, 0.1 mg",,,283.7,283.7,1
HCPCS,A9604,Sm 153 lexidronam,,,3159.8,44549.97,30
HCPCS,A960400,Sm 153 lexidronam,,,34780.24,34780.24,1
HCPCS,A9606,RADIUM 223 DICHLORIDE PER UCI,338.0,219.7,95.59,5961.96,61
HCPCS,A9606,Radium ra223 dichloride ther,,,361.02,361.02,1
HCPCS,A960600,Radium ra223 dichloride ther,,,361.02,361.02,1
HCPCS,A9607,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",486.0,315.9,1.1,17165.41,86
HCPCS,A9607,Lutetium lu 177 vipivotide,,,530.56,530.56,1
HCPCS,A960700,Lutetium lu 177 vipivotide,,,530.56,530.56,1
HCPCS,A9608,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1329.0,863.85,102.79,1988.53,61
HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,1466.1,1466.1,1
HCPCS,A9608,POSLUMA 296 MBQ/ML TO 5846 MBQ/ML INTRAVENOUS SOLUTION,9836.0,6393.4,102.79,9836.0,62
HCPCS,A960800,Flotufolastat f18 diag 1 mci,,,1466.1,1466.1,1
HCPCS,A9609,"F18 fdg, 15 millicuries",,,268.17,310.51,8
HCPCS,A9610,"Xe129 xenon, diagnostic",,,102.79,2845.44,10
HCPCS,A961000,"Xe129 xenon, diagnostic",,,2221.44,2221.44,1
HCPCS,A9611,"Flurpiridaz f18, diag, 1 mci",,,102.79,1457.5,22
HCPCS,A961100,"Flurpiridaz f18, diag, 1 mci",,,1068.0,1068.0,1
HCPCS,A9612,"Inj, fluorescein, 1 mg",,,0.8,22.96,9
HCPCS,A961200,"Inj, fluorescein, 1 mg",,,0.8,0.8,1
HCPCS,A9615,"Inj, pegulicianine, 1 mg",,,19.83,103.13,30
HCPCS,A961500,"Inj, pegulicianine, 1 mg",,,75.58,75.58,1
HCPCS,A9616,Gallium gozellix 1 millicuri,,,102.79,3221.08,22
HCPCS,A961600,Gallium gozellix 1 millicuri,,,2023.09,2023.09,1
HCPCS,A9697,"Inj, magtrace per study dose",,,19.83,3448.5,28
HCPCS,A9698,Non-rad contrast materialnoc,,,19.83,22.96,8
HCPCS,A9699,Radiopharm rx agent noc,,,97225.26,97225.26,1
HCPCS,A9700,Echocardiography contrast,,,19.83,22.96,8
HCPCS,A9800,Gallium locametz 1 millicuri,,,102.79,2254.46,31
HCPCS,A980000,Gallium locametz 1 millicuri,,,1307.48,1307.48,1
HCPCS,A9900,Supply/accessory/service,,,13.46,15.59,8
HCPCS,A9901,Delivery/set up/dispensing,,,13.46,15.59,8
HCPCS,A9999,"Dme supply or accessory, nos",,,13.46,15.59,8
HCPCS,A9999,"MISCELLANEOUS DME SUPPLY OR ACCESSORY, NOT OTHERWISE SPECIFIED",62.0,40.3,0.01,1792000.0,28
HCPCS,B0001,CD ATP (ADM),2000.0,1300.0,297.6,2000.0,38
HCPCS,C1052,"Hemostatic agent, gi, topic",,,159.5,184.68,8
HCPCS,C1062,Intravertebral fx aug impl,,,159.5,184.68,8
HCPCS,C1600,"Cath, bladed, vasc prep",,,159.5,184.68,8
HCPCS,C1601,"Endo, single, pulmonary",,,159.5,184.68,8
HCPCS,C1602,Orth/matrx/bn fill drug-elut,,,159.5,184.68,8
HCPCS,C1603,"Ret dev, laser, ivc filter",,,159.5,184.68,8
HCPCS,C1604,"Grft, trnsmurl/trnsvens byps",,,159.5,184.68,8
HCPCS,C1605,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,159.5,61950.0,49
HCPCS,C1606,"Adapter, us to endoscope",,,28.98,33.56,8
HCPCS,C1607,Neurostim integ rechg,,,159.5,184.68,8
HCPCS,C1608,"Prosthesis, dual mob cmc1",,,159.5,184.68,8
HCPCS,C1713,"Anchor/screw bn/bn,tis/bn",,,159.5,184.68,8
HCPCS,C1714,"Cath, trans atherectomy, dir",,,159.5,184.68,8
HCPCS,C1715,W NDL BRACHYTHRPY,56.0,36.4,8.33,184.68,47
HCPCS,C1716,"Brachytx, non-str, gold-198",,,245.91,1408.94,27
HCPCS,C1717,BRACHYTX NON-STR HDR IR-192,543.0,352.95,153.56,980.75,126
HCPCS,C1719,"Brachytx, ns, non-hdrir-192",,,245.91,2492.95,27
HCPCS,C1721,ICD  DUAL CHAMBER TIER II,71293.0,46340.45,159.5,71293.0,49
HCPCS,C1721,ICD DUAL CHAMBER TIER I,47202.0,30681.3,159.5,47202.0,49
HCPCS,C1722,ICD SGL GEN TIER 1,37780.0,24557.0,159.5,37780.0,49
HCPCS,C1722,ICD SGL GEN TIER 2,46738.0,30379.7,159.5,46738.0,49
HCPCS,C1722,ICD SGL GEN TIER 4,51000.0,33150.0,159.5,60060.81,49
HCPCS,C1722,ICD SINGLE CHAMBER TIER III,56507.0,36729.55,159.5,56507.0,49
HCPCS,C1722,VARIPULSE BI-DIRECTIONAL CATHETER,12346.0,8024.9,159.5,12346.0,47
HCPCS,C1724,"Cath, trans atherec,rotation",,,159.5,184.68,8
HCPCS,C1725,"BALLOON CATH, MUSTANG",628.0,408.2,93.45,628.0,47
HCPCS,C1725,CODA BALLOON CATH,2090.0,1358.5,159.5,2090.0,47
HCPCS,C1726,"Cath, bal dil, non-vascular",,,159.5,184.68,8
HCPCS,C1727,"Cath, bal tis dis, non-vas",,,159.5,184.68,8
HCPCS,C1728,BRACHYTX SEED ADMIN SET,56.0,36.4,8.33,184.68,47
HCPCS,C1728,W CATHETER MAMMOSITE,56.0,36.4,8.33,184.68,47
HCPCS,C1729,FOLEY DRAINAGE CATH,27.0,17.55,4.02,184.68,47
HCPCS,C1730,BARD DECAP STEER DIAG CATH,2145.0,1394.25,159.5,2145.0,47
HCPCS,C1730,BARD QUAD TIP CS CATH,1469.0,954.85,159.5,1469.0,47
HCPCS,C1730,BRIDGE BALLOON CATH 90CM,4490.0,2918.5,159.5,4490.0,47
HCPCS,C1730,BSW (GM) CS CATHETER,3028.0,1968.2,159.5,3028.0,47
HCPCS,C1730,BSW LASSO CATH,5704.0,3707.6,159.5,5704.0,47
HCPCS,C1730,BSW QUAD DX CATH,1721.0,1118.65,159.5,1721.0,47
HCPCS,C1730,SJM IBI 6FR DECA BI-DIR CATH,2886.0,1875.9,159.5,2886.0,47
HCPCS,C1730,SJM LWIRE DUO-DECA 7FR CTH,5676.0,3689.4,159.5,5676.0,47
HCPCS,C1730,SJM SUPREME DECA CATH,2377.0,1545.05,159.5,2377.0,47
HCPCS,C1730,SJM SUPREME QUAD CATH,608.0,395.2,90.47,608.0,48
HCPCS,C1730,SUPREME QUAD CRD-2 4FR,278.0,180.7,41.37,278.0,47
HCPCS,C1731,"Cath, ep, 20 or more elec",,,159.5,184.68,8
HCPCS,C1732,CARTO NAVIS STAR CATHETER,7855.0,5105.75,159.5,7855.0,47
HCPCS,C1732,FARAWAVE PFA W/CABLE,17300.0,11245.0,159.5,17300.0,47
HCPCS,C1732,OCTARAY MAPPING CATHETER,12136.0,7888.4,159.5,12136.0,47
HCPCS,C1732,"OPTRELL, 36 ELECTRODE WITH D-F CURVE",12136.0,7888.4,159.5,12136.0,47
HCPCS,C1733,"Cath, ep, othr than cool-tip",,,159.5,184.68,8
HCPCS,C1734,"Orth/devic/drug bn/bn,tis/bn",,,159.5,184.68,8
HCPCS,C1735,Cath renal denerv radiofreq,,,159.5,184.68,8
HCPCS,C1736,Cath renal denerv ultrasnd,,,159.5,184.68,8
HCPCS,C1737,Si&pelvis fusn&fixn dev,,,159.5,184.68,8
HCPCS,C1738,Power endo us-guid bx dev,,,159.5,184.68,8
HCPCS,C1739,TUMARK BIOPSY MARKER,165.0,107.25,24.55,184.68,48
HCPCS,C1740,"Lt vent pacing syst, sequen",,,159.5,184.68,8
HCPCS,C1741,Anchor/screw bone absorb,,,159.5,184.68,8
HCPCS,C1742,"Pressure sens syst, cont im",,,159.5,184.68,8
HCPCS,C1743,Scafld endovas resrb drg elu,,,159.5,184.68,8
HCPCS,C1747,"Endo, single, urinary tract",,,159.5,184.68,8
HCPCS,C1748,"Endoscope, single, ugi",,,159.5,184.68,8
HCPCS,C1749,"Endo, colon, retro imaging",,,159.5,184.68,8
HCPCS,C1750,"Cath, hemodialysis,long-term",,,159.5,184.68,8
HCPCS,C1751,ARROWGUARD BLUE PLUS CATHETER,267.0,173.55,39.73,267.0,47
HCPCS,C1751,"BALLOON, INTRA AORTIC",4877.0,3170.05,159.5,4877.0,49
HCPCS,C1751,CATH ART 7.5FR THRMDIL,54.0,35.1,8.04,184.68,47
HCPCS,C1751,KIT MAC ARROWG+ARD BLUE ARROW ADVANCER 9FR,272.0,176.8,40.47,272.0,47
HCPCS,C1751,PICC CATHETER,459.0,298.35,68.3,459.0,47
HCPCS,C1751,W CATH EKOS SYS ENDOVASCULAR,13678.0,8890.7,159.5,13678.0,47
HCPCS,C1751,W CATH PICC DUAL LUMEN,1250.0,812.5,159.5,1250.0,47
HCPCS,C1752,"Cath,hemodialysis,short-term",,,159.5,184.68,8
HCPCS,C1753,VERISIGHT PRO,6400.0,4160.0,159.5,6400.0,47
HCPCS,C1754,"Catheter, intradiscal",,,159.5,184.68,8
HCPCS,C1755,"Catheter, intraspinal",,,159.5,184.68,8
HCPCS,C1756,"Cath, pacing, transesoph",,,159.5,184.68,8
HCPCS,C1757,CORONARY ASPIRATION CATH (MECH THROMB),7081.0,4602.65,159.5,7081.0,47
HCPCS,C1757,EDWARDS ARTERIAL CATH TRUE WAVE 2 LUMEN,220.0,143.0,32.74,220.0,47
HCPCS,C1757,THROMBECT/EMBOLECTMY CATH,629.0,408.85,93.6,629.0,47
HCPCS,C1758,"Catheter, ureteral",,,159.5,184.68,8
HCPCS,C1759,BSW NUVISION,6400.0,4160.0,159.5,6400.0,47
HCPCS,C1759,SIEMENS ACCUNAVE 10F CATH,17394.0,11306.1,159.5,17394.0,49
HCPCS,C1760,ANGIOSEAL,685.0,445.25,101.93,685.0,48
HCPCS,C1760,DEV CLSR 6FR EXOSEAL VASC,872.0,566.8,129.75,872.0,48
HCPCS,C1760,MICRO VASCULAR PLUG MVP-5 US,8526.0,5541.9,159.5,8526.0,49
HCPCS,C1760,W DEVICE CLSURE VASC IMP/INSRT,1004.0,652.6,149.4,1004.0,48
HCPCS,C1761,"CATHETER, CORONARY IVL SHOCKWAVE",17155.0,11150.75,159.5,17155.0,47
HCPCS,C1764,W LOOP RECORDER REVEAL DX 9528,25586.0,16630.9,159.5,25586.0,49
HCPCS,C1765,Adhesion barrier,,,159.5,184.68,8
HCPCS,C1766,AGILIS NXT STEERABLE INTRODUCER 13FR MEDIUM CURL,2600.0,1690.0,159.5,2600.0,47
HCPCS,C1766,FARADRIVE PFA,2600.0,1690.0,159.5,2600.0,47
HCPCS,C1766,INTRO SHTH 8.5FR 71CM GUID,1664.0,1081.6,159.5,1664.0,47
HCPCS,C1767,"Generator, neuro non-recharg",,,159.5,184.68,8
HCPCS,C1768,"Graft, vascular",,,159.5,184.68,8
HCPCS,C1769,DIAGNOSTIC GUIDEWIRE,150.0,97.5,22.32,184.68,47
HCPCS,C1769,GUIDE WIRE,1709.5,1111.175,21.58,2591.0,188
HCPCS,C1769,GUIDEWIRE C1769 185,690.0,448.5,102.67,690.0,47
HCPCS,C1769,GUIDEWIRE C1769 54,195.0,126.75,29.02,195.0,47
HCPCS,C1769,MIRAGE GUIDEWIRE .008,2107.0,1369.55,159.5,2107.0,47
HCPCS,C1770,"Imaging coil, mr, insertable",,,159.5,184.68,8
HCPCS,C1771,"Rep dev, urinary, w/sling",,,159.5,184.68,8
HCPCS,C1772,"Infusion pump, programmable",,,159.5,184.68,8
HCPCS,C1773,AVEIR RETRIEVAL CATHETER 105CM,6000.0,3900.0,159.5,6000.0,47
HCPCS,C1773,SNARE VASC 120CM,1004.0,652.6,149.4,1004.0,47
HCPCS,C1773,W DEV RETRV 3MM ALGTR,12543.0,8152.95,159.5,12543.0,47
HCPCS,C1776,Joint device (implantable),,,159.5,184.68,8
HCPCS,C1777,"Lead, aicd, endo single coil",,,159.5,184.68,8
HCPCS,C1778,LEAD NEUROSTIMULATOR C1778 (278),14965.0,9727.25,159.5,14965.0,49
HCPCS,C1779,"Lead, pmkr, transvenous vdd",,,159.5,184.68,8
HCPCS,C1780,"Lens, intraocular (new tech)",,,159.5,184.68,8
HCPCS,C1781,Mesh (implantable),,,159.5,184.68,8
HCPCS,C1782,Morcellator,,,159.5,184.68,8
HCPCS,C1783,"Ocular imp, aqueous drain de",,,159.5,184.68,8
HCPCS,C1784,"Ocular dev, intraop, det ret",,,159.5,184.68,8
HCPCS,C1785,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,159.5,15938.0,49
HCPCS,C1785,PACEMAKER DUAL CHMBR TIER III,20332.0,13215.8,159.5,20332.0,49
HCPCS,C1785,PPM DUAL GEN TIER 1,10250.0,6662.5,159.5,10250.0,49
HCPCS,C1786,AVEIR LEADLESS AR PACEMAKER,37950.0,24667.5,159.5,37950.0,49
HCPCS,C1786,AVEIR LEADLESS VENTRICAL PACEMAKER,24000.0,15600.0,159.5,24000.0,49
HCPCS,C1786,MICRA AV LEADLESS PACEMAKER,30938.0,20109.7,159.5,30938.0,49
HCPCS,C1786,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,159.5,17500.0,49
HCPCS,C1786,PACEMAKER SGL CHAMBER TIER III,17955.0,11670.75,159.5,17955.0,49
HCPCS,C1786,PPM SGL GEN TIER 1,8677.0,5640.05,159.5,8677.0,49
HCPCS,C1786,PPM SGL GEN TIER 2,13831.0,8990.15,159.5,13831.0,49
HCPCS,C1786,W PM MICRA LEADLESS,37590.0,24433.5,159.5,37590.0,49
HCPCS,C1787,PATIENT PROGRAMMER NEUROSTIMULATOR C1787 (272),6935.0,4507.75,159.5,6935.0,47
HCPCS,C1788,W $ PORT INDWELLING IMP,1451.0,943.15,159.5,1451.0,48
HCPCS,C1789,"Prosthesis, breast, imp",,,159.5,184.68,8
HCPCS,C1813,"Prosthesis, penile, inflatab",,,159.5,184.68,8
HCPCS,C1814,"Retinal tamp, silicone oil",,,159.5,184.68,8
HCPCS,C1815,"Pros, urinary sph, imp",,,159.5,184.68,8
HCPCS,C1816,"Receiver/transmitter, neuro",,,159.5,184.68,8
HCPCS,C1817,Septal defect imp sys,,,159.5,184.68,8
HCPCS,C1818,Integrated keratoprosthesis,,,159.5,184.68,8
HCPCS,C1819,Tissue localization-excision,,,159.5,184.68,8
HCPCS,C1820,Generator neuro rechg bat sy,,,159.5,184.68,8
HCPCS,C1821,Interspinous implant,,,159.5,184.68,8
HCPCS,C1822,"Gen, neuro, hf, rechg bat",,,159.5,184.68,8
HCPCS,C1823,"Gen, neuro, trans sen/stim",,,159.5,184.68,8
HCPCS,C1824,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",83950.0,54567.5,159.5,83950.0,49
HCPCS,C1825,"Gen, neuro, carot sinus baro",,,159.5,184.68,8
HCPCS,C1826,"Gen, neuro, clo loop, rechg",,,159.5,184.68,8
HCPCS,C1827,"Gen, neuro, imp led, ex cntr",,,159.5,184.68,8
HCPCS,C1830,PWR BONE MARROW BX NEEDLE102MM,258.0,167.7,38.39,258.0,47
HCPCS,C1831,Personalized interbody cage,,,159.5,184.68,8
HCPCS,C1832,Auto cell process sys,,,159.5,184.68,8
HCPCS,C1833,Cardiac monitor sys,,,159.5,184.68,8
HCPCS,C1834,"Pressure sensor system, im",,,159.5,184.68,8
HCPCS,C1839,Iris prosthesis,,,159.5,184.68,8
HCPCS,C1840,Telescopic intraocular lens,,,159.5,184.68,8
HCPCS,C1841,Retinal prosth int/ext comp,,,159.5,184.68,8
HCPCS,C1842,"Retinal prosth, add-on",,,159.5,184.68,8
HCPCS,C1849,"Skin substitute, synthetic",,,874.33,1012.39,8
HCPCS,C1874,ABBOTT XIENCE STENT DRUG ELUTING,2920.0,1898.0,159.5,2920.0,48
HCPCS,C1874,DRUG ELUTING STENT,7393.0,4805.45,159.5,7393.0,49
HCPCS,C1874,ELUVIA DRUG-ELUTING STENT 7MM X 150MM X 130CM,10497.0,6823.05,159.5,10497.0,49
HCPCS,C1874,JOMED STENT,12656.0,8226.4,159.5,12656.0,49
HCPCS,C1874,MEDTRONIC STENT DRUG ELUTING,7117.0,4626.05,159.5,7117.0,49
HCPCS,C1874,STENT CTD/COV W/DEL MAQUET,8803.0,5721.95,159.5,8803.0,49
HCPCS,C1874,"STENT, GRAFTMASTER",12624.0,8205.6,159.5,12624.0,49
HCPCS,C1874,W STENT DRUG ELUTING PROMUS,5282.0,3433.3,159.5,5282.0,49
HCPCS,C1874,W STENT VIABAHN VBH061502,19871.0,12916.15,159.5,19871.0,49
HCPCS,C1875,"Stent, coated/cov w/o del sy",,,159.5,184.68,8
HCPCS,C1876,ABBOTT BM STENT,2515.0,1634.75,159.5,2515.0,48
HCPCS,C1876,RX ACCULINK CAROTID STENT,10797.0,7018.05,159.5,10797.0,49
HCPCS,C1876,"STENT, ACCULINK",10610.0,6896.5,159.5,10610.0,49
HCPCS,C1876,"STENT, ENTERPRISE",26275.0,17078.75,159.5,26275.0,49
HCPCS,C1876,"STENT, NEUROFORM",28663.0,18630.95,159.5,28663.0,49
HCPCS,C1876,"STENT, OMNILINK OTW",3618.0,2351.7,159.5,3618.0,48
HCPCS,C1876,"STENT, SYNERGY OTW",4100.0,2665.0,159.5,4100.0,48
HCPCS,C1876,"STENT, VASC 8/6MM 6FR",6935.0,4507.75,159.5,6935.0,49
HCPCS,C1876,"STENT, VIATORR",20557.0,13362.05,159.5,20557.0,49
HCPCS,C1876,"STENT, WALLFLEX",15808.0,10275.2,159.5,15808.0,49
HCPCS,C1876,"STENT, WALLSTENT W DEL SYS",5486.0,3565.9,159.5,5486.0,49
HCPCS,C1876,"STENT, XACT (ALL SIZES)",6023.0,3914.95,159.5,6023.0,49
HCPCS,C1876,SURPASS FLOWDIVERTER <40MM,45990.0,29893.5,159.5,45990.0,49
HCPCS,C1876,SURPASS FLOWDIVERTER >40MM,50370.0,32740.5,159.5,50370.0,49
HCPCS,C1876,W STENT 6MMX170MM LIFESTENT XL,5798.0,3768.7,159.5,5798.0,49
HCPCS,C1876,W STENT BIL HERCULNK ELITE,3962.0,2575.3,159.5,3962.0,48
HCPCS,C1876,W STENT LIFE FLEXSTAR SELF EXP,4481.0,2912.65,159.5,4481.0,48
HCPCS,C1876,W STNT NCOAT/COV,5536.0,3598.4,159.5,5536.0,49
HCPCS,C1876,W STNT NCOAT/COV2,3169.0,2059.85,159.5,3169.0,48
HCPCS,C1876,W STNT NCOAT/COV3,3294.0,2141.1,159.5,3294.0,48
HCPCS,C1877,"Stent, non-coat/cov w/o del",,,159.5,184.68,8
HCPCS,C1878,Matrl for vocal cord,,,874.33,1012.39,8
HCPCS,C1880,FILTER IVC ANGEL,11903.0,7736.95,159.5,11903.0,49
HCPCS,C1880,IVC FIILTER TIER I,4718.0,3066.7,159.5,4718.0,48
HCPCS,C1881,Dialysis access system,,,159.5,184.68,8
HCPCS,C1882,ICD BI-V GEN TIER 1,61524.0,39990.6,159.5,61524.0,49
HCPCS,C1882,ICD BI-V GEN TIER 2,80249.0,52161.85,159.5,80249.0,49
HCPCS,C1882,ICD BI-V GEN TIER 3,88721.0,57668.65,159.5,88721.0,49
HCPCS,C1882,ICD BI-V GEN TIER 4,98755.0,64190.75,159.5,98755.0,49
HCPCS,C1883,"Adapt/ext, pacing/neuro lead",,,159.5,184.68,8
HCPCS,C1884,SENTINEL CEREBRAL PROTECTION DEVICE,14600.0,9490.0,159.5,14600.0,49
HCPCS,C1885,W CATH ATHER TURBO ELITE OTW,10537.0,6849.05,159.5,10537.0,47
HCPCS,C1886,"Catheter, ablation",,,159.5,184.68,8
HCPCS,C1887,"CATH, 5 MAX ACE",13045.0,8479.25,159.5,13045.0,47
HCPCS,C1887,"CATH, LUMAX 8.0",1505.0,978.25,159.5,1505.0,47
HCPCS,C1887,"CATH, VELOCITY",5677.0,3690.05,159.5,5677.0,47
HCPCS,C1887,ECHELON 14 MICROCATH,3211.0,2087.15,159.5,3211.0,47
HCPCS,C1887,MARATHON MICROCATH,3036.0,1973.4,159.5,3036.0,47
HCPCS,C1887,RENEGADE MICROCATHETER,1686.0,1095.9,159.5,1686.0,47
HCPCS,C1887,W CATH ANG 135CM CROSSBOSS,2166.0,1407.9,159.5,2166.0,47
HCPCS,C1887,W CATH GUID EP FINECROSS,900.0,585.0,133.92,900.0,47
HCPCS,C1887,W CATH INF EXCELSIOR SL-10,4558.0,2962.7,159.5,4558.0,47
HCPCS,C1887,W CATH NEURON MAX SEL SIM,2588.0,1682.2,159.5,2588.0,47
HCPCS,C1888,Endovas non-cardiac abl cath,,,159.5,184.68,8
HCPCS,C1889,"Implant/insert device, noc",,,159.5,184.68,8
HCPCS,C1890,No device w/dev-intensive px,,,8.48,9.82,8
HCPCS,C1891,"Infusion pump,non-prog, perm",,,159.5,184.68,8
HCPCS,C1892,ABBOTT LV SHEATH,424.0,275.6,63.09,424.0,47
HCPCS,C1892,ABBOTT SHEATH,154.0,100.1,22.92,184.68,47
HCPCS,C1892,BSX SAFE SHEATH,100.0,65.0,14.88,184.68,47
HCPCS,C1892,WORLEY ADVANCED CSG STANDARD,630.0,409.5,93.74,630.0,47
HCPCS,C1892,WORLEY HEMOSTATIC SAFESHEATH 9FR X 40CM,630.0,409.5,93.74,630.0,47
HCPCS,C1892,WORLEY VEIN SELECTOR STD CURVE,248.0,161.2,36.9,248.0,47
HCPCS,C1893,"Intro/sheath, fixed,non-peel",,,159.5,184.68,8
HCPCS,C1894,"ACCUSTICK II W/RO MARK INTRO SYS, W/0.038 SS J-TIP & 0.018  NITI",461.0,299.65,68.6,461.0,47
HCPCS,C1894,AVEIR DELIVERY SYSTEM CATHETER,3500.0,2275.0,159.5,3500.0,47
HCPCS,C1894,AVEIR INTRODUCER 25F X 50CM,1200.0,780.0,159.5,1200.0,47
HCPCS,C1895,LEAD ICD SHOCK TIER 2,16899.0,10984.35,159.5,16899.0,49
HCPCS,C1895,LEAD ICD TIER I,13250.0,8612.5,159.5,13250.0,49
HCPCS,C1896,W ELECTRODE Q-TRAK,23739.0,15430.35,159.5,23739.0,49
HCPCS,C1897,"LEAD, NEUROSTIM TEST KIT",135.0,87.75,1.1,135.0,22
HCPCS,C1897,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,159.5,5275.0,49
HCPCS,C1897,W IMP LD NSTM TST,2525.0,1641.25,159.5,2525.0,48
HCPCS,C1898,LEAD PACEMAKER TIER II,2868.0,1864.2,159.5,2868.0,48
HCPCS,C1898,LEAD PPM PACING/EPICARD TIER 1,1637.0,1064.05,159.5,1637.0,48
HCPCS,C1898,LEAD PPM PACING/EPICARD TIER 3,5915.0,3844.75,159.5,5915.0,49
HCPCS,C1899,"Lead, pmkr/aicd combination",,,159.5,184.68,8
HCPCS,C1900,LEAD LV TRANSVENOUS TIER 1,5608.0,3645.2,159.5,5608.0,49
HCPCS,C1900,LEAD LV TRANSVENOUS TIER 2,7954.0,5170.1,159.5,7954.0,49
HCPCS,C1900,LEAD LV TRANSVENOUS TIER 3,10694.0,6951.1,159.5,10694.0,49
HCPCS,C1982,"Cath, pressure,valve-occlu",,,159.5,184.68,8
HCPCS,C2596,"PROBE, IMAGE-GUIDED, ROBOTIC, WATERJET ABLATION",11863.0,7710.95,159.5,11863.0,49
HCPCS,C2613,LUNG TRACT SEALANT,1663.0,1080.95,159.5,1663.0,48
HCPCS,C2614,"Probe, perc lumb disc",,,159.5,184.68,8
HCPCS,C2615,"Sealant, pulmonary, liquid",,,874.33,1012.39,8
HCPCS,C2616,"H980006 BRACHYTX,NON-STR,90 TH",79000.0,51350.0,10410.03,79000.0,64
HCPCS,C2617,W $ STENT NONCOR TEMP W/O DEL SYS,377.0,245.05,56.1,377.0,48
HCPCS,C2617,W STNT PERCU SFT,609.0,395.85,90.62,609.0,48
HCPCS,C2618,W NEEDLE CRYO SEEDNET ICEROD EA,4928.0,3203.2,159.5,4928.0,47
HCPCS,C2619,"Pmkr, dual, non rate-resp",,,159.5,184.68,8
HCPCS,C2620,"Pmkr, single, non rate-resp",,,159.5,184.68,8
HCPCS,C2621,PPM BI-V GEN TIER 1,24124.0,15680.6,159.5,24124.0,49
HCPCS,C2621,PPM BI-V GEN TIER 2,34881.0,22672.65,159.5,34881.0,49
HCPCS,C2622,"Prosthesis, penile, non-inf",,,159.5,184.68,8
HCPCS,C2623,"Cath, translumin, drug-coat",,,159.5,184.68,8
HCPCS,C2624,CARDIOMEMS SENSOR/DELIV SYSTEM,63875.0,41518.75,159.5,63875.0,49
HCPCS,C2625,"Stent, non-cor, tem w/del sy",,,159.5,184.68,8
HCPCS,C2626,"Infusion pump, non-prog,temp",,,159.5,184.68,8
HCPCS,C2627,"Cath, suprapubic/cystoscopic",,,159.5,184.68,8
HCPCS,C2628,"BALLOON CATH, EV3-HYPERGLIDE",5419.0,3522.35,159.5,5419.0,47
HCPCS,C2628,W CATH BLLN HYPERFORM 7MMX150CM,6698.0,4353.7,159.5,6698.0,47
HCPCS,C2629,"Intro/sheath, laser",,,159.5,184.68,8
HCPCS,C2630,"Cath, ep, cool-tip",,,159.5,184.68,8
HCPCS,C2631,"Rep dev, urinary, w/o sling",,,159.5,184.68,8
HCPCS,C2634,"Brachytx, non-str, ha, i-125",,,150.46,2520.05,27
HCPCS,C2635,"Brachytx, non-str, ha, p-103",,,64.11,292.86,27
HCPCS,C2636,"Brachy linear, non-str,p-103",,,48.89,2520.05,27
HCPCS,C2637,"Brachy,non-str,ytterbium-169",,,245.91,284.74,8
HCPCS,C2638,"BRACHY SOURCE TX, STRANDED I-125",195.0,126.75,32.65,284.74,63
HCPCS,C2638,"BRACHYTX, STRANDED, I-125",215.0,139.75,32.65,284.74,63
HCPCS,C2639,"Brachytx, non-stranded,i-125",,,32.44,284.74,27
HCPCS,C2640,"Brachytx, stranded, p-103",,,64.39,2520.05,27
HCPCS,C2641,"Brachytx, non-stranded,p-103",,,59.71,2520.05,27
HCPCS,C2642,"Brachytx, stranded, c-131",,,99.66,2520.05,27
HCPCS,C2643,"Brachytx, non-stranded,c-131",,,89.22,2520.05,27
HCPCS,C2644,Brachytx cesium-131 chloride,,,2176.4,2520.05,8
HCPCS,C2645,"Brachytx planar, p-103",,,4.33,284.74,27
HCPCS,C2698,"Brachytx, stranded, nos",,,32.65,284.74,27
HCPCS,C2699,"Brachytx, non-stranded, nos",,,32.44,284.74,27
HCPCS,C5271,Low cost skin substitute app,,,565.6,1350.24,14
HCPCS,C5272,Low cost skin substitute app,,,1166.12,1350.24,8
HCPCS,C5273,Low cost skin substitute app,,,1166.12,1825.39,14
HCPCS,C5274,Low cost skin substitute app,,,1166.12,1350.24,8
HCPCS,C5275,Low cost skin substitute app,,,565.6,1350.24,14
HCPCS,C5276,Low cost skin substitute app,,,1166.12,1350.24,8
HCPCS,C5277,Low cost skin substitute app,,,565.6,1350.24,14
HCPCS,C5278,Low cost skin substitute app,,,1166.12,1350.24,8
HCPCS,C7500,Deb bone 20 cm2 w/drug dev,,,444.21,514.35,8
HCPCS,C7501,Perc bx breast lesions stero,,,819.01,948.33,8
HCPCS,C7502,Perc bx breast lesions mr,,,819.01,948.33,8
HCPCS,C7503,Open exc cerv node(s) w/ id,,,1795.98,2079.56,8
HCPCS,C7504,Perq cvt&ls inj vert bodies,,,3026.0,3503.79,8
HCPCS,C7505,Perq ls&cvt inj vert bodies,,,3026.0,3503.79,8
HCPCS,C7506,Fusion of finger joints,,,927.34,1073.77,8
HCPCS,C7507,Perq thor&lumb vert aug,,,3026.0,3503.79,8
HCPCS,C7508,Perq lumb&thor vert aug,,,3026.0,3503.79,8
HCPCS,C7509,Dx bronch w/ navigation,,,884.47,1024.12,8
HCPCS,C7510,Bronch/lavag w/ navigation,,,884.47,1024.12,8
HCPCS,C7511,Bronch/bpsy(s) w/ navigation,,,884.47,1024.12,8
HCPCS,C7512,Bronch/bpsy(s) w/ ebus,,,2079.57,2407.92,8
HCPCS,C7513,Cath/angio dialcir w/aplasty,,,2003.13,2319.42,8
HCPCS,C7514,Cath/angio dial cir w/stents,,,6695.97,7753.23,8
HCPCS,C7515,Cath/angio dial cir w/embol,,,6695.97,7753.23,8
HCPCS,C7516,Cor angio w/ ivus or oct,,,1546.13,1790.26,8
HCPCS,C7517,Cor angio w/ilic/fem angio,,,1546.13,1790.26,8
HCPCS,C7518,Cor/gft angio w/ ivus or oct,,,1546.13,1790.26,8
HCPCS,C7519,Cor/gft angio w/ flow resrv,,,1546.13,1790.26,8
HCPCS,C7520,Cor/gft angio w/ilic/fem ang,,,1546.13,1790.26,8
HCPCS,C7521,R hrt angio w/ ivus or oct,,,1546.13,1790.26,8
HCPCS,C7522,R hrt angio w/flow resrv,,,1546.13,1790.26,8
HCPCS,C7523,L hrt angio w/ ivus or oct,,,1546.13,1790.26,8
HCPCS,C7524,L hrt angio w/flow resrv,,,1546.13,1790.26,8
HCPCS,C7525,L hrt gft ang w/ ivus or oct,,,1546.13,1790.26,8
HCPCS,C7526,L hrt gft ang w/flow resrv,,,1546.13,1790.26,8
HCPCS,C7527,R&l hrt angio w/ ivus or oct,,,1546.13,1790.26,8
HCPCS,C7528,R&l hrt angio w/flow resrv,,,1546.13,1790.26,8
HCPCS,C7529,R&l hrt gft ang w/flow resrv,,,1546.13,1790.26,8
HCPCS,C7530,Cath/aplasty dial cir w/stnt,,,6695.97,7753.23,8
HCPCS,C7531,Angio fem/pop w/ us,,,3708.64,4294.21,8
HCPCS,C7532,Angio w/ us non-coronary,,,4659.93,5395.71,8
HCPCS,C7533,Ptca w/ plcmt brachytx dev,,,4659.93,5395.71,8
HCPCS,C7534,Fem/pop revasc w/arthr & us,,,6695.97,7753.23,8
HCPCS,C7535,Fem/pop revasc w/stent & us,,,6695.97,7753.23,8
HCPCS,C7537,Insrt atril pm w/l vent lead,,,5003.75,5793.81,8
HCPCS,C7538,Insrt vent pm w/l vent lead,,,5003.75,5793.81,8
HCPCS,C7539,Insrt a & v pm w/l vent lead,,,5003.75,5793.81,8
HCPCS,C7540,Rmv&rplc pm dul w/l vnt lead,,,5003.75,5793.81,8
HCPCS,C7544,Ercp rmv calc pancreatoscopy,,,2272.63,2631.46,8
HCPCS,C7545,Exch bil cath w/ rmv calculi,,,2755.97,3191.12,8
HCPCS,C7546,Rep nph/urt cath w/dil stric,,,1680.64,1946.0,8
HCPCS,C7547,Cnvrt neph cath w/ dil stric,,,1680.64,1946.0,8
HCPCS,C7548,Exch neph cath w/ dil stric,,,1680.64,1946.0,8
HCPCS,C7549,Chge urtr stent w/ dil stric,,,1680.64,1946.0,8
HCPCS,C7550,Cysto w/ bx(s) w/ blue light,,,846.52,980.18,8
HCPCS,C7551,Exc neuroma w/ implnt nv end,,,2822.5,3268.16,8
HCPCS,C7552,R hrt art/grft ang hrt flow,,,1546.13,1790.26,8
HCPCS,C7553,R&i hrt art/vent ang drg ad,,,1546.13,1790.26,8
HCPCS,C7554,Cystureth blu li cyst fl img,,,846.52,980.18,8
HCPCS,C7555,Rmvl thyrd w/autotran parath,,,3424.1,3964.75,8
HCPCS,C7556,Bronch lavage w/ebus,,,2079.57,2407.92,8
HCPCS,C7557,Cor angio/vent w/ffr,,,1546.13,1790.26,8
HCPCS,C7558,Cor angio/vent w/drug admin,,,1546.13,1790.26,8
HCPCS,C7560,Ercp remove forgn body&endo,,,2272.63,2631.46,8
HCPCS,C7562,R&l hrt angio w/ffr & 3d map,,,1546.13,1790.26,8
HCPCS,C7563,Trluml ballo angiop all art,,,2003.13,2319.42,8
HCPCS,C7564,Vein mech throm w/intrvas us,,,2003.13,2319.42,8
HCPCS,C7565,Rpr aa hrn < 3 rdc w/ rmvl,,,2692.69,3117.85,8
HCPCS,C7566,Fuse finger joints w/grafts,,,927.34,1073.77,8
HCPCS,C7567,Bronch/needle bx(s) w/ nav,,,884.47,1024.12,8
HCPCS,C7568,COR ANGIO W/ FLOW RESRV,27869.0,18114.85,1546.13,27869.0,46
HCPCS,C7568,COR ANGIO W/FLOW RESRV,3045.0,1979.25,1.1,3045.0,22
HCPCS,C7569,PTCA W/ IVUS OR OCT,23726.5,15422.225,1.1,41751.0,68
HCPCS,C7570,COR ANGIO W/ FFR & 3D MAP,23119.0,15027.35,1546.13,23119.0,46
HCPCS,C7570,COR ANGIO W/FFR & 3D MAP,2605.0,1693.25,1.1,2605.0,22
HCPCS,C7571,PCTA W/ COR LITHOTRIP,26736.0,17378.4,1.1,47343.0,68
HCPCS,C7900,"Hopd mntl hlt, 15-29 min",,,27.53,167.27,27
HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,85.47,284.74,27
HCPCS,C7903,"HOPD MNTL HLT, GRP",89.0,57.85,25.17,121.1,61
HCPCS,C8000,"Suprt dev, a-v fistula, imp",,,159.5,184.68,8
HCPCS,C8001,3d anat seg imaging preop,,,68.91,445.75,28
HCPCS,C8002,"Prep skin cell susp, automtd",,,147.83,19891.22,27
HCPCS,C8003,Imp extar knee shck absrb,,,4234.94,49144.62,27
HCPCS,C8004,"SIM ANGRM W/ PRSR-GEN CATH (ONE-WAY VALVE, INTERMIT OCCLUDING) I",30915.0,20094.75,2003.13,32356.61,55
HCPCS,C8005,Pef bronch ablt 3d nav ebus,,,2079.57,48011.34,21
HCPCS,C8006,Inst pleu-perit shnt w pump,,,1611.33,18145.13,21
HCPCS,C8007,Opn mplnt hpgls ns ary ps gn,,,15220.57,17623.82,8
HCPCS,C8009,Rmv hpgls ns ary and pg,,,1720.7,1992.39,8
HCPCS,C8010,Pc plm pm c ctd emb prtc,,,3708.64,4294.21,8
HCPCS,C8011,Opn mplnt hpgls ns ary rec,,,15220.57,17623.82,8
HCPCS,C8013,Rmv hpls ns ary rec,,,1720.7,1992.39,8
HCPCS,C8900,"Mra w/cont, abd",,,246.69,1863.61,28
HCPCS,C8901,"Mra w/o cont, abd",,,223.34,1165.03,28
HCPCS,C8902,"Mra w/o fol w/cont, abd",,,246.69,1863.61,28
HCPCS,C8903,"Mri w/cont, breast,  uni",,,164.49,903.92,20
HCPCS,C8903,"Mri w/cont, breast, uni",,,306.46,354.85,8
HCPCS,C8905,"Mri w/o fol w/cont, brst, un",,,306.46,1863.61,28
HCPCS,C8906,"Mri w/cont, breast,  bi",,,329.98,1863.61,20
HCPCS,C8906,"Mri w/cont, breast, bi",,,306.46,354.85,8
HCPCS,C8908,"Mri w/o fol w/cont, breast,",,,306.46,1863.61,28
HCPCS,C8909,"Mra w/cont, chest",,,246.69,1863.61,28
HCPCS,C8910,"Mra w/o cont, chest",,,223.34,1165.03,28
HCPCS,C8911,"Mra w/o fol w/cont, chest",,,246.69,1863.61,28
HCPCS,C8912,"Mra w/cont, lwr ext",,,246.69,1863.61,28
HCPCS,C8913,"Mra w/o cont, lwr ext",,,223.34,1165.03,28
HCPCS,C8914,"Mra w/o fol w/cont, lwr ext",,,246.69,1863.61,28
HCPCS,C8918,"Mra w/cont, pelvis",,,246.69,1863.61,28
HCPCS,C8919,"Mra w/o cont, pelvis",,,223.34,1165.03,28
HCPCS,C8920,MR ANGIO PELVIS(MRA),6296.0,4092.4,1.1,7088.0,68
HCPCS,C8920,"Mra w/o fol w/cont, pelvis",,,246.69,1863.61,28
HCPCS,C8921,TTE CONGENITAL ANOMALIES W/CONTRAST,4543.0,2952.95,280.48,4543.0,61
HCPCS,C8922,"TTE CONGENITAL ANOMALIES, LIMITED W/CONTRAST",4543.0,2952.95,280.48,4543.0,61
HCPCS,C8923,"2d tte w or w/o fol w/con,co",,,280.48,2197.21,27
HCPCS,C8924,2DTTE W CONTR LTD,2053.0,1334.45,280.48,2053.0,61
HCPCS,C8924,ECHO LIMITED WITH CONTRAS,2053.0,1334.45,280.48,2053.0,61
HCPCS,C8925,TEE W/CONTRAST 2D,4543.0,2952.95,280.48,4543.0,61
HCPCS,C8926,TEE W/CONTRAST CONGENITAL ANOMALIES,4543.0,2952.95,280.48,4543.0,61
HCPCS,C8927,"Tee w or w/o fol w/cont, mon",,,280.48,2197.21,27
HCPCS,C8928,2D TTE W CONTR STRESS,4543.0,2952.95,280.48,4543.0,122
HCPCS,C8929,"TTE W/DOPPLER, COMPLETE W/CONT",4543.0,2952.95,280.48,4543.0,61
HCPCS,C8930,STRESS ECHO W/CONTRAST,4543.0,2952.95,280.48,4543.0,61
HCPCS,C8931,"Mra, w/dye, spinal canal",,,246.69,1863.61,28
HCPCS,C8932,"Mra, w/o dye, spinal canal",,,223.34,1165.03,28
HCPCS,C8933,"Mra, w/o&w/dye, spinal canal",,,246.69,1863.61,28
HCPCS,C8934,"Mra, w/dye, upper extremity",,,246.69,1863.61,28
HCPCS,C8935,"Mra, w/o dye, upper extr",,,223.34,1165.03,28
HCPCS,C8936,"Mra, w/o&w/dye, upper extr",,,246.69,1863.61,28
HCPCS,C8937,MRI BREAST 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1330.0,864.5,68.91,1330.0,46
HCPCS,C8957,"PROLONGED IV INF, REQ PUMP",1907.0,1239.55,201.23,1907.0,61
HCPCS,C9046,COCAINE 4 % NASAL SOLUTION,193.8,125.97,2.17,193.8,51
HCPCS,C9046,Cocaine hcl nasal (goprelto),,,3.79,3.79,1
HCPCS,C904600,Cocaine hcl nasal (goprelto),,,3.79,3.79,1
HCPCS,C9047,CABLIVI 11 MG INJECTION KIT,32092.38,20860.05,2.17,32092.38,59
HCPCS,C9047,"Injection, caplacizumab-yhdp",,,1664.46,1664.46,1
HCPCS,C904700,"Injection, caplacizumab-yhdp",,,1664.46,1664.46,1
HCPCS,C9055,"Inj, brexanolone",,,3815.3,4417.71,8
HCPCS,C9059,"Injection, meloxicam",,,7.65,8.86,8
HCPCS,C9060,Fluoroestradiol f18,,,102.79,119.02,8
HCPCS,C9061,"Injection, teprotumumab-trbw",,,11321.23,13108.79,8
HCPCS,C9062,Daratumumab hyaluronidase,,,3875.72,4487.68,8
HCPCS,C9063,"Injection, eptinezumab-jjmr",,,318.98,369.35,8
HCPCS,C9064,Mitomycin pyelocalyceal inst,,,11321.23,13108.79,8
HCPCS,C9065,Romidepsin non-lyophilized,,,2813.05,3257.22,8
HCPCS,C9066,Sacituzumab govitecan-hziy,,,3815.3,4417.71,8
HCPCS,C9067,Gallium ga-68 dotatoc,,,3.61,119.02,30
HCPCS,C906700,Gallium ga-68 dotatoc,,,16.18,16.18,1
HCPCS,C9068,"Copper cu-64, dotatate, dx",,,102.79,119.02,8
HCPCS,C9069,Belantamab mafodontin-blmf,,,6055.17,7011.25,8
HCPCS,C9070,"Injection, tafasitamab-cxix",,,3875.72,4487.68,8
HCPCS,C9071,"Injection, viltolarsen",,,11321.23,13108.79,8
HCPCS,C9072,"Inj, imm glob asceniv",,,2282.35,2642.72,8
HCPCS,C9073,Brexucabtagene autoleucel ca,,,8866.62,10266.61,8
HCPCS,C9074,"Injection, lumasiran",,,11321.23,13108.79,8
HCPCS,C9075,"Injection, casimersen, 10 mg",,,11321.23,13108.79,8
HCPCS,C9076,Lisocabtagene car pos t,,,8866.62,10266.61,8
HCPCS,C9077,Inj cabotegravir/rilpivirine,,,3875.72,4487.68,8
HCPCS,C9078,"Inj, trilaciclib, 1 mg",,,1112.18,1287.79,8
HCPCS,C9079,"Inj, evinacumab-dgnb, 5 mg",,,3815.3,4417.71,8
HCPCS,C9080,"Inj, melphalan flufen, 1 mg",,,6055.17,7011.25,8
HCPCS,C9081,Idecabtagene car pos t,,,8866.62,10266.61,8
HCPCS,C9082,"Inj dostarlimab-gxly, 100 mg",,,6055.17,7011.25,8
HCPCS,C9083,"Inj, amivantamab-vmjw, 10 mg",,,3815.3,4417.71,8
HCPCS,C9084,"Loncastuximab-lpyl, 0.1 mg",,,11321.23,13108.79,8
HCPCS,C9085,Inj avalglucosid alfa-ngpt,,,14351.75,16617.81,8
HCPCS,C9086,"Inj, anifrolumab-fnia",,,2813.05,3257.22,8
HCPCS,C9087,Inj cyclophosphamd auromedic,,,431.85,500.04,8
HCPCS,C9088,"Instill, bupivac and meloxic",,,0.77,8.86,16
HCPCS,C9089,"Bupivacaine implant, 1 mg",,,0.79,8.86,15
HCPCS,C9090,"Plasminogen, human-tvmh 1 mg",,,32.4,720.96,11
HCPCS,C909000,"Plasminogen, human-tvmh 1 mg",,,64.08,64.08,1
HCPCS,C9091,"Sirolimus, protein-bound,1mg",,,73.28,7011.25,11
HCPCS,C909100,"Sirolimus, protein-bound,1mg",,,144.93,144.93,1
HCPCS,C9092,"Inj., xipere, 1 mg",,,97.9,184.43,10
HCPCS,C909200,"Inj., xipere, 1 mg",,,97.9,97.9,1
HCPCS,C9093,"Inj., susvimo, 0.1 mg",,,86.4,4417.71,11
HCPCS,C909300,"Inj., susvimo, 0.1 mg",,,170.88,170.88,1
HCPCS,C9094,"Inj, sutimlimab-jome, 10 mg",,,3815.3,4417.71,8
HCPCS,C9095,"Inj, tebentafusp-tebn, 1 mcg",,,11321.23,13108.79,8
HCPCS,C9096,"Inj, releuko, 1 mcg",,,159.28,184.43,8
HCPCS,C9097,"Inj, faricimab-svoa, 0.1 mg",,,2282.35,2642.72,8
HCPCS,C9098,Ciltacabtagene car pos t,,,8866.62,10266.61,8
HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,1.23,8.86,18
HCPCS,C910100,"Inj, oliceridine 0.1 mg",,,2.76,2.76,1
HCPCS,C9113,"Inj pantoprazole sodium, via",,,7.65,12.45,10
HCPCS,C911300,"Inj pantoprazole sodium, via",,,9.72,9.72,1
HCPCS,C9122,Mometasone furoate (sinuva),,,1112.18,1287.79,8
HCPCS,C9132,"Kcentra, per i.u.",,,2813.05,3257.22,8
HCPCS,C9142,"Inj, alymsys, 10 mg",,,77.61,1287.79,9
HCPCS,C9143,Cocaine hcl nasal (numbrino),,,1.65,8.86,11
HCPCS,C914300,Cocaine hcl nasal (numbrino),,,4.79,4.79,1
HCPCS,C9144,"Inj, bupivacaine (posimir)",,,0.5,8.86,17
HCPCS,C914400,"Inj, bupivacaine (posimir)",,,1.03,1.03,1
HCPCS,C9145,"Inj, aponvie, 1 mg",,,1.86,130.36,30
HCPCS,C914500,"Inj, aponvie, 1 mg",,,4.08,4.08,1
HCPCS,C9146,"Inj, elahere, 1 mg",,,14351.75,16617.81,8
HCPCS,C9147,"Inj, tremelimumab-actl, 1 mg",,,3815.3,4417.71,8
HCPCS,C9148,"Inj, teclistamab-cqyv, 0.5mg",,,3875.72,4487.68,8
HCPCS,C9149,"Inj, teplizumab-mzwv, 5 mcg",,,14351.75,16617.81,8
HCPCS,C9150,"Xe129 xenon, diagnostic",,,102.79,2845.44,10
HCPCS,C915000,"Xe129 xenon, diagnostic",,,2221.44,2221.44,1
HCPCS,C9151,"Inj, pegcetacoplan 1 mg",,,3875.72,4487.68,8
HCPCS,C9152,"Inj, abilify asimtufii, 1 mg",,,2282.35,2642.72,8
HCPCS,C9153,"Inj, amisulpride, 1 mg",,,41.42,47.96,8
HCPCS,C9154,Inj buprenorph (brixadi) 1mg,,,41.42,47.96,8
HCPCS,C9155,"Inj epcoritamab-bysp,0.16 mg",,,3875.72,4487.68,8
HCPCS,C9156,"Flotufolastat f18, dia 1 mci",,,102.79,119.02,8
HCPCS,C9157,"Inj, tofersen, 1 mg",,,11321.23,13108.79,8
HCPCS,C9158,"Inj, uzedy, 1 mg",,,1112.18,1287.79,8
HCPCS,C9159,"Inj, balfaxar, per i.u",,,6.73,3257.22,10
HCPCS,C915900,"Inj, balfaxar, per i.u",,,6.73,6.73,1
HCPCS,C9160,Inj daxibotulinumtoxina-lanm,,,8.97,184.43,10
HCPCS,C916000,Inj daxibotulinumtoxina-lanm,,,8.97,8.97,1
HCPCS,C9161,"Inj, aflibercept hd, 1 mg",,,700.88,2642.72,10
HCPCS,C916100,"Inj, aflibercept hd, 1 mg",,,700.88,700.88,1
HCPCS,C9162,"Inj, avacincaptad peg 0.1 mg",,,224.28,2642.72,10
HCPCS,C916200,"Inj, avacincaptad peg 0.1 mg",,,224.28,224.28,1
HCPCS,C9163,Inj talquetamab-tgvs 0.25 mg,,,138.31,4417.71,10
HCPCS,C916300,Inj talquetamab-tgvs 0.25 mg,,,138.31,138.31,1
HCPCS,C9164,"Cantharidin top, applicator",,,1463.16,1463.16,1
HCPCS,C9164,YCANTH 0.7 % TOPICAL SOLUTION APPLICATOR,1725.6,1121.64,256.77,1725.6,51
HCPCS,C916400,"Cantharidin top, applicator",,,1463.16,1463.16,1
HCPCS,C9165,"Inj, elranatamab-bcmm, 1 mg",,,366.79,4417.71,10
HCPCS,C916500,"Inj, elranatamab-bcmm, 1 mg",,,366.79,366.79,1
HCPCS,C9166,"Injection, secukinumab",,,36.13,2642.72,10
HCPCS,C916600,"Injection, secukinumab",,,36.13,36.13,1
HCPCS,C9167,"Inj, adzynma, 10 iu",,,41.42,89.83,10
HCPCS,C916700,"Inj, adzynma, 10 iu",,,70.13,70.13,1
HCPCS,C9168,"Injection, mirikizumab-mrkz",,,68.3,4417.71,10
HCPCS,C916800,"Injection, mirikizumab-mrkz",,,68.3,68.3,1
HCPCS,C9169,"Inj, nogapendekin pmln 1 mcg",,,191.17,4487.68,10
HCPCS,C916900,"Inj, nogapendekin pmln 1 mcg",,,191.17,191.17,1
HCPCS,C9170,"Inj, tarlatamab-dlle, 1 mg",,,3204.0,7011.25,10
HCPCS,C917000,"Inj, tarlatamab-dlle, 1 mg",,,3204.0,3204.0,1
HCPCS,C9171,"Inj, pegulicianine, 1 mg",,,19.83,96.81,10
HCPCS,C917100,"Inj, pegulicianine, 1 mg",,,75.58,75.58,1
HCPCS,C9172,"Inj, beqvez, per tx dose",,,14351.75,16617.81,8
HCPCS,C9173,"Inj, nypozi, 1 mcg",,,0.54,184.43,16
HCPCS,C9174,"Datopotamab deruxtecan, 1 mg",,,11321.23,13108.79,8
HCPCS,C9175,"Inj, treosulfan, 50 mg",,,3815.3,4417.71,8
HCPCS,C9176,NON-HEU TC-99M ADD-ON/DOSE,11.0,7.15,3.11,119.02,55
HCPCS,C9248,"Inj, clevidipine butyrate",,,2.83,130.36,16
HCPCS,C9250,ARTISS 2.5 UNIT TO 6.5 UNIT/ML (4ML) TOPICAL SYRINGE,246.5,160.23,54.48,422.08,57
HCPCS,C9250,ARTISS 2.5 UNIT TO 6.5 UNIT/ML(10ML) TOPICAL SYRINGE,220.66,143.43,48.77,422.08,57
HCPCS,C9250,Artiss fibrin sealant,,,392.79,392.79,1
HCPCS,C925000,Artiss fibrin sealant,,,392.79,392.79,1
HCPCS,C9254,"Injection, lacosamide",,,0.43,0.43,1
HCPCS,C9254,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,11.79,7.66,1.75,47.96,51
HCPCS,C9254,VIMPAT 200 MG/20 ML INTRAVENOUS SOLUTION,17.85,11.6,2.66,47.96,51
HCPCS,C925400,"Injection, lacosamide",,,0.43,0.43,1
HCPCS,C9257,Bevacizumab injection,,,1.82,47.96,30
HCPCS,C925700,Bevacizumab injection,,,4.25,4.25,1
HCPCS,C9285,"Patch, lidocaine/tetracaine",,,36.21,47.96,10
HCPCS,C928500,"Patch, lidocaine/tetracaine",,,36.21,36.21,1
HCPCS,C9290,"Inj, bupivacaine liposome",,,3.03,8.86,10
HCPCS,C929000,"Inj, bupivacaine liposome",,,3.03,3.03,1
HCPCS,C9293,"Injection, glucarpidase",,,923.46,923.46,1
HCPCS,C9293,VORAXAZE 1000 UNIT INTRAVENOUS SOLUTION,155638.8,101165.22,448.69,155638.8,59
HCPCS,C929300,"Injection, glucarpidase",,,923.46,923.46,1
HCPCS,C9300,"Indigotindisulfonate, 1 mg",,,19.83,22.96,8
HCPCS,C9301,AUCATZYL INTRAVENOUS SUSPENSION,2520000.0,1638000.0,8866.62,2520000.0,47
HCPCS,C9302,"Inj zanidatamab, 2 mg",,,6055.17,7011.25,8
HCPCS,C9303,"Inj zolbetuximab, 1 mg",,,3815.3,4417.71,8
HCPCS,C9304,"Inj marstacimab, 0.5 mg",,,14351.75,16617.81,8
HCPCS,C9305,"Inj, nipocalimab-aahu, 3 mg",,,6055.17,7011.25,8
HCPCS,C9306,Telisotuzumab vedotin-tllv,,,6055.17,7011.25,8
HCPCS,C9307,Inj linvoseltamab-gcpt 1 mg,,,200.78,200.78,1
HCPCS,C9307,LYNOZYFIC 2 MG/ML INTRAVENOUS SOLUTION,902.4,586.56,96.82,7011.25,59
HCPCS,C9307,LYNOZYFIC 20 MG/ML INTRAVENOUS SOLUTION,9024.0,5865.6,96.82,9024.0,59
HCPCS,C930700,Inj linvoseltamab-gcpt 1 mg,,,200.78,200.78,1
HCPCS,C9308,"Inj, carboplatin (avyxa)",,,5.15,14.16,14
HCPCS,C930800,"Inj, carboplatin (avyxa)",,,10.68,10.68,1
HCPCS,C9309,Inj onase abepar-brve treat,,,14351.75,16617.81,8
HCPCS,C9352,"Neuragen nerve guide, per cm",,,874.33,2757.2,10
HCPCS,C935200,"Neuragen nerve guide, per cm",,,2217.17,2217.17,1
HCPCS,C9353,"Neurawrap nerve protector,cm",,,874.33,2940.52,10
HCPCS,C935300,"Neurawrap nerve protector,cm",,,2364.82,2364.82,1
HCPCS,C9354,"Veritas collagen matrix, cm2",,,40.58,1012.39,10
HCPCS,C935400,"Veritas collagen matrix, cm2",,,40.58,40.58,1
HCPCS,C9355,"Neuromatrix nerve cuff, cm",,,381.63,1012.39,10
HCPCS,C935500,"Neuromatrix nerve cuff, cm",,,381.63,381.63,1
HCPCS,C9356,"Tenoglide tendon prot, cm2",,,234.64,1012.39,10
HCPCS,C935600,"Tenoglide tendon prot, cm2",,,234.64,234.64,1
HCPCS,C9358,"Surgimend, fetal",,,42.33,1012.39,10
HCPCS,C935800,"Surgimend, fetal",,,42.33,42.33,1
HCPCS,C9359,"Implnt,bon void filler-putty",,,258.1,1012.39,10
HCPCS,C935900,"Implnt,bon void filler-putty",,,258.1,258.1,1
HCPCS,C9360,"Surgimend, neonatal",,,45.35,1012.39,10
HCPCS,C936000,"Surgimend, neonatal",,,45.35,45.35,1
HCPCS,C9361,Neuromend nerve wrap,,,371.2,1012.39,10
HCPCS,C936100,Neuromend nerve wrap,,,371.2,371.2,1
HCPCS,C9362,"Implnt,bon void filler-strip",,,219.24,1012.39,10
HCPCS,C936200,"Implnt,bon void filler-strip",,,219.24,219.24,1
HCPCS,C9363,Integra meshed bil wound mat,,,117.73,348.8,15
HCPCS,C936300,Integra meshed bil wound mat,,,144.09,144.09,1
HCPCS,C9364,"Porcine implant, permacol",,,38.5,1012.39,10
HCPCS,C936400,"Porcine implant, permacol",,,38.5,38.5,1
HCPCS,C9399,ADBRY 150 MG/ML SUBCUTANEOUS SYRINGE,3662.43,2380.58,41.42,3662.43,51
HCPCS,C9399,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,35.31,22.95,5.25,47.96,48
HCPCS,C9399,AMTAGVI 7.5 X 10EXP9 TO 72 X 10EXP9 CELL INTRAVENOUS SUSPENSION,2940384.0,1911249.6,41.42,2940384.0,47
HCPCS,C9399,ANTIVENIN MICRURUS FULVIUS 250 UNIT SOLUTION FOR INJECTION,33279.78,21631.86,41.42,33279.78,51
HCPCS,C9399,BESREMI 500 MCG/ML SUBCUTANEOUS SYRINGE,33084.0,21504.6,41.42,33084.0,51
HCPCS,C9399,BILDYOS 60 MG/ML SUBCUTANEOUS SYRINGE,3038.4,1974.96,41.42,3038.4,51
HCPCS,C9399,BILPREVDA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,3574.59,2323.48,41.42,3574.59,51
HCPCS,C9399,BIMZELX AUTOINJECTOR 320 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,38029.84,24719.4,41.42,38029.84,51
HCPCS,C9399,BLENREP 70 MG INTRAVENOUS SOLUTION,115200.0,74880.0,41.42,115200.0,51
HCPCS,C9399,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SYRINGE,7086.18,4606.02,41.42,7086.18,51
HCPCS,C9399,BRIVIACT 50 MG/5 ML INTRAVENOUS SOLUTION,45.45,29.54,6.76,47.96,51
HCPCS,C9399,COSENTYX 150 MG/ML SUBCUTANEOUS SYRINGE,27472.44,17857.09,41.42,27472.44,51
HCPCS,C9399,COSENTYX 300 MG/2 SYRINGES (150 MG/ML) SUBCUTANEOUS SYRINGE,13736.22,8928.54,41.42,13736.22,51
HCPCS,C9399,COSENTYX PEN 150 MG/ML SUBCUTANEOUS PEN INJECTOR,27472.44,17857.09,41.42,27472.44,51
HCPCS,C9399,DANZITEN 71 MG TABLET,386.26,251.07,41.42,386.26,51
HCPCS,C9399,DANZITEN 95 MG TABLET,386.26,251.07,41.42,386.26,51
HCPCS,C9399,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,6620.58,4303.38,41.42,6620.58,51
HCPCS,C9399,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,6620.58,4303.38,41.42,6620.58,51
HCPCS,C9399,DUPIXENT 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,3773.73,2452.92,41.42,3773.73,51
HCPCS,C9399,DUPIXENT 300 MG/2 ML SUBCUTANEOUS SYRINGE,3773.73,2452.92,41.42,3773.73,51
HCPCS,C9399,GIAPREZA 0.5 MG/ML INTRAVENOUS SOLUTION,1890.0,1228.5,41.42,1890.0,51
HCPCS,C9399,GIAPREZA 2.5 MG/ML INTRAVENOUS SOLUTION,6836.4,4443.66,41.42,6836.4,51
HCPCS,C9399,GOMEKLI 1 MG CAPSULE,534.6,347.49,41.42,534.6,51
HCPCS,C9399,GOMEKLI 2 MG CAPSULE,1069.2,694.98,41.42,1069.2,51
HCPCS,C9399,KESIMPTA PEN 20 MG/0.4 ML SUBCUTANEOUS PEN INJECTOR,84123.63,54680.36,41.42,84123.63,51
HCPCS,C9399,KEVZARA 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,7705.14,5008.34,41.42,7705.14,51
HCPCS,C9399,LIPIODOL 480 MG IODINE/ML OIL FOR INJECTION,440.64,286.42,41.42,440.64,51
HCPCS,C9399,OGSIVEO 100 MG TABLET,1327.98,863.19,41.42,1327.98,48
HCPCS,C9399,OGSIVEO 150 MG TABLET,1327.98,863.19,41.42,1327.98,48
HCPCS,C9399,OMISIRGE INTRAVENOUS SUSPENSION,3330720.0,2164968.0,41.42,3330720.0,47
HCPCS,C9399,OMNIPAQUE 12  MG IODINE/ML ORAL SOLUTION,0.03,0.02,0.01,47.96,51
HCPCS,C9399,OMNIPAQUE 9 MG IODINE/ML ORAL SOLUTION,0.02,0.01,0.01,47.96,51
HCPCS,C9399,PRAXBIND 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,187.35,121.78,27.88,187.35,51
HCPCS,C9399,REVUFORJ 110 MG TABLET,1639.26,1065.52,41.42,1639.26,51
HCPCS,C9399,REVUFORJ 160 MG TABLET,1639.26,1065.52,41.42,1639.26,51
HCPCS,C9399,REVUFORJ 25 MG TABLET,830.0,539.5,41.42,830.0,51
HCPCS,C9399,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,45692.85,29700.35,41.42,45692.85,51
HCPCS,C9399,TERLIVAZ 0.85 MG INTRAVENOUS SOLUTION,3556.8,2311.92,41.42,3556.8,51
HCPCS,C9399,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 2 ML TOPICAL SYRINGE,207.68,134.99,30.9,207.68,51
HCPCS,C9399,TRULICITY 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,41.42,1776.93,51
HCPCS,C9399,TRULICITY 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,41.42,1776.93,51
HCPCS,C9399,XACDURO 1 GRAM-1 GRAM (0.5 GRAM X 2) INTRAVENOUS SOLUTION,630.0,409.5,41.42,630.0,51
HCPCS,C9460,"Injection, cangrelor",,,42.77,42.77,1
HCPCS,C9460,KENGREAL 50 MG INTRAVENOUS SOLUTION,3780.93,2457.6,2.17,3780.93,130
HCPCS,C946000,"Injection, cangrelor",,,42.77,42.77,1
HCPCS,C9462,"Injection, delafloxacin",,,0.48,47.96,11
HCPCS,C946200,"Injection, delafloxacin",,,1.07,1.07,1
HCPCS,C9482,SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,1186.56,771.26,2.17,1186.56,65
HCPCS,C9482,Sotalol hydrochloride iv,,,51.58,51.58,1
HCPCS,C948200,Sotalol hydrochloride iv,,,51.58,51.58,1
HCPCS,C9488,Conivaptan hcl,,,95.19,95.19,1
HCPCS,C9488,VAPRISOL IN 5 % DEXTROSE 20 MG/100 ML INTRAVENOUS SOLUTION,33.42,21.72,2.17,667.03,51
HCPCS,C948800,Conivaptan hcl,,,95.19,95.19,1
HCPCS,C9507,Covid-19 convalescent plasma,,,165.96,1865.61,27
HCPCS,C9600,PERC DES W/ ANGIO SINGLE MAJOR,41649.0,27071.85,4659.93,41649.0,61
HCPCS,C9601,PERC DES W/ANGIO ADDTL BRANCH,18602.0,12091.3,2451.0,18602.0,46
HCPCS,C9602,PERC DES/ATHER/ANGIO 1 MAJ ART,44697.0,29053.05,4659.93,51380.79,61
HCPCS,C9603,PERC DES/ ATHER/ANGIO ADDTL BR,14577.0,9475.05,2169.06,14577.0,46
HCPCS,C9604,PERC DES REVASC CABG 1 VSL,42588.0,27682.2,4659.93,42588.0,61
HCPCS,C9605,PERC DES  REVASC CABG ADDTL BR,18602.0,12091.3,2767.98,18602.0,46
HCPCS,C9606,PERC DES REVASC W/AMI 1 VSL,33050.0,21482.5,4659.93,33050.0,46
HCPCS,C9607,PERC DES REVASC CTO SINGLE VSL,51254.0,33315.1,4659.93,51380.79,61
HCPCS,C9608,PERC DES REVASC CTO ADDTL VESSEL,33050.0,21482.5,3398.0,33050.0,46
HCPCS,C9610,AGENT BALLOON CATHETER-DRUG-COATED,16950.0,11017.5,10763.25,11339.55,2
HCPCS,C9610,AGENT DRUG COATED BALLOON,16950.0,11017.5,159.5,16950.0,47
HCPCS,C9725,Place endorectal app,,,842.4,2606.53,27
HCPCS,C9726,Rxt breast appl place/remov,,,819.01,948.33,8
HCPCS,C9727,Insert palate implants,,,745.85,4348.85,27
HCPCS,C9728,"Place device/marker, non pro",,,612.38,3879.51,27
HCPCS,C9733,Non-ophthalmic fva,,,65.08,1863.61,28
HCPCS,C9734,"U/s trtmt, not leiomyomata",,,1611.33,35984.87,21
HCPCS,C9738,Blue light cysto imag agent,,,846.52,980.18,8
HCPCS,C9739,Cystoscopy prostatic imp 1-3,,,2607.32,15028.3,27
HCPCS,C9740,Cysto impl 4 or more,,,2607.32,26533.05,27
HCPCS,C9745,Nasal endo eustachian tube,,,211.85,245.3,8
HCPCS,C9747,"Ablation, hifu, prostate",,,2607.32,3019.01,8
HCPCS,C9749,Repair nasal stenosis w/imp,,,1237.01,1432.33,8
HCPCS,C9751,"Microwave bronch, 3d, ebus",,,2079.57,3742.62,14
HCPCS,C9752,Intraosseous des lumb/sacrum,,,3026.0,3503.79,8
HCPCS,C9753,Intraosseous destruct add'l,,,7403.35,8572.3,8
HCPCS,C9756,Fluorescence lymph map w/icg,,,68.91,3398.0,9
HCPCS,C9757,Spine device implant surgery,,,7403.35,35984.87,27
HCPCS,C9758,Blind interatrial shunt ide,,,11343.93,48011.34,27
HCPCS,C9759,Transcath intraop microinf,,,2003.13,2319.42,8
HCPCS,C9760,Non-blind interatrial shunt,,,11343.93,75445.61,27
HCPCS,C9761,"Cysto, litho, vacuum kidney",,,1680.64,26533.05,28
HCPCS,C9762,Cardiac mri seg dys strain,,,202.79,2444.63,28
HCPCS,C9763,Cardiac mri seg dys stress,,,202.79,2444.63,28
HCPCS,C9764,REVASC ENDOV W/IVL INCL ANGIOPLASTY,65208.0,42385.2,2003.13,65208.0,61
HCPCS,C9765,REVASC ENDOV W/IVL W/STENT INCL ANGIOPLASTY,37311.0,24252.15,3708.64,51380.79,61
HCPCS,C9766,REVASC ENDOV W/IVL W/ATHERECTOMY INCL ANGIOPLASTY,103251.0,67113.15,3708.64,103251.0,61
HCPCS,C9767,REVASC ENDOV W/IVL W/STENT-ATHER INCL ANGIOPLASTY,34461.0,22399.65,6695.97,51380.79,61
HCPCS,C9768,Endo us-guide hep porto grad,,,1191.17,1379.25,8
HCPCS,C9769,Cysto w/temp pros implant,,,2607.32,3019.01,8
HCPCS,C9770,"Vitrec/mech pars, subret inj",,,2290.15,2651.75,8
HCPCS,C9771,Nsl/sins cryo post nasal tis,,,1124.06,1301.54,8
HCPCS,C9772,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",26829.0,17438.85,3708.64,32356.61,61
HCPCS,C9773,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",46149.0,29996.85,6075.0,51380.79,61
HCPCS,C9774,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",36344.0,23623.6,6075.0,51380.79,61
HCPCS,C9775,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",38839.0,25245.35,6075.0,51380.79,61
HCPCS,C9776,Fluo bile duct imaging w/icg,,,89.44,103.57,8
HCPCS,C9777,Esophag muc integ w/eso egd,,,619.37,10806.3,27
HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,1166.34,14021.11,27
HCPCS,C9779,Esd endoscopy or colonoscopy,,,1191.17,10806.3,27
HCPCS,C9780,Insert cv cath inf & sup app,,,1289.42,22634.64,27
HCPCS,C9781,Arthro/shoul surg; w/spacer,,,3451.33,35984.87,27
HCPCS,C9782,Blind myocar trpl bon marrow,,,4659.93,48011.34,27
HCPCS,C9783,Blind cor sinus reducer impl,,,4659.93,32356.61,27
HCPCS,C9784,Endo sleeve gastro w/tube,,,3788.7,10389.34,14
HCPCS,C9785,Endo outlet restrict w/tube,,,2505.22,29793.81,27
HCPCS,C9786,Echo cad for hf preserved ef,,,77.56,89.8,8
HCPCS,C9787,Gastric ep mapg simult pt sx,,,237.67,275.2,8
HCPCS,C9788,Uni breas optoacoustic imag,,,77.56,89.8,8
HCPCS,C9789,Instill pharm renal pelvis,,,226.03,3430.66,27
HCPCS,C9790,Kidney histotripsy w/image,,,1680.64,1946.0,8
HCPCS,C9791,Mri hyperpolarized xenon129,,,312.54,6330.67,28
HCPCS,C9792,Blind/nonblind trans atrial,,,9009.27,26749.78,27
HCPCS,C9793,Pre 3d mdl w/ccta and/or mri,,,359.94,2406.92,27
HCPCS,C9794,Complex simulation w/pet-ct,,,612.38,709.07,8
HCPCS,C9795,Sbrt w/positron emission del,,,785.65,909.7,8
HCPCS,C9796,Rpr intst excl anrect fist,,,1263.14,7779.76,27
HCPCS,C9797,VASCULAR EMBOLIZATION WITH PRESSURE-GENERATING CATHETER,35000.0,22750.0,5355.0,51380.79,61
HCPCS,C9803,Hopd covid-19 spec collect,,,2.09,25.77,9
HCPCS,C9804,Pump elastomc non-opioid dev,,,159.5,184.68,8
HCPCS,C9806,Pump perist non-opioid dev,,,159.5,184.68,8
HCPCS,C9807,Nerve stim non-opioid dev,,,159.5,184.68,8
HCPCS,C9808,Cryo probe non-opioid dev,,,159.5,184.68,8
HCPCS,C9809,GEN 2 SMART TIP 190,700.0,455.0,1.1,700.0,69
HCPCS,C9810,COLD THERAPY NON-OPIOID DEV,174.0,113.1,1.1,174.0,22
HCPCS,C9810,ICEMAN (COLD THERAPY SYSTEM),174.0,113.1,25.89,184.68,47
HCPCS,C9812,Echgnc nv ndls nonopioid dev,,,159.5,184.68,8
HCPCS,C9813,Prf infs cth nonopioid dev,,,28.98,33.56,8
HCPCS,C9814,Echognc cathr nonopioid dev,,,159.5,184.68,8
HCPCS,C9815,Peristlc pmp nonopioid dev,,,159.5,184.68,8
HCPCS,C9816,Pmp prs reusbl nonopioid dev,,,159.5,184.68,8
HCPCS,C9817,CRYPNM CMPRS NONOPIOID DEV,174.0,113.1,1.1,174.0,22
HCPCS,C9817,SYSTEM CRYO/CUFF IC UNIVERSAL COMPRESSION THERAPY COOLER,174.0,113.1,25.16,174.0,47
HCPCS,C9818,"Suzetrigine, orl, 1mg",,,7.65,8.86,8
HCPCS,C9898,Inpnt stay radiolabeled item,,,8.48,9.82,8
HCPCS,C9899,"Inpt implant pros dev,no cov",,,159.5,184.68,8
HCPCS,C9901,Endo defect closure gi tract,,,2504.73,29793.81,27
HCPCS,COSANES1,COSMETIC ANES 1 HOUR 45 MINUTES,1351.0,878.15,1.1,1351.0,22
HCPCS,COSANES1,COSMETIC ANES 2 HOURS,1448.0,941.2,1.1,1448.0,22
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 15 MINUTES,1544.0,1003.6,1.1,1544.0,22
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 30 MINUTES,1641.0,1066.65,1.1,1641.0,22
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 45 MINUTES,1737.0,1129.05,1.1,1737.0,22
HCPCS,COSANES1,COSMETIC ANES 3 HOURS,1834.0,1192.1,1.1,1834.0,22
HCPCS,COSANES1,COSMETIC ANES 3 HOURS 15 MINUTES,1930.0,1254.5,1.1,1930.0,22
HCPCS,COSANES2,COSMETIC ANES 3 HOURS 30 MINUTES,2027.0,1317.55,1.1,2027.0,22
HCPCS,COSANES2,COSMETIC ANES 3 HOURS 45 MINUTES,2123.0,1379.95,1.1,2123.0,22
HCPCS,COSANES2,COSMETIC ANES 4 HOURS,2220.0,1443.0,1.1,2220.0,22
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 15 MINUTES,2316.0,1505.4,1.1,2316.0,22
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 30 MINUTES,2413.0,1568.45,1.1,2413.0,22
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 45 MINUTES,2509.0,1630.85,1.1,2509.0,22
HCPCS,COSANES3,COSMETIC ANES 30 MINUTES,579.0,376.35,1.1,579.0,22
HCPCS,COSANES3,COSMETIC ANES 5 HOURS,2606.0,1693.9,1.1,2606.0,22
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 15 MINUTES,2702.0,1756.3,1.1,2702.0,22
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 30 MINUTES,2799.0,1819.35,1.1,2799.0,22
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 45 MINUTES,2895.0,1881.75,1.1,2895.0,22
HCPCS,COSANES3,COSMETIC ANES 6 HOURS,2992.0,1944.8,1.1,2992.0,22
HCPCS,COSANES3,COSMETIC ANES 6 HOURS 15 MINUTES,3088.0,2007.2,1.1,3088.0,22
HCPCS,COSANES3,COSMETIC ANES 6 HOURS 30 MINUTES,3185.0,2070.25,1.1,3185.0,22
HCPCS,COSANES4,COSMETIC ANES 45 MINUTES,772.0,501.8,1.1,772.0,22
HCPCS,COSANES4,COSMETIC ANES 6 HOURS 45 MINUTES,3281.0,2132.65,1.1,3281.0,22
HCPCS,COSANES4,COSMETIC ANES 7 HOURS,3378.0,2195.7,1.1,3378.0,22
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 15 MINUTES,3474.0,2258.1,1.1,3474.0,22
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 30 MINUTES,3571.0,2321.15,1.1,3571.0,22
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 45 MINUTES,3667.0,2383.55,1.1,3667.0,22
HCPCS,COSANES4,COSMETIC ANES 8 HOURS,3764.0,2446.6,1.1,3764.0,22
HCPCS,COSANES4,COSMETIC ANES 8 HOURS 15 MINUTES,3860.0,2509.0,1.1,3860.0,22
HCPCS,COSANES5,COSMETIC ANES 8 HOURS 30 MINUTES,3957.0,2572.05,1.1,3957.0,22
HCPCS,COSANES5,COSMETIC ANES 8 HOURS 45 MINUTES,4053.0,2634.45,1.1,4053.0,22
HCPCS,COSANES5,COSMETIC ANES 9 HOURS,4150.0,2697.5,1.1,4150.0,22
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 15 MINUTES,4247.0,2760.55,1.1,4247.0,22
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 30 MINUTES,4343.0,2822.95,1.1,4343.0,22
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 45 MINUTES,4440.0,2886.0,1.1,4440.0,22
HCPCS,COSANES6,COSMETIC ANES 1 HOUR,1062.0,690.3,1.1,1062.0,22
HCPCS,COSANES6,COSMETIC ANES 10 HOURS,4536.0,2948.4,1.1,4536.0,22
HCPCS,COSANES7,COSMETIC ANES 1 HOUR 15 MINUTES,1158.0,752.7,1.1,1158.0,22
HCPCS,COSANES9,COSMETIC ANES 1 HOUR 30 MINUTES,1258.0,817.7,1.1,1258.0,22
HCPCS,COSNANES,NON CCF PHYSICIANS COSMETIC CASES,1351.0,878.15,1.1,1351.0,22
HCPCS,D0120,PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT,95.0,61.75,1.1,95.0,31
HCPCS,D0120,Periodic oral evaluation,,,119.07,769.55,27
HCPCS,D0140,LIMITED ORAL EVALUATION - PROBLEM FOCUSED,125.0,81.25,1.1,145.11,31
HCPCS,D0140,Limit oral eval problm focus,,,119.07,769.55,27
HCPCS,D0145,ORAL EVALUATION FOR A PATIENT UNDER THREE YEARS OF AGE AND COUNS,100.0,65.0,1.1,100.0,31
HCPCS,D0145,"Oral evaluation, pt < 3yrs",,,664.61,769.55,8
HCPCS,D0150,COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT,160.0,104.0,1.1,424.99,31
HCPCS,D0150,Comprehensve oral evaluation,,,119.07,769.55,27
HCPCS,D0160,"DETAILED AND EXTENSIVE ORAL EVALUATION - PROBLEM FOCUSED, BY REP",225.0,146.25,1.1,424.99,31
HCPCS,D0160,Extensv oral eval prob focus,,,119.07,769.55,27
HCPCS,D0170,"RE-EVALUATION - LIMITED, PROBLEM FOCUSED (ESTABLISHED PATIENT; N",115.0,74.75,1.1,424.99,31
HCPCS,D0170,"Re-eval,est pt,problem focus",,,119.07,769.55,27
HCPCS,D0171,Re-eval post-op visit,,,119.07,769.55,27
HCPCS,D0180,ANNUAL PERIDONTAL RECALL,160.0,104.0,1.1,286.78,31
HCPCS,D0180,COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIEN,160.0,104.0,1.1,286.78,31
HCPCS,D0180,Comp periodontal evaluation,,,119.07,769.55,27
HCPCS,D0190,SCREENING OF A PATIENT,120.0,78.0,1.1,120.0,31
HCPCS,D0190,Screening of a patient,,,664.61,769.55,8
HCPCS,D0191,ASSESSMENT OF A PATIENT,120.0,78.0,1.1,120.0,31
HCPCS,D0191,Assessment of a patient,,,119.07,769.55,27
HCPCS,D0210,INTRAORAL - COMPREHENSIVE OF RADIOGRAPHIC IMAGES,200.0,130.0,1.1,279.87,31
HCPCS,D0210,Intraor comprehensive series,,,23.21,668.77,27
HCPCS,D0220,INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE,50.0,32.5,1.1,51.83,31
HCPCS,D0220,Intraoral periapical first,,,81.36,612.78,27
HCPCS,D0230,INTRAORAL - PERIAPICAL EACH ADDITIONAL RADIOGRAPHIC IMAGE,40.0,26.0,1.1,41.46,31
HCPCS,D0230,Intraoral periapical ea add,,,529.22,612.78,8
HCPCS,D0240,INTRAORAL - OCCLUSAL RADIOGRAPHIC IMAGE,50.0,32.5,1.1,79.47,31
HCPCS,D0240,Intraoral occlusal film,,,81.36,612.78,27
HCPCS,D0250,Extraoral 2d project image,,,81.36,612.78,27
HCPCS,D0251,EXTRA-ORAL POSTERIOR DENTAL RADIOGRAPHIC IMAGE,100.0,65.0,1.1,141.67,31
HCPCS,D0251,Extraoral posterior image,,,81.36,612.78,27
HCPCS,D0270,BITEWING - SINGLE RADIOGRAPHIC IMAGE,45.0,29.25,1.1,55.28,31
HCPCS,D0270,Dental bitewing single image,,,81.36,612.78,27
HCPCS,D0272,BITEWINGS - TWO RADIOGRAPHIC IMAGES,75.0,48.75,1.1,82.92,31
HCPCS,D0272,Dental bitewings two images,,,81.36,612.78,27
HCPCS,D0273,BITEWINGS - THREE RADIOGRAPHIC IMAGES,85.0,55.25,1.1,85.0,31
HCPCS,D0273,Bitewings - three images,,,223.34,668.77,27
HCPCS,D0274,BITEWINGS - FOUR RADIOGRAPHIC IMAGES,100.0,65.0,1.1,117.48,31
HCPCS,D0274,Bitewings four images,,,223.34,668.77,27
HCPCS,D0277,VERTICAL BITEWINGS - 7 TO 8 RADIOGRAPHIC IMAGES,150.0,97.5,1.1,150.0,31
HCPCS,D0277,Vert bitewings 7 to 8 images,,,23.21,668.77,27
HCPCS,D0310,DENTAL SALIOGRAPHY,500.0,325.0,1.1,967.45,31
HCPCS,D0310,Dental saliography,,,23.21,668.77,27
HCPCS,D0320,DENTAL TMJ ARTHROGRAM INCL I,750.0,487.5,1.1,1658.49,31
HCPCS,D0320,Dental tmj arthrogram incl i,,,23.21,668.77,27
HCPCS,D0321,"OTHER TEMPOROMANDIBULAR JOINT RADIOGRAPHIC IMAGES, BY REPORT",250.0,162.5,1.1,1658.49,31
HCPCS,D0321,Other tmj images by report,,,81.36,612.78,27
HCPCS,D0322,Dental tomographic survey,,,56.72,293.03,27
HCPCS,D0322,TOMOGRAPHIC SURVEY,650.0,422.5,1.1,1330.25,31
HCPCS,D0330,PANORAMIC RADIOGRAPHIC IMAGE,175.0,113.75,1.1,228.04,31
HCPCS,D0330,Panoramic image,,,223.34,668.77,27
HCPCS,D0340,"2D CEPHALOMETRIC RADIOGRAPHIC IMAGE ? ACQUISITION, MEASUREMENT A",170.0,110.5,1.1,283.32,31
HCPCS,D0340,2d cephalometric image,,,23.21,243.92,27
HCPCS,D0350,2D ORAL/FACIAL PHOTOGRAPHIC IMAGE OBTAINED INTRA-ORALLY OR EXTRA,100.0,65.0,1.1,283.32,31
HCPCS,D0350,Oral/facial photo images,,,81.36,612.78,27
HCPCS,D0351,3d photographic image,,,529.22,612.78,8
HCPCS,D0363,"CONE BEAM, THREE DIMENSIONAL",150.0,97.5,1.1,150.0,22
HCPCS,D0364,CONE BEAM CT CAPTURE AND INTERPRETATION WITH LIMITED FIELD OF VI,350.0,227.5,1.1,524.1,31
HCPCS,D0364,Cone beam ct capt & interp,,,56.72,293.03,27
HCPCS,D0365,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,31
HCPCS,D0365,Cone beam ct interprete man,,,56.72,293.03,27
HCPCS,D0366,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,31
HCPCS,D0366,Cone beam ct interprete max,,,56.72,293.03,27
HCPCS,D0367,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF BO,400.0,260.0,1.1,524.1,31
HCPCS,D0367,Cone beam ct interp both jaw,,,56.72,293.03,27
HCPCS,D0368,CONE BEAM CT CAPTURE AND INTERPRETATION FOR TMJ SERIES INCLUDING,500.0,325.0,1.1,766.86,31
HCPCS,D0368,Cone beam ct interprete tmj,,,56.72,293.03,27
HCPCS,D0369,MAXILLOFACIAL MRI CAPTURE AND INTERPRETATION,900.0,585.0,1.1,1364.8,31
HCPCS,D0369,Max mri capture & interprete,,,98.26,293.03,27
HCPCS,D0370,MAXILLOFACIAL ULTRASOUND CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,31
HCPCS,D0370,Max ultrasound capt & interp,,,77.56,293.03,27
HCPCS,D0371,SIALOENDOSCOPY CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,31
HCPCS,D0371,Sialoendoscopy capt & interp,,,23.21,243.92,27
HCPCS,D0372,Tomo comp series images,,,529.22,612.78,8
HCPCS,D0373,Tomo bitewing image,,,529.22,612.78,8
HCPCS,D0374,Tomo periapical image,,,529.22,612.78,8
HCPCS,D0380,CONE BEAM CT IMAGE CAPTURE WITH LIMITED FIELD OF VIEW ? LESS THA,400.0,260.0,1.1,418.41,31
HCPCS,D0380,Cone beam ct capture limited,,,56.72,293.03,27
HCPCS,D0381,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,31
HCPCS,D0381,Cone beam ct capt mandible,,,56.72,293.03,27
HCPCS,D0382,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,31
HCPCS,D0382,Cone beam ct capt maxilla,,,56.72,293.03,27
HCPCS,D0383,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF BOTH JAWS; WITH,400.0,260.0,1.1,418.41,31
HCPCS,D0383,Cone beam ct both jaws,,,56.72,293.03,27
HCPCS,D0384,CONE BEAM CT IMAGE CAPTURE FOR TMJ SERIES INCLUDING TWO OR MORE,500.0,325.0,1.1,611.83,31
HCPCS,D0384,Cone beam ct capture tmj,,,56.72,293.03,27
HCPCS,D0385,MAXILLOFACIAL MRI IMAGE CAPTURE,700.0,455.0,1.1,991.0,31
HCPCS,D0385,Max mri image capture,,,98.26,293.03,27
HCPCS,D0386,MAXILLOFACIAL ULTRASOUND IMAGE CAPTURE,360.0,234.0,1.1,360.0,31
HCPCS,D0386,Max ultrasound image capture,,,77.56,293.03,27
HCPCS,D0387,Comp image capture only,,,529.22,612.78,8
HCPCS,D0388,Bitewing image capture only,,,529.22,612.78,8
HCPCS,D0389,Periopic image capture only,,,529.22,612.78,8
HCPCS,D0391,INTERPRETATION OF DIAGNOSTIC IMAGE BY A PRACTITIONER NOT ASSOCIA,375.0,243.75,1.1,486.59,31
HCPCS,D0391,Imterprete diagnostic image,,,664.61,769.55,8
HCPCS,D0393,Trtmnt simulation 3d image,,,81.36,769.55,27
HCPCS,D0393,VIRTUAL TREATMENT SIMULATION USING 3D IMAGE VOLUME OR SURFACE SC,400.0,260.0,1.1,623.76,25
HCPCS,D0394,DIGITAL SUBTRACTION OF TWO OR MORE IMAGES OR IMAGE VOLUMES OF TH,400.0,260.0,1.1,400.0,25
HCPCS,D0394,Digital sub 2 or more images,,,81.36,769.55,27
HCPCS,D0395,FUSION OF TWO OR MORE 3D IMAGE VOLUMES OF ONE OR MORE MODALITIES,450.0,292.5,1.1,450.0,25
HCPCS,D0395,Fusion 2 or more 3d images,,,81.36,769.55,27
HCPCS,D0396,3d print of 3d surface scan,,,529.22,612.78,8
HCPCS,D0411,HBA1C IN-OFFICE POINT OF SERVICE TESTING,100.0,65.0,1.1,100.0,25
HCPCS,D0411,Hba1c in office testing,,,9.33,10.8,8
HCPCS,D0412,BLOOD GLUCOSE LEVEL TEST ? IN-OFFICE USING A GLUCOSE METER,100.0,65.0,0.01,100.0,31
HCPCS,D0412,Blood glucose level test,,,9.33,10.8,8
HCPCS,D0414,LABORATORY PROCESSING OF MICROBIAL SPECIMEN TO INCLUDE CULTURE A,250.0,162.5,0.01,250.0,31
HCPCS,D0414,Lab process microbial spec,,,13.21,15.29,8
HCPCS,D0415,COLLECTION OF MICROORGANISMS FOR CULTURE AND SENSITIVITY,270.0,175.5,1.1,270.0,31
HCPCS,D0415,Collection of microorganisms,,,13.21,15.29,8
HCPCS,D0416,VIRAL CULTURE,200.0,130.0,1.1,200.0,31
HCPCS,D0416,Viral culture,,,13.21,15.29,8
HCPCS,D0417,COLLECTION AND PREPERATION OF SALIVA SAMPLE FOR LABORATORY ANALY,275.0,178.75,1.1,275.0,31
HCPCS,D0417,Collect & prep saliva sample,,,2.09,2.42,8
HCPCS,D0418,ANALYSIS OF SALIVA SAMPLE - LABORATORY,200.0,130.0,1.1,200.0,31
HCPCS,D0418,Analysis of saliva sample,,,7.12,8.24,8
HCPCS,D0419,ASSESSMENT OF SALIVARY FLOW BY MEASUREMENT,200.0,130.0,1.1,200.0,25
HCPCS,D0419,Assess of salivary flow,,,664.61,769.55,8
HCPCS,D0422,COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORA,200.0,130.0,1.1,200.0,31
HCPCS,D0422,Collect & prep genetic samp,,,66.63,77.15,8
HCPCS,D0423,GENETIC TEST FOR SUSCEPTIBILITY TO DISEASES ? SPECIMEN ANALYSIS,300.0,195.0,1.1,300.0,28
HCPCS,D0423,Genetic test spec analysis,,,66.63,77.15,8
HCPCS,D0425,CARIES SUSCEPTIBILITY TESTS,125.0,81.25,1.1,125.0,31
HCPCS,D0425,Caries susceptibility test,,,13.21,15.29,8
HCPCS,D0426,"Coll, analys of saliva",,,2.09,2.42,8
HCPCS,D0431,ADJUNCTIVE PRE-DIAGNOSTIC TEST THAT AIDS IN DETECTION OF MUCOSAL,85.0,55.25,1.1,85.0,31
HCPCS,D0431,Diag tst detect mucos abnorm,,,664.61,769.55,8
HCPCS,D0460,PULP VITALITY TESTS,75.0,48.75,1.1,89.84,31
HCPCS,D0460,Pulp vitality test,,,611.63,1812.01,27
HCPCS,D0461,Testing for cracked tooth,,,802.93,929.71,8
HCPCS,D0470,DIAGNOSTIC CASTS,180.0,117.0,1.1,193.49,31
HCPCS,D0470,Diagnostic casts,,,664.61,769.55,8
HCPCS,D0472,"ACCESSION OF TISSUE, GROSS EXAMINATION, PREPARATION AND TRANSMIS",200.0,130.0,1.1,200.0,31
HCPCS,D0472,"Gross exam, prep & report",,,29.68,34.36,8
HCPCS,D0473,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, PREPARAT",250.0,162.5,1.1,250.0,31
HCPCS,D0473,"Micro exam, prep & report",,,29.68,34.36,8
HCPCS,D0474,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, INCLUDIN",275.0,178.75,1.1,275.0,31
HCPCS,D0474,Micro w exam of surg margins,,,29.68,34.36,8
HCPCS,D0475,DECALCIFICATION PROCEDURE,300.0,195.0,1.1,300.0,31
HCPCS,D0475,Decalcification procedure,,,7.12,8.24,8
HCPCS,D0476,SPECIAL STAINS FOR MICROORGANISMS,375.0,243.75,1.1,375.0,31
HCPCS,D0476,Spec stains for microorganis,,,7.12,8.24,8
HCPCS,D0477,"SPECIAL STAINS, NOT FOR MICROORGANISMS",400.0,260.0,1.1,400.0,31
HCPCS,D0477,Spec stains not for microorg,,,7.12,8.24,8
HCPCS,D0478,IMMUNOHISTOCHEMICAL STAINS,200.0,130.0,1.1,207.31,31
HCPCS,D0478,Immunohistochemical stains,,,7.12,8.24,8
HCPCS,D0479,"TISSUE IN-SITU HYBRIDIZATION, INCLUDING INTERPRETATION",300.0,195.0,1.1,300.0,31
HCPCS,D0479,Tissue in-situ hybridization,,,7.12,8.24,8
HCPCS,D0480,"ACCESSION OF EXFOLIATIVE CYTOLOGIC SMEARS, MICROSCOPIC EXAMINATI",200.0,130.0,1.1,200.0,31
HCPCS,D0480,Cytopath smear prep & report,,,29.68,34.36,8
HCPCS,D0481,Electron microscopy,,,7.12,8.24,8
HCPCS,D0482,DIRECT IMMUNOFLUORESCENCE,150.0,97.5,1.1,150.0,31
HCPCS,D0482,Direct immunofluorescence,,,7.12,8.24,8
HCPCS,D0483,INDIRECT IMMUNOFLUORESCENCE,175.0,113.75,1.1,175.0,31
HCPCS,D0483,Indirect immunofluorescence,,,7.12,8.24,8
HCPCS,D0484,CONSULTATION ON SLIDES PREPARED ELSEWHERE,200.0,130.0,1.1,200.0,31
HCPCS,D0484,Consult slides prep elsewher,,,27.56,31.91,8
HCPCS,D0485,"CONSULTATION, INCLUDING PREPARATION OF SLIDES FROM BIOPSY MATERI",400.0,260.0,1.1,400.0,31
HCPCS,D0485,Consult inc prep of slides,,,27.56,31.91,8
HCPCS,D0486,Access of transep cytol samp,,,29.68,34.36,8
HCPCS,D0502,"OTHER ORAL PATHOLOGY PROCEDURES, BY REPORT",200.0,130.0,0.01,200.0,31
HCPCS,D0502,Other oral pathology procedu,,,7.12,8.24,8
HCPCS,D0600,"NON-IONIZING DIAGNOSTIC PROCEDURE CAPABLE OF QUANTIFYING, MONITO",100.0,65.0,0.01,100.0,28
HCPCS,D0600,Non-ionizing diag proc,,,611.63,1812.01,27
HCPCS,D0601,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF LOW",100.0,65.0,1.1,100.0,25
HCPCS,D0601,Caries risk assess low risk,,,664.61,769.55,8
HCPCS,D0602,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF MODE",100.0,65.0,1.1,100.0,25
HCPCS,D0602,Caries risk assess mod risk,,,664.61,769.55,8
HCPCS,D0603,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF HIGH",100.0,65.0,1.1,100.0,25
HCPCS,D0603,Caries risk assess high risk,,,664.61,769.55,8
HCPCS,D0604,Antigen test pub hlth pathog,,,13.21,15.29,8
HCPCS,D0605,Antibody test pub hlth path,,,18.32,21.21,8
HCPCS,D0606,Molecular test pub hlth path,,,13.21,15.29,8
HCPCS,D0701,Pano radio image,,,81.36,612.78,27
HCPCS,D0702,2d cephal radio image,,,81.36,612.78,27
HCPCS,D0703,2d oral/facial photo image,,,81.36,612.78,27
HCPCS,D0704,3d photo image capture only,,,529.22,612.78,8
HCPCS,D0705,Extra oral post radio image,,,81.36,612.78,27
HCPCS,D0706,Intraoral occlus radio image,,,81.36,612.78,27
HCPCS,D0707,Intraoral periap radio image,,,81.36,612.78,27
HCPCS,D0708,Intraoral bite radio image,,,81.36,612.78,27
HCPCS,D0709,Intraoral comp image capture,,,81.36,612.78,27
HCPCS,D0801,3d intraoral scan direct,,,529.22,612.78,8
HCPCS,D0802,3d dental scan indirect,,,529.22,612.78,8
HCPCS,D0803,3d facial scan direct,,,529.22,612.78,8
HCPCS,D0804,3d facial scan indirect,,,529.22,612.78,8
HCPCS,D0999,"UNSPECIFIED DIAGNOSTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,28
HCPCS,D0999,Unspecified diagnostic proce,,,664.61,769.55,8
HCPCS,D1110,Dental prophylaxis adult,,,119.07,929.71,27
HCPCS,D1110,PROPHYLAXIS - ADULT,125.0,81.25,1.1,165.86,31
HCPCS,D1110,PROPHYLAXIS-ADULT PARTIAL MOUTH,75.0,48.75,1.1,165.86,31
HCPCS,D1120,Dental prophylaxis child,,,802.93,929.71,8
HCPCS,D1120,PROPHYLAXIS - CHILD,100.0,65.0,1.1,114.02,31
HCPCS,D1206,TOPICAL APPLICATION OF FLUORIDE VARNISH,50.0,32.5,1.1,176.21,31
HCPCS,D1206,Topical fluoride varnish,,,802.93,929.71,8
HCPCS,D1208,APPLICATION OF FLOURIDE VARNISH,30.0,19.5,1.1,72.56,31
HCPCS,D1208,TOPICAL APPLICATION OF FLUORIDE ? EXCLUDING VARNISH,50.0,32.5,1.1,72.56,31
HCPCS,D1208,Topical app fluorid ex vrnsh,,,802.93,929.71,8
HCPCS,D1301,Immunization counseling,,,68.71,79.56,8
HCPCS,D1310,Nutri counsel-control caries,,,802.93,929.71,8
HCPCS,D1320,TOBACCO COUNSELING FOR THE CONTROL AND PREVENTION OF ORAL DISEAS,30.0,19.5,1.1,93.29,31
HCPCS,D1320,Tobacco counseling,,,37.4,43.31,8
HCPCS,D1321,Couns for high risk sub use,,,37.4,43.31,8
HCPCS,D1330,Oral hygiene instructions,,,802.93,929.71,8
HCPCS,D1351,Dental sealant per tooth,,,834.58,966.35,8
HCPCS,D1351,SEALANT - PER TOOTH,75.0,48.75,1.1,103.66,31
HCPCS,D1352,PREVENTIVE RESIN RESTORATION IN A MODERATE TO HIGH CARIES RISK P,160.0,104.0,1.1,160.0,30
HCPCS,D1352,"Prev resin rest, perm tooth",,,802.93,929.71,8
HCPCS,D1353,SEALANT REPAIR ? PER TOOTH,75.0,48.75,1.1,107.8,31
HCPCS,D1353,Sealant repair per tooth,,,834.58,966.35,8
HCPCS,D1354,INTERIM CARIES ARRESTING MEDICAMENT APPLICATION ? PER TOOTH,125.0,81.25,1.1,167.45,31
HCPCS,D1354,Int caries med app per tooth,,,802.93,929.71,8
HCPCS,D1355,Caries med app per tooth,,,802.93,929.71,8
HCPCS,D1510,SPACE MAINTAINER - FIXED - UNILATERAL,450.0,292.5,1.1,670.31,31
HCPCS,D1510,Space maintainer fxd unilat,,,611.63,1812.01,27
HCPCS,D1516,"Fixed bilat space maint, max",,,611.63,1812.01,27
HCPCS,D1516,"SPACE MAINTAINER ? FIXED ? BILATERAL, MAXILLARY",500.0,325.0,1.1,1371.71,31
HCPCS,D1517,"Fixed bilat space maint, man",,,611.63,1812.01,27
HCPCS,D1517,"SPACE MAINTAINER ? FIXED ? BILATERAL, MANDIBULAR",550.0,357.5,1.1,1371.71,31
HCPCS,D1520,Remove unilat space maintain,,,611.63,1812.01,27
HCPCS,D1520,SPACE MAINTAINER - REMOVABLE - UNILATERAL,500.0,325.0,1.1,832.7,31
HCPCS,D1526,"Remove bilat space main, max",,,611.63,1812.01,27
HCPCS,D1526,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MAXILLARY",600.0,390.0,1.1,1285.32,31
HCPCS,D1527,"Remove bilat space main, man",,,611.63,1812.01,27
HCPCS,D1527,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MANDIBULAR",600.0,390.0,1.1,1285.32,31
HCPCS,D1551,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MAXILLARY,150.0,97.5,1.1,179.67,31
HCPCS,D1551,Recement space maint - max,,,611.63,1812.01,27
HCPCS,D1552,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MANDIBULAR,150.0,97.5,1.1,179.67,31
HCPCS,D1552,Recement space maint - man,,,611.63,1812.01,27
HCPCS,D1553,RE-CEMENT OR RE-BOND UNILATERAL SPACE MAINTAINER - PER QUADRANT,160.0,104.0,1.1,160.0,31
HCPCS,D1553,Recement unilat space maint,,,611.63,1812.01,27
HCPCS,D1556,REMOVAL OF FIXED UNILATERAL SPACE MAINTAINER - PER QUADRANT,150.0,97.5,1.1,179.67,31
HCPCS,D1556,Rem fixed unilat space maint,,,802.93,929.71,8
HCPCS,D1557,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MAXILLARY,165.0,107.25,1.1,179.67,31
HCPCS,D1557,Remove fixed bilat maint max,,,802.93,929.71,8
HCPCS,D1558,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MANDIBULAR,180.0,117.0,1.1,180.0,31
HCPCS,D1558,Remove fixed bilat man,,,802.93,929.71,8
HCPCS,D1575,DISTAL SHOE SPACE MAINTAINER ? FIXED ? UNILATERAL,520.0,338.0,1.1,863.79,31
HCPCS,D1575,"Dist space maint, fixed unil",,,611.63,1812.01,27
HCPCS,D1701,Pfizer vacc admin 1st dose,,,13.56,15.7,8
HCPCS,D1702,Pfizer vacc admin 2nd dose,,,13.56,15.7,8
HCPCS,D1703,Moderna vacc admin 1st dose,,,13.56,15.7,8
HCPCS,D1704,Moderna vacc admin 2nd dose,,,13.56,15.7,8
HCPCS,D1705,Astrazeneca vacc adm 1st dos,,,13.56,15.7,8
HCPCS,D1706,Astrazeneca vacc adm 2nd dos,,,13.56,15.7,8
HCPCS,D1707,Janssen vaccine admin,,,13.56,15.7,8
HCPCS,D1708,Pfizer vacc admin 3rd dose,,,13.56,15.7,8
HCPCS,D1709,Pfizer vaccine admin booster,,,13.56,15.7,8
HCPCS,D1710,Moderna vacc admin 3rd dose,,,13.56,15.7,8
HCPCS,D1711,Moderna vacc admin booster,,,13.56,15.7,8
HCPCS,D1712,Janssen vacc admin booster,,,13.56,15.7,8
HCPCS,D1713,Pfizer vacc adm ped 1st dose,,,13.56,15.7,8
HCPCS,D1714,Pfizer vacc adm ped 2nd dose,,,13.56,15.7,8
HCPCS,D1720,Influenza vacc admin,,,13.56,15.7,8
HCPCS,D1781,Vac admin human pap dose 1,,,13.56,15.7,8
HCPCS,D1782,Vac admin human pap dose 2,,,13.56,15.7,8
HCPCS,D1783,Vac admin human pap dose 3,,,13.56,15.7,8
HCPCS,D1999,"UNSPECIFIED PREVENTIVE PROCEDURE, BY REPORT",160.0,104.0,1.1,160.0,22
HCPCS,D1999,Unspecified preventive proc,,,802.93,929.71,8
HCPCS,D2140,"AMALGAM - ONE SURFACE, PRIMARY OR PERMANENT",200.0,130.0,1.1,231.49,31
HCPCS,D2140,Amalgam one surface permanen,,,611.63,1812.01,27
HCPCS,D2150,"AMALGAM - TWO SURFACES, PRIMARY OR PERMANENT",280.0,182.0,1.1,300.61,31
HCPCS,D2150,Amalgam two surfaces permane,,,611.63,1812.01,27
HCPCS,D2160,"AMALGAM - THREE SURFACES, PRIMARY OR PERMANENT",350.0,227.5,1.1,362.8,31
HCPCS,D2160,Amalgam three surfaces perma,,,611.63,1812.01,27
HCPCS,D2161,"AMALGAM - FOUR OR MORE SURFACES, PRIMARY OR PERMANENT",400.0,260.0,1.1,442.26,31
HCPCS,D2161,Amalgam 4 or > surfaces perm,,,611.63,1812.01,27
HCPCS,D2330,"RESIN-BASED COMPOSITE - ONE SURFACE, ANTERIOR",260.0,169.0,1.1,276.42,31
HCPCS,D2330,Resin one surface-anterior,,,611.63,1812.01,27
HCPCS,D2331,"RESIN-BASED COMPOSITE - TWO SURFACES, ANTERIOR",300.0,195.0,1.1,352.43,31
HCPCS,D2331,Resin two surfaces-anterior,,,611.63,1812.01,27
HCPCS,D2332,"RESIN-BASED COMPOSITE - THREE SURFACES, ANTERIOR",350.0,227.5,1.1,428.44,31
HCPCS,D2332,Resin three surfaces-anterio,,,611.63,1812.01,27
HCPCS,D2335,RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES (ANTERIOR),450.0,292.5,1.1,507.91,31
HCPCS,D2335,Resin 4/> surf or w incis an,,,611.63,1812.01,27
HCPCS,D2390,Ant resin-based cmpst crown,,,611.63,1812.01,27
HCPCS,D2390,"RESIN-BASED COMPOSITE CROWN, ANTERIOR",700.0,455.0,1.1,700.0,31
HCPCS,D2391,Post 1 srfc resinbased cmpst,,,611.63,1812.01,27
HCPCS,D2391,"RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR",275.0,178.75,1.1,310.96,31
HCPCS,D2392,Post 2 srfc resinbased cmpst,,,611.63,1812.01,27
HCPCS,D2392,"RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR",350.0,227.5,1.1,428.44,31
HCPCS,D2393,Post 3 srfc resinbased cmpst,,,611.63,1812.01,27
HCPCS,D2393,"RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR",425.0,276.25,1.1,532.1,31
HCPCS,D2394,Post >=4srfc resinbase cmpst,,,611.63,1812.01,27
HCPCS,D2394,"RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR",500.0,325.0,1.1,532.1,31
HCPCS,D2410,Dental gold foil one surface,,,611.63,1812.01,27
HCPCS,D2420,Dental gold foil two surface,,,611.63,1812.01,27
HCPCS,D2430,Dental gold foil three surfa,,,611.63,1812.01,27
HCPCS,D2510,Dental inlay metalic 1 surf,,,611.63,1812.01,27
HCPCS,D2510,INLAY - METALLIC - ONE SURFACE,1300.0,845.0,1.1,1551.37,31
HCPCS,D2520,Dental inlay metallic 2 surf,,,611.63,1812.01,27
HCPCS,D2520,INLAY - METALLIC - TWO SURFACES,1400.0,910.0,1.1,1758.69,31
HCPCS,D2530,Dental inlay metl 3/more sur,,,611.63,1812.01,27
HCPCS,D2530,INLAY - METALLIC - THREE OR MORE SURFACES,1500.0,975.0,1.1,2028.19,31
HCPCS,D2542,Dental onlay metallic 2 surf,,,611.63,1812.01,27
HCPCS,D2542,ONLAY - METALLIC - TWO SURFACES,2000.0,1300.0,1.1,2073.11,31
HCPCS,D2543,Dental onlay metallic 3 surf,,,611.63,1812.01,27
HCPCS,D2543,ONLAY - METALLIC - THREE SURFACES,2000.0,1300.0,1.1,2080.02,31
HCPCS,D2544,Dental onlay metl 4/more sur,,,611.63,1812.01,27
HCPCS,D2544,ONLAY - METALLIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2162.94,31
HCPCS,D2610,INLAY - PORCELAIN/CERAMIC - ONE SURFACE,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2610,Inlay porcelain/ceramic 1 su,,,611.63,1812.01,27
HCPCS,D2620,INLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2620,Inlay porcelain/ceramic 2 su,,,611.63,1812.01,27
HCPCS,D2630,Dental onlay porc 3/more sur,,,611.63,1812.01,27
HCPCS,D2630,INLAY - PORCELAIN/CERAMIC - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2052.38,31
HCPCS,D2642,Dental onlay porcelin 2 surf,,,611.63,1812.01,27
HCPCS,D2642,ONLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2643,Dental onlay porcelin 3 surf,,,611.63,1812.01,27
HCPCS,D2643,ONLAY - PORCELAIN/CERAMIC - THREE SURFACES,2000.0,1300.0,1.1,2149.12,31
HCPCS,D2644,Dental onlay porc 4/more sur,,,611.63,1812.01,27
HCPCS,D2644,ONLAY - PORCELAIN/CERAMIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2280.42,31
HCPCS,D2650,INLAY - RESIN-BASED COMPOSITE - ONE SURFACE,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2650,Inlay composite/resin one su,,,611.63,1812.01,27
HCPCS,D2651,INLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2651,Inlay composite/resin two su,,,611.63,1812.01,27
HCPCS,D2652,Dental inlay resin 3/mre sur,,,611.63,1812.01,27
HCPCS,D2652,INLAY - RESIN-BASED COMPOSITE - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2662,Dental onlay resin 2 surface,,,611.63,1812.01,27
HCPCS,D2662,ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2663,Dental onlay resin 3 surface,,,611.63,1812.01,27
HCPCS,D2663,ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES,2000.0,1300.0,1.1,2000.0,31
HCPCS,D2664,Dental onlay resin 4/mre sur,,,611.63,1812.01,27
HCPCS,D2664,ONLAY - RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2055.84,31
HCPCS,D2710,CROWN - RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,31
HCPCS,D2710,Crown resin-based indirect,,,611.63,1812.01,27
HCPCS,D2712,CROWN - 3/4CROWN RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,31
HCPCS,D2712,Crown 3/4 resin-based compos,,,611.63,1812.01,27
HCPCS,D2720,CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2280.42,31
HCPCS,D2720,Crown resin w/ high noble me,,,611.63,1812.01,27
HCPCS,D2721,CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2138.75,31
HCPCS,D2721,Crown resin w/ base metal,,,611.63,1812.01,27
HCPCS,D2722,CROWN - RESIN WITH NOBLE METAL,1600.0,1040.0,1.1,2183.67,31
HCPCS,D2722,Crown resin w/ noble metal,,,611.63,1812.01,27
HCPCS,D2740,CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2342.62,31
HCPCS,D2740,Crown porcelain/ceramic,,,611.63,1812.01,27
HCPCS,D2740.5,CEREC CROWN,1600.0,1040.0,1.1,1600.0,22
HCPCS,D2750,CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1675.0,1088.75,1.1,2308.07,31
HCPCS,D2750,Crown porcelain w/ h noble m,,,611.63,1812.01,27
HCPCS,D2751,CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1525.0,991.25,1.1,2149.12,31
HCPCS,D2751,Crown porcelain fused base m,,,611.63,1812.01,27
HCPCS,D2752,CROWN - PORCELAIN FUSED TO NOBLE METAL,1650.0,1072.5,1.1,2204.41,31
HCPCS,D2752,Crown porcelain w/ noble met,,,611.63,1812.01,27
HCPCS,D2753,CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1650.0,1072.5,1.1,2501.56,31
HCPCS,D2753,Crown porc fused to titanium,,,611.63,1812.01,27
HCPCS,D2780,CROWN - 3/4 CAST HIGH NOBLE METAL,1650.0,1072.5,1.1,2073.11,31
HCPCS,D2780,Crown 3/4 cast hi noble met,,,611.63,1812.01,27
HCPCS,D2781,CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2073.11,31
HCPCS,D2781,Crown 3/4 cast base metal,,,611.63,1812.01,27
HCPCS,D2782,CROWN - 3/4 CAST NOBLE METAL,1625.0,1056.25,1.1,2073.11,31
HCPCS,D2782,Crown 3/4 cast noble metal,,,611.63,1812.01,27
HCPCS,D2783,CROWN - 3/4 PORCELAIN/CERAMIC,1625.0,1056.25,1.1,2073.11,31
HCPCS,D2783,Crown 3/4 porcelain/ceramic,,,611.63,1812.01,27
HCPCS,D2790,CROWN - FULL CAST HIGH NOBLE METAL,1750.0,1137.5,1.1,2228.6,31
HCPCS,D2790,Crown full cast high noble m,,,611.63,1812.01,27
HCPCS,D2791,CROWN - FULL CAST PREDOMINANTLY BASE METAL,1625.0,1056.25,1.1,2111.12,31
HCPCS,D2791,Crown full cast base metal,,,611.63,1812.01,27
HCPCS,D2792,CROWN - FULL CAST NOBLE METAL,1675.0,1088.75,1.1,2149.12,31
HCPCS,D2792,Crown full cast noble metal,,,611.63,1812.01,27
HCPCS,D2794,CROWN - TITANIUM,1650.0,1072.5,1.1,2149.12,31
HCPCS,D2794,Crown-titanium,,,611.63,1812.01,27
HCPCS,D2799,Interim crown,,,611.63,1812.01,27
HCPCS,D2799,PROVISIONAL CROWN? FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS,600.0,390.0,1.1,2073.11,31
HCPCS,D2910,"RE-CEMENT OR RE-BOND INLAY, ONLAY, VENEER OR PARTIAL COVERAGE RE",175.0,113.75,1.1,200.4,31
HCPCS,D2910,Recement inlay onlay or part,,,45.8,1812.01,27
HCPCS,D2915,RE-CEMENT OR RE-BOND INDIRECTLY FABRICATED OR PREFABRICATED POST,160.0,104.0,1.1,200.4,31
HCPCS,D2915,Recement cast or prefab post,,,45.8,1812.01,27
HCPCS,D2919,"EVALUATION FOR MODERATE SEDATION, DEEP SEDATION OR GENERAL ANEST",150.0,97.5,1.1,150.0,22
HCPCS,D2920,RE-CEMENT OR RE-BOND CROWN,180.0,117.0,1.1,207.31,31
HCPCS,D2920,Re-cement or re-bond crown,,,45.8,1812.01,27
HCPCS,D2921,"REATTACHMENT OF TOOTH FRAGMENT, INCISAL EDGE OR CUSP",350.0,227.5,1.1,350.0,25
HCPCS,D2921,Reattach tooth fragment,,,45.8,1812.01,27
HCPCS,D2928,Prefab porc/cer crown perm,,,611.63,1812.01,27
HCPCS,D2929,PREFABRICATED PORCELAIN/CERAMIC CROWN ? PRIMARY TOOTH,550.0,357.5,1.1,550.0,31
HCPCS,D2929,Prefab porc/ceram crown pri,,,611.63,1812.01,27
HCPCS,D2930,PREFABRICATED STAINLESS STEEL CROWN - PRIMARY TOOTH,400.0,260.0,1.1,566.65,31
HCPCS,D2930,Prefab stnlss steel crwn pri,,,611.63,1812.01,27
HCPCS,D2931,PREFABRICATED STAINLESS STEEL CROWN - PERMANENT TOOTH,500.0,325.0,1.1,639.21,31
HCPCS,D2931,Prefab stnlss steel crown pe,,,611.63,1812.01,27
HCPCS,D2932,PREFABRICATED RESIN CROWN,510.0,331.5,1.1,694.49,31
HCPCS,D2932,Prefabricated resin crown,,,611.63,1812.01,27
HCPCS,D2933,Prefab stainless steel crown,,,611.63,1812.01,27
HCPCS,D2934,Prefab steel crown primary,,,611.63,1812.01,27
HCPCS,D2940,PLACEMENT OF INTERIM DIRECT RESTORATION,200.0,130.0,1.1,214.22,31
HCPCS,D2940,Place direct restoration,,,45.8,53.03,8
HCPCS,D2940,Protective restoration,,,611.63,1812.01,19
HCPCS,D2941,INTERIM THERAPEUTIC RESTORATION ? PRIMARY DENTITION,275.0,178.75,1.1,275.0,23
HCPCS,D2941,Int therapeutic restoration,,,45.8,53.03,8
HCPCS,D2949,RESTORATIVE FOUNDATION FOR AN INDIRECT RESTORATION,300.0,195.0,1.1,300.0,25
HCPCS,D2949,Restorative foundation,,,45.8,1812.01,27
HCPCS,D2950,"CORE BUILDUP, INCLUDING ANY PINS WHEN REQUIRED",450.0,292.5,1.1,539.01,31
HCPCS,D2950,Core build-up incl any pins,,,611.63,1812.01,27
HCPCS,D2951,"PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION",100.0,65.0,1.1,114.02,31
HCPCS,D2951,Tooth pin retention,,,45.8,1812.01,27
HCPCS,D2952,"POST AND CORE IN ADDITION TO CROWN, INDIRECTLY FABRICATED",600.0,390.0,1.1,822.34,31
HCPCS,D2952,Post and core cast + crown,,,611.63,1812.01,27
HCPCS,D2953,Each addtnl cast post,,,1358.5,1573.0,8
HCPCS,D2954,PREFABRICATED POST AND CORE IN ADDITION TO CROWN,450.0,292.5,1.1,680.67,31
HCPCS,D2954,Prefab post/core + crown,,,611.63,1812.01,27
HCPCS,D2955,POST REMOVAL,400.0,260.0,1.1,511.38,31
HCPCS,D2955,Post removal,,,1358.5,1573.0,8
HCPCS,D2956,Indirect rest remov,,,1358.5,1573.0,8
HCPCS,D2957,EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH,300.0,195.0,1.1,300.0,31
HCPCS,D2957,Each addtnl prefab post,,,611.63,1812.01,27
HCPCS,D2960,LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE,1000.0,650.0,1.1,1668.85,31
HCPCS,D2960,Labial veneer resin direct,,,611.63,1812.01,27
HCPCS,D2961,LABIAL VENEER (RESIN LAMINATE) - LABORATORY,1500.0,975.0,1.1,1869.26,31
HCPCS,D2961,Labial veneer resin indirect,,,611.63,1812.01,27
HCPCS,D2962,LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY,1700.0,1105.0,1.1,2031.65,31
HCPCS,D2962,Labial veneer porc indirect,,,611.63,1812.01,27
HCPCS,D2971,ADDITIONAL PROCEDURES TO CONSTRUCT NEW CROWN UNDER EXISTING PART,425.0,276.25,1.1,483.73,31
HCPCS,D2971,Add proc construct new crown,,,611.63,1812.01,27
HCPCS,D2975,Coping,,,611.63,1812.01,27
HCPCS,D2976,Band stabilization per tooth,,,1358.5,1573.0,8
HCPCS,D2980,CROWN REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,570.11,31
HCPCS,D2980,Crown repair,,,611.63,1812.01,27
HCPCS,D2981,INLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,28
HCPCS,D2981,Inlay repair,,,611.63,1812.01,27
HCPCS,D2982,ONLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,28
HCPCS,D2982,Onlay repair,,,611.63,1812.01,27
HCPCS,D2983,VENEER REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,430.0,279.5,1.1,430.0,28
HCPCS,D2983,Veneer repair,,,611.63,1812.01,27
HCPCS,D2989,Excavate tooth non-restorabl,,,45.8,53.03,8
HCPCS,D2990,Resin infiltration of lesion,,,45.8,1812.01,27
HCPCS,D2991,App of hydroxyapatite,,,45.8,53.03,8
HCPCS,D2999,CUSTOM WHITENING TRAYS - 1 TRAY,175.0,113.75,0.01,175.0,28
HCPCS,D2999,CUSTOM WHITENING TRAYS - 2 TRAYS,200.0,130.0,0.01,200.0,28
HCPCS,D2999,Dental unspec restorative pr,,,611.63,1812.01,27
HCPCS,D2999,"UNSPECIFIED RESTORATIVE PROCEDURE, BY REPORT",400.0,260.0,0.01,400.0,28
HCPCS,D3110,PULP CAP - DIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,141.67,31
HCPCS,D3110,Pulp cap direct,,,611.63,1812.01,27
HCPCS,D3120,PULP CAP - INDIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,125.0,31
HCPCS,D3120,Pulp cap indirect,,,611.63,1812.01,27
HCPCS,D3220,THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION) - REMOVAL OF,325.0,211.25,1.1,331.7,31
HCPCS,D3220,Therapeutic pulpotomy,,,611.63,1812.01,27
HCPCS,D3221,Gross pulpal debridement,,,611.63,1812.01,27
HCPCS,D3221,"PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH",350.0,227.5,1.1,350.0,31
HCPCS,D3222,PARTIAL PULPOTOMY FOR APEXOGENESIS - PERMANENT TOOTH WITH INCOMP,425.0,276.25,1.1,425.0,31
HCPCS,D3222,Part pulp for apexogenesis,,,611.63,1812.01,27
HCPCS,D3230,"PULPAL THERAPY (RESORBABLE FILLING) - ANTERIOR, PRIMARY TOOTH (E",400.0,260.0,1.1,604.67,31
HCPCS,D3230,Pulpal therapy anterior prim,,,611.63,1812.01,27
HCPCS,D3240,"PULPAL THERAPY (RESORBABLE FILLING) - POSTERIOR, PRIMARY TOOTH (",430.0,279.5,1.1,430.0,31
HCPCS,D3240,Pulpal therapy posterior pri,,,611.63,1812.01,27
HCPCS,D3310,"ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION)",1100.0,715.0,1.1,1402.8,31
HCPCS,D3310,"End thxpy, anterior tooth",,,611.63,1812.01,27
HCPCS,D3320,"ENDODONTIC THERAPY, PREMOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1200.0,780.0,1.1,1710.32,31
HCPCS,D3320,"End thxpy, premolar tooth",,,611.63,1812.01,27
HCPCS,D3330,"ENDODONTIC THERAPY, MOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1500.0,975.0,1.1,2211.32,31
HCPCS,D3330,"End thxpy, molar tooth",,,611.63,1812.01,27
HCPCS,D3331,Non-surg tx root canal obs,,,611.63,1812.01,27
HCPCS,D3331,TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS,900.0,585.0,1.1,900.0,31
HCPCS,D3332,"INCOMPLETE ENDODONTIC THERAPY; INOPERABLE, UNRESTORABLE OR FRACT",600.0,390.0,1.1,1174.77,31
HCPCS,D3332,Incomplete endodontic tx,,,611.63,1812.01,27
HCPCS,D3333,Internal root repair,,,611.63,1812.01,27
HCPCS,D3346,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - ANTERIOR,1300.0,845.0,1.1,1886.52,31
HCPCS,D3346,Retreat root canal anterior,,,611.63,1812.01,27
HCPCS,D3347,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - PREMOLAR,1400.0,910.0,1.1,2225.14,31
HCPCS,D3347,Retreat root canal premolar,,,611.63,1812.01,27
HCPCS,D3348,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - MOLAR,1700.0,1105.0,1.1,2674.32,31
HCPCS,D3348,Retreat root canal molar,,,611.63,1812.01,27
HCPCS,D3351,Apexification/recalc initial,,,611.63,1812.01,27
HCPCS,D3352,APEXIFICATION/RECALCIFICATION ? INTERIM MEDICATION REPLACEMENT,400.0,260.0,1.1,400.0,31
HCPCS,D3352,Apexification/recalc interim,,,611.63,1812.01,27
HCPCS,D3353,APEXIFICATION/RECALCIFICATION - FINAL VISIT (INCLUDES COMPLETED,750.0,487.5,1.1,1171.3,31
HCPCS,D3353,Apexification/recalc final,,,611.63,1812.01,27
HCPCS,D3355,PULPAL REGENERATION - INITIAL VISIT,600.0,390.0,1.1,600.0,25
HCPCS,D3355,Pulpal regeneration initial,,,611.63,1812.01,27
HCPCS,D3356,PULPAL REGENERATION - INTERIM MEDICATION REPLACEMENT,500.0,325.0,1.1,500.0,25
HCPCS,D3356,Pulpal regeneration interim,,,611.63,1812.01,27
HCPCS,D3357,PULPAL REGENERATION - COMPLETION OF TREATMENT,850.0,552.5,1.1,850.0,25
HCPCS,D3357,Pulpal regeneration complete,,,611.63,1812.01,27
HCPCS,D3410,APICOECTOMY - ANTERIOR,1100.0,715.0,1.1,1603.21,31
HCPCS,D3410,Apicoectomy - anterior,,,611.63,1812.01,27
HCPCS,D3421,APICOECTOMY - PREMOLAR (FIRST ROOT),1225.0,796.25,1.1,1751.78,31
HCPCS,D3421,Root surgery premolar,,,611.63,1812.01,27
HCPCS,D3425,APICOECTOMY - MOLAR (FIRST ROOT),1350.0,877.5,1.1,1979.82,31
HCPCS,D3425,Root surgery molar,,,611.63,1812.01,27
HCPCS,D3426,APICOECTOMY (EACH ADDITIONAL ROOT),650.0,422.5,1.1,659.95,31
HCPCS,D3426,Root surgery ea add root,,,1358.5,1573.0,8
HCPCS,D3427,Periradicular surgery,,,1358.5,1573.0,8
HCPCS,D3428,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? PER TOOTH,575.0,373.75,1.1,575.0,25
HCPCS,D3428,Bone graft peri per tooth,,,611.63,1812.01,27
HCPCS,D3429,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? EACH ADDI,500.0,325.0,1.1,500.0,25
HCPCS,D3429,Bone graft peri each addl,,,1358.5,1573.0,8
HCPCS,D3430,RETROGRADE FILLING - PER ROOT,430.0,279.5,1.1,483.73,31
HCPCS,D3430,Retrograde filling,,,611.63,1812.01,27
HCPCS,D3431,BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATIO,850.0,552.5,1.1,963.0,25
HCPCS,D3431,Biological materials,,,611.63,1812.01,27
HCPCS,D3432,"GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CON",575.0,373.75,1.1,1178.4,25
HCPCS,D3432,Guided tissue regeneration,,,611.63,1812.01,27
HCPCS,D3450,ROOT AMPUTATION - PER ROOT,600.0,390.0,1.1,984.73,31
HCPCS,D3450,Root amputation,,,611.63,1812.01,27
HCPCS,D3460,ENDODONTIC ENDOSSEOUS IMPLANT,2000.0,1300.0,1.1,4723.23,31
HCPCS,D3460,Endodontic endosseous implan,,,611.63,1812.01,27
HCPCS,D3470,INTENTIONAL REIMPLANTATION (INCLUDING NECESSARY SPLINTING),1100.0,715.0,1.1,1962.55,31
HCPCS,D3470,Intentional replantation,,,611.63,1812.01,27
HCPCS,D3471,SURGICAL REPAIR OF ROOT RESORPTION - ANTERIOR,900.0,585.0,1.1,2048.93,31
HCPCS,D3471,Surg rep root res anterior,,,611.63,1812.01,27
HCPCS,D3472,SURGICAL REPAIR OF ROOT RESORPTION ? PREMOLAR,900.0,585.0,1.1,2366.81,31
HCPCS,D3472,Surg rep root res premolar,,,611.63,1812.01,27
HCPCS,D3473,SURGICAL REPAIR OF ROOT RESORPTION ? MOLAR,1000.0,650.0,1.1,2660.49,31
HCPCS,D3473,Surg rep root res molar,,,611.63,1812.01,27
HCPCS,D3501,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,31
HCPCS,D3501,Surg exp root surf anterior,,,611.63,1812.01,27
HCPCS,D3502,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,31
HCPCS,D3502,Surg exp root surf premolar,,,611.63,1812.01,27
HCPCS,D3503,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,31
HCPCS,D3503,Surg exp root surf molar,,,611.63,1812.01,27
HCPCS,D3910,Isolation- tooth w rubb dam,,,611.63,1812.01,27
HCPCS,D3910,SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM,300.0,195.0,1.1,300.0,31
HCPCS,D3911,Intraorifice barrier,,,611.63,1812.01,27
HCPCS,D3920,"HEMISECTION (INCLUDING ANY ROOT REMOVAL), NOT INCLUDING ROOT CAN",700.0,455.0,1.1,767.05,31
HCPCS,D3920,Tooth splitting,,,611.63,1812.01,27
HCPCS,D3921,DECORONATION OR SUBMERGENCE OF AN ERUPTED TOOTH,550.0,357.5,1.1,1005.46,31
HCPCS,D3921,Decor or submerg erupt tooth,,,611.63,1812.01,27
HCPCS,D3950,CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST,350.0,227.5,1.1,350.0,31
HCPCS,D3950,Canal prep/fitting of dowel,,,611.63,1812.01,27
HCPCS,D3999,Endodontic procedure,,,611.63,1812.01,27
HCPCS,D3999,"UNSPECIFIED ENDODONTIC PROCEDURE, BY REPORT",500.0,325.0,0.01,500.0,28
HCPCS,D4210,GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR,1000.0,650.0,1.1,1219.68,31
HCPCS,D4210,Gingivectomy/plasty 4 or mor,,,1358.5,9292.73,27
HCPCS,D4211,GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE CONTIGUOUS TEETH OR,600.0,390.0,1.1,600.0,31
HCPCS,D4211,Gingivectomy/plasty 1 to 3,,,1358.5,9292.73,27
HCPCS,D4212,Gingivectomy/plasty rest,,,1358.5,9292.73,27
HCPCS,D4230,Ana crown exp 4 or> per quad,,,1358.5,9292.73,27
HCPCS,D4231,Ana crown exp 1-3 per quad,,,1358.5,4348.85,27
HCPCS,D4240,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE C",1100.0,715.0,1.1,1437.35,31
HCPCS,D4240,Gingival flap proc w/ planin,,,1358.5,9292.73,27
HCPCS,D4241,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE C",900.0,585.0,1.1,1437.35,31
HCPCS,D4241,Gngvl flap w rootplan 1-3 th,,,1358.5,4348.85,27
HCPCS,D4245,Apically positioned flap,,,1358.5,4348.85,27
HCPCS,D4249,CLINICAL CROWN LENGTHENING ? HARD TISSUE,1200.0,780.0,1.1,1641.22,31
HCPCS,D4249,Crown lengthen hard tissue,,,611.63,1812.01,27
HCPCS,D4260,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1500.0,975.0,1.1,2321.88,31
HCPCS,D4260,Osseous surgery 4 or more,,,1358.5,16592.38,27
HCPCS,D4261,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1200.0,780.0,1.1,2321.88,31
HCPCS,D4261,Osseous surg 1 to 3 teeth,,,1358.5,9292.73,27
HCPCS,D4263,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? FIRST SITE IN,575.0,373.75,1.1,1751.78,31
HCPCS,D4263,Bone replce graft first site,,,611.63,1812.01,27
HCPCS,D4264,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? EACH ADDITIONA,450.0,292.5,1.1,1330.25,31
HCPCS,D4264,Bone replce graft each add,,,1358.5,1573.0,8
HCPCS,D4265,BIO MTRLS TO AID SOFT/OS REG,700.0,455.0,1.1,1872.7,31
HCPCS,D4265,Bio mtrls to aid soft/os reg,,,45.8,1812.01,27
HCPCS,D4266,"GUIDED TISSUE REGENERATION, NATURAL TEETH - RESORBABLE BARRIER,",500.0,325.0,1.1,1872.7,31
HCPCS,D4266,Guided tiss regen resorble,,,1358.5,4348.85,27
HCPCS,D4267,"GUIDED TISSUE REGENERATION, NATURAL TEETH ? NON-RESORBABLE BARRI",600.0,390.0,1.1,1983.28,31
HCPCS,D4267,Guided tiss regen nonresorb,,,1358.5,4348.85,27
HCPCS,D4268,"SURGICAL REVISION PROCEDURE, PER TOOTH",800.0,520.0,1.1,800.0,31
HCPCS,D4268,Surgical revision procedure,,,611.63,1812.01,27
HCPCS,D4270,PEDICLE SOFT TISSUE GRAFT PROCEDURE,1100.0,715.0,1.1,1717.23,31
HCPCS,D4270,Pedicle soft tissue graft pr,,,1358.5,4348.85,27
HCPCS,D4273,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,1300.0,845.0,1.1,1883.08,31
HCPCS,D4273,Auto tissue graft 1st tooth,,,1358.5,4348.85,27
HCPCS,D4274,"MESIAL/DISTAL WEDGE PROCEDURE, SINGLE TOOTH (WHEN NOT PERFORMED",700.0,455.0,1.1,700.0,31
HCPCS,D4274,Mesial/distal wedge proc,,,611.63,1812.01,27
HCPCS,D4275,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT (INCLUDING RECIPIENT SITE,1450.0,942.5,1.1,1765.6,31
HCPCS,D4275,Non-auto graft 1st tooth,,,1358.5,4348.85,27
HCPCS,D4276,"COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PER TOOTH",1300.0,845.0,1.1,1883.08,31
HCPCS,D4276,Con tissue w pedicle graft,,,1358.5,4348.85,27
HCPCS,D4277,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1300.0,845.0,1.1,1790.14,31
HCPCS,D4277,Soft tissue graft firsttooth,,,1358.5,4348.85,27
HCPCS,D4278,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1000.0,650.0,1.1,1765.6,31
HCPCS,D4278,Soft tissue graft addl tooth,,,1358.5,1573.0,8
HCPCS,D4283,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,600.0,390.0,1.1,1917.64,31
HCPCS,D4283,Auto tissue graft addl tooth,,,1358.5,1573.0,8
HCPCS,D4285,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING RECI,650.0,422.5,1.1,1917.64,31
HCPCS,D4285,Non-auto graft addl tooth,,,1358.5,1573.0,8
HCPCS,D4286,Remove non-resorb barrier,,,1358.5,1573.0,8
HCPCS,D4320,Provision splnt intracoronal,,,1358.5,1573.0,8
HCPCS,D4321,PROVISIONAL SPLINTING - EXTRACORONAL,418.0,271.7,1.1,418.0,22
HCPCS,D4321,Provisional splint extracoro,,,1358.5,1573.0,8
HCPCS,D4322,Splint intra-coronal,,,611.63,1812.01,27
HCPCS,D4323,SPLINT ? EXTRA-CORONAL; NATURAL TEETH OR PROSTHETIC CROWNS,675.0,438.75,1.1,929.44,31
HCPCS,D4323,Splint extra-coronal,,,611.63,1812.01,27
HCPCS,D4341,PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QU,350.0,227.5,1.1,480.26,31
HCPCS,D4341,Periodontal scaling & root,,,611.63,1812.01,27
HCPCS,D4342,PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH PER QU,275.0,178.75,1.1,480.26,31
HCPCS,D4342,Periodontal scaling 1-3teeth,,,611.63,1812.01,27
HCPCS,D4346,SCALING IN PRESENCE OF GENERALIZED MODERATE OR SEVERE GINGIVAL I,250.0,162.5,1.1,536.66,31
HCPCS,D4346,Scaling gingiv inflammation,,,611.63,1812.01,27
HCPCS,D4355,FULL MOUTH DEBRIDEMENT TO ENABLE A COMPREHENSIVE?PERIODONTAL?EVA,230.0,149.5,1.1,317.87,31
HCPCS,D4355,Full mouth debridement,,,611.63,1812.01,27
HCPCS,D4381,LOCAL DELIV ANTIMICRB 1ST SITE,50.0,32.5,1.1,362.8,31
HCPCS,D4381,LOCALIZED DELIVERY OF ANTIMICROBIAL AGENTS VIA A CONTROLLED RELE,85.0,55.25,1.1,362.8,31
HCPCS,D4381,Localized delivery antimicro,,,45.8,1812.01,27
HCPCS,D4910,PERIODONTAL MAINTENANCE,180.0,117.0,1.1,286.78,31
HCPCS,D4910,Periodontal maint procedures,,,611.63,1812.01,27
HCPCS,D4920,UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENT,150.0,97.5,1.1,245.33,31
HCPCS,D4920,Unscheduled dressing change,,,45.8,1812.01,27
HCPCS,D4921,GINGIVAL IRRIGATION?WITH A MEDICINAL AGENT?? PER QUADRANT,100.0,65.0,1.1,100.0,25
HCPCS,D4921,Gingival irrigation per quad,,,45.8,373.16,27
HCPCS,D4999,"UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,28
HCPCS,D4999,Unspecified periodontal proc,,,214.57,1573.0,27
HCPCS,D5110,COMPLETE DENTURE - MAXILLARY,3000.0,1950.0,1.1,3000.0,31
HCPCS,D5110,Dentures complete maxillary,,,1358.5,1573.0,8
HCPCS,D5120,COMPLETE DENTURE - MANDIBULAR,3000.0,1950.0,1.1,3000.0,31
HCPCS,D5120,Dentures complete mandible,,,1358.5,1573.0,8
HCPCS,D5130,Dentures immediat maxillary,,,1358.5,1573.0,8
HCPCS,D5140,Dentures immediat mandible,,,1358.5,1573.0,8
HCPCS,D5211,Dentures maxill part resin,,,1358.5,1573.0,8
HCPCS,D5211,"MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CLA",2100.0,1365.0,1.1,2228.6,31
HCPCS,D5212,Dentures mand part resin,,,1358.5,1573.0,8
HCPCS,D5212,"MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CL",2100.0,1365.0,1.1,2587.93,31
HCPCS,D5213,Dentures maxill part metal,,,1358.5,1573.0,8
HCPCS,D5213,MAXILLARY PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENT,3000.0,1950.0,1.1,3000.0,31
HCPCS,D5214,Dentures mandibl part metal,,,1358.5,1573.0,8
HCPCS,D5214,MANDIBULAR PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DEN,3000.0,1950.0,1.1,3000.0,31
HCPCS,D5221,IMMEDIATE MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,31
HCPCS,D5221,Immed max part denture resin,,,1358.5,1573.0,8
HCPCS,D5222,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,31
HCPCS,D5222,Immed man part denture resin,,,1358.5,1573.0,8
HCPCS,D5223,IMMEDIATE MAXILLARY PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,31
HCPCS,D5223,Immed max part dent metal,,,1358.5,1573.0,8
HCPCS,D5224,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,31
HCPCS,D5224,Immed mand part dent metal,,,1358.5,1573.0,8
HCPCS,D5225,"MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,",2100.0,1365.0,1.1,2916.18,31
HCPCS,D5225,Maxillary part denture flex,,,1358.5,1573.0,8
HCPCS,D5226,MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,2100.0,1365.0,1.1,2916.18,31
HCPCS,D5226,Mandibular part denture flex,,,1358.5,1573.0,8
HCPCS,D5227,IMMEDIATE MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING A,2000.0,1300.0,1.1,3064.75,31
HCPCS,D5227,Immed max part denture,,,1358.5,1573.0,8
HCPCS,D5228,IMMEDIATE MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING,2000.0,1300.0,1.1,3064.75,31
HCPCS,D5228,Immed mand part denture,,,1358.5,1573.0,8
HCPCS,D5282,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,31
HCPCS,D5282,"Remove unil part denture,max",,,1358.5,1573.0,8
HCPCS,D5283,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,31
HCPCS,D5283,"Remove unil part denture,man",,,1358.5,1573.0,8
HCPCS,D5284,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE FLEXIBLE BASE (IN,1500.0,975.0,1.1,1820.88,31
HCPCS,D5284,Rem unilat dent flex base,,,1358.5,1573.0,8
HCPCS,D5286,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE RESIN (INCLUDING,1500.0,975.0,1.1,1820.88,31
HCPCS,D5286,Rem unilat dent 1 pc resin,,,1358.5,1573.0,8
HCPCS,D5410,ADJUST COMPLETE DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,31
HCPCS,D5410,Dentures adjust cmplt maxil,,,45.8,53.03,8
HCPCS,D5411,ADJUST COMPLETE DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,31
HCPCS,D5411,Dentures adjust cmplt mand,,,45.8,53.03,8
HCPCS,D5421,ADJUST PARTIAL DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,31
HCPCS,D5421,Dentures adjust part maxill,,,45.8,53.03,8
HCPCS,D5422,ADJUST PARTIAL DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,31
HCPCS,D5422,Dentures adjust part mandbl,,,45.8,53.03,8
HCPCS,D5511,"REPAIR BROKEN COMPLETE DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,31
HCPCS,D5511,Rep broke comp dent base man,,,1358.5,1573.0,8
HCPCS,D5512,"REPAIR BROKEN COMPLETE DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,31
HCPCS,D5512,Rep broke comp dent base max,,,1358.5,1573.0,8
HCPCS,D5520,RELACE MISSING OR BROKEN TEETH - COMPLETE DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,31
HCPCS,D5520,Replace denture teeth complt,,,1358.5,1573.0,8
HCPCS,D5611,"REPAIR RESIN PARTIAL DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,31
HCPCS,D5611,Rep resin part dent base man,,,1358.5,1573.0,8
HCPCS,D5612,"REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,31
HCPCS,D5612,Rep resin part dent base max,,,1358.5,1573.0,8
HCPCS,D5621,"REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR",425.0,276.25,1.1,611.57,31
HCPCS,D5621,Rep cast part frame man,,,1358.5,1573.0,8
HCPCS,D5622,"REPAIR CAST PARTIAL FRAMEWORK, MAXILLARY",425.0,276.25,1.1,611.57,31
HCPCS,D5622,Rep cast part frame max,,,1358.5,1573.0,8
HCPCS,D5630,REPAIR OR REPLACE BROKEN RETENTIVE CLASPING MATERIALS ? PER TOOT,400.0,260.0,1.1,411.16,31
HCPCS,D5630,Rep partial denture clasp,,,1358.5,1573.0,8
HCPCS,D5640,REPLACE MISSING OR BROKEN TEETH - PARTIAL DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,31
HCPCS,D5640,Replace part denture teeth,,,1358.5,1573.0,8
HCPCS,D5650,ADD TOOTH TO EXISTING PARTIAL DENTURE (PER TOOTH),350.0,227.5,1.1,362.8,31
HCPCS,D5650,Add tooth to partial denture,,,1358.5,1573.0,8
HCPCS,D5660,ADD CLASP TO EXISTING PARTIAL DENTURE - PER TOOTH,400.0,260.0,1.1,431.91,31
HCPCS,D5660,Add clasp to partial denture,,,1358.5,1573.0,8
HCPCS,D5670,Replc tth&acrlc on mtl frmwk,,,1358.5,1573.0,8
HCPCS,D5671,Replc tth&acrlc mandibular,,,1358.5,1573.0,8
HCPCS,D5710,Dentures rebase cmplt maxil,,,1358.5,1573.0,8
HCPCS,D5710,REBASE COMPLETE MAXILLARY DENTURE,800.0,520.0,1.1,1071.11,31
HCPCS,D5711,Dentures rebase cmplt mand,,,1358.5,1573.0,8
HCPCS,D5711,REBASE COMPLETE MANDIBULAR DENTURE,800.0,520.0,1.1,1022.73,31
HCPCS,D5720,Dentures rebase part maxill,,,1358.5,1573.0,8
HCPCS,D5720,REBASE MAXILLARY PARTIAL DENTURE,800.0,520.0,1.1,1012.36,31
HCPCS,D5721,Dentures rebase part mandbl,,,1358.5,1573.0,8
HCPCS,D5721,REBASE MANDIBULAR PARTIAL DENTURE,800.0,520.0,1.1,1012.36,31
HCPCS,D5725,Rebase hybrid prosthesis,,,1358.5,1573.0,8
HCPCS,D5730,Denture reln cmplt max dir,,,1358.5,1573.0,8
HCPCS,D5730,RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,31
HCPCS,D5731,Denture reln cmplt mand dir,,,1358.5,1573.0,8
HCPCS,D5731,RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,31
HCPCS,D5740,Denture reln part max dir,,,1358.5,1573.0,8
HCPCS,D5740,RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,31
HCPCS,D5741,Denture reln part mand dir,,,1358.5,1573.0,8
HCPCS,D5741,RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,31
HCPCS,D5750,Denture reln cmplt max indir,,,1358.5,1573.0,8
HCPCS,D5750,RELINE COMPLETE MAXILLARY DENTURE (LABORATORY),800.0,520.0,1.1,808.52,31
HCPCS,D5751,Denture reln cmplt mand ind,,,1358.5,1573.0,8
HCPCS,D5751,RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY),800.0,520.0,1.1,808.52,31
HCPCS,D5760,Denture reln part max indir,,,1358.5,1573.0,8
HCPCS,D5761,Denture reln part mand indir,,,1358.5,1573.0,8
HCPCS,D5765,Liner compl/partial rem dent,,,1358.5,1573.0,8
HCPCS,D5765,SOFT LINER FOR COMPLETE OR PARTIAL REMOVABLE DENTURE ? INDIRECT,500.0,325.0,1.1,1098.75,28
HCPCS,D5810,Denture interm cmplt maxill,,,1358.5,1573.0,8
HCPCS,D5810,INTERIM COMPLETE DENTURE (MAXILLARY),1000.0,650.0,1.1,1278.41,31
HCPCS,D5811,Denture interm cmplt mandbl,,,1358.5,1573.0,8
HCPCS,D5811,INTERIM COMPLETE DENTURE (MANDIBULAR),1000.0,650.0,1.1,1371.71,31
HCPCS,D5820,Denture interm part maxill,,,1358.5,1573.0,8
HCPCS,D5820,ESSIX APPLIANCE - MAXILLARY,300.0,195.0,1.1,988.19,31
HCPCS,D5820,INTERIM PARTIAL DENTURE (MAXILLARY),300.0,195.0,1.1,988.19,31
HCPCS,D5821,Denture interm part mandbl,,,1358.5,1573.0,8
HCPCS,D5821,ESSIX APPLIANCE - MANDIBULAR,300.0,195.0,1.1,1046.92,31
HCPCS,D5821,INTERIM PARTIAL DENTURE (MANDIBULAR),500.0,325.0,1.1,1046.92,31
HCPCS,D5850,Denture tiss conditn maxill,,,1358.5,1573.0,8
HCPCS,D5850,"TISSUE CONDITIONING, MAXILLARY",200.0,130.0,1.1,241.86,31
HCPCS,D5851,Denture tiss condtin mandbl,,,1358.5,1573.0,8
HCPCS,D5851,"TISSUE CONDITIONING, MANDIBULAR",200.0,130.0,1.1,252.23,31
HCPCS,D5862,Precision attachment,,,1358.5,1573.0,8
HCPCS,D5863,Overdenture complete max,,,1358.5,1573.0,8
HCPCS,D5864,Overdenture partial max,,,1358.5,1573.0,8
HCPCS,D5865,Overdenture complete mandib,,,1358.5,1573.0,8
HCPCS,D5866,Overdenture partial mandib,,,1358.5,1573.0,8
HCPCS,D5867,REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION A,500.0,325.0,1.1,500.0,31
HCPCS,D5867,Replacement of precision att,,,1358.5,1573.0,8
HCPCS,D5875,MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY,500.0,325.0,1.1,500.0,31
HCPCS,D5875,Prosthesis modification,,,1358.5,1573.0,8
HCPCS,D5876,Add metal sub to acrylc dent,,,1358.5,1573.0,8
HCPCS,D5877,Dup of complt dent-maxill,,,1358.5,1573.0,8
HCPCS,D5878,Dup of complt dent-mandib,,,1358.5,1573.0,8
HCPCS,D5899,Removable prosthodontic proc,,,1358.5,1573.0,8
HCPCS,D5899,"UNSPECIFIED REMOVABLE PROSTHODONTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,28
HCPCS,D5909,Max guid prothes w/ flange,,,1358.5,1573.0,8
HCPCS,D5911,FACIAL MOULAGE (SECTIONAL),650.0,422.5,1.1,670.31,31
HCPCS,D5911,Facial moulage sectional,,,611.63,1812.01,27
HCPCS,D5912,FACIAL MOULAGE (COMPLETE),700.0,455.0,1.1,700.0,31
HCPCS,D5912,Facial moulage complete,,,611.63,1812.01,27
HCPCS,D5913,NASAL PROSTHESIS,8000.0,5200.0,1.1,14100.61,31
HCPCS,D5913,Nasal prosthesis,,,1358.5,1573.0,8
HCPCS,D5914,AURICULAR PROSTHESIS,9000.0,5850.0,1.1,14100.61,31
HCPCS,D5914,Auricular prosthesis,,,1358.5,1573.0,8
HCPCS,D5915,ORBITAL PROSTHESIS,8500.0,5525.0,1.1,19082.98,31
HCPCS,D5915,Orbital prosthesis,,,1358.5,1573.0,8
HCPCS,D5916,OCULAR PROSTHESIS,6000.0,3900.0,1.1,10632.79,31
HCPCS,D5916,Ocular prosthesis,,,1358.5,1573.0,8
HCPCS,D5919,Facial prosthesis,,,1358.5,1573.0,8
HCPCS,D5922,NASAL SEPTAL PROSTHESIS,4000.0,2600.0,1.1,5182.77,31
HCPCS,D5922,Nasal septal prosthesis,,,1358.5,1573.0,8
HCPCS,D5923,Ocular prosthesis interim,,,1358.5,1573.0,8
HCPCS,D5924,Cranial prosthesis,,,1358.5,1573.0,8
HCPCS,D5925,Facial augmentation implant,,,1358.5,1573.0,8
HCPCS,D5926,Replacement nasal prosthesis,,,1358.5,1573.0,8
HCPCS,D5927,Auricular replacement,,,1358.5,1573.0,8
HCPCS,D5928,Orbital replacement,,,1358.5,1573.0,8
HCPCS,D5929,Facial replacement,,,1358.5,1573.0,8
HCPCS,D5930,Max guid prothes w/o flange,,,1358.5,1573.0,8
HCPCS,D5931,"OBTURATOR PROSTHESIS, SURGICAL",5000.0,3250.0,1.1,7591.04,31
HCPCS,D5931,Surgical obturator,,,1358.5,1573.0,8
HCPCS,D5932,"OBTURATOR PROSTHESIS, DEFINITIVE",7000.0,4550.0,1.1,14200.81,31
HCPCS,D5932,Postsurgical obturator,,,1358.5,1573.0,8
HCPCS,D5933,"OBTURATOR PROSTHESIS, MODIFICATION",850.0,552.5,1.1,1138.69,31
HCPCS,D5933,Refitting of obturator,,,1358.5,1573.0,8
HCPCS,D5934,Mandibular flange prosthesis,,,1358.5,1573.0,8
HCPCS,D5935,Mandibular denture prosth,,,1358.5,1573.0,8
HCPCS,D5936,Temp obturator prosthesis,,,1358.5,1573.0,8
HCPCS,D5937,Trismus appliance,,,1358.5,1573.0,8
HCPCS,D5938,Resct proth max comp remov,,,1358.5,1573.0,8
HCPCS,D5939,Resct proth mand comp remov,,,1358.5,1573.0,8
HCPCS,D5940,Resct proth max part remov,,,1358.5,1573.0,8
HCPCS,D5941,Resct proth mand part remov,,,1358.5,1573.0,8
HCPCS,D5942,Proth max implt sup remv,,,1358.5,1573.0,8
HCPCS,D5943,Proth mandib implt sup remv,,,1358.5,1573.0,8
HCPCS,D5944,Max implt sup remv part,,,1358.5,1573.0,8
HCPCS,D5945,Mand implt sup remv part,,,1358.5,1573.0,8
HCPCS,D5946,Max implt sup fix,,,1358.5,1573.0,8
HCPCS,D5947,Mand implt sup fix,,,1358.5,1573.0,8
HCPCS,D5948,Max implt sup fix part,,,1358.5,1573.0,8
HCPCS,D5949,Mand implt sup fix part,,,1358.5,1573.0,8
HCPCS,D5951,Feeding aid,,,1358.5,1573.0,8
HCPCS,D5952,Pediatric speech aid,,,1358.5,1573.0,8
HCPCS,D5953,Adult speech aid,,,1358.5,1573.0,8
HCPCS,D5954,Superimposed prosthesis,,,1358.5,1573.0,8
HCPCS,D5955,Palatal lift prosthesis,,,1358.5,1573.0,8
HCPCS,D5958,Intraoral con def inter plt,,,1358.5,1573.0,8
HCPCS,D5959,Intraoral con def mod palat,,,1358.5,1573.0,8
HCPCS,D5960,Modify speech aid prosthesis,,,1358.5,1573.0,8
HCPCS,D5982,Surgical stent,,,1358.5,1573.0,8
HCPCS,D5983,Radiation applicator,,,611.63,1812.01,27
HCPCS,D5984,Radiation shield,,,611.63,1812.01,27
HCPCS,D5985,Radiation cone locator,,,611.63,1812.01,27
HCPCS,D5986,FLUORIDE GEL CARRIER,200.0,130.0,1.1,269.51,31
HCPCS,D5986,Fluoride applicator,,,45.8,53.03,8
HCPCS,D5987,Commissure splint,,,611.63,1812.01,27
HCPCS,D5988,SURGICAL SPLINT,800.0,520.0,1.1,5079.12,31
HCPCS,D5988,Surgical splint,,,611.63,1812.01,27
HCPCS,D5991,VESICULOBULLOUS DISEASE MEDICAMENT CARRIER,350.0,227.5,1.1,350.0,31
HCPCS,D5991,Vesiculobullous disease carr,,,1358.5,1573.0,8
HCPCS,D5992,"ADJUST MAXILLOFACIAL PROSTHETIC APPLIANCE, BY REPORT",250.0,162.5,1.1,325.71,31
HCPCS,D5992,Adjust max prost appliance,,,1358.5,1573.0,8
HCPCS,D5993,Main/clean max prosthesis,,,1358.5,1573.0,8
HCPCS,D5994,Peridontal medicament,,,1358.5,1573.0,8
HCPCS,D5995,"Peri medicament w/seal, max",,,1358.5,1573.0,8
HCPCS,D5996,"Peri medicament w/seal, mand",,,1358.5,1573.0,8
HCPCS,D5999,Maxillofacial prosthesis,,,1358.5,1573.0,8
HCPCS,D5999,"UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT",2000.0,1300.0,0.01,2000.0,28
HCPCS,D6010,Odontics endosteal implant,,,1358.5,1573.0,8
HCPCS,D6010,SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT,2500.0,1625.0,1.1,4412.27,31
HCPCS,D6011,Second stage implant surgery,,,1358.5,1573.0,8
HCPCS,D6012,Endosteal implant,,,1358.5,1573.0,8
HCPCS,D6013,SURGICAL PLACEMENT OF MINI IMPLANT,1000.0,650.0,1.1,1543.8,25
HCPCS,D6013,Surgical place mini implant,,,1358.5,1573.0,8
HCPCS,D6040,Odontics eposteal implant,,,1358.5,1573.0,8
HCPCS,D6049,Scale implt peri-implt inflm,,,45.8,53.03,8
HCPCS,D6050,Odontics transosteal implnt,,,1358.5,1573.0,8
HCPCS,D6050,SURGICAL PLACEMENT: TRANSOSTEAL IMPLANT,7000.0,4550.0,1.1,12590.69,31
HCPCS,D6051,Interim implant abutment,,,1358.5,1573.0,8
HCPCS,D6051,PLACEMENT OF INTERIM IMPLANT ABUTMENT,700.0,455.0,1.1,700.0,31
HCPCS,D6052,SEMI-PRECISION ATTACHMENT ABUTMENT,581.0,377.65,1.1,581.0,22
HCPCS,D6052,Semi precision attach abut,,,1358.5,1573.0,8
HCPCS,D6055,CONNECTING BAR ? IMPLANT SUPPORTED OR ABUTMENT SUPPORTED,4000.0,2600.0,1.1,4000.0,31
HCPCS,D6055,Implant connecting bar,,,1358.5,1573.0,8
HCPCS,D6056,PREFABRICATED ABUTMENT ? INCLUDES MODIFICATION AND PLACEMENT,900.0,585.0,1.1,1036.55,31
HCPCS,D6056,Prefabricated abutment,,,1358.5,1573.0,8
HCPCS,D6057,CUSTOM FABRICATED ABUTMENT ? INCLUDES PLACEMENT,1100.0,715.0,1.1,2936.91,31
HCPCS,D6057,Custom abutment,,,1358.5,1573.0,8
HCPCS,D6058,ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN,1800.0,1170.0,1.1,4146.22,31
HCPCS,D6058,Abutment supported crown,,,1358.5,1573.0,8
HCPCS,D6059,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (HIGH NOBLE ME,1800.0,1170.0,1.1,4146.22,31
HCPCS,D6059,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6060,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY,1800.0,1170.0,1.1,4491.74,31
HCPCS,D6060,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6061,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,4491.74,31
HCPCS,D6061,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6062,ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL),1800.0,1170.0,1.1,3437.91,31
HCPCS,D6062,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6063,ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL),1800.0,1170.0,1.1,1800.0,31
HCPCS,D6063,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6064,ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,1800.0,31
HCPCS,D6064,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6065,IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN,2000.0,1300.0,1.1,3455.19,31
HCPCS,D6065,Implant supported crown,,,1358.5,1573.0,8
HCPCS,D6066,"IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN (TITANIUM, TITA",2000.0,1300.0,1.1,4750.89,31
HCPCS,D6066,Implant supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6067,"IMPLANT SUPPORTED METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NO",2000.0,1300.0,1.1,3109.67,31
HCPCS,D6067,Implant supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6068,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC FPD,1800.0,1170.0,1.1,1800.0,31
HCPCS,D6068,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6069,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HI,1800.0,1170.0,1.1,3627.95,31
HCPCS,D6069,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6070,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PR,1800.0,1170.0,1.1,2332.25,31
HCPCS,D6070,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6071,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NO,1800.0,1170.0,1.1,2515.38,31
HCPCS,D6071,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6072,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL,1800.0,1170.0,1.1,1800.0,31
HCPCS,D6072,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6073,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BA,1800.0,1170.0,1.1,1800.0,31
HCPCS,D6073,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6074,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL),1800.0,1170.0,1.1,1800.0,31
HCPCS,D6074,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6075,IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD,2000.0,1300.0,1.1,2000.0,31
HCPCS,D6075,Implant supported retainer,,,1358.5,1573.0,8
HCPCS,D6076,IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (TIT,2000.0,1300.0,1.1,2000.0,31
HCPCS,D6076,Implant supported retainer,,,1358.5,1573.0,8
HCPCS,D6077,"IMPLANT SUPPORTED RETAINER FOR CAST METAL FPD (TITANIUM, TITANIU",2000.0,1300.0,1.1,2000.0,31
HCPCS,D6077,Implant supported retainer,,,1358.5,1573.0,8
HCPCS,D6080,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH FIXED HYBRID PRO,400.0,260.0,1.1,400.0,31
HCPCS,D6080,Implant maintenance,,,45.8,53.03,8
HCPCS,D6081,"SCALING/DEBRIDEMENT OF SINGLE IMPLANT IN PRESENCE OF MUCOSITIS,",250.0,162.5,0.01,306.32,31
HCPCS,D6081,"Scale & debride, single imp",,,45.8,53.03,8
HCPCS,D6082,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE,2000.0,1300.0,1.1,3990.74,31
HCPCS,D6082,Imp crown porc to base alloy,,,1358.5,1573.0,8
HCPCS,D6083,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO NOBLE ALLOYS,2000.0,1300.0,1.1,3990.74,31
HCPCS,D6083,Imp crown porc to noble allo,,,1358.5,1573.0,8
HCPCS,D6084,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITANI,2000.0,1300.0,1.1,3990.74,31
HCPCS,D6084,Imp crown porc to titanium,,,1358.5,1573.0,8
HCPCS,D6085,Interim implant crown,,,1358.5,1573.0,8
HCPCS,D6085,PROVISIONAL IMPLANT CROWN,700.0,455.0,1.1,700.0,31
HCPCS,D6086,IMPLANT SUPPORTED CROWN - PREDOMINANTLY BASE ALLOYS,2000.0,1300.0,1.1,3507.02,31
HCPCS,D6086,Imp crown base alloys,,,1358.5,1573.0,8
HCPCS,D6087,IMPLANT SUPPORTED CROWN - NOBLE ALLOYS,2000.0,1300.0,1.1,3507.02,31
HCPCS,D6087,Implant crown noble alloys,,,1358.5,1573.0,8
HCPCS,D6088,IMPLANT SUPPORTED CROWN - TITANIUM AND TITANIUM ALLOYS,2000.0,1300.0,1.1,3507.02,31
HCPCS,D6088,Imp crown titanium alloys,,,1358.5,1573.0,8
HCPCS,D6089,Access/retorq implant screw,,,45.8,53.03,8
HCPCS,D6090,REPAIR OF IMPLANT/ABUTMENT SUPPORTED PROSTHESIS,1000.0,650.0,1.1,2073.11,31
HCPCS,D6090,Repair implant,,,1358.5,1573.0,8
HCPCS,D6091,REPLACEMENT OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR F,500.0,325.0,1.1,539.36,31
HCPCS,D6091,Repl semi/precision attach,,,1358.5,1573.0,8
HCPCS,D6092,Recement supp crown,,,45.8,53.03,8
HCPCS,D6093,Recement supp part denture,,,45.8,53.03,8
HCPCS,D6094,ABUTMENT SUPPORTED CROWN - (TITANIUM),2000.0,1300.0,1.1,2073.11,31
HCPCS,D6094,Abut support crown titanium,,,1358.5,1573.0,8
HCPCS,D6095,Odontics repr abutment,,,1358.5,1573.0,8
HCPCS,D6095,"REPAIR IMPLANT ABUTMENT, BY REPORT",900.0,585.0,1.1,900.0,23
HCPCS,D6096,REMOVE BROKEN IMPLANT RETAINING SCREW,1000.0,650.0,1.1,1000.0,31
HCPCS,D6096,Remove broken imp ret screw,,,45.8,53.03,8
HCPCS,D6097,ABUTMENT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITAN,2000.0,1300.0,1.1,3911.26,31
HCPCS,D6097,Abut crown porc to titanium,,,1358.5,1573.0,8
HCPCS,D6098,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO PREDOMINANTLY BA,2000.0,1300.0,1.1,3911.26,31
HCPCS,D6098,Imp retain porc to base allo,,,1358.5,1573.0,8
HCPCS,D6099,IMPLANT SUPPORTED RETAINER FOR FPD - PORCELAIN FUSED TO NOBLE AL,2000.0,1300.0,1.1,3990.74,31
HCPCS,D6099,Imp retainer for fpd,,,1358.5,1573.0,8
HCPCS,D6100,"IMPLANT REMOVAL, BY REPORT",900.0,585.0,1.1,1036.55,31
HCPCS,D6100,Surg removal of implant body,,,1358.5,1573.0,8
HCPCS,D6101,DEBRIDEMENT OF A PERI-IMPLANT DEFECT OR DEFECTS SURROUNDING A SI,900.0,585.0,1.1,900.0,31
HCPCS,D6101,Debridement of a periimplant,,,45.8,53.03,8
HCPCS,D6102,Debridement & contouring,,,45.8,53.03,8
HCPCS,D6103,Bone graft repair perimplant,,,1358.5,1573.0,8
HCPCS,D6104,BONE GRAFT AT TIME OF IMPLANT PLACEMENT,575.0,373.75,1.1,2073.11,31
HCPCS,D6104,Bone graft time of implant,,,1358.5,1573.0,8
HCPCS,D6105,Remove implant body,,,1358.5,1573.0,8
HCPCS,D6106,Tissue regen resorbable,,,45.8,53.03,8
HCPCS,D6107,Tissue regen non-resorbable,,,45.8,53.03,8
HCPCS,D6110,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,31
HCPCS,D6110,Implnt/abut remov dent max,,,1358.5,1573.0,8
HCPCS,D6111,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,31
HCPCS,D6111,Implnt/abut remov dent mand,,,1358.5,1573.0,8
HCPCS,D6112,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,31
HCPCS,D6112,Imp/abut rem dent part max,,,1358.5,1573.0,8
HCPCS,D6113,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,31
HCPCS,D6113,Imp/abut rem dent part mand,,,1358.5,1573.0,8
HCPCS,D6114,Implnt/abut fixed dent max,,,1358.5,1573.0,8
HCPCS,D6115,Implnt/abut fixed dent mand,,,1358.5,1573.0,8
HCPCS,D6116,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,31
HCPCS,D6116,Imp/abut fixed dent part max,,,1358.5,1573.0,8
HCPCS,D6117,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,31
HCPCS,D6117,Imp/abut fixed dent part man,,,1358.5,1573.0,8
HCPCS,D6118,Imp/abut int fixed dent man,,,1358.5,1573.0,8
HCPCS,D6119,Int/abut int fixed dent max,,,1358.5,1573.0,8
HCPCS,D6120,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TIT,1600.0,1040.0,1.1,3911.26,31
HCPCS,D6120,Imp retain porc to titanium,,,1358.5,1573.0,8
HCPCS,D6121,IMPLANT SUPPORTED RETAINER FOR METAL FPD - PREDOMINANTLY BASE AL,1600.0,1040.0,1.1,3624.49,31
HCPCS,D6121,Retain metal fpd base alloys,,,1358.5,1573.0,8
HCPCS,D6122,IMPLANT SUPPORTED RETAINER FOR METAL FPD - NOBLE ALLOYS,1600.0,1040.0,1.1,3914.72,31
HCPCS,D6122,Retain metal fpd noble alloy,,,1358.5,1573.0,8
HCPCS,D6123,IMPLANT SUPPORTED RETAINER FOR METAL FPD - TITANIUM AND TITANIUM,1600.0,1040.0,1.1,3624.49,31
HCPCS,D6123,Retain metal fpd titanium,,,1358.5,1573.0,8
HCPCS,D6180,Implnt maint proced,,,45.8,53.03,8
HCPCS,D6190,Radio/surgical implant index,,,23.21,26.87,8
HCPCS,D6190,SURGICAL INDEX - NON-GUIDED,350.0,227.5,1.1,2073.11,31
HCPCS,D6191,Semi precision abutment,,,1358.5,1573.0,8
HCPCS,D6192,Semi precision attachment,,,1358.5,1573.0,8
HCPCS,D6193,Replace implnt screw,,,45.8,53.03,8
HCPCS,D6194,ABUTMENT SUPPORTED RETAINER CROWN FOR FPD (TITANIUM),1600.0,1040.0,1.1,2073.11,31
HCPCS,D6194,Abut support retainer titani,,,1358.5,1573.0,8
HCPCS,D6195,ABUTMENT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TI,1600.0,1040.0,1.1,3911.26,31
HCPCS,D6195,Abut retain porc to titanium,,,1358.5,1573.0,8
HCPCS,D6196,Remv of ind rest on implt,,,1358.5,1573.0,8
HCPCS,D6197,Replace material prosthesis,,,1358.5,1573.0,8
HCPCS,D6198,REMOVE INTERIM IMPLANT COMPONENT,400.0,260.0,1.1,400.0,31
HCPCS,D6198,Remove interim implant,,,1358.5,1573.0,8
HCPCS,D6199,Implant procedure,,,1358.5,1573.0,8
HCPCS,D6199,RESIDENT IMPLANT PROMO,2200.0,1430.0,1.1,2619.04,28
HCPCS,D6205,Pontic-indirect resin based,,,1358.5,1573.0,8
HCPCS,D6210,PONTIC - CAST HIGH NOBLE METAL,1500.0,975.0,1.1,2176.76,31
HCPCS,D6210,Prosthodont high noble metal,,,1358.5,1573.0,8
HCPCS,D6211,Bridge base metal cast,,,1358.5,1573.0,8
HCPCS,D6211,PONTIC - CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2038.56,31
HCPCS,D6212,Bridge noble metal cast,,,1358.5,1573.0,8
HCPCS,D6212,PONTIC - CAST NOBLE METAL,1500.0,975.0,1.1,2121.48,31
HCPCS,D6214,PONTIC - TITANIUM,1500.0,975.0,1.1,2121.48,31
HCPCS,D6214,Pontic titanium,,,1358.5,1573.0,8
HCPCS,D6240,Bridge porcelain high noble,,,1358.5,1573.0,8
HCPCS,D6240,PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL,1500.0,975.0,1.1,2149.12,31
HCPCS,D6241,Bridge porcelain base metal,,,1358.5,1573.0,8
HCPCS,D6241,PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1983.28,31
HCPCS,D6242,Bridge porcelain nobel metal,,,1358.5,1573.0,8
HCPCS,D6242,PONTIC - PORCELAIN FUSED TO NOBLE METAL,1500.0,975.0,1.1,2093.84,31
HCPCS,D6243,PONTIC - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1500.0,975.0,1.1,2501.56,31
HCPCS,D6243,Pontic porcelain to titanium,,,1358.5,1573.0,8
HCPCS,D6245,Bridge porcelain/ceramic,,,1358.5,1573.0,8
HCPCS,D6245,PONTIC - PORCELAIN/CERAMIC,1500.0,975.0,1.1,2073.11,31
HCPCS,D6250,Bridge resin w/high noble,,,1358.5,1573.0,8
HCPCS,D6250,PONTIC - RESIN WITH HIGH NOBLE METAL,1500.0,975.0,1.1,2121.48,31
HCPCS,D6251,Bridge resin base metal,,,1358.5,1573.0,8
HCPCS,D6251,PONTIC - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1955.64,31
HCPCS,D6252,Bridge resin w/noble metal,,,1358.5,1573.0,8
HCPCS,D6252,PONTIC - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2017.83,31
HCPCS,D6253,Interim pontic,,,1358.5,1573.0,8
HCPCS,D6253,PROVISIONAL PONTIC - FURTHER TREATMENT OR COMPLETION OF DIAGNOSI,500.0,325.0,1.1,2017.83,31
HCPCS,D6280,Implt maint procd remv implt,,,45.8,53.03,8
HCPCS,D6545,Dental retainr cast metl,,,1358.5,1573.0,8
HCPCS,D6545,RETAINER - CAST METAL FOR RESIN BONDED FIXED PROSTHESIS,1200.0,780.0,1.1,1200.0,31
HCPCS,D6548,Porcelain/ceramic retainer,,,1358.5,1573.0,8
HCPCS,D6548,RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,1300.0,31
HCPCS,D6549,RETAINER ? FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,2332.25,31
HCPCS,D6549,Resin retainer,,,1358.5,1573.0,8
HCPCS,D6600,Porcelain/ceramic inlay 2srf,,,1358.5,1573.0,8
HCPCS,D6600,"RETAINER INLAY - PORCELAIN/CERAMIC, TWO SURFACES",1400.0,910.0,1.1,1872.7,31
HCPCS,D6601,Porc/ceram inlay >= 3 surfac,,,1358.5,1573.0,8
HCPCS,D6601,"RETAINER INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,31
HCPCS,D6602,Cst hgh nble mtl inlay 2 srf,,,1358.5,1573.0,8
HCPCS,D6602,"RETAINER INLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,31
HCPCS,D6603,Cst hgh nble mtl inlay >=3sr,,,1358.5,1573.0,8
HCPCS,D6603,"RETAINER INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,31
HCPCS,D6604,Cst bse mtl inlay 2 surfaces,,,1358.5,1573.0,8
HCPCS,D6604,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,31
HCPCS,D6605,Cst bse mtl inlay >= 3 surfa,,,1358.5,1573.0,8
HCPCS,D6605,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1500.0,975.0,1.1,2149.12,31
HCPCS,D6606,Cast noble metal inlay 2 sur,,,1358.5,1573.0,8
HCPCS,D6606,"RETAINER INLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,1872.7,31
HCPCS,D6607,Cst noble mtl inlay >=3 surf,,,1358.5,1573.0,8
HCPCS,D6607,"RETAINER INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2149.12,31
HCPCS,D6608,Onlay porc/crmc 2 surfaces,,,1358.5,1573.0,8
HCPCS,D6608,"RETAINER ONLAY - PORCELAIN/CERAMIC, TWO SURFACES",1500.0,975.0,1.1,2200.95,31
HCPCS,D6609,Onlay porc/crmc >=3 surfaces,,,1358.5,1573.0,8
HCPCS,D6609,"RETAINER ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,31
HCPCS,D6610,Onlay cst hgh nbl mtl 2 srfc,,,1358.5,1573.0,8
HCPCS,D6610,"RETAINER ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1600.0,1040.0,1.1,2200.95,31
HCPCS,D6611,Onlay cst hgh nbl mtl >=3srf,,,1358.5,1573.0,8
HCPCS,D6611,"RETAINER ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,31
HCPCS,D6612,Onlay cst base mtl 2 surface,,,1358.5,1573.0,8
HCPCS,D6612,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,31
HCPCS,D6613,Onlay cst base mtl >=3 surfa,,,1358.5,1573.0,8
HCPCS,D6613,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1600.0,1040.0,1.1,2200.95,31
HCPCS,D6614,Onlay cst nbl mtl 2 surfaces,,,1358.5,1573.0,8
HCPCS,D6614,"RETAINER ONLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,31
HCPCS,D6615,Onlay cst nbl mtl >=3 surfac,,,1358.5,1573.0,8
HCPCS,D6615,"RETAINER ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,31
HCPCS,D6624,Inlay titanium,,,1358.5,1573.0,8
HCPCS,D6624,RETAINER INLAY - TITANIUM,1500.0,975.0,1.1,1872.7,31
HCPCS,D6634,Onlay titanium,,,1358.5,1573.0,8
HCPCS,D6634,RETAINER ONLAY - TITANIUM,1600.0,1040.0,1.1,2200.95,31
HCPCS,D6710,Crown-indirect resin based,,,1358.5,1573.0,8
HCPCS,D6710,RETAINER CROWN - INDIRECT RESIN BASED COMPOSITE,1500.0,975.0,1.1,2394.44,31
HCPCS,D6720,RETAINER CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2394.44,31
HCPCS,D6720,Retain crown resin w hi nble,,,1358.5,1573.0,8
HCPCS,D6721,Crown resin w/base metal,,,1358.5,1573.0,8
HCPCS,D6721,RETAINER CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2270.05,31
HCPCS,D6722,Crown resin w/noble metal,,,1358.5,1573.0,8
HCPCS,D6722,RETAINER CROWN - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2311.51,31
HCPCS,D6740,Crown porcelain/ceramic,,,1358.5,1573.0,8
HCPCS,D6740,RETAINER CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2418.63,31
HCPCS,D6750,Crown porcelain high noble,,,1358.5,1573.0,8
HCPCS,D6750,RETAINER CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1600.0,1040.0,1.1,2453.18,31
HCPCS,D6751,Crown porcelain base metal,,,1358.5,1573.0,8
HCPCS,D6751,RETAINER CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2287.33,31
HCPCS,D6752,Crown porcelain noble metal,,,1358.5,1573.0,8
HCPCS,D6752,RETAINER CROWN - PORCELAIN FUSED TO NOBLE METAL,1600.0,1040.0,1.1,2342.62,31
HCPCS,D6753,RETAINER CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,31
HCPCS,D6753,Retain crown porc to titaniu,,,1358.5,1573.0,8
HCPCS,D6780,Crown 3/4 high noble metal,,,1358.5,1573.0,8
HCPCS,D6780,RETAINER CROWN - 3/4 CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2311.51,31
HCPCS,D6781,Crown 3/4 cast based metal,,,1358.5,1573.0,8
HCPCS,D6781,RETAINER CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2314.98,31
HCPCS,D6782,Crown 3/4 cast noble metal,,,1358.5,1573.0,8
HCPCS,D6782,RETAINER CROWN - 3/4 CAST NOBLE METAL,1600.0,1040.0,1.1,2314.98,31
HCPCS,D6783,Crown 3/4 porcelain/ceramic,,,1358.5,1573.0,8
HCPCS,D6783,RETAINER CROWN - 3/4 PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2314.98,31
HCPCS,D6784,RETAINER CROWN 3/4 - TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,31
HCPCS,D6784,Retainer crown 3/4 titanium,,,1358.5,1573.0,8
HCPCS,D6790,Crown full high noble metal,,,1358.5,1573.0,8
HCPCS,D6790,RETAINER CROWN - FULL CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2366.81,31
HCPCS,D6791,Crown full base metal cast,,,1358.5,1573.0,8
HCPCS,D6791,RETAINER CROWN - FULL CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2242.41,31
HCPCS,D6792,Crown full noble metal cast,,,1358.5,1573.0,8
HCPCS,D6792,RETAINER CROWN - FULL CAST NOBLE METAL,1600.0,1040.0,1.1,2325.33,31
HCPCS,D6793,Interim retainer crown,,,1358.5,1573.0,8
HCPCS,D6793,PROVISIONAL RETAINER CROWN,500.0,325.0,1.1,2270.05,31
HCPCS,D6794,Crown titanium,,,1358.5,1573.0,8
HCPCS,D6794,RETAINER CROWN - TITANIUM,1600.0,1040.0,1.1,2270.05,31
HCPCS,D6920,CONNECTOR BAR,1600.0,1040.0,1.1,1600.0,31
HCPCS,D6920,Dental connector bar,,,611.63,1812.01,27
HCPCS,D6930,RE-CEMENT OR RE-BOND FIXED PARTIAL DENTURE,250.0,162.5,1.1,286.78,31
HCPCS,D6930,Recement/bond part denture,,,1358.5,1573.0,8
HCPCS,D6940,STRESS BREAKER,700.0,455.0,1.1,700.0,31
HCPCS,D6940,Stress breaker,,,1358.5,1573.0,8
HCPCS,D6950,PRECISION ATTACHMENT,900.0,585.0,1.1,1271.51,31
HCPCS,D6950,Precision attachment,,,1358.5,1573.0,8
HCPCS,D6973,CORE BUILD UP FOR RETAINER,245.0,159.25,1.1,245.0,22
HCPCS,D6980,Fixed partial repair,,,1358.5,1573.0,8
HCPCS,D6985,Pediatric partial denture fx,,,1358.5,1573.0,8
HCPCS,D6999,Fixed prosthodontic proc,,,1358.5,1573.0,8
HCPCS,D6999,"UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE, BY REPORT",900.0,585.0,0.01,900.0,28
HCPCS,D7111,Extraction coronal remnants,,,611.63,1812.01,27
HCPCS,D7140,"EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORC",300.0,195.0,1.1,300.0,31
HCPCS,D7140,Extraction erupted tooth/exr,,,611.63,1812.01,27
HCPCS,D7210,"EXTRACTION, ERUPTED TOOTH REQUIRING REMOVAL OF BONE AND/OR SECTI",400.0,260.0,1.1,463.0,31
HCPCS,D7210,Rem imp tooth w mucoper flp,,,1358.5,4348.85,27
HCPCS,D7220,Impact tooth remov soft tiss,,,611.63,1812.01,27
HCPCS,D7220,REMOVAL OF IMPACTED TOOTH - SOFT TISSUE,500.0,325.0,1.1,580.48,31
HCPCS,D7230,Impact tooth remov part bony,,,611.63,1812.01,27
HCPCS,D7230,REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY,550.0,357.5,1.1,773.96,31
HCPCS,D7240,Impact tooth remov comp bony,,,611.63,1812.01,27
HCPCS,D7241,Impact tooth rem bony w/comp,,,611.63,1812.01,27
HCPCS,D7250,REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE),400.0,260.0,1.1,490.63,31
HCPCS,D7250,Tooth root removal,,,611.63,1812.01,27
HCPCS,D7251,"CORONECTOMY ? INTENTIONAL PARTIAL TOOTH REMOVAL, IMPACTED TEETH",600.0,390.0,1.1,770.61,31
HCPCS,D7251,Coronectomy,,,1358.5,4348.85,27
HCPCS,D7252,Part extract for implant,,,1358.5,1573.0,8
HCPCS,D7259,Nerve dissection,,,1358.5,1573.0,8
HCPCS,D7260,OROANTRAL FISTULA CLOSURE,1600.0,1040.0,1.1,4816.53,31
HCPCS,D7260,Oral antral fistula closure,,,611.63,1812.01,27
HCPCS,D7261,PRIMARY CLOSURE OF A SINUS PERFORATION,1100.0,715.0,1.1,4720.48,31
HCPCS,D7261,Primary closure sinus perf,,,611.63,1812.01,27
HCPCS,D7270,TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSE,800.0,520.0,1.1,998.54,31
HCPCS,D7270,Tooth reimplantation,,,611.63,1812.01,27
HCPCS,D7272,TOOTH TRANSPLANTATION (INCLUDES REIMPLANTATION FROM ONE SITE TO,1000.0,650.0,1.1,1420.08,31
HCPCS,D7272,Tooth transplantation,,,611.63,1812.01,27
HCPCS,D7280,Exposure of unerupted tooth,,,611.63,1812.01,27
HCPCS,D7282,MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION,600.0,390.0,1.1,925.99,31
HCPCS,D7282,Mobilize erupted/malpos toot,,,1358.5,1573.0,8
HCPCS,D7283,PLACEMENT OF DEVICE TO FACILITATE ERUPTION OF IMPACTED TOOTH,600.0,390.0,1.1,925.99,31
HCPCS,D7283,Place device impacted tooth,,,1358.5,1573.0,8
HCPCS,D7284,Exc biopsy of saliv glands,,,1358.5,1573.0,8
HCPCS,D7285,Biopsy of oral tissue hard,,,1358.5,1573.0,8
HCPCS,D7285,"INCISIONAL BIOPSY OF ORAL TISSUE-HARD (BONE, TOOTH)",800.0,520.0,1.1,1934.9,31
HCPCS,D7286,Biopsy of oral tissue soft,,,1358.5,1573.0,8
HCPCS,D7286,INCISIONAL BIOPSY OF ORAL TISSUE-SOFT,500.0,325.0,1.1,794.69,31
HCPCS,D7287,EXFOLIATIVE CYTOLOGICAL SAMPLE COLLECTION,300.0,195.0,1.1,300.0,31
HCPCS,D7287,Exfoliative cytolog collect,,,1358.5,1573.0,8
HCPCS,D7288,BRUSH BIOPSY - TRANSEPITHELIAL SAMPLE COLLECTION,300.0,195.0,1.1,1934.9,31
HCPCS,D7288,Brush biopsy,,,1358.5,1573.0,8
HCPCS,D7290,Repositioning of teeth,,,1358.5,1573.0,8
HCPCS,D7290,SURGICAL REPOSITIONING OF TEETH,600.0,390.0,1.1,1339.03,31
HCPCS,D7291,"TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT",400.0,260.0,1.1,1036.55,31
HCPCS,D7291,Transseptal fiberotomy,,,611.63,1812.01,27
HCPCS,D7292,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE [SCREW RETAINED PLATE] R,3900.0,2535.0,1.1,8519.64,31
HCPCS,D7292,Screw retained plate,,,1358.5,1573.0,8
HCPCS,D7293,Temp anchorage dev w flap,,,1358.5,1573.0,8
HCPCS,D7294,Temp anchorage dev w/o flap,,,1358.5,1573.0,8
HCPCS,D7295,"Bone harvest,auto graft proc",,,1358.5,1573.0,8
HCPCS,D7295,HARVEST OF BONE FOR USE IN AUTOGENOUS GRAFTING PROCEDURE,1400.0,910.0,1.1,2272.05,31
HCPCS,D7296,"CORTICOTOMY ? ONE TO THREE TEETH OR TOOTH SPACES, PER QUADRANT",1800.0,1170.0,1.1,1948.1,31
HCPCS,D7296,"Corticotomy, 1-3 teeth",,,1358.5,1573.0,8
HCPCS,D7297,"CORTICOTOMY ? FOUR OR MORE TEETH OR TOOTH SPACES, PER QUADRANT",1500.0,975.0,1.1,2028.4,31
HCPCS,D7297,"Corticotomy, 4 or more teeth",,,1358.5,1573.0,8
HCPCS,D7298,Remove screw retained plate,,,1358.5,1573.0,8
HCPCS,D7299,Rem anchorage device w/flap,,,1358.5,1573.0,8
HCPCS,D7300,Rem anchorage dev w/o flap,,,1358.5,1573.0,8
HCPCS,D7310,ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEE,500.0,325.0,1.1,542.47,31
HCPCS,D7310,Alveoplasty w/ extraction,,,1358.5,4348.85,27
HCPCS,D7311,Alveoloplasty w/extract 1-3,,,1358.5,4348.85,27
HCPCS,D7320,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE,700.0,455.0,1.1,2418.63,31
HCPCS,D7320,Alveoplasty w/o extraction,,,1358.5,4348.85,27
HCPCS,D7321,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE,600.0,390.0,1.1,2418.63,31
HCPCS,D7321,Alveoloplasty not w/extracts,,,1358.5,4348.85,27
HCPCS,D7340,VESTIBULOPLASTY - RIDGE EXTENSION (SECONDARY EPITHELIALIZATION),1800.0,1170.0,1.1,4329.35,31
HCPCS,D7340,Vestibuloplasty ridge extens,,,1358.5,16592.38,27
HCPCS,D7350,"VESTIBULOPLASTY - RIDGE EXTENSION (INCLUDING SOFT TISSUE GRAFTS,",3600.0,2340.0,1.1,13533.95,31
HCPCS,D7350,Vestibuloplasty exten graft,,,1358.5,16592.38,27
HCPCS,D7410,EXCISION OF BENIGN LESION UP TO 1.25 CM,600.0,390.0,1.1,3006.01,31
HCPCS,D7410,Rad exc lesion up to 1.25 cm,,,1358.5,4348.85,27
HCPCS,D7411,EXCISION OF BENIGN LESION GREATER THAN 1.25 CM,800.0,520.0,1.1,800.0,31
HCPCS,D7411,Excision benign lesion>1.25c,,,1358.5,4348.85,27
HCPCS,D7412,"EXCISION OF BENIGN LESION, COMPLICATED",1500.0,975.0,1.1,2947.27,31
HCPCS,D7412,Excision benign lesion compl,,,1358.5,4348.85,27
HCPCS,D7413,EXCISION OF MALIGNANT LESION UP TO 1.25 CM,1000.0,650.0,1.1,3044.02,31
HCPCS,D7413,Excision malig lesion<=1.25c,,,1358.5,4348.85,27
HCPCS,D7414,EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM,1500.0,975.0,1.1,4733.6,31
HCPCS,D7414,Excision malig lesion>1.25cm,,,1358.5,4348.85,27
HCPCS,D7415,"EXCISION OF MALIGNANT LESION, COMPLICATED",1600.0,1040.0,1.1,4733.6,31
HCPCS,D7415,Excision malig les complicat,,,1358.5,4348.85,27
HCPCS,D7440,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER UP TO 1.25 CM,1200.0,780.0,1.1,3044.02,31
HCPCS,D7440,Malig tumor exc to 1.25 cm,,,1358.5,9292.73,27
HCPCS,D7441,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER GREATER THAN 1.25,2100.0,1365.0,1.1,4733.6,31
HCPCS,D7441,Malig tumor > 1.25 cm,,,1358.5,9292.73,27
HCPCS,D7450,REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER UP,900.0,585.0,1.1,1724.13,31
HCPCS,D7450,Rem odontogen cyst to 1.25cm,,,1358.5,9292.73,27
HCPCS,D7451,Rem odontogen cyst > 1.25 cm,,,1358.5,9292.73,27
HCPCS,D7460,Rem nonodonto cyst to 1.25cm,,,611.63,1812.01,27
HCPCS,D7461,Rem nonodonto cyst > 1.25 cm,,,611.63,1812.01,27
HCPCS,D7465,Lesion destruction,,,1358.5,1573.0,8
HCPCS,D7471,REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE),900.0,585.0,1.1,1727.59,31
HCPCS,D7471,Rem exostosis any site,,,1358.5,9292.73,27
HCPCS,D7472,REMOVAL OF TORUS PALATINUS,1300.0,845.0,1.1,1727.59,31
HCPCS,D7472,Removal of torus palatinus,,,611.63,1812.01,27
HCPCS,D7473,REMOVE TORUS MANDIBULARIS,1300.0,845.0,1.1,1727.59,31
HCPCS,D7473,Remove torus mandibularis,,,611.63,1812.01,27
HCPCS,D7485,SURG REDUCT OSSEOUSTUBEROSIT,1100.0,715.0,1.1,2363.34,31
HCPCS,D7485,Surg reduct osseoustuberosit,,,1358.5,16592.38,27
HCPCS,D7490,Maxilla or mandible resectio,,,3594.14,4161.63,8
HCPCS,D7490,RADICAL RESECTION OF MAXILLA OR MANDIBLE,9500.0,6175.0,1.1,24431.61,31
HCPCS,D7509,Marsupialization odon cyst,,,1358.5,1573.0,8
HCPCS,D7510,I&d absc intraoral soft tiss,,,650.1,1984.79,27
HCPCS,D7510,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE,400.0,260.0,1.1,518.28,31
HCPCS,D7511,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPL,500.0,325.0,1.1,518.28,31
HCPCS,D7511,Incision/drain abscess intra,,,650.1,1984.79,27
HCPCS,D7520,I&d abscess extraoral,,,45.8,1984.79,27
HCPCS,D7521,INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE - COMPL,800.0,520.0,1.1,2463.55,31
HCPCS,D7521,Incision/drain abscess extra,,,650.1,1984.79,27
HCPCS,D7530,Removal fb skin/areolar tiss,,,611.63,1812.01,27
HCPCS,D7540,"REMOVAL OF REACTION PRODUCING FOREIGN BODIES, MUSCULOSKELETAL SY",900.0,585.0,1.1,984.73,31
HCPCS,D7540,Removal of fb reaction,,,611.63,1812.01,27
HCPCS,D7550,PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE,500.0,325.0,1.1,615.02,31
HCPCS,D7550,Removal of sloughed off bone,,,611.63,1812.01,27
HCPCS,D7560,MAXILLARY SINUSOTOMY FOR REMOVAL OF TOOTH FRAGMENT OR FOREIGN BO,2000.0,1300.0,1.1,4871.81,31
HCPCS,D7560,Maxillary sinusotomy,,,1358.5,1573.0,8
HCPCS,D7610,Maxilla open reduct simple,,,3594.14,4161.63,8
HCPCS,D7620,Clsd reduct simpl maxilla fx,,,1634.67,1892.77,8
HCPCS,D7630,Open red simpl mandible fx,,,3594.14,4161.63,8
HCPCS,D7640,Clsd red simpl mandible fx,,,1634.67,1892.77,8
HCPCS,D7650,Open red simp malar/zygom fx,,,1634.67,1892.77,8
HCPCS,D7660,Clsd red simp malar/zygom fx,,,234.24,271.23,8
HCPCS,D7670,"ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH",2000.0,1300.0,1.1,3842.16,31
HCPCS,D7670,Closd rductn splint alveolus,,,234.24,9292.73,27
HCPCS,D7671,Alveolus open reduction,,,234.24,16592.38,27
HCPCS,D7680,Reduct simple facial bone fx,,,3594.14,4161.63,8
HCPCS,D7710,Maxilla open reduct compound,,,3594.14,4161.63,8
HCPCS,D7720,Clsd reduct compd maxilla fx,,,234.24,271.23,8
HCPCS,D7730,Open reduct compd mandble fx,,,3594.14,4161.63,8
HCPCS,D7740,Clsd reduct compd mandble fx,,,3594.14,4161.63,8
HCPCS,D7750,Open red comp malar/zygma fx,,,3594.14,4161.63,8
HCPCS,D7760,Clsd red comp malar/zygma fx,,,234.24,271.23,8
HCPCS,D7770,Open reduc compd alveolus fx,,,234.24,16592.38,27
HCPCS,D7771,Alveolus clsd reduc stblz te,,,234.24,9292.73,27
HCPCS,D7780,Reduct compnd facial bone fx,,,3594.14,4161.63,8
HCPCS,D7810,TMJ OPEN REDUCT-DISLOCATION,6000.0,3900.0,1.1,8665.61,31
HCPCS,D7810,Tmj open reduct-dislocation,,,3594.14,4161.63,8
HCPCS,D7820,CLOSED REDUCTION OF DISLOCATION,900.0,585.0,1.1,1420.08,31
HCPCS,D7820,Closed tmp manipulation,,,1358.5,1573.0,8
HCPCS,D7830,Tmj manipulation under anest,,,654.6,757.96,8
HCPCS,D7840,Removal of tmj condyle,,,3594.14,4161.63,8
HCPCS,D7850,Tmj meniscectomy,,,3594.14,4161.63,8
HCPCS,D7852,Tmj repair of joint disc,,,3594.14,4161.63,8
HCPCS,D7854,Tmj excisn of joint membrane,,,3594.14,4161.63,8
HCPCS,D7856,Tmj cutting of a muscle,,,3594.14,4161.63,8
HCPCS,D7858,Tmj reconstruction,,,3594.14,4161.63,8
HCPCS,D7860,Tmj cutting into joint,,,3594.14,4161.63,8
HCPCS,D7865,Tmj reshaping components,,,3594.14,4161.63,8
HCPCS,D7870,Tmj aspiration joint fluid,,,138.73,160.63,8
HCPCS,D7871,Lysis + lavage w catheters,,,1358.5,1573.0,8
HCPCS,D7872,Tmj diagnostic arthroscopy,,,1358.5,1573.0,8
HCPCS,D7873,Tmj arthroscopy lysis adhesn,,,3594.14,4161.63,8
HCPCS,D7874,Tmj arthroscopy disc reposit,,,2997.95,9170.92,27
HCPCS,D7875,Tmj arthroscopy synovectomy,,,3594.14,4161.63,8
HCPCS,D7876,Tmj arthroscopy discectomy,,,3594.14,4161.63,8
HCPCS,D7877,Tmj arthroscopy debridement,,,3594.14,4161.63,8
HCPCS,D7880,"OCCLUSAL ORTHOTIC DEVICE, BY REPORT",1400.0,910.0,1.1,1506.46,31
HCPCS,D7880,Occlusal orthotic appliance,,,1358.5,1573.0,8
HCPCS,D7881,OCCLUSAL ORTHOTIC DEVICE ADJUSTMENT,250.0,162.5,1.1,518.28,31
HCPCS,D7881,Occ orthotic device adjust,,,45.8,53.03,8
HCPCS,D7899,Tmj unspecified therapy,,,1358.5,1573.0,8
HCPCS,D7899,"UNSPECIFIED TMD THERAPY, BY REPORT",700.0,455.0,0.01,700.0,28
HCPCS,D7910,Dent sutur recent wnd to 5cm,,,1358.5,1573.0,8
HCPCS,D7911,Dental suture wound to 5 cm,,,1358.5,1573.0,8
HCPCS,D7912,Suture complicate wnd > 5 cm,,,1358.5,1573.0,8
HCPCS,D7920,Dental skin graft,,,1358.5,1573.0,8
HCPCS,D7921,COLLECTION AND APPLICATION OF AUTOLOGOUS BLOOD CONCENTRATE PRODU,600.0,390.0,1.1,1420.08,31
HCPCS,D7921,Collect & appl blood product,,,45.8,53.03,8
HCPCS,D7922,PLACEMENT OF INTRA-SOCKET BIOLOGICAL DRESSING TO AID IN HEMOSTAS,150.0,97.5,1.1,324.8,25
HCPCS,D7922,Place intra-socket bio dress,,,45.8,1812.01,27
HCPCS,D7939,Indexing for osteotomy,,,23.21,26.87,8
HCPCS,D7940,Reshaping bone orthognathic,,,611.63,4161.63,27
HCPCS,D7941,Bone cutting ramus closed,,,3594.14,4161.63,8
HCPCS,D7943,Cutting ramus open w/graft,,,3594.14,4161.63,8
HCPCS,D7944,BONE CUTTING SEGMENTED,9000.0,5850.0,1.1,16152.99,31
HCPCS,D7944,Bone cutting segmented,,,3594.14,4161.63,8
HCPCS,D7945,Bone cutting body mandible,,,3594.14,4161.63,8
HCPCS,D7946,Reconstruction maxilla total,,,3594.14,4161.63,8
HCPCS,D7947,Reconstruct maxilla segment,,,3594.14,4161.63,8
HCPCS,D7948,Reconstruct midface no graft,,,3594.14,4161.63,8
HCPCS,D7949,Reconstruct midface w/graft,,,3594.14,4161.63,8
HCPCS,D7950,Mandible graft,,,1634.67,16592.38,27
HCPCS,D7950,"OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR",3700.0,2405.0,1.1,3700.0,31
HCPCS,D7951,SINUS AUGMENTATION WITH BONE OR BONE SUBSTITUTES VIA A LATERAL O,3900.0,2535.0,1.1,3900.0,31
HCPCS,D7951,Sinus aug w bone or bone sub,,,1634.67,1892.77,8
HCPCS,D7952,SINUS AUGMENTATION VIA A VERTICAL APPROACH,2800.0,1820.0,1.1,2800.0,31
HCPCS,D7952,Sinus augmentation vertical,,,1634.67,1892.77,8
HCPCS,D7953,BONE REPLACEMENT GRAFT FOR RIDGE PRESERVATION - PER SITE,900.0,585.0,1.1,2764.15,31
HCPCS,D7953,Bone replacement graft,,,1634.67,1892.77,8
HCPCS,D7955,REPAIR OF MAXILLOFACIAL SOFT AND/OR HARD TISSUE DEFECT,4000.0,2600.0,1.1,17275.92,31
HCPCS,D7955,Repair maxillofacial defects,,,1634.67,1892.77,8
HCPCS,D7956,Tiss regen edent resorb,,,45.8,53.03,8
HCPCS,D7957,Tiss regen edent nonresorb,,,45.8,53.03,8
HCPCS,D7960,Frenulectomy/frenectomy,,,1358.5,1573.0,8
HCPCS,D7961,Buccal/labial frenectomy,,,1358.5,1573.0,8
HCPCS,D7962,Lingual frenectomy,,,1358.5,1573.0,8
HCPCS,D7963,Frenuloplasty,,,1358.5,1573.0,8
HCPCS,D7970,EXCISION OF HYPERPLASTIC TISSUE - PER ARCH,700.0,455.0,1.1,1174.77,31
HCPCS,D7970,Excision hyperplastic tissue,,,1358.5,1573.0,8
HCPCS,D7971,EXCISION OF PERICORONAL GINGIVA,400.0,260.0,1.1,400.0,31
HCPCS,D7971,Excision pericoronal gingiva,,,1358.5,1573.0,8
HCPCS,D7972,SURGICAL REDUCTION OF FIBROUS TUBEROSITY,1000.0,650.0,1.1,1000.0,31
HCPCS,D7972,Surg redct fibrous tuberosit,,,1358.5,1573.0,8
HCPCS,D7979,NON ? SURGICAL SIALOLITHOTOMY,850.0,552.5,1.1,850.0,25
HCPCS,D7979,Non-surgical sialolithotomy,,,1358.5,1573.0,8
HCPCS,D7980,Surgical sialolithotomy,,,1358.5,1573.0,8
HCPCS,D7981,Excision of salivary gland,,,1358.5,1573.0,8
HCPCS,D7982,Sialodochoplasty,,,1358.5,1573.0,8
HCPCS,D7983,Closure of salivary fistula,,,1358.5,1573.0,8
HCPCS,D7991,Dental coronoidectomy,,,3594.14,4161.63,8
HCPCS,D7993,Surg place craniofacial impl,,,1634.67,1892.77,8
HCPCS,D7994,Surg place zygomatic impl,,,1634.67,1892.77,8
HCPCS,D7995,Synthetic graft facial bones,,,3594.14,4161.63,8
HCPCS,D7996,Implant mandible for augment,,,1634.67,1892.77,8
HCPCS,D7997,Appliance removal,,,1358.5,1573.0,8
HCPCS,D7998,Intraoral place of fix dev,,,1358.5,1573.0,8
HCPCS,D7999,Oral surgery procedure,,,1358.5,1573.0,8
HCPCS,D7999,"UNSPECIFIED ORAL SURGERY PROCEDURE, BY REPORT",850.0,552.5,0.01,850.0,28
HCPCS,D8010,LIMITED ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION,3500.0,2275.0,1.1,3500.0,31
HCPCS,D8010,Limited dental tx primary,,,1358.5,1573.0,8
HCPCS,D8020,LIMITED ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION,3000.0,1950.0,1.1,4837.26,31
HCPCS,D8020,Limited dental tx transition,,,1358.5,1573.0,8
HCPCS,D8030,Limited dental tx adolescent,,,1358.5,1573.0,8
HCPCS,D8040,Limited dental tx adult,,,1358.5,1573.0,8
HCPCS,D8050,Intercep dental tx primary,,,1358.5,1573.0,8
HCPCS,D8060,Intercep dental tx transitn,,,1358.5,1573.0,8
HCPCS,D8070,Compre dental tx transition,,,1358.5,1573.0,8
HCPCS,D8080,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION,5500.0,3575.0,1.1,16584.89,31
HCPCS,D8080,Compre dental tx adolescent,,,1358.5,1573.0,8
HCPCS,D8090,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADULT DENTITION,6000.0,3900.0,1.1,17275.92,31
HCPCS,D8090,Compre dental tx adult,,,1358.5,1573.0,8
HCPCS,D8090,REFINEMENT ORTHODONTIC TREATMENT OF THE ADULT DENTITION,200.0,130.0,1.1,17275.92,31
HCPCS,D8091,Compre ortho treat w surg,,,1634.67,1892.77,8
HCPCS,D8210,Orthodontic rem appliance tx,,,1358.5,1573.0,8
HCPCS,D8210,REMOVABLE APPLIANCE THERAPY,500.0,325.0,1.1,853.88,31
HCPCS,D8220,Fixed appliance therapy habt,,,1358.5,1573.0,8
HCPCS,D8660,PRE-ORTHODONTIC TREATMENT EXAMINATION TO MONITOR GROWTH AND DEVE,400.0,260.0,1.1,400.0,31
HCPCS,D8660,Preorthodontic tx visit,,,1358.5,1573.0,8
HCPCS,D8670,PERIODIC ORTHODONTIC TREATMENT VISIT,400.0,260.0,1.1,525.19,31
HCPCS,D8670,Periodic orthodontc tx visit,,,1358.5,1573.0,8
HCPCS,D8671,Periodic orth treat w surg,,,1358.5,1573.0,8
HCPCS,D8680,"ORTHODONTIC RETENTION (REMOVAL OF APPLIANCES, CONSTRUCTION AND P",600.0,390.0,1.1,1154.03,31
HCPCS,D8680,ORTHODONTIC RETENTION LOWER,250.0,162.5,1.1,1154.03,31
HCPCS,D8680,ORTHODONTIC RETENTION UPPER,250.0,162.5,1.1,1154.03,31
HCPCS,D8680,Orthodontic retention,,,1358.5,1573.0,8
HCPCS,D8681,REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT,275.0,178.75,1.1,863.79,31
HCPCS,D8681,Removable retainer adjust,,,45.8,53.03,8
HCPCS,D8690,Orthodontic treatment,,,1358.5,1573.0,8
HCPCS,D8695,REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN C,300.0,195.0,1.1,300.0,25
HCPCS,D8695,Remove fixed ortho appliance,,,45.8,53.03,8
HCPCS,D8696,REPAIR OF ORTHODONTIC APPLIANCE - MAXILLARY,250.0,162.5,1.1,518.28,31
HCPCS,D8696,Rep of ortho appliance max,,,45.8,53.03,8
HCPCS,D8697,REPAIR OF ORTHODONTIC APPLIANCE - MANDIBULAR,250.0,162.5,1.1,518.28,31
HCPCS,D8697,Rep of ortho appliance man,,,45.8,53.03,8
HCPCS,D8698,RE-CEMENT OR RE-BOND FIXED RETAINER - MAXILLARY,300.0,195.0,1.1,863.79,31
HCPCS,D8698,Recement fixed retainer max,,,45.8,53.03,8
HCPCS,D8699,RE-CEMENT OR RE-BOND FIXED RETAINER - MANDIBULAR,300.0,195.0,1.1,863.79,31
HCPCS,D8699,Recement fixed retainer man,,,45.8,53.03,8
HCPCS,D8701,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MAXILLARY",250.0,162.5,1.1,863.79,31
HCPCS,D8701,Repair fixed retainer max,,,45.8,53.03,8
HCPCS,D8702,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MANDIBULAR",250.0,162.5,1.1,863.79,31
HCPCS,D8702,Repair of fixed retainer man,,,45.8,53.03,8
HCPCS,D8703,REPLACEMENT OF LOST OR BROKEN RETAINER - MAXILLARY,200.0,130.0,1.1,863.79,31
HCPCS,D8703,Replace broken retainer max,,,45.8,53.03,8
HCPCS,D8704,REPLACEMENT OF LOST OR BROKEN RETAINER - MANDIBULAR,200.0,130.0,1.1,863.79,31
HCPCS,D8704,Replace broken retainer man,,,45.8,53.03,8
HCPCS,D8999,INVISALIGN UPCHARGES,2200.0,1430.0,0.01,2200.0,28
HCPCS,D8999,ORTHODONTIC RECORDS,300.0,195.0,0.01,300.0,28
HCPCS,D8999,Orthodontic procedure,,,1358.5,1573.0,8
HCPCS,D8999,"UNSPECIFIED ORTHODONTIC PROCEDURE, BY REPORT",600.0,390.0,0.01,600.0,28
HCPCS,D9110,PALLIATIVE TREATMENT OF DENTAL PAIN ??PER VISIT,175.0,113.75,1.1,183.13,31
HCPCS,D9110,Palliative tx dental pain,,,45.8,53.03,8
HCPCS,D9120,FIXED PARTIAL DENTURE SECTIONING,300.0,195.0,1.1,570.11,31
HCPCS,D9120,Fix partial denture section,,,45.8,53.03,8
HCPCS,D9128,Photobio therpy-first 15 min,,,45.8,53.03,8
HCPCS,D9129,Photobio therpy-sub 15 mins,,,45.8,53.03,8
HCPCS,D9130,TEMPOROMANDIBULAR JOINT DYSFUNCTION ? NON-INVASIVE PHYSICAL THER,300.0,195.0,0.01,300.0,31
HCPCS,D9130,Temporomandibular joint dysf,,,24.68,28.58,8
HCPCS,D9210,Dent anesthesia w/o surgery,,,158.44,183.46,8
HCPCS,D9210,LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL P,100.0,65.0,1.1,100.0,31
HCPCS,D9211,Regional block anesthesia,,,158.44,183.46,8
HCPCS,D9212,Trigeminal block anesthesia,,,158.44,183.46,8
HCPCS,D9215,Local anesthesia,,,158.44,183.46,8
HCPCS,D9219,Eval mod/deep sed/gen anest,,,664.61,769.55,8
HCPCS,D9222,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MI,350.0,227.5,1.1,494.09,31
HCPCS,D9222,"Deep anest, 1st 15 min",,,158.44,183.46,8
HCPCS,D9223,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA ? EACH SUBSEQ,300.0,195.0,1.1,300.0,31
HCPCS,D9223,General anesth ea addl 15 mi,,,158.44,183.46,8
HCPCS,D9224,Gen anes adv air-15 min,,,158.44,183.46,8
HCPCS,D9225,Gen anes adv air-sub 15 min,,,158.44,183.46,8
HCPCS,D9230,Analgesia,,,158.44,183.46,8
HCPCS,D9230,"INHALATION OF NITROUS OXIDE/ANALGESIA, ANXIOLYSIS",100.0,65.0,1.1,100.2,31
HCPCS,D9239,"Iv mod sedation, 1st 15 min",,,158.44,183.46,8
HCPCS,D9243,ADMINISTRATION OF MODERATE SEDATION - INTRAVENOUS - EACH SUBSEQU,350.0,227.5,1.1,350.0,31
HCPCS,D9243,Iv sedation ea addl 15m,,,158.44,183.46,8
HCPCS,D9244,Office min sed drug enteral,,,158.44,183.46,8
HCPCS,D9245,Admin mod sedation-enteral,,,158.44,183.46,8
HCPCS,D9246,Mod sedation noniv-15 min,,,158.44,183.46,8
HCPCS,D9247,Mod sedation noniv-sub15min,,,158.44,183.46,8
HCPCS,D9248,Sedation (non-iv),,,158.44,183.46,8
HCPCS,D9310,Dental consultation,,,50.62,58.61,8
HCPCS,D9311,CONSULTATION WITH A MEDICAL HEALTH CARE PROFESSIONAL,250.0,162.5,1.1,290.24,31
HCPCS,D9311,Consult w/med hlth care prof,,,50.62,58.61,8
HCPCS,D9410,Dental house call,,,50.62,58.61,8
HCPCS,D9420,HOSPITAL OR AMBULATORY SURGICAL CENTER CALL,400.0,260.0,1.1,708.31,31
HCPCS,D9420,Hospital/asc call,,,50.62,58.61,8
HCPCS,D9430,OFFICE VISIT FOR OBSERVATION (DURING REGULARLY SCHEDULED HOURS),100.0,65.0,1.1,131.3,31
HCPCS,D9430,Office visit during hours,,,45.8,53.03,8
HCPCS,D9440,OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS,250.0,162.5,1.1,250.0,31
HCPCS,D9440,Office visit after hours,,,45.8,53.03,8
HCPCS,D9450,"CASE PRESENTATION,?SUBSEQUENT TO?DETAILED AND EXTENSIVE TREATMEN",240.0,156.0,1.1,390.43,31
HCPCS,D9450,Case presentation tx plan,,,17.35,20.09,8
HCPCS,D9610,Dent therapeutic drug inject,,,36.15,41.86,8
HCPCS,D9612,Thera par drugs 2 or > admin,,,36.15,41.86,8
HCPCS,D9613,INFILTRATION OF SUSTAINED RELEASE THERAPEUTIC DRUG ? SINGLE OR M,260.0,169.0,0.01,260.0,31
HCPCS,D9613,Infiltration thera drug,,,36.15,41.86,8
HCPCS,D9630,DRUGS OR MEDICAMENTS DISPENSED IN THE OFFICE FOR HOME USE,65.0,42.25,1.1,86.39,31
HCPCS,D9630,Drugs/meds disp for home use,,,45.8,53.03,8
HCPCS,D9910,APPLICATION OF DESENSITIZING MEDICAMENT,75.0,48.75,1.1,82.92,31
HCPCS,D9910,Dent appl desensitizing med,,,45.8,53.03,8
HCPCS,D9911,APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURF,100.0,65.0,1.1,224.59,31
HCPCS,D9911,Appl desensitizing resin,,,45.8,53.03,8
HCPCS,D9912,PRE-VISIT PATIENT SCREENING,180.0,117.0,1.1,1257.69,31
HCPCS,D9912,Pre-visit patient screening,,,50.62,58.61,8
HCPCS,D9913,Admin of neuromod,,,45.8,53.03,8
HCPCS,D9914,Admin of dermal fill,,,45.8,53.03,8
HCPCS,D9920,Behavior management,,,45.8,53.03,8
HCPCS,D9930,Treatment of complications,,,611.63,1812.01,27
HCPCS,D9932,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,31
HCPCS,D9932,Clean & inspect rem dent max,,,45.8,53.03,8
HCPCS,D9933,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MANDIBULA",125.0,81.25,1.1,224.59,31
HCPCS,D9933,Clean & inspect rem dent man,,,45.8,53.03,8
HCPCS,D9934,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,31
HCPCS,D9934,Clean rem part denture max,,,45.8,53.03,8
HCPCS,D9935,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MANDIBULAR",125.0,81.25,1.1,224.59,31
HCPCS,D9935,Clean rem part denture mand,,,45.8,53.03,8
HCPCS,D9936,Clean occ guard,,,45.8,53.03,8
HCPCS,D9938,Fab removable appliance,,,45.8,53.03,8
HCPCS,D9939,Placemnt removable appliance,,,45.8,53.03,8
HCPCS,D9941,FABRICATION OF ATHLETIC MOUTHGUARD,350.0,227.5,1.1,350.0,31
HCPCS,D9941,Fabrication athletic guard,,,45.8,53.03,8
HCPCS,D9942,REPAIR AND/OR RELINE OF OCCLUSAL GUARD,300.0,195.0,1.1,1364.8,31
HCPCS,D9942,Repair/reline occlusal guard,,,45.8,53.03,8
HCPCS,D9943,OCCLUSAL GUARD ADJUSTMENT,175.0,113.75,1.1,324.79,31
HCPCS,D9943,Occlusal guard adjustment,,,45.8,53.03,8
HCPCS,D9944,"OCCLUSAL GUARD ? HARD APPLIANCE, FULL ARCH",1600.0,1040.0,1.1,1600.0,31
HCPCS,D9944,"Occ guard, hard, full arch",,,45.8,1812.01,27
HCPCS,D9945,"OCCLUSAL GUARD ? SOFT APPLIANCE, FULL ARCH",700.0,455.0,1.1,700.0,31
HCPCS,D9945,"Occ guard, soft, full arch",,,611.63,1812.01,27
HCPCS,D9946,"OCCLUSAL GUARD ? HARD APPLIANCE, PARTIAL ARCH",700.0,455.0,0.01,700.0,31
HCPCS,D9946,"Occ guard, hard, part arch",,,611.63,1812.01,27
HCPCS,D9947,CUSTOM SLEEP APNEA APPLIANCE FABRICATION AND PLACEMENT,4000.0,2600.0,1.1,4000.0,31
HCPCS,D9947,Sleep apnea appliance,,,45.8,53.03,8
HCPCS,D9948,Adjust sleep apnea appliance,,,50.62,58.61,8
HCPCS,D9949,REPAIR OF CUSTOM SLEEP APNEA APPLIANCE,500.0,325.0,1.1,1257.69,28
HCPCS,D9949,Repair sleep apnea appliance,,,50.62,58.61,8
HCPCS,D9950,Occlusion analysis,,,45.8,1812.01,27
HCPCS,D9951,Limited occlusal adjustment,,,45.8,1812.01,27
HCPCS,D9951,OCCLUSAL ADJUSTMENT - LIMITED,250.0,162.5,1.1,250.0,31
HCPCS,D9952,Complete occlusal adjustment,,,611.63,1812.01,27
HCPCS,D9952,OCCLUSAL ADJUSTMENT - COMPLETE,900.0,585.0,1.1,1323.34,31
HCPCS,D9953,Reline sleep apnea appliance,,,50.62,58.61,8
HCPCS,D9954,Fab/del oral appliance thxpy,,,45.8,53.03,8
HCPCS,D9955,Oral app thxpy titration vis,,,664.61,769.55,8
HCPCS,D9956,Admin home sleep apnea test,,,802.93,929.71,8
HCPCS,D9957,Screening sleep disorders,,,802.93,929.71,8
HCPCS,D9959,Unspec sleep ap proc,,,50.62,58.61,8
HCPCS,D9961,Dup/copy patient's records,,,50.62,58.61,8
HCPCS,D9970,ENAMEL MICROABRASION,250.0,162.5,1.1,250.0,31
HCPCS,D9970,Enamel microabrasion,,,45.8,53.03,8
HCPCS,D9971,ODONTOPLASTY 1 - 2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS,200.0,130.0,1.1,200.0,31
HCPCS,D9971,Odontoplasty per tooth,,,45.8,53.03,8
HCPCS,D9972,Extrnl bleaching per arch,,,45.8,53.03,8
HCPCS,D9973,Extrnl bleaching per tooth,,,45.8,53.03,8
HCPCS,D9974,INTERNAL BLEACHING - PER TOOTH,350.0,227.5,1.1,350.0,31
HCPCS,D9974,Intrnl bleaching per tooth,,,45.8,53.03,8
HCPCS,D9975,"EXTERNAL BLEACHING FOR HOME APPLICATION, PER ARCH; INCLUDES MATE",400.0,260.0,1.1,400.0,31
HCPCS,D9975,External bleaching home app,,,45.8,53.03,8
HCPCS,D9985,Sales tax,,,50.62,58.61,8
HCPCS,D9986,MISSED APPOINTMENT,75.0,48.75,1.1,127.85,28
HCPCS,D9986,Missed appointment,,,50.62,58.61,8
HCPCS,D9987,Cancelled appointment,,,50.62,58.61,8
HCPCS,D9990,CERTIFIED TRANSLATION OR SIGN-LANGUAGE SERVICES ? PER VISIT,125.0,81.25,0.01,125.0,31
HCPCS,D9990,Trans or sign language svcs,,,50.62,58.61,8
HCPCS,D9991,"Case mgmt, appt barriers",,,17.35,20.09,8
HCPCS,D9991,DENTAL CASE MANAGEMENT ? ADDRESSING APPOINTMENT COMPLIANCE BARRI,125.0,81.25,0.01,125.0,31
HCPCS,D9992,"Case mgmt, care coordination",,,17.35,20.09,8
HCPCS,D9992,DENTAL CASE MANAGEMENT ? CARE COORDINATION,172.0,111.8,0.01,172.0,31
HCPCS,D9993,"Case mgmt, interviewing",,,17.35,20.09,8
HCPCS,D9993,DENTAL CASE MANAGEMENT ? MOTIVATIONAL INTERVIEWING,125.0,81.25,0.01,125.0,31
HCPCS,D9994,"Case mgmt, pt education",,,31.04,35.94,8
HCPCS,D9994,DENTAL CASE MANAGEMENT ? PATIENT EDUCATION TO IMPROVE ORAL HEALT,100.0,65.0,0.01,100.0,31
HCPCS,D9995,TELEDENTISTRY ? SYNCHRONOUS; REAL-TIME ENCOUNTER,300.0,195.0,1.1,300.0,25
HCPCS,D9995,Teledentistry real-time,,,45.8,53.03,8
HCPCS,D9996,TELEDENTISTRY ? ASYNCHRONOUS; INFORMATION STORED AND FORWARDED T,175.0,113.75,1.1,175.0,25
HCPCS,D9996,Teledentistry dent review,,,45.8,53.03,8
HCPCS,D9997,DENTAL CASE MANAGEMENT - PATIENTS WITH SPECIAL HEALTH CARE NEEDS,150.0,97.5,1.1,150.0,25
HCPCS,D9997,Dent case mgmt special needs,,,17.35,20.09,8
HCPCS,D9999,Adjunctive procedure,,,45.8,53.03,8
HCPCS,D9999,"UNSPECIFIED ADJUNCTIVE PROCEDURE, BY REPORT",300.0,195.0,0.01,300.0,28
HCPCS,E0100,CANES OF ANY MATERIAL,40.0,26.0,1.1,68.69,32
HCPCS,E0100,Cane adjust/fixed with tip,,,8.84,33.74,10
HCPCS,E0105,Cane adjust/fixed quad/3 pro,,,25.16,50.54,10
HCPCS,E0110,Crutch forearm pair,,,25.16,91.08,10
HCPCS,E0111,Crutch forearm each,,,25.16,48.06,10
HCPCS,E0112,Crutch underarm pair wood,,,28.98,56.65,10
HCPCS,E0113,Crutch underarm each wood,,,8.84,29.27,10
HCPCS,E0114,Crutch underarm pair no wood,,,28.98,48.82,10
HCPCS,E0116,Crutch underarm each no wood,,,26.24,33.56,10
HCPCS,E0117,Underarm springassist crutch,,,93.29,322.97,10
HCPCS,E0118,Crutch substitute,,,25.16,29.13,8
HCPCS,E0130,Walker rigid adjust/fixed ht,,,19.88,29.13,10
HCPCS,E0135,Walker folding adjust/fixed,,,19.95,29.13,10
HCPCS,E0140,Walker w trunk support,,,72.46,152.13,10
HCPCS,E0141,Rigid wheeled walker adj/fix,,,20.49,53.79,10
HCPCS,E0143,Walker folding wheeled w/o s,,,20.49,53.79,10
HCPCS,E0144,Enclosed walker w rear seat,,,116.77,322.97,10
HCPCS,E0147,Walker variable wheel resist,,,174.17,306.12,10
HCPCS,E0148,Heavyduty walker no wheels,,,35.82,53.79,10
HCPCS,E0149,Heavy duty wheeled walker,,,50.94,322.97,10
HCPCS,E0150,Combo walker-transport chair,,,531.62,615.56,8
HCPCS,E0152,"Walker, battery power wheels",,,25.16,29.13,8
HCPCS,E0153,Forearm crutch platform atta,,,25.16,38.02,10
HCPCS,E0154,Walker platform attachment,,,21.04,29.13,10
HCPCS,E0155,"Walker wheel attachment,pair",,,9.04,33.56,10
HCPCS,E0156,Walker seat attachment,,,6.7,10.24,10
HCPCS,E0157,Walker crutch attachment,,,25.16,30.11,10
HCPCS,E0158,Walker leg extenders set of4,,,9.72,33.56,10
HCPCS,E0159,Brake for wheeled walker,,,6.66,10.24,10
HCPCS,E0160,Sitz type bath or equipment,,,12.88,33.56,10
HCPCS,E0161,Sitz bath/equipment w/faucet,,,10.94,33.56,10
HCPCS,E0162,Sitz bath chair,,,46.46,87.16,10
HCPCS,E0163,Commode chair with fixed arm,,,22.63,53.79,10
HCPCS,E0165,Commode chair with detacharm,,,8.84,62.33,10
HCPCS,E0167,Commode chair pail or pan,,,4.93,10.24,10
HCPCS,E0168,Heavyduty/wide commode chair,,,46.46,59.17,10
HCPCS,E0170,Commode chair electric,,,46.46,834.38,10
HCPCS,E0171,Commode chair non-electric,,,28.98,156.45,10
HCPCS,E0172,Seat lift mechanism toilet,,,28.98,33.56,8
HCPCS,E0175,Commode chair foot rest,,,25.16,34.58,10
HCPCS,E0181,Press pad alternating w/ pum,,,28.98,77.13,10
HCPCS,E0182,"Replace pump, alt press pad",,,28.98,113.51,10
HCPCS,E0183,Press underlay alter w/pump,,,28.98,77.13,10
HCPCS,E0184,Dry pressure mattress,,,66.13,322.97,10
HCPCS,E0185,Gel pressure mattress pad,,,70.76,83.9,10
HCPCS,E0186,Air pressure mattress,,,8.84,96.12,10
HCPCS,E0187,Water pressure mattress,,,8.84,113.39,10
HCPCS,E0188,Synthetic sheepskin pad,,,11.05,33.56,10
HCPCS,E0189,Lambswool sheepskin pad,,,20.8,29.13,10
HCPCS,E0190,Positioning cushion,,,13.46,15.59,8
HCPCS,E0191,Protector heel or elbow,,,5.0,15.59,10
HCPCS,E0193,Powered air flotation bed,,,1022.49,3623.05,10
HCPCS,E0194,Air fluidized bed,,,25.16,16961.64,10
HCPCS,E0196,Gel pressure mattress,,,28.98,168.64,10
HCPCS,E0197,Air pressure pad for mattres,,,79.86,322.97,10
HCPCS,E0198,Water pressure pad for mattr,,,107.36,322.97,10
HCPCS,E0199,Dry pressure pad for mattres,,,12.37,33.56,10
HCPCS,E0200,Heat lamp without stand,,,25.16,61.33,10
HCPCS,E0201,Penile contractur devic manu,,,49.79,306.12,10
HCPCS,E0202,Phototherapy light w/ photom,,,25.16,356.84,10
HCPCS,E0203,Therapeutic lightbox tabletp,,,46.46,53.79,8
HCPCS,E0205,Heat lamp with stand,,,103.42,322.97,10
HCPCS,E0210,Electric heat pad standard,,,14.92,33.56,10
HCPCS,E0215,Electric heat pad moist,,,25.16,42.26,10
HCPCS,E0217,Water circ heat pad w pump,,,227.53,306.12,10
HCPCS,E0218,Fluid circ cold pad w pump,,,25.16,29.13,8
HCPCS,E0221,Infrared heating pad system,,,28.98,33.56,8
HCPCS,E0225,Hydrocollator unit,,,157.69,778.15,10
HCPCS,E0231,Wound warming device,,,28.98,33.56,8
HCPCS,E0232,Warming card for nwt,,,28.98,33.56,8
HCPCS,E0235,Paraffin bath unit portable,,,8.84,83.52,10
HCPCS,E0236,Pump for water circulating p,,,28.98,214.3,10
HCPCS,E0239,Hydrocollator unit portable,,,185.22,778.15,10
HCPCS,E0240,Bath/shower chair,,,28.98,33.56,8
HCPCS,E0241,Bath tub wall rail,,,28.98,33.56,8
HCPCS,E0242,Bath tub rail floor,,,28.98,33.56,8
HCPCS,E0243,Toilet rail,,,28.98,33.56,8
HCPCS,E0244,Toilet seat raised,,,28.98,33.56,8
HCPCS,E0245,Tub stool or bench,,,28.98,33.56,8
HCPCS,E0246,Transfer tub rail attachment,,,28.98,33.56,8
HCPCS,E0247,Trans bench w/wo comm open,,,28.98,33.56,8
HCPCS,E0248,Hdtrans bench w/wo comm open,,,28.98,33.56,8
HCPCS,E0249,Pad water circulating heat u,,,45.06,53.79,10
HCPCS,E0250,Hosp bed fixed ht w/ mattres,,,25.16,299.87,10
HCPCS,E0251,Hosp bed fixd ht w/o mattres,,,25.16,291.07,10
HCPCS,E0255,Hospital bed var ht w/ mattr,,,46.46,303.42,10
HCPCS,E0256,Hospital bed var ht w/o matt,,,25.16,293.47,10
HCPCS,E0260,Hosp bed semi-electr w/ matt,,,257.91,322.97,10
HCPCS,E0261,Hosp bed semi-electr w/o mat,,,46.46,303.42,10
HCPCS,E0265,Hosp bed total electr w/ mat,,,46.46,735.71,10
HCPCS,E0266,Hosp bed total elec w/o matt,,,46.46,640.15,10
HCPCS,E0270,Hospital bed institutional t,,,25.16,29.13,8
HCPCS,E0271,Mattress innerspring,,,53.19,322.97,10
HCPCS,E0272,Mattress foam rubber,,,46.46,70.61,10
HCPCS,E0273,Bed board,,,28.98,33.56,8
HCPCS,E0274,Over-bed table,,,28.98,33.56,8
HCPCS,E0275,Bed pan standard,,,5.91,10.24,10
HCPCS,E0276,Bed pan fracture,,,5.27,10.24,10
HCPCS,E0277,Powered pres-redu air mattrs,,,28.98,919.67,10
HCPCS,E0280,Bed cradle,,,13.42,33.56,10
HCPCS,E0290,Hosp bed fx ht w/o rails w/m,,,25.16,287.75,10
HCPCS,E0291,Hosp bed fx ht w/o rail w/o,,,28.98,220.3,10
HCPCS,E0292,Hosp bed var ht no sr w/matt,,,25.16,297.95,10
HCPCS,E0293,Hosp bed var ht no sr no mat,,,25.16,281.11,10
HCPCS,E0294,Hosp bed semi-elect w/ mattr,,,46.46,303.42,10
HCPCS,E0295,Hosp bed semi-elect w/o matt,,,46.46,303.42,10
HCPCS,E0296,Hosp bed total elect w/ matt,,,46.46,574.02,10
HCPCS,E0297,Hosp bed total elect w/o mat,,,46.46,506.53,10
HCPCS,E0300,Enclosed ped crib hosp grade,,,1087.21,1279.06,2
HCPCS,E0301,"Hd hosp bed, 350-600 lbs",,,278.93,805.28,10
HCPCS,E0302,Ex hd hosp bed > 600 lbs,,,264.38,2305.28,10
HCPCS,E0303,Hosp bed hvy dty xtra wide,,,278.93,819.67,10
HCPCS,E0304,Hosp bed xtra hvy dty x wide,,,264.38,2433.22,10
HCPCS,E0305,Rails bed side half length,,,8.84,53.94,10
HCPCS,E0310,Rails bed side full length,,,46.46,54.9,10
HCPCS,E0315,Bed accessory brd/tbl/supprt,,,28.98,33.56,8
HCPCS,E0316,Bed safety enclosure,,,46.46,974.76,10
HCPCS,E0325,Urinal male jug-type,,,3.87,15.59,10
HCPCS,E0326,Urinal female jug-type,,,4.21,10.24,10
HCPCS,E0328,"Ped hospital bed, manual",,,25.16,29.13,8
HCPCS,E0329,Ped hospital bed semi/elect,,,13433.1,15554.11,8
HCPCS,E0350,Control unit bowel system,,,13.46,15.59,8
HCPCS,E0352,Disposable pack w/bowel syst,,,13.46,15.59,8
HCPCS,E0370,Air elevator for heel,,,13.46,15.59,8
HCPCS,E0371,Nonpower mattress overlay,,,672.04,919.67,10
HCPCS,E0372,Powered air mattress overlay,,,672.04,919.67,10
HCPCS,E0373,Nonpowered pressure mattress,,,264.38,919.67,10
HCPCS,E0424,Stationary compressed gas 02,,,337.51,397.06,2
HCPCS,E0431,Portable gaseous 02,,,75.17,88.44,2
HCPCS,E0433,Portable liquid oxygen sys,,,157.28,185.04,2
HCPCS,E0434,Portable liquid 02,,,157.28,185.04,2
HCPCS,E0439,Stationary liquid 02,,,337.51,397.06,2
HCPCS,E0441,"Stationary o2 contents, gas",,,229.6,270.12,2
HCPCS,E0442,"Stationary o2 contents, liq",,,229.6,270.12,2
HCPCS,E0443,"Portable 02 contents, gas",,,206.12,242.49,2
HCPCS,E0444,"Portable 02 contents, liquid",,,206.12,242.49,2
HCPCS,E0445,Oximeter non-invasive,,,13.46,15.59,8
HCPCS,E0447,"Port o2 cont, liq over 4 lpm",,,309.2,363.76,2
HCPCS,E0457,Chest shell,,,264.38,306.12,8
HCPCS,E0459,Chest wrap,,,25.16,29.13,8
HCPCS,E0462,Rocking bed w/ or w/o side r,,,72.46,1641.5,10
HCPCS,E0465,Home vent invasive interface,,,531.62,5438.87,10
HCPCS,E0466,Home vent non-invasive inter,,,531.62,5438.87,10
HCPCS,E0467,Home vent multi-function,,,531.62,6350.26,10
HCPCS,E0468,Home vent dual fnct incl all,,,531.62,5847.25,10
HCPCS,E0469,Lung expans high oscil neb,,,531.62,6267.1,10
HCPCS,E0470,Rad w/o backup non-inv intfc,,,278.93,546.43,10
HCPCS,E0471,Rad w/backup non inv intrfc,,,264.38,1375.5,10
HCPCS,E0472,Rad w backup invasive intrfc,,,264.38,2134.92,10
HCPCS,E0480,Percussor elect/pneum home m,,,28.98,250.45,10
HCPCS,E0482,Cough stimulating device,,,672.04,2450.34,10
HCPCS,E0483,Hi freq chest wall oscil sys,,,531.62,6057.75,10
HCPCS,E0484,Non-elec oscillatory pep dvc,,,17.88,33.56,10
HCPCS,E0485,Oral device/appliance prefab,,,672.04,778.15,8
HCPCS,E0486,Oral device/appliance cusfab,,,264.38,306.12,8
HCPCS,E0487,Electronic spirometer,,,13.46,15.59,8
HCPCS,E0490,Control unit nm hw remote,,,433.58,615.56,10
HCPCS,E0491,Oral dv nm mouthpc hw remote,,,46.46,421.29,10
HCPCS,E0492,Control unit nm stim w phone,,,531.62,615.56,8
HCPCS,E0493,Oral dv/app neuromus mouthpi,,,46.46,53.79,8
HCPCS,E0500,Ippb all types,,,46.46,625.44,10
HCPCS,E0530,Electronic posa treatment,,,25.16,148.41,10
HCPCS,E0550,Humidif extens supple w ippb,,,25.16,242.81,10
HCPCS,E0555,Humidifier for use w/ regula,,,13.46,15.59,8
HCPCS,E0560,Humidifier supplemental w/ i,,,46.46,98.68,10
HCPCS,E0561,Humidifier nonheated w pap,,,25.16,38.42,10
HCPCS,E0562,Humidifier heated used w pap,,,57.88,322.97,10
HCPCS,E0565,Compressor air power source,,,25.16,216.5,10
HCPCS,E0570,Nebulizer with compression,,,25.16,30.83,10
HCPCS,E0572,Aerosol compressor adjust pr,,,28.98,157.69,10
HCPCS,E0574,Ultrasonic generator w svneb,,,28.98,229.34,10
HCPCS,E0575,Nebulizer ultrasonic,,,46.46,585.66,10
HCPCS,E0580,Nebulizer for use w/ regulat,,,46.46,65.85,10
HCPCS,E0585,Nebulizer w/ compressor & he,,,28.98,153.93,10
HCPCS,E0600,Suction pump portab hom modl,,,28.98,260.88,10
HCPCS,E0601,Cont airway pressure device,,,46.46,210.51,10
HCPCS,E0602,Manual breast pump,,,14.41,33.56,10
HCPCS,E0603,Electric breast pump,,,278.93,322.97,8
HCPCS,E0604,Hosp grade elec breast pump,,,25.16,29.13,8
HCPCS,E0605,Vaporizer room type,,,14.92,33.56,10
HCPCS,E0606,Drainage board postural,,,8.84,130.74,10
HCPCS,E0607,Blood glucose monitor home,,,25.16,38.06,10
HCPCS,E0610,Pacemaker monitr audible/vis,,,121.5,322.97,10
HCPCS,E0615,Pacemaker monitr digital/vis,,,264.38,333.33,10
HCPCS,E0616,Cardiac event recorder,,,159.5,184.68,8
HCPCS,E0617,Automatic ext defibrillator,,,72.46,1732.42,10
HCPCS,E0618,Apnea monitor,,,278.93,1597.48,10
HCPCS,E0619,Apnea monitor w recorder,,,672.04,778.15,8
HCPCS,E0620,Cap bld skin piercing laser,,,423.42,1183.93,10
HCPCS,E0621,Patient lift sling or seat,,,36.57,53.79,10
HCPCS,E0625,Patient lift bathroom or toi,,,13.46,15.59,8
HCPCS,E0627,"Seat lift mech, electric any",,,72.46,135.22,10
HCPCS,E0629,"Seat lift mech, non-electric",,,72.46,133.66,10
HCPCS,E0630,Patient lift hydraulic,,,46.46,296.59,10
HCPCS,E0635,Patient lift electric,,,46.46,577.26,10
HCPCS,E0636,Pt support & positioning sys,,,531.62,4985.68,10
HCPCS,E0637,Combination sit to stand sys,,,72.46,83.9,8
HCPCS,E0638,Standing frame sys,,,72.46,83.9,8
HCPCS,E0639,Moveable patient lift system,,,46.46,566.31,10
HCPCS,E0640,Fixed patient lift system,,,46.46,566.31,10
HCPCS,E0641,Multi-position stnd fram sys,,,72.46,83.9,8
HCPCS,E0642,Dynamic standing frame,,,72.46,83.9,8
HCPCS,E0650,Pneuma compresor non-segment,,,423.28,1183.93,10
HCPCS,E0651,Pneum compressor segmental,,,386.24,1183.93,10
HCPCS,E0652,Pneum compres w/cal pressure,,,2537.59,3667.14,10
HCPCS,E0655,Pneumatic appliance half arm,,,46.46,61.45,10
HCPCS,E0656,Segmental pneumatic trunk,,,264.38,329.25,10
HCPCS,E0657,Segmental pneumatic chest,,,262.94,309.34,10
HCPCS,E0658,Seg pneum comp 2 arm chest,,,264.38,716.28,10
HCPCS,E0659,Seg pneum comp head neck che,,,264.38,716.28,10
HCPCS,E0660,Pneumatic appliance full leg,,,46.46,80.48,10
HCPCS,E0665,Pneumatic appliance full arm,,,46.46,68.09,10
HCPCS,E0666,Pneumatic appliance half leg,,,46.46,68.89,10
HCPCS,E0667,Seg pneumatic appl full leg,,,72.46,184.64,10
HCPCS,E0668,Seg pneumatic appl full arm,,,179.54,778.15,10
HCPCS,E0669,Seg pneumatic appli half leg,,,46.46,99.16,10
HCPCS,E0670,Seg pneum int legs/trunk,,,264.38,716.24,10
HCPCS,E0671,Pressure pneum appl full leg,,,201.29,778.15,10
HCPCS,E0672,Pressure pneum appl full arm,,,72.46,184.04,10
HCPCS,E0673,Pressure pneum appl half leg,,,129.89,322.97,10
HCPCS,E0675,Pneumatic compression device,,,672.04,2191.13,10
HCPCS,E0676,Inter limb compress dev nos,,,1022.49,1183.93,8
HCPCS,E0677,Non pneum seq comp trunk,,,279.87,778.15,10
HCPCS,E0678,Non pneum seq comp full leg,,,46.46,184.48,10
HCPCS,E0679,Non pneum seq comp half leg,,,46.46,99.16,10
HCPCS,E0680,Non pneum comp control cal,,,2537.73,3667.14,10
HCPCS,E0681,Non pneu comp control w/o ca,,,378.08,1183.93,10
HCPCS,E0682,Non pneum compress full arm,,,181.92,778.15,10
HCPCS,E0683,Non pneu peristalic comp pmp,,,25.16,325.97,10
HCPCS,E0691,Uvl pnl 2 sq ft or less,,,435.18,1183.93,10
HCPCS,E0692,Uvl sys panel 4 ft,,,531.62,642.83,10
HCPCS,E0693,Uvl sys panel 6 ft,,,531.62,792.64,10
HCPCS,E0694,Uvl md cabinet sys 6 ft,,,2144.28,2522.66,2
HCPCS,E0700,Safety equipment,,,13.46,15.59,8
HCPCS,E0705,Transfer device,,,19.3,29.13,10
HCPCS,E0710,Restraints any type,,,13.46,15.59,8
HCPCS,E0711,Ue enclosure restr rom,,,28.98,33.56,8
HCPCS,E0715,Intravag pelvic floor kegel,,,531.62,615.56,8
HCPCS,E0716,Supp and acces intravag pelv,,,264.38,306.12,8
HCPCS,E0720,Tens two lead,,,72.46,365.4,10
HCPCS,E0730,Tens four lead,,,72.46,369.19,10
HCPCS,E0731,Conductive garment for tens/,,,72.46,447.64,10
HCPCS,E0732,Ces system,,,72.46,209.31,10
HCPCS,E0733,Trans elec nerv for trigemin,,,25.16,209.31,10
HCPCS,E0734,Ext up limb tremor stim wris,,,1523.65,1792.51,2
HCPCS,E0735,Non-invasive vagus nerv stim,,,177.91,778.15,10
HCPCS,E0736,Transcut tibial nerv stimula,,,177.91,209.31,2
HCPCS,E0738,Upper extremity rehab,,,6931.72,8154.89,2
HCPCS,E0739,Rehab sys active assist rt,,,264.38,6387.76,10
HCPCS,E0740,Non-implant pelv flr e-stim,,,253.26,306.12,10
HCPCS,E0743,Ext low ext nerve stimu rls,,,46.46,968.36,10
HCPCS,E0744,Neuromuscular stim for scoli,,,25.16,445.8,10
HCPCS,E0745,Neuromuscular stim for shock,,,25.16,510.09,10
HCPCS,E0746,Electromyograph biofeedback,,,72.46,83.9,8
HCPCS,E0747,Elec osteogen stim not spine,,,1884.71,2217.28,2
HCPCS,E0748,Elec osteogen stim spinal,,,1884.26,2216.76,2
HCPCS,E0749,Elec osteogen stim implanted,,,278.93,1377.26,10
HCPCS,E0755,Electronic salivary reflex s,,,25.16,29.13,8
HCPCS,E0760,Osteogen ultrasound stimltor,,,1565.89,1842.21,2
HCPCS,E0761,Nontherm electromgntc device,,,531.62,615.56,8
HCPCS,E0762,Trans elec jt stim dev sys,,,452.68,615.56,10
HCPCS,E0764,Functional neuromuscularstim,,,5359.91,6305.72,2
HCPCS,E0765,Nerve stimulator for tx n&v,,,25.16,29.13,8
HCPCS,E0766,Elec stim cancer treatment,,,25.16,65509.43,10
HCPCS,E0767,Intrabuc am rf emf cancer tx,,,531.62,615.56,8
HCPCS,E0769,Electric wound treatment dev,,,531.62,615.56,8
HCPCS,E0770,Functional electric stim nos,,,72.46,83.9,8
HCPCS,E0776,Iv pole,,,46.46,73.45,10
HCPCS,E0779,Amb infusion pump mechanical,,,8.84,95.28,10
HCPCS,E0780,Mech amb infusion pump <8hrs,,,13.46,59.09,10
HCPCS,E0781,External ambulatory infus pu,,,278.93,1236.76,10
HCPCS,E0782,Non-programble infusion pump,,,1962.09,2308.32,2
HCPCS,E0783,Programmable infusion pump,,,3965.27,4664.98,2
HCPCS,E0784,Ext amb infusn pump insulin,,,672.04,2230.0,10
HCPCS,E0785,Replacement impl pump cathet,,,672.04,2692.35,10
HCPCS,E0786,Implantable pump replacement,,,3867.76,4550.27,2
HCPCS,E0787,Cgs dose adj insulin inf pmp,,,672.04,778.15,8
HCPCS,E0791,Parenteral infusion pump sta,,,72.46,1469.26,10
HCPCS,E0830,Ambulatory traction device,,,46.46,53.79,8
HCPCS,E0840,Tract frame attach headboard,,,25.16,93.04,10
HCPCS,E0849,Cervical pneum trac equip,,,249.62,306.12,10
HCPCS,E0850,Traction stand free standing,,,46.46,82.2,10
HCPCS,E0855,DELUXE HOME TRACTION KIT,631.0,410.15,137.56,631.0,46
HCPCS,E0856,Cervic collar w air bladders,,,46.46,87.68,10
HCPCS,E0860,Tract equip cervical tract,,,28.98,37.14,10
HCPCS,E0870,Tract frame attach footboard,,,46.46,73.69,10
HCPCS,E0880,Trac stand free stand extrem,,,46.46,112.31,10
HCPCS,E0890,Traction frame attach pelvic,,,46.46,187.12,10
HCPCS,E0900,Trac stand free stand pelvic,,,46.46,133.78,10
HCPCS,E0910,Trapeze bar attached to bed,,,8.84,57.53,10
HCPCS,E0911,Hd trapeze bar attach to bed,,,28.98,209.23,10
HCPCS,E0912,Hd trapeze bar free standing,,,46.46,411.69,10
HCPCS,E0920,Fracture frame attached to b,,,28.98,263.0,10
HCPCS,E0930,Fracture frame free standing,,,28.98,260.28,10
HCPCS,E0935,Cont pas motion exercise dev,,,8.84,129.62,10
HCPCS,E0936,"Cpm device, other than knee",,,8.84,10.24,8
HCPCS,E0940,Trapeze bar free standing,,,28.98,107.11,10
HCPCS,E0941,Gravity assisted traction de,,,28.98,218.02,10
HCPCS,E0942,Cervical head harness/halter,,,8.84,11.43,10
HCPCS,E0944,Pelvic belt/harness/boot,,,19.0,33.56,10
HCPCS,E0945,Belt/harness extremity,,,21.41,33.56,10
HCPCS,E0946,Fracture frame dual w cross,,,25.16,286.55,10
HCPCS,E0947,Fracture frame attachmnts pe,,,258.86,306.12,10
HCPCS,E0948,Fracture frame attachmnts ce,,,241.4,306.12,10
HCPCS,E0950,Tray,,,32.35,53.79,10
HCPCS,E0951,Loop heel,,,5.71,10.24,10
HCPCS,E0952,"Toe loop/holder, each",,,6.9,10.24,10
HCPCS,E0953,W/c lateral thigh/knee sup,,,33.03,53.79,10
HCPCS,E0954,"Foot box, any type each foot",,,22.67,53.79,10
HCPCS,E0955,Cushioned headrest,,,61.85,322.97,10
HCPCS,E0956,W/c lateral trunk/hip suppor,,,33.03,53.79,10
HCPCS,E0957,W/c medial thigh support,,,46.46,59.29,10
HCPCS,E0958,Whlchr att- conv 1 arm drive,,,28.98,207.39,10
HCPCS,E0959,Amputee adapter,,,17.77,33.56,10
HCPCS,E0960,W/c shoulder harness/straps,,,25.16,37.14,10
HCPCS,E0961,Wheelchair brake extension,,,8.5,33.56,10
HCPCS,E0966,Wheelchair head rest extensi,,,25.16,35.9,10
HCPCS,E0967,Man wc rim/projection rep ea,,,25.16,36.1,10
HCPCS,E0968,Wheelchair commode seat,,,8.84,102.11,10
HCPCS,E0969,Wheelchair narrowing device,,,46.46,75.13,10
HCPCS,E0970,Wheelchair no. 2 footplates,,,8.84,10.24,8
HCPCS,E0971,Wheelchair anti-tipping devi,,,12.64,33.56,10
HCPCS,E0973,W/ch access det adj armrest,,,22.36,53.79,10
HCPCS,E0974,W/ch access anti-rollback,,,25.16,37.06,10
HCPCS,E0978,"W/c acc,saf belt pelv strap",,,10.5,33.56,10
HCPCS,E0980,Wheelchair safety vest,,,15.4,33.56,10
HCPCS,E0981,"Seat upholstery, replacement",,,17.03,33.56,10
HCPCS,E0982,"Back upholstery, replacement",,,18.22,29.13,10
HCPCS,E0983,Add pwr joystick,,,278.93,1424.08,10
HCPCS,E0984,Add pwr tiller,,,786.51,925.3,2
HCPCS,E0985,W/c seat lift mechanism,,,94.58,322.97,10
HCPCS,E0986,Man w/c powr assist syst,,,2355.98,3667.14,10
HCPCS,E0988,Lever-activated wheel drive,,,46.46,1705.71,10
HCPCS,E0990,Wheelchair elevating leg res,,,29.87,53.79,10
HCPCS,E0992,Wheelchair solid seat insert,,,25.16,40.58,10
HCPCS,E0994,Wheelchair arm rest,,,8.63,10.24,10
HCPCS,E0995,"Wc calf rest, pad replacemnt",,,10.81,33.56,10
HCPCS,E1002,Pwr seat tilt,,,1575.0,1852.93,2
HCPCS,E1003,Pwr seat recline,,,1833.15,2156.63,2
HCPCS,E1004,Pwr seat recline mech,,,2026.25,3667.14,10
HCPCS,E1005,Pwr seat recline pwr,,,2200.05,3667.14,10
HCPCS,E1006,Pwr seat combo w/o shear,,,2694.84,3667.14,10
HCPCS,E1007,Pwr seat combo w/shear,,,3392.42,3991.04,2
HCPCS,E1008,Pwr seat combo pwr shear,,,3479.69,4093.72,2
HCPCS,E1010,Add pwr leg elevation,,,472.87,615.56,10
HCPCS,E1011,Ped wc modify width adjustm,,,13.46,15.59,8
HCPCS,E1012,Ctr mount pwr elev leg rest,,,472.87,556.31,2
HCPCS,E1014,Reclining back add ped w/c,,,72.46,208.15,10
HCPCS,E1015,Shock absorber for man w/c,,,46.46,62.09,10
HCPCS,E1016,Shock absorber for power w/c,,,46.46,59.29,10
HCPCS,E1017,Hd shck absrbr for hd man wc,,,278.93,322.97,8
HCPCS,E1020,Residual limb support system,,,76.3,322.97,10
HCPCS,E1022,Wheelchr transport secur,,,28.98,33.56,8
HCPCS,E1023,Wheelchr transit securement,,,28.98,33.56,8
HCPCS,E1028,W/c manual swingaway,,,55.6,322.97,10
HCPCS,E1029,W/c vent tray fixed,,,72.46,181.4,10
HCPCS,E1030,W/c vent tray gimbaled,,,486.43,615.56,10
HCPCS,E1031,Rollabout chair with casters,,,25.16,214.94,10
HCPCS,E1032,Wheelchair joystick drive,,,55.6,322.97,10
HCPCS,E1033,Wheelchair hardware headrest,,,55.6,322.97,10
HCPCS,E1034,Wheelchair trunk hip support,,,55.6,322.97,10
HCPCS,E1035,Patient transfer system <300,,,264.38,2926.16,10
HCPCS,E1036,Patient transfer system >300,,,1022.49,4300.54,10
HCPCS,E1037,"Transport chair, ped size",,,46.46,552.39,10
HCPCS,E1038,Transport chair pt wt<=300lb,,,8.84,71.53,10
HCPCS,E1039,Transport chair pt wt >300lb,,,28.98,164.45,10
HCPCS,E1050,Whelchr fxd full length arms,,,46.46,580.38,10
HCPCS,E1060,Wheelchair detachable arms,,,46.46,718.28,10
HCPCS,E1070,Wheelchair detachable foot r,,,46.46,530.52,10
HCPCS,E1083,Hemi-wheelchair fixed arms,,,25.16,448.64,10
HCPCS,E1084,Hemi-wheelchair detachable a,,,46.46,558.95,10
HCPCS,E1085,Hemi-wheelchair fixed arms,,,46.46,53.79,8
HCPCS,E1086,Hemi-wheelchair detachable a,,,46.46,53.79,8
HCPCS,E1087,Wheelchair lightwt fixed arm,,,46.46,701.24,10
HCPCS,E1088,Wheelchair lightweight det a,,,46.46,767.89,10
HCPCS,E1089,Wheelchair lightwt fixed arm,,,278.93,322.97,8
HCPCS,E1090,Wheelchair lightweight det a,,,278.93,322.97,8
HCPCS,E1092,Wheelchair wide w/ leg rests,,,46.46,637.51,10
HCPCS,E1093,Wheelchair wide w/ foot rest,,,46.46,567.3,10
HCPCS,E1100,Whchr s-recl fxd arm leg res,,,46.46,502.73,10
HCPCS,E1110,Wheelchair semi-recl detach,,,46.46,510.65,10
HCPCS,E1130,Whlchr stand fxd arm ft rest,,,25.16,29.13,8
HCPCS,E1140,Wheelchair standard detach a,,,46.46,53.79,8
HCPCS,E1150,Wheelchair standard w/ leg r,,,25.16,464.79,10
HCPCS,E1160,Wheelchair fixed arms,,,25.16,356.2,10
HCPCS,E1161,Manual adult wc w tiltinspac,,,1145.94,1348.15,2
HCPCS,E1170,Whlchr ampu fxd arm leg rest,,,25.16,432.65,10
HCPCS,E1171,Wheelchair amputee w/o leg r,,,25.16,388.19,10
HCPCS,E1172,Wheelchair amputee detach ar,,,46.46,474.55,10
HCPCS,E1180,Wheelchair amputee w/ foot r,,,46.46,509.69,10
HCPCS,E1190,Wheelchair amputee w/ leg re,,,46.46,586.18,10
HCPCS,E1195,Wheelchair amputee heavy dut,,,46.46,608.41,10
HCPCS,E1200,Wheelchair amputee fixed arm,,,25.16,421.41,10
HCPCS,E1221,Wheelchair spec size w foot,,,28.98,270.76,10
HCPCS,E1222,Wheelchair spec size w/ leg,,,25.16,362.6,10
HCPCS,E1223,Wheelchair spec size w foot,,,25.16,421.73,10
HCPCS,E1224,Wheelchair spec size w/ leg,,,25.16,462.43,10
HCPCS,E1225,Manual semi-reclining back,,,28.98,197.55,10
HCPCS,E1226,Manual fully reclining back,,,156.91,306.12,10
HCPCS,E1227,Wheelchair spec sz spec ht a,,,114.29,322.97,10
HCPCS,E1228,Wheelchair spec sz spec ht b,,,28.98,159.69,10
HCPCS,E1229,Pediatric wheelchair nos,,,1022.49,1183.93,8
HCPCS,E1230,Power operated vehicle,,,1077.43,1267.55,2
HCPCS,E1232,Folding ped wc tilt-in-space,,,1035.79,1218.57,2
HCPCS,E1233,Rig ped wc tltnspc w/o seat,,,1073.11,1262.47,2
HCPCS,E1234,Fld ped wc tltnspc w/o seat,,,934.28,1099.15,2
HCPCS,E1235,Rigid ped wc adjustable,,,531.62,1058.4,10
HCPCS,E1236,Folding ped wc adjustable,,,531.62,933.78,10
HCPCS,E1237,Rgd ped wc adjstabl w/o seat,,,531.62,941.86,10
HCPCS,E1238,Fld ped wc adjstabl w/o seat,,,531.62,933.78,10
HCPCS,E1240,Whchr litwt det arm leg rest,,,46.46,587.06,10
HCPCS,E1250,Wheelchair lightwt fixed arm,,,46.46,53.79,8
HCPCS,E1260,Wheelchair lightwt foot rest,,,278.93,322.97,8
HCPCS,E1270,Wheelchair lightweight leg r,,,25.16,449.84,10
HCPCS,E1280,Whchr h-duty det arm leg res,,,46.46,684.33,10
HCPCS,E1285,Wheelchair heavy duty fixed,,,46.46,53.79,8
HCPCS,E1290,Wheelchair hvy duty detach a,,,46.46,53.79,8
HCPCS,E1295,Wheelchair heavy duty fixed,,,46.46,640.15,10
HCPCS,E1296,Wheelchair special seat heig,,,205.71,306.12,10
HCPCS,E1297,Wheelchair special seat dept,,,46.46,56.29,10
HCPCS,E1298,Wheelchair spec seat depth/w,,,178.42,778.15,10
HCPCS,E1310,Whirlpool non-portable,,,800.07,941.26,2
HCPCS,E1353,Oxygen supplies regulator,,,28.98,161.37,10
HCPCS,E1355,Oxygen supplies stand/rack,,,8.84,121.63,10
HCPCS,E1372,Oxy suppl heater for nebuliz,,,46.46,67.57,10
HCPCS,E1390,Oxygen concentrator,,,337.51,397.06,2
HCPCS,E1391,"Oxygen concentrator, dual",,,337.51,397.06,2
HCPCS,E1392,Portable oxygen concentrator,,,157.28,185.04,2
HCPCS,E1399,Durable medical equipment mi,,,13.46,15.59,8
HCPCS,E1405,O2/water vapor enrich w/heat,,,468.35,550.99,2
HCPCS,E1406,O2/water vapor enrich w/o he,,,363.71,427.89,2
HCPCS,E1500,Centrifuge,,,72.46,83.9,8
HCPCS,E1510,Kidney dialysate delivry sys,,,1022.49,1183.93,8
HCPCS,E1520,Heparin infusion pump,,,278.93,322.97,8
HCPCS,E1530,Replacement air bubble detec,,,28.98,33.56,8
HCPCS,E1540,Replacement pressure alarm,,,28.98,33.56,8
HCPCS,E1550,Bath conductivity meter,,,28.98,33.56,8
HCPCS,E1560,Replace blood leak detector,,,28.98,33.56,8
HCPCS,E1570,Adjustable chair for esrd pt,,,25.16,29.13,8
HCPCS,E1575,Transducer protect/fld bar,,,28.98,33.56,8
HCPCS,E1580,Unipuncture control system,,,28.98,33.56,8
HCPCS,E1590,Hemodialysis machine,,,13433.1,15554.11,8
HCPCS,E1594,Cycler dialysis machine,,,1022.49,1183.93,8
HCPCS,E1600,Deli/install chrg hemo equip,,,28.98,33.56,8
HCPCS,E1620,Replacement blood pump,,,278.93,322.97,8
HCPCS,E1625,Water softening system,,,72.46,83.9,8
HCPCS,E1629,Tablo for dialysis service,,,13433.1,15554.11,8
HCPCS,E1632,Wearable artificial kidney,,,1022.49,1183.93,8
HCPCS,E1634,Peritoneal dialysis clamp,,,28.98,33.56,8
HCPCS,E1635,Compact travel hemodialyzer,,,1022.49,1183.93,8
HCPCS,E1636,Sorbent cartridges per 10,,,28.98,33.56,8
HCPCS,E1637,"Hemostats for dialysis, each",,,28.98,33.56,8
HCPCS,E1639,"Scale, each",,,28.98,33.56,8
HCPCS,E1699,Dialysis equipment noc,,,13.46,15.59,8
HCPCS,E1700,Jaw motion rehab system,,,72.46,167.04,10
HCPCS,E1701,Repl cushions for jaw motion,,,8.84,60.41,10
HCPCS,E1702,Repl measr scales jaw motion,,,8.84,128.54,10
HCPCS,E1800,Adjust elbow ext & flex dev,,,46.46,698.01,10
HCPCS,E1801,Sps/pass elbow device,,,46.46,735.11,10
HCPCS,E1802,Adjst forearm pro/sup device,,,72.46,1862.16,10
HCPCS,E1803,Adjust elbow extension dev,,,46.46,698.01,10
HCPCS,E1804,Adjust elbow flexion dev,,,46.46,698.01,10
HCPCS,E1805,Adjust wrist ext & flex dev,,,46.46,719.96,10
HCPCS,E1806,Sps wrist device,,,46.46,603.61,10
HCPCS,E1807,Adjust wrist extension dev,,,46.46,719.96,10
HCPCS,E1808,Adjust wrist flexion device,,,46.46,719.96,10
HCPCS,E1810,Adjust knee ext & flex dev,,,46.46,709.92,10
HCPCS,E1811,Sps/pass knee device,,,46.46,764.18,10
HCPCS,E1812,Knee ext/flex w act res ctrl,,,25.16,489.98,10
HCPCS,E1813,Adjust knee extension device,,,46.46,709.92,10
HCPCS,E1814,Adjust knee flexion device,,,46.46,709.92,10
HCPCS,E1815,Adjust ankle ext & flex dev,,,46.46,719.96,10
HCPCS,E1816,Sps/pass ankle device,,,46.46,776.33,10
HCPCS,E1818,Sps/pass forearm device,,,46.46,792.48,10
HCPCS,E1820,Soft interface material,,,25.16,44.02,10
HCPCS,E1821,Replacement interface spsd,,,46.46,59.77,10
HCPCS,E1822,Adjust ankle extension dev,,,46.46,719.96,10
HCPCS,E1823,Adjust ankle flexion device,,,46.46,719.96,10
HCPCS,E1825,Adjust finger ext & flex dev,,,46.46,719.96,10
HCPCS,E1826,Adjust finger extension dev,,,46.46,719.96,10
HCPCS,E1827,Adjust finger flexion device,,,46.46,719.96,10
HCPCS,E1828,Adjust toe extension device,,,46.46,719.96,10
HCPCS,E1829,Adjust toe flexion device,,,46.46,719.96,10
HCPCS,E1830,Adjust toe ext & flex device,,,46.46,719.96,10
HCPCS,E1831,Static str toe dev ext/flex,,,25.16,376.43,10
HCPCS,E1832,Sps finger device,,,25.16,376.43,10
HCPCS,E1840,Adj shoulder ext/flex device,,,672.04,2180.7,10
HCPCS,E1841,Sps/pass shoulder device,,,672.04,2581.12,10
HCPCS,E1902,Aac non-electronic board,,,28.98,33.56,8
HCPCS,E1905,Vr cbt therapy,,,2293.21,2697.87,2
HCPCS,E2000,Gastric suction pump hme mdl,,,25.16,295.35,10
HCPCS,E2001,Suct pum ext mgmt sys,,,25.16,260.88,10
HCPCS,E2100,Bld glucose monitor w voice,,,264.38,366.59,10
HCPCS,E2101,Bld glucose monitor w lance,,,46.46,107.47,10
HCPCS,E2102,Adju cgm receiver/monitor,,,46.46,95.6,10
HCPCS,E2103,Non-adju cgm receiver/mon,,,46.46,120.47,10
HCPCS,E2104,Glucose monitor w cartridge,,,18.59,29.13,10
HCPCS,E2120,Pulse gen sys tx endolymp fl,,,278.93,1615.47,10
HCPCS,E2201,"Man w/ch acc seat w>=20""<24""",,,72.46,151.89,10
HCPCS,E2202,Seat width 24-27 in,,,191.3,778.15,10
HCPCS,E2203,Frame depth less than 22 in,,,178.8,306.12,10
HCPCS,E2204,Frame depth 22 to 25 in,,,319.05,1183.93,10
HCPCS,E2205,"Manual wc accessory, handrim",,,14.85,33.56,10
HCPCS,E2206,Man wc whl lock comp repl ea,,,16.11,33.56,10
HCPCS,E2207,Crutch and cane holder,,,19.64,33.56,10
HCPCS,E2208,Cylinder tank carrier,,,32.73,53.79,10
HCPCS,E2209,Arm trough each,,,36.06,53.79,10
HCPCS,E2210,Wheelchair bearings,,,2.45,15.59,10
HCPCS,E2211,Pneumatic propulsion tire,,,14.1,33.56,10
HCPCS,E2212,Pneumatic prop tire tube,,,2.72,15.59,10
HCPCS,E2213,Pneumatic prop tire insert,,,12.64,33.56,10
HCPCS,E2214,Pneumatic caster tire each,,,13.83,33.56,10
HCPCS,E2215,Pneumatic caster tire tube,,,4.35,15.59,10
HCPCS,E2216,Foam filled propulsion tire,,,8.84,23.83,10
HCPCS,E2217,Foam filled caster tire each,,,8.84,21.07,10
HCPCS,E2218,Foam propulsion tire each,,,8.84,23.83,10
HCPCS,E2219,Foam caster tire any size ea,,,17.91,33.56,10
HCPCS,E2220,"Solid propuls tire, repl, ea",,,11.72,33.56,10
HCPCS,E2221,"Solid caster tire repl, each",,,11.55,33.56,10
HCPCS,E2222,"Solid caster integ whl, repl",,,8.84,11.23,10
HCPCS,E2224,Propulsion whl excl tire rep,,,38.17,53.79,10
HCPCS,E2225,Caster wheel excludes tire,,,7.99,10.24,10
HCPCS,E2226,Caster fork replacement only,,,17.03,33.56,10
HCPCS,E2227,Gear reduction drive wheel,,,531.62,1066.0,10
HCPCS,E2228,"Mwc acc, wheelchair brake",,,406.63,1183.93,10
HCPCS,E2230,Manual standing system,,,8.84,10.24,8
HCPCS,E2231,Solid seat support base,,,46.46,70.49,10
HCPCS,E2291,Planar back for ped size wc,,,28.98,33.56,8
HCPCS,E2292,Planar seat for ped size wc,,,28.98,33.56,8
HCPCS,E2293,Contour back for ped size wc,,,28.98,33.56,8
HCPCS,E2294,Contour seat for ped size wc,,,28.98,33.56,8
HCPCS,E2295,Ped dynamic seating frame,,,28.98,33.56,8
HCPCS,E2298,Pwr seat elev sys for crt,,,714.84,840.98,2
HCPCS,E2310,Electro connect btw control,,,461.18,615.56,10
HCPCS,E2311,Electro connect btw 2 sys,,,930.65,1094.87,2
HCPCS,E2312,Mini-prop remote joystick,,,976.69,1149.04,2
HCPCS,E2313,"Pwc harness, expand control",,,72.46,182.6,10
HCPCS,E2321,Hand interface joystick,,,626.62,737.19,2
HCPCS,E2322,Mult mech switches,,,588.69,692.57,2
HCPCS,E2323,Special joystick handle,,,25.16,33.86,10
HCPCS,E2324,Chin cup interface,,,18.18,33.56,10
HCPCS,E2325,Sip and puff interface,,,531.62,661.46,10
HCPCS,E2326,Breath tube kit,,,72.46,170.52,10
HCPCS,E2327,Head control interface mech,,,1090.48,1282.9,2
HCPCS,E2328,Head/extremity control inter,,,2068.53,3667.14,10
HCPCS,E2329,Head control nonproportional,,,531.62,867.29,10
HCPCS,E2330,Head control proximity switc,,,1428.49,1680.56,2
HCPCS,E2340,W/c wdth 20-23 in seat frame,,,72.46,204.27,10
HCPCS,E2341,W/c wdth 24-27 in seat frame,,,260.33,306.26,10
HCPCS,E2342,W/c dpth 20-21 in seat frame,,,216.96,778.15,10
HCPCS,E2343,W/c dpth 22-25 in seat frame,,,347.12,1183.93,10
HCPCS,E2351,Electronic sgd interface,,,264.38,343.21,10
HCPCS,E2358,Gr 34 nonsealed leadacid,,,264.38,306.12,8
HCPCS,E2359,Gr34 sealed leadacid battery,,,72.86,306.12,10
HCPCS,E2360,22nf nonsealed leadacid,,,46.46,58.17,10
HCPCS,E2361,22nf sealed leadacid battery,,,46.46,57.53,10
HCPCS,E2362,Gr24 nonsealed leadacid,,,25.16,52.42,10
HCPCS,E2363,Gr24 sealed leadacid battery,,,46.46,75.17,10
HCPCS,E2364,U1nonsealed leadacid battery,,,46.46,56.05,10
HCPCS,E2365,U1 sealed leadacid battery,,,32.63,53.79,10
HCPCS,E2366,"Battery charger, single mode",,,67.9,322.97,10
HCPCS,E2367,"Battery charger, dual mode",,,159.49,778.15,10
HCPCS,E2368,Pwr wc drivewheel motor repl,,,181.0,306.12,10
HCPCS,E2369,Pwr wc drivewheel gear repl,,,171.15,778.15,10
HCPCS,E2370,Pwr wc dr wh motor/gear comb,,,219.92,1183.93,10
HCPCS,E2371,Gr27 sealed leadacid battery,,,46.46,71.09,10
HCPCS,E2373,Hand/chin ctrl spec joystick,,,335.98,615.56,10
HCPCS,E2374,Hand/chin ctrl std joystick,,,212.51,306.12,10
HCPCS,E2375,Non-expandable controller,,,285.1,1183.93,10
HCPCS,E2376,"Expandable controller, repl",,,527.96,621.12,10
HCPCS,E2377,"Expandable controller, initl",,,195.58,306.12,10
HCPCS,E2378,Pw actuator replacement,,,234.02,306.12,10
HCPCS,E2381,Pneum drive wheel tire,,,25.16,31.87,10
HCPCS,E2382,"Tube, pneum wheel drive tire",,,7.75,10.24,10
HCPCS,E2383,"Insert, pneum wheel drive",,,46.46,65.69,10
HCPCS,E2384,Pneumatic caster tire,,,25.16,32.35,10
HCPCS,E2385,"Tube, pneumatic caster tire",,,18.59,29.13,10
HCPCS,E2386,Foam filled drive wheel tire,,,43.81,53.79,10
HCPCS,E2387,Foam filled caster tire,,,22.33,29.13,10
HCPCS,E2388,Foam drive wheel tire,,,20.22,29.13,10
HCPCS,E2389,Foam caster tire,,,11.32,33.56,10
HCPCS,E2390,Solid drive wheel tire,,,17.5,33.56,10
HCPCS,E2391,Solid caster tire,,,7.78,10.24,10
HCPCS,E2392,"Solid caster tire, integrate",,,19.2,29.13,10
HCPCS,E2394,Drive wheel excludes tire,,,25.05,29.47,10
HCPCS,E2395,Caster wheel excludes tire,,,19.51,29.13,10
HCPCS,E2396,Caster fork,,,21.61,29.13,10
HCPCS,E2397,"Pwc acc, lith-based battery",,,191.13,778.15,10
HCPCS,E2398,Wc dynamic pos back hardware,,,25.16,65.37,10
HCPCS,E2402,Neg press wound therapy pump,,,531.62,3286.96,10
HCPCS,E2500,Sgd digitized pre-rec <=8min,,,189.4,778.15,10
HCPCS,E2502,Sgd prerec msg >8min <=20min,,,531.62,681.45,10
HCPCS,E2504,Sgd prerec msg>20min <=40min,,,531.62,898.92,10
HCPCS,E2506,Sgd prerec msg > 40 min,,,1120.18,1317.85,2
HCPCS,E2508,Sgd spelling phys contact,,,1732.25,2037.92,2
HCPCS,E2510,Sgd w multi methods msg/accs,,,3278.06,3856.5,2
HCPCS,E2513,"Sgd accessory, emg sensor",,,1526.33,1795.67,2
HCPCS,E2601,Gen w/c cushion wdth < 22 in,,,16.24,29.13,10
HCPCS,E2602,Gen w/c cushion wdth >=22 in,,,36.26,53.79,10
HCPCS,E2603,Skin protect wc cus wd <22in,,,43.7,53.79,10
HCPCS,E2604,Skin protect wc cus wd>=22in,,,46.46,71.53,10
HCPCS,E2605,Position wc cush wdth <22 in,,,88.77,322.97,10
HCPCS,E2606,Position wc cush wdth>=22 in,,,148.55,778.15,10
HCPCS,E2607,Skin pro/pos wc cus wd <22in,,,72.46,102.79,10
HCPCS,E2608,Skin pro/pos wc cus wd>=22in,,,72.46,128.38,10
HCPCS,E2609,Custom fabricate w/c cushion,,,531.62,615.56,8
HCPCS,E2611,Gen use back cush wdth <22in,,,61.95,83.9,10
HCPCS,E2612,Gen use back cush wdth>=22in,,,128.29,778.15,10
HCPCS,E2613,Position back cush wd <22in,,,131.28,778.15,10
HCPCS,E2614,Position back cush wd>=22in,,,201.7,306.12,10
HCPCS,E2615,Pos back post/lat wdth <22in,,,147.49,778.15,10
HCPCS,E2616,Pos back post/lat wdth>=22in,,,205.3,306.12,10
HCPCS,E2617,Custom fab w/c back cushion,,,531.62,615.56,8
HCPCS,E2619,Replace cover w/c seat cush,,,20.83,29.13,10
HCPCS,E2620,Wc planar back cush wd <22in,,,160.21,306.12,10
HCPCS,E2621,Wc planar back cush wd>=22in,,,193.58,306.12,10
HCPCS,E2622,Adj skin pro w/c cus wd<22in,,,72.46,155.45,10
HCPCS,E2623,Adj skin pro wc cus wd>=22in,,,167.07,778.15,10
HCPCS,E2624,Adj skin pro/pos cus<22in,,,72.46,157.97,10
HCPCS,E2625,Adj skin pro/pos wc cus>=22,,,166.15,778.15,10
HCPCS,E2626,Seo mobile arm sup att to wc,,,264.38,318.02,10
HCPCS,E2627,Arm supp att to wc rancho ty,,,394.43,615.56,10
HCPCS,E2628,Mobile arm supports reclinin,,,307.33,1183.93,10
HCPCS,E2629,Friction dampening arm supp,,,415.74,615.56,10
HCPCS,E2630,Monosuspension arm/hand supp,,,264.38,319.98,10
HCPCS,E2631,Elevat proximal arm support,,,108.72,322.97,10
HCPCS,E2632,Offset/lat rocker arm w/ela,,,46.46,81.36,10
HCPCS,E2633,Mobile arm support supinator,,,46.46,68.73,10
HCPCS,E3000,Speech volume modulation sys,,,832.09,1183.93,10
HCPCS,E3200,Gait mod systm rhym auditory,,,531.62,4712.52,10
HCPCS,E8000,Posterior gait trainer,,,72.46,83.9,8
HCPCS,E8001,Upright gait trainer,,,72.46,83.9,8
HCPCS,E8002,Anterior gait trainer,,,72.46,83.9,8
HCPCS,ECC,JOINT VENTURE DIGITAL SECOND OPINION,500.0,325.0,1.1,500.0,22
HCPCS,ECC,JV MULTIDISCIPLINARY BOARD REVIEW,700.0,455.0,1.1,700.0,22
HCPCS,G0008,ADMIN FLU VACCINE,109.0,70.85,1.1,185.0,94
HCPCS,G0009,Admin pneumococcal vaccine,,,13.56,131.25,27
HCPCS,G0009,MEDICAR PT ADMIN.PNEUMOCCAL VIR,43.0,27.95,1.1,80.64,33
HCPCS,G0010,ADMIN HEPATITIS B VACCINE,185.0,120.25,13.56,185.0,61
HCPCS,G0010,HEPATITIS B ADMINIS,99.0,64.35,1.1,99.0,33
HCPCS,G0011,"Hiv prep counsel, md 15-30m",,,68.71,79.56,8
HCPCS,G0012,Injection of hiv prep drug,,,36.15,201.81,27
HCPCS,G0013,"Hiv prep counsel, clin staff",,,27.53,105.02,27
HCPCS,G0017,Crisis psychotherapy 60m,,,47.45,54.95,8
HCPCS,G0018,Crisis psychotherapy add 30m,,,47.45,54.95,8
HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,85.47,284.74,19
HCPCS,G0023,Pin service 60m per month,,,85.47,284.74,19
HCPCS,G0027,ABSENCE/PRESENCE SPERM (POC) (POINT OF CARE LAB),45.0,29.25,6.5,45.0,60
HCPCS,G0028,Doc med rsn no scr tob,,,8.48,9.82,8
HCPCS,G0029,No tob scr/cess int,,,8.48,9.82,8
HCPCS,G0030,Pt scr tob & cess int,,,8.48,9.82,8
HCPCS,G0031,Pall serv during meas,,,8.48,9.82,8
HCPCS,G0032,2+ antipsy schiz,,,8.48,9.82,8
HCPCS,G0033,2+ benzo seiz,,,8.48,9.82,8
HCPCS,G0034,Pall serv during meas,,,8.48,9.82,8
HCPCS,G0035,Pt ed pos 23,,,8.48,9.82,8
HCPCS,G0036,Pt/ptn decln assess,,,8.48,9.82,8
HCPCS,G0037,Pt not able to participate,,,8.48,9.82,8
HCPCS,G0038,Clin pt no ref,,,8.48,9.82,8
HCPCS,G0039,"Pt no ref, rn spec",,,8.48,9.82,8
HCPCS,G0040,Pt phys/occ therapy,,,8.48,9.82,8
HCPCS,G0041,Pt/ptn decln referral,,,8.48,9.82,8
HCPCS,G0042,Ref to therapy,,,8.48,9.82,8
HCPCS,G0043,Pt mech pros ht valv,,,8.48,9.82,8
HCPCS,G0044,Pt mitral stenosis,,,8.48,9.82,8
HCPCS,G0045,Mrs 90 days post stk,,,8.48,9.82,8
HCPCS,G0046,No mrs 90 days post stk,,,8.48,9.82,8
HCPCS,G0047,Ped blunt hd traum,,,8.48,9.82,8
HCPCS,G0048,Pall serv during meas,,,8.48,9.82,8
HCPCS,G0049,Main hemo in-cntr,,,8.48,9.82,8
HCPCS,G0050,Pt w/ lmted life expec,,,8.48,9.82,8
HCPCS,G0051,Pt hospice mnth,,,8.48,9.82,8
HCPCS,G0052,Pt peri dialysis dur mo,,,8.48,9.82,8
HCPCS,G0053,Adv rheum pt care mvp,,,8.48,9.82,8
HCPCS,G0054,Strk cr prev pos outcme mvp,,,8.48,9.82,8
HCPCS,G0055,Adv care heart dx mvp,,,8.48,9.82,8
HCPCS,G0056,Opt chronic dx mang mvp,,,8.48,9.82,8
HCPCS,G0057,Best pct pt safety em mvp,,,8.48,9.82,8
HCPCS,G0058,Imprv care le jnt repr mvp,,,8.48,9.82,8
HCPCS,G0059,Pt sfty pos exp w aneth mvp,,,8.48,9.82,8
HCPCS,G0060,Allergy/immunology ss,,,8.48,9.82,8
HCPCS,G0061,Anesthesiology ss,,,8.48,9.82,8
HCPCS,G0062,Audiology ss,,,8.48,9.82,8
HCPCS,G0063,Cardiology ss,,,8.48,9.82,8
HCPCS,G0064,Cert nurse midwife ss,,,8.48,9.82,8
HCPCS,G0065,Chiropractic ss,,,8.48,9.82,8
HCPCS,G0066,Clinical social work ss,,,8.48,9.82,8
HCPCS,G0067,Dentistry ss,,,8.48,9.82,8
HCPCS,G0071,Comm svcs by rhc/fqhc 5 min,,,8.52,9.87,8
HCPCS,G0076,Care manag h vst new pt 20 m,,,17.35,20.09,8
HCPCS,G0077,Care manag h vst new pt 30 m,,,17.35,20.09,8
HCPCS,G0078,Care manag h vst new pt 45 m,,,17.35,20.09,8
HCPCS,G0079,Care manag h vst new pt 60 m,,,17.35,20.09,8
HCPCS,G0080,Care manag h vst new pt 75 m,,,17.35,20.09,8
HCPCS,G0081,Care man h v ext pt 20 mi,,,17.35,20.09,8
HCPCS,G0082,Care man h v ext pt 30 m,,,17.35,20.09,8
HCPCS,G0083,Care man h v ext pt 45 m,,,17.35,20.09,8
HCPCS,G0084,Care man h v ext pt 60 m,,,17.35,20.09,8
HCPCS,G0085,Care man h v ext pt 75 m,,,17.35,20.09,8
HCPCS,G0086,Care man home care plan 30 m,,,17.35,20.09,8
HCPCS,G0087,Care man home care plan 60 m,,,17.35,20.09,8
HCPCS,G0101,"CERV/VAG CANC SCRN,PELV/BREAST EXAM",198.0,128.7,1.1,198.0,51
HCPCS,G0101,SCREEN CERV/VAG & PELV/BREAST,370.0,240.5,45.16,370.0,61
HCPCS,G0102,PROSTATE CA SCREENING; DRE,79.0,51.35,1.1,79.0,45
HCPCS,G0102,Prostate ca screening; dre,,,50.62,58.61,8
HCPCS,G0103,"PSA, TOTAL SCREENING",76.0,49.4,1.1,76.0,32
HCPCS,G0103,Psa screening,,,18.32,79.13,29
HCPCS,G0104,Ca screen;flexi sigmoidscope,,,706.64,2606.53,27
HCPCS,G0104,SCREENING SIGMOIDOSCOPY,370.0,240.5,1.1,1560.83,45
HCPCS,G0105,"COLONOSCOPY, SCREENING, HIGH RISK",1434.0,932.1,1.1,1560.83,45
HCPCS,G0105,Colorectal scrn; hi risk ind,,,706.64,3728.0,28
HCPCS,G0106,Colon ca screen;barium enema,,,113.2,131.08,8
HCPCS,G0108,"DIAB OUTPT TRAINING INDIV, PER SESSN",396.0,257.4,1.1,396.0,50
HCPCS,G0108,Diab manage trn  per indiv,,,68.91,197.42,22
HCPCS,G0108,Diab manage trn per indiv,,,31.04,35.94,8
HCPCS,G0109,MGMT DIABETES GROUP 30MIN,121.0,78.65,19.66,121.0,60
HCPCS,G0117,Glaucoma scrn hgh risk direc,,,22.63,81.07,27
HCPCS,G0118,Glaucoma scrn hgh risk direc,,,35.34,104.69,27
HCPCS,G0120,Colon ca scrn; barium enema,,,113.2,131.08,8
HCPCS,G0121,COLONOSCOPY MCR SCREENING,657.0,427.05,1.1,1560.83,45
HCPCS,G0121,COLONOSCOPY SCRN NOT HIGH RISK,1434.0,932.1,1.1,1560.83,45
HCPCS,G0121,Colon ca scrn not hi rsk ind,,,706.64,2606.53,27
HCPCS,G0122,Colon ca scrn; barium enema,,,45.07,52.18,8
HCPCS,G0123,Screen cerv/vag thin layer,,,12.13,116.83,29
HCPCS,G0124,Screen c/v thin layer by md,,,12.13,49.46,10
HCPCS,G0127,"TRIMMING DYSTROPHIC NAILS,ANY NUMBER",75.0,48.75,1.1,103.94,45
HCPCS,G0127,Trim nail(s),,,37.85,165.35,27
HCPCS,G0128,Corf skilled nursing service,,,24.68,28.58,8
HCPCS,G0129,Php/iop ot service,,,67.54,78.2,8
HCPCS,G0130,Single energy x-ray study,,,98.26,551.66,20
HCPCS,G0136,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED SOCIAL DETERMIN",79.0,51.35,1.1,79.0,44
HCPCS,G0136,Adm of pa/n assess 5-15 m,,,27.53,105.02,19
HCPCS,G0136,Adm of soc dtr assess 5-15 m,,,37.4,43.31,8
HCPCS,G0137,"Inten outpt svs,min 9 pr 7 d",,,84.09,97.37,8
HCPCS,G0138,Iv cipaglucosidase alfa-atga,,,310.37,1784.6,27
HCPCS,G0140,Nav srv peer sup 60 min pr m,,,85.47,284.74,19
HCPCS,G0141,"Scr c/v cyto,autosys and md",,,12.13,49.46,10
HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,12.13,116.83,29
HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,12.13,202.65,29
HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,12.13,202.65,29
HCPCS,G0147,"Scr c/v cyto, automated sys",,,12.13,85.7,29
HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,12.13,130.88,29
HCPCS,G0166,COUNTERPULSE EXTRNL EA TX,516.0,335.4,68.77,516.0,61
HCPCS,G0168,WOUND CLOSURE BY ADHESIVE,136.0,88.4,1.1,401.5,45
HCPCS,G0168,Wound closure by adhesive,,,147.83,171.17,8
HCPCS,G0175,"Opps service,sched team conf",,,17.35,1169.52,27
HCPCS,G0176,Opps/php/iop; activity thrpy,,,38.59,44.68,8
HCPCS,G0177,Opps/php/iop; train & educ,,,38.59,44.68,8
HCPCS,G0179,MD RECERTIFICATION HHA PT,198.0,128.7,1.1,198.0,44
HCPCS,G0179,Md recertification hha pt,,,17.35,20.09,8
HCPCS,G0180,MD CERTIFICATION HHA PATIENT,295.0,191.75,1.1,295.0,44
HCPCS,G0180,Md certification hha patient,,,17.35,20.09,8
HCPCS,G0181,HOME HEALTH CARE SUPERVISION,761.0,494.65,1.1,761.0,44
HCPCS,G0181,Home health care supervision,,,17.35,20.09,8
HCPCS,G0183,Software meas of cardiac vol,,,82.33,243.92,21
HCPCS,G0186,"Dstry eye lesn,fdr vssl tech",,,319.13,1541.56,27
HCPCS,G0235,PET NOT OTHERWISE SPECIFIED,8227.0,5347.55,0.01,8870.0,74
HCPCS,G0235,Pet not otherwise specified,,,371.28,1909.17,20
HCPCS,G0237,Therapeutic procd strg endur,,,22.63,81.07,27
HCPCS,G0238,"OTH RESP PROC, INDIV",119.0,77.35,1.1,119.0,44
HCPCS,G0238,"Oth resp proc, indiv",,,22.63,81.07,27
HCPCS,G0239,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,157.0,102.05,24.67,157.0,61
HCPCS,G0245,Initial foot exam pt lops,,,54.56,373.16,27
HCPCS,G0246,Followup eval of foot pt lop,,,54.56,373.16,27
HCPCS,G0247,Routine footcare pt w lops,,,54.56,562.35,27
HCPCS,G0248,Demonstrate use home inr mon,,,31.04,373.16,27
HCPCS,G0249,Provide inr test mater/equip,,,50.62,373.16,27
HCPCS,G0250,MD REVIEW INTERPRET OF TEST,79.0,51.35,1.1,79.0,44
HCPCS,G0250,Md inr test revie inter mgmt,,,50.62,58.61,8
HCPCS,G0255,Current percep threshold tst,,,310.96,360.06,8
HCPCS,G0257,Unsched dialysis esrd pt hos,,,296.15,1923.64,27
HCPCS,G0259,Inject for sacroiliac joint,,,251.27,290.94,8
HCPCS,G0260,SIJ INJ - ARTHROGR/ANESTHETIC,1977.0,1285.05,251.27,3728.0,61
HCPCS,G0268,REMOVAL OF IMPACTED WAX MD,268.0,174.2,1.1,268.0,45
HCPCS,G0268,Removal of impacted wax md,,,50.62,58.61,8
HCPCS,G0269,PLC OCCL DVC ARTERY VEIN,838.0,544.7,50.62,9496.0,46
HCPCS,G0270,MEDICAL NUTRITION THERAPY; REASSESSMENT,198.0,128.7,1.1,198.0,45
HCPCS,G0270,Mnt subs tx for change dx,,,29.84,82.06,30
HCPCS,G0271,Group mnt 2 or more 30 mins,,,16.62,76.49,30
HCPCS,G0276,Pild/placebo control clin tr,,,3026.0,20338.07,27
HCPCS,G0277,HYPERBARIC O2 30MIN,552.0,358.8,127.42,552.0,61
HCPCS,G0277,TRMT CRITICAL PT (30MIN),552.0,358.8,127.42,552.0,61
HCPCS,G0277,TRMT NORMAL PT (30MIN),552.0,358.8,127.42,552.0,61
HCPCS,G0278,"Iliac art angio,cardiac cath",,,2270.79,2629.34,8
HCPCS,G0279,"TOMOSYNTHESIS, MAMMO",264.0,171.6,1.1,351.0,142
HCPCS,G0279,"Tomosynthesis, mammo",,,41.14,140.53,31
HCPCS,G0281,WND CARE UNATT ELECT STIM 15M,147.0,95.55,14.52,239.0,60
HCPCS,G0282,Elect stim wound care not pd,,,147.83,171.17,8
HCPCS,G0283,ELEC STIM OTHER THAN WOUND,79.0,51.35,1.1,79.0,44
HCPCS,G0283,Elec stim other than wound,,,15.57,44.0,30
HCPCS,G0288,"Recon, cta for surg plan",,,321.96,372.8,8
HCPCS,G0289,"ARTHRO, LOOSE BODY + CHONDRO",651.0,423.15,1.1,651.0,44
HCPCS,G0289,"Arthro, loose body + chondro",,,3451.33,3996.28,8
HCPCS,G0293,"Non-cov surg proc,clin trial",,,35.34,184.37,27
HCPCS,G0294,"Non-cov proc, clinical trial",,,35.34,372.8,27
HCPCS,G0295,Electromagnetic therapy onc,,,147.83,171.17,8
HCPCS,G0296,VISIT TO DETERM LDCT ELIG,299.5,194.675,1.1,370.0,112
HCPCS,G0297,Ldct for lung ca screen,,,145.8,168.82,8
HCPCS,G0302,Pre-op service lvrs complete,,,321.96,1045.9,27
HCPCS,G0303,Pre-op service lvrs 10-15dos,,,204.28,605.2,27
HCPCS,G0304,Pre-op service lvrs 1-9 dos,,,321.96,1045.9,27
HCPCS,G0305,Post op service lvrs min 6,,,50.62,1045.9,27
HCPCS,G0306,Cbc/diffwbc w/o platelet,,,6.74,31.84,29
HCPCS,G0307,Cbc without platelet,,,6.47,26.51,29
HCPCS,G0308,180 d implant glucose sensor,,,309.06,357.86,8
HCPCS,G0309,Rem/inser glu sensor dif sit,,,309.06,357.86,8
HCPCS,G0310,5-15 MINS TIME,78.0,50.7,0.01,1791901.44,28
HCPCS,G0310,Immunize counsel 5-15 min,,,68.71,79.56,8
HCPCS,G0311,Immunize counsel 16-30 mins,,,68.71,79.56,8
HCPCS,G0312,Immunize couns < 21yr 5-15 m,,,68.71,79.56,8
HCPCS,G0313,Immunize couns < 21yr 6-30 m,,,68.71,79.56,8
HCPCS,G0314,Counsel immune <21 16-30 m,,,68.71,79.56,8
HCPCS,G0315,Counsel immune <21 5-15 m,,,68.71,79.56,8
HCPCS,G0316,PROLONG INPT EVAL ADD15 M,268.0,174.2,1.1,268.0,50
HCPCS,G0316,Prolong inpt eval add15 m,,,50.62,58.61,8
HCPCS,G0317,PROLONG NURSIN FAC EVAL 15M,244.0,158.6,1.1,244.0,50
HCPCS,G0317,Prolong nursin fac eval 15m,,,50.62,58.61,8
HCPCS,G0318,PROLONG HOME EVAL ADD 15M,244.0,158.6,1.1,244.0,50
HCPCS,G0318,Prolong home eval add 15m,,,50.62,58.61,8
HCPCS,G0322,Home h physio data collec tr,,,68.77,79.63,8
HCPCS,G0323,Care manage beh svs 20mins,,,27.53,105.02,19
HCPCS,G0327,Colon ca scrn;bld-bsd biomrk,,,66.63,77.15,8
HCPCS,G0328,FECAL BLOOD SCRN IMMUNOASSAY,51.0,33.15,1.1,51.0,32
HCPCS,G0328,Fecal blood scrn immunoassay,,,18.05,73.97,29
HCPCS,G0328QW,Fecal blood scrn immunoassay,,,20.23,20.23,1
HCPCS,G0329,Electromagntic tx for ulcers,,,13.92,171.17,30
HCPCS,G0330,Facility svs dental rehab,,,1358.5,9292.73,27
HCPCS,G0333,Dispense fee initial 30 day,,,50.62,58.61,8
HCPCS,G0337,Hospice evaluation preelecti,,,54.56,63.17,8
HCPCS,G0339,"Robot lin-radsurg com, first",,,3184.72,3687.57,8
HCPCS,G0340,Robt lin-radsurg fractx 2-5,,,3184.72,3687.57,8
HCPCS,G0341,Percutaneous islet celltrans,,,2755.97,3191.12,8
HCPCS,G0342,Laparoscopy islet cell trans,,,2755.97,3191.12,8
HCPCS,G0343,Laparotomy islet cell transp,,,2755.97,3191.12,8
HCPCS,G0372,MD SERVICE REQUIRED FOR PMD,75.0,48.75,1.1,75.0,44
HCPCS,G0372,Md service required for pmd,,,321.96,372.8,8
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 1,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 10,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 2,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 3,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 4,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 5,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 6,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 9,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT GRP 7,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERV CARVE OUT GRP 8,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERVATION 6100 PSYCH > 24 HRS PER HR (MANUAL),119.0,77.35,17.71,13224.0,47
HCPCS,G0378,OBSERVATION 6400 PSYCH > 24 HRS PER HR (MANUAL),109.0,70.85,16.22,13224.0,47
HCPCS,G0378,OBSERVATION CARVE-OUT PER HR,133.0,86.45,19.79,13224.0,47
HCPCS,G0378,OBSERVATION L&D/OB TRIAGE > 24 HRS PER HR (MANUAL),83.0,53.95,12.35,13224.0,47
HCPCS,G0378,OBSERVATION MED/SURG > 24 HRS PER HR (MANUAL),92.0,59.8,13.69,13224.0,47
HCPCS,G0378,OBSERVATION ONCOLOGY > 24 HRS PER HR (MANUAL),92.0,59.8,13.69,13224.0,47
HCPCS,G0378,OBSERVATION ORTHO > 24 HRS PER HR (MANUAL),92.0,59.8,13.69,13224.0,47
HCPCS,G0378,OBSERVATION PACU > 24 HRS PER HR (MANUAL),343.0,222.95,51.04,13224.0,47
HCPCS,G0378,OBSERVATION PER HR-FIRST HOUR,1011.0,657.15,150.44,13224.0,47
HCPCS,G0378,OBSERVATION PERINATAL > 24 HRS PER HR (MANUAL),161.0,104.65,23.96,13224.0,47
HCPCS,G0379,DIR ADMIT FOR HOSP OBV CARE,2452.0,1593.8,54.56,13224.0,62
HCPCS,G0380,Lev 1 hosp type b ed visit,,,54.56,208.34,27
HCPCS,G0381,Lev 2 hosp type b ed visit,,,54.56,260.35,27
HCPCS,G0382,Lev 3 hosp type b ed visit,,,54.56,481.77,27
HCPCS,G0383,Lev 4 hosp type b ed visit,,,54.56,740.81,27
HCPCS,G0384,Lev 5 hosp type b ed visit,,,54.56,1151.2,27
HCPCS,G0390,TRAUMA LVL 1 - CAT 1,5293.0,3440.45,54.56,5293.0,71
HCPCS,G0390,TRAUMA LVL 1 - CAT 2,5293.0,3440.45,54.56,5293.0,71
HCPCS,G0390,TRAUMA LVL 1 - CAT 3,5293.0,3440.45,54.56,5293.0,71
HCPCS,G0390,TRAUMA RESPONS W/HOSP CRITI,433.0,281.45,1.1,2016.71,28
HCPCS,G0396,ALCOHOL/SUBS INTERV 15-30MN,286.0,185.9,1.1,286.0,51
HCPCS,G0396,Alcohol/subs interv 15-30mn,,,27.53,105.02,27
HCPCS,G0397,ALCOHOL/SUBS INTERV >30 MIN,572.0,371.8,1.1,572.0,51
HCPCS,G0397,Alcohol/subs interv >30 min,,,94.44,497.49,27
HCPCS,G0398,HOME SLEEP TEST/TYPE 2 PORTA,573.0,372.45,1.1,714.51,32
HCPCS,G0398,Home sleep test/type 2 porta,,,68.51,605.2,27
HCPCS,G0399,HOME SLEEP TEST/TYPE 3 PORTA,706.0,458.9,1.1,706.0,32
HCPCS,G0399,Home sleep test/type 3 porta,,,68.51,605.2,27
HCPCS,G0400,Home sleep test/type 4 porta,,,68.51,605.2,27
HCPCS,G0402,INIT PREVENTIVE EXAM NEW,515.0,334.75,0.01,515.0,61
HCPCS,G0402,INITIAL PREVENTIVE EXAM,1144.0,743.6,1.1,1144.0,45
HCPCS,G0403,EKG FOR INITIAL PREVENT EXAM,233.0,151.45,1.1,391.0,88
HCPCS,G0403,Ekg for initial prevent exam,,,18.66,21.6,8
HCPCS,G0404,EKG TRACING FOR INITIAL PREV,279.0,181.35,1.1,279.0,44
HCPCS,G0404,Ekg tracing for initial prev,,,18.66,81.07,27
HCPCS,G0405,EKG INTERPRET & REPORT PREVE,75.0,48.75,1.1,75.0,44
HCPCS,G0405,Ekg interpret & report preve,,,18.66,21.6,8
HCPCS,G0405,PRO FEE - INITIAL PREVENT PHY,15.0,9.75,1.1,27.57,44
HCPCS,G0406,Inpt/tele follow up 15,,,54.56,63.17,8
HCPCS,G0406,TELEHEALTH FOLLOW-UP INPT CONSULTATION 15 MINS,334.0,217.1,1.1,334.0,50
HCPCS,G0407,Inpt/tele follow up 25,,,54.56,63.17,8
HCPCS,G0407,TELEHEALTH FOLLOW-UP INPT CONSULTATION 25 MINS,612.0,397.8,1.1,612.0,50
HCPCS,G0408,Inpt/tele follow up 35,,,54.56,63.17,8
HCPCS,G0408,TELEHEALTH FOLLOW-UP INPT CONSULTATION 35 MINS,880.0,572.0,1.1,880.0,50
HCPCS,G0409,Corf related serv 15 mins ea,,,32.9,38.09,8
HCPCS,G0410,Grp psych php/iop 45-50,,,104.59,121.1,8
HCPCS,G0411,Interactive grp psyc php/iop,,,104.59,121.1,8
HCPCS,G0412,Open tx iliac spine uni/bil,,,2860.13,20338.07,21
HCPCS,G0413,PELVIC RING FRACTURE UNI/BIL,6921.0,4498.65,1.1,12214.27,44
HCPCS,G0413,Pelvic ring fracture uni/bil,,,2860.13,20338.07,27
HCPCS,G0414,PELVIC RING FX TREAT INT FIX,6446.0,4189.9,1.1,6446.0,44
HCPCS,G0414,Pelvic ring fx treat int fix,,,2860.13,20338.07,21
HCPCS,G0415,OPEN TX POST PELVIC FXCTURE,9209.0,5985.85,1.1,9209.0,44
HCPCS,G0415,Open tx post pelvic fxcture,,,2860.13,9170.92,21
HCPCS,G0416,SAT BIOPSY PROSTATE 1-20 SPC,1440.0,936.0,1.1,1440.0,44
HCPCS,G0416,VCAR MUGA GATING IMAGING,1439.0,935.35,54.37,1439.0,61
HCPCS,G0420,Ed svc ckd ind per session,,,31.04,411.18,30
HCPCS,G0421,Ed svc ckd grp per session,,,33.58,98.78,30
HCPCS,G0422,Intens cardiac rehab w/exerc,,,54.89,361.31,27
HCPCS,G0423,Intens cardiac rehab no exer,,,54.89,361.31,27
HCPCS,G0424,Pulmonary rehab w exer,,,27.26,31.56,8
HCPCS,G0425,Inpt/ed teleconsult30,,,54.56,63.17,8
HCPCS,G0425,PR INPT TELEHEALTH CONSULT 30M,845.0,549.25,1.1,845.0,50
HCPCS,G0426,Inpt/ed teleconsult50,,,54.56,63.17,8
HCPCS,G0426,PR INPT TELEHEALTH CONSULT 50M,1148.0,746.2,1.1,1148.0,50
HCPCS,G0427,Inpt/ed teleconsult70,,,54.56,63.17,8
HCPCS,G0427,PR INPT TELEHEALTH CON 70/>M,1698.0,1103.7,1.1,1698.0,50
HCPCS,G0428,Collagen meniscus implant,,,1971.0,2282.21,8
HCPCS,G0429,Dermal filler injection(s),,,841.82,5783.06,27
HCPCS,G0432,Eia hiv-1/hiv-2 screen,,,13.21,80.19,29
HCPCS,G0433,Elisa hiv-1/hiv-2 screen,,,13.21,74.95,30
HCPCS,G0433QW,Elisa hiv-1/hiv-2 screen,,,20.49,20.49,1
HCPCS,G0435,Oral hiv-1/hiv-2 screen,,,11.98,49.09,29
HCPCS,G0438,PPPS INITIAL VISIT,203.0,131.95,0.01,639.79,60
HCPCS,G0438,"PPPS, INITIAL VISIT",1040.0,676.0,1.1,1040.0,44
HCPCS,G0439,PPPS SUBSEQ VISIT,189.0,122.85,0.01,502.48,60
HCPCS,G0439,"PPPS, SUBSEQ VISIT",768.0,499.2,1.1,768.0,44
HCPCS,G0442,ANNUAL ALCOHOL SCREEN 15 MIN,139.0,90.35,0.01,206.0,106
HCPCS,G0443,BRIEF ALCOHOL MISUSE COUNSEL,638.0,414.7,0.01,638.0,61
HCPCS,G0444,DEPRESSION SCREEN ANNUAL,99.0,64.35,0.01,119.0,106
HCPCS,G0445,HIGH INTEN BEH COUNS STD 30M,638.0,414.7,0.01,638.0,61
HCPCS,G0446,INTENS BEHAVE THER CARDIO DX,235.0,152.75,0.01,264.0,106
HCPCS,G0447,BEHAVIOR COUNSEL OBESITY 15M,451.0,293.15,0.01,638.0,106
HCPCS,G0448,Place perm pacing cardiovert,,,17330.27,20066.63,8
HCPCS,G0451,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,21.54,425.0,183
HCPCS,G0451,XM VIRTUAL - SINGLE INDIVIDUAL,425.0,276.25,21.54,425.0,61
HCPCS,G0452,Molecular pathology interpr,,,7.07,372.8,9
HCPCS,G0453,Cont intraop neuro monitor,,,321.96,372.8,8
HCPCS,G0454,Md document visit by npp,,,50.62,58.61,8
HCPCS,G0455,FECAL MICROBIOTA PREP INSTILL,590.0,383.5,1.1,1560.83,45
HCPCS,G0455,Fecal microbiota prep instil,,,321.96,2606.53,27
HCPCS,G0458,Ldr prostate brachy comp rat,,,321.96,372.8,8
HCPCS,G0459,Telehealth inpt pharm mgmt,,,8.4,9.72,8
HCPCS,G0460,Autolog prp not diab ulcer,,,444.21,5783.06,27
HCPCS,G0463,OFFICE VISIT,515.0,334.75,0.01,515.0,61
HCPCS,G0465,Autolog prp diab wound ulcer,,,444.21,5783.06,27
HCPCS,G0466,Fqhc visit new patient,,,50.62,58.61,8
HCPCS,G0467,"Fqhc visit, estab pt",,,50.62,58.61,8
HCPCS,G0468,"Fqhc visit, ippe or awv",,,50.62,58.61,8
HCPCS,G0469,"Fqhc visit, mh new pt",,,50.62,58.61,8
HCPCS,G0470,"Fqhc visit, mh estab pt",,,50.62,58.61,8
HCPCS,G0471,Ven blood coll snf/hha,,,2.09,46.47,27
HCPCS,G0472,HEP SCREEN HIGH RISK/OTHER,234.0,152.1,22.75,234.0,60
HCPCS,G0472,Hep c screen high risk/other,,,51.93,51.93,1
HCPCS,G0472QW,Hep c screen high risk/other,,,51.93,51.93,1
HCPCS,G0473,Group behave couns 2-10,,,27.53,121.1,27
HCPCS,G0475,Hiv combination assay,,,18.32,98.68,30
HCPCS,G0475QW,Hiv combination assay,,,26.98,26.98,1
HCPCS,G0476,Hpv combo assay ca screen,,,26.69,143.79,29
HCPCS,G0480,%AMITRIPTYLINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%DESIPRAMINE PL,164.0,106.6,27.64,468.91,60
HCPCS,G0480,%IMIPRAMINE PL,147.0,95.55,27.64,468.91,60
HCPCS,G0480,%UQNTPP AMPHET,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP BUPRENORPHINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP CANNABINOID NAT,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP COCAINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP FENTANYL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP HEROIN METABOLITE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP METHADONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP OPIATE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP OPIOIDS 5+,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP OXYCODONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,%UQNTPP TRAMADOL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,*DRUG SCREEN QUAL SNGL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"ALCOHOL CONF, UR",742.0,482.3,27.64,742.0,60
HCPCS,G0480,ALKALOID DRUGS (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,ALPRAZOLAM,739.0,480.35,27.64,739.0,60
HCPCS,G0480,AMPCQ METHYLENDIOXY%,742.0,482.3,27.64,742.0,60
HCPCS,G0480,AMPHETAMINE CONF URINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"AMPHETAMINE CONF, UR",742.0,482.3,27.64,742.0,60
HCPCS,G0480,AMPHETAMINE CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,AMPHETAMINES (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,AMPHETAMINES CONF URINE,739.0,480.35,27.64,739.0,60
HCPCS,G0480,ANALGESICS NON-OPIOID 1 OR 2,742.0,482.3,27.64,742.0,60
HCPCS,G0480,ANTIDEPRESSANT TRICYCLIC 1/2,116.0,75.4,27.64,468.91,60
HCPCS,G0480,ARIPIPRAZOLE AND METABOLITE,85.0,55.25,24.04,468.91,60
HCPCS,G0480,"BACLOFEN (BACLOF), SKELETAL MUSCLE RELAXANT 1 OR 2",21.0,13.65,5.94,468.91,60
HCPCS,G0480,BARBITURATES,742.0,482.3,27.64,742.0,60
HCPCS,G0480,BARBITURATES (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,BARBITURATES CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,"BARBITURATES, BLOOD",104.0,67.6,27.64,468.91,60
HCPCS,G0480,"BENZO, QUANT, UR",742.0,482.3,27.64,742.0,60
HCPCS,G0480,"BENZO, SER PL, QNT RFLX",742.0,482.3,27.64,742.0,60
HCPCS,G0480,"BENZODIAZEPINE, BLOOD",104.0,67.6,27.64,468.91,60
HCPCS,G0480,BENZODIAZEPINES CONF UR,742.0,482.3,27.64,742.0,60
HCPCS,G0480,BENZODIAZEPINES1-12,742.0,482.3,27.64,742.0,60
HCPCS,G0480,BENZODIAZEPINES1-12 (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,BRWK ACETAMINOPHEN BL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,BUPRENOR & METAB QNT UR,742.0,482.3,27.64,742.0,60
HCPCS,G0480,CANNABANOIDS,742.0,482.3,27.64,742.0,60
HCPCS,G0480,CANNABINOIDS CONF UR,740.5,481.32500000000005,27.64,742.0,120
HCPCS,G0480,CARBOXY-THC (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,CHROM QUANT,742.0,482.3,27.64,742.0,60
HCPCS,G0480,CLONAZEPAM METAB (SEND OUT),78.0,50.7,22.06,468.91,60
HCPCS,G0480,COCAINE CONFIRM UR,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"COCAINE METABOLITE, SER OR PL, QNT RFLX",742.0,482.3,27.64,742.0,60
HCPCS,G0480,COLUMN CHROM QUANT,157.0,102.05,27.64,468.91,60
HCPCS,G0480,DESIPRAMINE PLASMA,153.0,99.45,27.64,468.91,60
HCPCS,G0480,DIGITOXIN,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DIHYDROTESTOSTERONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"DIPHENHYDRAMINE, SERUM/PLASMA",32.0,20.8,9.05,468.91,60
HCPCS,G0480,"DIURETIC SURVEY, URINE",739.0,480.35,27.64,739.0,60
HCPCS,G0480,DOXEPIN/NORDOXEPIN,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRG BUPRENORPHINE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,DRG COCAINE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,DRGTOF AMPHETAMINES,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRGTOF BENZODIAZEPINES1-12,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRGTOF DRG SCRN BARBITURATES,238.0,154.7,27.64,468.91,60
HCPCS,G0480,DRGTOF DRG SCRN BUPRENORPHINE,238.0,154.7,27.64,468.91,60
HCPCS,G0480,DRGTOF DRG SCRN COCAINE,238.0,154.7,27.64,468.91,60
HCPCS,G0480,DRGTOF DRG SCRN METHADONE,238.0,154.7,27.64,468.91,60
HCPCS,G0480,DRGTOF FENTANYL AND METABOLITE,170.0,110.5,27.64,468.91,60
HCPCS,G0480,DRGTOF GABAPENTIN,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRGTOF METHYLENEDIOXYAMPHETAMINE,173.0,112.45,27.64,468.91,60
HCPCS,G0480,DRGTOF OPIATE CONFIRMATION,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRGTOF OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DRGTOF OPISEC DRG SCRN OXYCODONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRGTOF ORLOPI OPIATES 1 OR MORE,246.0,159.9,27.64,468.91,60
HCPCS,G0480,DRGTOF PHENCYCLIDINE,238.0,154.7,27.64,468.91,60
HCPCS,G0480,DRGTOF PROPOXYPHENE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DRGTOF TAPENTADOL AND MET,170.0,110.5,27.64,468.91,60
HCPCS,G0480,DRGTOF TRAMADOL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,DRGTOF ZOLPIDEM,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"DRUG TEST, DEFINITVE, PER DAY?1-7?DRUG CLASSES",742.0,482.3,27.64,742.0,60
HCPCS,G0480,DTOFMP AMPHETAMINES,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP BARBITURATES,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP BENZODIAZEPINES,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP BUPRENORPHINE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP COCAINE METABOLITE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP FENTANYL,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP HEROIN METABOLITE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP HYDROCODONE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP MARIJUANA METABOLITE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP MDMA,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP METHADONE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP OPIOIDS,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP OXYCODONE AND METABOLITE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP PHENCYCLIDINE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP PROPOXYPHENE,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP SEDATIVE HYPNOTICS,53.0,34.45,14.99,468.91,60
HCPCS,G0480,DTOFMP TAPENTADOL,53.0,34.45,14.99,468.91,60
HCPCS,G0480,ETHAMBUTOL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,ETHANOL PLASMA,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"FATTY ACID PROFILE,SER PL",157.0,102.05,27.64,468.91,60
HCPCS,G0480,FENTANYL AND METABOLITE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,FENTANYL CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,FENTANYL URINE,740.5,481.32500000000005,27.64,742.0,120
HCPCS,G0480,FLUVOXAMINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,GABAPENTIN (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,IMIPRAMINE,157.0,102.05,27.64,468.91,60
HCPCS,G0480,ISOPROPANOL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,LAMOTRIGINE,86.0,55.9,24.32,468.91,60
HCPCS,G0480,LORAZEPAM,742.0,482.3,27.64,742.0,60
HCPCS,G0480,MARIJUANA METAB UMB CRD QUAL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,MELATONIN,295.0,191.75,27.64,468.91,60
HCPCS,G0480,METHADONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,METHADONE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,"METHADONE QNT, UR",742.0,482.3,27.64,742.0,60
HCPCS,G0480,METHYLEEDIOXAMPHETAMINE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,METHYLENEDIOXYAMPHETAMINES CONF URINE,739.0,480.35,27.64,739.0,60
HCPCS,G0480,"METHYLONE CONF, UR",146.0,94.9,27.64,468.91,60
HCPCS,G0480,METHYLPHENIDATE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,METHYLPHENIDATE QNT,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"METOPROLOL, SER/PL",32.0,20.8,9.05,468.91,60
HCPCS,G0480,NICOTINE AND METAB UR,742.0,482.3,27.64,742.0,60
HCPCS,G0480,NICOTINE/COTININE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,NORFENTANYL (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,NORTRIPTYLINE,118.0,76.7,27.64,468.91,60
HCPCS,G0480,NORTRIPTYLINE PLASMA,742.0,482.3,27.64,742.0,60
HCPCS,G0480,ONE DRUG CONFIRMATION,55.0,35.75,1.1,277.16,32
HCPCS,G0480,OPIATE CONFIRMATION (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,OPIATE CONFIRMATION UR,742.0,482.3,27.64,742.0,60
HCPCS,G0480,OPIATES 1 OR MORE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,OPIOIDS AND OPIATE ANALOGS (DRGTOF),742.0,482.3,27.64,742.0,60
HCPCS,G0480,OPIOIDS AND OPIATE ANALOGS (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,OPISEC OPIATES 1 OR MORE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,OPISEC OXYCODONE (MEDDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,ORLOPI OPIATES 1 OR MORE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,OXYCODONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,"OXYCODONE CONF/QT, URINE",742.0,482.3,27.64,742.0,60
HCPCS,G0480,OXYCODONE SCREEN (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,PCP CONFIRM URINE,739.0,480.35,27.64,739.0,60
HCPCS,G0480,"PCP SER OR PL, QNT RFLX",742.0,482.3,27.64,742.0,60
HCPCS,G0480,PENTOBARBITAL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,PHENCYCLID CONFIRM (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,PHENCYCLIDINE (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,PHENCYCLIDINE (PCP),187.0,121.55,27.64,468.91,60
HCPCS,G0480,"PHENOLPHTHALEIN, STOOL",53.0,34.45,14.99,468.91,60
HCPCS,G0480,PHOSPHATIDYLETHANOL,742.0,482.3,27.64,742.0,60
HCPCS,G0480,PREGABALIN,405.0,263.25,19.23,742.0,120
HCPCS,G0480,RFLX AMPHETAMINES,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX BARBITUATES,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX BENZODIAZIPINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX BUPRENORPHINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX COCAINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX METHADONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX OPIATES,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX PHENCYCLIDINE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RFLX THC METABOLITE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,RISPERIDONE AND METAB,742.0,482.3,27.64,742.0,60
HCPCS,G0480,SULFONYLUREA HYPO URINE,240.0,156.0,27.64,468.91,60
HCPCS,G0480,"SULFONYLUREA HYPOGLY, SER",309.0,200.85,27.64,468.91,60
HCPCS,G0480,"SULFONYLUREA HYPOGLYCEMIA PANEL, QUANTITATIVE, URINE",739.0,480.35,27.64,739.0,60
HCPCS,G0480,SYNTH CANNABIN SCREEN (SD OUT),78.0,50.7,22.06,468.91,60
HCPCS,G0480,SYNTH STIM SCREEN (SEND OUT),78.0,50.7,22.06,468.91,60
HCPCS,G0480,TAPENTADOL AND MET (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,THC CONFIRM (GS/MS) (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,TOX 8 (BUP) PANEL (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,TOX PROFILE 56 PANEL (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,"TRAMADOL & METAB, QUANT",740.5,481.32500000000005,27.64,742.0,120
HCPCS,G0480,TRAMADOL (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0480,TRAZODONE,742.0,482.3,27.64,742.0,60
HCPCS,G0480,TRICYCLIC ANTIDEPRESS CONFIRM,742.0,482.3,27.64,742.0,60
HCPCS,G0480,UQNTOX AMPHETAMINES,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX BUPRENORPHINE,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX CANNABINOIDS NATURAL,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX COCCAINE,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX FENTANYL,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX HEROINE METABOLITE,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX METHADONE,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX METHYLENEDIOXYAMPHETAMINES,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX OPIATES,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX OPIOIDS 5+,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX OXYCODONE,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX PHENCYCLIDINE,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UQNTOX TRAMADOL,78.0,50.7,22.06,468.91,60
HCPCS,G0480,UR QUANT ALC (SEND OUT),78.0,50.7,22.06,468.91,60
HCPCS,G0480,UR QUANT BUP (SEND OUT),742.0,482.3,27.64,742.0,60
HCPCS,G0480,URDRG 6-MONOACETYLMORPHINE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG ALKALOIDS NOS,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG AMPHETAMINES,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG ASSAY FOR PHENCYCLIDINE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG BENZODIAZEPINES,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG BUPRENORPHINE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG CANNABINOIDS,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG COCAINE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,"URDRG DRUG SCREENING, TAPENTADOL",68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG DRUGS NOT OTHERWISE SPECIFIED,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG FENTANYL,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG GABAPENTIN,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG KETAMINE AND NORKETAMINE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG METHADONE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG METHYLENEDIOXYAMPHETAMINES,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG OPIATES,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG OPIOIDS,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG OXYCODONE,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG PREGABALIN,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG SKELETAL MUSCLE RELAXANTS,68.0,44.2,19.23,468.91,60
HCPCS,G0480,"URDRG STIMULANTS, SYNTHETIC",68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG TRAMADOL,68.0,44.2,19.23,468.91,60
HCPCS,G0480,URDRG ZOLPIDEM,68.0,44.2,19.23,468.91,60
HCPCS,G0480,"VOLATILES, QUAL (SEND OUT)",78.0,50.7,22.06,468.91,60
HCPCS,G0480,ZOLPIDEM (MECDRG),64.4,41.86,18.21,468.91,60
HCPCS,G0481,DRUG TEST DEF 8-14 CLASSES,651.0,423.15,1.1,651.0,32
HCPCS,G0481,"DRUG TEST, DEFINITVE, PER DAY?8-14?DRUG CLASSES",1015.0,659.75,59.88,1015.0,60
HCPCS,G0481,DTOFMP GABAPENTIN,1015.0,659.75,59.88,1015.0,60
HCPCS,G0481,ENTIRE PANEL CONFIRMATION,72.0,46.8,1.1,379.28,32
HCPCS,G0481,MECDRG AMPHETAMINES 5 OR MORE,1015.0,659.75,59.88,1015.0,60
HCPCS,G0481,MECDRG DRUG SCRN BENZODIAZ 13 OR MORE,1015.0,659.75,59.88,1015.0,60
HCPCS,G0481,MECDRG OPIOIDS AND OPIATE ANALOGS 5 OR MORE,1015.0,659.75,59.88,1015.0,60
HCPCS,G0481,PAIN PANEL QNT UR,1015.0,659.75,59.88,1015.0,60
HCPCS,G0482,"DRUG TEST, DEFINITVE, PER DAY?15-21 DRUG CLASSES",1288.0,837.2,59.88,1288.0,60
HCPCS,G0483,"DRUG TEST, DEFINITVE, PER DAY?22 OR MORE DRUG CLASSES",1600.0,1040.0,59.88,1600.0,60
HCPCS,G0491,Dialysis acu kidney no esrd,,,296.15,342.91,8
HCPCS,G0492,Md/oth eval acut kid no esrd,,,296.15,342.91,8
HCPCS,G0498,CHEMO EXTEND IV INFUS W/PUMP,2289.0,1487.85,306.47,2289.0,61
HCPCS,G0499,Hepb screen high risk indiv,,,22.75,115.84,29
HCPCS,G0500,MOD SEDAT ENDO SERVICE >5YRS,44.0,28.6,1.1,179.7,45
HCPCS,G0500,Mod sedat endo service >5yrs,,,159.23,184.37,8
HCPCS,G0501,Resource-inten svc during ov,,,50.62,58.61,8
HCPCS,G0508,Crit care telehea consult 60,,,54.56,63.17,8
HCPCS,G0509,Crit care telehea consult 50,,,54.56,63.17,8
HCPCS,G0513,"Prolong prev svcs, first 30m",,,50.62,58.61,8
HCPCS,G0514,"Prolong prev svcs, addl 30m",,,50.62,58.61,8
HCPCS,G0516,"Insert drug del implant, >=4",,,133.98,1252.1,27
HCPCS,G0517,Remove drug implant,,,133.98,1252.1,27
HCPCS,G0518,Remove w insert drug implant,,,133.98,1252.1,27
HCPCS,G0519,New pt-cg dyad dem low cmplx,,,17.35,20.09,8
HCPCS,G0520,New pt-cg dyad dem mod cmplx,,,17.35,20.09,8
HCPCS,G0521,New pt-cg dyad dem hig cmplx,,,17.35,20.09,8
HCPCS,G0522,Mgt nw pt dementia low cmplx,,,17.35,20.09,8
HCPCS,G0523,Mgt nw pt dem mod-high cmplx,,,17.35,20.09,8
HCPCS,G0524,Est pt-cg dyad dem low cmplx,,,17.35,20.09,8
HCPCS,G0525,Est pt-cg dyad dem mod cmplx,,,17.35,20.09,8
HCPCS,G0526,Est pt-cg dyad dem hig cmplx,,,17.35,20.09,8
HCPCS,G0527,Mgt est pt dmentia low cmplx,,,17.35,20.09,8
HCPCS,G0528,Mgt est pt dem mod-hi cmplx,,,17.35,20.09,8
HCPCS,G0529,"In home respite care, 4 hr u",,,17.35,20.09,8
HCPCS,G0530,"Adult daycare center, 8 hr u",,,17.35,20.09,8
HCPCS,G0531,"Fclty-based respite, 24 hr u",,,17.35,20.09,8
HCPCS,G0532,Take home supp nasal spray,,,7.65,8.86,8
HCPCS,G0533,Buprenorphone inj weekly,,,30.27,35.05,8
HCPCS,G0534,Coordinated care/or referral,,,30.27,35.05,8
HCPCS,G0535,Pt navigat svs direct/ref,,,30.27,35.05,8
HCPCS,G0536,Peer recover support svs,,,30.27,35.05,8
HCPCS,G0537,RISK ASCVD TST ONCE PR 12 MO,224.5,145.925,1.1,370.0,104
HCPCS,G0538,ASCVD RSK MNG CLIN STF PR MO,224.5,145.925,1.1,370.0,96
HCPCS,G0539,Initial care training 30 m,,,31.04,155.9,30
HCPCS,G0540,Train for caregiver add 15,,,30.26,83.22,30
HCPCS,G0541,No pt prsnt train initial 30,,,27.36,81.07,26
HCPCS,G0542,No pt prsnt train add 15,,,31.04,35.94,13
HCPCS,G0543,Group train w/o patient,,,14.15,81.07,26
HCPCS,G0544,Post d/c phone follow up,,,85.47,284.74,19
HCPCS,G0545,INFECTIOUS DISEASE CONFIRMED/SUSPECTED INHERENT TO INPATIENT OR,392.0,254.8,1.1,392.0,43
HCPCS,G0545,Inherent visit to inpt,,,50.62,58.61,8
HCPCS,G0552,SUPPLY OF DIGITAL DEVICE,381.5,247.975,1.1,515.0,85
HCPCS,G0553,MONTHLY TX FOR DMHT 20MINS,394.0,256.1,1.1,515.0,90
HCPCS,G0554,ADD 20 M OF MONTHLY TX,263.0,170.95,1.1,268.0,75
HCPCS,G0555,Replacment pt electronic sys,,,68.77,2406.92,27
HCPCS,G0556,ADV PRIM CARE MGMT LVL 1,110.0,71.5,1.1,110.0,43
HCPCS,G0556,Adv prim care mgmt lvl 1,,,27.53,105.02,19
HCPCS,G0557,ADV PRIM CARE MGMT LVL 2,339.0,220.35,1.1,339.0,43
HCPCS,G0557,Adv prim care mgmt lvl 2,,,27.53,105.02,19
HCPCS,G0558,ADV PRIM CARE MGMT LVL 3,735.0,477.75,1.1,735.0,43
HCPCS,G0558,Adv prim care mgmt lvl 3,,,85.47,284.74,19
HCPCS,G0559,POST-OP FOLLOW-UP PROVIDED BY A DIFFERENT PRACTICE FROM THE SURG,70.0,45.5,1.1,70.0,43
HCPCS,G0559,Unrelat prac follow up visit,,,50.62,58.61,8
HCPCS,G0560,Safety plan interven,,,32.9,158.51,30
HCPCS,G0561,"Temp tube delivery, unil",,,159.5,184.68,8
HCPCS,G0562,Complex simulation w/pet-ct,,,388.13,5351.05,27
HCPCS,G0563,Sbrt w/positron emission del,,,785.65,8917.51,27
HCPCS,G0564,365 d implant glucose sensor,,,309.06,3243.67,14
HCPCS,G0565,Rem/ins glu snsr 365 dif sit,,,309.06,3243.67,14
HCPCS,G0566,3d bn img algor drvd fr mri,,,68.91,792.09,22
HCPCS,G0567,Screening hep c detect,,,26.69,143.79,22
HCPCS,G0568,"Int psych care mng, 1 cal mo",,,96.11,284.74,13
HCPCS,G0569,"Subs psych care mng, subs mo",,,96.11,284.74,13
HCPCS,G0570,"Care manage serv, pr cal mo",,,35.45,105.02,13
HCPCS,G0571,INTRAOP NERVE CRYOABLATION,598.0,388.7,1.1,598.0,35
HCPCS,G0571,Intraop nerve cryoablation,,,534.53,618.93,8
HCPCS,G0659,Drug test def simple all cl,,,27.64,254.64,29
HCPCS,G0660,Team remote e/m new pt 10 mn,,,54.56,63.17,8
HCPCS,G0661,Team remote e/m new pt 20 mn,,,54.56,63.17,8
HCPCS,G0662,Team remote e/m new pt 30 mn,,,54.56,63.17,8
HCPCS,G0663,Team remote e/m new pt 45 mn,,,54.56,63.17,8
HCPCS,G0664,Team remote e/m new pt 60 mn,,,54.56,63.17,8
HCPCS,G0665,Team remote e/m est pt 10 mn,,,54.56,63.17,8
HCPCS,G0666,Team remote e/m est pt 15 mn,,,54.56,63.17,8
HCPCS,G0667,Team remote e/m est pt 25 mn,,,54.56,63.17,8
HCPCS,G0668,Team remote e/m est pt 40 mn,,,54.56,63.17,8
HCPCS,G0680,Cr art clc art vlv clc w rpt,,,145.8,168.82,8
HCPCS,G0681,App of non-sheet skin sub,,,1166.12,1350.24,8
HCPCS,G0682,App of non-sheet skin sub ad,,,1166.12,1350.24,8
HCPCS,G0683,App of non-sheet skin sub g,,,1166.12,1350.24,8
HCPCS,G0684,App non-sheet skin sb g add,,,1166.12,1350.24,8
HCPCS,G0913,Improve visual funct,,,8.48,9.82,8
HCPCS,G0914,Survey not complete,,,8.48,9.82,8
HCPCS,G0915,No improve visual funct,,,8.48,9.82,8
HCPCS,G0916,Satisfy with care,,,8.48,9.82,8
HCPCS,G0917,Care survey not complete,,,8.48,9.82,8
HCPCS,G0918,No satisfy with care,,,8.48,9.82,8
HCPCS,G1001,Cdsm evicore,,,8.48,9.82,8
HCPCS,G1002,Cdsm medcurrent,,,8.48,9.82,8
HCPCS,G1003,Cdsm medicalis,,,8.48,9.82,8
HCPCS,G1004,Cdsm ndsc,,,8.48,9.82,8
HCPCS,G1005,Cdsm nia,,,8.48,9.82,8
HCPCS,G1006,Cdsm test approp,,,8.48,9.82,8
HCPCS,G1007,Cdsm aim,,,8.48,9.82,8
HCPCS,G1008,Cdsm cranberry pk,,,8.48,9.82,8
HCPCS,G1009,Cdsm sage health,,,8.48,9.82,8
HCPCS,G1010,Cdsm stanson,,,8.48,9.82,8
HCPCS,G1011,Cdsm qualified nos,,,8.48,9.82,8
HCPCS,G1012,Cdsm agilemd,,,8.48,9.82,8
HCPCS,G1013,Cdsm evidencecare,,,8.48,9.82,8
HCPCS,G1014,Cdsm inveniqa,,,8.48,9.82,8
HCPCS,G1015,Cdsm reliant,,,8.48,9.82,8
HCPCS,G1016,Cdsm speed of care,,,8.48,9.82,8
HCPCS,G1017,Cdsm healthhelp,,,8.48,9.82,8
HCPCS,G1018,Cdsm infinx,,,8.48,9.82,8
HCPCS,G1019,Cdsm logicnets,,,8.48,9.82,8
HCPCS,G1020,Cdsm curbside,,,8.48,9.82,8
HCPCS,G1021,Cdsm ehealthline,,,8.48,9.82,8
HCPCS,G1022,Cdsm intermountain,,,8.48,9.82,8
HCPCS,G1023,Cdsm persivia,,,8.48,9.82,8
HCPCS,G1024,Cdsm radrite,,,8.48,9.82,8
HCPCS,G1025,Pt mnth 1 mcp prov,,,8.48,9.82,8
HCPCS,G1026,Pt hemo > 3mo,,,8.48,9.82,8
HCPCS,G1027,Pt hemo < 3mo,,,8.48,9.82,8
HCPCS,G1028,Take home supply 8mg per 0.1,,,7.65,8.86,8
HCPCS,G2000,Blinded conv. tx mdd clin tr,,,353.04,1045.9,27
HCPCS,G2010,Remot image submit by pt,,,8.52,9.87,8
HCPCS,G2011,Alcohol/sub misuse assess,,,22.63,81.07,27
HCPCS,G2012,Brief check in by md/qhp,,,8.52,9.87,8
HCPCS,G2020,Hi inten serv for sip model,,,17.35,20.09,8
HCPCS,G2021,Hea care pract tx in place,,,8.48,9.82,8
HCPCS,G2022,"Benef refuses service, mod",,,8.48,9.82,8
HCPCS,G2023,Specimen collect covid-19,,,2.09,49.46,10
HCPCS,G2024,Spec coll snf/lab covid-19,,,2.09,53.68,10
HCPCS,G2025,Dis site tele svcs rhc/fqhc,,,54.56,63.17,8
HCPCS,G2061,Qual nonmd est pt 5-10m,,,54.56,63.17,8
HCPCS,G2062,Qual nonmd est pt 11-20m,,,54.56,63.17,8
HCPCS,G2063,Qual nonmd est pt 21>min,,,54.56,63.17,8
HCPCS,G2067,Med assist tx meth wk,,,30.27,35.05,8
HCPCS,G2068,Med assist tx bupre oral,,,30.27,35.05,8
HCPCS,G2069,Med assist tx inject,,,30.27,35.05,8
HCPCS,G2070,Med assist tx implant,,,84.09,97.37,8
HCPCS,G2071,Med tx remove implant,,,30.27,35.05,8
HCPCS,G2072,Med tx insert/remove imp,,,84.09,97.37,8
HCPCS,G2073,Med tx naltrexone,,,30.27,35.05,8
HCPCS,G2074,Med assist tx no drug,,,30.27,35.05,8
HCPCS,G2075,Med tx meds nos,,,30.27,35.05,8
HCPCS,G2076,Intake act w/med exam,,,156.65,181.38,8
HCPCS,G2077,Periodic assessment,,,156.65,181.38,8
HCPCS,G2078,Take-home meth,,,7.65,8.86,8
HCPCS,G2079,Take-hom buprenorphine,,,7.65,8.86,8
HCPCS,G2080,Add 30 mins counsel,,,8.4,9.72,8
HCPCS,G2081,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G2082,Visit esketamine 56m or less,,,310.37,2881.97,27
HCPCS,G2083,"Visit esketamine, > 56m",,,310.37,4528.03,27
HCPCS,G2086,Off base opioid tx 70min,,,148.46,497.49,19
HCPCS,G2087,"Off base opioid tx, 60 m",,,148.46,497.49,19
HCPCS,G2089,A1c level 7 to 9%,,,8.48,9.82,8
HCPCS,G2090,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,G2091,Pt 66+ frailty and adv ill,,,8.48,9.82,8
HCPCS,G2092,Ace arb arni,,,8.48,9.82,8
HCPCS,G2093,Med doc rsn no ace arn arni,,,8.48,9.82,8
HCPCS,G2094,Pt rsn no ace arn arni,,,8.48,9.82,8
HCPCS,G2095,Sys rsn no ace arn arni,,,8.48,9.82,8
HCPCS,G2096,No rsn ace arb arni,,,8.48,9.82,8
HCPCS,G2097,Dx uri 3d after other dx,,,8.48,9.82,8
HCPCS,G2098,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,G2099,Pt 66+ frailty and adv ill,,,8.48,9.82,8
HCPCS,G2100,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,G2101,Pt 66+ frailty and adv ill,,,8.48,9.82,8
HCPCS,G2102,Dil retinal eye exam,,,8.48,9.82,8
HCPCS,G2103,7 stereo photos interpret,,,8.48,9.82,8
HCPCS,G2104,Eye img valid w/7 stereo,,,8.48,9.82,8
HCPCS,G2105,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G2106,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,G2107,Pt 66+ frailty and adv ill,,,8.48,9.82,8
HCPCS,G2108,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G2109,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,G2110,Pt 66+ frailty and adv ill,,,8.48,9.82,8
HCPCS,G2112,Pred<=5 mg ra glu <6m,,,8.48,9.82,8
HCPCS,G2113,"Pred>5 mg >6m, no chg da",,,8.48,9.82,8
HCPCS,G2114,Pt 66-80 frailty and med dem,,,8.48,9.82,8
HCPCS,G2115,Pt 66-80 frailty and med dem,,,8.48,9.82,8
HCPCS,G2116,Pt 66-80 frailty and adv ill,,,8.48,9.82,8
HCPCS,G2117,Pt 66-80 frailty and adv ill,,,8.48,9.82,8
HCPCS,G2118,Pt 81+ frailty,,,8.48,9.82,8
HCPCS,G2119,Calc vitd opt,,,8.48,9.82,8
HCPCS,G2120,No calc vitd opt,,,8.48,9.82,8
HCPCS,G2121,Psy dep anx ap and icd asse,,,8.48,9.82,8
HCPCS,G2122,Psy/dep/anx/apandicd noasse,,,8.48,9.82,8
HCPCS,G2123,Pt 66-80 frailty med dem,,,8.48,9.82,8
HCPCS,G2124,Pt 66-80 frailty adv ill,,,8.48,9.82,8
HCPCS,G2125,Pt 81+ frailty,,,8.48,9.82,8
HCPCS,G2126,Pt 66-80 frailty and adv ill,,,8.48,9.82,8
HCPCS,G2127,Pt 66-80 frailty and med dem,,,8.48,9.82,8
HCPCS,G2128,No aspirin med rsn,,,8.48,9.82,8
HCPCS,G2129,No bp outpt,,,8.48,9.82,8
HCPCS,G2130,Pt 66+ lt inst > 90,,,8.48,9.82,8
HCPCS,G2131,Pt 81+ frailty,,,8.48,9.82,8
HCPCS,G2132,Pt 66-80 frailty and med dem,,,8.48,9.82,8
HCPCS,G2133,Pt 66-80 frailty and adv ill,,,8.48,9.82,8
HCPCS,G2134,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,G2135,Pt 66+ frailty and adv ill,,,8.48,9.82,8
HCPCS,G2136,Bk pain vas 6-20wk <= 3,,,8.48,9.82,8
HCPCS,G2137,Bk pain vas 6-20wk > 3,,,8.48,9.82,8
HCPCS,G2138,Bk pain vas 9-15mo <= 3,,,8.48,9.82,8
HCPCS,G2139,Bk pain vas 9-15mo > 3,,,8.48,9.82,8
HCPCS,G2140,Leg pain vas 6-20wk <= 3,,,8.48,9.82,8
HCPCS,G2141,Leg pain vas 6-20wk > 3,,,8.48,9.82,8
HCPCS,G2142,Fs odi 9-15mo postop<= 22,,,8.48,9.82,8
HCPCS,G2143,Fs odi 9-15mo > 22,,,8.48,9.82,8
HCPCS,G2144,Fs odi 6-20wk postop <= 22,,,8.48,9.82,8
HCPCS,G2145,Fsodi 6-20wk >22 or chg 30pt,,,8.48,9.82,8
HCPCS,G2146,Leg pain vas 9-15mo <= 3,,,8.48,9.82,8
HCPCS,G2147,Leg pain vas 9-15mo > 3,,,8.48,9.82,8
HCPCS,G2148,Mpm used,,,8.48,9.82,8
HCPCS,G2149,No mpm med rsn,,,8.48,9.82,8
HCPCS,G2150,No mpm,,,8.48,9.82,8
HCPCS,G2151,Dx degen neuro,,,8.48,9.82,8
HCPCS,G2152,Res change sc >=0,,,8.48,9.82,8
HCPCS,G2153,Hosp dur meas pd,,,8.48,9.82,8
HCPCS,G2154,Td 9 yrs start end meas,,,8.48,9.82,8
HCPCS,G2155,Hist contraindications,,,8.48,9.82,8
HCPCS,G2156,No prior td or hx contra,,,8.48,9.82,8
HCPCS,G2157,Pneum vacc 12 mo 60+,,,8.48,9.82,8
HCPCS,G2158,Pneum vacc adv rx,,,8.48,9.82,8
HCPCS,G2159,No pneum vacc 12 mo 60+,,,8.48,9.82,8
HCPCS,G2160,Herpzos 50+,,,8.48,9.82,8
HCPCS,G2161,Adv rx zos,,,8.48,9.82,8
HCPCS,G2162,No herpzos 50+,,,8.48,9.82,8
HCPCS,G2163,Infl vacc 07/01 to 06/30,,,8.48,9.82,8
HCPCS,G2164,Adv rx infl vacc,,,8.48,9.82,8
HCPCS,G2165,No infl vacc 07/01 to 06/30,,,8.48,9.82,8
HCPCS,G2166,No pt adm dx no neck fs prom,,,8.48,9.82,8
HCPCS,G2167,Res change sc < 0,,,8.48,9.82,8
HCPCS,G2170,Avf by tissue w thermal e,,,2503.09,2898.31,8
HCPCS,G2171,Avf use magnetic/art/ven,,,2503.09,2898.31,8
HCPCS,G2172,Tx for opioid use demo proj,,,30.27,35.05,8
HCPCS,G2173,Uri w comorb 12m oth dx,,,8.48,9.82,8
HCPCS,G2174,Uri new rx antibiotic 30d,,,8.48,9.82,8
HCPCS,G2175,Pt comorb dx 12m of epi,,,8.48,9.82,8
HCPCS,G2176,Outpt ed obs w inpt admit,,,8.48,9.82,8
HCPCS,G2177,Bronch w rx antibx 30d,,,8.48,9.82,8
HCPCS,G2178,Pt not elig low neuro ex,,,8.48,9.82,8
HCPCS,G2179,Med doc rsn no low ex,,,8.48,9.82,8
HCPCS,G2180,Inelig footwr eval,,,8.48,9.82,8
HCPCS,G2181,Bmi not doc medrsn ptref,,,8.48,9.82,8
HCPCS,G2182,Pt 1st biolog antirheum,,,8.48,9.82,8
HCPCS,G2183,Doc pt unable comm,,,8.48,9.82,8
HCPCS,G2184,No caregiver,,,8.48,9.82,8
HCPCS,G2185,Caregiver dem trained,,,8.48,9.82,8
HCPCS,G2186,Pt ref app rsrcs,,,8.48,9.82,8
HCPCS,G2187,Clin ind img hd trauma,,,8.48,9.82,8
HCPCS,G2188,Pt 50 yrs w/clin ind hd,,,8.48,9.82,8
HCPCS,G2189,Img hd abnml neuro exam,,,8.48,9.82,8
HCPCS,G2190,Ind img hd rad neck,,,8.48,9.82,8
HCPCS,G2191,Ind img hd pos hd ache,,,8.48,9.82,8
HCPCS,G2192,>55 yrs temp hd ache,,,8.48,9.82,8
HCPCS,G2193,<6yr new onset hd ache,,,8.48,9.82,8
HCPCS,G2194,New hdache ped pt dis,,,8.48,9.82,8
HCPCS,G2195,Occip hdache child,,,8.48,9.82,8
HCPCS,G2196,Screen unhlthy etoh use,,,8.48,9.82,8
HCPCS,G2197,Screen hlthy etoh use,,,8.48,9.82,8
HCPCS,G2198,Med rsn no unhlthy etoh,,,8.48,9.82,8
HCPCS,G2199,Not scrn etoh no rsn,,,8.48,9.82,8
HCPCS,G2200,Unhlthy etoh rcvd couns,,,8.48,9.82,8
HCPCS,G2201,Med rsn no brief couns,,,8.48,9.82,8
HCPCS,G2202,No rsn no brief couns,,,8.48,9.82,8
HCPCS,G2203,Med rsn no etoh couns,,,8.48,9.82,8
HCPCS,G2204,Pt 45-85 w/ scope,,,8.48,9.82,8
HCPCS,G2205,Preg drng adjv trtmt,,,8.48,9.82,8
HCPCS,G2206,Adjv trtmt chemo her2,,,8.48,9.82,8
HCPCS,G2207,Rsn no trtmt chem her2,,,8.48,9.82,8
HCPCS,G2208,No trtmt chemo and her2,,,8.48,9.82,8
HCPCS,G2209,Refused to participate,,,8.48,9.82,8
HCPCS,G2210,No neck fs prom no rsn,,,8.48,9.82,8
HCPCS,G2211,Complex e/m visit add on,,,50.62,58.61,8
HCPCS,G2211,VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC,145.0,94.25,1.1,145.0,44
HCPCS,G2212,PROLONG OUTPT/OFFICE VIS,268.0,174.2,1.1,268.0,50
HCPCS,G2212,Prolong outpt/office vis,,,50.62,58.61,8
HCPCS,G2213,INITIAT MED ASSIST TX IN ER,572.0,371.8,1.1,572.0,44
HCPCS,G2213,Initiat med assist tx in er,,,8.4,9.72,8
HCPCS,G2214,Init/sub psych care m 1st 30,,,85.47,284.74,19
HCPCS,G2215,Home supply nasal naloxone,,,7.65,8.86,8
HCPCS,G2216,Home supply inject naloxon,,,7.65,8.86,8
HCPCS,G2250,"Remot img sub by pt, non e/m",,,8.52,30.2,30
HCPCS,G2251,"Brief chkin, 5-10, non-e/m",,,8.52,40.81,30
HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,8.52,83.63,30
HCPCS,G3002,"CHRONIC PAIN MANAGEMENT AND TREATMENT, MONTHLY 30 MINUTES",638.0,414.7,1.1,638.0,44
HCPCS,G3003,"CHRONIC PAIN MANAGEMENT AND TREATMENT, MONTHLY EACH ADDITIONAL 1",220.0,143.0,1.1,220.0,44
HCPCS,G4000,Dermatology ss,,,8.48,9.82,8
HCPCS,G4001,Diagnostic rad ss,,,8.48,9.82,8
HCPCS,G4002,Ep cardio ss,,,8.48,9.82,8
HCPCS,G4003,Emergency med ss,,,8.48,9.82,8
HCPCS,G4004,Endocrinology ss,,,8.48,9.82,8
HCPCS,G4005,Family medicine ss,,,8.48,9.82,8
HCPCS,G4006,Gastroenterology ss,,,8.48,9.82,8
HCPCS,G4007,General surgery ss,,,8.48,9.82,8
HCPCS,G4008,Geriatrics ss,,,8.48,9.82,8
HCPCS,G4009,Hospitalists ss,,,8.48,9.82,8
HCPCS,G4010,Infectious disease ss,,,8.48,9.82,8
HCPCS,G4011,Internal medicine ss,,,8.48,9.82,8
HCPCS,G4012,Interventional rad ss,,,8.48,9.82,8
HCPCS,G4013,Mntal/behav/psych hlth ss,,,8.48,9.82,8
HCPCS,G4014,Nephrology ss,,,8.48,9.82,8
HCPCS,G4015,Neurology ss,,,8.48,9.82,8
HCPCS,G4016,Neurosurgical ss,,,8.48,9.82,8
HCPCS,G4017,Nutrition/dietician ss,,,8.48,9.82,8
HCPCS,G4018,Ob/gyn ss,,,8.48,9.82,8
HCPCS,G4019,Oncology/hema ss,,,8.48,9.82,8
HCPCS,G4020,Ophthalmology/optometry ss,,,8.48,9.82,8
HCPCS,G4021,Orthopedic surgery ss,,,8.48,9.82,8
HCPCS,G4022,Otolaryngology ss,,,8.48,9.82,8
HCPCS,G4023,Pathology ss,,,8.48,9.82,8
HCPCS,G4024,Pediatrics ss,,,8.48,9.82,8
HCPCS,G4025,Physical medicine ss,,,8.48,9.82,8
HCPCS,G4026,Phys/occ therapy ss,,,8.48,9.82,8
HCPCS,G4027,Plastic surgery ss,,,8.48,9.82,8
HCPCS,G4028,Podiatry ss,,,8.48,9.82,8
HCPCS,G4029,Preventive medicine ss,,,8.48,9.82,8
HCPCS,G4030,Pulmonology ss,,,8.48,9.82,8
HCPCS,G4031,Radiation oncology ss,,,8.48,9.82,8
HCPCS,G4032,Rheumatology ss,,,8.48,9.82,8
HCPCS,G4033,Skilled nursing facility ss,,,8.48,9.82,8
HCPCS,G4034,Speech language path ss,,,8.48,9.82,8
HCPCS,G4035,Thoracic surgery ss,,,8.48,9.82,8
HCPCS,G4036,Urgent care ss,,,8.48,9.82,8
HCPCS,G4037,Urology ss,,,8.48,9.82,8
HCPCS,G4038,Vascular surgery ss,,,8.48,9.82,8
HCPCS,G6001,Echo guidance radiotherapy,,,74.0,85.68,8
HCPCS,G6002,Stereoscopic x-ray guidance,,,89.44,103.57,8
HCPCS,G6003,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6004,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6005,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6006,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6007,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6008,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6009,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6010,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6011,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6012,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6013,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6014,Radiation treatment delivery,,,108.37,125.48,8
HCPCS,G6015,Radiation tx delivery imrt,,,284.58,329.52,8
HCPCS,G6016,Delivery comp imrt,,,388.13,449.42,8
HCPCS,G6017,Intrafraction track motion,,,8.48,9.82,8
HCPCS,G8395,Lvef>=40% doc normal or mild,,,8.48,9.82,8
HCPCS,G8396,Lvef not performed,,,8.48,9.82,8
HCPCS,G8397,Dil macula/fundus exam/w doc,,,8.48,9.82,8
HCPCS,G8398,Dil macular/fundus not perfo,,,8.48,9.82,8
HCPCS,G8399,Pt w/dxa results document,,,8.48,9.82,8
HCPCS,G8400,Pt w/dxa no results doc,,,8.48,9.82,8
HCPCS,G8404,Low extemity neur exam docum,,,8.48,9.82,8
HCPCS,G8405,Low extemity neur not perfor,,,8.48,9.82,8
HCPCS,G8410,Eval on foot documented,,,8.48,9.82,8
HCPCS,G8415,Eval on foot not performed,,,8.48,9.82,8
HCPCS,G8416,Pt inelig footwear evaluatio,,,8.48,9.82,8
HCPCS,G8417,Calc bmi abv up param f/u,,,8.48,9.82,8
HCPCS,G8418,Calc bmi blw low param f/u,,,8.48,9.82,8
HCPCS,G8419,Calc bmi out nrm param nof/u,,,8.48,9.82,8
HCPCS,G8420,Calc bmi norm parameters,,,8.48,9.82,8
HCPCS,G8421,Bmi not calculated,,,8.48,9.82,8
HCPCS,G8422,Pt inelig bmi calculation,,,8.48,9.82,8
HCPCS,G8427,Docrev cur meds by elig clin,,,8.48,9.82,8
HCPCS,G8428,Cur meds not document,,,8.48,9.82,8
HCPCS,G8430,Doc med rsn no medrec,,,8.48,9.82,8
HCPCS,G8431,Pos clin depres scrn f/u doc,,,8.48,9.82,8
HCPCS,G8432,"Dep scr not doc, rng",,,8.48,9.82,8
HCPCS,G8433,Scr for dep not cpt doc rsn,,,8.48,9.82,8
HCPCS,G8442,"Doc pain as nt perf, not elg",,,8.48,9.82,8
HCPCS,G8450,Beta-bloc rx pt w/abn lvef,,,8.48,9.82,8
HCPCS,G8451,Pt w/abn lvef inelig b-bloc,,,8.48,9.82,8
HCPCS,G8452,Pt w/abn lvef b-bloc no rx,,,8.48,9.82,8
HCPCS,G8465,High risk recurrence pro ca,,,8.48,9.82,8
HCPCS,G8473,Ace/arb thxpy rx'd,,,8.48,9.82,8
HCPCS,G8474,Ace/arb not rx'd; doc reas,,,8.48,9.82,8
HCPCS,G8475,Ace/arb thxpy not rx'd,,,8.48,9.82,8
HCPCS,G8476,Bp sys <140 and dias <90,,,8.48,9.82,8
HCPCS,G8477,Bp sys>=140 and/or dias >=90,,,8.48,9.82,8
HCPCS,G8478,Bp not performed/doc,,,8.48,9.82,8
HCPCS,G8482,Flu immunize order/admin,,,8.48,9.82,8
HCPCS,G8483,Flu imm no admin doc rea,,,8.48,9.82,8
HCPCS,G8484,Flu immunize no admin,,,8.48,9.82,8
HCPCS,G8506,Pt rec ace/arb,,,8.48,9.82,8
HCPCS,G8509,Pos pain assess no f/u doc,,,8.48,9.82,8
HCPCS,G8510,"Scr dep neg, no plan reqd",,,8.48,9.82,8
HCPCS,G8511,"Scr dep pos, no plan doc rng",,,8.48,9.82,8
HCPCS,G8535,Eld maltreatment not doc,,,8.48,9.82,8
HCPCS,G8536,No doc elder mal scrn,,,8.48,9.82,8
HCPCS,G8539,Doc funct and care plan,,,8.48,9.82,8
HCPCS,G8540,Foa not doc as being perf,,,8.48,9.82,8
HCPCS,G8541,No doc cur funct assess,,,8.48,9.82,8
HCPCS,G8542,Doc funct no deficiencies,,,8.48,9.82,8
HCPCS,G8543,Cur funct asses; no care pln,,,8.48,9.82,8
HCPCS,G8559,Pt ref doc oto eval,,,8.48,9.82,8
HCPCS,G8560,Pt hx act drain prev 90 days,,,8.48,9.82,8
HCPCS,G8561,Pt inelig for ref oto eval,,,8.48,9.82,8
HCPCS,G8562,Pt no hx act drain 90 d,,,8.48,9.82,8
HCPCS,G8563,Pt no ref oto reas no spec,,,8.48,9.82,8
HCPCS,G8564,Pt ref oto eval,,,8.48,9.82,8
HCPCS,G8565,Ver doc hear loss,,,8.48,9.82,8
HCPCS,G8566,Pt inelig ref oto eval,,,8.48,9.82,8
HCPCS,G8567,Pt no doc hear loss,,,8.48,9.82,8
HCPCS,G8568,Pt no ref otolo no spec,,,8.48,9.82,8
HCPCS,G8569,Prol intubation req,,,8.48,9.82,8
HCPCS,G8570,No prol intub req,,,8.48,9.82,8
HCPCS,G8571,Ster wd ifx 30 d postop,,,8.48,9.82,8
HCPCS,G8572,No ster wd ifx,,,8.48,9.82,8
HCPCS,G8573,Stk cabg,,,8.48,9.82,8
HCPCS,G8574,No strk cabg,,,8.48,9.82,8
HCPCS,G8575,Postop ren fail,,,8.48,9.82,8
HCPCS,G8576,No postop ren fail,,,8.48,9.82,8
HCPCS,G8577,Reop req bld grft oth,,,8.48,9.82,8
HCPCS,G8578,No reop req bld grft oth,,,8.48,9.82,8
HCPCS,G8598,Asa/antiplat ther used,,,8.48,9.82,8
HCPCS,G8599,No asa/antiplat ther use rng,,,8.48,9.82,8
HCPCS,G8600,Tpa initi w/in 4.5 hr,,,8.48,9.82,8
HCPCS,G8601,No elig tpa init w/in 4.5 hr,,,8.48,9.82,8
HCPCS,G8602,No tpa init w/in 4.5 hr,,,8.48,9.82,8
HCPCS,G8627,Surg proc w/in 30 days,,,8.48,9.82,8
HCPCS,G8628,No surg proc w/in 30 days,,,8.48,9.82,8
HCPCS,G8633,Pharm ther osteo rx,,,8.48,9.82,8
HCPCS,G8635,No pharm ther osteo rx,,,8.48,9.82,8
HCPCS,G8647,Rafscrs ki scor >= 0,,,8.48,9.82,8
HCPCS,G8648,Rafscrs ki scor < 0,,,8.48,9.82,8
HCPCS,G8650,Rafs crs ki no scor no rsn,,,8.48,9.82,8
HCPCS,G8651,Rafscrs hi scor >=0,,,8.48,9.82,8
HCPCS,G8652,Rafscrs hi scor < 0,,,8.48,9.82,8
HCPCS,G8654,Rafs crs hi no scor no surv,,,8.48,9.82,8
HCPCS,G8655,Rafscrs llfai scor >= 0,,,8.48,9.82,8
HCPCS,G8656,Rafscrs llfai scor < 0,,,8.48,9.82,8
HCPCS,G8658,Rafscrs llfai no scor + surv,,,8.48,9.82,8
HCPCS,G8659,Rafscrs lbi scor >= 0,,,8.48,9.82,8
HCPCS,G8660,Rafscrs lbi scor < 0,,,8.48,9.82,8
HCPCS,G8661,Rafscrs lbi no scor,,,8.48,9.82,8
HCPCS,G8662,Rafs crs lbi no scor no surv,,,8.48,9.82,8
HCPCS,G8663,Rafscrs si scor >= 0,,,8.48,9.82,8
HCPCS,G8664,Rafscrs si scor < 0,,,8.48,9.82,8
HCPCS,G8666,Rafs crs si no scor no surv,,,8.48,9.82,8
HCPCS,G8667,Rafscrs ewh scor >= 0,,,8.48,9.82,8
HCPCS,G8668,Rafscrs ewh scor < 0,,,8.48,9.82,8
HCPCS,G8670,Rafs crs ewh no scor no surv,,,8.48,9.82,8
HCPCS,G8671,Rafscrs goi scor >= 0,,,8.48,9.82,8
HCPCS,G8672,Rafscrs goi scor < 0,,,8.48,9.82,8
HCPCS,G8674,"Rafscrs neck, no msr/no foto",,,8.48,9.82,8
HCPCS,G8694,Lvef <=40%,,,8.48,9.82,8
HCPCS,G8708,Antibiotic not pres,,,8.48,9.82,8
HCPCS,G8709,Uri ep compete diag,,,8.48,9.82,8
HCPCS,G8710,Pt pres antibiotic,,,8.48,9.82,8
HCPCS,G8711,Pres antibx on/within 3 day,,,8.48,9.82,8
HCPCS,G8712,Not pres antibiotic,,,8.48,9.82,8
HCPCS,G8721,"Pt, pn, hist grade doc",,,8.48,9.82,8
HCPCS,G8722,"Med reas pt, pn, not doc",,,8.48,9.82,8
HCPCS,G8723,Spec sit not prim tumor,,,8.48,9.82,8
HCPCS,G8724,"Pt, pn, hist grade not doc",,,8.48,9.82,8
HCPCS,G8730,Pain doc pos and plan,,,8.48,9.82,8
HCPCS,G8731,Pain neg no plan,,,8.48,9.82,8
HCPCS,G8732,No doc of pain,,,8.48,9.82,8
HCPCS,G8733,Doc pos elder mal scrn plan,,,8.48,9.82,8
HCPCS,G8734,Doc neg eld req,,,8.48,9.82,8
HCPCS,G8735,Eld mal scrn pos no plan,,,8.48,9.82,8
HCPCS,G8749,No signs melanoma,,,8.48,9.82,8
HCPCS,G8752,Sys bp less 140,,,8.48,9.82,8
HCPCS,G8753,Sys bp > or = 140,,,8.48,9.82,8
HCPCS,G8754,Dias bp less 90,,,8.48,9.82,8
HCPCS,G8755,Dias bp > or = 90,,,8.48,9.82,8
HCPCS,G8756,No bp measure doc,,,8.48,9.82,8
HCPCS,G8783,Bp scrn perf rec interval,,,8.48,9.82,8
HCPCS,G8785,Bp scrn no perf at interval,,,8.48,9.82,8
HCPCS,G8797,Specimen site not esophagus,,,8.48,9.82,8
HCPCS,G8798,Specimen site not prostate,,,8.48,9.82,8
HCPCS,G8806,Perf ultrsnd to lct preg doc,,,8.48,9.82,8
HCPCS,G8807,No ta tv ultrasnd,,,8.48,9.82,8
HCPCS,G8808,"Ultrasound not perf, rng",,,8.48,9.82,8
HCPCS,G8809,Rh-immunoglobulin order,,,8.48,9.82,8
HCPCS,G8810,Doc reas no rh-immuno,,,8.48,9.82,8
HCPCS,G8811,No rh-immunoglobulin order,,,8.48,9.82,8
HCPCS,G8815,Doc reas no statin therapy,,,8.48,9.82,8
HCPCS,G8816,Statin med pres at disch,,,8.48,9.82,8
HCPCS,G8817,Doc reas no statin med disch,,,8.48,9.82,8
HCPCS,G8818,Pt disch to home by day#7,,,8.48,9.82,8
HCPCS,G8825,Pt not disch to home day#7,,,8.48,9.82,8
HCPCS,G8826,Pt disch home day #2 evar,,,8.48,9.82,8
HCPCS,G8833,Pt not disch home day#2 evar,,,8.48,9.82,8
HCPCS,G8834,Pt disch home day #2 cea,,,8.48,9.82,8
HCPCS,G8838,Not disch home by day #2,,,8.48,9.82,8
HCPCS,G8839,Sleep apnea assess,,,8.48,9.82,8
HCPCS,G8840,Doc reas no sleep apnea,,,8.48,9.82,8
HCPCS,G8841,No sleep apnea assess,,,8.48,9.82,8
HCPCS,G8842,Ahi rdi rei doc win 2mo,,,8.48,9.82,8
HCPCS,G8843,Doc reas no ahi rdi rei,,,8.48,9.82,8
HCPCS,G8844,No ahi rdi rei ini dx no rsn,,,8.48,9.82,8
HCPCS,G8845,Pos airway press prescribed,,,8.48,9.82,8
HCPCS,G8846,Mod or severe osa,,,8.48,9.82,8
HCPCS,G8849,Doc reas no pos air press,,,8.48,9.82,8
HCPCS,G8850,No pap prescribed,,,8.48,9.82,8
HCPCS,G8851,Adhere tx assess at lst ann,,,8.48,9.82,8
HCPCS,G8852,Pos air press prescribe,,,8.48,9.82,8
HCPCS,G8854,Reas no adhere therapy,,,8.48,9.82,8
HCPCS,G8855,Ther not assessed annually,,,8.48,9.82,8
HCPCS,G8856,Ref for oto eval,,,8.48,9.82,8
HCPCS,G8857,No elig ref for oto eval,,,8.48,9.82,8
HCPCS,G8858,Not ref for oto eval,,,8.48,9.82,8
HCPCS,G8863,No assess bone loss,,,8.48,9.82,8
HCPCS,G8864,Pneumococcal vaccine admin,,,8.48,9.82,8
HCPCS,G8865,Doc med reas no pneumococcal,,,8.48,9.82,8
HCPCS,G8866,Doc pt reas no pneumococcal,,,8.48,9.82,8
HCPCS,G8867,No pneumococcal admin,,,8.48,9.82,8
HCPCS,G8869,Doc immune hep b antitnf,,,8.48,9.82,8
HCPCS,G8872,Intraop image confirm excise,,,8.48,9.82,8
HCPCS,G8873,Specimen not intraop image,,,8.48,9.82,8
HCPCS,G8874,Tissue not image intraop,,,8.48,9.82,8
HCPCS,G8875,Breast cancer dx min invsive,,,8.48,9.82,8
HCPCS,G8876,Doc reas no min inv dx,,,8.48,9.82,8
HCPCS,G8877,No brst cncr dx min invasive,,,8.48,9.82,8
HCPCS,G8878,Sent lymph node biopsy,,,8.48,9.82,8
HCPCS,G8880,Sen lym p node biop not perf,,,8.48,9.82,8
HCPCS,G8881,Brst cncr stage > t1n0m0,,,8.48,9.82,8
HCPCS,G8882,No sent lymph node biopsy,,,8.48,9.82,8
HCPCS,G8883,"Rev, comm, track, doc biopsy",,,8.48,9.82,8
HCPCS,G8884,Doc reas biopsy not review,,,8.48,9.82,8
HCPCS,G8885,"No rev, comm, track biopsy",,,8.48,9.82,8
HCPCS,G8907,Pt doc no events on discharg,,,8.48,9.82,8
HCPCS,G8908,Pt doc w burn prior to d/c,,,8.48,9.82,8
HCPCS,G8909,Pt doc no burn prior to d/c,,,8.48,9.82,8
HCPCS,G8910,Pt doc to have fall in asc,,,8.48,9.82,8
HCPCS,G8911,Pt doc no fall in asc,,,8.48,9.82,8
HCPCS,G8912,Pt doc with wrong event,,,8.48,9.82,8
HCPCS,G8913,Pt doc no wrong event,,,8.48,9.82,8
HCPCS,G8914,Pt trans to hosp post d/c,,,8.48,9.82,8
HCPCS,G8915,Pt not trans to hosp at d/c,,,8.48,9.82,8
HCPCS,G8916,Pt w iv ab given on time,,,8.48,9.82,8
HCPCS,G8917,Pt w iv ab not given on time,,,8.48,9.82,8
HCPCS,G8918,Pt w/o preop order iv ab pro,,,8.48,9.82,8
HCPCS,G8923,Lvef <= 40% or lvsd,,,8.48,9.82,8
HCPCS,G8924,Spir res doc fev1/fvc<70%,,,8.48,9.82,8
HCPCS,G8925,Spir fev1/fvc>=60% & no copd,,,8.48,9.82,8
HCPCS,G8926,Spiro no perf or doc,,,8.48,9.82,8
HCPCS,G8934,Lvef <=40% or dep lv sys fcn,,,8.48,9.82,8
HCPCS,G8935,Rx ace or arb therapy,,,8.48,9.82,8
HCPCS,G8936,Pt not eligible ace/arb,,,8.48,9.82,8
HCPCS,G8937,No rx ace/arb therapy,,,8.48,9.82,8
HCPCS,G8938,Bmi doc onl fup nt doc,,,8.48,9.82,8
HCPCS,G8939,"Pain as doc positive, no f/u",,,8.48,9.82,8
HCPCS,G8941,Eld maltreatment doc as pos,,,8.48,9.82,8
HCPCS,G8942,Doc fcn/care plan w/30 days,,,8.48,9.82,8
HCPCS,G8944,Ajcc mel cnr stg 0 - iic,,,8.48,9.82,8
HCPCS,G8946,Mibm but no dx of breast ca,,,8.48,9.82,8
HCPCS,G8950,"Pre-htn or htn doc, f/u indc",,,8.48,9.82,8
HCPCS,G8952,"Pre-htn/htn, no f/u, not gvn",,,8.48,9.82,8
HCPCS,G8955,Most recent assess vol mgmt,,,8.48,9.82,8
HCPCS,G8956,Pt rcv hedia outpt dyls fac,,,8.48,9.82,8
HCPCS,G8958,Assess vol mgmt not doc,,,8.48,9.82,8
HCPCS,G8959,Clin tx mdd comm to tx clin,,,8.48,9.82,8
HCPCS,G8960,Clin tx mdd not comm,,,8.48,9.82,8
HCPCS,G8961,Csit lowrisk surg pts preop,,,8.48,9.82,8
HCPCS,G8962,Csit on pt any reas 30 days,,,8.48,9.82,8
HCPCS,G8963,Csi per asx pt w/pci 2 yrs,,,8.48,9.82,8
HCPCS,G8964,Csi any other than pci 2 yr,,,8.48,9.82,8
HCPCS,G8965,Csit perf on low chd rsk,,,8.48,9.82,8
HCPCS,G8966,Csit perf sx or high chd rsk,,,8.48,9.82,8
HCPCS,G8967,Warf or other fda drug presc,,,8.48,9.82,8
HCPCS,G8968,Doc med not presb,,,8.48,9.82,8
HCPCS,G8969,Doc pt rsn no presc warf/fda,,,8.48,9.82,8
HCPCS,G8970,No rsk fac or 1 mod risk te,,,8.48,9.82,8
HCPCS,G8973,Mst rcnt hbb < 10g/dl,,,8.48,9.82,8
HCPCS,G8974,Hgb not doc rns not gvn,,,8.48,9.82,8
HCPCS,G8975,"Hgb <10g/dl, med rsn",,,8.48,9.82,8
HCPCS,G8976,Hgb >= 10 g/dl,,,8.48,9.82,8
HCPCS,G9001,"Mccd, initial rate",,,17.35,20.09,8
HCPCS,G9002,"Mccd,maintenance rate",,,17.35,20.09,8
HCPCS,G9003,"Mccd, risk adj hi, initial",,,17.35,20.09,8
HCPCS,G9004,"Mccd, risk adj lo, initial",,,17.35,20.09,8
HCPCS,G9005,"Mccd, risk adj, maintenance",,,17.35,20.09,8
HCPCS,G9006,"Mccd, home monitoring",,,17.35,20.09,8
HCPCS,G9007,"Mccd, sch team conf",,,17.35,20.09,8
HCPCS,G9008,"Mccd,phys coor-care ovrsght",,,17.35,20.09,8
HCPCS,G9009,"Mccd, risk adj, level 3",,,17.35,20.09,8
HCPCS,G9010,"Mccd, risk adj, level 4",,,17.35,20.09,8
HCPCS,G9011,"Mccd, risk adj, level 5",,,17.35,20.09,8
HCPCS,G9012,Other specified case mgmt,,,17.35,20.09,8
HCPCS,G9013,Esrd demo bundle level i,,,283.64,328.43,8
HCPCS,G9014,Esrd demo bundle-level ii,,,283.64,328.43,8
HCPCS,G9016,Demo-smoking cessation coun,,,37.4,43.31,8
HCPCS,G9037,Intrpro req fr rec phys/qhcp,,,50.45,54.49,5
HCPCS,G9038,Co-management services,,,17.35,67.9,13
HCPCS,G9050,Oncology work-up evaluation,,,8.48,9.82,8
HCPCS,G9051,Oncology tx decision-mgmt,,,8.48,9.82,8
HCPCS,G9052,Onc surveillance for disease,,,8.48,9.82,8
HCPCS,G9053,Onc expectant management pt,,,8.48,9.82,8
HCPCS,G9054,Onc supervision palliative,,,8.48,9.82,8
HCPCS,G9055,Onc visit unspecified nos,,,8.48,9.82,8
HCPCS,G9056,Onc prac mgmt adheres guide,,,8.48,9.82,8
HCPCS,G9057,Onc pract mgmt differs trial,,,8.48,9.82,8
HCPCS,G9058,Onc prac mgmt disagree w/gui,,,8.48,9.82,8
HCPCS,G9059,Onc prac mgmt pt opt alterna,,,8.48,9.82,8
HCPCS,G9060,Onc prac mgmt dif pt comorb,,,8.48,9.82,8
HCPCS,G9061,Onc prac cond noadd by guide,,,8.48,9.82,8
HCPCS,G9062,Onc prac guide differs nos,,,8.48,9.82,8
HCPCS,G9063,Onc dx nsclc stgi no progres,,,8.48,9.82,8
HCPCS,G9064,Onc dx nsclc stg2 no progres,,,8.48,9.82,8
HCPCS,G9065,Onc dx nsclc stg3a no progre,,,8.48,9.82,8
HCPCS,G9066,Onc dx nsclc stg3b-4 metasta,,,8.48,9.82,8
HCPCS,G9067,Onc dx nsclc dx unknown nos,,,8.48,9.82,8
HCPCS,G9068,Onc dx sclc/nsclc limited,,,8.48,9.82,8
HCPCS,G9069,Onc dx sclc/nsclc ext at dx,,,8.48,9.82,8
HCPCS,G9070,Onc dx sclc/nsclc ext unknwn,,,8.48,9.82,8
HCPCS,G9071,"Onc dx brst stg1-2b hr,nopro",,,8.48,9.82,8
HCPCS,G9072,Onc dx brst stg1-2 noprogres,,,8.48,9.82,8
HCPCS,G9073,"Onc dx brst stg3-hr, no pro",,,8.48,9.82,8
HCPCS,G9074,Onc dx brst stg3-noprogress,,,8.48,9.82,8
HCPCS,G9075,Onc dx brst metastic/ recur,,,8.48,9.82,8
HCPCS,G9077,Onc dx prostate t1no progres,,,8.48,9.82,8
HCPCS,G9078,Onc dx prostate t2no progres,,,8.48,9.82,8
HCPCS,G9079,Onc dx prostate t3b-t4noprog,,,8.48,9.82,8
HCPCS,G9080,Onc dx prostate w/rise psa,,,8.48,9.82,8
HCPCS,G9083,Onc dx prostate unknwn nos,,,8.48,9.82,8
HCPCS,G9084,"Onc dx colon t1-3,n1-2,no pr",,,8.48,9.82,8
HCPCS,G9085,"Onc dx colon t4, n0 w/o prog",,,8.48,9.82,8
HCPCS,G9086,Onc dx colon t1-4 no dx prog,,,8.48,9.82,8
HCPCS,G9087,Onc dx colon metas evid dx,,,8.48,9.82,8
HCPCS,G9088,Onc dx colon metas noevid dx,,,8.48,9.82,8
HCPCS,G9089,Onc dx colon extent unknown,,,8.48,9.82,8
HCPCS,G9090,Onc dx rectal t1-2 no progr,,,8.48,9.82,8
HCPCS,G9091,Onc dx rectal t3 n0 no prog,,,8.48,9.82,8
HCPCS,G9092,"Onc dx rectal t1-3,n1-2noprg",,,8.48,9.82,8
HCPCS,G9093,"Onc dx rectal t4,n,m0 no prg",,,8.48,9.82,8
HCPCS,G9094,Onc dx rectal m1 w/mets prog,,,8.48,9.82,8
HCPCS,G9095,Onc dx rectal extent unknwn,,,8.48,9.82,8
HCPCS,G9096,Onc dx esophag t1-t3 noprog,,,8.48,9.82,8
HCPCS,G9097,Onc dx esophageal t4 no prog,,,8.48,9.82,8
HCPCS,G9098,Onc dx esophageal mets recur,,,8.48,9.82,8
HCPCS,G9099,Onc dx esophageal unknown,,,8.48,9.82,8
HCPCS,G9100,Onc dx gastric no recurrence,,,8.48,9.82,8
HCPCS,G9101,Onc dx gastric p r1-r2noprog,,,8.48,9.82,8
HCPCS,G9102,Onc dx gastric unresectable,,,8.48,9.82,8
HCPCS,G9103,Onc dx gastric recurrent,,,8.48,9.82,8
HCPCS,G9104,Onc dx gastric unknown nos,,,8.48,9.82,8
HCPCS,G9105,Onc dx pancreatc p r0 res no,,,8.48,9.82,8
HCPCS,G9106,Onc dx pancreatc p r1/r2 no,,,8.48,9.82,8
HCPCS,G9107,Onc dx pancreatic unresectab,,,8.48,9.82,8
HCPCS,G9108,Onc dx pancreatic unknwn nos,,,8.48,9.82,8
HCPCS,G9109,Onc dx head/neck t1-t2no prg,,,8.48,9.82,8
HCPCS,G9110,Onc dx head/neck t3-4 noprog,,,8.48,9.82,8
HCPCS,G9111,Onc dx head/neck m1 mets rec,,,8.48,9.82,8
HCPCS,G9112,Onc dx head/neck ext unknown,,,8.48,9.82,8
HCPCS,G9113,Onc dx ovarian stg1a-b no pr,,,8.48,9.82,8
HCPCS,G9114,Onc dx ovarian stg1a-b or 2,,,8.48,9.82,8
HCPCS,G9115,Onc dx ovarian stg3/4 noprog,,,8.48,9.82,8
HCPCS,G9116,Onc dx ovarian recurrence,,,8.48,9.82,8
HCPCS,G9117,Onc dx ovarian unknown nos,,,8.48,9.82,8
HCPCS,G9123,Onc dx cml chronic phase,,,8.48,9.82,8
HCPCS,G9124,Onc dx cml acceler phase,,,8.48,9.82,8
HCPCS,G9125,Onc dx cml blast phase,,,8.48,9.82,8
HCPCS,G9126,Onc dx cml remission,,,8.48,9.82,8
HCPCS,G9128,Onc dx multi myeloma stage i,,,8.48,9.82,8
HCPCS,G9129,Onc dx mult myeloma stg2 hig,,,8.48,9.82,8
HCPCS,G9130,Onc dx multi myeloma unknown,,,8.48,9.82,8
HCPCS,G9131,Onc dx brst unknown nos,,,8.48,9.82,8
HCPCS,G9132,Onc dx prostate mets no cast,,,8.48,9.82,8
HCPCS,G9133,Onc dx prostate clinical met,,,8.48,9.82,8
HCPCS,G9134,Onc nhlstg 1-2 no relap no,,,8.48,9.82,8
HCPCS,G9135,Onc dx nhl stg 3-4 not relap,,,8.48,9.82,8
HCPCS,G9136,Onc dx nhl trans to lg bcell,,,8.48,9.82,8
HCPCS,G9137,Onc dx nhl relapse/refractor,,,8.48,9.82,8
HCPCS,G9138,Onc dx nhl stg unknown,,,8.48,9.82,8
HCPCS,G9139,Onc dx cml dx status unknown,,,8.48,9.82,8
HCPCS,G9140,Frontier extended stay demo,,,50.62,58.61,8
HCPCS,G9143,Warfarin respon genetic test,,,66.63,494.69,13
HCPCS,G9147,Outpt iv insulin tx any mea,,,310.37,359.38,8
HCPCS,G9148,Medical home level 1,,,8.48,9.82,8
HCPCS,G9149,Medical home level ii,,,8.48,9.82,8
HCPCS,G9150,Medical home level iii,,,8.48,9.82,8
HCPCS,G9151,Mapcp demo state,,,8.48,9.82,8
HCPCS,G9152,Mapcp demo community,,,8.48,9.82,8
HCPCS,G9153,Mapcp demo physician,,,8.48,9.82,8
HCPCS,G9156,Evaluation for wheelchair,,,50.62,58.61,8
HCPCS,G9157,Transesoph doppl cardiac mon,,,280.48,324.76,8
HCPCS,G9187,Bpci home visit,,,17.35,20.09,8
HCPCS,G9188,Beta not given no reason,,,8.48,9.82,8
HCPCS,G9189,Beta pres or already taking,,,8.48,9.82,8
HCPCS,G9190,Medical reason for no beta,,,8.48,9.82,8
HCPCS,G9191,Pt reason for no beta,,,8.48,9.82,8
HCPCS,G9192,System reason for no beta,,,8.48,9.82,8
HCPCS,G9196,Med reason for no ceph,,,8.48,9.82,8
HCPCS,G9197,Order for ceph,,,8.48,9.82,8
HCPCS,G9198,No order for ceph no reason,,,8.48,9.82,8
HCPCS,G9212,Doc of dsm-iv init eval,,,8.48,9.82,8
HCPCS,G9213,No doc of dsm-iv,,,8.48,9.82,8
HCPCS,G9223,Pjp proph ordered cd4 low,,,8.48,9.82,8
HCPCS,G9225,Norsn no foot exam,,,8.48,9.82,8
HCPCS,G9226,3 comp foot exam completed,,,8.48,9.82,8
HCPCS,G9227,"Foa doc, care plan not doc",,,8.48,9.82,8
HCPCS,G9228,Gc chl syp documented,,,8.48,9.82,8
HCPCS,G9229,Ptrsn no gc chl syp test,,,8.48,9.82,8
HCPCS,G9230,Norsn for gc chl syp test,,,8.48,9.82,8
HCPCS,G9231,Doc esrd dia trans preg,,,8.48,9.82,8
HCPCS,G9232,Ptrsn no comm comorbid,,,8.48,9.82,8
HCPCS,G9239,Doc rsn hemod & cath acc,,,8.48,9.82,8
HCPCS,G9240,Doc pt w cath maint dia,,,8.48,9.82,8
HCPCS,G9241,Doc pt w out cath maint dia,,,8.48,9.82,8
HCPCS,G9242,Doc viral load >=200,,,8.48,9.82,8
HCPCS,G9243,Doc viral load <200,,,8.48,9.82,8
HCPCS,G9246,No enc or enc/vir ld 90days,,,8.48,9.82,8
HCPCS,G9247,2 enc enc/vir ld 90d,,,8.48,9.82,8
HCPCS,G9250,Doc of pain comfort 48hr,,,8.48,9.82,8
HCPCS,G9251,Doc no pain comfort 48hr,,,8.48,9.82,8
HCPCS,G9254,Doc pt dischg >2d,,,8.48,9.82,8
HCPCS,G9255,Pt dc home 2nd po day,,,8.48,9.82,8
HCPCS,G9256,Doc of pat death after cas,,,8.48,9.82,8
HCPCS,G9257,Doc of pat stroke after cas,,,8.48,9.82,8
HCPCS,G9258,Doc of pat stroke after cea,,,8.48,9.82,8
HCPCS,G9259,Survive/no stroke post cas,,,8.48,9.82,8
HCPCS,G9260,Doc of pat death after cea,,,8.48,9.82,8
HCPCS,G9261,Survive/no stroke post cea,,,8.48,9.82,8
HCPCS,G9262,Doc of death post-aaa repair,,,8.48,9.82,8
HCPCS,G9263,Doc of disch post-aaa repair,,,8.48,9.82,8
HCPCS,G9264,Doc rsn hemod w/cath >=90d,,,8.48,9.82,8
HCPCS,G9265,Doc cath >90d for maint dia,,,8.48,9.82,8
HCPCS,G9266,Norsn pt cath >=90d,,,8.48,9.82,8
HCPCS,G9267,Doc comp or mort w in 30d,,,8.48,9.82,8
HCPCS,G9268,Doc comp or mort w in 90d,,,8.48,9.82,8
HCPCS,G9269,Doc no comp or mort w in 30d,,,8.48,9.82,8
HCPCS,G9270,Doc no comp or mort w in 90d,,,8.48,9.82,8
HCPCS,G9273,Sys<140 and dia<90,,,8.48,9.82,8
HCPCS,G9274,Bp out of nrml limits,,,8.48,9.82,8
HCPCS,G9275,Doc of non tobacco user,,,8.48,9.82,8
HCPCS,G9276,Doc of tobacco user,,,8.48,9.82,8
HCPCS,G9277,Doc daily aspirin or contra,,,8.48,9.82,8
HCPCS,G9278,Doc no daily aspirin,,,8.48,9.82,8
HCPCS,G9279,Pne scrn done doc vac done,,,8.48,9.82,8
HCPCS,G9280,Pne not given norsn,,,8.48,9.82,8
HCPCS,G9281,Pne scrn done doc not ind,,,8.48,9.82,8
HCPCS,G9282,Doc medrsn no histo type,,,8.48,9.82,8
HCPCS,G9283,Hist type doc on report,,,8.48,9.82,8
HCPCS,G9284,No hist type doc on report,,,8.48,9.82,8
HCPCS,G9285,Site not small cell lung ca,,,8.48,9.82,8
HCPCS,G9286,Antibio rx w in 10d of sympt,,,8.48,9.82,8
HCPCS,G9287,No antibio w in 10d of sympt,,,8.48,9.82,8
HCPCS,G9288,Doc medrsn no hist type rpt,,,8.48,9.82,8
HCPCS,G9289,Doc type nsm lung ca,,,8.48,9.82,8
HCPCS,G9290,No doc type nsm lung ca,,,8.48,9.82,8
HCPCS,G9291,Not nsm lung ca,,,8.48,9.82,8
HCPCS,G9292,Medrsn no pt category,,,8.48,9.82,8
HCPCS,G9293,No pt category on report,,,8.48,9.82,8
HCPCS,G9294,Pt cat and thck on report,,,8.48,9.82,8
HCPCS,G9295,Non cutaneous loc,,,8.48,9.82,8
HCPCS,G9296,Doc share dec prior proc,,,8.48,9.82,8
HCPCS,G9297,No doc share dec prior proc,,,8.48,9.82,8
HCPCS,G9298,Eval risk vte card 30d prior,,,8.48,9.82,8
HCPCS,G9299,No eval risk vte card prior,,,8.48,9.82,8
HCPCS,G9300,Doc medrsn no compl antibio,,,8.48,9.82,8
HCPCS,G9301,Doc compl inf antibio,,,8.48,9.82,8
HCPCS,G9302,Norsn incomp inf antibio,,,8.48,9.82,8
HCPCS,G9303,Norsn no pros info op rpt,,,8.48,9.82,8
HCPCS,G9304,Pros info op rpt,,,8.48,9.82,8
HCPCS,G9305,No interv req for leak,,,8.48,9.82,8
HCPCS,G9306,Interv req for leak,,,8.48,9.82,8
HCPCS,G9307,No ret for surg w in 30d,,,8.48,9.82,8
HCPCS,G9308,Unpl ret or w/compl w/in 30d,,,8.48,9.82,8
HCPCS,G9309,No unplnd hosp readm in 30d,,,8.48,9.82,8
HCPCS,G9310,Unplnd hosp readm in 30d,,,8.48,9.82,8
HCPCS,G9311,No surg site infection,,,8.48,9.82,8
HCPCS,G9312,Surgical site infection,,,8.48,9.82,8
HCPCS,G9313,Amoxic not presc as 1st line,,,8.48,9.82,8
HCPCS,G9314,Norsn not first line amox,,,8.48,9.82,8
HCPCS,G9315,Amox w/wo clav rx,,,8.48,9.82,8
HCPCS,G9316,Doc comm risk calc,,,8.48,9.82,8
HCPCS,G9317,No doc comm risk calc,,,8.48,9.82,8
HCPCS,G9318,Image std nomenclature,,,8.48,9.82,8
HCPCS,G9319,Image not std nomenclature,,,8.48,9.82,8
HCPCS,G9321,Prev ct nuc med cnt doc 12mo,,,8.48,9.82,8
HCPCS,G9322,No cnt ct nuc med doc 12mo,,,8.48,9.82,8
HCPCS,G9326,"Ct done no rad ds index, nrg",,,8.48,9.82,8
HCPCS,G9327,Ct done rad ds index,,,8.48,9.82,8
HCPCS,G9329,Norsn no dicom format doc,,,8.48,9.82,8
HCPCS,G9340,Dicom format doc on rpt,,,8.48,9.82,8
HCPCS,G9341,Srch for ct w in 12 mos,,,8.48,9.82,8
HCPCS,G9342,No srch for ct in 12mo norsn,,,8.48,9.82,8
HCPCS,G9344,Sysrsn no dicom srch,,,8.48,9.82,8
HCPCS,G9345,Follow up pulm nod,,,8.48,9.82,8
HCPCS,G9347,No follow up pulm nod norsn,,,8.48,9.82,8
HCPCS,G9348,Doc rsn for ord ct scan,,,8.48,9.82,8
HCPCS,G9349,Ct within 28 days,,,8.48,9.82,8
HCPCS,G9350,No doc sinus ct 28d or dx,,,8.48,9.82,8
HCPCS,G9351,Doc >1 sinus ct w 90d dx,,,8.48,9.82,8
HCPCS,G9352,Not >1 sinus ct w 90d dx,,,8.48,9.82,8
HCPCS,G9353,Medrsn >1 sinus ct w 90d dx,,,8.48,9.82,8
HCPCS,G9354,1 or no ct sinus w/in 90d dx,,,8.48,9.82,8
HCPCS,G9355,No early ind/delivery,,,8.48,9.82,8
HCPCS,G9356,Early ind/delivery,,,8.48,9.82,8
HCPCS,G9357,Pp eval/edu perf,,,8.48,9.82,8
HCPCS,G9358,Pp eval/edu not perf,,,8.48,9.82,8
HCPCS,G9359,Neg mgd pos tb notact,,,8.48,9.82,8
HCPCS,G9360,No doc of neg or man pos tb,,,8.48,9.82,8
HCPCS,G9361,Doc rsn elect c-sec/induct,,,8.48,9.82,8
HCPCS,G9364,Sinus caus bac inx,,,8.48,9.82,8
HCPCS,G9365,1high risk med ord,,,8.48,9.82,8
HCPCS,G9366,1high risk no ord,,,8.48,9.82,8
HCPCS,G9367,>= 2 same hi-rsk med ord,,,8.48,9.82,8
HCPCS,G9368,>= 2 same hi-rsk med not ord,,,8.48,9.82,8
HCPCS,G9380,Off assis eol iss,,,8.48,9.82,8
HCPCS,G9382,No off assis eol,,,8.48,9.82,8
HCPCS,G9383,Recd scrn hcv infec,,,8.48,9.82,8
HCPCS,G9384,Doc med rsn no hcv scrn,,,8.48,9.82,8
HCPCS,G9385,Doc pt reas not rec hcv srn,,,8.48,9.82,8
HCPCS,G9386,Scrn hcv infec not recd,,,8.48,9.82,8
HCPCS,G9389,Unpln rup post cap,,,8.48,9.82,8
HCPCS,G9390,No unpln rup post cap,,,8.48,9.82,8
HCPCS,G9393,Ini phq9 >9 remiss <5,,,8.48,9.82,8
HCPCS,G9394,"Dx bipol, death, nhres, hosp",,,8.48,9.82,8
HCPCS,G9395,Ini phq9 >9 no remiss >=5,,,8.48,9.82,8
HCPCS,G9396,Ini phq9 >9 not assess,,,8.48,9.82,8
HCPCS,G9399,Doc disc tx choices,,,8.48,9.82,8
HCPCS,G9400,Doc reas no disc tx opt,,,8.48,9.82,8
HCPCS,G9401,No disc tx choices,,,8.48,9.82,8
HCPCS,G9402,Recd f/u w/in 30d disch,,,8.48,9.82,8
HCPCS,G9403,Doc reas no 30 day f/u,,,8.48,9.82,8
HCPCS,G9404,No 30 day f/u,,,8.48,9.82,8
HCPCS,G9405,Recd f/u w/in 7d dc,,,8.48,9.82,8
HCPCS,G9406,Doc reas no 7d f/u,,,8.48,9.82,8
HCPCS,G9407,No 7d f/u,,,8.48,9.82,8
HCPCS,G9408,Card tamp w/in 30d,,,8.48,9.82,8
HCPCS,G9409,No card tamp e/in 30d,,,8.48,9.82,8
HCPCS,G9410,Admit w/in 180d req remov,,,8.48,9.82,8
HCPCS,G9411,No admit w/in 180d req remov,,,8.48,9.82,8
HCPCS,G9412,Admit w/in 180d req surg rev,,,8.48,9.82,8
HCPCS,G9413,No admit req surg rev,,,8.48,9.82,8
HCPCS,G9414,1dose menig vac btwn 10 & 13,,,8.48,9.82,8
HCPCS,G9415,No 1dose meni vac btwn 10&13,,,8.48,9.82,8
HCPCS,G9416,Pt 1 tdap betw 10-13 yrs,,,8.48,9.82,8
HCPCS,G9417,Pt not 1 tdap betw 10-13 yrs,,,8.48,9.82,8
HCPCS,G9418,Lungcx bx rpt docs class,,,8.48,9.82,8
HCPCS,G9419,Med reas not incl histo type,,,8.48,9.82,8
HCPCS,G9420,Spec site no lung,,,8.48,9.82,8
HCPCS,G9421,Lung cx bx rpt no doc class,,,8.48,9.82,8
HCPCS,G9422,Rpt doc class histo type,,,8.48,9.82,8
HCPCS,G9423,Med reas rpt no histo type,,,8.48,9.82,8
HCPCS,G9424,Site no lung or lung cx,,,8.48,9.82,8
HCPCS,G9425,Spec rpt no doc class histo,,,8.48,9.82,8
HCPCS,G9426,Impr med time edarr pain med,,,8.48,9.82,8
HCPCS,G9427,No impro med time pain med,,,8.48,9.82,8
HCPCS,G9428,Patho rpt incl pt ctg,,,8.48,9.82,8
HCPCS,G9429,Doc med rsn no pt cat,,,8.48,9.82,8
HCPCS,G9430,Spec site no cutaneous,,,8.48,9.82,8
HCPCS,G9431,Patho rpt no pt ctg,,,8.48,9.82,8
HCPCS,G9432,Asth controlled,,,8.48,9.82,8
HCPCS,G9434,Asth not controlled,,,8.48,9.82,8
HCPCS,G9448,Born 1945-1965,,,8.48,9.82,8
HCPCS,G9449,Hx bld transf b/f 1992,,,8.48,9.82,8
HCPCS,G9450,Hx injec drug use,,,8.48,9.82,8
HCPCS,G9451,1x scrn hcv infect,,,8.48,9.82,8
HCPCS,G9452,Doc med reas no hcv test,,,8.48,9.82,8
HCPCS,G9453,Pt reas no hcv infect,,,8.48,9.82,8
HCPCS,G9454,No scr hcv inf 12 mth rp,,,8.48,9.82,8
HCPCS,G9455,"Abd imag w/us, ct or mri",,,8.48,9.82,8
HCPCS,G9456,Doc med pt reas no hcc scrn,,,8.48,9.82,8
HCPCS,G9457,Pt no abd img no doc rsn,,,8.48,9.82,8
HCPCS,G9458,Tob user recd cess interv,,,8.48,9.82,8
HCPCS,G9459,Tob non-user,,,8.48,9.82,8
HCPCS,G9460,No tob assess or cess inter,,,8.48,9.82,8
HCPCS,G9468,No recd cortico>=10mg/d >60d,,,8.48,9.82,8
HCPCS,G9469,Rec cortico>90d or 1rx 900mg,,,8.48,9.82,8
HCPCS,G9470,No rec cortico>60d 1rx 600mg,,,8.48,9.82,8
HCPCS,G9471,W/in 2yr dxa not order,,,8.48,9.82,8
HCPCS,G9473,Chap services at hospice,,,50.62,58.61,8
HCPCS,G9474,Diet counsel at hospice,,,50.62,58.61,8
HCPCS,G9475,Other counselor at hospice,,,50.62,58.61,8
HCPCS,G9476,Volun service at hospice,,,50.62,58.61,8
HCPCS,G9477,Care coord at hospice,,,17.35,20.09,8
HCPCS,G9478,Othe therapist at hospice,,,50.62,58.61,8
HCPCS,G9479,Pharmacist at hospice,,,50.62,58.61,8
HCPCS,G9480,Admission to mccm,,,8.48,9.82,8
HCPCS,G9497,Rec inst no smoke day surg,,,8.48,9.82,8
HCPCS,G9498,Abx reg prescribed,,,8.48,9.82,8
HCPCS,G9500,Rad expos ind/exp tm doc,,,8.48,9.82,8
HCPCS,G9501,Rad expos ind/exp tm no doc,,,8.48,9.82,8
HCPCS,G9502,Med reas no perf foot exam,,,8.48,9.82,8
HCPCS,G9503,Pt tk tams hcl,,,8.48,9.82,8
HCPCS,G9504,Doc rsn hep b stat not asses,,,8.48,9.82,8
HCPCS,G9505,Abx pres w/in 10 dys of symp,,,8.48,9.82,8
HCPCS,G9506,Bio imm resp mod presc,,,8.48,9.82,8
HCPCS,G9507,Doc reas on statin or contra,,,8.48,9.82,8
HCPCS,G9508,Doc pt not on statin,,,8.48,9.82,8
HCPCS,G9509,Adit mdd dys rem 12 mnths,,,8.48,9.82,8
HCPCS,G9510,Remis12m not phq-9 score <5,,,8.48,9.82,8
HCPCS,G9511,Idx evt dte phq>9 doc 12 mo,,,8.48,9.82,8
HCPCS,G9512,Indiv pdc > 0.8,,,8.48,9.82,8
HCPCS,G9513,Indiv pdc not > 0.8,,,8.48,9.82,8
HCPCS,G9514,Req ret or w/in 90d of surg,,,8.48,9.82,8
HCPCS,G9515,"No reas, no ret or w/in 90d",,,8.48,9.82,8
HCPCS,G9516,Impr vis acuit w/in 90d,,,8.48,9.82,8
HCPCS,G9517,No impr vis acuit w/in 90d,,,8.48,9.82,8
HCPCS,G9518,Doc active inj drug use,,,8.48,9.82,8
HCPCS,G9519,Final ref +/- 1.0 w/in 90d,,,8.48,9.82,8
HCPCS,G9520,Refract not +/- 1.0 w/in 90d,,,8.48,9.82,8
HCPCS,G9521,Er and ip hosp <2 in 12 mos,,,8.48,9.82,8
HCPCS,G9522,Er/ip hosp =/>2 in 12 mos,,,8.48,9.82,8
HCPCS,G9523,D/c hemo or perit dialysis,,,8.48,9.82,8
HCPCS,G9524,Refer to hospice,,,8.48,9.82,8
HCPCS,G9525,Doc pt reas no hospice refer,,,8.48,9.82,8
HCPCS,G9526,"No reason, no refer hospice",,,8.48,9.82,8
HCPCS,G9529,Minor blunt trauma w/head ct,,,8.48,9.82,8
HCPCS,G9530,Pt mbht hd ct ord ec prov,,,8.48,9.82,8
HCPCS,G9531,Pt doc,,,8.48,9.82,8
HCPCS,G9532,Pt hd ct ord,,,8.48,9.82,8
HCPCS,G9533,Indic for head ct not valid,,,8.48,9.82,8
HCPCS,G9537,Img hd clin trial,,,8.48,9.82,8
HCPCS,G9539,Intent pot remv time placemt,,,8.48,9.82,8
HCPCS,G9540,Pt alive 3 mos post proc,,,8.48,9.82,8
HCPCS,G9541,Filter rem 3 mon plmt,,,8.48,9.82,8
HCPCS,G9542,Doc reass appr remo filt 3ms,,,8.48,9.82,8
HCPCS,G9543,Doc 2x re-assess filt remov,,,8.48,9.82,8
HCPCS,G9544,No filt remov w/in 3mos plcm,,,8.48,9.82,8
HCPCS,G9547,Cys ren les or adren,,,8.48,9.82,8
HCPCS,G9548,No f/u rec image study,,,8.48,9.82,8
HCPCS,G9549,Doc med rsn for f/u imag,,,8.48,9.82,8
HCPCS,G9550,Imag rec,,,8.48,9.82,8
HCPCS,G9551,Imag no les,,,8.48,9.82,8
HCPCS,G9552,Inc thyr node <1.0 in rpt,,,8.48,9.82,8
HCPCS,G9553,Prior thyroid dise dx,,,8.48,9.82,8
HCPCS,G9554,Ct/cta/mri/a chst foll rec,,,8.48,9.82,8
HCPCS,G9555,Doc med rsn for follup image,,,8.48,9.82,8
HCPCS,G9556,Ct/cta/mri/a no follup imag,,,8.48,9.82,8
HCPCS,G9557,Ct/cta/mri/a no thyr <1.0cm,,,8.48,9.82,8
HCPCS,G9558,Tx beta-lactam abx therapy,,,8.48,9.82,8
HCPCS,G9559,Doc med reas no abx therapy,,,8.48,9.82,8
HCPCS,G9560,"No beta-lactam abx ther, rng",,,8.48,9.82,8
HCPCS,G9561,Presc opiates >6 wks,,,8.48,9.82,8
HCPCS,G9562,Foll-up eval q3mo opiod tx,,,8.48,9.82,8
HCPCS,G9563,No f/u eval q3mo opiod tx,,,8.48,9.82,8
HCPCS,G9573,Adl pt md or dys rem 6 mon,,,8.48,9.82,8
HCPCS,G9574,Adl pt md dys no rem 6 mon,,,8.48,9.82,8
HCPCS,G9577,Presc opiates >6 wks,,,8.48,9.82,8
HCPCS,G9578,Doc opioid tx 1x during ther,,,8.48,9.82,8
HCPCS,G9579,No doc opioid tx 1x at ther,,,8.48,9.82,8
HCPCS,G9580,Door to punc time <2hrs,,,8.48,9.82,8
HCPCS,G9582,"Door to punc time >2hr, nrg",,,8.48,9.82,8
HCPCS,G9583,Presc opiates >6 wks,,,8.48,9.82,8
HCPCS,G9584,Eval opioid use instr/pt int,,,8.48,9.82,8
HCPCS,G9585,No eval opi use instr/intv,,,8.48,9.82,8
HCPCS,G9593,Low pecarn ped head trauma,,,8.48,9.82,8
HCPCS,G9594,Pt mbht hd ct ord ec prov,,,8.48,9.82,8
HCPCS,G9595,Doc shnt/tum/coag,,,8.48,9.82,8
HCPCS,G9596,Ped pt hd ct ord,,,8.48,9.82,8
HCPCS,G9597,No low pecarn ped head traum,,,8.48,9.82,8
HCPCS,G9598,Aor ane 5.5-5.9 cm max diam,,,8.48,9.82,8
HCPCS,G9599,Aor ane >=6.0 cm max diam,,,8.48,9.82,8
HCPCS,G9600,Symp aaa urgent repair,,,8.48,9.82,8
HCPCS,G9601,Pt dchg home post op day 7,,,8.48,9.82,8
HCPCS,G9602,Pt no dchg home postop day 7,,,8.48,9.82,8
HCPCS,G9603,Pt surv improv bsline tx,,,8.48,9.82,8
HCPCS,G9604,Pt surv results not avail,,,8.48,9.82,8
HCPCS,G9605,Surv score no improv w/tx,,,8.48,9.82,8
HCPCS,G9606,Intraop cyst eval trac inj,,,8.48,9.82,8
HCPCS,G9607,Doc med rsn not perf cystosc,,,8.48,9.82,8
HCPCS,G9608,Intraop cyst eval not done,,,8.48,9.82,8
HCPCS,G9609,Doc order anti-plat,,,8.48,9.82,8
HCPCS,G9610,Doc md rsn no antipla,,,8.48,9.82,8
HCPCS,G9611,No doc order anti-plat rng,,,8.48,9.82,8
HCPCS,G9612,Phodoc 2 mr cec lndmk,,,8.48,9.82,8
HCPCS,G9613,Doc post surg anatomy,,,8.48,9.82,8
HCPCS,G9614,Photodoc < 2 cec lndmk,,,8.48,9.82,8
HCPCS,G9615,Pre-op asst doc,,,8.48,9.82,8
HCPCS,G9616,Doc rsn no preop assmt,,,8.48,9.82,8
HCPCS,G9617,"Pre-op asst not doc, rng",,,8.48,9.82,8
HCPCS,G9618,Doc scr uter mal or us/samp,,,8.48,9.82,8
HCPCS,G9620,No scr utr malig/us/samp rng,,,8.48,9.82,8
HCPCS,G9621,Scr unheal etoh w/counsel,,,8.48,9.82,8
HCPCS,G9622,No unheal etoh user,,,8.48,9.82,8
HCPCS,G9623,Doc med rsn no scr etoh use,,,8.48,9.82,8
HCPCS,G9624,Pt not scrn or no counseling,,,8.48,9.82,8
HCPCS,G9625,Pt bl srg 30 day pst srg,,,8.48,9.82,8
HCPCS,G9626,Med rsn no rpt bladder inj,,,8.48,9.82,8
HCPCS,G9627,Pt no bl srg 30 day pst srg,,,8.48,9.82,8
HCPCS,G9628,Pt bwli srg 30 day pst srg,,,8.48,9.82,8
HCPCS,G9629,Med rsn no rpt bowel inj,,,8.48,9.82,8
HCPCS,G9630,Pt no bwli srg 30 day srg,,,8.48,9.82,8
HCPCS,G9631,Pt ui srg 30 day pst srg,,,8.48,9.82,8
HCPCS,G9632,Med rsn for no rpt uret inj,,,8.48,9.82,8
HCPCS,G9633,Pt no ui srg 30 day pst srg,,,8.48,9.82,8
HCPCS,G9634,Qual life tool 2x same/impr,,,8.48,9.82,8
HCPCS,G9635,No doc rsn do qual life assm,,,8.48,9.82,8
HCPCS,G9636,No life asst 2x same/decr,,,8.48,9.82,8
HCPCS,G9637,Doc >1 dose reduc tech,,,8.48,9.82,8
HCPCS,G9638,No doc >1 dose reduc tech,,,8.48,9.82,8
HCPCS,G9639,Amp no reqd in48h ieler proc,,,8.48,9.82,8
HCPCS,G9640,Doc plan hybrid/stage proc,,,8.48,9.82,8
HCPCS,G9641,Amp reqd w/in 48h ieler proc,,,8.48,9.82,8
HCPCS,G9642,Current smoker,,,8.48,9.82,8
HCPCS,G9643,Elective surgery,,,8.48,9.82,8
HCPCS,G9644,No smok b/4 anes day of surg,,,8.48,9.82,8
HCPCS,G9645,Had smoke b/4 anes day surg,,,8.48,9.82,8
HCPCS,G9646,Pt w/90d mrs 0-2,,,8.48,9.82,8
HCPCS,G9647,No mrs score in 90d followup,,,8.48,9.82,8
HCPCS,G9648,Pt w/90d mrs >2,,,8.48,9.82,8
HCPCS,G9649,Psor as doc spc bm,,,8.48,9.82,8
HCPCS,G9651,Psor as doc no spc bm,,,8.48,9.82,8
HCPCS,G9654,Mon anesth care,,,8.48,9.82,8
HCPCS,G9655,Toc tool incl key elem,,,8.48,9.82,8
HCPCS,G9656,Pt trans from anest to pacu,,,8.48,9.82,8
HCPCS,G9658,Toc tool incl elem not used,,,8.48,9.82,8
HCPCS,G9659,>=86y scr colo nomed rsn,,,8.48,9.82,8
HCPCS,G9660,Doc med rsn colo pt >= 86y,,,8.48,9.82,8
HCPCS,G9661,Pt >= 86 w/ hi risk,,,8.48,9.82,8
HCPCS,G9662,Prior dx/active clin ascvd,,,8.48,9.82,8
HCPCS,G9663,Fast/dir ldl >= 190 mg/dl,,,8.48,9.82,8
HCPCS,G9664,Taking statin or rec'd order,,,8.48,9.82,8
HCPCS,G9665,No statin/no order statin,,,8.48,9.82,8
HCPCS,G9666,Fas/dir ldl 70-189mg/dl mst,,,8.48,9.82,8
HCPCS,G9674,Pt w/clin ascvd dx,,,8.48,9.82,8
HCPCS,G9675,Pt w/fast/dir lab ldl-c >190,,,8.48,9.82,8
HCPCS,G9676,40-75y w/type 1/2 w/ldl-c rs,,,8.48,9.82,8
HCPCS,G9678,Oncology care model service,,,8.48,9.82,8
HCPCS,G9679,Acute care pneumonia,,,8.48,9.82,8
HCPCS,G9680,Acute care congestive heart,,,8.48,9.82,8
HCPCS,G9681,Acute care chronic obstruct,,,8.48,9.82,8
HCPCS,G9682,Acute care skin infection,,,8.48,9.82,8
HCPCS,G9683,Acute fluid/electro disorder,,,8.48,9.82,8
HCPCS,G9684,Acute care urinary tract inf,,,8.48,9.82,8
HCPCS,G9685,Acute nursing facility care,,,54.56,63.17,8
HCPCS,G9687,Hospice anytime msmt per,,,8.48,9.82,8
HCPCS,G9688,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9689,Inpt elect carotid intervent,,,8.48,9.82,8
HCPCS,G9690,Pt in hos,,,8.48,9.82,8
HCPCS,G9691,Pt hosp dur msmt period,,,8.48,9.82,8
HCPCS,G9692,Hosp recd by pt dur msmt per,,,8.48,9.82,8
HCPCS,G9693,Pt use hosp during msmt per,,,8.48,9.82,8
HCPCS,G9694,Hosp srv used pt in msmt per,,,8.48,9.82,8
HCPCS,G9695,Long act inhal bronchdil pre,,,8.48,9.82,8
HCPCS,G9696,Med rsn no presc bronchdil,,,8.48,9.82,8
HCPCS,G9697,Pt rsn no presc bronchdil,,,8.48,9.82,8
HCPCS,G9698,Sys rsn no presc bronchdil,,,8.48,9.82,8
HCPCS,G9699,Long inhal bronchdil no pres,,,8.48,9.82,8
HCPCS,G9700,Pt is w/hosp during msmt per,,,8.48,9.82,8
HCPCS,G9701,Child anbx 30 prior dx estab,,,8.48,9.82,8
HCPCS,G9702,Pt use hosp during msmt per,,,8.48,9.82,8
HCPCS,G9703,Anbx 30 prior to episode,,,8.48,9.82,8
HCPCS,G9704,Ajcc br ca stg i: t1 mic/t1a,,,8.48,9.82,8
HCPCS,G9705,Ajcc br ca stg ib,,,8.48,9.82,8
HCPCS,G9706,Low recur prost ca,,,8.48,9.82,8
HCPCS,G9707,Pt had hosp dur msmt per,,,8.48,9.82,8
HCPCS,G9708,Bilat mast/hx bi /unilat mas,,,8.48,9.82,8
HCPCS,G9709,Hosp srv used pt in msmt per,,,8.48,9.82,8
HCPCS,G9710,Pt prov hosp srv msmt per,,,8.48,9.82,8
HCPCS,G9711,Pt hx tot col or colon ca,,,8.48,9.82,8
HCPCS,G9712,Doc med rsn presc anbx,,,8.48,9.82,8
HCPCS,G9713,Pt use hosp during msmt per,,,8.48,9.82,8
HCPCS,G9714,Pt is w/hosp during msmt per,,,8.48,9.82,8
HCPCS,G9715,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9716,Bmi doc onl fup not cmpltd,,,8.48,9.82,8
HCPCS,G9717,Doc pt dx bipol,,,8.48,9.82,8
HCPCS,G9718,Hospice anytime msmt per,,,8.48,9.82,8
HCPCS,G9719,Pt not ambul/immob/wc,,,8.48,9.82,8
HCPCS,G9720,Hospice anytime msmt per,,,8.48,9.82,8
HCPCS,G9721,Pt not ambul/immob/wc,,,8.48,9.82,8
HCPCS,G9722,Doc hx renal fail or cr+ >=4,,,8.48,9.82,8
HCPCS,G9723,Hosp recd by pt dur msmt per,,,8.48,9.82,8
HCPCS,G9724,Pt w/doc use anticoag mst yr,,,8.48,9.82,8
HCPCS,G9725,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9726,Refused to participate,,,8.48,9.82,8
HCPCS,G9727,Pt unable cmplt lepf prom,,,8.48,9.82,8
HCPCS,G9728,Refused to participate,,,8.48,9.82,8
HCPCS,G9729,Pt unbl cmplt lepf prom,,,8.48,9.82,8
HCPCS,G9730,Refused to participate,,,8.48,9.82,8
HCPCS,G9731,Pt unbl cmplt lepf prom,,,8.48,9.82,8
HCPCS,G9732,Refused to participate,,,8.48,9.82,8
HCPCS,G9733,Pt unbl cmplt lb fs prom,,,8.48,9.82,8
HCPCS,G9734,Refused to participate,,,8.48,9.82,8
HCPCS,G9735,Pt unbl cmplt shld fs prom,,,8.48,9.82,8
HCPCS,G9736,Refused to participate,,,8.48,9.82,8
HCPCS,G9737,Pt unbl cmplt ewh fs prom,,,8.48,9.82,8
HCPCS,G9738,Refused to participate,,,8.48,9.82,8
HCPCS,G9739,Pt unbl cmplt go fs prom,,,8.48,9.82,8
HCPCS,G9740,Hosp srv to pt dur msmt per,,,8.48,9.82,8
HCPCS,G9741,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9744,Pt not eli d/t act dig htn,,,8.48,9.82,8
HCPCS,G9745,Doc rsn no hbp scrn or f/u,,,8.48,9.82,8
HCPCS,G9746,"Mit sten, valve or trans af",,,8.48,9.82,8
HCPCS,G9747,Pall dialysis with catheter,,,8.48,9.82,8
HCPCS,G9748,App transpl lvg kidney donor,,,8.48,9.82,8
HCPCS,G9749,Pall dialysis with catheter,,,8.48,9.82,8
HCPCS,G9750,App transpl lvg kidney donor,,,8.48,9.82,8
HCPCS,G9751,Pt died w/in 24 mos rpt time,,,8.48,9.82,8
HCPCS,G9752,Urgent surgery,,,8.48,9.82,8
HCPCS,G9753,"Doc no dicom, ct other fac",,,8.48,9.82,8
HCPCS,G9754,Incid pulm nodule,,,8.48,9.82,8
HCPCS,G9755,Doc med rsn no fllw up,,,8.48,9.82,8
HCPCS,G9756,Surg proc w/silicone oil,,,8.48,9.82,8
HCPCS,G9757,Surg proc w/silicone oil,,,8.48,9.82,8
HCPCS,G9758,Pt in hos,,,8.48,9.82,8
HCPCS,G9759,Hx preop post cap rup,,,8.48,9.82,8
HCPCS,G9760,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9761,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9762,Pt had >= 2-3 hpv vaccines,,,8.48,9.82,8
HCPCS,G9763,Pt not have 2-3 hpv vaccines,,,8.48,9.82,8
HCPCS,G9764,Pt treatd w/oral syst or bio,,,8.48,9.82,8
HCPCS,G9765,Doc pat declined therapy,,,8.48,9.82,8
HCPCS,G9766,Cva stroke dx tx transf fac,,,8.48,9.82,8
HCPCS,G9767,Hosp new dx cva consid evst,,,8.48,9.82,8
HCPCS,G9768,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9769,Bn den 2yr/got ost med/ther,,,8.48,9.82,8
HCPCS,G9770,Perip nerve block,,,8.48,9.82,8
HCPCS,G9771,"Anes end, 1 temp >35.5(95.9)",,,8.48,9.82,8
HCPCS,G9772,Doc med rsn no temp >= 35.5,,,8.48,9.82,8
HCPCS,G9773,1 bod temp >=35.5,,,8.48,9.82,8
HCPCS,G9774,Pt had hyst,,,8.48,9.82,8
HCPCS,G9775,Recd 2 anti-emet pre/intraop,,,8.48,9.82,8
HCPCS,G9776,Doc med rsn no proph antiem,,,8.48,9.82,8
HCPCS,G9777,Pt no antiemet pre/intraop,,,8.48,9.82,8
HCPCS,G9778,Pts dx w/pregn,,,8.48,9.82,8
HCPCS,G9779,Pts breastfeeding,,,8.48,9.82,8
HCPCS,G9780,Pts dx w/rhabdomyolysis,,,8.48,9.82,8
HCPCS,G9781,Doc rsn no statin,,,8.48,9.82,8
HCPCS,G9782,Hx dx fam/pure hypercholes,,,8.48,9.82,8
HCPCS,G9783,"Doc dx dm, fast <70, no stat",,,8.48,9.82,8
HCPCS,G9784,Path/derm prov 2nd biop opin,,,8.48,9.82,8
HCPCS,G9785,Path report sent,,,8.48,9.82,8
HCPCS,G9786,Path report not sent,,,8.48,9.82,8
HCPCS,G9787,Pt alive,,,8.48,9.82,8
HCPCS,G9788,Most rct bp </= 130/80,,,8.48,9.82,8
HCPCS,G9789,"Record bp ip, er, urg/self",,,8.48,9.82,8
HCPCS,G9790,Most rct bp >/= 130/80,,,8.48,9.82,8
HCPCS,G9791,Most rct tob stat free,,,8.48,9.82,8
HCPCS,G9792,Most rct tob stat not free,,,8.48,9.82,8
HCPCS,G9793,Pt on daily asa/antiplat,,,8.48,9.82,8
HCPCS,G9794,Doc med rsn no daily aspirin,,,8.48,9.82,8
HCPCS,G9795,Pt no daily asa/antiplat,,,8.48,9.82,8
HCPCS,G9796,Pt currently on statin,,,8.48,9.82,8
HCPCS,G9797,Pt not currently on statin,,,8.48,9.82,8
HCPCS,G9798,D/c ami btw 7/1-6/30 meas pd,,,8.48,9.82,8
HCPCS,G9799,Med disp evt indic hx asth,,,8.48,9.82,8
HCPCS,G9800,Pt id intol/alleg beta-block,,,8.48,9.82,8
HCPCS,G9801,Nonacut transf from inpt,,,8.48,9.82,8
HCPCS,G9802,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9803,Pt presc 135 day trmt,,,8.48,9.82,8
HCPCS,G9804,Pt not presc 135 day trmt,,,8.48,9.82,8
HCPCS,G9805,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9806,Pt recd cerv cyto/hpv,,,8.48,9.82,8
HCPCS,G9807,Pt no recd cerv cyto/hpv,,,8.48,9.82,8
HCPCS,G9808,Pt no asthm cont med mst per,,,8.48,9.82,8
HCPCS,G9809,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9810,Pdc 75% w/asth cont med,,,8.48,9.82,8
HCPCS,G9811,No pdc 75% w/asth cont med,,,8.48,9.82,8
HCPCS,G9812,Pt died during inpt/30d aft,,,8.48,9.82,8
HCPCS,G9813,Pt not died w/in 30d of proc,,,8.48,9.82,8
HCPCS,G9814,Death during index hosp,,,8.48,9.82,8
HCPCS,G9815,Death not during index hosp,,,8.48,9.82,8
HCPCS,G9816,Death <30 day post discharge,,,8.48,9.82,8
HCPCS,G9817,No death 30-days post-disch,,,8.48,9.82,8
HCPCS,G9818,Doc sex activity,,,8.48,9.82,8
HCPCS,G9819,Pt w/hosp anytime msmt per,,,8.48,9.82,8
HCPCS,G9820,Doc chlam scr test w/follow,,,8.48,9.82,8
HCPCS,G9821,No doc chlam scr ts w/follow,,,8.48,9.82,8
HCPCS,G9822,Endo abl proc yr prev ind dt,,,8.48,9.82,8
HCPCS,G9823,Endo smpl/hyst bx res doc,,,8.48,9.82,8
HCPCS,G9824,Endo smpl/hyst bx res no doc,,,8.48,9.82,8
HCPCS,G9825,"Her-2 neg,undoc/unkn",,,8.48,9.82,8
HCPCS,G9826,Transf pract aft init chemo,,,8.48,9.82,8
HCPCS,G9827,Her-2 targ ther no init tx,,,8.48,9.82,8
HCPCS,G9828,Her-2 targ ther dur init tx,,,8.48,9.82,8
HCPCS,G9829,Breast adj chemo admin,,,8.48,9.82,8
HCPCS,G9830,Her-2 pos,,,8.48,9.82,8
HCPCS,G9831,Ajcc stg brt ca dx ii or iii,,,8.48,9.82,8
HCPCS,G9832,Br ca stg = 1 t stg = t1c,,,8.48,9.82,8
HCPCS,G9833,Transf pract aft init chemo,,,8.48,9.82,8
HCPCS,G9834,Pt met dis at dx,,,8.48,9.82,8
HCPCS,G9835,Trastuz given w/in 12 mos dx,,,8.48,9.82,8
HCPCS,G9836,Rsn no trast given doc,,,8.48,9.82,8
HCPCS,G9837,Trastuz not in 12 mos dx,,,8.48,9.82,8
HCPCS,G9838,Pt met dis at dx,,,8.48,9.82,8
HCPCS,G9839,Anti-egfr mon anti ther,,,8.48,9.82,8
HCPCS,G9840,Gene testing performed,,,8.48,9.82,8
HCPCS,G9841,Gene testing not performed,,,8.48,9.82,8
HCPCS,G9842,Pt met dis at dx,,,8.48,9.82,8
HCPCS,G9843,Kras or nras gene mutation,,,8.48,9.82,8
HCPCS,G9844,Pt no recd anti-egfr ther,,,8.48,9.82,8
HCPCS,G9845,Pt recd anti-egfr ther,,,8.48,9.82,8
HCPCS,G9846,Pt died from cancer,,,8.48,9.82,8
HCPCS,G9847,Pt recd chemo last 14d life,,,8.48,9.82,8
HCPCS,G9848,Pt no chemo last 14d life,,,8.48,9.82,8
HCPCS,G9849,Pt died from cancer,,,8.48,9.82,8
HCPCS,G9850,1/more ed last 30d life,,,8.48,9.82,8
HCPCS,G9851,1/no ed visit last 30d life,,,8.48,9.82,8
HCPCS,G9852,Pt died from cancer,,,8.48,9.82,8
HCPCS,G9853,Icu stay last 30d life,,,8.48,9.82,8
HCPCS,G9854,No icu stay last 30d life,,,8.48,9.82,8
HCPCS,G9855,Pt died from cancer,,,8.48,9.82,8
HCPCS,G9856,Pt no hospice,,,8.48,9.82,8
HCPCS,G9857,Pt admit hospice,,,8.48,9.82,8
HCPCS,G9858,Pt enroll hospice,,,8.48,9.82,8
HCPCS,G9859,Pt died from cancer,,,8.48,9.82,8
HCPCS,G9860,Pt less 3d hospice,,,8.48,9.82,8
HCPCS,G9861,Pt more than 3d hospice,,,8.48,9.82,8
HCPCS,G9862,Doc rsn no 10 yr follow,,,8.48,9.82,8
HCPCS,G9868,Cmmi asyntelehealth <10min,,,8.48,9.82,8
HCPCS,G9869,Cmmi asyntelehealth 10-20min,,,8.48,9.82,8
HCPCS,G9870,Cmmi asyntelehealth >20min,,,8.48,9.82,8
HCPCS,G9871,"Bhv couns dm prev, onln 60 m",,,68.71,79.56,8
HCPCS,G9886,In-person attendance g code,,,68.71,79.56,8
HCPCS,G9887,Distance learning attendance,,,68.71,79.56,8
HCPCS,G9891,Em session reporting,,,8.48,9.82,8
HCPCS,G9892,Doc pt rsn no dil mac exam,,,8.48,9.82,8
HCPCS,G9893,No mac exam,,,8.48,9.82,8
HCPCS,G9894,Adr dep thrpy prescribed,,,8.48,9.82,8
HCPCS,G9895,Doc med rsn no adr dep thrpy,,,8.48,9.82,8
HCPCS,G9896,Doc pt rsn no adr dep thrpy,,,8.48,9.82,8
HCPCS,G9897,Pt nt prsc adr dep thrpy rng,,,8.48,9.82,8
HCPCS,G9898,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G9899,Scrn mam perf rslts doc,,,8.48,9.82,8
HCPCS,G9900,Scrn mam perf rslts not doc,,,8.48,9.82,8
HCPCS,G9901,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G9902,Pt scrn tbco and id as user,,,8.48,9.82,8
HCPCS,G9903,Pt scrn tbco id as non user,,,8.48,9.82,8
HCPCS,G9904,Doc med rsn no tbco scrn,,,8.48,9.82,8
HCPCS,G9905,No pt tbco scrn rng,,,8.48,9.82,8
HCPCS,G9906,Pt recv tbco cess interv,,,8.48,9.82,8
HCPCS,G9907,Doc med rsn no tbco interv,,,8.48,9.82,8
HCPCS,G9908,No pt tbco cess interv rng,,,8.48,9.82,8
HCPCS,G9909,Doc med rsn no tbco interv,,,8.48,9.82,8
HCPCS,G9910,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G9911,Node neg pre/post syst ther,,,8.48,9.82,8
HCPCS,G9912,Hbv status assesed and int,,,8.48,9.82,8
HCPCS,G9913,No hbv status assesd and int,,,8.48,9.82,8
HCPCS,G9914,Pt initiated anti-tnf agent,,,8.48,9.82,8
HCPCS,G9915,No documntd hbv results rcd,,,8.48,9.82,8
HCPCS,G9916,Funct status past 12 months,,,8.48,9.82,8
HCPCS,G9917,Adv dem crgvr limited,,,8.48,9.82,8
HCPCS,G9918,"No funct stat perf, rsn nos",,,8.48,9.82,8
HCPCS,G9919,Scrn nd pos nd prov of rec,,,8.48,9.82,8
HCPCS,G9920,Scrning perf and negative,,,8.48,9.82,8
HCPCS,G9921,No or part scrn nd rng or os,,,8.48,9.82,8
HCPCS,G9922,Sfty cncrns scrn nd mit recs,,,8.48,9.82,8
HCPCS,G9923,Safty cncrns scrn and neg,,,8.48,9.82,8
HCPCS,G9924,Doc med rsn no scrn or recs,,,8.48,9.82,8
HCPCS,G9925,No scrn prov rsn nos,,,8.48,9.82,8
HCPCS,G9926,Sfty cncrns scrn but no recs,,,8.48,9.82,8
HCPCS,G9927,Doc no warf /fda pt trial,,,8.48,9.82,8
HCPCS,G9928,No warf or fda drug presc,,,8.48,9.82,8
HCPCS,G9929,Trs/rev af,,,8.48,9.82,8
HCPCS,G9930,Com care,,,8.48,9.82,8
HCPCS,G9931,No chad or chad scr 0 or 1,,,8.48,9.82,8
HCPCS,G9932,Doc pt rsn no tb scrn recrds,,,8.48,9.82,8
HCPCS,G9933,Canc detectd during col scrn,,,8.48,9.82,8
HCPCS,G9934,Doc rsn not detecting cancer,,,8.48,9.82,8
HCPCS,G9935,Canc not detectd during srcn,,,8.48,9.82,8
HCPCS,G9936,Pmh plyp/neo co/rect/jun/ans,,,8.48,9.82,8
HCPCS,G9937,Dig or surv colsco,,,8.48,9.82,8
HCPCS,G9938,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,G9939,Same path/derm perf biopsy,,,8.48,9.82,8
HCPCS,G9940,Doc reas no statin therapy,,,8.48,9.82,8
HCPCS,G9942,Adtl spine proc on same date,,,8.48,9.82,8
HCPCS,G9943,Bk pn nt msr vas scl pre/pst,,,8.48,9.82,8
HCPCS,G9945,Pt w/cancer scoliosis,,,8.48,9.82,8
HCPCS,G9946,Bk pain no vas,,,8.48,9.82,8
HCPCS,G9948,Adtl spine proc on same date,,,8.48,9.82,8
HCPCS,G9949,Leg pain no vas,,,8.48,9.82,8
HCPCS,G9954,Pt >2 rsk fac post-op vomit,,,8.48,9.82,8
HCPCS,G9955,Inhlnt anesth only for induc,,,8.48,9.82,8
HCPCS,G9956,Combo thrpy of >= 2 prophly,,,8.48,9.82,8
HCPCS,G9957,Doc med rsn no combo thrpy,,,8.48,9.82,8
HCPCS,G9958,No combo prohpyl thrp for pt,,,8.48,9.82,8
HCPCS,G9959,Systemic antimicro not presc,,,8.48,9.82,8
HCPCS,G9960,Med rsn sys antimi nt rx,,,8.48,9.82,8
HCPCS,G9961,Systemic antimicro presc,,,8.48,9.82,8
HCPCS,G9962,Embolization doc separatly,,,8.48,9.82,8
HCPCS,G9963,Embolization not doc separat,,,8.48,9.82,8
HCPCS,G9964,Pt recv >=1 well-chld visit,,,8.48,9.82,8
HCPCS,G9965,No well-chld vist recv by pt,,,8.48,9.82,8
HCPCS,G9966,"Scrn, inter, report child",,,8.48,9.82,8
HCPCS,G9967,"No scrn, inter, reprt child",,,8.48,9.82,8
HCPCS,G9968,Pt refrd 2 pvdr/spclst in pp,,,8.48,9.82,8
HCPCS,G9969,Pvdr rfrd pt rprt rcvd,,,8.48,9.82,8
HCPCS,G9970,Pvdr rfrd pt no rprt rcvd,,,8.48,9.82,8
HCPCS,G9974,Mac exam perf,,,8.48,9.82,8
HCPCS,G9975,Doc med rsn no dil mac exam,,,8.48,9.82,8
HCPCS,G9988,Pall serv during meas,,,8.48,9.82,8
HCPCS,G9989,Med rsn no pneum vax,,,8.48,9.82,8
HCPCS,G9990,No pneum vax admin 19+,,,8.48,9.82,8
HCPCS,G9991,Pneum vax admin 19+,,,8.48,9.82,8
HCPCS,G9992,Pall serv during meas,,,8.48,9.82,8
HCPCS,G9993,Pall serv during meas,,,8.48,9.82,8
HCPCS,G9994,Pall serv during meas,,,8.48,9.82,8
HCPCS,G9995,Pall serv during meas,,,8.48,9.82,8
HCPCS,G9996,Doc pt pal or hospice,,,8.48,9.82,8
HCPCS,G9997,Doc pt preg dur msrmt pd,,,8.48,9.82,8
HCPCS,G9998,Doc med rsn <3 colon,,,8.48,9.82,8
HCPCS,G9999,Doc sys rsn <3 colon,,,8.48,9.82,8
HCPCS,H0001,CD ASSMT PER MIN (ADM),3.0,1.95,0.45,181.38,46
HCPCS,H0002,Alcohol and/or drug screenin,,,156.65,181.38,8
HCPCS,H0003,Alcohol and/or drug screenin,,,23.91,27.69,8
HCPCS,H0004,CD IND COUNS-15 MIN (ADM),93.0,60.45,13.84,93.0,46
HCPCS,H0005,CD GRP COUNS-15 MIN(ADM),33.0,21.45,4.91,121.1,46
HCPCS,H0006,CD CASE MGT PER MIN(ADM),3.0,1.95,0.45,38.09,46
HCPCS,H0007,CD CRISISINTV PERHR(ADM),357.0,232.05,47.45,357.0,46
HCPCS,H0008,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0009,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0010,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0011,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0012,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0013,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0014,OP AMB DETOX (DRUG),720.0,468.0,8.4,720.0,46
HCPCS,H0015,CD IOP DAY (ADM),532.0,345.8,79.16,532.0,48
HCPCS,H0015,CD IOP GROUP THERAPY,178.0,115.7,26.49,178.0,46
HCPCS,H0015,VIRTUAL VISIT CD IOP GROUP THERAPY,178.0,115.7,26.49,178.0,46
HCPCS,H0016,MED SOM PER 15 MIN (ADM),107.0,69.55,15.92,107.0,38
HCPCS,H0017,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0018,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0019,Alcohol and/or drug services,,,216.58,250.78,8
HCPCS,H0020,Alcohol and/or drug services,,,8.4,9.72,8
HCPCS,H0022,Alcohol and/or drug interven,,,75.49,87.41,8
HCPCS,H0031,Mh health assess by non-md,,,156.65,181.38,8
HCPCS,H0032,Mh svc plan dev by non-md,,,32.9,38.09,8
HCPCS,H0033,Oral med adm direct observe,,,8.4,28.84,9
HCPCS,H0034,Med trng & support per 15min,,,8.4,9.72,8
HCPCS,H0035,PHP PER DIEM RATE,1844.0,1198.6,118.99,1844.0,48
HCPCS,H0037,Comm psy sup tx pgm per diem,,,118.99,137.78,8
HCPCS,H0046,"Mental health service, nos",,,75.49,87.41,8
HCPCS,H0047,Alcohol/drug abuse svc nos,,,75.49,87.41,8
HCPCS,H0048,Spec coll non-blood:a/d test,,,2.09,2.42,8
HCPCS,H0049,Alcohol/drug screening,,,37.4,43.31,8
HCPCS,H0050,ALCOHOL/DRUG SERVICE 15 MIN,222.0,144.3,1.1,222.0,29
HCPCS,H0050,Alcohol/drug service 15 min,,,75.49,87.41,8
HCPCS,H0052,Mmip mental health and care,,,75.49,87.41,8
HCPCS,H0053,Ht mental health and care,,,75.49,87.41,8
HCPCS,H1000,PRENATAL CARE ATRISK ASSESSM,281.0,182.65,1.1,281.0,35
HCPCS,H1000,Prenatal care atrisk assessm,,,101.63,117.68,8
HCPCS,H1001,ANTEPARTUM MANAGEMENT,48.0,31.2,1.1,48.0,35
HCPCS,H1001,Antepartum management,,,54.56,63.17,8
HCPCS,H1002,Carecoordination prenatal,,,17.35,20.09,8
HCPCS,H1003,Prenatal at risk education,,,31.04,35.94,8
HCPCS,H1005,Prenatalcare enhanced srv pk,,,101.63,117.68,8
HCPCS,H1010,Nonmed family planning ed,,,31.04,35.94,8
HCPCS,H1011,Family assessment,,,156.65,181.38,8
HCPCS,H2000,CANS ASSESSMENT,162.5,105.625,1.1,1592889.09,80
HCPCS,H2001,Rehabilitation program 1/2 d,,,70.73,81.9,8
HCPCS,H2010,Comprehensive med svc 15 min,,,8.4,9.72,8
HCPCS,H2011,"Crisis interven svc, 15 min",,,47.45,54.95,8
HCPCS,H2012,"Behav hlth day treat, per hr",,,51.98,60.19,8
HCPCS,H2014,"Skills train and dev, 15 min",,,38.59,44.68,8
HCPCS,H2015,FUNCTIONAL FAMILY THERAPY FOR JUVENILES (FFT),84.0,54.6,1.1,133.0,67
HCPCS,H2015,INTENSIVE HOME BASED TREATMENT,85.5,55.575,1.1,133.0,67
HCPCS,H2017,"Psysoc rehab svc, per 15 min",,,75.49,87.41,8
HCPCS,H2018,"Psysoc rehab svc, per diem",,,118.99,137.78,8
HCPCS,H2019,"Ther behav svc, per 15 min",,,75.49,87.41,8
HCPCS,H2020,"Ther behav svc, per diem",,,118.99,137.78,8
HCPCS,H2027,"Psychoed svc, per 15 min",,,75.49,87.41,8
HCPCS,H2028,"Sex offend tx svc, 15 min",,,75.49,87.41,8
HCPCS,H2029,"Sex offend tx svc, per diem",,,118.99,137.78,8
HCPCS,H2032,"Activity therapy, per 15 min",,,38.59,44.68,8
HCPCS,H2033,MULTI SYSTEMIC THERAPY FOR JUVENILES (MST),87.5,56.875,1.1,133.0,75
HCPCS,H2034,"A/d halfway house, per diem",,,216.58,250.78,8
HCPCS,H2035,"A/d tx program, per hour",,,75.49,87.41,8
HCPCS,H2036,"A/d tx program, per diem",,,118.99,137.78,8
HCPCS,H2041,Coord special care encounter,,,32.9,38.09,8
HCPCS,HASUP,HEARING AID SUPPLY,10.0,6.5,1.1,10.0,22
HCPCS,J0013,"Esketamine, nasal spray",,,31.83,31.83,1
HCPCS,J0013,SPRAVATO 28 MG NASAL SPRAY,1001.04,650.68,148.95,1001.04,51
HCPCS,J0013,SPRAVATO 56 MG (28 MG X 2) NASAL SPRAY,1001.04,650.68,148.95,1001.04,51
HCPCS,J0013,SPRAVATO 84 MG (28 MG X 3) NASAL SPRAY,1001.04,650.68,148.95,1001.04,51
HCPCS,J001300,"Esketamine, nasal spray",,,31.83,31.83,1
HCPCS,J0120,Tetracyclin injection,,,29.62,47.96,10
HCPCS,J012000,Tetracyclin injection,,,29.62,29.62,1
HCPCS,J0121,"Inj., omadacycline, 1 mg",,,7.37,7.37,1
HCPCS,J0121,NUZYRA 100 MG INTRAVENOUS SOLUTION,1770.78,1151.01,2.17,1770.78,65
HCPCS,J012100,"Inj., omadacycline, 1 mg",,,7.37,7.37,1
HCPCS,J0122,"Inj., eravacycline, 1 mg",,,2.3,2.3,1
HCPCS,J0122,XERAVA 50 MG INTRAVENOUS SOLUTION,262.5,170.63,1.29,262.5,59
HCPCS,J012200,"Inj., eravacycline, 1 mg",,,2.3,2.3,1
HCPCS,J0129,Abatacept injection,,,79.69,79.69,1
HCPCS,J0129,ORENCIA (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,5580.0,3627.0,2.17,5580.0,65
HCPCS,J012900,Abatacept injection,,,79.69,79.69,1
HCPCS,J0130,Abciximab injection,,,1201.03,3688.63,12
HCPCS,J013000,Abciximab injection,,,2879.72,2879.72,1
HCPCS,J0131,ACETAMINOPHEN 650 MG/65 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.04,8.86,51
HCPCS,J0131,"Inj, acetaminophen (nos)",,,0.11,0.11,1
HCPCS,J013100,"Inj, acetaminophen (nos)",,,0.11,0.11,1
HCPCS,J0132,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,6.0,3.9,0.66,8.86,51
HCPCS,J0132,Acetylcysteine injection,,,0.66,0.66,1
HCPCS,J013200,Acetylcysteine injection,,,0.66,0.66,1
HCPCS,J0133,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,5.16,3.35,0.11,8.86,153
HCPCS,J0133,Acyclovir injection,,,0.21,0.21,1
HCPCS,J013300,Acyclovir injection,,,0.21,0.21,1
HCPCS,J0134,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.36,0.23,0.05,8.86,51
HCPCS,J0134,Inj acetaminophen -fresenius,,,0.11,0.11,1
HCPCS,J013400,Inj acetaminophen -fresenius,,,0.11,0.11,1
HCPCS,J0135,Adalimumab injection,,,1069.3,3332.47,11
HCPCS,J013500,Adalimumab injection,,,2601.67,2601.67,1
HCPCS,J0136,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.04,8.86,51
HCPCS,J0136,ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.45,0.29,0.07,8.86,51
HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.09,0.09,1
HCPCS,J013600,"Inj, acetaminophen (b braun)",,,0.09,0.09,1
HCPCS,J0137,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.855,0.5549999999999999,0.06,8.86,102
HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.09,0.09,1
HCPCS,J013700,"Inj, acetaminophen (hikma)",,,0.09,0.09,1
HCPCS,J0138,Inj acetaminoph 10mg/ibu 3mg,,,0.09,8.86,26
HCPCS,J013800,Inj acetaminoph 10mg/ibu 3mg,,,0.16,0.16,1
HCPCS,J0139,HUMIRA 40 MG/0.8 ML SUBCUTANEOUS SYRINGE KIT,12460.71,8099.46,2.17,12460.71,57
HCPCS,J0139,HUMIRA PEN 40 MG/0.8 ML SUBCUTANEOUS KIT,11537.7,7499.51,2.17,11537.7,57
HCPCS,J0139,HUMIRA(CF) 40 MG/0.4 ML SUBCUTANEOUS SYRINGE KIT,11537.7,7499.51,2.17,11537.7,57
HCPCS,J0139,HUMIRA(CF) PEN 40 MG/0.4 ML SUBCUTANEOUS KIT,15383.6,9999.34,2.17,15383.6,57
HCPCS,J0139,HUMIRA(CF) PEN CROHN'S-ULC COLITIS-HID SUP STRT 80 MG/0.8 ML SUBCUT KT,30767.32,19998.76,2.17,30767.32,57
HCPCS,J0153,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.4,15.21,0.69,47.96,153
HCPCS,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,11.025,7.164999999999999,0.69,47.96,306
HCPCS,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,26.1,16.965,0.69,47.96,102
HCPCS,J0153,Adenosine inj 1mg,,,0.94,0.94,1
HCPCS,J015300,Adenosine inj 1mg,,,0.94,0.94,1
HCPCS,J0162,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,27.0,17.55,0.82,27.0,51
HCPCS,J0162,Inj epinephrine (fresenius),,,0.82,0.82,1
HCPCS,J016200,Inj epinephrine (fresenius),,,0.82,0.82,1
HCPCS,J0163,ADRENALIN IN 0.9 % SODIUM CHLORIDE 4 MG/250 ML (16 MCG/ML) IV SOLUTION,0.57,0.37,0.08,8.86,51
HCPCS,J0163,Epinephrine in nacl (endo),,,1.57,1.57,1
HCPCS,J016300,Epinephrine in nacl (endo),,,1.57,1.57,1
HCPCS,J0164,Epinephrine in nacl (baxter),,,1.67,8.86,11
HCPCS,J016400,Epinephrine in nacl (baxter),,,1.67,1.67,1
HCPCS,J0165,Inj epinephrine nos 0.1 mg,,,0.77,8.86,11
HCPCS,J016500,Inj epinephrine nos 0.1 mg,,,0.77,0.77,1
HCPCS,J0166,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,28.5,18.53,1.98,28.5,51
HCPCS,J0166,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,52.5,34.13,1.98,52.5,102
HCPCS,J0166,Inj epinephrine (bpi),,,1.98,1.98,1
HCPCS,J016600,Inj epinephrine (bpi),,,1.98,1.98,1
HCPCS,J0167,Inj epinephrine (hospira),,,2.53,8.86,11
HCPCS,J016700,Inj epinephrine (hospira),,,2.53,2.53,1
HCPCS,J0168,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,4.95,3.22,0.74,8.86,51
HCPCS,J0168,Epinephrine (intl med sys),,,5.34,5.34,1
HCPCS,J016800,Epinephrine (intl med sys),,,5.34,5.34,1
HCPCS,J0169,ADRENALIN 1 MG/ML (1 ML) INJECTION SOLUTION,29.52,19.19,2.17,29.52,102
HCPCS,J0169,ADRENALIN 1 MG/ML INJECTION SOLUTION,11.76,7.64,1.75,11.76,51
HCPCS,J0169,Inj epinephrine (adrenalin),,,2.46,2.46,1
HCPCS,J016900,Inj epinephrine (adrenalin),,,2.46,2.46,1
HCPCS,J0171,EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,540.0,351.0,1.63,540.0,51
HCPCS,J0171,EPINEPHRINE 0.15 MG/0.15 ML AUTO-INJECTOR (FOR 33 TO 66 LB PATIENTS),741.03,481.67,1.63,741.03,51
HCPCS,J0171,EPINEPHRINE 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,540.0,351.0,1.63,540.0,51
HCPCS,J0171,EPIPEN 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
HCPCS,J0171,EPIPEN 2-PAK 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
HCPCS,J0171,EPIPEN JR 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
HCPCS,J0171,EPIPEN JR 2-PAK 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
HCPCS,J0172,"Inj, aducanumab-avwa, 2 mg",,,5.85,4487.68,17
HCPCS,J0173,"Inj, epinephrine (belcher)",,,0.76,8.86,11
HCPCS,J0174,LEQEMBI 100 MG/ML INTRAVENOUS SOLUTION,474.91499999999996,308.695,1.33,720.96,130
HCPCS,J0174,"Lecanemab-irmb, for iv inj",,,2.37,2.37,1
HCPCS,J017400,"Lecanemab-irmb, for iv inj",,,2.37,2.37,1
HCPCS,J0175,"Inj, donanemab-azbt, 2 mg",,,7.42,7.42,1
HCPCS,J0175,KISUNLA 17.5 MG/ML INTRAVENOUS SOLUTION,126.78,82.41,2.17,720.96,65
HCPCS,J017500,"Inj, donanemab-azbt, 2 mg",,,7.42,7.42,1
HCPCS,J0177,EYLEA HD 8 MG/0.07 ML INTRAVITREAL SOLUTION FOR INJECTION,140454.0,91295.1,2.17,140454.0,65
HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,546.44,546.44,1
HCPCS,J017700,"Inj, aflibercept hd, 1 mg",,,546.44,546.44,1
HCPCS,J0178,Aflibercept injection,,,1359.74,1359.74,1
HCPCS,J0178,EYLEA 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,139847.76,90901.04,2.17,139847.76,65
HCPCS,J0178,EYLEA 2 MG/0.05 ML INTRAVITREAL SYRINGE,139847.76,90901.04,2.17,139847.76,65
HCPCS,J017800,Aflibercept injection,,,1359.74,1359.74,1
HCPCS,J0179,BEOVU 6 MG/0.05 ML INTRAVITREAL SYRINGE,150004.08,97502.65,2.17,150004.08,65
HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,628.0,628.0,1
HCPCS,J017900,"Inj, brolucizumab-dbll, 1 mg",,,628.0,628.0,1
HCPCS,J0180,Agalsidase beta injection,,,409.97,409.97,1
HCPCS,J0180,FABRAZYME 35 MG INTRAVENOUS SOLUTION,38699.0,25154.35,2.17,38699.0,65
HCPCS,J0180,FABRAZYME 5 MG INTRAVENOUS SOLUTION,5527.48,3592.86,2.17,7011.25,65
HCPCS,J018000,Agalsidase beta injection,,,409.97,409.97,1
HCPCS,J0184,"Inj, amisulpride, 1 mg",,,9.06,47.96,30
HCPCS,J018400,"Inj, amisulpride, 1 mg",,,20.38,20.38,1
HCPCS,J0185,CINVANTI 130 MG/18 ML (7.2 MG/ML) INTRAVENOUS EMULSION,92.73,60.27,1.71,184.43,65
HCPCS,J0185,"Inj., aprepitant, 1 mg",,,3.04,3.04,1
HCPCS,J018500,"Inj., aprepitant, 1 mg",,,3.04,3.04,1
HCPCS,J0190,Inj biperiden lactate/5 mg,,,7.39,47.96,9
HCPCS,J0200,Alatrofloxacin mesylate,,,41.42,47.96,9
HCPCS,J0202,"Injection, alemtuzumab",,,4355.84,4355.84,1
HCPCS,J0202,LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION,118976.96,77335.02,2.17,118976.96,65
HCPCS,J020200,"Injection, alemtuzumab",,,4355.84,4355.84,1
HCPCS,J0205,Alglucerase injection,,,43.57,184.43,11
HCPCS,J0206,Inj allopurinol sodium 1 mg,,,4.4,3257.22,32
HCPCS,J020600,Inj allopurinol sodium 1 mg,,,7.83,7.83,1
HCPCS,J0207,Amifostine,,,2288.53,2288.53,1
HCPCS,J0207,ETHYOL 500 MG INTRAVENOUS SOLUTION,3857.07,2507.1,2.17,3857.07,51
HCPCS,J020700,Amifostine,,,2288.53,2288.53,1
HCPCS,J0208,"Inj, pedmark, 100 mg",,,96.06,4417.71,30
HCPCS,J020800,"Inj, pedmark, 100 mg",,,195.09,195.09,1
HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,1.71,1.71,1
HCPCS,J0209,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,7.2,4.68,0.88,4417.71,59
HCPCS,J020900,"Inj, sod thiosulfate (hope)",,,1.71,1.71,1
HCPCS,J0210,METHYLDOPATE 250 MG/5 ML INTRAVENOUS SOLUTION,28.8,18.72,2.17,184.43,51
HCPCS,J0210,Methyldopate hcl injection,,,85.44,85.44,1
HCPCS,J021000,Methyldopate hcl injection,,,85.44,85.44,1
HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,4.18,4.18,1
HCPCS,J0211,NITHIODOTE 300 MG/10 ML-12.5 GRAM/50 ML INTRAVENOUS SOLUTION,11.76,7.64,2.16,184.43,65
HCPCS,J021100,"Inj, nithiodote, 3mg / 125mg",,,4.18,4.18,1
HCPCS,J0215,Alefacept,,,54.24,1287.79,10
HCPCS,J0216,"Inj, alfentanil hcl, 500mcg",,,4.57,9.72,11
HCPCS,J021600,"Inj, alfentanil hcl, 500mcg",,,4.57,4.57,1
HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,828.11,828.11,1
HCPCS,J0217,LAMZEDE 10 MG INTRAVENOUS SOLUTION,16274.4,10578.36,2.17,16617.81,65
HCPCS,J021700,Inj velmanase alfa-tycv 1 mg,,,828.11,828.11,1
HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,704.03,704.03,1
HCPCS,J0218,XENPOZYME 20 MG INTRAVENOUS SOLUTION,28092.66,18260.23,2.17,28092.66,65
HCPCS,J021800,Inj olipudase alfa-rpcp 1mg,,,704.03,704.03,1
HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,144.71,144.71,1
HCPCS,J0219,NEXVIAZYME 100 MG INTRAVENOUS SOLUTION,7295.25,4741.91,2.17,16617.81,65
HCPCS,J021900,Inj aval alfa-nqpt 4mg,,,144.71,144.71,1
HCPCS,J0220,Alglucosidase alfa injection,,,214.5,13108.79,11
HCPCS,J022000,Alglucosidase alfa injection,,,416.52,416.52,1
HCPCS,J0221,LUMIZYME 50 MG INTRAVENOUS SOLUTION,3647.64,2370.97,2.17,16617.81,65
HCPCS,J0221,Lumizyme injection,,,369.15,369.15,1
HCPCS,J022100,Lumizyme injection,,,369.15,369.15,1
HCPCS,J0222,"Inj., patisiran, 0.1 mg",,,177.95,177.95,1
HCPCS,J0222,ONPATTRO 2 MG/ML INTRAVENOUS SOLUTION,7045.2,4579.38,2.17,13108.79,65
HCPCS,J022200,"Inj., patisiran, 0.1 mg",,,177.95,177.95,1
HCPCS,J0223,GIVLAARI 189 MG/ML SUBCUTANEOUS SOLUTION,158018.4,102711.96,2.17,158018.4,65
HCPCS,J0223,Inj givosiran 0.5 mg,,,214.83,214.83,1
HCPCS,J022300,Inj givosiran 0.5 mg,,,214.83,214.83,1
HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,317.88,13108.79,33
HCPCS,J022400,"Inj. lumasiran, 0.5 mg",,,583.88,583.88,1
HCPCS,J0225,AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,859327.2,558562.68,2.17,859327.2,65
HCPCS,J0225,"Inj, vutrisiran, 1 mg",,,8917.02,8917.02,1
HCPCS,J022500,"Inj, vutrisiran, 1 mg",,,8917.02,8917.02,1
HCPCS,J0248,"Inj, remdesivir, 1 mg",,,12.28,12.28,1
HCPCS,J0248,REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),93.6,60.84,2.17,667.03,65
HCPCS,J0248,VEKLURY 100 MG INTRAVENOUS POWDER FOR SOLUTION,2342.58,1522.68,2.17,2342.58,65
HCPCS,J024800,"Inj, remdesivir, 1 mg",,,12.28,12.28,1
HCPCS,J0256,ARALAST NP 500 MG INTRAVENOUS SOLUTION,2.34,1.52,0.52,2642.72,65
HCPCS,J0256,Alpha 1 proteinase inhibitor,,,9.56,9.56,1
HCPCS,J0256,PROLASTIN-C 1000  MG (+/-)/20 ML INTRAVENOUS SOLUTION,2.22,1.44,0.49,2642.72,130
HCPCS,J0256,ZEMAIRA 1000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.5,2642.72,65
HCPCS,J0256,ZEMAIRA 4000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.5,2642.72,65
HCPCS,J0256,ZEMAIRA 5000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.5,2642.72,65
HCPCS,J025600,Alpha 1 proteinase inhibitor,,,9.56,9.56,1
HCPCS,J0257,Glassia injection,,,5.16,2642.72,33
HCPCS,J025700,Glassia injection,,,10.13,10.13,1
HCPCS,J0270,Alprostadil for injection,,,21.95,21.95,1
HCPCS,J0270,CAVERJECT 20 MCG INTRACAVERNOSAL SOLUTION,396.96,258.02,1.01,396.96,51
HCPCS,J0270,CAVERJECT 20 MCG INTRACAVERNOSAL SYRINGE,400.02,260.01,1.01,400.02,51
HCPCS,J0270,CAVERJECT 40 MCG INTRACAVERNOSAL SOLUTION,523.62,340.35,1.01,523.62,51
HCPCS,J0270,CAVERJECT IMPULSE 20 MCG INTRACAVERNOSAL KIT,400.02,260.01,1.01,400.02,51
HCPCS,J0270,EDEX 20 MCG INTRACAVERNOSAL KIT,1681.2,1092.78,1.01,2521.77,102
HCPCS,J0270,PROSTIN VR PEDIATRIC 500 MCG/ML INJECTION SOLUTION,609.63,396.26,1.01,609.63,102
HCPCS,J027000,Alprostadil for injection,,,21.95,21.95,1
HCPCS,J0275,Alprostadil urethral suppos,,,7.87,112.2,11
HCPCS,J027500,Alprostadil urethral suppos,,,87.59,87.59,1
HCPCS,J0278,AMIKACIN 1000 MG/4 ML INJECTION SOLUTION,12.87,8.37,1.1,12.87,51
HCPCS,J0278,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,13.95,9.07,1.1,14.4,153
HCPCS,J0278,Amikacin sulfate injection,,,1.1,1.1,1
HCPCS,J027800,Amikacin sulfate injection,,,1.1,1.1,1
HCPCS,J0280,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,4.08,2.6550000000000002,0.04,18.53,153
HCPCS,J0280,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,2.55,1.66,0.38,18.53,102
HCPCS,J0280,Aminophyllin 250 mg inj,,,18.53,18.53,1
HCPCS,J028000,Aminophyllin 250 mg inj,,,18.53,18.53,1
HCPCS,J0281,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,1.905,1.24,0.28,47.96,102
HCPCS,J0281,Inj aminocaproic acid 1 gram,,,2.83,2.83,1
HCPCS,J028100,Inj aminocaproic acid 1 gram,,,2.83,2.83,1
HCPCS,J0282,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.4,1.56,0.33,47.96,204
HCPCS,J0282,Amiodarone hcl,,,0.73,0.73,1
HCPCS,J0282,NEXTERONE 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLUTION,1.26,0.82,0.19,47.96,51
HCPCS,J0282,NEXTERONE 360 MG/200 ML (1.8 MG/ML) INTRAVENOUS SOLUTION,0.84,0.55,0.12,47.96,51
HCPCS,J028200,Amiodarone hcl,,,0.73,0.73,1
HCPCS,J0283,"Inj, amiodarone (nexterone)",,,4.5,47.96,14
HCPCS,J028300,"Inj, amiodarone (nexterone)",,,4.5,4.5,1
HCPCS,J0285,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,180.0,117.0,2.17,180.0,51
HCPCS,J0285,Amphotericin b,,,77.06,77.06,1
HCPCS,J028500,Amphotericin b,,,77.06,77.06,1
HCPCS,J0287,Amphotericin b lipid complex,,,10.07,184.43,18
HCPCS,J028700,Amphotericin b lipid complex,,,22.43,22.43,1
HCPCS,J0288,Ampho b cholesteryl sulfate,,,36.48,152.31,10
HCPCS,J0289,AMBISOME 50 MG INTRAVENOUS SUSPENSION,1145.91,744.84,2.17,1145.91,65
HCPCS,J0289,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,842.46,547.6,2.17,842.46,65
HCPCS,J0289,Amphotericin b liposome inj,,,36.88,36.88,1
HCPCS,J028900,Amphotericin b liposome inj,,,36.88,36.88,1
HCPCS,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,22.935,14.91,1.05,25.92,255
HCPCS,J0290,AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,323.31,210.15,1.05,323.31,51
HCPCS,J0290,AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,104.25,67.76,1.05,104.25,51
HCPCS,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,49.004999999999995,31.849999999999998,1.05,50.25,204
HCPCS,J0290,AMPICILLIN 250 MG SOLUTION FOR INJECTION,12.57,8.17,1.05,12.57,51
HCPCS,J0290,AMPICILLIN 500 MG SOLUTION FOR INJECTION,13.23,8.6,1.05,13.23,51
HCPCS,J0290,Ampicillin 500 mg inj,,,1.05,1.05,1
HCPCS,J029000,Ampicillin 500 mg inj,,,1.05,1.05,1
HCPCS,J0291,"Inj., plazomicin, 5 mg",,,3.26,184.43,33
HCPCS,J029100,"Inj., plazomicin, 5 mg",,,6.25,6.25,1
HCPCS,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,19.38,12.6,2.17,19.38,102
HCPCS,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,15.12,9.83,2.08,23.22,153
HCPCS,J0295,AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,142.56,92.66,2.17,142.56,51
HCPCS,J0295,AMPICILLIN-SULBACTAM 3 GRAM INTRAVENOUS SOLUTION,33.24,21.61,2.17,33.24,51
HCPCS,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,43.8,28.47,2.14,54.0,306
HCPCS,J0295,Ampicillin sulbactam 1.5 gm,,,2.37,2.37,1
HCPCS,J0295,UNASYN 1.5 GRAM SOLUTION FOR INJECTION,27.75,18.04,2.17,27.75,51
HCPCS,J0295,UNASYN 15 GRAM SOLUTION FOR INJECTION,262.11,170.37,2.17,262.11,51
HCPCS,J0295,UNASYN 3 GRAM SOLUTION FOR INJECTION,52.41,34.07,2.17,52.41,51
HCPCS,J029500,Ampicillin sulbactam 1.5 gm,,,2.37,2.37,1
HCPCS,J0300,Amobarbital 125 mg inj,,,24.34,501.42,12
HCPCS,J030000,Amobarbital 125 mg inj,,,391.46,391.46,1
HCPCS,J0330,QUELICIN 20 MG/ML INJECTION SOLUTION,6.99,4.54,1.04,8.86,51
HCPCS,J0330,Succinycholine chloride inj,,,1.82,1.82,1
HCPCS,J033000,Succinycholine chloride inj,,,1.82,1.82,1
HCPCS,J0348,Anidulafungin injection,,,0.91,0.91,1
HCPCS,J0348,ERAXIS(WATER DILUENT) 100 MG INTRAVENOUS SOLUTION,687.21,446.69,0.91,687.21,51
HCPCS,J034800,Anidulafungin injection,,,0.91,0.91,1
HCPCS,J0349,"Inj, rezafungin, 1 mg",,,19.26,19.26,1
HCPCS,J0349,REZZAYO 200 MG INTRAVENOUS SOLUTION,7673.16,4987.55,2.17,7673.16,65
HCPCS,J034900,"Inj, rezafungin, 1 mg",,,19.26,19.26,1
HCPCS,J0350,Injection anistreplase 30 u,,,3875.72,6465.12,9
HCPCS,J0360,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,53.175,34.565,2.17,61.35,204
HCPCS,J0360,Hydralazine hcl injection,,,7.81,7.81,1
HCPCS,J036000,Hydralazine hcl injection,,,7.81,7.81,1
HCPCS,J0364,Apomorphine hydrochloride,,,74.15,369.35,11
HCPCS,J036400,Apomorphine hydrochloride,,,74.15,74.15,1
HCPCS,J0365,"Aprotonin, 10,000 kiu",,,5.57,184.43,10
HCPCS,J0380,Inj metaraminol bitartrate,,,2.09,47.96,10
HCPCS,J0390,Chloroquine injection,,,36.88,47.96,10
HCPCS,J039000,Chloroquine injection,,,36.88,36.88,1
HCPCS,J0391,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,16135.5,10488.08,2.17,16135.5,65
HCPCS,J0391,"Inj, artesunate, 1mg",,,104.43,104.43,1
HCPCS,J039100,"Inj, artesunate, 1mg",,,104.43,104.43,1
HCPCS,J0395,Arbutamine hcl injection,,,41.42,437.76,9
HCPCS,J0400,Aripiprazole injection,,,0.69,47.96,12
HCPCS,J040000,Aripiprazole injection,,,1.53,1.53,1
HCPCS,J0401,ABILIFY MAINTENA 300 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,7842.0,5097.3,2.17,7842.0,130
HCPCS,J0401,ABILIFY MAINTENA 300 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,7842.0,5097.3,2.17,7842.0,65
HCPCS,J0401,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,2.17,10455.99,195
HCPCS,J0401,ABILIFY MAINTENA 400 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,10455.99,6796.39,2.17,10455.99,65
HCPCS,J0401,"Inj, abilify maintena, 1 mg",,,12.96,12.96,1
HCPCS,J040100,"Inj, abilify maintena, 1 mg",,,12.96,12.96,1
HCPCS,J0402,ABILIFY ASIMTUFII 960 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,6534.99,4247.74,2.17,6534.99,65
HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,10.72,10.72,1
HCPCS,J040200,"Inj, abilify asimtufii, 1 mg",,,10.72,10.72,1
HCPCS,J0456,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,26.76,17.39,2.17,89.85,153
HCPCS,J0456,Azithromycin,,,3.63,3.63,1
HCPCS,J0456,ZITHROMAX 500 MG INTRAVENOUS SOLUTION,21.93,14.25,2.17,21.93,51
HCPCS,J045600,Azithromycin,,,3.63,3.63,1
HCPCS,J0457,AZACTAM 2 GRAM SOLUTION FOR INJECTION,214.02,139.11,2.17,214.02,51
HCPCS,J0457,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,205.92,133.85,2.17,241.02,204
HCPCS,J0457,"Injection, aztreonam, 100 mg",,,3.97,3.97,1
HCPCS,J045700,"Injection, aztreonam, 100 mg",,,3.97,3.97,1
HCPCS,J0458,Aztreonam/avibactam 10 mg,,,2.99,2.99,1
HCPCS,J0458,EMBLAVEO 2 GRAM INTRAVENOUS SOLUTION,1177.2,765.18,1.67,4417.71,59
HCPCS,J045800,Aztreonam/avibactam 10 mg,,,2.99,2.99,1
HCPCS,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE,3.7199999999999998,2.42,0.18,8.86,102
HCPCS,J0461,Atropine sulfate injection,,,0.18,0.18,1
HCPCS,J046100,Atropine sulfate injection,,,0.18,0.18,1
HCPCS,J0462,ATROPINE 0.4 MG/ML INJECTION SOLUTION,13.74,8.93,0.23,13.74,51
HCPCS,J0462,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,40.44,26.29,0.23,40.44,51
HCPCS,J0462,ATROPINE 1 MG/ML INJECTION SOLUTION,53.129999999999995,34.535,0.23,61.05,102
HCPCS,J0462,"Atropine sulf, nte, 0.01 mg",,,0.23,0.23,1
HCPCS,J046200,"Atropine sulf, nte, 0.01 mg",,,0.23,0.23,1
HCPCS,J0463,Inj atr sulf(fres equ).01 mg,,,7.65,8.86,8
HCPCS,J0470,Dimecaprol injection,,,41.42,146.33,12
HCPCS,J047000,Dimecaprol injection,,,114.24,114.24,1
HCPCS,J0475,BACLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,21.24,13.81,2.17,667.03,65
HCPCS,J0475,BACLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,112.155,72.9,2.17,667.03,130
HCPCS,J0475,Baclofen 10 mg injection,,,323.02,323.02,1
HCPCS,J0475,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,46.35,30.13,2.17,667.03,65
HCPCS,J0475,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SYRINGE,49.8,32.37,2.17,667.03,65
HCPCS,J0475,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SOLUTION,92.73,60.27,2.17,667.03,65
HCPCS,J0475,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SYRINGE,99.63,64.76,2.17,667.03,65
HCPCS,J0475,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,185.43,120.53,2.17,667.03,65
HCPCS,J0475,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SYRINGE,199.44,129.64,2.17,667.03,65
HCPCS,J0475,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,390
HCPCS,J0475,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,871.89,566.73,2.17,1701.24,260
HCPCS,J047500,Baclofen 10 mg injection,,,323.02,323.02,1
HCPCS,J0476,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,158.4,102.96,2.17,158.4,51
HCPCS,J0476,Baclofen intrathecal trial,,,105.93,105.93,1
HCPCS,J0476,GABLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,345.0,224.25,2.17,345.0,51
HCPCS,J0476,LIORESAL 50 MCG/ML INTRATHECAL SOLUTION,118.68,77.14,2.17,118.68,51
HCPCS,J047600,Baclofen intrathecal trial,,,105.93,105.93,1
HCPCS,J0480,Basiliximab,,,8510.3,8510.3,1
HCPCS,J0480,SIMULECT 10 MG INTRAVENOUS SOLUTION,17007.04,11054.58,2.17,17007.04,65
HCPCS,J0480,SIMULECT 20 MG INTRAVENOUS SOLUTION,22321.68,14509.09,2.17,22321.68,65
HCPCS,J048000,Basiliximab,,,8510.3,8510.3,1
HCPCS,J0485,Belatacept injection,,,6.92,6.92,1
HCPCS,J0485,NULOJIX 250 MG INTRAVENOUS SOLUTION,3491.58,2269.53,2.17,3491.58,65
HCPCS,J048500,Belatacept injection,,,6.92,6.92,1
HCPCS,J0490,BENLYSTA 120 MG INTRAVENOUS SOLUTION,3169.92,2060.45,2.17,3169.92,65
HCPCS,J0490,BENLYSTA 200 MG/ML SUBCUTANEOUS AUTO-INJECTOR,6164.88,4007.17,2.17,6164.88,65
HCPCS,J0490,BENLYSTA 400 MG INTRAVENOUS SOLUTION,10565.6,6867.64,2.17,10565.6,65
HCPCS,J0490,Belimumab injection,,,101.74,101.74,1
HCPCS,J049000,Belimumab injection,,,101.74,101.74,1
HCPCS,J0491,Inj anifrolumab-fnia 1mg,,,32.65,32.65,1
HCPCS,J0491,SAPHNELO 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,9793.14,6365.54,2.17,9793.14,65
HCPCS,J049100,Inj anifrolumab-fnia 1mg,,,32.65,32.65,1
HCPCS,J0500,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,56.91,36.99,2.17,70.2,102
HCPCS,J0500,Dicyclomine injection,,,20.17,20.17,1
HCPCS,J050000,Dicyclomine injection,,,20.17,20.17,1
HCPCS,J0515,BENZTROPINE 1 MG/ML INJECTION SOLUTION,94.5,61.425,2.17,108.0,102
HCPCS,J0515,Inj benztropine mesylate,,,24.6,24.6,1
HCPCS,J051500,Inj benztropine mesylate,,,24.6,24.6,1
HCPCS,J0517,FASENRA 30 MG/ML SUBCUTANEOUS SYRINGE,21049.38,13682.1,2.17,21049.38,65
HCPCS,J0517,FASENRA PEN 30 MG/ML SUBCUTANEOUS AUTO-INJECTOR,21049.38,13682.1,2.17,21049.38,65
HCPCS,J0517,"Inj., benralizumab, 1 mg",,,291.87,291.87,1
HCPCS,J051700,"Inj., benralizumab, 1 mg",,,291.87,291.87,1
HCPCS,J0520,Bethanechol chloride inject,,,10.0,47.96,10
HCPCS,J052000,Bethanechol chloride inject,,,10.0,10.0,1
HCPCS,J0525,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,87.18,56.67,0.52,87.18,51
HCPCS,J0525,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,174.39,113.35,0.52,174.39,51
HCPCS,J0525,Inj cefotetan disodium 10 mg,,,0.52,0.52,1
HCPCS,J052500,Inj cefotetan disodium 10 mg,,,0.52,0.52,1
HCPCS,J0558,BICILLIN C-R 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,437.61,284.45,2.17,437.61,130
HCPCS,J0558,Peng benzathine/procaine inj,,,34.75,34.75,1
HCPCS,J055800,Peng benzathine/procaine inj,,,34.75,34.75,1
HCPCS,J0561,BICILLIN L-A 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,730.68,474.94,2.17,730.68,65
HCPCS,J0561,BICILLIN L-A 2400000 UNIT/4 ML INTRAMUSCULAR SYRINGE,748.65,486.62,2.17,748.65,130
HCPCS,J0561,BICILLIN L-A 600000 UNIT/ML INTRAMUSCULAR SYRINGE,843.78,548.46,2.17,843.78,65
HCPCS,J0561,PENICILLIN G BENZ INJ 100000,15.83,10.29,2.17,130.36,65
HCPCS,J0561,PENICILLIN G BENZATHINE INJ,31.0,20.15,1.1,55.94,27
HCPCS,J0561,Penicillin g benzathine inj,,,56.91,56.91,1
HCPCS,J056100,Penicillin g benzathine inj,,,56.91,56.91,1
HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,39.82,2642.72,33
HCPCS,J056500,"Inj, bezlotoxumab, 10 mg",,,70.9,70.9,1
HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,121.19,13108.79,24
HCPCS,J056700,"Inj., cerliponase alfa 1 mg",,,250.41,250.41,1
HCPCS,J0570,Buprenorphine implant 74.2mg,,,1112.18,3385.8,11
HCPCS,J057000,Buprenorphine implant 74.2mg,,,2643.3,2643.3,1
HCPCS,J0571,Buprenorphine oral 1mg,,,0.57,47.96,11
HCPCS,J057100,Buprenorphine oral 1mg,,,0.57,0.57,1
HCPCS,J0572,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,9.82,6.38,1.46,47.96,48
HCPCS,J0572,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,7.8,5.075,0.91,47.96,96
HCPCS,J0572,Bupren/nal up to 3mg bupreno,,,8.37,8.37,1
HCPCS,J0572,SUBOXONE 2 MG-0.5 MG SUBLINGUAL FILM,12.02,7.81,1.79,47.96,96
HCPCS,J057200,Bupren/nal up to 3mg bupreno,,,8.37,8.37,1
HCPCS,J0573,Bupren/nal 3.1 to 6mg bupren,,,16.57,47.96,11
HCPCS,J057300,Bupren/nal 3.1 to 6mg bupren,,,16.57,16.57,1
HCPCS,J0574,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.6,11.44,2.17,47.96,192
HCPCS,J0574,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,18.880000000000003,12.275,2.17,47.96,96
HCPCS,J0574,Bupren/nal 6.1 to 10mg bupre,,,16.57,16.57,1
HCPCS,J0574,SUBOXONE 8 MG-2 MG SUBLINGUAL FILM,21.56,14.01,2.17,47.96,96
HCPCS,J057400,Bupren/nal 6.1 to 10mg bupre,,,16.57,16.57,1
HCPCS,J0575,BUPRENORPHINE 12 MG-NALOXONE 3 MG SUBLINGUAL FILM,36.86,23.96,2.17,47.96,51
HCPCS,J0575,Bupren/nal over 10mg bupreno,,,33.14,33.14,1
HCPCS,J057500,Bupren/nal over 10mg bupreno,,,33.14,33.14,1
HCPCS,J0576,Inj buprenorph (brixadi) 1mg,,,41.42,47.96,8
HCPCS,J0577,BRIXADI WEEKLY 16 MG/0.32 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,4803.75,3122.44,2.17,4803.75,65
HCPCS,J0577,BRIXADI WEEKLY 24 MG/0.48 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,3202.5,2081.63,2.17,3202.5,65
HCPCS,J0577,BRIXADI WEEKLY 32 MG/0.64 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,2401.89,1561.23,2.17,2401.89,65
HCPCS,J0577,BRIXADI WEEKLY 8 MG/0.16 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,9607.5,6244.88,2.17,9607.5,65
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,747.69,747.69,1
HCPCS,J057700,"Inj, brixadi, 7 days or less",,,747.69,747.69,1
HCPCS,J0578,BRIXADI MONTHLY 128 MG/0.36 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,17079.99,11101.99,2.17,17079.99,65
HCPCS,J0578,BRIXADI MONTHLY 64 MG/0.18 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,34160.01,22204.01,2.17,34160.01,65
HCPCS,J0578,BRIXADI MONTHLY 96 MG/0.27 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,22773.33,14802.66,2.17,22773.33,65
HCPCS,J0578,"Inj brixadi, more than 7 day",,,2990.77,2990.77,1
HCPCS,J057800,"Inj brixadi, more than 7 day",,,2990.77,2990.77,1
HCPCS,J0582,Bivalirudin (endo) 1 mg,,,0.25,130.36,11
HCPCS,J058200,Bivalirudin (endo) 1 mg,,,0.25,0.25,1
HCPCS,J0583,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,1831.905,1190.74,0.28,3411.81,102
HCPCS,J0583,Bivalirudin,,,0.28,0.28,1
HCPCS,J058300,Bivalirudin,,,0.28,0.28,1
HCPCS,J0584,"Injection, burosumab-twza 1m",,,394.44,13108.79,33
HCPCS,J058400,"Injection, burosumab-twza 1m",,,886.48,886.48,1
HCPCS,J0585,BOTOX 100 UNIT INJECTION,2343.6,1523.34,2.17,2343.6,65
HCPCS,J0585,BOTOX 200 UNIT INJECTION,4687.2,3046.68,2.17,4687.2,65
HCPCS,J0585,BOTOX COSMETIC 100 UNIT INTRAMUSCULAR SOLUTION,2361.6,1535.04,2.17,2361.6,65
HCPCS,J0585,BOTOX COSMETIC 50 UNIT INTRAMUSCULAR SOLUTION,1303.2,847.08,2.17,1303.2,65
HCPCS,J0585,BOTOX PER UNIT,14.0,9.1,1.1,14.0,27
HCPCS,J0585,BOTULINUM TOXIN A PER 1 UNIT,11.0,7.15,1.1,11.39,27
HCPCS,J0585,BOTULINUM TOXIN TYPE A/UNIT,47.69,31.0,2.17,667.03,65
HCPCS,J0585,"Injection,onabotulinumtoxina",,,11.59,11.59,1
HCPCS,J058500,"Injection,onabotulinumtoxina",,,11.59,11.59,1
HCPCS,J0586,Abobotulinumtoxina,,,15.66,15.66,1
HCPCS,J0586,DYSPORT 300 UNIT INTRAMUSCULAR SOLUTION,1751.88,1138.72,2.17,1902.6,130
HCPCS,J0586,DYSPORT 500 UNIT INTRAMUSCULAR SOLUTION,3169.8,2060.37,2.17,3169.8,65
HCPCS,J058600,Abobotulinumtoxina,,,15.66,15.66,1
HCPCS,J0587,BOTULINUM TOX B INJ PER 100U,40.65,26.42,2.17,667.03,65
HCPCS,J0587,"Inj, rimabotulinumtoxinb",,,23.66,23.66,1
HCPCS,J0587,MYOBLOC 10000 UNIT/2 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,2.17,2286.3,65
HCPCS,J0587,MYOBLOC 2500 UNIT/0.5 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,2.17,2286.3,65
HCPCS,J0587,MYOBLOC 5000 UNIT/ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,2.17,2286.3,65
HCPCS,J058700,"Inj, rimabotulinumtoxinb",,,23.66,23.66,1
HCPCS,J0588,INCOBOTULINUMTOXIN A 1 UNIT,25.18,16.37,2.17,667.03,65
HCPCS,J0588,Incobotulinumtoxin a,,,9.35,9.35,1
HCPCS,J0588,XEOMIN 100 UNIT INTRAMUSCULAR SOLUTION,1787.4,1161.81,2.17,1839.6,130
HCPCS,J0588,XEOMIN 50 UNIT INTRAMUSCULAR SOLUTION,1402.1999999999998,911.4300000000001,2.17,1839.6,130
HCPCS,J058800,Incobotulinumtoxin a,,,9.35,9.35,1
HCPCS,J0589,DAXXIFY 100 UNIT INTRAMUSCULAR SOLUTION,1512.0,982.8,2.17,1512.0,65
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,5.54,5.54,1
HCPCS,J058900,Inj daxibotulinumtoxina-lanm,,,5.54,5.54,1
HCPCS,J0591,"Inj deoxycholic acid, 1 mg",,,32.04,32.04,1
HCPCS,J0591,KYBELLA 10 MG/ML SUBCUTANEOUS SOLUTION,2160.0,1404.0,2.17,2160.0,51
HCPCS,J059100,"Inj deoxycholic acid, 1 mg",,,32.04,32.04,1
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,57.19,37.17,2.17,65.36,102
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SYRINGE,115.2,74.88,2.17,115.2,51
HCPCS,J0592,Buprenorphine hydrochloride,,,7.49,7.49,1
HCPCS,J059200,Buprenorphine hydrochloride,,,7.49,7.49,1
HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,81.84,13108.79,27
HCPCS,J059300,"Inj., lanadelumab-flyo, 1 mg",,,155.2,155.2,1
HCPCS,J0594,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,189.68,123.29,0.89,500.04,65
HCPCS,J0594,Busulfan injection,,,1.58,1.58,1
HCPCS,J059400,Busulfan injection,,,1.58,1.58,1
HCPCS,J0595,BUTORPHANOL 1 MG/ML INJECTION SOLUTION,60.84,39.55,2.17,60.84,51
HCPCS,J0595,BUTORPHANOL 2 MG/ML INJECTION SOLUTION,74.43,48.38,2.17,74.43,51
HCPCS,J0595,Butorphanol tartrate 1 mg,,,9.86,9.86,1
HCPCS,J059500,Butorphanol tartrate 1 mg,,,9.86,9.86,1
HCPCS,J0596,"Injection, ruconest",,,31.24,7011.25,33
HCPCS,J059600,"Injection, ruconest",,,65.47,65.47,1
HCPCS,J0597,BERINERT 500 UNIT (10 ML) INTRAVENOUS KIT,15992.88,10395.37,2.17,15992.88,65
HCPCS,J0597,"C-1 esterase, berinert",,,135.03,135.03,1
HCPCS,J059700,"C-1 esterase, berinert",,,135.03,135.03,1
HCPCS,J0598,"C-1 esterase, cinryze",,,116.82,116.82,1
HCPCS,J0598,CINRYZE 500 UNIT (5 ML) INTRAVENOUS SOLUTION,11513.49,7483.77,2.17,11513.49,130
HCPCS,J059800,"C-1 esterase, cinryze",,,116.82,116.82,1
HCPCS,J0599,"Inj., haegarda 10 units",,,25.85,4487.68,11
HCPCS,J059900,"Inj., haegarda 10 units",,,25.85,25.85,1
HCPCS,J0600,EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,4676.13,3039.48,2.17,18396.77,65
HCPCS,J0600,EDETATE CALCIUM DISODIUM 50 MG/ML INTRAVENOUS SOLUTION,126.0,81.9,2.17,18396.77,65
HCPCS,J0600,Edetate calcium disodium inj,,,11053.23,11053.23,1
HCPCS,J060000,Edetate calcium disodium inj,,,11053.23,11053.23,1
HCPCS,J0601,Sevelamer carbonate 20 mg,,,0.02,47.96,11
HCPCS,J060100,Sevelamer carbonate 20 mg,,,0.02,0.02,1
HCPCS,J0602,Sevelamer carbonate pdr 20mg,,,0.11,47.96,11
HCPCS,J060200,Sevelamer carbonate pdr 20mg,,,0.11,0.11,1
HCPCS,J0603,Sevelamer hydrochloride 20mg,,,0.21,47.96,11
HCPCS,J060300,Sevelamer hydrochloride 20mg,,,0.21,0.21,1
HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,0.04,130.36,12
HCPCS,J060400,"Cinacalcet, esrd on dialysis",,,0.04,0.04,1
HCPCS,J0605,Sucroferric oxyhydroxide 5mg,,,0.37,47.96,11
HCPCS,J060500,Sucroferric oxyhydroxide 5mg,,,0.37,0.37,1
HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,2.29,130.36,25
HCPCS,J060600,"Inj, etelcalcetide, 0.1 mg",,,8.81,8.81,1
HCPCS,J0607,Lanthanum carbonate oral 5mg,,,0.09,47.96,11
HCPCS,J060700,Lanthanum carbonate oral 5mg,,,0.09,0.09,1
HCPCS,J0608,Lanthanum carbonate pwdr 5mg,,,0.12,47.96,11
HCPCS,J060800,Lanthanum carbonate pwdr 5mg,,,0.12,0.12,1
HCPCS,J0609,Ferric citrate orl 3 mg iron,,,0.06,47.96,11
HCPCS,J060900,Ferric citrate orl 3 mg iron,,,0.23,0.23,1
HCPCS,J0610,Calcium glucon (fresenius),,,7.65,8.86,8
HCPCS,J0611,Calcium glucon (wg critical),,,7.65,8.86,8
HCPCS,J0612,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,2.775,1.805,0.05,8.86,255
HCPCS,J0612,"Inj, calcium gluconate, nos",,,0.05,0.05,1
HCPCS,J061200,"Inj, calcium gluconate, nos",,,0.05,0.05,1
HCPCS,J0613,CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE ISO-OSM IV SOLUTION,1.41,0.92,0.16,8.86,51
HCPCS,J0613,Calcium glucon (wg critical),,,0.16,0.16,1
HCPCS,J061300,Calcium glucon (wg critical),,,0.16,0.16,1
HCPCS,J0614,"Inj, treosulfan, 50 mg",,,31.2,4417.71,24
HCPCS,J061400,"Inj, treosulfan, 50 mg",,,55.55,55.55,1
HCPCS,J0615,"Calcium acetate, oral, 23 mg",,,0.04,47.96,11
HCPCS,J061500,"Calcium acetate, oral, 23 mg",,,0.04,0.04,1
HCPCS,J0616,Inj metoprolol tartrate 1 mg,,,0.21,0.21,1
HCPCS,J0616,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,0.885,0.575,0.11,8.86,102
HCPCS,J061600,Inj metoprolol tartrate 1 mg,,,0.21,0.21,1
HCPCS,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,7.29,4.74,0.05,8.86,51
HCPCS,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,4.53,2.94,0.05,8.86,51
HCPCS,J0618,"Inj, calcium chloride, 2 mg",,,0.05,0.05,1
HCPCS,J061800,"Inj, calcium chloride, 2 mg",,,0.05,0.05,1
HCPCS,J0620,Calcium glycer & lact/10 ml,,,23.65,47.96,11
HCPCS,J062000,Calcium glycer & lact/10 ml,,,27.41,27.41,1
HCPCS,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,1440.0,936.0,2.17,2642.72,57
HCPCS,J0630,Calcitonin salmon injection,,,1708.8,1708.8,1
HCPCS,J063000,Calcitonin salmon injection,,,1708.8,1708.8,1
HCPCS,J0636,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,28.695,18.65,2.12,35.82,102
HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,2.12,2.12,1
HCPCS,J063600,Inj calcitriol per 0.1 mcg,,,2.12,2.12,1
HCPCS,J0637,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION,1213.2,788.58,2.17,1213.2,51
HCPCS,J0637,Caspofungin acetate,,,6.8,6.8,1
HCPCS,J063700,Caspofungin acetate,,,6.8,6.8,1
HCPCS,J0638,Canakinumab injection,,,262.98,262.98,1
HCPCS,J0638,ILARIS (PF) 150 MG/ML SUBCUTANEOUS SOLUTION,76983.66,50039.38,2.17,76983.66,65
HCPCS,J063800,Canakinumab injection,,,262.98,262.98,1
HCPCS,J0640,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,7.845,5.1,1.16,9.48,86
HCPCS,J0640,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,72.0,46.8,2.17,72.0,43
HCPCS,J0640,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,54.0,35.099999999999994,2.17,72.0,86
HCPCS,J0640,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,252.0,163.8,2.17,252.0,43
HCPCS,J0640,LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,31.68,20.59,2.17,31.68,43
HCPCS,J0640,LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,310.29,201.69,2.17,310.29,43
HCPCS,J0640,Leucovorin calcium injection,,,6.84,6.84,1
HCPCS,J064000,Leucovorin calcium injection,,,6.84,6.84,1
HCPCS,J0641,Inj levoleucovorin nos 0.5mg,,,0.09,327.06,14
HCPCS,J064100,Inj levoleucovorin nos 0.5mg,,,0.09,0.09,1
HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,1.37,667.03,14
HCPCS,J064200,"Injection, khapzory, 0.5 mg",,,2.51,2.51,1
HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,10.64,10.64,1
HCPCS,J0650,LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,375.555,244.11,2.17,433.29,102
HCPCS,J0650,LEVOTHYROXINE 500 MCG INTRAVENOUS POWDER FOR SOLUTION,1900.47,1235.31,2.17,1900.47,51
HCPCS,J065000,"Inj, levothyroxine nos 10mcg",,,10.64,10.64,1
HCPCS,J0651,"Inj, levothyroxine, freskabi",,,12.35,12.35,1
HCPCS,J0651,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,58.905,38.290000000000006,2.17,130.36,130
HCPCS,J0651,LEVOTHYROXINE 40 MCG/ML INTRAVENOUS SOLUTION,159.63,103.76,2.17,159.63,65
HCPCS,J065100,"Inj, levothyroxine, freskabi",,,12.35,12.35,1
HCPCS,J0652,"Inj, levothyroxine, hikma",,,5.14,130.36,19
HCPCS,J065200,"Inj, levothyroxine, hikma",,,13.69,13.69,1
HCPCS,J0654,"Inj, liothyronine, 1 mcg",,,39.52,130.36,22
HCPCS,J065400,"Inj, liothyronine, 1 mcg",,,94.13,94.13,1
HCPCS,J0665,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.75,0.49,0.02,8.86,153
HCPCS,J0665,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.99,0.64,0.02,8.86,306
HCPCS,J0665,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,0.81,0.525,0.02,8.86,102
HCPCS,J0665,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.27,0.18,0.02,8.86,51
HCPCS,J0665,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,0.21,0.14,0.02,8.86,51
HCPCS,J0665,"Inj, bupivacaine, nos, 0.5mg",,,0.02,0.02,1
HCPCS,J0665,MARCAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.6,0.39,0.02,8.86,51
HCPCS,J0665,MARCAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,1.86,1.21,0.02,8.86,51
HCPCS,J0665,MARCAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,1.89,1.23,0.02,8.86,51
HCPCS,J0665,SENSORCAINE 0.5 % (5 MG/ML) INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
HCPCS,J0665,SENSORCAINE-MPF 0.5 % (5 MG/ML) INJECTION SOLUTION,2.07,1.35,0.02,8.86,51
HCPCS,J066500,"Inj, bupivacaine, nos, 0.5mg",,,0.02,0.02,1
HCPCS,J0666,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,75.36,48.98,1.32,91.2,195
HCPCS,J0666,"Inj, bupivacaine liposome",,,2.56,2.56,1
HCPCS,J066600,"Inj, bupivacaine liposome",,,2.56,2.56,1
HCPCS,J0668,"Instill, bupivac and meloxic",,,0.76,8.86,22
HCPCS,J066800,"Instill, bupivac and meloxic",,,1.62,1.62,1
HCPCS,J0670,Inj mepivacaine hcl/10 ml,,,6.68,6.68,1
HCPCS,J0670,POLOCAINE 1 % (10 MG/ML) INJECTION SOLUTION,1.14,0.74,0.17,8.86,51
HCPCS,J0670,POLOCAINE 2 % INJECTION SOLUTION,1.17,0.76,0.17,8.86,51
HCPCS,J0670,POLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,1.35,0.88,0.2,8.86,51
HCPCS,J0670,POLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,1.8,1.17,0.27,8.86,51
HCPCS,J0670,POLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.33,8.86,51
HCPCS,J067000,Inj mepivacaine hcl/10 ml,,,6.68,6.68,1
HCPCS,J0675,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1148.37,746.44,2.17,1148.37,59
HCPCS,J0675,HEMABATE 250 MCG/ML INTRAMUSCULAR SOLUTION,504.0,327.6,2.17,504.0,118
HCPCS,J0675,"Inj, carboprost, 0.1 mg",,,64.08,64.08,1
HCPCS,J067500,"Inj, carboprost, 0.1 mg",,,64.08,64.08,1
HCPCS,J0681,Inj ceftobipole medocarl 3mg,,,1.12,184.43,22
HCPCS,J068100,Inj ceftobipole medocarl 3mg,,,2.26,2.26,1
HCPCS,J0687,Inj cefazolin (wg crit care),,,1.04,8.86,19
HCPCS,J068700,Inj cefazolin (wg crit care),,,1.57,1.57,1
HCPCS,J0688,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,39.78,25.86,0.98,39.78,57
HCPCS,J0688,CEFAZOLIN 2 GRAM INTRAVENOUS SOLUTION,21.06,13.69,0.98,21.06,57
HCPCS,J0688,CEFAZOLIN 3 GRAM INTRAVENOUS SOLUTION,31.59,20.53,0.98,31.59,57
HCPCS,J0688,"Inj cefazolin sodium, hikma",,,1.57,1.57,1
HCPCS,J068800,"Inj cefazolin sodium, hikma",,,1.57,1.57,1
HCPCS,J0689,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.33,0.21,0.05,8.86,51
HCPCS,J0689,"Inj cefazolin sodium, baxter",,,2.26,2.26,1
HCPCS,J068900,"Inj cefazolin sodium, baxter",,,2.26,2.26,1
HCPCS,J0690,CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,9.84,6.4,1.46,9.84,51
HCPCS,J0690,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,6.375,4.145,0.56,22.5,204
HCPCS,J0690,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,25.155,16.35,0.06,49.92,102
HCPCS,J0690,CEFAZOLIN 10 GRAM INTRAVENOUS SOLUTION,45.15,29.35,1.48,45.15,51
HCPCS,J0690,CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,56.16,36.5,1.48,56.16,51
HCPCS,J0690,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,6.48,4.21,0.86,8.86,102
HCPCS,J0690,CEFAZOLIN SODIUM INJECTION,33.0,21.45,0.83,33.0,27
HCPCS,J0690,Cefazolin sodium injection,,,1.48,1.48,1
HCPCS,J069000,Cefazolin sodium injection,,,1.48,1.48,1
HCPCS,J0691,Inj lefamulin 1 mg,,,0.75,184.43,12
HCPCS,J069100,Inj lefamulin 1 mg,,,1.46,1.46,1
HCPCS,J0692,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.405,13.91,1.55,21.93,102
HCPCS,J0692,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,35.91,23.345,1.55,36.18,102
HCPCS,J0692,Cefepime hcl for injection,,,1.55,1.55,1
HCPCS,J069200,Cefepime hcl for injection,,,1.55,1.55,1
HCPCS,J0693,"Inj., cefiderocol, 5 mg",,,159.28,184.43,8
HCPCS,J0694,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,22.98,14.94,2.17,22.98,102
HCPCS,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,61.035,39.67,2.17,71.82,102
HCPCS,J0694,CEFOXITIN 2 GRAM/50 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,120.75,78.49,2.17,120.75,51
HCPCS,J0694,Cefoxitin sodium injection,,,8.44,8.44,1
HCPCS,J069400,Cefoxitin sodium injection,,,8.44,8.44,1
HCPCS,J0695,Inj ceftolozane tazobactam,,,15.93,15.93,1
HCPCS,J0695,ZERBAXA 1.5 GRAM INTRAVENOUS SOLUTION,627.69,408.0,2.17,627.69,65
HCPCS,J069500,Inj ceftolozane tazobactam,,,15.93,15.93,1
HCPCS,J0696,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,6.345000000000001,4.125,0.67,138.0,204
HCPCS,J0696,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,35.94,23.36,0.15,70.86,102
HCPCS,J0696,CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,703.8149999999999,457.48,0.82,1345.29,102
HCPCS,J0696,CEFTRIAXONE 2 GRAM INTRAVENOUS SOLUTION,28.71,18.66,0.82,28.71,51
HCPCS,J0696,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,142.32000000000002,92.51,0.82,274.23,102
HCPCS,J0696,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,48.45,31.494999999999997,0.36,94.47,102
HCPCS,J0696,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,44.475,28.91,0.41,47.82,204
HCPCS,J0696,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,4.5,2.93,0.52,80.64,204
HCPCS,J0696,CEFTRIAXONE PER 250 MG,6.4,4.16,0.82,8.86,51
HCPCS,J0696,CEFTRIAXONE SODIUM INJECTION,32.0,20.8,0.49,32.0,27
HCPCS,J0696,Ceftriaxone sodium injection,,,0.82,0.82,1
HCPCS,J069600,Ceftriaxone sodium injection,,,0.82,0.82,1
HCPCS,J0697,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,21.06,13.69,2.17,21.06,102
HCPCS,J0697,CEFUROXIME SODIUM 750 MG SOLUTION FOR INJECTION,11.01,7.16,1.64,11.01,51
HCPCS,J0697,Sterile cefuroxime injection,,,3.65,3.65,1
HCPCS,J069700,Sterile cefuroxime injection,,,3.65,3.65,1
HCPCS,J0698,CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION,35.1,22.82,2.17,35.1,51
HCPCS,J0698,CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,70.32,45.71,2.17,70.32,51
HCPCS,J0698,Cefotaxime sodium injection,,,20.93,20.93,1
HCPCS,J069800,Cefotaxime sodium injection,,,20.93,20.93,1
HCPCS,J0699,FETROJA 1 GRAM INTRAVENOUS SOLUTION,838.23,544.85,2.17,838.23,130
HCPCS,J0699,"Inj, cefiderocol, 10 mg",,,4.31,4.31,1
HCPCS,J069900,"Inj, cefiderocol, 10 mg",,,4.31,4.31,1
HCPCS,J0701,Inj. cefepime hcl (baxter),,,1.81,13.09,14
HCPCS,J070100,Inj. cefepime hcl (baxter),,,10.63,10.63,1
HCPCS,J0702,BETAMETHASONE ACET&SOD PHOSP,20.0,13.0,1.1,20.0,27
HCPCS,J0702,BETAMETHASONE ACET/SOD PHOS 3MG,23.0,14.95,2.17,23.0,51
HCPCS,J0702,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,39.63,25.76,2.17,39.63,51
HCPCS,J0702,Betamethasone acet&sod phosp,,,12.3,12.3,1
HCPCS,J0702,CELESTONE IM 3MG,17.0,11.05,2.17,17.12,51
HCPCS,J070200,Betamethasone acet&sod phosp,,,12.3,12.3,1
HCPCS,J0703,CEFEPIME 1 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,70.86,46.06,2.17,70.86,51
HCPCS,J0703,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,107.46,69.85,2.17,107.46,51
HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,8.81,8.81,1
HCPCS,J070300,"Inj, cefepime hcl (b braun)",,,8.81,8.81,1
HCPCS,J0706,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,24.0,15.6,2.17,24.0,51
HCPCS,J0706,Caffeine citrate injection,,,2.58,2.58,1
HCPCS,J070600,Caffeine citrate injection,,,2.58,2.58,1
HCPCS,J0710,Cephapirin sodium injection,,,3.01,47.96,10
HCPCS,J0712,Ceftaroline fosamil inj,,,7.55,7.55,1
HCPCS,J0712,TEFLARO 400 MG INTRAVENOUS SOLUTION,926.85,602.45,2.17,926.85,65
HCPCS,J0712,TEFLARO 600 MG INTRAVENOUS SOLUTION,926.85,602.45,2.17,926.85,65
HCPCS,J071200,Ceftaroline fosamil inj,,,7.55,7.55,1
HCPCS,J0713,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,16.2,10.53,2.17,16.2,51
HCPCS,J0713,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,36.0,23.4,2.17,36.0,51
HCPCS,J0713,Inj ceftazidime per 500 mg,,,2.62,2.62,1
HCPCS,J0713,TAZICEF 1 GRAM SOLUTION FOR INJECTION,15.36,9.98,2.17,15.36,51
HCPCS,J0713,TAZICEF 2 GRAM SOLUTION FOR INJECTION,34.38,22.35,2.17,34.38,51
HCPCS,J0713,TAZICEF 6 GRAM SOLUTION FOR INJECTION,110.04,71.53,2.17,110.04,51
HCPCS,J071300,Inj ceftazidime per 500 mg,,,2.62,2.62,1
HCPCS,J0714,AVYCAZ 2.5 GRAM INTRAVENOUS SOLUTION,1495.32,971.96,2.17,1495.32,130
HCPCS,J0714,Ceftazidime and avibactam,,,186.38,186.38,1
HCPCS,J071400,Ceftazidime and avibactam,,,186.38,186.38,1
HCPCS,J0715,Ceftizoxime sodium / 500 mg,,,6.07,47.96,10
HCPCS,J0716,Centruroides immune f(ab),,,1051.33,14353.33,30
HCPCS,J071600,Centruroides immune f(ab),,,11205.67,11205.67,1
HCPCS,J0717,CIMZIA 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYRINGE KIT,21597.96,14038.67,2.17,21597.96,65
HCPCS,J0717,CIMZIA POWDER FOR RECON 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,28797.28,18718.23,2.17,28797.28,65
HCPCS,J0717,Certolizumab pegol inj 1mg,,,6.89,6.89,1
HCPCS,J071700,Certolizumab pegol inj 1mg,,,6.89,6.89,1
HCPCS,J0720,CHLORAMPHENICOL SODIUM SUCCINATE 1 GRAM INTRAVENOUS SOLUTION,175.14,113.84,2.17,175.14,59
HCPCS,J0720,Chloramphenicol sodium injec,,,103.92,103.92,1
HCPCS,J072000,Chloramphenicol sodium injec,,,103.92,103.92,1
HCPCS,J0725,CHORIONIC GONADOTROPIN HUMAN 10000 UNIT IM POWDER FOR SOLUTION,1124.1,730.67,2.17,1124.1,51
HCPCS,J0725,Chorionic gonadotropin/1000u,,,27.41,27.41,1
HCPCS,J0725,NOVAREL 5000 UNIT INTRAMUSCULAR SOLUTION,607.65,394.97,2.17,607.65,51
HCPCS,J072500,Chorionic gonadotropin/1000u,,,27.41,27.41,1
HCPCS,J0735,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,9.0,5.85,1.07,47.96,204
HCPCS,J0735,CLONIDINE (PF) 5000 MCG/10 ML EPIDURAL SOLUTION,63.0,40.95,2.17,63.0,51
HCPCS,J0735,"CLONIDINE HCL,1 MG",174.0,113.1,1.1,174.0,27
HCPCS,J0735,Clonidine hydrochloride,,,30.67,30.67,1
HCPCS,J0735,DURACLON (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,11.28,7.33,1.68,47.96,51
HCPCS,J073500,Clonidine hydrochloride,,,30.67,30.67,1
HCPCS,J0736,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.12,47.96,51
HCPCS,J0736,"Inj, clindamycin phosp 300mg",,,3.4,3.4,1
HCPCS,J073600,"Inj, clindamycin phosp 300mg",,,3.4,3.4,1
HCPCS,J0737,CLINDAMYCIN 300 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.5549999999999999,0.36,0.08,47.96,102
HCPCS,J0737,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.93,0.6,0.14,47.96,51
HCPCS,J0737,"Inj, clindamycin (baxter)",,,4.18,4.18,1
HCPCS,J073700,"Inj, clindamycin (baxter)",,,4.18,4.18,1
HCPCS,J0738,"Hiv prep, inj, lenacapavir",,,28.71,28.71,1
HCPCS,J0738,YEZTUGO 309 MG/ML SUBCUTANEOUS SOLUTION,16930.8,11005.02,2.17,16930.8,59
HCPCS,J073800,"Hiv prep, inj, lenacapavir",,,28.71,28.71,1
HCPCS,J0739,APRETUDE 600 MG/3 ML (200 MG/ML) IM SUSPENSION EXTENDED RELEASE,4677.285,3040.2349999999997,2.17,5074.8,130
HCPCS,J0739,"Hiv prep, inj, cabotegravir",,,12.73,12.73,1
HCPCS,J073900,"Hiv prep, inj, cabotegravir",,,12.73,12.73,1
HCPCS,J0740,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,711.87,462.72,2.17,1676.17,65
HCPCS,J0740,Cidofovir injection,,,933.57,933.57,1
HCPCS,J074000,Cidofovir injection,,,933.57,933.57,1
HCPCS,J0741,CABENUVA 400 MG/2 ML-600 MG/2 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,2.17,4487.68,65
HCPCS,J0741,CABENUVA 600 MG/3 ML-900 MG/3 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,2.17,4487.68,65
HCPCS,J0741,"Inj, cabote rilpivir 2mg 3mg",,,43.0,43.0,1
HCPCS,J074100,"Inj, cabote rilpivir 2mg 3mg",,,43.0,43.0,1
HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,4.63,4.63,1
HCPCS,J0742,RECARBRIO 1.25 GRAM INTRAVENOUS SOLUTION,1138.11,739.77,2.17,1138.11,114
HCPCS,J074200,Inj imip 4 cilas 4 releb 2mg,,,4.63,4.63,1
HCPCS,J0743,Cilastatin sodium injection,,,12.64,12.64,1
HCPCS,J0743,IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,61.53,39.99,2.17,61.53,51
HCPCS,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,74.16,48.205,2.17,107.94,102
HCPCS,J0743,PRIMAXIN 500 MG INTRAVENOUS SOLUTION,117.54,76.4,2.17,117.54,51
HCPCS,J074300,Cilastatin sodium injection,,,12.64,12.64,1
HCPCS,J0744,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,8.86,51
HCPCS,J0744,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,8.86,102
HCPCS,J0744,Ciprofloxacin iv,,,3.56,3.56,1
HCPCS,J074400,Ciprofloxacin iv,,,3.56,3.56,1
HCPCS,J0745,Inj codeine phosphate /30 mg,,,1.37,8.86,12
HCPCS,J074500,Inj codeine phosphate /30 mg,,,2.71,2.71,1
HCPCS,J0750,"Hiv prep, ftc/tdf 200/300mg",,,1.34,47.96,32
HCPCS,J075000,"Hiv prep, ftc/tdf 200/300mg",,,2.39,2.39,1
HCPCS,J0751,"Hiv prep, ftc/taf 200/25mg",,,41.42,196.13,32
HCPCS,J075100,"Hiv prep, ftc/taf 200/25mg",,,126.97,126.97,1
HCPCS,J0752,"Hiv prep, oral lenacapavir",,,1109.21,1109.21,1
HCPCS,J0752,YEZTUGO 300 MG TABLET,1410.9,917.09,2.17,1846.11,59
HCPCS,J075200,"Hiv prep, oral lenacapavir",,,1109.21,1109.21,1
HCPCS,J0759,CLEVIPREX 25 MG/50 ML INTRAVENOUS EMULSION,6.54,4.25,1.45,130.36,59
HCPCS,J0759,CLEVIPREX 50 MG/100 ML INTRAVENOUS EMULSION,6.54,4.25,1.45,130.36,59
HCPCS,J0759,"Inj, clevidipine, 1 mg",,,7.53,7.53,1
HCPCS,J075900,"Inj, clevidipine, 1 mg",,,7.53,7.53,1
HCPCS,J0770,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,100.785,65.50999999999999,2.17,100.8,102
HCPCS,J0770,Colistimethate sodium inj,,,21.5,21.5,1
HCPCS,J077000,Colistimethate sodium inj,,,21.5,21.5,1
HCPCS,J0775,"Collagenase, clost hist inj",,,134.84,134.84,1
HCPCS,J0775,XIAFLEX 0.9 MG SOLUTION FOR INJECTION,26586.84,17281.45,2.17,26586.84,65
HCPCS,J0775,XIAFLEX INJ 0.01 MG,145.79,94.76,2.17,3257.22,65
HCPCS,J077500,"Collagenase, clost hist inj",,,134.84,134.84,1
HCPCS,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,13.05,8.48,1.42,16.2,153
HCPCS,J0780,Prochlorperazine injection,,,4.49,4.49,1
HCPCS,J078000,Prochlorperazine injection,,,4.49,4.49,1
HCPCS,J0791,ADAKVEO 10 MG/ML INTRAVENOUS SOLUTION,874.32,568.31,2.17,1287.79,65
HCPCS,J0791,Inj crizanlizumab-tmca 5mg,,,230.67,230.67,1
HCPCS,J079100,Inj crizanlizumab-tmca 5mg,,,230.67,230.67,1
HCPCS,J0795,Corticorelin ovine triflutal,,,9.05,720.96,11
HCPCS,J0799,"Hiv prep, fda approved, noc",,,41.42,47.96,8
HCPCS,J0800,Corticotropin injection,,,3875.72,9569.16,10
HCPCS,J080000,Corticotropin injection,,,7470.66,7470.66,1
HCPCS,J0801,ACTHAR 80 UNIT/ML INJECTION GEL,32618.88,21202.27,2.17,32618.88,59
HCPCS,J0801,ACTHAR H.P. 80 UNIT/ML INJECTION GEL,21514.5,13984.43,2.17,21514.5,59
HCPCS,J0801,Inj. acthar gel to 40 units,,,7427.1,7427.1,1
HCPCS,J080100,Inj. acthar gel to 40 units,,,7427.1,7427.1,1
HCPCS,J0802,"Inj. (ani), up to 40 units",,,3551.73,9767.26,26
HCPCS,J080200,"Inj. (ani), up to 40 units",,,6322.1,6322.1,1
HCPCS,J0834,CORTROSYN 0.25 MG SOLUTION FOR INJECTION,383.7,249.41,2.17,383.7,51
HCPCS,J0834,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,303.07500000000005,197.0,2.17,317.43,102
HCPCS,J0834,"Inj., cosyntropin, 0.25 mg",,,36.76,36.76,1
HCPCS,J083400,"Inj., cosyntropin, 0.25 mg",,,36.76,36.76,1
HCPCS,J0840,CROFAB 1 GRAM SOLUTION FOR INJECTION,11512.8,7483.32,2.17,11512.8,65
HCPCS,J0840,Crotalidae poly immune fab,,,3251.21,3251.21,1
HCPCS,J084000,Crotalidae poly immune fab,,,3251.21,3251.21,1
HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,953.52,13544.19,33
HCPCS,J084100,Inj crotalidae im f(ab')2 eq,,,8766.78,8766.78,1
HCPCS,J0850,CYTOGAM 50 MG/ML INTRAVENOUS SOLUTION,130.29,84.69,2.17,5357.33,65
HCPCS,J0850,Cytomegalovirus imm iv /vial,,,3218.83,3218.83,1
HCPCS,J085000,Cytomegalovirus imm iv /vial,,,3218.83,3218.83,1
HCPCS,J0870,"Injection, imetelstat, 1 mg",,,103.77,103.77,1
HCPCS,J0870,RYTELO 188 MG INTRAVENOUS SOLUTION,49966.0,32477.9,2.17,49966.0,65
HCPCS,J0870,RYTELO 47 MG INTRAVENOUS SOLUTION,12491.52,8119.49,2.17,12491.52,65
HCPCS,J087000,"Injection, imetelstat, 1 mg",,,103.77,103.77,1
HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.04,47.96,19
HCPCS,J087200,Daptomycin (xellia) unrefrig,,,0.11,0.11,1
HCPCS,J0873,DAPTOMYCIN 350 MG INTRAVENOUS SOLUTION,86.22,56.04,0.04,86.22,57
HCPCS,J0873,Inj daptomycin (xellia),,,0.05,0.05,1
HCPCS,J087300,Inj daptomycin (xellia),,,0.05,0.05,1
HCPCS,J0874,DAPTOMYCIN 1000 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.37,1.54,0.11,47.96,51
HCPCS,J0874,DAPTOMYCIN 350 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.37,1.54,0.11,47.96,51
HCPCS,J0874,DAPTOMYCIN 500 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.82,1.83,0.11,47.96,51
HCPCS,J0874,DAPTOMYCIN 700 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.04,1.33,0.11,47.96,51
HCPCS,J0874,"Inj, daptomycin (baxter)",,,0.11,0.11,1
HCPCS,J087400,"Inj, daptomycin (baxter)",,,0.11,0.11,1
HCPCS,J0875,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6404.4,4162.86,2.17,6404.4,65
HCPCS,J0875,"Injection, dalbavancin",,,27.75,27.75,1
HCPCS,J087500,"Injection, dalbavancin",,,27.75,27.75,1
HCPCS,J0877,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,62.1,40.37,0.09,62.1,51
HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.11,0.11,1
HCPCS,J087700,"Inj, daptomycin (hospira)",,,0.11,0.11,1
HCPCS,J0878,Daptomycin injection,,,0.05,47.96,14
HCPCS,J087800,Daptomycin injection,,,0.05,0.05,1
HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.15,369.35,18
HCPCS,J087900,"Difelikefalin, esrd on dialy",,,0.5,0.5,1
HCPCS,J0881,ARANESP 100 MCG/0.5 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.17,5572.8,130
HCPCS,J0881,ARANESP 100 MCG/ML (IN POLYSORBATE) INJECTION,2786.4,1811.16,2.17,2786.4,65
HCPCS,J0881,ARANESP 150 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,130
HCPCS,J0881,ARANESP 200 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
HCPCS,J0881,ARANESP 200 MCG/ML (IN POLYSORBATE) INJECTION,5572.8,3622.32,2.17,5572.8,65
HCPCS,J0881,ARANESP 25 MCG/0.42 ML (IN POLYSORBATE) INJECTION SYRINGE,1658.58,1078.08,2.17,1658.58,130
HCPCS,J0881,ARANESP 25 MCG/ML (IN POLYSORBATE) INJECTION,696.6,452.79,2.17,696.6,65
HCPCS,J0881,ARANESP 300 MCG/0.6 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
HCPCS,J0881,ARANESP 40 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,2786.4,1811.16,2.17,2786.4,130
HCPCS,J0881,ARANESP 40 MCG/ML (IN POLYSORBATE) INJECTION,1114.56,724.46,2.17,1114.56,65
HCPCS,J0881,ARANESP 500 MCG/ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
HCPCS,J0881,ARANESP 60 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.17,5572.8,130
HCPCS,J0881,ARANESP 60 MCG/ML (IN POLYSORBATE) INJECTION,1671.84,1086.7,2.17,1671.84,65
HCPCS,J0881,"Darbepoetin alfa, non-esrd",,,5.38,5.38,1
HCPCS,J088100,"Darbepoetin alfa, non-esrd",,,5.38,5.38,1
HCPCS,J0882,"Darbepoetin alfa, esrd use",,,3.02,184.43,33
HCPCS,J088200,"Darbepoetin alfa, esrd use",,,5.38,5.38,1
HCPCS,J0883,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,14.25,9.26,0.6,130.36,65
HCPCS,J0883,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,734.4,477.36,0.6,1702.29,195
HCPCS,J0883,Argatroban nonesrd use 1mg,,,1.09,1.09,1
HCPCS,J088300,Argatroban nonesrd use 1mg,,,1.09,1.09,1
HCPCS,J0884,Argatroban esrd dialysis 1mg,,,1.09,130.36,13
HCPCS,J088400,Argatroban esrd dialysis 1mg,,,1.09,1.09,1
HCPCS,J0885,EPOGEN 10000 UNIT/ML INJECTION SOLUTION,596.88,387.97,2.17,596.88,130
HCPCS,J0885,EPOGEN 2000 UNIT/ML INJECTION SOLUTION,119.37,77.59,2.17,184.43,130
HCPCS,J0885,EPOGEN 20000 UNIT/2 ML INJECTION SOLUTION,596.88,387.97,2.17,596.88,65
HCPCS,J0885,EPOGEN 20000 UNIT/ML INJECTION SOLUTION,1193.76,775.94,2.17,1193.76,130
HCPCS,J0885,EPOGEN 3000 UNIT/ML INJECTION SOLUTION,179.07,116.4,2.17,184.43,130
HCPCS,J0885,EPOGEN 4000 UNIT/ML INJECTION SOLUTION,238.74,155.18,2.17,238.74,130
HCPCS,J0885,"Epoetin alfa, non-esrd",,,13.78,13.78,1
HCPCS,J0885,PROCRIT 10000 UNIT/ML INJECTION SOLUTION,962.1,625.37,2.17,962.1,65
HCPCS,J0885,PROCRIT 2000 UNIT/ML INJECTION SOLUTION,192.45,125.09,2.17,192.45,65
HCPCS,J0885,PROCRIT 20000 UNIT/2 ML INJECTION SOLUTION,962.1,625.37,2.17,962.1,65
HCPCS,J0885,PROCRIT 20000 UNIT/ML INJECTION SOLUTION,1924.2,1250.73,2.17,1924.2,130
HCPCS,J0885,PROCRIT 3000 UNIT/ML INJECTION SOLUTION,288.66,187.63,2.17,288.66,65
HCPCS,J0885,PROCRIT 4000 UNIT/ML INJECTION SOLUTION,384.84,250.15,2.17,384.84,130
HCPCS,J0885,PROCRIT 40000 UNIT/ML INJECTION SOLUTION,3848.4,2501.46,2.17,3848.4,130
HCPCS,J088500,"Epoetin alfa, non-esrd",,,13.78,13.78,1
HCPCS,J0887,Epoetin beta esrd use,,,1.62,8.86,14
HCPCS,J088700,Epoetin beta esrd use,,,2.17,2.17,1
HCPCS,J0888,Epoetin beta non esrd,,,1.16,47.96,20
HCPCS,J088800,Epoetin beta non esrd,,,2.17,2.17,1
HCPCS,J0889,Daprodustat oral 1mg esrd,,,10.69,184.43,9
HCPCS,J0890,Peginesatide injection,,,23.09,184.43,10
HCPCS,J089000,Peginesatide injection,,,23.09,23.09,1
HCPCS,J0891,Argatroban nonesrd (accord),,,1.81,130.36,31
HCPCS,J089100,Argatroban nonesrd (accord),,,8.46,8.46,1
HCPCS,J0892,Argatroban dialysis (accord),,,2.16,130.36,12
HCPCS,J089200,Argatroban dialysis (accord),,,8.46,8.46,1
HCPCS,J0893,DECITABINE 50 MG INTRAVENOUS SOLUTION,480.0,312.0,1.39,480.0,51
HCPCS,J0893,"Inj, decitabine (sun pharma)",,,1.39,1.39,1
HCPCS,J089300,"Inj, decitabine (sun pharma)",,,1.39,1.39,1
HCPCS,J0894,DECITABINE 50 MG INTRAVENOUS SOLUTION,2304.0,1497.6,1.16,2304.0,51
HCPCS,J0894,Decitabine injection,,,1.16,1.16,1
HCPCS,J089400,Decitabine injection,,,1.16,1.16,1
HCPCS,J0895,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,147.465,95.85499999999999,2.17,148.32,102
HCPCS,J0895,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,53.13,34.53,2.17,53.13,51
HCPCS,J0895,DESFERAL 500 MG SOLUTION FOR INJECTION,124.98,81.24,2.17,124.98,51
HCPCS,J0895,Deferoxamine mesylate inj,,,15.08,15.08,1
HCPCS,J089500,Deferoxamine mesylate inj,,,15.08,15.08,1
HCPCS,J0896,Inj luspatercept-aamt 0.25mg,,,76.13,76.13,1
HCPCS,J0896,REBLOZYL 25 MG SUBCUTANEOUS SOLUTION,19743.08,12833.0,2.17,19743.08,65
HCPCS,J0896,REBLOZYL 75 MG SUBCUTANEOUS SOLUTION,59228.96,38498.82,2.17,59228.96,65
HCPCS,J089600,Inj luspatercept-aamt 0.25mg,,,76.13,76.13,1
HCPCS,J0897,DENOSUMAB INJECTION,28.0,18.2,1.1,62.28,27
HCPCS,J0897,Denosumab injection,,,52.44,52.44,1
HCPCS,J0897,PROLIA 60 MG/ML SUBCUTANEOUS SYRINGE,6751.56,4388.51,2.17,6751.56,130
HCPCS,J0897,XGEVA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7305.33,4748.46,2.17,7305.33,130
HCPCS,J089700,Denosumab injection,,,52.44,52.44,1
HCPCS,J0898,Argatroban nonesrd (auromed),,,1.49,130.36,20
HCPCS,J089800,Argatroban nonesrd (auromed),,,2.58,2.58,1
HCPCS,J0899,"Argatroban dialysis, auromed",,,2.16,130.36,14
HCPCS,J089900,"Argatroban dialysis, auromed",,,2.58,2.58,1
HCPCS,J0901,Vadadustat oral 1mg for esrd,,,0.25,47.96,13
HCPCS,J090100,Vadadustat oral 1mg for esrd,,,0.25,0.25,1
HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,5.97,184.43,30
HCPCS,J091100,Inst tauro 1.35mg/hep 100u,,,17.8,17.8,1
HCPCS,J0945,Brompheniramine maleate inj,,,0.69,47.96,12
HCPCS,J094500,Brompheniramine maleate inj,,,1.64,1.64,1
HCPCS,J1000,ADMIN DEPO-ESTRADIOL INJ,23.0,14.95,1.1,90.68,27
HCPCS,J1000,DEPO-ESTRADIOL 5 MG/ML INTRAMUSCULAR OIL,185.73,120.72,2.17,185.73,51
HCPCS,J1000,Depo-estradiol cypionate inj,,,92.24,92.24,1
HCPCS,J100000,Depo-estradiol cypionate inj,,,92.24,92.24,1
HCPCS,J1010,DEPO-MEDROL 20 MG/ML SUSPENSION FOR INJECTION,25.59,16.63,0.12,25.59,57
HCPCS,J1010,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.505,23.08,0.12,40.92,399
HCPCS,J1010,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.025,46.17,0.12,71.07,228
HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.21,0.21,1
HCPCS,J1010,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,34.71,22.56,0.12,34.71,57
HCPCS,J1010,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,58.74,38.18,0.12,58.74,57
HCPCS,J101000,"Inj, methylpred acetate 1 mg",,,0.21,0.21,1
HCPCS,J1020,METHYLPREDNISOLONE 20 MG INJ,7.0,4.55,1.1,12.54,24
HCPCS,J1020,Methylprednisolone 20 mg inj,,,3.31,19.45,11
HCPCS,J102000,Methylprednisolone 20 mg inj,,,15.18,15.18,1
HCPCS,J1030,METHLYPREDNISOLONE 40MG,28.26,18.37,2.17,28.26,51
HCPCS,J1030,Methylprednisolone 40 mg inj,,,19.4,19.4,1
HCPCS,J103000,Methylprednisolone 40 mg inj,,,19.4,19.4,1
HCPCS,J1040,METHYLPREDNISOLONE 80 MG INJ,26.0,16.9,1.1,26.0,24
HCPCS,J1040,Methylprednisolone 80 mg inj,,,7.65,42.7,11
HCPCS,J104000,Methylprednisolone 80 mg inj,,,33.34,33.34,1
HCPCS,J1050,DEPO-PROVERA 150 MG/ML INTRAMUSCULAR SUSPENSION,189.48,123.16,1.08,189.48,51
HCPCS,J1050,DEPO-SUBQ PROVERA 104 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,291.48,189.46,1.08,291.48,51
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.25,190.61,1.08,293.55,255
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,171.0,111.15,1.08,252.0,102
HCPCS,J1050,Medroxyprogesterone acetate,,,1.16,1.16,1
HCPCS,J105000,Medroxyprogesterone acetate,,,1.16,1.16,1
HCPCS,J1071,DEPO-TESTOSTERONE 100 MG/ML INTRAMUSCULAR OIL,31.47,20.46,0.05,31.47,51
HCPCS,J1071,DEPO-TESTOSTERONE 200 MG/ML INTRAMUSCULAR OIL,67.69500000000001,44.0,0.05,85.65,102
HCPCS,J1071,Inj testosterone cypionate,,,0.05,0.05,1
HCPCS,J1071,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,30.54,19.85,0.05,30.54,51
HCPCS,J1071,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,54.0,35.1,0.05,69.3,153
HCPCS,J107100,Inj testosterone cypionate,,,0.05,0.05,1
HCPCS,J1072,"Inj, testosterone, azmiro",,,1.32,8.86,24
HCPCS,J107200,"Inj, testosterone, azmiro",,,2.37,2.37,1
HCPCS,J1073,TESTOPEL 75 MG IMPLANT PELLET,259.64,168.77,2.17,720.96,118
HCPCS,J1073,Testosterone pellet 75 mg,,,224.56,224.56,1
HCPCS,J107300,Testosterone pellet 75 mg,,,224.56,224.56,1
HCPCS,J1094,Inj dexamethasone acetate,,,0.29,47.96,12
HCPCS,J109400,Inj dexamethasone acetate,,,0.61,0.61,1
HCPCS,J1095,"Injection, dexamethasone 9%",,,0.01,667.03,12
HCPCS,J109500,"Injection, dexamethasone 9%",,,2.46,2.46,1
HCPCS,J1096,DEXTENZA 0.4 MG INTRACANALICULAR INSERT,1536.0,998.4,2.17,1536.0,130
HCPCS,J1096,Dexametha opth insert 0.1 mg,,,175.61,175.61,1
HCPCS,J109600,Dexametha opth insert 0.1 mg,,,175.61,175.61,1
HCPCS,J1097,Phenylep ketorolac opth soln,,,89.25,322.85,31
HCPCS,J109700,Phenylep ketorolac opth soln,,,252.05,252.05,1
HCPCS,J1098,Articaine ophthalmi 8% 0.4ml,,,41.42,47.96,8
HCPCS,J1100,DECADRON 4MG/1ML VIAL,8.0,5.2,0.09,8.0,27
HCPCS,J1100,DEXAMETH SOD INJ TO 1MG,3.64,2.37,0.2,8.86,51
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,22.935000000000002,14.91,0.2,27.0,102
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SYRINGE,20.82,13.53,0.2,20.82,51
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.16,3.35,0.2,8.86,204
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,4.23,2.75,0.2,10.38,306
HCPCS,J1100,DEXAMETHOSONE SODIUM PHOS,20.0,13.0,0.09,20.0,27
HCPCS,J1100,Dexamethasone sodium phos,,,0.2,0.2,1
HCPCS,J110000,Dexamethasone sodium phos,,,0.2,0.2,1
HCPCS,J1105,"Dexmedetomidine film, 1 mcg",,,0.78,47.96,15
HCPCS,J1110,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,378.0,245.7,2.17,378.0,102
HCPCS,J1110,Inj dihydroergotamine mesylt,,,101.6,101.6,1
HCPCS,J111000,Inj dihydroergotamine mesylt,,,101.6,101.6,1
HCPCS,J1120,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,158.25,102.86,2.17,158.25,51
HCPCS,J1120,Acetazolamid sodium injectio,,,45.55,45.55,1
HCPCS,J112000,Acetazolamid sodium injectio,,,45.55,45.55,1
HCPCS,J1130,Inj diclofenac sodium 0.5mg,,,0.45,47.96,10
HCPCS,J113000,Inj diclofenac sodium 0.5mg,,,0.45,0.45,1
HCPCS,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,10.56,6.865,1.47,20.11,153
HCPCS,J1160,Digoxin injection,,,17.03,17.03,1
HCPCS,J1160,LANOXIN PEDIATRIC 100 MCG/ML (0.1 MG/ML) INJECTION SOLUTION,515.61,335.15,2.17,515.61,51
HCPCS,J116000,Digoxin injection,,,17.03,17.03,1
HCPCS,J1162,DIGIFAB 40 MG INTRAVENOUS SOLUTION,17906.4,11639.16,2.17,17906.4,65
HCPCS,J1162,Digoxin immune fab (ovine),,,9197.24,9197.24,1
HCPCS,J116200,Digoxin immune fab (ovine),,,9197.24,9197.24,1
HCPCS,J1163,DILTIAZEM 100 MG INTRAVENOUS SOLUTION,41.07,26.7,0.05,41.07,102
HCPCS,J1163,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.4249999999999998,0.9299999999999999,0.05,8.86,408
HCPCS,J1163,"Inj, diltiazem hcl, 0.5 mg",,,0.05,0.05,1
HCPCS,J116300,"Inj, diltiazem hcl, 0.5 mg",,,0.05,0.05,1
HCPCS,J1164,"Inj dil hyd sod chlo,0.5mg",,,7.65,8.86,8
HCPCS,J1165,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,1.77,1.155,0.17,8.86,255
HCPCS,J1165,Phenytoin sodium injection,,,1.07,1.07,1
HCPCS,J116500,Phenytoin sodium injection,,,1.07,1.07,1
HCPCS,J1170,Hydromorphone injection,,,2.97,10.44,11
HCPCS,J117000,Hydromorphone injection,,,8.15,8.15,1
HCPCS,J1171,DILAUDID (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,29.88,19.42,0.09,29.88,114
HCPCS,J1171,DILAUDID (PF) 1 MG/ML INJECTION SYRINGE,14.94,9.71,0.09,14.94,57
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,15.54,10.1,0.09,15.54,57
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,13.44,8.74,0.09,13.44,57
HCPCS,J1171,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,17.04,11.075,0.09,281.01,228
HCPCS,J1171,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,10.8,7.02,0.09,10.8,57
HCPCS,J1171,HYDROMORPHONE (PF) 4 MG/ML INJECTION SOLUTION,16.14,10.49,0.09,16.14,57
HCPCS,J1171,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,115.2,74.88,0.09,115.2,57
HCPCS,J1171,HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE,108.0,70.2,0.09,108.0,57
HCPCS,J1171,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,41.400000000000006,26.909999999999997,0.09,43.2,171
HCPCS,J1171,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,38.31,24.905,0.09,72.75,114
HCPCS,J1171,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.09,57.6,114
HCPCS,J1171,HYDROMORPHONE 4 MG/ML INJECTION SYRINGE,54.0,35.1,0.09,54.0,57
HCPCS,J1171,"Inj, hydromorphone, 0.1 mg",,,0.25,0.25,1
HCPCS,J117100,"Inj, hydromorphone, 0.1 mg",,,0.25,0.25,1
HCPCS,J1180,Dyphylline injection,,,16.89,47.96,10
HCPCS,J118000,Dyphylline injection,,,16.89,16.89,1
HCPCS,J1190,DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,987.33,641.76,2.17,1095.84,65
HCPCS,J1190,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,720.0,468.0,2.17,1095.84,65
HCPCS,J1190,Dexrazoxane hcl injection,,,103.26,103.26,1
HCPCS,J119000,Dexrazoxane hcl injection,,,103.26,103.26,1
HCPCS,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.44,10.83,255
HCPCS,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SYRINGE,9.36,6.08,1.26,9.36,51
HCPCS,J1200,DIPHENHYDRAMINE HCL INJECTIO,21.0,13.65,0.66,21.0,27
HCPCS,J1200,Diphenhydramine hcl injectio,,,1.26,1.26,1
HCPCS,J120000,Diphenhydramine hcl injectio,,,1.26,1.26,1
HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,14.87,47.96,33
HCPCS,J120100,Inj. cetirizine hcl 0.5mg,,,30.42,30.42,1
HCPCS,J1202,Miglustat oral 65 mg,,,72.52,72.52,1
HCPCS,J1202,OPFOLDA 65 MG CAPSULE,85.2,55.38,2.17,130.36,51
HCPCS,J120200,Miglustat oral 65 mg,,,72.52,72.52,1
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,162.34,162.34,1
HCPCS,J1203,POMBILITI 105 MG INTRAVENOUS SOLUTION,7052.4,4584.06,2.17,13108.79,65
HCPCS,J120300,"Inj, cipaglucosidase, 5 mg",,,162.34,162.34,1
HCPCS,J1205,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,375.645,244.17,2.17,1071.72,204
HCPCS,J1205,Chlorothiazide sodium inj,,,103.47,103.47,1
HCPCS,J120500,Chlorothiazide sodium inj,,,103.47,103.47,1
HCPCS,J1212,Dimethyl sulfoxide 50% 50 ml,,,1333.63,1333.63,1
HCPCS,J1212,RIMSO-50  50 % INTRAVESICAL SOLUTION,52.53,34.14,2.17,2219.67,65
HCPCS,J121200,Dimethyl sulfoxide 50% 50 ml,,,1333.63,1333.63,1
HCPCS,J1230,METHADONE 10 MG/ML INJECTION SOLUTION,76.95,50.02,2.17,76.95,51
HCPCS,J1230,Methadone injection,,,31.51,31.51,1
HCPCS,J123000,Methadone injection,,,31.51,31.51,1
HCPCS,J1240,DIMENHYDRINATE 50 MG/ML INJECTION SOLUTION,47.31,30.75,1.64,47.31,51
HCPCS,J1240,Dimenhydrinate injection,,,1.64,1.64,1
HCPCS,J124000,Dimenhydrinate injection,,,1.64,1.64,1
HCPCS,J1245,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,7.14,4.64,1.06,14.97,51
HCPCS,J1245,Dipyridamole injection,,,14.97,14.97,1
HCPCS,J124500,Dipyridamole injection,,,14.97,14.97,1
HCPCS,J1246,"Inj, dinutuximab, 0.1 mg",,,192.49,192.49,1
HCPCS,J1246,UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION,20095.64,13062.17,2.17,20095.64,43
HCPCS,J124600,"Inj, dinutuximab, 0.1 mg",,,192.49,192.49,1
HCPCS,J1250,DOBUTAMINE 1000 MG/250 ML(4000 MCG/ML) IN 5 % DEXTROSE IV,0.42,0.27,0.06,16.85,102
HCPCS,J1250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,1.155,0.75,0.14,16.85,102
HCPCS,J1250,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.05,16.85,102
HCPCS,J1250,DOBUTAMINE 500 MG/250 ML (2000 MCG/ML) IN 5 % DEXTROSE IV,0.57,0.37,0.08,16.85,102
HCPCS,J1250,Inj dobutamine hcl/250 mg,,,14.28,14.28,1
HCPCS,J125000,Inj dobutamine hcl/250 mg,,,14.28,14.28,1
HCPCS,J1260,Dolasetron mesylate,,,7.27,16.05,12
HCPCS,J126000,Dolasetron mesylate,,,12.53,12.53,1
HCPCS,J1265,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,3.18,2.07,0.47,8.86,51
HCPCS,J1265,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,2.46,1.6,0.31,8.86,102
HCPCS,J1265,DOPAMINE 400 MG/250 ML (1600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.21,0.14,0.03,8.86,51
HCPCS,J1265,DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,2.37,1.54,0.35,8.86,51
HCPCS,J1265,DOPAMINE 800 MG/250 ML (3200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.315,0.20500000000000002,0.04,8.86,102
HCPCS,J1265,Dopamine injection,,,1.42,1.42,1
HCPCS,J126500,Dopamine injection,,,1.42,1.42,1
HCPCS,J1267,Doripenem injection,,,0.77,130.36,11
HCPCS,J1270,"Injection, doxercalciferol",,,0.32,8.86,14
HCPCS,J127000,"Injection, doxercalciferol",,,0.55,0.55,1
HCPCS,J1271,DOXY-100 100 MG INTRAVENOUS SOLUTION,78.585,51.08,0.18,94.8,153
HCPCS,J1271,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,60.03,39.02,0.18,60.03,51
HCPCS,J1271,Inj doxycycline hyclate 1 mg,,,0.18,0.18,1
HCPCS,J127100,Inj doxycycline hyclate 1 mg,,,0.18,0.18,1
HCPCS,J1290,Ecallantide injection,,,1031.96,1031.96,1
HCPCS,J1290,KALBITOR 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,20543.67,13353.39,2.17,20543.67,65
HCPCS,J129000,Ecallantide injection,,,1031.96,1031.96,1
HCPCS,J1299,"Inj, eculizumab, 2 mg",,,80.15,80.15,1
HCPCS,J1299,SOLIRIS 300 MG/30 ML INTRAVENOUS SOLUTION,782.76,508.79,2.17,16617.81,59
HCPCS,J129900,"Inj, eculizumab, 2 mg",,,80.15,80.15,1
HCPCS,J1300,Eculizumab injection,,,224.63,16617.81,18
HCPCS,J130000,Eculizumab injection,,,464.44,464.44,1
HCPCS,J1301,"Injection, edaravone, 1 mg",,,31.1,31.1,1
HCPCS,J1301,RADICAVA 30 MG/100 ML INTRAVENOUS SOLUTION,23.37,15.19,2.17,720.96,65
HCPCS,J130100,"Injection, edaravone, 1 mg",,,31.1,31.1,1
HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,17.67,4417.71,33
HCPCS,J130200,"Inj, sutimlimab-jome, 10 mg",,,33.87,33.87,1
HCPCS,J1303,"Inj., ravulizumab-cwvz 10 mg",,,400.14,400.14,1
HCPCS,J1303,ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION,10712.6,6963.19,2.17,16617.81,130
HCPCS,J130300,"Inj., ravulizumab-cwvz 10 mg",,,400.14,400.14,1
HCPCS,J1304,Inj tofersen intrathec 1 mg,,,284.82,284.82,1
HCPCS,J1304,QALSODY 100 MG/15 ML (6.7 MG/ML) INTRATHECAL SOLUTION,3623.19,2355.07,2.17,13108.79,65
HCPCS,J130400,Inj tofersen intrathec 1 mg,,,284.82,284.82,1
HCPCS,J1305,"Inj, evinacumab-dgnb, 5mg",,,175.5,4417.71,33
HCPCS,J130500,"Inj, evinacumab-dgnb, 5mg",,,350.96,350.96,1
HCPCS,J1306,"Injection, inclisiran, 1 mg",,,22.59,22.59,1
HCPCS,J1306,LEQVIO 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,8610.54,5596.85,2.17,8610.54,65
HCPCS,J130600,"Injection, inclisiran, 1 mg",,,22.59,22.59,1
HCPCS,J1307,"Inj, crovalimab-akkz, 10 mg",,,535.9,13108.79,32
HCPCS,J130700,"Inj, crovalimab-akkz, 10 mg",,,981.69,981.69,1
HCPCS,J1308,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1.605,1.04,0.02,47.96,102
HCPCS,J1308,FAMOTIDINE (PF) 20 MG/50 ML IN 0.9 % NACL (ISO) INTRAVENOUS PIGGYBACK,0.39,0.25,0.02,47.96,51
HCPCS,J1308,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.605,1.04,0.02,47.96,153
HCPCS,J1308,"Inj, famotidine, 0.25 mg",,,0.02,0.02,1
HCPCS,J130800,"Inj, famotidine, 0.25 mg",,,0.02,0.02,1
HCPCS,J1320,Amitriptyline injection,,,4.7,47.96,10
HCPCS,J132000,Amitriptyline injection,,,4.7,4.7,1
HCPCS,J1322,"Elosulfase alfa, injection",,,259.74,7011.25,33
HCPCS,J132200,"Elosulfase alfa, injection",,,555.25,555.25,1
HCPCS,J1323,ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION,37534.86,24397.66,2.17,37534.88,130
HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,335.57,335.57,1
HCPCS,J132300,"Inj, elranatamab-bcmm, 1 mg",,,335.57,335.57,1
HCPCS,J1324,Enfuvirtide injection,,,1.42,50.19,12
HCPCS,J132400,Enfuvirtide injection,,,1.42,1.42,1
HCPCS,J1325,Epoprostenol injection,,,27.86,27.86,1
HCPCS,J1325,FLOLAN 0.5 MG INTRAVENOUS SOLUTION,67.29,43.74,2.17,67.29,43
HCPCS,J1325,VELETRI 0.5 MG INTRAVENOUS SOLUTION,99.48,64.66,2.17,99.48,43
HCPCS,J1325,VELETRI 1.5 MG INTRAVENOUS SOLUTION,198.93,129.3,2.17,198.93,43
HCPCS,J132500,Epoprostenol injection,,,27.86,27.86,1
HCPCS,J1326,"Inj, zolbetuximab-clzb, 2 mg",,,59.93,59.93,1
HCPCS,J1326,VYLOY 100 MG INTRAVENOUS SOLUTION,7680.0,4992.0,2.17,7680.0,59
HCPCS,J1326,VYLOY 300 MG INTRAVENOUS SOLUTION,23040.0,14976.0,2.17,23040.0,59
HCPCS,J132600,"Inj, zolbetuximab-clzb, 2 mg",,,59.93,59.93,1
HCPCS,J1327,EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,9.735,6.33,1.19,327.06,118
HCPCS,J1327,EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION,56.295,36.59,2.17,327.06,118
HCPCS,J1327,Eptifibatide injection,,,21.36,21.36,1
HCPCS,J132700,Eptifibatide injection,,,21.36,21.36,1
HCPCS,J1330,Ergonovine maleate injection,,,5.34,47.96,10
HCPCS,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,144.0,93.6,2.17,144.0,102
HCPCS,J1335,Ertapenem injection,,,16.3,16.3,1
HCPCS,J133500,Ertapenem injection,,,16.3,16.3,1
HCPCS,J1364,ERYTHROCIN 500 MG INTRAVENOUS SOLUTION,507.72,330.02,2.17,711.12,102
HCPCS,J1364,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,720.0,468.0,2.17,720.0,51
HCPCS,J1364,Erythro lactobionate /500 mg,,,35.88,35.88,1
HCPCS,J136400,Erythro lactobionate /500 mg,,,35.88,35.88,1
HCPCS,J1370,ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,125.64,81.67,0.43,125.64,51
HCPCS,J1370,"Inj, esomeprazole sod, 1 mg",,,0.43,0.43,1
HCPCS,J137000,"Inj, esomeprazole sod, 1 mg",,,0.43,0.43,1
HCPCS,J1380,DELESTROGEN 20 MG/ML INTRAMUSCULAR OIL,134.7,87.56,2.17,134.7,51
HCPCS,J1380,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,100.14,65.09,2.17,100.14,51
HCPCS,J1380,Estradiol valerate 10 mg inj,,,13.26,13.26,1
HCPCS,J138000,Estradiol valerate 10 mg inj,,,13.26,13.26,1
HCPCS,J1410,Inj estrogen conjugate 25 mg,,,697.33,697.33,1
HCPCS,J1410,PREMARIN 25 MG SOLUTION FOR INJECTION,1393.41,905.72,2.17,1393.41,65
HCPCS,J141000,Inj estrogen conjugate 25 mg,,,697.33,697.33,1
HCPCS,J1411,"Inj, hemgenix, per tx dose",,,0.02,10134483.32,28
HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,0.02,34522.7,30
HCPCS,J141200,Inj roctavian ml 2x10^13vc g,,,25296.92,25296.92,1
HCPCS,J1413,Inj delandistrogene mox rokl,,,0.02,9151614.23,28
HCPCS,J1414,"Inj, beqvez, per tx dose",,,14351.75,7976500.0,15
HCPCS,J1426,"Injection, casimersen, 10 mg",,,166.19,13108.79,25
HCPCS,J142600,"Injection, casimersen, 10 mg",,,341.76,341.76,1
HCPCS,J1427,Inj. viltolarsen,,,60.91,13108.79,12
HCPCS,J142700,Inj. viltolarsen,,,120.47,120.47,1
HCPCS,J1428,EXONDYS-51  50 MG/ML INTRAVENOUS SOLUTION,2880.0,1872.0,2.17,13108.79,59
HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,341.76,341.76,1
HCPCS,J142800,"Inj, eteplirsen, 10 mg",,,341.76,341.76,1
HCPCS,J1429,Inj golodirsen 10 mg,,,172.8,13108.79,12
HCPCS,J142900,Inj golodirsen 10 mg,,,341.76,341.76,1
HCPCS,J1430,ETHAMOLIN 5 % INTRAVENOUS SOLUTION,951.48,618.46,2.17,1531.87,65
HCPCS,J1430,Ethanolamine oleate 100 mg,,,920.4,920.4,1
HCPCS,J143000,Ethanolamine oleate 100 mg,,,920.4,920.4,1
HCPCS,J1434,FOCINVEZ 150 MG/50 ML (3 MG/ML) INTRAVENOUS SOLUTION,33.93,22.05,2.17,47.96,65
HCPCS,J1434,"Inj, focinvez, 1mg",,,4.68,4.68,1
HCPCS,J143400,"Inj, focinvez, 1mg",,,4.68,4.68,1
HCPCS,J1435,Injection estrone per 1 mg,,,0.36,47.96,11
HCPCS,J143500,Injection estrone per 1 mg,,,0.36,0.36,1
HCPCS,J1436,Etidronate disodium inj,,,112.58,184.32,10
HCPCS,J143600,Etidronate disodium inj,,,143.9,143.9,1
HCPCS,J1437,Inj. fe derisomaltose 10 mg,,,40.64,40.64,1
HCPCS,J1437,MONOFERRIC 100 MG IRON/ML INTRAVENOUS SOLUTION,1314.78,854.61,2.17,1314.78,65
HCPCS,J143700,Inj. fe derisomaltose 10 mg,,,40.64,40.64,1
HCPCS,J1438,ENBREL 25 MG/0.5 ML (0.5 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,2.17,7341.84,57
HCPCS,J1438,ENBREL 25 MG/0.5 ML SUBCUTANEOUS SOLUTION,7341.84,4772.2,2.17,7341.84,57
HCPCS,J1438,ENBREL 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,2.17,7341.84,57
HCPCS,J1438,ENBREL MINI 50 MG/ML (1 ML) SUBCUTANEOUS CARTRIDGE,7341.84,4772.2,2.17,7341.84,57
HCPCS,J1438,ENBREL SURECLICK 50 MG/ML (1 ML) SUBCUTANEOUS PEN INJECTOR,7341.84,4772.2,2.17,7341.84,57
HCPCS,J1438,Etanercept injection,,,2178.08,2178.08,1
HCPCS,J143800,Etanercept injection,,,2178.08,2178.08,1
HCPCS,J1439,INJECTAFER 50 MG IRON/ML INTRAVENOUS SOLUTION,371.1,241.22,1.1,667.03,65
HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,1.99,1.99,1
HCPCS,J143900,Inj ferric carboxymaltos 1mg,,,1.99,1.99,1
HCPCS,J1440,Fecal microbiota jslm 1 ml,,,115.04,115.04,1
HCPCS,J1440,REBYOTA 150 ML ENEMA,148.36,96.43,2.17,4417.71,130
HCPCS,J144000,Fecal microbiota jslm 1 ml,,,115.04,115.04,1
HCPCS,J1442,Inj filgrastim excl biosimil,,,1.78,1.78,1
HCPCS,J1442,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.6549999999997,1561.73,0.99,2402.67,195
HCPCS,J1442,NEUPOGEN 300 MCG/ML INJECTION SOLUTION,1133.4,736.71,0.99,1133.4,130
HCPCS,J1442,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.435,1554.43,0.99,2391.45,195
HCPCS,J1442,NEUPOGEN 480 MCG/1.6 ML INJECTION SOLUTION,1128.0,733.2,0.99,1128.0,130
HCPCS,J144200,Inj filgrastim excl biosimil,,,1.78,1.78,1
HCPCS,J1443,Inj ferric pyrophosphate cit,,,0.09,47.96,9
HCPCS,J1444,Fe pyro cit pow 0.1 mg iron,,,0.03,47.96,10
HCPCS,J1445,Inj triferic avnu 0.1mg iron,,,0.03,47.96,10
HCPCS,J1447,GRANIX 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1798.995,1169.35,0.24,1799.01,130
HCPCS,J1447,GRANIX 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1799.49,1169.67,0.24,1799.49,65
HCPCS,J1447,Inj tbo filgrastim 1 microg,,,0.45,0.45,1
HCPCS,J144700,Inj tbo filgrastim 1 microg,,,0.45,0.45,1
HCPCS,J1448,"Injection, trilaciclib, 1mg",,,5.13,1287.79,33
HCPCS,J144800,"Injection, trilaciclib, 1mg",,,9.65,9.65,1
HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,22.75,4487.68,32
HCPCS,J144900,Inj eflapegrastim-xnst 0.1mg,,,41.92,41.92,1
HCPCS,J1450,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.7350000000000001,0.48,0.1,8.86,102
HCPCS,J1450,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.315,0.20500000000000002,0.04,8.86,102
HCPCS,J1450,Fluconazole,,,7.97,7.97,1
HCPCS,J145000,Fluconazole,,,7.97,7.97,1
HCPCS,J1451,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,3600.0,2340.0,2.17,4155.87,195
HCPCS,J1451,"Fomepizole, 15 mg",,,26.98,26.98,1
HCPCS,J145100,"Fomepizole, 15 mg",,,26.98,26.98,1
HCPCS,J1452,Intraocular fomivirsen na,,,576.07,2280.0,9
HCPCS,J1453,Fosaprepitant injection,,,0.18,47.96,14
HCPCS,J145300,Fosaprepitant injection,,,0.2,0.2,1
HCPCS,J1454,"Inj fosnetupitant, palonoset",,,318.98,1504.06,33
HCPCS,J145400,"Inj fosnetupitant, palonoset",,,973.54,973.54,1
HCPCS,J1455,FOSCAVIR 24 MG/ML INTRAVENOUS SOLUTION,5.925000000000001,3.8550000000000004,0.74,184.43,114
HCPCS,J1455,Foscarnet sodium injection,,,11.94,11.94,1
HCPCS,J145500,Foscarnet sodium injection,,,11.94,11.94,1
HCPCS,J1456,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,234.0,152.1,0.63,234.0,65
HCPCS,J1456,"Inj, fosaprepitant (teva)",,,1.14,1.14,1
HCPCS,J145600,"Inj, fosaprepitant (teva)",,,1.14,1.14,1
HCPCS,J1457,Gallium nitrate injection,,,2.77,4487.68,12
HCPCS,J145700,Gallium nitrate injection,,,4.27,4.27,1
HCPCS,J1458,Galsulfase injection,,,914.67,914.67,1
HCPCS,J1458,NAGLAZYME 5 MG/5 ML INTRAVENOUS SOLUTION,1790.64,1163.92,2.17,13108.79,59
HCPCS,J145800,Galsulfase injection,,,914.67,914.67,1
HCPCS,J1459,Inj ivig privigen 500 mg,,,89.5,89.5,1
HCPCS,J1459,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,2.17,2642.72,260
HCPCS,J145900,Inj ivig privigen 500 mg,,,89.5,89.5,1
HCPCS,J1460,GAMASTAN 15 %-18 % RANGE INTRAMUSCULAR SOLUTION,179.20499999999998,116.485,2.17,187.26,130
HCPCS,J1460,Gamma globulin 1 cc inj,,,88.86,88.86,1
HCPCS,J146000,Gamma globulin 1 cc inj,,,88.86,88.86,1
HCPCS,J1551,Inj cutaquig 100 mg,,,14.82,3257.22,26
HCPCS,J155100,Inj cutaquig 100 mg,,,26.38,26.38,1
HCPCS,J1552,"Inj, alyglo, 500 mg",,,123.84,2642.72,32
HCPCS,J155200,"Inj, alyglo, 500 mg",,,220.44,220.44,1
HCPCS,J1553,Inj immune glob(yim)100mg,,,6055.17,7011.25,8
HCPCS,J1554,Inj. asceniv,,,490.45,2642.72,33
HCPCS,J155400,Inj. asceniv,,,873.02,873.02,1
HCPCS,J1555,"Inj cuvitru, 100 mg",,,15.3,2642.72,33
HCPCS,J155500,"Inj cuvitru, 100 mg",,,30.72,30.72,1
HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,73.15,720.96,27
HCPCS,J155600,"Inj, imm glob bivigam, 500mg",,,141.78,141.78,1
HCPCS,J1557,Gammaplex injection,,,52.65,3257.22,33
HCPCS,J155700,Gammaplex injection,,,113.8,113.8,1
HCPCS,J1558,"Inj. xembify, 100 mg",,,14.17,720.96,33
HCPCS,J155800,"Inj. xembify, 100 mg",,,26.81,26.81,1
HCPCS,J1559,Hizentra injection,,,12.23,720.96,33
HCPCS,J155900,Hizentra injection,,,25.88,25.88,1
HCPCS,J1560,Gamma globulin > 10 cc inj,,,104.52,1126.68,33
HCPCS,J156000,Gamma globulin > 10 cc inj,,,186.05,186.05,1
HCPCS,J1561,GAMUNEX-C 1 GRAM/10 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
HCPCS,J1561,GAMUNEX-C 10 GRAM/100 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
HCPCS,J1561,GAMUNEX-C 2.5 GRAM/25 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
HCPCS,J1561,GAMUNEX-C 20 GRAM/200 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
HCPCS,J1561,GAMUNEX-C 40 GRAM/400 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
HCPCS,J1561,GAMUNEX-C 5 GRAM/50 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
HCPCS,J1561,Gamunex-c/gammaked,,,87.36,87.36,1
HCPCS,J156100,Gamunex-c/gammaked,,,87.36,87.36,1
HCPCS,J1562,"Vivaglobin, inj",,,19.48,720.96,10
HCPCS,J1566,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM INTRAVENOUS SOLUTION,8194.32,5326.31,2.17,8194.32,65
HCPCS,J1566,GAMMAGARD S-D (IGA < 1 MCG/ML) 5 GRAM INTRAVENOUS SOLUTION,4097.16,2663.15,2.17,4097.16,65
HCPCS,J1566,"Immune globulin, powder",,,140.42,140.42,1
HCPCS,J156600,"Immune globulin, powder",,,140.42,140.42,1
HCPCS,J1568,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,650
HCPCS,J1568,Octagam injection,,,84.35,84.35,1
HCPCS,J156800,Octagam injection,,,84.35,84.35,1
HCPCS,J1569,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,520
HCPCS,J1569,Gammagard liquid injection,,,84.18,84.18,1
HCPCS,J156900,Gammagard liquid injection,,,84.18,84.18,1
HCPCS,J1570,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,298.20000000000005,193.82999999999998,2.17,350.16,102
HCPCS,J1570,Ganciclovir sodium injection,,,59.67,59.67,1
HCPCS,J157000,Ganciclovir sodium injection,,,59.67,59.67,1
HCPCS,J1571,HEPAT B IM GLOB 1ML/0.5ML TRGR,1299.09,844.41,2.17,1299.09,65
HCPCS,J1571,HEPATITIS B IMMUNE GLOB 0.5ML,697.88,453.62,2.17,697.88,65
HCPCS,J1571,Hepagam b im injection,,,123.87,123.87,1
HCPCS,J157100,Hepagam b im injection,,,123.87,123.87,1
HCPCS,J1572,FLEBOGAMMA DIF 10 % INTRAVENOUS SOLUTION,38.13,24.78,2.17,2642.72,62
HCPCS,J1572,Flebogamma injection,,,113.08,113.08,1
HCPCS,J157200,Flebogamma injection,,,113.08,113.08,1
HCPCS,J1573,"Hepagam b intravenous, inj",,,68.66,191.35,32
HCPCS,J157300,"Hepagam b intravenous, inj",,,123.87,123.87,1
HCPCS,J1574,"Inj, ganciclovir (exela)",,,7.65,136.8,12
HCPCS,J157400,"Inj, ganciclovir (exela)",,,106.8,106.8,1
HCPCS,J1575,HYQVIA 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
HCPCS,J1575,HYQVIA 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
HCPCS,J1575,HYQVIA 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
HCPCS,J1575,HYQVIA 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
HCPCS,J1575,HYQVIA 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,32.63,32.63,1
HCPCS,J157500,Hyqvia 100mg immuneglobulin,,,32.63,32.63,1
HCPCS,J1576,"Inj, panzyga, 500 mg",,,67.46,7011.25,32
HCPCS,J157600,"Inj, panzyga, 500 mg",,,126.77,126.77,1
HCPCS,J1580,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
HCPCS,J1580,GENTAMICIN 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
HCPCS,J1580,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
HCPCS,J1580,GENTAMICIN 40 MG/ML INJECTION SOLUTION,6.51,4.23,0.78,8.86,204
HCPCS,J1580,GENTAMICIN 60 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
HCPCS,J1580,"GENTAMICIN 80 MG, INJ",7.0,4.55,1.04,8.86,51
HCPCS,J1580,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
HCPCS,J1580,GENTAMICIN 80 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
HCPCS,J1580,GENTAMICIN PER 80MG,17.0,11.05,1.1,17.0,27
HCPCS,J1580,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,9.75,6.34,1.45,9.75,102
HCPCS,J1580,Garamycin gentamicin inj,,,3.86,3.86,1
HCPCS,J158000,Garamycin gentamicin inj,,,3.86,3.86,1
HCPCS,J1595,COPAXONE 20 MG/ML SUBCUTANEOUS SYRINGE,853.68,554.89,2.17,853.68,57
HCPCS,J1595,COPAXONE 40 MG/ML SUBCUTANEOUS SYRINGE,1837.08,1194.1,2.17,1837.08,57
HCPCS,J1595,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,2.17,649.23,57
HCPCS,J1595,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,2.17,1572.9,57
HCPCS,J1595,GLATOPA 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,2.17,649.23,114
HCPCS,J1595,GLATOPA 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,2.17,1572.9,114
HCPCS,J1595,Injection glatiramer acetate,,,133.5,133.5,1
HCPCS,J159500,Injection glatiramer acetate,,,133.5,133.5,1
HCPCS,J1596,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,36.54,23.75,0.51,46.8,228
HCPCS,J1596,"Inj, glycopyrrolate, 0.1 mg",,,0.68,0.68,1
HCPCS,J159600,"Inj, glycopyrrolate, 0.1 mg",,,0.68,0.68,1
HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,2.28,8.86,13
HCPCS,J159700,"Inj glycopyrrolate, glyrx-pf",,,2.28,2.28,1
HCPCS,J1598,Inj glycopyrrolate fres kabi,,,1.8,8.86,19
HCPCS,J159800,Inj glycopyrrolate fres kabi,,,2.39,2.39,1
HCPCS,J1599,"Ivig non-lyophilized, nos",,,253.37,1287.79,10
HCPCS,J159900,"Ivig non-lyophilized, nos",,,253.37,253.37,1
HCPCS,J1600,Gold sodium thiomaleate inj,,,28.51,47.96,11
HCPCS,J160000,Gold sodium thiomaleate inj,,,31.15,31.15,1
HCPCS,J1602,Golimumab for iv use 1mg,,,20.7,20.7,1
HCPCS,J1602,SIMPONI 100 MG/ML SUBCUTANEOUS SYRINGE,26273.4,17077.71,2.17,26273.4,65
HCPCS,J1602,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS SYRINGE,45692.85,29700.35,2.17,45692.85,65
HCPCS,J1602,SIMPONI ARIA 12.5 MG/ML INTRAVENOUS SOLUTION,1799.28,1169.53,2.17,2642.72,65
HCPCS,J160200,Golimumab for iv use 1mg,,,20.7,20.7,1
HCPCS,J1610,GLUCAGON EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1008.0,655.2,2.17,1008.0,65
HCPCS,J1610,Glucagon hydrochloride/1 mg,,,293.45,293.45,1
HCPCS,J161000,Glucagon hydrochloride/1 mg,,,293.45,293.45,1
HCPCS,J1611,GLUCAGON (HCL) EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1007.28,654.73,2.17,1007.28,65
HCPCS,J1611,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,797.94,518.66,2.17,909.66,195
HCPCS,J1611,"Inj glucagon hcl, fresenius",,,254.99,254.99,1
HCPCS,J161100,"Inj glucagon hcl, fresenius",,,254.99,254.99,1
HCPCS,J1612,Inj glucagon (gvoke) 0.01 mg,,,2.59,184.43,22
HCPCS,J161200,Inj glucagon (gvoke) 0.01 mg,,,5.38,5.38,1
HCPCS,J1620,Gonadorelin hydroch/ 100 mcg,,,484.75,484.75,1
HCPCS,J1626,GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,32.4,21.06,0.27,32.4,51
HCPCS,J1626,Granisetron hcl injection,,,0.27,0.27,1
HCPCS,J162600,Granisetron hcl injection,,,0.27,0.27,1
HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,4.29,47.96,33
HCPCS,J162700,"Inj, granisetron, xr, 0.1 mg",,,7.65,7.65,1
HCPCS,J1628,"Inj., guselkumab, 1 mg",,,129.83,129.83,1
HCPCS,J1628,TREMFYA 100 MG/ML SUBCUTANEOUS SYRINGE,52439.19,34085.47,2.17,52439.19,65
HCPCS,J1628,TREMFYA 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,2621.97,1704.28,2.17,7011.25,65
HCPCS,J1628,TREMFYA ONE-PRESS 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,52439.19,34085.47,2.17,52439.19,65
HCPCS,J162800,"Inj., guselkumab, 1 mg",,,129.83,129.83,1
HCPCS,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,10.8,7.02,0.64,21.57,255
HCPCS,J1630,Haloperidol injection,,,1.3,1.3,1
HCPCS,J163000,Haloperidol injection,,,1.3,1.3,1
HCPCS,J1631,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,177.66,115.48,2.17,185.34,153
HCPCS,J1631,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,93.75,60.94,2.17,101.1,153
HCPCS,J1631,Haloperidol decanoate inj,,,7.01,7.01,1
HCPCS,J163100,Haloperidol decanoate inj,,,7.01,7.01,1
HCPCS,J1632,"Inj., brexanolone, 1 mg",,,80.46,4417.71,12
HCPCS,J163200,"Inj., brexanolone, 1 mg",,,159.13,159.13,1
HCPCS,J1640,"Hemin, 1 mg",,,62.85,62.85,1
HCPCS,J1640,PANHEMATIN 350 MG INTRAVENOUS SOLUTION,41137.77,26739.55,2.17,41137.77,65
HCPCS,J164000,"Hemin, 1 mg",,,62.85,62.85,1
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.84,0.55,0.04,8.86,153
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.51,0.33,0.04,8.86,51
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION,3.495,2.27,0.04,8.86,102
HCPCS,J1642,HEPARIN PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.42,0.27,0.04,8.86,51
HCPCS,J1642,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.48,0.31,0.04,8.86,153
HCPCS,J1642,Inj heparin sodium per 10 u,,,0.04,0.04,1
HCPCS,J164200,Inj heparin sodium per 10 u,,,0.04,0.04,1
HCPCS,J1643,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.18,8.86,51
HCPCS,J1643,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,18.72,12.17,2.17,18.72,51
HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,3.74,3.74,1
HCPCS,J164300,"Inj heparin, pfizer, 1000u",,,3.74,3.74,1
HCPCS,J1644,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,255
HCPCS,J1644,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,204
HCPCS,J1644,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.26,0.8200000000000001,0.12,8.86,357
HCPCS,J1644,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,15.165,9.855,0.32,31.32,408
HCPCS,J1644,HEPARIN (PORCINE) 20000 UNIT/ML INJECTION SOLUTION,48.165,31.305,0.32,60.33,102
HCPCS,J1644,HEPARIN (PORCINE) 25000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN,0.24,0.16,0.04,8.86,51
HCPCS,J1644,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,5.91,3.84,0.32,8.86,153
HCPCS,J1644,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,23.73,15.42,0.32,23.73,51
HCPCS,J1644,HEPARIN PORCINE (PF) 5000 UNIT/0.5 ML INJECTION SYRINGE,29.76,19.34,0.32,29.76,51
HCPCS,J1644,Inj heparin sodium per 1000u,,,0.32,0.32,1
HCPCS,J164400,Inj heparin sodium per 1000u,,,0.32,0.32,1
HCPCS,J1645,Dalteparin sodium,,,26.52,26.52,1
HCPCS,J1645,FRAGMIN 10000 ANTI-XA UNIT/ML SUBCUTANEOUS SYRINGE,1136.67,738.84,2.17,1136.67,51
HCPCS,J1645,FRAGMIN 12500 ANTI-XA UNIT/0.5 ML SUBCUTANEOUS SYRINGE,2841.93,1847.25,2.17,2841.93,51
HCPCS,J1645,FRAGMIN 15000 ANTI-XA UNIT/0.6 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,2.17,2841.75,51
HCPCS,J1645,FRAGMIN 18000 ANTI-XA UNIT/0.72 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,2.17,2841.75,51
HCPCS,J1645,FRAGMIN 2500 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,1751.55,1138.51,2.17,1751.55,51
HCPCS,J1645,FRAGMIN 5000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,2841.69,1847.1,2.17,2841.69,51
HCPCS,J1645,FRAGMIN 7500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRINGE,2842.02,1847.31,2.17,2842.02,51
HCPCS,J164500,Dalteparin sodium,,,26.52,26.52,1
HCPCS,J1650,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,52.56,34.165,0.94,71.58,102
HCPCS,J1650,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,52.08,33.855000000000004,0.94,54.24,102
HCPCS,J1650,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,78.78,51.205,0.94,107.31,153
HCPCS,J1650,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,33.24,21.61,0.94,33.24,51
HCPCS,J1650,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,33.12,21.53,0.94,33.12,51
HCPCS,J1650,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,51.9,33.735,0.94,71.58,153
HCPCS,J1650,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,52.425,34.08,0.94,71.55,102
HCPCS,J1650,Inj enoxaparin sodium,,,0.94,0.94,1
HCPCS,J1650,LOVENOX 100 MG/ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.94,89.4,51
HCPCS,J1650,LOVENOX 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.94,134.16,51
HCPCS,J1650,LOVENOX 150 MG/ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.94,134.16,51
HCPCS,J1650,LOVENOX 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.94,89.31,51
HCPCS,J1650,LOVENOX 300 MG/3 ML SUBCUTANEOUS SOLUTION,89.31,58.05,0.94,89.31,51
HCPCS,J1650,LOVENOX 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.94,89.31,51
HCPCS,J1650,LOVENOX 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.94,89.4,51
HCPCS,J1650,LOVENOX 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.94,89.4,51
HCPCS,J165000,Inj enoxaparin sodium,,,0.94,0.94,1
HCPCS,J1652,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,482.28,313.48,1.44,482.28,51
HCPCS,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,327.9,213.14,1.44,327.9,51
HCPCS,J1652,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,964.59,626.98,1.44,964.59,102
HCPCS,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,494.34,321.32,1.44,643.05,153
HCPCS,J1652,Fondaparinux sodium,,,1.57,1.57,1
HCPCS,J165200,Fondaparinux sodium,,,1.57,1.57,1
HCPCS,J1655,Tinzaparin sodium injection,,,7.65,47.96,10
HCPCS,J1670,HYPERTET (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2360.37,1534.24,2.17,2360.37,65
HCPCS,J1670,Tetanus immune globulin inj,,,1047.6,1047.6,1
HCPCS,J167000,Tetanus immune globulin inj,,,1047.6,1047.6,1
HCPCS,J1675,Histrelin acetate,,,0.69,2642.72,10
HCPCS,J1700,Hydrocortisone acetate inj,,,1.3,8.86,11
HCPCS,J170000,Hydrocortisone acetate inj,,,2.3,2.3,1
HCPCS,J1710,Hydrocortisone sodium ph inj,,,7.65,13.36,9
HCPCS,J1720,Hydrocortisone sodium succ i,,,39.27,39.27,1
HCPCS,J1720,SOLU-CORTEF 100 MG SOLUTION FOR INJECTION,72.39,47.05,2.17,72.39,51
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 100 MG/2 ML SOLUTION FOR INJECTION,90.13499999999999,58.584999999999994,2.17,90.96,102
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 1000 MG/8 ML SOLUTION FOR INJECTION,723.78,470.46,2.17,723.78,51
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 250 MG/2 ML SOLUTION FOR INJECTION,178.695,116.155,2.17,184.35,102
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 500 MG/4 ML SOLUTION FOR INJECTION,362.01,235.31,2.17,362.01,51
HCPCS,J172000,Hydrocortisone sodium succ i,,,39.27,39.27,1
HCPCS,J1726,"Makena, 10 mg",,,14.46,130.36,17
HCPCS,J172600,"Makena, 10 mg",,,43.18,43.18,1
HCPCS,J1729,Inj hydroxyprogst capoat nos,,,29.14,130.36,11
HCPCS,J172900,Inj hydroxyprogst capoat nos,,,29.14,29.14,1
HCPCS,J1730,Diazoxide injection,,,41.42,295.08,11
HCPCS,J173000,Diazoxide injection,,,230.37,230.37,1
HCPCS,J1736,Inj meloxicam (delova) 1mg,,,7.65,8.86,8
HCPCS,J1737,Inj meloxicam (azurity) 1mg,,,1.06,8.86,22
HCPCS,J173700,Inj meloxicam (azurity) 1mg,,,2.14,2.14,1
HCPCS,J1738,Inj. meloxicam 1 mg,,,3.38,8.86,12
HCPCS,J173800,Inj. meloxicam 1 mg,,,6.69,6.69,1
HCPCS,J1740,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,500.01,325.01,2.17,505.2,204
HCPCS,J1740,Ibandronate sodium injection,,,23.39,23.39,1
HCPCS,J174000,Ibandronate sodium injection,,,23.39,23.39,1
HCPCS,J1741,IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,594.0,386.1,2.17,594.0,51
HCPCS,J1741,Ibuprofen injection,,,5.66,5.66,1
HCPCS,J174100,Ibuprofen injection,,,5.66,5.66,1
HCPCS,J1742,CORVERT 0.1 MG/ML INTRAVENOUS SOLUTION,201.54,131.0,2.17,833.16,65
HCPCS,J1742,Ibutilide fumarate injection,,,650.45,650.45,1
HCPCS,J174200,Ibutilide fumarate injection,,,650.45,650.45,1
HCPCS,J1743,ELAPRASE 6 MG/3 ML INTRAVENOUS SOLUTION,3875.88,2519.32,2.17,13108.79,65
HCPCS,J1743,Idursulfase injection,,,993.42,993.42,1
HCPCS,J174300,Idursulfase injection,,,993.42,993.42,1
HCPCS,J1744,FIRAZYR 30 MG/3 ML SUBCUTANEOUS SYRINGE,13377.0,8695.05,2.17,13377.0,114
HCPCS,J1744,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,12708.15,8260.3,2.17,12708.15,57
HCPCS,J1744,Icatibant injection,,,99.68,99.68,1
HCPCS,J174400,Icatibant injection,,,99.68,99.68,1
HCPCS,J1745,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,1710.0,1111.5,2.17,1710.0,65
HCPCS,J1745,Infliximab not biosimil 10mg,,,57.71,57.71,1
HCPCS,J1745,REMICADE 100 MG INTRAVENOUS SOLUTION,4204.14,2732.69,2.17,4204.14,65
HCPCS,J174500,Infliximab not biosimil 10mg,,,57.71,57.71,1
HCPCS,J1746,"Inj., ibalizumab-uiyk, 10 mg",,,138.02,138.02,1
HCPCS,J1746,TROGARZO 200 MG/1.33 ML (150 MG/ML) INTRAVENOUS SOLUTION,4126.47,2682.21,2.17,4417.71,65
HCPCS,J174600,"Inj., ibalizumab-uiyk, 10 mg",,,138.02,138.02,1
HCPCS,J1747,"Inj, spesolimab-sbzo, 1 mg",,,61.43,16617.81,32
HCPCS,J174700,"Inj, spesolimab-sbzo, 1 mg",,,117.0,117.0,1
HCPCS,J1748,"Inj, zymfentra, 10 mg",,,99.76,1287.79,24
HCPCS,J174800,"Inj, zymfentra, 10 mg",,,572.13,572.13,1
HCPCS,J1749,"Inj, iloprost, 0.1 mcg",,,10.16,667.03,13
HCPCS,J174900,"Inj, iloprost, 0.1 mcg",,,10.16,10.16,1
HCPCS,J1750,INFED 50 MG/ML INJECTION SOLUTION,67.11,43.62,2.17,130.36,130
HCPCS,J1750,Inj iron dextran,,,32.18,32.18,1
HCPCS,J175000,Inj iron dextran,,,32.18,32.18,1
HCPCS,J1756,Iron sucrose injection,,,0.43,0.43,1
HCPCS,J1756,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,153
HCPCS,J1756,VENOFER 200 MG IRON/10 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
HCPCS,J1756,VENOFER 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
HCPCS,J175600,Iron sucrose injection,,,0.43,0.43,1
HCPCS,J1786,CEREZYME 400 UNIT INTRAVENOUS SOLUTION,6305.28,4098.43,2.17,7011.25,65
HCPCS,J1786,Imuglucerase injection,,,76.95,76.95,1
HCPCS,J178600,Imuglucerase injection,,,76.95,76.95,1
HCPCS,J1790,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,18.285,11.885,2.17,29.09,102
HCPCS,J1790,Droperidol injection,,,12.78,12.78,1
HCPCS,J179000,Droperidol injection,,,12.78,12.78,1
HCPCS,J1800,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,35.07,22.795,2.17,41.34,102
HCPCS,J1800,Propranolol injection,,,20.81,20.81,1
HCPCS,J180000,Propranolol injection,,,20.81,20.81,1
HCPCS,J1805,BREVIBLOC 2000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,18.15,11.8,0.37,47.96,51
HCPCS,J1805,BREVIBLOC 2500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,1.86,1.21,0.28,47.96,51
HCPCS,J1805,"Inj, esmolol hcl, 10mg",,,0.37,0.37,1
HCPCS,J180500,"Inj, esmolol hcl, 10mg",,,0.37,0.37,1
HCPCS,J1806,ESMOLOL 2500 MG/250 ML (10 MG/ML) IN STERILE WATER INTRAVENOUS SOLN,1.71,1.11,0.25,47.96,51
HCPCS,J1806,Inj esmolol hcl wg crit care,,,0.73,0.73,1
HCPCS,J180600,Inj esmolol hcl wg crit care,,,0.73,0.73,1
HCPCS,J1807,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,13680.0,8892.0,2.17,13680.0,59
HCPCS,J1807,"Inj, ethacrynate sod, 1 mg",,,121.75,121.75,1
HCPCS,J180700,"Inj, ethacrynate sod, 1 mg",,,121.75,121.75,1
HCPCS,J1808,FOLIC ACID 5 MG/ML INJECTION SOLUTION,23.01,14.96,0.09,23.01,51
HCPCS,J1808,"Inj, folic acid, 0.1 mg",,,0.09,0.09,1
HCPCS,J180800,"Inj, folic acid, 0.1 mg",,,0.09,0.09,1
HCPCS,J1809,"Inj, fosdenopterin, 0.1mg",,,17.23,4417.71,24
HCPCS,J180900,"Inj, fosdenopterin, 0.1mg",,,30.69,30.69,1
HCPCS,J1810,Droperidol/fentanyl inj,,,30.14,47.96,10
HCPCS,J181000,Droperidol/fentanyl inj,,,30.14,30.14,1
HCPCS,J1811,Fiasp for insulin pump use,,,7.41,47.96,19
HCPCS,J181100,Fiasp for insulin pump use,,,14.06,14.06,1
HCPCS,J1812,Inj. insulin (fiasp),,,3.1,8.86,11
HCPCS,J181200,Inj. insulin (fiasp),,,3.1,3.1,1
HCPCS,J1813,Lyumjev for insulin pump use,,,26.88,47.96,13
HCPCS,J181300,Lyumjev for insulin pump use,,,26.88,26.88,1
HCPCS,J1814,Inj. insulin (lyumjev),,,2.94,8.86,11
HCPCS,J181400,Inj. insulin (lyumjev),,,2.94,2.94,1
HCPCS,J1815,ADMELOG SOLOSTAR U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS PEN,45.45,29.54,0.48,45.45,51
HCPCS,J1815,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,47.07,30.6,0.48,47.07,48
HCPCS,J1815,APIDRA SOLOSTAR U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,39.51,25.68,0.48,39.51,48
HCPCS,J1815,APIDRA U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,30.66,19.93,0.48,30.66,51
HCPCS,J1815,HUMALOG KWIKPEN (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS,38.19,24.82,0.48,38.19,96
HCPCS,J1815,HUMALOG MIX 50-50 KWIKPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.48,38.19,96
HCPCS,J1815,HUMALOG MIX 75-25 (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,30.75,19.99,0.48,30.75,48
HCPCS,J1815,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,36.75,23.89,0.48,36.75,48
HCPCS,J1815,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,61.394999999999996,39.905,0.48,98.88,102
HCPCS,J1815,HUMULIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,16.05,10.43,0.48,16.05,96
HCPCS,J1815,HUMULIN 70/30 U-100 INSULIN KWIKPEN 100 UNIT/ML SUBCUTANEOUS,33.93,22.05,0.48,33.93,96
HCPCS,J1815,HUMULIN N NPH U-100 INSULIN (ISOPHANE SUSP) 100 UNIT/ML SUBCUTANEOUS,34.785000000000004,22.61,0.48,53.52,96
HCPCS,J1815,HUMULIN N NPH U-100 INSULIN KWIKPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.93,22.05,0.48,33.93,96
HCPCS,J1815,HUMULIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,16.05,10.43,0.48,16.05,51
HCPCS,J1815,HUMULIN R U-500 (CONC) INSULIN KWIKPEN 500 UNIT/ML (3 ML) SUBCUTANEOUS,344.52,223.94,0.48,344.52,48
HCPCS,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.48,38.19,48
HCPCS,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,9.0,5.85,0.48,9.0,51
HCPCS,J1815,Insulin injection,,,0.48,0.48,1
HCPCS,J1815,LANTUS SOLOSTAR U-100 INSULIN 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,23.13,15.03,0.48,23.13,48
HCPCS,J1815,LANTUS U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,23.13,15.03,0.48,23.13,51
HCPCS,J1815,MYXREDLIN (REGULAR INSULIN) 100 UNIT/100 ML (1 UNIT/ML) IV SOLUTION,1.26,0.82,0.19,8.86,51
HCPCS,J1815,NOVOLIN 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS,21.87,14.22,0.48,21.87,48
HCPCS,J1815,NOVOLIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,17.34,11.27,0.48,17.34,48
HCPCS,J1815,NOVOLIN N FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.48,21.87,48
HCPCS,J1815,NOVOLIN N NPH U-100 INSULIN ISOPHANE 100 UNIT/ML SUBCUTANEOUS SUSP,17.34,11.27,0.48,17.34,48
HCPCS,J1815,NOVOLIN R FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.48,21.87,102
HCPCS,J1815,NOVOLIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,17.34,11.27,0.48,17.34,102
HCPCS,J1815,NOVOLOG FLEXPEN U-100 INSULIN ASPART 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.54,21.8,0.48,33.54,48
HCPCS,J1815,NOVOLOG MIX 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,33.54,21.8,0.48,33.54,48
HCPCS,J1815,NOVOLOG MIX 70-30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.48,26.04,48
HCPCS,J1815,NOVOLOG U-100 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.48,26.04,48
HCPCS,J181500,Insulin injection,,,0.48,0.48,1
HCPCS,J1817,Insulin for insulin pump use,,,5.12,47.96,14
HCPCS,J181700,Insulin for insulin pump use,,,5.7,5.7,1
HCPCS,J1823,"Inj. inebilizumab-cdon, 1 mg",,,882.08,882.08,1
HCPCS,J1823,UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION,16829.82,10939.38,2.17,16829.82,65
HCPCS,J182300,"Inj. inebilizumab-cdon, 1 mg",,,882.08,882.08,1
HCPCS,J1826,Interferon beta-1a inj,,,1112.18,5653.83,17
HCPCS,J182600,Interferon beta-1a inj,,,4612.59,4612.59,1
HCPCS,J1830,BETASERON 0.3 MG SUBCUTANEOUS KIT,2558.01,1662.71,2.17,2558.01,51
HCPCS,J1830,Interferon beta-1b / .25 mg,,,1517.75,1517.75,1
HCPCS,J183000,Interferon beta-1b / .25 mg,,,1517.75,1517.75,1
HCPCS,J1833,"Injection, isavuconazonium",,,0.98,369.35,30
HCPCS,J183300,"Injection, isavuconazonium",,,2.26,2.26,1
HCPCS,J1834,ISONIAZID 100 MG/ML INJECTION SOLUTION,105.63,68.66,0.3,105.63,59
HCPCS,J1834,"Inj, isoniazid, 1 mg",,,0.62,0.62,1
HCPCS,J183400,"Inj, isoniazid, 1 mg",,,0.62,0.62,1
HCPCS,J1835,Itraconazole injection,,,41.42,1955.6,11
HCPCS,J183500,Itraconazole injection,,,88.75,88.75,1
HCPCS,J1836,"Inj, metronidazole, 10 mg",,,0.05,8.86,13
HCPCS,J183600,"Inj, metronidazole, 10 mg",,,0.05,0.05,1
HCPCS,J1837,"Inj, posaconazole, 1 mg",,,0.34,184.43,24
HCPCS,J183700,"Inj, posaconazole, 1 mg",,,0.62,0.62,1
HCPCS,J1840,Kanamycin sulfate 500 mg inj,,,7.98,47.96,9
HCPCS,J1850,Kanamycin sulfate 75 mg inj,,,1.2,8.86,9
HCPCS,J1885,KETOROLAC 15 MG/ML INJECTION SOLUTION,12.15,7.9,0.31,13.5,260
HCPCS,J1885,KETOROLAC 15MG,2.14,1.39,0.01,8.86,61
HCPCS,J1885,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,6.3,4.1,0.31,23.52,390
HCPCS,J1885,KETOROLAC 30MG/ML INJECTION (2 X15MG INJECTION),7.09,4.61,0.31,8.86,65
HCPCS,J1885,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.79,3.7649999999999997,0.31,14.76,325
HCPCS,J1885,KETOROLAC TROMETHAMINE INJ,20.0,13.0,0.44,20.0,27
HCPCS,J1885,Ketorolac tromethamine inj,,,0.59,0.59,1
HCPCS,J1885,TORADOL (KETOROLAC) 15MG,17.0,11.05,0.31,17.0,65
HCPCS,J1885,TORADOL INJ PER 15 MG,2.14,1.39,0.31,8.86,65
HCPCS,J1885,TORODOL 30MG OR 60MG ML INJECTION,8.0,5.2,0.44,8.0,27
HCPCS,J188500,Ketorolac tromethamine inj,,,0.59,0.59,1
HCPCS,J1890,Cephalothin sodium injection,,,19.22,47.96,10
HCPCS,J189000,Cephalothin sodium injection,,,19.22,19.22,1
HCPCS,J1920,"Inj, labetalol hcl, 5mg",,,0.62,0.62,1
HCPCS,J1920,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,14.4,9.36,0.62,14.4,102
HCPCS,J1920,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.66,0.425,0.06,8.86,102
HCPCS,J192000,"Inj, labetalol hcl, 5mg",,,0.62,0.62,1
HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,1.94,1.94,1
HCPCS,J1921,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.795,0.515,0.06,8.86,204
HCPCS,J192100,"Inj labetalol hcl hikma, 5mg",,,1.94,1.94,1
HCPCS,J1930,Lanreotide injection,,,62.99,62.99,1
HCPCS,J1930,SOMATULINE DEPOT 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,71596.8,46537.92,2.17,71596.8,65
HCPCS,J1930,SOMATULINE DEPOT 60 MG/0.2 ML SUBCUTANEOUS SYRINGE,113976.0,74084.4,2.17,113976.0,65
HCPCS,J1930,SOMATULINE DEPOT 90 MG/0.3 ML SUBCUTANEOUS SYRINGE,101184.0,65769.6,2.17,101184.0,65
HCPCS,J193000,Lanreotide injection,,,62.99,62.99,1
HCPCS,J1931,ALDURAZYME 2.9 MG/5 ML INTRAVENOUS SOLUTION,833.7,541.91,2.17,7011.25,65
HCPCS,J1931,Laronidase injection,,,71.11,71.11,1
HCPCS,J193100,Laronidase injection,,,71.11,71.11,1
HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,68.03,68.03,1
HCPCS,J1932,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,64027.14,41617.64,2.17,64027.14,65
HCPCS,J193200,"Inj, lanreotide, (cipla) 1mg",,,68.03,68.03,1
HCPCS,J1938,FUROSEMIDE 10 MG/ML INJ,2.37,1.545,0.04,8.86,612
HCPCS,J1938,"Inj, furosemide, 1 mg",,,0.04,0.04,1
HCPCS,J193800,"Inj, furosemide, 1 mg",,,0.04,0.04,1
HCPCS,J1939,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,1.95,1.2650000000000001,0.17,47.96,114
HCPCS,J1939,"Inj, bumetanide, 0.5 mg",,,0.64,0.64,1
HCPCS,J193900,"Inj, bumetanide, 0.5 mg",,,0.64,0.64,1
HCPCS,J1940,Furosemide injection,,,0.66,8.86,12
HCPCS,J194000,Furosemide injection,,,1.92,1.92,1
HCPCS,J1941,"INJ, FUROSCIX, 20 MG",882.8,573.82,1.1,1791901.44,25
HCPCS,J1941,"Inj, furoscix, 20 mg",,,41.42,648.04,11
HCPCS,J194100,"Inj, furoscix, 20 mg",,,523.64,523.64,1
HCPCS,J1943,ARISTADA INITIO 675 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3652.83,2374.34,2.17,3652.83,65
HCPCS,J1943,"Inj., aristada initio, 1 mg",,,5.79,5.79,1
HCPCS,J194300,"Inj., aristada initio, 1 mg",,,5.79,5.79,1
HCPCS,J1944,ARISTADA 1064 MG/3.9 ML SUSPENSION EXTEND.REL. IM SYRINGE,3543.33,2303.16,2.17,3543.33,65
HCPCS,J1944,ARISTADA 441 MG/1.6 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.17,3579.75,65
HCPCS,J1944,ARISTADA 662 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3582.48,2328.61,2.17,3582.48,65
HCPCS,J1944,ARISTADA 882 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.17,3579.75,65
HCPCS,J1944,Aripiprazole lauroxil 1 mg,,,5.95,5.95,1
HCPCS,J194400,Aripiprazole lauroxil 1 mg,,,5.95,5.95,1
HCPCS,J1945,Lepirudin,,,312.27,1472.63,10
HCPCS,J1950,LEUPROLIDE ACETATE /3.75 MG,1768.0,1149.2,1.1,3700.02,27
HCPCS,J1950,LUPRON DEPOT 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,19452.12,12643.88,2.17,19452.12,65
HCPCS,J1950,LUPRON DEPOT 3.75 MG INTRAMUSCULAR SYRINGE KIT,6483.99,4214.59,2.17,6483.99,65
HCPCS,J1950,LUPRON DEPOT-PED 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,42483.9,27614.54,2.17,42483.9,65
HCPCS,J1950,LUPRON DEPOT-PED 11.25 MG INTRAMUSCULAR KIT,14161.26,9204.82,2.17,14161.26,65
HCPCS,J1950,LUPRON DEPOT-PED 15 MG INTRAMUSCULAR KIT,15597.18,10138.17,2.17,15597.18,65
HCPCS,J1950,LUPRON DEPOT-PED 30 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,46791.75,30414.64,2.17,46791.75,65
HCPCS,J1950,LUPRON DEPOT-PED 7.5 MG (PED) INTRAMUSCULAR KIT,7800.3,5070.2,2.17,7800.3,65
HCPCS,J1950,Leuprolide acetate /3.75 mg,,,3139.69,3139.69,1
HCPCS,J195000,Leuprolide acetate /3.75 mg,,,3139.69,3139.69,1
HCPCS,J1951,FENSOLVI 45 MG SUBCUTANEOUS SYRINGE,103734.78,67427.61,2.17,103734.78,65
HCPCS,J1951,Inj fensolvi 0.25 mg,,,248.99,248.99,1
HCPCS,J195100,Inj fensolvi 0.25 mg,,,248.99,248.99,1
HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,55.0,1676.17,32
HCPCS,J195200,"Leuprolide inj, camcevi, 1mg",,,101.51,101.51,1
HCPCS,J1953,KEPPRA 500 MG/5 ML INTRAVENOUS SOLUTION,49.11,31.92,0.07,49.11,51
HCPCS,J1953,LEVETIRACETAM 1000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,1.8,1.17,0.07,8.86,102
HCPCS,J1953,LEVETIRACETAM 1500 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,2.67,1.74,0.07,8.86,51
HCPCS,J1953,LEVETIRACETAM 500 MG/100 ML IN SODIUM CHLORIDE (ISO-OSM) IV PIGGYBACK,1.08,0.7,0.07,8.86,51
HCPCS,J1953,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,1.9649999999999999,1.275,0.07,8.86,357
HCPCS,J1953,Levetiracetam injection,,,0.07,0.07,1
HCPCS,J195300,Levetiracetam injection,,,0.07,0.07,1
HCPCS,J1954,Inj leu acet lutr dpt 7.5 mg,,,257.7,1943.32,32
HCPCS,J195400,Inj leu acet lutr dpt 7.5 mg,,,1257.87,1257.87,1
HCPCS,J1955,CARNITOR 200 MG/ML INTRAVENOUS SOLUTION,27.99,18.19,2.17,58.28,51
HCPCS,J1955,Inj levocarnitine per 1 gm,,,41.42,41.42,1
HCPCS,J1955,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,25.68,16.69,2.17,58.28,102
HCPCS,J195500,Inj levocarnitine per 1 gm,,,41.42,41.42,1
HCPCS,J1956,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.42,0.27,0.06,8.86,51
HCPCS,J1956,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.21,0.14,0.01,8.86,204
HCPCS,J1956,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.15,0.1,0.01,8.86,153
HCPCS,J1956,Levofloxacin injection,,,3.84,3.84,1
HCPCS,J195600,Levofloxacin injection,,,3.84,3.84,1
HCPCS,J1960,Levorphanol tartrate inj,,,0.8,47.96,11
HCPCS,J196000,Levorphanol tartrate inj,,,0.8,0.8,1
HCPCS,J1961,Inj lenacapavir (hiv tx) 1mg,,,39.69,39.69,1
HCPCS,J1961,SUNLENCA 309 MG/ML SUBCUTANEOUS SOLUTION,23400.0,15210.0,2.17,23400.0,65
HCPCS,J196100,Inj lenacapavir (hiv tx) 1mg,,,39.69,39.69,1
HCPCS,J1980,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,388.5,252.53,2.17,388.5,51
HCPCS,J1980,Hyoscyamine sulfate inj,,,115.34,115.34,1
HCPCS,J198000,Hyoscyamine sulfate inj,,,115.34,115.34,1
HCPCS,J1990,Chlordiazepoxide injection,,,41.42,59.99,11
HCPCS,J199000,Chlordiazepoxide injection,,,46.83,46.83,1
HCPCS,J2001,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
HCPCS,J2001,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
HCPCS,J2001,Lidocaine injection,,,0.09,0.09,1
HCPCS,J200100,Lidocaine injection,,,0.09,0.09,1
HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.02,0.02,1
HCPCS,J2002,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
HCPCS,J200200,"Inj, lidocaine in d5w, 1 mg",,,0.02,0.02,1
HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.02,0.02,1
HCPCS,J2003,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.29,0.84,0.02,8.86,357
HCPCS,J2003,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,5.85,3.8000000000000003,0.02,8.86,102
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.61,1.7,0.02,8.86,306
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,2.7,1.76,0.02,8.86,51
HCPCS,J2003,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.3,0.2,0.02,8.86,51
HCPCS,J2003,LIDOCAINE (PF) 50 MG/5 ML (1 %) INTRAVENOUS SYRINGE,10.8,7.02,0.02,10.8,51
HCPCS,J2003,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.7649999999999999,0.495,0.02,8.86,357
HCPCS,J2003,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.75,0.49,0.02,8.86,306
HCPCS,J2003,XYLOCAINE 10 MG/ML (1 %) INJECTION SOLUTION,0.51,0.33,0.02,8.86,102
HCPCS,J2003,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,0.6,0.39,0.02,8.86,153
HCPCS,J2003,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,2.82,1.83,0.02,8.86,204
HCPCS,J2003,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.58,1.68,0.02,8.86,153
HCPCS,J2003,XYLOCAINE-MPF 5 MG/ML (0.5 %) INJECTION SOLUTION,1.05,0.68,0.02,8.86,51
HCPCS,J200300,"Inj, lidocaine hcl, 1 mg",,,0.02,0.02,1
HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.02,0.02,1
HCPCS,J2004,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,255
HCPCS,J2004,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.885,0.575,0.02,8.86,204
HCPCS,J2004,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,3.45,2.24,0.02,8.86,153
HCPCS,J2004,LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
HCPCS,J2004,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,153
HCPCS,J2004,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,0.885,0.575,0.02,8.86,153
HCPCS,J2004,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,1.86,1.21,0.02,8.86,204
HCPCS,J2004,XYLOCAINE-MPF/EPINEPHRINE 1.5 %-1:200000 INJECTION SOLUTION,3.0300000000000002,1.9649999999999999,0.02,8.86,102
HCPCS,J2004,XYLOCAINE-MPF/EPINEPHRINE 2 %-1:200000 INJECTION SOLUTION,4.23,2.75,0.02,8.86,102
HCPCS,J200400,"Inj, lidocaine w epinephrine",,,0.02,0.02,1
HCPCS,J2010,Lincomycin injection,,,9.61,47.96,14
HCPCS,J201000,Lincomycin injection,,,9.61,9.61,1
HCPCS,J2020,Linezolid injection,,,4.88,4.88,1
HCPCS,J2020,ZYVOX 600 MG/300 ML INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,47.96,102
HCPCS,J202000,Linezolid injection,,,4.88,4.88,1
HCPCS,J2021,"Inj, linezolid (hospira)",,,4.34,47.96,14
HCPCS,J202100,"Inj, linezolid (hospira)",,,38.5,38.5,1
HCPCS,J2060,ATIVAN 2 MG/ML INJECTION SOLUTION,8.64,5.62,1.29,8.86,51
HCPCS,J2060,LORAZEPAM 2 MG/ML INJECTION SOLUTION,4.635,3.01,0.57,8.86,204
HCPCS,J2060,LORAZEPAM 2 MG/ML INJECTION SYRINGE,57.6,37.44,2.17,57.6,102
HCPCS,J2060,LORAZEPAM 4 MG/ML INJECTION SOLUTION,9.3,6.05,0.94,12.3,102
HCPCS,J2060,Lorazepam injection,,,2.51,2.51,1
HCPCS,J206000,Lorazepam injection,,,2.51,2.51,1
HCPCS,J2062,Loxapine for inhalation 1 mg,,,15.9,130.36,24
HCPCS,J206200,Loxapine for inhalation 1 mg,,,32.04,32.04,1
HCPCS,J2150,OSMITROL 20 % INTRAVENOUS SOLUTION,0.615,0.4,0.07,8.86,102
HCPCS,J2151,"Inj, mannitol, 250 mg",,,0.11,0.11,1
HCPCS,J2151,MANNITOL 25 % INTRAVENOUS SOLUTION,0.555,0.36,0.07,8.86,102
HCPCS,J215100,"Inj, mannitol, 250 mg",,,0.11,0.11,1
HCPCS,J2170,Mecasermin injection,,,363.07,785.25,11
HCPCS,J217000,Mecasermin injection,,,785.25,785.25,1
HCPCS,J2175,DEMEROL (PF) 25 MG/ML INJECTION SYRINGE,79.2,51.48,2.17,79.2,51
HCPCS,J2175,DEMEROL (PF) 50 MG/ML INJECTION SYRINGE,100.8,65.52,2.17,100.8,51
HCPCS,J2175,DEMEROL (PF) 75 MG/ML INJECTION SYRINGE,23.04,14.98,2.17,23.04,102
HCPCS,J2175,DEMEROL 50 MG/ML INJECTION SOLUTION,78.66,51.13,2.17,78.66,51
HCPCS,J2175,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,15.87,102
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,9.12,5.93,1.36,15.87,102
HCPCS,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,9.51,6.18,1.42,15.87,102
HCPCS,J2175,Meperidine hydrochl /100 mg,,,14.51,14.51,1
HCPCS,J217500,Meperidine hydrochl /100 mg,,,14.51,14.51,1
HCPCS,J2180,Meperidine/promethazine inj,,,7.65,21.59,11
HCPCS,J218000,Meperidine/promethazine inj,,,16.86,16.86,1
HCPCS,J2182,"Injection, mepolizumab, 1mg",,,56.76,56.76,1
HCPCS,J2182,NUCALA 100 MG SUBCUTANEOUS SOLUTION,13229.58,8599.23,2.17,13229.58,65
HCPCS,J2182,NUCALA 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,14367.54,9338.9,2.17,14367.54,65
HCPCS,J2182,NUCALA 100 MG/ML SUBCUTANEOUS SYRINGE,14367.54,9338.9,2.17,14367.54,65
HCPCS,J218200,"Injection, mepolizumab, 1mg",,,56.76,56.76,1
HCPCS,J2183,Inj meropenem (wg crit care),,,2.79,2.79,1
HCPCS,J2183,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,115.485,75.065,1.62,118.44,114
HCPCS,J218300,Inj meropenem (wg crit care),,,2.79,2.79,1
HCPCS,J2184,"Inj, meropenem (b. braun)",,,3.58,3.58,1
HCPCS,J2184,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,107.67,69.99,2.17,107.67,51
HCPCS,J2184,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,73.8,47.97,2.17,73.8,51
HCPCS,J218400,"Inj, meropenem (b. braun)",,,3.58,3.58,1
HCPCS,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,21.24,13.81,0.68,21.24,51
HCPCS,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.68,10.8,51
HCPCS,J2185,Meropenem,,,0.68,0.68,1
HCPCS,J218500,Meropenem,,,0.68,0.68,1
HCPCS,J2186,"Inj., meropenem, vaborbactam",,,4.75,4.75,1
HCPCS,J2186,VABOMERE 2 GRAM INTRAVENOUS SOLUTION,825.03,536.27,2.09,825.03,130
HCPCS,J218600,"Inj., meropenem, vaborbactam",,,4.75,4.75,1
HCPCS,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,91.875,59.715,2.17,112.62,153
HCPCS,J2210,Methylergonovin maleate inj,,,38.02,38.02,1
HCPCS,J221000,Methylergonovin maleate inj,,,38.02,38.02,1
HCPCS,J2212,Methylnaltrexone injection,,,3.33,3.33,1
HCPCS,J2212,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,1120.5,728.33,2.17,1120.5,51
HCPCS,J2212,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,1120.5,728.33,2.17,1120.5,102
HCPCS,J2212,RELISTOR 8 MG/0.4 ML SUBCUTANEOUS SYRINGE,1680.75,1092.49,2.17,1680.75,51
HCPCS,J221200,Methylnaltrexone injection,,,3.33,3.33,1
HCPCS,J2246,"Inj, micafungin (baxter)",,,0.73,47.96,13
HCPCS,J224600,"Inj, micafungin (baxter)",,,0.73,0.73,1
HCPCS,J2247,"Inj, micafungin (par pharm)",,,0.39,0.39,1
HCPCS,J2247,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,538.56,350.06,0.39,538.56,51
HCPCS,J2247,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,269.28,175.03,0.39,269.28,51
HCPCS,J224700,"Inj, micafungin (par pharm)",,,0.39,0.39,1
HCPCS,J2248,Micafungin sodium injection,,,0.45,47.96,14
HCPCS,J224800,Micafungin sodium injection,,,0.45,0.45,1
HCPCS,J2249,BYFAVO 20 MG INTRAVENOUS SOLUTION,157.74,102.53,2.17,157.74,51
HCPCS,J2249,"Inj, remimazolam, 1 mg",,,4.68,4.68,1
HCPCS,J224900,"Inj, remimazolam, 1 mg",,,4.68,4.68,1
HCPCS,J2250,Inj midazolam hydrochloride,,,0.25,0.25,1
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,1.08,0.7,0.16,8.86,51
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.09,8.86,204
HCPCS,J2250,MIDAZOLAM (PF) 2 MG/2 ML (1 MG/ML) INJECTION SYRINGE,5.64,3.67,0.25,8.86,51
HCPCS,J2250,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,3.39,2.2,0.25,8.86,204
HCPCS,J2250,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN SOD CHLORISO-OSM IV SYRINGE,1.5,0.98,0.22,8.86,51
HCPCS,J2250,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.9,0.585,0.12,8.86,204
HCPCS,J2250,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.595,1.69,0.25,8.86,357
HCPCS,J2250,MIDAZOLAM HYDRO 2MG VL,18.61,12.1,0.25,18.61,51
HCPCS,J2250,MIDAZOLAM PER 1MG,9.31,6.05,0.25,9.31,51
HCPCS,J225000,Inj midazolam hydrochloride,,,0.25,0.25,1
HCPCS,J2251,Inj midazolam in 0.9% nacl,,,0.32,0.32,1
HCPCS,J2251,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.96,0.62,0.14,8.86,51
HCPCS,J225100,Inj midazolam in 0.9% nacl,,,0.32,0.32,1
HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.17,8.86,11
HCPCS,J225200,Inj midazolam in 0.8% nacl,,,0.21,0.21,1
HCPCS,J2253,Inj midazolam (seizalam),,,7.65,8.86,8
HCPCS,J2260,Inj milrinone lactate / 5 mg,,,2.4,2.4,1
HCPCS,J2260,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.25,1.46,0.21,8.86,459
HCPCS,J2260,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,0.33,0.21,0.05,8.86,51
HCPCS,J226000,Inj milrinone lactate / 5 mg,,,2.4,2.4,1
HCPCS,J2265,MINOCIN 100 MG INTRAVENOUS SOLUTION,958.53,623.04,2.17,958.53,65
HCPCS,J2265,Minocycline hydrochloride,,,5.52,5.52,1
HCPCS,J226500,Minocycline hydrochloride,,,5.52,5.52,1
HCPCS,J2267,"Inj, mirikizumab-mrkz, 1 mg",,,74.62,74.62,1
HCPCS,J2267,OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION,2302.38,1496.55,2.17,4417.71,65
HCPCS,J226700,"Inj, mirikizumab-mrkz, 1 mg",,,74.62,74.62,1
HCPCS,J2270,MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.57,0.37,0.08,10.44,51
HCPCS,J2270,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,1.11,0.72,0.17,10.44,51
HCPCS,J2270,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,9.18,5.97,1.37,10.44,102
HCPCS,J2270,MORPHINE 10 MG/ML INTRAVENOUS SYRINGE,100.8,65.52,2.17,100.8,51
HCPCS,J2270,MORPHINE 2 MG/ML INTRAVENOUS SYRINGE,28.275,18.38,2.17,36.0,102
HCPCS,J2270,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.34,10.44,51
HCPCS,J2270,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,32.4,21.06,2.17,32.4,51
HCPCS,J2270,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,15.66,10.18,2.17,15.66,51
HCPCS,J2270,MORPHINE 8 MG/ML INJECTION SOLUTION,10.59,6.88,1.58,10.59,51
HCPCS,J2270,MORPHINE 8 MG/ML INTRAVENOUS SOLUTION,10.17,6.61,1.51,10.44,51
HCPCS,J2270,Morphine sulfate injection,,,5.41,5.41,1
HCPCS,J227000,Morphine sulfate injection,,,5.41,5.41,1
HCPCS,J2272,"Inj, morphine (fresenius)",,,12.05,12.05,1
HCPCS,J2272,MORPHINE 10 MG/ML INJECTION SOLUTION,10.98,7.14,1.63,12.05,51
HCPCS,J2272,MORPHINE 2 MG/ML INJECTION SOLUTION,10.32,6.71,1.54,12.05,51
HCPCS,J2272,MORPHINE 2 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,51
HCPCS,J2272,MORPHINE 4 MG/ML INJECTION SOLUTION,10.32,6.71,1.54,12.05,51
HCPCS,J2272,MORPHINE 4 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,102
HCPCS,J2272,MORPHINE 5 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,51
HCPCS,J227200,"Inj, morphine (fresenius)",,,12.05,12.05,1
HCPCS,J2274,DURAMORPH (PF) 0.5 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,47.96,51
HCPCS,J2274,DURAMORPH (PF) 1 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,47.96,51
HCPCS,J2274,INFUMORPH P/F 10 MG/ML INJECTION SOLUTION,37.44,24.34,2.17,47.96,51
HCPCS,J2274,INFUMORPH P/F 25 MG/ML INJECTION SOLUTION,63.66,41.38,2.17,63.66,51
HCPCS,J2274,Inj morphine pf epid ithc,,,24.03,24.03,1
HCPCS,J2274,MITIGO (PF) 25 MG/ML INJECTION SOLUTION,69.45,45.14,2.17,69.45,51
HCPCS,J2274,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,8.37,5.44,1.25,47.96,102
HCPCS,J2274,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,16.77,10.9,2.17,47.96,51
HCPCS,J227400,Inj morphine pf epid ithc,,,24.03,24.03,1
HCPCS,J2277,APHEXDA 62 MG SUBCUTANEOUS SOLUTION,21240.0,13806.0,2.17,21240.0,65
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,47.13,47.13,1
HCPCS,J227700,"Inj, motixafortide, 0.25 mg",,,47.13,47.13,1
HCPCS,J2278,PRIALT 100 MCG/ML INTRATHECAL SOLUTION,4405.665,2863.6800000000003,2.17,4520.82,130
HCPCS,J2278,PRIALT 25 MCG/ML INTRATHECAL SOLUTION,1072.62,697.2,2.17,2642.72,65
HCPCS,J2278,Ziconotide injection,,,18.81,18.81,1
HCPCS,J227800,Ziconotide injection,,,18.81,18.81,1
HCPCS,J2280,"Inj, moxifloxacin 100 mg",,,16.3,16.3,1
HCPCS,J2280,MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.66,0.43,0.1,19.72,51
HCPCS,J228000,"Inj, moxifloxacin 100 mg",,,16.3,16.3,1
HCPCS,J2281,Inj moxifloxacin (fres kabi),,,11.82,11.82,1
HCPCS,J2281,MOXIFLOXACIN 400 MG/250 ML-SODIUM ACETSUL-WATER INTRAVENOUS PIGGYBACK,0.66,0.43,0.1,14.07,51
HCPCS,J228100,Inj moxifloxacin (fres kabi),,,11.82,11.82,1
HCPCS,J2290,"Inj, nafcillin sodium, 20 mg",,,0.11,0.11,1
HCPCS,J2290,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,43.5,28.28,0.11,53.61,153
HCPCS,J2290,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,104.01,67.61,0.11,104.01,51
HCPCS,J229000,"Inj, nafcillin sodium, 20 mg",,,0.11,0.11,1
HCPCS,J2291,"Inj, nafcillin (baxter) 20mg",,,0.27,0.27,1
HCPCS,J2291,NAFCILLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.87,0.57,0.13,8.86,51
HCPCS,J229100,"Inj, nafcillin (baxter) 20mg",,,0.27,0.27,1
HCPCS,J2300,Inj nalbuphine hydrochloride,,,6.14,6.14,1
HCPCS,J2300,NALBUPHINE 10 MG/ML INJECTION SOLUTION,19.77,12.85,1.92,22.29,255
HCPCS,J2300,NALBUPHINE 20 MG/ML INJECTION SOLUTION,38.64,25.12,2.17,40.26,153
HCPCS,J230000,Inj nalbuphine hydrochloride,,,6.14,6.14,1
HCPCS,J2305,"Inj, nitroglycerin, 5 mg",,,2.71,2.71,1
HCPCS,J2305,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,0.3,0.2,0.04,8.86,51
HCPCS,J2305,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.05,8.86,51
HCPCS,J2305,NITROGLYCERIN INTRACORONARY 0.2 MG/ML,2.88,1.87,0.43,8.86,51
HCPCS,J230500,"Inj, nitroglycerin, 5 mg",,,2.71,2.71,1
HCPCS,J2310,Inj naloxone hydrochloride,,,12.6,47.96,11
HCPCS,J2311,"Inj, naloxone hcl (zimhi)",,,3.23,47.96,10
HCPCS,J2312,"Inj naloxone hcl nos, 0.01mg",,,0.12,0.12,1
HCPCS,J2312,NALOXONE 0.4 MG/ML INJECTION SOLUTION,49.875,32.42,0.12,57.0,153
HCPCS,J2312,NALOXONE 0.4 MG/ML INJECTION SYRINGE,241.2,156.78,0.12,241.2,51
HCPCS,J2312,NALOXONE 1 MG/ML INJECTION SYRINGE,58.05,37.735,0.12,59.4,102
HCPCS,J231200,"Inj naloxone hcl nos, 0.01mg",,,0.12,0.12,1
HCPCS,J2313,"Inj, naloxone (zimhi) 0.01mg",,,0.03,47.96,11
HCPCS,J231300,"Inj, naloxone (zimhi) 0.01mg",,,0.04,0.04,1
HCPCS,J2315,"NALTREXONE, DEPOT FORM",6.0,3.9,1.1,7.43,27
HCPCS,J2315,"Naltrexone, depot form",,,7.55,7.55,1
HCPCS,J2315,VIVITROL 380 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,6085.23,3955.4,2.17,6085.23,65
HCPCS,J231500,"Naltrexone, depot form",,,7.55,7.55,1
HCPCS,J2320,Nandrolone decanoate 50 mg,,,7.57,47.96,11
HCPCS,J232000,Nandrolone decanoate 50 mg,,,7.57,7.57,1
HCPCS,J2323,Natalizumab injection,,,43.63,43.63,1
HCPCS,J2323,TYSABRI 300 MG/15 ML INTRAVENOUS SOLUTION,2131.02,1385.16,2.17,4417.71,65
HCPCS,J232300,Natalizumab injection,,,43.63,43.63,1
HCPCS,J2325,Nesiritide injection,,,62.59,720.96,11
HCPCS,J232500,Nesiritide injection,,,150.73,150.73,1
HCPCS,J2326,"Inj, nusinersen, 0.1mg",,,2604.12,2604.12,1
HCPCS,J2326,SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION,105335.25,68467.91,2.17,105335.25,65
HCPCS,J232600,"Inj, nusinersen, 0.1mg",,,2604.12,2604.12,1
HCPCS,J2327,Inj risankizumab-rzaa 1 mg,,,26.58,26.58,1
HCPCS,J2327,SKYRIZI 150 MG/ML SUBCUTANEOUS PEN INJECTOR,80580.57,52377.37,2.17,80580.57,65
HCPCS,J2327,SKYRIZI 60 MG/ML INTRAVENOUS SOLUTION,3827.52,2487.89,2.17,4417.71,65
HCPCS,J232700,Inj risankizumab-rzaa 1 mg,,,26.58,26.58,1
HCPCS,J2329,BRIUMVI 25 MG/ML INTRAVENOUS SOLUTION,6666.0,4332.9,2.17,13108.79,65
HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,124.92,124.92,1
HCPCS,J232900,"Inj ublituximab-xiiy, 1 mg",,,124.92,124.92,1
HCPCS,J2350,"Injection, ocrelizumab, 1 mg",,,105.59,105.59,1
HCPCS,J2350,OCREVUS 30 MG/ML INTRAVENOUS SOLUTION,7430.76,4829.99,2.17,16617.81,65
HCPCS,J235000,"Injection, ocrelizumab, 1 mg",,,105.59,105.59,1
HCPCS,J2351,Inj ocrelizumab 1mg hya-ocsq,,,83.75,83.75,1
HCPCS,J2351,OCREVUS ZUNOVO 920 MG-23000 UNIT/23 ML SUBCUTANEOUS SOLUTION,6461.52,4199.99,2.17,16617.81,59
HCPCS,J235100,Inj ocrelizumab 1mg hya-ocsq,,,83.75,83.75,1
HCPCS,J2353,"Octreotide injection, depot",,,354.52,354.52,1
HCPCS,J2353,SANDOSTATIN LAR DEPOT 10 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,12684.36,8244.83,2.17,12684.36,65
HCPCS,J2353,SANDOSTATIN LAR DEPOT 20 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,16618.68,10802.14,2.17,16618.68,130
HCPCS,J2353,SANDOSTATIN LAR DEPOT 30 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,24885.21,16175.39,2.17,24885.21,130
HCPCS,J235300,"Octreotide injection, depot",,,354.52,354.52,1
HCPCS,J2354,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,35.79,23.26,0.88,35.79,50
HCPCS,J2354,OCTREOTIDE ACETATE 1000 MCG/ML INJECTION SOLUTION,357.75,232.54,1.17,357.75,51
HCPCS,J2354,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,71.55,46.51,1.17,71.55,51
HCPCS,J2354,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,17.205,11.184999999999999,1.17,18.21,204
HCPCS,J2354,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,178.89,116.28,1.17,178.89,51
HCPCS,J2354,"Octreotide inj, non-depot",,,1.17,1.17,1
HCPCS,J2354,SANDOSTATIN 100 MCG/ML INJECTION SOLUTION,98.58,64.08,1.17,98.58,51
HCPCS,J2354,SANDOSTATIN 50 MCG/ML INJECTION SOLUTION,50.82,33.03,1.17,50.82,51
HCPCS,J2354,SANDOSTATIN 500 MCG/ML INJECTION SOLUTION,475.44,309.04,1.17,475.44,51
HCPCS,J235400,"Octreotide inj, non-depot",,,1.17,1.17,1
HCPCS,J2355,Oprelvekin injection,,,318.98,1205.94,12
HCPCS,J235500,Oprelvekin injection,,,941.48,941.48,1
HCPCS,J2356,"Inj tezepelumab-ekko, 1mg",,,31.72,31.72,1
HCPCS,J2356,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS PEN INJECTOR,8811.84,5727.7,2.17,8811.84,65
HCPCS,J2356,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRINGE,8234.7,5352.56,2.17,8234.7,65
HCPCS,J235600,"Inj tezepelumab-ekko, 1mg",,,31.72,31.72,1
HCPCS,J2357,Omalizumab injection,,,80.99,80.99,1
HCPCS,J2357,XOLAIR 150 MG SUBCUTANEOUS SOLUTION,7069.24,4595.01,2.17,7069.24,65
HCPCS,J2357,XOLAIR 150 MG/ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,2.17,5301.93,65
HCPCS,J2357,XOLAIR 150 MG/ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,2.17,5301.93,130
HCPCS,J2357,XOLAIR 300 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,5301.96,3446.27,2.17,5301.96,65
HCPCS,J2357,XOLAIR 300 MG/2 ML SUBCUTANEOUS SYRINGE,5301.96,3446.27,2.17,5301.96,65
HCPCS,J2357,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,2.17,5301.93,65
HCPCS,J2357,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,2.17,5301.93,130
HCPCS,J235700,Omalizumab injection,,,80.99,80.99,1
HCPCS,J2358,Olanzapine long-acting inj,,,2.92,47.96,20
HCPCS,J235800,Olanzapine long-acting inj,,,5.62,5.62,1
HCPCS,J2359,"Inj. olanzapine, 0.5mg",,,1.44,1.44,1
HCPCS,J2359,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,124.5,80.93,1.44,142.17,153
HCPCS,J235900,"Inj. olanzapine, 0.5mg",,,1.44,1.44,1
HCPCS,J2360,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,24.84,16.145,2.17,31.9,102
HCPCS,J2360,ORPHENADRINE INJ TO 60 MG,24.0,15.6,1.1,24.0,27
HCPCS,J2360,Orphenadrine injection,,,11.37,11.37,1
HCPCS,J236000,Orphenadrine injection,,,11.37,11.37,1
HCPCS,J2370,Phenylephrine hcl injection,,,7.65,8.86,8
HCPCS,J2371,Inj phenylephrine hcl 20 mcg,,,0.02,0.02,1
HCPCS,J2371,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.28,9.28,0.02,14.58,306
HCPCS,J237100,Inj phenylephrine hcl 20 mcg,,,0.02,0.02,1
HCPCS,J2372,"Inj, biorphen, 20 micrograms",,,0.28,8.86,13
HCPCS,J237200,"Inj, biorphen, 20 micrograms",,,0.28,0.28,1
HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.15,8.86,19
HCPCS,J237300,"Inj, immphentiv, 20 mcg",,,0.25,0.25,1
HCPCS,J2400,Chloroprocaine hcl injection,,,31.73,47.96,9
HCPCS,J2401,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.84,2.5,0.06,47.96,102
HCPCS,J2401,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.06,47.96,102
HCPCS,J2401,Chloroprocaine hcl injection,,,0.07,0.07,1
HCPCS,J2401,NESACAINE 10 MG/ML (1 %) INJECTION SOLUTION,2.16,1.4,0.06,47.96,51
HCPCS,J2401,NESACAINE 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.06,47.96,51
HCPCS,J2401,NESACAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.38,2.85,0.06,47.96,102
HCPCS,J2401,NESACAINE-MPF 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.06,47.96,51
HCPCS,J240100,Chloroprocaine hcl injection,,,0.07,0.07,1
HCPCS,J2402,Chloroprocaine (clorotekal),,,0.09,47.96,12
HCPCS,J240200,Chloroprocaine (clorotekal),,,0.66,0.66,1
HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,0.58,47.96,32
HCPCS,J240300,"Chloroprocaine opht gel, 1mg",,,1.03,1.03,1
HCPCS,J2404,"Inj, nicardipine 0.1 mg",,,0.12,0.12,1
HCPCS,J2404,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,10.125,6.585,0.12,130.36,102
HCPCS,J240400,"Inj, nicardipine 0.1 mg",,,0.12,0.12,1
HCPCS,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,1.86,1.21,0.16,8.86,204
HCPCS,J2405,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,1.35,0.88,0.16,8.86,102
HCPCS,J2405,Ondansetron hcl injection,,,0.16,0.16,1
HCPCS,J240500,Ondansetron hcl injection,,,0.16,0.16,1
HCPCS,J2406,"Injection, oritavancin 10 mg",,,76.65,76.65,1
HCPCS,J2406,KIMYRSA 1200 MG INTRAVENOUS SOLUTION,20173.38,13112.7,2.17,20173.38,65
HCPCS,J240600,"Injection, oritavancin 10 mg",,,76.65,76.65,1
HCPCS,J2407,"Injection, oritavancin",,,25.44,2642.72,33
HCPCS,J240700,"Injection, oritavancin",,,50.68,50.68,1
HCPCS,J2410,Oxymorphone hcl injection,,,3.01,8.86,12
HCPCS,J241000,Oxymorphone hcl injection,,,6.68,6.68,1
HCPCS,J2425,Palifermin injection,,,24.83,2642.72,33
HCPCS,J242500,Palifermin injection,,,65.2,65.2,1
HCPCS,J2426,INVEGA SUSTENNA 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8565.84,5567.8,2.17,8565.84,65
HCPCS,J2426,INVEGA SUSTENNA 156 MG/ML INTRAMUSCULAR SYRINGE,8566.17,5568.01,2.17,8566.17,65
HCPCS,J2426,INVEGA SUSTENNA 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,8565.96,5567.87,2.17,8565.96,65
HCPCS,J2426,INVEGA SUSTENNA 39 MG/0.25 ML INTRAMUSCULAR SYRINGE,8565.27,5567.43,2.17,8565.27,65
HCPCS,J2426,INVEGA SUSTENNA 78 MG/0.5 ML INTRAMUSCULAR SYRINGE,8565.69,5567.7,2.17,8565.69,65
HCPCS,J2426,"Inj, invega sustenna, 1 mg",,,26.9,26.9,1
HCPCS,J242600,"Inj, invega sustenna, 1 mg",,,26.9,26.9,1
HCPCS,J2427,INVEGA HAFYERA 1092 MG/3.5 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,2.17,14684.85,65
HCPCS,J2427,INVEGA HAFYERA 1560 MG/5 ML INTRAMUSCULAR SYRINGE,15418.74,10022.18,2.17,15418.74,65
HCPCS,J2427,INVEGA TRINZA 410 MG/1.32 ML INTRAMUSCULAR SYRINGE,14600.88,9490.57,2.17,14600.88,65
HCPCS,J2427,INVEGA TRINZA 546 MG/1.75 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,2.17,14684.85,65
HCPCS,J2427,INVEGA TRINZA 819 MG/2.63 ML INTRAMUSCULAR SYRINGE,14656.59,9526.78,2.17,14656.59,65
HCPCS,J2427,"Inj, invega hafyera/trinza",,,23.12,23.12,1
HCPCS,J242700,"Inj, invega hafyera/trinza",,,23.12,23.12,1
HCPCS,J2428,"Inj, erzofri, 1 mg",,,15.3,1287.79,24
HCPCS,J242800,"Inj, erzofri, 1 mg",,,27.23,27.23,1
HCPCS,J2430,PAMIDRONATE 30 MG INTRAVENOUS SOLUTION,67.65,43.97,2.17,67.65,51
HCPCS,J2430,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,9.72,6.32,0.77,47.96,153
HCPCS,J2430,PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,16.35,10.63,2.17,47.96,51
HCPCS,J2430,PAMIDRONATE 90 MG INTRAVENOUS SOLUTION,202.92,131.9,2.17,202.92,51
HCPCS,J2430,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,33.69,21.9,2.01,47.96,153
HCPCS,J2430,Pamidronate disodium /30 mg,,,20.1,20.1,1
HCPCS,J243000,Pamidronate disodium /30 mg,,,20.1,20.1,1
HCPCS,J2440,PAPAVERINE 30 MG/ML INJECTION SOLUTION,71.025,46.17,2.17,102.6,102
HCPCS,J2440,Papaverin hcl injection,,,80.1,80.1,1
HCPCS,J244000,Papaverin hcl injection,,,80.1,80.1,1
HCPCS,J2460,Oxytetracycline injection,,,1.96,47.96,10
HCPCS,J246000,Oxytetracycline injection,,,1.96,1.96,1
HCPCS,J2468,"Inj, palonosetron (posfrea)",,,7.65,161.07,31
HCPCS,J246800,"Inj, palonosetron (posfrea)",,,104.27,104.27,1
HCPCS,J2469,PALONOSETRON 0.25 MG/2 ML INTRAVENOUS SOLUTION,72.0,46.8,0.62,72.0,51
HCPCS,J2469,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,6.48,4.21,0.62,8.86,51
HCPCS,J2469,Palonosetron hcl,,,0.62,0.62,1
HCPCS,J246900,Palonosetron hcl,,,0.62,0.62,1
HCPCS,J2470,Inj pantoprazole sodium 40mg,,,4.04,4.04,1
HCPCS,J2470,PROTONIX 40 MG INTRAVENOUS SOLUTION,18.27,11.88,2.17,21.03,51
HCPCS,J247000,Inj pantoprazole sodium 40mg,,,4.04,4.04,1
HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,7.48,7.48,1
HCPCS,J2471,PROTONIX 40 MG INTRAVENOUS SOLUTION,12.54,8.155000000000001,1.01,18.27,102
HCPCS,J247100,Inj pantoprazole(hikma) 40mg,,,7.48,7.48,1
HCPCS,J2472,"Inj, pantoprazole sodium chl",,,7.65,24.12,11
HCPCS,J247200,"Inj, pantoprazole sodium chl",,,18.83,18.83,1
HCPCS,J2501,Paricalcitol,,,1.73,1.73,1
HCPCS,J2501,ZEMPLAR 5 MCG/ML INTRAVENOUS SOLUTION,54.54,35.45,1.73,54.54,102
HCPCS,J250100,Paricalcitol,,,1.73,1.73,1
HCPCS,J2502,"Inj, pasireotide long acting",,,1023.62,1023.62,1
HCPCS,J2502,SIGNIFOR LAR 60 MG IM SUSPENSION,78332.04,50915.83,2.17,78332.04,130
HCPCS,J250200,"Inj, pasireotide long acting",,,1023.62,1023.62,1
HCPCS,J2503,Pegaptanib sodium injection,,,815.14,2027.49,11
HCPCS,J2504,"Pegademase bovine, 25 iu",,,318.98,949.76,11
HCPCS,J2505,"Injection, pegfilgrastim 6mg",,,2813.05,3257.22,8
HCPCS,J2506,Inj pegfilgrast ex bio 0.5mg,,,218.66,218.66,1
HCPCS,J2506,NEULASTA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,38507.94,25030.16,2.17,38507.94,65
HCPCS,J2506,NEULASTA ONPRO 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,38507.94,25030.16,2.17,38507.94,65
HCPCS,J250600,Inj pegfilgrast ex bio 0.5mg,,,218.66,218.66,1
HCPCS,J2507,KRYSTEXXA 8 MG/50 ML INTRAVENOUS SOLUTION,2213.49,1438.77,2.17,13108.79,65
HCPCS,J2507,KRYSTEXXA 8 MG/ML INTRAVENOUS SOLUTION,110674.77,71938.6,2.17,110674.77,65
HCPCS,J2507,Pegloticase injection,,,6708.48,6708.48,1
HCPCS,J250700,Pegloticase injection,,,6708.48,6708.48,1
HCPCS,J2508,ELFABRIO 2 MG/ML INTRAVENOUS SOLUTION,1626.21,1057.04,2.17,3257.22,65
HCPCS,J2508,Pegunigalsidase alfa-iwxj,,,402.19,402.19,1
HCPCS,J250800,Pegunigalsidase alfa-iwxj,,,402.19,402.19,1
HCPCS,J2510,PENICILLIN G SODIUM 5 MILLION UNIT SOLUTION FOR INJECTION,172.8,112.32,2.17,172.8,57
HCPCS,J2510,Penicillin g procaine inj,,,98.15,98.15,1
HCPCS,J251000,Penicillin g procaine inj,,,98.15,98.15,1
HCPCS,J2513,Pentastarch 10% solution,,,36.25,500.04,9
HCPCS,J2515,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,184.5,119.925,2.17,217.8,118
HCPCS,J2515,Pentobarbital sodium inj,,,90.25,90.25,1
HCPCS,J251500,Pentobarbital sodium inj,,,90.25,90.25,1
HCPCS,J2516,"Inj, pentamidine isethionate",,,0.43,0.43,1
HCPCS,J2516,PENTAM 300 MG SOLUTION FOR INJECTION,600.81,390.53,0.43,600.81,51
HCPCS,J2516,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,337.5,219.38,0.43,337.5,51
HCPCS,J251600,"Inj, pentamidine isethionate",,,0.43,0.43,1
HCPCS,J2536,VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV,9.54,6.2,1.42,9.54,40
HCPCS,J2540,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.12,8.86,51
HCPCS,J2540,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,47.64,30.97,1.39,47.64,51
HCPCS,J2540,PFIZERPEN-G 5 MILLION UNIT SOLUTION FOR INJECTION,45.81,29.78,1.39,45.81,51
HCPCS,J2540,Penicillin g potassium inj,,,1.39,1.39,1
HCPCS,J254000,Penicillin g potassium inj,,,1.39,1.39,1
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,10.8,7.02,1.61,10.8,51
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,37.65,24.47,1.94,55.38,153
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,528.36,343.43,1.94,528.36,51
HCPCS,J2543,Piperacillin/tazobactam,,,1.94,1.94,1
HCPCS,J2543,ZOSYN 2.25 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.11,0.72,0.17,8.86,51
HCPCS,J2543,ZOSYN 3.375 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.47,0.96,0.22,8.86,51
HCPCS,J2543,ZOSYN 4.5 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.93,0.6,0.14,8.86,51
HCPCS,J254300,Piperacillin/tazobactam,,,1.94,1.94,1
HCPCS,J2545,Pentamidine non-comp unit,,,112.58,200.25,12
HCPCS,J254500,Pentamidine non-comp unit,,,200.25,200.25,1
HCPCS,J2547,"Injection, peramivir",,,3.38,3.38,1
HCPCS,J2547,RAPIVAB (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,57.0,37.05,1.67,2642.72,65
HCPCS,J254700,"Injection, peramivir",,,3.38,3.38,1
HCPCS,J2550,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.48,4.215,0.94,8.86,306
HCPCS,J2550,PROMETHAZINE 50 MG/ML INJECTION SOLUTION,9.33,6.06,1.39,9.33,102
HCPCS,J2550,PROMETHAZINE HCL INJECTION,21.0,13.65,1.1,21.0,27
HCPCS,J2550,Promethazine hcl injection,,,7.07,7.07,1
HCPCS,J255000,Promethazine hcl injection,,,7.07,7.07,1
HCPCS,J2560,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,162.0,105.3,2.17,165.6,102
HCPCS,J2560,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,67.5,43.875,2.17,72.0,102
HCPCS,J2560,Phenobarbital sodium inj,,,51.76,51.76,1
HCPCS,J256000,Phenobarbital sodium inj,,,51.76,51.76,1
HCPCS,J2561,"Inj, sezaby, 1 mg",,,1.17,47.96,30
HCPCS,J256100,"Inj, sezaby, 1 mg",,,2.85,2.85,1
HCPCS,J2562,MOZOBIL 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,29904.21,19437.74,2.17,29904.21,65
HCPCS,J2562,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,3171.0,2061.15,2.17,4417.71,65
HCPCS,J2562,Plerixafor injection,,,54.57,54.57,1
HCPCS,J256200,Plerixafor injection,,,54.57,54.57,1
HCPCS,J2590,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,5.94,3.86,0.55,10.8,255
HCPCS,J2590,Oxytocin injection,,,2.99,2.99,1
HCPCS,J2590,PITOCIN 10 UNIT/ML INJECTION SOLUTION,9.0,5.85,0.75,12.96,102
HCPCS,J259000,Oxytocin injection,,,2.99,2.99,1
HCPCS,J2596,Vasopressin (long grove) 1 u,,,3.19,47.96,11
HCPCS,J259600,Vasopressin (long grove) 1 u,,,3.19,3.19,1
HCPCS,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,152.4,99.06,2.17,285.2,456
HCPCS,J2597,Inj desmopressin acetate,,,6.07,6.07,1
HCPCS,J259700,Inj desmopressin acetate,,,6.07,6.07,1
HCPCS,J2598,"Inj, vasopressin, 1 unit",,,0.94,0.94,1
HCPCS,J2598,VASOSTRICT 0.2 UNIT/ML INTRAVENOUS SOLUTION,1.23,0.8,0.18,47.96,51
HCPCS,J2598,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,41.07,26.700000000000003,0.94,47.96,153
HCPCS,J259800,"Inj, vasopressin, 1 unit",,,0.94,0.94,1
HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,1.53,47.96,13
HCPCS,J259900,Inj vasopressin (am reg) 1 u,,,1.53,1.53,1
HCPCS,J2601,"Inj, vasopressin (baxter)",,,2.22,47.96,32
HCPCS,J260100,"Inj, vasopressin (baxter)",,,3.95,3.95,1
HCPCS,J2650,Prednisolone acetate inj,,,0.89,8.86,10
HCPCS,J265000,Prednisolone acetate inj,,,0.89,0.89,1
HCPCS,J2670,Totazoline hcl injection,,,7.35,47.96,10
HCPCS,J267000,Totazoline hcl injection,,,7.35,7.35,1
HCPCS,J2675,Inj progesterone per 50 mg,,,1.28,1.28,1
HCPCS,J2675,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,10.8,7.02,1.28,11.64,153
HCPCS,J267500,Inj progesterone per 50 mg,,,1.28,1.28,1
HCPCS,J2679,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,69.15,44.95,2.17,69.15,57
HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,13.15,13.15,1
HCPCS,J267900,Inj fluphenazine hcl 1.25 mg,,,13.15,13.15,1
HCPCS,J2680,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,108.0,70.2,2.17,111.57,153
HCPCS,J2680,Fluphenazine decanoate 25 mg,,,11.04,11.04,1
HCPCS,J268000,Fluphenazine decanoate 25 mg,,,11.04,11.04,1
HCPCS,J2690,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,90.33,58.715,2.17,1020.7,130
HCPCS,J2690,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,810.0,526.5,2.17,1020.7,65
HCPCS,J2690,Procainamide hcl injection,,,613.26,613.26,1
HCPCS,J269000,Procainamide hcl injection,,,613.26,613.26,1
HCPCS,J2700,OXACILLIN 1 GRAM SOLUTION FOR INJECTION,42.78,27.810000000000002,1.01,43.5,102
HCPCS,J2700,OXACILLIN 10 GRAM SOLUTION FOR INJECTION,420.48,273.31,1.01,420.48,51
HCPCS,J2700,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,84.09,54.66,1.01,87.0,204
HCPCS,J2700,OXACILLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.77,1.15,0.26,8.86,51
HCPCS,J2700,Oxacillin sodium injeciton,,,1.01,1.01,1
HCPCS,J270000,Oxacillin sodium injeciton,,,1.01,1.01,1
HCPCS,J2704,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.06,8.86,408
HCPCS,J2704,"Inj, propofol, 10 mg",,,0.16,0.16,1
HCPCS,J2704,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.12,8.86,153
HCPCS,J270400,"Inj, propofol, 10 mg",,,0.16,0.16,1
HCPCS,J2710,BLOXIVERZ 0.5 MG/ML INTRAVENOUS SOLUTION,27.45,17.84,1.5,27.45,51
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.43,8.86,102
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,3.24,2.11,0.48,8.86,51
HCPCS,J2710,Neostigmine methylslfte inj,,,1.5,1.5,1
HCPCS,J271000,Neostigmine methylslfte inj,,,1.5,1.5,1
HCPCS,J2711,Inj neostigmin/glycopyrrolat,,,1.51,8.86,9
HCPCS,J271100,Inj neostigmin/glycopyrrolat,,,1.51,1.51,1
HCPCS,J2720,Inj protamine sulfate/10 mg,,,2.79,2.79,1
HCPCS,J2720,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,7.365,4.79,0.71,11.16,204
HCPCS,J272000,Inj protamine sulfate/10 mg,,,2.79,2.79,1
HCPCS,J2724,CEPROTIN (GREEN BAR) 1000 UNIT INTRAVENOUS SOLUTION,5.4,3.51,1.19,3257.22,65
HCPCS,J2724,Protein c concentrate,,,26.72,26.72,1
HCPCS,J272400,Protein c concentrate,,,26.72,26.72,1
HCPCS,J2725,Inj protirelin per 250 mcg,,,41.42,58.55,10
HCPCS,J272500,Inj protirelin per 250 mcg,,,45.71,45.71,1
HCPCS,J2730,PROTOPAM CHLORIDE 1 GRAM SOLUTION FOR INJECTION,312.12,202.88,2.17,312.12,102
HCPCS,J2730,Pralidoxime chloride inj,,,185.19,185.19,1
HCPCS,J273000,Pralidoxime chloride inj,,,185.19,185.19,1
HCPCS,J2760,PHENTOLAMINE 5 MG INJECTION SOLUTION,1763.865,1146.51,2.17,1763.88,130
HCPCS,J2760,Phentolaine mesylate inj,,,748.6,748.6,1
HCPCS,J276000,Phentolaine mesylate inj,,,748.6,748.6,1
HCPCS,J2765,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,4.140000000000001,2.69,0.33,8.86,153
HCPCS,J2765,Metoclopramide hcl injection,,,1.92,1.92,1
HCPCS,J276500,Metoclopramide hcl injection,,,1.92,1.92,1
HCPCS,J2770,Quinupristin/dalfopristin,,,4.26,1275.0,18
HCPCS,J277000,Quinupristin/dalfopristin,,,995.39,995.39,1
HCPCS,J2777,"Inj, faricimab-svoa, 0.1mg",,,58.56,58.56,1
HCPCS,J2777,VABYSMO 6 MG/0.05 ML INTRAVITREAL SOLUTION,168976.08,109834.45,2.17,168976.08,65
HCPCS,J2777,VABYSMO 6 MG/0.05 ML INTRAVITREAL SYRINGE,168976.08,109834.45,2.17,168976.08,65
HCPCS,J277700,"Inj, faricimab-svoa, 0.1mg",,,58.56,58.56,1
HCPCS,J2778,DARVOCET-N 50 50 MG-325 MG TAB,140400.0,91260.0,2.17,140400.0,65
HCPCS,J2778,LUCENTIS 0.3 MG/0.05 ML INTRAVITREAL SYRINGE,84240.0,54756.0,2.17,84240.0,65
HCPCS,J2778,LUCENTIS 0.5 MG/0.05 ML INTRAVITREAL SYRINGE,140400.0,91260.0,2.17,140400.0,65
HCPCS,J2778,Ranibizumab injection,,,116.48,116.48,1
HCPCS,J277800,Ranibizumab injection,,,116.48,116.48,1
HCPCS,J2779,"Inj, susvimo 0.1 mg",,,135.67,135.67,1
HCPCS,J2779,SUSVIMO (INITIAL FILL) 10 MG/0.1 ML INTRAVITREAL IMPLANT SOLUTION,288000.0,187200.0,2.17,288000.0,65
HCPCS,J2779,SUSVIMO 10 MG/0.1 ML INTRAVITREAL SOLUTION,288000.0,187200.0,2.17,288000.0,65
HCPCS,J277900,"Inj, susvimo 0.1 mg",,,135.67,135.67,1
HCPCS,J2780,Ranitidine hydrochloride inj,,,3.98,17.62,11
HCPCS,J278000,Ranitidine hydrochloride inj,,,13.76,13.76,1
HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,245.73,245.73,1
HCPCS,J2781,SYFOVRE (PF) 15 MG/0.1 ML INTRAVITREAL SOLUTION,84470.04,54905.53,2.17,84470.04,130
HCPCS,J278100,"Inj, pegcetacoplan, 1mg",,,245.73,245.73,1
HCPCS,J2782,IZERVAY (PF) 2 MG/0.1 ML INTRAVITREAL SOLUTION,75600.0,49140.0,2.17,75600.0,65
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,183.2,183.2,1
HCPCS,J278200,Inj avacincaptad pegol 0.1mg,,,183.2,183.2,1
HCPCS,J2783,ELITEK 1.5 MG INTRAVENOUS SOLUTION,4025.04,2616.28,2.17,4025.04,130
HCPCS,J2783,ELITEK 7.5 MG INTRAVENOUS SOLUTION,20125.11,13081.32,2.17,20125.11,65
HCPCS,J2783,Rasburicase,,,682.4,682.4,1
HCPCS,J278300,Rasburicase,,,682.4,682.4,1
HCPCS,J2785,LEXISCAN 0.4 MG/5 ML INTRAVENOUS SYRINGE,185.58,120.63,2.17,185.58,51
HCPCS,J2785,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,72.06,46.84,2.17,126.12,153
HCPCS,J2785,Regadenoson injection,,,4.77,4.77,1
HCPCS,J278500,Regadenoson injection,,,4.77,4.77,1
HCPCS,J2786,CINQAIR 10 MG/ML INTRAVENOUS SOLUTION,408.96,265.82,2.17,2642.72,65
HCPCS,J2786,"Injection, reslizumab, 1mg",,,19.81,19.81,1
HCPCS,J278600,"Injection, reslizumab, 1mg",,,19.81,19.81,1
HCPCS,J2787,Riboflavin 5'phos opth<=3ml,,,7.65,5882.4,12
HCPCS,J278700,Riboflavin 5'phos opth<=3ml,,,4870.08,4870.08,1
HCPCS,J2788,Rho d immune globulin 50 mcg,,,25.78,56.0,14
HCPCS,J278800,Rho d immune globulin 50 mcg,,,40.82,40.82,1
HCPCS,J2790,HYPERRHO 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,307.11,199.62,2.17,307.11,51
HCPCS,J2790,RHO D IMMUNE GLOBULIN INJ,142.0,92.3,1.1,145.15,27
HCPCS,J2790,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,2.17,442.8,204
HCPCS,J2790,Rho d immune globulin inj,,,143.34,143.34,1
HCPCS,J279000,Rho d immune globulin inj,,,143.34,143.34,1
HCPCS,J2791,RHOPHYLAC 1500 UNIT (300 MCG)/2 ML INJECTION SYRINGE,304.05,197.63,2.17,318.54,102
HCPCS,J2791,RHOPHYLAC INJECTION,64.0,41.6,1.1,64.0,27
HCPCS,J2791,Rhophylac injection,,,8.6,8.6,1
HCPCS,J279100,Rhophylac injection,,,8.6,8.6,1
HCPCS,J2792,"Rho(d) immune globulin h, sd",,,31.77,4487.68,33
HCPCS,J279200,"Rho(d) immune globulin h, sd",,,60.36,60.36,1
HCPCS,J2793,Rilonacept injection,,,25.55,667.03,12
HCPCS,J279300,Rilonacept injection,,,57.89,57.89,1
HCPCS,J2794,"Inj risperdal consta, 0.5 mg",,,19.9,19.9,1
HCPCS,J2794,RISPERDAL CONSTA 12.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,1161.66,755.08,2.17,1161.66,65
HCPCS,J2794,RISPERDAL CONSTA 25 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,2323.05,1509.98,2.17,2323.05,65
HCPCS,J2794,RISPERDAL CONSTA 37.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,3484.68,2265.04,2.17,3484.68,65
HCPCS,J2794,RISPERDAL CONSTA 50 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,4646.4,3020.16,2.17,4646.4,65
HCPCS,J279400,"Inj risperdal consta, 0.5 mg",,,19.9,19.9,1
HCPCS,J2795,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,306
HCPCS,J2795,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.4249999999999998,0.9299999999999999,0.09,8.86,510
HCPCS,J2795,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.19,1.42,0.09,8.86,204
HCPCS,J2795,NAROPIN (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,3.39,2.2,0.09,8.86,102
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.09,8.86,204
HCPCS,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,1.02,0.66,0.09,8.86,153
HCPCS,J2795,ROPIVACAINE HCL INJ 1 MG,7.0,4.55,0.06,7.0,27
HCPCS,J2795,Ropivacaine hcl injection,,,0.09,0.09,1
HCPCS,J279500,Ropivacaine hcl injection,,,0.09,0.09,1
HCPCS,J2796,Romiplostim injection,,,87.06,1287.79,11
HCPCS,J279600,Romiplostim injection,,,224.01,224.01,1
HCPCS,J2797,"Inj., rolapitant, 0.5 mg",,,0.96,184.43,11
HCPCS,J279700,"Inj., rolapitant, 0.5 mg",,,1.89,1.89,1
HCPCS,J2798,"Inj., perseris, 0.5 mg",,,21.61,21.61,1
HCPCS,J2798,PERSERIS 120 MG SUBCUTANEOUS EXTENDED RELEASE SUSPENSION SYRINGE,10435.83,6783.29,2.17,10435.83,65
HCPCS,J279800,"Inj., perseris, 0.5 mg",,,21.61,21.61,1
HCPCS,J2799,"Inj, uzedy, 1 mg",,,44.57,44.57,1
HCPCS,J2799,UZEDY 100 MG/0.28 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.87,21951.72,2.17,33771.87,65
HCPCS,J2799,UZEDY 125 MG/0.35 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,2.17,33771.09,65
HCPCS,J2799,UZEDY 150 MG/0.42 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,2.17,33770.58,65
HCPCS,J2799,UZEDY 200 MG/0.56 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,2.17,33770.58,65
HCPCS,J2799,UZEDY 250 MG/0.7 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,2.17,33771.09,65
HCPCS,J2799,UZEDY 50 MG/0.14 ML SUBCUT EXT REL SUSPENSION SYRINGE,33768.0,21949.2,2.17,33768.0,65
HCPCS,J2799,UZEDY 75 MG/0.21 ML SUBCUT EXT REL SUSPENSION SYRINGE,33769.71,21950.31,2.17,33769.71,65
HCPCS,J279900,"Inj, uzedy, 1 mg",,,44.57,44.57,1
HCPCS,J2800,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,3.6,2.34,0.54,14.98,51
HCPCS,J2800,Methocarbamol injection,,,8.08,8.08,1
HCPCS,J280000,Methocarbamol injection,,,8.08,8.08,1
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,13.03,667.03,30
HCPCS,J280100,"Inj, rykindo, 0.5 mg",,,26.26,26.26,1
HCPCS,J2802,"Inj, romiplostim 1 microgram",,,19.67,19.67,1
HCPCS,J2802,NPLATE 125 MCG SUBCUTANEOUS SOLUTION,4955.52,3221.09,2.17,4955.52,65
HCPCS,J2802,NPLATE 250 MCG SUBCUTANEOUS SOLUTION,9910.86,6442.06,2.17,9910.86,65
HCPCS,J2802,NPLATE 500 MCG SUBCUTANEOUS SOLUTION,19821.66,12884.08,2.17,19821.66,65
HCPCS,J280200,"Inj, romiplostim 1 microgram",,,19.67,19.67,1
HCPCS,J2804,"Inj, rifampin, 1 mg",,,0.27,0.27,1
HCPCS,J2804,RIFADIN 600 MG INTRAVENOUS SOLUTION,642.81,417.83,0.27,642.81,51
HCPCS,J2804,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,550.8,358.02,0.27,550.8,51
HCPCS,J280400,"Inj, rifampin, 1 mg",,,0.27,0.27,1
HCPCS,J2805,CCK DOSE,320.0,208.0,2.17,320.0,51
HCPCS,J2805,KINEVAC 5 MCG SOLUTION FOR INJECTION,469.68,305.29,2.17,469.68,51
HCPCS,J2805,SINCALIDE 5MCG VIAL,320.0,208.0,2.17,320.0,51
HCPCS,J2805,Sincalide injection,,,196.03,196.03,1
HCPCS,J280500,Sincalide injection,,,196.03,196.03,1
HCPCS,J2806,"Inj sincalide, maia, 5 mcg",,,58.37,130.36,10
HCPCS,J280600,"Inj sincalide, maia, 5 mcg",,,58.37,58.37,1
HCPCS,J2810,Inj theophylline per 40 mg,,,0.39,8.86,12
HCPCS,J281000,Inj theophylline per 40 mg,,,0.84,0.84,1
HCPCS,J2820,LEUKINE 250 MCG SOLUTION FOR INJECTION,1132.65,736.22,2.17,1132.65,65
HCPCS,J2820,Sargramostim injection,,,109.92,109.92,1
HCPCS,J282000,Sargramostim injection,,,109.92,109.92,1
HCPCS,J2840,Inj sebelipase alfa 1 mg,,,539.42,16617.81,30
HCPCS,J284000,Inj sebelipase alfa 1 mg,,,1090.43,1090.43,1
HCPCS,J2850,CHIRHOSTIM 16 MCG INTRAVENOUS SOLUTION,2379.6,1546.74,2.17,2379.6,65
HCPCS,J2850,Inj secretin synthetic human,,,88.25,88.25,1
HCPCS,J285000,Inj secretin synthetic human,,,88.25,88.25,1
HCPCS,J2860,"Injection, siltuximab",,,300.25,300.25,1
HCPCS,J2860,SYLVANT 100 MG INTRAVENOUS SOLUTION,7882.64,5123.72,2.17,7882.64,65
HCPCS,J2860,SYLVANT 400 MG INTRAVENOUS SOLUTION,31530.64,20494.92,2.17,31530.64,65
HCPCS,J286000,"Injection, siltuximab",,,300.25,300.25,1
HCPCS,J2865,Inj sulfameth/trim 5 mg/1 mg,,,0.07,0.07,1
HCPCS,J2865,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.545,2.95,0.07,47.96,255
HCPCS,J286500,Inj sulfameth/trim 5 mg/1 mg,,,0.07,0.07,1
HCPCS,J2910,Aurothioglucose injeciton,,,41.42,67.03,9
HCPCS,J2916,FERRLECIT 62.5 MG/5 ML INTRAVENOUS SOLUTION,22.89,14.88,2.17,47.96,51
HCPCS,J2916,Na ferric gluconate complex,,,3.93,3.93,1
HCPCS,J2916,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,22.89,14.88,2.17,47.96,102
HCPCS,J291600,Na ferric gluconate complex,,,3.93,3.93,1
HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.46,0.46,1
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG INTRAVENOUS SOLUTION,136.995,89.05,0.3,150.81,114
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,34.65,22.520000000000003,0.3,41.94,114
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,21.9,14.24,0.3,21.9,57
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,83.22,54.09,0.3,83.22,57
HCPCS,J2919,SOLU-MEDROL (PF) 1000 MG/8 ML INTRAVENOUS SOLUTION,248.1,161.27,0.3,248.1,57
HCPCS,J2919,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,34.125,22.185,0.3,37.5,228
HCPCS,J2919,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,21.3,13.845,0.3,23.28,228
HCPCS,J2919,SOLU-MEDROL (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,170.58,110.88,0.3,170.58,57
HCPCS,J2919,SOLU-MEDROL 1000 MG INTRAVENOUS SOLUTION,158.34,102.92,0.3,158.34,57
HCPCS,J2919,SOLU-MEDROL 2 GRAM INTRAVENOUS SOLUTION,391.89,254.73,0.3,391.89,57
HCPCS,J2919,SOLU-MEDROL 500 MG INTRAVENOUS SOLUTION,87.42,56.82,0.3,87.42,57
HCPCS,J291900,"Inj, methylpred sod succ 5mg",,,0.46,0.46,1
HCPCS,J2920,Methylprednisolone injection,,,4.41,13.13,11
HCPCS,J292000,Methylprednisolone injection,,,10.25,10.25,1
HCPCS,J2930,Methylprednisolone injection,,,6.35,20.79,11
HCPCS,J293000,Methylprednisolone injection,,,16.23,16.23,1
HCPCS,J2940,Somatrem injection,,,41.42,120.54,9
HCPCS,J2941,GENOTROPIN MINIQUICK 0.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,115.26,74.92,2.17,415.35,57
HCPCS,J2941,GENOTROPIN MINIQUICK 0.6 MG/0.25 ML SUBCUTANEOUS SYRINGE,345.84,224.8,2.17,415.35,57
HCPCS,J2941,GENOTROPIN MINIQUICK 1.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,691.68,449.59,2.17,691.68,57
HCPCS,J2941,NORDITROPIN FLEXPRO 10 MG/1.5 ML (6.7 MG/ML) SUBCUTANEOUS PEN INJECTOR,4262.16,2770.4,2.17,4262.16,57
HCPCS,J2941,NUTROPIN AQ NUSPIN 5 MG/2 ML (2.5 MG/ML) SUBCUTANEOUS PEN INJECTOR,1131.6,735.54,2.17,1131.6,57
HCPCS,J2941,Somatropin injection,,,332.04,332.04,1
HCPCS,J294100,Somatropin injection,,,332.04,332.04,1
HCPCS,J2950,Promazine hcl injection,,,1.85,8.86,10
HCPCS,J295000,Promazine hcl injection,,,1.85,1.85,1
HCPCS,J2993,Reteplase injection,,,2684.24,8265.55,31
HCPCS,J299300,Reteplase injection,,,6452.93,6452.93,1
HCPCS,J2995,Inj streptokinase /250000 iu,,,41.42,213.75,10
HCPCS,J2997,ACTIVASE 100 MG INTRAVENOUS SOLUTION,31681.29,20592.84,2.17,31681.29,65
HCPCS,J2997,ACTIVASE 50 MG INTRAVENOUS SOLUTION,15840.66,10296.43,2.17,15840.66,65
HCPCS,J2997,Alteplase recombinant,,,167.02,167.02,1
HCPCS,J2997,CATHFLO ACTIVASE 2 MG INTRA-CATHETER SOLUTION,666.6,433.29,2.17,666.6,65
HCPCS,J299700,Alteplase recombinant,,,167.02,167.02,1
HCPCS,J2998,Inj plasminogen tvmh 1mg,,,32.55,720.96,30
HCPCS,J299800,Inj plasminogen tvmh 1mg,,,85.24,85.24,1
HCPCS,J3000,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,149.625,97.255,2.17,270.0,102
HCPCS,J3000,Streptomycin injection,,,60.31,60.31,1
HCPCS,J300000,Streptomycin injection,,,60.31,60.31,1
HCPCS,J3010,FENTANYL (PF) 20 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,8.86,51
HCPCS,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.51,2.2800000000000002,0.28,8.86,510
HCPCS,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,7.95,5.17,1.18,8.86,51
HCPCS,J3010,FENTANYL 100MCG/2ML INJ,18.61,12.1,1.83,18.61,51
HCPCS,J3010,Fentanyl citrate injection,,,2.12,2.12,1
HCPCS,J301000,Fentanyl citrate injection,,,2.12,2.12,1
HCPCS,J3030,IMITREX STATDOSE PEN 6 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1737.03,1129.07,2.17,1737.03,51
HCPCS,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,216.0,140.4,2.17,352.8,153
HCPCS,J3030,Sumatriptan succinate / 6 mg,,,79.03,79.03,1
HCPCS,J303000,Sumatriptan succinate / 6 mg,,,79.03,79.03,1
HCPCS,J3031,AJOVY SYRINGE 225 MG/1.5 ML SUBCUTANEOUS,1812.36,1178.03,2.17,1812.36,51
HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,7.17,7.17,1
HCPCS,J303100,"Inj., fremanezumab-vfrm 1 mg",,,7.17,7.17,1
HCPCS,J3032,Inj. eptinezumab-jjmr 1 mg,,,36.49,36.49,1
HCPCS,J3032,VYEPTI 100 MG/ML INTRAVENOUS SOLUTION,6984.24,4539.76,2.17,6984.24,65
HCPCS,J303200,Inj. eptinezumab-jjmr 1 mg,,,36.49,36.49,1
HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,133.36,133.36,1
HCPCS,J3055,TALVEY 2 MG/ML SUBCUTANEOUS SOLUTION,2772.72,1802.27,2.17,4417.71,65
HCPCS,J3055,TALVEY 40 MG/ML SUBCUTANEOUS SOLUTION,55454.56,36045.46,2.17,55454.56,65
HCPCS,J305500,Inj talquetamab-tgvs 0.25 mg,,,133.36,133.36,1
HCPCS,J3060,ELELYSO 200 UNIT INTRAVENOUS SOLUTION,3397.65,2208.47,2.17,13108.79,65
HCPCS,J3060,"Inj, taliglucerase alfa 10 u",,,72.87,72.87,1
HCPCS,J306000,"Inj, taliglucerase alfa 10 u",,,72.87,72.87,1
HCPCS,J3070,Pentazocine injection,,,7.65,279.76,12
HCPCS,J307000,Pentazocine injection,,,218.41,218.41,1
HCPCS,J3090,Inj tedizolid phosphate,,,3.49,3.49,1
HCPCS,J3090,SIVEXTRO 200 MG INTRAVENOUS SOLUTION,1333.74,866.93,1.81,1333.74,65
HCPCS,J309000,Inj tedizolid phosphate,,,3.49,3.49,1
HCPCS,J3095,Telavancin injection,,,6.38,369.35,33
HCPCS,J309500,Telavancin injection,,,13.12,13.12,1
HCPCS,J3101,TNKASE 25 MG INTRAVENOUS SOLUTION,30766.26,19998.07,2.17,30766.26,65
HCPCS,J3101,TNKASE 50 MG INTRAVENOUS SOLUTION,29870.13,19415.58,2.17,29870.13,130
HCPCS,J3101,Tenecteplase injection,,,332.81,332.81,1
HCPCS,J310100,Tenecteplase injection,,,332.81,332.81,1
HCPCS,J3105,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,14.4,9.36,0.96,70.92,153
HCPCS,J3105,Terbutaline sulfate inj,,,4.4,4.4,1
HCPCS,J310500,Terbutaline sulfate inj,,,4.4,4.4,1
HCPCS,J3110,Teriparatide injection,,,9.75,3257.22,12
HCPCS,J311000,Teriparatide injection,,,99.13,99.13,1
HCPCS,J3111,EVENITY 210 MG/2.34 ML (105 MG/1.17 ML X 2) SUBCUTANEOUS SYRINGE,4044.48,2628.91,2.17,4044.48,130
HCPCS,J3111,Inj. romosozumab-aqqg 1 mg,,,21.56,21.56,1
HCPCS,J311100,Inj. romosozumab-aqqg 1 mg,,,21.56,21.56,1
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.09,0.09,1
HCPCS,J3121,TESTOSTERONE ENANTHATE 200 MG/ML INTRAMUSCULAR OIL,50.97,33.13,0.09,50.97,51
HCPCS,J312100,Inj testostero enanthate 1mg,,,0.09,0.09,1
HCPCS,J3145,AVEED 750 MG/3 ML (250MG/ML) INTRAMUSCULAR SOLUTION,2607.6,1694.94,1.95,2607.6,65
HCPCS,J3145,Testosterone undecanoate 1mg,,,3.68,3.68,1
HCPCS,J314500,Testosterone undecanoate 1mg,,,3.68,3.68,1
HCPCS,J3230,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,81.795,53.17,2.17,104.01,204
HCPCS,J3230,Chlorpromazine hcl injection,,,42.31,42.31,1
HCPCS,J323000,Chlorpromazine hcl injection,,,42.31,42.31,1
HCPCS,J3240,THYROGEN 0.9 MG INTRAMUSCULAR SOLUTION,6613.77,4298.95,2.17,6613.77,65
HCPCS,J3240,Thyrotropin injection,,,3783.64,3783.64,1
HCPCS,J324000,Thyrotropin injection,,,3783.64,3783.64,1
HCPCS,J3241,Inj. teprotumumab-trbw 10 mg,,,657.37,657.37,1
HCPCS,J3241,TEPEZZA 500 MG INTRAVENOUS SOLUTION,64868.22,42164.34,2.17,64868.22,65
HCPCS,J324100,Inj. teprotumumab-trbw 10 mg,,,657.37,657.37,1
HCPCS,J3243,TYGACIL 50 MG INTRAVENOUS SOLUTION,360.0,234.0,1.0,360.0,51
HCPCS,J3243,Tigecycline injection,,,1.0,1.0,1
HCPCS,J324300,Tigecycline injection,,,1.0,1.0,1
HCPCS,J3244,Inj. tigecycline (accord),,,5.34,5.34,1
HCPCS,J3244,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,469.8,305.37,2.17,561.6,102
HCPCS,J324400,Inj. tigecycline (accord),,,5.34,5.34,1
HCPCS,J3245,ILUMYA 100 MG/ML SUBCUTANEOUS SYRINGE,64661.19,42029.77,2.17,64661.19,65
HCPCS,J3245,"INJ., TILDRAKIZUMAB, 1 MB",500.95,325.62,1.1,500.95,27
HCPCS,J3245,"Inj., tildrakizumab, 1 mg",,,220.35,220.35,1
HCPCS,J324500,"Inj., tildrakizumab, 1 mg",,,220.35,220.35,1
HCPCS,J3246,AGGRASTAT 12.5 MG/250 ML (50 MCG/ML) IN ISO-OSMOTIC SODIUM CHLORIDE IV,3.45,2.24,0.51,327.06,51
HCPCS,J3246,AGGRASTAT 5 MG/100 ML (50 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,3.3,2.15,0.49,327.06,102
HCPCS,J3246,AGGRASTAT CONCENTRATE 250 MCG/ML INTRAVENOUS,14.07,9.15,2.09,327.06,51
HCPCS,J3246,TIROFIBAN 12.5 MG/250 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,2.31,1.5,0.34,327.06,51
HCPCS,J3246,Tirofiban hcl,,,6.14,6.14,1
HCPCS,J324600,Tirofiban hcl,,,6.14,6.14,1
HCPCS,J3247,COSENTYX 25 MG/ML INTRAVENOUS SOLUTION,1584.48,1029.91,2.17,2642.72,65
HCPCS,J3247,Inj secukinumab intrav 1mg,,,32.16,32.16,1
HCPCS,J324700,Inj secukinumab intrav 1mg,,,32.16,32.16,1
HCPCS,J3250,TIGAN 100 MG/ML INTRAMUSCULAR SOLUTION,118.95,77.32,2.17,118.95,51
HCPCS,J3250,Trimethobenzamide hcl inj,,,102.53,102.53,1
HCPCS,J325000,Trimethobenzamide hcl inj,,,102.53,102.53,1
HCPCS,J3260,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,294.3,191.295,2.17,708.75,204
HCPCS,J3260,TOBRAMYCIN 10 MG/ML INJECTION SOLUTION,23.01,14.96,2.17,23.01,51
HCPCS,J3260,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,3.57,2.32,0.38,8.86,459
HCPCS,J3260,Tobramycin sulfate injection,,,3.68,3.68,1
HCPCS,J326000,Tobramycin sulfate injection,,,3.68,3.68,1
HCPCS,J3262,ACTEMRA 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,6265.64,4072.67,2.17,6265.64,65
HCPCS,J3262,ACTEMRA 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,2.17,1287.79,65
HCPCS,J3262,ACTEMRA 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,2.17,1287.79,65
HCPCS,J3262,ACTEMRA 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,2.17,1287.79,65
HCPCS,J3262,Tocilizumab injection,,,9.99,9.99,1
HCPCS,J326200,Tocilizumab injection,,,9.99,9.99,1
HCPCS,J3263,"Inj, toripalimab-tpzi, 1 mg",,,71.57,71.57,1
HCPCS,J3263,LOQTORZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,7805.8,5073.77,2.17,7805.8,65
HCPCS,J326300,"Inj, toripalimab-tpzi, 1 mg",,,71.57,71.57,1
HCPCS,J3265,Injection torsemide 10 mg/ml,,,6.35,47.96,10
HCPCS,J326500,Injection torsemide 10 mg/ml,,,6.35,6.35,1
HCPCS,J3280,Thiethylperazine maleate inj,,,4.11,16.92,11
HCPCS,J3285,REMODULIN 1 MG/ML INJECTION SOLUTION,229.2,148.98,2.17,667.03,65
HCPCS,J3285,REMODULIN 10 MG/ML INJECTION SOLUTION,2291.97,1489.78,2.17,2291.97,65
HCPCS,J3285,REMODULIN 2.5 MG/ML INJECTION SOLUTION,573.0,372.45,2.17,667.03,65
HCPCS,J3285,REMODULIN 5 MG/ML INJECTION SOLUTION,1146.0,744.9,2.17,1146.0,65
HCPCS,J3285,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,544.35,353.83,2.17,667.03,65
HCPCS,J3285,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,1088.7,707.66,2.17,1088.7,65
HCPCS,J3285,Treprostinil injection,,,96.97,96.97,1
HCPCS,J328500,Treprostinil injection,,,96.97,96.97,1
HCPCS,J3290,"Inj, tranexamic acid 5 mg",,,0.05,0.05,1
HCPCS,J3290,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.875,1.2149999999999999,0.05,47.96,153
HCPCS,J329000,"Inj, tranexamic acid 5 mg",,,0.05,0.05,1
HCPCS,J3291,Tranexamic acid in sod chlor,,,0.21,47.96,9
HCPCS,J329100,Tranexamic acid in sod chlor,,,0.21,0.21,1
HCPCS,J3299,Inj xipere 1 mg,,,85.17,85.17,1
HCPCS,J3299,XIPERE (PF) 40 MG/ML SUPRACHOROIDAL SUSPENSION,6600.0,4290.0,2.17,6600.0,65
HCPCS,J329900,Inj xipere 1 mg,,,85.17,85.17,1
HCPCS,J3300,TRIESENCE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,2606.4,1694.16,2.17,2606.4,59
HCPCS,J3300,Triamcinolone a inj prs-free,,,43.59,43.59,1
HCPCS,J330000,Triamcinolone a inj prs-free,,,43.59,43.59,1
HCPCS,J3301,KENALOG 10 MG/ML SUSPENSION FOR INJECTION,8.7,5.66,1.29,8.86,102
HCPCS,J3301,KENALOG 10MG,300.0,195.0,0.87,300.0,27
HCPCS,J3301,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,33.69,21.9,1.32,34.2,153
HCPCS,J3301,KENALOG 40MG/ML INJECTION,25.5,16.58,0.87,25.5,27
HCPCS,J3301,KENALOG PER 10MG,14.0,9.1,0.87,14.0,27
HCPCS,J3301,KENALOG-80  80 MG/ML SUSPENSION FOR INJECTION,67.38,43.8,1.32,67.38,51
HCPCS,J3301,TRIAMCINOLONE ACET INJ 10 MG,19.17,12.46,1.32,19.17,51
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,8.07,5.25,1.2,8.86,51
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,29.34,19.07,1.32,31.2,459
HCPCS,J3301,Triamcinolone acet inj nos,,,1.32,1.32,1
HCPCS,J330100,Triamcinolone acet inj nos,,,1.32,1.32,1
HCPCS,J3302,TRIAMCINOLONE DIACETATE INJ,6.0,3.9,0.46,6.0,26
HCPCS,J3302,Triamcinolone diacetate inj,,,0.5,8.86,11
HCPCS,J330200,Triamcinolone diacetate inj,,,0.5,0.5,1
HCPCS,J3303,Triamcinolone hexacetonl inj,,,1.88,47.96,12
HCPCS,J330300,Triamcinolone hexacetonl inj,,,17.36,17.36,1
HCPCS,J3304,INJ TRIAMCINOLONE ACE XR 1MG,73.0,47.45,1.1,73.0,27
HCPCS,J3304,Inj triamcinolone ace xr 1mg,,,17.75,667.03,33
HCPCS,J330400,Inj triamcinolone ace xr 1mg,,,33.07,33.07,1
HCPCS,J3305,Inj trimetrexate glucoronate,,,41.42,402.53,9
HCPCS,J3310,Perphenazine injeciton,,,1.36,17.12,10
HCPCS,J3315,TRELSTAR 11.25 MG IM SUSPENSION,10362.0,6735.3,2.17,10362.0,65
HCPCS,J3315,TRELSTAR 22.5 MG IM SUSPENSION,20724.0,13470.6,2.17,20724.0,65
HCPCS,J3315,"TRIPTORELIN PAMOATE, 3.75 MG",1136.24,738.56,2.17,1372.25,65
HCPCS,J3315,Triptorelin pamoate,,,824.5,824.5,1
HCPCS,J331500,Triptorelin pamoate,,,824.5,824.5,1
HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,3418.49,10353.7,32
HCPCS,J331600,"Inj., triptorelin xr 3.75 mg",,,6701.68,6701.68,1
HCPCS,J3320,Spectinomycn di-hcl inj,,,13.05,80.89,10
HCPCS,J3350,Urea injection,,,41.42,202.65,10
HCPCS,J335000,Urea injection,,,158.21,158.21,1
HCPCS,J3355,"Urofollitropin, 75 iu",,,127.26,342.41,10
HCPCS,J3357,STELARA 45 MG/0.5 ML SUBCUTANEOUS SOLUTION,104945.34,68214.47,2.17,104945.34,57
HCPCS,J3357,STELARA 45 MG/0.5 ML SUBCUTANEOUS SYRINGE,104945.34,68214.47,2.17,104945.34,57
HCPCS,J3357,STELARA 90 MG/ML SUBCUTANEOUS SYRINGE,104945.25,68214.41,2.17,104945.25,57
HCPCS,J3357,USTEKINUMAB INJECTION,402.0,261.3,1.1,402.46,27
HCPCS,J3357,"Ustekinumab sub cu inj, 1 mg",,,605.38,605.38,1
HCPCS,J335700,"Ustekinumab sub cu inj, 1 mg",,,605.38,605.38,1
HCPCS,J3358,STELARA 130 MG/26 ML INTRAVENOUS SOLUTION,293.49,190.77,2.17,4487.68,65
HCPCS,J3358,"Ustekinumab, iv inject, 1 mg",,,22.23,22.23,1
HCPCS,J335800,"Ustekinumab, iv inject, 1 mg",,,22.23,22.23,1
HCPCS,J3360,DIAZEPAM 5 MG/ML INJECTION SOLUTION,20.85,13.55,2.17,20.85,51
HCPCS,J3360,DIAZEPAM 5 MG/ML INJECTION SYRINGE,58.155,37.8,2.17,72.0,204
HCPCS,J3360,DIAZEPAM INJ TO 5 MG,18.61,12.1,2.17,19.49,51
HCPCS,J3360,Diazepam injection,,,11.91,11.91,1
HCPCS,J336000,Diazepam injection,,,11.91,11.91,1
HCPCS,J3364,Urokinase 5000 iu injection,,,7.65,23.62,10
HCPCS,J3365,"Urokinase 250,000 iu inj",,,466.36,1181.45,10
HCPCS,J3370,Vancomycin hcl injection,,,2.84,8.86,11
HCPCS,J3371,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,38.67,25.135,2.17,58.62,102
HCPCS,J3371,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,322.545,209.64999999999998,2.17,324.93,102
HCPCS,J3371,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,2.17,29.37,51
HCPCS,J3372,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,560.685,364.445,2.17,765.0,102
HCPCS,J3372,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,43.71,28.415,2.17,57.24,102
HCPCS,J3373,"Inj, vancomycin hcl, 10 mg",,,0.05,0.05,1
HCPCS,J3373,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.48,0.31,0.05,8.86,51
HCPCS,J3373,VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.42,0.27,0.05,8.86,51
HCPCS,J3373,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,87.66,56.98,0.05,87.66,51
HCPCS,J3373,VANCOMYCIN 1.5 GRAM/300 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.39,0.25,0.05,8.86,51
HCPCS,J3373,VANCOMYCIN 100 GRAM SOLUTION FOR INJECTION,1440.0,936.0,0.05,1440.0,51
HCPCS,J3373,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,0.05,29.37,51
HCPCS,J3373,VANCOMYCIN 500 MG/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
HCPCS,J3373,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
HCPCS,J3373,VANCOMYCIN 750 MG/150 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
HCPCS,J337300,"Inj, vancomycin hcl, 10 mg",,,0.05,0.05,1
HCPCS,J3374,"Inj, vancomycin (mylan) 10mg",,,0.18,0.18,1
HCPCS,J3374,VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION,72.36,47.03,0.18,72.36,51
HCPCS,J3374,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.18,86.82,153
HCPCS,J3374,VANCOMYCIN 2 GRAM INTRAVENOUS SOLUTION,154.08,100.15,0.18,154.08,51
HCPCS,J3374,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,29.729999999999997,19.325000000000003,0.18,35.4,153
HCPCS,J337400,"Inj, vancomycin (mylan) 10mg",,,0.18,0.18,1
HCPCS,J3375,Inj vancomycin (xellia) 10mg,,,0.23,8.86,11
HCPCS,J337500,Inj vancomycin (xellia) 10mg,,,0.23,0.23,1
HCPCS,J3376,Inj vancomycin (hikma) 10mg,,,0.04,0.04,1
HCPCS,J3376,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,782.04,508.33,0.04,782.04,51
HCPCS,J3376,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,57.75,37.54,0.04,57.75,51
HCPCS,J3376,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,71.97,46.78,0.04,71.97,51
HCPCS,J3376,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,15.165000000000001,9.855,0.04,19.53,153
HCPCS,J337600,Inj vancomycin (hikma) 10mg,,,0.04,0.04,1
HCPCS,J3379,"Inj, valproate sod, 5 mg",,,0.09,0.09,1
HCPCS,J3379,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,4.83,3.14,0.09,184.43,306
HCPCS,J337900,"Inj, valproate sod, 5 mg",,,0.09,0.09,1
HCPCS,J3380,ENTYVIO 300 MG INTRAVENOUS SOLUTION,36391.32,23654.36,2.17,36391.32,65
HCPCS,J3380,Inj vedolizumab iv 1 mg,,,38.04,38.04,1
HCPCS,J338000,Inj vedolizumab iv 1 mg,,,38.04,38.04,1
HCPCS,J3385,VPRIV 400 UNIT INTRAVENOUS SOLUTION,5418.03,3521.72,2.17,7011.25,65
HCPCS,J3385,Velaglucerase alfa,,,687.85,687.85,1
HCPCS,J338500,Velaglucerase alfa,,,687.85,687.85,1
HCPCS,J3387,Inj elivaldogene autotemecel,,,0.02,8745000.0,21
HCPCS,J3389,Topi adm prad zami per treat,,,0.02,9173505.0,21
HCPCS,J3391,"Inj, atidarsagene autotemcel",,,0.02,12388750.0,21
HCPCS,J3392,CASGEVY 4X10EXP6 TO 13X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,10560000.0,6864000.0,0.02,10560000.0,62
HCPCS,J3393,ZYNTEGLO 2 X 10EXP6 TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,13440000.0,8736000.0,0.02,13440000.0,62
HCPCS,J3394,LYFGENIA 1.7 X TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,14880000.0,9672000.0,0.02,14880000.0,62
HCPCS,J3396,VISUDYNE 15 MG INTRAVENOUS SOLUTION,8206.6,5334.29,2.17,8206.6,65
HCPCS,J3396,Verteporfin injection,,,20.58,20.58,1
HCPCS,J339600,Verteporfin injection,,,20.58,20.58,1
HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,234.14,13108.79,25
HCPCS,J339700,"Inj., vestronidase alfa-vjbk",,,580.14,580.14,1
HCPCS,J3398,Inj luxturna 1 billion vec g,,,0.02,13108.79,31
HCPCS,J339800,Inj luxturna 1 billion vec g,,,6505.9,6505.9,1
HCPCS,J3399,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,1430
HCPCS,J3400,Triflupromazine hcl inj,,,29.64,47.96,9
HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,996.96,13108.79,32
HCPCS,J340100,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1806.33,1806.33,1
HCPCS,J3402,Inj. remestemcel-l-rknd/ td,,,358970.86,358970.86,1
HCPCS,J3402,RYONCIL 6.68 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,931200.0,605280.0,0.02,931200.0,59
HCPCS,J340200,Inj. remestemcel-l-rknd/ td,,,358970.86,358970.86,1
HCPCS,J3403,"Revakinagene, per implant",,,8866.62,728750.0,22
HCPCS,J340300,"Revakinagene, per implant",,,471700.0,471700.0,1
HCPCS,J3404,Inj zopap imad-drba,,,14351.75,16617.81,8
HCPCS,J3410,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,110.04,71.53,2.17,110.04,51
HCPCS,J3410,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,102.44999999999999,66.595,2.17,121.35,102
HCPCS,J3410,Hydroxyzine hcl injection,,,23.14,23.14,1
HCPCS,J341000,Hydroxyzine hcl injection,,,23.14,23.14,1
HCPCS,J3411,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,15.99,10.39,1.37,17.91,204
HCPCS,J3411,Thiamine hcl 100 mg,,,3.22,3.22,1
HCPCS,J341100,Thiamine hcl 100 mg,,,3.22,3.22,1
HCPCS,J3415,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,78.24,50.86,2.17,78.24,51
HCPCS,J3415,Pyridoxine hcl 100 mg,,,27.7,27.7,1
HCPCS,J341500,Pyridoxine hcl 100 mg,,,27.7,27.7,1
HCPCS,J3420,ADMIN VITAMIN B12 INJ,9.0,5.85,0.67,9.0,27
HCPCS,J3420,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.825,8.34,0.54,25.17,510
HCPCS,J3420,VITAMIN B-12 INJ TO 1000 MCG,8.0,5.2,1.14,8.86,51
HCPCS,J3420,Vitamin b12 injection,,,1.14,1.14,1
HCPCS,J342000,Vitamin b12 injection,,,1.14,1.14,1
HCPCS,J3424,CYANOKIT 5 GRAM INTRAVENOUS SOLUTION,3772.8,2452.32,2.17,3772.8,65
HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,11.2,11.2,1
HCPCS,J342400,Inj hydroxocobalamin iv 25mg,,,11.2,11.2,1
HCPCS,J3425,HYDROXOCOBALAMIN 1000 MCG/ML INTRAMUSCULAR SOLUTION,3.84,2.5,0.01,8.86,57
HCPCS,J3425,Hydroxocobalamin im 10mcg,,,0.02,0.02,1
HCPCS,J342500,Hydroxocobalamin im 10mcg,,,0.02,0.02,1
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,43.2,28.08,2.17,47.96,51
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,178.05,115.73,2.17,178.05,51
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,153.96,100.07,2.17,153.96,51
HCPCS,J3430,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.17,47.96,153
HCPCS,J3430,VITAMIN K1 10 MG/ML INJECTION SOLUTION,176.28,114.58,2.17,176.28,51
HCPCS,J3430,Vitamin k phytonadione inj,,,5.0,5.0,1
HCPCS,J343000,Vitamin k phytonadione inj,,,5.0,5.0,1
HCPCS,J3465,"Injection, voriconazole",,,1.34,1.34,1
HCPCS,J3465,VFEND IV 200 MG INTRAVENOUS SOLUTION,217.08,141.1,1.34,217.08,51
HCPCS,J3465,VORICONAZOLE 200 MG INTRAVENOUS POWDER FOR SOLUTION,126.0,81.9,1.34,126.0,51
HCPCS,J346500,"Injection, voriconazole",,,1.34,1.34,1
HCPCS,J3470,AMPHADASE 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,2.17,200.88,51
HCPCS,J3470,Hyaluronidase injection,,,56.62,56.62,1
HCPCS,J347000,Hyaluronidase injection,,,56.62,56.62,1
HCPCS,J3471,"Ovine, up to 999 usp units",,,0.49,130.36,14
HCPCS,J347100,"Ovine, up to 999 usp units",,,0.89,0.89,1
HCPCS,J3472,"Ovine, 1000 usp units",,,59.93,370.5,12
HCPCS,J347200,"Ovine, 1000 usp units",,,289.25,289.25,1
HCPCS,J3473,HYLENEX 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,0.64,200.88,51
HCPCS,J3473,Hyaluronidase recombinant,,,0.64,0.64,1
HCPCS,J347300,Hyaluronidase recombinant,,,0.64,0.64,1
HCPCS,J3475,Inj magnesium sulfate,,,0.73,0.73,1
HCPCS,J3475,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.02,8.86,204
HCPCS,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.93,0.6,0.13,8.86,153
HCPCS,J3475,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,153
HCPCS,J3475,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.54,0.35,0.07,8.86,153
HCPCS,J3475,MAGNESIUM SULFATE 40 GRAM/1000 ML (4 %) IN WATER INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
HCPCS,J3475,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.8,1.17,0.09,8.86,459
HCPCS,J347500,Inj magnesium sulfate,,,0.73,0.73,1
HCPCS,J3480,Inj potassium chloride,,,0.21,0.21,1
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.16499999999999998,0.11,0.02,8.86,102
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
HCPCS,J3480,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.9,0.59,0.07,8.86,459
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,8.86,153
HCPCS,J3480,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
HCPCS,J3480,"POTASSIUM CHLORIDE, PER 2 MEQ",14.0,9.1,0.01,14.0,27
HCPCS,J3480,SODIUM CHLORIDE 0.45 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
HCPCS,J3480,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
HCPCS,J3480,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,153
HCPCS,J348000,Inj potassium chloride,,,0.21,0.21,1
HCPCS,J3485,RETROVIR 10 MG/ML INTRAVENOUS SOLUTION,5.25,3.41,1.16,47.96,118
HCPCS,J3485,Zidovudine,,,2.69,2.69,1
HCPCS,J348500,Zidovudine,,,2.69,2.69,1
HCPCS,J3486,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,118.05,76.73,2.17,118.05,51
HCPCS,J3486,Ziprasidone mesylate,,,16.29,16.29,1
HCPCS,J348600,Ziprasidone mesylate,,,16.29,16.29,1
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1.71,1.11,0.25,47.96,51
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,3.705,2.405,0.14,47.96,102
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,277.2,180.18,2.17,424.8,102
HCPCS,J3489,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,11.7,7.6049999999999995,0.54,47.96,204
HCPCS,J3489,Zoledronic acid 1mg,,,9.04,9.04,1
HCPCS,J348900,Zoledronic acid 1mg,,,9.04,9.04,1
HCPCS,J3490,BUPIVACAINE 0.25% 10ML VIAL,11.37,7.39,1.69,47.96,51
HCPCS,J3490,BUPIVACAINE 0.5% 10ML VIAL,10.72,6.97,1.6,47.96,51
HCPCS,J3490,BUPIVACAINE 0.75% 10ML VIAL,10.64,6.92,1.58,47.96,51
HCPCS,J3490,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,47.96,144
HCPCS,J3490,DUOVISC VISCO ELASTIC 3 %-4 %(0.5 ML) 1 %(0.55 ML) INTRAOCULAR SYRINGE,944.94,614.21,2.17,944.94,51
HCPCS,J3490,MANNITOL 20 % INTRAVENOUS SOLUTION,0.24,0.155,0.02,47.96,153
HCPCS,J3490,MOUNJARO 10 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
HCPCS,J3490,MOUNJARO 12.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
HCPCS,J3490,MOUNJARO 15 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
HCPCS,J3490,MOUNJARO 2.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
HCPCS,J3490,MOUNJARO 5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
HCPCS,J3490,MOUNJARO 7.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
HCPCS,J3490,NOREPINEPHRINE BITARTRATE 4 MG/250 ML (16 MCG/ML) IN DEXTROSE 5 % IV,0.345,0.22,0.05,47.96,102
HCPCS,J3520,Edetate disodium per 150 mg,,,0.01,47.96,12
HCPCS,J352000,Edetate disodium per 150 mg,,,2.65,2.65,1
HCPCS,J3530,Nasal vaccine inhalation,,,7.65,8.86,8
HCPCS,J3535,SPIRIVA RESPIMAT 2.5 MCG/ACTUATION SOLUTION FOR INHALATION,180.72,117.47,2.17,316.44,102
HCPCS,J3570,Laetrile amygdalin vit b17,,,41.42,47.96,8
HCPCS,J3590,JUVADERM VOLBELLA 1CC SYRINGE,725.0,471.25,1.1,725.0,22
HCPCS,J3590,JUVADERM VOLUMA,800.0,520.0,1.1,800.0,22
HCPCS,J3590,JUVEDERM ULTRA  XC 1CC,600.0,390.0,1.1,600.0,22
HCPCS,J3590,JUVEDERM ULTRA PLUS,600.0,390.0,1.1,600.0,22
HCPCS,J3590,JUVEDERM ULTRA PLUS .55CC,455.0,295.75,1.1,455.0,22
HCPCS,J3590,JUVEDERM ULTRA XC  .55CC,455.0,295.75,1.1,455.0,22
HCPCS,J3590,RESTYLANE 1CC SYRINGE,600.0,390.0,1.1,600.0,22
HCPCS,J3590,RESTYLANE EYELIGHT .5,400.0,260.0,1.1,400.0,22
HCPCS,J3590,Unclassified biologics,,,41.42,47.96,8
HCPCS,J3591,Esrd on dialysi drug/bio noc,,,7.65,8.86,8
HCPCS,J7030,F NACL .9 1000ML,5.0,3.25,0.74,8.86,51
HCPCS,J7030,Normal saline solution infus,,,3.54,3.54,1
HCPCS,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,459
HCPCS,J703000,Normal saline solution infus,,,3.54,3.54,1
HCPCS,J7040,"INFUSION, NORMAL SALINE 500ML",5.0,3.25,0.74,8.86,51
HCPCS,J7040,NORMAL SALINE SOLUTION INFUS,4.0,2.6,0.99,4.0,27
HCPCS,J7040,Normal saline solution infus,,,2.3,2.3,1
HCPCS,J7040,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.105,0.07,0.01,8.86,408
HCPCS,J7040,STRL SALINE SOLN 500 ML=1 UNIT,23.0,14.95,2.17,23.0,51
HCPCS,J704000,Normal saline solution infus,,,2.3,2.3,1
HCPCS,J7042,5% dextrose/normal saline,,,2.33,2.33,1
HCPCS,J7042,DEXTROSE 2.5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,50
HCPCS,J7042,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,204
HCPCS,J7042,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,102
HCPCS,J7042,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,204
HCPCS,J704200,5% dextrose/normal saline,,,2.33,2.33,1
HCPCS,J7050,"NRML SALINE SOLUTION, 250 CC",4.5,2.93,0.67,8.86,51
HCPCS,J7050,Normal saline solution infus,,,1.17,1.17,1
HCPCS,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.105,0.07,0.01,8.86,612
HCPCS,J705000,Normal saline solution infus,,,1.17,1.17,1
HCPCS,J7060,5% dextrose/water,,,3.12,3.12,1
HCPCS,J7060,D5W 500ML,7.5,4.88,1.12,8.86,51
HCPCS,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.12,0.08,0.01,8.86,561
HCPCS,J706000,5% dextrose/water,,,3.12,3.12,1
HCPCS,J7070,"D5LR, 1000ML",5.14,3.34,0.76,8.86,51
HCPCS,J7070,D5w infusion,,,5.23,5.23,1
HCPCS,J7070,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.18,0.12,0.01,8.86,255
HCPCS,J7070,"INFUSION, D-5-W, 1000 CC",27.0,17.55,2.17,27.0,51
HCPCS,J707000,D5w infusion,,,5.23,5.23,1
HCPCS,J7100,Dextran 40 infusion,,,142.17,142.17,1
HCPCS,J7100,LMD (DEXTRAN 40) 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,2.37,1.54,0.35,142.17,51
HCPCS,J7100,LMD (DEXTRAN 40) 10 % IN 5 % DEXTROSE INTRAVENOUS SOLUTION,2.28,1.48,0.34,142.17,51
HCPCS,J710000,Dextran 40 infusion,,,142.17,142.17,1
HCPCS,J7110,Dextran 75 infusion,,,7.65,33.11,11
HCPCS,J711000,Dextran 75 infusion,,,25.85,25.85,1
HCPCS,J7120,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,153
HCPCS,J7120,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,153
HCPCS,J7120,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,0.045,0.03,0.01,8.86,102
HCPCS,J7120,Ringers lactate infusion,,,4.24,4.24,1
HCPCS,J712000,Ringers lactate infusion,,,4.24,4.24,1
HCPCS,J7121,5% dextrose in lac ringers,,,7.65,21.84,11
HCPCS,J712100,5% dextrose in lac ringers,,,17.05,17.05,1
HCPCS,J7131,Hypertonic saline sol,,,0.36,0.36,1
HCPCS,J7131,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.51,0.11,8.86,153
HCPCS,J7131,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.045,0.03,0.01,8.86,153
HCPCS,J7131,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.505,0.09,8.86,102
HCPCS,J7131,SODIUM CHLORIDE 5 % HYPERTONIC INTRAVENOUS SOLUTION,0.045,0.03,0.01,8.86,102
HCPCS,J713100,Hypertonic saline sol,,,0.36,0.36,1
HCPCS,J7165,"Inj, human-lans, per i.u",,,1.7,3257.22,30
HCPCS,J716500,"Inj, human-lans, per i.u",,,6.73,6.73,1
HCPCS,J7168,KCENTRA 1000 UNIT (800-1240 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,3257.22,65
HCPCS,J7168,KCENTRA 500 UNIT (400-620 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,3257.22,65
HCPCS,J7168,Prothrombin complex kcentra,,,6.37,6.37,1
HCPCS,J716800,Prothrombin complex kcentra,,,6.37,6.37,1
HCPCS,J7169,"Inj andexxa, 10 mg",,,131.37,13108.79,31
HCPCS,J716900,"Inj andexxa, 10 mg",,,267.0,267.0,1
HCPCS,J7170,HEMLIBRA 150 MG/ML SUBCUTANEOUS SOLUTION,65288.37,42437.44,2.17,65288.37,65
HCPCS,J7170,HEMLIBRA 30 MG/ML SUBCUTANEOUS SOLUTION,13057.68,8487.49,2.17,16617.81,65
HCPCS,J7170,HEMLIBRA 60 MG/0.4 ML SUBCUTANEOUS SOLUTION,65288.34,42437.42,2.17,65288.34,65
HCPCS,J7170,"Inj., emicizumab-kxwh 0.5 mg",,,100.5,100.5,1
HCPCS,J717000,"Inj., emicizumab-kxwh 0.5 mg",,,100.5,100.5,1
HCPCS,J7171,ADZYNMA 1500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,2.17,105.08,65
HCPCS,J7171,ADZYNMA 500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,2.17,105.08,130
HCPCS,J7171,"Inj, adzynma, 10 iu",,,63.15,63.15,1
HCPCS,J717100,"Inj, adzynma, 10 iu",,,63.15,63.15,1
HCPCS,J7172,"Inj marstacim-hncq, 0.5 mg",,,50.47,16617.81,24
HCPCS,J717200,"Inj marstacim-hncq, 0.5 mg",,,89.84,89.84,1
HCPCS,J7173,"Inj. concizumab-mtci, 0.5 mg",,,85.5,2642.72,24
HCPCS,J717300,"Inj. concizumab-mtci, 0.5 mg",,,152.19,152.19,1
HCPCS,J7174,Injection fitusiran 0.04 mg,,,132.62,16617.81,24
HCPCS,J717400,Injection fitusiran 0.04 mg,,,236.06,236.06,1
HCPCS,J7175,COAGADEX 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,40.98,26.64,2.17,16617.81,65
HCPCS,J7175,"Inj, factor x, (human), 1iu",,,17.66,17.66,1
HCPCS,J717500,"Inj, factor x, (human), 1iu",,,17.66,17.66,1
HCPCS,J7177,"Inj., fibryga, 1 mg",,,1.11,2642.72,33
HCPCS,J717700,"Inj., fibryga, 1 mg",,,2.19,2.19,1
HCPCS,J7178,Inj human fibrinogen con nos,,,2.72,2.72,1
HCPCS,J7178,RIASTAP 1 GRAM (900 MG-1300 MG) INTRAVENOUS SOLUTION,5.46,3.55,1.21,4417.71,65
HCPCS,J717800,Inj human fibrinogen con nos,,,2.72,2.72,1
HCPCS,J7179,VONVENDI 1300 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.58,4417.71,65
HCPCS,J7179,VONVENDI 650 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.58,4417.71,65
HCPCS,J7179,Vonvendi inj 1 iu vwf:rco,,,3.28,3.28,1
HCPCS,J717900,Vonvendi inj 1 iu vwf:rco,,,3.28,3.28,1
HCPCS,J7180,Factor xiii anti-hem factor,,,9.73,16617.81,33
HCPCS,J718000,Factor xiii anti-hem factor,,,19.15,19.15,1
HCPCS,J7181,Factor xiii recomb a-subunit,,,33.04,33.04,1
HCPCS,J7181,TRETTEN 2500 UNIT INTRAVENOUS SOLUTION,71.46,46.45,2.17,13108.79,65
HCPCS,J718100,Factor xiii recomb a-subunit,,,33.04,33.04,1
HCPCS,J7182,Factor viii recomb novoeight,,,1.34,4417.71,33
HCPCS,J718200,Factor viii recomb novoeight,,,2.76,2.76,1
HCPCS,J7183,Wilate injection,,,1.17,4487.68,33
HCPCS,J718300,Wilate injection,,,2.35,2.35,1
HCPCS,J7185,Xyntha inj,,,1.3,3257.22,33
HCPCS,J718500,Xyntha inj,,,2.83,2.83,1
HCPCS,J7186,ALPHANATE 1000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.13,4487.68,65
HCPCS,J7186,ALPHANATE 1500 (600 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.13,4487.68,65
HCPCS,J7186,ALPHANATE 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,5.1,3.32,1.13,4487.68,65
HCPCS,J7186,Antihemophilic viii/vwf comp,,,2.21,2.21,1
HCPCS,J718600,Antihemophilic viii/vwf comp,,,2.21,2.21,1
HCPCS,J7187,HUMATE-P 1000 UNIT-2400 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.36,4487.68,65
HCPCS,J7187,HUMATE-P 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.36,4487.68,65
HCPCS,J7187,HUMATE-P 500 UNIT-1200 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.36,4487.68,65
HCPCS,J7187,"Humate-p, inj",,,2.65,2.65,1
HCPCS,J718700,"Humate-p, inj",,,2.65,2.65,1
HCPCS,J7188,Factor viii recomb obizur,,,5.75,5.75,1
HCPCS,J7188,OBIZUR 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
HCPCS,J718800,Factor viii recomb obizur,,,5.75,5.75,1
HCPCS,J7189,Factor viia recomb novoseven,,,4.66,4.66,1
HCPCS,J7189,NOVOSEVEN RT 1 MG (1000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
HCPCS,J7189,NOVOSEVEN RT 2 MG (2000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
HCPCS,J7189,NOVOSEVEN RT 5 MG (5000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
HCPCS,J718900,Factor viia recomb novoseven,,,4.66,4.66,1
HCPCS,J7190,Factor viii,,,1.11,4487.68,33
HCPCS,J719000,Factor viii,,,1.98,1.98,1
HCPCS,J7191,Factor viii (porcine),,,3.92,4417.71,23
HCPCS,J719100,Factor viii (porcine),,,3.92,3.92,1
HCPCS,J7192,ADVATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
HCPCS,J7192,ADVATE 1500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
HCPCS,J7192,ADVATE 250 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
HCPCS,J7192,ADVATE 500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
HCPCS,J7192,Factor viii recombinant nos,,,2.83,2.83,1
HCPCS,J7192,RECOMBINATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
HCPCS,J719200,Factor viii recombinant nos,,,2.83,2.83,1
HCPCS,J7193,Factor ix non-recombinant,,,1.23,4417.71,33
HCPCS,J719300,Factor ix non-recombinant,,,2.44,2.44,1
HCPCS,J7194,Factor ix complex,,,1.59,4487.68,33
HCPCS,J719400,Factor ix complex,,,3.03,3.03,1
HCPCS,J7195,BENEFIX 1000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
HCPCS,J7195,BENEFIX 2000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
HCPCS,J7195,BENEFIX 3000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
HCPCS,J7195,BENEFIX 500 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
HCPCS,J7195,Factor ix recombinant nos,,,3.26,3.26,1
HCPCS,J719500,Factor ix recombinant nos,,,3.26,3.26,1
HCPCS,J7196,Antithrombin recombinant,,,300.11,384.41,10
HCPCS,J719600,Antithrombin recombinant,,,300.11,300.11,1
HCPCS,J7197,Antithrombin iii injection,,,7.21,7.21,1
HCPCS,J7197,THROMBATE III 500 (+/-) UNIT INTRAVENOUS SOLUTION,16.53,10.74,2.17,4417.71,130
HCPCS,J719700,Antithrombin iii injection,,,7.21,7.21,1
HCPCS,J7198,Anti-inhibitor,,,4.34,4.34,1
HCPCS,J7198,FEIBA NF 1750 UNIT-3250 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.15,4417.71,65
HCPCS,J7198,FEIBA NF 350 UNIT-650 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.15,4417.71,65
HCPCS,J7198,FEIBA NF 700 UNIT-1300 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.15,4417.71,65
HCPCS,J719800,Anti-inhibitor,,,4.34,4.34,1
HCPCS,J7199,Hemophilia clot factor noc,,,159.28,184.43,8
HCPCS,J7200,Factor ix recombinan rixubis,,,1.51,4417.71,27
HCPCS,J720000,Factor ix recombinan rixubis,,,3.1,3.1,1
HCPCS,J7201,ALPROLIX 1000 UNIT INTRAVENOUS SOLUTION,14.55,9.46,2.17,4417.71,65
HCPCS,J7201,ALPROLIX 500 UNIT INTRAVENOUS SOLUTION,14.55,9.46,2.17,4417.71,65
HCPCS,J7201,Factor ix alprolix recomb,,,6.41,6.41,1
HCPCS,J720100,Factor ix alprolix recomb,,,6.41,6.41,1
HCPCS,J7202,Factor ix idelvion inj,,,4.88,4417.71,33
HCPCS,J720200,Factor ix idelvion inj,,,9.47,9.47,1
HCPCS,J7203,Factor ix recomb gly rebinyn,,,4.22,4417.71,33
HCPCS,J720300,Factor ix recomb gly rebinyn,,,8.1,8.1,1
HCPCS,J7204,ESPEROCT 3000 (+/-) UNIT INTRAVENOUS SOLUTION,10.2,6.63,2.17,4417.71,65
HCPCS,J7204,Inj recombin esperoct per iu,,,3.99,3.99,1
HCPCS,J720400,Inj recombin esperoct per iu,,,3.99,3.99,1
HCPCS,J7205,ELOCTATE 1000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 1500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 2000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 250 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 3000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 4000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 5000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 6000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,ELOCTATE 750 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
HCPCS,J7205,Factor viii fc fusion recomb,,,4.4,4.4,1
HCPCS,J720500,Factor viii fc fusion recomb,,,4.4,4.4,1
HCPCS,J7207,Factor viii pegylated recomb,,,2.0,4417.71,33
HCPCS,J720700,Factor viii pegylated recomb,,,3.84,3.84,1
HCPCS,J7208,Inj. jivi 1 iu,,,2.17,4417.71,33
HCPCS,J720800,Inj. jivi 1 iu,,,4.72,4.72,1
HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,1.13,4487.68,33
HCPCS,J720900,Factor viii nuwiq recomb 1iu,,,2.01,2.01,1
HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,1.44,4417.71,33
HCPCS,J721000,"Inj, afstyla, 1 i.u.",,,2.81,2.81,1
HCPCS,J7211,"Inj, kovaltry, 1 i.u.",,,1.27,4417.71,33
HCPCS,J721100,"Inj, kovaltry, 1 i.u.",,,2.79,2.79,1
HCPCS,J7212,Factor viia recomb sevenfact,,,2.09,4417.71,27
HCPCS,J721200,Factor viia recomb sevenfact,,,4.18,4.18,1
HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,1.81,4417.71,32
HCPCS,J721300,"Inj, ixinity, 1 i.u.",,,3.68,3.68,1
HCPCS,J7214,ALTUVIIIO 1000 (+/-) UNIT INTRAVENOUS SOLUTION,20.49,13.32,2.17,4487.68,65
HCPCS,J7214,Altuviiio per factor viii iu,,,8.21,8.21,1
HCPCS,J721400,Altuviiio per factor viii iu,,,8.21,8.21,1
HCPCS,J7294,Seg acet and eth estr yearly,,,112.58,6622.62,12
HCPCS,J729400,Seg acet and eth estr yearly,,,5170.29,5170.29,1
HCPCS,J7295,Eth estr and eton monthly,,,112.58,401.94,12
HCPCS,J729500,Eth estr and eton monthly,,,221.75,221.75,1
HCPCS,J7296,KYLEENA 17.5 MCG/24 HR (UP TO 5 YEARS) 19.5 MG INTRAUTERINE DEVICE,2915.12,1894.83,2.17,3164.98,51
HCPCS,J7296,"Kyleena, 19.5 mg",,,2594.46,2594.46,1
HCPCS,J7296,"LEVONORGESTREL-RELEASING INTR CONTRACEPTIVE  (KYLEENA), 19.5 MG",1653.0,1074.45,1.1,1811.71,26
HCPCS,J729600,"Kyleena, 19.5 mg",,,2594.46,2594.46,1
HCPCS,J7297,LEVONORGESTREL IU 52MG 3 YR,1133.0,736.45,1.1,1544.7,26
HCPCS,J7297,LILETTA 20.4 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2236.16,1453.5,2.17,2427.81,51
HCPCS,J7297,"Liletta, 52 mg",,,1990.18,1990.18,1
HCPCS,J729700,"Liletta, 52 mg",,,1990.18,1990.18,1
HCPCS,J7298,LEVONORGESTREL IU 52MG,1548.63,1006.61,2.17,3164.98,51
HCPCS,J7298,LEVONORGESTREL IU 52MG 5 YR,1530.0,994.5,1.1,2014.21,26
HCPCS,J7298,MIRENA 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2915.12,1894.83,2.17,3164.98,51
HCPCS,J7298,"Mirena, 52 mg",,,2594.46,2594.46,1
HCPCS,J729800,"Mirena, 52 mg",,,2594.46,2594.46,1
HCPCS,J7299,Intraut copp cont (miudella),,,112.58,2432.9,9
HCPCS,J729900,Intraut copp cont (miudella),,,2432.9,2432.9,1
HCPCS,J7300,INTRAUT COPPER CONTRACEPTIVE,916.0,595.4,1.1,1874.43,26
HCPCS,J7300,Intra copp contra (paragard),,,2431.48,2431.48,1
HCPCS,J7300,PARAGARD T380A (SINGLE HAND) 380 SQUARE MM INTRAUTERINE DEVICE,2732.0,1775.8,2.17,2968.56,51
HCPCS,J7300,W IUD COPPER CONTRACEPTIVE,830.0,539.5,2.17,2968.56,51
HCPCS,J730000,Intra copp contra (paragard),,,2431.48,2431.48,1
HCPCS,J7301,SKYLA,1223.0,794.95,1.1,2553.6,26
HCPCS,J7301,SKYLA 14 MCG/24 HR (UP TO 3 YEARS) 13.5 MG INTRAUTERINE DEVICE,2427.32,1577.76,2.17,2635.36,51
HCPCS,J7301,"Skyla, 13.5 mg",,,2160.31,2160.31,1
HCPCS,J730100,"Skyla, 13.5 mg",,,2160.31,2160.31,1
HCPCS,J7303,Contraceptive vaginal ring,,,112.58,130.36,8
HCPCS,J7304,Contraceptive hormone patch,,,86.97,130.36,10
HCPCS,J730400,Contraceptive hormone patch,,,86.97,86.97,1
HCPCS,J7306,Levonorgestrel implant sys,,,159.28,1157.1,11
HCPCS,J730600,Levonorgestrel implant sys,,,903.35,903.35,1
HCPCS,J7307,ETONOGESTREL IMPLANT SYSTEM,1675.325,1088.96,1.1,3163.59,77
HCPCS,J7307,Etonogestrel implant system,,,2594.46,2594.46,1
HCPCS,J7307,NEXPLANON 68 MG SUBDERMAL IMPLANT,3060.86,1989.56,2.17,3163.59,51
HCPCS,J730700,Etonogestrel implant system,,,2594.46,2594.46,1
HCPCS,J7308,Aminolevulinic acid hcl top,,,693.9,693.9,1
HCPCS,J7308,LEVULAN 20 % TOPICAL SOLUTION,943.72,613.42,2.17,1154.88,65
HCPCS,J730800,Aminolevulinic acid hcl top,,,693.9,693.9,1
HCPCS,J7309,"Methyl aminolevulinate, top",,,216.01,369.35,9
HCPCS,J7310,Ganciclovir long act implant,,,8825.26,43776.0,11
HCPCS,J7311,"Inj., retisert, 0.01 mg",,,603.31,603.31,1
HCPCS,J7311,RETISERT 0.59 MG INTRAVITREAL IMPLANT,45660.0,29679.0,2.17,45660.0,65
HCPCS,J731100,"Inj., retisert, 0.01 mg",,,603.31,603.31,1
HCPCS,J7312,Dexamethasone intra implant,,,364.08,364.08,1
HCPCS,J7312,OZURDEX 0.7 MG INTRAVITREAL IMPLANT,4798.8,3119.22,2.17,4798.8,65
HCPCS,J731200,Dexamethasone intra implant,,,364.08,364.08,1
HCPCS,J7313,ILUVIEN 0.19 MG INTRAVITREAL IMPLANT,22092.0,14359.8,2.17,22092.0,65
HCPCS,J7313,"Inj., iluvien, 0.01 mg",,,903.24,903.24,1
HCPCS,J731300,"Inj., iluvien, 0.01 mg",,,903.24,903.24,1
HCPCS,J7314,"Inj., yutiq, 0.01 mg",,,943.2,943.2,1
HCPCS,J7314,YUTIQ 0.18 MG INTRAVITREAL IMPLANT,22244.0,14458.6,2.17,22244.0,65
HCPCS,J731400,"Inj., yutiq, 0.01 mg",,,943.2,943.2,1
HCPCS,J7315,Ophthalmic mitomycin,,,112.58,1176.48,10
HCPCS,J731500,Ophthalmic mitomycin,,,918.48,918.48,1
HCPCS,J7316,"Inj, ocriplasmin, 0.125 mg",,,1086.43,4487.68,11
HCPCS,J731600,"Inj, ocriplasmin, 0.125 mg",,,2109.66,2109.66,1
HCPCS,J7318,DUROLANE 60 MG/3 ML INTRA-ARTICULAR SYRINGE,1338.0,869.7,2.17,1338.0,65
HCPCS,J7318,"Inj, durolane 1 mg",,,11.61,11.61,1
HCPCS,J731800,"Inj, durolane 1 mg",,,11.61,11.61,1
HCPCS,J7320,"Genvisc 850, inj, 1mg",,,4.75,184.43,33
HCPCS,J732000,"Genvisc 850, inj, 1mg",,,8.47,8.47,1
HCPCS,J7321,HYALGAN 10 MG/ML INTRA-ARTICULAR SOLUTION,342.0,222.3,2.17,342.0,51
HCPCS,J7321,HYALGAN 10 MG/ML INTRA-ARTICULAR SYRINGE,342.0,222.3,2.17,342.0,51
HCPCS,J7321,HYALGAN/SUPARTZ INJ PER DOSE,1067.185,693.67,1.1,1822.37,78
HCPCS,J7321,Hyalgan supartz visco-3 dose,,,129.89,129.89,1
HCPCS,J7321,SUPARTZ FX 10 MG/ML INTRA-ARTICULAR SYRINGE,341.58,222.03,2.17,341.58,51
HCPCS,J732100,Hyalgan supartz visco-3 dose,,,129.89,129.89,1
HCPCS,J7322,HYMOVIS 24 MG/3 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,2.17,860.4,65
HCPCS,J7322,"Hyaluronan, hymo or hymo one",,,31.4,31.4,1
HCPCS,J732200,"Hyaluronan, hymo or hymo one",,,31.4,31.4,1
HCPCS,J7323,EUFLEXXA 10 MG/ML (MW 2.4-3.6 MILLION) INTRA-ARTICULAR SYRINGE,649.14,421.94,2.17,649.14,65
HCPCS,J7323,EUFLEXXA INJ PER DOSE,1497.07,973.095,1.1,2682.14,92
HCPCS,J7323,Euflexxa inj per dose,,,187.72,187.72,1
HCPCS,J732300,Euflexxa inj per dose,,,187.72,187.72,1
HCPCS,J7324,ORTHOVISC 30 MG/2 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,2.17,860.4,65
HCPCS,J7324,ORTHOVISC INJ PER DOSE,317.0,206.05,1.1,317.0,27
HCPCS,J7324,Orthovisc inj per dose,,,198.04,198.04,1
HCPCS,J732400,Orthovisc inj per dose,,,198.04,198.04,1
HCPCS,J7325,"HYALURONAN, SYNVISC 2ML SYR",1847.81,1201.08,2.17,1847.81,65
HCPCS,J7325,SYNVISC 16 MG/2 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,2.17,821.76,65
HCPCS,J7325,SYNVISC OR SYNVISC-ONE,23.0,14.95,1.1,23.0,27
HCPCS,J7325,SYNVISC OR SYNVISC-ONE 1 MG,115.49,75.07,2.17,369.35,65
HCPCS,J7325,SYNVISC-ONE 48 MG/6 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,2.17,821.76,65
HCPCS,J7325,Synvisc or synvisc-one,,,13.46,13.46,1
HCPCS,J732500,Synvisc or synvisc-one,,,13.46,13.46,1
HCPCS,J7326,GEL-ONE 30 MG/3 ML INTRA-ARTICULAR SYRINGE,1380.0,897.0,2.17,1564.4,65
HCPCS,J7326,GEL-ONE PER DOSE,1015.0,659.75,1.1,1015.0,26
HCPCS,J7326,Gel-one,,,939.93,939.93,1
HCPCS,J732600,Gel-one,,,939.93,939.93,1
HCPCS,J7327,MONOVISC 88 MG/4 ML INTRA-ARTICULAR SYRINGE,1350.0,877.5,2.17,1673.19,65
HCPCS,J7327,Monovisc inj per dose,,,1005.29,1005.29,1
HCPCS,J732700,Monovisc inj per dose,,,1005.29,1005.29,1
HCPCS,J7328,GELSYN-3  16.8 MG/2 ML INTRA-ARTICULAR SYRINGE,698.4,453.96,0.67,698.4,59
HCPCS,J7328,Gelsyn-3 injection 0.1 mg,,,1.19,1.19,1
HCPCS,J732800,Gelsyn-3 injection 0.1 mg,,,1.19,1.19,1
HCPCS,J7329,"Inj, trivisc 1 mg",,,3.6,369.35,32
HCPCS,J732900,"Inj, trivisc 1 mg",,,6.43,6.43,1
HCPCS,J7330,Cultured chondrocytes implnt,,,874.33,165979.44,11
HCPCS,J733000,Cultured chondrocytes implnt,,,149032.28,149032.28,1
HCPCS,J7331,"Synojoynt, inj., 1 mg",,,5.55,369.35,14
HCPCS,J733100,"Synojoynt, inj., 1 mg",,,5.55,5.55,1
HCPCS,J7332,"Inj., triluron, 1 mg",,,10.11,369.35,33
HCPCS,J733200,"Inj., triluron, 1 mg",,,18.01,18.01,1
HCPCS,J7333,Visco-3 inj dose,,,112.58,130.36,8
HCPCS,J7336,Capsaicin 8% patch,,,6.09,6.09,1
HCPCS,J7336,QUTENZA 8 % TOPICAL KIT,4360.48,2834.31,2.17,8721.0,195
HCPCS,J733600,Capsaicin 8% patch,,,6.09,6.09,1
HCPCS,J7340,Carbidopa levodopa ent 100ml,,,159.28,670.4,33
HCPCS,J734000,Carbidopa levodopa ent 100ml,,,433.95,433.95,1
HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,31.11,77.47,12
HCPCS,J734200,Ciprofloxacin otic susp 6 mg,,,60.48,60.48,1
HCPCS,J7345,AMELUZ 10 % TOPICAL GEL,457.2,297.18,1.72,457.2,65
HCPCS,J7345,"Aminolevulinic acid, 10% gel",,,3.19,3.19,1
HCPCS,J734500,"Aminolevulinic acid, 10% gel",,,3.19,3.19,1
HCPCS,J7351,DURYSTA 10 MCG INTRACAMERAL IMPLANT,7290.0,4738.5,2.17,7290.0,65
HCPCS,J7351,Inj bimatoprost itc imp1mcg,,,380.72,380.72,1
HCPCS,J735100,Inj bimatoprost itc imp1mcg,,,380.72,380.72,1
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,6729.63,6729.63,1
HCPCS,J7352,SCENESSE 16 MG SUBCUTANEOUS IMPLANT,120982.0,78638.3,2.17,120982.0,65
HCPCS,J735200,"Afamelanotide implant, 1 mg",,,6729.63,6729.63,1
HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,57.17,369.35,30
HCPCS,J735300,Anacaulase-bcdb 8.8% gel 1 g,,,122.34,122.34,1
HCPCS,J7354,"Cantharidin top, applicator",,,318.98,1805.35,32
HCPCS,J735400,"Cantharidin top, applicator",,,1168.57,1168.57,1
HCPCS,J7355,Inj travoprost intra impl,,,196.22,1287.79,32
HCPCS,J735500,Inj travoprost intra impl,,,349.29,349.29,1
HCPCS,J7356,Inj foscarb/foslevodopa 5 mg,,,1.25,667.03,11
HCPCS,J735600,Inj foscarb/foslevodopa 5 mg,,,1.25,1.25,1
HCPCS,J7401,Mometasone furoate sinus imp,,,622.65,720.96,8
HCPCS,J7402,Mometasone sinus sinuva,,,20.2,20.2,1
HCPCS,J7402,SINUVA 1350 MCG SINUS IMPLANT,3538.44,2299.99,2.17,3538.44,65
HCPCS,J740200,Mometasone sinus sinuva,,,20.2,20.2,1
HCPCS,J7500,AZATHIOPRINE 50 MG TABLET,2.96,1.9250000000000003,0.11,8.86,102
HCPCS,J7500,Azathioprine oral 50mg,,,0.11,0.11,1
HCPCS,J750000,Azathioprine oral 50mg,,,0.11,0.11,1
HCPCS,J7501,Azathioprine parenteral,,,112.58,697.18,31
HCPCS,J750100,Azathioprine parenteral,,,534.0,534.0,1
HCPCS,J7502,CYCLOSPORINE 100 MG ORAL CAP (SANDIMMUNE),37.519999999999996,24.39,2.17,39.72,102
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.64,11.0,153
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,14.98,9.74,2.17,14.98,51
HCPCS,J7502,Cyclosporine oral 100 mg,,,3.22,3.22,1
HCPCS,J7502,GENGRAF 100 MG CAPSULE,17.64,11.47,2.17,17.64,51
HCPCS,J7502,GENGRAF 100 MG/ML ORAL SOLUTION,24.9,16.19,2.17,24.9,51
HCPCS,J7502,NEORAL 100 MG CAPSULE,28.25,18.36,2.17,28.28,102
HCPCS,J7502,NEORAL 100 MG/ML ORAL SOLUTION,38.45,24.99,2.17,38.45,51
HCPCS,J7502,SANDIMMUNE 100 MG CAPSULE,43.82,28.48,2.17,43.82,51
HCPCS,J750200,Cyclosporine oral 100 mg,,,3.22,3.22,1
HCPCS,J7503,ENVARSUS XR 0.75 MG TABLETEXTENDED RELEASE,12.86,8.36,1.91,47.96,102
HCPCS,J7503,ENVARSUS XR 1 MG TABLETEXTENDED RELEASE,17.14,11.14,2.17,47.96,102
HCPCS,J7503,ENVARSUS XR 4 MG TABLETEXTENDED RELEASE,68.58,44.58,2.17,68.58,102
HCPCS,J7503,Tacrol envarsus ex rel oral,,,3.33,3.33,1
HCPCS,J750300,Tacrol envarsus ex rel oral,,,3.33,3.33,1
HCPCS,J7504,ATGAM 50 MG/ML INTRAVENOUS SOLUTION,3826.35,2487.13,2.17,15725.27,65
HCPCS,J7504,Lymphocyte immune globulin,,,9448.12,9448.12,1
HCPCS,J750400,Lymphocyte immune globulin,,,9448.12,9448.12,1
HCPCS,J7505,Monoclonal antibodies,,,1069.3,2984.0,10
HCPCS,J7507,PROGRAF 0.5 MG CAPSULE,8.88,5.77,0.36,8.88,51
HCPCS,J7507,PROGRAF 1 MG CAPSULE,17.76,11.54,0.36,17.76,51
HCPCS,J7507,TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASE,4.46,2.9,0.36,8.86,102
HCPCS,J7507,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.36,8.92,153
HCPCS,J7507,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.36,44.6,153
HCPCS,J7507,Tacrolimus imme rel oral 1mg,,,0.36,0.36,1
HCPCS,J750700,Tacrolimus imme rel oral 1mg,,,0.36,0.36,1
HCPCS,J7508,ASTAGRAF XL 1 MG CAPSULEEXTENDED RELEASE,13.86,9.01,1.05,13.86,51
HCPCS,J7508,Tacrol astagraf ex rel oral,,,1.05,1.05,1
HCPCS,J750800,Tacrol astagraf ex rel oral,,,1.05,1.05,1
HCPCS,J7509,MEDROL (PAK) 4 MG TABLETS IN A DOSE PACK,0.74,0.48,0.11,8.86,51
HCPCS,J7509,MEDROL 16 MG TABLET,6.9,4.49,0.25,8.86,51
HCPCS,J7509,MEDROL 2 MG TABLET,3.94,2.56,0.25,8.86,51
HCPCS,J7509,METHYLPREDNISOLONE 16 MG TABLET,6.22,4.04,0.25,8.86,51
HCPCS,J7509,METHYLPREDNISOLONE 4 MG TABLET,4.3,2.8,0.25,8.86,51
HCPCS,J7509,METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK,3.08,2.005,0.25,8.86,102
HCPCS,J7509,METHYLPREDNISOLONE 8 MG TABLET,4.02,2.61,0.25,8.86,50
HCPCS,J7509,Methylprednisolone oral,,,0.25,0.25,1
HCPCS,J750900,Methylprednisolone oral,,,0.25,0.25,1
HCPCS,J7510,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,4.13,2.68,0.61,8.86,51
HCPCS,J7510,Prednisolone oral per 5 mg,,,1.64,1.64,1
HCPCS,J751000,Prednisolone oral per 5 mg,,,1.64,1.64,1
HCPCS,J7511,Antithymocyte globuln rabbit,,,1797.36,1797.36,1
HCPCS,J7511,THYMOGLOBULIN 25 MG INTRAVENOUS SOLUTION,4130.85,2685.05,2.17,4130.85,65
HCPCS,J751100,Antithymocyte globuln rabbit,,,1797.36,1797.36,1
HCPCS,J7512,PREDNISONE 1 MG TABLET,0.53,0.345,0.02,8.86,204
HCPCS,J7512,PREDNISONE 10 MG TABLET,0.51,0.32999999999999996,0.02,8.86,102
HCPCS,J7512,PREDNISONE 2.5 MG TABLET,0.35,0.225,0.02,8.86,153
HCPCS,J7512,PREDNISONE 20 MG TABLET,0.52,0.34,0.02,8.86,153
HCPCS,J7512,PREDNISONE 5 MG TABLET,0.46,0.3,0.02,8.86,255
HCPCS,J7512,PREDNISONE 5 MG/5 ML ORAL SOLUTION,1.925,1.25,0.02,8.86,102
HCPCS,J7512,PREDNISONE 50 MG TABLET,0.84,0.55,0.02,8.86,153
HCPCS,J7512,PREDNISONE INTENSOL 5 MG/ML ORAL CONCENTRATE,13.0,8.45,0.02,13.0,51
HCPCS,J7512,Prednisone ir or dr oral 1mg,,,0.41,0.41,1
HCPCS,J751200,Prednisone ir or dr oral 1mg,,,0.41,0.41,1
HCPCS,J7513,"Daclizumab, parenteral",,,806.04,2642.72,10
HCPCS,J7514,Mycophenol (myhibbin) 100 mg,,,3.99,8.86,13
HCPCS,J751400,Mycophenol (myhibbin) 100 mg,,,3.99,3.99,1
HCPCS,J7515,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),10.17,6.615,0.94,11.5,153
HCPCS,J7515,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.41,8.86,153
HCPCS,J7515,Cyclosporine oral 25 mg,,,0.94,0.94,1
HCPCS,J7515,NEORAL 25 MG CAPSULE,7.06,4.59,0.94,8.86,51
HCPCS,J7515,SANDIMMUNE 25 MG CAPSULE,10.98,7.14,0.94,10.98,51
HCPCS,J751500,Cyclosporine oral 25 mg,,,0.94,0.94,1
HCPCS,J7516,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,28.17,18.31,2.17,162.7,51
HCPCS,J7516,"Inj, cyclosporine 250mg",,,131.15,131.15,1
HCPCS,J7516,SANDIMMUNE 250 MG/5 ML INTRAVENOUS SOLUTION,51.24,33.31,2.17,162.7,51
HCPCS,J751600,"Inj, cyclosporine 250mg",,,131.15,131.15,1
HCPCS,J7517,CELLCEPT 250 MG CAPSULE,21.6,14.04,0.27,21.6,51
HCPCS,J7517,CELLCEPT 500 MG TABLET,43.18,28.07,0.27,43.18,51
HCPCS,J7517,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,7.94,5.16,0.27,8.86,102
HCPCS,J7517,MYCOPHENOLATE MOFETIL 500 MG TABLET,9.5,6.175,0.27,15.88,102
HCPCS,J7517,Mycophenolate mofetil oral,,,0.27,0.27,1
HCPCS,J751700,Mycophenolate mofetil oral,,,0.27,0.27,1
HCPCS,J7518,MYCOPHENOLATE SODIUM 180 MG TABLETDELAYED RELEASE,9.14,5.94,0.57,9.14,51
HCPCS,J7518,MYCOPHENOLATE SODIUM 360 MG TABLETDELAYED RELEASE,18.28,11.88,0.57,18.28,51
HCPCS,J7518,MYFORTIC 360 MG TABLETDELAYED RELEASE,35.8,23.27,0.57,35.8,51
HCPCS,J7518,Mycophenolic acid,,,0.57,0.57,1
HCPCS,J751800,Mycophenolic acid,,,0.57,0.57,1
HCPCS,J7519,CELLCEPT INTRAVENOUS 500 MG INTRAVENOUS SOLUTION,388.71,252.66,0.66,667.03,51
HCPCS,J7519,Inj. mycophenolate mofetil,,,0.66,0.66,1
HCPCS,J7519,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,261.0,169.65,0.66,667.03,51
HCPCS,J751900,Inj. mycophenolate mofetil,,,0.66,0.66,1
HCPCS,J7520,SIROLIMUS 0.5 MG TABLET,16.94,11.01,1.73,16.94,51
HCPCS,J7520,SIROLIMUS 1 MG TABLET,34.0,22.105,1.73,34.1,153
HCPCS,J7520,SIROLIMUS 1 MG/ML ORAL SOLUTION,83.225,54.1,1.73,87.5,102
HCPCS,J7520,SIROLIMUS 2 MG TABLET,67.8,44.07,1.73,67.8,51
HCPCS,J7520,"Sirolimus, oral",,,1.73,1.73,1
HCPCS,J752000,"Sirolimus, oral",,,1.73,1.73,1
HCPCS,J7521,Tacrolim granules oral susp,,,2.35,47.96,11
HCPCS,J752100,Tacrolim granules oral susp,,,2.35,2.35,1
HCPCS,J7525,PROGRAF 5 MG/ML INTRAVENOUS SOLUTION,918.09,596.76,2.17,918.09,65
HCPCS,J7525,Tacrolimus injection,,,467.16,467.16,1
HCPCS,J752500,Tacrolimus injection,,,467.16,467.16,1
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,20.08,13.05,2.1,20.08,43
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,41.21,26.785,2.1,42.28,86
HCPCS,J7527,Oral everolimus,,,2.1,2.1,1
HCPCS,J7527,ZORTRESS 0.5 MG TABLET,52.64,34.22,2.1,52.64,43
HCPCS,J7527,ZORTRESS 0.75 MG TABLET,78.96,51.32,2.1,78.96,43
HCPCS,J752700,Oral everolimus,,,2.1,2.1,1
HCPCS,J7528,CELLCEPT 200 MG/ML ORAL SUSPENSION,25.9,16.84,0.43,25.9,51
HCPCS,J7528,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,22.65,14.72,0.43,22.65,102
HCPCS,J7528,Mycophen mofetil for susp,,,0.43,0.43,1
HCPCS,J752800,Mycophen mofetil for susp,,,0.43,0.43,1
HCPCS,J7599,Immunosuppressive drug noc,,,41.42,47.96,8
HCPCS,J7601,Ensifentrine inh 3 mg,,,7.65,134.52,13
HCPCS,J760100,Ensifentrine inh 3 mg,,,92.77,92.77,1
HCPCS,J7604,Acetylcysteine comp unit,,,41.42,47.96,8
HCPCS,J7605,Arformoterol non-comp unit,,,1.28,8.86,14
HCPCS,J760500,Arformoterol non-comp unit,,,1.28,1.28,1
HCPCS,J7606,"Formoterol fumarate, inh",,,3.92,9.25,14
HCPCS,J760600,"Formoterol fumarate, inh",,,3.92,3.92,1
HCPCS,J7607,Levalbuterol comp con,,,41.42,47.96,8
HCPCS,J7608,Acetylcysteine non-comp unit,,,6.0,18.58,14
HCPCS,J760800,Acetylcysteine non-comp unit,,,15.06,15.06,1
HCPCS,J7609,Albuterol comp unit,,,1.07,47.96,10
HCPCS,J760900,Albuterol comp unit,,,1.07,1.07,1
HCPCS,J7610,Albuterol comp con,,,2.58,47.96,10
HCPCS,J761000,Albuterol comp con,,,2.58,2.58,1
HCPCS,J7611,Albuterol non-comp con,,,0.25,8.86,14
HCPCS,J761100,Albuterol non-comp con,,,0.46,0.46,1
HCPCS,J7612,Levalbuterol non-comp con,,,0.28,8.86,14
HCPCS,J761200,Levalbuterol non-comp con,,,0.68,0.68,1
HCPCS,J7613,ALBUTEROL SULF .083,1.75,1.14,0.06,1.75,27
HCPCS,J7613,ALBUTEROL UNIT DOSE,11.0,7.15,0.06,11.0,27
HCPCS,J7613,Albuterol non-comp unit,,,0.05,8.86,14
HCPCS,J761300,Albuterol non-comp unit,,,0.12,0.12,1
HCPCS,J7614,Levalbuterol non-comp unit,,,0.07,8.86,14
HCPCS,J761400,Levalbuterol non-comp unit,,,0.14,0.14,1
HCPCS,J7615,Levalbuterol comp unit,,,0.2,47.96,12
HCPCS,J761500,Levalbuterol comp unit,,,3.01,3.01,1
HCPCS,J7620,Albuterol ipratrop non-comp,,,0.13,8.86,14
HCPCS,J762000,Albuterol ipratrop non-comp,,,0.36,0.36,1
HCPCS,J7622,Beclomethasone comp unit,,,0.05,47.96,10
HCPCS,J762200,Beclomethasone comp unit,,,0.05,0.05,1
HCPCS,J7624,Betamethasone comp unit,,,2.15,47.96,10
HCPCS,J762400,Betamethasone comp unit,,,2.15,2.15,1
HCPCS,J7626,Budesonide non-comp unit,,,1.07,8.86,14
HCPCS,J762600,Budesonide non-comp unit,,,1.87,1.87,1
HCPCS,J7627,Budesonide comp unit,,,0.64,47.96,11
HCPCS,J762700,Budesonide comp unit,,,0.64,0.64,1
HCPCS,J7628,Bitolterol mesylate comp con,,,0.46,47.96,10
HCPCS,J762800,Bitolterol mesylate comp con,,,0.46,0.46,1
HCPCS,J7629,Bitolterol mesylate comp unt,,,0.5,47.96,10
HCPCS,J762900,Bitolterol mesylate comp unt,,,0.5,0.5,1
HCPCS,J7631,Cromolyn sodium noncomp unit,,,0.45,8.86,14
HCPCS,J763100,Cromolyn sodium noncomp unit,,,1.62,1.62,1
HCPCS,J7632,Cromolyn sodium comp unit,,,0.69,47.96,9
HCPCS,J7633,Budesonide non-comp con,,,13.9,47.96,10
HCPCS,J763300,Budesonide non-comp con,,,13.9,13.9,1
HCPCS,J7634,Budesonide comp con,,,41.42,47.96,8
HCPCS,J7635,Atropine comp con,,,0.21,47.96,10
HCPCS,J763500,Atropine comp con,,,0.21,0.21,1
HCPCS,J7636,Atropine comp unit,,,1.21,47.96,10
HCPCS,J763600,Atropine comp unit,,,1.21,1.21,1
HCPCS,J7637,Dexamethasone comp con,,,0.11,47.96,10
HCPCS,J763700,Dexamethasone comp con,,,0.11,0.11,1
HCPCS,J7638,Dexamethasone comp unit,,,0.21,47.96,10
HCPCS,J763800,Dexamethasone comp unit,,,0.21,0.21,1
HCPCS,J7639,Dornase alfa non-comp unit,,,49.61,130.36,14
HCPCS,J763900,Dornase alfa non-comp unit,,,98.18,98.18,1
HCPCS,J7640,Formoterol comp unit,,,5.25,47.96,10
HCPCS,J764000,Formoterol comp unit,,,5.25,5.25,1
HCPCS,J7641,Flunisolide comp unit,,,0.37,47.96,11
HCPCS,J764100,Flunisolide comp unit,,,0.37,0.37,1
HCPCS,J7642,Glycopyrrolate comp con,,,2.12,47.96,10
HCPCS,J764200,Glycopyrrolate comp con,,,2.12,2.12,1
HCPCS,J7643,Glycopyrrolate comp unit,,,1.58,47.96,10
HCPCS,J764300,Glycopyrrolate comp unit,,,1.58,1.58,1
HCPCS,J7644,Ipratropium bromide non-comp,,,0.2,8.86,14
HCPCS,J764400,Ipratropium bromide non-comp,,,0.71,0.71,1
HCPCS,J7645,Ipratropium bromide comp,,,0.11,47.96,10
HCPCS,J764500,Ipratropium bromide comp,,,0.11,0.11,1
HCPCS,J7647,Isoetharine comp con,,,41.42,47.96,8
HCPCS,J7648,Isoetharine non-comp con,,,0.32,47.96,10
HCPCS,J764800,Isoetharine non-comp con,,,0.32,0.32,1
HCPCS,J7649,Isoetharine non-comp unit,,,0.36,47.96,10
HCPCS,J764900,Isoetharine non-comp unit,,,0.36,0.36,1
HCPCS,J7650,Isoetharine comp unit,,,41.42,47.96,8
HCPCS,J7657,Isoproterenol comp con,,,41.42,47.96,8
HCPCS,J7658,Isoproterenol non-comp con,,,3.68,47.96,10
HCPCS,J765800,Isoproterenol non-comp con,,,3.68,3.68,1
HCPCS,J7659,Isoproterenol non-comp unit,,,3.68,47.96,10
HCPCS,J765900,Isoproterenol non-comp unit,,,3.68,3.68,1
HCPCS,J7660,Isoproterenol comp unit,,,41.42,47.96,8
HCPCS,J7665,Mannitol for inhaler,,,0.69,17.99,12
HCPCS,J766500,Mannitol for inhaler,,,14.04,14.04,1
HCPCS,J7667,Metaproterenol comp con,,,41.42,47.96,8
HCPCS,J7668,Metaproterenol non-comp con,,,0.55,47.96,10
HCPCS,J766800,Metaproterenol non-comp con,,,0.55,0.55,1
HCPCS,J7669,Metaproterenol non-comp unit,,,0.77,8.86,10
HCPCS,J766900,Metaproterenol non-comp unit,,,0.77,0.77,1
HCPCS,J7670,Metaproterenol comp unit,,,41.42,47.96,8
HCPCS,J7674,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,218.4,141.96,2.17,218.4,51
HCPCS,J7674,METHACHOLINE PER 1 MG,5.88,3.82,0.87,47.96,51
HCPCS,J7674,"Methacholine chloride, neb",,,3.38,3.38,1
HCPCS,J7674,PROVOCHOLINE 0 TO 48 MG/3 ML SOLUTION FOR NEBULIZATION,18.0,11.7,2.17,47.96,51
HCPCS,J7674,PROVOCHOLINE 100 MG SOLUTION FOR INHALATION,218.4,141.96,2.17,218.4,51
HCPCS,J767400,"Methacholine chloride, neb",,,3.38,3.38,1
HCPCS,J7676,Pentamidine comp unit dose,,,41.42,47.96,8
HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.2,47.96,14
HCPCS,J767700,Revefenacin inh non-com 1mcg,,,0.36,0.36,1
HCPCS,J7680,Terbutaline sulf comp con,,,0.04,47.96,11
HCPCS,J768000,Terbutaline sulf comp con,,,0.04,0.04,1
HCPCS,J7681,Terbutaline sulf comp unit,,,0.04,47.96,11
HCPCS,J768100,Terbutaline sulf comp unit,,,0.04,0.04,1
HCPCS,J7682,Tobramycin non-comp unit,,,22.2,47.96,14
HCPCS,J768200,Tobramycin non-comp unit,,,22.2,22.2,1
HCPCS,J7683,Triamcinolone comp con,,,1.0,47.96,11
HCPCS,J768300,Triamcinolone comp con,,,1.0,1.0,1
HCPCS,J7684,Triamcinolone comp unit,,,1.0,47.96,10
HCPCS,J768400,Triamcinolone comp unit,,,1.0,1.0,1
HCPCS,J7685,Tobramycin comp unit,,,124.49,369.35,9
HCPCS,J7686,"Treprostinil, non-comp unit",,,159.28,1733.14,14
HCPCS,J768600,"Treprostinil, non-comp unit",,,1409.72,1409.72,1
HCPCS,J7699,Inhalation solution for dme,,,41.42,47.96,8
HCPCS,J7799,Non-inhalation drug for dme,,,41.42,47.96,8
HCPCS,J7999,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,6.645,4.32,0.84,47.96,102
HCPCS,J7999,KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLORISO-OSMOTIC IV SYRINGE,4.77,3.1,0.71,47.96,51
HCPCS,J8498,Antiemetic rectal/supp nos,,,7.65,8.86,8
HCPCS,J8499,ORAL PRESCIP DRUG NON CHEMO NOS,2.0,1.3,0.3,47.96,51
HCPCS,J8501,APREPITANT 125 MG CAPSULE,636.78,413.91,2.17,636.78,51
HCPCS,J8501,Oral aprepitant,,,4.93,4.93,1
HCPCS,J850100,Oral aprepitant,,,4.93,4.93,1
HCPCS,J8502,Inj aprep (aponvie) 1 mg,,,41.42,47.96,8
HCPCS,J8510,MYLERAN 2 MG TABLET,720.86,468.56,2.17,720.86,65
HCPCS,J8510,Oral busulfan,,,293.42,293.42,1
HCPCS,J851000,Oral busulfan,,,293.42,293.42,1
HCPCS,J8515,CABERGOLINE 0.5 MG TABLET,73.32,47.66,1.95,73.32,144
HCPCS,J8515,"Cabergoline, oral 0.25mg",,,3.35,3.35,1
HCPCS,J851500,"Cabergoline, oral 0.25mg",,,3.35,3.35,1
HCPCS,J8520,"Capecitabine, oral, 150 mg",,,0.42,15.18,11
HCPCS,J852000,"Capecitabine, oral, 150 mg",,,1.1,1.1,1
HCPCS,J8521,"Capecitabine, oral, 500 mg",,,0.83,15.18,11
HCPCS,J852100,"Capecitabine, oral, 500 mg",,,2.14,2.14,1
HCPCS,J8522,CAPECITABINE 150 MG TABLET,23.48,15.26,0.03,23.48,65
HCPCS,J8522,CAPECITABINE 500 MG TABLET,54.12,35.18,0.03,78.24,130
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.07,0.07,1
HCPCS,J852200,"Capecitabine, oral, 50 mg",,,0.07,0.07,1
HCPCS,J8530,CYCLOPHOSPHAMIDE 25 MG CAPSULE,18.34,11.92,1.81,18.72,86
HCPCS,J8530,CYCLOPHOSPHAMIDE 50 MG CAPSULE,32.98,21.44,1.81,32.98,43
HCPCS,J8530,Cyclophosphamide oral 25 mg,,,3.24,3.24,1
HCPCS,J853000,Cyclophosphamide oral 25 mg,,,3.24,3.24,1
HCPCS,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,0.405,0.26,0.02,8.86,102
HCPCS,J8540,DEXAMETHASONE 0.75 MG TABLET,0.5,0.33,0.02,8.86,51
HCPCS,J8540,DEXAMETHASONE 1 MG TABLET,0.6699999999999999,0.435,0.02,8.86,102
HCPCS,J8540,DEXAMETHASONE 1.5 MG TABLET,0.96,0.62,0.02,8.86,51
HCPCS,J8540,DEXAMETHASONE 2 MG TABLET,1.48,0.96,0.02,8.86,204
HCPCS,J8540,DEXAMETHASONE 6 MG TABLET,3.8,2.47,0.02,8.86,51
HCPCS,J8540,Oral dexamethasone,,,0.02,0.02,1
HCPCS,J854000,Oral dexamethasone,,,0.02,0.02,1
HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.78,8.86,11
HCPCS,J854100,"Oral, hemady, 0.25 mg",,,0.78,0.78,1
HCPCS,J8560,ETOPOSIDE 50 MG CAPSULE,207.72,135.02,2.17,327.06,59
HCPCS,J8560,Etoposide oral 50 mg,,,154.49,154.49,1
HCPCS,J856000,Etoposide oral 50 mg,,,154.49,154.49,1
HCPCS,J8562,Oral fludarabine phosphate,,,159.28,211.06,9
HCPCS,J8565,Gefitinib oral,,,299.49,299.49,1
HCPCS,J8565,IRESSA 250 MG TABLET,623.12,405.03,2.17,1676.17,48
HCPCS,J856500,Gefitinib oral,,,299.49,299.49,1
HCPCS,J8597,Antiemetic drug oral nos,,,7.65,8.86,8
HCPCS,J8600,ALKERAN 2 MG TABLET,27.16,17.65,2.17,27.74,43
HCPCS,J8600,Melphalan oral 2 mg,,,19.56,19.56,1
HCPCS,J860000,Melphalan oral 2 mg,,,19.56,19.56,1
HCPCS,J8610,METHOTREXATE SODIUM 2.5 MG TABLET,7.16,4.65,0.27,15.18,255
HCPCS,J8610,Methotrexate oral 2.5 mg,,,0.27,0.27,1
HCPCS,J861000,Methotrexate oral 2.5 mg,,,0.27,0.27,1
HCPCS,J8611,Oral methotrexate (jylamvo),,,13.11,51.26,32
HCPCS,J861100,Oral methotrexate (jylamvo),,,33.18,33.18,1
HCPCS,J8612,Oral methotrexate (xatmep),,,13.11,61.68,32
HCPCS,J861200,Oral methotrexate (xatmep),,,39.93,39.93,1
HCPCS,J8650,Nabilone oral,,,13.11,107.25,10
HCPCS,J8655,"Oral netupitant, palonosetro",,,159.28,1045.5,33
HCPCS,J865500,"Oral netupitant, palonosetro",,,676.74,676.74,1
HCPCS,J8670,"Rolapitant, oral, 1mg",,,1.58,47.96,33
HCPCS,J867000,"Rolapitant, oral, 1mg",,,3.56,3.56,1
HCPCS,J8700,TEMOZOLOMIDE 100 MG CAPSULE,152.84,99.35,0.58,152.84,51
HCPCS,J8700,TEMOZOLOMIDE 180 MG CAPSULE,1035.94,673.36,0.58,1035.94,51
HCPCS,J8700,TEMOZOLOMIDE 20 MG CAPSULE,115.11,74.82499999999999,0.32,115.12,100
HCPCS,J8700,TEMOZOLOMIDE 5 MG CAPSULE,28.75,18.689999999999998,0.32,28.92,100
HCPCS,J8700,Temozolomide,,,0.96,0.96,1
HCPCS,J870000,Temozolomide,,,0.96,0.96,1
HCPCS,J8705,Topotecan oral,,,108.24,369.35,27
HCPCS,J870500,Topotecan oral,,,222.66,222.66,1
HCPCS,J9000,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,9.76,6.34,1.45,9.76,43
HCPCS,J9000,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,6.4,4.16,0.95,7.57,43
HCPCS,J9000,DOXORUBICIN 20 MG/10 ML INTRAVENOUS SOLUTION,9.76,6.34,1.45,9.76,43
HCPCS,J9000,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,1262.56,820.66,2.17,1262.56,43
HCPCS,J9000,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,6.4,4.16,0.95,7.57,43
HCPCS,J9000,Doxorubicin hcl injection,,,4.95,4.95,1
HCPCS,J900000,Doxorubicin hcl injection,,,4.95,4.95,1
HCPCS,J9003,Leup inj (camcevi etm) 1 mg,,,1069.3,1238.14,8
HCPCS,J9011,DATROWAY 100 MG INTRAVENOUS SOLUTION,23477.12,15260.13,2.17,23477.12,59
HCPCS,J9011,"Datopotamab deruxtecan, 1 mg",,,91.76,91.76,1
HCPCS,J901100,"Datopotamab deruxtecan, 1 mg",,,91.76,91.76,1
HCPCS,J9015,Aldesleukin injection,,,103.6,15188.81,31
HCPCS,J901500,Aldesleukin injection,,,12944.16,12944.16,1
HCPCS,J9017,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,180.96,117.62,2.17,500.04,57
HCPCS,J9017,Arsenic trioxide injection,,,13.15,13.15,1
HCPCS,J901700,Arsenic trioxide injection,,,13.15,13.15,1
HCPCS,J9019,Erwinaze injection,,,443.39,13108.79,11
HCPCS,J9020,"Asparaginase, nos",,,67.0,500.04,11
HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,100.0,100.0,1
HCPCS,J9021,RYLAZE 10 MG/0.5 ML INTRAMUSCULAR SOLUTION,50976.0,33134.4,2.17,50976.0,65
HCPCS,J902100,"Inj, aspara, rylaze, 0.1 mg",,,100.0,100.0,1
HCPCS,J9022,"Inj, atezolizumab,10 mg",,,167.16,167.16,1
HCPCS,J9022,TECENTRIQ 1200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,2.17,7011.25,65
HCPCS,J9022,TECENTRIQ 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,2.17,7011.25,65
HCPCS,J902200,"Inj, atezolizumab,10 mg",,,167.16,167.16,1
HCPCS,J9023,BAVENCIO 20 MG/ML INTRAVENOUS SOLUTION,1005.12,653.33,2.17,4417.71,65
HCPCS,J9023,"Injection, avelumab, 10 mg",,,186.88,186.88,1
HCPCS,J902300,"Injection, avelumab, 10 mg",,,186.88,186.88,1
HCPCS,J9024,Inj atezolizumb 5mg hya-tqjs,,,32.1,7011.25,24
HCPCS,J902400,Inj atezolizumb 5mg hya-tqjs,,,57.14,57.14,1
HCPCS,J9025,AZACITIDINE 100 MG SOLUTION FOR INJECTION,432.04,280.83,0.62,432.04,51
HCPCS,J9025,Azacitidine injection,,,0.82,0.82,1
HCPCS,J902500,Azacitidine injection,,,0.82,0.82,1
HCPCS,J9026,IMDELLTRA 1 MG INTRAVENOUS SOLUTION,7200.0,4680.0,2.17,7200.0,65
HCPCS,J9026,IMDELLTRA 10 MG INTRAVENOUS SOLUTION,72000.0,46800.0,2.17,72000.0,65
HCPCS,J9026,"Inj, tarlatamab-dlle, 1 mg",,,2788.53,2788.53,1
HCPCS,J902600,"Inj, tarlatamab-dlle, 1 mg",,,2788.53,2788.53,1
HCPCS,J9027,CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,704.32,457.81,2.17,1287.79,65
HCPCS,J9027,Clofarabine injection,,,25.58,25.58,1
HCPCS,J902700,Clofarabine injection,,,25.58,25.58,1
HCPCS,J9028,ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION,322200.0,209430.0,2.17,322200.0,65
HCPCS,J9028,"Inj, nogapendekin pmln, 1mcg",,,168.62,168.62,1
HCPCS,J902800,"Inj, nogapendekin pmln, 1mcg",,,168.62,168.62,1
HCPCS,J9029,ADSTILADRIN 3X10EXP11 VP/ML INTRAVESICAL SUSPENSION,73080.0,47502.0,2.17,190420.49,65
HCPCS,J9029,"Instill adstiladrin, tx dose",,,114409.13,114409.13,1
HCPCS,J902900,"Instill adstiladrin, tx dose",,,114409.13,114409.13,1
HCPCS,J9030,Bcg live intravesical 1mg,,,5.84,5.84,1
HCPCS,J9030,TICE BCG 50 MG INTRAVESICAL SUSPENSION,873.44,567.74,2.17,873.44,59
HCPCS,J903000,Bcg live intravesical 1mg,,,5.84,5.84,1
HCPCS,J9031,BCG VACCINE LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION,655.08,425.8,2.17,655.08,43
HCPCS,J9032,BELEODAQ 500 MG INTRAVENOUS SOLUTION,12327.52,8012.89,2.17,12327.52,65
HCPCS,J9032,"Injection, belinostat, 10mg",,,94.54,94.54,1
HCPCS,J903200,"Injection, belinostat, 10mg",,,94.54,94.54,1
HCPCS,J9033,"Inj, bendamustine hcl, 1mg",,,3.65,3.65,1
HCPCS,J9033,TREANDA 100 MG INTRAVENOUS POWDER FOR SOLUTION,14264.64,9272.02,2.04,14264.64,65
HCPCS,J9033,TREANDA 25 MG INTRAVENOUS POWDER FOR SOLUTION,3566.16,2318.0,2.04,3566.16,65
HCPCS,J903300,"Inj, bendamustine hcl, 1mg",,,3.65,3.65,1
HCPCS,J9034,BENDEKA 25 MG/ML INTRAVENOUS SOLUTION,2968.56,1929.56,2.17,3257.22,65
HCPCS,J9034,"Inj., bendeka 1 mg",,,22.84,22.84,1
HCPCS,J903400,"Inj., bendeka 1 mg",,,22.84,22.84,1
HCPCS,J9035,AVASTIN 25 MG/ML INTRAVENOUS SOLUTION,956.32,621.61,2.17,3257.22,130
HCPCS,J9035,Bevacizumab injection,,,131.06,131.06,1
HCPCS,J903500,Bevacizumab injection,,,131.06,131.06,1
HCPCS,J9036,BELRAPZO 25 MG/ML INTRAVENOUS SOLUTION,3120.0,2028.0,2.17,3257.22,65
HCPCS,J9036,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,2808.0,1825.2,2.17,3257.22,65
HCPCS,J9036,Inj. belrapzo/bendamustine,,,24.3,24.3,1
HCPCS,J903600,Inj. belrapzo/bendamustine,,,24.3,24.3,1
HCPCS,J9037,Inj belantamab mafodot blmf,,,44.79,7011.25,18
HCPCS,J903700,Inj belantamab mafodot blmf,,,94.27,94.27,1
HCPCS,J9038,Inj axatilimab-csfr 0.1 mg,,,99.06,99.06,1
HCPCS,J9038,NIKTIMVO 50 MG/ML INTRAVENOUS SOLUTION,94500.0,61425.0,2.17,94500.0,118
HCPCS,J903800,Inj axatilimab-csfr 0.1 mg,,,99.06,99.06,1
HCPCS,J9039,BLINCYTO 35 MCG INTRAVENOUS KIT,26672.48,17337.11,2.17,26672.48,65
HCPCS,J9039,BLINCYTO 35 MCG INTRAVENOUS SOLUTION,26672.48,17337.11,2.17,26672.48,65
HCPCS,J9039,"Injection, blinatumomab",,,291.35,291.35,1
HCPCS,J903900,"Injection, blinatumomab",,,291.35,291.35,1
HCPCS,J9040,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,181.65,118.07,2.17,274.56,129
HCPCS,J9040,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,449.36,292.08,2.17,509.28,129
HCPCS,J9040,Bleomycin sulfate injection,,,40.98,40.98,1
HCPCS,J904000,Bleomycin sulfate injection,,,40.98,40.98,1
HCPCS,J9041,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,201.6,131.04,2.17,940.91,153
HCPCS,J9041,"Injection, bortezomib, 0.1mg",,,4.77,4.77,1
HCPCS,J9041,VELCADE 3.5 MG SOLUTION FOR INJECTION,7694.4,5001.36,2.17,7694.4,51
HCPCS,J904100,"Injection, bortezomib, 0.1mg",,,4.77,4.77,1
HCPCS,J9042,ADCETRIS 50 MG INTRAVENOUS SOLUTION,63216.76,41090.89,2.17,63216.76,65
HCPCS,J9042,Brentuximab vedotin inj,,,477.84,477.84,1
HCPCS,J904200,Brentuximab vedotin inj,,,477.84,477.84,1
HCPCS,J9043,Cabazitaxel injection,,,410.82,410.82,1
HCPCS,J9043,JEVTANA 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,47103.52,30617.29,2.17,47103.52,65
HCPCS,J904300,Cabazitaxel injection,,,410.82,410.82,1
HCPCS,J9044,"Inj, bortezomib, nos, 0.1 mg",,,16.25,500.04,9
HCPCS,J9045,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.5,4.875,0.53,12.88,430
HCPCS,J9045,Carboplatin injection,,,5.22,5.22,1
HCPCS,J904500,Carboplatin injection,,,5.22,5.22,1
HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,3.46,500.04,31
HCPCS,J904600,"Inj, bortezomib, dr. reddy's",,,97.83,97.83,1
HCPCS,J9047,"Injection, carfilzomib, 1 mg",,,98.99,98.99,1
HCPCS,J9047,KYPROLIS 10 MG INTRAVENOUS SOLUTION,2829.76,1839.34,2.17,2829.76,65
HCPCS,J9047,KYPROLIS 30 MG INTRAVENOUS SOLUTION,8489.28,5518.03,2.17,8489.28,65
HCPCS,J9047,KYPROLIS 60 MG INTRAVENOUS SOLUTION,16978.52,11036.04,2.17,16978.52,65
HCPCS,J904700,"Injection, carfilzomib, 1 mg",,,98.99,98.99,1
HCPCS,J9048,"Inj, bortezomib freseniuskab",,,6.97,500.04,31
HCPCS,J904800,"Inj, bortezomib freseniuskab",,,97.83,97.83,1
HCPCS,J9049,"Inj, bortezomib, hospira",,,2.58,500.04,14
HCPCS,J904900,"Inj, bortezomib, hospira",,,2.58,2.58,1
HCPCS,J9050,BICNU 100 MG INTRAVENOUS SOLUTION,9845.259999999998,6399.415000000001,2.17,18867.76,130
HCPCS,J9050,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,3600.0,2340.0,2.17,3600.0,65
HCPCS,J9050,Carmustine injection,,,414.06,414.06,1
HCPCS,J905000,Carmustine injection,,,414.06,414.06,1
HCPCS,J9051,"Inj, bortezomib (maia)",,,7.32,500.04,10
HCPCS,J905100,"Inj, bortezomib (maia)",,,7.32,7.32,1
HCPCS,J9052,"Inj, carmustine (accord)",,,0.11,3257.22,17
HCPCS,J905200,"Inj, carmustine (accord)",,,523.32,523.32,1
HCPCS,J9054,Inj bortezomib boruzu 0.1 mg,,,25.63,940.91,24
HCPCS,J905400,Inj bortezomib boruzu 0.1 mg,,,45.62,45.62,1
HCPCS,J9055,Cetuximab injection,,,143.01,143.01,1
HCPCS,J9055,ERBITUX 100 MG/50 ML INTRAVENOUS SOLUTION,80.32,52.21,2.17,3257.22,65
HCPCS,J9055,ERBITUX 200 MG/100 ML INTRAVENOUS SOLUTION,80.32,52.21,2.17,3257.22,65
HCPCS,J905500,Cetuximab injection,,,143.01,143.01,1
HCPCS,J9056,"Inj, vivimusta, 1 mg",,,27.84,3257.22,32
HCPCS,J905600,"Inj, vivimusta, 1 mg",,,56.94,56.94,1
HCPCS,J9057,"Inj., copanlisib, 1 mg",,,83.98,4487.68,18
HCPCS,J905700,"Inj., copanlisib, 1 mg",,,187.02,187.02,1
HCPCS,J9058,Inj apotex/bendamustine 1 mg,,,69.58,3257.22,10
HCPCS,J905800,Inj apotex/bendamustine 1 mg,,,69.58,69.58,1
HCPCS,J9059,"Inj bendamustine, baxter 1mg",,,49.98,3257.22,10
HCPCS,J905900,"Inj bendamustine, baxter 1mg",,,49.98,49.98,1
HCPCS,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.29,15.18,306
HCPCS,J9060,Cisplatin 10 mg injection,,,3.76,3.76,1
HCPCS,J906000,Cisplatin 10 mg injection,,,3.76,3.76,1
HCPCS,J9061,"Inj, amivantamab-vmjw",,,40.16,40.16,1
HCPCS,J9061,RYBREVANT 50 MG/ML INTRAVENOUS SOLUTION,2610.28,1696.68,2.17,4417.71,65
HCPCS,J906100,"Inj, amivantamab-vmjw",,,40.16,40.16,1
HCPCS,J9063,ELAHERE 5 MG/ML INTRAVENOUS SOLUTION,1627.76,1058.04,2.17,13108.79,65
HCPCS,J9063,"Inj, elahere, 1 mg",,,126.68,126.68,1
HCPCS,J906300,"Inj, elahere, 1 mg",,,126.68,126.68,1
HCPCS,J9064,"Inj, cabazitaxel (sandoz)",,,3815.3,4417.71,8
HCPCS,J9065,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,188.4,122.46000000000001,2.17,500.04,130
HCPCS,J9065,Inj cladribine per 1 mg,,,13.21,13.21,1
HCPCS,J906500,Inj cladribine per 1 mg,,,13.21,13.21,1
HCPCS,J9070,Cyclophosphamide 100 mg inj,,,24.78,500.04,11
HCPCS,J907000,Cyclophosphamide 100 mg inj,,,99.36,99.36,1
HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.6,500.04,32
HCPCS,J907100,Inj cyclophosphamd auromedic,,,1.09,1.09,1
HCPCS,J9072,Inj cyclophos frindovyx 5 mg,,,8.99,500.04,26
HCPCS,J907200,Inj cyclophos frindovyx 5 mg,,,16.0,16.0,1
HCPCS,J9073,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,527.4,342.81,0.69,527.4,65
HCPCS,J9073,Inj cyclophos dr reddys 5 mg,,,1.25,1.25,1
HCPCS,J907300,Inj cyclophos dr reddys 5 mg,,,1.25,1.25,1
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.84,500.04,32
HCPCS,J907400,"Inj, cyclophosphamd, sandoz",,,6.84,6.84,1
HCPCS,J9075,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,3296.24,2142.56,0.58,3296.24,65
HCPCS,J9075,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,6592.52,4285.14,0.58,6592.52,65
HCPCS,J9075,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1648.12,1071.28,0.58,1648.12,65
HCPCS,J9075,"Inj, cyclophosphamide, nos",,,1.05,1.05,1
HCPCS,J907500,"Inj, cyclophosphamide, nos",,,1.05,1.05,1
HCPCS,J9076,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,2253.52,1464.79,2.17,2253.52,59
HCPCS,J9076,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,7032.0,4570.8,2.17,7032.0,59
HCPCS,J9076,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1758.0,1142.7,2.17,1758.0,59
HCPCS,J9076,"Inj, cyclophos (baxter) 5mg",,,8.76,8.76,1
HCPCS,J907600,"Inj, cyclophos (baxter) 5mg",,,8.76,8.76,1
HCPCS,J9098,Cytarabine liposome inj,,,652.08,3257.22,11
HCPCS,J9100,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,5.4399999999999995,3.535,0.68,15.18,153
HCPCS,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,4.640000000000001,3.0149999999999997,0.65,15.18,102
HCPCS,J9100,CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,2.8,1.82,0.42,15.18,51
HCPCS,J9100,CYTARABINE 20 MG/ML INJECTION SOLUTION,3.2,2.08,0.48,15.18,51
HCPCS,J9100,Cytarabine hcl 100 mg inj,,,1.5,1.5,1
HCPCS,J910000,Cytarabine hcl 100 mg inj,,,1.5,1.5,1
HCPCS,J9118,ASPARLAS 750 UNIT/ML INTRAVENOUS SOLUTION,21428.67,13928.64,2.17,21428.67,59
HCPCS,J9118,Inj. calaspargase pegol-mknl,,,146.1,146.1,1
HCPCS,J911800,Inj. calaspargase pegol-mknl,,,146.1,146.1,1
HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,51.07,51.07,1
HCPCS,J9119,LIBTAYO 50 MG/ML INTRAVENOUS SOLUTION,7772.32,5052.01,2.17,7772.32,65
HCPCS,J911900,"Inj., cemiplimab-rwlc, 1 mg",,,51.07,51.07,1
HCPCS,J9120,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,2655.0,1725.75,2.17,2655.0,65
HCPCS,J9120,Dactinomycin injection,,,548.22,548.22,1
HCPCS,J912000,Dactinomycin injection,,,548.22,548.22,1
HCPCS,J9130,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,59.48,38.66,2.17,59.48,43
HCPCS,J9130,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,57.6,37.44,2.17,57.6,43
HCPCS,J9130,Dacarbazine 100 mg inj,,,7.33,7.33,1
HCPCS,J913000,Dacarbazine 100 mg inj,,,7.33,7.33,1
HCPCS,J9144,DARZALEX FASPRO 1800 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,2537.25,1649.21,2.17,4487.68,65
HCPCS,J9144,"Daratumumab, hyaluronidase",,,98.01,98.01,1
HCPCS,J914400,"Daratumumab, hyaluronidase",,,98.01,98.01,1
HCPCS,J9145,DARZALEX 20 MG/ML INTRAVENOUS SOLUTION,744.6,483.99,2.17,4487.68,130
HCPCS,J9145,"Injection, daratumumab 10 mg",,,126.01,126.01,1
HCPCS,J914500,"Injection, daratumumab 10 mg",,,126.01,126.01,1
HCPCS,J9150,DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,160.96,104.62,2.17,500.04,57
HCPCS,J9150,Daunorubicin injection,,,46.87,46.87,1
HCPCS,J915000,Daunorubicin injection,,,46.87,46.87,1
HCPCS,J9151,Daunorubicin citrate inj,,,18.5,629.28,11
HCPCS,J9153,"Inj daunorubicin, cytarabine",,,463.67,463.67,1
HCPCS,J9153,VYXEOS 44 MG-100 MG INTRAVENOUS SOLUTION,52704.0,34257.6,2.17,52704.0,65
HCPCS,J915300,"Inj daunorubicin, cytarabine",,,463.67,463.67,1
HCPCS,J9155,DEGARELIX INJECTION,6.0,3.9,1.1,9.29,27
HCPCS,J9155,Degarelix injection,,,7.92,7.92,1
HCPCS,J9155,FIRMAGON (240) 1MG (CUH),22.71,14.76,2.17,940.91,65
HCPCS,J9155,FIRMAGON (80) 1MG (CUH),22.71,14.76,2.17,940.91,65
HCPCS,J9155,FIRMAGON KIT WITH DILUENT SYRINGE 120 MG SUBCUTANEOUS SOLUTION,3658.04,2377.73,2.17,3658.04,65
HCPCS,J9155,FIRMAGON KIT WITH DILUENT SYRINGE 80 MG SUBCUTANEOUS SOLUTION,1758.42,1142.97,2.17,1758.42,65
HCPCS,J915500,Degarelix injection,,,7.92,7.92,1
HCPCS,J9160,Denileukin diftitox inj,,,3317.21,4417.71,10
HCPCS,J916000,Denileukin diftitox inj,,,3317.21,3317.21,1
HCPCS,J9161,Inj denileuk difti-cxdl 1mcg,,,3815.3,4417.71,8
HCPCS,J9165,Diethylstilbestrol injection,,,34.59,47.96,9
HCPCS,J9171,DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.04,98.18,1.16,327.06,51
HCPCS,J9171,DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,1.16,1460.6,102
HCPCS,J9171,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,991.9,644.735,1.16,1460.6,102
HCPCS,J9171,DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,991.3,644.345,1.16,1460.6,102
HCPCS,J9171,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.24,98.31,1.16,327.06,51
HCPCS,J9171,Docetaxel injection,,,1.16,1.16,1
HCPCS,J917100,Docetaxel injection,,,1.16,1.16,1
HCPCS,J9172,DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,167.48,108.86,2.17,327.06,65
HCPCS,J9172,"Docetaxel (docivyx), 1 mg",,,88.57,88.57,1
HCPCS,J917200,"Docetaxel (docivyx), 1 mg",,,88.57,88.57,1
HCPCS,J9173,IMFINZI 50 MG/ML INTRAVENOUS SOLUTION,2061.44,1339.94,2.17,3257.22,130
HCPCS,J9173,"Inj., durvalumab, 10 mg",,,153.56,153.56,1
HCPCS,J917300,"Inj., durvalumab, 10 mg",,,153.56,153.56,1
HCPCS,J9174,"Inj, docetaxel (beizray) 1mg",,,47.43,327.06,22
HCPCS,J917400,"Inj, docetaxel (beizray) 1mg",,,95.59,95.59,1
HCPCS,J9175,ELLIOTTS B (PF) 73 MG-19 MG-8 MG-3 MG/10 ML INTRATHECAL SOLUTION,37.8,24.57,2.17,47.96,51
HCPCS,J9175,Elliotts b solution per ml,,,21.79,21.79,1
HCPCS,J917500,Elliotts b solution per ml,,,21.79,21.79,1
HCPCS,J9176,EMPLICITI 300 MG INTRAVENOUS SOLUTION,10709.0,6960.85,2.17,10709.0,65
HCPCS,J9176,EMPLICITI 400 MG INTRAVENOUS SOLUTION,14278.52,9281.04,2.17,14278.52,65
HCPCS,J9176,"Injection, elotuzumab, 1mg",,,14.31,14.31,1
HCPCS,J917600,"Injection, elotuzumab, 1mg",,,14.31,14.31,1
HCPCS,J9177,Inj enfort vedo-ejfv 0.25mg,,,65.36,65.36,1
HCPCS,J9177,PADCEV 20 MG INTRAVENOUS SOLUTION,13483.2,8764.08,2.17,13483.2,65
HCPCS,J9177,PADCEV 30 MG INTRAVENOUS SOLUTION,20224.8,13146.12,2.17,20224.8,65
HCPCS,J917700,Inj enfort vedo-ejfv 0.25mg,,,65.36,65.36,1
HCPCS,J9178,ELLENCE 50 MG/25 ML INTRAVENOUS SOLUTION,9.24,6.01,1.37,9.24,43
HCPCS,J9178,"Inj, epirubicin hcl, 2 mg",,,3.51,3.51,1
HCPCS,J917800,"Inj, epirubicin hcl, 2 mg",,,3.51,3.51,1
HCPCS,J9179,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3084.0,2004.6,2.17,3084.0,65
HCPCS,J9179,Eribulin mesylate injection,,,129.25,129.25,1
HCPCS,J9179,HALAVEN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3384.0,2199.6,2.17,3384.0,65
HCPCS,J917900,Eribulin mesylate injection,,,129.25,129.25,1
HCPCS,J9181,ETOPOPHOS 100 MG INTRAVENOUS SOLUTION,817.68,531.49,1.85,817.68,51
HCPCS,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,9.08,5.9,1.34,15.18,255
HCPCS,J9181,Etoposide injection,,,1.85,1.85,1
HCPCS,J918100,Etoposide injection,,,1.85,1.85,1
HCPCS,J9183,"Gemcit intraves sys, 225 mg",,,14351.75,16617.81,8
HCPCS,J9184,Inj gemcitabin (avyxa) 200mg,,,401.7,1104.68,22
HCPCS,J918400,Inj gemcitabin (avyxa) 200mg,,,833.04,833.04,1
HCPCS,J9185,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,587.26,381.72,2.17,652.52,98
HCPCS,J9185,Fludarabine phosphate inj,,,144.91,144.91,1
HCPCS,J918500,Fludarabine phosphate inj,,,144.91,144.91,1
HCPCS,J9190,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,1.64,1.07,0.24,15.18,51
HCPCS,J9190,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,1.14,0.74,0.13,15.18,102
HCPCS,J9190,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,1.4,0.91,0.21,15.18,102
HCPCS,J9190,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.64,1.07,0.2,15.18,255
HCPCS,J9190,Fluorouracil injection,,,3.45,3.45,1
HCPCS,J919000,Fluorouracil injection,,,3.45,3.45,1
HCPCS,J9196,Inj gemcitabine hcl (accord),,,9.42,500.04,13
HCPCS,J919600,Inj gemcitabine hcl (accord),,,9.42,9.42,1
HCPCS,J9198,"Inj. infugem, 100 mg",,,26.55,940.91,17
HCPCS,J919800,"Inj. infugem, 100 mg",,,81.17,81.17,1
HCPCS,J9200,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,17474.92,11358.7,2.17,17474.92,57
HCPCS,J9200,Floxuridine injection,,,7573.76,7573.76,1
HCPCS,J920000,Floxuridine injection,,,7573.76,7573.76,1
HCPCS,J9201,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,238.32,154.91,2.17,243.76,153
HCPCS,J9201,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,5.66,3.6799999999999997,0.35,47.96,204
HCPCS,J9201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,3.34,2.17,0.39,47.96,102
HCPCS,J9201,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,55.480000000000004,36.06,2.17,57.6,102
HCPCS,J9201,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,7.32,4.76,0.63,47.96,153
HCPCS,J9201,In gemcitabine hcl nos 200mg,,,6.39,6.39,1
HCPCS,J920100,In gemcitabine hcl nos 200mg,,,6.39,6.39,1
HCPCS,J9202,GOSERELIN ACETATE IMPLANT,656.0,426.4,1.1,1563.74,27
HCPCS,J9202,Goserelin acetate implant,,,1383.95,1383.95,1
HCPCS,J9202,ZOLADEX 10.8 MG SUBCUTANEOUS IMPLANT,15421.96,10024.27,2.17,15421.96,65
HCPCS,J9202,ZOLADEX 3.6 MG SUBCUTANEOUS IMPLANT,5659.28,3678.53,2.17,5659.28,65
HCPCS,J920200,Goserelin acetate implant,,,1383.95,1383.95,1
HCPCS,J9203,Gemtuzumab ozogamicin 0.1 mg,,,427.5,427.5,1
HCPCS,J9203,MYLOTARG 4.5 MG (1 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,50407.44,32764.84,2.17,50407.44,65
HCPCS,J920300,Gemtuzumab ozogamicin 0.1 mg,,,427.5,427.5,1
HCPCS,J9204,"Inj mogamulizumab-kpkc, 1 mg",,,451.18,451.18,1
HCPCS,J9204,POTELIGEO 4 MG/ML INTRAVENOUS SOLUTION,4591.08,2984.2,2.17,7011.25,65
HCPCS,J920400,"Inj mogamulizumab-kpkc, 1 mg",,,451.18,451.18,1
HCPCS,J9205,Inj irinotecan liposome 1 mg,,,117.41,117.41,1
HCPCS,J9205,ONIVYDE 4.3 MG/ML INTRAVENOUS DISPERSION,1465.44,952.54,2.17,4487.68,65
HCPCS,J920500,Inj irinotecan liposome 1 mg,,,117.41,117.41,1
HCPCS,J9206,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,21.08,13.7,2.17,21.08,43
HCPCS,J9206,IRINOTECAN 300 MG/15 ML INTRAVENOUS SOLUTION,32.0,20.8,2.17,32.0,43
HCPCS,J9206,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,36.32,23.61,2.17,41.2,172
HCPCS,J9206,IRINOTECAN 500 MG/25 ML INTRAVENOUS SOLUTION,32.0,20.8,2.17,32.0,43
HCPCS,J9206,Irinotecan injection,,,3.19,3.19,1
HCPCS,J920600,Irinotecan injection,,,3.19,3.19,1
HCPCS,J9207,IXEMPRA 15 MG INTRAVENOUS SOLUTION,9669.88,6285.42,2.17,9669.88,65
HCPCS,J9207,IXEMPRA 45 MG INTRAVENOUS SOLUTION,29009.68,18856.29,2.17,29009.68,65
HCPCS,J9207,Ixabepilone injection,,,249.16,249.16,1
HCPCS,J920700,Ixabepilone injection,,,249.16,249.16,1
HCPCS,J9208,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,278.64,181.12,2.17,290.24,129
HCPCS,J9208,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,516.2,335.53,2.17,516.2,86
HCPCS,J9208,Ifosfamide injection,,,44.22,44.22,1
HCPCS,J920800,Ifosfamide injection,,,44.22,44.22,1
HCPCS,J9209,MESNA 100 MG/ML INTRAVENOUS SOLUTION,16.439999999999998,10.684999999999999,1.07,31.84,215
HCPCS,J9209,MESNEX 100 MG/ML INTRAVENOUS SOLUTION,12.0,7.8,1.79,12.0,43
HCPCS,J9209,Mesna injection,,,3.03,3.03,1
HCPCS,J920900,Mesna injection,,,3.03,3.03,1
HCPCS,J9210,GAMIFANT 5 MG/ML INTRAVENOUS SOLUTION,6679.8,4341.87,2.17,16617.81,130
HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,683.75,683.75,1
HCPCS,J921000,"Inj., emapalumab-lzsg, 1 mg",,,683.75,683.75,1
HCPCS,J9211,IDAMYCIN PFS 1 MG/ML INTRAVENOUS SOLUTION,44.489999999999995,28.919999999999998,2.17,327.06,102
HCPCS,J9211,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,41.34,26.87,2.17,327.06,204
HCPCS,J9211,Idarubicin hcl injection,,,71.29,71.29,1
HCPCS,J921100,Idarubicin hcl injection,,,71.29,71.29,1
HCPCS,J9212,Interferon alfacon-1 inj,,,7.65,312.82,11
HCPCS,J9213,Interferon alfa-2a inj,,,73.01,1676.17,11
HCPCS,J921300,Interferon alfa-2a inj,,,90.67,90.67,1
HCPCS,J9214,Interferon alfa-2b inj,,,27.13,1238.14,12
HCPCS,J921400,Interferon alfa-2b inj,,,65.65,65.65,1
HCPCS,J9215,Interferon alfa-n3 inj,,,64.33,325.3,4
HCPCS,J921500,Interferon alfa-n3 inj,,,64.33,64.33,1
HCPCS,J9216,ACTIMMUNE 100 MCG (2 MILLION UNIT)/0.5 ML SUBCUTANEOUS SOLUTION,40606.35,26394.13,2.17,40606.35,51
HCPCS,J9216,Interferon gamma 1-b inj,,,18069.81,18069.81,1
HCPCS,J921600,Interferon gamma 1-b inj,,,18069.81,18069.81,1
HCPCS,J9217,ELIGARD 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,4878.24,3170.86,2.17,4878.24,130
HCPCS,J9217,ELIGARD 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,6504.33,4227.81,2.17,6504.33,130
HCPCS,J9217,ELIGARD 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,9756.48,6341.71,2.17,9756.48,130
HCPCS,J9217,ELIGARD 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,2168.12,1409.28,2.17,2168.12,130
HCPCS,J9217,LEUPROLIDE ACETATE 7.5 MG,1288.48,837.51,2.17,1676.17,65
HCPCS,J9217,LEUPROLIDE ACETATE SUSPNSION,820.0,533.0,1.1,820.0,27
HCPCS,J9217,LUPRON DEPOT 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,23179.98,15066.99,2.17,23179.98,65
HCPCS,J9217,LUPRON DEPOT 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,30906.72,20089.37,2.17,30906.72,65
HCPCS,J9217,LUPRON DEPOT 45 MG (6 MONTH) INTRAMUSCULAR SYRINGE KIT,46360.77,30134.5,2.17,46360.77,65
HCPCS,J9217,LUPRON DEPOT 7.5 MG INTRAMUSCULAR SYRINGE KIT,7726.71,5022.36,2.17,7726.71,65
HCPCS,J9217,Leuprolide acetate suspnsion,,,303.99,303.99,1
HCPCS,J921700,Leuprolide acetate suspnsion,,,303.99,303.99,1
HCPCS,J9218,LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,2673.0,1737.45,2.17,2673.0,43
HCPCS,J9218,Leuprolide acetate injeciton,,,107.67,107.67,1
HCPCS,J921800,Leuprolide acetate injeciton,,,107.67,107.67,1
HCPCS,J9219,Leuprolide acetate implant,,,3815.3,10989.19,11
HCPCS,J921900,Leuprolide acetate implant,,,8579.28,8579.28,1
HCPCS,J9220,BLUDIGO 8 MG/ML (0.8 %) INTRAVENOUS SOLUTION,288.0,187.2,2.17,288.0,59
HCPCS,J9220,INDIGO CARMINE 8 MG/ML (0.8 %) INJECTION SOLUTION,5.19,3.37,1.15,27.55,59
HCPCS,J9220,Indigotindisulfonate sod 1mg,,,21.36,21.36,1
HCPCS,J922000,Indigotindisulfonate sod 1mg,,,21.36,21.36,1
HCPCS,J9223,"Inj. lurbinectedin, 0.1 mg",,,375.19,375.19,1
HCPCS,J9223,ZEPZELCA 4 MG INTRAVENOUS SOLUTION,39600.0,25740.0,2.17,39600.0,65
HCPCS,J922300,"Inj. lurbinectedin, 0.1 mg",,,375.19,375.19,1
HCPCS,J9225,Vantas implant,,,3875.72,13334.88,12
HCPCS,J922500,Vantas implant,,,10410.56,10410.56,1
HCPCS,J9226,SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT,180653.82,117424.98,2.17,180653.82,65
HCPCS,J9226,Supprelin la implant,,,76869.91,76869.91,1
HCPCS,J922600,Supprelin la implant,,,76869.91,76869.91,1
HCPCS,J9227,Inj. isatuximab-irfc 10 mg,,,150.05,150.05,1
HCPCS,J9227,SARCLISA 20 MG/ML INTRAVENOUS SOLUTION,889.4,578.11,2.17,4487.68,130
HCPCS,J922700,Inj. isatuximab-irfc 10 mg,,,150.05,150.05,1
HCPCS,J9228,Ipilimumab injection,,,332.7,332.7,1
HCPCS,J9228,YERVOY 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,2.17,7011.25,65
HCPCS,J9228,YERVOY 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,2.17,7011.25,65
HCPCS,J922800,Ipilimumab injection,,,332.7,332.7,1
HCPCS,J9229,BESPONSA 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,117092.48,76110.11,2.17,117092.48,65
HCPCS,J9229,Inj inotuzumab ozogam 0.1 mg,,,5013.85,5013.85,1
HCPCS,J922900,Inj inotuzumab ozogam 0.1 mg,,,5013.85,5013.85,1
HCPCS,J9230,Mechlorethamine hcl inj,,,272.62,847.36,12
HCPCS,J923000,Mechlorethamine hcl inj,,,661.54,661.54,1
HCPCS,J9245,Inj melpha hydroch nos 50 mg,,,154.75,154.75,1
HCPCS,J9245,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,3236.64,2103.815,2.17,5513.28,130
HCPCS,J924500,Inj melpha hydroch nos 50 mg,,,154.75,154.75,1
HCPCS,J9246,"Inj., evomela, 1 mg",,,17.35,4417.71,33
HCPCS,J924600,"Inj., evomela, 1 mg",,,33.16,33.16,1
HCPCS,J9247,"Inj, melphalan flufenami 1mg",,,516.0,7011.25,11
HCPCS,J924700,"Inj, melphalan flufenami 1mg",,,1014.6,1014.6,1
HCPCS,J9248,HEPZATO (62 MM CATHETER) 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,2.17,181536.0,65
HCPCS,J9248,HEPZATO 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,2.17,181536.0,65
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,1415.1,1415.1,1
HCPCS,J924800,Inj melphalan (hepzato) 1 mg,,,1415.1,1415.1,1
HCPCS,J9249,"Inj, melphalan (apotex) 1 mg",,,64.77,1095.84,22
HCPCS,J924900,"Inj, melphalan (apotex) 1 mg",,,130.53,130.53,1
HCPCS,J9250,Methotrexate sodium inj,,,0.24,15.18,11
HCPCS,J925000,Methotrexate sodium inj,,,0.39,0.39,1
HCPCS,J9255,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.220000000000001,2.745,0.6,15.18,204
HCPCS,J9256,IMAAVY 185 MG/ML INTRAVENOUS SOLUTION,6912.0,4492.8,2.17,7011.25,59
HCPCS,J9256,"Inj, nipocalimab-aahu, 3 mg",,,58.28,58.28,1
HCPCS,J925600,"Inj, nipocalimab-aahu, 3 mg",,,58.28,58.28,1
HCPCS,J9258,Paclitaxel (teva),,,2282.35,2642.72,8
HCPCS,J9259,Paclitaxel (american regent),,,35.01,2642.72,10
HCPCS,J925900,Paclitaxel (american regent),,,35.01,35.01,1
HCPCS,J9260,Inj methotrexate sodium 50mg,,,4.59,4.59,1
HCPCS,J9260,METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION,305.28,198.43,2.17,305.28,102
HCPCS,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,8.08,5.25,1.2,15.18,51
HCPCS,J9260,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,14.420000000000002,9.375,1.61,17.44,204
HCPCS,J926000,Inj methotrexate sodium 50mg,,,4.59,4.59,1
HCPCS,J9261,NELARABINE 5 MG/ML INTRAVENOUS SOLUTION,63.44,41.24,2.17,4417.71,65
HCPCS,J9261,Nelarabine injection,,,115.98,115.98,1
HCPCS,J926100,Nelarabine injection,,,115.98,115.98,1
HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,3.42,1095.84,18
HCPCS,J926200,"Inj, omacetaxine mep, 0.01mg",,,8.12,8.12,1
HCPCS,J9263,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,14.52,9.44,0.09,47.96,102
HCPCS,J9263,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,23.04,14.98,0.09,47.96,51
HCPCS,J9263,Oxaliplatin,,,0.09,0.09,1
HCPCS,J926300,Oxaliplatin,,,0.09,0.09,1
HCPCS,J9264,ABRAXANE 100 MG INTRAVENOUS SUSPENSION,7584.28,4929.78,2.17,7584.28,65
HCPCS,J9264,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,7867.04,5113.58,2.17,7867.04,65
HCPCS,J9264,Paclitaxel protein bound,,,14.56,14.56,1
HCPCS,J926400,Paclitaxel protein bound,,,14.56,14.56,1
HCPCS,J9266,ONCASPAR 750 UNIT/ML INJECTION SOLUTION,26386.12,17150.98,2.17,84209.09,65
HCPCS,J9266,Pegaspargase injection,,,50594.83,50594.83,1
HCPCS,J926600,Pegaspargase injection,,,50594.83,50594.83,1
HCPCS,J9267,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,8.12,5.28,0.18,9.6,129
HCPCS,J9267,Paclitaxel injection,,,0.18,0.18,1
HCPCS,J926700,Paclitaxel injection,,,0.18,0.18,1
HCPCS,J9268,NIPENT 10 MG INTRAVENOUS SOLUTION,14661.92,9530.25,2.17,14661.92,65
HCPCS,J9268,Pentostatin injection,,,4516.04,4516.04,1
HCPCS,J926800,Pentostatin injection,,,4516.04,4516.04,1
HCPCS,J9269,ELZONRIS 1000 MCG/ML INTRAVENOUS SOLUTION,162031.92,105320.75,2.17,162031.92,65
HCPCS,J9269,Inj. tagraxofusp-erzs 10 mcg,,,635.5,635.5,1
HCPCS,J926900,Inj. tagraxofusp-erzs 10 mcg,,,635.5,635.5,1
HCPCS,J9270,Plicamycin (mithramycin) inj,,,225.13,1676.17,9
HCPCS,J9271,Inj pembrolizumab,,,106.32,106.32,1
HCPCS,J9271,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,2.17,7218.8,195
HCPCS,J927100,Inj pembrolizumab,,,106.32,106.32,1
HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,440.44,440.44,1
HCPCS,J9272,JEMPERLI 50 MG/ML INTRAVENOUS SOLUTION,4417.53,2871.39,2.17,7011.25,65
HCPCS,J927200,"Inj, dostarlimab-gxly, 10 mg",,,440.44,440.44,1
HCPCS,J9273,"Inj tisotu vedotin-tftv, 1mg",,,349.0,349.0,1
HCPCS,J9273,TIVDAK 40 MG INTRAVENOUS SOLUTION,35523.84,23090.5,2.17,35523.84,65
HCPCS,J927300,"Inj tisotu vedotin-tftv, 1mg",,,349.0,349.0,1
HCPCS,J9274,"Inj, tebentafusp-tebn, 1 mcg",,,395.53,395.53,1
HCPCS,J9274,KIMMTRAK 100 MCG/0.5 ML INTRAVENOUS SOLUTION,201504.0,130977.6,2.17,201504.0,65
HCPCS,J927400,"Inj, tebentafusp-tebn, 1 mcg",,,395.53,395.53,1
HCPCS,J9275,"Inj cosibelimab-ipdl, 2 mg",,,22.92,4417.71,22
HCPCS,J927500,"Inj cosibelimab-ipdl, 2 mg",,,46.19,46.19,1
HCPCS,J9276,"Inj zanidatamab-hrii, 2 mg",,,44.5,44.5,1
HCPCS,J9276,ZIIHERA 300 MG INTRAVENOUS SOLUTION,17064.0,11091.6,2.17,17064.0,59
HCPCS,J927600,"Inj zanidatamab-hrii, 2 mg",,,44.5,44.5,1
HCPCS,J9277,Inj pem 1 mg bera alfa-pmph,,,6055.17,7011.25,8
HCPCS,J9280,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2639.6400000000003,1715.7649999999999,2.17,2831.28,195
HCPCS,J9280,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,5231.280000000001,3400.33,2.17,5662.56,195
HCPCS,J9280,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,1089.84,708.4,2.17,1089.84,65
HCPCS,J9280,Mitomycin injection,,,46.46,46.46,1
HCPCS,J928000,Mitomycin injection,,,46.46,46.46,1
HCPCS,J9281,JELMYTO 40 MG X 2 INTRA-PYELOCALYCEAL KIT,122136.0,79388.4,2.17,122136.0,65
HCPCS,J9281,Mitomycin instillation,,,576.56,576.56,1
HCPCS,J928100,Mitomycin instillation,,,576.56,576.56,1
HCPCS,J9282,Mitomycin intravesical inst,,,276.81,13108.79,22
HCPCS,J928200,Mitomycin intravesical inst,,,574.05,574.05,1
HCPCS,J9285,"Inj, olaratumab, 10 mg",,,54.03,4487.68,12
HCPCS,J928500,"Inj, olaratumab, 10 mg",,,104.91,104.91,1
HCPCS,J9286,COLUMVI 1 MG/ML INTRAVENOUS SOLUTION,5203.82,3382.4849999999997,2.17,8424.39,130
HCPCS,J9286,"Inj glofitamab gxbm, 2.5 mg",,,5061.59,5061.59,1
HCPCS,J928600,"Inj glofitamab gxbm, 2.5 mg",,,5061.59,5061.59,1
HCPCS,J9289,Inj nivolumab 2 mg hyaluron,,,27.8,4417.71,24
HCPCS,J928900,Inj nivolumab 2 mg hyaluron,,,49.48,49.48,1
HCPCS,J9292,"Inj, pemetrexed dipotassium",,,81.23,2642.72,25
HCPCS,J929200,"Inj, pemetrexed dipotassium",,,144.59,144.59,1
HCPCS,J9293,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,85.72,55.72,2.17,500.04,260
HCPCS,J9293,Mitoxantrone hydrochl / 5 mg,,,54.97,54.97,1
HCPCS,J929300,Mitoxantrone hydrochl / 5 mg,,,54.97,54.97,1
HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,7.46,7.46,1
HCPCS,J9294,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,94.305,61.3,0.62,2642.72,130
HCPCS,J929400,"Inj pemetrexed, hospira 10mg",,,7.46,7.46,1
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,5.73,4417.71,33
HCPCS,J929500,"Injection, necitumumab, 1 mg",,,10.2,10.2,1
HCPCS,J9296,ALIMTA 500 MG INTRAVENOUS SOLUTION,19406.4,12614.16,2.17,19406.4,65
HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,17.34,17.34,1
HCPCS,J9296,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,720.0,468.0,2.17,2642.72,65
HCPCS,J929600,Inj pemetrexed (accord) 10mg,,,17.34,17.34,1
HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,2.65,2642.72,13
HCPCS,J929700,Inj pemetrexed (sandoz) 10mg,,,2.65,2.65,1
HCPCS,J9298,Inj nivol relatlimab 3mg/1mg,,,358.94,358.94,1
HCPCS,J9298,OPDUALAG 240 MG-80 MG/20 ML INTRAVENOUS SOLUTION,3701.28,2405.83,2.17,16617.81,65
HCPCS,J929800,Inj nivol relatlimab 3mg/1mg,,,358.94,358.94,1
HCPCS,J9299,"Injection, nivolumab",,,59.75,59.75,1
HCPCS,J9299,OPDIVO 100 MG/10 ML INTRAVENOUS SOLUTION,1588.6,1032.59,2.17,4417.71,65
HCPCS,J9299,OPDIVO 120 MG/12 ML INTRAVENOUS SOLUTION,1588.6,1032.59,2.17,4417.71,65
HCPCS,J9299,OPDIVO 240 MG/24 ML INTRAVENOUS SOLUTION,1588.6,1032.59,2.17,4417.71,65
HCPCS,J9299,OPDIVO 40 MG/4 ML INTRAVENOUS SOLUTION,1588.64,1032.62,2.17,4417.71,65
HCPCS,J929900,"Injection, nivolumab",,,59.75,59.75,1
HCPCS,J9301,GAZYVA 1000 MG/40 ML INTRAVENOUS SOLUTION,1080.04,702.03,2.17,4417.71,65
HCPCS,J9301,Obinutuzumab inj,,,145.3,145.3,1
HCPCS,J930100,Obinutuzumab inj,,,145.3,145.3,1
HCPCS,J9302,ARZERRA 100 MG/5 ML INTRAVENOUS SOLUTION,579.24,376.51,2.17,4417.71,65
HCPCS,J9302,ARZERRA 1000 MG/50 ML INTRAVENOUS SOLUTION,579.24,376.51,2.17,4417.71,65
HCPCS,J9302,Ofatumumab injection,,,128.87,128.87,1
HCPCS,J930200,Ofatumumab injection,,,128.87,128.87,1
HCPCS,J9303,Panitumumab injection,,,309.13,309.13,1
HCPCS,J9303,VECTIBIX 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,2.17,4487.68,65
HCPCS,J9303,VECTIBIX 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,2.17,4487.68,65
HCPCS,J930300,Panitumumab injection,,,309.13,309.13,1
HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,39.93,4417.71,33
HCPCS,J930400,"Inj. pemetrexed, 10 mg",,,71.08,71.08,1
HCPCS,J9305,ALIMTA 100 MG INTRAVENOUS SOLUTION,3881.28,2522.83,2.17,3881.28,65
HCPCS,J9305,Inj. pemetrexed nos 10mg,,,6.39,6.39,1
HCPCS,J9305,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,144.0,93.6,2.17,2642.72,65
HCPCS,J930500,Inj. pemetrexed nos 10mg,,,6.39,6.39,1
HCPCS,J9306,"Injection, pertuzumab, 1 mg",,,30.28,30.28,1
HCPCS,J9306,PERJETA 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,2338.44,1519.99,2.17,4487.68,65
HCPCS,J930600,"Injection, pertuzumab, 1 mg",,,30.28,30.28,1
HCPCS,J9307,PRALATREXATE 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,23913.44,15543.74,2.17,23913.44,65
HCPCS,J9307,PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION,23913.44,15543.74,2.17,23913.44,65
HCPCS,J9307,Pralatrexate injection,,,699.04,699.04,1
HCPCS,J930700,Pralatrexate injection,,,699.04,699.04,1
HCPCS,J9308,CYRAMZA 10 MG/ML INTRAVENOUS SOLUTION,720.38,468.245,2.17,4417.71,130
HCPCS,J9308,"Injection, ramucirumab",,,134.53,134.53,1
HCPCS,J930800,"Injection, ramucirumab",,,134.53,134.53,1
HCPCS,J9309,"Inj, polatuzumab vedotin 1mg",,,243.45,243.45,1
HCPCS,J9309,POLIVY 140 MG INTRAVENOUS SOLUTION,89334.76,58067.59,2.17,89334.76,65
HCPCS,J9309,POLIVY 30 MG INTRAVENOUS SOLUTION,19143.2,12443.08,2.17,19143.2,65
HCPCS,J930900,"Inj, polatuzumab vedotin 1mg",,,243.45,243.45,1
HCPCS,J9311,"Inj rituximab, hyaluronidase",,,65.63,65.63,1
HCPCS,J9311,RITUXAN HYCELA 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2698.08,1753.75,2.17,4487.68,65
HCPCS,J9311,RITUXAN HYCELA 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2019.24,1312.51,2.17,4487.68,65
HCPCS,J931100,"Inj rituximab, hyaluronidase",,,65.63,65.63,1
HCPCS,J9312,"Inj., rituximab, 10 mg",,,133.09,133.09,1
HCPCS,J9312,RITUXAN 10 MG/ML CONCENTRATEINTRAVENOUS,450.96,293.12,2.17,4487.68,130
HCPCS,J931200,"Inj., rituximab, 10 mg",,,133.09,133.09,1
HCPCS,J9313,"Inj., lumoxiti, 0.01 mg",,,23.39,4417.71,31
HCPCS,J931300,"Inj., lumoxiti, 0.01 mg",,,47.13,47.13,1
HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,5.52,2642.72,32
HCPCS,J931400,Inj pemetrexed (teva) 10mg,,,27.29,27.29,1
HCPCS,J9315,Romidepsin injection,,,3815.3,4417.71,8
HCPCS,J9316,PHESGO 1200 MG-600 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,4453.28,2894.63,2.17,4487.68,65
HCPCS,J9316,PHESGO 600 MG-600 MG-20000 UNIT/10 ML SUBCUTANEOUS SOLUTION,4453.12,2894.53,2.17,4487.68,65
HCPCS,J9316,"Pertuzu, trastuzu, 10 mg",,,108.51,108.51,1
HCPCS,J931600,"Pertuzu, trastuzu, 10 mg",,,108.51,108.51,1
HCPCS,J9317,Sacituzumab govitecan-hziy,,,65.82,65.82,1
HCPCS,J9317,TRODELVY 180 MG INTRAVENOUS SOLUTION,12304.8,7998.12,2.17,12304.8,65
HCPCS,J931700,Sacituzumab govitecan-hziy,,,65.82,65.82,1
HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,50.77,50.77,1
HCPCS,J9318,ROMIDEPSIN 5 MG/ML INTRAVENOUS SOLUTION,7292.92,4740.4,2.17,7292.92,65
HCPCS,J931800,Inj romidepsin non-lyo 0.1mg,,,50.77,50.77,1
HCPCS,J9319,ISTODAX 10 MG/2 ML INTRAVENOUS SOLUTION,15353.52,9979.79,2.17,15353.52,65
HCPCS,J9319,Inj romidepsin lyophil 0.1mg,,,55.02,55.02,1
HCPCS,J9319,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,15209.52,9886.19,2.17,15209.52,65
HCPCS,J931900,Inj romidepsin lyophil 0.1mg,,,55.02,55.02,1
HCPCS,J9320,Streptozocin injection,,,362.0,2776.8,12
HCPCS,J932000,Streptozocin injection,,,2776.8,2776.8,1
HCPCS,J9321,EPKINLY 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,8405.0,5463.25,2.17,8405.0,65
HCPCS,J9321,EPKINLY 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,100859.76,65558.84,2.17,100859.76,65
HCPCS,J9321,Inj epcoritamab-bysp 0.16 mg,,,101.12,101.12,1
HCPCS,J932100,Inj epcoritamab-bysp 0.16 mg,,,101.12,101.12,1
HCPCS,J9322,Inj pemetrexed (bluepoint),,,10.6,2642.72,23
HCPCS,J932200,Inj pemetrexed (bluepoint),,,19.46,19.46,1
HCPCS,J9323,Inj pemetrexed ditromethamin,,,0.12,2642.72,32
HCPCS,J932300,Inj pemetrexed ditromethamin,,,0.23,0.23,1
HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,73.31,2642.72,32
HCPCS,J932400,"Inj, pemrydi rtu, 10 mg",,,130.51,130.51,1
HCPCS,J9325,IMLYGIC 10EXP6 (1 MILLION) PFU/ML SUSPENSION FOR INJECTION,335.36,217.98,2.17,4417.71,65
HCPCS,J9325,IMLYGIC 10EXP8 (100 MILLION) PFU/ML SUSPENSION FOR INJECTION,33531.8,21795.67,2.17,33531.8,65
HCPCS,J9325,Inj talimogene laherparepvec,,,131.61,131.61,1
HCPCS,J932500,Inj talimogene laherparepvec,,,131.61,131.61,1
HCPCS,J9326,EMRELIS 100 MG INTRAVENOUS SOLUTION,67104.0,43617.6,2.17,67104.0,59
HCPCS,J9326,EMRELIS 20 MG INTRAVENOUS SOLUTION,13420.8,8723.52,2.17,13420.8,59
HCPCS,J9326,Telisotuzumab vedotin-tllv,,,259.65,259.65,1
HCPCS,J932600,Telisotuzumab vedotin-tllv,,,259.65,259.65,1
HCPCS,J9328,TEMODAR 100 MG INTRAVENOUS SOLUTION,4814.92,3129.7,2.17,4814.92,65
HCPCS,J9328,Temozolomide injection,,,18.51,18.51,1
HCPCS,J932800,Temozolomide injection,,,18.51,18.51,1
HCPCS,J9329,"Inj, tislelizumab-jsgr",,,58.37,4487.68,32
HCPCS,J932900,"Inj, tislelizumab-jsgr",,,103.9,103.9,1
HCPCS,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,4643.61,3018.35,2.17,4643.61,65
HCPCS,J9330,TORISEL 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLUTION,7561.23,4914.8,2.17,7561.23,65
HCPCS,J9330,Temsirolimus injection,,,36.17,36.17,1
HCPCS,J933000,Temsirolimus injection,,,36.17,36.17,1
HCPCS,J9331,Inj sirolimus prot part 1 mg,,,87.11,7011.25,32
HCPCS,J933100,Inj sirolimus prot part 1 mg,,,155.06,155.06,1
HCPCS,J9332,Inj efgartigimod 2mg,,,57.35,57.35,1
HCPCS,J9332,VYVGART 20 MG/ML INTRAVENOUS SOLUTION,1136.55,738.76,2.17,7011.25,65
HCPCS,J933200,Inj efgartigimod 2mg,,,57.35,57.35,1
HCPCS,J9333,Inj rozanolixizum-noli 1 mg,,,41.62,41.62,1
HCPCS,J9333,RYSTIGGO 140 MG/ML SUBCUTANEOUS SOLUTION,11163.96,7256.57,2.17,11163.96,65
HCPCS,J933300,Inj rozanolixizum-noli 1 mg,,,41.62,41.62,1
HCPCS,J9334,Inj efgart-alfa 2mg hya-qvfc,,,60.73,60.73,1
HCPCS,J9334,VYVGART HYTRULO 1008 MG-11200 UNIT/5.6 ML SUBCUTANEOUS SOLUTION,10549.44,6857.14,2.17,10549.44,65
HCPCS,J933400,Inj efgart-alfa 2mg hya-qvfc,,,60.73,60.73,1
HCPCS,J9340,Thiotepa injection,,,209.02,940.91,17
HCPCS,J9341,Inj thiotepa (tepylute) 1 mg,,,68.62,940.91,11
HCPCS,J934100,Inj thiotepa (tepylute) 1 mg,,,68.62,68.62,1
HCPCS,J9342,Inj thiotepa nos 1 mg,,,15.77,15.77,1
HCPCS,J9342,TEPADINA 100 MG SOLUTION FOR INJECTION,8640.0,5616.0,2.17,8640.0,59
HCPCS,J9342,THIOTEPA 15 MG SOLUTION FOR INJECTION,960.0,624.0,2.17,960.0,59
HCPCS,J934200,Inj thiotepa nos 1 mg,,,15.77,15.77,1
HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,54.34,54.34,1
HCPCS,J9345,ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION,3538.32,2299.91,2.17,7011.25,65
HCPCS,J934500,"Inj, retifanlimab-dlwr, 1 mg",,,54.34,54.34,1
HCPCS,J9347,IMJUDO 20 MG/ML INTRAVENOUS SOLUTION,13243.88,8608.52,2.17,13243.88,130
HCPCS,J9347,"Inj, tremelimumab-actl, 1 mg",,,254.58,254.58,1
HCPCS,J934700,"Inj, tremelimumab-actl, 1 mg",,,254.58,254.58,1
HCPCS,J9348,DANYELZA 4 MG/ML INTRAVENOUS SOLUTION,12511.64,8132.57,2.17,13108.79,65
HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,1221.22,1221.22,1
HCPCS,J934800,"Inj. naxitamab-gqgk, 1 mg",,,1221.22,1221.22,1
HCPCS,J9349,"Inj., tafasitamab-cxix",,,25.35,25.35,1
HCPCS,J9349,MONJUVI 200 MG INTRAVENOUS SOLUTION,6700.16,4355.1,2.17,6700.16,65
HCPCS,J934900,"Inj., tafasitamab-cxix",,,25.35,25.35,1
HCPCS,J9350,"Inj mosunetuzumab-axgb, 1 mg",,,1166.58,1166.58,1
HCPCS,J9350,LUNSUMIO 1 MG/ML INTRAVENOUS SOLUTION,2996.42,1947.6750000000002,2.17,16617.81,130
HCPCS,J935000,"Inj mosunetuzumab-axgb, 1 mg",,,1166.58,1166.58,1
HCPCS,J9351,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,1042.98,677.9350000000001,2.17,1433.0,86
HCPCS,J9351,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,519.24,337.51,2.17,519.24,43
HCPCS,J9351,Topotecan injection,,,2.23,2.23,1
HCPCS,J935100,Topotecan injection,,,2.23,2.23,1
HCPCS,J9352,Injection trabectedin 0.1mg,,,696.1,696.1,1
HCPCS,J9352,YONDELIS 1 MG INTRAVENOUS SOLUTION,17708.84,11510.75,2.17,17708.84,65
HCPCS,J935200,Injection trabectedin 0.1mg,,,696.1,696.1,1
HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,95.68,95.68,1
HCPCS,J9353,MARGENZA 25 MG/ML INTRAVENOUS SOLUTION,1034.73,672.57,2.17,4487.68,65
HCPCS,J935300,"Inj. margetuximab-cmkb, 5 mg",,,95.68,95.68,1
HCPCS,J9354,"Inj, ado-trastuzumab emt 1mg",,,75.1,75.1,1
HCPCS,J9354,KADCYLA 100 MG INTRAVENOUS SOLUTION,19150.24,12447.66,2.17,19150.24,65
HCPCS,J9354,KADCYLA 160 MG INTRAVENOUS SOLUTION,30640.32,19916.21,2.17,30640.32,65
HCPCS,J935400,"Inj, ado-trastuzumab emt 1mg",,,75.1,75.1,1
HCPCS,J9355,HERCEPTIN 150 MG INTRAVENOUS SOLUTION,7480.4,4862.26,2.17,7480.4,65
HCPCS,J9355,Inj trastuzumab excl biosimi,,,130.79,130.79,1
HCPCS,J935500,Inj trastuzumab excl biosimi,,,130.79,130.79,1
HCPCS,J9356,HERCEPTIN HYLECTA 600 MG-10000 UNIT/5 ML SUBCUTANEOUS SOLUTION,4488.24,2917.36,2.17,4488.24,65
HCPCS,J9356,"Inj. herceptin hylecta, 10mg",,,108.7,108.7,1
HCPCS,J935600,"Inj. herceptin hylecta, 10mg",,,108.7,108.7,1
HCPCS,J9357,VALSTAR 40 MG/ML INTRAVESICAL SOLUTION,1776.24,1154.56,2.17,4487.68,65
HCPCS,J9357,Valrubicin injection,,,2319.95,2319.95,1
HCPCS,J935700,Valrubicin injection,,,2319.95,2319.95,1
HCPCS,J9358,ENHERTU 100 MG INTRAVENOUS SOLUTION,14815.04,9629.78,2.17,14815.04,65
HCPCS,J9358,Inj fam-trastu deru-nxki 1mg,,,55.71,55.71,1
HCPCS,J935800,Inj fam-trastu deru-nxki 1mg,,,55.71,55.71,1
HCPCS,J9359,Inj lon tesirin-lpyl 0.075mg,,,393.77,393.77,1
HCPCS,J9359,ZYNLONTA 10 MG INTRAVENOUS SOLUTION,104507.16,67929.65,2.17,104507.16,65
HCPCS,J935900,Inj lon tesirin-lpyl 0.075mg,,,393.77,393.77,1
HCPCS,J9360,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,25.8,16.77,2.17,25.8,43
HCPCS,J9360,Vinblastine sulfate inj,,,9.22,9.22,1
HCPCS,J936000,Vinblastine sulfate inj,,,9.22,9.22,1
HCPCS,J9361,"Inj, efbemalenograstim alfa-",,,245.64,3257.22,9
HCPCS,J936100,"Inj, efbemalenograstim alfa-",,,245.64,245.64,1
HCPCS,J9370,VINCASAR PFS 1 MG/ML INTRAVENOUS SOLUTION,72.24,46.96,2.17,72.24,51
HCPCS,J9370,VINCASAR PFS 2 MG/2 ML INTRAVENOUS SOLUTION,72.24,46.96,2.17,72.24,51
HCPCS,J9370,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,58.980000000000004,38.335,2.17,89.48,102
HCPCS,J9370,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,35.96,23.375,2.17,45.44,102
HCPCS,J9370,Vincristine sulfate 1 mg inj,,,14.51,14.51,1
HCPCS,J937000,Vincristine sulfate 1 mg inj,,,14.51,14.51,1
HCPCS,J9371,"Inj, vincristine sul lip 1mg",,,3549.87,9410.04,11
HCPCS,J937100,"Inj, vincristine sul lip 1mg",,,7346.43,7346.43,1
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,91.73,16617.81,24
HCPCS,J937600,"Inj pozelimab-bbfg, 1 mg",,,184.85,184.85,1
HCPCS,J9380,Inj teclistamab cqyv 0.5 mg,,,61.55,61.55,1
HCPCS,J9380,TECVAYLI 10 MG/ML SUBCUTANEOUS SOLUTION,3277.64,2130.47,2.17,4487.68,65
HCPCS,J9380,TECVAYLI 90 MG/ML SUBCUTANEOUS SOLUTION,29498.96,19174.32,2.17,29498.96,65
HCPCS,J938000,Inj teclistamab cqyv 0.5 mg,,,61.55,61.55,1
HCPCS,J9381,Inj teplizumab mzwv 5 mcg,,,36.9,16617.81,32
HCPCS,J938100,Inj teplizumab mzwv 5 mcg,,,68.33,68.33,1
HCPCS,J9382,BIZENGRI 375 MG/18.75 ML (20 MG/ML) INTRAVENOUS SOLUTION,3067.36,1993.78,2.17,4417.71,59
HCPCS,J9382,Inj zenocutuzumab-zbco 1 mg,,,59.75,59.75,1
HCPCS,J938200,Inj zenocutuzumab-zbco 1 mg,,,59.75,59.75,1
HCPCS,J9390,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,120.0,78.0,2.17,120.0,43
HCPCS,J9390,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,86.4,56.16,2.17,86.4,43
HCPCS,J9390,Vinorelbine tartrate inj,,,9.68,9.68,1
HCPCS,J939000,Vinorelbine tartrate inj,,,9.68,9.68,1
HCPCS,J9393,"Inj, fulvestrant (teva)",,,11.46,500.04,31
HCPCS,J939300,"Inj, fulvestrant (teva)",,,42.72,42.72,1
HCPCS,J9394,FASLODEX 250 MG/5 ML INTRAMUSCULAR SYRINGE,930.76,604.99,2.17,930.76,65
HCPCS,J9394,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,84.0,54.6,2.17,500.04,65
HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,48.26,48.26,1
HCPCS,J939400,"Inj, fulvestrant (fresenius)",,,48.26,48.26,1
HCPCS,J9395,"Injection, fulvestrant",,,7.51,500.04,20
HCPCS,J939500,"Injection, fulvestrant",,,10.18,10.18,1
HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,6.5,1287.79,33
HCPCS,J940000,"Inj, ziv-aflibercept, 1mg",,,12.85,12.85,1
HCPCS,J9600,PHOTOFRIN 75 MG INTRAVENOUS SOLUTION,111950.4,72767.76,2.17,111950.4,65
HCPCS,J9600,Porfimer sodium injection,,,49817.93,49817.93,1
HCPCS,J960000,Porfimer sodium injection,,,49817.93,49817.93,1
HCPCS,J9601,Inj linvoselt-gcpt 1 mg,,,6055.17,7011.25,8
HCPCS,J9999,TALTZ AUTOINJECTOR 80 MG/ML SUBCUTANEOUS,26141.43,16991.93,2.17,26141.43,43
HCPCS,K0001,Standard wheelchair,,,25.16,118.31,10
HCPCS,K0002,Stnd hemi (low seat) whlchr,,,25.16,199.87,10
HCPCS,K0003,Lightweight wheelchair,,,25.16,173.8,10
HCPCS,K0004,High strength ltwt whlchr,,,46.46,208.83,10
HCPCS,K0005,Ultralightweight wheelchair,,,531.62,1053.33,10
HCPCS,K0006,Heavy duty wheelchair,,,46.46,307.54,10
HCPCS,K0007,Extra heavy duty wheelchair,,,46.46,437.56,10
HCPCS,K0008,Cstm manual wheelchair/base,,,28.98,33.56,8
HCPCS,K0009,Other manual wheelchair/base,,,8.84,423.61,10
HCPCS,K0010,Stnd wt frame power whlchr,,,672.04,2278.41,10
HCPCS,K0011,Stnd wt pwr whlchr w control,,,2481.14,2918.97,2
HCPCS,K0012,Ltwt portbl power whlchr,,,72.46,1851.37,10
HCPCS,K0013,Custom power whlchr base,,,25.16,29.13,8
HCPCS,K0014,Other power whlchr base,,,8.84,10.24,8
HCPCS,K0015,Detach non-adj ht armrst rep,,,46.46,74.45,10
HCPCS,K0017,Detach adjust armrest base,,,20.05,29.13,10
HCPCS,K0018,Detach adjust armrst upper,,,11.35,33.56,10
HCPCS,K0019,"Arm pad repl, each",,,5.78,10.24,10
HCPCS,K0020,Fixed adjust armrest pair,,,19.41,33.56,10
HCPCS,K0037,Hi mount flip-up footrest ea,,,15.23,29.13,10
HCPCS,K0038,Leg strap each,,,8.84,11.79,10
HCPCS,K0039,Leg strap h style each,,,21.51,29.13,10
HCPCS,K0040,Adjustable angle footplate,,,22.19,29.13,10
HCPCS,K0041,Large size footplate each,,,20.56,29.13,10
HCPCS,K0042,Standard size ftplate rep ea,,,13.22,33.56,10
HCPCS,K0043,Ftrst lowr exten tube rep ea,,,8.09,10.24,10
HCPCS,K0044,Ftrst upr hanger brac rep ea,,,6.97,10.24,10
HCPCS,K0045,Ftrst compl assembly repl ea,,,23.35,29.13,10
HCPCS,K0046,Elev lgrst lwr exten repl ea,,,8.09,10.24,10
HCPCS,K0047,Elev legrst upr hangr rep ea,,,25.16,34.1,10
HCPCS,K0050,Ratchet assembly replacement,,,13.46,33.56,10
HCPCS,K0051,Cam rel asm ft/legrst rep ea,,,21.27,29.13,10
HCPCS,K0052,Swingaway detach ftrest repl,,,25.16,37.46,10
HCPCS,K0053,Elevate footrest articulate,,,35.82,53.79,10
HCPCS,K0056,Seat ht <17 or >=21 ltwt wc,,,25.16,47.34,10
HCPCS,K0065,Spoke protectors,,,20.29,33.56,10
HCPCS,K0069,Rr whl compl sol tire rep ea,,,41.05,53.79,10
HCPCS,K0070,Rr whl compl pne tire rep ea,,,46.46,79.84,10
HCPCS,K0071,Fr cstr comp pne tire rep ea,,,46.46,55.69,10
HCPCS,K0072,Fr cstr semi-pne tire rep ea,,,25.16,34.26,10
HCPCS,K0073,Caster pin lock each,,,15.36,33.56,10
HCPCS,K0077,Fr cstr asmb sol tire rep ea,,,23.25,29.13,10
HCPCS,K0098,"Drive belt for pwc, repl",,,10.47,33.56,10
HCPCS,K0105,Iv hanger,,,43.3,53.79,10
HCPCS,K0108,W/c component-accessory nos,,,28.98,33.56,8
HCPCS,K0195,Elevating whlchair leg rests,,,8.84,52.82,10
HCPCS,K0455,Pump uninterrupted infusion,,,278.93,1509.16,10
HCPCS,K0462,Temporary replacement eqpmnt,,,13.46,15.59,8
HCPCS,K0552,Sup/ext non-ins inf pump syr,,,11.79,15.59,10
HCPCS,K0553,Ther cgm supply allowance,,,46.46,53.79,8
HCPCS,K0554,Ther cgm receiver/monitor,,,46.46,53.79,8
HCPCS,K0601,Repl batt silver oxide 1.5 v,,,5.34,15.59,10
HCPCS,K0602,Repl batt silver oxide 3 v,,,13.46,35.5,10
HCPCS,K0603,Repl batt alkaline 1.5 v,,,2.72,15.59,10
HCPCS,K0604,Repl batt lithium 3.6 v,,,13.46,34.22,10
HCPCS,K0605,Repl batt lithium 4.5 v,,,8.84,81.76,10
HCPCS,K0606,Aed garment w elec analysis,,,12196.88,14349.14,2
HCPCS,K0607,Repl batt for aed,,,94.1,322.97,10
HCPCS,K0608,Repl garment for aed,,,46.46,69.21,10
HCPCS,K0609,Repl electrode for aed,,,1022.49,4593.05,10
HCPCS,K0669,Seat/back cus no dmepdac ver,,,25.16,29.13,8
HCPCS,K0672,Removable soft interface le,,,25.16,416.69,10
HCPCS,K0730,Ctrl dose inh drug deliv sys,,,531.62,982.32,10
HCPCS,K0733,12-24hr sealed lead acid,,,12.06,33.56,10
HCPCS,K0738,Portable gas oxygen system,,,157.28,185.04,2
HCPCS,K0739,Repair/svc dme non-oxygen eq,,,13.46,80.4,10
HCPCS,K0743,Portable home suction pump,,,28.98,33.56,8
HCPCS,K0744,Absorp drg <= 16 suc pump,,,28.98,33.56,8
HCPCS,K0745,Absorp drg >16<=48 suc pump,,,28.98,33.56,8
HCPCS,K0746,Absorp drg >48 suc pump,,,28.98,33.56,8
HCPCS,K0800,Pov group 1 std up to 300lbs,,,347.09,615.56,10
HCPCS,K0801,Pov group 1 hd 301-450 lbs,,,531.62,741.27,10
HCPCS,K0802,Pov group 1 vhd 451-600 lbs,,,865.33,1018.02,2
HCPCS,K0806,Pov group 2 std up to 300lbs,,,531.62,699.21,10
HCPCS,K0807,Pov group 2 hd 301-450 lbs,,,921.06,1083.59,2
HCPCS,K0808,Pov group 2 vhd 451-600 lbs,,,1423.84,1675.09,2
HCPCS,K0813,Pwc gp 1 std port seat/back,,,72.46,1309.13,10
HCPCS,K0814,Pwc gp 1 std port cap chair,,,672.04,1299.69,10
HCPCS,K0815,Pwc gp 1 std seat/back,,,672.04,1436.19,10
HCPCS,K0816,Pwc gp 1 std cap chair,,,672.04,1359.43,10
HCPCS,K0820,Pwc gp 2 std port seat/back,,,72.46,1325.44,10
HCPCS,K0821,Pwc gp 2 std port cap chair,,,672.04,1372.98,10
HCPCS,K0822,Pwc gp 2 std seat/back,,,264.38,1449.95,10
HCPCS,K0823,Pwc gp 2 std cap chair,,,264.38,1374.54,10
HCPCS,K0824,Pwc gp 2 hd seat/back,,,264.38,2070.63,10
HCPCS,K0825,Pwc gp 2 hd cap chair,,,264.38,1889.75,10
HCPCS,K0826,Pwc gp 2 vhd seat/back,,,1022.49,3832.03,10
HCPCS,K0827,Pwc gp vhd cap chair,,,264.38,3303.19,10
HCPCS,K0828,Pwc gp 2 xtra hd seat/back,,,1022.49,4690.49,10
HCPCS,K0829,Pwc gp 2 xtra hd cap chair,,,1022.49,4432.48,10
HCPCS,K0835,Pwc gp2 std sing pow opt s/b,,,264.38,1796.59,10
HCPCS,K0836,Pwc gp2 std sing pow opt cap,,,264.38,1863.44,10
HCPCS,K0837,Pwc gp 2 hd sing pow opt s/b,,,264.38,2304.32,10
HCPCS,K0838,Pwc gp 2 hd sing pow opt cap,,,264.38,2042.4,10
HCPCS,K0839,Pwc gp2 vhd sing pow opt s/b,,,1022.49,3060.94,10
HCPCS,K0840,Pwc gp2 xhd sing pow opt s/b,,,531.62,4699.52,10
HCPCS,K0841,Pwc gp2 std mult pow opt s/b,,,264.38,2024.61,10
HCPCS,K0842,Pwc gp2 std mult pow opt cap,,,264.38,2021.65,10
HCPCS,K0843,Pwc gp2 hd mult pow opt s/b,,,264.38,2399.96,10
HCPCS,K0848,Pwc gp 3 std seat/back,,,264.38,3892.89,10
HCPCS,K0849,Pwc gp 3 std cap chair,,,264.38,3742.76,10
HCPCS,K0850,Pwc gp 3 hd seat/back,,,1022.49,4515.49,10
HCPCS,K0851,Pwc gp 3 hd cap chair,,,1022.49,4341.73,10
HCPCS,K0852,Pwc gp 3 vhd seat/back,,,1022.49,5217.41,10
HCPCS,K0853,Pwc gp 3 vhd cap chair,,,1022.49,5359.63,10
HCPCS,K0854,Pwc gp 3 xhd seat/back,,,531.62,7100.36,10
HCPCS,K0855,Pwc gp 3 xhd cap chair,,,531.62,6707.3,10
HCPCS,K0856,Pwc gp3 std sing pow opt s/b,,,1022.49,4178.48,10
HCPCS,K0857,Pwc gp3 std sing pow opt cap,,,1022.49,4262.28,10
HCPCS,K0858,Pwc gp3 hd sing pow opt s/b,,,1022.49,5184.31,10
HCPCS,K0859,Pwc gp3 hd sing pow opt cap,,,1022.49,4944.29,10
HCPCS,K0860,Pwc gp3 vhd sing pow opt s/b,,,531.62,7406.51,10
HCPCS,K0861,Pwc gp3 std mult pow opt s/b,,,1022.49,4185.24,10
HCPCS,K0862,Pwc gp3 hd mult pow opt s/b,,,1022.49,5184.31,10
HCPCS,K0863,Pwc gp3 vhd mult pow opt s/b,,,531.62,7406.51,10
HCPCS,K0864,Pwc gp3 xhd mult pow opt s/b,,,531.62,8813.71,10
HCPCS,K0900,Cstm dme other than wheelchr,,,13.46,15.59,8
HCPCS,K1001,Electronic posa treatment,,,25.16,29.13,8
HCPCS,K1002,Ces system,,,1022.49,1183.93,8
HCPCS,K1004,Lo freq us diathermy device,,,46.46,53.79,8
HCPCS,K1005,Disp col sto bag breast milk,,,8.84,10.24,8
HCPCS,K1006,Suct pum ext urine mgmt sys,,,25.16,29.13,8
HCPCS,K1007,Bil hkaf pc s/d micro sensor,,,13433.1,380152.97,10
HCPCS,K1009,Speech volume modulation sys,,,1022.49,1183.93,8
HCPCS,K1010,Intraurethral drainag device,,,13.46,15.59,8
HCPCS,K1011,Acti intraurethral drainage,,,13.46,15.59,8
HCPCS,K1012,Charger base station intraur,,,13.46,15.59,8
HCPCS,K1013,Enema tube any type repl,,,13.46,15.59,8
HCPCS,K1015,"Foot, adductus position, adj",,,46.46,53.79,8
HCPCS,K1016,Trans elec nerv for trigemin,,,25.16,29.13,8
HCPCS,K1017,Monthly supp use with k1016,,,28.98,33.56,8
HCPCS,K1019,Supp ext up limb tremor stim,,,28.98,33.56,8
HCPCS,K1020,Non-invasive vagus nerv stim,,,672.04,778.15,8
HCPCS,K1021,Exsuff belt incl all sup acc,,,1022.49,1183.93,8
HCPCS,K1022,Endoskel posit rotat unit,,,672.04,778.15,8
HCPCS,K1023,Trans elec nerv periph nerv,,,72.46,83.9,8
HCPCS,K1024,Non pneum comp control cal,,,3167.07,3667.14,8
HCPCS,K1025,Non pneum compress full arm,,,672.04,778.15,8
HCPCS,K1026,Mech allergen parti barrier,,,278.93,322.97,8
HCPCS,K1027,Oral dev without fix mech,,,264.38,306.12,8
HCPCS,K1028,Control unit nm stim w phone,,,531.62,615.56,8
HCPCS,K1029,Oral dv/app neuromus mouthpi,,,46.46,53.79,8
HCPCS,K1030,Ext recharge bat replacement,,,531.62,615.56,8
HCPCS,K1031,Non pneu comp control w/o ca,,,1022.49,1183.93,8
HCPCS,K1032,Non pneum seq comp full leg,,,46.46,53.79,8
HCPCS,K1033,Non pneum seq comp half leg,,,46.46,53.79,8
HCPCS,K1034,Covid test self-admn/collect,,,13.46,15.59,8
HCPCS,K1035,Mol diag reader self-admn,,,25.16,29.13,8
HCPCS,K1036,Supplies for ultra diatherm,,,8.84,10.24,8
HCPCS,K1037,Docking station for oral dev,,,264.38,306.12,8
HCPCS,L0112,Cranial cervical orthosis,,,531.62,6877.14,10
HCPCS,L0113,Cranial cervical torticollis,,,72.46,1401.25,10
HCPCS,L0120,"CERVICAL, FLEXIBLE, NON-ADJUSTABLE",41.0,26.65,1.1,104.79,33
HCPCS,L0120,COLLAR ADULT - REG,22.0,14.3,4.8,129.98,48
HCPCS,L0120,YB CERVICAL FLEXIBLE NON-ADJ FOAM COLLAR,131.0,85.15,28.56,131.0,48
HCPCS,L0130,Flex thermoplastic collar mo,,,46.46,750.02,10
HCPCS,L0140,Cervical semi-rigid adjustab,,,25.16,294.11,10
HCPCS,L0150,"COLLAR, ASPEN VISTA UNIVERSAL",195.0,126.75,42.51,525.92,48
HCPCS,L0150,YB CERVICAL COLLAR CHIN CUP,573.0,372.45,46.46,573.0,48
HCPCS,L0160,Cerv sr wire occ/man pre ots,,,46.46,767.97,10
HCPCS,L0170,Cervical collar molded to pt,,,264.38,3950.66,10
HCPCS,L0172,ASPEN COLLAR,68.0,44.2,14.82,695.89,48
HCPCS,L0172,CERVICAL COLLAR MED.,3156.0,2051.4,46.46,3156.0,48
HCPCS,L0172,SEMI-RIGID CERVICAL COLLAR,161.0,104.65,1.1,561.19,33
HCPCS,L0174,YB CERV COLLAR W/THOR EXT,1498.0,973.7,72.46,1498.0,48
HCPCS,L0180,"YB - CERVICAL, MULTIPLE POST COLLAR OCCIPITAL/MANIBULA, ADJUSTAB",1894.0,1231.1,412.89,2216.8,48
HCPCS,L0190,YB CERV M-POST COLLAR (SOMI),3236.0,2103.4,264.38,3236.0,48
HCPCS,L0200,"YB CERV COLLAR M-POST,THOR EXT",3156.0,2051.4,264.38,3156.0,48
HCPCS,L0220,Thor rib belt custom fabrica,,,46.46,634.75,10
HCPCS,L0450,TLSO BACK BRACE,240.0,156.0,46.46,492.46,48
HCPCS,L0452,Tlso flex custom fab thoraci,,,278.93,322.97,8
HCPCS,L0454,YB TLSO BACK BRACE,1766.0,1147.9,72.46,1766.0,48
HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,72.46,914.23,10
HCPCS,L0456,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,75.92,4887.04,48
HCPCS,L0456,SPINOMED BRACE (BASIC),263.0,170.95,57.33,4887.04,48
HCPCS,L0456,SPINOMED BRACE (FULL),305.0,198.25,66.49,4887.04,48
HCPCS,L0456,YB TLSO FLEX TRNK SJ-SS PRE CAST,4161.0,2704.65,531.62,4887.04,48
HCPCS,L0457,YB TLSO FLEX PROV TRUNK SUPP,4161.0,2704.65,531.62,4161.0,48
HCPCS,L0458,Tlso 2mod symphis-xipho pre,,,1022.49,4382.27,10
HCPCS,L0460,YB TLSO 2 SHELL BOA DUAL,5351.0,3478.15,531.62,5351.0,48
HCPCS,L0462,YB TLSO 3 SHELL,3732.0,2425.8,531.62,6135.12,48
HCPCS,L0464,YB TLSO 4 SHELL,7931.0,5155.15,531.62,7931.0,48
HCPCS,L0466,YB TLSO SAG RIG POST FRAME,2297.0,1493.05,500.75,2297.0,48
HCPCS,L0467,Tlso r fram soft pre ots,,,672.04,1025.34,10
HCPCS,L0468,Tlso rig fram pelvic pre cst,,,264.38,2336.31,10
HCPCS,L0469,Tlso rig fram pelvic pre ots,,,264.38,1306.45,10
HCPCS,L0470,Tlso rigid frame pre subclav,,,264.38,3232.9,10
HCPCS,L0472,YB TLSO HYPEREXT,2059.0,1338.35,448.86,2059.0,48
HCPCS,L0480,Tlso rigid plastic custom fa,,,531.62,7421.82,10
HCPCS,L0482,Tlso rigid lined custom fab,,,531.62,8290.23,10
HCPCS,L0484,Tlso rigid plastic cust fab,,,7610.16,8953.05,2
HCPCS,L0486,YB TLSO 2 SHELL W/LINER,10459.0,6798.35,2280.06,10459.0,40
HCPCS,L0488,Tlso rigid lined pre one pie,,,531.62,4932.5,10
HCPCS,L0490,Tlso rigid plastic pre one,,,72.46,1389.93,10
HCPCS,L0491,Tlso 2 piece rigid shell,,,1022.49,3773.66,10
HCPCS,L0492,Tlso 3 piece rigid shell,,,264.38,2457.25,10
HCPCS,L0621,SIO FLEX PELVISACRAL PREFAB,159.0,103.35,34.66,259.64,48
HCPCS,L0622,Sio flex pelvisacral custom,,,278.93,1313.33,10
HCPCS,L0623,Sio rig pnl pelv/sac pre ots,,,46.46,465.43,10
HCPCS,L0624,Sio panel custom,,,46.46,53.79,8
HCPCS,L0625,LUMBOSACRAL SUPPORT,175.0,113.75,25.16,175.0,48
HCPCS,L0626,Lo sag rig pnl stays pre cst,,,25.16,382.99,10
HCPCS,L0627,LO SAGITT RIGID PANEL PREFAB,611.0,397.15,1.1,1628.64,33
HCPCS,L0627,LSO BACK BRACE,655.0,425.75,142.79,2019.61,48
HCPCS,L0627,POH LO SAG RIGID PANEL PREFAB,3301.0,2145.65,672.04,3301.0,48
HCPCS,L0627,YB LO SAG RIGID PANEL (BOA),2420.0,1573.0,527.56,2420.0,48
HCPCS,L0628,YB LSO CORSET,868.0,564.2,25.16,868.0,48
HCPCS,L0629,Lso flex w/rigid stays cust,,,46.46,53.79,8
HCPCS,L0630,Lso r post pnl sj-t9 pre cst,,,46.46,795.84,10
HCPCS,L0631,Lso sag r an/pos pnl pre cst,,,531.62,5044.13,10
HCPCS,L0632,Lso sag rigid frame cust,,,531.62,615.56,8
HCPCS,L0633,YB LSO AP CORSET W/APRON,1972.0,1281.8,72.46,1972.0,48
HCPCS,L0634,YB LSO SAG-COR W/RIG POST FRM,2376.0,1544.4,264.38,2376.0,48
HCPCS,L0635,Lso sagit rigid panel prefab,,,531.62,4909.87,10
HCPCS,L0636,Lso sagittal rigid panel cus,,,531.62,6661.88,10
HCPCS,L0637,LSO SAG-CORONAL PANEL PREFAB,1507.0,979.55,1.1,5133.37,33
HCPCS,L0637,W BRACE LSO SAG-CORONL PNL PRFB,249.0,161.85,54.28,6365.65,48
HCPCS,L0637,YB LSO SAG-COR RIG POST PREFAB,6638.0,4314.7,531.62,6638.0,48
HCPCS,L0638,Lso sag-coronal panel custom,,,531.62,6480.72,10
HCPCS,L0639,Lso s/c shell/panel prefab,,,531.62,6365.65,10
HCPCS,L0640,Lso s/c shell/panel custom,,,531.62,5141.57,10
HCPCS,L0641,YB LO SAG W/RIG PANEL POS L1-5,394.0,256.1,85.89,778.15,48
HCPCS,L0642,YB LO SAG RIGID AN/POS PREFAB,2732.0,1775.8,595.58,2732.0,48
HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,46.46,427.01,10
HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,531.62,2706.74,10
HCPCS,L0649,YB LSO SAG-COR RIGD PREFAB OTS,2138.0,1389.7,72.46,2138.0,48
HCPCS,L0650,YB LSO SAG-COR RIGD PNL PREFAB,7506.0,4878.9,531.62,7506.0,48
HCPCS,L0651,Lso sag-co shell pnl pre ots,,,531.62,3131.83,10
HCPCS,L0700,YB CTLSO ANT/POST/LAT MOLDED,12114.0,7874.1,2640.85,12114.0,40
HCPCS,L0710,YB CTLSO ANT/POST/LAT CONTROL,11722.0,7619.3,2555.4,11722.0,40
HCPCS,L0720,Ctlso a-p-l control custom,,,8092.64,9520.67,2
HCPCS,L0810,YB HALO JACKET VEST,13670.0,8885.5,2980.06,13670.0,40
HCPCS,L0820,Halo cervical into body jack,,,8781.79,10331.43,2
HCPCS,L0830,Halo cerv into milwaukee typ,,,13437.4,15808.56,2
HCPCS,L0859,YB ADTN HALO MRI COMP SYSTEM,5210.0,3386.5,531.62,5597.04,48
HCPCS,L0861,YB ADTN HALO LINER/INTERFACE,1097.0,713.05,239.15,1097.0,48
HCPCS,L0970,Tlso corset front,,,46.46,525.12,10
HCPCS,L0972,Lso corset front,,,46.46,477.94,10
HCPCS,L0974,Tlso full corset,,,278.93,858.65,10
HCPCS,L0976,Lso full corset,,,46.46,734.67,10
HCPCS,L0978,Axillary crutch extension,,,278.93,924.58,10
HCPCS,L0980,Peroneal straps pair pre ots,,,8.84,83.92,10
HCPCS,L0982,Stocking sup grips 4 pre ots,,,8.84,76.89,10
HCPCS,L0984,Protect body sock ea pre ots,,,25.16,332.49,10
HCPCS,L0999,YB ADTL SPINAL ORTHO HALO RING,219.0,142.35,13.46,219.0,48
HCPCS,L1000,Ctlso milwauke initial model,,,8469.2,9963.67,2
HCPCS,L1001,Ctlso infant immobilizer,,,46.46,53.79,8
HCPCS,L1005,Tension based scoliosis orth,,,13367.86,15726.76,2
HCPCS,L1006,Scoliosis orth sag/ cor,,,531.62,5234.0,10
HCPCS,L1007,Scoliosis orth s-c custom,,,531.62,615.56,8
HCPCS,L1010,Ctlso axilla sling,,,25.16,411.13,10
HCPCS,L1020,Kyphosis pad,,,25.16,529.48,10
HCPCS,L1025,Kyphosis pad floating,,,46.46,763.9,10
HCPCS,L1030,Lumbar bolster pad,,,25.16,384.75,10
HCPCS,L1040,Lumbar or lumbar rib pad,,,25.16,435.64,10
HCPCS,L1050,Sternal pad,,,25.16,493.02,10
HCPCS,L1060,Thoracic pad,,,46.46,532.16,10
HCPCS,L1070,Trapezius sling,,,46.46,551.27,10
HCPCS,L1080,Outrigger,,,25.16,257.08,10
HCPCS,L1085,Outrigger bil w/ vert extens,,,25.16,860.69,10
HCPCS,L1090,Lumbar sling,,,46.46,494.42,10
HCPCS,L1100,Ring flange plastic/leather,,,46.46,933.14,10
HCPCS,L1110,Ring flange plas/leather mol,,,278.93,1564.54,10
HCPCS,L1120,Covers for upright each,,,28.98,186.88,10
HCPCS,L1200,Furnsh initial orthosis only,,,531.62,8793.0,10
HCPCS,L1210,Lateral thoracic extension,,,278.93,1202.18,10
HCPCS,L1220,Anterior thoracic extension,,,278.93,1170.11,10
HCPCS,L1230,Milwaukee type superstructur,,,264.38,3277.96,10
HCPCS,L1240,Lumbar derotation pad,,,25.16,446.88,10
HCPCS,L1250,Anterior asis pad,,,25.16,388.63,10
HCPCS,L1260,Anterior thoracic derotation,,,25.16,463.43,10
HCPCS,L1270,Abdominal pad,,,25.16,407.26,10
HCPCS,L1280,Rib gusset (elastic) each,,,25.16,429.37,10
HCPCS,L1290,Lateral trochanteric pad,,,25.16,381.79,10
HCPCS,L1300,Body jacket mold to patient,,,531.62,8468.47,10
HCPCS,L1310,Post-operative body jacket,,,531.62,8820.63,10
HCPCS,L1499,YB SPINAL ORTHOSIS,155.0,100.75,13.46,155.0,48
HCPCS,L1600,Ho flex frejka w/cov pre cst,,,46.46,633.19,10
HCPCS,L1610,Ho frejka cov only pre cst,,,28.98,268.92,10
HCPCS,L1620,Ho flex pavlik harns pre cst,,,46.46,772.05,10
HCPCS,L1630,Abduct control hip semi-flex,,,46.46,1038.05,10
HCPCS,L1640,Pelv band/spread bar thigh c,,,264.38,2326.11,10
HCPCS,L1650,Ho abduction hip adjustable,,,278.93,1211.73,10
HCPCS,L1652,Ho bi thighcuffs w sprdr bar,,,72.46,1751.57,10
HCPCS,L1653,Ho abduction static ots,,,72.46,1751.57,10
HCPCS,L1660,Ho abduction static plastic,,,46.46,887.92,10
HCPCS,L1680,Pelvic & hip control thigh c,,,531.62,5597.92,10
HCPCS,L1681,Ho bilateral hip abduction,,,7827.15,9208.33,2
HCPCS,L1685,Post-op hip abduct custom fa,,,531.62,5464.98,10
HCPCS,L1686,YB HO HIP JOINT,4791.0,3114.15,531.62,4791.0,48
HCPCS,L1690,Combination bilateral ho,,,8076.57,9501.76,2
HCPCS,L1700,Leg perthes orth toronto typ,,,531.62,7644.72,10
HCPCS,L1710,Legg perthes orth newington,,,8274.63,9734.78,2
HCPCS,L1720,Legg perthes orthosis trilat,,,531.62,7248.5,10
HCPCS,L1730,Legg perthes orth scottish r,,,531.62,6119.33,10
HCPCS,L1755,Legg perthes patten bottom t,,,531.62,8797.84,10
HCPCS,L1810,KO ELASTIC W/JOINTS,165.0,107.25,1.1,407.92,33
HCPCS,L1810,"LATERAL ""J"" BRACE",92.75,60.29,20.22,505.85,48
HCPCS,L1810,PREFAB ELASTIC KO W JNTS,175.0,113.75,38.15,505.85,48
HCPCS,L1810,REACTION KNEE BRACE,95.0,61.75,20.71,505.85,48
HCPCS,L1810,TRU PULL LITE,146.0,94.9,31.83,505.85,48
HCPCS,L1812,OA REACTION BRACE,153.0,99.45,1.1,294.32,33
HCPCS,L1812,OA REACTION KNEE BRACE,135.0,87.75,29.43,313.9,48
HCPCS,L1812ORD,KO ELASTIC W/JOINTS PRE OTS,135.0,87.75,1.1,135.0,22
HCPCS,L1820,ECONOMY HINGED KNEE BRACE,69.0,44.85,15.04,698.29,48
HCPCS,L1820,HINGED KNEE BRACE,97.0,63.05,21.15,698.29,48
HCPCS,L1820,KO ELAS W/ CONDYLE PADS & JO,211.0,137.15,1.1,563.13,33
HCPCS,L1820,PLAYMAKER KNEE BRACE,167.28,108.73,36.47,698.29,48
HCPCS,L1820,YB KO KNEE W/PADS & JTS,1046.0,679.9,46.46,1046.0,48
HCPCS,L1821,Ko elas w/ condyle pads otf,,,46.46,698.29,10
HCPCS,L1830,"KO IMMOBILIZER, CANVAS LONGITUDE",124.0,80.6,1.1,255.71,33
HCPCS,L1830,PREFAB CANVAS KO IMMOBILIZER,109.5,71.175,18.53,282.87,96
HCPCS,L1830,YB KO KNEE BRACE IMMOB,528.0,343.2,25.16,528.0,48
HCPCS,L1831,Knee orth pos locking joint,,,72.46,1446.15,10
HCPCS,L1832,"KO ADJUSTABLE KNEE JOINTS,RIGID",1023.0,664.95,1.1,2729.31,33
HCPCS,L1832,PLAYMAKER KNEE BRACE,836.0,543.4,182.25,3384.52,48
HCPCS,L1832,THROM ADVANCE KNEE,589.0,382.85,128.4,3384.52,48
HCPCS,L1832,TROM KNEE BRACE,1097.0,713.05,239.15,3384.52,48
HCPCS,L1832,W BRACE ACL T-ROM KO ADJ JNT,151.0,98.15,32.92,3384.52,48
HCPCS,L1832,YB KO KNEE ADJ JOINTS,3523.0,2289.95,264.38,3523.0,48
HCPCS,L1834,Ko w/0 joint rigid molded to,,,1022.49,3566.47,10
HCPCS,L1836,Ko rigid w/o joints pre ots,,,46.46,399.94,10
HCPCS,L1840,Ko derot ant cruciate custom,,,531.62,4620.8,10
HCPCS,L1843,KO SINGLE UPRIGHT CUSTOM FIT,958.5,623.0250000000001,1.1,4408.86,81
HCPCS,L1843,YB KNEE ORTHOSIS (BRACE) SINGLE UPRIGHT PRE-FAB,3077.0,2000.05,670.79,4408.86,48
HCPCS,L1844,"KNEE ORTHOSIS (KO), SINGLE UPRIGHT CUSTOM FABRICATED",950.0,617.5,207.1,7482.67,48
HCPCS,L1845,ACL BRACE-OTS,159.0,103.35,34.66,4116.07,48
HCPCS,L1845,"KO DOUBLE UPRIGHT, CUSTOM FITTED",1244.0,808.6,1.1,3319.22,33
HCPCS,L1845,OA KNEE BRACE,1584.0,1029.6,345.31,4116.07,48
HCPCS,L1845,OTS BRACE - ACL/PCL,759.0,493.35,165.46,4116.07,48
HCPCS,L1845,W KO W/ ADJ FLEX/EXT ROTAT CUS,1041.52,676.99,227.05,4116.07,48
HCPCS,L1846,CUSTOM ACL/PCL W/PNEUMATIC KNE,1059.0,688.35,230.86,5749.09,48
HCPCS,L1846,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,278.17,5749.09,48
HCPCS,L1846,"KO DOUBLE UPRIGHT, MOLDED",1738.0,1129.7,1.1,4636.16,33
HCPCS,L1847,Ko dbl upright w/air pre cst,,,264.38,2826.17,10
HCPCS,L1848,Ko dbl upright w/air pre ots,,,264.38,2826.17,10
HCPCS,L1850,Ko swedish type pre ots,,,72.46,921.19,10
HCPCS,L1851,Ko single upright prefab ots,,,264.38,2689.47,10
HCPCS,L1852,KO DOUBLE UPRIGHT PREFAB OTS,612.0,397.8,1.1,2401.88,33
HCPCS,L1852,Ko double upright prefab ots,,,264.38,2565.72,10
HCPCS,L1860,Ko supracondylar socket mold,,,531.62,6127.2,10
HCPCS,L1900,Afo sprng wir drsflx calf bd,,,72.46,1401.93,10
HCPCS,L1902,AFO ANKLE GAUNTLET,119.0,77.35,25.16,366.75,48
HCPCS,L1902,AIR SPORT/ANKLE BRACE,163.0,105.95,25.16,366.75,48
HCPCS,L1902,"ASO ANKLE GAUNTLET, CUSTOM FITTED",111.0,72.15,1.1,295.77,33
HCPCS,L1902,YB AFO ANKLE GAUNTLET PREFAB INC FIT & ADJ,314.0,204.1,25.16,366.75,48
HCPCS,L1904,Afo molded ankle gauntlet,,,264.38,2217.88,10
HCPCS,L1906,AFO AIR CAST,182.0,118.3,39.68,552.55,48
HCPCS,L1907,Afo supramalleolar custom,,,264.38,2764.96,10
HCPCS,L1910,Afo sing bar clasp attach sh,,,72.46,1377.98,10
HCPCS,L1920,Afo sing upright w/ adjust s,,,72.46,2018.53,10
HCPCS,L1930,YB AFO SINGLE UPRIGHT,1502.0,976.3,278.93,1502.0,48
HCPCS,L1932,"AFO,RIGID,ANTERIOR,CRB, PREFAB",3734.0,2427.1,814.01,4384.59,48
HCPCS,L1933,Afo rig ant tib tcf/= ots,,,1022.49,4384.59,10
HCPCS,L1940,YB AFO PLASTIC,2490.0,1618.5,264.38,2490.0,48
HCPCS,L1945,Afo molded plas rig ant tib,,,531.62,5515.48,10
HCPCS,L1950,Afo spiral molded to pt plas,,,1022.49,3778.86,10
HCPCS,L1951,PREFAB SPIRAL AFO,3515.0,2284.75,766.27,4126.5,48
HCPCS,L1952,Afo spiral prefab ots,,,1022.49,4126.5,10
HCPCS,L1960,"YB AFO POS SOLID ANKLE, PLASTIC, CUSTOM FAB",2606.0,1693.9,264.38,3045.83,48
HCPCS,L1970,YB AFO PLASTIC ANKLE JOINT,3543.0,2302.95,772.37,3543.0,48
HCPCS,L1971,"Afo w/ankle joint, prefab",,,264.38,2303.36,10
HCPCS,L1980,Afo sing solid stirrup calf,,,672.04,1983.95,10
HCPCS,L1990,Afo doub solid stirrup calf,,,264.38,2296.17,10
HCPCS,L2000,Kafo sing fre stirr thi/calf,,,531.62,5496.77,10
HCPCS,L2005,Kafo sng/dbl mechanical act,,,17114.61,20134.66,2
HCPCS,L2006,Kaf sng/dbl swg/stn mcpr cus,,,134369.52,158080.39,2
HCPCS,L2010,Kafo sng solid stirrup w/o j,,,531.62,4287.43,10
HCPCS,L2020,Kafo dbl solid stirrup band/,,,531.62,5414.88,10
HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,531.62,5322.36,10
HCPCS,L2034,Kafo pla sin up w/wo k/a cus,,,8484.66,9981.87,2
HCPCS,L2035,Kafo plastic pediatric size,,,46.46,851.26,10
HCPCS,L2036,Kafo plas doub free knee mol,,,7743.24,9109.62,2
HCPCS,L2037,Kafo plas sing free knee mol,,,531.62,8148.41,10
HCPCS,L2038,Kafo w/o joint multi-axis an,,,531.62,6568.8,10
HCPCS,L2040,Hkafo torsion bil rot straps,,,278.93,994.07,10
HCPCS,L2050,Hkafo torsion cable hip pelv,,,264.38,2394.44,10
HCPCS,L2060,Hkafo torsion ball bearing j,,,264.38,2994.97,10
HCPCS,L2070,Hkafo torsion unilat rot str,,,46.46,762.66,10
HCPCS,L2080,Hkafo unilat torsion cable,,,672.04,1833.69,10
HCPCS,L2090,Hkafo unilat torsion ball br,,,672.04,2443.18,10
HCPCS,L2106,YB AFO TIBIAL FRACT PLASTIC,4801.0,3120.65,1022.49,4801.0,48
HCPCS,L2108,Afo tib fx cast molded to pt,,,531.62,5648.86,10
HCPCS,L2112,Afo tibial fracture soft,,,264.38,2478.96,10
HCPCS,L2114,Afo tib fx semi-rigid,,,264.38,3104.96,10
HCPCS,L2116,YB AFO TIBIAL FRACT RIGID,6591.0,4284.15,1022.49,6591.0,48
HCPCS,L2126,Kafo fem fx cast thermoplas,,,531.62,6274.14,10
HCPCS,L2128,Kafo fem fx cast molded to p,,,531.62,7878.21,10
HCPCS,L2132,Kafo femoral fx cast soft,,,1022.49,4781.93,10
HCPCS,L2134,Kafo fem fx cast semi-rigid,,,531.62,5662.41,10
HCPCS,L2136,Kafo femoral fx cast rigid,,,531.62,6196.65,10
HCPCS,L2180,Plas shoe insert w ank joint,,,46.46,651.39,10
HCPCS,L2182,Drop lock knee,,,46.46,561.47,10
HCPCS,L2184,Limited motion knee joint,,,46.46,569.14,10
HCPCS,L2186,Adj motion knee jnt lerman t,,,46.46,756.9,10
HCPCS,L2188,Quadrilateral brim,,,72.46,1375.98,10
HCPCS,L2190,Waist belt,,,25.16,419.13,10
HCPCS,L2192,Pelvic band & belt thigh fla,,,672.04,1638.18,10
HCPCS,L2200,"YB ADTN LOW EXTREM, LIMITED ANKLE MOTION EA JOINT",208.0,135.2,25.16,246.89,48
HCPCS,L2210,YB AD LW EXT DORSI/PLNTR EA JT,771.0,501.15,25.16,771.0,48
HCPCS,L2220,Dorsi & plantar flex ass/res,,,25.16,397.54,10
HCPCS,L2221,Add lw ext ort ank w micro,,,531.62,615.56,8
HCPCS,L2230,Split flat caliper stirr & p,,,25.16,470.03,10
HCPCS,L2232,"Rocker bottom, contact afo",,,46.46,477.31,10
HCPCS,L2240,Round caliper and plate atta,,,25.16,467.83,10
HCPCS,L2250,Foot plate molded stirrup at,,,672.04,1641.26,10
HCPCS,L2260,Reinforced solid stirrup,,,278.93,920.99,10
HCPCS,L2265,Long tongue stirrup,,,46.46,660.54,10
HCPCS,L2270,Varus/valgus strap padded/li,,,25.16,302.9,10
HCPCS,L2275,Plastic mod low ext pad/line,,,46.46,640.47,10
HCPCS,L2280,Molded inner boot,,,264.38,2773.87,10
HCPCS,L2300,Abduction bar jointed adjust,,,72.46,1237.0,10
HCPCS,L2310,Abduction bar-straight,,,46.46,565.23,10
HCPCS,L2320,Non-molded lacer,,,278.93,947.89,10
HCPCS,L2330,Lacer molded to patient mode,,,672.04,1804.03,10
HCPCS,L2335,Anterior swing band,,,278.93,1381.22,10
HCPCS,L2340,Pre-tibial shell molded to p,,,264.38,2053.4,10
HCPCS,L2350,Prosthetic type socket molde,,,531.62,4093.84,10
HCPCS,L2360,Extended steel shank,,,25.16,253.37,10
HCPCS,L2370,Patten bottom,,,278.93,1572.53,10
HCPCS,L2375,Torsion ank & half solid sti,,,46.46,604.61,10
HCPCS,L2380,Torsion straight knee joint,,,46.46,634.11,10
HCPCS,L2385,Straight knee joint heavy du,,,46.46,721.99,10
HCPCS,L2387,Add le poly knee custom kafo,,,46.46,937.98,10
HCPCS,L2390,Offset knee joint each,,,46.46,502.93,10
HCPCS,L2395,Offset knee joint heavy duty,,,46.46,718.88,10
HCPCS,L2397,Suspension sleeve lower ext,,,46.46,599.73,10
HCPCS,L2405,Knee joint drop lock ea jnt,,,25.16,428.37,10
HCPCS,L2415,Knee joint cam lock each joi,,,46.46,596.93,10
HCPCS,L2425,Knee disc/dial lock/adj flex,,,46.46,704.36,10
HCPCS,L2430,Knee jnt ratchet lock ea jnt,,,46.46,704.36,10
HCPCS,L2492,Knee lift loop drop lock rin,,,46.46,576.34,10
HCPCS,L2500,Thi/glut/ischia wgt bearing,,,72.46,1537.63,10
HCPCS,L2510,Th/wght bear quad-lat brim m,,,1022.49,3962.98,10
HCPCS,L2520,Th/wght bear quad-lat brim c,,,264.38,2641.13,10
HCPCS,L2525,Th/wght bear nar m-l brim mo,,,531.62,5600.56,10
HCPCS,L2526,Th/wght bear nar m-l brim cu,,,1022.49,3146.94,10
HCPCS,L2530,Thigh/wght bear lacer non-mo,,,278.93,1178.39,10
HCPCS,L2540,Thigh/wght bear lacer molded,,,672.04,2229.8,10
HCPCS,L2550,Thigh/wght bear high roll cu,,,72.46,1671.89,10
HCPCS,L2570,Hip clevis type 2 posit jnt,,,264.38,2188.37,10
HCPCS,L2580,Pelvic control pelvic sling,,,264.38,2132.32,10
HCPCS,L2600,Hip clevis/thrust bearing fr,,,278.93,1048.01,10
HCPCS,L2610,Hip clevis/thrust bearing lo,,,278.93,1158.08,10
HCPCS,L2620,Pelvic control hip heavy dut,,,72.46,1228.45,10
HCPCS,L2622,Hip joint adjustable flexion,,,72.46,1563.58,10
HCPCS,L2624,YB ADTN LW EXT PELVIC/HIP FLEX,1608.0,1045.2,72.46,1917.22,48
HCPCS,L2627,Plastic mold recipro hip & c,,,531.62,10501.59,10
HCPCS,L2628,Metal frame recipro hip & ca,,,531.62,7697.45,10
HCPCS,L2630,Pelvic control band & belt u,,,278.93,1137.69,10
HCPCS,L2640,Pelvic control band & belt b,,,72.46,1543.98,10
HCPCS,L2650,Pelv & thor control gluteal,,,46.46,679.93,10
HCPCS,L2660,Thoracic control thoracic ba,,,278.93,880.4,10
HCPCS,L2670,Thorac cont paraspinal uprig,,,46.46,783.73,10
HCPCS,L2680,Thorac cont lat support upri,,,46.46,718.96,10
HCPCS,L2750,Plating chrome/nickel pr bar,,,25.16,384.03,10
HCPCS,L2755,Carbon graphite lamination,,,46.46,642.03,10
HCPCS,L2760,Extension per extension per,,,25.16,279.15,10
HCPCS,L2768,Ortho sidebar disconnect,,,46.46,640.15,10
HCPCS,L2780,Non-corrosive finish,,,25.16,310.94,10
HCPCS,L2785,Drop lock retainer each,,,28.98,145.61,10
HCPCS,L2795,Knee control full kneecap,,,25.16,403.02,10
HCPCS,L2800,VAR/VAL KNEE CAP,101.0,65.65,22.02,494.82,48
HCPCS,L2810,Knee control condylar pad,,,25.16,401.34,10
HCPCS,L2820,YB - SOFT INTERFACE PAD ON PLASTIC SECTION OF BRACE,154.5,100.43,25.16,398.98,48
HCPCS,L2820,YB ADTN BELOW KNEE,373.0,242.45,25.16,398.98,48
HCPCS,L2830,Soft interface above knee se,,,46.46,431.65,10
HCPCS,L2840,YB ADTN LOW EXTREM TIBIAL SOCK,232.0,150.8,28.98,232.0,48
HCPCS,L2850,"YB ADTN LOW EXTREM ORTHO, FEM LENGTH SOCK, FRACT OR EQUAL, EACH",256.0,166.4,25.16,297.23,48
HCPCS,L2861,Torsion mechanism knee/ankle,,,672.04,778.15,8
HCPCS,L2999,Lower extremity orthosis nos,,,13.46,15.59,8
HCPCS,L3000,Ft insert ucb berkeley shell,,,72.46,1543.55,10
HCPCS,L3001,Foot insert remov molded spe,,,46.46,649.95,10
HCPCS,L3002,Foot insert plastazote or eq,,,46.46,793.56,10
HCPCS,L3003,Foot insert silicone gel eac,,,46.46,856.05,10
HCPCS,L3010,Foot longitudinal arch suppo,,,46.46,856.05,10
HCPCS,L3020,CUSTOM FOOT ORTHOTIC,120.0,78.0,26.16,974.88,48
HCPCS,L3020,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,26.16,974.88,48
HCPCS,L3020,FOOT INSERT REMOVABLE LONG/MT SPPT,194.0,126.1,1.1,786.15,33
HCPCS,L3030,Foot arch support remov prem,,,25.16,374.91,10
HCPCS,L3031,Foot lamin/prepreg composite,,,25.16,601.77,10
HCPCS,L3040,Ft arch suprt premold longit,,,25.16,231.26,10
HCPCS,L3050,Foot arch supp premold metat,,,25.16,231.26,10
HCPCS,L3060,FOOT ARCH SUPPORT REMV LONG/METATAR,154.0,100.1,1.1,292.27,33
HCPCS,L3060,Foot arch supp longitud/meta,,,25.16,362.44,10
HCPCS,L3070,Arch suprt att to sho longit,,,28.98,156.25,10
HCPCS,L3080,Arch supp att to shoe metata,,,28.98,156.25,10
HCPCS,L3090,Arch supp att to shoe long/m,,,28.98,199.99,10
HCPCS,L3100,Hallus-valgus nt dyn pre ots,,,28.98,212.54,10
HCPCS,L3140,Abduction rotation bar shoe,,,25.16,437.44,10
HCPCS,L3150,Abduct rotation bar w/o shoe,,,25.16,400.02,10
HCPCS,L3160,Shoe styled positioning dev,,,13.46,15.59,8
HCPCS,L3161,"Foot, adductus position, adj",,,46.46,53.79,8
HCPCS,L3170,FOOT PLASTIC HEEL STABILIZER,84.0,54.6,1.1,201.54,33
HCPCS,L3170,Foot plas heel stabi pre ots,,,25.16,249.97,10
HCPCS,L3201,Oxford w supinat/pronat inf,,,25.16,29.13,8
HCPCS,L3202,Oxford w/ supinat/pronator c,,,25.16,29.13,8
HCPCS,L3203,Oxford w/ supinator/pronator,,,25.16,29.13,8
HCPCS,L3204,Hightop w/ supp/pronator inf,,,25.16,29.13,8
HCPCS,L3206,Hightop w/ supp/pronator chi,,,25.16,29.13,8
HCPCS,L3207,Hightop w/ supp/pronator jun,,,25.16,29.13,8
HCPCS,L3208,Surgical boot each infant,,,13.46,15.59,8
HCPCS,L3209,Surgical boot each child,,,13.46,15.59,8
HCPCS,L3211,Surgical boot each junior,,,13.46,15.59,8
HCPCS,L3212,Benesch boot pair infant,,,25.16,29.13,8
HCPCS,L3213,Benesch boot pair child,,,25.16,29.13,8
HCPCS,L3214,Benesch boot pair junior,,,25.16,29.13,8
HCPCS,L3215,Orthopedic ftwear ladies oxf,,,25.16,29.13,8
HCPCS,L3216,Orthoped ladies shoes dpth i,,,25.16,29.13,8
HCPCS,L3217,Ladies shoes hightop depth i,,,25.16,29.13,8
HCPCS,L3219,Orthopedic mens shoes oxford,,,25.16,29.13,8
HCPCS,L3221,Orthopedic mens shoes dpth i,,,25.16,29.13,8
HCPCS,L3222,Mens shoes hightop depth inl,,,25.16,29.13,8
HCPCS,L3224,Woman's shoe oxford brace,,,25.16,332.01,10
HCPCS,L3225,Man's shoe oxford brace,,,25.16,362.64,10
HCPCS,L3230,Custom shoes depth inlay,,,25.16,29.13,8
HCPCS,L3250,Custom mold shoe remov prost,,,25.16,29.13,8
HCPCS,L3251,Shoe molded to pt silicone s,,,46.46,53.79,8
HCPCS,L3252,Shoe molded plastazote cust,,,278.93,322.97,8
HCPCS,L3253,YB PLASTAZOTE MOLDED SHOE,397.0,258.05,25.16,397.0,48
HCPCS,L3254,Orth foot non-stndard size/w,,,13.46,15.59,8
HCPCS,L3255,Orth foot non-standard size/,,,13.46,15.59,8
HCPCS,L3257,Orth foot add charge split s,,,25.16,29.13,8
HCPCS,L3260,AMBULATORY SURGICAL BOOT EAC,26.0,16.9,1.1,48.82,32
HCPCS,L3260,ORTHOWEDGE SHOE EACH,46.0,29.9,6.84,46.0,47
HCPCS,L3265,Plastazote sandal each,,,13.46,15.59,8
HCPCS,L3300,Sho lift taper to metatarsal,,,25.16,256.28,10
HCPCS,L3310,Shoe lift elev heel/sole neo,,,25.16,400.02,10
HCPCS,L3320,Shoe lift elev heel/sole cor,,,8.84,10.24,8
HCPCS,L3330,Lifts elevation metal extens,,,264.38,2780.79,10
HCPCS,L3332,FELT HEEL LIFTS,137.0,89.05,25.16,362.44,48
HCPCS,L3332,SHOE LIFT,110.0,71.5,1.1,292.27,33
HCPCS,L3334,Shoe lifts elevation heel /i,,,28.98,187.4,10
HCPCS,L3340,Shoe wedge sach,,,25.16,418.77,10
HCPCS,L3350,Shoe heel wedge,,,8.84,112.39,10
HCPCS,L3360,Shoe sole wedge outside sole,,,28.98,174.96,10
HCPCS,L3370,Shoe sole wedge between sole,,,25.16,243.73,10
HCPCS,L3380,Shoe clubfoot wedge,,,25.16,243.73,10
HCPCS,L3390,Shoe outflare wedge,,,25.16,243.73,10
HCPCS,L3400,Shoe metatarsal bar wedge ro,,,28.98,199.99,10
HCPCS,L3410,Shoe metatarsal bar between,,,46.46,456.15,10
HCPCS,L3420,Full sole/heel wedge btween,,,25.16,268.72,10
HCPCS,L3430,Sho heel count plast reinfor,,,46.46,787.41,10
HCPCS,L3440,Heel leather reinforced,,,25.16,374.91,10
HCPCS,L3450,Shoe heel sach cushion type,,,46.46,518.53,10
HCPCS,L3455,Shoe heel new leather standa,,,28.98,199.99,10
HCPCS,L3460,Shoe heel new rubber standar,,,28.98,168.8,10
HCPCS,L3465,Shoe heel thomas with wedge,,,25.16,287.63,10
HCPCS,L3470,Shoe heel thomas extend to b,,,25.16,306.14,10
HCPCS,L3480,HEEL PAD AND DEPRESSION FOR SPUR,39.0,25.35,1.1,246.87,33
HCPCS,L3480,"HEEL, PAD AND DEPRESSION SPUR",51.0,33.15,11.12,306.14,48
HCPCS,L3485,Shoe heel pad removable for,,,13.46,15.59,8
HCPCS,L3500,Ortho shoe add leather insol,,,28.98,143.66,10
HCPCS,L3510,Orthopedic shoe add rub insl,,,28.98,143.66,10
HCPCS,L3520,O shoe add felt w leath insl,,,28.98,156.25,10
HCPCS,L3530,Ortho shoe add half sole,,,28.98,156.25,10
HCPCS,L3540,Ortho shoe add full sole,,,25.16,249.97,10
HCPCS,L3550,O shoe add standard toe tap,,,13.46,43.94,10
HCPCS,L3560,O shoe add horseshoe toe tap,,,8.84,112.39,10
HCPCS,L3570,O shoe add instep extension,,,25.16,418.77,10
HCPCS,L3580,O shoe add instep velcro clo,,,25.16,318.66,10
HCPCS,L3590,O shoe convert to sof counte,,,25.16,262.52,10
HCPCS,L3595,Ortho shoe add march bar,,,28.98,206.07,10
HCPCS,L3600,Trans shoe calip plate exist,,,25.16,374.91,10
HCPCS,L3610,Trans shoe caliper plate new,,,46.46,493.7,10
HCPCS,L3620,Trans shoe solid stirrup exi,,,25.16,374.91,10
HCPCS,L3630,Trans shoe solid stirrup new,,,46.46,493.7,10
HCPCS,L3640,Shoe dennis browne splint bo,,,28.98,212.54,10
HCPCS,L3649,Orthopedic shoe modifica nos,,,13.46,15.59,8
HCPCS,L3650,SHOULDER ORTHOSIS,333.0,216.45,1.1,333.0,33
HCPCS,L3650,SO-PREFAB FIG OF 8 RESTRAINER,44.0,28.6,9.59,322.25,48
HCPCS,L3660,SO FIG 8 RESTR CANV WEBBING,39.0,25.35,8.5,462.07,48
HCPCS,L3670,SHLDR ORTHOSIS ACROMIO/CLAVICULAR,124.0,80.6,1.1,409.96,33
HCPCS,L3670,ULTRA SLING,56.0,36.4,12.21,508.37,48
HCPCS,L3670,UNIV QUICK FIT SHOULDER IMMOBILIZER,55.0,35.75,11.99,508.37,48
HCPCS,L3671,So cap design w/o jnts cf,,,1022.49,4029.35,10
HCPCS,L3674,So airplane w/wo joint cf,,,531.62,5285.86,10
HCPCS,L3675,"SHLDR ORTHOSIS,VEST TYPE ABDUC RESTR",232.0,150.8,1.1,632.95,33
HCPCS,L3675,So vest canvas/web pre ots,,,25.16,784.89,10
HCPCS,L3677,So hard plas stabili pre cst,,,25.16,29.13,8
HCPCS,L3678,So hard plas stabili pre ots,,,1022.49,1183.93,8
HCPCS,L3702,EO CUSTOM W/O WRIST,806.0,523.9,175.71,1291.3,48
HCPCS,L3702,EO W/O JOINTS CF,806.0,523.9,175.71,1291.3,48
HCPCS,L3710,EO PREFAB ELASTIC W METAL JOINTS,548.0,356.2,46.46,638.51,48
HCPCS,L3720,Forearm/arm cuffs free motio,,,264.38,3055.5,10
HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,1022.49,4052.82,10
HCPCS,L3740,YB EO DOUBLE UPRIGHT,4998.0,3248.7,531.62,4998.0,48
HCPCS,L3760,ELBOW-DJ IROM BRACE,526.0,341.9,114.67,2236.43,48
HCPCS,L3760,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,119.46,2236.43,48
HCPCS,L3760,"EO WITHJOINT, PREFABRICATED",516.0,335.4,1.1,1803.51,33
HCPCS,L3760,ROM ELBOW,160.0,104.0,34.88,2236.43,48
HCPCS,L3760,YB EO ADJ LOCK JT PREFAB,2368.0,1539.2,516.22,2368.0,48
HCPCS,L3761,"EO W/ADJ JOINT, PREFAB, OFF THE SHELF",152.0,98.8,1.1,1803.51,33
HCPCS,L3761,"Eo, adj lock joint prefab ot",,,1022.49,2236.43,10
HCPCS,L3762,EO PREFAB RIGID W/O JOINTS,180.0,117.0,39.24,480.78,48
HCPCS,L3763,EO CUSTOM W/WRIST,1151.0,748.15,250.92,3346.45,48
HCPCS,L3764,Ewho w/joint(s) cf,,,1022.49,3502.18,10
HCPCS,L3765,Ewhfo rigid w/o jnts cf,,,531.62,5734.02,10
HCPCS,L3766,Ewhfo w/joint(s) cf,,,531.62,6071.99,10
HCPCS,L3806,WHFO CUSTOM W/JOINTS,1119.0,727.35,243.94,2031.21,48
HCPCS,L3807,W PREFAB WHFO WO JNTS,449.0,291.85,97.88,1118.18,48
HCPCS,L3807,WHFO PREFAB W/O JOINTS,602.0,391.3,131.24,1118.18,48
HCPCS,L3807,WHFO W INFLATABLE AIRCHAMBER,419.0,272.35,1.1,901.69,33
HCPCS,L3808,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,58.21,1593.0,48
HCPCS,L3808,WHFO CUSTOM RIGID W/OUT JOINTS,553.0,359.45,72.46,1593.0,48
HCPCS,L3808,"WHFO, RIGID W/O JOINTS",25.0,16.25,1.1,1284.6,33
HCPCS,L3809,THUMB SPICA,161.0,104.65,35.1,1118.18,48
HCPCS,L3809,YB WHFO W/O JOINTS OFF THE SHELF,524.0,340.6,114.23,1118.18,48
HCPCS,L3891,Torsion mechanism wrist/elbo,,,46.46,53.79,8
HCPCS,L3900,Hinge extension/flex wrist/f,,,531.62,7244.14,10
HCPCS,L3901,Hinge ext/flex wrist finger,,,531.62,9493.85,10
HCPCS,L3904,Whfo electric custom fitted,,,531.62,15094.12,10
HCPCS,L3905,WHO CUSTOM W/NONTORSION JOINTS,1210.0,786.5,263.78,4434.64,48
HCPCS,L3906,WHO CUSTOM W/O JOINTS,726.0,471.9,158.27,2266.14,48
HCPCS,L3906,WRIST CUSTOM (OT),298.0,193.7,64.96,2266.14,48
HCPCS,L3908,FOREARM SPLINT,30.0,19.5,6.54,327.85,48
HCPCS,L3908,WHFO WRIST EXTENSION CONTROL,98.0,63.7,1.1,264.4,33
HCPCS,L3908,WHO PREFAB WRIST W/O JOINTS,92.0,59.8,20.06,327.85,48
HCPCS,L3908,WRIST SPLINT,107.0,69.55,23.33,327.85,48
HCPCS,L3912,WHFO PREFAB FLEXION GLOVE,146.0,94.9,13.46,471.15,48
HCPCS,L3913,HFO CUSTOM W/O JOINTS,442.0,287.3,96.36,1211.05,48
HCPCS,L3915,Who nontorsion jnts pre cst,,,264.38,2377.09,10
HCPCS,L3916,Who nontorsion jnts pre ots,,,264.38,2377.09,10
HCPCS,L3917,PREFAB METACARPL FX ORTHOSIS,76.0,49.4,1.1,472.23,81
HCPCS,L3918,Metacarp fx orthosis pre ots,,,46.46,472.23,10
HCPCS,L3919,HO CUSTOM W/O FINGERS,353.0,229.45,76.95,1211.05,48
HCPCS,L3921,HFO CUSTOM W/JOINTS,587.0,381.55,72.46,1436.47,48
HCPCS,L3923,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,11.77,431.97,48
HCPCS,L3923,HFO PREFAB W/O JOINTS SOFT,105.0,68.25,22.89,431.97,48
HCPCS,L3923,HFO W/O JOINTS PF,100.0,65.0,1.1,348.35,33
HCPCS,L3924,Hfo without joints pre ots,,,25.16,431.97,10
HCPCS,L3925,FO PREFAB SPRING TENSION FINGER,105.0,68.25,22.89,293.75,48
HCPCS,L3927,FO PIP/DIP W/O JOINT/SPRING,13.0,8.45,1.1,126.22,33
HCPCS,L3927,FO PREFAB STATIC FINGER,63.0,40.95,13.73,156.53,48
HCPCS,L3929,HFO PREFAB HINGED W/ JOINTS,327.0,212.55,25.16,408.46,48
HCPCS,L3930,Hfo nontorsion jnts pre ots,,,72.46,408.46,10
HCPCS,L3931,WHFO PREFAB W/ JOINTS,657.0,427.05,143.23,932.38,48
HCPCS,L3933,FINGER ORTH STATIC FIT & ADJ,244.0,158.6,53.19,954.13,48
HCPCS,L3933,FO CUSTOM STATIC FINGER,244.0,158.6,53.19,954.13,48
HCPCS,L3933,FO STATIC FINGER CUSTOM,25.0,16.25,5.45,954.13,48
HCPCS,L3935,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",348.0,226.2,75.86,987.84,48
HCPCS,L3935,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,57.99,987.84,48
HCPCS,L3956,Add joint upper ext orthosis,,,72.46,83.9,8
HCPCS,L3960,QUADRANT SHOULDER BRACE,993.0,645.45,216.47,3566.59,48
HCPCS,L3960,SEWHO ABDUCTION POSITIONING,254.0,165.1,1.1,2876.16,33
HCPCS,L3960,"SEWHO, ABDUCTION POSITIONING, AIRPLANE DESIGN",1672.0,1086.8,364.5,3566.59,48
HCPCS,L3961,Sewho cap design w/o jnts cf,,,531.62,7513.3,10
HCPCS,L3962,Sewho erbs palsey design abd,,,1022.49,3225.75,10
HCPCS,L3967,Sewho airplane w/o jnts cf,,,531.62,8870.53,10
HCPCS,L3971,Sewho cap design w/jnt(s) cf,,,531.62,8420.21,10
HCPCS,L3973,Sewho airplane w/jnt(s) cf,,,531.62,8870.53,10
HCPCS,L3975,Sewhfo cap design w/o jnt cf,,,531.62,7513.3,10
HCPCS,L3976,Sewhfo airplane w/o jnts cf,,,531.62,7513.3,10
HCPCS,L3977,Sewhfo cap desgn w/jnt(s) cf,,,531.62,8420.21,10
HCPCS,L3978,Sewhfo airplane w/jnt(s) cf,,,531.62,8870.53,10
HCPCS,L3980,HUMERAL FRACT CUFF FIT & ADJ,462.0,300.3,72.46,1729.98,48
HCPCS,L3980,HUMERAL FX CUFF,51.0,33.15,11.12,1729.98,48
HCPCS,L3980,UE PREFAB HUMERAL BRACE,438.0,284.7,72.46,1729.98,48
HCPCS,L3980,"UPPER LIMB FX ORTHOSIS, HUMERAL",524.0,340.6,1.1,1395.1,33
HCPCS,L3980,YB UP EXTREM HUMERAL PREFAB,1803.0,1171.95,72.46,1803.0,48
HCPCS,L3981,YB UP EXT FRAC ORTH HUM PREFAB,5360.0,3484.0,72.46,5360.0,48
HCPCS,L3982,"UPPER LIMB FX ORTHOSIS, RADIUS/ULNA",657.0,427.05,1.1,1416.56,33
HCPCS,L3982,Upper ext fx orthosis rad/ul,,,672.04,1756.61,10
HCPCS,L3984,"UPPER LIMB FX ORTHOSIS, WRIST",314.0,204.1,1.1,1247.87,33
HCPCS,L3984,Upper ext fx orthosis wrist,,,72.46,1547.42,10
HCPCS,L3995,YB ADTN UP EXT ORTHO SOCK,190.0,123.5,28.98,190.0,48
HCPCS,L3999,Upper limb orthosis nos,,,13.46,15.59,8
HCPCS,L4000,Repl girdle milwaukee orth,,,531.62,6492.96,10
HCPCS,L4002,"Replace strap, any orthosis",,,25.16,29.13,8
HCPCS,L4010,Replace trilateral socket br,,,1022.49,3946.5,10
HCPCS,L4020,Replace quadlat socket brim,,,1022.49,4740.83,10
HCPCS,L4030,Replace socket brim cust fit,,,264.38,3012.64,10
HCPCS,L4040,Replace molded thigh lacer,,,672.04,2040.24,10
HCPCS,L4045,Replace non-molded thigh lac,,,72.46,1507.08,10
HCPCS,L4050,Replace molded calf lacer,,,672.04,2020.57,10
HCPCS,L4055,Replace non-molded calf lace,,,72.46,1228.25,10
HCPCS,L4060,Replace high roll cuff,,,72.46,1596.56,10
HCPCS,L4070,Replace prox & dist upright,,,72.46,1292.98,10
HCPCS,L4080,Repl met band kafo-afo prox,,,46.46,488.14,10
HCPCS,L4090,Repl met band kafo-afo calf/,,,46.46,415.33,10
HCPCS,L4100,Repl leath cuff kafo prox th,,,46.46,499.02,10
HCPCS,L4110,Repl leath cuff kafo-afo cal,,,25.16,389.62,10
HCPCS,L4130,Replace pretibial shell,,,264.38,2355.14,10
HCPCS,L4205,YB ORTHO DVC REPAIR PER 15 MIN,1986.0,1290.9,13.46,1986.0,48
HCPCS,L4210,ORTH DEV REPAIR/REPL MINOR P,105.0,68.25,13.46,105.0,48
HCPCS,L4210,"REPAIR OF ORTHOTIC DEVICE, MINOR",113.0,73.45,1.1,113.0,29
HCPCS,L4350,PNEUMATIC ANKLE CNTRL SPLINT,75.0,48.75,1.1,383.38,33
HCPCS,L4350,PREFAB ANKLE AIRCAST,59.0,38.35,12.86,475.39,48
HCPCS,L4360,AIRCAST PNEUMATIC WALKER,414.0,269.1,72.46,1272.15,48
HCPCS,L4360,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,49.49,1272.15,48
HCPCS,L4360,PNEUMATIC WALKING SPLINT,385.0,250.25,1.1,1025.88,33
HCPCS,L4360,YB WALKING BOOT PNEUM,1105.0,718.25,72.46,1272.15,48
HCPCS,L4361,YB WALKING BOOT PNEUM/VACUUM,1202.0,781.3,72.46,1272.15,48
HCPCS,L4370,Pneum full leg splnt pre ots,,,278.93,1156.48,10
HCPCS,L4386,NON-PNEUM WALK BOOT PREFAB,235.0,152.75,1.1,628.25,33
HCPCS,L4386,NON-PNEUMATIC WALKING SPLINT,125.0,81.25,27.25,779.09,48
HCPCS,L4387,NON-PNEUM WALK BOOT PRE OTS,153.0,99.45,1.1,628.25,33
HCPCS,L4387,Non-pneum walk boot pre ots,,,46.46,779.09,10
HCPCS,L4387ORD,NON-PNEUM WALK BOOT PRE OTS,65.0,42.25,1.1,65.0,22
HCPCS,L4392,Replace afo soft interface,,,8.84,115.59,10
HCPCS,L4394,Replace foot drop spint,,,8.84,84.32,10
HCPCS,L4396,ANKLE CONTRACTURE SPLINT,190.0,123.5,1.1,664.95,33
HCPCS,L4396,DORSIWEDGE NIGHT SPLINT,68.0,44.2,14.82,824.55,48
HCPCS,L4396,NIGHT SPLINT,59.0,38.35,12.86,824.55,48
HCPCS,L4396,W ORTHOSIS ANK/FT STATIC,204.0,132.6,44.47,824.55,48
HCPCS,L4396,YB AFO STATIC/DYNAMIC PREFAB,2043.0,1327.95,46.46,2043.0,48
HCPCS,L4397,YB AFO STATIC/DYN PREFAB OTS,1023.0,664.95,46.46,1023.0,48
HCPCS,L4398,Foot drop splint pre ots,,,25.16,379.51,10
HCPCS,L4631,PTB CROW,3520.0,2288.0,531.62,7243.42,48
HCPCS,L4631,STANDARD CROW,3520.0,2288.0,531.62,7243.42,48
HCPCS,L5000,Sho insert w arch toe filler,,,264.38,2821.57,10
HCPCS,L5010,Mold socket ank hgt w/ toe f,,,531.62,7883.73,10
HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,10498.65,12351.24,2
HCPCS,L5050,Ank symes mold sckt sach ft,,,11466.54,13489.93,2
HCPCS,L5060,Symes met fr leath socket ar,,,14134.91,16629.15,2
HCPCS,L5100,Molded socket shin sach foot,,,11417.46,13432.19,2
HCPCS,L5105,Plast socket jts/thgh lacer,,,16112.53,18955.75,2
HCPCS,L5150,Mold sckt ext knee shin sach,,,17913.29,21074.27,2
HCPCS,L5160,Mold socket bent knee shin s,,,19667.97,23138.58,2
HCPCS,L5200,Kne sing axis fric shin sach,,,15211.75,17896.02,2
HCPCS,L5210,No knee/ankle joints w/ ft b,,,12078.1,14209.4,2
HCPCS,L5220,No knee joint with artic ali,,,13304.82,15652.59,2
HCPCS,L5230,Fem focal defic constant fri,,,19955.18,23476.47,2
HCPCS,L5250,Hip canad sing axi cons fric,,,3167.07,27526.85,10
HCPCS,L5270,Tilt table locking hip sing,,,3167.07,30670.23,10
HCPCS,L5280,Hemipelvect canad sing axis,,,3167.07,29812.7,10
HCPCS,L5301,Bk mold socket sach ft endo,,,11211.69,13190.1,2
HCPCS,L5312,"Knee disart, sach ft, endo",,,17664.83,20781.96,2
HCPCS,L5321,Ak open end sach,,,14950.44,17588.6,2
HCPCS,L5331,Hip disart canadian sach ft,,,3167.07,25760.88,10
HCPCS,L5341,Hemipelvectomy canadian sach,,,3167.07,27383.43,10
HCPCS,L5400,Postop dress & 1 cast chg bk,,,531.62,7854.74,10
HCPCS,L5410,Postop dsg bk ea add cast ch,,,264.38,2170.02,10
HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,531.62,9920.21,10
HCPCS,L5430,Postop dsg ak ea add cast ch,,,264.38,2692.83,10
HCPCS,L5450,YB RIGID DRESSING BELOW KNEE,2422.0,1574.3,528.0,2422.0,48
HCPCS,L5460,Postop app non-wgt bear dsg,,,264.38,3053.91,10
HCPCS,L5500,Init bk ptb plaster direct,,,531.62,7260.05,10
HCPCS,L5505,Init ak ischal plstr direct,,,8681.06,10212.92,2
HCPCS,L5510,Prep bk ptb plaster molded,,,531.62,8669.78,10
HCPCS,L5520,Perp bk ptb thermopls direct,,,531.62,7771.38,10
HCPCS,L5530,Prep bk ptb thermopls molded,,,8683.68,10216.0,2
HCPCS,L5535,Prep bk ptb open end socket,,,8095.02,9523.47,2
HCPCS,L5540,Prep bk ptb laminated socket,,,8573.8,10086.74,2
HCPCS,L5560,Prep ak ischial plast molded,,,9769.4,11493.31,2
HCPCS,L5570,Prep ak ischial direct form,,,9481.54,11154.66,2
HCPCS,L5580,Prep ak ischial thermo mold,,,11768.02,13844.61,2
HCPCS,L5585,Prep ak ischial open end,,,13781.22,16213.06,2
HCPCS,L5590,Prep ak ischial laminated,,,12269.3,14434.34,2
HCPCS,L5595,Hip disartic sach thermopls,,,19173.73,22557.12,2
HCPCS,L5600,Hip disart sach laminat mold,,,3167.07,25673.36,10
HCPCS,L5610,Above knee hydracadence,,,10524.88,12382.11,2
HCPCS,L5611,Ak 4 bar link w/fric swing,,,531.62,7886.33,10
HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,10196.38,11995.64,2
HCPCS,L5614,4-bar link above knee w/swng,,,531.62,8307.78,10
HCPCS,L5615,Ak 4 bar link hydl swg/stanc,,,23544.77,27699.49,2
HCPCS,L5616,Ak univ multiplex sys frict,,,531.62,7232.98,10
HCPCS,L5617,Ak/bk self-aligning unit ea,,,264.38,2754.6,10
HCPCS,L5618,Test socket symes,,,72.46,1644.98,10
HCPCS,L5620,Test socket below knee,,,72.46,1459.5,10
HCPCS,L5622,Test socket knee disarticula,,,672.04,1966.27,10
HCPCS,L5624,Test socket above knee,,,672.04,1965.56,10
HCPCS,L5626,Test socket hip disarticulat,,,264.38,3111.68,10
HCPCS,L5628,Test socket hemipelvectomy,,,264.38,3151.02,10
HCPCS,L5629,Below knee acrylic socket,,,72.46,1555.54,10
HCPCS,L5630,Syme typ expandabl wall sckt,,,264.38,2702.82,10
HCPCS,L5631,Ak/knee disartic acrylic soc,,,264.38,2150.67,10
HCPCS,L5632,Symes type ptb brim design s,,,278.93,1325.56,10
HCPCS,L5634,Symes type poster opening so,,,72.46,1657.73,10
HCPCS,L5636,Symes type medial opening so,,,72.46,1267.07,10
HCPCS,L5637,Below knee total contact,,,72.46,1885.39,10
HCPCS,L5638,Below knee leather socket,,,264.38,3176.13,10
HCPCS,L5639,Below knee wood socket,,,531.62,5487.93,10
HCPCS,L5640,Knee disarticulat leather so,,,1022.49,3607.22,10
HCPCS,L5642,Above knee leather socket,,,264.38,3343.77,10
HCPCS,L5643,Hip flex inner socket ext fr,,,531.62,9862.48,10
HCPCS,L5644,Above knee wood socket,,,264.38,2891.06,10
HCPCS,L5645,Bk flex inner socket ext fra,,,1022.49,4796.08,10
HCPCS,L5646,Below knee cushion socket,,,264.38,3039.43,10
HCPCS,L5647,Below knee suction socket,,,1022.49,3893.61,10
HCPCS,L5648,Above knee cushion socket,,,1022.49,3591.3,10
HCPCS,L5649,Isch containmt/narrow m-l so,,,10257.15,12067.13,2
HCPCS,L5650,Tot contact ak/knee disart s,,,264.38,2389.56,10
HCPCS,L5651,Ak flex inner socket ext fra,,,531.62,7001.09,10
HCPCS,L5652,Suction susp ak/knee disart,,,264.38,2134.04,10
HCPCS,L5653,Knee disart expand wall sock,,,264.38,3329.74,10
HCPCS,L5654,Socket insert symes,,,72.46,1930.21,10
HCPCS,L5655,Socket insert below knee,,,72.46,1393.61,10
HCPCS,L5656,Socket insert knee articulat,,,672.04,2117.21,10
HCPCS,L5658,Socket insert above knee,,,672.04,2234.75,10
HCPCS,L5661,Multi-durometer symes,,,264.38,3206.4,10
HCPCS,L5665,Multi-durometer below knee,,,264.38,2850.6,10
HCPCS,L5666,Below knee cuff suspension,,,25.16,377.43,10
HCPCS,L5668,Bk molded distal cushion,,,46.46,562.23,10
HCPCS,L5670,Bk molded supracondylar susp,,,72.46,1328.2,10
HCPCS,L5671,Bk/ak locking mechanism,,,264.38,2434.74,10
HCPCS,L5672,Bk removable medial brim sus,,,72.46,1757.61,10
HCPCS,L5673,Socket insert w lock mech,,,1022.49,3869.54,10
HCPCS,L5676,Bk knee joints single axis p,,,672.04,1773.72,10
HCPCS,L5677,Bk knee joints polycentric p,,,264.38,2716.46,10
HCPCS,L5678,Bk joint covers pair,,,28.98,194.35,10
HCPCS,L5679,Socket insert w/o lock mech,,,264.38,3224.51,10
HCPCS,L5680,Bk thigh lacer non-molded,,,72.46,1489.85,10
HCPCS,L5681,Intl custm cong/latyp insert,,,531.62,6476.04,10
HCPCS,L5682,Bk thigh lacer glut/ischia m,,,1022.49,3061.14,10
HCPCS,L5683,Initial custom socket insert,,,531.62,6476.04,10
HCPCS,L5684,Bk fork strap,,,25.16,235.61,10
HCPCS,L5685,YB BELOW KNEE SUSPSN SLEEVE,875.0,568.75,46.46,875.0,48
HCPCS,L5686,Bk back check,,,25.16,283.35,10
HCPCS,L5688,Bk waist belt webbing,,,25.16,300.98,10
HCPCS,L5690,Bk waist belt padded and lin,,,46.46,614.32,10
HCPCS,L5692,Ak pelvic control belt light,,,46.46,650.39,10
HCPCS,L5694,Ak pelvic control belt pad/l,,,278.93,888.0,10
HCPCS,L5695,Ak sleeve susp neoprene/equa,,,46.46,798.24,10
HCPCS,L5696,Ak/knee disartic pelvic join,,,278.93,964.25,10
HCPCS,L5697,Ak/knee disartic pelvic band,,,25.16,457.91,10
HCPCS,L5698,Ak/knee disartic silesian ba,,,46.46,587.42,10
HCPCS,L5699,Shoulder harness,,,278.93,1003.95,10
HCPCS,L5700,Replace socket below knee,,,12836.1,15101.16,2
HCPCS,L5701,Replace socket above knee,,,15924.35,18734.37,2
HCPCS,L5702,Replace socket hip,,,3167.07,23611.81,10
HCPCS,L5703,Symes ankle w/o (sach) foot,,,10557.51,12420.49,2
HCPCS,L5704,Custom shape cover bk,,,264.38,3079.05,10
HCPCS,L5705,Custom shape cover ak,,,531.62,5645.06,10
HCPCS,L5706,Custom shape cvr knee disart,,,531.62,5506.0,10
HCPCS,L5707,Custom shape cvr hip disart,,,531.62,7397.51,10
HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,672.04,1760.45,10
HCPCS,L5711,Knee-shin exo mnl lock ultra,,,264.38,2954.55,10
HCPCS,L5712,Knee-shin exo frict swg & st,,,264.38,2109.13,10
HCPCS,L5714,Knee-shin exo variable frict,,,264.38,2146.03,10
HCPCS,L5716,Knee-shin exo mech stance ph,,,1022.49,4243.53,10
HCPCS,L5718,Knee-shin exo frct swg & sta,,,531.62,4537.64,10
HCPCS,L5722,Knee-shin pneum swg frct exo,,,531.62,5518.12,10
HCPCS,L5724,Knee-shin exo fluid swing ph,,,531.62,8505.25,10
HCPCS,L5726,Knee-shin ext jnts fld swg e,,,8607.04,10125.84,2
HCPCS,L5728,Knee-shin fluid swg & stance,,,10086.51,11866.38,2
HCPCS,L5780,Knee-shin pneum/hydra pneum,,,531.62,6533.34,10
HCPCS,L5781,Lower limb pros vacuum pump,,,16744.07,19698.73,2
HCPCS,L5782,Hd low limb pros vacuum pump,,,17652.01,20766.89,2
HCPCS,L5783,Add low ext mec limb vol lam,,,10705.51,12594.61,2
HCPCS,L5785,Exoskeletal bk ultralt mater,,,264.38,2543.1,10
HCPCS,L5790,Exoskeletal ak ultra-light m,,,1022.49,3670.31,10
HCPCS,L5795,Exoskel hip ultra-light mate,,,531.62,5255.47,10
HCPCS,L5810,Endoskel knee-shin mnl lock,,,264.38,2800.06,10
HCPCS,L5811,Endo knee-shin mnl lck ultra,,,1022.49,3864.14,10
HCPCS,L5812,Endo knee-shin frct swg & st,,,264.38,2907.93,10
HCPCS,L5814,Endo knee-shin hydral swg ph,,,15541.75,18284.25,2
HCPCS,L5816,Endo knee-shin polyc mch sta,,,531.62,4162.77,10
HCPCS,L5818,Endo knee-shin frct swg & st,,,531.62,4700.56,10
HCPCS,L5822,Endo knee-shin pneum swg frc,,,7329.71,8623.12,2
HCPCS,L5824,Endo knee-shin fluid swing p,,,531.62,8151.37,10
HCPCS,L5826,Miniature knee joint,,,13068.66,15374.76,2
HCPCS,L5827,Endo knee shin single axis,,,531.62,28625.75,10
HCPCS,L5828,Endo knee-shin fluid swg/sta,,,12331.42,14507.43,2
HCPCS,L5830,Endo knee-shin pneum/swg pha,,,8314.67,9781.88,2
HCPCS,L5840,Multi-axial knee/shin system,,,16319.46,19199.2,2
HCPCS,L5841,Addition endoskletl knee-shi,,,9564.67,11252.45,2
HCPCS,L5845,Knee-shin sys stance flexion,,,531.62,8824.23,10
HCPCS,L5848,Knee-shin sys hydraul stance,,,531.62,5294.1,10
HCPCS,L5850,Endo ak/hip knee extens assi,,,46.46,626.16,10
HCPCS,L5855,Mech hip extension assist,,,72.46,1511.68,10
HCPCS,L5856,Elec knee-shin swing/stance,,,13433.1,118185.91,10
HCPCS,L5857,Elec knee-shin swing only,,,35646.59,41936.8,2
HCPCS,L5858,Stance phase only,,,13433.1,91499.01,10
HCPCS,L5859,Knee-shin pro flex/ext cont,,,531.62,71432.4,10
HCPCS,L5910,Endo below knee alignable sy,,,672.04,1772.76,10
HCPCS,L5920,Endo ak/hip alignable system,,,264.38,2597.15,10
HCPCS,L5925,Above knee manual lock,,,672.04,1644.7,10
HCPCS,L5926,Endoskel posit rotat unit,,,672.04,3165.53,10
HCPCS,L5930,High activity knee frame,,,14085.63,16571.18,2
HCPCS,L5940,Endo bk ultra-light material,,,264.38,2455.29,10
HCPCS,L5950,Endo ak ultra-light material,,,1022.49,3808.17,10
HCPCS,L5960,Endo hip ultra-light materia,,,531.62,5694.2,10
HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,3167.07,23499.86,10
HCPCS,L5962,Below knee flex cover system,,,264.38,2877.1,10
HCPCS,L5964,Above knee flex cover system,,,531.62,5518.88,10
HCPCS,L5966,Hip flexible cover system,,,531.62,7109.28,10
HCPCS,L5968,Multiaxial ankle w dorsiflex,,,15207.0,17890.43,2
HCPCS,L5969,Ak/ft power asst incl motors,,,13433.1,15554.11,8
HCPCS,L5970,Foot external keel sach foot,,,278.93,1069.4,10
HCPCS,L5971,"Sach foot, replacement",,,278.93,1069.4,10
HCPCS,L5972,Flexible keel foot,,,672.04,1948.04,10
HCPCS,L5973,Ank-foot sys dors-plant flex,,,13433.1,86918.95,10
HCPCS,L5974,Foot single axis ankle/foot,,,278.93,1140.65,10
HCPCS,L5975,Combo ankle/foot prosthesis,,,264.38,2282.41,10
HCPCS,L5976,Energy storing foot,,,264.38,2893.26,10
HCPCS,L5978,Ft prosth multiaxial ankl/ft,,,72.46,1533.07,10
HCPCS,L5979,Multi-axial ankle/ft prosth,,,10433.77,12274.91,2
HCPCS,L5980,Flex foot system,,,15896.79,18701.94,2
HCPCS,L5981,Flex-walk sys low ext prosth,,,14279.14,16798.84,2
HCPCS,L5982,Exoskeletal axial rotation u,,,264.38,3155.82,10
HCPCS,L5984,Endoskeletal axial rotation,,,264.38,3165.53,10
HCPCS,L5985,Lwr ext dynamic prosth pylon,,,72.46,1390.29,10
HCPCS,L5986,Multi-axial rotation unit,,,1022.49,3818.6,10
HCPCS,L5987,Shank ft w vert load pylon,,,30104.25,35416.46,2
HCPCS,L5988,Vertical shock reducing pylo,,,8359.87,9835.05,2
HCPCS,L5990,User adjustable heel height,,,531.62,8931.46,10
HCPCS,L5991,Low pros ext osseo connector,,,3167.07,46999.0,10
HCPCS,L5992,Add lw ext foot shell,,,46.46,53.79,8
HCPCS,L5999,Lowr extremity prosthes nos,,,25.16,29.13,8
HCPCS,L6000,Part hand thumb rem,,,531.62,8671.58,10
HCPCS,L6010,Part hand little/ring,,,531.62,9650.02,10
HCPCS,L6020,Part hand no fingers,,,531.62,8997.07,10
HCPCS,L6026,Part hand myo exclu term dev,,,18203.22,21415.36,2
HCPCS,L6029,Test interface part handfing,,,278.93,322.97,8
HCPCS,L6030,External frame part handfing,,,264.38,306.12,8
HCPCS,L6031,Rep interface handfng molded,,,1022.49,1183.93,8
HCPCS,L6032,Part handfng ultralite tcf/=,,,264.38,306.12,8
HCPCS,L6033,Part handfing acrylic,,,531.62,615.56,8
HCPCS,L6037,Postop dsg cast chg handfing,,,531.62,615.56,8
HCPCS,L6038,Multiax rotation attachment,,,531.62,615.56,8
HCPCS,L6050,Wrst mld sck flx hng tri pad,,,10402.26,12237.85,2
HCPCS,L6055,Wrst mold sock w/exp interfa,,,13268.66,15610.05,2
HCPCS,L6100,Elb mold sock flex hinge pad,,,10526.72,12384.26,2
HCPCS,L6110,Elbow mold sock suspension t,,,11136.58,13101.74,2
HCPCS,L6120,Elbow mold doub splt soc ste,,,12595.52,14818.13,2
HCPCS,L6130,Elbow stump activated lock h,,,13288.54,15633.44,2
HCPCS,L6200,Elbow mold outsid lock hinge,,,13688.75,16104.27,2
HCPCS,L6205,Elbow molded w/ expand inter,,,18883.36,22215.52,2
HCPCS,L6250,Elbow inter loc elbow forarm,,,13467.34,15843.79,2
HCPCS,L6300,Shlder disart int lock elbow,,,18575.18,21852.96,2
HCPCS,L6310,Shoulder passive restor comp,,,16834.37,19804.96,2
HCPCS,L6320,Shoulder passive restor cap,,,8773.53,10321.71,2
HCPCS,L6350,Thoracic intern lock elbow,,,20352.66,23944.1,2
HCPCS,L6360,Thoracic passive restor comp,,,17669.69,20787.68,2
HCPCS,L6370,Thoracic passive restor cap,,,10247.23,12055.45,2
HCPCS,L6380,Postop dsg cast chg wrst/elb,,,531.62,6972.5,10
HCPCS,L6382,Postop dsg cast chg elb dis/,,,531.62,8300.46,10
HCPCS,L6384,Postop dsg cast chg shlder/t,,,8925.58,10500.59,2
HCPCS,L6386,Postop ea cast chg & realign,,,672.04,2301.8,10
HCPCS,L6388,Postop applicat rigid dsg on,,,264.38,2534.82,10
HCPCS,L6400,Below elbow prosth tiss shap,,,11387.25,13396.65,2
HCPCS,L6450,Elb disart prosth tiss shap,,,14882.58,17508.76,2
HCPCS,L6500,Above elbow prosth tiss shap,,,14614.4,17193.26,2
HCPCS,L6550,Shldr disar prosth tiss shap,,,18928.66,22268.81,2
HCPCS,L6570,Scap thorac prosth tiss shap,,,3167.07,24860.21,10
HCPCS,L6580,Wrist/elbow bowden cable mol,,,531.62,9939.69,10
HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,531.62,8348.0,10
HCPCS,L6584,Elbow fair lead cable molded,,,10507.04,12361.11,2
HCPCS,L6586,Elbow fair lead cable dir fo,,,9362.43,11014.52,2
HCPCS,L6588,Shdr fair lead cable molded,,,14910.88,17542.06,2
HCPCS,L6590,Shdr fair lead cable direct,,,12995.35,15288.52,2
HCPCS,L6600,Polycentric hinge pair,,,278.93,1116.7,10
HCPCS,L6605,Single pivot hinge pair,,,278.93,1149.4,10
HCPCS,L6610,Flexible metal hinge pair,,,278.93,1086.59,10
HCPCS,L6611,"Additional switch, ext power",,,672.04,2026.97,10
HCPCS,L6615,Disconnect locking wrist uni,,,278.93,1054.73,10
HCPCS,L6616,Disconnect insert locking wr,,,25.16,317.5,10
HCPCS,L6620,Flexion/extension wrist unit,,,72.46,1843.85,10
HCPCS,L6621,Flex/ext wrist w/wo friction,,,9571.88,11260.93,2
HCPCS,L6623,Spring-ass rot wrst w/ latch,,,1022.49,3512.54,10
HCPCS,L6624,Flex/ext/rotation wrist unit,,,15760.17,18541.21,2
HCPCS,L6625,Rotation wrst w/ cable lock,,,264.38,2603.27,10
HCPCS,L6628,Quick disconn hook adapter o,,,264.38,2802.18,10
HCPCS,L6629,Lamination collar w/ couplin,,,46.46,954.81,10
HCPCS,L6630,Stainless steel any wrist,,,278.93,1406.57,10
HCPCS,L6632,Latex suspension sleeve each,,,25.16,318.02,10
HCPCS,L6635,Lift assist for elbow,,,278.93,1016.58,10
HCPCS,L6637,Nudge control elbow lock,,,672.04,1990.3,10
HCPCS,L6638,Elec lock on manual pw elbow,,,10465.04,12311.7,2
HCPCS,L6640,Shoulder abduction joint pai,,,72.46,1657.57,10
HCPCS,L6641,Excursion amplifier pulley t,,,46.46,965.21,10
HCPCS,L6642,Excursion amplifier lever ty,,,278.93,1419.12,10
HCPCS,L6645,Shoulder flexion-abduction j,,,72.46,1792.59,10
HCPCS,L6646,Multipo locking shoulder jnt,,,13198.75,15527.81,2
HCPCS,L6647,Shoulder lock actuator,,,264.38,2556.41,10
HCPCS,L6648,Ext pwrd shlder lock/unlock,,,13612.66,16014.75,2
HCPCS,L6650,Shoulder universal joint,,,672.04,1944.28,10
HCPCS,L6655,Standard control cable extra,,,25.16,377.19,10
HCPCS,L6660,Heavy duty control cable,,,46.46,504.73,10
HCPCS,L6665,Teflon or equal cable lining,,,25.16,225.42,10
HCPCS,L6670,Hook to hand cable adapter,,,25.16,234.73,10
HCPCS,L6672,Harness chest/shlder saddle,,,278.93,1077.24,10
HCPCS,L6675,Harness figure of 8 sing con,,,46.46,587.82,10
HCPCS,L6676,Harness figure of 8 dual con,,,46.46,615.0,10
HCPCS,L6677,Ue triple control harness,,,72.46,1460.38,10
HCPCS,L6680,Test sock wrist disart/bel e,,,278.93,1514.16,10
HCPCS,L6682,Test sock elbw disart/above,,,72.46,1674.09,10
HCPCS,L6684,Test socket shldr disart/tho,,,672.04,2274.9,10
HCPCS,L6686,Suction socket,,,264.38,3375.64,10
HCPCS,L6687,Frame typ socket bel elbow/w,,,264.38,2823.37,10
HCPCS,L6688,Frame typ sock above elb/dis,,,264.38,3124.71,10
HCPCS,L6689,Frame typ socket shoulder di,,,1022.49,3724.08,10
HCPCS,L6690,Frame typ sock interscap-tho,,,1022.49,4384.55,10
HCPCS,L6691,Removable insert each,,,672.04,1730.74,10
HCPCS,L6692,Silicon gel insert w/wo lock,,,264.38,3148.7,10
HCPCS,L6693,Lockingelbow forearm cntrbal,,,11880.65,13977.11,2
HCPCS,L6694,Elbow socket ins use w/lock,,,1022.49,3869.54,10
HCPCS,L6695,Elbow socket ins use w/o lck,,,264.38,3224.51,10
HCPCS,L6696,Cus elbo skt in for con/atyp,,,531.62,6476.04,10
HCPCS,L6697,Cus elbo skt in not con/atyp,,,531.62,6476.04,10
HCPCS,L6698,Add up-ex prosthes lock mech,,,264.38,2434.74,10
HCPCS,L6700,Ue add ext power myoel,,,100290.38,117987.64,2
HCPCS,L6703,"Term dev, passive hand mitt",,,72.46,1722.02,10
HCPCS,L6704,"Term dev, sport/rec/work att",,,264.38,3323.9,10
HCPCS,L6706,Term dev mech hook vol open,,,672.04,2062.71,10
HCPCS,L6707,Term dev mech hook vol close,,,531.62,7296.91,10
HCPCS,L6708,Term dev mech hand vol open,,,531.62,4823.51,10
HCPCS,L6709,Term dev mech hand vol close,,,531.62,6845.76,10
HCPCS,L6711,"Ped term dev, hook, vol open",,,264.38,3309.91,10
HCPCS,L6712,"Ped term dev, hook, vol clos",,,531.62,6094.38,10
HCPCS,L6713,"Ped term dev, hand, vol open",,,531.62,7691.5,10
HCPCS,L6714,"Ped term dev, hand, vol clos",,,531.62,6514.67,10
HCPCS,L6715,"Term device, multi art digit",,,13212.01,15543.4,2
HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,9842.57,11579.39,2
HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,8484.83,9982.07,2
HCPCS,L6805,Term dev modifier wrist unit,,,672.04,1888.19,10
HCPCS,L6810,Term dev precision pinch dev,,,278.93,1003.79,10
HCPCS,L6880,Elec hand ind art digits,,,13433.1,117627.88,10
HCPCS,L6881,Term dev auto grasp feature,,,17108.46,20127.42,2
HCPCS,L6882,Microprocessor control uplmb,,,12977.55,15267.57,2
HCPCS,L6883,Replc sockt below e/w disa,,,531.62,9779.88,10
HCPCS,L6884,Replc sockt above elbow disa,,,11374.0,13381.06,2
HCPCS,L6885,Replc sockt shldr dis/interc,,,17669.69,20787.68,2
HCPCS,L6890,Prefab glove for term device,,,278.93,983.28,10
HCPCS,L6895,Custom glove for term device,,,264.38,3287.84,10
HCPCS,L6900,Hand restorat thumb/1 finger,,,531.62,9547.62,10
HCPCS,L6905,Hand restoration multiple fi,,,531.62,9449.47,10
HCPCS,L6910,Hand restoration no fingers,,,531.62,9289.5,10
HCPCS,L6915,Hand restoration replacmnt g,,,1022.49,3991.32,10
HCPCS,L6920,Wrist disarticul switch ctrl,,,35055.56,41241.47,2
HCPCS,L6925,Wrist disart myoelectronic c,,,37451.03,44059.64,2
HCPCS,L6930,Below elbow switch control,,,33763.42,39721.32,2
HCPCS,L6935,Below elbow myoelectronic ct,,,37275.02,43852.58,2
HCPCS,L6940,Elbow disarticulation switch,,,43599.63,51293.23,2
HCPCS,L6945,Elbow disart myoelectronic c,,,48641.03,57224.24,2
HCPCS,L6950,Above elbow switch control,,,43518.74,51198.07,2
HCPCS,L6955,Above elbow myoelectronic ct,,,50468.06,59373.67,2
HCPCS,L6960,Shldr disartic switch contro,,,53090.48,62458.84,2
HCPCS,L6965,Shldr disartic myoelectronic,,,13433.1,73992.17,10
HCPCS,L6970,Interscapular-thor switch ct,,,13433.1,79200.42,10
HCPCS,L6975,Interscap-thor myoelectronic,,,13433.1,87297.54,10
HCPCS,L7007,Adult electric hand,,,15284.92,17982.1,2
HCPCS,L7008,Pediatric electric hand,,,3167.07,27884.85,10
HCPCS,L7009,Adult electric hook,,,15638.3,18397.84,2
HCPCS,L7040,Prehensile actuator,,,12728.57,14974.66,2
HCPCS,L7045,Pediatric electric hook,,,531.62,7911.6,10
HCPCS,L7170,Electronic elbow hosmer swit,,,25172.25,29614.15,2
HCPCS,L7180,Electronic elbow sequential,,,13433.1,191593.7,10
HCPCS,L7181,Electronic elbo simultaneous,,,13433.1,197263.91,10
HCPCS,L7185,Electron elbow adolescent sw,,,26464.26,31134.14,2
HCPCS,L7186,Electron elbow child switch,,,44490.14,52340.88,2
HCPCS,L7190,Elbow adolescent myoelectron,,,35115.51,41312.0,2
HCPCS,L7191,Elbow child myoelectronic ct,,,46796.56,55054.29,2
HCPCS,L7259,Electronic wrist rotator any,,,17150.22,20176.56,2
HCPCS,L7360,Six volt bat otto bock/eq ea,,,278.93,1302.45,10
HCPCS,L7362,Battery chrgr six volt otto,,,72.46,1422.84,10
HCPCS,L7364,Twelve volt battery utah/equ,,,672.04,2517.63,10
HCPCS,L7366,Battery chrgr 12 volt utah/e,,,264.38,3462.36,10
HCPCS,L7367,Replacemnt lithium ionbatter,,,672.04,1916.82,10
HCPCS,L7368,Lithium ion battery charger,,,264.38,2484.72,10
HCPCS,L7400,"Add ue prost be/wd, ultlite",,,72.46,1508.88,10
HCPCS,L7401,Add ue prost a/e ultlite mat,,,72.46,1689.04,10
HCPCS,L7402,Add ue prost s/d ultlite mat,,,672.04,1824.26,10
HCPCS,L7403,Add ue prost b/e acrylic,,,72.46,1813.1,10
HCPCS,L7404,Add ue prost a/e acrylic,,,264.38,2736.57,10
HCPCS,L7405,Add ue prost s/d acrylic,,,1022.49,3578.71,10
HCPCS,L7406,Add upp ext mec limb vol lam,,,10705.51,12594.61,2
HCPCS,L7499,Upper extremity prosthes nos,,,13.46,15.59,8
HCPCS,L7510,Prosthetic device repair rep,,,13.46,15.59,8
HCPCS,L7520,Repair prosthesis per 15 min,,,13.46,162.61,10
HCPCS,L7600,Prosthetic donning sleeve,,,8.84,10.24,8
HCPCS,L7700,Pros soc insert gasket/seal,,,46.46,736.55,10
HCPCS,L7900,Male vacuum erection system,,,264.38,306.12,8
HCPCS,L7902,"Tension ring, vac erect dev",,,13.46,15.59,8
HCPCS,L8000,Mastectomy bra,,,28.98,208.43,10
HCPCS,L8001,Breast prosthesis bra & form,,,46.46,617.68,10
HCPCS,L8002,Brst prsth bra & bilat form,,,46.46,812.23,10
HCPCS,L8010,Mastectomy sleeve,,,28.98,33.56,8
HCPCS,L8015,Ext breastprosthesis garment,,,25.16,295.11,10
HCPCS,L8020,Mastectomy form,,,278.93,1113.1,10
HCPCS,L8030,Breast prosthes w/o adhesive,,,72.46,1720.79,10
HCPCS,L8031,Breast prosthesis w adhesive,,,72.46,1720.79,10
HCPCS,L8032,Reusable nipple prosthesis,,,28.98,192.83,10
HCPCS,L8033,"Nipple prosthesis custom, ea",,,25.16,29.13,8
HCPCS,L8035,Custom breast prosthesis,,,15331.35,18036.72,2
HCPCS,L8039,Breast prosthesis nos,,,672.04,778.15,8
HCPCS,L8040,Nasal prosthesis,,,4149.87,4882.16,2
HCPCS,L8041,Midfacial prosthesis,,,5001.61,5884.19,2
HCPCS,L8042,Orbital prosthesis,,,5619.73,6611.38,2
HCPCS,L8043,Upper facial prosthesis,,,6294.09,7404.75,2
HCPCS,L8044,Hemi-facial prosthesis,,,6968.32,8197.95,2
HCPCS,L8045,Auricular prosthesis,,,5456.7,6419.59,2
HCPCS,L8046,Partial facial prosthesis,,,4495.84,5289.18,2
HCPCS,L8047,Nasal septal prosthesis,,,531.62,2710.78,10
HCPCS,L8048,Unspec maxillofacial prosth,,,13.46,15.59,8
HCPCS,L8049,Repair maxillofacial prosth,,,13.46,15.59,8
HCPCS,L8300,Truss single w/ standard pad,,,46.46,412.93,10
HCPCS,L8310,Truss double w/ standard pad,,,46.46,731.47,10
HCPCS,L8320,Truss addition to std pad wa,,,25.16,303.46,10
HCPCS,L8330,Truss add to std pad scrotal,,,25.16,241.65,10
HCPCS,L8400,YB PROS SHEATH BELOW KNEE,92.0,59.8,8.84,92.0,48
HCPCS,L8410,Sheath above knee,,,8.84,101.39,10
HCPCS,L8415,Sheath upper limb,,,8.84,104.91,10
HCPCS,L8417,Pros sheath/sock w gel cushn,,,8.84,370.31,10
HCPCS,L8420,"YB PROS SOCK, MULTI BELOW KNEE",123.0,79.95,8.84,123.0,48
HCPCS,L8430,YB PROS SOCK ABOVE KNEE EACH,106.0,68.9,23.11,116.31,48
HCPCS,L8435,Pros sock multi ply upper lm,,,8.84,110.51,10
HCPCS,L8440,YB PROS SHRINKER BELOW KNEE,237.0,154.05,25.16,237.0,48
HCPCS,L8460,YB PROS SHRINKER ABOVE KNEE,353.0,229.45,25.16,353.0,48
HCPCS,L8465,Shrinker upper limb,,,25.16,301.5,10
HCPCS,L8470,YB PROS SOCK BELOW KNEE,36.0,23.4,7.85,36.0,48
HCPCS,L8480,Pros sock single ply ak,,,8.84,45.06,10
HCPCS,L8485,Pros sock single ply upper l,,,8.84,60.65,10
HCPCS,L8499,Unlisted misc prosthetic ser,,,13.46,15.59,8
HCPCS,L8500,Artificial larynx,,,1022.49,3239.82,10
HCPCS,L8501,W VALVE TRACH PASSY MUIR,333.0,216.45,46.46,591.25,48
HCPCS,L8505,"Artificial larynx, accessory",,,264.38,306.12,8
HCPCS,L8507,Trach-esoph voice pros pt in,,,28.98,206.11,10
HCPCS,L8509,Trach-esoph voice pros md in,,,46.46,537.68,10
HCPCS,L8510,Voice amplifier,,,278.93,1244.12,10
HCPCS,L8511,Indwelling trach insert,,,25.16,358.04,10
HCPCS,L8512,Gel cap for trach voice pros,,,9.11,15.59,10
HCPCS,L8513,Trach pros cleaning device,,,13.46,25.63,10
HCPCS,L8514,Repl trach puncture dilator,,,46.46,464.31,10
HCPCS,L8515,Gel cap app device for trach,,,25.16,310.82,10
HCPCS,L8600,Implant breast silicone/eq,,,1022.49,4075.37,10
HCPCS,L8603,Collagen imp urinary 2.5 ml,,,874.33,2143.4,10
HCPCS,L8604,Dextranomer/hyaluronic acid,,,874.33,1012.39,8
HCPCS,L8605,Inj bulking agent anal canal,,,874.33,4014.92,13
HCPCS,L860500,Inj bulking agent anal canal,,,3134.46,3134.46,1
HCPCS,L8606,SYNTHETIC IMPLNT URINARY 1ML,635.0,412.75,1.1,815.32,33
HCPCS,L8606,W INJ BULK AGENT COLLAGEN IMP U,1765.0,1147.25,384.77,1765.0,48
HCPCS,L8607,Inj vocal cord bulking agent,,,132.63,1012.39,11
HCPCS,L8608,Arg ii ext com/sup/acc misc,,,13.46,15.59,8
HCPCS,L8609,Artificial cornea,,,27265.66,32076.96,2
HCPCS,L8610,Ocular implant,,,264.38,3346.57,10
HCPCS,L8612,Aqueous shunt prosthesis,,,264.38,3896.57,10
HCPCS,L8613,Ossicular implant,,,72.46,1673.09,10
HCPCS,L8614,Cochlear device,,,13433.1,96395.84,10
HCPCS,L8615,Coch implant headset replace,,,672.04,2220.4,10
HCPCS,L8616,Coch implant microphone repl,,,46.46,517.13,10
HCPCS,L8617,Coch implant trans coil repl,,,25.16,451.72,10
HCPCS,L8618,Coch implant tran cable repl,,,28.98,129.1,10
HCPCS,L8619,Coch imp ext proc/contr rplc,,,13433.1,41381.61,10
HCPCS,L8621,Repl zinc air battery,,,2.62,33.56,10
HCPCS,L8622,Repl alkaline battery,,,1.36,15.59,10
HCPCS,L8623,"Lith ion batt cid,non-earlvl",,,25.16,318.46,10
HCPCS,L8624,"Lith ion batt cid, ear level",,,46.46,793.92,10
HCPCS,L8625,Charger coch impl/aoi battry,,,46.46,929.86,10
HCPCS,L8627,Cid ext speech process repl,,,29855.52,35123.83,2
HCPCS,L8628,Cid ext controller repl,,,531.62,6257.7,10
HCPCS,L8629,Cid transmit coil and cable,,,46.46,881.52,10
HCPCS,L8630,Metacarpophalangeal implant,,,672.04,2198.77,10
HCPCS,L8631,Mcp joint repl 2 pc or more,,,9205.65,10830.08,2
HCPCS,L8641,Metatarsal joint implant,,,672.04,1713.43,10
HCPCS,L8642,Hallux implant,,,72.46,1532.03,10
HCPCS,L8658,Interphalangeal joint spacer,,,72.46,1493.89,10
HCPCS,L8659,Interphalangeal joint repl,,,8075.31,9500.28,2
HCPCS,L8670,"Vascular graft, synthetic",,,264.38,2724.73,10
HCPCS,L8678,Ext sply implt neurostim,,,13.46,50.86,10
HCPCS,L8679,Imp neurosti pls gn any type,,,3167.07,42185.17,10
HCPCS,L8680,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,264.38,14965.0,49
HCPCS,L8681,Pt prgrm for implt neurostim,,,531.62,5614.99,10
HCPCS,L8682,Implt neurostim radiofq rec,,,3167.07,30140.39,10
HCPCS,L8683,Radiofq trsmtr for implt neu,,,3167.07,26530.5,10
HCPCS,L8684,Radiof trsmtr implt scrl neu,,,1022.49,4162.97,10
HCPCS,L8687,Implt nrostm pls gen dua rec,,,13433.1,15554.11,8
HCPCS,L8689,External recharg sys intern,,,531.62,8492.3,10
HCPCS,L8690,"Aud osseo dev, int/ext comp",,,3167.07,23420.42,10
HCPCS,L8691,Aoi snd proc repl excl actua,,,7206.79,8478.5,2
HCPCS,L8692,Non-osseointegrated snd proc,,,3167.07,3667.14,8
HCPCS,L8693,"Aud osseo dev, abutment",,,531.62,7465.16,10
HCPCS,L8694,Aoi transducer/actuator repl,,,3167.07,4649.39,10
HCPCS,L8695,External recharg sys extern,,,8.84,82.08,10
HCPCS,L8696,Ext antenna phren nerve stim,,,72.46,1066.96,10
HCPCS,L8698,Misc used with tot art heart,,,13.46,15.59,8
HCPCS,L8699,RICHARDS T TUBE,64.0,41.6,9.52,64.0,48
HCPCS,L8699,TRUMPET TUBE,84.0,54.6,12.5,84.0,48
HCPCS,L8701,Ewh s/d uprt micro sensor,,,118845.99,139817.57,2
HCPCS,L8702,Ewhf s/d uprt micro sensor,,,233822.61,275083.0,2
HCPCS,L8720,Ext low ext sens prosthe mec,,,25.16,29.13,8
HCPCS,L8721,Receptor sole l8720 replace,,,25.16,29.13,8
HCPCS,L9900,O&p supply/accessory/service,,,13.46,15.59,8
HCPCS,M0001,Advancing cancer care mvp,,,8.48,9.82,8
HCPCS,M0002,Opt care kidney hlth mvp,,,8.48,9.82,8
HCPCS,M0003,Opt care episod neuro mvp,,,8.48,9.82,8
HCPCS,M0004,Qual care neurologic cnd mvp,,,8.48,9.82,8
HCPCS,M0005,Value in primary care mvp,,,8.48,9.82,8
HCPCS,M0075,Cellular therapy,,,1254.9,1453.05,8
HCPCS,M0076,PROLOTHERAPY,185.0,120.25,1.1,185.0,29
HCPCS,M0076,Prolotherapy,,,138.73,160.63,8
HCPCS,M0100,Intragastric hypothermia,,,237.67,275.2,8
HCPCS,M0201,Pne flu hepb cov home admin,,,13.56,101.1,27
HCPCS,M0220,Tixagev and cilgav inj,,,36.15,150.5,15
HCPCS,M0221,Tixagev and cilgav inj hm,,,36.15,250.5,15
HCPCS,M0222,Bebtelovimab injection,,,36.15,349.76,14
HCPCS,M0223,Bebtelovimab injection home,,,36.15,549.34,14
HCPCS,M0224,PEMIVIBART INFUSION (IV INFUSION FOR IMMUNE-COMPROMISED COVID-19,1800.0,1170.0,220.33,1800.0,61
HCPCS,M0233,Iv inf toc hos ad cort ft ds,,,220.33,255.12,8
HCPCS,M0234,Iv inf toc hos ad cort sec,,,220.33,255.12,8
HCPCS,M0235,"Intrav inf, mon anti, fir do",,,220.33,1235.91,21
HCPCS,M0236,"Intrav inf, mon anti, sec do",,,220.33,1235.91,21
HCPCS,M0237,"Intrav inf, toci, first dose",,,220.33,1235.91,21
HCPCS,M0238,"Intrav inf, toci, second dos",,,220.33,1235.91,21
HCPCS,M0239,Bamlanivimab-xxxx infusion,,,220.33,346.87,9
HCPCS,M0240,Casiri and imdev repeat,,,220.33,449.55,14
HCPCS,M0241,Casiri and imdev repeat hm,,,693.45,748.92,6
HCPCS,M0243,Casirivi and imdevi inj,,,220.33,449.55,14
HCPCS,M0244,Casirivi and imdevi inj hm,,,693.45,748.92,6
HCPCS,M0245,Bamlan and etesev infusion,,,220.33,449.55,14
HCPCS,M0246,Bamlan and etesev infus home,,,693.45,748.92,6
HCPCS,M0247,Sotrovimab infusion,,,220.33,449.55,14
HCPCS,M0248,"Sotrovimab inf, home admin",,,693.45,748.92,6
HCPCS,M0249,ADM TOCILIZU COVID-19 1ST,1081.5,702.975,1.1,1802.0,89
HCPCS,M0250,ADM TOCILIZU COVID-19 2ND,1081.5,702.975,1.1,1802.0,89
HCPCS,M0300,Iv chelationtherapy,,,41.42,47.96,8
HCPCS,M0301,Fabric wrapping of aneurysm,,,2082.17,2410.94,8
HCPCS,M1003,Tb scr 12 mo pri fst bio dz,,,8.48,9.82,8
HCPCS,M1004,Doc med rsn no srn tb,,,8.48,9.82,8
HCPCS,M1005,Tb scr no perf,,,8.48,9.82,8
HCPCS,M1006,"Dz not ases, no rsn",,,8.48,9.82,8
HCPCS,M1007,>=50% total pt outpt ra enct,,,8.48,9.82,8
HCPCS,M1008,<50% total pt outpt ra encts,,,8.48,9.82,8
HCPCS,M1009,Dc eoc doc med rec,,,8.48,9.82,8
HCPCS,M1010,Dc eoc doc med rec,,,8.48,9.82,8
HCPCS,M1011,Dc eoc doc med rec,,,8.48,9.82,8
HCPCS,M1012,Dc eoc doc med rec,,,8.48,9.82,8
HCPCS,M1013,Dc eoc doc med rec,,,8.48,9.82,8
HCPCS,M1014,Dc epi care doc medrec,,,8.48,9.82,8
HCPCS,M1015,Dc eoc doc med rec,,,8.48,9.82,8
HCPCS,M1016,Pt dx meop or sur steri,,,8.48,9.82,8
HCPCS,M1017,Pt admt to palitve serv,,,8.48,9.82,8
HCPCS,M1018,Pt dx hst cr pt sk lg cr scr,,,8.48,9.82,8
HCPCS,M1019,Adl pt mj dep ds rs 12 phq<5,,,8.48,9.82,8
HCPCS,M1020,Adl pt mj dep ds no rs 12 mo,,,8.48,9.82,8
HCPCS,M1021,Pt uc in pp,,,8.48,9.82,8
HCPCS,M1022,Pt hospice during perf pd,,,8.48,9.82,8
HCPCS,M1023,Adl pt mj dep ds rs 6 phq<5,,,8.48,9.82,8
HCPCS,M1024,Adl pt mj dep ds no rs 6 mo,,,8.48,9.82,8
HCPCS,M1025,Pt hospice during perf pd,,,8.48,9.82,8
HCPCS,M1026,Pt hospice during perf pd,,,8.48,9.82,8
HCPCS,M1027,Img head (ct or mri) obtnd,,,8.48,9.82,8
HCPCS,M1028,Doc of pt prm hda dx and otr,,,8.48,9.82,8
HCPCS,M1029,Doc sysm rsn img hd,,,8.48,9.82,8
HCPCS,M1031,Pt clin ind img hd,,,8.48,9.82,8
HCPCS,M1032,Adt tkng pharmthry for oud,,,8.48,9.82,8
HCPCS,M1033,Pharmthry for oud afr 6.30,,,8.48,9.82,8
HCPCS,M1034,Adt 180 dys pharmthry oud,,,8.48,9.82,8
HCPCS,M1035,Adt pd out mat pr 180 dys tx,,,8.48,9.82,8
HCPCS,M1036,Adt no 180 dys pharmthry oud,,,8.48,9.82,8
HCPCS,M1037,Pt dx lum sp reg cacr,,,8.48,9.82,8
HCPCS,M1038,Pt dx lum sp reg fract,,,8.48,9.82,8
HCPCS,M1039,Pt dx lum sp reg inf,,,8.48,9.82,8
HCPCS,M1040,Pt dx lum idi or cong scol,,,8.48,9.82,8
HCPCS,M1041,Pt cr ft inf lm or pt id sl,,,8.48,9.82,8
HCPCS,M1043,Fs no odi 9-15mo,,,8.48,9.82,8
HCPCS,M1045,Fs oks 9-15mo >= 37 >= 71,,,8.48,9.82,8
HCPCS,M1046,Fs oks 9-15mo < 37 < 71,,,8.48,9.82,8
HCPCS,M1049,Fs wth scr no odi pre and p,,,8.48,9.82,8
HCPCS,M1051,Pt w/cancer scoliosis,,,8.48,9.82,8
HCPCS,M1052,Lg pn not meas w/ vas 1yr po,,,8.48,9.82,8
HCPCS,M1054,Pt uc in pp,,,8.48,9.82,8
HCPCS,M1055,Aspirin used,,,8.48,9.82,8
HCPCS,M1056,Presc antico med in pp,,,8.48,9.82,8
HCPCS,M1057,"Aspirin not used, no rsn",,,8.48,9.82,8
HCPCS,M1058,Pt prm nurs hm res in pp,,,8.48,9.82,8
HCPCS,M1059,Pt no prm nurs hm res in pp,,,8.48,9.82,8
HCPCS,M1060,Pt died in pp,,,8.48,9.82,8
HCPCS,M1061,Pt preg,,,8.48,9.82,8
HCPCS,M1062,Pt imcomprmd,,,8.48,9.82,8
HCPCS,M1063,Pt rec hg dos imsup thpy,,,8.48,9.82,8
HCPCS,M1064,Shing vac doc adm or pv rec,,,8.48,9.82,8
HCPCS,M1065,Shing vac no adm clinc rsn,,,8.48,9.82,8
HCPCS,M1066,Shing vac no doc no rsn,,,8.48,9.82,8
HCPCS,M1067,Hspc pt prv time meam per,,,8.48,9.82,8
HCPCS,M1068,Pt not ambulatory,,,8.48,9.82,8
HCPCS,M1069,Pt scr ft fall rsk,,,8.48,9.82,8
HCPCS,M1070,Pt not scrn fut fall no rsn,,,8.48,9.82,8
HCPCS,M1071,Pt had add'l sp pcr perf,,,8.48,9.82,8
HCPCS,M1073,"ROM RAD THERAPY ANAL, TC",67428.0,43828.2,10033.29,67428.0,38
HCPCS,M1075,"ROM RAD THERAPY BLADDER, TC",54154.0,35200.1,8058.12,54154.0,38
HCPCS,M1077,"ROM RAD THER BONE METS, TC",24248.0,15761.2,3608.1,24248.0,38
HCPCS,M1079,"ROM RAD THER BRAIN METS, TC",38984.0,25339.6,5800.82,38984.0,38
HCPCS,M1081,"ROM RAD THERAPY BREAST, TC",39712.0,25812.8,5909.15,39712.0,38
HCPCS,M1083,"ROM RAD THERAPY CERVICAL, TC",54252.0,35263.8,8072.7,54252.0,38
HCPCS,M1085,"ROM RAD THERAPY CNS, TC",59412.0,38617.8,8840.51,59412.0,38
HCPCS,M1087,"ROM RAD THER COLORECTAL, TC",48679.0,31641.35,7243.44,48679.0,38
HCPCS,M1089,"ROM RAD THER HEAD/NECK, TC",70144.0,45593.6,10437.43,70144.0,38
HCPCS,M1095,"ROM RAD THERAPY LUNG, TC",48030.0,31219.5,7146.86,48030.0,38
HCPCS,M1097,"ROM RAD THERAPY LYMPHOMA, TC",31717.0,20616.05,4719.49,31717.0,38
HCPCS,M1099,"ROM RAD THERAPY PANCREAS, TC",54386.0,35350.9,8092.64,54386.0,38
HCPCS,M1101,"ROM RAD THERAPY PROSTATE, TC",81221.0,52793.65,12085.68,81221.0,38
HCPCS,M1103,"ROM RAD THERAPY GI, TC",58634.0,38112.1,8724.74,58634.0,38
HCPCS,M1105,"ROM RAD THERAPY UTERUS, TC",56879.0,36971.35,8463.6,56879.0,38
HCPCS,M1106,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1107,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1108,Oc ni pt home prog,,,8.48,9.82,8
HCPCS,M1109,Oc ni pt dc,,,8.48,9.82,8
HCPCS,M1110,Oc not p pt selfdc,,,8.48,9.82,8
HCPCS,M1111,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1112,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1113,Oc ni pt home prog,,,8.48,9.82,8
HCPCS,M1114,Oc ni pt dc,,,8.48,9.82,8
HCPCS,M1115,Oc ni pt selfdc,,,8.48,9.82,8
HCPCS,M1116,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1117,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1118,Oc ni pt home prog,,,8.48,9.82,8
HCPCS,M1119,Oc ni pt dc,,,8.48,9.82,8
HCPCS,M1120,Oc ni pt selfdc,,,8.48,9.82,8
HCPCS,M1121,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1122,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1123,Oc ni pt home prog,,,8.48,9.82,8
HCPCS,M1124,Oc ni pt dc 1-2 vis,,,8.48,9.82,8
HCPCS,M1125,Oc ni pt selfdc 1-2 vis,,,8.48,9.82,8
HCPCS,M1126,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1127,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1128,Oc ni pt home prog,,,8.48,9.82,8
HCPCS,M1129,Oc ni pt dc,,,8.48,9.82,8
HCPCS,M1130,Oc ni pt selfdc,,,8.48,9.82,8
HCPCS,M1131,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1132,Oc ni pt home prog,,,8.48,9.82,8
HCPCS,M1133,Oc ni pt dc,,,8.48,9.82,8
HCPCS,M1134,Oc ni pt selfdc,,,8.48,9.82,8
HCPCS,M1135,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1136,Start eoc doc med rec,,,8.48,9.82,8
HCPCS,M1137,Docu dx degen neuro,,,8.48,9.82,8
HCPCS,M1138,Oc ni pt 1-2 vis,,,8.48,9.82,8
HCPCS,M1139,Oc ni pt self dc 1-2 vis,,,8.48,9.82,8
HCPCS,M1140,Oc ni pt dc 1-2 vis,,,8.48,9.82,8
HCPCS,M1141,Fs no oks,,,8.48,9.82,8
HCPCS,M1142,Emerge cases,,,8.48,9.82,8
HCPCS,M1143,Ni rehab med chiro,,,8.48,9.82,8
HCPCS,M1144,Oc no ind pt 1-2 vis,,,8.48,9.82,8
HCPCS,M1145,"Mfn drug add-on, per dose",,,8.48,9.82,8
HCPCS,M1146,Ongoing care not ind,,,8.48,9.82,8
HCPCS,M1147,Care not poss med rsn,,,8.48,9.82,8
HCPCS,M1148,Pt self dschg,,,8.48,9.82,8
HCPCS,M1149,No neck fs prom incap,,,8.48,9.82,8
HCPCS,M1150,Lvef <=40% or mod/sev l vsf,,,8.48,9.82,8
HCPCS,M1151,Pt w/ hx trnsplt or lvad,,,8.48,9.82,8
HCPCS,M1152,Pt w/ hx trnsplt or lvad,,,8.48,9.82,8
HCPCS,M1153,Pt w/ dx osteo doe,,,8.48,9.82,8
HCPCS,M1154,Hospc serv dur meas pd,,,8.48,9.82,8
HCPCS,M1155,Pt anphx due to pneum,,,8.48,9.82,8
HCPCS,M1156,Pt recd actv chemo any time,,,8.48,9.82,8
HCPCS,M1157,Pt recd bone mar trnsplt,,,8.48,9.82,8
HCPCS,M1158,Pt hx immcomp prior/dur pd,,,8.48,9.82,8
HCPCS,M1159,Hospc serv dur meas pd,,,8.48,9.82,8
HCPCS,M1160,Pt anphx due to mengb bef 13,,,8.48,9.82,8
HCPCS,M1161,Pt anphx due to dtp bef 13,,,8.48,9.82,8
HCPCS,M1162,Pt enceph due to dtp bef 13,,,8.48,9.82,8
HCPCS,M1163,Pt anphx due to hpv bef 13,,,8.48,9.82,8
HCPCS,M1164,Pt w/ dementia any time,,,8.48,9.82,8
HCPCS,M1165,Pt use hspc dur meas pd,,,8.48,9.82,8
HCPCS,M1166,Path rpt tis spec wle/reexc,,,8.48,9.82,8
HCPCS,M1167,Hspc dur meas pd,,,8.48,9.82,8
HCPCS,M1168,Pt recd flu vax 7/1-6/30,,,8.48,9.82,8
HCPCS,M1169,Doc med rsn no flu vax,,,8.48,9.82,8
HCPCS,M1170,Pt w/o flu vax 7/1-6/30,,,8.48,9.82,8
HCPCS,M1171,Pt recd 1 td/tdap 9yrs prior,,,8.48,9.82,8
HCPCS,M1172,Doc med rsn no td/tdap,,,8.48,9.82,8
HCPCS,M1173,Pt no rec td/tdap 9yrs prior,,,8.48,9.82,8
HCPCS,M1174,Pt w/ 2 hzv 10/2017 - mp,,,8.48,9.82,8
HCPCS,M1175,Doc med rsn no hzv,,,8.48,9.82,8
HCPCS,M1176,No 2 hzv 10/2017-meas pd,,,8.48,9.82,8
HCPCS,M1177,Pt recd pcv on/aft 19,,,8.48,9.82,8
HCPCS,M1178,Doc med rsn no pcv,,,8.48,9.82,8
HCPCS,M1179,No pcv recd,,,8.48,9.82,8
HCPCS,M1180,Pt imm ckpt inhib therapy,,,8.48,9.82,8
HCPCS,M1181,Gr 2 or> dia or gr2 or> col,,,8.48,9.82,8
HCPCS,M1182,Not elg pre ex ibd/uc/crohn,,,8.48,9.82,8
HCPCS,M1183,Doc imm ckpt inhib hld,,,8.48,9.82,8
HCPCS,M1184,Doc med rsn no cst/ist rx,,,8.48,9.82,8
HCPCS,M1185,Imm ckpt inhib not hld no rx,,,8.48,9.82,8
HCPCS,M1186,Pt w/ rx for hspc/plltv care,,,8.48,9.82,8
HCPCS,M1187,Pt w/ esrd,,,8.48,9.82,8
HCPCS,M1188,Pt w/ ckd stg 5,,,8.48,9.82,8
HCPCS,M1189,Doc khe pef w/efgr/uacr,,,8.48,9.82,8
HCPCS,M1190,Doc khe not pef w/efgr/uacr,,,8.48,9.82,8
HCPCS,M1191,Hspc svc any time in meas pd,,,8.48,9.82,8
HCPCS,M1192,Pt w/ dx sq cell ca of esoph,,,8.48,9.82,8
HCPCS,M1193,Rpts w/ imp/con mmr/msi,,,8.48,9.82,8
HCPCS,M1194,Med rsn no imp/con mmr/msi,,,8.48,9.82,8
HCPCS,M1195,Rpt wo imp/con mmr/msi,,,8.48,9.82,8
HCPCS,M1196,Ixv nrs vrs iqa >=4,,,8.48,9.82,8
HCPCS,M1197,Isa reduced >=3 fr ixv,,,8.48,9.82,8
HCPCS,M1198,Isa not red 3pts /no assess,,,8.48,9.82,8
HCPCS,M1199,Pt rec'g rrt,,,8.48,9.82,8
HCPCS,M1200,Ace-i/arb rx,,,8.48,9.82,8
HCPCS,M1201,Med rsn no ace-i/arb rx,,,8.48,9.82,8
HCPCS,M1202,Pt rsn no ace-i/arb rx,,,8.48,9.82,8
HCPCS,M1203,No rsn ace-i/arb rx,,,8.48,9.82,8
HCPCS,M1204,Ixv nrs vrs iqa >=4,,,8.48,9.82,8
HCPCS,M1205,Isa reduced >=3,,,8.48,9.82,8
HCPCS,M1206,Isa not red 3pts/no assess,,,8.48,9.82,8
HCPCS,M1207,Pt scrn sdoh,,,8.48,9.82,8
HCPCS,M1208,Pt no scrn sdoh,,,8.48,9.82,8
HCPCS,M1209,>=2 same hi-rsk med w/o diag,,,8.48,9.82,8
HCPCS,M1210,>=2 same meds tbl4 not ord,,,8.48,9.82,8
HCPCS,M1211,Gsa level>9.0%,,,8.48,9.82,8
HCPCS,M1212,Missing gsa not perf,,,8.48,9.82,8
HCPCS,M1213,No hx spiro prs spiro>=70%,,,8.48,9.82,8
HCPCS,M1214,Spiro results wth obs doc,,,8.48,9.82,8
HCPCS,M1215,Med rsn for no doc spiro,,,8.48,9.82,8
HCPCS,M1216,No spiro doc no res doc,,,8.48,9.82,8
HCPCS,M1217,Sys rsn no doc spiro,,,8.48,9.82,8
HCPCS,M1218,Pt copd symptoms,,,8.48,9.82,8
HCPCS,M1219,Anphx due to vax,,,8.48,9.82,8
HCPCS,M1220,Dre wth interp rtnopthy,,,8.48,9.82,8
HCPCS,M1221,Dre w/o rtnopthy,,,8.48,9.82,8
HCPCS,M1222,Glaucoma pln of care not doc,,,8.48,9.82,8
HCPCS,M1223,Glaucoma plan of care doc,,,8.48,9.82,8
HCPCS,M1224,Iop dec <20% from base,,,8.48,9.82,8
HCPCS,M1225,Iop dec>=20% from base,,,8.48,9.82,8
HCPCS,M1226,Iop not doc,,,8.48,9.82,8
HCPCS,M1227,Eb therapy prescribed,,,8.48,9.82,8
HCPCS,M1228,Pt + hcv aby +vir w/ rx 3 mo,,,8.48,9.82,8
HCPCS,M1229,Pt w/ +hcv +vir ref win 1 mo,,,8.48,9.82,8
HCPCS,M1230,Pt hcv rctv aby no f/u tst,,,8.48,9.82,8
HCPCS,M1231,Pt hcv tst no reactive res,,,8.48,9.82,8
HCPCS,M1232,Pt hcv tst reactive result,,,8.48,9.82,8
HCPCS,M1233,Pt no hcv aby or result,,,8.48,9.82,8
HCPCS,M1234,Pt hcv rctv aby f/u neg,,,8.48,9.82,8
HCPCS,M1235,Doc pt hcv aby rna tst,,,8.48,9.82,8
HCPCS,M1236,Baseline mrs > 2,,,8.48,9.82,8
HCPCS,M1237,Pt rsn no scrn,,,8.48,9.82,8
HCPCS,M1238,Doc 2nd recom hzv 2-6 mo int,,,8.48,9.82,8
HCPCS,M1239,Pt no resp heard,,,8.48,9.82,8
HCPCS,M1240,Pt no resp best int,,,8.48,9.82,8
HCPCS,M1241,Pt no resp seen as person,,,8.48,9.82,8
HCPCS,M1242,Pt no resp imprt to me,,,8.48,9.82,8
HCPCS,M1243,Pt othr thn true heard,,,8.48,9.82,8
HCPCS,M1244,Pt othr thn true best int,,,8.48,9.82,8
HCPCS,M1245,Pt othr thn true person,,,8.48,9.82,8
HCPCS,M1246,Pt othr thn true imprt to me,,,8.48,9.82,8
HCPCS,M1247,Pt resp true best int,,,8.48,9.82,8
HCPCS,M1248,Pt resp true seen as person,,,8.48,9.82,8
HCPCS,M1249,Pt resp true imprt to me,,,8.48,9.82,8
HCPCS,M1250,Pt resp true heard,,,8.48,9.82,8
HCPCS,M1251,Pts proxy cmplt hu surv,,,8.48,9.82,8
HCPCS,M1252,Pts no cmplt hu survey,,,8.48,9.82,8
HCPCS,M1253,Pts hu surv no amb plltv,,,8.48,9.82,8
HCPCS,M1254,Pts deceased prior hu surv,,,8.48,9.82,8
HCPCS,M1255,"Pts w/ othr rsn vst,+prg tst",,,8.48,9.82,8
HCPCS,M1256,Prior history of known cvd,,,8.48,9.82,8
HCPCS,M1257,Cvd risk assess not perf,,,8.48,9.82,8
HCPCS,M1258,Cvd risk assess perf,,,8.48,9.82,8
HCPCS,M1259,Pt stat doc <= 1 yr dialysis,,,8.48,9.82,8
HCPCS,M1260,Pt not doc <= 1 yr dialysis,,,8.48,9.82,8
HCPCS,M1261,Pts on wtlist bef dialysis,,,8.48,9.82,8
HCPCS,M1262,Pts transplt bef dialysis,,,8.48,9.82,8
HCPCS,M1263,Pts hosp dialysis dt,,,8.48,9.82,8
HCPCS,M1264,Pts 75+ dialysis dt,,,8.48,9.82,8
HCPCS,M1265,Cms 2728 completed,,,8.48,9.82,8
HCPCS,M1266,Pts admit snf,,,8.48,9.82,8
HCPCS,M1267,Pt no act kid transplt wtlst,,,8.48,9.82,8
HCPCS,M1268,Pt ac stat kid trnsplt wtlst,,,8.48,9.82,8
HCPCS,M1269,Rec'd esrd mcp lst day of mo,,,8.48,9.82,8
HCPCS,M1270,Pts no kid transplt wtlst,,,8.48,9.82,8
HCPCS,M1271,Pts dem any time/dur mo,,,8.48,9.82,8
HCPCS,M1272,Pts kid transplt wtlst,,,8.48,9.82,8
HCPCS,M1273,Pts snf 1 yr dialysis,,,8.48,9.82,8
HCPCS,M1274,Pts snf exl mo,,,8.48,9.82,8
HCPCS,M1275,Pts hosp exl,,,8.48,9.82,8
HCPCS,M1276,Calc bmi out nrm param nof/u,,,8.48,9.82,8
HCPCS,M1277,Colorectal ca screen doc rev,,,8.48,9.82,8
HCPCS,M1278,"Pre-htn or htn doc, f/u indc",,,8.48,9.82,8
HCPCS,M1279,"Pre-htn/htn, no f/u, not gvn",,,8.48,9.82,8
HCPCS,M1280,Bilat mast/hx bi /unilat mas,,,8.48,9.82,8
HCPCS,M1281,Bp scrn no perf at interval,,,8.48,9.82,8
HCPCS,M1282,Pt scrn tbco id as non user,,,8.48,9.82,8
HCPCS,M1283,Pt scrn tbco and id as user,,,8.48,9.82,8
HCPCS,M1284,Pt 66+ snp or ltc pos > 90d,,,8.48,9.82,8
HCPCS,M1285,Scrn mam perf rslts not doc,,,8.48,9.82,8
HCPCS,M1286,Bmi doc onl fup not cmpltd,,,8.48,9.82,8
HCPCS,M1287,Calc bmi blw low param f/u,,,8.48,9.82,8
HCPCS,M1288,Doc rsn no hbp scrn or f/u,,,8.48,9.82,8
HCPCS,M1289,No pt tbco cess interv rng,,,8.48,9.82,8
HCPCS,M1290,Pt not eli d/t act dig htn,,,8.48,9.82,8
HCPCS,M1291,Pt 66+ frailty and med dem,,,8.48,9.82,8
HCPCS,M1292,Pt 66+ frail inpt adv ill,,,8.48,9.82,8
HCPCS,M1293,Calc bmi abv up param f/u,,,8.48,9.82,8
HCPCS,M1294,Bp scrn perf rec interval,,,8.48,9.82,8
HCPCS,M1295,Pt hx tot col or colon ca,,,8.48,9.82,8
HCPCS,M1296,Calc bmi norm parameters,,,8.48,9.82,8
HCPCS,M1297,Bmi not doc medrsn ptref,,,8.48,9.82,8
HCPCS,M1298,Doc pt preg dur msrmt pd,,,8.48,9.82,8
HCPCS,M1299,Flu immunize order/admin,,,8.48,9.82,8
HCPCS,M1300,Flu imm no admin doc rea,,,8.48,9.82,8
HCPCS,M1301,Pt recv tbco cess interv,,,8.48,9.82,8
HCPCS,M1302,Scrn mam perf rslts doc,,,8.48,9.82,8
HCPCS,M1303,Hospc serv dur meas pd,,,8.48,9.82,8
HCPCS,M1304,No pneum vax admin 19+,,,8.48,9.82,8
HCPCS,M1305,Pneum vax admin 19+,,,8.48,9.82,8
HCPCS,M1306,Pt anphx due to pneum,,,8.48,9.82,8
HCPCS,M1307,Doc pt pal or hospice,,,8.48,9.82,8
HCPCS,M1308,Flu immunize no admin,,,8.48,9.82,8
HCPCS,M1309,Pall serv during meas,,,8.48,9.82,8
HCPCS,M1310,Pt scr tob & cess int,,,8.48,9.82,8
HCPCS,M1311,Aphlx to vax bef enc,,,8.48,9.82,8
HCPCS,M1312,No pt tbco scrn rng,,,8.48,9.82,8
HCPCS,M1313,No tob scr/cess int,,,8.48,9.82,8
HCPCS,M1314,Bmi not calculated,,,8.48,9.82,8
HCPCS,M1315,Crc no doc no rsn,,,8.48,9.82,8
HCPCS,M1316,Tobacco non-user,,,8.48,9.82,8
HCPCS,M1317,Pts counsl cpt opt out,,,8.48,9.82,8
HCPCS,M1318,Pts no csp doc contact,,,8.48,9.82,8
HCPCS,M1319,Pts csp doc contact,,,8.48,9.82,8
HCPCS,M1320,Pts scrn + hrsn,,,8.48,9.82,8
HCPCS,M1321,"Pts no 7wk inj,no iop,iop>25",,,8.48,9.82,8
HCPCS,M1322,"Pts 7wk inj, scrn iop =<25",,,8.48,9.82,8
HCPCS,M1323,"Pts 7wk inj, scrn iop >25",,,8.48,9.82,8
HCPCS,M1324,Pts intravitreal/pci,,,8.48,9.82,8
HCPCS,M1325,Doc med rsn not seen,,,8.48,9.82,8
HCPCS,M1326,Pts dx hypotony,,,8.48,9.82,8
HCPCS,M1327,Pts no eval ini xm no 8 wks,,,8.48,9.82,8
HCPCS,M1328,Pts dx acute vitreous hem,,,8.48,9.82,8
HCPCS,M1329,Pts act pvd 2 wks 8 wks,,,8.48,9.82,8
HCPCS,M1330,Doc pts rsn no f/u xm,,,8.48,9.82,8
HCPCS,M1331,Pts eval ini xm 8 wks,,,8.48,9.82,8
HCPCS,M1332,Pts no eval ini xm no 2 wks,,,8.48,9.82,8
HCPCS,M1333,Acute vitreous hemorrhage,,,8.48,9.82,8
HCPCS,M1334,Pts act pvd 2 wks 2 wks,,,8.48,9.82,8
HCPCS,M1335,Doc pts rsn no f/u xm,,,8.48,9.82,8
HCPCS,M1336,Pts eval ini xm 2 wks,,,8.48,9.82,8
HCPCS,M1337,Acute pvd,,,8.48,9.82,8
HCPCS,M1338,Pt f/u 30-180 dys no + imprv,,,8.48,9.82,8
HCPCS,M1339,Pts f/u 30-180 dys + improv,,,8.48,9.82,8
HCPCS,M1340,Indx whodas 2.0 or sds,,,8.48,9.82,8
HCPCS,M1341,Pt no f/u 30-180 dys,,,8.48,9.82,8
HCPCS,M1342,Pts died perf per,,,8.48,9.82,8
HCPCS,M1343,Pt pam lvl 4 base or srt lin,,,8.48,9.82,8
HCPCS,M1344,No bsln/2nd pam score 4-12mo,,,8.48,9.82,8
HCPCS,M1345,"Pt bsln pam, 2nd scr 4-12 mo",,,8.48,9.82,8
HCPCS,M1346,No pam inc 6 pts 4-12 mo,,,8.48,9.82,8
HCPCS,M1347,Pt pam incr 3 pt 4-12 mo,,,8.48,9.82,8
HCPCS,M1348,Pam incr 6 pt 4-12 mo,,,8.48,9.82,8
HCPCS,M1349,No pam inc 3 pts 4-12 mo,,,8.48,9.82,8
HCPCS,M1350,Pt w/ suic saf pln init rev,,,8.48,9.82,8
HCPCS,M1351,Pt cmplt suicd saf pln 120dy,,,8.48,9.82,8
HCPCS,M1352,"Suicd c-ssrs assessment, equ",,,8.48,9.82,8
HCPCS,M1353,Pts no cmplt suicd saf pln,,,8.48,9.82,8
HCPCS,M1354,Pt no suicd saf pln 120dy,,,8.48,9.82,8
HCPCS,M1355,Suicd based cln eval,,,8.48,9.82,8
HCPCS,M1356,Pt died dur meas pd,,,8.48,9.82,8
HCPCS,M1357,Pt w/red suic idea 120 days,,,8.48,9.82,8
HCPCS,M1358,Pts no <suicd idea 120 dys,,,8.48,9.82,8
HCPCS,M1359,"Indx suicd idea, no 0 scr",,,8.48,9.82,8
HCPCS,M1360,Suicd c-ssrs assessment,,,8.48,9.82,8
HCPCS,M1361,Suicd based cln eval,,,8.48,9.82,8
HCPCS,M1362,Pt died dur meas pd,,,8.48,9.82,8
HCPCS,M1363,Pts no f/u 120 dys,,,8.48,9.82,8
HCPCS,M1364,Ascvd risk >=20pct,,,8.48,9.82,8
HCPCS,M1365,Hosp+pall care spec code 17,,,8.48,9.82,8
HCPCS,M1366,Focus on women's health mvp,,,8.48,9.82,8
HCPCS,M1367,Qual care ent disorder mvp,,,8.48,9.82,8
HCPCS,M1368,Prev trt inf d/o hiv/hep mvp,,,8.48,9.82,8
HCPCS,M1369,Qualcare mental hlth/sud mvp,,,8.48,9.82,8
HCPCS,M1370,Rehab support msk care mvp,,,8.48,9.82,8
HCPCS,M1371,Mst rec gsa<7,,,8.48,9.82,8
HCPCS,M1372,Mst rec gsa >=7 and<8,,,8.48,9.82,8
HCPCS,M1373,Mst rec gsa >=8 and <=9,,,8.48,9.82,8
HCPCS,M1374,Ra dx enc 90 days dur per pd,,,8.48,9.82,8
HCPCS,M1375,Ra dx enc 90 days dur per pd,,,8.48,9.82,8
HCPCS,M1376,Ra dx enc 90 days dur per pd,,,8.48,9.82,8
HCPCS,M1377,Fu colscop 10 yr doc w/ disc,,,8.48,9.82,8
HCPCS,M1378,Med rsn no 10 yr fu colscope,,,8.48,9.82,8
HCPCS,M1379,10 yr fu no rec rsn not giv,,,8.48,9.82,8
HCPCS,M1380,2 rx in perf pd any com meds,,,8.48,9.82,8
HCPCS,M1381,Pt sec strk wthin 5 days,,,8.48,9.82,8
HCPCS,M1382,Enc dur perf pd pos 11,,,8.48,9.82,8
HCPCS,M1383,Acute pvd,,,8.48,9.82,8
HCPCS,M1384,Pt died dur perf pd,,,8.48,9.82,8
HCPCS,M1385,Pt rsn not seen 2nd pam,,,8.48,9.82,8
HCPCS,M1386,Exc sx melmn or mlnm is,,,8.48,9.82,8
HCPCS,M1387,Pt died dur perf pd,,,8.48,9.82,8
HCPCS,M1388,Pt doc exm rec melmn,,,8.48,9.82,8
HCPCS,M1390,Pt no doc exm for rec,,,8.48,9.82,8
HCPCS,M1391,All pt dx w/ rec mlnm,,,8.48,9.82,8
HCPCS,M1392,Pt rsn no exm or lst to fu,,,8.48,9.82,8
HCPCS,M1393,Pr no dx rec mlnm,,,8.48,9.82,8
HCPCS,M1394,Stg i-iii br ca,,,8.48,9.82,8
HCPCS,M1395,Init chemo w/def dur ec grp,,,8.48,9.82,8
HCPCS,M1396,Pt ther clin trial,,,8.48,9.82,8
HCPCS,M1397,Pt w/ recur/prog,,,8.48,9.82,8
HCPCS,M1398,Bslne and fu promis doc,,,8.48,9.82,8
HCPCS,M1399,Pt lve prac,,,8.48,9.82,8
HCPCS,M1400,Pt died dur perf pd,,,8.48,9.82,8
HCPCS,M1401,Stg i-iii br ca,,,8.48,9.82,8
HCPCS,M1402,Init chemo w/def dur ec grp,,,8.48,9.82,8
HCPCS,M1403,Bslne and fu promis doc,,,8.48,9.82,8
HCPCS,M1404,Pt ther clin trial,,,8.48,9.82,8
HCPCS,M1405,Pt w/ recur/prog,,,8.48,9.82,8
HCPCS,M1406,Pt lve prac,,,8.48,9.82,8
HCPCS,M1407,Pt died dur perf pd,,,8.48,9.82,8
HCPCS,M1408,Gmln brca bef dx ca,,,8.48,9.82,8
HCPCS,M1409,Recd gmln brca1/brca2 couns,,,8.48,9.82,8
HCPCS,M1410,No gmln brca1/brca2 couns,,,8.48,9.82,8
HCPCS,M1411,1st ln ici no chemo,,,8.48,9.82,8
HCPCS,M1412,Met nsclc w/ egfr alk oth ab,,,8.48,9.82,8
HCPCS,M1413,Pos pdl1 bef init ici tx,,,8.48,9.82,8
HCPCS,M1414,Med rsn no pdl1 bef 1st ther,,,8.48,9.82,8
HCPCS,M1415,No pos pdl1 bef ici ther,,,8.48,9.82,8
HCPCS,M1416,Pt rec hosp,,,8.48,9.82,8
HCPCS,M1417,Pt up to date cov,,,8.48,9.82,8
HCPCS,M1418,Med rsn not up to date cov,,,8.48,9.82,8
HCPCS,M1419,Pt not up to date cov,,,8.48,9.82,8
HCPCS,M1420,Complete ophthalmologic mvp,,,8.48,9.82,8
HCPCS,M1421,Dermatological care mvp,,,8.48,9.82,8
HCPCS,M1422,Gastroenterology care mvp,,,8.48,9.82,8
HCPCS,M1423,Opt care urologic cnd mvp,,,8.48,9.82,8
HCPCS,M1424,Pulmonology care mvp,,,8.48,9.82,8
HCPCS,M1425,Surgical care mvp,,,8.48,9.82,8
HCPCS,M1426,Telehealth enc,,,8.48,9.82,8
HCPCS,M1427,Doc med rsn bone scn,,,8.48,9.82,8
HCPCS,M1428,Bilateral absence of eyes,,,8.48,9.82,8
HCPCS,M1429,"Retinopathy in od, os, ou",,,8.48,9.82,8
HCPCS,M1430,Ret exm ou no retinopthy doc,,,8.48,9.82,8
HCPCS,M1431,Telehealth enc,,,8.48,9.82,8
HCPCS,M1432,Telehealth enc,,,8.48,9.82,8
HCPCS,M1433,Oral chemo wthn 30 days enc,,,8.48,9.82,8
HCPCS,M1434,Orl chemo wthn 30 d post enc,,,8.48,9.82,8
HCPCS,M1435,Oral chemo in perf pd,,,8.48,9.82,8
HCPCS,M1436,Telehealth enc,,,8.48,9.82,8
HCPCS,M1437,Telehealth enc,,,8.48,9.82,8
HCPCS,M1438,Lst knwn well <=210 min,,,8.48,9.82,8
HCPCS,M1439,Sig ocu cond imp surg out,,,8.48,9.82,8
HCPCS,M1440,Telehealth enc,,,8.48,9.82,8
HCPCS,M1441,Init dx slp apn = 1st enc,,,8.48,9.82,8
HCPCS,M1442,Telehealth enc,,,8.48,9.82,8
HCPCS,M1443,Telehealth enc,,,8.48,9.82,8
HCPCS,M1444,Del < 39 weeks gest,,,8.48,9.82,8
HCPCS,M1445,Pp care visit by 12 weeks,,,8.48,9.82,8
HCPCS,M1446,Pt died bef end meas pd,,,8.48,9.82,8
HCPCS,M1447,Pt dx bd bef end meas pd,,,8.48,9.82,8
HCPCS,M1448,Pt dx pd bef end meas pd,,,8.48,9.82,8
HCPCS,M1449,Pt dx scz/pys bef end msr pd,,,8.48,9.82,8
HCPCS,M1450,Pt hos/pal care dur id/pf pd,,,8.48,9.82,8
HCPCS,M1451,Pt dx ppd dur id/pf pd,,,8.48,9.82,8
HCPCS,M1452,Pt dx dementia ever,,,8.48,9.82,8
HCPCS,M1453,Preop vis acu > 20/40,,,8.48,9.82,8
HCPCS,M1454,New cied,,,8.48,9.82,8
HCPCS,M1455,Rep/rev cied,,,8.48,9.82,8
HCPCS,M1456,Pt had htx,,,8.48,9.82,8
HCPCS,M1457,Dx asth dur crnt/prv perf pd,,,8.48,9.82,8
HCPCS,M1458,Pt died bef end meas pd,,,8.48,9.82,8
HCPCS,M1459,Pt hosp/pal care dur perf pd,,,8.48,9.82,8
HCPCS,M1460,"Dx copd, cf, or arf",,,8.48,9.82,8
HCPCS,M1461,Pt dx chron hepc,,,8.48,9.82,8
HCPCS,M1462,Pt clin ind hd image,,,8.48,9.82,8
HCPCS,M1463,2 f/u wthn 180 day rx atmp,,,8.48,9.82,8
HCPCS,M1464,No record of f/u by 180 days,,,8.48,9.82,8
HCPCS,M1465,F/u > 180 days after rx,,,8.48,9.82,8
HCPCS,M1466,Pt disc/lam proc same day,,,8.48,9.82,8
HCPCS,M1467,Pt dx lynch syn,,,8.48,9.82,8
HCPCS,M1468,Hep b vaccine received,,,8.48,9.82,8
HCPCS,M1469,"Hx of hep b, or pos bld test",,,8.48,9.82,8
HCPCS,M1470,Hep b vac not rec'd med rsn,,,8.48,9.82,8
HCPCS,M1471,Ffs hep b not covered,,,8.48,9.82,8
HCPCS,M1472,Hep b vaccine not received,,,8.48,9.82,8
HCPCS,M1473,Pt func cap not allow impr,,,8.48,9.82,8
HCPCS,M1474,Pt dx dementia,,,8.48,9.82,8
HCPCS,M1475,Pt dx huntington,,,8.48,9.82,8
HCPCS,M1476,Pt dx cog imp or ad,,,8.48,9.82,8
HCPCS,M1477,Dx delirium,,,8.48,9.82,8
HCPCS,M1478,Psychoactive sub abuse,,,8.48,9.82,8
HCPCS,M1479,Pt func cap not allow impr,,,8.48,9.82,8
HCPCS,M1480,Pt func cap not allow impr,,,8.48,9.82,8
HCPCS,M1481,Pt in hosp/pal care who died,,,8.48,9.82,8
HCPCS,M1482,Pos quan hep c or qual rna,,,8.48,9.82,8
HCPCS,M1483,Neg quan hep c or qual rna,,,8.48,9.82,8
HCPCS,M1484,No rpt hcv rna perf med rsn,,,8.48,9.82,8
HCPCS,M1485,Neg viro resp hep c/qual rna,,,8.48,9.82,8
HCPCS,M1486,Pt admitted to snf dur eval,,,8.48,9.82,8
HCPCS,M1487,Pt adm to hospice dur eval,,,8.48,9.82,8
HCPCS,M1488,Dx dementia in msr timeframe,,,8.48,9.82,8
HCPCS,M1489,Pt status doc,,,8.48,9.82,8
HCPCS,M1490,Pt status not doc,,,8.48,9.82,8
HCPCS,M1491,Rec'd esrd mcp dur perf pd,,,8.48,9.82,8
HCPCS,M1492,No reported fall,,,8.48,9.82,8
HCPCS,M1493,No fall doc med rsn,,,8.48,9.82,8
HCPCS,M1494,Fall rep since last visit,,,8.48,9.82,8
HCPCS,M1495,"Fall w/ poc, no fall",,,8.48,9.82,8
HCPCS,M1496,No doc of fall or poc,,,8.48,9.82,8
HCPCS,M1497,No doc fall med rsn,,,8.48,9.82,8
HCPCS,M1498,Diagnostic radiology mvp,,,8.48,9.82,8
HCPCS,M1499,Interventional radiology mvp,,,8.48,9.82,8
HCPCS,M1500,Neuropsychology mvp,,,8.48,9.82,8
HCPCS,M1501,Pathology mvp,,,8.48,9.82,8
HCPCS,M1502,Podiatry mvp,,,8.48,9.82,8
HCPCS,M1503,Vascular surgery mvp,,,8.48,9.82,8
HCPCS,P2028,Cephalin floculation test,,,4.95,35.08,29
HCPCS,P2029,Congo red blood test,,,4.95,35.08,29
HCPCS,P2031,Hair analysis,,,5.54,21.21,13
HCPCS,P2033,Blood thymol turbidity,,,4.95,35.08,29
HCPCS,P2038,Blood mucoprotein,,,4.95,22.09,29
HCPCS,P3000,Screen pap by tech w md supv,,,12.13,75.97,29
HCPCS,P3001,Screening pap smear by phys,,,12.13,49.46,10
HCPCS,P7001,Culture bacterial urine,,,13.21,59.59,10
HCPCS,P9010,WHOLE BLOOD TXFUS PER UNIT,1553.0,1009.45,165.96,1553.0,61
HCPCS,P9011,SPLIT UNIT,978.0,635.7,131.02,978.0,61
HCPCS,P9012,CRYOPRECIPITATE EA UNIT,439.0,285.35,58.74,439.0,61
HCPCS,P9016,RBC LR EA UNIT,1256.0,816.4,165.96,1256.0,61
HCPCS,P9017,FFP SNGL DONOR WITHIN 8 HR,582.0,378.3,77.88,582.0,61
HCPCS,P9019,"Platelets, each unit",,,49.24,192.16,27
HCPCS,P9020,PLATELET RICH PLASMA UNIT,3846.0,2499.9,165.96,3846.0,61
HCPCS,P9021,RBC EA UNIT,996.0,647.4,133.35,996.0,61
HCPCS,P9022,RED CELLS WASHED EA UNIT,2738.0,1779.7,272.25,2738.0,61
HCPCS,P9023,"Frozen plasma, pooled, sd",,,1.82,192.16,29
HCPCS,P902300,"Frozen plasma, pooled, sd",,,1.82,1.82,1
HCPCS,P9025,Plasma cryo redu path each,,,123.86,366.96,27
HCPCS,P9026,Cryo fib comp path redu each,,,165.96,1506.91,27
HCPCS,P9027,Rbc o2 co2 reduced,,,165.96,1403.51,27
HCPCS,P9031,PLT LR EA UNIT,868.0,564.2,116.21,868.0,61
HCPCS,P9032,PLATELETS IRRADIATED EA UNIT,937.0,609.05,125.46,1078.08,61
HCPCS,P9033,PLATELETS LEUKORED IRRAD EA UNIT,1417.0,921.05,175.56,1417.0,61
HCPCS,P9034,"Platelets, pheresis",,,272.25,847.61,27
HCPCS,P9035,PLT PHERESIS LR EA UNIT,3361.0,2184.65,272.25,3361.0,61
HCPCS,P9036,PLATELET PHERESIS IRRAD EA UNIT,4055.0,2635.75,272.25,4055.0,61
HCPCS,P9037,PLTS PHERESIS LEUKOR IRR,4662.0,3030.3,272.25,4662.0,61
HCPCS,P9038,Rbc irradiated,,,134.48,398.4,27
HCPCS,P9039,RED CELL FROZ/THAW 1 UNIT,4511.0,2932.15,165.96,4511.0,61
HCPCS,P9040,RBC LR IRRAD EA UNIT,1765.0,1147.25,165.96,1765.0,61
HCPCS,P9041,ALBUTEIN 5 % INTRAVENOUS SOLUTION,2.37,1.54,0.52,192.16,59
HCPCS,P9041,"Albumin (human),5%, 50ml",,,18.9,18.9,1
HCPCS,P904100,"Albumin (human),5%, 50ml",,,18.9,18.9,1
HCPCS,P9043,"Plasma protein fract,5%,50ml",,,7.46,192.16,29
HCPCS,P904300,"Plasma protein fract,5%,50ml",,,48.1,48.1,1
HCPCS,P9044,PLASMA CRYOPRECIPITATE REDUCED EA UNIT,1016.0,660.4,2.17,1016.0,61
HCPCS,P9045,ALBURX (HUMAN) 5 % INTRAVENOUS SOLUTION,1.29,0.84,0.29,315.24,65
HCPCS,P9045,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.675,0.44,0.15,315.24,260
HCPCS,P9045,"Albumin (human), 5%, 250 ml",,,94.48,94.48,1
HCPCS,P9045,FLEXBUMIN 5 % INTRAVENOUS SOLUTION,0.84,0.55,0.19,315.24,65
HCPCS,P904500,"Albumin (human), 5%, 250 ml",,,94.48,94.48,1
HCPCS,P9046,ALBUTEIN 25 % INTRAVENOUS SOLUTION,5.01,3.26,1.11,192.16,65
HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,37.79,37.79,1
HCPCS,P904600,"Albumin (human), 25%, 20 ml",,,37.79,37.79,1
HCPCS,P9047,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.74,192.16,236
HCPCS,P9047,"Albumin (human), 25%, 50ml",,,94.48,94.48,1
HCPCS,P9047,FLEXBUMIN 25 % INTRAVENOUS SOLUTION,4.17,2.71,0.92,192.16,118
HCPCS,P904700,"Albumin (human), 25%, 50ml",,,94.48,94.48,1
HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,32.71,192.16,29
HCPCS,P904800,"Plasmaprotein fract,5%,250ml",,,112.98,112.98,1
HCPCS,P9050,"Granulocytes, pheresis unit",,,272.25,315.24,8
HCPCS,P9051,WH BLD OR RBC L/R CMV NEG EA UNIT,1188.0,772.2,140.37,1188.0,61
HCPCS,P9052,"Platelets, hla-m, l/r, unit",,,272.25,1942.51,27
HCPCS,P9053,PLT PHER IRR L/R CMV NEG EA UNIT,3169.0,2059.85,272.25,3169.0,61
HCPCS,P9054,WSH LR FROZ DW WB/RBC EA UNIT,1673.0,1087.45,165.96,1673.0,61
HCPCS,P9055,"Plt, aph/pher, l/r, cmv-neg",,,209.97,687.2,27
HCPCS,P9056,"Blood, l/r, irradiated",,,77.77,231.96,27
HCPCS,P9057,RED CELL LEUKOREDUCED DEGLYCEROLIZED IRRADIATED,3349.0,2176.85,165.96,3349.0,61
HCPCS,P9058,RBC L/R IRR CMV NEG EA UNIT,1538.0,999.7,165.96,1538.0,61
HCPCS,P9059,CONVALESCENT PLASMA,491.0,319.15,65.69,491.0,61
HCPCS,P9059,FR FRZ PLASMA FRZN 8-24 HOURS EA UNIT,491.0,319.15,65.69,491.0,61
HCPCS,P9060,FR FRZ PLASMA DONOR RETESTED EA UNIT,338.0,219.7,45.21,338.0,61
HCPCS,P9070,Pathogen reduced plasma pool,,,51.65,192.16,27
HCPCS,P9071,PLASMA SNGL DONOR PATHOGEN REDUCED FRZN EACH UNIT,2018.0,1311.7,165.96,2018.0,61
HCPCS,P9073,PLT PHER PATH-RED EA,4052.0,2633.8,272.25,4052.0,61
HCPCS,P9099,Blood component/product noc,,,32.71,192.16,27
HCPCS,P9100,Pathogen test for platelets,,,36.09,165.35,28
HCPCS,P9603,One-way allow prorated miles,,,2.09,2.42,8
HCPCS,P9604,One-way allow prorated trip,,,2.09,2.42,8
HCPCS,P9612,"CATH COLL SPEC,1 PT,ALL PLACES SERVC",63.0,40.95,1.1,63.0,33
HCPCS,P9612,CATH FOR COLL SPECIMEN,63.0,40.95,0.01,3004.0,60
HCPCS,P9612,STRAIGHT CATH - SPECIMEN COLLECTION,63.0,40.95,2.09,3004.0,60
HCPCS,P9615,Urine specimen collect mult,,,2.09,38.27,12
HCPCS,PKG6699F,FEMTO LASER NO LENS,1900.0,1235.0,1.1,1900.0,22
HCPCS,PKGA270T,TRULIGN,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA270V,VIVITY W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA290A,ACTIVEFOCUS TORIC2.5,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA2970,ACTIVEFOCUS TORIC2.5 WFEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA2970,RESTOR W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA2970,SYNERGY,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA2970,SYNERGY W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA2970,TRULIGN,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA9270,CRYSTALENS,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,CRYSTALENS W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA9270,PANOPTIX,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,PANOPTIX TORIC (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,PANOPTIX TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA9270,PANOPTIX W/FEMTO,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,RESTOR,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,RESTOR TORIC,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,SYMFONY,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,SYMFONY TORIC,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,SYMFONY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA9270,SYMFONY W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA9270,SYNERGY TORIC,2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGA9270,SYNERGY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,22
HCPCS,PKGA9270,TORIC W/FEMTO,1900.0,1235.0,1.1,1900.0,22
HCPCS,PKGA9270,TORIC? (INC EYHANCE AND CLAREON TORIC),1400.0,910.0,1.1,1400.0,22
HCPCS,PKGA9270,VIVITY (TORIC)? (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,22
HCPCS,PKGFETAL,FETAL INJECTION,1500.0,975.0,1.1,1500.0,22
HCPCS,PKGICG,ICG PACKAGE,3434.0,2232.1,1.1,3434.0,22
HCPCS,PKGTERMC,PREGNANCY TERMINATION CONSULT,950.0,617.5,1.1,950.0,22
HCPCS,Q0035,Cardiokymography,,,18.66,104.69,27
HCPCS,Q0081,Infusion ther other than che,,,220.33,255.12,8
HCPCS,Q0083,Chemo by other than infusion,,,36.15,41.86,8
HCPCS,Q0084,Chemotherapy by infusion,,,220.33,255.12,8
HCPCS,Q0085,Chemo by both infusion and o,,,220.33,255.12,8
HCPCS,Q0091,PAP SMEAR,130.5,84.825,1.1,163.0,106
HCPCS,Q0092,Set up port xray equipment,,,68.91,79.79,8
HCPCS,Q0111,OIL TEST (SCABIES) (POC) (POINT OF CARE LAB),153.0,99.45,0.95,153.0,60
HCPCS,Q0112,POTASSIUM HYDROXIDE (KOH) PREPS (POC) (POINT OF CARE LAB),40.0,26.0,0.95,40.0,60
HCPCS,Q0113,Pinworm examinations,,,4.27,23.68,28
HCPCS,Q0114,FERN TEST (POINT OF CARE LAB),67.0,43.55,0.95,67.0,60
HCPCS,Q0115,Post-coital mucous exam,,,12.13,102.45,28
HCPCS,Q0138,FERAHEME 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,252.78,164.31,0.34,369.35,65
HCPCS,Q0138,"Ferumoxytol, non-esrd",,,0.64,0.64,1
HCPCS,Q013800,"Ferumoxytol, non-esrd",,,0.64,0.64,1
HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.34,369.35,33
HCPCS,Q013900,"Ferumoxytol, esrd use",,,0.64,0.64,1
HCPCS,Q0144,"Azithromycin dihydrate, oral",,,7.65,67.58,12
HCPCS,Q014400,"Azithromycin dihydrate, oral",,,47.26,47.26,1
HCPCS,Q0155,Dronabinol (syndros) 0.1 mg,,,6.92,8.87,11
HCPCS,Q015500,Dronabinol (syndros) 0.1 mg,,,6.92,6.92,1
HCPCS,Q0161,Chlorpromazine hcl 5mg oral,,,0.69,47.96,10
HCPCS,Q016100,Chlorpromazine hcl 5mg oral,,,0.69,0.69,1
HCPCS,Q0162,Ondansetron oral,,,0.01,8.86,14
HCPCS,Q016200,Ondansetron oral,,,0.02,0.02,1
HCPCS,Q0163,Diphenhydramine hcl 50mg,,,0.04,8.86,12
HCPCS,Q016300,Diphenhydramine hcl 50mg,,,0.04,0.04,1
HCPCS,Q0164,Prochlorperazine maleate 5mg,,,0.44,8.86,12
HCPCS,Q016400,Prochlorperazine maleate 5mg,,,0.73,0.73,1
HCPCS,Q0166,Granisetron hcl 1 mg oral,,,0.76,110.94,12
HCPCS,Q016600,Granisetron hcl 1 mg oral,,,6.41,6.41,1
HCPCS,Q0167,Dronabinol 2.5mg oral,,,0.52,8.86,14
HCPCS,Q016700,Dronabinol 2.5mg oral,,,2.4,2.4,1
HCPCS,Q0169,Promethazine hcl 12.5mg oral,,,0.04,8.86,12
HCPCS,Q016900,Promethazine hcl 12.5mg oral,,,0.18,0.18,1
HCPCS,Q0173,Trimethobenzamide hcl 250mg,,,0.01,8.86,12
HCPCS,Q017300,Trimethobenzamide hcl 250mg,,,0.62,0.62,1
HCPCS,Q0174,Thiethylperazine maleate10mg,,,1.39,8.86,10
HCPCS,Q0175,Perphenazine 4mg oral,,,1.0,8.86,12
HCPCS,Q017500,Perphenazine 4mg oral,,,1.0,1.0,1
HCPCS,Q0177,Hydroxyzine pamoate 25mg,,,0.19,8.86,12
HCPCS,Q017700,Hydroxyzine pamoate 25mg,,,0.27,0.27,1
HCPCS,Q0180,Dolasetron mesylate oral,,,7.65,309.11,12
HCPCS,Q018000,Dolasetron mesylate oral,,,128.84,128.84,1
HCPCS,Q0181,Unspecified oral anti-emetic,,,7.65,8.86,8
HCPCS,Q0220,"Tixagev and cilgav, 300mg",,,0.02,184.43,10
HCPCS,Q0221,"Tixagev and cilgav, 600mg",,,0.02,184.43,9
HCPCS,Q0222,Bebtelovimab 175 mg,,,159.28,5745.6,10
HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,12885.42,12885.42,1
HCPCS,Q0224,PEMGARDA (EUA) 125 MG/ML INTRAVENOUS SOLUTION,635.01,412.76,138.43,15274.29,51
HCPCS,Q022400,"Inj, pemivibart, 4500 mg",,,12885.42,12885.42,1
HCPCS,Q0235,"Inj, monoclon antibody, 1 mg",,,8.79,47.96,11
HCPCS,Q023500,"Inj, monoclon antibody, 1 mg",,,10.47,10.47,1
HCPCS,Q0237,"Inj, tocilizumab-anoh, hospi",,,7.75,2642.72,11
HCPCS,Q023700,"Inj, tocilizumab-anoh, hospi",,,9.22,9.22,1
HCPCS,Q0238,Inj tocilizumab-aazg 1 mg,,,2282.35,2642.72,8
HCPCS,Q0239,Bamlanivimab-xxxx,,,0.01,184.43,9
HCPCS,Q0240,Casirivi and imdevi 600 mg,,,0.02,184.43,9
HCPCS,Q0243,Casirivimab and imdevimab,,,0.02,184.43,9
HCPCS,Q0244,Casirivi and imdevi 1200 mg,,,0.02,184.43,9
HCPCS,Q0245,Bamlanivimab and etesevima,,,0.02,184.43,9
HCPCS,Q0247,Sotrovimab,,,159.28,5745.6,10
HCPCS,Q0249,Tocilizumab for covid-19,,,13.47,1287.79,15
HCPCS,Q024900,Tocilizumab for covid-19,,,13.47,13.47,1
HCPCS,Q0477,Pwr module pt cable lvad rpl,,,3246.76,3819.68,2
HCPCS,Q0478,"Power adapter, combo vad",,,46.46,904.71,10
HCPCS,Q0479,"Power module combo vad, rep",,,50232.85,59096.95,2
HCPCS,Q0480,"Driver pneumatic vad, rep",,,13433.1,443407.42,10
HCPCS,Q0481,"Microprcsr cu elec vad, rep",,,13433.1,71538.79,10
HCPCS,Q0482,"Microprcsr cu combo vad, rep",,,19046.35,22407.27,2
HCPCS,Q0483,"Monitor elec vad, rep",,,13433.1,92307.72,10
HCPCS,Q0484,Monitor elec or comb vad rep,,,15237.11,17925.85,2
HCPCS,Q0485,"Monitor cable elec vad, rep",,,72.46,1730.82,10
HCPCS,Q0486,Mon cable elec/pneum vad rep,,,72.46,1440.47,10
HCPCS,Q0487,"Leads any type vad, rep only",,,72.46,1680.48,10
HCPCS,Q0488,"Pwr pack base elec vad, rep",,,13433.1,15554.11,8
HCPCS,Q0489,"Pwr pck base combo vad, rep",,,13433.1,80025.81,10
HCPCS,Q0490,"Emr pwr source elec vad, rep",,,1022.49,3461.56,10
HCPCS,Q0491,Emr pwr source combo vad rep,,,531.62,5441.95,10
HCPCS,Q0492,"Emr pwr cbl elec vad, rep",,,25.16,438.48,10
HCPCS,Q0493,"Emr pwr cbl combo vad, rep",,,278.93,1248.32,10
HCPCS,Q0494,"Emr hd pmp elec/combo, rep",,,278.93,1056.28,10
HCPCS,Q0495,"Charger elec/combo vad, rep",,,17480.08,20564.62,2
HCPCS,Q0496,"Battery elec/combo vad, rep",,,531.62,7381.04,10
HCPCS,Q0497,"Bat clps elec/comb vad, rep",,,264.38,2304.72,10
HCPCS,Q0498,"Holster elec/combo vad, rep",,,264.38,2528.78,10
HCPCS,Q0499,Belt/vest elec/combo vad rep,,,46.46,821.67,10
HCPCS,Q0500,"Filters elec/combo vad, rep",,,28.98,150.25,10
HCPCS,Q0501,"Shwr cov elec/combo vad, rep",,,264.38,2514.23,10
HCPCS,Q0502,"Mobility cart pneum vad, rep",,,264.38,3201.16,10
HCPCS,Q0503,Battery pneum vad replacemnt,,,531.62,6401.92,10
HCPCS,Q0504,"Pwr adpt pneum vad, rep veh",,,264.38,3378.32,10
HCPCS,Q0506,Lith-ion batt elec/pneum vad,,,1022.49,4204.95,10
HCPCS,Q0507,Misc sup/acc ext vad,,,13.46,15.59,8
HCPCS,Q0508,Mis sup/acc imp vad,,,159.5,184.68,8
HCPCS,Q0509,Mis sup/ac imp vad nopay med,,,159.5,184.68,8
HCPCS,Q0510,Dispens fee immunosupressive,,,50.62,58.61,8
HCPCS,Q0511,"Sup fee antiem,antica,immuno",,,13.46,15.59,8
HCPCS,Q0512,Px sup fee anti-can sub pres,,,13.46,15.59,8
HCPCS,Q0513,Disp fee inhal drugs/30 days,,,13.46,15.59,8
HCPCS,Q0514,Disp fee inhal drugs/90 days,,,50.62,58.61,8
HCPCS,Q0515,Sermorelin acetate injection,,,1.87,1238.14,12
HCPCS,Q051500,Sermorelin acetate injection,,,3.2,3.2,1
HCPCS,Q0516,Supply fee hiv prep oral 30,,,321.96,372.8,8
HCPCS,Q0517,Supply fee hiv prep oral 60,,,321.96,372.8,8
HCPCS,Q0518,Supply fee hiv prep oral 90,,,321.96,372.8,8
HCPCS,Q0519,Supply fee hiv prep inj 30,,,321.96,372.8,8
HCPCS,Q0520,Supply fee hiv prep inj 60,,,321.96,372.8,8
HCPCS,Q0521,Supply fee hiv prep fda appr,,,321.96,372.8,8
HCPCS,Q1004,Ntiol category 4,,,159.5,184.68,8
HCPCS,Q1005,Ntiol category 5,,,159.5,184.68,8
HCPCS,Q2004,Bladder calculi irrig sol,,,0.07,270.09,12
HCPCS,Q200400,Bladder calculi irrig sol,,,216.15,216.15,1
HCPCS,Q2009,CEREBYX 100 MG PE/2 ML INJECTION SOLUTION,72.78,47.31,1.34,72.78,59
HCPCS,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,9.84,6.4,1.34,47.96,59
HCPCS,Q2009,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,7.2,4.68,1.34,47.96,59
HCPCS,Q2009,Fosphenytoin inj pe,,,5.13,5.13,1
HCPCS,Q200900,Fosphenytoin inj pe,,,5.13,5.13,1
HCPCS,Q2017,"Teniposide, 50 mg",,,2282.35,6828.92,10
HCPCS,Q2026,Radiesse injection,,,41.42,960.27,28
HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,1.0,1012.39,30
HCPCS,Q202800,"Inj, sculptra, 0.5mg",,,1.39,1.39,1
HCPCS,Q2034,Agriflu vaccine,,,7.93,9.19,8
HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,7.93,53.28,12
HCPCS,Q203500,"Afluria vacc, 3 yrs & >, im",,,34.18,34.18,1
HCPCS,Q2036,"Flulaval vacc, 3 yrs & >, im",,,7.93,20.59,11
HCPCS,Q203600,"Flulaval vacc, 3 yrs & >, im",,,16.07,16.07,1
HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,7.93,42.45,12
HCPCS,Q203700,"Fluvirin vacc, 3 yrs & >, im",,,33.14,33.14,1
HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,7.93,106.68,12
HCPCS,Q2038,"PR FLUZONE VACC, 3 YRS & >, IM",65.0,42.25,1.1,101.21,28
HCPCS,Q203800,"Fluzone vacc, 3 yrs & >, im",,,22.57,22.57,1
HCPCS,Q2039,"Influenza virus vaccine, nos",,,7.93,37.83,10
HCPCS,Q203900,"Influenza virus vaccine, nos",,,29.53,29.53,1
HCPCS,Q2041,Axicabtagene ciloleucel car+,,,947302.19,947302.19,1
HCPCS,Q2041,YESCARTA INTRAVENOUS SUSPENSION,2417184.0,1571169.6,0.02,2417184.0,64
HCPCS,Q204100,Axicabtagene ciloleucel car+,,,947302.19,947302.19,1
HCPCS,Q2042,KYMRIAH 0.2 X 10EXP6 TO 2.5 X 10EXP8 CELL INTRAVENOUS SUSPENSION,2905939.24,1888860.51,0.02,2905939.24,64
HCPCS,Q2042,KYMRIAH 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2511128.6,1632233.59,0.02,2511128.6,64
HCPCS,Q2042,Tisagenlecleucel car-pos t,,,1008425.71,1008425.71,1
HCPCS,Q204200,Tisagenlecleucel car-pos t,,,1008425.71,1008425.71,1
HCPCS,Q2043,PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION,901.47,585.96,199.22,161177.59,65
HCPCS,Q2043,Sipuleucel-t auto cd54+,,,96839.32,96839.32,1
HCPCS,Q204300,Sipuleucel-t auto cd54+,,,96839.32,96839.32,1
HCPCS,Q2049,Imported lipodox inj,,,298.74,4487.68,31
HCPCS,Q204900,Imported lipodox inj,,,1024.57,1024.57,1
HCPCS,Q2050,DOXIL 2 MG/ML INTRAVENOUS SUSPENSION,238.5,155.025,2.17,720.96,130
HCPCS,Q2050,Doxorubicin inj 10mg,,,185.14,185.14,1
HCPCS,Q205000,Doxorubicin inj 10mg,,,185.14,185.14,1
HCPCS,Q2052,"Home ivig, services/supplies",,,13.46,15.59,8
HCPCS,Q2053,Brexucabtagene car pos t,,,871221.36,871221.36,1
HCPCS,Q2053,TECARTUS 1X10EXP6 TO 1X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,0.02,2217600.0,64
HCPCS,Q2053,TECARTUS 2X10EXP6 TO 2X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,0.02,2217600.0,64
HCPCS,Q205300,Brexucabtagene car pos t,,,871221.36,871221.36,1
HCPCS,Q2054,BREYANZI 1.5X TO 70X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,2678006.0,1740703.9,0.02,2678006.0,64
HCPCS,Q2054,Lisocabtagene mara car pos t,,,1000718.21,1000718.21,1
HCPCS,Q205400,Lisocabtagene mara car pos t,,,1000718.21,1000718.21,1
HCPCS,Q2055,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,10447.92,6791.15,0.02,1653372.9,192
HCPCS,Q2055,Idecabtagene vicleucel car,,,993385.48,993385.48,1
HCPCS,Q205500,Idecabtagene vicleucel car,,,993385.48,993385.48,1
HCPCS,Q2056,CARVYKTI 0.5X 10EXP6 TO 1X 10EXP8 CELL INTRAVENOUS SUSPENSION,2665490.12,1732568.58,0.02,2665490.12,128
HCPCS,Q2056,Ciltacabtagene car-pos t,,,1046016.23,1046016.23,1
HCPCS,Q205600,Ciltacabtagene car-pos t,,,1046016.23,1046016.23,1
HCPCS,Q2057,Afamitresgene autoleucel,,,1371703.6,1371703.6,1
HCPCS,Q2057,TECELRA 2.68X 10EXP9 TO 10X 10EXP9 CELL INTRAVENOUS SUSPENSION,3489600.0,2268240.0,0.02,3489600.0,58
HCPCS,Q205700,Afamitresgene autoleucel,,,1371703.6,1371703.6,1
HCPCS,Q2058,Obecbtge autol up to 400 mil,,,0.02,765187.5,22
HCPCS,Q205800,Obecbtge autol up to 400 mil,,,560700.0,560700.0,1
HCPCS,Q3001,Brachytherapy radioelements,,,128.66,284.74,9
HCPCS,Q3014,TELEHEALTH ORIGINATING SITE FEE (W/ PO MODIFIER),43.0,27.95,0.01,60.0,46
HCPCS,Q3027,AVONEX 30 MCG/0.5 ML INTRAMUSCULAR SYRINGE KIT,7774.02,5053.11,2.17,7774.02,57
HCPCS,Q3027,Inj beta interferon im 1 mcg,,,153.76,153.76,1
HCPCS,Q302700,Inj beta interferon im 1 mcg,,,153.76,153.76,1
HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,88.91,88.91,1
HCPCS,Q3028,REBIF (WITH ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRINGE,6592.98,4285.44,2.17,6592.98,51
HCPCS,Q302800,Inj beta interferon sq 1 mcg,,,88.91,88.91,1
HCPCS,Q3031,Collagen skin test,,,50.62,58.61,8
HCPCS,Q4001,Cast sup body cast plaster,,,28.98,249.33,10
HCPCS,Q4002,Cast sup body cast fiberglas,,,28.98,942.14,10
HCPCS,Q4003,"CAST SUPPLIES, SHOULDER CAST, 11 YRS +, PLASTER",72.34,47.02,15.77,179.04,47
HCPCS,Q4004,"CAST SUPPLIES, SHOULDER CAST, 11 YRS+, FIBERGLASS",250.5,162.83,28.98,619.84,47
HCPCS,Q4005,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, PLASTER",26.68,17.34,5.82,66.01,47
HCPCS,Q4006,CAST SUP LONG ARM ADULT FBRG,52.0,33.8,1.1,119.97,39
HCPCS,Q4006,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, FIBERGLASS",26.68,17.34,5.82,148.73,47
HCPCS,Q4007,"CAST SUPPLIES, LONG ARM CAST, PEDS, PLASTER",13.34,8.67,2.91,32.99,47
HCPCS,Q4008,CAST SUP LONG ARM PED FBRGLS,52.0,33.8,1.1,59.94,39
HCPCS,Q4008,"CAST SUPPLIES, LONG ARM CAST, PEDS, FIBERGLASS",30.0,19.5,6.54,74.33,47
HCPCS,Q4009,CAST SUP SHT ARM ADULT PLSTR,83.0,53.95,1.1,83.0,39
HCPCS,Q4009,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, PLASTER",17.82,11.58,3.88,44.1,47
HCPCS,Q4010,CAST SUP SHT ARM ADULT FBRGL,47.0,30.55,1.1,79.96,39
HCPCS,Q4010,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, FIBERGLASS",40.08,26.05,8.74,99.16,47
HCPCS,Q4011,CAST SUP SHT ARM PED PLASTER,29.0,18.85,1.1,29.0,39
HCPCS,Q4011,"CAST SUPPLIES, SHORT ARM CAST, PEDS, PLASTER",8.88,5.77,1.94,21.99,47
HCPCS,Q4012,CAST SUP SHT ARM PED FBRGLAS,47.0,30.55,1.1,47.0,39
HCPCS,Q4012,"CAST SUPPLIES, SHORT ARM CAST, PEDS, FIBERGLASS",20.08,13.05,4.38,49.7,47
HCPCS,Q4013,CAST SUP GAUNTLET PLASTER,25.0,16.25,5.45,80.24,47
HCPCS,Q4014,CAST SUP GAUNTLET FIBERGLASS,47.0,30.55,1.1,109.12,39
HCPCS,Q4014,"CAST SUPPLIES, GAUNTLET CAST, 11 YRS +, FIBERGLASS",54.66,35.53,11.92,135.3,47
HCPCS,Q4015,"CAST SUPPLIES, GAUNTLET CAST, PEDS, PLASTER",16.24,10.56,3.54,40.18,47
HCPCS,Q4016,CAST SUP GAUNTLET FBRGLS,47.0,30.55,1.1,54.53,39
HCPCS,Q4016,"CAST SUPPLIES, GAUNTLET CAST, PEDS, FIBERGLASS",27.34,17.77,5.96,67.61,47
HCPCS,Q4017,CAST SUP LNG ARM SPLINT PLST,77.0,50.05,1.1,77.0,39
HCPCS,Q4017,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, PLASTER",75.0,48.75,8.84,75.0,47
HCPCS,Q4018,CAST SUP LNG ARM SPLINT FBRG,52.0,33.8,1.1,59.6,39
HCPCS,Q4018,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, FIBERGLASS",29.88,19.42,6.51,73.89,47
HCPCS,Q4019,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, PLASTER",9.4,6.11,2.05,23.19,47
HCPCS,Q4020,CAST SUP LNG ARM SPLNT PED F,55.0,35.75,1.1,55.0,39
HCPCS,Q4020,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, FIBERGLASS",14.98,9.74,3.27,37.1,47
HCPCS,Q4021,CAST SUP SHT ARM SPLINT PLST,29.0,18.85,1.1,29.0,39
HCPCS,Q4021,"CAST SUPPLIES, SHORT ARM SPLINT, 11 YRS +, PLASTER",13.88,9.02,3.03,34.34,47
HCPCS,Q4022,CAST SUP SHT ARM SPLINT FBRG,47.0,30.55,1.1,49.97,39
HCPCS,Q4022,Cast sup sht arm splint fbrg,,,13.46,61.97,10
HCPCS,Q4023,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, PLASTER",6.98,4.54,1.52,17.23,47
HCPCS,Q4024,CAST SUP SHT ARM SPLNT PED F,46.0,29.9,1.1,46.0,39
HCPCS,Q4024,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, FIBERGLASS",12.54,8.15,2.73,31.03,47
HCPCS,Q4025,Cast sup hip spica plaster,,,28.98,192.39,10
HCPCS,Q4026,Cast sup hip spica fiberglas,,,28.98,601.01,10
HCPCS,Q4027,Cast sup hip spica ped plstr,,,8.84,96.28,10
HCPCS,Q4028,Cast sup hip spica ped fbrgl,,,28.98,300.66,10
HCPCS,Q4029,Cast sup long leg plaster,,,28.98,147.21,10
HCPCS,Q4030,CAST SUP LONG LEG FIBERGLASS,94.0,61.1,1.1,312.49,39
HCPCS,Q4030,Cast sup long leg fiberglass,,,28.98,387.51,10
HCPCS,Q4031,Cast sup lng leg ped plaster,,,28.98,73.53,10
HCPCS,Q4032,CAST SUP LNG LEG FBRGLS,55.0,35.75,1.1,156.24,39
HCPCS,Q4032,Cast sup lng leg ped fbrgls,,,28.98,193.75,10
HCPCS,Q4033,Cast sup lng leg cylinder pl,,,28.98,137.34,10
HCPCS,Q4034,Cast sup lng leg cylinder fb,,,28.98,341.41,10
HCPCS,Q4035,CAST SUP LNGLEG CYLNDR PED P,32.0,20.8,1.1,55.35,39
HCPCS,Q4035,Cast sup lngleg cylndr ped p,,,28.98,68.65,10
HCPCS,Q4036,Cast sup lngleg cylndr ped f,,,28.98,170.84,10
HCPCS,Q4037,Cast sup shrt leg plaster,,,28.98,83.64,10
HCPCS,Q4038,CAST SUP SHRT LEG FIBERGLASS,51.0,33.15,1.1,169.2,39
HCPCS,Q4038,Cast sup shrt leg fiberglass,,,13.46,209.83,10
HCPCS,Q4039,Cast sup shrt leg ped plster,,,8.84,41.98,10
HCPCS,Q4040,CAST SUP SHRT LEG PED FBRGLS,47.0,30.55,1.1,84.59,39
HCPCS,Q4040,Cast sup shrt leg ped fbrgls,,,28.98,104.87,10
HCPCS,Q4041,CAST SUP LNG LEG SPLNT PLSTR,32.0,20.8,1.1,82.13,39
HCPCS,Q4041,Cast sup lng leg splnt plstr,,,28.98,101.87,10
HCPCS,Q4042,CAST SUP LNG LEG SPLNT FBRGL,52.0,33.8,1.1,140.22,39
HCPCS,Q4042,Cast sup lng leg splnt fbrgl,,,28.98,173.88,10
HCPCS,Q4043,CAST SUP LNG LEG SPLNT PED P,44.0,28.6,1.1,44.0,39
HCPCS,Q4043,Cast sup lng leg splnt ped p,,,8.84,50.94,10
HCPCS,Q4044,CAST SUP LNG LEG SPLNT PED F,55.0,35.75,1.1,70.2,39
HCPCS,Q4044,Cast sup lng leg splnt ped f,,,28.98,87.08,10
HCPCS,Q4045,CAST SUP SHT LEG SPLNT PLSTR,85.0,55.25,1.1,85.0,39
HCPCS,Q4045,Cast sup sht leg splnt plstr,,,8.84,59.13,10
HCPCS,Q4046,CAST SUP SHT LEG SPLNT FBRGL,47.0,30.55,1.1,76.67,39
HCPCS,Q4046,Cast sup sht leg splnt fbrgl,,,13.46,95.12,10
HCPCS,Q4047,CAST SUP SHT LEG SPLNT PED P,7.0,4.55,1.1,23.73,39
HCPCS,Q4047,Cast sup sht leg splnt ped p,,,13.46,29.43,10
HCPCS,Q4048,CAST SUP SHT LEG SPLNT FIBERGLASS,47.0,30.55,1.1,47.0,39
HCPCS,Q4048,Cast sup sht leg splnt ped f,,,8.84,47.58,10
HCPCS,Q4049,"FINGER SPLINT, STATIC",9.0,5.85,1.1,9.0,33
HCPCS,Q4049,"Finger splint, static",,,8.84,10.72,10
HCPCS,Q4050,Cast supplies unlisted,,,28.98,33.56,8
HCPCS,Q4051,Splint supplies misc,,,8.84,10.24,8
HCPCS,Q4074,Iloprost non-comp unit dose,,,145.33,667.03,14
HCPCS,Q407400,Iloprost non-comp unit dose,,,282.88,282.88,1
HCPCS,Q4081,"Epoetin alfa, 100 units esrd",,,0.84,130.36,14
HCPCS,Q408100,"Epoetin alfa, 100 units esrd",,,1.37,1.37,1
HCPCS,Q4082,Drug/bio noc part b drug cap,,,7.65,8.86,8
HCPCS,Q4100,"Skin substitute, nos",,,874.33,1012.39,8
HCPCS,Q4101,"APLIGRAFT,9978000199",196.99,128.04,43.53,348.8,51
HCPCS,Q4101,Apligraf,,,53.81,53.81,1
HCPCS,Q410100,Apligraf,,,53.81,53.81,1
HCPCS,Q4102,"OASIS WOUND MATRIX,8213100015",45.8,29.77,10.12,348.8,51
HCPCS,Q4102,Oasis wound matrix,,,21.15,21.15,1
HCPCS,Q410200,Oasis wound matrix,,,21.15,21.15,1
HCPCS,Q4103,Oasis burn matrix,,,22.23,348.8,16
HCPCS,Q410300,Oasis burn matrix,,,22.23,22.23,1
HCPCS,Q4104,Integra bmwd,,,35.66,348.8,17
HCPCS,Q410400,Integra bmwd,,,90.78,90.78,1
HCPCS,Q4105,Integra drt or omnigraft,,,26.4,348.8,17
HCPCS,Q410500,Integra drt or omnigraft,,,47.95,47.95,1
HCPCS,Q4106,Dermagraft,,,30.32,109.52,3
HCPCS,Q4107,Graftjacket,,,93.52,1012.39,25
HCPCS,Q410700,Graftjacket,,,180.01,180.01,1
HCPCS,Q4108,Integra matrix,,,33.02,348.8,17
HCPCS,Q410800,Integra matrix,,,68.6,68.6,1
HCPCS,Q4110,Primatrix,,,41.85,348.8,17
HCPCS,Q411000,Primatrix,,,116.43,116.43,1
HCPCS,Q4111,Gammagraft,,,7.16,348.8,17
HCPCS,Q411100,Gammagraft,,,14.01,14.01,1
HCPCS,Q4112,Cymetra injectable,,,841.78,1988.34,11
HCPCS,Q411200,Cymetra injectable,,,1552.3,1552.3,1
HCPCS,Q4113,Graftjacket xpress,,,841.78,4294.63,4
HCPCS,Q411300,Graftjacket xpress,,,1597.55,1597.55,1
HCPCS,Q4114,Integra flowable wound matri,,,1459.23,5038.82,4
HCPCS,Q411400,Integra flowable wound matri,,,5038.82,5038.82,1
HCPCS,Q4115,Alloskin,,,20.3,348.8,17
HCPCS,Q411500,Alloskin,,,22.89,22.89,1
HCPCS,Q4116,Alloderm,,,55.38,55.38,1
HCPCS,Q4116,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.56,1012.39,57
HCPCS,Q411600,Alloderm,,,55.38,55.38,1
HCPCS,Q4117,Hyalomatrix,,,51.07,348.8,16
HCPCS,Q411700,Hyalomatrix,,,51.07,51.07,1
HCPCS,Q4118,Matristem micromatrix,,,5.46,6.84,3
HCPCS,Q411800,Matristem micromatrix,,,6.84,6.84,1
HCPCS,Q4121,Theraskin,,,47.79,348.8,17
HCPCS,Q412100,Theraskin,,,93.9,93.9,1
HCPCS,Q4122,"Dermacell, awm, porous sq cm",,,117.73,348.8,16
HCPCS,Q412200,"Dermacell, awm, porous sq cm",,,215.38,215.38,1
HCPCS,Q4123,Alloskin,,,23.04,348.8,17
HCPCS,Q412300,Alloskin,,,127.36,127.36,1
HCPCS,Q4124,DRSG OASIS TRI-LAYER PER SQ CM,67.01,43.56,14.81,348.8,51
HCPCS,Q4124,Oasis tri-layer wound matrix,,,4.43,4.43,1
HCPCS,Q412400,Oasis tri-layer wound matrix,,,4.43,4.43,1
HCPCS,Q4125,Arthroflex,,,117.73,348.8,13
HCPCS,Q4126,Memoderm/derma/tranz/integup,,,111.09,348.8,16
HCPCS,Q412600,Memoderm/derma/tranz/integup,,,111.09,111.09,1
HCPCS,Q4127,Talymed,,,117.73,348.8,16
HCPCS,Q412700,Talymed,,,121.91,121.91,1
HCPCS,Q4128,Flexhd/allopatchhd/sq cm,,,53.24,348.8,16
HCPCS,Q412800,Flexhd/allopatchhd/sq cm,,,53.24,53.24,1
HCPCS,Q4130,Strattice tm,,,117.73,348.8,13
HCPCS,Q4132,DRSG GRAFIX CORE 14MM PER SQCM,1697.0,1103.05,117.73,1697.0,51
HCPCS,Q4132,"Grafix core, grafixpl core",,,189.93,189.93,1
HCPCS,Q413200,"Grafix core, grafixpl core",,,189.93,189.93,1
HCPCS,Q4133,DRSG GRAFIX PRM 14MM PER SQ CM,1697.0,1103.05,117.73,1697.0,51
HCPCS,Q4133,DRSG GRAFIX PRM 2X3 PER SQ CM,967.75,629.04,117.73,967.75,51
HCPCS,Q4133,GRFT STRAVIX 2CMX2CM,525.0,341.25,116.03,525.0,51
HCPCS,Q4133,Grafix stravix prime pl sqcm,,,246.96,246.96,1
HCPCS,Q413300,Grafix stravix prime pl sqcm,,,246.96,246.96,1
HCPCS,Q4134,Hmatrix,,,117.73,369.54,15
HCPCS,Q413400,Hmatrix,,,288.5,288.5,1
HCPCS,Q4135,Mediskin,,,117.73,348.8,13
HCPCS,Q4136,Ezderm,,,117.73,348.8,13
HCPCS,Q4137,Amnioexcel biodexcel 1sq cm,,,115.25,348.8,17
HCPCS,Q413700,Amnioexcel biodexcel 1sq cm,,,181.06,181.06,1
HCPCS,Q4138,"Biodfence dryflex, 1cm",,,117.73,348.8,16
HCPCS,Q413800,"Biodfence dryflex, 1cm",,,174.64,174.64,1
HCPCS,Q4139,"Amnio or biodmatrix, inj 1cc",,,874.33,1012.39,8
HCPCS,Q4140,Biodfence 1cm,,,117.73,391.73,16
HCPCS,Q414000,Biodfence 1cm,,,287.68,287.68,1
HCPCS,Q4141,"Alloskin ac, 1 cm",,,81.66,348.8,16
HCPCS,Q414100,"Alloskin ac, 1 cm",,,190.41,190.41,1
HCPCS,Q4142,Xcm biologic tiss matrix 1cm,,,117.73,348.8,13
HCPCS,Q4143,"Repriza, 1cm",,,60.38,1012.39,23
HCPCS,Q414300,"Repriza, 1cm",,,60.38,60.38,1
HCPCS,Q4145,"Epifix, inj, 1mg",,,16.88,68.4,3
HCPCS,Q414500,"Epifix, inj, 1mg",,,53.4,53.4,1
HCPCS,Q4146,"Tensix, 1cm",,,117.73,1012.39,21
HCPCS,Q4147,Architect ecm px fx 1 sq cm,,,101.69,3389.0,16
HCPCS,Q414700,Architect ecm px fx 1 sq cm,,,101.69,101.69,1
HCPCS,Q4148,Neox neox rt or clarix cord,,,117.73,348.8,16
HCPCS,Q414800,Neox neox rt or clarix cord,,,220.36,220.36,1
HCPCS,Q4149,"Excellagen, 0.1 cc",,,309.72,396.72,3
HCPCS,Q414900,"Excellagen, 0.1 cc",,,309.72,309.72,1
HCPCS,Q4150,Allowrap ds or dry 1 sq cm,,,117.73,1012.39,24
HCPCS,Q415000,Allowrap ds or dry 1 sq cm,,,139.14,139.14,1
HCPCS,Q4151,"Amnioband, guardian 1 sq cm",,,117.73,348.8,17
HCPCS,Q415100,"Amnioband, guardian 1 sq cm",,,240.1,240.1,1
HCPCS,Q4152,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,117.73,2450.0,49
HCPCS,Q4152,Dermapure 1 square cm,,,90.28,90.28,1
HCPCS,Q415200,Dermapure 1 square cm,,,90.28,90.28,1
HCPCS,Q4153,"Dermavest, plurivest sq cm",,,117.73,530.58,16
HCPCS,Q415300,"Dermavest, plurivest sq cm",,,245.52,245.52,1
HCPCS,Q4154,Biovance 1 square cm,,,117.73,348.8,17
HCPCS,Q415400,Biovance 1 square cm,,,234.78,234.78,1
HCPCS,Q4155,Neoxflo or clarixflo 1 mg,,,61.75,68.35,3
HCPCS,Q415500,Neoxflo or clarixflo 1 mg,,,68.35,68.35,1
HCPCS,Q4156,Neox 100 or clarix 100,,,117.27,348.8,16
HCPCS,Q415600,Neox 100 or clarix 100,,,117.27,117.27,1
HCPCS,Q4157,Revitalon 1 square cm,,,117.73,477.8,16
HCPCS,Q415700,Revitalon 1 square cm,,,373.02,373.02,1
HCPCS,Q4158,KERECIS 1.75 X 1.75,1938.0,1259.7,117.73,1938.0,49
HCPCS,Q4158,KERECIS 16 MM,1825.0,1186.25,117.73,1825.0,49
HCPCS,Q4158,KERECIS 3 X 3.5 CM,2668.0,1734.2,117.73,2668.0,49
HCPCS,Q4158,"Kerecis omega3, per sq cm",,,119.74,119.74,1
HCPCS,Q415800,"Kerecis omega3, per sq cm",,,119.74,119.74,1
HCPCS,Q4159,"AFFINITY, 1.5CM X 1.5CM",1149.99,747.49,117.73,1149.99,51
HCPCS,Q4159,"AFFINITY, 2.5CM X 2.5CM",546.42,355.17,117.73,566.2,51
HCPCS,Q4159,Affinity1 square cm,,,364.83,364.83,1
HCPCS,Q415900,Affinity1 square cm,,,364.83,364.83,1
HCPCS,Q4160,Nushield 1 square cm,,,94.63,4956.2,17
HCPCS,Q416000,Nushield 1 square cm,,,4956.2,4956.2,1
HCPCS,Q4161,Bio-connekt per square cm,,,117.73,6840.0,16
HCPCS,Q416100,Bio-connekt per square cm,,,2831.16,2831.16,1
HCPCS,Q4162,"Wndex flw, bioskn flw, 0.5cc",,,3916.0,5518.34,3
HCPCS,Q416200,"Wndex flw, bioskn flw, 0.5cc",,,3916.0,3916.0,1
HCPCS,Q4163,"Woundex, bioskin, per sq cm",,,117.73,415.37,17
HCPCS,Q416300,"Woundex, bioskin, per sq cm",,,324.28,324.28,1
HCPCS,Q4164,"Helicoll, per square cm",,,117.73,3556.8,16
HCPCS,Q416400,"Helicoll, per square cm",,,2920.86,2920.86,1
HCPCS,Q4165,"Keramatrix, kerasorb sq cm",,,82.03,348.8,16
HCPCS,Q416500,"Keramatrix, kerasorb sq cm",,,94.77,94.77,1
HCPCS,Q4166,"Cytal, per square centimeter",,,35.55,35.55,1
HCPCS,Q4166,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.48,348.8,49
HCPCS,Q416600,"Cytal, per square centimeter",,,35.55,35.55,1
HCPCS,Q4167,"Truskin, per sq centimeter",,,117.73,348.8,16
HCPCS,Q416700,"Truskin, per sq centimeter",,,215.27,215.27,1
HCPCS,Q4168,"Amnioband, 1 mg",,,30.35,38.87,2
HCPCS,Q416800,"Amnioband, 1 mg",,,30.35,30.35,1
HCPCS,Q4169,"Artacent wound, per sq cm",,,117.73,7578.72,16
HCPCS,Q416900,"Artacent wound, per sq cm",,,3681.88,3681.88,1
HCPCS,Q4170,"Cygnus, per sq cm",,,69.97,2599.2,16
HCPCS,Q417000,"Cygnus, per sq cm",,,69.97,69.97,1
HCPCS,Q4171,"Interfyl, 1 mg",,,25.61,69.42,3
HCPCS,Q417100,"Interfyl, 1 mg",,,69.42,69.42,1
HCPCS,Q4173,Palingen or palingen xplus,,,117.73,2450.01,17
HCPCS,Q417300,Palingen or palingen xplus,,,621.26,621.26,1
HCPCS,Q4174,Palingen or promatrx,,,302.26,3406.32,4
HCPCS,Q417400,Palingen or promatrx,,,2659.32,2659.32,1
HCPCS,Q4175,Miroderm,,,117.73,348.8,16
HCPCS,Q417500,Miroderm,,,162.94,162.94,1
HCPCS,Q4176,"Neopatch or therion, 1 sq cm",,,117.73,433.2,16
HCPCS,Q417600,"Neopatch or therion, 1 sq cm",,,338.2,338.2,1
HCPCS,Q4177,"Floweramnioflo, 0.1 cc",,,320.4,410.4,3
HCPCS,Q417700,"Floweramnioflo, 0.1 cc",,,320.4,320.4,1
HCPCS,Q4178,"Floweramniopatch, per sq cm",,,117.73,348.8,16
HCPCS,Q417800,"Floweramniopatch, per sq cm",,,159.15,159.15,1
HCPCS,Q4179,"Flowerderm, per sq cm",,,117.73,348.8,13
HCPCS,Q4180,"Revita, per sq cm",,,117.73,3803.04,16
HCPCS,Q418000,"Revita, per sq cm",,,1167.89,1167.89,1
HCPCS,Q4181,"Amnio wound, per square cm",,,117.73,350.54,14
HCPCS,Q4182,"Transcyte, per sq centimeter",,,84.02,348.8,15
HCPCS,Q418200,"Transcyte, per sq centimeter",,,84.02,84.02,1
HCPCS,Q4183,"Surgigraft, 1 sq cm",,,117.73,1012.39,24
HCPCS,Q418300,"Surgigraft, 1 sq cm",,,178.0,178.0,1
HCPCS,Q4184,Cellesta or duo per sq cm,,,117.73,1423.5,16
HCPCS,Q418400,Cellesta or duo per sq cm,,,142.47,142.47,1
HCPCS,Q4186,DRSG EPIFIX PER SQ CM,1203.35,782.18,117.73,1203.35,51
HCPCS,Q4186,Epifix 1 sq cm,,,269.08,269.08,1
HCPCS,Q4186,GRAFT EPIFIX 14MM DISC PER SQ CM,399.0,259.35,88.18,399.0,51
HCPCS,Q4186,GRAFT EPIFIX 2 X 3 PER SQ CM MESH,1716.0,1115.4,117.73,1716.0,51
HCPCS,Q4186,GRAFT EPIFIX 2X2 PER SQ CM,629.94,409.46,117.73,629.94,51
HCPCS,Q418600,Epifix 1 sq cm,,,269.08,269.08,1
HCPCS,Q4187,Epicord 1 sq cm,,,117.73,553.42,17
HCPCS,Q418700,Epicord 1 sq cm,,,436.63,436.63,1
HCPCS,Q4188,Amnioarmor 1 sq cm,,,117.73,867.91,16
HCPCS,Q418800,Amnioarmor 1 sq cm,,,867.91,867.91,1
HCPCS,Q4189,"Artacent ac, 1 mg",,,44.54,57.05,2
HCPCS,Q418900,"Artacent ac, 1 mg",,,44.54,44.54,1
HCPCS,Q4190,Artacent ac 1 sq cm,,,117.73,537.37,16
HCPCS,Q419000,Artacent ac 1 sq cm,,,199.93,199.93,1
HCPCS,Q4191,Restorigin 1 sq cm,,,117.73,2317.19,16
HCPCS,Q419100,Restorigin 1 sq cm,,,1166.43,1166.43,1
HCPCS,Q4193,Coll-e-derm 1 sq cm,,,117.73,5335.2,24
HCPCS,Q419300,Coll-e-derm 1 sq cm,,,2479.75,2479.75,1
HCPCS,Q4194,Novachor 1 sq cm,,,117.73,1958.34,16
HCPCS,Q419400,Novachor 1 sq cm,,,1181.26,1181.26,1
HCPCS,Q4195,Puraply 1 sq cm,,,76.01,348.8,17
HCPCS,Q419500,Puraply 1 sq cm,,,174.33,174.33,1
HCPCS,Q4196,DRSG PURAPLY AM PER SQ CM,591.55,384.51,117.73,591.55,51
HCPCS,Q4196,Puraply am 1 sq cm,,,179.83,179.83,1
HCPCS,Q419600,Puraply am 1 sq cm,,,179.83,179.83,1
HCPCS,Q4197,Puraply xt 1 sq cm,,,117.73,348.8,16
HCPCS,Q419700,Puraply xt 1 sq cm,,,125.85,125.85,1
HCPCS,Q4198,Genesis amnio membrane 1sqcm,,,117.73,348.8,13
HCPCS,Q4199,"Cygnus matrix, per sq cm",,,117.73,829.44,16
HCPCS,Q419900,"Cygnus matrix, per sq cm",,,197.85,197.85,1
HCPCS,Q4200,Skin te 1 sq cm,,,117.73,348.8,13
HCPCS,Q4201,Matrion 1 sq cm,,,117.73,348.8,16
HCPCS,Q420100,Matrion 1 sq cm,,,135.44,135.44,1
HCPCS,Q4203,"Derma-gide, 1 sq cm",,,117.73,1874.14,16
HCPCS,Q420300,"Derma-gide, 1 sq cm",,,1874.14,1874.14,1
HCPCS,Q4204,Xwrap 1 sq cm,,,117.73,7797.6,24
HCPCS,Q420400,Xwrap 1 sq cm,,,6572.01,6572.01,1
HCPCS,Q4205,Membrane graft or wrap sq cm,,,117.73,2643.91,16
HCPCS,Q420500,Membrane graft or wrap sq cm,,,2202.36,2202.36,1
HCPCS,Q4206,Fluid flow or fluid gf 1 cc,,,5126.4,6566.4,2
HCPCS,Q420600,Fluid flow or fluid gf 1 cc,,,5126.4,5126.4,1
HCPCS,Q4208,Novafix per sq cm,,,117.73,1094.4,15
HCPCS,Q420800,Novafix per sq cm,,,854.4,854.4,1
HCPCS,Q4209,Surgraft per sq cm,,,117.73,348.8,13
HCPCS,Q4210,Axolotl graf dualgraf sq cm,,,3615.63,4631.25,2
HCPCS,Q421000,Axolotl graf dualgraf sq cm,,,3615.63,3615.63,1
HCPCS,Q4211,Amnion bio or axobio sq cm,,,117.73,348.8,13
HCPCS,Q4213,"Ascent, 0.5 mg",,,122.71,157.18,3
HCPCS,Q421300,"Ascent, 0.5 mg",,,122.71,122.71,1
HCPCS,Q4214,Cellesta cord per sq cm,,,117.73,348.8,13
HCPCS,Q4216,Artacent cord per sq cm,,,117.73,348.8,13
HCPCS,Q4217,Woundfix biowound plus xplus,,,117.73,845.56,16
HCPCS,Q421700,Woundfix biowound plus xplus,,,566.04,566.04,1
HCPCS,Q4218,Surgicord per sq cm,,,117.73,348.8,15
HCPCS,Q421800,Surgicord per sq cm,,,267.0,267.0,1
HCPCS,Q4219,Surgigraft dual per sq cm,,,117.73,2736.0,16
HCPCS,Q421900,Surgigraft dual per sq cm,,,2136.0,2136.0,1
HCPCS,Q4220,"Bellacell hd, surederm sq cm",,,117.73,348.8,13
HCPCS,Q4221,Amniowrap2 per sq cm,,,117.73,4377.6,16
HCPCS,Q422100,Amniowrap2 per sq cm,,,3490.58,3490.58,1
HCPCS,Q4222,"Progenamatrix, per sq cm",,,117.73,348.8,16
HCPCS,Q422200,"Progenamatrix, per sq cm",,,258.97,258.97,1
HCPCS,Q4224,Hhf10-p per sq cm,,,874.33,1012.39,8
HCPCS,Q4225,"Amnio or derma tl, per sq cm",,,117.73,3327.77,24
HCPCS,Q422500,"Amnio or derma tl, per sq cm",,,2540.86,2540.86,1
HCPCS,Q4226,Myown harv prep proc sq cm,,,2563.2,3283.2,2
HCPCS,Q422600,Myown harv prep proc sq cm,,,2563.2,2563.2,1
HCPCS,Q4227,Amniocore per sq cm,,,117.73,3078.0,16
HCPCS,Q422700,Amniocore per sq cm,,,2087.16,2087.16,1
HCPCS,Q4229,Cogenex amnio memb per sq cm,,,117.73,1187.95,16
HCPCS,Q422900,Cogenex amnio memb per sq cm,,,821.22,821.22,1
HCPCS,Q4231,"Corplex p, per cc",,,1167.93,2309.89,3
HCPCS,Q423100,"Corplex p, per cc",,,1167.93,1167.93,1
HCPCS,Q4232,"Corplex, per sq cm",,,117.73,604.52,16
HCPCS,Q423200,"Corplex, per sq cm",,,194.8,194.8,1
HCPCS,Q4234,"Xcellerate, per sq cm",,,117.73,986.01,16
HCPCS,Q423400,"Xcellerate, per sq cm",,,986.01,986.01,1
HCPCS,Q4235,Amniorepair or altiply sq cm,,,117.73,348.8,16
HCPCS,Q423500,Amniorepair or altiply sq cm,,,156.6,156.6,1
HCPCS,Q4236,Carepatch per sq cm,,,117.73,1399.01,16
HCPCS,Q423600,Carepatch per sq cm,,,799.95,799.95,1
HCPCS,Q4237,"Cryo-cord, per sq cm",,,117.73,1138.59,16
HCPCS,Q423700,"Cryo-cord, per sq cm",,,888.9,888.9,1
HCPCS,Q4238,"Derm-maxx, per sq cm",,,117.73,3552.22,16
HCPCS,Q423800,"Derm-maxx, per sq cm",,,2585.01,2585.01,1
HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,117.73,6156.0,16
HCPCS,Q423900,Amnio-maxx or lite per sq cm,,,3386.66,3386.66,1
HCPCS,Q4246,"Coretext or protext, per cc",,,6923.0,11012.4,3
HCPCS,Q424600,"Coretext or protext, per cc",,,8597.4,8597.4,1
HCPCS,Q4247,"Amniotext patch, per sq cm",,,117.73,6550.4,16
HCPCS,Q424700,"Amniotext patch, per sq cm",,,6550.4,6550.4,1
HCPCS,Q4248,Dermacyte amn mem allo sq cm,,,117.73,6144.6,16
HCPCS,Q424800,Dermacyte amn mem allo sq cm,,,988.26,988.26,1
HCPCS,Q4249,"Amniply, per sq cm",,,117.73,6158.74,16
HCPCS,Q424900,"Amniply, per sq cm",,,3506.4,3506.4,1
HCPCS,Q4250,Amnioamp-mp per sq cm,,,117.73,6498.0,16
HCPCS,Q425000,Amnioamp-mp per sq cm,,,5303.62,5303.62,1
HCPCS,Q4251,"Vim, per square centimeter",,,117.73,410.4,16
HCPCS,Q425100,"Vim, per square centimeter",,,320.4,320.4,1
HCPCS,Q4252,"Vendaje, per square centimet",,,94.34,348.8,16
HCPCS,Q425200,"Vendaje, per square centimet",,,94.34,94.34,1
HCPCS,Q4253,Zenith amniotic membrane psc,,,117.73,348.8,16
HCPCS,Q425300,Zenith amniotic membrane psc,,,134.91,134.91,1
HCPCS,Q4254,Novafix dl per sq cm,,,117.73,811.41,15
HCPCS,Q425400,Novafix dl per sq cm,,,633.47,633.47,1
HCPCS,Q4255,"Reguard, topical use per sq",,,117.73,348.8,13
HCPCS,Q4256,"Mlg complet, per sq cm",,,117.73,2218.05,24
HCPCS,Q425600,"Mlg complet, per sq cm",,,1308.39,1308.39,1
HCPCS,Q4257,"Relese, per sq cm",,,117.73,1628.86,24
HCPCS,Q425700,"Relese, per sq cm",,,1628.86,1628.86,1
HCPCS,Q4258,"Enverse, per sq cm",,,117.73,1012.39,24
HCPCS,Q425800,"Enverse, per sq cm",,,159.76,159.76,1
HCPCS,Q4259,Celera per sq cm,,,117.73,2920.09,24
HCPCS,Q425900,Celera per sq cm,,,1270.03,1270.03,1
HCPCS,Q4260,"Signature apatch, per sq cm",,,117.73,1012.39,21
HCPCS,Q4261,"Tag, per square centimeter",,,117.73,1650.36,24
HCPCS,Q426100,"Tag, per square centimeter",,,1288.44,1288.44,1
HCPCS,Q4262,"Dual layer impax, per sq cm",,,117.73,689.75,16
HCPCS,Q426200,"Dual layer impax, per sq cm",,,176.27,176.27,1
HCPCS,Q4263,"Surgraft tl, per sq cm",,,117.73,3232.09,16
HCPCS,Q426300,"Surgraft tl, per sq cm",,,3232.09,3232.09,1
HCPCS,Q4264,"Cocoon membrane, per sq cm",,,117.73,6965.7,15
HCPCS,Q426400,"Cocoon membrane, per sq cm",,,663.74,663.74,1
HCPCS,Q4265,Neostim tl per sq cm,,,117.73,4821.52,16
HCPCS,Q426500,Neostim tl per sq cm,,,2467.88,2467.88,1
HCPCS,Q4266,Neostim per sq cm,,,117.73,2026.74,16
HCPCS,Q426600,Neostim per sq cm,,,961.73,961.73,1
HCPCS,Q4267,Neostim dl per sq cm,,,117.73,846.59,16
HCPCS,Q426700,Neostim dl per sq cm,,,575.31,575.31,1
HCPCS,Q4268,Surgraft ft per sq cm,,,117.73,2992.5,16
HCPCS,Q426800,Surgraft ft per sq cm,,,805.82,805.82,1
HCPCS,Q4269,Surgraft xt per sq cm,,,117.73,3212.83,16
HCPCS,Q426900,Surgraft xt per sq cm,,,3212.83,3212.83,1
HCPCS,Q4270,Complete sl per sq cm,,,117.73,5909.33,14
HCPCS,Q427000,Complete sl per sq cm,,,5909.33,5909.33,1
HCPCS,Q4271,Complete ft per sq cm,,,117.73,3514.87,16
HCPCS,Q427100,Complete ft per sq cm,,,2031.59,2031.59,1
HCPCS,Q4272,"Esano a, per sq cm",,,117.73,798.0,16
HCPCS,Q427200,"Esano a, per sq cm",,,623.0,623.0,1
HCPCS,Q4273,"Esano aaa, per sq cm",,,117.73,348.8,13
HCPCS,Q4274,"Esano ac, per sq cm",,,117.73,4856.4,16
HCPCS,Q427400,"Esano ac, per sq cm",,,3349.07,3349.07,1
HCPCS,Q4275,"Esano aca, per sq cm",,,117.73,5531.13,15
HCPCS,Q427500,"Esano aca, per sq cm",,,4818.99,4818.99,1
HCPCS,Q4276,"Orion, per sq cm",,,117.73,1103.04,16
HCPCS,Q427600,"Orion, per sq cm",,,483.77,483.77,1
HCPCS,Q4277,"Woundplus e-grat, per sq cm",,,3337.5,4275.0,2
HCPCS,Q427700,"Woundplus e-grat, per sq cm",,,3337.5,3337.5,1
HCPCS,Q4278,"Epieffect, per sq cm",,,117.73,697.84,16
HCPCS,Q427800,"Epieffect, per sq cm",,,374.78,374.78,1
HCPCS,Q4279,"Vendaje ac, per sq cm",,,117.73,5437.8,16
HCPCS,Q427900,"Vendaje ac, per sq cm",,,3778.44,3778.44,1
HCPCS,Q4280,Xcell amnio matrix per sq cm,,,117.73,4697.71,16
HCPCS,Q428000,Xcell amnio matrix per sq cm,,,4193.41,4193.41,1
HCPCS,Q4281,Barrera slor dl per sq cm,,,117.73,2024.89,16
HCPCS,Q428100,Barrera slor dl per sq cm,,,731.86,731.86,1
HCPCS,Q4282,Cygnus dual per sq cm,,,117.73,1109.86,16
HCPCS,Q428200,Cygnus dual per sq cm,,,599.17,599.17,1
HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,117.73,1505.67,16
HCPCS,Q428300,"Biovance tri or 3l, sq cm",,,811.22,811.22,1
HCPCS,Q4284,"Dermabind sl, per sq cm",,,117.73,348.8,13
HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,117.73,456.46,16
HCPCS,Q428500,Nudyn dl or dl mesh pr sq cm,,,356.36,356.36,1
HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,117.73,544.81,16
HCPCS,Q428600,"Nudyn sl or slw, per sq cm",,,381.01,381.01,1
HCPCS,Q4287,"Dermabind dl, per sq cm",,,117.73,348.8,13
HCPCS,Q4288,"Dermabind ch, per sq cm",,,117.73,348.8,13
HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,117.73,4239.66,16
HCPCS,Q428900,"Revoshield+ amnio, per sq cm",,,2711.03,2711.03,1
HCPCS,Q4290,Membrane wrap hydr per sq cm,,,117.73,5061.6,16
HCPCS,Q429000,Membrane wrap hydr per sq cm,,,3323.28,3323.28,1
HCPCS,Q4291,"Lamellas xt, per sq cm",,,117.73,7496.96,16
HCPCS,Q429100,"Lamellas xt, per sq cm",,,6215.76,6215.76,1
HCPCS,Q4292,"Lamellas, per sq cm",,,117.73,3283.2,16
HCPCS,Q429200,"Lamellas, per sq cm",,,2563.2,2563.2,1
HCPCS,Q4293,"Acesso dl, per sq cm",,,117.73,3408.6,16
HCPCS,Q429300,"Acesso dl, per sq cm",,,2820.77,2820.77,1
HCPCS,Q4294,"Amnio quad-core, per sq cm",,,117.73,6840.0,16
HCPCS,Q429400,"Amnio quad-core, per sq cm",,,5987.58,5987.58,1
HCPCS,Q4295,"Amnio tri-core, per sq cm",,,117.73,6019.2,16
HCPCS,Q429500,"Amnio tri-core, per sq cm",,,5171.7,5171.7,1
HCPCS,Q4296,"Rebound matrix, per sq cm",,,117.73,6156.0,16
HCPCS,Q429600,"Rebound matrix, per sq cm",,,1492.48,1492.48,1
HCPCS,Q4297,"Emerge matrix, per sq cm",,,117.73,4077.0,16
HCPCS,Q429700,"Emerge matrix, per sq cm",,,2318.09,2318.09,1
HCPCS,Q4298,"Amniocore pro, per sq cm",,,117.73,4953.09,16
HCPCS,Q429800,"Amniocore pro, per sq cm",,,4688.79,4688.79,1
HCPCS,Q4299,"Amniocore pro+, per sq cm",,,117.73,6703.2,15
HCPCS,Q429900,"Amniocore pro+, per sq cm",,,5627.01,5627.01,1
HCPCS,Q4300,"Acesso tl, per sq cm",,,117.73,4821.52,16
HCPCS,Q430000,"Acesso tl, per sq cm",,,3778.48,3778.48,1
HCPCS,Q4301,"Activate matrix, per sq cm",,,117.73,4411.64,16
HCPCS,Q430100,"Activate matrix, per sq cm",,,3200.64,3200.64,1
HCPCS,Q4302,"Complete aca, per sq cm",,,117.73,4579.84,16
HCPCS,Q430200,"Complete aca, per sq cm",,,2207.02,2207.02,1
HCPCS,Q4303,"Complete aa, per sq cm",,,117.73,7781.16,16
HCPCS,Q430300,"Complete aa, per sq cm",,,5995.73,5995.73,1
HCPCS,Q4304,"Grafix plus, per sq cm",,,117.73,2097.58,16
HCPCS,Q430400,"Grafix plus, per sq cm",,,796.48,796.48,1
HCPCS,Q4305,Amer am ac tri-lay per sq cm,,,117.73,348.8,13
HCPCS,Q4306,Americ amnion ac per sq cm,,,117.73,348.8,13
HCPCS,Q4307,"American amnion, per sq cm",,,117.73,348.8,13
HCPCS,Q4308,"Sanopellis, per sq cm",,,117.73,348.8,13
HCPCS,Q4309,"Via matrix, per sq cm",,,117.73,4788.0,16
HCPCS,Q430900,"Via matrix, per sq cm",,,1566.45,1566.45,1
HCPCS,Q4310,"Procenta, per 100 mg",,,4633.21,10573.2,3
HCPCS,Q431000,"Procenta, per 100 mg",,,10573.2,10573.2,1
HCPCS,Q4311,"Acesso, per sq cm",,,117.73,348.8,13
HCPCS,Q4312,"Acesso ac, per sq cm",,,117.73,4292.93,14
HCPCS,Q431200,"Acesso ac, per sq cm",,,4292.93,4292.93,1
HCPCS,Q4313,"Dermabind fm, per sq cm",,,117.73,7866.0,16
HCPCS,Q431300,"Dermabind fm, per sq cm",,,5896.29,5896.29,1
HCPCS,Q4314,"Reeva, per sq cm",,,117.73,4150.96,14
HCPCS,Q431400,"Reeva, per sq cm",,,4150.96,4150.96,1
HCPCS,Q4315,Regenelink amniotic mem allo,,,117.73,348.8,13
HCPCS,Q4316,"Amchoplast, per sq cm",,,117.73,7525.79,14
HCPCS,Q431600,"Amchoplast, per sq cm",,,7525.79,7525.79,1
HCPCS,Q4317,"Vitograft, per sq cm",,,117.73,8490.6,14
HCPCS,Q431700,"Vitograft, per sq cm",,,8490.6,8490.6,1
HCPCS,Q4318,"E-graft, per sq cm",,,117.73,348.8,13
HCPCS,Q4319,"Sanograft, per sq cm",,,117.73,5000.02,16
HCPCS,Q431900,"Sanograft, per sq cm",,,5000.02,5000.02,1
HCPCS,Q4320,"Pellograft, per sq cm",,,117.73,2052.0,16
HCPCS,Q432000,"Pellograft, per sq cm",,,317.8,317.8,1
HCPCS,Q4321,"Renograft, per sq cm",,,117.73,6792.48,14
HCPCS,Q432100,"Renograft, per sq cm",,,6792.48,6792.48,1
HCPCS,Q4322,"Caregraft, per sq cm",,,117.73,5403.6,16
HCPCS,Q432200,"Caregraft, per sq cm",,,3249.6,3249.6,1
HCPCS,Q4323,"Alloply, per sq cm",,,117.73,4514.4,16
HCPCS,Q432300,"Alloply, per sq cm",,,2782.41,2782.41,1
HCPCS,Q4324,"Amniotx, per sq cm",,,117.73,4514.4,16
HCPCS,Q432400,"Amniotx, per sq cm",,,3524.4,3524.4,1
HCPCS,Q4325,"Acapatch, per sq cm",,,117.73,6566.4,16
HCPCS,Q432500,"Acapatch, per sq cm",,,3039.9,3039.9,1
HCPCS,Q4326,"Woundplus, per sq cm",,,117.73,4275.0,16
HCPCS,Q432600,"Woundplus, per sq cm",,,1891.64,1891.64,1
HCPCS,Q4327,"Duoamnion, per sq cm",,,117.73,348.8,13
HCPCS,Q4328,"Most, per sq cm",,,117.73,7512.36,15
HCPCS,Q432800,"Most, per sq cm",,,6124.32,6124.32,1
HCPCS,Q4329,"Singlay, per sq cm",,,117.73,348.8,13
HCPCS,Q4330,"Total, per sq cm",,,117.73,348.8,13
HCPCS,Q4331,"Axolotl graft, per sq cm",,,117.73,4631.25,16
HCPCS,Q433100,"Axolotl graft, per sq cm",,,2829.7,2829.7,1
HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,117.73,4631.25,16
HCPCS,Q433200,"Axolotl dualgraft, per sq cm",,,2992.77,2992.77,1
HCPCS,Q4333,"Ardeograft, per sq cm",,,117.73,2052.0,16
HCPCS,Q433300,"Ardeograft, per sq cm",,,1602.0,1602.0,1
HCPCS,Q4334,"Amnioplast 1, per sq cm",,,117.73,348.8,13
HCPCS,Q4335,"Amnioplast 2, per sq cm",,,117.73,348.8,13
HCPCS,Q4336,"Artecent c, per sq cm",,,117.73,348.8,13
HCPCS,Q4337,"Artecent trident, per sq cm",,,117.73,348.8,13
HCPCS,Q4338,"Artacent velos, per sq cm",,,117.73,348.8,13
HCPCS,Q4339,"Artacent vericlen, per sq cm",,,117.73,6315.6,16
HCPCS,Q433900,"Artacent vericlen, per sq cm",,,3658.51,3658.51,1
HCPCS,Q4340,"Simpligraft, per sq cm",,,117.73,2452.64,14
HCPCS,Q434000,"Simpligraft, per sq cm",,,2452.64,2452.64,1
HCPCS,Q4341,"Simplimax, per sq cm",,,117.73,7590.77,15
HCPCS,Q434100,"Simplimax, per sq cm",,,6272.92,6272.92,1
HCPCS,Q4342,"Theramend, per sq cm",,,117.73,9113.05,15
HCPCS,Q434200,"Theramend, per sq cm",,,4042.72,4042.72,1
HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,117.73,6349.8,16
HCPCS,Q434300,Dermacyte ac matrx per sq cm,,,5254.74,5254.74,1
HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,117.73,6976.8,16
HCPCS,Q434400,"Tri membrane wrap, per sq cm",,,6362.41,6362.41,1
HCPCS,Q4345,Matrix hd allogrft per sq cm,,,117.73,4717.0,14
HCPCS,Q434500,Matrix hd allogrft per sq cm,,,4717.0,4717.0,1
HCPCS,Q4346,Shelter dm matrix per sq cm,,,117.73,9037.76,15
HCPCS,Q434600,Shelter dm matrix per sq cm,,,6521.55,6521.55,1
HCPCS,Q4347,Rampart dl matrix per sq cm,,,117.73,5516.99,14
HCPCS,Q434700,Rampart dl matrix per sq cm,,,5516.99,5516.99,1
HCPCS,Q4348,Sentry sl matrix per sq cm,,,117.73,5035.32,15
HCPCS,Q434800,Sentry sl matrix per sq cm,,,3622.09,3622.09,1
HCPCS,Q4349,Mantle dl matrix per sq cm,,,117.73,9037.76,15
HCPCS,Q434900,Mantle dl matrix per sq cm,,,7476.0,7476.0,1
HCPCS,Q4350,Palisade dm matrix per sq cm,,,117.73,9037.76,15
HCPCS,Q435000,Palisade dm matrix per sq cm,,,6422.4,6422.4,1
HCPCS,Q4351,"Enclose tl matrix, per sq cm",,,117.73,9683.32,15
HCPCS,Q435100,"Enclose tl matrix, per sq cm",,,8010.0,8010.0,1
HCPCS,Q4352,"Overlay sl matrix, per sq cm",,,117.73,5035.32,15
HCPCS,Q435200,"Overlay sl matrix, per sq cm",,,4165.2,4165.2,1
HCPCS,Q4353,Xceed tl matrix per sq cm,,,117.73,8071.2,16
HCPCS,Q435300,Xceed tl matrix per sq cm,,,7384.94,7384.94,1
HCPCS,Q4354,Palingen dl-palingen dl-x,,,117.73,8873.3,14
HCPCS,Q435400,Palingen dl-palingen dl-x,,,8873.3,8873.3,1
HCPCS,Q4355,Abio xpl abio xpl hy p sq cm,,,117.73,5047.58,14
HCPCS,Q435500,Abio xpl abio xpl hy p sq cm,,,5047.58,5047.58,1
HCPCS,Q4356,Abio mem abio hyd per sq cm,,,117.73,5340.0,14
HCPCS,Q435600,Abio mem abio hyd per sq cm,,,5340.0,5340.0,1
HCPCS,Q4357,"Xwrap plus, per sq cm",,,117.73,8490.6,14
HCPCS,Q435700,"Xwrap plus, per sq cm",,,8490.6,8490.6,1
HCPCS,Q4358,"Xwrap dual, per sq cm",,,117.73,10490.15,14
HCPCS,Q435800,"Xwrap dual, per sq cm",,,10490.15,10490.15,1
HCPCS,Q4359,"Choriply, per sq cm",,,117.73,4947.19,14
HCPCS,Q435900,"Choriply, per sq cm",,,4947.19,4947.19,1
HCPCS,Q4360,Amchoplast fd per sq cm,,,117.73,4975.1,14
HCPCS,Q436000,Amchoplast fd per sq cm,,,4975.1,4975.1,1
HCPCS,Q4361,"Epixpress, per sq cm",,,117.73,3773.6,14
HCPCS,Q436100,"Epixpress, per sq cm",,,3773.6,3773.6,1
HCPCS,Q4362,"Cygnus disk, per sq cm",,,117.73,348.8,13
HCPCS,Q4363,Am bur mem hydro per sq cm,,,117.73,348.8,13
HCPCS,Q4364,Am bur xp mem xpl hy p sq cm,,,117.73,6595.97,14
HCPCS,Q436400,Am bur xp mem xpl hy p sq cm,,,6595.97,6595.97,1
HCPCS,Q4365,Amnio bur dl mem per sq cm,,,117.73,348.8,13
HCPCS,Q4366,Dl amnio bur x-mem per sq cm,,,117.73,348.8,13
HCPCS,Q4367,"Amniocore sl, per sq cm",,,117.73,1339.25,14
HCPCS,Q436700,"Amniocore sl, per sq cm",,,1339.25,1339.25,1
HCPCS,Q4368,Amchothick per sq cm,,,117.73,8294.8,14
HCPCS,Q436800,Amchothick per sq cm,,,8294.8,8294.8,1
HCPCS,Q4369,Amnioplast 3 per sq cm,,,117.73,348.8,13
HCPCS,Q4370,Aeroguard per sq cm,,,117.73,348.8,13
HCPCS,Q4371,Neoguard per sq cm,,,117.73,348.8,13
HCPCS,Q4372,Amchoplast excl per sq cm,,,117.73,348.8,13
HCPCS,Q4373,Membrane wrp lt per sq cm,,,117.73,5867.59,14
HCPCS,Q437300,Membrane wrp lt per sq cm,,,5867.59,5867.59,1
HCPCS,Q4375,Duograft ac per sq cm,,,117.73,348.8,13
HCPCS,Q4376,Duograft aa per sq cm,,,117.73,348.8,13
HCPCS,Q4377,Trigraft ft per sq cm,,,117.73,348.8,13
HCPCS,Q4378,Renew ft matrix per sq cm,,,117.73,8223.6,14
HCPCS,Q437800,Renew ft matrix per sq cm,,,8223.6,8223.6,1
HCPCS,Q4379,Amniodefend ft per sq cm,,,117.73,6087.6,14
HCPCS,Q437900,Amniodefend ft per sq cm,,,6087.6,6087.6,1
HCPCS,Q4380,Advograft one per sq cm,,,117.73,348.8,13
HCPCS,Q4382,Advograft dual per sq cm,,,117.73,348.8,13
HCPCS,Q4383,Axolotl graft ult per sq cm,,,117.73,348.8,13
HCPCS,Q4384,Axolotl dual ult per sq cm,,,117.73,348.8,13
HCPCS,Q4385,Apollo ft per sq cm,,,117.73,348.8,13
HCPCS,Q4386,Acesso trifaca per sq cm,,,117.73,348.8,13
HCPCS,Q4387,Neothelium ft per sq cm,,,117.73,348.8,13
HCPCS,Q4388,Neothelium 4l per sq cm,,,117.73,348.8,13
HCPCS,Q4389,Neothelium 4l+ per sq cm,,,117.73,348.8,13
HCPCS,Q4390,Ascendion per sq cm,,,117.73,348.8,13
HCPCS,Q4391,Amnioplast double per sq cm,,,117.73,348.8,13
HCPCS,Q4392,Grafix duo per sq cm,,,117.73,348.8,13
HCPCS,Q4393,Surgraft ac per sq cm,,,117.73,348.8,13
HCPCS,Q4394,Surgraft aca per sq cm,,,117.73,348.8,13
HCPCS,Q4395,Acelagraft per sq cm,,,117.73,348.8,13
HCPCS,Q4396,Natalin per sq cm,,,117.73,5980.8,14
HCPCS,Q439600,Natalin per sq cm,,,5980.8,5980.8,1
HCPCS,Q4397,Summit aaa per sq cm,,,117.73,348.8,13
HCPCS,Q4398,Summit ac per sq cm,,,117.73,348.8,13
HCPCS,Q4399,Summit fx per sq cm,,,117.73,348.8,13
HCPCS,Q4400,Polygon3 per sq cm,,,117.73,348.8,13
HCPCS,Q4401,Absolv3 per sq cm,,,117.73,348.8,13
HCPCS,Q4402,Xwrap 2.0 per sq cm,,,117.73,348.8,13
HCPCS,Q4403,Xwrap dual plus per sq cm,,,117.73,348.8,13
HCPCS,Q4404,Xwrap hydro plus per sq cm,,,117.73,348.8,13
HCPCS,Q4405,Xwrap fenestra plus sq cm,,,117.73,348.8,13
HCPCS,Q4406,Xwrap fenestra per sq cm,,,117.73,348.8,13
HCPCS,Q4407,Xwrap tribus per sq cm,,,117.73,348.8,13
HCPCS,Q4408,Xwrap hydro per sq cm,,,117.73,348.8,13
HCPCS,Q4409,Amniomatrixf3x per sq cm,,,117.73,348.8,13
HCPCS,Q4410,Amchomatrixdl per sq cm,,,117.73,348.8,13
HCPCS,Q4411,Amniomatrixf4x per sq cm,,,117.73,348.8,13
HCPCS,Q4412,Choriofix per sq cm,,,117.73,348.8,13
HCPCS,Q4413,Cygnus solo per sq cm,,,117.73,348.8,13
HCPCS,Q4414,Simplichor per sq cm,,,117.73,348.8,13
HCPCS,Q4415,Alexiguard st-l per sq cm,,,117.73,348.8,13
HCPCS,Q4416,Alexiguard tl-t per sq cm,,,117.73,348.8,13
HCPCS,Q4417,Alexiguard dl-t per sq cm,,,117.73,348.8,13
HCPCS,Q4420,Nuform per sq cm,,,117.73,348.8,13
HCPCS,Q4431,"Pma skin substitute, nos",,,117.73,348.8,13
HCPCS,Q4432,"510(k) skin subs, nos",,,117.73,348.8,13
HCPCS,Q4433,"361 hct/p skin subs, nos",,,117.73,348.8,13
HCPCS,Q5003,Hospice in lt/non-skilled nf,,,50.62,58.61,8
HCPCS,Q5004,Hospice in snf,,,50.62,58.61,8
HCPCS,Q5005,"Hospice, inpatient hospital",,,50.62,58.61,8
HCPCS,Q5006,Hospice in hospice facility,,,50.62,58.61,8
HCPCS,Q5007,Hospice in ltch,,,50.62,58.61,8
HCPCS,Q5008,Hospice in inpatient psych,,,50.62,58.61,8
HCPCS,Q5098,IMULDOSA 130 MG/26 ML INTRAVENOUS SOLUTION,205.44,133.54,30.57,4487.68,51
HCPCS,Q5098,"Inj ustekinumab-srlf, 1 mg",,,18.07,18.07,1
HCPCS,Q509800,"Inj ustekinumab-srlf, 1 mg",,,18.07,18.07,1
HCPCS,Q5099,"Inj ustekinumab-stba, 1 mg",,,21.09,21.09,1
HCPCS,Q5099,STEQEYMA 130 MG/26 ML INTRAVENOUS SOLUTION,42.06,27.34,6.26,4487.68,51
HCPCS,Q509900,"Inj ustekinumab-stba, 1 mg",,,21.09,21.09,1
HCPCS,Q5100,"Inj ustekinumab-kfce, 1 mg",,,43.93,43.93,1
HCPCS,Q5100,YESINTEK 130 MG/26 ML INTRAVENOUS SOLUTION,55.38,36.0,12.24,4487.68,59
HCPCS,Q5100,YESINTEK 90 MG/ML SUBCUTANEOUS SYRINGE,10799.94,7019.96,24.68,10799.94,59
HCPCS,Q510000,"Inj ustekinumab-kfce, 1 mg",,,43.93,43.93,1
HCPCS,Q5101,"Injection, zarxio",,,0.62,0.62,1
HCPCS,Q5101,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.395,1284.01,0.34,1975.41,195
HCPCS,Q5101,ZARXIO 480 MCG/0.8 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,130
HCPCS,Q510100,"Injection, zarxio",,,0.62,0.62,1
HCPCS,Q5103,INFLECTRA 100 MG INTRAVENOUS SOLUTION,3406.62,2214.3,2.17,3406.62,65
HCPCS,Q5103,"Injection, inflectra",,,57.71,57.71,1
HCPCS,Q510300,"Injection, inflectra",,,57.71,57.71,1
HCPCS,Q5104,"Injection, renflexis",,,49.4,49.4,1
HCPCS,Q5104,RENFLEXIS 100 MG INTRAVENOUS SOLUTION,2712.21,1762.94,2.17,2712.21,130
HCPCS,Q510400,"Injection, renflexis",,,49.4,49.4,1
HCPCS,Q5105,Inj retacrit esrd on dialysi,,,0.76,130.36,20
HCPCS,Q510500,Inj retacrit esrd on dialysi,,,1.35,1.35,1
HCPCS,Q5106,Inj retacrit non-esrd use,,,13.47,13.47,1
HCPCS,Q5106,RETACRIT 10000 UNIT/ML INJECTION SOLUTION,406.86,264.46,2.17,406.86,65
HCPCS,Q5106,RETACRIT 2000 UNIT/ML INJECTION SOLUTION,81.36,52.88,2.17,369.35,65
HCPCS,Q5106,RETACRIT 20000 UNIT/2 ML INJECTION SOLUTION,406.86,264.46,2.17,406.86,65
HCPCS,Q5106,RETACRIT 20000 UNIT/ML INJECTION SOLUTION,813.69,528.9,2.17,813.69,130
HCPCS,Q5106,RETACRIT 3000 UNIT/ML INJECTION SOLUTION,122.07,79.35,2.17,369.35,65
HCPCS,Q5106,RETACRIT 4000 UNIT/ML INJECTION SOLUTION,162.75,105.79,2.17,369.35,65
HCPCS,Q5106,RETACRIT 40000 UNIT/ML INJECTION SOLUTION,1627.38,1057.8,2.17,1627.38,65
HCPCS,Q510600,Inj retacrit non-esrd use,,,13.47,13.47,1
HCPCS,Q5107,Inj mvasi 10 mg,,,42.44,42.44,1
HCPCS,Q5107,MVASI 25 MG/ML INTRAVENOUS SOLUTION,837.28,544.23,2.17,1287.79,130
HCPCS,Q510700,Inj mvasi 10 mg,,,42.44,42.44,1
HCPCS,Q5108,FULPHILA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,12525.0,8141.25,2.17,12525.0,130
HCPCS,Q5108,"Injection, fulphila",,,175.99,175.99,1
HCPCS,Q510800,"Injection, fulphila",,,175.99,175.99,1
HCPCS,Q5109,"Injection, ixifi, 10 mg",,,318.98,369.35,8
HCPCS,Q5110,NIVESTYM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.27,1576.8,130
HCPCS,Q5110,NIVESTYM 300 MCG/ML INJECTION SOLUTION,788.4,512.46,0.27,788.4,130
HCPCS,Q5110,NIVESTYM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.27,1576.8,130
HCPCS,Q5110,NIVESTYM 480 MCG/1.6 ML INJECTION SOLUTION,788.4,512.46,0.27,788.4,130
HCPCS,Q5110,Nivestym,,,0.5,0.5,1
HCPCS,Q511000,Nivestym,,,0.5,0.5,1
HCPCS,Q5111,"Injection, udenyca 0.5 mg",,,288.34,288.34,1
HCPCS,Q5111,UDENYCA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,25050.0,16282.5,2.17,25050.0,130
HCPCS,Q5111,UDENYCA ONBODY 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,25050.0,16282.5,2.17,25050.0,65
HCPCS,Q511100,"Injection, udenyca 0.5 mg",,,288.34,288.34,1
HCPCS,Q5112,Inj ontruzant 10 mg,,,48.54,48.54,1
HCPCS,Q5112,ONTRUZANT 150 MG INTRAVENOUS SOLUTION,6358.36,4132.93,2.17,6358.36,65
HCPCS,Q5112,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,2.17,17803.4,260
HCPCS,Q511200,Inj ontruzant 10 mg,,,48.54,48.54,1
HCPCS,Q5113,HERZUMA 150 MG INTRAVENOUS SOLUTION,5235.6,3403.14,2.17,5235.6,65
HCPCS,Q5113,HERZUMA 420 MG INTRAVENOUS SOLUTION,14659.68,9528.79,2.17,14659.68,65
HCPCS,Q5113,Inj herzuma 10 mg,,,98.67,98.67,1
HCPCS,Q511300,Inj herzuma 10 mg,,,98.67,98.67,1
HCPCS,Q5114,Inj ogivri 10 mg,,,67.12,67.12,1
HCPCS,Q5114,OGIVRI 150 MG INTRAVENOUS SOLUTION,4514.44,2934.39,2.17,4514.44,65
HCPCS,Q5114,OGIVRI 420 MG INTRAVENOUS SOLUTION,12600.24,8190.16,2.17,12600.24,65
HCPCS,Q511400,Inj ogivri 10 mg,,,67.12,67.12,1
HCPCS,Q5115,Inj truxima 10 mg,,,53.67,53.67,1
HCPCS,Q5115,TRUXIMA 10 MG/ML INTRAVENOUS SOLUTION,405.88,263.82,2.17,3257.22,130
HCPCS,Q511500,Inj truxima 10 mg,,,53.67,53.67,1
HCPCS,Q5116,"Inj., trazimera, 10 mg",,,14.61,14.61,1
HCPCS,Q5116,TRAZIMERA 150 MG INTRAVENOUS SOLUTION,5813.28,3778.63,2.17,5813.28,65
HCPCS,Q5116,TRAZIMERA 420 MG INTRAVENOUS SOLUTION,16277.2,10580.18,2.17,16277.2,65
HCPCS,Q511600,"Inj., trazimera, 10 mg",,,14.61,14.61,1
HCPCS,Q5117,"Inj., kanjinti, 10 mg",,,91.56,91.56,1
HCPCS,Q5117,KANJINTI 150 MG INTRAVENOUS SOLUTION,6528.32,4243.41,2.17,6528.32,65
HCPCS,Q5117,KANJINTI 420 MG INTRAVENOUS SOLUTION,18279.28,11881.53,2.17,18279.28,65
HCPCS,Q511700,"Inj., kanjinti, 10 mg",,,91.56,91.56,1
HCPCS,Q5118,"Inj., zirabev, 10 mg",,,45.92,45.92,1
HCPCS,Q5118,ZIRABEV 25 MG/ML INTRAVENOUS SOLUTION,736.08,478.45,2.17,1287.79,130
HCPCS,Q511800,"Inj., zirabev, 10 mg",,,45.92,45.92,1
HCPCS,Q5119,"Inj ruxience, 10 mg",,,23.62,23.62,1
HCPCS,Q5119,RUXIENCE 10 MG/ML INTRAVENOUS SOLUTION,344.08,223.65,2.17,3257.22,130
HCPCS,Q511900,"Inj ruxience, 10 mg",,,23.62,23.62,1
HCPCS,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,53.13,3257.22,33
HCPCS,Q512000,Inj pegfilgrastim-bmez 0.5mg,,,212.34,212.34,1
HCPCS,Q5121,AVSOLA 100 MG INTRAVENOUS SOLUTION,2400.0,1560.0,2.17,2400.0,65
HCPCS,Q5121,"Inj. avsola, 10 mg",,,57.71,57.71,1
HCPCS,Q512100,"Inj. avsola, 10 mg",,,57.71,57.71,1
HCPCS,Q5122,"Inj, nyvepria",,,236.83,236.83,1
HCPCS,Q5122,NYVEPRIA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,23550.0,15307.5,2.17,23550.0,65
HCPCS,Q512200,"Inj, nyvepria",,,236.83,236.83,1
HCPCS,Q5123,"Inj. riabni, 10 mg",,,37.2,37.2,1
HCPCS,Q5123,RIABNI 10 MG/ML INTRAVENOUS SOLUTION,258.06,167.74,2.17,3257.22,130
HCPCS,Q512300,"Inj. riabni, 10 mg",,,37.2,37.2,1
HCPCS,Q5124,BYOOVIZ 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,83800.8,54470.52,60.21,83800.8,65
HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,107.19,107.19,1
HCPCS,Q512400,"Inj. byooviz, 0.1 mg",,,107.19,107.19,1
HCPCS,Q5125,"Inj, releuko 1 mcg",,,0.33,184.43,33
HCPCS,Q512500,"Inj, releuko 1 mcg",,,0.61,0.61,1
HCPCS,Q5126,ALYMSYS 25 MG/ML INTRAVENOUS SOLUTION,646.74,420.38,33.01,1287.79,130
HCPCS,Q5126,Inj alymsys 10 mg,,,58.76,58.76,1
HCPCS,Q512600,Inj alymsys 10 mg,,,58.76,58.76,1
HCPCS,Q5127,"Inj, stimufend, 0.5 mg",,,147.23,3257.22,32
HCPCS,Q512700,"Inj, stimufend, 0.5 mg",,,262.09,262.09,1
HCPCS,Q5128,CIMERLI 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,97920.0,63648.0,83.34,97920.0,65
HCPCS,Q5128,"Inj, cimerli, 0.1 mg",,,148.35,148.35,1
HCPCS,Q512800,"Inj, cimerli, 0.1 mg",,,148.35,148.35,1
HCPCS,Q5129,"Inj, vegzelma, 10 mg",,,67.92,67.92,1
HCPCS,Q5129,VEGZELMA 25 MG/ML INTRAVENOUS SOLUTION,812.88,528.37,38.15,1287.79,130
HCPCS,Q512900,"Inj, vegzelma, 10 mg",,,67.92,67.92,1
HCPCS,Q5130,FYLNETRA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15000.0,9750.0,127.22,15000.0,65
HCPCS,Q5130,"Inj, fylnetra, 0.5 mg",,,226.47,226.47,1
HCPCS,Q513000,"Inj, fylnetra, 0.5 mg",,,226.47,226.47,1
HCPCS,Q5131,"Inj, idacio, 20 mg",,,960.13,4487.68,10
HCPCS,Q513100,"Inj, idacio, 20 mg",,,960.13,960.13,1
HCPCS,Q5132,"Inj, abrilada, 10 mg",,,622.65,720.96,8
HCPCS,Q5133,"Inj, tofidence, 1 mg",,,9.95,9.95,1
HCPCS,Q5133,TOFIDENCE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,720.96,65
HCPCS,Q5133,TOFIDENCE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,720.96,65
HCPCS,Q5133,TOFIDENCE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,720.96,65
HCPCS,Q513300,"Inj, tofidence, 1 mg",,,9.95,9.95,1
HCPCS,Q5134,"Inj, tyruko, 1 mg",,,24.38,4417.71,22
HCPCS,Q513400,"Inj, tyruko, 1 mg",,,50.57,50.57,1
HCPCS,Q5135,"Inj, tyenne, 1 mg",,,7.46,7.46,1
HCPCS,Q5135,TYENNE 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,4072.68,2647.24,4.19,4072.68,65
HCPCS,Q5135,TYENNE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,65
HCPCS,Q5135,TYENNE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,65
HCPCS,Q5135,TYENNE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,65
HCPCS,Q513500,"Inj, tyenne, 1 mg",,,7.46,7.46,1
HCPCS,Q5136,"Inj. denosumab-bbdz, 1 mg",,,50.25,50.25,1
HCPCS,Q5136,JUBBONTI 60 MG/ML SUBCUTANEOUS SYRINGE,5774.88,3753.67,28.23,5774.88,59
HCPCS,Q5136,WYOST 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6793.95,4416.07,28.23,6793.95,59
HCPCS,Q513600,"Inj. denosumab-bbdz, 1 mg",,,50.25,50.25,1
HCPCS,Q5137,"Inj, wezlana, sub cu, 1 mg",,,132.17,7011.25,10
HCPCS,Q513700,"Inj, wezlana, sub cu, 1 mg",,,132.17,132.17,1
HCPCS,Q5138,"Inj, wezlana, iv, 1 mg",,,20.72,20.72,1
HCPCS,Q5138,WEZLANA 130 MG/26 ML INTRAVENOUS SOLUTION,27.69,18.0,6.12,4487.68,59
HCPCS,Q513800,"Inj, wezlana, iv, 1 mg",,,20.72,20.72,1
HCPCS,Q5139,"Inj, eculizumab-aeeb, 10 mg",,,14351.75,16617.81,8
HCPCS,Q5140,"Inj adalimumab-fkjp, 1 mg",,,87.14,187.35,15
HCPCS,Q5141,"Inj adalimumab-aaty, 1 mg",,,43.57,184.43,15
HCPCS,Q5142,"Inj adalimumab-ryvk, 1 mg",,,13.36,184.43,17
HCPCS,Q514200,"Inj adalimumab-ryvk, 1 mg",,,27.71,27.71,1
HCPCS,Q5143,"Inj adalimumab-adbm, 1 mg",,,22.42,184.43,15
HCPCS,Q5144,"Inj, idacio, 1 mg",,,14.63,184.43,17
HCPCS,Q514400,"Inj, idacio, 1 mg",,,24.01,24.01,1
HCPCS,Q5145,"Inj, abrilada, 1 mg",,,99.63,275.35,15
HCPCS,Q5146,"Inj, hercessi, 10 mg",,,37.15,3257.22,26
HCPCS,Q514600,"Inj, hercessi, 10 mg",,,66.13,66.13,1
HCPCS,Q5147,"Inj, aflibercept-ayyh, 1 mg",,,866.2,2642.72,24
HCPCS,Q514700,"Inj, aflibercept-ayyh, 1 mg",,,1541.84,1541.84,1
HCPCS,Q5148,"Inj, nyposi 1 mcg",,,0.99,184.43,24
HCPCS,Q514800,"Inj, nyposi 1 mcg",,,1.78,1.78,1
HCPCS,Q5149,"Inj, aflibercept-abzv, 1 mg",,,2282.35,2642.72,8
HCPCS,Q5150,"Inj, aflibercept-mrbb, 1 mg",,,2282.35,2642.72,8
HCPCS,Q5151,EPYSQLI 300 MG/30 ML INTRAVENOUS SOLUTION,730.56,474.86,31.67,2642.72,59
HCPCS,Q5151,"Inj, eculizumab-aagh, 2 mg",,,56.37,56.37,1
HCPCS,Q515100,"Inj, eculizumab-aagh, 2 mg",,,56.37,56.37,1
HCPCS,Q5152,BKEMV 300 MG/30 ML INTRAVENOUS SOLUTION,939.32,610.56,42.34,2642.72,59
HCPCS,Q5152,"Inj, eculizumab-aeeb, 2 mg",,,75.38,75.38,1
HCPCS,Q515200,"Inj, eculizumab-aeeb, 2 mg",,,75.38,75.38,1
HCPCS,Q5153,"Inj, aflibercept-yszy, 1 mg",,,2282.35,2642.72,8
HCPCS,Q5154,"Inj, omlyclo, 5 mg",,,1112.18,1287.79,8
HCPCS,Q5155,"Inj, aflibercept-jbvf, 1 mg",,,1112.18,1287.79,8
HCPCS,Q5156,"Inj, tocilizumab-anoh, 1 mg",,,9.22,1287.79,9
HCPCS,Q515600,"Inj, tocilizumab-anoh, 1 mg",,,9.22,9.22,1
HCPCS,Q5157,"Inj, denosumab-bmwo, 1 mg",,,60.88,60.88,1
HCPCS,Q5157,OSENVELT 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6940.05,4511.03,28.13,6940.05,59
HCPCS,Q5157,STOBOCLO 60 MG/ML SUBCUTANEOUS SYRINGE,6413.97,4169.08,28.13,6413.97,59
HCPCS,Q515700,"Inj, denosumab-bmwo, 1 mg",,,60.88,60.88,1
HCPCS,Q5158,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7086.18,4606.02,28.72,7086.18,59
HCPCS,Q5158,CONEXXENCE 60 MG/ML SUBCUTANEOUS SYRINGE,6549.0,4256.85,28.72,6549.0,59
HCPCS,Q5158,"Inj, denosumab-bnht, 1 mg",,,62.16,62.16,1
HCPCS,Q515800,"Inj, denosumab-bnht, 1 mg",,,62.16,62.16,1
HCPCS,Q5159,"Inj, denosumab-dssb, 1 mg",,,34.71,1238.14,9
HCPCS,Q515900,"Inj, denosumab-dssb, 1 mg",,,34.71,34.71,1
HCPCS,Q5160,"Inj, jobevne, 10 mg",,,84.37,3257.22,22
HCPCS,Q516000,"Inj, jobevne, 10 mg",,,170.03,170.03,1
HCPCS,Q5161,"Inj den (auk/bos),biosim 1mg",,,1069.3,1238.14,8
HCPCS,Q5162,"Injection, denosumab-nxxp",,,576.07,667.03,8
HCPCS,Q9001,Chaplain assessment,,,50.62,58.61,8
HCPCS,Q9002,Chaplain counsel individu,,,50.62,58.61,8
HCPCS,Q9003,Chaplain counsel group,,,50.62,58.61,8
HCPCS,Q9004,Va whole health partner serv,,,50.62,58.61,8
HCPCS,Q9950,Inj sulf hexa lipid microsph,,,32.34,32.34,1
HCPCS,Q9950,LUMASON 25 MG INTRAVENOUS SUSPENSION,522.0,339.3,2.17,522.0,51
HCPCS,Q995000,Inj sulf hexa lipid microsph,,,32.34,32.34,1
HCPCS,Q9951,"Locm >= 400 mg/ml iodine,1ml",,,19.83,22.96,8
HCPCS,Q9953,"Inj fe-based mr contrast,1ml",,,19.83,39.97,11
HCPCS,Q995300,"Inj fe-based mr contrast,1ml",,,31.2,31.2,1
HCPCS,Q9954,"Oral mr contrast, 100 ml",,,10.92,28.66,11
HCPCS,Q995400,"Oral mr contrast, 100 ml",,,22.37,22.37,1
HCPCS,Q9955,"Inj perflexane lip micros,ml",,,19.83,36.94,10
HCPCS,Q995500,"Inj perflexane lip micros,ml",,,28.84,28.84,1
HCPCS,Q9956,"Inj octafluoropropane mic,ml",,,71.57,71.57,1
HCPCS,Q9956,OPTISON 0.22 MG/ML INTRAVENOUS SUSPENSION,154.44,100.39,2.17,154.44,51
HCPCS,Q995600,"Inj octafluoropropane mic,ml",,,71.57,71.57,1
HCPCS,Q9957,DEFINITY 1.1 MG/ML INTRAVENOUS SUSPENSION,675.0,438.75,2.17,675.0,51
HCPCS,Q9957,"INJ PERFLUTREN LIP MICROS, ML",547.87,356.12,2.17,547.87,51
HCPCS,Q9957,"Inj perflutren lip micros,ml",,,71.57,71.57,1
HCPCS,Q995700,"Inj perflutren lip micros,ml",,,71.57,71.57,1
HCPCS,Q9958,CONRAY-30 30 % INTRAVENOUS SOLUTION,0.57,0.37,0.08,22.96,51
HCPCS,Q9958,CYSTO-CONRAY II 17.2 % URETHRAL SOLUTION,0.39,0.25,0.05,22.96,102
HCPCS,Q9958,CYSTOGRAFIN 30 % URETHRAL SOLUTION,0.885,0.575,0.1,22.96,102
HCPCS,Q9958,CYSTOGRAFIN 300ML,1.5,0.98,0.15,22.96,51
HCPCS,Q9958,"Hocm <=149 mg/ml iodine, 1ml",,,0.12,0.12,1
HCPCS,Q995800,"Hocm <=149 mg/ml iodine, 1ml",,,0.12,0.12,1
HCPCS,Q9959,"Hocm 150-199mg/ml iodine,1ml",,,0.2,22.96,10
HCPCS,Q995900,"Hocm 150-199mg/ml iodine,1ml",,,0.2,0.2,1
HCPCS,Q9960,"Hocm 200-249mg/ml iodine,1ml",,,0.21,22.96,11
HCPCS,Q996000,"Hocm 200-249mg/ml iodine,1ml",,,0.32,0.32,1
HCPCS,Q9961,CONRAY 60 % INJECTION SOLUTION,1.17,0.76,0.13,22.96,153
HCPCS,Q9961,"Hocm 250-299mg/ml iodine,1ml",,,0.46,0.46,1
HCPCS,Q996100,"Hocm 250-299mg/ml iodine,1ml",,,0.46,0.46,1
HCPCS,Q9962,"Hocm 300-349mg/ml iodine,1ml",,,0.55,22.96,10
HCPCS,Q996200,"Hocm 300-349mg/ml iodine,1ml",,,0.55,0.55,1
HCPCS,Q9963,GASTROGRAFIN 66 %-10 % ORAL SOLUTION,1.68,1.09,0.25,22.96,51
HCPCS,Q9963,"HOCM, 350?399 MG/ML IODINE PER ML",1.83,1.19,0.27,22.96,51
HCPCS,Q9963,"Hocm 350-399mg/ml iodine,1ml",,,0.39,0.39,1
HCPCS,Q996300,"Hocm 350-399mg/ml iodine,1ml",,,0.39,0.39,1
HCPCS,Q9964,"Hocm>= 400mg/ml iodine, 1ml",,,0.69,22.96,10
HCPCS,Q996400,"Hocm>= 400mg/ml iodine, 1ml",,,0.69,0.69,1
HCPCS,Q9965,"Locm 100-199mg/ml iodine,1ml",,,1.85,1.85,1
HCPCS,Q9965,OMNIPAQUE 180 MG IODINE/ML INTRATHECAL SOLUTION,17.34,11.27,0.01,22.96,49
HCPCS,Q996500,"Locm 100-199mg/ml iodine,1ml",,,1.85,1.85,1
HCPCS,Q9966,CNTRST RAD OMPQ 240 100ML,8.25,5.36,0.01,22.96,49
HCPCS,Q9966,CONTRAST LOCM 200-299,14.36,9.33,0.01,22.96,49
HCPCS,Q9966,ISOVUE-M 200  41 % INTRATHECAL SOLUTION,23.28,15.13,0.01,23.28,49
HCPCS,Q9966,LOCM 250-299 MG/ML PER ML,8.25,5.36,0.01,22.96,49
HCPCS,Q9966,"Locm 200-299mg/ml iodine,1ml",,,0.71,0.71,1
HCPCS,Q9966,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,2.79,1.81,0.01,22.96,245
HCPCS,Q9966,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.9,2.54,0.01,22.96,147
HCPCS,Q996600,"Locm 200-299mg/ml iodine,1ml",,,0.71,0.71,1
HCPCS,Q9967,CONTR LOCM 300-399 MG 1 ML,8.25,5.36,0.01,22.96,49
HCPCS,Q9967,IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.27,2.13,0.01,22.96,49
HCPCS,Q9967,"ISOVUE 300, 100 ML, PER ML",8.25,5.36,0.01,22.96,49
HCPCS,Q9967,ISOVUE-300  61 % INTRAVENOUS SOLUTION,1.68,1.09,0.01,22.96,147
HCPCS,Q9967,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.01,22.96,147
HCPCS,Q9967,ISOVUE-M 300  61 % INTRATHECAL SOLUTION,20.61,13.4,0.01,22.96,49
HCPCS,Q9967,LOCM 300-399MG/ML IODINE 1ML,14.36,9.33,0.01,22.96,49
HCPCS,Q9967,"Locm 300-399mg/ml iodine,1ml",,,0.27,0.27,1
HCPCS,Q9967,OMNIPAQUE 300 / 100 ML,3.48,2.26,0.01,22.96,49
HCPCS,Q9967,OMNIPAQUE 300 / 150 ML,8.25,5.36,0.01,22.96,49
HCPCS,Q9967,OMNIPAQUE 300 / 200 ML,8.25,5.36,0.01,22.96,49
HCPCS,Q9967,OMNIPAQUE 300 / 500 ML,3.48,2.26,0.01,22.96,49
HCPCS,Q9967,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.36,2.18,0.01,22.96,343
HCPCS,Q9967,OMNIPAQUE 350 / 500 ML PER ML,8.25,5.36,0.01,22.96,49
HCPCS,Q9967,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.33,2.16,0.01,22.96,392
HCPCS,Q9967,"OMNIPAQUE 350, 100 ML, PER ML",8.25,5.36,0.01,22.96,49
HCPCS,Q9967,"OMNIPAQUE 350, 150 ML, PER ML",3.48,2.26,0.01,22.96,49
HCPCS,Q9967,OPTIRAY 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.3,2.15,0.01,22.96,49
HCPCS,Q9967,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.01,22.96,245
HCPCS,Q9967,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SYRINGE,1.47,0.96,0.01,22.96,49
HCPCS,Q9967,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.42,2.22,0.01,22.96,147
HCPCS,Q9967,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SYRINGE,1.3,0.85,0.01,22.96,49
HCPCS,Q9967,ULTRAVIST 300 MG IODINE/ML INJECTION SOLUTION,1.5,0.98,0.01,22.96,49
HCPCS,Q9967,VISIPAQUE 320 / 100 ML,3.48,2.26,0.01,22.96,49
HCPCS,Q9967,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.155,2.7,0.01,22.96,196
HCPCS,Q9967,VISIPAQUE 320/150 ML,3.48,2.26,0.01,22.96,49
HCPCS,Q996700,"Locm 300-399mg/ml iodine,1ml",,,0.27,0.27,1
HCPCS,Q9968,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,874.23,568.25,8.53,874.23,65
HCPCS,Q9968,LYMPHAZURIN 1 % SUBCUTANEOUS SOLUTION,452.91,294.39,8.53,452.91,65
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,21.33,13.865,0.68,49.17,260
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,48.6,31.59,8.53,48.6,65
HCPCS,Q9968,PROVAYBLUE 5 MG/ML INTRAVENOUS SOLUTION,84.39,54.85,8.53,84.39,130
HCPCS,Q9968,Visualization adjunct,,,5.77,5.77,1
HCPCS,Q996800,Visualization adjunct,,,5.77,5.77,1
HCPCS,Q9969,Non-heu tc-99m add-on/dose,,,10.0,22.96,15
HCPCS,Q9982,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,0.01,8400.0,59
HCPCS,Q9982,Flutemetamol f18 diagnostic,,,6835.2,6835.2,1
HCPCS,Q998200,Flutemetamol f18 diagnostic,,,6835.2,6835.2,1
HCPCS,Q9983,Florbetaben f18 diagnostic,,,7262.4,7262.4,1
HCPCS,Q9983,NEURACEQ 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,6200.0,4030.0,0.01,6200.0,60
HCPCS,Q998300,Florbetaben f18 diagnostic,,,7262.4,7262.4,1
HCPCS,Q9988,"Platelets, pathogen reduced",,,671.54,671.54,1
HCPCS,Q9991,Buprenorph xr 100 mg or less,,,3557.38,3557.38,1
HCPCS,Q9991,SUBLOCADE 100 MG/0.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,15854.61,10305.5,2.17,15854.61,65
HCPCS,Q9991,SUBLOCADE 300 MG/1.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,5284.86,3435.16,2.17,5920.84,65
HCPCS,Q999100,Buprenorph xr 100 mg or less,,,3557.38,3557.38,1
HCPCS,Q9992,Buprenorphine xr over 100 mg,,,1112.18,5495.96,33
HCPCS,Q999200,Buprenorphine xr over 100 mg,,,3557.38,3557.38,1
HCPCS,Q9996,Ustekinumab- ttwe sub cu inj,,,98.49,7011.25,9
HCPCS,Q999600,Ustekinumab- ttwe sub cu inj,,,98.49,98.49,1
HCPCS,Q9997,PYZCHIVA 130 MG/26 ML INTRAVENOUS SOLUTION,152.31,99.0,8.26,4487.68,59
HCPCS,Q9997,Ustekinumab-ttwe iv inj 1 mg,,,14.72,14.72,1
HCPCS,Q999700,Ustekinumab-ttwe iv inj 1 mg,,,14.72,14.72,1
HCPCS,Q9998,"Inj ustekinumab-aekn, 1 mg",,,76.9,76.9,1
HCPCS,Q9998,SELARSDI 130 MG/26 ML INTRAVENOUS SOLUTION,193.86,126.01,42.84,7011.25,59
HCPCS,Q999800,"Inj ustekinumab-aekn, 1 mg",,,76.9,76.9,1
HCPCS,Q9999,Inj ustekinumab-aauz 1 mg,,,58.67,58.67,1
HCPCS,Q9999,OTULFI 130 MG/26 ML INTRAVENOUS SOLUTION,233.4,151.71,32.95,4487.68,59
HCPCS,Q999900,Inj ustekinumab-aauz 1 mg,,,58.67,58.67,1
HCPCS,R0070,Transport portable x-ray,,,68.91,79.79,8
HCPCS,R0075,Transport port x-ray multipl,,,50.62,58.61,8
HCPCS,R0076,Transport portable ekg,,,50.62,58.61,8
HCPCS,S0012,"Butorphanol tartrate, nasal",,,27.09,154.31,11
HCPCS,S001200,"Butorphanol tartrate, nasal",,,129.51,129.51,1
HCPCS,S0013,"Esketamine, nasal spray",,,13.19,184.43,10
HCPCS,S0014,"Tacrine hydrochloride, 10 mg",,,2.62,47.96,11
HCPCS,S001400,"Tacrine hydrochloride, 10 mg",,,5.2,5.2,1
HCPCS,S0017,"Injection, aminocaproic acid",,,17.39,47.96,10
HCPCS,S001700,"Injection, aminocaproic acid",,,17.39,17.39,1
HCPCS,S0020,BUPIVACAINE 0.5% VIAL 30ML,11.5,7.48,1.1,11.5,22
HCPCS,S0020,"Injection, bupivicaine hydro",,,1.97,47.96,9
HCPCS,S0021,"Injection, cefoperazone sod",,,17.0,47.96,11
HCPCS,S002100,"Injection, cefoperazone sod",,,32.04,32.04,1
HCPCS,S0023,"Injection, cimetidine hydroc",,,0.01,47.96,11
HCPCS,S002300,"Injection, cimetidine hydroc",,,5.11,5.11,1
HCPCS,S0028,"Injection, famotidine, 20 mg",,,0.85,47.96,11
HCPCS,S002800,"Injection, famotidine, 20 mg",,,1.9,1.9,1
HCPCS,S0030,"Injection, metronidazole",,,1.95,47.96,9
HCPCS,S0032,"Injection, nafcillin sodium",,,25.49,47.96,11
HCPCS,S003200,"Injection, nafcillin sodium",,,28.09,28.09,1
HCPCS,S0034,"Injection, ofloxacin, 400 mg",,,41.42,60.19,10
HCPCS,S003400,"Injection, ofloxacin, 400 mg",,,46.99,46.99,1
HCPCS,S0039,"Injection, sulfamethoxazole",,,26.79,47.96,10
HCPCS,S003900,"Injection, sulfamethoxazole",,,26.79,26.79,1
HCPCS,S0040,"Injection, ticarcillin disod",,,14.4,2642.72,11
HCPCS,S004000,"Injection, ticarcillin disod",,,28.48,28.48,1
HCPCS,S0073,"Injection, aztreonam, 500 mg",,,15.66,47.96,9
HCPCS,S0074,"Injection, cefotetan disodiu",,,11.37,47.96,10
HCPCS,S0077,"Injection, clindamycin phosp",,,2.66,47.96,9
HCPCS,S0078,"Injection, fosphenytoin sodi",,,12.96,100.98,11
HCPCS,S007800,"Injection, fosphenytoin sodi",,,76.9,76.9,1
HCPCS,S0080,"Injection, pentamidine iseth",,,41.42,267.31,10
HCPCS,S0081,"Injection, piperacillin sodi",,,1.96,47.96,11
HCPCS,S008100,"Injection, piperacillin sodi",,,3.72,3.72,1
HCPCS,S0088,Imatinib 100 mg,,,6.34,1676.17,11
HCPCS,S008800,Imatinib 100 mg,,,6.34,6.34,1
HCPCS,S0090,"Sildenafil citrate, 25 mg",,,0.57,47.96,11
HCPCS,S009000,"Sildenafil citrate, 25 mg",,,0.57,0.57,1
HCPCS,S0091,Granisetron 1mg,,,3.77,8.86,11
HCPCS,S009100,Granisetron 1mg,,,6.41,6.41,1
HCPCS,S0092,Hydromorphone 250 mg,,,41.42,228.23,11
HCPCS,S009200,Hydromorphone 250 mg,,,178.18,178.18,1
HCPCS,S0093,Morphine 500 mg,,,21.93,237.6,11
HCPCS,S009300,Morphine 500 mg,,,23.23,23.23,1
HCPCS,S0104,"Zidovudine, oral, 100 mg",,,0.72,47.96,11
HCPCS,S010400,"Zidovudine, oral, 100 mg",,,3.24,3.24,1
HCPCS,S0106,Bupropion hcl sr 60 tablets,,,31.24,104.49,11
HCPCS,S010600,Bupropion hcl sr 60 tablets,,,31.24,31.24,1
HCPCS,S0108,Mercaptopurine 50 mg,,,3.68,7.8,3
HCPCS,S010800,Mercaptopurine 50 mg,,,6.94,6.94,1
HCPCS,S0109,Methadone oral 5mg,,,0.24,47.96,11
HCPCS,S010900,Methadone oral 5mg,,,0.59,0.59,1
HCPCS,S0117,Tretinoin topical 5 g,,,2.2,47.96,11
HCPCS,S011700,Tretinoin topical 5 g,,,8.81,8.81,1
HCPCS,S0119,Ondansetron 4 mg,,,0.98,8.86,10
HCPCS,S011900,Ondansetron 4 mg,,,0.98,0.98,1
HCPCS,S0122,Inj menotropins 75 iu,,,41.42,664.16,11
HCPCS,S012200,Inj menotropins 75 iu,,,539.25,539.25,1
HCPCS,S0126,Inj follitropin alfa 75 iu,,,112.58,660.77,11
HCPCS,S012600,Inj follitropin alfa 75 iu,,,515.86,515.86,1
HCPCS,S0128,Inj follitropin beta 75 iu,,,41.42,595.08,11
HCPCS,S012800,Inj follitropin beta 75 iu,,,464.58,464.58,1
HCPCS,S0132,Inj ganirelix acetat 250 mcg,,,129.75,503.42,11
HCPCS,S013200,Inj ganirelix acetat 250 mcg,,,401.25,401.25,1
HCPCS,S0136,"Clozapine, 25 mg",,,1.19,47.96,11
HCPCS,S013600,"Clozapine, 25 mg",,,1.58,1.58,1
HCPCS,S0137,"Didanosine, 25 mg",,,1.19,47.96,10
HCPCS,S013700,"Didanosine, 25 mg",,,1.19,1.19,1
HCPCS,S0138,"Finasteride, 5 mg",,,0.32,47.96,11
HCPCS,S013800,"Finasteride, 5 mg",,,0.32,0.32,1
HCPCS,S0139,"Minoxidil, 10 mg",,,0.98,47.96,11
HCPCS,S013900,"Minoxidil, 10 mg",,,0.98,0.98,1
HCPCS,S0140,"Saquinavir, 200 mg",,,2.6,184.43,11
HCPCS,S014000,"Saquinavir, 200 mg",,,2.6,2.6,1
HCPCS,S0142,Colistimethate inh sol mg,,,0.2,184.43,9
HCPCS,S0145,Peg interferon alfa-2a/180,,,112.58,3046.31,11
HCPCS,S014500,Peg interferon alfa-2a/180,,,2378.26,2378.26,1
HCPCS,S0148,Peg interferon alfa-2b/10,,,159.28,411.59,10
HCPCS,S014800,Peg interferon alfa-2b/10,,,321.33,321.33,1
HCPCS,S0155,Epoprostenol dilutant,,,30.97,184.43,10
HCPCS,S015500,Epoprostenol dilutant,,,30.97,30.97,1
HCPCS,S0156,"Exemestane, 25 mg",,,3.56,11.78,3
HCPCS,S015600,"Exemestane, 25 mg",,,3.56,3.56,1
HCPCS,S0157,"Becaplermin gel 1%, 0.5 gm",,,24.35,124.01,11
HCPCS,S015700,"Becaplermin gel 1%, 0.5 gm",,,96.81,96.81,1
HCPCS,S0160,Dextroamphetamine,,,0.03,47.96,11
HCPCS,S016000,Dextroamphetamine,,,1.48,1.48,1
HCPCS,S0164,Injection pantroprazole,,,1.84,12.45,11
HCPCS,S016400,Injection pantroprazole,,,9.72,9.72,1
HCPCS,S0166,Inj olanzapine 2.5mg,,,7.16,667.03,11
HCPCS,S016600,Inj olanzapine 2.5mg,,,17.27,17.27,1
HCPCS,S0169,Calcitrol,,,0.59,47.96,10
HCPCS,S016900,Calcitrol,,,0.59,0.59,1
HCPCS,S0170,Anastrozole 1 mg,,,1.03,12.13,3
HCPCS,S017000,Anastrozole 1 mg,,,1.03,1.03,1
HCPCS,S0171,Bumetanide 0.5 mg,,,41.42,47.96,8
HCPCS,S0172,Chlorambucil 2 mg,,,5.01,722.71,3
HCPCS,S017200,Chlorambucil 2 mg,,,564.22,564.22,1
HCPCS,S0174,Dolasetron 50 mg,,,7.65,80.87,11
HCPCS,S017400,Dolasetron 50 mg,,,63.14,63.14,1
HCPCS,S0175,Flutamide 125 mg,,,1.88,500.04,11
HCPCS,S017500,Flutamide 125 mg,,,95.14,95.14,1
HCPCS,S0176,Hydroxyurea 500 mg,,,0.85,1.53,3
HCPCS,S017600,Hydroxyurea 500 mg,,,0.85,0.85,1
HCPCS,S0177,Levamisole 50 mg,,,11.32,47.96,10
HCPCS,S017700,Levamisole 50 mg,,,11.32,11.32,1
HCPCS,S0178,Lomustine 10 mg,,,14.78,1676.17,11
HCPCS,S017800,Lomustine 10 mg,,,224.21,224.21,1
HCPCS,S0179,Megestrol 20 mg,,,0.59,0.75,3
HCPCS,S017900,Megestrol 20 mg,,,0.59,0.59,1
HCPCS,S0182,"Procarbazine, oral",,,55.95,377.52,3
HCPCS,S018200,"Procarbazine, oral",,,377.52,377.52,1
HCPCS,S0183,Prochlorperazine 5 mg,,,0.53,8.86,11
HCPCS,S018300,Prochlorperazine 5 mg,,,0.73,0.73,1
HCPCS,S0187,Tamoxifen 10 mg,,,0.41,1.7,3
HCPCS,S018700,Tamoxifen 10 mg,,,0.41,0.41,1
HCPCS,S0189,Testosterone pellet 75 mg,,,41.42,287.64,10
HCPCS,S0190,"MIFEPRISTONE, ORAL, 200 MG",103.2,67.08,1.1,103.2,26
HCPCS,S0190,"Mifepristone, oral, 200 mg",,,45.0,130.36,11
HCPCS,S019000,"Mifepristone, oral, 200 mg",,,76.54,76.54,1
HCPCS,S0191,"Misoprostol, oral, 200 mcg",,,1.08,47.96,11
HCPCS,S019100,"Misoprostol, oral, 200 mcg",,,2.06,2.06,1
HCPCS,S0194,Vitamin suppl 100 caps,,,7.65,26.95,10
HCPCS,S019400,Vitamin suppl 100 caps,,,21.04,21.04,1
HCPCS,S0197,Prenatal vitamins 30 day,,,0.15,8.86,9
HCPCS,S0199,Med abortion inc all ex drug,,,1625.04,1881.63,8
HCPCS,S0201,Partial hospitalization serv,,,118.99,137.78,8
HCPCS,S0220,Medical conference by physic,,,17.35,20.09,8
HCPCS,S0221,"Medical conference, 60 min",,,17.35,20.09,8
HCPCS,S0250,Comp geriatr assmt team,,,17.35,20.09,8
HCPCS,S0255,Hospice refer visit nonmd,,,50.62,58.61,8
HCPCS,S0257,End of life counseling,,,17.35,20.09,8
HCPCS,S0260,H&p for surgery,,,321.96,372.8,8
HCPCS,S0265,GENETIC COUNSEL 15 MINS,95.0,61.75,14.14,95.0,46
HCPCS,S0273,Md home visit outside cap,,,17.35,20.09,8
HCPCS,S0280,"Medical home, initial plan",,,17.35,20.09,8
HCPCS,S0281,"Medical home, maintenance",,,17.35,20.09,8
HCPCS,S0285,Cnslt before screen colonosc,,,54.56,63.17,8
HCPCS,S0302,Completed epsdt,,,8.48,9.82,8
HCPCS,S0310,Hospitalist visit,,,50.62,58.61,8
HCPCS,S0315,Disease management program,,,17.35,20.09,8
HCPCS,S0316,Follow-up/reassessment,,,17.35,20.09,8
HCPCS,S0317,Disease mgmt per diem,,,17.35,20.09,8
HCPCS,S0320,Rn telephone calls to dmp,,,50.62,58.61,8
HCPCS,S0340,Lifestyle mod 1st stage,,,17.35,20.09,8
HCPCS,S0341,Lifestyle mod 2 or 3 stage,,,17.35,20.09,8
HCPCS,S0342,Lifestyle mod 4th stage,,,68.71,79.56,8
HCPCS,S0353,CANCER TREATMENT PLAN INITIAL,463.0,300.95,1.1,575.23,23
HCPCS,S0353,Cancer treatmentplan initial,,,17.35,20.09,8
HCPCS,S0354,CANCER TREATMENT PLAN CHANGE,463.0,300.95,1.1,716.8,23
HCPCS,S0354,Cancer treatment plan change,,,17.35,20.09,8
HCPCS,S0390,Rout foot care per visit,,,37.85,43.82,8
HCPCS,S0395,Impression casting ft,,,83.58,96.78,8
HCPCS,S0400,Global eswl kidney,,,1680.64,1946.0,8
HCPCS,S0500,Dispos cont lens,,,25.16,29.13,8
HCPCS,S0504,Singl prscrp lens,,,28.98,33.56,8
HCPCS,S0506,Bifoc prscp lens,,,28.98,33.56,8
HCPCS,S0508,Trifoc prscrp lens,,,28.98,33.56,8
HCPCS,S0510,Non-prscrp lens,,,28.98,33.56,8
HCPCS,S0512,Daily cont lens,,,28.98,33.56,8
HCPCS,S0514,Color cont lens,,,28.98,33.56,8
HCPCS,S0515,Scleral lens liquid bandage,,,28.98,33.56,8
HCPCS,S0516,Safety frames,,,28.98,33.56,8
HCPCS,S0518,Sunglass frames,,,28.98,33.56,8
HCPCS,S0580,Polycarb lens,,,28.98,33.56,8
HCPCS,S0581,Nonstnd lens,,,28.98,33.56,8
HCPCS,S0590,Misc integral lens serv,,,28.98,33.56,8
HCPCS,S0592,Comp cont lens eval,,,38.61,44.7,8
HCPCS,S0595,New lenses in pts old frame,,,28.98,33.56,8
HCPCS,S0596,Phakic iol refractive error,,,159.5,184.68,8
HCPCS,S0601,Screening proctoscopy,,,706.64,818.21,8
HCPCS,S0610,Annual gynecological examina,,,54.56,63.17,8
HCPCS,S0610,"GYN EXAM, NEW PT., ANNUAL",373.0,242.45,1.1,373.0,29
HCPCS,S0612,Annual gynecological examina,,,54.56,63.17,8
HCPCS,S0612,"GYN EXAM, EST PT., ANNUAL",303.0,196.95,1.1,303.0,29
HCPCS,S0613,Ann breast exam,,,54.56,63.17,8
HCPCS,S0618,Audiometry for hearing aid,,,31.75,36.76,8
HCPCS,S0620,Routine ophthalmological exa,,,54.56,63.17,8
HCPCS,S0621,Routine ophthalmological exa,,,54.56,63.17,8
HCPCS,S0622,Phys exam for college,,,54.56,63.17,8
HCPCS,S0630,Removal of sutures,,,50.62,58.61,8
HCPCS,S0800,Laser in situ keratomileusis,,,252.71,292.61,8
HCPCS,S0810,Photorefractive keratectomy,,,252.71,292.61,8
HCPCS,S0812,Phototherap keratect,,,252.71,292.61,8
HCPCS,S1001,Deluxe item,,,13.46,15.59,8
HCPCS,S1002,Custom item,,,13.46,15.59,8
HCPCS,S1015,Iv tubing extension set,,,13.46,15.59,8
HCPCS,S1016,Non-pvc intravenous administ,,,13.46,15.59,8
HCPCS,S1030,Gluc monitor purchase,,,672.04,778.15,8
HCPCS,S1031,Gluc monitor rental,,,672.04,778.15,8
HCPCS,S1034,Art pancreas system,,,1022.49,1183.93,8
HCPCS,S1035,Art pancreas inv disp sensor,,,28.98,33.56,8
HCPCS,S1036,Art pancreas ext transmitter,,,28.98,33.56,8
HCPCS,S1037,Art pancreas ext receiver,,,28.98,33.56,8
HCPCS,S1091,Stent non-coronary propel,,,159.5,4514.4,11
HCPCS,S109100,Stent non-coronary propel,,,3684.6,3684.6,1
HCPCS,S2053,Transplantation of small int,,,975.94,1130.04,8
HCPCS,S2054,Transplantation of multivisc,,,975.94,1130.04,8
HCPCS,S2055,Harvesting of donor multivis,,,975.94,1130.04,8
HCPCS,S2060,Lobar lung transplantation,,,2489.17,2882.2,8
HCPCS,S2061,Donor lobectomy (lung),,,2489.17,2882.2,8
HCPCS,S2065,Simult panc kidn trans,,,1422.38,1646.96,8
HCPCS,S2066,Breast gap flap reconst,,,3875.91,4487.9,8
HCPCS,S2067,"Breast ""stacked"" diep/gap",,,3875.91,4487.9,8
HCPCS,S2068,BREAST DIEP FLAP RECONSTRUCT,21547.0,14005.55,1.1,31963.9,29
HCPCS,S2068,Breast diep or siea flap,,,3875.91,4487.9,8
HCPCS,S2070,Cysto laser tx ureteral calc,,,846.52,980.18,8
HCPCS,S2079,Lap esophagomyotomy,,,3788.7,4386.91,8
HCPCS,S2080,Laup,,,745.85,863.61,8
HCPCS,S2083,Adjustment gastric band,,,321.96,372.8,8
HCPCS,S2095,Transcath emboliz microspher,,,6695.97,7753.23,8
HCPCS,S2102,Islet cell tissue transplant,,,2755.97,3191.12,8
HCPCS,S2103,Adrenal tissue transplant,,,975.94,1130.04,8
HCPCS,S2107,Adoptive immunotherapy,,,1254.9,1453.05,8
HCPCS,S2112,Knee arthroscp harv,,,1453.77,1683.31,8
HCPCS,S2115,Periacetabular osteotomy,,,2435.09,2819.58,8
HCPCS,S2117,"Arthroereisis, subtalar",,,1392.99,1612.93,8
HCPCS,S2118,Total hip resurfacing,,,2435.09,2819.58,8
HCPCS,S2120,Low density lipoprotein(ldl),,,1254.9,1453.05,8
HCPCS,S2140,Cord blood harvesting,,,360.34,417.23,8
HCPCS,S2142,Cord blood-derived stem-cell,,,360.34,417.23,8
HCPCS,S2150,Bmt harv/transpl 28d pkg,,,1372.76,1589.51,8
HCPCS,S2152,Solid organ transpl pkg,,,975.94,1130.04,8
HCPCS,S2202,Echosclerotherapy,,,317.1,367.17,8
HCPCS,S2205,Minimally invasive direct co,,,11343.93,13135.08,8
HCPCS,S2206,Minimally invasive direct co,,,11343.93,13135.08,8
HCPCS,S2207,Minimally invasive direct co,,,11343.93,13135.08,8
HCPCS,S2208,Minimally invasive direct co,,,11343.93,13135.08,8
HCPCS,S2209,Minimally invasive direct co,,,11343.93,13135.08,8
HCPCS,S2225,Myringotomy laser-assist,,,745.85,863.61,8
HCPCS,S2230,Implant semi-imp hear,,,1237.01,1432.33,8
HCPCS,S2235,Implant auditory brain imp,,,7765.06,8991.13,8
HCPCS,S2260,Induced abortion 17-24 weeks,,,1625.04,1881.63,8
HCPCS,S2265,Induced abortion 25-28 wks,,,1625.04,1881.63,8
HCPCS,S2266,Induced abortion 29-31 wks,,,1625.04,1881.63,8
HCPCS,S2267,Induced abortion 32 or more,,,1625.04,1881.63,8
HCPCS,S2300,"Arthroscopy, shoulder, surgi",,,1453.77,1683.31,8
HCPCS,S2325,Hip core decompression,,,54.56,63.17,8
HCPCS,S2340,Chemodenervation of abductor,,,1124.06,1301.54,8
HCPCS,S2341,Chemodenerv adduct vocal,,,1124.06,1301.54,8
HCPCS,S2342,Nasal endoscop po debrid,,,211.85,245.3,8
HCPCS,S2348,Decompress disc rf lumbar,,,3026.0,3503.79,8
HCPCS,S2350,"Diskectomy, anterior, with d",,,3026.0,3503.79,8
HCPCS,S2351,"Diskectomy, anterior, with d",,,3026.0,3503.79,8
HCPCS,S2400,Fetal surg congen hernia,,,1875.34,2171.44,8
HCPCS,S2401,Fetal surg urin trac obstr,,,1875.34,2171.44,8
HCPCS,S2402,Fetal surg cong cyst malf,,,1875.34,2171.44,8
HCPCS,S2403,Fetal surg pulmon sequest,,,1875.34,2171.44,8
HCPCS,S2404,Fetal surg myelomeningo,,,1875.34,2171.44,8
HCPCS,S2405,Fetal surg sacrococ teratoma,,,1875.34,2171.44,8
HCPCS,S2409,Fetal surg noc,,,1875.34,2171.44,8
HCPCS,S2411,Fetoscop laser ther ttts,,,204.11,236.34,8
HCPCS,S2900,ROBOTIC SURGICAL SYSTEM,526.0,341.9,0.01,526.0,29
HCPCS,S2900,Robotic surgical system,,,321.96,372.8,8
HCPCS,S3000,Bilat dil retinal exam,,,54.56,63.17,8
HCPCS,S3005,Eval self-assess depression,,,8.48,9.82,8
HCPCS,S3600,Stat lab,,,26.64,30.84,8
HCPCS,S3601,Stat lab home/nf,,,26.64,30.84,8
HCPCS,S3620,Newborn metabolic screening,,,15.61,171.59,9
HCPCS,S3630,Eosinophil blood count,,,6.74,7.8,8
HCPCS,S3645,Hiv-1 antibody testing of or,,,18.32,21.21,8
HCPCS,S3650,"Saliva test, hormone level;",,,14.4,16.68,8
HCPCS,S3652,"Saliva test, hormone level;",,,14.4,16.68,8
HCPCS,S3655,Antisperm antibodies test,,,18.32,21.21,8
HCPCS,S3708,Gastrointestinal fat absorpt,,,14.4,16.68,8
HCPCS,S3722,Dose optimization auc - 5fu,,,14.54,16.83,8
HCPCS,S3800,Genetic testing als,,,66.63,77.15,8
HCPCS,S3840,Dna analysis ret-oncogene,,,66.63,77.15,8
HCPCS,S3841,Gene test retinoblastoma,,,66.63,77.15,8
HCPCS,S3842,Gene test hippel-lindau,,,66.63,77.15,8
HCPCS,S3844,Dna analysis deafness,,,66.63,77.15,8
HCPCS,S3845,Gene test alpha-thalassemia,,,66.63,77.15,8
HCPCS,S3846,Gene test beta-thalassemia,,,66.63,77.15,8
HCPCS,S3849,Gene test niemann-pick,,,66.63,77.15,8
HCPCS,S3850,Gene test sickle cell,,,66.63,77.15,8
HCPCS,S3852,Dna analysis apoe alzheimer,,,66.63,77.15,8
HCPCS,S3853,Gene test myo musclr dyst,,,66.63,77.15,8
HCPCS,S3854,Gene profile panel breast,,,66.63,77.15,8
HCPCS,S3861,Genetic test brugada,,,66.63,77.15,8
HCPCS,S3865,Comp genet test hyp cardiomy,,,66.63,77.15,8
HCPCS,S3866,Spec gene test hyp cardiomy,,,66.63,77.15,8
HCPCS,S3870,Cgh test developmental delay,,,87.06,100.8,8
HCPCS,S3900,Surface emg,,,310.96,360.06,8
HCPCS,S3902,Ballistocardiogram,,,18.66,21.6,8
HCPCS,S3904,Masters two step,,,68.77,79.63,8
HCPCS,S4005,Interim labor facility globa,,,50.62,58.61,8
HCPCS,S4011,Ivf package,,,120.06,139.02,8
HCPCS,S4013,Compl gift case rate,,,120.06,139.02,8
HCPCS,S4014,Compl zift case rate,,,120.06,139.02,8
HCPCS,S4015,Complete ivf nos case rate,,,120.06,139.02,8
HCPCS,S4016,Frozen ivf case rate,,,120.06,139.02,8
HCPCS,S4017,Ivf canc a stim case rate,,,120.06,139.02,8
HCPCS,S4018,F emb trns canc case rate,,,120.06,139.02,8
HCPCS,S4020,Ivf canc b4 aspir case rate,,,120.06,139.02,8
HCPCS,S4021,Ivf canc aftr aspr case rate,,,120.06,139.02,8
HCPCS,S4022,Asst oocyte fert case rate,,,120.06,139.02,8
HCPCS,S4023,Incompl donor egg case rate,,,120.06,139.02,8
HCPCS,S4024,Air polymer foam per study,,,19.83,1986.48,9
HCPCS,S402400,Air polymer foam per study,,,1986.48,1986.48,1
HCPCS,S4025,Donor serv ivf case rate,,,120.06,139.02,8
HCPCS,S4026,Procure donor sperm,,,19.72,22.84,8
HCPCS,S4027,Store prev froz embryos,,,19.72,22.84,8
HCPCS,S4028,Microsurg epi sperm asp,,,120.06,139.02,8
HCPCS,S4030,Sperm procure init visit,,,120.06,139.02,8
HCPCS,S4031,Sperm procure subs visit,,,120.06,139.02,8
HCPCS,S4035,Stimulated iui case rate,,,120.06,139.02,8
HCPCS,S4037,Cryo embryo transf case rate,,,120.06,139.02,8
HCPCS,S4040,Monit store cryo embryo 30 d,,,19.72,22.84,8
HCPCS,S4042,Ovulation mgmt per cycle,,,17.35,20.09,8
HCPCS,S4981,Insert levonorgestrel ius,,,54.44,63.04,8
HCPCS,S4988,Penile contractur devic manu,,,264.38,306.12,8
HCPCS,S4989,CONTRACEPT IUD,1929.0,1253.85,1.1,1939.72,32
HCPCS,S4989,Contracept iud,,,576.07,702.34,9
HCPCS,S4990,Nicotine patch legend,,,4.49,9.82,10
HCPCS,S499000,Nicotine patch legend,,,4.49,4.49,1
HCPCS,S4991,Nicotine patch nonlegend,,,4.25,9.82,10
HCPCS,S499100,Nicotine patch nonlegend,,,4.25,4.25,1
HCPCS,S4993,Contraceptive pills for bc,,,2.46,47.96,10
HCPCS,S499300,Contraceptive pills for bc,,,2.46,2.46,1
HCPCS,S4995,Smoking cessation gum,,,0.75,9.82,10
HCPCS,S499500,Smoking cessation gum,,,0.75,0.75,1
HCPCS,S5000,"Prescription drug, generic",,,13.46,15.59,8
HCPCS,S5001,"Prescription drug,brand name",,,13.46,15.59,8
HCPCS,S5010,5% dextrose and 0.45% saline,,,13.46,21.61,10
HCPCS,S501000,5% dextrose and 0.45% saline,,,18.51,18.51,1
HCPCS,S5012,5% dextrose with potassium,,,10.15,15.59,10
HCPCS,S501200,5% dextrose with potassium,,,10.15,10.15,1
HCPCS,S5013,5%dextrose/0.45%saline1000ml,,,13.46,15.59,8
HCPCS,S5014,D5w/0.45ns w kcl and mgs04,,,13.46,15.59,8
HCPCS,S5035,Hit routine device maint,,,13.46,15.59,8
HCPCS,S5036,Hit device repair,,,13.46,15.59,8
HCPCS,S5100,Adult daycare services 15min,,,50.62,58.61,8
HCPCS,S5101,Adult day care per half day,,,50.62,58.61,8
HCPCS,S5102,Adult day care per diem,,,50.62,58.61,8
HCPCS,S5105,Centerbased day care perdiem,,,50.62,58.61,8
HCPCS,S5135,Adult companioncare per 15m,,,50.62,58.61,8
HCPCS,S5136,Adult companioncare per diem,,,50.62,58.61,8
HCPCS,S5140,Adult foster care per diem,,,50.62,58.61,8
HCPCS,S5141,Adult foster care per month,,,50.62,58.61,8
HCPCS,S5145,Child fostercare th per diem,,,50.62,58.61,8
HCPCS,S5146,Ther fostercare child /month,,,50.62,58.61,8
HCPCS,S5150,BEHAVIORAL HEALTH RESPITE 15 MIN - 3HR,10.0,6.5,1.1,1791901.44,28
HCPCS,S5150,Unskilled respite care /15m,,,50.62,58.61,8
HCPCS,S5151,BEHAVIORAL HEALTH RESPITE PER DIEM 3+HOURS,106.0,68.9,1.1,1791901.44,28
HCPCS,S5151,Unskilled respitecare /diem,,,50.62,58.61,8
HCPCS,S5160,Emer response sys instal&tst,,,28.98,33.56,8
HCPCS,S5161,Emer rspns sys serv permonth,,,28.98,33.56,8
HCPCS,S5162,Emer rspns system purchase,,,28.98,33.56,8
HCPCS,S5185,Med reminder serv per month,,,50.62,58.61,8
HCPCS,S5190,Wellness assessment by nonph,,,321.96,372.8,8
HCPCS,S5199,Personal care item nos each,,,13.46,15.59,8
HCPCS,S5550,Insulin rapid 5 u,,,0.5,0.75,3
HCPCS,S555000,Insulin rapid 5 u,,,0.5,0.5,1
HCPCS,S5551,Insulin most rapid 5 u,,,0.77,1.16,3
HCPCS,S555100,Insulin most rapid 5 u,,,0.77,0.77,1
HCPCS,S5552,Insulin intermed 5 u,,,0.49,0.64,3
HCPCS,S555200,Insulin intermed 5 u,,,0.5,0.5,1
HCPCS,S5553,Insulin long acting 5 u,,,0.9,1.55,3
HCPCS,S555300,Insulin long acting 5 u,,,1.25,1.25,1
HCPCS,S5561,Insulin reuse pen 3 ml,,,91.49,117.19,2
HCPCS,S556100,Insulin reuse pen 3 ml,,,91.49,91.49,1
HCPCS,S5566,Insulin cartridge 300 u,,,57.41,73.53,2
HCPCS,S556600,Insulin cartridge 300 u,,,57.41,57.41,1
HCPCS,S5570,Insulin dispos pen 1.5 ml,,,213.6,273.6,2
HCPCS,S557000,Insulin dispos pen 1.5 ml,,,213.6,213.6,1
HCPCS,S5571,Insulin dispos pen 3 ml,,,67.96,87.05,2
HCPCS,S557100,Insulin dispos pen 3 ml,,,67.96,67.96,1
HCPCS,S8030,Tantalum ring application,,,302.55,350.32,8
HCPCS,S8035,Magnetic source imaging,,,202.79,234.81,8
HCPCS,S8037,Mrcp,,,246.69,285.64,8
HCPCS,S8040,Topographic brain mapping,,,552.3,639.51,8
HCPCS,S8042,Mri low field,,,202.79,234.81,8
HCPCS,S8055,Us guidance fetal reduct,,,74.0,85.68,8
HCPCS,S8080,Scintimammography,,,247.14,286.17,8
HCPCS,S8092,Electron beam computed tomog,,,56.72,65.67,8
HCPCS,S8096,Portable peak flow meter,,,8.84,10.24,8
HCPCS,S8097,Asthma kit,,,8.84,10.24,8
HCPCS,S8100,Spacer without mask,,,28.98,35.66,9
HCPCS,S8101,Spacer with mask,,,13.46,48.07,9
HCPCS,S8110,Peak expiratory flow rate (p,,,51.58,59.72,8
HCPCS,S8130,Interferential stim 2 chan,,,72.46,83.9,8
HCPCS,S8131,Interferential stim 4 chan,,,72.46,83.9,8
HCPCS,S8185,Flutter device,,,13.46,15.59,8
HCPCS,S8186,Swivel adaptor,,,13.46,15.59,8
HCPCS,S8189,Trach supply noc,,,28.98,33.56,8
HCPCS,S8210,Mucus trap,,,13.46,15.59,8
HCPCS,S8265,Haberman feeder,,,8.84,10.24,8
HCPCS,S8270,Enuresis alarm,,,28.98,33.56,8
HCPCS,S8301,Infect control supplies nos,,,13.46,15.59,8
HCPCS,S8415,Supplies for home delivery,,,13.46,15.59,8
HCPCS,S8420,Custom gradient sleev/glov,,,8.84,10.24,8
HCPCS,S8421,Ready gradient sleev/glov,,,8.84,10.24,8
HCPCS,S8422,Custom grad sleeve med,,,8.84,10.24,8
HCPCS,S8423,Custom grad sleeve heavy,,,8.84,10.24,8
HCPCS,S8424,Ready gradient sleeve,,,8.84,10.24,8
HCPCS,S8425,Custom grad glove med,,,8.84,10.24,8
HCPCS,S8426,Custom grad glove heavy,,,8.84,10.24,8
HCPCS,S8427,Ready gradient glove,,,8.84,10.24,8
HCPCS,S8428,Ready gradient gauntlet,,,8.84,10.24,8
HCPCS,S8429,Gradient pressure wrap,,,8.84,10.24,8
HCPCS,S8430,Padding for comprssn bdg,,,13.46,15.59,8
HCPCS,S8431,Compression bandage,,,13.46,15.59,8
HCPCS,S8450,Splint digit,,,13.46,15.59,8
HCPCS,S8451,Splint wrist or ankle,,,8.84,10.24,8
HCPCS,S8452,Splint elbow,,,13.46,15.59,8
HCPCS,S8460,Camisole post-mast,,,28.98,33.56,8
HCPCS,S8490,100 insulin syringes,,,13.46,70.66,11
HCPCS,S849000,100 insulin syringes,,,69.78,69.78,1
HCPCS,S8930,Auricular electrostimulation,,,310.96,360.06,8
HCPCS,S8940,Hippotherapy per session,,,24.68,28.58,8
HCPCS,S8948,Low-level laser trmt 15 min,,,24.68,28.58,8
HCPCS,S8950,"Complex lymphedema therapy,",,,24.68,28.58,8
HCPCS,S8990,Pt or manip for maint,,,24.68,28.58,8
HCPCS,S8999,Resuscitation bag,,,8.84,10.24,8
HCPCS,S9002,Intra-vag motion sens biofk,,,531.62,615.56,8
HCPCS,S9007,Ultrafiltration monitor,,,46.46,53.79,8
HCPCS,S9024,Paranasal sinus ultrasound,,,77.56,89.8,8
HCPCS,S9025,Omnicardiogram/cardiointegra,,,18.66,21.6,8
HCPCS,S9034,Eswl for gallstones,,,1082.41,1253.32,8
HCPCS,S9055,Procuren or other growth fac,,,444.21,514.35,8
HCPCS,S9056,Coma stimulation per diem,,,321.96,372.8,8
HCPCS,S9083,Urgent care center global,,,321.96,372.8,8
HCPCS,S9088,Services provided in urgent,,,321.96,372.8,8
HCPCS,S9090,Vertebral axial decompressio,,,24.68,28.58,8
HCPCS,S9117,Back school visit,,,50.62,58.61,8
HCPCS,S9140,"Diabetic management program,",,,31.04,35.94,8
HCPCS,S9141,"Diabetic management program,",,,31.04,35.94,8
HCPCS,S9145,Insulin pump initiation,,,31.04,35.94,8
HCPCS,S9150,Evaluation by ocularist,,,50.62,58.61,8
HCPCS,S9152,"Speech therapy, re-eval",,,56.15,65.01,8
HCPCS,S9335,Ht hemodialysis diem,,,296.15,342.91,8
HCPCS,S9339,Hit periton dialysis diem,,,296.15,342.91,8
HCPCS,S9370,Ht inj antiemetic diem,,,17.35,20.09,8
HCPCS,S9372,Ht inj anticoag diem,,,17.35,20.09,8
HCPCS,S9381,Hit high risk/escort,,,50.62,58.61,8
HCPCS,S9401,Anticoag clinic per session,,,54.56,63.17,8
HCPCS,S9430,Pharmacy comp/disp serv,,,321.96,372.8,8
HCPCS,S9436,Lamaze class,,,31.04,35.94,8
HCPCS,S9437,Childbirth refresher class,,,31.04,35.94,8
HCPCS,S9438,Cesarean birth class,,,31.04,35.94,8
HCPCS,S9439,Vbac class,,,31.04,35.94,8
HCPCS,S9441,Asthma education,,,31.04,35.94,8
HCPCS,S9442,Birthing class,,,31.04,35.94,8
HCPCS,S9443,LACTATION CLASS,102.0,66.3,15.18,102.0,46
HCPCS,S9444,Parenting class,,,31.04,35.94,8
HCPCS,S9445,Pt education noc individ,,,31.04,35.94,8
HCPCS,S9446,Pt education noc group,,,35.45,41.05,8
HCPCS,S9447,Infant safety class,,,31.04,35.94,8
HCPCS,S9449,Weight mgmt class,,,31.04,35.94,8
HCPCS,S9451,Exercise class,,,31.04,35.94,8
HCPCS,S9452,Nutrition class,,,35.45,41.05,8
HCPCS,S9453,Smoking cessation class,,,37.4,43.31,8
HCPCS,S9454,Stress mgmt class,,,31.04,35.94,8
HCPCS,S9455,"Diabetic management program,",,,35.45,41.05,8
HCPCS,S9460,"Diabetic management program,",,,50.62,58.61,8
HCPCS,S9465,"Diabetic management program,",,,66.06,76.49,8
HCPCS,S9470,"Nutritional counseling, diet",,,66.06,76.49,8
HCPCS,S9472,Cardiac rehabilitation progr,,,54.89,63.56,8
HCPCS,S9473,Pulmonary rehabilitation pro,,,27.26,31.56,8
HCPCS,S9474,Enterostomal therapy by a re,,,321.96,372.8,8
HCPCS,S9475,Ambulatory setting substance,,,118.99,137.78,8
HCPCS,S9476,Vestibular rehab per diem,,,56.15,65.01,8
HCPCS,S9480,Intensive outpatient psychia,,,105.62,122.3,8
HCPCS,S9482,MRSS STABILIZATION SERVICE,84.0,54.6,1.1,1791901.44,74
HCPCS,S9484,CRISIS MOBILE RESPONSE FU,136.5,88.725,1.1,473.41,75
HCPCS,S9485,CRISIS MOBILE RESPONSE,305.0,198.25,1.1,1791901.44,74
HCPCS,S9529,Venipuncture home/snf,,,2.09,2.42,8
HCPCS,S9537,Ht hem horm inj diem,,,17.35,20.09,8
HCPCS,S9538,Hit blood products diem,,,360.34,417.23,8
HCPCS,S9558,Ht inj growth horm diem,,,17.35,20.09,8
HCPCS,S9559,Hit inj interferon diem,,,17.35,20.09,8
HCPCS,S9560,Ht inj hormone diem,,,17.35,20.09,8
HCPCS,S9562,Ht inj palivizumab/ab diem,,,17.35,20.09,8
HCPCS,S9900,Christian sci pract visit,,,50.62,58.61,8
HCPCS,S9901,Christian sci nurse visit,,,50.62,58.61,8
HCPCS,S9970,Health club membership yr,,,8.48,9.82,8
HCPCS,S9981,Med record copy admin,,,50.62,58.61,8
HCPCS,S9982,Med record copy per page,,,50.62,58.61,8
HCPCS,S9986,Not medically necessary svc,,,50.62,58.61,8
HCPCS,S9988,Serv part of phase i trial,,,50.62,58.61,8
HCPCS,S9989,Services outside us,,,50.62,58.61,8
HCPCS,S9990,Services provided as part of,,,50.62,58.61,8
HCPCS,S9991,Services provided as part of,,,50.62,58.61,8
HCPCS,S9999,Sales tax,,,50.62,58.61,8
HCPCS,SP99212,UPS SPORTS PHYSICAL FAM,30.0,19.5,1.1,30.0,22
HCPCS,SP99213,UPS SPORTS PHYSICAL,35.0,22.75,1.1,35.0,22
HCPCS,T1006,Family/couple counseling,,,126.06,145.96,8
HCPCS,T1007,Treatment plan development,,,32.9,38.09,8
HCPCS,T1012,Alcohol/substance abuse skil,,,38.59,44.68,8
HCPCS,T1013,Sign lang/oral interpreter,,,50.62,58.61,8
HCPCS,T1014,"Telehealth transmit, per min",,,321.96,372.8,8
HCPCS,T1015,Clinic service,,,54.56,63.17,8
HCPCS,T1016,Case management,,,17.35,20.09,8
HCPCS,T1017,Targeted case management,,,17.35,20.09,8
HCPCS,T1023,Program intake assessment,,,37.4,43.31,8
HCPCS,T1024,Team evaluation & management,,,17.35,20.09,8
HCPCS,T1025,"Ped compr care pkg, per diem",,,32.9,38.09,8
HCPCS,T1026,"Ped compr care pkg, per hour",,,32.9,38.09,8
HCPCS,T1032,Sv doula brth wrk per 15 min,,,50.62,58.61,8
HCPCS,T1033,Sv doula brth wrk per diem,,,50.62,58.61,8
HCPCS,T1040,Comm bh clinic svc per diem,,,118.99,137.78,8
HCPCS,T1502,Medication admin visit,,,36.15,41.86,8
HCPCS,T1503,"Med admin, not oral/inject",,,36.15,41.86,8
HCPCS,T1505,"Elec med comp dev, noc",,,13.46,15.59,8
HCPCS,T1999,Noc retail items andsupplies,,,13.46,15.59,8
HCPCS,T2022,MOD CARE COOR FULL MONTH,274.0,178.1,1.1,1791901.44,66
HCPCS,T2023,MOD CARE COOR PARTIAL MONTH,170.5,110.82499999999999,1.1,1791901.44,66
HCPCS,T2028,"Special supply, nos waiver",,,13.46,15.59,8
HCPCS,T2029,"Special med equip, noswaiver",,,13.46,15.59,8
HCPCS,T2035,Utility services waiver,,,13.46,15.59,8
HCPCS,T2048,"Bh ltc res r&b, per diem",,,216.58,250.78,8
HCPCS,T4521,Adult size brief/diaper sm,,,13.46,15.59,8
HCPCS,T4522,Adult size brief/diaper med,,,13.46,15.59,8
HCPCS,T4523,Adult size brief/diaper lg,,,13.46,15.59,8
HCPCS,T4524,Adult size brief/diaper xl,,,13.46,15.59,8
HCPCS,T4525,Adult size pull-on sm,,,13.46,15.59,8
HCPCS,T4526,Adult size pull-on med,,,13.46,15.59,8
HCPCS,T4527,Adult size pull-on lg,,,13.46,15.59,8
HCPCS,T4528,Adult size pull-on xl,,,13.46,15.59,8
HCPCS,T4529,Ped size brief/diaper sm/med,,,13.46,15.59,8
HCPCS,T4530,Ped size brief/diaper lg,,,13.46,15.59,8
HCPCS,T4531,Ped size pull-on sm/med,,,13.46,15.59,8
HCPCS,T4532,Ped size pull-on lg,,,13.46,15.59,8
HCPCS,T4533,Youth size brief/diaper,,,13.46,15.59,8
HCPCS,T4534,Youth size pull-on,,,13.46,15.59,8
HCPCS,T4535,Disposable liner/shield/pad,,,13.46,15.59,8
HCPCS,T4536,Reusable pull-on any size,,,13.46,15.59,8
HCPCS,T4537,Reusable underpad bed size,,,13.46,15.59,8
HCPCS,T4538,Diaper serv reusable diaper,,,13.46,15.59,8
HCPCS,T4539,Reuse diaper/brief any size,,,13.46,15.59,8
HCPCS,T4540,Reusable underpad chair size,,,13.46,15.59,8
HCPCS,T4541,Large disposable underpad,,,13.46,15.59,8
HCPCS,T4542,Small disposable underpad,,,13.46,15.59,8
HCPCS,T4543,Adult disp brief/diap abv xl,,,13.46,15.59,8
HCPCS,T4544,Adlt disp und/pull on abv xl,,,13.46,15.59,8
HCPCS,T4545,Incon disposable penile wrap,,,13.46,15.59,8
HCPCS,T5001,Position seat spec orth need,,,13.46,15.59,8
HCPCS,T5999,"Supply, nos",,,13.46,15.59,8
HCPCS,U0001,COVID19 INHOUSE,248.0,161.2,13.21,248.0,61
HCPCS,U0001,COVID19 SENDOUT,248.0,161.2,13.21,248.0,61
HCPCS,U0002,COVID19 INHOUSE,354.0,230.1,13.21,354.0,61
HCPCS,U0002,COVID19 SENDOUT,354.0,230.1,13.21,354.0,61
HCPCS,U0002,Covid-19 lab test non-cdc,,,57.49,57.49,1
HCPCS,U0002QW,Covid-19 lab test non-cdc,,,57.49,57.49,1
HCPCS,U0003,Cov-19 amp prb hgh thruput,,,26.69,84.03,15
HCPCS,U0004,Cov-19 test non-cdc hgh thru,,,26.69,84.03,15
HCPCS,U0005,Infec agen detec ampli probe,,,13.21,28.01,15
HCPCS,V2020,Vision svcs frames purchases,,,25.16,368.23,10
HCPCS,V2025,Eyeglasses delux frames,,,28.98,33.56,8
HCPCS,V2100,Lens spher single plano 4.00,,,28.98,227.58,10
HCPCS,V2101,Single visn sphere 4.12-7.00,,,28.98,218.66,10
HCPCS,V2102,Singl visn sphere 7.12-20.00,,,25.16,378.03,10
HCPCS,V2103,Spherocylindr 4.00d/12-2.00d,,,28.98,191.55,10
HCPCS,V2104,Spherocylindr 4.00d/2.12-4d,,,28.98,197.47,10
HCPCS,V2105,Spherocylinder 4.00d/4.25-6d,,,28.98,234.89,10
HCPCS,V2106,Spherocylinder 4.00d/>6.00d,,,25.16,260.2,10
HCPCS,V2107,Spherocylinder 4.25d/12-2d,,,25.16,231.7,10
HCPCS,V2108,Spherocylinder 4.25d/2.12-4d,,,25.16,232.34,10
HCPCS,V2109,Spherocylinder 4.25d/4.25-6d,,,25.16,323.57,10
HCPCS,V2110,Spherocylinder 4.25d/over 6d,,,25.16,261.32,10
HCPCS,V2111,Spherocylindr 7.25d/.25-2.25,,,25.16,316.7,10
HCPCS,V2112,Spherocylindr 7.25d/2.25-4d,,,25.16,357.76,10
HCPCS,V2113,Spherocylindr 7.25d/4.25-6d,,,25.16,361.8,10
HCPCS,V2114,Spherocylinder over 12.00d,,,25.16,428.65,10
HCPCS,V2115,Lens lenticular bifocal,,,25.16,432.05,10
HCPCS,V2118,Lens aniseikonic single,,,25.16,470.15,10
HCPCS,V2121,"Lenticular lens, single",,,25.16,423.97,10
HCPCS,V2199,Lens single vision not oth c,,,13.46,15.59,8
HCPCS,V2200,Lens spher bifoc plano 4.00d,,,25.16,256.28,10
HCPCS,V2201,Lens sphere bifocal 4.12-7.0,,,25.16,274.6,10
HCPCS,V2202,Lens sphere bifocal 7.12-20.,,,25.16,340.41,10
HCPCS,V2203,Lens sphcyl bifocal 4.00d/.1,,,25.16,263.92,10
HCPCS,V2204,Lens sphcy bifocal 4.00d/2.1,,,25.16,271.56,10
HCPCS,V2205,Lens sphcy bifocal 4.00d/4.2,,,25.16,301.1,10
HCPCS,V2206,Lens sphcy bifocal 4.00d/ove,,,25.16,353.4,10
HCPCS,V2207,Lens sphcy bifocal 4.25-7d/.,,,25.16,298.75,10
HCPCS,V2208,Lens sphcy bifocal 4.25-7/2.,,,25.16,293.55,10
HCPCS,V2209,Lens sphcy bifocal 4.25-7/4.,,,25.16,344.6,10
HCPCS,V2210,Lens sphcy bifocal 4.25-7/ov,,,25.16,371.31,10
HCPCS,V2211,Lens sphcy bifo 7.25-12/.25-,,,25.16,361.48,10
HCPCS,V2212,Lens sphcyl bifo 7.25-12/2.2,,,25.16,378.39,10
HCPCS,V2213,Lens sphcyl bifo 7.25-12/4.2,,,25.16,397.86,10
HCPCS,V2214,Lens sphcyl bifocal over 12.,,,46.46,415.81,10
HCPCS,V2215,Lens lenticular bifocal,,,46.46,519.17,10
HCPCS,V2218,Lens aniseikonic bifocal,,,46.46,529.04,10
HCPCS,V2219,Lens bifocal seg width over,,,25.16,244.05,10
HCPCS,V2220,Lens bifocal add over 3.25d,,,28.98,216.78,10
HCPCS,V2221,"Lenticular lens, bifocal",,,46.46,432.37,10
HCPCS,V2299,Lens bifocal speciality,,,13.46,15.59,8
HCPCS,V2300,Lens sphere trifocal 4.00d,,,25.16,350.32,10
HCPCS,V2301,Lens sphere trifocal 4.12-7.,,,25.16,429.69,10
HCPCS,V2302,Lens sphere trifocal 7.12-20,,,25.16,401.38,10
HCPCS,V2303,Lens sphcy trifocal 4.0/.12-,,,25.16,337.21,10
HCPCS,V2304,Lens sphcy trifocal 4.0/2.25,,,25.16,341.13,10
HCPCS,V2305,Lens sphcy trifocal 4.0/4.25,,,25.16,381.11,10
HCPCS,V2306,Lens sphcyl trifocal 4.00/>6,,,25.16,392.42,10
HCPCS,V2307,Lens sphcy trifocal 4.25-7/.,,,25.16,373.63,10
HCPCS,V2308,Lens sphc trifocal 4.25-7/2.,,,25.16,407.54,10
HCPCS,V2309,Lens sphc trifocal 4.25-7/4.,,,46.46,426.49,10
HCPCS,V2310,Lens sphc trifocal 4.25-7/>6,,,46.46,445.44,10
HCPCS,V2311,Lens sphc trifo 7.25-12/.25-,,,46.46,514.37,10
HCPCS,V2312,Lens sphc trifo 7.25-12/2.25,,,46.46,471.47,10
HCPCS,V2313,Lens sphc trifo 7.25-12/4.25,,,46.46,514.65,10
HCPCS,V2314,Lens sphcyl trifocal over 12,,,46.46,526.08,10
HCPCS,V2315,Lens lenticular trifocal,,,46.46,584.06,10
HCPCS,V2318,Lens aniseikonic trifocal,,,46.46,718.0,10
HCPCS,V2319,Lens trifocal seg width > 28,,,25.16,324.13,10
HCPCS,V2320,Lens trifocal add over 3.25d,,,25.16,341.93,10
HCPCS,V2321,"Lenticular lens, trifocal",,,46.46,575.66,10
HCPCS,V2399,Lens trifocal speciality,,,13.46,15.59,8
HCPCS,V2410,Lens variab asphericity sing,,,46.46,503.29,10
HCPCS,V2430,Lens variable asphericity bi,,,46.46,532.72,10
HCPCS,V2499,Variable asphericity lens,,,13.46,15.59,8
HCPCS,V2500,Contact lens pmma spherical,,,25.16,450.36,10
HCPCS,V2501,Cntct lens pmma-toric/prism,,,46.46,639.07,10
HCPCS,V2502,Contact lens pmma bifocal,,,46.46,865.97,10
HCPCS,V2503,Cntct lens pmma color vision,,,46.46,836.38,10
HCPCS,V2510,Cntct gas permeable sphericl,,,46.46,600.53,10
HCPCS,V2511,Cntct toric prism ballast,,,46.46,890.12,10
HCPCS,V2512,Cntct lens gas permbl bifocl,,,278.93,1024.54,10
HCPCS,V2513,Contact lens extended wear,,,46.46,1032.18,10
HCPCS,V2520,Contact lens hydrophilic,,,46.46,598.37,10
HCPCS,V2521,Cntct lens hydrophilic toric,,,278.93,1184.99,10
HCPCS,V2522,Cntct lens hydrophil bifocl,,,278.93,867.17,10
HCPCS,V2523,Cntct lens hydrophil extend,,,46.46,910.51,10
HCPCS,V2524,Cntct lens hydrophil photoch,,,46.46,685.65,10
HCPCS,V2525,"Cl, hydrophilic, dual focus",,,46.46,53.79,8
HCPCS,V2526,Cntct lens blue violet,,,278.93,322.97,8
HCPCS,V2530,Contact lens gas impermeable,,,278.93,1455.62,10
HCPCS,V2531,Contact lens gas permeable,,,264.38,2665.64,10
HCPCS,V2599,Contact lens/es other type,,,13.46,15.59,8
HCPCS,V2600,Hand held low vision aids,,,13.46,15.59,8
HCPCS,V2610,Single lens spectacle mount,,,13.46,15.59,8
HCPCS,V2615,Telescop/othr compound lens,,,159.5,184.68,8
HCPCS,V2623,Plastic eye prosth custom,,,531.62,4615.64,10
HCPCS,V2624,Polishing artifical eye,,,25.16,297.99,10
HCPCS,V2625,Enlargemnt of eye prosthesis,,,672.04,2359.9,10
HCPCS,V2626,Reduction of eye prosthesis,,,278.93,976.56,10
HCPCS,V2627,Scleral cover shell,,,531.62,7001.05,10
HCPCS,V2628,Fabrication & fitting,,,72.46,1489.25,10
HCPCS,V2629,Prosthetic eye other type,,,159.5,184.68,8
HCPCS,V2630,Anter chamber intraocul lens,,,159.5,582.66,10
HCPCS,V2631,Iris support intraoclr lens,,,159.5,582.66,10
HCPCS,V2632,Post chmbr intraocular lens,,,159.5,582.66,10
HCPCS,V2700,Balance lens,,,25.16,219.5,10
HCPCS,V2702,Deluxe lens feature,,,25.16,29.13,8
HCPCS,V2710,Glass/plastic slab off prism,,,25.16,359.8,10
HCPCS,V2715,Prism lens/es,,,8.84,70.57,10
HCPCS,V2718,Fresnell prism press-on lens,,,28.98,152.37,10
HCPCS,V2730,Special base curve,,,8.84,127.54,10
HCPCS,V2744,Tint photochromatic lens/es,,,8.84,87.28,10
HCPCS,V2745,"Tint, any color/solid/grad",,,8.84,50.26,10
HCPCS,V2750,Anti-reflective coating,,,8.84,97.96,10
HCPCS,V2755,Uv lens/es,,,8.84,82.0,10
HCPCS,V2756,Eye glass case,,,13.46,15.59,8
HCPCS,V2760,Scratch resistant coating,,,8.84,80.84,10
HCPCS,V2761,Mirror coating,,,13.46,15.59,8
HCPCS,V2762,"Polarization, any lens",,,25.16,293.47,10
HCPCS,V2770,Occluder lens/es,,,8.84,95.52,10
HCPCS,V2780,Oversize lens/es,,,8.84,61.33,10
HCPCS,V2781,Progressive lens per lens,,,46.46,53.79,8
HCPCS,V2782,"Lens, 1.54-1.65 p/1.60-1.79g",,,25.16,316.9,10
HCPCS,V2783,"Lens, >= 1.66 p/>=1.80 g",,,25.16,357.4,10
HCPCS,V2784,Lens polycarb or equal,,,25.16,232.42,10
HCPCS,V2785,Corneal tissue processing,,,1462.44,1693.35,8
HCPCS,V2786,Occupational multifocal lens,,,13.46,15.59,8
HCPCS,V2787,Astigmatism-correct function,,,159.5,184.68,8
HCPCS,V2788,Presbyopia-correct function,,,159.5,184.68,8
HCPCS,V2790,Amniotic membrane,,,874.33,1012.39,8
HCPCS,V2797,Vis item/svc in other code,,,28.98,33.56,8
HCPCS,V2799,Misc vision item or service,,,28.98,33.56,8
HCPCS,V5008,Hearing screening,,,31.75,36.76,8
HCPCS,V5010,ASSESSMENT FOR HEARING AID,122.0,79.3,1.1,179.2,32
HCPCS,V5010,Assessment for hearing aid,,,31.75,36.76,8
HCPCS,V5011,Hearing aid fitting/checking,,,31.75,36.76,8
HCPCS,V5014,HEARING AID REPAIR (AGE 5 YRS+),400.0,260.0,31.75,400.0,46
HCPCS,V5014,HEARING AID REPAIR(12 MO),303.0,196.95,31.75,303.0,46
HCPCS,V5014,HEARING AID REPAIR/MODIFYING,307.0,199.55,1.1,358.4,32
HCPCS,V5020,Conformity evaluation,,,31.75,36.76,8
HCPCS,V5030,Body-worn hearing aid air,,,264.38,306.12,8
HCPCS,V5040,Body-worn hearing aid bone,,,264.38,306.12,8
HCPCS,V5050,HEAR AID A BASIC MON ITE,800.0,520.0,119.04,800.0,46
HCPCS,V5060,HEAR AID A BASIC MON BTE,700.0,455.0,104.16,700.0,46
HCPCS,V5070,Glasses air conduction,,,72.46,83.9,8
HCPCS,V5080,Glasses bone conduction,,,72.46,83.9,8
HCPCS,V5090,"DISPENSING FEE, MONAURAL",459.0,298.35,1.1,806.4,32
HCPCS,V5090,Hearing aid dispensing fee,,,31.75,36.76,8
HCPCS,V5095,Implant mid ear hearing pros,,,72.46,83.9,8
HCPCS,V5100,Body-worn bilat hearing aid,,,672.04,778.15,8
HCPCS,V5110,HEARING AID DISPENSING FEE,459.0,298.35,1.1,1209.6,32
HCPCS,V5110,Hearing aid dispensing fee,,,31.75,36.76,8
HCPCS,V5120,Body-worn binaur hearing aid,,,1022.49,1183.93,8
HCPCS,V5130,HEAR AID B BASIC BIN ITE,1600.0,1040.0,238.08,1600.0,46
HCPCS,V5140,HEAR AID B BASIC BIN BTE,1400.0,910.0,208.32,1400.0,46
HCPCS,V5150,Glasses binaural hearing aid,,,1022.49,1183.93,8
HCPCS,V5160,HEAR AID B BASIC BIN DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5160,HEAR AID C DIGLTDBIN DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5160,HEAR AID D DIGADVBIN DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5171,Hearing aid monaural ite,,,264.38,306.12,8
HCPCS,V5172,Hearing aid monaural itc,,,264.38,306.12,8
HCPCS,V5181,Hearing aid monaural bte,,,264.38,306.12,8
HCPCS,V5190,Hearing aid monaural glasses,,,72.46,83.9,8
HCPCS,V5200,Disp fee contralateral monau,,,31.75,36.76,8
HCPCS,V5211,Hearing aid binaural ite/ite,,,264.38,306.12,8
HCPCS,V5212,Hearing aid binaural ite/itc,,,264.38,306.12,8
HCPCS,V5213,Hearing aid binaural ite/bte,,,264.38,306.12,8
HCPCS,V5214,Hearing aid binaural itc/itc,,,264.38,306.12,8
HCPCS,V5215,Hearing aid binaural itc/bte,,,264.38,306.12,8
HCPCS,V5221,Hearing aid binaural bte/bte,,,264.38,306.12,8
HCPCS,V5230,Hearing aid binaural glasses,,,72.46,83.9,8
HCPCS,V5240,Disp fee contralateral binau,,,31.75,36.76,8
HCPCS,V5241,HEAR AID A BASIC MON DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5241,HEAR AID B DIGLTDMON DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5241,HEAR AID C DIGADVMON DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5241,HEAR AID D DIGMAXMON DISP,300.0,195.0,31.75,300.0,46
HCPCS,V5242,"Hearing aid, monaural, cic",,,531.62,615.56,8
HCPCS,V5243,"Hearing aid, monaural, itc",,,531.62,615.56,8
HCPCS,V5244,"Hearing aid, prog, mon, cic",,,531.62,615.56,8
HCPCS,V5245,"Hearing aid, prog, mon, itc",,,531.62,615.56,8
HCPCS,V5246,"Hearing aid, prog, mon, ite",,,1022.49,1183.93,8
HCPCS,V5247,"Hearing aid, prog, mon, bte",,,1022.49,1183.93,8
HCPCS,V5248,"Hearing aid, binaural, cic",,,531.62,615.56,8
HCPCS,V5249,"Hearing aid, binaural, itc",,,531.62,615.56,8
HCPCS,V5250,"Hearing aid, prog, bin, cic",,,531.62,615.56,8
HCPCS,V5251,"Hearing aid, prog, bin, itc",,,531.62,615.56,8
HCPCS,V5252,"Hearing aid, prog, bin, ite",,,531.62,615.56,8
HCPCS,V5253,"Hearing aid, prog, bin, bte",,,531.62,615.56,8
HCPCS,V5254,HEAR AID B DIGLTDMON CIC,1400.0,910.0,208.32,1400.0,46
HCPCS,V5254,HEAR AID C DIGADVMON CIC,2000.0,1300.0,297.6,2000.0,46
HCPCS,V5254,HEAR AID D DIGMAXMON CIC,2700.0,1755.0,401.76,2700.0,46
HCPCS,V5254,"HEARING AID DIGITAL MONAURAL CIC, BASIC",1238.0,804.7,1.1,4146.22,32
HCPCS,V5254,"HEARING AID DIGITAL MONAURAL CIC, INTERMEDIATE",2338.0,1519.7,1.1,4146.22,32
HCPCS,V5254,"HEARING AID DIGITAL MONAURAL CIC, PREMIUM",3438.0,2234.7,1.1,4146.22,32
HCPCS,V5254,"HEARING ID, DIGIT, MON, CIC",643.0,417.95,1.1,4146.22,32
HCPCS,V5255,"HEARING AID DIGITAL MONAURAL ITC, BASIC",1238.0,804.7,1.1,4146.22,32
HCPCS,V5255,"HEARING AID DIGITAL MONAURAL ITC, INTERMEDIATE",2338.0,1519.7,1.1,4146.22,32
HCPCS,V5255,"HEARING AID DIGITAL MONAURAL ITC, PREMIUM",3438.0,2234.7,1.1,4146.22,32
HCPCS,V5255,"HEARING AID, DIGIT, MON, ITC",643.0,417.95,1.1,4146.22,32
HCPCS,V5255,"Hearing aid, digit, mon, itc",,,531.62,615.56,8
HCPCS,V5256,HEAR AID B DIGLTDMON ITE,1300.0,845.0,193.44,1300.0,46
HCPCS,V5256,HEAR AID C DIGADVMON ITE,1900.0,1235.0,282.72,1900.0,46
HCPCS,V5256,HEAR AID D DIGMAXMON ITE,2600.0,1690.0,386.88,2600.0,46
HCPCS,V5256,"HEARING AID DIGITAL MONAURAL ITE, BASIC",1238.0,804.7,1.1,4146.22,32
HCPCS,V5256,"HEARING AID DIGITAL MONAURAL ITE, INTERMEDIATE",2338.0,1519.7,1.1,4146.22,32
HCPCS,V5256,"HEARING AID DIGITAL MONAURAL ITE, PREMIUM",3438.0,2234.7,1.1,4146.22,32
HCPCS,V5256,"HEARING AID, DIGIT, MON, ITE",643.0,417.95,1.1,4146.22,32
HCPCS,V5257,HEAR AID B DIGLTDMON BTE,1200.0,780.0,178.56,1200.0,46
HCPCS,V5257,HEAR AID C DIGADVMON BTE,1800.0,1170.0,267.84,1800.0,46
HCPCS,V5257,HEAR AID D DIGMAXMON BTE,2750.0,1787.5,409.2,2750.0,46
HCPCS,V5257,"HEARING AID DIGITAL MONAURAL BTE, BASIC",1238.0,804.7,1.1,3455.19,32
HCPCS,V5257,"HEARING AID DIGITAL MONAURAL BTE, INTERMEDIATE",2338.0,1519.7,1.1,3455.19,32
HCPCS,V5257,"HEARING AID DIGITAL MONAURAL BTE, PREMIUM",3438.0,2234.7,1.1,3455.19,32
HCPCS,V5257,"HEARING AID, DIGIT, MON, BTE",643.0,417.95,1.1,3455.19,32
HCPCS,V5258,HEAR AID C DIGLTDBIN CIC,2800.0,1820.0,416.64,2800.0,46
HCPCS,V5258,HEAR AID D DIGADVBIN CIC,4400.0,2860.0,531.62,4400.0,46
HCPCS,V5258,"HEARING AID DIGITAL BINAURAL CIC, BASIC",2998.0,1948.7,1.1,9674.51,32
HCPCS,V5258,"HEARING AID DIGITAL BINAURAL CIC, INTERMEDIATE",5198.0,3378.7,1.1,9674.51,32
HCPCS,V5258,"HEARING AID DIGITAL BINAURAL CIC, PREMIUM",7398.0,4808.7,1.1,9674.51,32
HCPCS,V5258,"HEARING AID, DIGIT, BIN, CIC",1867.0,1213.55,1.1,9674.51,32
HCPCS,V5259,"HEARING AID DIGITAL BINAURAL ITC, BASIC",2998.0,1948.7,1.1,9674.51,32
HCPCS,V5259,"HEARING AID DIGITAL BINAURAL ITC, INTERMEDIATE",5198.0,3378.7,1.1,9674.51,32
HCPCS,V5259,"HEARING AID DIGITAL BINAURAL ITC, PREMIUM",7398.0,4808.7,1.1,9674.51,32
HCPCS,V5259,"HEARING AID, DIGIT, BIN, ITC",1867.0,1213.55,1.1,9674.51,32
HCPCS,V5259,"Hearing aid, digit, bin, itc",,,531.62,615.56,8
HCPCS,V5260,HEAR AID C DIGLTDBIN ITE,2600.0,1690.0,386.88,2600.0,46
HCPCS,V5260,HEAR AID D DIGADVBIN ITE,3800.0,2470.0,531.62,3800.0,46
HCPCS,V5260,"HEARING AID DIGITAL BINAURAL ITE, BASIC",2998.0,1948.7,1.1,9674.51,32
HCPCS,V5260,"HEARING AID DIGITAL BINAURAL ITE, INTERMEDIATE",5198.0,3378.7,1.1,9674.51,32
HCPCS,V5260,"HEARING AID DIGITAL BINAURAL ITE, PREMIUM",7398.0,4808.7,1.1,9674.51,32
HCPCS,V5260,"HEARING AID, DIGIT, BIN, ITE",1867.0,1213.55,1.1,9674.51,32
HCPCS,V5261,HEAR AID C DIGLTDBIN BTE,2400.0,1560.0,357.12,2400.0,46
HCPCS,V5261,HEAR AID D DIGADVBIN BTE,3960.0,2574.0,531.62,3960.0,46
HCPCS,V5261,"HEARING AID DIGITAL BINAURAL BTE, BASIC",2998.0,1948.7,1.1,6910.37,32
HCPCS,V5261,"HEARING AID DIGITAL BINAURAL BTE, INTERMEDIATE",5198.0,3378.7,1.1,6910.37,32
HCPCS,V5261,"HEARING AID DIGITAL BINAURAL BTE, PREMIUM",7398.0,4808.7,1.1,7398.0,32
HCPCS,V5261,"HEARING AID, DIGIT, BIN, BTE",1867.0,1213.55,1.1,6910.37,32
HCPCS,V5262,"Hearing aid, disp, monaural",,,25.16,29.13,8
HCPCS,V5263,"Hearing aid, disp, binaural",,,46.46,53.79,8
HCPCS,V5264,EAR MOLD/INSERT,85.0,55.25,1.1,169.3,29
HCPCS,V5264,EARMOLD - BINAURAL,120.0,78.0,17.86,120.0,46
HCPCS,V5264,EARMOLD - MONAURAL,66.0,42.9,9.82,66.0,46
HCPCS,V5265,"Ear mold/insert, disp",,,28.98,33.56,8
HCPCS,V5266,Battery for hearing device,,,13.46,15.59,8
HCPCS,V5267,Hearing aid sup/access/dev,,,8.84,10.24,8
HCPCS,V5268,Ald telephone amplifier,,,28.98,33.56,8
HCPCS,V5269,"Alerting device, any type",,,46.46,53.79,8
HCPCS,V5270,"Ald, tv amplifier, any type",,,25.16,29.13,8
HCPCS,V5271,"Ald, tv caption decoder",,,25.16,29.13,8
HCPCS,V5272,Tdd,,,28.98,33.56,8
HCPCS,V5273,Ald for cochlear implant,,,72.46,83.9,8
HCPCS,V5274,HEARING AMPLIFIER,250.0,162.5,25.16,250.0,46
HCPCS,V5275,Ear impression,,,8.84,10.24,8
HCPCS,V5281,"Ald fm/dm system, monaural",,,1022.49,1183.93,8
HCPCS,V5282,Ald fm/dm system binaural,,,1022.49,1183.93,8
HCPCS,V5283,"Ald neck, loop ind receiver",,,46.46,53.79,8
HCPCS,V5284,Ald fm/dm ear level receiver,,,72.46,83.9,8
HCPCS,V5285,Ald fm/dm aud input receiver,,,46.46,53.79,8
HCPCS,V5286,Ald blu tooth fm/dm receiver,,,25.16,29.13,8
HCPCS,V5287,"Ald fm/dm receiver, nos",,,46.46,53.79,8
HCPCS,V5288,Ald fm/dm transmitter ald,,,1022.49,1183.93,8
HCPCS,V5289,Ald fm/dm adapt/boot couplin,,,28.98,33.56,8
HCPCS,V5290,Ald transmitter microphone,,,672.04,778.15,8
HCPCS,V5298,HEARING AID RENTAL (MO),66.0,42.9,9.82,66.0,47
HCPCS,V5299,Hearing service,,,25.16,29.13,8
HCPCS,V5336,Repair communication device,,,72.46,83.9,8
HCPCS,V5362,Speech screening,,,24.68,28.58,8
HCPCS,V5363,Language screening,,,24.68,28.58,8
HCPCS,V5364,Dysphagia screening,,,24.68,28.58,8
HCPCS,W0644,ERGONOMIC STUDY,281.0,182.65,41.81,281.0,38
HCPCS,W0645,JOB SITE ANALYSIS,562.0,365.3,83.63,562.0,38
HCPCS,W0710,OT WK CNDITIONNG PER 15 MIN,242.0,157.3,36.01,242.0,38
HCPCS,W0710,PT WK CNDITIONNG PER 15 MIN,242.0,157.3,36.01,242.0,38
HCPCS,l1833,YB KO ADJ KNEE JT RIGID PREFAB,4188.0,2722.2,264.38,4188.0,48
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,226904.27,467382.6,19
MS-DRG,001-A,Craniotomy Age> 17,,,36400.0,36400.0,1
MS-DRG,001-A,Heart - Adult,,,361500.0,446380.0,3
MS-DRG,001-B,Deep Brain Stimulation Unilateral,,,45300.0,45300.0,1
MS-DRG,001-C,Deep Brain Stimulation Bilateral,,,69100.0,69100.0,1
MS-DRG,001-P,Heart - Pediatric,,,535426.0,535426.0,1
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,92257.56,188991.76,19
MS-DRG,002-A,Heart - Adult,,,361500.0,446380.0,3
MS-DRG,002-P,Heart - Pediatric,,,444900.0,535426.0,3
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,10630.0,401113.0,19
MS-DRG,003-P,Heart - Pediatric,,,444900.0,444900.0,2
MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,10630.0,213976.43,19
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,84019.25,171958.52,19
MS-DRG,005-A,Liver/Intestinal - Adult,,,603170.0,603170.0,1
MS-DRG,005-DA,Liver (Deceased Donor) - Adult,,,486600.0,486600.0,2
MS-DRG,005-DP,Liver (Deceased Donor) -Pediatric,,,471700.0,471700.0,2
MS-DRG,005-I,Intestinal - Adult,,,563700.0,563700.0,2
MS-DRG,005-LA,Liver (Live Donor) - Adult,,,561500.0,561500.0,2
MS-DRG,005-LP,Liver (Live Donor) - Pediatric,,,560500.0,560500.0,2
MS-DRG,005-P,Liver/Intestinal - Pediatric,,,696055.0,696055.0,1
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,,,38254.0,77335.89,19
MS-DRG,006-DA,Liver (Deceased Donor) - Adult,,,358735.0,486600.0,3
MS-DRG,006-DP,Liver (Deceased Donor) -Pediatric,,,471700.0,471700.0,2
MS-DRG,006-LA,Liver (Live Donor) - Adult,,,374196.0,561500.0,3
MS-DRG,006-LP,Liver (Live Donor) - Pediatric,,,560500.0,560500.0,2
MS-DRG,006-P,Liver (Live & Deceased Donor) - Pediatric,,,449447.0,449447.0,1
MS-DRG,007,LUNG TRANSPLANT,,,105312.37,105312.37,10
MS-DRG,007,Lung transplant,,,130706.37,215983.44,9
MS-DRG,007-D,Lung (Double) - Adult,,,433900.0,479141.0,3
MS-DRG,007-S,Lung (Single) - Adult,,,428300.0,451839.0,3
MS-DRG,008,Kidney/Pancreas - Adult,,,274261.0,292000.0,3
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,46059.14,46059.14,10
MS-DRG,008,Simultaneous pancreas/kidney transplant,,,56567.23,93473.52,9
MS-DRG,010,PANCREAS TRANSPLANT,,,58732.41,58732.41,10
MS-DRG,010,Pancreas - Adult,,,228000.0,235615.0,3
MS-DRG,010,Pancreas transplant,,,72424.34,119676.32,9
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,44845.13,44845.13,10
MS-DRG,011,"Tracheostomy for face,mouth & neck diagnoses w MCC",,,55048.23,90963.48,9
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,34858.01,34858.01,10
MS-DRG,012,"Tracheostomy for face,mouth & neck diagnoses w CC",,,42552.09,70314.45,9
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,24095.69,24095.69,10
MS-DRG,013,"Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC",,,29086.01,48062.66,9
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,,,97791.98,200434.54,19
MS-DRG,014-R,Allogeneic Related BMT ? Adult & Pediatric,,,428000.0,428000.0,2
MS-DRG,014-RA,Allogeneic Related BMT - Adult,,,366514.0,366514.0,1
MS-DRG,014-RP,Allogeneic Related BMT - Pediatric,,,440327.0,440327.0,1
MS-DRG,014-U,Allogeneic Unrelated BMT ? Adult & Pediatric,,,481200.0,481200.0,2
MS-DRG,014-UA,Allogeneic Unrelated BMT - Adult,,,430092.0,430092.0,1
MS-DRG,014-UP,Allogeneic Unrelated BMT - Pediatric,,,540638.0,540638.0,1
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,48681.56,98895.54,19
MS-DRG,016,Autologous BMT - Adult & Pediatric,,,240500.0,240500.0,2
MS-DRG,016-A,Autologous BMT - Adult,,,205695.0,205695.0,1
MS-DRG,016-P,Autologous BMT - Pediatric,,,247521.0,247521.0,1
MS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,44669.28,90599.9,19
MS-DRG,017,Autologous BMT - Adult & Pediatric,,,240500.0,240500.0,2
MS-DRG,017-A,Autologous BMT - Adult,,,205695.0,205695.0,1
MS-DRG,017-P,Autologous BMT - Pediatric,,,247521.0,247521.0,1
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,349183.43,349183.43,10
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY,,,435844.0,720202.74,9
MS-DRG,019,Kidney/Pancreas - Adult,,,274261.0,292000.0,3
MS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,58400.88,118990.86,19
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,12109.0,289300.0,20
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,12109.0,160500.0,20
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,12109.0,39320.33,19
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,47073.1,47073.1,10
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,12109.0,139200.0,10
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,12109.0,94700.0,20
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,12109.0,135700.0,20
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,12109.0,87500.0,20
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,12374.0,77400.0,20
MS-DRG,028,SPINAL PROCEDURES WITH MCC,,,12109.0,108100.0,20
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,12109.0,70100.0,20
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,,,12109.0,59300.0,20
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,12109.0,79700.0,20
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,,,12109.0,46900.0,20
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,12109.0,50400.0,20
MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,12109.0,75400.0,20
MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,,,12109.0,59600.0,20
MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,12109.0,48200.0,20
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,,,12109.0,92700.0,20
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,,,12109.0,54900.0,20
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,10331.84,43400.0,20
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,12109.0,71900.0,20
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,12109.0,50100.0,20
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,12109.0,52200.0,20
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,15460.51,30234.0,19
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,8748.38,16405.0,19
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,13166.4,32000.0,20
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,9074.27,25700.0,20
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,19588.94,41200.0,20
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,11300.62,21608.02,20
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,14639.34,28511.04,19
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,10859.39,34500.0,20
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,8269.24,21000.0,20
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,23089.8,45982.91,19
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,15024.12,35992.0,19
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,12173.42,30075.0,19
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,17071.39,56900.0,20
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,8999.25,35300.0,20
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,6370.38,24000.0,20
MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,12696.93,24494.98,19
MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,7822.35,25600.0,20
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,7293.19,15300.0,20
MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,14278.77,64800.0,20
MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,9125.9,24100.0,20
MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,6949.56,25700.0,20
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,13790.75,52600.0,20
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,9164.62,17191.68,20
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,,,16317.18,33100.0,20
MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,,,7506.14,13762.69,20
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,15450.03,30187.18,19
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,8074.03,18000.0,20
MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,19286.45,38119.24,19
MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,12108.89,24451.0,19
MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,8559.63,17671.0,19
MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,19175.94,37890.75,19
MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,11357.9,23500.0,20
MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,8228.1,15397.0,20
MS-DRG,088,CONCUSSION WITH MCC,,,11753.96,22545.32,19
MS-DRG,089,CONCUSSION WITH CC,,,9711.52,18322.45,19
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,,,7490.01,13729.33,19
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,15016.05,43200.0,20
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,9101.7,20800.0,20
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,7273.02,14800.0,20
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,29238.89,82500.0,20
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,21654.77,57400.0,20
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,21654.77,63500.0,20
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,29984.23,60237.6,19
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,19361.47,50100.0,20
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,11839.47,22722.11,19
MS-DRG,1,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,233711.4,249594.7,6
MS-DRG,10,NeNous System Neoplasms with cc,,,10700.0,10700.0,1
MS-DRG,10,PANCREAS TRANSPLANT,,,60494.38,240800.0,7
MS-DRG,100,SEIZURES WITH MCC,,,16472.86,39800.0,26
MS-DRG,101,SEIZURES WITHOUT MCC,,,8130.49,33500.0,26
MS-DRG,102,HEADACHES WITH MCC,,,9891.41,22600.0,26
MS-DRG,103,HEADACHES WITHOUT MCC,,,7595.68,14200.0,26
MS-DRG,11,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,46190.48,49329.64,6
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,19814.81,39211.65,25
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,11763.64,22565.33,25
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,13230.94,14554.03,16
MS-DRG,115,Extraocular procedures except orbit,,,15491.75,25599.06,9
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,15434.7,30155.49,25
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,9601.01,18093.96,25
MS-DRG,12,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,35903.75,38343.81,6
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,10233.43,19401.52,25
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,7188.33,13105.57,25
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,7291.58,8020.74,16
MS-DRG,123,Neurological eye disorders,,,8060.27,13319.05,9
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,,11522.45,22066.66,25
MS-DRG,124-A,Circulatory Disorders W/Cath. and Complex DX,,,10300.0,10300.0,1
MS-DRG,124-B,Circulatory Disorders W/Cath and Complex DX,,,19300.0,19300.0,1
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,7043.13,12805.37,25
MS-DRG,125-A,Circulatory Disorders W/Cath. W/O Complex DX,,,7800.0,7800.0,1
MS-DRG,125-B,Circulatory Disorders W/Cath. W/O Complex DX,,,12900.0,12900.0,1
MS-DRG,13,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,24818.56,26505.26,6
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,18353.96,36191.26,25
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,9039.59,16933.17,25
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,12894.56,24903.59,25
MS-DRG,138,Cardiac Arrhythmia and Conduction Disorders wt Cath,,,9200.0,9200.0,1
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,7998.2,14780.04,25
MS-DRG,139,Cardiac Arrhythmia and Conduction Disorders W/0  Gath,,,5700.0,5700.0,1
MS-DRG,139,SALIVARY GLAND PROCEDURES,,,10817.44,11899.18,16
MS-DRG,139,Salivary gland procedures,,,12471.92,20609.0,9
MS-DRG,14,ALLOGENEIC BONE MARROW TRANSPLANT,,,100725.74,254000.0,7
MS-DRG,14,Specific Cerebrovascular Disorders,,,12900.0,12900.0,1
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,35255.69,71136.67,25
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,18443.5,36376.39,25
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,13727.02,26624.76,25
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,,31071.6,62485.79,25
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,,14828.1,28901.31,25
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,,10548.02,20051.96,25
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,17929.67,35314.0,25
MS-DRG,146,Rectal Resection W/CC,,,30500.0,30500.0,1
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,11106.22,21206.08,25
MS-DRG,147,Rectal Resection WIO CC,,,22600.0,22600.0,1
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,7279.48,13294.03,25
MS-DRG,148,Major Small/Large Bowel W/CC,,,34800.0,34800.0,1
MS-DRG,149,DYSEQUILIBRIUM,,,6912.45,7603.7,16
MS-DRG,149,Dysequilibrium,,,7585.9,12535.18,9
MS-DRG,149,Pelvic Pouch,,,31200.0,31200.0,1
MS-DRG,150,EPISTAXIS WITH MCC,,,11590.21,22206.76,25
MS-DRG,151,EPISTAXIS WITHOUT MCC,,,6770.48,12241.65,25
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,,,10385.88,19716.73,25
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,,,6804.36,12311.7,25
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,,13461.64,26076.05,25
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,,8242.62,15285.39,25
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,,6424.43,11526.17,25
MS-DRG,157,Anal and Stomal Procedures  W/CC,,,12400.0,12400.0,1
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,,,14698.23,28632.79,25
MS-DRG,158,Anal and Stomal Procedures W/0 cc,,,7000.0,7000.0,1
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,,,8188.57,15173.64,25
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,6564.79,11816.36,25
MS-DRG,16,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,50142.01,53549.72,6
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,37002.08,119500.0,26
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,21209.5,78100.0,26
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,16290.56,57400.0,26
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,10399.0,78400.0,26
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,15396.79,50100.0,26
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,11871.73,34500.0,26
MS-DRG,17,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,46009.36,49136.21,6
MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,,24858.78,27344.66,16
MS-DRG,173,Ultrasound Accelerated and other Thrombolysis with Principal Diagnosis Pulmonary Embolism,,,30040.81,49640.4,9
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,11929.81,37600.0,26
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,7343.2,25000.0,26
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,10399.0,46700.0,26
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,8722.57,28900.0,26
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,6939.88,18500.0,26
MS-DRG,18,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,359658.93,384101.77,6
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,15095.1,37100.0,26
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,9488.89,25400.0,26
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,6930.2,31800.0,26
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,13190.6,25515.67,25
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,9433.23,17747.06,25
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,7193.97,13117.25,25
MS-DRG,186,PLEURAL EFFUSION WITH MCC,,,13421.3,36600.0,26
MS-DRG,187,PLEURAL EFFUSION WITH CC,,,8828.24,20900.0,26
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,6634.96,11961.46,25
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,9785.0,41000.0,26
MS-DRG,19,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,60152.91,64240.97,6
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,9784.93,29600.0,26
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,7649.73,24500.0,26
MS-DRG,191,Major Pancreas Shunt and Liver,,,46700.0,46700.0,1
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,6028.36,17300.0,26
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,10399.0,31800.0,26
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,7350.46,21000.0,26
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,5919.47,12234.0,26
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,16072.76,50400.0,26
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,8505.58,21600.0,26
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,6626.9,17400.0,26
MS-DRG,199,PNEUMOTHORAX WITH MCC,,,15079.78,29421.66,25
MS-DRG,2,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,95025.29,101483.32,6
MS-DRG,20,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,66252.99,70755.62,6
MS-DRG,200,PNEUMOTHORAX WITH CC,,,9717.17,18334.13,26
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,6618.02,11926.44,26
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,8683.85,17200.0,26
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,6254.23,12234.0,26
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,7362.56,16800.0,26
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,15619.42,30537.42,26
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,8441.05,18700.0,26
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,52755.14,148400.0,26
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,23022.04,59600.0,26
MS-DRG,209,COMPLEX AORTIC ARCH PROCEDURES,,,92152.7,200761.56,19
MS-DRG,21,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,44858.64,47907.29,6
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,,88565.53,97422.08,16
MS-DRG,212,Concomitant Aortic and Mitral Valve Procedures,,,12109.0,181358.24,9
MS-DRG,213,ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES,,,46884.34,101223.29,19
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,81167.75,89284.53,16
MS-DRG,215,Other heart assist system implant,,,100496.0,166062.85,9
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,12109.0,283600.0,26
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,12109.0,223200.0,26
MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,12109.0,81369.34,25
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,12109.0,193600.0,26
MS-DRG,22,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,27274.55,29128.17,6
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,12109.0,146600.0,26
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,12109.0,127500.0,26
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,17737.0,185200.0,26
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,17737.0,143800.0,26
MS-DRG,23,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,48485.29,51780.41,6
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,17737.0,104320.01,25
MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,17737.0,75024.68,25
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,,62519.63,68771.59,16
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC,,,12374.0,217200.0,10
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,,44914.51,49405.96,16
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC,,,12374.0,158100.0,10
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,12374.0,168400.0,26
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,12109.0,130900.0,26
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,40550.53,159900.0,26
MS-DRG,24,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,33377.14,35645.49,6
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,23843.21,77600.0,26
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,12016.93,53900.0,26
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,12109.0,119200.0,26
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,12109.0,71700.0,26
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,12109.0,48730.0,26
MS-DRG,245,AICD GENERATOR PROCEDURES,,,37652.24,41417.46,16
MS-DRG,245,AICD generator procedures,,,12109.0,114194.0,10
MS-DRG,25,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,38651.37,41278.16,6
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,12374.0,114400.0,26
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,12374.0,58200.0,26
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,17737.0,96400.0,26
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,17737.0,63240.0,26
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,15221.75,49600.0,26
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,22608.23,44987.24,25
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,14545.77,28500.0,26
MS-DRG,257,Mastectomy With TramFlap Breast Reconstruction,,,35400.0,35400.0,1
MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,9659.9,18215.71,25
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,26195.4,52403.94,25
MS-DRG,258,Mastectomy with Microsurgery Breast Reconstruclion,,,35400.0,35400.0,1
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,17160.93,47608.0,26
MS-DRG,259,Mastectomy With TramFlap Breast Reconstruction,,,35400.0,35400.0,1
MS-DRG,26,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,26707.91,28523.01,6
MS-DRG,260,Axillary Lymph Node Removal With or Without Partial Mastectomy,,,35400.0,35400.0,1
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,27088.36,100800.0,26
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,16099.38,46841.0,26
MS-DRG,261,Simple Complete Mastectomy,,,35400.0,35400.0,1
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,13997.25,41900.0,26
MS-DRG,263,VEIN LIGATION AND STRIPPING,,,25512.17,50991.32,25
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,27796.6,30576.26,16
MS-DRG,264,Other circulatory system O.R. procedures,,,33716.68,55714.53,10
MS-DRG,265,AICD LEAD PROCEDURES,,,30035.86,33039.45,16
MS-DRG,265,AICD lead procedures,,,12109.0,76800.0,9
MS-DRG,265,Modified Radical Mastectomy,,,35400.0,35400.0,1
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,50284.37,55312.81,16
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC,,,12109.0,173600.0,10
MS-DRG,266,Mastectomy With TramFlap Breast Reconstruction,,,35400.0,35400.0,1
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,39252.63,43177.89,16
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC,,,12109.0,159600.0,10
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,12109.0,150790.0,25
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,12109.0,96323.0,25
MS-DRG,27,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,21836.65,23320.69,6
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,12109.0,113821.0,25
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,12109.0,74794.0,25
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,12109.0,55296.0,25
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,,34127.99,37540.79,16
MS-DRG,273,PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC,,,12109.0,86209.0,9
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,,27402.15,30142.37,16
MS-DRG,274,PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC,,,12109.0,60519.0,9
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,12109.0,88238.7,25
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,12374.0,74331.68,25
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,38104.77,41915.25,16
MS-DRG,277,Cardiac Defibrillator Implant without MCC,,,12109.0,109092.0,9
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,45749.39,50324.33,16
MS-DRG,278,Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC,,,12109.0,68881.73,9
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,29940.68,32934.75,16
MS-DRG,279,Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC,,,12109.0,58263.0,9
MS-DRG,28,SPINAL PROCEDURES WITH MCC,,,50795.05,54247.14,6
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,12355.0,59200.0,26
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,8263.59,40000.0,26
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,6682.56,30200.0,26
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,16827.78,60200.0,26
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,6433.3,18044.0,25
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,5680.7,12414.0,25
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,,10630.0,73600.0,26
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,,9481.63,33100.0,26
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,853.0,78100.0,27
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,853.0,28467.68,26
MS-DRG,29,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,29220.4,31206.25,6
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,853.0,15505.54,26
MS-DRG,290,Thyroid Procedures,,,13400.0,13400.0,1
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,10399.0,38900.0,26
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,7698.13,26700.0,26
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,5415.31,18500.0,26
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,13448.73,26049.37,25
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,5963.83,10573.85,25
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,4520.74,7590.16,25
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,10399.0,36100.0,26
MS-DRG,3,Craniotomy Age 0-17,,,41100.0,41100.0,1
MS-DRG,3,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,177224.48,189268.86,6
MS-DRG,30,SPINAL PROCEDURES WITHOUT CC/MCC,,,19113.96,20412.96,6
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,9460.66,19500.0,26
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,6655.13,18100.0,26
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,10502.04,19956.89,25
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,6280.04,16900.0,26
MS-DRG,303,Kidney Ureter Major Bladder Procedures For Neoplasm,,,39400.0,39400.0,1
MS-DRG,304,HYPERTENSION WITH MCC,,,10448.8,19846.82,25
MS-DRG,304,Kidney Ureter Major Bladder Procedures for Non-Neoplasm With cc,,,27100.0,27100.0,1
MS-DRG,305,HYPERTENSION WITHOUT MCC,,,6940.68,12600.0,26
MS-DRG,305,Kidney Ureter Major Bladder Procedures For Non-Neoplasm W/0 cc,,,16700.0,16700.0,1
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,13560.85,47500.0,26
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,8216.0,19477.0,26
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,10561.73,27600.0,26
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,6784.19,19112.0,26
MS-DRG,31,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,38101.35,40690.76,6
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,5416.12,14800.0,26
MS-DRG,311,ANGINA PECTORIS,,,6511.55,7162.71,16
MS-DRG,311,Angina pectoris,,,7084.28,14200.0,10
MS-DRG,312,SYNCOPE AND COLLAPSE,,,7880.43,17000.0,26
MS-DRG,313,CHEST PAIN,,,6657.55,7323.31,16
MS-DRG,313,Chest pain,,,7266.96,14800.0,10
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,10630.0,43600.0,26
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,8620.13,27400.0,26
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6351.83,18000.0,26
MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,17737.0,111517.45,24
MS-DRG,318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE,,,12374.0,42962.56,20
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,17737.0,74432.25,25
MS-DRG,32,VENTRICULAR SHUNT PROCEDURES WITH CC,,,18580.55,19843.31,6
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,17737.0,40115.59,25
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,22796.99,25076.69,16
MS-DRG,321,Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices,,,12109.0,40039.0,9
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,15070.9,16577.99,16
MS-DRG,322,Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC,,,12109.0,52229.0,9
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,35756.62,39332.28,16
MS-DRG,323,Coronary Intravascular Lithotripsy with Intraluminal Device with MCC,,,12109.0,72172.38,9
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,26267.19,28893.91,16
MS-DRG,324,Coronary Intravascular Lithotripsy with Intraluminal Device without MCC,,,12109.0,52552.38,9
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,26746.34,29420.97,16
MS-DRG,325,Coronary Intravascular Lithotripsy without Intraluminal Device,,,12109.0,53543.05,9
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,,41080.5,144100.0,26
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,,20565.8,74300.0,26
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,,13774.62,46000.0,26
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,10630.0,117800.0,26
MS-DRG,33,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,14691.35,15689.8,6
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,10630.0,59600.0,26
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,10399.0,46400.0,26
MS-DRG,332,RECTAL RESECTION WITH MCC,,,30056.03,60386.03,25
MS-DRG,333,RECTAL RESECTION WITH CC,,,19743.01,61900.0,26
MS-DRG,334,Prostatectomy,,,22200.0,22200.0,1
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,14061.78,51500.0,26
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,29654.31,89400.0,26
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,17859.49,35300.0,26
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,13231.74,35300.0,26
MS-DRG,34,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,33034.83,35279.92,6
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,21683.81,48600.0,26
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,12987.33,28400.0,26
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,10418.15,23000.0,26
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,19367.12,38286.02,25
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,11407.1,25400.0,26
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,7872.36,19500.0,26
MS-DRG,35,CAROTID ARTERY STENT PROCEDURES WITH CC,,,20736.61,22145.89,6
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,20950.57,41559.91,25
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,13147.04,40300.0,26
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,10269.73,24600.0,26
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,24258.64,48399.56,25
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,14420.74,40400.0,26
MS-DRG,354,Uterine and Adnexa Procedures for Nonovarian/Adnexal Malignancy W/ cc,,,17600.0,17600.0,1
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,11699.11,30400.0,26
MS-DRG,355,Uterine and Adnexa Procedures for Nonovarian/Adnexal Malignancy W/0 cc,,,13600.0,13600.0,1
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,36284.17,97400.0,26
MS-DRG,356,Uterine and Adnexa Procedures for Nonmalignancy W/ CC,,,16400.0,16400.0,1
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,19608.3,48700.0,26
MS-DRG,357,Uterine and Adnexa Procedures for Ovarian or Adnexal Malicmancv,,,22800.0,22800.0,1
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,12125.83,37100.0,26
MS-DRG,359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC,,,28587.12,60990.45,19
MS-DRG,36,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,17016.9,18173.39,6
MS-DRG,36,Complex Retinal Procedures,,,13700.0,13700.0,1
MS-DRG,360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,20324.61,42822.44,19
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,13690.73,27298.0,25
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,8917.78,16681.34,25
MS-DRG,37,EXTRACRANIAL PROCEDURES WITH MCC,,,28227.54,30145.92,6
MS-DRG,37,Simple Orbital Procedures excludes,,,9800.0,9800.0,1
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,6502.67,11687.94,25
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,15152.37,46500.0,26
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,9085.56,20900.0,26
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,6717.24,17500.0,26
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,18101.48,42100.0,26
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,10606.9,33500.0,26
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,8305.53,15415.48,26
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,10399.0,40800.0,26
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,8760.48,21200.0,26
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,5934.79,16900.0,26
MS-DRG,38,EXTRACRANIAL PROCEDURES WITH CC,,,14356.52,15332.21,6
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,16677.75,32725.57,25
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,9589.72,18070.61,25
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,7307.71,14800.0,26
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,11987.08,23027.31,25
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,7744.91,14256.35,25
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,13613.29,34400.0,26
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,8724.99,19400.0,26
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,6345.38,15300.0,26
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,10399.0,33100.0,26
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,7220.59,18700.0,26
MS-DRG,39,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,10641.8,11365.02,6
MS-DRG,39,Intermediate Retinal Procedures,,,11900.0,11900.0,1
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,5237.85,10800.0,26
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,,11080.41,21200.0,26
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,,7138.31,14200.0,26
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,13750.42,34500.0,26
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,8397.49,17300.0,26
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6084.83,14800.0,26
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,,,20168.12,22184.93,16
MS-DRG,397,Appendix Procedures with MCC,,,24171.73,39942.14,9
MS-DRG,398,APPENDIX PROCEDURES WITH CC,,,13059.12,14365.03,16
MS-DRG,398,Appendix Procedures without MCC/CC,,,15276.76,25243.82,9
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,,,10083.39,19091.31,25
MS-DRG,4,Spinal Procedures,,,28700.0,28700.0,1
MS-DRG,4,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,115959.36,123840.09,6
MS-DRG,40,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,32955.9,35195.62,6
MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,17737.0,172700.0,25
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,44977.42,128400.0,26
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,24244.12,73800.0,26
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,18754.06,47500.0,26
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,29611.56,59467.08,25
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,18412.85,70100.0,26
MS-DRG,41,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,19143.03,20444.02,6
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,13656.85,26479.66,25
MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,27495.72,55092.44,25
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,17809.48,35065.5,25
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,14244.09,27693.82,25
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,29587.36,59417.04,25
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,17520.7,34468.42,25
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,11846.72,22737.12,25
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,20099.55,61900.0,26
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,10399.0,44600.0,26
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,11866.89,33300.0,26
MS-DRG,42,Intermediate Retinal Procedures,,,11900.0,11900.0,1
MS-DRG,42,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,15229.73,16264.77,6
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,28333.02,56823.61,25
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,14865.21,28978.03,25
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,12138.73,23340.86,25
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,34349.82,111300.0,26
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,18498.35,36489.8,25
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,12951.83,25022.0,25
MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,17737.0,136387.35,24
MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,17737.0,269394.0,25
MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,17737.0,203786.0,25
MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,17737.0,111493.8,24
MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,17737.0,228300.0,25
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,16726.15,40800.0,26
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,9369.5,17615.3,26
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,6597.05,11883.08,26
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,15665.4,30632.48,26
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,9973.69,23400.0,26
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,7732.81,14231.34,26
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,10399.0,28900.0,26
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,7635.21,21800.0,26
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,5862.19,13700.0,26
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,15326.61,46000.0,26
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,8636.26,24500.0,26
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,6493.8,12000.0,26
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,14327.98,40700.0,26
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,9677.64,22500.0,26
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,7523.08,15600.0,26
MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,13118.0,133464.96,24
MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,13118.0,132220.0,25
MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,13118.0,106458.76,24
MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,13118.0,108180.0,25
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,,12109.0,212600.0,26
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,,12374.0,158200.0,26
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,,12109.0,145800.0,26
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,45400.92,49941.01,16
MS-DRG,461,Bilateral or multiple major joint procs of lower extremity w MCC,,,12109.0,116800.0,10
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,22306.55,24537.21,16
MS-DRG,462,Bilateral or multiple major joint procs of lower extremity w/o MCC,,,13118.0,85200.0,10
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,46824.65,188200.0,26
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,25974.38,105500.0,26
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,15560.54,67300.0,26
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,12109.0,120500.0,26
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,12109.0,90700.0,26
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,12109.0,75200.0,26
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,25316.96,27848.66,16
MS-DRG,469,Major joint replacement or reattachment of lower extremity w MCC,,,12109.0,95100.0,10
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,16409.13,18050.04,16
MS-DRG,470,Major joint replacement or reattachment of lower extremity w/o MCC,,,12374.0,60600.0,10
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,12109.0,125500.0,26
MS-DRG,471A,Bilateral Total Hip Replacement  Proc. of Lower Extremitv,,,43800.0,43800.0,1
MS-DRG,471B,Bilateral Total Knee Replacement Proc. of Low Extr,,,36700.0,36700.0,1
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,12109.0,102300.0,26
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,12109.0,83000.0,26
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,35478.32,71596.99,25
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,19206.59,57400.0,26
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,10369.75,19683.38,25
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,28716.18,57615.82,25
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,20686.79,60800.0,26
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,15844.48,42700.0,26
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,24341.72,85900.0,26
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,12109.0,67000.0,26
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,12109.0,47500.0,26
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,,23209.19,25530.11,16
MS-DRG,483,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,27976.79,62100.0,10
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,12109.0,140400.0,26
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,12109.0,77200.0,26
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,12109.0,27812.0,25
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,12109.0,45100.0,26
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,9858.33,40900.0,26
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,,12109.0,45436.05,25
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,,12109.0,50500.0,26
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,,12109.0,37500.0,26
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,30096.36,98000.0,26
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,15400.82,64200.0,26
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,10596.42,44600.0,26
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,25184.67,50314.19,25
MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,16754.0,33602.83,25
MS-DRG,5,Carotid Endarterectomy,,,27200.0,27200.0,1
MS-DRG,5,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,86539.83,92421.18,6
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,26378.51,60800.0,26
MS-DRG,501,Knee Procedures W/CC/Excludina,,,30000.0,30000.0,1
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,14950.71,51600.0,26
MS-DRG,502,Anterior Cruciate Ligament Repair/Augmentation or Reconstruction,,,30000.0,30000.0,1
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,11706.37,38100.0,26
MS-DRG,503,Anterior Cruciate Ligament Repair/Augmentation or Reconstruction,,,30000.0,30000.0,1
MS-DRG,503,FOOT PROCEDURES WITH MCC,,,23364.06,46549.97,25
MS-DRG,504,FOOT PROCEDURES WITH CC,,,15927.56,31174.52,25
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,15311.28,34400.0,26
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,11732.99,12906.29,16
MS-DRG,506,Major thumb or joint procedures,,,13617.48,23816.0,9
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,15420.99,35227.0,25
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,13065.57,30401.0,25
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,25214.52,27735.97,16
MS-DRG,510,"Shoulder,elbow or forearm proc,exc major joint proc w MCC",,,30485.91,50375.9,9
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,17623.14,19385.45,16
MS-DRG,511,"Shoulder,elbow or forearm proc,exc major joint proc w CC",,,20987.38,34680.23,9
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,14202.95,15623.25,16
MS-DRG,512,"Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC",,,16707.95,34500.0,10
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,13548.75,27079.0,25
MS-DRG,514,Cardiac Defibrillator Implant w/ Gath,,,81100.0,81100.0,1
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,9096.05,17537.0,25
MS-DRG,515,Cardiac Defibrillator Implant w/o Cath,,,64500.0,64500.0,1
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,26556.78,97000.0,26
MS-DRG,516,Cardiovascular Procedure w/ AMI,,,22900.0,22900.0,1
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,17612.65,54500.0,26
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,13245.45,49400.0,26
MS-DRG,517C,Cardiovascular Procedure w/ Stent w/oAMI,,,16600.0,16600.0,1
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,30996.58,62330.69,25
MS-DRG,518,Cardiovascular Procedure w/o Stent w/o AMI,,,15600.0,15600.0,1
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,16984.27,33359.34,25
MS-DRG,519,Cervical Spinal Fusion w/CC,,,37400.0,37400.0,1
MS-DRG,52,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,15924.33,17006.56,6
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,12900.21,24915.26,25
MS-DRG,520,Cervical Spinal Fusion without CC,,,28600.0,28600.0,1
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,12109.0,47869.2,25
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,12109.0,35319.0,25
MS-DRG,53,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,9010.83,9623.22,6
MS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,13495.52,26146.1,25
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,7352.07,15300.0,26
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,11190.92,21381.2,25
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,7364.17,13469.15,25
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,8547.53,15915.82,25
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,6659.97,12013.16,25
MS-DRG,539,OSTEOMYELITIS WITH MCC,,,16738.25,63600.0,26
MS-DRG,54,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,13561.39,14483.04,6
MS-DRG,540,OSTEOMYELITIS WITH CC,,,11306.27,21619.69,26
MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,7201.23,13132.26,25
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,15099.13,43500.0,26
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,9142.03,35600.0,26
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,6936.65,23800.0,26
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,20868.29,52500.0,26
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,10153.57,31800.0,26
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,7594.88,19700.0,26
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,16425.27,32203.55,25
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,10587.55,20133.68,25
MS-DRG,55,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,9346.5,9981.7,6
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,7900.6,14578.24,25
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,14369.92,29900.0,26
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,8603.99,16800.0,26
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,11306.27,21800.0,26
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,7545.67,13844.41,26
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,11511.97,22044.98,25
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,7549.7,14800.0,26
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,12843.74,30400.0,26
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,8054.67,14896.79,26
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,15892.88,31102.8,25
MS-DRG,56,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,20176.61,21547.83,6
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,9933.35,18781.1,25
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,7334.33,16800.0,26
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,,12342.81,13577.09,16
MS-DRG,562,"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC",,,14380.51,23762.81,9
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,,8073.22,8880.54,16
MS-DRG,563,"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC",,,9038.28,14935.15,10
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,13301.11,25744.16,25
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,8709.67,21000.0,26
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,6893.9,12496.83,26
MS-DRG,57,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,11639.64,12430.68,6
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,24574.04,49051.67,25
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,14478.01,28177.48,25
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,10096.3,19117.99,25
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,53696.5,109264.25,25
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,28851.7,57896.01,25
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,15345.16,29970.37,25
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,40385.17,81742.21,25
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,22231.53,44208.37,25
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,13807.69,26791.54,25
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,26973.01,54011.7,25
MS-DRG,58,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,15078.52,16103.27,6
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,14788.57,28819.58,25
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,12490.43,24068.02,25
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,16390.58,32131.83,25
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,14759.54,28759.54,25
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,18117.62,35702.59,25
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,16410.75,32173.53,25
MS-DRG,59,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,11185.17,11945.33,6
MS-DRG,592,SKIN ULCERS WITH MCC,,,16460.76,32276.93,25
MS-DRG,593,SKIN ULCERS WITH CC,,,10418.96,19785.11,25
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,7841.71,14456.49,25
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,17956.29,35369.03,25
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,9581.65,18053.94,25
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,14297.33,27803.89,25
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,9975.3,18867.82,25
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,7056.03,12832.05,25
MS-DRG,6,LIVER TRANSPLANT WITHOUT MCC,,,39401.62,42079.4,6
MS-DRG,60,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,8517.32,9096.16,6
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,9251.73,17371.8,25
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,5729.9,10090.19,25
MS-DRG,602,CELLULITIS WITH MCC,,,10399.0,23704.44,25
MS-DRG,603,CELLULITIS WITHOUT MCC,,,7874.78,14524.87,25
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,,12724.36,24551.68,25
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,,8238.58,15277.05,25
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,13055.89,25237.15,25
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,8161.14,15116.94,25
MS-DRG,61,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,23782.49,25398.78,6
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,18529.81,36554.84,25
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,12137.12,23337.53,25
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,28980.76,58162.86,25
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,15936.44,31192.86,25
MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,12290.38,23654.41,25
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,24140.87,97600.0,26
MS-DRG,62,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,15474.84,16526.53,6
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,13758.48,68400.0,26
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,8023.0,56100.0,26
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,29559.94,59360.34,25
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,15320.16,29918.66,25
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,10948.12,20879.19,25
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,25211.29,50369.23,25
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,12944.57,25006.99,25
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,11564.4,22153.39,25
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,30911.88,62155.57,25
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,18424.95,36338.03,25
MS-DRG,63,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,12538.62,13390.76,6
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,12622.72,24341.54,25
MS-DRG,637,DIABETES WITH MCC,,,12438.81,23961.28,25
MS-DRG,638,DIABETES WITH CC,,,8078.87,14946.82,25
MS-DRG,639,DIABETES WITHOUT CC/MCC,,,5860.58,10360.37,25
MS-DRG,64,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,17583.53,18778.53,6
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,,11623.28,12785.61,16
MS-DRG,640,Nutritional & misc metabolic disorders w MCC,,,13480.21,22275.14,9
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,,7127.02,7839.72,16
MS-DRG,641,Nutritional & misc metabolic disorders w/o MCC,,,7854.37,12978.82,9
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,12321.03,13553.13,16
MS-DRG,642,Inborn errors of metabolism,,,14353.26,23717.78,9
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,14127.93,27453.66,25
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,9117.83,17094.95,25
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,7047.16,12813.71,25
MS-DRG,65,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,9269.23,9899.18,6
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,38773.48,78409.95,25
MS-DRG,650-A,Kidney (Deceased & Live Donor) - Adult,,,158573.0,158573.0,1
MS-DRG,650-C,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC - Cadaveric,,,185100.0,185100.0,1
MS-DRG,650-D,Kidney (Deceased) - Adult & Pediatric,,,175300.0,175300.0,2
MS-DRG,650-L,Kidney ( Live Donor) - Adult & Pediatric,,,161100.0,161100.0,2
MS-DRG,650-LD,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC - Live Donor,,,170100.0,170100.0,1
MS-DRG,650-P,Kidney (Deceased & Live Donor) - Pediatric,,,175870.0,175870.0,1
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,30742.48,61805.33,25
MS-DRG,651-A,Kidney (Deceased & Live Donor) - Adult,,,158573.0,158573.0,1
MS-DRG,651-C,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC - Cadaveric,,,185100.0,185100.0,1
MS-DRG,651-D,Kidney (Deceased) - Adult & Pediatric,,,175300.0,175300.0,2
MS-DRG,651-L,Kidney ( Live Donor) - Adult & Pediatric,,,161100.0,161100.0,2
MS-DRG,651-LD,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC - Live Donor,,,170100.0,170100.0,1
MS-DRG,651-P,Kidney (Deceased & Live Donor) - Pediatric,,,175870.0,175870.0,1
MS-DRG,652,KIDNEY TRANSPLANT,,,26900.41,29590.45,16
MS-DRG,652,Kidney transplant,,,32595.34,53861.6,9
MS-DRG,652-A,Kidney (Deceased & Live Donor) - Adult,,,158573.0,158573.0,1
MS-DRG,652-C,KIDNEY TRANSPLANT - Cadaveric,,,185100.0,185100.0,1
MS-DRG,652-D,Kidney (Deceased) - Adult & Pediatric,,,175300.0,175300.0,2
MS-DRG,652-L,Kidney (Live Donor) - Adult & Pediatric,,,161100.0,161100.0,2
MS-DRG,652-LD,KIDNEY TRANSPLANT - Live Donor,,,170100.0,170100.0,1
MS-DRG,652-P,Kidney (Deceased & Live Donor) - Pediatric,,,175870.0,175870.0,1
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,42766.4,144700.0,26
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,23430.21,115500.0,26
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,17923.21,92000.0,26
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,26531.78,103500.0,26
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,10630.0,68300.0,26
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,13367.26,59500.0,26
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,21345.83,72100.0,26
MS-DRG,66,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,6561.49,7007.42,6
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,10399.0,51200.0,26
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,9201.72,50400.0,26
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,25545.24,51059.7,25
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,13112.36,50900.0,26
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,9294.49,38900.0,26
MS-DRG,665,PROSTATECTOMY WITH MCC,,,26026.81,52055.37,25
MS-DRG,666,PROSTATECTOMY WITH CC,,,14960.39,29174.83,25
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,9772.83,18449.2,25
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,24403.83,48699.76,25
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,13368.87,37800.0,26
MS-DRG,67,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,13077.84,13966.62,6
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,8733.06,29500.0,26
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,,,15329.03,45200.0,26
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,9557.45,46000.0,26
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,34741.85,70074.28,26
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,19713.98,49800.0,26
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,14090.02,27500.0,26
MS-DRG,68,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,8057.02,8604.59,6
MS-DRG,682,RENAL FAILURE WITH MCC,,,10630.0,33500.0,26
MS-DRG,683,RENAL FAILURE WITH CC,,,7914.31,20400.0,26
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,5691.99,14000.0,26
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,15399.21,39300.0,26
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,9301.75,28000.0,26
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,7224.62,19400.0,26
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,10209.23,29900.0,26
MS-DRG,69,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,7511.99,8022.51,6
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,7379.5,15900.0,26
MS-DRG,693,URINARY STONES WITH MCC,,,11695.07,22423.57,26
MS-DRG,694,URINARY STONES WITHOUT MCC,,,7155.25,16900.0,26
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,10076.13,19076.3,25
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,6407.49,15100.0,26
MS-DRG,697,URETHRAL STRICTURE,,,9543.74,10498.11,16
MS-DRG,697,Urethral stricture,,,10878.24,17975.55,9
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,10630.0,26900.0,26
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,9037.17,19900.0,26
MS-DRG,7,LUNG TRANSPLANT,,,108471.74,115843.61,6
MS-DRG,7,Vagal NeNe Stimulation,,,26000.0,26000.0,1
MS-DRG,70,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,14707.13,15706.65,6
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,6414.75,14500.0,26
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,10630.0,77411.61,25
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,10630.0,59373.54,25
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,19621.21,38811.37,25
MS-DRG,71,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,9399.68,10038.49,6
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,12152.44,23369.21,25
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,,,17658.63,34753.62,25
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,,,9720.4,18340.8,25
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,12976.84,25073.71,25
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,9379.18,17635.32,25
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,18896.84,37313.69,25
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,12715.49,24533.34,25
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,16099.38,31529.76,25
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,11683.78,22400.22,25
MS-DRG,72,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,7158.05,7644.52,6
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,15447.61,30182.18,25
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,10067.26,19057.95,25
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,6138.87,10935.76,25
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,10289.09,19516.6,25
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,6673.68,12041.52,25
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,12811.48,24731.81,25
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,7393.21,13529.19,25
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,9389.67,17657.0,25
MS-DRG,73,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,14204.47,15169.83,6
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6270.36,11207.62,25
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,18031.3,35524.14,25
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,11703.14,22440.25,25
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,29683.35,59615.51,25
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,17471.49,34366.69,25
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,12695.32,24491.64,25
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,,29750.31,32725.34,16
MS-DRG,739,"Uterine,adnexa proc for non-ovarian/adnexal malig w MCC",,,36161.2,59753.94,9
MS-DRG,74,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,9439.56,10081.08,6
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,,15446.8,16991.48,16
MS-DRG,740,"Uterine,adnexa proc for non-ovarian/adnexal malig w CC",,,18264.29,30180.51,9
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,12353.3,13588.63,16
MS-DRG,741,"Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC",,,14393.63,23784.5,9
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,10399.0,30600.79,25
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,10399.0,20692.39,25
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,17378.73,34174.89,25
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,10025.31,18971.23,25
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,14861.98,28971.35,25
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,7784.44,14338.08,25
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,12040.32,13244.35,16
MS-DRG,748,Female reproductive system reconstructive procedures,,,14002.02,23137.39,9
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,21561.2,42822.43,25
MS-DRG,75,Major Chest Procedures,,,32300.0,32300.0,1
MS-DRG,75,VIRAL MENINGITIS WITH CC/MCC,,,16806.7,17948.9,6
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,12754.21,24613.39,25
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,15705.74,30715.87,25
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,9624.41,18142.33,25
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,8597.54,16019.22,25
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,12400.09,23881.23,25
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,8746.77,16327.76,25
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,6202.6,11067.52,25
MS-DRG,76,VIRAL MENINGITIS WITHOUT CC/MCC,,,7731.32,8256.75,6
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,8976.67,16803.09,25
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,5451.61,9514.8,25
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,,4955.0,10828.0,25
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,14480.43,28182.48,25
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,8937.95,16723.03,25
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,6130.81,10919.09,25
MS-DRG,779,ABORTION WITHOUT D&C,,,7636.02,14031.2,25
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,6972.0,22719.09,25
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,6972.0,13672.0,25
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,6972.0,13672.0,25
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,6972.0,15570.9,25
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,6972.0,15288.0,25
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,6972.0,13844.0,25
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,,15387.11,16925.82,16
MS-DRG,789,"Neonates, died or transferred to another acute care facility",,,1412.0,30057.09,10
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,,48792.88,53672.17,16
MS-DRG,790,"Extreme immaturity or respiratory distress syndrome, neonate",,,3320.0,99125.69,10
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,,,3320.0,67696.0,26
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,1412.0,40847.76,26
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,2463.0,69540.59,26
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,1412.0,24615.06,26
MS-DRG,795,NORMAL NEWBORN,,,2461.36,2707.5,16
MS-DRG,795,Normal newborn,,,743.0,3332.26,10
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,4955.0,11289.6,25
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,4955.0,10828.0,25
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,4955.0,10828.0,25
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,,,37382.01,75532.99,25
MS-DRG,8,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,47440.91,308400.0,7
MS-DRG,8,Vagal NeNe Stimulation,,,26000.0,26000.0,1
MS-DRG,80,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,15913.53,16995.03,6
MS-DRG,800,SPLENIC PROCEDURES WITH CC,,,23511.68,46855.17,25
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,,,16247.8,31836.63,25
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,32987.39,66446.82,25
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,15844.48,31002.73,25
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,11787.84,22615.37,25
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,,4955.0,10828.0,25
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,,4955.0,10828.0,25
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,,4955.0,10828.0,25
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,18659.68,36823.36,25
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,10630.0,19555.62,25
MS-DRG,81,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,8316.25,8881.43,6
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,9292.07,17455.19,25
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,,,12177.45,23420.92,25
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,8256.33,15313.74,25
MS-DRG,813,COAGULATION DISORDERS,,,13153.5,14468.85,16
MS-DRG,813,Coagulation disorders,,,15394.85,25438.95,9
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,18004.69,35469.1,25
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,9029.1,16911.49,25
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,5947.7,10540.5,25
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,19254.19,38052.52,25
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,10200.35,19333.14,25
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,7786.05,14341.41,25
MS-DRG,82,Respiratory Neoplasms,,,9600.0,9600.0,1
MS-DRG,82,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,19865.04,21215.1,6
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,48158.04,207900.0,26
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,18907.33,62300.0,26
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,10561.73,53000.0,26
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,37832.93,112000.0,26
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,19125.12,72800.0,26
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,11734.6,45700.0,26
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,38583.12,78016.35,25
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,19492.95,98600.0,26
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,14593.37,28415.98,25
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,26339.79,104500.0,26
MS-DRG,83,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,12472.16,13319.78,6
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,12989.75,25100.39,25
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,8510.0,20055.3,25
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,6670.46,12034.84,25
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,5067.64,8720.93,25
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,,,45133.91,49647.3,16
MS-DRG,834,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC,,,55409.56,152300.0,10
MS-DRG,835,ACUTE LEUKEMIA WITH CC,,,17674.77,19442.25,16
MS-DRG,835,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC,,,21051.98,106100.0,10
MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC,,,10686.76,11755.44,16
MS-DRG,836,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,12308.41,28500.0,10
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,39603.53,171600.0,26
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,17687.67,71900.0,26
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,12496.88,24081.36,26
MS-DRG,84,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,8816.42,9415.59,6
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,26943.97,72000.0,26
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,14009.35,30200.0,26
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,9000.06,28400.0,26
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,16940.72,33269.27,25
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,10669.82,28600.0,26
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,7719.1,14202.98,25
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,21762.06,43237.72,26
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,11402.26,21818.16,26
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,7701.35,14166.29,26
MS-DRG,849,RADIOTHERAPY,,,22705.84,24976.42,16
MS-DRG,849,Radiotherapy,,,27346.98,45189.04,10
MS-DRG,85,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,19751.22,21093.53,6
MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,48143.0,144423.14,24
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,10630.0,124000.0,26
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,10630.0,30866.65,25
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,12926.83,24970.3,25
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,37541.73,103500.0,26
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,18124.07,48700.0,26
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,12085.49,38300.0,26
MS-DRG,86,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,11698.64,12493.69,6
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,15560.54,36000.0,26
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,8899.23,18200.0,26
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,,,8010.3,17600.0,26
MS-DRG,865,VIRAL ILLNESS WITH MCC,,,12935.7,24988.65,25
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,,,7864.3,14503.19,26
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,17734.46,50700.0,26
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,9167.04,37600.0,26
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,6735.79,12169.94,25
MS-DRG,87,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,8474.94,9050.91,6
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,56603.66,194500.0,26
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,,10630.0,49800.0,26
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,,9104.12,28200.0,26
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,940.0,64458.8,26
MS-DRG,88,CONCUSSION WITH MCC,,,12106.58,12929.36,6
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,1483.0,16014.22,25
MS-DRG,881,DEPRESSIVE NEUROSES,,,8439.44,9283.38,16
MS-DRG,881,Depressive neuroses,,,1483.0,15692.33,9
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,9511.48,10462.63,16
MS-DRG,882,Neuroses except depressive,,,1483.0,17908.84,9
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,1483.0,32793.95,25
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,1483.0,26833.23,25
MS-DRG,885,PSYCHOSES,,,12116.95,13328.65,16
MS-DRG,885,Psychoses,,,1528.0,23295.83,9
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,940.0,34611.85,26
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,9488.08,10436.89,16
MS-DRG,887,Other mental disorder diagnoses,,,940.0,17860.47,10
MS-DRG,89,CONCUSSION WITH CC,,,10002.87,10682.67,6
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,5825.89,6408.48,16
MS-DRG,894,"Alcohol/drug abuse or dependence, left AMA",,,940.0,10288.66,10
MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,12268.6,13495.46,16
MS-DRG,895,Alcohol/drug abuse or dependence w rehabilitation therapy,,,940.0,23609.38,10
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,14926.51,16419.16,16
MS-DRG,896,Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC,,,940.0,29104.78,10
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,,7970.77,8767.85,16
MS-DRG,897,Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC,,,940.0,14723.34,10
MS-DRG,90,CONCUSSION WITHOUT CC/MCC,,,7714.71,8239.01,6
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,34701.52,69990.89,25
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,16292.98,31930.03,25
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,10284.25,19506.59,25
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,30478.71,61259.96,25
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,12815.51,24740.15,25
MS-DRG,906,HAND PROCEDURES FOR INJURIES,,,16694.69,18364.16,16
MS-DRG,906,Hand procedures for injuries,,,19825.68,32760.6,9
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,31819.36,64031.85,25
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,16943.94,33275.95,25
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,10630.0,20278.59,25
MS-DRG,91,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,15466.53,16517.66,6
MS-DRG,913,TRAUMATIC INJURY WITH MCC,,,14035.16,27261.86,25
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,,,7992.55,14768.37,25
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,,,14414.29,28045.72,25
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,,,6224.38,11112.55,25
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,13501.16,26157.78,25
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,7763.47,14294.71,25
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,15617.81,30534.08,25
MS-DRG,92,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,9374.75,10011.87,6
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,8934.72,16716.36,25
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,6402.65,11481.14,25
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,14961.2,29176.49,25
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,9058.94,16973.2,25
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,173073.33,356083.64,25
MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,58708.21,119626.29,25
MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,26830.24,53716.5,25
MS-DRG,93,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,7491.21,8000.32,6
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,32262.21,64947.47,25
MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,18681.46,36868.39,25
MS-DRG,935,NON-EXTENSIVE BURNS,,,17466.65,19213.32,16
MS-DRG,935,Non-extensive burns,,,20791.58,34356.68,9
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,30118.94,60516.12,25
MS-DRG,94,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,30116.06,32162.78,6
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,19700.26,38974.82,25
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,17206.1,33817.98,25
MS-DRG,945,REHABILITATION WITH CC/MCC,,,1287.0,25827.55,26
MS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,1287.0,19126.33,26
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,11089.28,21171.05,25
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,7306.9,13350.74,25
MS-DRG,949,AFTERCARE WITH CC/MCC,,,10446.38,19841.82,25
MS-DRG,95,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,22304.41,23820.25,6
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,5913.01,10468.78,25
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,5334.65,5868.12,16
MS-DRG,951,Other factors influencing health status,,,5611.71,9272.97,9
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,55146.05,60660.66,16
MS-DRG,955,Craniotomy for multiple significant trauma,,,67936.99,112261.29,9
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,31203.89,62759.31,25
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,62315.54,127084.69,25
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,34841.07,70279.42,25
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,24598.24,49101.7,25
MS-DRG,96,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,22304.41,23820.25,6
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,22901.85,45594.32,25
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,13212.38,25560.7,25
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,8436.21,15685.66,25
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,50227.1,102091.04,25
MS-DRG,97,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,30883.76,32982.65,6
MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,22124.24,43986.56,25
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,24129.57,48132.71,25
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,11295.78,21598.01,25
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,8131.3,15055.23,25
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,11317.56,21643.04,25
MS-DRG,98,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,19942.31,21297.62,6
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,38696.05,78249.84,25
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,20681.15,41002.86,25
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,14675.64,28586.09,25
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,28504.84,57178.86,25
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,14107.76,27411.96,25
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,10523.01,20000.26,25
MS-DRG,99,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,12194.65,13023.42,6
NDC,0002015201,ZEPBOUND 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION,538.2,349.83,80.08,538.2,43
NDC,0002120001,AMYVID 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,5720.0,3718.0,0.01,5720.0,60
NDC,0002143301,TRULICITY 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,41.42,1776.93,51
NDC,0002143401,TRULICITY 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,41.42,1776.93,51
NDC,0002143601,EMGALITY PEN 120 MG/ML SUBCUTANEOUS PEN INJECTOR,2670.09,1735.56,397.31,2670.09,40
NDC,0002144511,TALTZ AUTOINJECTOR 80 MG/ML SUBCUTANEOUS,26141.43,16991.93,2.17,26141.43,43
NDC,0002145701,MOUNJARO 15 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
NDC,0002146001,MOUNJARO 12.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
NDC,0002147101,MOUNJARO 10 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
NDC,0002148401,MOUNJARO 7.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
NDC,0002149501,MOUNJARO 5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
NDC,0002150601,MOUNJARO 2.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,2.17,1943.58,51
NDC,0002223601,TRULICITY 3 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,264.41,1776.93,40
NDC,0002237711,EMGALITY 120 MG/ML SUBCUTANEOUS SYRINGE,2670.09,1735.56,397.31,2670.09,40
NDC,0002418230,OLUMIANT 2 MG TABLET,221.4,143.91,32.94,221.4,40
NDC,0002473230,OLUMIANT 1 MG TABLET,221.4,143.91,32.94,221.4,40
NDC,0002534060,RETEVMO 40 MG TABLET,316.36,205.63,47.07,316.36,40
NDC,0002556260,RETEVMO 160 MG TABLET,949.1,616.92,141.23,949.1,40
NDC,0002608260,RETEVMO 80 MG TABLET,474.56,308.46,70.61,474.56,40
NDC,0002612060,RETEVMO 120 MG TABLET,949.1,616.92,141.23,949.1,40
NDC,0002690230,JAYPIRCA 50 MG TABLET,614.46,399.4,91.43,614.46,40
NDC,0002702660,JAYPIRCA 100 MG TABLET,921.7,599.11,137.15,921.7,40
NDC,0002751001,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,23.91,15.54,0.48,23.91,51
NDC,0002751017,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,98.88,64.27,0.48,98.88,51
NDC,0002751101,HUMALOG MIX 75-25 (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,30.75,19.99,0.48,30.75,48
NDC,0002751659,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,36.75,23.89,0.48,36.75,48
NDC,0002757501,OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION,2302.38,1496.55,2.17,4417.71,65
NDC,0002762301,ALIMTA 500 MG INTRAVENOUS SOLUTION,19406.4,12614.16,2.17,19406.4,65
NDC,0002764001,ALIMTA 100 MG INTRAVENOUS SOLUTION,3881.28,2522.83,2.17,3881.28,65
NDC,0002766901,CYRAMZA 10 MG/ML INTRAVENOUS SOLUTION,720.4,468.26,2.17,4417.71,65
NDC,0002767801,CYRAMZA 10 MG/ML INTRAVENOUS SOLUTION,720.36,468.23,2.17,4417.71,65
NDC,0002773701,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,9.0,5.85,0.48,9.0,51
NDC,0002821501,HUMULIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,16.05,10.43,0.48,16.05,51
NDC,0002822201,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.48,38.19,48
NDC,0002831501,HUMULIN N NPH U-100 INSULIN (ISOPHANE SUSP) 100 UNIT/ML SUBCUTANEOUS,16.05,10.43,0.48,16.05,48
NDC,0002831517,HUMULIN N NPH U-100 INSULIN (ISOPHANE SUSP) 100 UNIT/ML SUBCUTANEOUS,53.52,34.79,0.48,53.52,48
NDC,0002871501,HUMULIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,16.05,10.43,0.48,16.05,48
NDC,0002871517,HUMULIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,16.05,10.43,0.48,16.05,48
NDC,0002879801,HUMALOG MIX 50-50 KWIKPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.48,38.19,48
NDC,0002879859,HUMALOG MIX 50-50 KWIKPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.48,38.19,48
NDC,0002879901,HUMALOG KWIKPEN (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS,38.19,24.82,0.48,38.19,48
NDC,0002879959,HUMALOG KWIKPEN (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS,38.19,24.82,0.48,38.19,48
NDC,0002880301,HUMULIN 70/30 U-100 INSULIN KWIKPEN 100 UNIT/ML SUBCUTANEOUS,33.93,22.05,0.48,33.93,48
NDC,0002880359,HUMULIN 70/30 U-100 INSULIN KWIKPEN 100 UNIT/ML SUBCUTANEOUS,33.93,22.05,0.48,33.93,48
NDC,0002880501,HUMULIN N NPH U-100 INSULIN KWIKPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.93,22.05,0.48,33.93,48
NDC,0002880559,HUMULIN N NPH U-100 INSULIN KWIKPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.93,22.05,0.48,33.93,48
NDC,0002882427,HUMULIN R U-500 (CONC) INSULIN KWIKPEN 500 UNIT/ML (3 ML) SUBCUTANEOUS,344.52,223.94,0.48,344.52,48
NDC,0002940101,KISUNLA 17.5 MG/ML INTRAVENOUS SOLUTION,126.78,82.41,2.17,720.96,65
NDC,0003029305,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,33.69,21.9,1.32,33.69,51
NDC,0003029320,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,34.2,22.23,1.32,34.2,51
NDC,0003029328,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,25.56,16.61,1.32,25.56,51
NDC,0003031505,KENALOG-80  80 MG/ML SUSPENSION FOR INJECTION,67.38,43.8,1.32,67.38,51
NDC,0003037113,NULOJIX 250 MG INTRAVENOUS SOLUTION,3491.58,2269.53,2.17,3491.58,65
NDC,0003049420,KENALOG 10 MG/ML SUSPENSION FOR INJECTION,8.7,5.66,1.29,8.86,51
NDC,0003085222,SPRYCEL 100 MG TABLET,1459.7,948.81,217.2,1459.7,40
NDC,0003085522,SPRYCEL 80 MG TABLET,1459.7,948.81,217.2,1459.7,40
NDC,0003085722,SPRYCEL 140 MG TABLET,1459.7,948.81,217.2,1459.7,43
NDC,0003089321,ELIQUIS 2.5 MG TABLET,24.26,15.77,3.61,24.26,40
NDC,0003089331,ELIQUIS 2.5 MG TABLET,24.26,15.77,3.61,24.26,40
NDC,0003089421,ELIQUIS 5 MG TABLET,24.26,15.77,3.61,24.26,40
NDC,0003089431,ELIQUIS 5 MG TABLET,24.26,15.77,3.61,24.26,40
NDC,0003161412,BARACLUDE 0.05 MG/ML ORAL SOLUTION,13.73,8.92,2.04,13.73,40
NDC,0003218713,ORENCIA (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,5580.0,3627.0,2.17,5580.0,65
NDC,0003229111,EMPLICITI 300 MG INTRAVENOUS SOLUTION,10709.0,6960.85,2.17,10709.0,65
NDC,0003232711,YERVOY 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,2.17,7011.25,65
NDC,0003232822,YERVOY 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,2.17,7011.25,65
NDC,0003257016,AZACTAM 2 GRAM SOLUTION FOR INJECTION,214.02,139.11,2.17,214.02,51
NDC,0003362212,REYATAZ 300 MG CAPSULE,115.96,75.37,17.25,115.96,40
NDC,0003363112,REYATAZ 200 MG CAPSULE,58.54,38.05,8.71,58.54,40
NDC,0003364111,EVOTAZ 300 MG-150 MG TABLET,128.44,83.49,19.11,128.44,40
NDC,0003373413,OPDIVO 240 MG/24 ML INTRAVENOUS SOLUTION,1588.6,1032.59,2.17,4417.71,65
NDC,0003375614,OPDIVO 120 MG/12 ML INTRAVENOUS SOLUTION,1588.6,1032.59,2.17,4417.71,65
NDC,0003377211,OPDIVO 40 MG/4 ML INTRAVENOUS SOLUTION,1588.64,1032.62,2.17,4417.71,65
NDC,0003377412,OPDIVO 100 MG/10 ML INTRAVENOUS SOLUTION,1588.6,1032.59,2.17,4417.71,65
NDC,0003404060,AUGTYRO 40 MG CAPSULE,307.4,199.81,45.74,307.4,40
NDC,0003452211,EMPLICITI 400 MG INTRAVENOUS SOLUTION,14278.52,9281.04,2.17,14278.52,65
NDC,0003712511,OPDUALAG 240 MG-80 MG/20 ML INTRAVENOUS SOLUTION,3701.28,2405.83,2.17,16617.81,65
NDC,0004025901,CELLCEPT 250 MG CAPSULE,21.6,14.04,0.27,21.6,51
NDC,0004026001,CELLCEPT 500 MG TABLET,43.18,28.07,0.27,43.18,51
NDC,0004026129,CELLCEPT 200 MG/ML ORAL SUSPENSION,25.9,16.84,0.43,25.9,51
NDC,0004029809,CELLCEPT INTRAVENOUS 500 MG INTRAVENOUS SOLUTION,388.71,252.66,0.66,667.03,51
NDC,0004080085,TAMIFLU 75 MG CAPSULE,36.46,23.7,5.43,36.46,40
NDC,0004080285,TAMIFLU 30 MG CAPSULE,33.44,21.74,4.98,33.44,40
NDC,0005010005,TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1621.14,1053.74,13.37,1621.14,51
NDC,0005010010,TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1621.14,1053.74,13.37,1621.14,51
NDC,0005197101,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1624.89,1056.18,13.37,1624.89,51
NDC,0005197102,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1624.89,1056.18,13.37,1624.89,51
NDC,0005197105,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1675.86,1089.31,13.37,1675.86,51
NDC,0005200001,PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2216.73,1440.87,13.37,2216.73,51
NDC,0005200010,PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2149.2,1396.98,13.37,2149.2,51
NDC,0005250002,FIBERCON 625 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,0005434462,CENTRUM 9 MG IRON/15 ML ORAL LIQUID,0.1,0.07,0.01,0.1,40
NDC,0005445174,CENTRUM COMPLETE 18 MG-400 MCG TABLET,0.14,0.09,0.02,0.14,40
NDC,0006003220,STROMECTOL 3 MG TABLET,11.16,7.25,1.66,11.16,40
NDC,0006011201,JANUVIA 50 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006011228,JANUVIA 50 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006011231,JANUVIA 50 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006011254,JANUVIA 50 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006022101,JANUVIA 25 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006022128,JANUVIA 25 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006022131,JANUVIA 25 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006022761,ISENTRESS 400 MG TABLET,83.32,54.16,12.4,83.32,40
NDC,0006027701,JANUVIA 100 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006027728,JANUVIA 100 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006027731,JANUVIA 100 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006027754,JANUVIA 100 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,0006046102,EMEND 80 MG CAPSULE,525.04,341.28,78.13,525.04,40
NDC,0006047761,ISENTRESS 100 MG CHEWABLE TABLET,20.84,13.55,3.1,20.84,40
NDC,0006056840,ZOLINZA 100 MG CAPSULE,300.2,195.13,44.67,300.2,40
NDC,0006302601,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,2.17,7218.8,65
NDC,0006302602,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,2.17,7218.8,65
NDC,0006302604,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,2.17,7218.8,65
NDC,0006306901,PIFELTRO 100 MG TABLET,147.2,95.68,21.9,147.2,40
NDC,0006307502,PREVYMIS 240 MG TABLET,658.54,428.05,97.99,658.54,40
NDC,0006307602,PREVYMIS 480 MG TABLET,658.54,428.05,97.99,658.54,40
NDC,0006307604,PREVYMIS 480 MG TABLET,658.54,428.05,97.99,658.54,40
NDC,0006308001,ISENTRESS HD 600 MG TABLET,83.32,54.16,12.4,83.32,40
NDC,0006351659,PRIMAXIN 500 MG INTRAVENOUS SOLUTION,117.54,76.4,2.17,117.54,51
NDC,0006360361,ISENTRESS 100 MG ORAL POWDER PACKET,26.05,16.93,3.88,26.05,40
NDC,0006385601,RECARBRIO 1.25 GRAM INTRAVENOUS SOLUTION,1138.11,739.77,2.17,1138.11,57
NDC,0006385602,RECARBRIO 1.25 GRAM INTRAVENOUS SOLUTION,1138.11,739.77,2.17,1138.11,57
NDC,0006404741,ROTATEQ VACCINE 2 ML ORAL SOLUTION,153.0,99.45,13.37,254.62,51
NDC,0006409302,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,205.32,133.46,7.93,205.32,51
NDC,0006409402,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE,257.28,167.23,7.93,257.28,51
NDC,0006409502,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,282.51,183.63,7.93,282.51,51
NDC,0006409601,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,298.74,194.18,7.93,298.74,51
NDC,0006409602,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,298.74,194.18,7.93,298.74,51
NDC,0006411903,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION,2364.06,1536.64,13.37,2364.06,51
NDC,0006412101,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2364.06,1536.64,13.37,2364.06,51
NDC,0006412102,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2364.06,1536.64,13.37,2364.06,51
NDC,0006417100,PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION,1030.2,669.63,7.93,1030.2,51
NDC,0006468100,M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION,344.67,224.04,7.93,344.67,51
NDC,0006468101,M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION,344.67,224.04,7.93,344.67,51
NDC,0006482700,VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION,688.92,447.8,13.37,688.92,51
NDC,0006483141,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,282.51,183.63,7.93,282.51,51
NDC,0006483701,PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE,842.97,547.93,7.93,842.97,51
NDC,0006483703,PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE,842.97,547.93,7.93,842.97,51
NDC,0006484141,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,298.74,194.18,7.93,298.74,51
NDC,0006489700,PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION,221.22,143.79,7.93,221.22,51
NDC,0006498100,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,205.32,133.46,7.93,205.32,51
NDC,0006498101,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,205.32,133.46,7.93,205.32,51
NDC,0006499200,RECOMBIVAX HB (PF) 40 MCG/ML INTRAMUSCULAR SUSPENSION,703.23,457.1,13.37,703.23,51
NDC,0006499541,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION,257.28,167.23,7.93,257.28,51
NDC,0006500301,PREVYMIS 240 MG/12 ML INTRAVENOUS SOLUTION,113.82,73.98,16.94,113.82,40
NDC,0006500401,PREVYMIS 480 MG/24 ML INTRAVENOUS SOLUTION,56.91,36.99,8.47,56.91,40
NDC,0006503401,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,2.17,17803.4,65
NDC,0006503402,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,2.17,17803.4,65
NDC,0006505509,LAGEVRIO 200 MG CAPSULE (EUA),59.84,38.9,8.9,59.84,40
NDC,0006508501,PREVYMIS 120 MG ORAL PELLETS IN PACKET,164.64,107.02,24.5,164.64,40
NDC,0006508601,PREVYMIS 20 MG ORAL PELLETS IN PACKET,27.44,17.84,4.08,27.44,40
NDC,0006542302,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,245.04,159.28,36.46,245.04,40
NDC,0006542312,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,245.04,159.28,36.46,245.04,40
NDC,0006542402,ANTIVENIN LATRODECTUS MACTANS 6000 UNIT SOLUTION FOR INJECTION,99.75,64.84,14.84,99.75,40
NDC,0006542505,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,179.52,116.69,26.71,179.52,40
NDC,0006542515,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,179.52,116.69,26.71,179.52,40
NDC,0008010001,BESPONSA 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,117092.48,76110.11,2.17,117092.48,65
NDC,0008042303,ANTIVENIN MICRURUS FULVIUS 250 UNIT SOLUTION FOR INJECTION,33279.78,21631.86,41.42,33279.78,51
NDC,0008084381,PROTONIX 20 MG TABLETDELAYED RELEASE,35.78,23.26,5.32,35.78,40
NDC,0008084401,PROTONIX 40 MG GRANULES DELAYED-RELEASE PACKET,35.62,23.15,5.3,35.62,40
NDC,0008084402,PROTONIX 40 MG GRANULES DELAYED-RELEASE PACKET,44.53,28.94,6.63,44.53,40
NDC,0008092351,PROTONIX 40 MG INTRAVENOUS SOLUTION,18.27,11.88,2.17,18.27,51
NDC,0008092355,PROTONIX 40 MG INTRAVENOUS SOLUTION,18.27,11.88,2.17,21.03,51
NDC,0008117901,TORISEL 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLUTION,7561.23,4914.8,2.17,7561.23,65
NDC,0008400125,PROTONIX 40 MG INTRAVENOUS SOLUTION,6.81,4.43,1.01,17.78,51
NDC,0008451001,MYLOTARG 4.5 MG (1 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,50407.44,32764.84,2.17,50407.44,65
NDC,0008499020,TYGACIL 50 MG INTRAVENOUS SOLUTION,360.0,234.0,1.0,360.0,51
NDC,0009000302,SOLU-MEDROL (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,170.58,110.88,0.3,170.58,57
NDC,0009000501,SOLU-CORTEF ACT-O-VIAL (PF) 1000 MG/8 ML SOLUTION FOR INJECTION,723.78,470.46,2.17,723.78,51
NDC,0009001103,SOLU-CORTEF ACT-O-VIAL (PF) 100 MG/2 ML SOLUTION FOR INJECTION,90.96,59.12,2.17,90.96,51
NDC,0009001104,SOLU-CORTEF ACT-O-VIAL (PF) 100 MG/2 ML SOLUTION FOR INJECTION,89.31,58.05,2.17,89.31,51
NDC,0009001201,CORTEF 5 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,0009001305,SOLU-CORTEF ACT-O-VIAL (PF) 250 MG/2 ML SOLUTION FOR INJECTION,184.35,119.83,2.17,184.35,51
NDC,0009001306,SOLU-CORTEF ACT-O-VIAL (PF) 250 MG/2 ML SOLUTION FOR INJECTION,173.04,112.48,2.17,173.04,51
NDC,0009001612,SOLU-CORTEF ACT-O-VIAL (PF) 500 MG/4 ML SOLUTION FOR INJECTION,362.01,235.31,2.17,362.01,51
NDC,0009001820,SOLU-MEDROL (PF) 1000 MG/8 ML INTRAVENOUS SOLUTION,248.1,161.27,0.3,248.1,57
NDC,0009002001,MEDROL 2 MG TABLET,3.94,2.56,0.25,8.86,51
NDC,0009003101,CORTEF 10 MG TABLET,4.08,2.65,0.61,4.08,40
NDC,0009003928,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,23.28,15.13,0.3,23.28,57
NDC,0009003930,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,23.28,15.13,0.3,23.28,57
NDC,0009003932,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,19.32,12.56,0.3,19.32,57
NDC,0009003933,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,19.32,12.56,0.3,19.32,57
NDC,0009004722,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,37.5,24.38,0.3,37.5,57
NDC,0009004725,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,37.5,24.38,0.3,37.5,57
NDC,0009004726,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,30.75,19.99,0.3,30.75,57
NDC,0009004727,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,30.75,19.99,0.3,30.75,57
NDC,0009005604,MEDROL (PAK) 4 MG TABLETS IN A DOSE PACK,0.74,0.48,0.11,8.86,51
NDC,0009007301,MEDROL 16 MG TABLET,6.9,4.49,0.25,8.86,51
NDC,0009022502,CLEOCIN HCL 150 MG CAPSULE,0.36,0.23,0.05,0.36,40
NDC,0009027101,DEPO-ESTRADIOL 5 MG/ML INTRAMUSCULAR OIL,185.73,120.72,2.17,185.73,51
NDC,0009027401,DEPO-MEDROL 20 MG/ML SUSPENSION FOR INJECTION,25.59,16.63,0.12,25.59,57
NDC,0009028002,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.49,23.07,0.12,35.49,57
NDC,0009028003,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.52,23.09,0.12,35.52,57
NDC,0009028051,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.49,23.07,0.12,35.49,57
NDC,0009029703,GELFILM FOR THE EYE,595.08,386.8,88.55,595.08,40
NDC,0009030602,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.07,46.2,0.12,71.07,57
NDC,0009030612,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.04,46.18,0.12,71.04,57
NDC,0009032301,GELFOAM SPONGE SIZE 50,74.1,48.17,11.03,74.1,40
NDC,0009034702,DEPO-TESTOSTERONE 100 MG/ML INTRAMUSCULAR OIL,31.47,20.46,0.05,31.47,51
NDC,0009035301,GELFOAM COMPRESSED SIZE 100 100 CM SPONGE,110.56,71.86,16.45,110.56,40
NDC,0009041701,DEPO-TESTOSTERONE 200 MG/ML INTRAMUSCULAR OIL,85.65,55.67,0.05,85.65,51
NDC,0009041702,DEPO-TESTOSTERONE 200 MG/ML INTRAMUSCULAR OIL,49.74,32.33,0.05,49.74,51
NDC,0009043304,GELFOAM MUCOSAL POWDER,100.68,65.44,14.98,100.68,40
NDC,0009043601,R-GENE 10 % INTRAVENOUS SOLUTION,0.48,0.31,0.07,0.48,40
NDC,0009045003,COLESTID 1 GRAM TABLET,5.4,3.51,0.8,5.4,40
NDC,0009069801,SOLU-MEDROL 1000 MG INTRAVENOUS SOLUTION,158.34,102.92,0.3,158.34,57
NDC,0009072805,CLEOCIN 150 MG/ML INJECTION SOLUTION,1.47,0.96,0.22,1.47,40
NDC,0009072809,CLEOCIN 150 MG/ML INJECTION SOLUTION,1.47,0.96,0.22,1.47,40
NDC,0009074630,DEPO-PROVERA 150 MG/ML INTRAMUSCULAR SUSPENSION,189.48,123.16,1.08,189.48,51
NDC,0009075801,SOLU-MEDROL 500 MG INTRAVENOUS SOLUTION,87.42,56.82,0.3,87.42,57
NDC,0009077526,CLEOCIN 150 MG/ML INJECTION SOLUTION,2.64,1.72,0.39,2.64,40
NDC,0009082501,SOLU-CORTEF 100 MG SOLUTION FOR INJECTION,72.39,47.05,2.17,72.39,51
NDC,0009085001,SOLU-MEDROL 2 GRAM INTRAVENOUS SOLUTION,391.89,254.73,0.3,391.89,57
NDC,0009085605,HEMABATE 250 MCG/ML INTRAMUSCULAR SOLUTION,504.0,327.6,2.17,504.0,59
NDC,0009085608,HEMABATE 250 MCG/ML INTRAMUSCULAR SOLUTION,504.0,327.6,2.17,504.0,59
NDC,0009087026,CLEOCIN 150 MG/ML INJECTION SOLUTION,4.47,2.91,0.67,4.47,40
NDC,0009090218,CLEOCIN 150 MG/ML INJECTION SOLUTION,2.55,1.66,0.38,2.55,40
NDC,0009307301,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,40.89,26.58,0.12,40.89,57
NDC,0009307303,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,40.92,26.6,0.12,40.92,57
NDC,0009307322,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,14.37,9.34,0.12,14.37,57
NDC,0009307323,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,16.62,10.8,0.12,16.62,57
NDC,0009316901,PROSTIN VR PEDIATRIC 500 MCG/ML INJECTION SOLUTION,609.63,396.26,1.01,609.63,51
NDC,0009316906,PROSTIN VR PEDIATRIC 500 MCG/ML INJECTION SOLUTION,609.63,396.26,1.01,609.63,51
NDC,0009344801,CLEOCIN 2 % VAGINAL CREAM,4.5,2.93,0.67,4.5,40
NDC,0009347501,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,70.98,46.14,0.12,70.98,57
NDC,0009347503,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.01,46.16,0.12,71.01,57
NDC,0009370105,CAVERJECT 20 MCG INTRACAVERNOSAL SOLUTION,396.96,258.02,1.01,396.96,51
NDC,0009379401,CORVERT 0.1 MG/ML INTRAVENOUS SOLUTION,201.54,131.0,2.17,833.16,65
NDC,0009470913,DEPO-SUBQ PROVERA 104 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,291.48,189.46,1.08,291.48,51
NDC,0009509101,ELLENCE 50 MG/25 ML INTRAVENOUS SOLUTION,9.24,6.01,1.37,9.24,43
NDC,0009513601,ZYVOX 100 MG/5 ML ORAL SUSPENSION,4.9,3.19,0.73,4.9,40
NDC,0009514001,ZYVOX 600 MG/300 ML INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,47.96,51
NDC,0009514004,ZYVOX 600 MG/300 ML INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,47.96,51
NDC,0009518201,CAVERJECT IMPULSE 20 MCG INTRACAVERNOSAL KIT,400.02,260.01,1.01,400.02,51
NDC,0009518211,CAVERJECT 20 MCG INTRACAVERNOSAL SYRINGE,400.02,260.01,1.01,400.02,51
NDC,0009722402,ATGAM 50 MG/ML INTRAVENOUS SOLUTION,3826.35,2487.13,2.17,15725.27,65
NDC,0009766304,AROMASIN 25 MG TABLET,96.7,62.86,14.39,96.7,40
NDC,0009768604,CAVERJECT 40 MCG INTRACAVERNOSAL SOLUTION,523.62,340.35,1.01,523.62,51
NDC,0013111415,CYKLOKAPRON 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,10.95,7.12,1.63,10.95,40
NDC,0013258691,IDAMYCIN PFS 1 MG/ML INTRAVENOUS SOLUTION,51.72,33.62,2.17,327.06,51
NDC,0013259691,IDAMYCIN PFS 1 MG/ML INTRAVENOUS SOLUTION,37.26,24.22,2.17,327.06,51
NDC,0013264902,GENOTROPIN MINIQUICK 0.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,115.26,74.92,2.17,415.35,57
NDC,0013265102,GENOTROPIN MINIQUICK 0.6 MG/0.25 ML SUBCUTANEOUS SYRINGE,345.84,224.8,2.17,415.35,57
NDC,0013265402,GENOTROPIN MINIQUICK 1.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,691.68,449.59,2.17,691.68,57
NDC,0015301260,BICNU 100 MG INTRAVENOUS SOLUTION,822.76,534.79,2.17,3257.22,65
NDC,0019086207,CYSTO-CONRAY II 17.2 % URETHRAL SOLUTION,0.36,0.23,0.05,22.96,51
NDC,0019086250,CYSTO-CONRAY II 17.2 % URETHRAL SOLUTION,0.42,0.27,0.06,22.96,51
NDC,0019095211,CONRAY-30 30 % INTRAVENOUS SOLUTION,0.57,0.37,0.08,22.96,51
NDC,0019095305,CONRAY 60 % INJECTION SOLUTION,0.87,0.57,0.13,22.96,51
NDC,0019095313,CONRAY 60 % INJECTION SOLUTION,1.17,0.76,0.17,22.96,51
NDC,0019095323,CONRAY 60 % INJECTION SOLUTION,1.47,0.96,0.22,22.96,51
NDC,0019118881,SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,0.66,0.43,0.1,0.66,40
NDC,0019132302,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.74,3.08,0.01,22.96,49
NDC,0019132304,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.71,3.06,0.01,22.96,49
NDC,0019132306,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.01,22.96,49
NDC,0019132311,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,2.6,1.69,0.01,22.96,49
NDC,0019132316,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.0,1.95,0.01,22.96,49
NDC,0019132352,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SYRINGE,1.47,0.96,0.01,22.96,49
NDC,0019133206,OPTIRAY 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.3,2.15,0.01,22.96,49
NDC,0019133275,OPTIRAY 300 MG IODINE/ML INTRAVENOUS SYRINGE,2.6,1.69,0.39,2.6,40
NDC,0019133306,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.96,2.57,0.01,22.96,49
NDC,0019133311,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.42,2.22,0.01,22.96,49
NDC,0019133316,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.18,2.07,0.01,22.96,49
NDC,0019133352,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SYRINGE,1.3,0.85,0.01,22.96,49
NDC,0019318309,CONRAY-43 43 % INTRAVENOUS SOLUTION,6.87,4.47,1.02,6.87,40
NDC,0019905040,OCTREOSCAN 3 MCI/ML-10 MCG INTRAVENOUS KIT,10558.0,6862.7,0.01,10558.0,60
NDC,0019909240,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,66.0,42.9,0.01,968.75,45
NDC,0023024004,REFRESH P.M. 57.3 %-42.5 % EYE OINTMENT,5.88,3.82,0.87,5.88,40
NDC,0023031204,REFRESH LACRI-LUBE 56.8 %-42.5 % EYE OINTMENT,6.7,4.36,1.0,6.7,40
NDC,0023040330,REFRESH PLUS 0.5 % EYE DROPS IN A DROPPERETTE,0.72,0.47,0.11,0.72,40
NDC,0023040350,REFRESH PLUS 0.5 % EYE DROPS IN A DROPPERETTE,0.66,0.43,0.1,0.66,40
NDC,0023050601,REFRESH CLASSIC (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE,0.74,0.48,0.11,0.74,40
NDC,0023050650,REFRESH CLASSIC (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE,0.68,0.44,0.1,0.68,40
NDC,0023079815,REFRESH TEARS 0.5 % EYE DROPS,1.34,0.87,0.2,1.34,40
NDC,0023114501,BOTOX 100 UNIT INJECTION,2343.6,1523.34,2.17,2343.6,65
NDC,0023218105,ACULAR 0.5 % EYE DROPS,132.2,85.93,19.67,132.2,40
NDC,0023334807,OZURDEX 0.7 MG INTRAVITREAL IMPLANT,4798.8,3119.22,2.17,4798.8,65
NDC,0023391950,BOTOX COSMETIC 50 UNIT INTRAMUSCULAR SOLUTION,1303.2,847.08,2.17,1303.2,65
NDC,0023392102,BOTOX 200 UNIT INJECTION,4687.2,3046.68,2.17,4687.2,65
NDC,0023455430,REFRESH CELLUVISC 1 % EYE GEL IN A DROPPERETTE,0.88,0.57,0.13,0.88,40
NDC,0023585801,LILETTA 20.4 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2236.16,1453.5,2.17,2427.81,51
NDC,0023608201,INFED 50 MG/ML INJECTION SOLUTION,67.11,43.62,2.17,130.36,65
NDC,0023608210,INFED 50 MG/ML INJECTION SOLUTION,67.11,43.62,2.17,130.36,65
NDC,0023614230,RAPAFLO 8 MG CAPSULE,20.92,13.6,3.11,20.92,40
NDC,0023916330,RESTASIS 0.05 % EYE DROPS IN A DROPPERETTE,25.82,16.78,3.84,25.82,40
NDC,0023917705,ALPHAGAN P 0.15 % EYE DROPS,99.5,64.68,14.81,99.5,40
NDC,0023920515,REFRESH LIQUIGEL 1 % EYE LIQUID GEL DROPS,1.38,0.9,0.21,1.38,40
NDC,0023923201,BOTOX COSMETIC 100 UNIT INTRAMUSCULAR SOLUTION,2361.6,1535.04,2.17,2361.6,65
NDC,0023932105,ALPHAGAN P 0.1 % EYE DROPS,88.88,57.77,13.23,88.88,40
NDC,0023963708,OXYTROL FOR WOMEN 3.9 MG/24 HOUR TRANSDERMAL PATCH,5.96,3.87,0.89,5.96,40
NDC,0023965201,DURYSTA 10 MCG INTRACAMERAL IMPLANT,7290.0,4738.5,2.17,7290.0,65
NDC,0024065401,SARCLISA 20 MG/ML INTRAVENOUS SOLUTION,889.4,578.11,2.17,4487.68,65
NDC,0024065601,SARCLISA 20 MG/ML INTRAVENOUS SOLUTION,889.4,578.11,2.17,4487.68,65
NDC,0024135202,NEO-SYNEPHRINE (PHENYLEPHRINE) 1 % NASAL SPRAY,0.86,0.56,0.13,0.86,40
NDC,0024159601,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,4.92,3.2,0.73,4.92,40
NDC,0024279210,FERRLECIT 62.5 MG/5 ML INTRAVENOUS SOLUTION,22.89,14.88,2.17,47.96,51
NDC,0024414260,MULTAQ 400 MG TABLET,33.04,21.48,4.92,33.04,40
NDC,0024515006,CAMPHO-PHENIQUE 10.8 %-4.7 % TOPICAL SOLUTION,0.24,0.16,0.04,0.24,40
NDC,0024515010,ELITEK 1.5 MG INTRAVENOUS SOLUTION,4025.04,2616.28,2.17,4025.04,65
NDC,0024515011,ELITEK 1.5 MG INTRAVENOUS SOLUTION,4025.04,2616.28,2.17,4025.04,65
NDC,0024515175,ELITEK 7.5 MG INTRAVENOUS SOLUTION,20125.11,13081.32,2.17,20125.11,65
NDC,0024540131,AMBIEN 5 MG TABLET,51.56,33.51,7.67,51.56,40
NDC,0024542131,AMBIEN 10 MG TABLET,51.56,33.51,7.67,51.56,40
NDC,0024582411,JEVTANA 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,47103.52,30617.29,2.17,47103.52,65
NDC,0024586201,MOZOBIL 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,29904.21,19437.74,2.17,29904.21,65
NDC,0024591001,KEVZARA 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,7705.14,5008.34,41.42,7705.14,51
NDC,0024591401,DUPIXENT 300 MG/2 ML SUBCUTANEOUS SYRINGE,3773.73,2452.92,41.42,3773.73,51
NDC,0024591502,DUPIXENT 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,3773.73,2452.92,41.42,3773.73,51
NDC,0024591801,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,6620.58,4303.38,41.42,6620.58,51
NDC,0024591902,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,6620.58,4303.38,41.42,6620.58,51
NDC,0024592410,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,35.31,22.95,5.25,47.96,48
NDC,0024592505,ADMELOG SOLOSTAR U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS PEN,45.45,29.54,0.48,45.45,51
NDC,0024592605,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,47.07,30.6,0.48,47.07,48
NDC,0025100131,ALDACTONE 25 MG TABLET,6.56,4.26,0.98,6.56,40
NDC,0025103131,ALDACTONE 100 MG TABLET,19.34,12.57,2.88,19.34,40
NDC,0025141160,ARTHROTEC 50 MG-200 MCG TABLETFILM-COATED,21.22,13.79,3.16,21.22,40
NDC,0025142160,ARTHROTEC 75  75 MG-200 MCG TABLETFILM-COATED,21.22,13.79,3.16,21.22,40
NDC,0025152534,CELEBREX 200 MG CAPSULE,39.4,25.61,5.86,39.4,40
NDC,0025171001,INSPRA 25 MG TABLET,35.48,23.06,5.28,35.48,40
NDC,0025273231,NORPACE CR 100 MG CAPSULEEXTENDED RELEASE,10.36,6.73,1.54,10.36,40
NDC,0025274231,NORPACE CR 150 MG CAPSULEEXTENDED RELEASE,12.24,7.96,1.82,12.24,40
NDC,0032004570,CREON 3000 UNIT-9500 UNIT-15000 UNIT CAPSULEDELAYED RELEASE,4.36,2.83,0.65,4.36,40
NDC,0032004670,CREON 6000-19000-30000 UNIT CAPSULEDELAYED RELEASE,5.16,3.35,0.77,5.16,40
NDC,0032004770,CREON 12000-38000-60000 UNIT CAPSULEDELAYED RELEASE,10.3,6.7,1.53,10.3,40
NDC,0032263601,CREON 24000-76000-120000 UNIT CAPSULEDELAYED RELEASE,20.42,13.27,3.04,20.42,40
NDC,0032301613,CREON 36000 UNIT-114000 UNIT-180000 UNIT CAPSULEDELAYED RELEASE,31.0,20.15,4.61,31.0,40
NDC,0037043001,FELBATOL 400 MG TABLET,37.04,24.08,5.51,37.04,40
NDC,0037043101,FELBATOL 600 MG TABLET,42.46,27.6,6.32,42.46,40
NDC,0037682210,PROCTOFOAM HC 1 %-1 %,48.98,31.84,7.29,48.98,40
NDC,0037682315,PROCTOFOAM 1 % TOPICAL,16.2,10.53,2.41,16.2,40
NDC,0037682410,EPIFOAM 1 %-1 % TOPICAL,25.24,16.41,3.76,25.24,40
NDC,0037683015,CORTIFOAM 10 % (80 MG) RECTAL,77.38,50.3,11.51,77.38,40
NDC,0037686010,DIPENTUM 250 MG CAPSULE,39.5,25.68,5.88,39.5,40
NDC,0039413012,MERIBIN 5 MG CAPSULE,0.56,0.36,0.08,0.56,40
NDC,00406030412,BISMUTH SUBGALLATE (BULK) POWDER,0.42,0.27,0.06,0.42,40
NDC,0046074905,PREMARIN 25 MG SOLUTION FOR INJECTION,1393.41,905.72,2.17,1393.41,65
NDC,0046087221,PREMARIN 0.625 MG/GRAM VAGINAL CREAM,37.86,24.61,5.63,37.86,40
NDC,0046110081,PREMARIN 0.3 MG TABLET,17.44,11.34,2.6,17.44,40
NDC,0046110181,PREMARIN 0.45 MG TABLET,17.44,11.34,2.6,17.44,40
NDC,0046110281,PREMARIN 0.625 MG TABLET,17.44,11.34,2.6,17.44,40
NDC,0046110381,PREMARIN 0.9 MG TABLET,17.44,11.34,2.6,17.44,40
NDC,0046110481,PREMARIN 1.25 MG TABLET,17.44,11.34,2.6,17.44,40
NDC,0046110611,PREMPRO 0.45 MG-1.5 MG TABLET,21.8,14.17,3.24,21.8,40
NDC,0046110711,PREMPRO 0.625 MG-2.5 MG TABLET,21.8,14.17,3.24,21.8,40
NDC,0046110811,PREMPRO 0.625 MG-5 MG TABLET,21.8,14.17,3.24,21.8,40
NDC,0049001383,UNASYN 1.5 GRAM SOLUTION FOR INJECTION,27.75,18.04,2.17,27.75,51
NDC,0049001483,UNASYN 3 GRAM SOLUTION FOR INJECTION,52.41,34.07,2.17,52.41,51
NDC,0049002428,UNASYN 15 GRAM SOLUTION FOR INJECTION,262.11,170.37,2.17,262.11,51
NDC,0049011628,ERAXIS(WATER DILUENT) 100 MG INTRAVENOUS SOLUTION,687.21,446.69,0.91,687.21,51
NDC,0049052083,PFIZERPEN-G 5 MILLION UNIT SOLUTION FOR INJECTION,45.81,29.78,1.39,45.81,51
NDC,0049233045,RELPAX 20 MG TABLET,193.84,126.0,28.84,193.84,40
NDC,0049276066,CARDURA 2 MG TABLET,13.8,8.97,2.05,13.8,40
NDC,0049277066,CARDURA 4 MG TABLET,14.48,9.41,2.15,14.48,40
NDC,0049319028,VFEND IV 200 MG INTRAVENOUS SOLUTION,217.08,141.1,1.34,217.08,51
NDC,0049345019,DIFLUCAN 40 MG/ML ORAL SUSPENSION,2.4,1.56,0.36,2.4,40
NDC,0049491041,ZOLOFT 100 MG TABLET,37.54,24.4,5.59,37.54,40
NDC,0052045016,ZEMURON 10 MG/ML INTRAVENOUS SOLUTION,14.64,9.52,2.18,14.64,40
NDC,0052060202,TICE BCG 50 MG INTRAVESICAL SUSPENSION,873.44,567.74,2.17,873.44,59
NDC,0052060302,BCG VACCINE LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION,655.08,425.8,2.17,655.08,43
NDC,0053720102,ZEMAIRA 1000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.5,2642.72,65
NDC,0053720202,ZEMAIRA 4000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.5,2642.72,65
NDC,0053720302,ZEMAIRA 5000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.5,2642.72,65
NDC,0054000713,CALCITRIOL 0.25 MCG CAPSULE,2.56,1.66,0.38,2.56,40
NDC,0054001020,FLECAINIDE 50 MG TABLET,4.04,2.63,0.6,4.04,40
NDC,0054001025,FLECAINIDE 50 MG TABLET,4.04,2.63,0.6,4.04,40
NDC,0054001120,FLECAINIDE 100 MG TABLET,7.16,4.65,1.07,7.16,40
NDC,0054001121,FLECAINIDE 100 MG TABLET,7.16,4.65,1.07,7.16,40
NDC,0054001225,FLECAINIDE 150 MG TABLET,8.68,5.64,1.29,8.68,40
NDC,0054001720,PREDNISONE 10 MG TABLET,0.54,0.35,0.02,8.86,51
NDC,0054001820,PREDNISONE 20 MG TABLET,0.58,0.38,0.02,8.86,51
NDC,0054001920,PREDNISONE 50 MG TABLET,0.84,0.55,0.02,8.86,51
NDC,0054001925,PREDNISONE 50 MG TABLET,0.82,0.53,0.02,8.86,51
NDC,0054002025,LITHIUM CARBONATE ER 450 MG TABLETEXTENDED RELEASE,1.08,0.7,0.16,1.08,40
NDC,0054002125,LITHIUM CARBONATE ER 300 MG TABLETEXTENDED RELEASE,0.94,0.61,0.14,0.94,40
NDC,0054004544,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,7.44,4.84,1.11,7.44,40
NDC,0054004641,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,12.76,8.29,1.9,12.76,40
NDC,0054005746,DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,7.0,4.55,1.04,7.0,40
NDC,0054006447,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,12.0,7.8,1.79,12.0,40
NDC,0054007928,BALSALAZIDE 750 MG CAPSULE,3.2,2.08,0.48,3.2,40
NDC,0054008013,EXEMESTANE 25 MG TABLET,40.46,26.3,6.02,40.46,40
NDC,0054014125,ACARBOSE 50 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,0054017613,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,8.28,5.38,1.23,8.28,40
NDC,0054017713,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,15.48,10.06,2.3,15.48,40
NDC,0054018913,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,20.84,13.55,2.17,47.96,48
NDC,0054023524,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,1.82,1.18,0.27,1.82,40
NDC,0054023525,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,1.04,0.68,0.15,1.04,40
NDC,0054023624,MORPHINE 30 MG IMMEDIATE RELEASE TABLET,3.08,2.0,0.46,3.08,40
NDC,0054023749,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.3,0.2,0.04,0.3,40
NDC,0054023763,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.14,0.09,0.02,0.14,40
NDC,0054024324,CODEINE SULFATE 15 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,0054024424,CODEINE SULFATE 30 MG TABLET,2.06,1.34,0.31,2.06,40
NDC,0054024425,CODEINE SULFATE 30 MG TABLET,1.86,1.21,0.28,1.86,40
NDC,0054028259,ALENDRONATE 70 MG/75 ML ORAL SOLUTION,2.88,1.87,0.43,2.88,40
NDC,0054028325,OXYMORPHONE 5 MG TABLET,6.48,4.21,0.96,6.48,40
NDC,0054029399,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,7.02,4.56,1.04,7.02,40
NDC,0054031950,LINEZOLID 100 MG/5 ML ORAL SUSPENSION,15.95,10.37,2.37,15.95,40
NDC,0054033425,CEVIMELINE 30 MG CAPSULE,6.98,4.54,1.04,6.98,40
NDC,0054038225,CYCLOPHOSPHAMIDE 25 MG CAPSULE,18.72,12.17,1.81,18.72,43
NDC,0054038663,HYDROMORPHONE 1 MG/ML ORAL LIQUID,0.9,0.59,0.13,0.9,40
NDC,0054039063,OXYCODONE 5 MG/5 ML ORAL SOLUTION,0.73,0.47,0.11,0.73,40
NDC,0054039168,METHADONE 10 MG/ML ORAL CONCENTRATE,0.17,0.11,0.03,0.17,40
NDC,0054047121,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,42.28,27.48,2.1,42.28,43
NDC,0054048113,EVEROLIMUS (ANTINEOPLASTIC) 5 MG TABLET,1193.72,775.92,177.63,1193.72,40
NDC,0054050823,ICOSAPENT ETHYL 1 GRAM CAPSULE,6.28,4.08,0.93,6.28,40
NDC,0054051744,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,1.26,0.82,0.19,1.26,40
NDC,0054057625,DEFERIPRONE 500 MG TABLET,164.52,106.94,24.48,164.52,40
NDC,0054062263,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,0.75,0.49,0.11,0.75,40
NDC,0054063913,METHYLERGONOVINE 0.2 MG TABLET,134.38,87.35,20.0,134.38,40
NDC,0054071020,METHADONE 10 MG TABLET,0.88,0.57,0.13,0.88,40
NDC,0054087949,MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,40.85,26.55,6.08,40.85,40
NDC,0054252625,LITHIUM CARBONATE 150 MG CAPSULE,0.34,0.22,0.05,0.34,40
NDC,0054252725,LITHIUM CARBONATE 300 MG CAPSULE,0.56,0.36,0.08,0.56,40
NDC,0054253125,LITHIUM CARBONATE 600 MG CAPSULE,0.94,0.61,0.14,0.94,40
NDC,0054306844,ALPRAZOLAM INTENSOL 1 MG/ML ORAL CONCENTRATE,9.15,5.95,1.36,9.15,40
NDC,0054309036,BUTORPHANOL 10 MG/ML NASAL SPRAY,77.06,50.09,11.47,77.06,40
NDC,0054311763,CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1250 MG/5 ML) ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,0054312041,CALCITRIOL 1 MCG/ML ORAL SOLUTION,29.83,19.39,4.44,29.83,40
NDC,0054317644,DEXAMETHASONE INTENSOL 1 MG/ML DROPS (CONCENTRATE),2.68,1.74,0.4,2.68,40
NDC,0054317757,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,0.68,0.44,0.02,8.86,51
NDC,0054317763,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,0.13,0.08,0.02,8.86,51
NDC,0054318863,DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,0.4,0.26,0.06,0.4,40
NDC,0054319446,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,5.0,3.25,0.74,5.0,40
NDC,0054327099,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAYSUSPENSION,11.66,7.58,1.74,11.66,40
NDC,0054329446,FUROSEMIDE 10 MG/ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,0054329450,FUROSEMIDE 10 MG/ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,0054329863,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,0.25,0.16,0.04,0.25,40
NDC,0054350049,LIDOCAINE VISCOUS 2 % MUCOSAL SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0054350547,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,1.92,1.25,0.29,1.92,40
NDC,0054353244,LORAZEPAM INTENSOL 2 MG/ML ORAL CONCENTRATE,2.4,1.56,0.36,2.4,40
NDC,0054355344,METHADONE INTENSOL 10 MG/ML ORAL CONCENTRATE,1.28,0.83,0.19,1.28,40
NDC,0054355563,METHADONE 5 MG/5 ML ORAL SOLUTION,0.12,0.08,0.02,0.12,40
NDC,0054355663,METHADONE 10 MG/5 ML ORAL SOLUTION,0.35,0.23,0.05,0.35,40
NDC,0054356699,MIDAZOLAM 2 MG/ML ORAL SYRUP,3.24,2.11,0.48,3.24,40
NDC,0054363063,NAPROXEN 125 MG/5 ML ORAL SUSPENSION,5.98,3.89,0.89,5.98,40
NDC,0054372144,PREDNISONE INTENSOL 5 MG/ML ORAL CONCENTRATE,13.0,8.45,0.02,13.0,51
NDC,0054372250,PREDNISONE 5 MG/5 ML ORAL SOLUTION,2.0,1.3,0.02,8.86,51
NDC,0054372263,PREDNISONE 5 MG/5 ML ORAL SOLUTION,1.85,1.2,0.02,8.86,51
NDC,0054372763,PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0054373063,PROPRANOLOL 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,0.48,0.31,0.07,0.48,40
NDC,0054417925,DEXAMETHASONE 0.5 MG TABLET,0.28,0.18,0.04,0.28,40
NDC,0054418025,DEXAMETHASONE 0.75 MG TABLET,0.5,0.33,0.02,8.86,51
NDC,0054418125,DEXAMETHASONE 1 MG TABLET,0.6,0.39,0.02,8.86,51
NDC,0054418325,DEXAMETHASONE 2 MG TABLET,1.2,0.78,0.02,8.86,51
NDC,0054418425,DEXAMETHASONE 4 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,0054449625,LEUCOVORIN CALCIUM 5 MG TABLET,4.06,2.64,0.6,4.06,40
NDC,0054449705,LEUCOVORIN CALCIUM 10 MG TABLET,16.82,10.93,2.5,16.82,40
NDC,0054449911,LEUCOVORIN CALCIUM 25 MG TABLET,49.46,32.15,7.36,49.46,40
NDC,0054458111,MERCAPTOPURINE 50 MG TABLET,16.38,10.65,2.44,16.38,40
NDC,0054472825,PREDNISONE 5 MG TABLET,0.46,0.3,0.02,8.86,51
NDC,0054472831,PREDNISONE 5 MG TABLET,0.44,0.29,0.02,8.86,51
NDC,0054474125,PREDNISONE 1 MG TABLET,0.5,0.33,0.02,8.86,51
NDC,0054474225,PREDNISONE 2.5 MG TABLET,0.34,0.22,0.02,8.86,51
NDC,0054485825,TRIAZOLAM 0.125 MG TABLET,12.08,7.85,1.8,12.08,40
NDC,0054814622,CLOTRIMAZOLE 10 MG TROCHE,6.88,4.47,1.02,6.88,40
NDC,0054817425,DEXAMETHASONE 1 MG TABLET,0.74,0.48,0.02,8.86,51
NDC,0054817525,DEXAMETHASONE 4 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,0054817625,DEXAMETHASONE 2 MG TABLET,1.48,0.96,0.02,8.86,51
NDC,0054817925,DEXAMETHASONE 0.5 MG TABLET,0.42,0.27,0.06,0.42,40
NDC,0054818325,DEXAMETHASONE 6 MG TABLET,3.8,2.47,0.02,8.86,51
NDC,0054829725,FUROSEMIDE 20 MG TABLET,1.04,0.68,0.15,1.04,40
NDC,0054829925,FUROSEMIDE 40 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,0054830125,FUROSEMIDE 80 MG TABLET,3.14,2.04,0.47,3.14,40
NDC,0054849619,LEUCOVORIN CALCIUM 5 MG TABLET,5.6,3.64,0.83,5.6,40
NDC,0054852625,LITHIUM CARBONATE 150 MG CAPSULE,0.38,0.25,0.06,0.38,40
NDC,0054852725,LITHIUM CARBONATE 300 MG CAPSULE,0.74,0.48,0.11,0.74,40
NDC,0054852825,LITHIUM CARBONATE 300 MG TABLET,0.68,0.44,0.1,0.68,40
NDC,0054855025,METHOTREXATE SODIUM 2.5 MG TABLET,7.12,4.63,0.27,15.18,51
NDC,0054872425,PREDNISONE 5 MG TABLET,0.5,0.33,0.02,8.86,51
NDC,0054873925,PREDNISONE 1 MG TABLET,0.56,0.36,0.02,8.86,51
NDC,0054874025,PREDNISONE 2.5 MG TABLET,0.36,0.23,0.02,8.86,51
NDC,0065002315,MIOSTAT 0.01 % INTRAOCULAR SOLUTION,111.54,72.5,16.6,111.54,40
NDC,0065008515,NAPHCON-A 0.025 %-0.3 % EYE DROPS,1.26,0.82,0.19,1.26,40
NDC,0065019093,SYSTANE CONTACTS EYE DROPS,1.68,1.09,0.25,1.68,40
NDC,0065024610,BETOPTIC S 0.25 % EYE DROPSSUSPENSION,78.26,50.87,11.65,78.26,40
NDC,0065035604,OPTI-FREE REPLENISH SOLUTION,0.08,0.05,0.01,0.08,40
NDC,0065035902,CYCLOMYDRIL 0.2 %-1 % EYE DROPS,44.42,28.87,6.61,44.42,40
NDC,0065035905,CYCLOMYDRIL 0.2 %-1 % EYE DROPS,31.22,20.29,4.65,31.22,40
NDC,0065039515,CYCLOGYL 0.5 % EYE DROPS,16.2,10.53,2.41,16.2,40
NDC,0065039602,CYCLOGYL 1 % EYE DROPS,42.52,27.64,6.33,42.52,40
NDC,0065039605,CYCLOGYL 1 % EYE DROPS,30.58,19.88,4.55,30.58,40
NDC,0065039702,CYCLOGYL 2 % EYE DROPS,55.64,36.17,8.28,55.64,40
NDC,0065039705,CYCLOGYL 2 % EYE DROPS,36.8,23.92,5.48,36.8,40
NDC,0065039715,CYCLOGYL 2 % EYE DROPS,20.38,13.25,3.03,20.38,40
NDC,0065041130,BETADINE OPHTHALMIC PREP 5 % SOLUTION,1.42,0.92,0.21,1.42,40
NDC,0065042636,GENTEAL TEARS MODERATE 0.1 %-0.3 %-0.2 % EYE DROPS,1.06,0.69,0.16,1.06,40
NDC,0065045407,SYSTANE GEL 0.4 %-0.3 % EYE DROPS,2.48,1.61,0.37,2.48,40
NDC,0065050935,SYSTANE NIGHTTIME 94 %-3 % EYE OINTMENT,6.28,4.08,0.93,6.28,40
NDC,0065051801,GENTEAL TEARS SEVERE (PETROLATUM-MINERAL OIL) 94 %-3 % EYE OINTMENT,4.9,3.19,0.73,4.9,40
NDC,0065074114,TETRACAINE HCL (PF) 0.5 % EYE DROPS,8.32,5.41,1.24,8.32,40
NDC,0065079515,BSS INTRAOCULAR SOLUTION,2.02,1.31,0.3,2.02,40
NDC,0065079550,BSS INTRAOCULAR SOLUTION,0.18,0.12,0.03,0.18,40
NDC,0065080050,BSS PLUS INTRAOCULAR SOLUTION,0.5,0.33,0.07,0.5,40
NDC,0065080094,BSS PLUS INTRAOCULAR SOLUTION,0.48,0.31,0.07,0.48,40
NDC,0065143105,SYSTANE ULTRA 0.4 %-0.3 % EYE DROPS,2.32,1.51,0.35,2.32,40
NDC,0065179504,BSS INTRAOCULAR SOLUTION,0.18,0.12,0.03,0.18,40
NDC,0065179540,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,0.03,0.02,0.01,0.03,40
NDC,0065806401,GENTEAL TEARS SEVERE 0.3 % EYE GEL,1.72,1.12,0.26,1.72,40
NDC,0067208601,4 WAY 1 % NASAL SPRAY,0.64,0.42,0.1,0.64,40
NDC,0067813902,EXCEDRIN TENSION HEADACHE 500 MG-65 MG TABLET,0.26,0.17,0.04,0.26,40
NDC,0067815202,VOLTAREN ARTHRITIS PAIN 1 % TOPICAL GEL,0.62,0.4,0.09,0.62,40
NDC,0067815203,VOLTAREN ARTHRITIS PAIN 1 % TOPICAL GEL,0.5,0.33,0.07,0.5,40
NDC,0068059701,RIFADIN 600 MG INTRAVENOUS SOLUTION,642.81,417.83,0.27,642.81,51
NDC,0069005801,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.18,8.86,51
NDC,0069010601,ELELYSO 200 UNIT INTRAVENOUS SOLUTION,3397.65,2208.47,2.17,13108.79,65
NDC,0069013501,BOSULIF 100 MG TABLET,444.96,289.22,66.21,444.96,40
NDC,0069013601,BOSULIF 500 MG TABLET,1779.84,1156.9,264.84,1779.84,40
NDC,0069014501,INLYTA 1 MG TABLET,282.16,183.4,41.99,282.16,40
NDC,0069015111,INLYTA 5 MG TABLET,846.48,550.21,125.96,846.48,40
NDC,0069018721,IBRANCE 75 MG CAPSULE,1881.38,1222.9,279.95,1881.38,40
NDC,0069018821,IBRANCE 100 MG CAPSULE,1881.38,1222.9,279.95,1881.38,40
NDC,0069018921,IBRANCE 125 MG CAPSULE,1881.38,1222.9,279.95,1881.38,40
NDC,0069019301,BOSULIF 400 MG TABLET,1779.84,1156.9,264.84,1779.84,40
NDC,0069019502,FRAGMIN 2500 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,1751.55,1138.51,2.17,1751.55,51
NDC,0069019602,FRAGMIN 5000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,2841.69,1847.1,2.17,2841.69,51
NDC,0069019730,VIZIMPRO 15 MG TABLET,1386.84,901.45,206.36,1386.84,40
NDC,0069020602,FRAGMIN 7500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRINGE,2842.02,1847.31,2.17,2842.02,51
NDC,0069020910,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.12,8.86,51
NDC,0069021702,FRAGMIN 10000 ANTI-XA UNIT/ML SUBCUTANEOUS SYRINGE,1136.67,738.84,2.17,1136.67,51
NDC,0069022002,FRAGMIN 12500 ANTI-XA UNIT/0.5 ML SUBCUTANEOUS SYRINGE,2841.93,1847.25,2.17,2841.93,51
NDC,0069022302,FRAGMIN 15000 ANTI-XA UNIT/0.6 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,2.17,2841.75,51
NDC,0069022701,LORBRENA 25 MG TABLET,598.06,388.74,88.99,598.06,40
NDC,0069022802,FRAGMIN 18000 ANTI-XA UNIT/0.72 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,2.17,2841.75,51
NDC,0069023101,LORBRENA 100 MG TABLET,1794.2,1166.23,266.98,1794.2,40
NDC,0069023801,RUXIENCE 10 MG/ML INTRAVENOUS SOLUTION,344.08,223.65,2.17,3257.22,65
NDC,0069024901,RUXIENCE 10 MG/ML INTRAVENOUS SOLUTION,344.08,223.65,2.17,3257.22,65
NDC,0069025160,XALKORI 20 MG ORAL PELLETS,95.1,61.82,14.15,95.1,40
NDC,0069027702,DOXORUBICIN 20 MG/10 ML INTRAVENOUS SOLUTION,9.76,6.34,1.45,9.76,43
NDC,0069028403,IBRANCE 75 MG TABLET,1937.82,1259.58,288.35,1937.82,40
NDC,0069029101,NIVESTYM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.27,1576.8,65
NDC,0069029110,NIVESTYM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.27,1576.8,65
NDC,0069029201,NIVESTYM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.27,1576.8,65
NDC,0069029210,NIVESTYM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.27,1576.8,65
NDC,0069029301,NIVESTYM 300 MCG/ML INJECTION SOLUTION,788.4,512.46,0.27,788.4,65
NDC,0069029310,NIVESTYM 300 MCG/ML INJECTION SOLUTION,788.4,512.46,0.27,788.4,65
NDC,0069029401,NIVESTYM 480 MCG/1.6 ML INJECTION SOLUTION,788.4,512.46,0.27,788.4,65
NDC,0069029410,NIVESTYM 480 MCG/1.6 ML INJECTION SOLUTION,788.4,512.46,0.27,788.4,65
NDC,0069029860,DAURISMO 25 MG TABLET,929.8,604.37,138.35,929.8,40
NDC,0069030501,TRAZIMERA 420 MG INTRAVENOUS SOLUTION,16277.2,10580.18,2.17,16277.2,65
NDC,0069030801,TRAZIMERA 150 MG INTRAVENOUS SOLUTION,5813.28,3778.63,2.17,5813.28,65
NDC,0069031501,ZIRABEV 25 MG/ML INTRAVENOUS SOLUTION,736.08,478.45,2.17,1287.79,65
NDC,0069032401,NYVEPRIA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,23550.0,15307.5,2.17,23550.0,65
NDC,0069033801,REVATIO 10 MG/12.5 ML INTRAVENOUS SOLUTION,60.3,39.2,8.97,60.3,40
NDC,0069034201,ZIRABEV 25 MG/ML INTRAVENOUS SOLUTION,736.08,478.45,2.17,1287.79,65
NDC,0069046856,CHANTIX 0.5 MG TABLET,8.56,5.56,1.27,8.56,40
NDC,0069046956,CHANTIX 1 MG TABLET,8.56,5.56,1.27,8.56,40
NDC,0069048603,IBRANCE 100 MG TABLET,1937.82,1259.58,288.35,1937.82,40
NDC,0069050130,XELJANZ XR 11 MG TABLETEXTENDED RELEASE,512.58,333.18,76.27,512.58,40
NDC,0069050760,XALKORI 50 MG ORAL PELLETS,224.28,145.78,33.37,224.28,40
NDC,0069055038,SUTENT 12.5 MG CAPSULE,553.4,359.71,82.35,553.4,40
NDC,0069068803,IBRANCE 125 MG TABLET,1937.82,1259.58,288.35,1937.82,40
NDC,0069077038,SUTENT 25 MG CAPSULE,1106.82,719.43,164.69,1106.82,40
NDC,0069080901,INFLECTRA 100 MG INTRAVENOUS SOLUTION,3406.62,2214.3,2.17,3406.62,65
NDC,0069083038,SUTENT 37.5 MG CAPSULE,1660.22,1079.14,247.04,1660.22,40
NDC,0069098038,SUTENT 50 MG CAPSULE,1926.82,1252.43,286.71,1926.82,40
NDC,0069100101,XELJANZ 5 MG TABLET,182.2,118.43,27.11,182.2,40
NDC,0069100201,XELJANZ 10 MG TABLET,256.28,166.58,38.13,256.28,40
NDC,0069119830,VIZIMPRO 30 MG TABLET,1386.84,901.45,206.36,1386.84,40
NDC,0069130510,RETACRIT 2000 UNIT/ML INJECTION SOLUTION,81.36,52.88,2.17,369.35,65
NDC,0069130610,RETACRIT 3000 UNIT/ML INJECTION SOLUTION,122.07,79.35,2.17,369.35,65
NDC,0069130710,RETACRIT 4000 UNIT/ML INJECTION SOLUTION,162.75,105.79,2.17,369.35,65
NDC,0069130810,RETACRIT 10000 UNIT/ML INJECTION SOLUTION,406.86,264.46,2.17,406.86,65
NDC,0069130904,RETACRIT 40000 UNIT/ML INJECTION SOLUTION,1627.38,1057.8,2.17,1627.38,65
NDC,0069131101,RETACRIT 20000 UNIT/ML INJECTION SOLUTION,813.69,528.9,2.17,813.69,65
NDC,0069131110,RETACRIT 20000 UNIT/ML INJECTION SOLUTION,813.69,528.9,2.17,813.69,65
NDC,0069131810,RETACRIT 20000 UNIT/2 ML INJECTION SOLUTION,406.86,264.46,2.17,406.86,65
NDC,0069150060,XALKORI 150 MG ORAL PELLETS,672.82,437.33,100.12,672.82,40
NDC,0069153130,DAURISMO 100 MG TABLET,1859.6,1208.74,276.71,1859.6,40
NDC,0069229930,VIZIMPRO 45 MG TABLET,1386.84,901.45,206.36,1386.84,40
NDC,0069246501,ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1148.64,746.62,7.93,1148.64,51
NDC,0069252202,ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION,37534.88,24397.67,2.17,37534.88,65
NDC,0069252810,COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE,2038.14,1324.79,7.93,2038.14,51
NDC,0069303020,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,9.76,6.34,1.45,9.76,43
NDC,0069313019,ZITHROMAX 200 MG/5 ML ORAL SUSPENSION,6.78,4.41,1.01,6.78,40
NDC,0069314019,ZITHROMAX 200 MG/5 ML ORAL SUSPENSION,2.65,1.72,0.39,2.65,40
NDC,0069315083,ZITHROMAX 500 MG INTRAVENOUS SOLUTION,21.93,14.25,2.17,21.93,51
NDC,0069419068,REVATIO 20 MG TABLET,155.88,101.32,23.19,155.88,40
NDC,0069420030,VIAGRA 25 MG TABLET,209.82,136.38,31.22,209.82,40
NDC,0069421030,VIAGRA 50 MG TABLET,209.82,136.38,31.22,209.82,40
NDC,0069422030,VIAGRA 100 MG TABLET,161.64,105.07,24.05,161.64,40
NDC,0069449402,ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION,37534.84,24397.65,2.17,37534.84,65
NDC,0069504530,PAXLOVID 300 MG (150 MG X 2)-100 MG TABLETS IN A DOSE PACK,359.08,233.4,53.43,359.08,40
NDC,0069543420,PAXLOVID 150 MG-100 MG TABLETS IN A DOSE PACK (MODERATE RENAL DOSE),359.08,233.4,53.43,359.08,40
NDC,0069580060,TIKOSYN 125 MCG CAPSULE,26.86,17.46,4.0,26.86,40
NDC,0069581060,TIKOSYN 250 MCG CAPSULE,26.86,17.46,4.0,26.86,40
NDC,0069600125,CEREBYX 100 MG PE/2 ML INJECTION SOLUTION,72.78,47.31,1.34,72.78,59
NDC,0069600202,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,0069611102,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,0069623702,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,0069633902,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,0069655002,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,0069814020,XALKORI 250 MG CAPSULE,950.92,618.1,141.5,950.92,40
NDC,0069814120,XALKORI 200 MG CAPSULE,950.92,618.1,141.5,950.92,40
NDC,0069873030,VYNDAMAX 61 MG CAPSULE,1884.84,1225.15,280.46,1884.84,40
NDC,0071000724,DILANTIN INFATABS 50 MG CHEWABLE TABLET,3.98,2.59,0.59,3.98,40
NDC,0071015623,LIPITOR 20 MG TABLET,47.98,31.19,7.14,47.98,40
NDC,0071015723,LIPITOR 40 MG TABLET,47.98,31.19,7.14,47.98,40
NDC,0071023724,ZARONTIN 250 MG CAPSULE,3.28,2.13,0.49,3.28,40
NDC,0071035060,NARDIL 15 MG TABLET,6.36,4.13,0.95,6.36,40
NDC,0071036924,DILANTIN EXTENDED 100 MG CAPSULE,4.36,2.83,0.65,4.36,40
NDC,0071036940,DILANTIN EXTENDED 100 MG CAPSULE,4.82,3.13,0.72,4.82,40
NDC,0071041813,NITROSTAT 0.4 MG SUBLINGUAL TABLET,3.88,2.52,0.58,3.88,40
NDC,0071041924,NITROSTAT 0.6 MG SUBLINGUAL TABLET,1.78,1.16,0.26,1.78,40
NDC,0071052524,CELONTIN 300 MG CAPSULE,11.02,7.16,1.64,11.02,40
NDC,0071073720,LOPID 600 MG TABLET,3.16,2.05,0.47,3.16,40
NDC,0071101441,LYRICA 75 MG CAPSULE,26.72,17.37,3.98,26.72,40
NDC,0071101468,LYRICA 75 MG CAPSULE,24.28,15.78,3.61,24.28,40
NDC,0071101541,LYRICA 100 MG CAPSULE,26.72,17.37,3.98,26.72,40
NDC,0071101568,LYRICA 100 MG CAPSULE,24.28,15.78,3.61,24.28,40
NDC,0071101768,LYRICA 200 MG CAPSULE,24.28,15.78,3.61,24.28,40
NDC,0071101968,LYRICA 225 MG CAPSULE,24.28,15.78,3.61,24.28,40
NDC,0071374066,DILANTIN 30 MG CAPSULE,3.76,2.44,0.56,3.76,40
NDC,0073140106,ZINC-220 50 MG ZINC (220 MG) CAPSULE,0.24,0.16,0.04,0.24,40
NDC,0074012403,HUMIRA(CF) PEN CROHN'S-ULC COLITIS-HID SUP STRT 80 MG/0.8 ML SUBCUT KT,30767.32,19998.76,2.17,30767.32,57
NDC,0074024302,HUMIRA(CF) 40 MG/0.4 ML SUBCUTANEOUS SYRINGE KIT,11537.7,7499.51,2.17,11537.7,57
NDC,0074055402,HUMIRA(CF) PEN 40 MG/0.4 ML SUBCUTANEOUS KIT,15383.6,9999.34,2.17,15383.6,57
NDC,0074056111,VENCLEXTA 10 MG TABLET,31.22,20.29,4.65,31.22,40
NDC,0074056114,VENCLEXTA 10 MG TABLET,31.24,20.31,4.65,31.24,40
NDC,0074056607,VENCLEXTA 50 MG TABLET,156.22,101.54,23.25,156.22,40
NDC,0074056611,VENCLEXTA 50 MG TABLET,156.22,101.54,23.25,156.22,40
NDC,0074057611,VENCLEXTA 100 MG TABLET,312.36,203.03,46.48,312.36,40
NDC,0074057622,VENCLEXTA 100 MG TABLET,312.42,203.07,46.49,312.42,40
NDC,0074104004,SURVANTA 25 MG/ML INTRATRACHEAL SUSPENSION,344.7,224.06,51.29,344.7,40
NDC,0074104008,SURVANTA 25 MG/ML INTRATRACHEAL SUSPENSION,305.04,198.28,45.39,305.04,40
NDC,0074104328,RINVOQ 45 MG TABLETEXTENDED RELEASE,1080.44,702.29,160.77,1080.44,40
NDC,0074104401,EMRELIS 20 MG INTRAVENOUS SOLUTION,13420.8,8723.52,2.17,13420.8,59
NDC,0074105501,EMRELIS 100 MG INTRAVENOUS SOLUTION,67104.0,43617.6,2.17,67104.0,59
NDC,0074157521,KALETRA 100 MG-25 MG TABLET,10.24,6.66,1.52,10.24,40
NDC,0074165801,ZEMPLAR 5 MCG/ML INTRAVENOUS SOLUTION,54.54,35.45,1.73,54.54,51
NDC,0074165805,ZEMPLAR 5 MCG/ML INTRAVENOUS SOLUTION,54.54,35.45,1.73,54.54,51
NDC,0074194063,NORVIR 80 MG/ML ORAL SOLUTION,18.0,11.7,2.68,18.0,40
NDC,0074210001,SKYRIZI 150 MG/ML SUBCUTANEOUS PEN INJECTOR,80580.57,52377.37,2.17,80580.57,65
NDC,0074210803,LUPRON DEPOT-PED 7.5 MG (PED) INTRAMUSCULAR KIT,7800.3,5070.2,2.17,7800.3,65
NDC,0074228203,LUPRON DEPOT-PED 11.25 MG INTRAMUSCULAR KIT,14161.26,9204.82,2.17,14161.26,65
NDC,0074230630,RINVOQ 15 MG TABLETEXTENDED RELEASE,540.22,351.14,80.38,540.22,40
NDC,0074231030,RINVOQ 30 MG TABLETEXTENDED RELEASE,540.22,351.14,80.38,540.22,40
NDC,0074244003,LUPRON DEPOT-PED 15 MG INTRAMUSCULAR KIT,15597.18,10138.17,2.17,15597.18,65
NDC,0074262528,MAVYRET 100 MG-40 MG TABLET,377.14,245.14,56.12,377.14,40
NDC,0074301207,DUOPA 4.63 MG-20 MG/ML SUSPENSION IN J-TUBE PUMP,7.03,4.57,1.05,7.03,40
NDC,0074310932,GENGRAF 100 MG CAPSULE,17.64,11.47,2.17,17.64,51
NDC,0074334603,LUPRON DEPOT 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,23179.98,15066.99,2.17,23179.98,65
NDC,0074339930,NORVIR 100 MG ORAL POWDER PACKET,20.58,13.38,3.06,20.58,40
NDC,0074347303,LUPRON DEPOT 45 MG (6 MONTH) INTRAMUSCULAR SYRINGE KIT,46360.77,30134.5,2.17,46360.77,65
NDC,0074364103,LUPRON DEPOT 3.75 MG INTRAMUSCULAR SYRINGE KIT,6483.99,4214.59,2.17,6483.99,65
NDC,0074364203,LUPRON DEPOT 7.5 MG INTRAMUSCULAR SYRINGE KIT,7726.71,5022.36,2.17,7726.71,65
NDC,0074366303,LUPRON DEPOT 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,19452.12,12643.88,2.17,19452.12,65
NDC,0074368303,LUPRON DEPOT 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,30906.72,20089.37,2.17,30906.72,65
NDC,0074372790,SYNTHROID 137 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074377903,LUPRON DEPOT-PED 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,42483.9,27614.54,2.17,42483.9,65
NDC,0074379902,HUMIRA 40 MG/0.8 ML SUBCUTANEOUS SYRINGE KIT,12460.71,8099.46,2.17,12460.71,57
NDC,0074387810,EMBLAVEO 2 GRAM INTRAVENOUS SOLUTION,1177.2,765.18,1.67,4417.71,59
NDC,0074395646,KALETRA 400 MG-100 MG/5 ML ORAL SOLUTION,9.6,6.24,1.43,9.6,40
NDC,0074433902,HUMIRA PEN 40 MG/0.8 ML SUBCUTANEOUS KIT,11537.7,7499.51,2.17,11537.7,57
NDC,0074434119,SYNTHROID 25 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074434190,SYNTHROID 25 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074437805,NIMBEX 2 MG/ML INTRAVENOUS SOLUTION,11.28,7.33,1.68,11.28,40
NDC,0074438010,NIMBEX 2 MG/ML INTRAVENOUS SOLUTION,9.9,6.44,1.47,9.9,40
NDC,0074438220,NIMBEX CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,53.46,34.75,7.95,53.46,40
NDC,0074455211,SYNTHROID 50 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074455290,SYNTHROID 50 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074501501,SKYRIZI 60 MG/ML INTRAVENOUS SOLUTION,3827.52,2487.89,2.17,4417.71,65
NDC,0074518211,SYNTHROID 75 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074518290,SYNTHROID 75 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074659490,SYNTHROID 88 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074662411,SYNTHROID 100 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074662419,SYNTHROID 100 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074663330,NORVIR 100 MG CAPSULE,20.58,13.38,3.06,20.58,40
NDC,0074706811,SYNTHROID 125 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074706890,SYNTHROID 125 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074706911,SYNTHROID 150 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074706919,SYNTHROID 150 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074706990,SYNTHROID 150 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074707019,SYNTHROID 175 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074707090,SYNTHROID 175 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074712611,DEPAKOTE ER 500 MG TABLETEXTENDED RELEASE,15.58,10.13,2.32,15.58,40
NDC,0074714811,SYNTHROID 200 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074714890,SYNTHROID 200 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074714990,SYNTHROID 300 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074726950,GENGRAF 100 MG/ML ORAL SOLUTION,24.9,16.19,2.17,24.9,51
NDC,0074929690,SYNTHROID 112 MCG TABLET,3.98,2.59,0.59,3.98,40
NDC,0074969403,LUPRON DEPOT-PED 30 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,46791.75,30414.64,2.17,46791.75,65
NDC,0075062040,LOVENOX 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.94,89.31,51
NDC,0075062160,LOVENOX 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.94,89.4,51
NDC,0075062280,LOVENOX 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.94,89.4,51
NDC,0075062300,LOVENOX 100 MG/ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.94,89.4,51
NDC,0075062430,LOVENOX 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.94,89.31,51
NDC,0075062603,LOVENOX 300 MG/3 ML SUBCUTANEOUS SOLUTION,89.31,58.05,0.94,89.31,51
NDC,0075291201,LOVENOX 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.94,134.16,51
NDC,0075291501,LOVENOX 150 MG/ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.94,134.16,51
NDC,0078010901,SANDIMMUNE 250 MG/5 ML INTRAVENOUS SOLUTION,51.24,33.31,2.17,162.7,51
NDC,0078018001,SANDOSTATIN 50 MCG/ML INJECTION SOLUTION,50.82,33.03,1.17,50.82,51
NDC,0078018101,SANDOSTATIN 100 MCG/ML INJECTION SOLUTION,98.58,64.08,1.17,98.58,51
NDC,0078018201,SANDOSTATIN 500 MCG/ML INJECTION SOLUTION,475.44,309.04,1.17,475.44,51
NDC,0078024015,SANDIMMUNE 25 MG CAPSULE,10.98,7.14,0.94,10.98,51
NDC,0078024115,SANDIMMUNE 100 MG CAPSULE,43.82,28.48,2.17,43.82,51
NDC,0078024615,NEORAL 25 MG CAPSULE,7.06,4.59,0.94,8.86,51
NDC,0078024815,NEORAL 100 MG CAPSULE,28.22,18.34,2.17,28.22,51
NDC,0078024861,NEORAL 100 MG CAPSULE,28.28,18.38,2.17,28.28,51
NDC,0078024915,FEMARA 2.5 MG TABLET,65.16,42.35,9.7,65.16,40
NDC,0078027422,NEORAL 100 MG/ML ORAL SOLUTION,38.45,24.99,2.17,38.45,51
NDC,0078033184,SIMULECT 20 MG INTRAVENOUS SOLUTION,22321.68,14509.09,2.17,22321.68,65
NDC,0078035752,TRILEPTAL 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,5.88,3.82,0.87,5.88,40
NDC,0078036034,DIOVAN 320 MG TABLET,30.94,20.11,4.6,30.94,40
NDC,0078036405,LOTREL 10 MG-20 MG CAPSULE,35.46,23.05,5.28,35.46,40
NDC,0078038666,MYFORTIC 360 MG TABLETDELAYED RELEASE,35.8,23.27,0.57,35.8,51
NDC,0078039361,SIMULECT 10 MG INTRAVENOUS SOLUTION,17007.04,11054.58,2.17,17007.04,65
NDC,0078040505,LOTREL 5 MG-10 MG CAPSULE,28.9,18.79,4.3,28.9,40
NDC,0078041420,ZORTRESS 0.5 MG TABLET,52.64,34.22,2.1,52.64,43
NDC,0078041520,ZORTRESS 0.75 MG TABLET,78.96,51.32,2.1,78.96,43
NDC,0078045605,TRILEPTAL 150 MG TABLET,13.98,9.09,2.08,13.98,40
NDC,0078045705,TRILEPTAL 600 MG TABLET,46.9,30.49,6.98,46.9,40
NDC,0078046791,DESFERAL 500 MG SOLUTION FOR INJECTION,124.98,81.24,2.17,124.98,51
NDC,0078046815,EXJADE 125 MG DISPERSIBLE TABLET,123.48,80.26,18.37,123.48,40
NDC,0078047015,EXJADE 500 MG DISPERSIBLE TABLET,493.86,321.01,73.49,493.86,40
NDC,0078051005,TEGRETOL XR 100 MG TABLETEXTENDED RELEASE,3.96,2.57,0.59,3.96,40
NDC,0078051205,TEGRETOL XR 400 MG TABLETEXTENDED RELEASE,15.82,10.28,2.35,15.82,40
NDC,0078052687,TASIGNA 200 MG CAPSULE,463.82,301.48,69.02,463.82,40
NDC,0078056751,AFINITOR 10 MG TABLET,1640.16,1066.1,244.06,1640.16,40
NDC,0078056845,COARTEM 20 MG-120 MG TABLET,12.26,7.97,1.82,12.26,40
NDC,0078059287,TASIGNA 150 MG CAPSULE,463.82,301.48,69.02,463.82,40
NDC,0078059451,AFINITOR 2.5 MG TABLET,1568.06,1019.24,233.33,1568.06,40
NDC,0078060715,GILENYA 0.5 MG CAPSULE,934.72,607.57,139.09,934.72,40
NDC,0078062051,AFINITOR 7.5 MG TABLET,1640.16,1066.1,244.06,1640.16,40
NDC,0078063968,COSENTYX PEN 150 MG/ML SUBCUTANEOUS PEN INJECTOR,27472.44,17857.09,41.42,27472.44,51
NDC,0078063997,COSENTYX 150 MG/ML SUBCUTANEOUS SYRINGE,27472.44,17857.09,41.42,27472.44,51
NDC,0078063998,COSENTYX 300 MG/2 SYRINGES (150 MG/ML) SUBCUTANEOUS SYRINGE,13736.22,8928.54,41.42,13736.22,51
NDC,0078065006,FARYDAK 10 MG CAPSULE,5633.0,3661.45,838.19,5633.0,40
NDC,0078065106,FARYDAK 15 MG CAPSULE,5633.0,3661.45,838.19,5633.0,40
NDC,0078065206,FARYDAK 20 MG CAPSULE,5633.0,3661.45,838.19,5633.0,40
NDC,0078065415,JADENU 90 MG TABLET,132.38,86.05,19.7,132.38,40
NDC,0078065920,ENTRESTO 24 MG-26 MG TABLET,28.2,18.33,4.2,28.2,40
NDC,0078066913,ARZERRA 100 MG/5 ML INTRAVENOUS SOLUTION,579.24,376.51,2.17,4417.71,65
NDC,0078067119,TYKERB 250 MG TABLET,162.82,105.83,24.23,162.82,40
NDC,0078068166,TAFINLAR 75 MG CAPSULE,314.66,204.53,46.82,314.66,40
NDC,0078068266,TAFINLAR 50 MG CAPSULE,244.16,158.7,36.33,244.16,40
NDC,0078069061,ARZERRA 1000 MG/50 ML INTRAVENOUS SOLUTION,579.24,376.51,2.17,4417.71,65
NDC,0078069484,ZYKADIA 150 MG TABLET,393.82,255.98,58.6,393.82,40
NDC,0078069620,ENTRESTO 97 MG-103 MG TABLET,28.2,18.33,4.2,28.2,40
NDC,0078069899,RYDAPT 25 MG CAPSULE,523.0,339.95,77.82,523.0,40
NDC,0078070184,PIQRAY 200 MG/DAY (200 MG X 1) TABLET,2040.24,1326.16,303.59,2040.24,40
NDC,0078070802,PIQRAY 300 MG/DAY (150 MG X 2) TABLET,1020.12,663.08,151.79,1020.12,40
NDC,0078070956,TABRECTA 150 MG TABLET,500.0,325.0,74.4,500.0,40
NDC,0078071502,PIQRAY 250 MG/DAY (200 MG X 1 AND 50 MG X 1) TABLET,1020.12,663.08,151.79,1020.12,40
NDC,0078071656,TABRECTA 200 MG TABLET,500.0,325.0,74.4,500.0,40
NDC,0078073461,ILARIS (PF) 150 MG/ML SUBCUTANEOUS SOLUTION,76983.66,50039.38,2.17,76983.66,65
NDC,0078077720,ENTRESTO 49 MG-51 MG TABLET,28.2,18.33,4.2,28.2,40
NDC,0078079761,SANDOSTATIN LAR DEPOT 20 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,16618.68,10802.14,2.17,16618.68,65
NDC,0078080461,SANDOSTATIN LAR DEPOT 30 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,24885.21,16175.39,2.17,24885.21,65
NDC,0078081181,SANDOSTATIN LAR DEPOT 10 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,12684.36,8244.83,2.17,12684.36,65
NDC,0078081301,TOBREX 0.3 % EYE OINTMENT,192.0,124.8,28.57,192.0,40
NDC,0078081881,SANDOSTATIN LAR DEPOT 20 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,16618.68,10802.14,2.17,16618.68,65
NDC,0078082581,SANDOSTATIN LAR DEPOT 30 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,24885.21,16175.39,2.17,24885.21,65
NDC,0078082760,BEOVU 6 MG/0.05 ML INTRAVITREAL SYRINGE,150004.08,97502.65,2.17,150004.08,65
NDC,0078084619,KYMRIAH 0.2 X 10EXP6 TO 2.5 X 10EXP8 CELL INTRAVENOUS SUSPENSION,2905939.24,1888860.51,0.02,2905939.24,64
NDC,0078087601,TOBRADEX 0.3 %-0.1 % EYE OINTMENT,204.4,132.86,30.41,204.4,40
NDC,0078088361,ADAKVEO 10 MG/ML INTRAVENOUS SOLUTION,874.32,568.31,2.17,1287.79,65
NDC,0078095166,TASIGNA 50 MG CAPSULE,463.82,301.48,69.02,463.82,40
NDC,0078095819,KYMRIAH 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2511128.6,1632233.59,0.02,2511128.6,64
NDC,0078100060,LEQVIO 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,8610.54,5596.85,2.17,8610.54,65
NDC,0078100768,KESIMPTA PEN 20 MG/0.4 ML SUBCUTANEOUS PEN INJECTOR,84123.63,54680.36,41.42,84123.63,51
NDC,0078102184,VIJOICE 50 MG TABLET,2785.72,1810.72,414.52,2785.72,40
NDC,0078102884,VIJOICE 125 MG TABLET,2785.72,1810.72,414.52,2785.72,40
NDC,0078103502,VIJOICE 250 MG/DAY(200 MG X 1 AND 50 MG X 1) TABLET,1392.86,905.36,207.26,1392.86,40
NDC,0078107766,VOTRIENT 200 MG TABLET,356.38,231.65,53.03,356.38,40
NDC,0078109120,SCEMBLIX 20 MG TABLET,894.6,581.49,133.12,894.6,40
NDC,0078109820,SCEMBLIX 40 MG TABLET,894.6,581.49,133.12,894.6,40
NDC,0078110515,MEKINIST 0.5 MG TABLET,401.5,260.98,59.74,401.5,40
NDC,0078111215,MEKINIST 2 MG TABLET,1366.5,888.23,203.34,1366.5,40
NDC,0078116861,COSENTYX 25 MG/ML INTRAVENOUS SOLUTION,1584.48,1029.91,2.17,2642.72,65
NDC,0078119620,SCEMBLIX 100 MG TABLET,894.6,581.49,133.12,894.6,40
NDC,0081073088,NEOSPORIN (NEO-BAC-POLYM) 3.5 MG-400 UNIT-5000 UNIT/GRAM TOP OINTMENT,0.74,0.48,0.11,0.74,40
NDC,0081079887,POLYSPORIN 500 UNIT-10000 UNIT/GRAM TOPICAL OINTMENT,0.68,0.44,0.1,0.68,40
NDC,0084795024,PHENYLADE ESSENTIAL (FLAX) 10 GRAM-156 KCAL/40 GRAM ORAL POWDER PACKET,9.94,6.46,1.48,9.94,40
NDC,0085132801,NOXAFIL 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,41.13,26.73,6.12,41.13,40
NDC,0085138101,TEMODAR 100 MG INTRAVENOUS SOLUTION,4814.92,3129.7,2.17,4814.92,65
NDC,0087020142,ENFAMIL A.R. 2.5-5.1-11.3 GRAM/100 KCAL ORAL POWDER,0.23,0.15,0.03,0.23,40
NDC,0087040203,POLY-VI-SOL 250 MCG-50 MG-10 MCG/ML ORAL DROPS,0.5,0.33,0.07,0.5,40
NDC,0087040303,TRI-VI-SOL 250 MCG-50 MG-10 MCG/ML ORAL DROPS,0.5,0.33,0.07,0.5,40
NDC,0087040501,POLY-VI-SOL WITH IRON 11 MG IRON/ML ORAL DROPS,0.5,0.33,0.07,0.5,40
NDC,0088210224,PRIFTIN 150 MG TABLET,12.16,7.9,1.81,12.16,40
NDC,0088216030,ARAVA 10 MG TABLET,119.56,77.71,17.79,119.56,40
NDC,0088216130,ARAVA 20 MG TABLET,119.56,77.71,17.79,119.56,40
NDC,0088221905,LANTUS SOLOSTAR U-100 INSULIN 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,23.13,15.03,0.48,23.13,48
NDC,0088222033,LANTUS U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,23.13,15.03,0.48,23.13,51
NDC,0088250033,APIDRA U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,30.66,19.93,0.48,30.66,51
NDC,0088250205,APIDRA SOLOSTAR U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,39.51,25.68,0.48,39.51,48
NDC,0093001006,TOLTERODINE 1 MG TABLET,6.62,4.3,0.99,6.62,40
NDC,0093005301,BUSPIRONE 5 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,0093005401,BUSPIRONE 10 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,0093026215,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,0.9,6.08,40
NDC,0093026230,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,0.9,6.08,40
NDC,0093026292,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,0.9,6.08,40
NDC,0093026415,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.4,9.44,40
NDC,0093031401,KETOROLAC 10 MG TABLET,4.32,2.81,0.64,4.32,40
NDC,0093032001,DILTIAZEM 90 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,0093075305,ATENOLOL 100 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,0093075601,PIROXICAM 10 MG CAPSULE,5.22,3.39,0.78,5.22,40
NDC,0093075701,PIROXICAM 20 MG CAPSULE,8.98,5.84,1.34,8.98,40
NDC,0093078701,ATENOLOL 25 MG TABLET,1.64,1.07,0.24,1.64,40
NDC,0093081001,NORTRIPTYLINE 10 MG CAPSULE,1.48,0.96,0.22,1.48,40
NDC,0093081101,NORTRIPTYLINE 25 MG CAPSULE,2.94,1.91,0.44,2.94,40
NDC,0093094801,DICLOFENAC POTASSIUM 50 MG TABLET,5.52,3.59,0.82,5.52,40
NDC,0093101042,MUPIROCIN 2 % TOPICAL OINTMENT,7.78,5.06,1.16,7.78,40
NDC,0093102406,NEFAZODONE 100 MG TABLET,9.6,6.24,1.43,9.6,40
NDC,0093102506,NEFAZODONE 200 MG TABLET,9.96,6.47,1.48,9.96,40
NDC,0093106001,SOTALOL 120 MG TABLET,6.26,4.07,0.93,6.26,40
NDC,0093106101,SOTALOL 80 MG TABLET,4.7,3.06,0.7,4.7,40
NDC,0093106201,SOTALOL 160 MG TABLET,7.84,5.1,1.17,7.84,40
NDC,0093106301,SOTALOL 240 MG TABLET,10.18,6.62,1.51,10.18,40
NDC,0093111801,ETODOLAC ER 600 MG TABLETEXTENDED RELEASE 24 HR,6.54,4.25,0.97,6.54,40
NDC,0093117201,PENICILLIN V POTASSIUM 250 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,0093117701,NEOMYCIN 500 MG TABLET,2.98,1.94,0.44,2.98,40
NDC,0093171201,WARFARIN 1 MG TABLET,1.22,0.79,0.18,1.22,40
NDC,0093172001,WARFARIN 10 MG TABLET,2.04,1.33,0.3,2.04,40
NDC,0093172301,WARFARIN 7.5 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,0093202623,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,5.83,3.79,0.87,5.83,40
NDC,0093202631,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,2.9,1.89,0.43,2.9,40
NDC,0093202694,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,3.88,2.52,0.58,3.88,40
NDC,0093206406,CILOSTAZOL 100 MG TABLET,3.66,2.38,0.54,3.66,40
NDC,0093206506,CILOSTAZOL 50 MG TABLET,3.86,2.51,0.57,3.86,40
NDC,0093220301,METOCLOPRAMIDE 10 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,0093220310,METOCLOPRAMIDE 10 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,0093220401,METOCLOPRAMIDE 5 MG TABLET,0.66,0.43,0.1,0.66,40
NDC,0093220405,METOCLOPRAMIDE 5 MG TABLET,0.66,0.43,0.1,0.66,40
NDC,0093221001,SUCRALFATE 1 GRAM TABLET,1.6,1.04,0.24,1.6,40
NDC,0093226401,AMOXICILLIN 875 MG TABLET,1.74,1.13,0.26,1.74,40
NDC,0093226701,AMOXICILLIN 125 MG CHEWABLE TABLET,0.74,0.48,0.11,0.74,40
NDC,0093226801,AMOXICILLIN 250 MG CHEWABLE TABLET,1.48,0.96,0.22,1.48,40
NDC,0093300993,LANSOPRAZOLE 30 MG DELAYED RELEASEDISINTEGRATING TABLET,31.54,20.5,4.69,31.54,40
NDC,0093306156,RASAGILINE 1 MG TABLET,50.0,32.5,7.44,50.0,40
NDC,0093306634,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,12708.15,8260.3,2.17,12708.15,57
NDC,0093309844,RISEDRONATE 35 MG TABLET,123.9,80.54,18.44,123.9,40
NDC,0093310701,AMOXICILLIN 250 MG CAPSULE,0.5,0.33,0.07,0.5,40
NDC,0093310953,AMOXICILLIN 500 MG CAPSULE,0.94,0.61,0.14,0.94,40
NDC,0093312301,DICLOXACILLIN 250 MG CAPSULE,3.0,1.95,0.45,3.0,40
NDC,0093312501,DICLOXACILLIN 500 MG CAPSULE,5.46,3.55,0.81,5.46,40
NDC,0093312701,DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,5.72,3.72,0.85,5.72,40
NDC,0093312901,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,6.76,4.39,1.01,6.76,40
NDC,0093317431,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,17.42,11.32,2.59,17.42,40
NDC,0093322308,ESTRADIOL 10 MCG VAGINAL TABLET,48.5,31.53,7.22,48.5,40
NDC,0093342501,LORAZEPAM 0.5 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,0093342601,LORAZEPAM 1 MG TABLET,1.76,1.14,0.26,1.76,40
NDC,0093354143,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,16.9,10.99,2.51,16.9,40
NDC,0093354256,ATOMOXETINE 10 MG CAPSULE,28.46,18.5,4.23,28.46,40
NDC,0093354356,ATOMOXETINE 18 MG CAPSULE,28.46,18.5,4.23,28.46,40
NDC,0093354456,ATOMOXETINE 25 MG CAPSULE,28.46,18.5,4.23,28.46,40
NDC,0093354656,ATOMOXETINE 60 MG CAPSULE,30.94,20.11,4.6,30.94,40
NDC,0093365940,BUPRENORPHINE 20 MCG/HOUR WEEKLY TRANSDERMAL PATCH,406.34,264.12,60.46,406.34,40
NDC,0093412573,PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLUTION,0.25,0.16,0.04,0.25,40
NDC,0093412574,PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLUTION,0.18,0.12,0.03,0.18,40
NDC,0093412773,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,0.28,0.18,0.04,0.28,40
NDC,0093412774,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,40
NDC,0093415573,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.02,0.15,40
NDC,0093415579,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.18,0.12,0.03,0.18,40
NDC,0093416176,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,40
NDC,0093417573,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,0.6,0.39,0.09,0.6,40
NDC,0093417574,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,0.5,0.33,0.07,0.5,40
NDC,0093417773,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,0.73,0.47,0.11,0.73,40
NDC,0093417774,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,0.65,0.42,0.1,0.65,40
NDC,0093503056,TIAGABINE 2 MG TABLET,15.88,10.32,2.36,15.88,40
NDC,0093503156,TIAGABINE 4 MG TABLET,15.88,10.32,2.36,15.88,40
NDC,0093506201,HYDROXYZINE HCL 50 MG TABLET,2.24,1.46,0.33,2.24,40
NDC,0093523456,EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,227.6,147.94,33.87,227.6,40
NDC,0093524565,OLANZAPINE 5 MG DISINTEGRATING TABLET,28.54,18.55,4.25,28.54,40
NDC,0093524665,OLANZAPINE 10 MG DISINTEGRATING TABLET,41.94,27.26,6.24,41.94,40
NDC,0093537684,CLOZAPINE 150 MG DISINTEGRATING TABLET,41.44,26.94,6.17,41.44,40
NDC,0093537784,CLOZAPINE 200 MG DISINTEGRATING TABLET,55.24,35.91,8.22,55.24,40
NDC,0093541601,CLOZAPINE 12.5 MG DISINTEGRATING TABLET,4.46,2.9,0.66,4.46,40
NDC,0093541784,CLOZAPINE 25 MG DISINTEGRATING TABLET,6.0,3.9,0.89,6.0,40
NDC,0093541984,CLOZAPINE 100 MG DISINTEGRATING TABLET,16.36,10.63,2.43,16.36,40
NDC,0093542088,CABERGOLINE 0.5 MG TABLET,73.32,47.66,1.95,73.32,48
NDC,0093550456,OLANZAPINE-FLUOXETINE 6 MG-25 MG CAPSULE,28.96,18.82,4.31,28.96,40
NDC,0093550656,OLANZAPINE-FLUOXETINE 12 MG-25 MG CAPSULE,43.66,28.38,6.5,43.66,40
NDC,0093550756,OLANZAPINE-FLUOXETINE 12 MG-50 MG CAPSULE,43.66,28.38,6.5,43.66,40
NDC,0093552706,ATAZANAVIR 200 MG CAPSULE,55.6,36.14,8.27,55.6,40
NDC,0093552856,ATAZANAVIR 300 MG CAPSULE,110.16,71.6,16.39,110.16,40
NDC,0093557101,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,3.94,26.46,40
NDC,0093557156,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,3.94,26.46,40
NDC,0093681545,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,9.42,6.12,1.4,9.42,40
NDC,0093681573,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,9.42,6.12,1.4,9.42,40
NDC,0093681645,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.08,7.2,1.65,11.08,40
NDC,0093681673,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.08,7.2,1.65,11.08,40
NDC,0093716405,TOLTERODINE ER 4 MG CAPSULEEXTENDED RELEASE 24 HR,16.08,10.45,2.39,16.08,40
NDC,0093717801,NEFAZODONE 50 MG TABLET,9.38,6.1,1.4,9.38,40
NDC,0093727156,PIOGLITAZONE 15 MG TABLET,14.02,9.11,2.09,14.02,40
NDC,0093727256,PIOGLITAZONE 30 MG TABLET,21.44,13.94,3.19,21.44,40
NDC,0093727398,PIOGLITAZONE 45 MG TABLET,23.26,15.12,3.46,23.26,40
NDC,0093733401,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,7.94,5.16,0.27,8.86,51
NDC,0093739398,NIACIN ER 750 MG TABLETEXTENDED RELEASE 24 HR,12.08,7.85,1.8,12.08,40
NDC,0093739498,NIACIN ER 1000 MG TABLETEXTENDED RELEASE 24 HR,14.98,9.74,2.23,14.98,40
NDC,0093762056,LETROZOLE 2.5 MG TABLET,36.28,23.58,5.4,36.28,40
NDC,0093762998,IMATINIB 100 MG TABLET,202.26,131.47,30.1,202.26,40
NDC,0093763056,IMATINIB 400 MG TABLET,728.82,473.73,108.45,728.82,40
NDC,0093766256,ERLOTINIB 25 MG TABLET,206.76,134.39,30.77,206.76,40
NDC,0093803501,GLYBURIDE MICRONIZED 3 MG TABLET,1.32,0.86,0.2,1.32,40
NDC,0093807656,TIAGABINE 16 MG TABLET,30.16,19.6,4.49,30.16,40
NDC,0093811756,FAMCICLOVIR 125 MG TABLET,11.62,7.55,1.73,11.62,40
NDC,0093811956,FAMCICLOVIR 500 MG TABLET,25.38,16.5,3.78,25.38,40
NDC,0093834301,GLYBURIDE 2.5 MG TABLET,0.92,0.6,0.14,0.92,40
NDC,0093834401,GLYBURIDE 5 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,0093873901,MEXILETINE 150 MG CAPSULE,5.08,3.3,0.76,5.08,40
NDC,0093874001,MEXILETINE 200 MG CAPSULE,6.06,3.94,0.9,6.06,40
NDC,0093874101,MEXILETINE 250 MG CAPSULE,7.0,4.55,1.04,7.0,40
NDC,0093901819,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.41,8.86,51
NDC,0093901865,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.41,8.86,51
NDC,0093902019,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.64,11.0,51
NDC,0093902065,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.64,11.0,51
NDC,0093922201,DIFLUNISAL 500 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,0093922206,DIFLUNISAL 500 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,0093929067,CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,2.6,1.69,0.39,2.6,40
NDC,0093929167,CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,2.6,1.69,0.39,2.6,40
NDC,0093929267,CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,2.6,1.69,0.39,2.6,40
NDC,0093929367,CLONAZEPAM 1 MG DISINTEGRATING TABLET,2.96,1.92,0.44,2.96,40
NDC,0093943301,GLYBURIDE 2.5 MG TABLET,0.92,0.6,0.14,0.92,40
NDC,0093947753,GLYBURIDE 1.25 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,0093970201,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,1.74,1.13,0.26,1.74,40
NDC,0096070737,DRYSOL 20 % TOPICAL SOLUTION,0.54,0.35,0.08,0.54,40
NDC,0096070760,DRYSOL DAB-O-MATIC 20 % TOPICAL SOLUTION,0.5,0.33,0.07,0.5,40
NDC,0096073204,AQUANIL HC 1 % LOTION,0.3,0.2,0.04,0.3,40
NDC,0096073704,DHS TAR 0.5 % SHAMPOO,0.12,0.08,0.02,0.12,40
NDC,00998101002,MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,607.24,394.71,90.36,607.24,40
NDC,0115107001,DIPYRIDAMOLE 25 MG TABLET,2.84,1.85,0.42,2.84,40
NDC,0115124808,CARVEDILOL PHOSPHATE ER 10 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.07,20.64,40
NDC,0115124908,CARVEDILOL PHOSPHATE ER 20 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.07,20.64,40
NDC,0115125008,CARVEDILOL PHOSPHATE ER 40 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.07,20.64,40
NDC,0115125108,CARVEDILOL PHOSPHATE ER 80 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.07,20.64,40
NDC,0115148601,DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0115164301,NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,4.26,2.77,0.63,4.26,40
NDC,0115164501,NITROFURANTOIN MACROCRYSTAL 100 MG CAPSULE,7.06,4.59,1.05,7.06,40
NDC,0115169549,EPINEPHRINE 0.15 MG/0.15 ML AUTO-INJECTOR (FOR 33 TO 66 LB PATIENTS),741.03,481.67,1.63,741.03,51
NDC,0115169606,HYDROCORTISONE 5 MG TABLET,0.68,0.44,0.1,0.68,40
NDC,0115191101,RIMANTADINE 100 MG TABLET,6.5,4.23,0.97,6.5,40
NDC,0115261101,TERBUTALINE 2.5 MG TABLET,10.88,7.07,1.62,10.88,40
NDC,0115262201,TERBUTALINE 5 MG TABLET,13.3,8.65,1.98,13.3,40
NDC,0115351101,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,2.56,1.66,0.38,2.56,40
NDC,0115441101,DANTROLENE 25 MG CAPSULE,2.14,1.39,0.32,2.14,40
NDC,0115442201,DANTROLENE 50 MG CAPSULE,3.46,2.25,0.51,3.46,40
NDC,0115443301,DANTROLENE 100 MG CAPSULE,4.34,2.82,0.65,4.34,40
NDC,0115703301,FLUDROCORTISONE 0.1 MG TABLET,1.5,0.98,0.22,1.5,40
NDC,0115703701,METHITEST 10 MG TABLET,167.78,109.06,24.97,167.78,40
NDC,0116200116,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.08,0.05,0.01,0.08,40
NDC,0121043130,MILK OF MAGNESIA 400 MG/5 ML ORAL SUSPENSION,0.2,0.13,0.03,0.2,40
NDC,0121048900,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,2.6,1.69,0.39,2.6,40
NDC,0121048905,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,2.6,1.69,0.39,2.6,40
NDC,0121050404,ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ORAL SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0121053005,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,2.03,1.32,0.3,2.03,40
NDC,0121058104,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,1.13,0.73,0.17,1.13,40
NDC,0121058105,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,2.1,1.37,0.31,2.1,40
NDC,0121059500,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.98,0.64,0.15,0.98,40
NDC,0121059516,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.1,0.07,0.01,0.1,40
NDC,0121063800,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.25,0.81,0.19,1.25,40
NDC,0121063805,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.25,0.81,0.19,1.25,40
NDC,0121064610,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,1.23,0.8,0.18,1.23,40
NDC,0121064616,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,0121065304,FLUPHENAZINE 5 MG/ML ORAL CONCENTRATE,7.85,5.1,1.17,7.85,40
NDC,0121065402,FLUPHENAZINE 2.5 MG/5 ML ORAL ELIXIR,1.6,1.04,0.24,1.6,40
NDC,0121065416,FLUPHENAZINE 2.5 MG/5 ML ORAL ELIXIR,1.63,1.06,0.24,1.63,40
NDC,0121065705,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,0.98,0.64,0.15,0.98,40
NDC,0121065816,TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,0.28,0.18,0.04,0.28,40
NDC,0121067016,ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,1.25,0.81,0.19,1.25,40
NDC,0121067585,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,0121067616,POTASSIUM CITRATE-CITRIC ACID 1100 MG-334 MG/5 ML ORAL SOLUTION,0.28,0.18,0.04,0.28,40
NDC,0121067716,TRICITRATES 550 MG-500 MG-334 MG/5 ML ORAL SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0121067816,NORTRIPTYLINE 10 MG/5 ML ORAL SOLUTION,1.2,0.78,0.18,1.2,40
NDC,0121072104,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,2.45,1.59,0.36,2.45,40
NDC,0121075908,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,0.78,0.51,0.12,0.78,40
NDC,0121076616,CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1250 MG/5 ML) ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,0121077001,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,2.4,1.56,0.36,2.4,40
NDC,0121077504,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.18,0.12,0.03,0.18,40
NDC,0121079916,LEVETIRACETAM 100 MG/ML ORAL SOLUTION,1.63,1.06,0.24,1.63,40
NDC,0121082016,THEOPHYLLINE 80 MG/15 ML ORAL ELIXIR,0.6,0.39,0.09,0.6,40
NDC,0121085340,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,2.55,1.66,0.38,2.55,40
NDC,0121085416,SULFATRIM 200 MG-40 MG/5 ML ORAL SUSPENSION,0.6,0.39,0.09,0.6,40
NDC,0121086505,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.23,0.8,0.18,1.23,40
NDC,0121086802,NYSTATIN 100000 UNIT/ML ORAL SUSPENSION,0.6,0.39,0.09,0.6,40
NDC,0121086816,NYSTATIN 100000 UNIT/ML ORAL SUSPENSION,0.63,0.41,0.09,0.63,40
NDC,0121086850,NYSTATIN 100000 UNIT/ML ORAL SUSPENSION,1.18,0.77,0.18,1.18,40
NDC,0121087316,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.18,0.12,0.03,0.18,40
NDC,0121087332,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0121087416,CETIRIZINE 1 MG/ML ORAL SOLUTION,2.08,1.35,0.31,2.08,40
NDC,0121089300,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.35,0.23,0.05,0.35,40
NDC,0121089340,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.38,0.25,0.06,0.38,40
NDC,0121091400,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.43,0.28,0.06,0.43,40
NDC,0121094216,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,0.29,0.19,0.04,0.29,40
NDC,0121094500,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,1.25,0.81,0.19,1.25,40
NDC,0121094540,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,1.68,1.09,0.25,1.68,40
NDC,0121096600,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,0.7,0.46,0.1,0.7,40
NDC,0121097440,SUCRALFATE 100 MG/ML ORAL SUSPENSION,3.05,1.98,0.45,3.05,40
NDC,0121097800,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,1.3,0.85,0.19,1.3,40
NDC,0121097810,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,1.3,0.85,0.19,1.3,40
NDC,0121100840,ACETAMINOPHEN 300 MG-CODEINE 30 MG/12.5 ML (12.5 ML) ORAL SOLUTION,2.18,1.42,0.32,2.18,40
NDC,0121103640,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML (5 ML) ORAL SOLUTION,8.0,5.2,1.19,8.0,40
NDC,0121115400,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,40
NDC,0121119000,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.53,0.34,0.08,0.53,40
NDC,0121119030,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.53,0.34,0.08,0.53,40
NDC,0121127600,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,0.7,0.46,0.1,0.7,40
NDC,0121127610,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,0.7,0.46,0.1,0.7,40
NDC,0121148800,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.48,0.31,0.07,0.48,40
NDC,0121157610,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,1.23,0.8,0.18,1.23,40
NDC,0121173000,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,0.68,0.44,0.1,0.68,40
NDC,0121174400,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.95,0.62,0.14,0.95,40
NDC,0121176030,MAG-AL 200 MG-200 MG/5 ML ORAL SUSPENSION,0.48,0.31,0.07,0.48,40
NDC,0121176130,MAG-AL PLUS 200 MG-200 MG-20 MG/5 ML ORAL SUSPENSION,0.33,0.21,0.05,0.33,40
NDC,0121176230,MAG-AL PLUS EXTRA STRENGTH 400 MG-400 MG-40 MG/5 ML ORAL SUSPENSION,0.38,0.25,0.06,0.38,40
NDC,0121177540,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,2.15,1.4,0.32,2.15,40
NDC,0121178100,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,0.7,0.46,0.1,0.7,40
NDC,0121187000,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,0.55,0.36,0.08,0.55,40
NDC,0121189410,CARBAMAZEPINE 200 MG/10 ML ORAL SUSPENSION,1.13,0.73,0.17,1.13,40
NDC,0121197100,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.3,0.2,0.04,0.3,40
NDC,0121197121,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.3,0.2,0.04,0.3,40
NDC,0121202495,LACOSAMIDE 10 MG/ML ORAL SOLUTION,16.85,10.95,2.51,16.85,40
NDC,0121223200,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.38,0.25,0.06,0.38,40
NDC,0121282394,ACETAMINOPHEN 650 MG/20.3 ML ORAL SUSPENSION,0.28,0.18,0.04,0.28,40
NDC,0121457740,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,0121467500,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,0.85,0.55,0.13,0.85,40
NDC,0121467505,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,0.85,0.55,0.13,0.85,40
NDC,0121467540,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,1.35,0.88,0.2,1.35,40
NDC,0121472105,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,3.43,2.23,0.51,3.43,40
NDC,0121472215,SENNA 176 MG/5 ML ORAL SYRUP,0.8,0.52,0.12,0.8,40
NDC,0121475950,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,4.13,2.68,0.61,8.86,51
NDC,0121476605,CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1250 MG/5 ML) ORAL SUSPENSION,1.55,1.01,0.23,1.55,40
NDC,0121477240,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,5.8,3.77,0.86,5.8,40
NDC,0121479940,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,4.68,3.04,0.7,4.68,40
NDC,0121482040,THEOPHYLLINE 80 MG/15 ML ORAL ELIXIR,2.1,1.37,0.31,2.1,40
NDC,0121495040,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,1.28,0.83,0.19,1.28,40
NDC,0131181067,VIMPAT 200 MG/20 ML INTRAVENOUS SOLUTION,17.85,11.6,2.66,47.96,51
NDC,0131247760,VIMPAT 50 MG TABLET,31.88,20.72,4.74,31.88,40
NDC,0131247835,VIMPAT 100 MG TABLET,45.3,29.45,6.74,45.3,40
NDC,0131247860,VIMPAT 100 MG TABLET,49.84,32.4,7.42,49.84,40
NDC,0131247960,VIMPAT 150 MG TABLET,52.78,34.31,7.85,52.78,40
NDC,0131248060,VIMPAT 200 MG TABLET,52.8,34.32,7.86,52.8,40
NDC,0131541072,VIMPAT 10 MG/ML ORAL SOLUTION,4.22,2.74,0.63,4.22,40
NDC,0132007912,FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.34,0.22,0.05,0.34,40
NDC,0132007924,FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.3,0.2,0.04,0.3,40
NDC,0132007950,FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.2,0.13,0.03,0.2,40
NDC,0132019012,PEDIA-LAX 2.8 GRAM/2.7 ML RECTAL SOLUTION,0.66,0.43,0.1,0.66,40
NDC,0132020140,FLEET ENEMA 19 GRAM-7 GRAM/118 ML,0.04,0.03,0.01,0.04,40
NDC,0132020220,FLEET PEDIATRIC 9.5 GRAM-3.5 GRAM/59 ML ENEMA,0.08,0.05,0.01,0.08,40
NDC,0132030140,FLEET MINERAL OIL ENEMA,0.04,0.03,0.01,0.04,40
NDC,0135019402,NICODERM CQ 21 MG/24 HR DAILY TRANSDERMAL PATCH,11.78,7.66,1.75,11.78,40
NDC,0135019502,NICODERM CQ 14 MG/24 HR DAILY TRANSDERMAL PATCH,11.78,7.66,1.75,11.78,40
NDC,0135020001,ABREVA 10 % TOPICAL CREAM,30.98,20.14,4.61,30.98,40
NDC,0135020003,ABREVA 10 % TOPICAL CREAM,30.98,20.14,4.61,30.98,40
NDC,0140000401,VALIUM 2 MG TABLET,8.16,5.3,1.21,8.16,40
NDC,0140000501,VALIUM 5 MG TABLET,12.7,8.26,1.89,12.7,40
NDC,0143117101,CAPTOPRIL 12.5 MG TABLET,3.12,2.03,0.46,3.12,40
NDC,0143117201,CAPTOPRIL 25 MG TABLET,3.34,2.17,0.5,3.34,40
NDC,0143117301,CAPTOPRIL 50 MG TABLET,5.8,3.77,0.86,5.8,40
NDC,0143124001,DIGOXIN 125 MCG (0.125 MG) TABLET,4.6,2.99,0.68,4.6,40
NDC,0143124101,DIGOXIN 250 MCG (0.25 MG) TABLET,4.6,2.99,0.68,4.6,40
NDC,0143145505,PHENOBARBITAL 60 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,0143145801,PHENOBARBITAL 100 MG TABLET,1.48,0.96,0.22,1.48,40
NDC,0143176901,ISOSORBIDE DINITRATE 5 MG TABLET,1.98,1.29,0.29,1.98,40
NDC,0143177101,ISOSORBIDE DINITRATE 10 MG TABLET,2.16,1.4,0.32,2.16,40
NDC,0143177210,ISOSORBIDE DINITRATE 20 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,0143301801,COLCHICINE 0.6 MG CAPSULE,15.0,9.75,2.23,15.0,40
NDC,0143314150,DOXYCYCLINE HYCLATE 50 MG CAPSULE,4.5,2.93,0.67,4.5,40
NDC,0143314250,DOXYCYCLINE HYCLATE 100 MG CAPSULE,11.06,7.19,1.65,11.06,40
NDC,0143913925,CEFAZOLIN 2 GRAM INTRAVENOUS SOLUTION,21.06,13.69,0.98,21.06,57
NDC,0143914025,CEFAZOLIN 3 GRAM INTRAVENOUS SOLUTION,31.59,20.53,0.98,31.59,57
NDC,0143914110,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,1.38,0.9,0.21,16.85,51
NDC,0143915301,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.18,86.82,51
NDC,0143915310,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.18,86.82,51
NDC,0143919901,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,64.8,42.12,1.44,64.8,51
NDC,0143920901,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.84,2.5,0.06,47.96,51
NDC,0143920910,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.84,2.5,0.06,47.96,51
NDC,0143921001,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.06,47.96,51
NDC,0143921010,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.06,47.96,51
NDC,0143921701,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,55.62,36.15,2.17,327.06,51
NDC,0143923210,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,37.08,24.1,5.52,37.08,40
NDC,0143923305,BENZTROPINE 1 MG/ML INJECTION SOLUTION,81.0,52.65,2.17,81.0,51
NDC,0143924001,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,274.56,178.46,2.17,274.56,43
NDC,0143924101,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,509.28,331.03,2.17,509.28,43
NDC,0143924701,DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,987.33,641.76,2.17,1095.84,65
NDC,0143924801,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,720.0,468.0,2.17,1095.84,65
NDC,0143925425,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,2.1,1.37,0.31,8.86,51
NDC,0143926225,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,3.78,2.46,0.56,8.86,51
NDC,0143926310,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,0.72,0.47,0.09,8.86,51
NDC,0143927301,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,378.0,245.7,2.17,378.0,51
NDC,0143927310,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,378.0,245.7,2.17,378.0,51
NDC,0143927901,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2448.0,1591.2,2.17,2448.0,65
NDC,0143928001,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,4800.0,3120.0,2.17,4800.0,65
NDC,0143929701,DANTROLENE 20 MG INTRAVENOUS SOLUTION,255.27,165.93,37.98,255.27,40
NDC,0143929910,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,246.24,160.06,2.17,246.24,51
NDC,0143930701,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,28.8,18.72,2.17,327.06,51
NDC,0143930801,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,28.8,18.72,2.17,327.06,51
NDC,0143931601,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,8.86,51
NDC,0143931701,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.06,0.04,0.01,8.86,51
NDC,0143933001,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.75,0.49,0.02,8.86,51
NDC,0143933401,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.36,0.23,0.02,8.86,51
NDC,0143936801,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,36.0,23.4,2.17,36.0,43
NDC,0143938010,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,1.08,0.7,0.16,8.86,51
NDC,0143938501,DECITABINE 50 MG INTRAVENOUS SOLUTION,480.0,312.0,1.39,480.0,51
NDC,0143950125,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,5.76,3.74,0.86,8.86,51
NDC,0143950201,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,10.8,7.02,1.3,10.8,51
NDC,0143950301,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,158.25,102.86,2.17,158.25,51
NDC,0143950710,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,1.2,0.78,0.18,1.2,40
NDC,0143950810,KETAMINE 50 MG/ML INJECTION SOLUTION,2.31,1.5,0.34,2.31,40
NDC,0143950901,KETAMINE 100 MG/ML INJECTION SOLUTION,9.18,5.97,1.37,9.18,40
NDC,0143950910,KETAMINE 100 MG/ML INJECTION SOLUTION,9.18,5.97,1.37,9.18,40
NDC,0143951001,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.34,15.18,51
NDC,0143951301,PALONOSETRON 0.25 MG/2 ML INTRAVENOUS SOLUTION,72.0,46.8,0.62,72.0,51
NDC,0143951525,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,17.43,11.33,2.17,29.09,51
NDC,0143951910,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,8.08,5.25,1.2,15.18,51
NDC,0143952901,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,87.12,56.63,2.17,87.12,51
NDC,0143955110,DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,160.96,104.62,2.17,500.04,57
NDC,0143955901,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,14.25,9.26,0.6,130.36,65
NDC,0143956401,PHENTOLAMINE 5 MG INJECTION SOLUTION,1763.88,1146.52,2.17,1763.88,65
NDC,0143956410,PHENTOLAMINE 5 MG INJECTION SOLUTION,1763.85,1146.5,2.17,1763.85,65
NDC,0143957001,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,22.89,14.88,2.17,47.96,51
NDC,0143957010,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,22.89,14.88,2.17,47.96,51
NDC,0143957710,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.21,0.14,0.02,8.86,51
NDC,0143959525,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.29,0.84,0.02,8.86,51
NDC,0143961901,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,3.6,2.34,0.54,8.86,51
NDC,0143963310,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,2.94,1.91,0.44,2.94,40
NDC,0143963701,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.77,1.15,0.09,184.43,51
NDC,0143963710,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.77,1.15,0.09,184.43,51
NDC,0143965901,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,54.0,35.1,0.05,54.0,51
NDC,0143967301,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,1.14,0.74,0.07,8.86,51
NDC,0143967325,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,1.14,0.74,0.07,8.86,51
NDC,0143967401,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,1702.29,1106.49,0.6,1702.29,65
NDC,0143968401,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.7,4.68,40
NDC,0143968410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.7,4.68,40
NDC,0143968910,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,9.18,5.97,0.12,130.36,51
NDC,0143970201,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,18.0,11.7,2.17,18.0,43
NDC,0143970910,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,1.65,1.07,0.25,8.86,51
NDC,0143971010,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.25,1.46,0.33,8.86,51
NDC,0143972024,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0143972101,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.21,0.14,0.03,8.86,51
NDC,0143972124,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.21,0.14,0.03,8.86,51
NDC,0143972224,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.42,0.27,0.06,8.86,51
NDC,0143972401,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,15.12,9.83,2.17,47.96,51
NDC,0143972501,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,10.8,7.02,1.28,10.8,51
NDC,0143972601,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,33.87,22.02,0.05,33.87,51
NDC,0143972905,BENZTROPINE 1 MG/ML INJECTION SOLUTION,108.0,70.2,2.17,108.0,51
NDC,0143974401,GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,32.4,21.06,0.27,32.4,51
NDC,0143974610,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,14.4,9.36,2.14,14.4,51
NDC,0143975001,TESTOSTERONE ENANTHATE 200 MG/ML INTRAMUSCULAR OIL,50.97,33.13,0.09,50.97,51
NDC,0143978310,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.7,4.68,40
NDC,0143978410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.7,4.68,40
NDC,0143978501,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,5.04,3.28,0.09,184.43,51
NDC,0143978510,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,5.04,3.28,0.09,184.43,51
NDC,0143978610,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,17.07,11.1,2.54,17.07,40
NDC,0143978701,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,19.11,12.42,2.84,19.11,40
NDC,0143978710,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,19.11,12.42,2.84,19.11,40
NDC,0143980250,DOXYCYCLINE HYCLATE 50 MG CAPSULE,4.5,2.93,0.67,4.5,40
NDC,0143980305,DOXYCYCLINE HYCLATE 100 MG CAPSULE,11.06,7.19,1.65,11.06,40
NDC,0143980350,DOXYCYCLINE HYCLATE 100 MG CAPSULE,11.06,7.19,1.65,11.06,40
NDC,0143983001,METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION,305.28,198.43,2.17,305.28,51
NDC,0143983601,PENICILLIN V POTASSIUM 500 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,0143983701,PENICILLIN V POTASSIUM 250 MG TABLET,1.7,1.11,0.25,1.7,40
NDC,0143985001,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,83.22,54.09,0.3,83.22,57
NDC,0143985101,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG INTRAVENOUS SOLUTION,150.81,98.03,0.3,150.81,57
NDC,0143985201,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,25.68,16.69,2.17,58.28,51
NDC,0143985210,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,25.68,16.69,2.17,58.28,51
NDC,0143985701,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,7.2,4.68,0.82,8.86,51
NDC,0143985825,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,4.5,2.93,0.67,8.86,51
NDC,0143987201,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,28.8,18.72,2.17,28.8,51
NDC,0143987525,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.4,1.56,0.36,47.96,51
NDC,0143988601,AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION,0.23,0.15,0.03,0.23,40
NDC,0143988675,AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION,0.23,0.15,0.03,0.23,40
NDC,0143988701,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,40
NDC,0143988750,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,40
NDC,0143988775,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,40
NDC,0143988801,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,0143988815,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,0143988880,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,0143988901,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.02,0.15,40
NDC,0143988915,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.13,0.08,0.02,0.13,40
NDC,0143988980,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.18,0.12,0.03,0.18,40
NDC,0143992390,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,7.2,4.68,1.07,8.86,51
NDC,0143992490,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,4.92,3.2,0.73,8.86,51
NDC,0143997722,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,21.06,13.69,2.17,21.06,51
NDC,0143997790,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,21.06,13.69,2.17,21.06,51
NDC,0143998250,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.9,1.24,0.28,1.9,40
NDC,0143998303,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,39.78,25.86,0.98,39.78,57
NDC,0149003904,PEPTO-BISMOL 262 MG/15 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,0149003916,PEPTO-BISMOL 262 MG/15 ML ORAL SUSPENSION,0.03,0.02,0.01,0.03,40
NDC,0168000215,TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,1.48,0.96,0.22,1.48,40
NDC,0168000315,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.6,0.39,0.09,0.6,40
NDC,0168000380,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.28,0.18,0.04,0.28,40
NDC,0168000415,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.48,0.31,0.07,0.48,40
NDC,0168000416,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.1,0.07,0.01,0.1,40
NDC,0168000480,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.22,0.14,0.03,0.22,40
NDC,0168000580,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,0.28,0.18,0.04,0.28,40
NDC,0168000615,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.74,0.48,0.11,0.74,40
NDC,0168000680,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.34,0.22,0.05,0.34,40
NDC,0168001531,HYDROCORTISONE 1 % TOPICAL CREAM,0.5,0.33,0.07,0.5,40
NDC,0168002031,HYDROCORTISONE 1 % TOPICAL OINTMENT,0.58,0.38,0.09,0.58,40
NDC,0168003315,BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,2.72,1.77,0.4,2.72,40
NDC,0168003346,BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,1.84,1.2,0.27,1.84,40
NDC,0168004015,BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,3.74,2.43,0.56,3.74,40
NDC,0168004046,BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,2.54,1.65,0.38,2.54,40
NDC,0168004160,BETAMETHASONE VALERATE 0.1 % LOTION,2.4,1.56,0.36,2.4,40
NDC,0168005515,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,7.04,4.58,1.05,7.04,40
NDC,0168005546,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,4.7,3.06,0.7,4.7,40
NDC,0168005615,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,8.2,5.33,1.22,8.2,40
NDC,0168005760,BETAMETHASONE DIPROPIONATE 0.05 % LOTION,1.6,1.04,0.24,1.6,40
NDC,0168006415,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,4.5,2.93,0.67,4.5,40
NDC,0168006460,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,3.38,2.2,0.5,3.38,40
NDC,0168008031,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.26,0.17,0.04,0.26,40
NDC,0168012691,SWIM EAR 95 %-5 % DROPS,0.22,0.14,0.03,0.22,40
NDC,0168013460,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,1.6,1.04,0.24,1.6,40
NDC,0168014630,HYDROCORTISONE 2.5 % TOPICAL OINTMENT,0.28,0.18,0.04,0.28,40
NDC,0168016315,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.54,17.1,40
NDC,0168016330,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.54,17.1,40
NDC,0168020130,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,2.72,1.77,0.4,2.72,40
NDC,0168020160,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,1.44,0.94,0.21,1.44,40
NDC,0168020230,CLINDAMYCIN 1 % TOPICAL GEL,6.92,4.5,1.03,6.92,40
NDC,0168020437,LIDOCAINE 5 % TOPICAL OINTMENT,16.94,11.01,2.52,16.94,40
NDC,0168025815,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,2.7,1.76,0.4,2.7,40
NDC,0168025846,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,1.94,1.26,0.29,1.94,40
NDC,0168026815,BETAMETHASONE AUGMENTED 0.05 % TOPICAL OINTMENT,11.1,7.22,1.65,11.1,40
NDC,0168027740,CLINDAMYCIN 2 % VAGINAL CREAM,6.52,4.24,0.97,6.52,40
NDC,0168029330,CLOBETASOL 0.05 % TOPICAL GEL,18.54,12.05,2.76,18.54,40
NDC,0168030115,CLOBETASOL-EMOLLIENT 0.05 % TOPICAL CREAM,9.08,5.9,1.35,9.08,40
NDC,0168032346,METRONIDAZOLE 0.75 % TOPICAL CREAM,3.8,2.47,0.57,3.8,40
NDC,0168034646,TERCONAZOLE 0.4 % VAGINAL CREAM,1.92,1.25,0.29,1.92,40
NDC,0168035755,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,3.96,2.57,0.59,3.96,40
NDC,0169183302,NOVOLIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,17.34,11.27,0.48,17.34,51
NDC,0169183311,NOVOLIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,17.34,11.27,0.48,17.34,51
NDC,0169183411,NOVOLIN N NPH U-100 INSULIN ISOPHANE 100 UNIT/ML SUBCUTANEOUS SUSP,17.34,11.27,0.48,17.34,48
NDC,0169183711,NOVOLIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,17.34,11.27,0.48,17.34,48
NDC,0169300315,NOVOLIN R FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.48,21.87,51
NDC,0169300325,NOVOLIN R FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.48,21.87,51
NDC,0169300415,NOVOLIN N FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.48,21.87,48
NDC,0169300715,NOVOLIN 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS,21.87,14.22,0.48,21.87,48
NDC,0169368512,NOVOLOG MIX 70-30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.48,26.04,48
NDC,0169369619,NOVOLOG MIX 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,33.54,21.8,0.48,33.54,48
NDC,0169517603,VAGIFEM 10 MCG VAGINAL TABLET,51.04,33.18,7.59,51.04,40
NDC,0169633910,NOVOLOG FLEXPEN U-100 INSULIN ASPART 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.54,21.8,0.48,33.54,48
NDC,0169701301,TRETTEN 2500 UNIT INTRAVENOUS SOLUTION,71.46,46.45,2.17,13108.79,65
NDC,0169720101,NOVOSEVEN RT 1 MG (1000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
NDC,0169720201,NOVOSEVEN RT 2 MG (2000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
NDC,0169720501,NOVOSEVEN RT 5 MG (5000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
NDC,0169750111,NOVOLOG U-100 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.48,26.04,48
NDC,0169770521,NORDITROPIN FLEXPRO 10 MG/1.5 ML (6.7 MG/ML) SUBCUTANEOUS PEN INJECTOR,4262.16,2770.4,2.17,4262.16,57
NDC,0169830111,ESPEROCT 3000 (+/-) UNIT INTRAVENOUS SOLUTION,10.2,6.63,2.17,4417.71,65
NDC,0172208380,HYDROCHLOROTHIAZIDE 25 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,0172208960,HYDROCHLOROTHIAZIDE 50 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,0172409760,BACLOFEN 20 MG TABLET,10.26,6.67,1.53,10.26,40
NDC,0172640605,CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,6.8,4.42,1.01,6.8,40
NDC,0172640649,CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,6.8,4.42,1.01,6.8,40
NDC,0172731320,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,14.98,9.74,2.17,14.98,51
NDC,0173013555,WELLBUTRIN SR 150 MG TABLET 12 HR SUSTAINED-RELEASE,18.9,12.29,2.81,18.9,40
NDC,0173047900,IMITREX STATDOSE PEN 6 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1737.03,1129.07,2.17,1737.03,51
NDC,0173051700,FLOLAN 0.5 MG INTRAVENOUS SOLUTION,67.29,43.74,2.17,67.29,43
NDC,0173052100,SEREVENT DISKUS 50 MCG/DOSE POWDER FOR INHALATION,16.94,11.01,2.52,16.94,40
NDC,0173052700,LAMICTAL 25 MG CHEWABLE DISPERSIBLE TABLET,28.2,18.33,4.2,28.2,40
NDC,0173054700,MEPRON 750 MG/5 ML ORAL SUSPENSION,19.9,12.94,2.96,19.9,40
NDC,0173063302,LAMICTAL 25 MG TABLET,25.78,16.76,3.84,25.78,40
NDC,0173064255,LAMICTAL 100 MG TABLET,27.42,17.82,4.08,27.42,40
NDC,0173066518,MEPRON 750 MG/5 ML ORAL SUSPENSION,21.53,13.99,3.2,21.53,40
NDC,0173067601,MALARONE PEDIATRIC 62.5 MG-25 MG TABLET,5.98,3.89,0.89,5.98,40
NDC,0173068101,RELENZA DISKHALER 5 MG/ACTUATION POWDER FOR INHALATION,7.08,4.6,1.05,7.08,40
NDC,0173068220,VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER,7.6,4.94,1.13,7.6,40
NDC,0173068224,VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER,6.82,4.43,1.01,6.82,40
NDC,0173069600,ADVAIR DISKUS 250 MCG-50 MCG/DOSE POWDER FOR INHALATION,7.84,5.1,1.17,7.84,40
NDC,0173071520,ADVAIR HFA 45 MCG-21 MCG/ACTUATION AEROSOL INHALER,50.16,32.6,7.46,50.16,40
NDC,0173071522,ADVAIR HFA 45 MCG-21 MCG/ACTUATION AEROSOL INHALER,50.56,32.86,7.52,50.56,40
NDC,0173071620,ADVAIR HFA 115 MCG-21 MCG/ACTUATION AEROSOL INHALER,63.78,41.46,9.49,63.78,40
NDC,0173071622,ADVAIR HFA 115 MCG-21 MCG/ACTUATION AEROSOL INHALER,46.94,30.51,6.98,46.94,40
NDC,0173071720,ADVAIR HFA 230 MCG-21 MCG/ACTUATION AEROSOL INHALER,87.94,57.16,13.09,87.94,40
NDC,0173071722,ADVAIR HFA 230 MCG-21 MCG/ACTUATION AEROSOL INHALER,76.72,49.87,11.42,76.72,40
NDC,0173073500,IMITREX 25 MG TABLET,83.36,54.18,12.4,83.36,40
NDC,0173073601,IMITREX 50 MG TABLET,181.72,118.12,27.04,181.72,40
NDC,0173085702,PH 12 DILUENT FOR FLOLAN INTRAVENOUS SOLUTION,1.05,0.68,0.16,1.05,43
NDC,0173085910,BREO ELLIPTA 100 MCG-25 MCG/DOSE POWDER FOR INHALATION,16.28,10.58,2.42,16.28,40
NDC,0173085914,BREO ELLIPTA 100 MCG-25 MCG/DOSE POWDER FOR INHALATION,13.44,8.74,2.0,13.44,40
NDC,0173086906,ANORO ELLIPTA 62.5 MCG-25 MCG/ACTUATION POWDER FOR INHALATION,20.16,13.1,3.0,20.16,40
NDC,0173088101,NUCALA 100 MG SUBCUTANEOUS SOLUTION,13229.58,8599.23,2.17,13229.58,65
NDC,0173088210,BREO ELLIPTA 200 MCG-25 MCG/DOSE POWDER FOR INHALATION,16.28,10.58,2.42,16.28,40
NDC,0173088214,BREO ELLIPTA 200 MCG-25 MCG/DOSE POWDER FOR INHALATION,13.44,8.74,2.0,13.44,40
NDC,0173089201,NUCALA 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,14367.54,9338.9,2.17,14367.54,65
NDC,0173089242,NUCALA 100 MG/ML SUBCUTANEOUS SYRINGE,14367.54,9338.9,2.17,14367.54,65
NDC,0173089803,JEMPERLI 50 MG/ML INTRAVENOUS SOLUTION,4417.53,2871.39,2.17,7011.25,65
NDC,0173090913,ZEJULA 100 MG TABLET,1555.42,1011.02,231.45,1555.42,40
NDC,0173091213,ZEJULA 200 MG TABLET,1555.42,1011.02,231.45,1555.42,40
NDC,0173091301,BLENREP 70 MG INTRAVENOUS SOLUTION,115200.0,74880.0,41.42,115200.0,51
NDC,0173091513,ZEJULA 300 MG TABLET,1555.42,1011.02,231.45,1555.42,40
NDC,0173093308,VALTREX 500 MG TABLET,32.22,20.94,4.79,32.22,40
NDC,0173094755,WELLBUTRIN SR 100 MG TABLET 12 HR SUSTAINED-RELEASE,17.64,11.47,2.62,17.64,40
NDC,0178061001,UROCIT-K 10 10 MEQ (1080 MG) TABLETEXTENDED RELEASE,5.14,3.34,0.76,5.14,40
NDC,0179805202,VITAMIN E (DL ACETATE) 45 MG (100 UNIT) CAPSULE,0.04,0.03,0.01,0.04,40
NDC,0185002201,ORPHENADRINE CITRATE ER 100 MG TABLETEXTENDED RELEASE,4.36,2.83,0.65,4.36,40
NDC,0185005501,METOLAZONE 5 MG TABLET,4.72,3.07,0.7,4.72,40
NDC,0185012801,BUMETANIDE 0.5 MG TABLET,2.16,1.4,0.32,2.16,40
NDC,0185012901,BUMETANIDE 1 MG TABLET,2.18,1.42,0.32,2.18,40
NDC,0185013001,BUMETANIDE 2 MG TABLET,4.04,2.63,0.6,4.04,40
NDC,0185084201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0185505001,METOLAZONE 2.5 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,0185560001,METOLAZONE 10 MG TABLET,5.64,3.67,0.84,5.64,40
NDC,0186037020,SYMBICORT 160 MCG-4.5 MCG/ACTUATION HFA AEROSOL INHALER,55.12,35.83,8.2,55.12,40
NDC,0186037028,SYMBICORT 160 MCG-4.5 MCG/ACTUATION HFA AEROSOL INHALER,63.68,41.39,9.48,63.68,40
NDC,0186037228,SYMBICORT 80 MCG-4.5 MCG/ACTUATION HFA AEROSOL INHALER,48.14,31.29,7.16,48.14,40
NDC,0186077660,BRILINTA 60 MG TABLET,18.6,12.09,2.77,18.6,40
NDC,0186077739,BRILINTA 90 MG TABLET,18.6,12.09,2.77,18.6,40
NDC,0186077760,BRILINTA 90 MG TABLET,18.6,12.09,2.77,18.6,40
NDC,0186198804,PULMICORT 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,10.46,6.8,1.56,10.46,40
NDC,0186198904,PULMICORT 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,12.3,8.0,1.83,12.3,40
NDC,0186199004,PULMICORT 1 MG/2 ML SUSPENSION FOR NEBULIZATION,24.62,16.0,3.66,24.62,40
NDC,0186404001,NEXIUM PACKET 40 MG GRANULES DELAYED RELEASE FOR SUSP,28.73,18.67,4.28,28.73,40
NDC,0186502031,NEXIUM 20 MG CAPSULEDELAYED RELEASE,22.02,14.31,3.28,22.02,40
NDC,0186504031,NEXIUM 40 MG CAPSULEDELAYED RELEASE,22.02,14.31,3.28,22.02,40
NDC,0187045302,ZELAPAR 1.25 MG DISINTEGRATING TABLET,244.04,158.63,36.31,244.04,40
NDC,0187093801,TASMAR 100 MG TABLET,284.5,184.93,42.33,284.5,40
NDC,0187212010,SYPRINE 250 MG CAPSULE,510.4,331.76,75.95,510.4,40
NDC,0187301030,MESTINON 60 MG TABLET,57.04,37.08,8.49,57.04,40
NDC,0187301220,MESTINON 60 MG/5 ML ORAL SYRUP,12.25,7.96,1.82,12.25,40
NDC,0187301330,MESTINON TIMESPAN 180 MG TABLETEXTENDED RELEASE,108.18,70.32,16.1,108.18,40
NDC,0187320447,EFUDEX 5 % TOPICAL CREAM,3.6,2.34,0.54,3.6,40
NDC,0187355510,ANCOBON 500 MG CAPSULE,356.86,231.96,53.1,356.86,40
NDC,0187510001,ELIDEL 1 % TOPICAL CREAM,23.92,15.55,3.56,23.92,40
NDC,0187515060,RENOVA 0.02 % TOPICAL CREAM,11.76,7.64,1.75,11.76,40
NDC,0187560015,VISUDYNE 15 MG INTRAVENOUS SOLUTION,8206.6,5334.29,2.17,8206.6,65
NDC,0193288250,KETO-DIASTIX STRIPS,0.54,0.35,0.08,0.54,40
NDC,0223172001,SODIUM BICARBONATE 325 MG TABLET,0.1,0.07,0.01,0.1,40
NDC,0223172101,SODIUM BICARBONATE 650 MG TABLET,0.12,0.08,0.02,0.12,40
NDC,0223176001,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.2,0.13,0.03,0.2,40
NDC,0225029515,ANASPAZ 0.125 MG DISINTEGRATING TABLET,0.6,0.39,0.09,0.6,40
NDC,0225038280,AYR SALINE 0.65 % NASAL DROPS,0.1,0.07,0.01,0.1,40
NDC,0225052547,AYR SALINE NASAL GEL,0.48,0.31,0.07,0.48,40
NDC,0225052848,AYR SALINE GEL NASAL SPRAY,0.5,0.33,0.07,0.5,40
NDC,0225080047,NEO-SYNEPHRINE (PHENYLEPHRINE) 0.25 % NASAL SPRAY,0.56,0.36,0.08,0.56,40
NDC,0225080547,NEO-SYNEPHRINE (PHENYLEPHRINE) 0.5 % NASAL SPRAY,0.56,0.36,0.08,0.56,40
NDC,0225081047,NEO-SYNEPHRINE (PHENYLEPHRINE) 1 % NASAL SPRAY,0.62,0.4,0.09,0.62,40
NDC,0228207610,TEMAZEPAM 15 MG CAPSULE,1.48,0.96,0.22,1.48,40
NDC,0228207650,TEMAZEPAM 15 MG CAPSULE,1.42,0.92,0.21,1.42,40
NDC,0228207710,TEMAZEPAM 30 MG CAPSULE,1.78,1.16,0.26,1.78,40
NDC,0228212910,CLONIDINE HCL 0.3 MG TABLET,1.04,0.68,0.15,1.04,40
NDC,0228255111,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,2.3,1.5,0.34,2.3,40
NDC,0228257111,INDAPAMIDE 2.5 MG TABLET,1.66,1.08,0.25,1.66,40
NDC,0228259711,INDAPAMIDE 1.25 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,0228277811,PROPRANOLOL ER 60 MG CAPSULE24 HREXTENDED RELEASE,4.12,2.68,0.61,4.12,40
NDC,0228277911,PROPRANOLOL ER 80 MG CAPSULE24 HREXTENDED RELEASE,4.82,3.13,0.72,4.82,40
NDC,0228278111,PROPRANOLOL ER 160 MG CAPSULE24 HREXTENDED RELEASE,7.82,5.08,1.16,7.82,40
NDC,0228280111,PILOCARPINE 5 MG TABLET,3.04,1.98,0.45,3.04,40
NDC,0228284903,FLUVOXAMINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,21.86,14.21,3.25,21.86,40
NDC,0228309011,MORPHINE ER 30 MG CAPSULEEXTENDED RELEASE 24 HR MULTIPHASE,11.46,7.45,1.71,11.46,40
NDC,0228315303,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,16.92,11.0,2.52,16.92,40
NDC,0228315603,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,9.0,5.85,1.34,9.0,40
NDC,0234057504,HIBICLENS 4 % TOPICAL LIQUID,0.06,0.04,0.01,0.06,40
NDC,0234057508,HIBICLENS 4 % TOPICAL LIQUID,0.04,0.03,0.01,0.04,40
NDC,0234057516,HIBICLENS 4 % TOPICAL LIQUID,0.04,0.03,0.01,0.04,40
NDC,0234057532,HIBICLENS 4 % TOPICAL LIQUID,0.02,0.01,0.01,0.02,40
NDC,0245021111,MIDODRINE 2.5 MG TABLET,3.38,2.2,0.5,3.38,40
NDC,0245021311,MIDODRINE 10 MG TABLET,19.44,12.64,2.89,19.44,40
NDC,0245086070,VANDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,4.66,3.03,0.69,4.66,40
NDC,0245531501,KLOR-CON 8 MEQ TABLETEXTENDED RELEASE,1.32,0.86,0.2,1.32,40
NDC,0245531589,KLOR-CON 8 MEQ TABLETEXTENDED RELEASE,1.32,0.86,0.2,1.32,40
NDC,0245531701,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.24,0.81,0.18,1.24,40
NDC,0245531710,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.2,0.78,0.18,1.2,40
NDC,0245531711,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.2,0.78,0.18,1.2,40
NDC,0245531789,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.24,0.81,0.18,1.24,40
NDC,0245531901,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.36,0.88,0.2,1.36,40
NDC,0245531910,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.26,0.82,0.19,1.26,40
NDC,0245531911,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.26,0.82,0.19,1.26,40
NDC,0245531989,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.36,0.88,0.2,1.36,40
NDC,0254200001,PENICILLAMINE 250 MG TABLET,130.86,85.06,19.47,130.86,40
NDC,0254302802,LUBIPROSTONE 8 MCG CAPSULE,13.36,8.68,1.99,13.36,40
NDC,0254302902,LUBIPROSTONE 24 MCG CAPSULE,13.36,8.68,1.99,13.36,40
NDC,0259050116,CUVPOSA 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,3.18,2.07,0.47,3.18,40
NDC,0259160501,XEOMIN 50 UNIT INTRAMUSCULAR SOLUTION,964.8,627.12,2.17,964.8,65
NDC,0259161001,XEOMIN 100 UNIT INTRAMUSCULAR SOLUTION,1839.6,1195.74,2.17,1839.6,65
NDC,0264151031,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.18,0.12,0.03,8.86,51
NDC,0264151032,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,43
NDC,0264180031,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.21,0.14,0.03,8.86,51
NDC,0264180032,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,51
NDC,0264193310,TROPHAMINE 10 % INTRAVENOUS SOLUTION,0.27,0.18,0.04,0.27,40
NDC,0264210100,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0264230410,ACETIC ACID 0.25 % IRRIGATION SOLUTION,0.06,0.04,0.01,0.06,40
NDC,0264310311,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,49.92,32.45,1.48,49.92,51
NDC,0264310511,CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,56.16,36.5,1.48,56.16,51
NDC,0264312511,CEFOXITIN 2 GRAM/50 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,120.75,78.49,2.17,120.75,51
NDC,0264315311,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,70.86,46.06,0.82,70.86,51
NDC,0264315511,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,94.47,61.41,0.82,94.47,51
NDC,0264318311,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,73.8,47.97,2.17,73.8,51
NDC,0264318511,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,107.67,69.99,2.17,107.67,51
NDC,0264319311,CEFEPIME 1 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,70.86,46.06,2.17,70.86,51
NDC,0264319511,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,107.46,69.85,2.17,107.46,51
NDC,0264446000,NUTRILIPID 20 % INTRAVENOUS EMULSION,0.15,0.1,0.02,0.15,40
NDC,0264446030,NUTRILIPID 20 % INTRAVENOUS EMULSION,0.36,0.23,0.05,0.36,40
NDC,0264738750,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0264762200,DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0264762320,DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,40
NDC,0264763600,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0264780010,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0264780020,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0264780510,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0264780610,SODIUM CHLORIDE 5 % HYPERTONIC INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0264785010,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0264785020,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,40
NDC,0264905748,PAB MIXING CONTAINER,6.84,4.45,1.02,6.84,40
NDC,0264934155,TROPHAMINE 10 % INTRAVENOUS SOLUTION,0.27,0.18,0.04,0.27,40
NDC,0264959820,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,0264987210,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0268024705,HISTATROL 1 MG/ML (2.75 MG/ML) PERCUTANEOUS SOLUTION,285.12,185.33,42.43,285.12,40
NDC,0268024805,HISTATROL 0.1 MG/ML (0.275 MG/ML) INTRADERMAL INJECTION SOLUTION,272.88,177.37,40.6,272.88,40
NDC,0270008320,CHOLETEC 45 MG INTRAVENOUS SOLUTION,62.0,40.3,0.01,243.94,45
NDC,0270014957,CYSTOGRAFIN 30 % URETHRAL SOLUTION,0.66,0.43,0.1,22.96,51
NDC,0270014960,CYSTOGRAFIN 30 % URETHRAL SOLUTION,1.11,0.72,0.15,22.96,51
NDC,0270044540,GASTROGRAFIN 66 %-10 % ORAL SOLUTION,1.68,1.09,0.25,22.96,51
NDC,0270055615,KINEVAC 5 MCG SOLUTION FOR INJECTION,469.68,305.29,2.17,469.68,51
NDC,0270131525,ISOVUE-300  61 % INTRAVENOUS SOLUTION,2.64,1.72,0.01,22.96,49
NDC,0270131530,ISOVUE-300  61 % INTRAVENOUS SOLUTION,1.68,1.09,0.01,22.96,49
NDC,0270131535,ISOVUE-300  61 % INTRAVENOUS SOLUTION,1.65,1.07,0.01,22.96,49
NDC,0270131630,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.01,22.96,49
NDC,0270131635,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.01,22.96,49
NDC,0270131695,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.01,22.96,49
NDC,0270131702,ISOVUE-250  51 % INTRAVENOUS SOLUTION,1.44,0.94,0.21,1.44,43
NDC,0270141111,ISOVUE-M 200  41 % INTRATHECAL SOLUTION,23.28,15.13,0.01,23.28,49
NDC,0270141215,ISOVUE-M 300  61 % INTRATHECAL SOLUTION,20.61,13.4,0.01,22.96,49
NDC,0270516413,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,20.94,13.61,0.01,22.96,49
NDC,0270516414,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,20.43,13.28,0.01,22.96,49
NDC,0270516415,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,18.93,12.3,0.01,22.96,49
NDC,0270709916,LUMASON 25 MG INTRAVENOUS SUSPENSION,522.0,339.3,2.17,522.0,51
NDC,0281020502,SURGILUBE TOPICAL GEL,0.08,0.05,0.01,0.08,40
NDC,0281020512,SURGILUBE TOPICAL GEL,0.08,0.05,0.01,0.08,40
NDC,0281020536,SURGILUBE TOPICAL GEL,0.06,0.04,0.01,0.06,40
NDC,0281020543,SURGILUBE TOPICAL GEL,0.1,0.07,0.01,0.1,40
NDC,0281020545,SURGILUBE TOPICAL GEL,0.1,0.07,0.01,0.1,40
NDC,0281032608,NITRO-BID 2 % TRANSDERMAL OINTMENT,6.06,3.94,0.9,6.06,40
NDC,0281032630,NITRO-BID 2 % TRANSDERMAL OINTMENT,3.12,2.03,0.46,3.12,40
NDC,0281032660,NITRO-BID 2 % TRANSDERMAL OINTMENT,3.12,2.03,0.46,3.12,40
NDC,0283061026,HURRICAINE ONE 20 % MUCOSAL SPRAY,27.66,17.98,4.12,27.66,40
NDC,0283067902,HURRICAINE 20 % MUCOSAL SPRAY,1.54,1.0,0.23,1.54,40
NDC,0283067960,HURRICAINE 20 % MUCOSAL SPRAY,2.02,1.31,0.3,2.02,40
NDC,0283087131,HURRICAINE 20 % MUCOSAL GEL,0.96,0.62,0.14,0.96,40
NDC,0283118520,HURRICAINE SPRAY EXTENSION TUBE,0.24,0.16,0.04,0.24,39
NDC,0295752040,CALCIUM GLUCONATE 2.5% TOPICAL GEL,11.84,7.7,1.76,11.84,40
NDC,0299011024,CETAPHIL GENTLE CLEANSER TOPICAL CLEANSER,0.12,0.08,0.02,0.12,40
NDC,0299011026,CETAPHIL GENTLE CLEANSER TOPICAL CLEANSER,0.08,0.05,0.01,0.08,40
NDC,0299391408,CETAPHIL DAILYADVANCE LOTION,0.08,0.05,0.01,0.08,40
NDC,0299391702,CETAPHIL MOISTURIZING TOPICAL CREAM,0.18,0.12,0.03,0.18,40
NDC,0299391808,CETAPHIL MOISTURIZING LOTION,0.06,0.04,0.01,0.06,40
NDC,0299392708,CETAPHIL TOPICAL CLEANSER,0.06,0.04,0.01,0.06,40
NDC,0299591545,DIFFERIN 0.1 % TOPICAL CREAM,28.22,18.34,4.2,28.22,40
NDC,0299596230,DYSPORT 300 UNIT INTRAMUSCULAR SOLUTION,1601.16,1040.75,2.17,1601.16,65
NDC,0299622015,NEMLUVIO 30 MG SUBCUTANEOUS PEN INJECTOR,16027.2,10417.68,2384.85,16027.2,40
NDC,0310009590,DALIRESP 500 MCG TABLET,36.58,23.78,5.44,36.58,40
NDC,0310027110,SEROQUEL 100 MG TABLET,16.0,10.4,2.38,16.0,40
NDC,0310027460,SEROQUEL 300 MG TABLET,39.58,25.73,5.89,39.58,40
NDC,0310027510,SEROQUEL 25 MG TABLET,9.32,6.06,1.39,9.32,40
NDC,0310027810,SEROQUEL 50 MG TABLET,15.32,9.96,2.28,15.32,40
NDC,0310028060,SEROQUEL XR 50 MG TABLETEXTENDED RELEASE,19.7,12.81,2.93,19.7,40
NDC,0310028160,SEROQUEL XR 150 MG TABLETEXTENDED RELEASE,35.4,23.01,5.27,35.4,40
NDC,0310028260,SEROQUEL XR 200 MG TABLETEXTENDED RELEASE,38.96,25.32,5.8,38.96,40
NDC,0310028360,SEROQUEL XR 300 MG TABLETEXTENDED RELEASE,51.08,33.2,7.6,51.08,40
NDC,0310048230,IRESSA 250 MG TABLET,623.12,405.03,2.17,1676.17,48
NDC,0310061060,KOSELUGO 10 MG CAPSULE,238.92,155.3,35.55,238.92,40
NDC,0310062560,KOSELUGO 25 MG CAPSULE,597.32,388.26,88.88,597.32,40
NDC,0310066860,LYNPARZA 100 MG TABLET,347.2,225.68,51.66,347.2,40
NDC,0310067960,LYNPARZA 150 MG TABLET,347.2,225.68,51.66,347.2,40
NDC,0310072010,FASLODEX 250 MG/5 ML INTRAMUSCULAR SYRINGE,930.76,604.99,2.17,930.76,65
NDC,0310075430,CRESTOR 40 MG TABLET,22.12,14.38,3.29,22.12,40
NDC,0310110530,LOKELMA 5 GRAM ORAL POWDER PACKET,68.92,44.8,10.26,68.92,40
NDC,0310111001,LOKELMA 10 GRAM ORAL POWDER PACKET,68.92,44.8,10.26,68.92,40
NDC,0310111030,LOKELMA 10 GRAM ORAL POWDER PACKET,68.92,44.8,10.26,68.92,40
NDC,0310111039,LOKELMA 10 GRAM ORAL POWDER PACKET,68.92,44.8,10.26,68.92,40
NDC,0310134930,TAGRISSO 40 MG TABLET,1410.46,916.8,209.88,1410.46,40
NDC,0310135030,TAGRISSO 80 MG TABLET,1410.46,916.8,209.88,1410.46,40
NDC,0310173030,FASENRA 30 MG/ML SUBCUTANEOUS SYRINGE,21049.38,13682.1,2.17,21049.38,65
NDC,0310183030,FASENRA PEN 30 MG/ML SUBCUTANEOUS AUTO-INJECTOR,21049.38,13682.1,2.17,21049.38,65
NDC,0310304000,SAPHNELO 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,9793.14,6365.54,2.17,9793.14,65
NDC,0310351260,CALQUENCE (ACALABRUTINIB MALEATE) 100 MG TABLET,633.16,411.55,94.21,633.16,40
NDC,0310450012,IMFINZI 50 MG/ML INTRAVENOUS SOLUTION,2061.44,1339.94,2.17,3257.22,65
NDC,0310450525,IMJUDO 20 MG/ML INTRAVENOUS SOLUTION,13243.88,8608.52,2.17,13243.88,65
NDC,0310453530,IMJUDO 20 MG/ML INTRAVENOUS SOLUTION,13243.88,8608.52,2.17,13243.88,65
NDC,0310461150,IMFINZI 50 MG/ML INTRAVENOUS SOLUTION,2061.44,1339.94,2.17,3257.22,65
NDC,0310661502,SYMLINPEN 60 1500 MCG/1.5 ML SUBCUTANEOUS PEN INJECTOR,1243.08,808.0,184.97,1243.08,40
NDC,0310662702,SYMLINPEN 120 2700 MCG/2.7 ML SUBCUTANEOUS PEN INJECTOR,820.11,533.07,122.03,820.11,40
NDC,0310950101,TRUQAP 200 MG TABLET,885.36,575.48,131.74,885.36,40
NDC,0316019316,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.32,0.21,0.05,0.32,40
NDC,0316022515,DESENEX 2 % TOPICAL POWDER,0.26,0.17,0.04,0.26,40
NDC,0316022530,DESENEX 2 % TOPICAL POWDER,0.2,0.13,0.03,0.2,40
NDC,0316023125,ZEASORB AF 2 % TOPICAL POWDER,0.22,0.14,0.03,0.22,40
NDC,0327000110,CLORPACTIN WCS-90 TOPICAL POWDER FOR SOLUTION,6.88,4.47,1.02,6.88,40
NDC,0327001230,RENACIDIN 1980.6 MG-59.4MG-980.4MG/30ML IRRIGATION SOLUTION,0.72,0.47,0.11,0.72,40
NDC,0338000344,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338000346,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338000347,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338000402,WATER FOR IRRIGATION STERILE SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0338000403,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338000404,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338001304,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338001702,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,0338001703,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338001704,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338001710,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.42,0.27,0.06,8.86,51
NDC,0338001711,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.21,0.14,0.03,8.86,51
NDC,0338001718,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,51
NDC,0338001731,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.18,0.12,0.03,8.86,51
NDC,0338001738,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,43
NDC,0338001741,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.21,0.14,0.03,8.86,51
NDC,0338001748,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,43
NDC,0338002302,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0338002303,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,47.96,48
NDC,0338002304,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004303,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004304,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004727,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004729,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004744,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004746,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004747,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004802,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.06,0.04,0.01,0.06,40
NDC,0338004803,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004804,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338004902,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,0338004903,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338004904,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338004910,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.39,0.25,0.06,8.86,51
NDC,0338004911,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,43
NDC,0338004918,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,43
NDC,0338004931,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,43
NDC,0338004938,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,51
NDC,0338004941,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,43
NDC,0338004948,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,0338005403,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.06,0.04,0.01,8.86,51
NDC,0338005603,SODIUM CHLORIDE 5 % HYPERTONIC INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,0338006230,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,43
NDC,0338006301,DOXIL 2 MG/ML INTRAVENOUS SUSPENSION,153.68,99.89,2.17,720.96,65
NDC,0338006620,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338006701,DOXIL 2 MG/ML INTRAVENOUS SUSPENSION,323.32,210.16,2.17,720.96,65
NDC,0338007304,DEXTROSE 2.5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,50
NDC,0338007704,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338008503,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338008504,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338008903,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338008904,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338011220,NOREPINEPHRINE BITARTRATE 4 MG/250 ML (16 MCG/ML) IN DEXTROSE 5 % IV,0.33,0.21,0.05,47.96,51
NDC,0338011620,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN DEXTROSE 5 % IV,0.96,0.62,0.14,0.96,40
NDC,0338011702,LACTATED RINGERS INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,40
NDC,0338011703,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338011704,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338012204,VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.42,0.27,0.05,8.86,51
NDC,0338012404,VANCOMYCIN 1.5 GRAM/300 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.39,0.25,0.05,8.86,51
NDC,0338012503,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338012504,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338012612,MYXREDLIN (REGULAR INSULIN) 100 UNIT/100 ML (1 UNIT/ML) IV SOLUTION,1.26,0.82,0.19,8.86,51
NDC,0338013727,LACTATED RINGERS IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338013729,LACTATED RINGERS IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338018401,CLINIMIX 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,40
NDC,0338018404,CLINIMIX 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,40
NDC,0338020601,CLINIMIX E 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,43
NDC,0338020604,CLINIMIX E 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,43
NDC,0338022103,PLASMA-LYTE A INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0338022104,PLASMA-LYTE A INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,40
NDC,0338028947,GLYCINE UROLOGIC 1.5 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338032201,RECOTHROM 5000 UNIT TOPICAL SOLUTION,206.4,134.16,30.71,206.4,40
NDC,0338032601,RECOTHROM 20000 UNIT TOPICAL SOLUTION,825.6,536.64,122.85,825.6,40
NDC,0338035303,OSMITROL 10 % INTRAVENOUS SOLUTION,0.36,0.23,0.05,0.36,40
NDC,0338035702,OSMITROL 20 % INTRAVENOUS SOLUTION,0.78,0.51,0.12,8.86,51
NDC,0338035703,OSMITROL 20 % INTRAVENOUS SOLUTION,0.45,0.29,0.07,8.86,51
NDC,0338040903,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,0338041102,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,0338042418,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0338043103,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0338043304,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0338049906,PROSOL 20 % INTRAVENOUS SOLUTION,0.3,0.2,0.04,0.3,40
NDC,0338050206,CLINISOL SF 15 % INTRAVENOUS SOLUTION,0.24,0.16,0.04,0.24,40
NDC,0338050348,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0338050548,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0338050741,GENTAMICIN 60 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
NDC,0338050748,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0338050941,GENTAMICIN 80 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0338051141,GENTAMICIN 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0338055111,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.48,0.31,0.07,0.48,40
NDC,0338055118,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,0.27,40
NDC,0338055311,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.51,0.33,0.08,0.51,40
NDC,0338055318,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,0.27,40
NDC,0338064404,TRAVASOL 10 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,40
NDC,0338064406,TRAVASOL 10 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0338065604,ACETIC ACID 0.25 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338066304,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0338066904,POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0338067104,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0338067304,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0338067504,POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0338068304,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338069104,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
NDC,0338069504,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
NDC,0338070341,POTASSIUM CHLORIDE 20 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
NDC,0338070348,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0338070434,SODIUM CHLORIDE 0.45 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
NDC,0338070541,POTASSIUM CHLORIDE 10 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
NDC,0338070548,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0338070948,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,8.86,51
NDC,0338071224,DAPTOMYCIN 350 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.37,1.54,0.11,47.96,51
NDC,0338071424,DAPTOMYCIN 500 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.82,1.83,0.11,47.96,51
NDC,0338071612,DAPTOMYCIN 700 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.04,1.33,0.11,47.96,51
NDC,0338071812,DAPTOMYCIN 1000 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.37,1.54,0.11,47.96,51
NDC,0338071906,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0338080304,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,8.86,51
NDC,0338080704,POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,0.03,40
NDC,0338081104,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,0.03,0.02,0.01,8.86,51
NDC,0338100702,DOPAMINE 400 MG/250 ML (1600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.21,0.14,0.03,8.86,51
NDC,0338100902,DOPAMINE 800 MG/250 ML (3200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.3,0.2,0.04,8.86,51
NDC,0338101541,OXACILLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.77,1.15,0.26,8.86,51
NDC,0338101948,NAFCILLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.87,0.57,0.13,8.86,51
NDC,0338102541,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.12,8.86,51
NDC,0338104702,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,0.3,0.2,0.04,8.86,51
NDC,0338104902,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.05,8.86,51
NDC,0338105102,NITROGLYCERIN IN D5W 100 MG/250 ML IV,0.36,0.23,0.05,0.36,40
NDC,0338105548,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,0.09,40
NDC,0338107302,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.05,16.85,51
NDC,0338107502,DOBUTAMINE 500 MG/250 ML (2000 MCG/ML) IN 5 % DEXTROSE IV,0.57,0.37,0.08,16.85,51
NDC,0338107702,DOBUTAMINE 1000 MG/250 ML(4000 MCG/ML) IN 5 % DEXTROSE IV,0.42,0.27,0.06,16.85,51
NDC,0338108904,CLINIMIX 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338109104,CLINIMIX 4.25 % IN 10 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338109904,CLINIMIX 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338110104,CLINIMIX 5 % IN 20 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338112304,CLINIMIX E 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338112504,CLINIMIX E 5 % IN 20 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338113003,PREMASOL 10 % INTRAVENOUS SOLUTION,0.39,0.25,0.06,0.39,40
NDC,0338113303,CLINIMIX 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338113403,CLINIMIX 4.25 % IN 10 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338113703,CLINIMIX 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338114403,CLINIMIX E 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338114703,CLINIMIX E 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338114803,CLINIMIX E 5 % IN 20 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338130501,MESNEX 100 MG/ML INTRAVENOUS SOLUTION,12.0,7.8,1.79,12.0,43
NDC,0338170840,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.9,0.59,0.13,8.86,51
NDC,0338170940,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.24,0.16,0.04,8.86,51
NDC,0338171540,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.24,0.16,0.04,8.86,51
NDC,0338171940,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.45,0.29,0.07,8.86,51
NDC,0338341024,CLINDAMYCIN 300 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.51,0.33,0.08,47.96,51
NDC,0338350341,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,8.86,51
NDC,0338350841,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.33,0.21,0.05,8.86,51
NDC,0338355148,VANCOMYCIN 500 MG/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
NDC,0338355248,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.48,0.31,0.05,8.86,51
NDC,0338358048,VANCOMYCIN 750 MG/150 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0338358201,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0338361224,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.12,47.96,51
NDC,0338381424,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.93,0.6,0.14,47.96,51
NDC,0338430102,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 2 ML TOPICAL KIT,445.7,289.71,66.32,445.7,40
NDC,0338430204,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 4 ML TOPICAL KIT,765.34,497.47,113.88,765.34,40
NDC,0338430310,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 10 ML TOPICAL KIT,1857.92,1207.65,276.46,1857.92,40
NDC,0338500241,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,1.02,0.66,0.15,8.86,51
NDC,0338500341,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,2.43,1.58,0.36,8.86,51
NDC,0338519741,FAMOTIDINE (PF) 20 MG/50 ML IN 0.9 % NACL (ISO) INTRAVENOUS PIGGYBACK,0.39,0.25,0.02,47.96,51
NDC,0338604537,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,8.86,51
NDC,0338604648,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.66,0.43,0.1,8.86,51
NDC,0338700304,CLINIMIX 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338701104,CLINIMIX 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338701504,CLINIMIX 5 % IN 20 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338702404,CLINIMIX E 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338702804,CLINIMIX E 4.25 % IN 10 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338703204,CLINIMIX E 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0338850304,ARTISS 2.5 UNIT TO 6.5 UNIT/ML (4ML) TOPICAL SYRINGE,246.5,160.23,54.48,422.08,57
NDC,0338915130,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.51,0.33,0.08,0.51,40
NDC,0338915930,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,0.27,40
NDC,0338954005,FAT EMULSION-OLIVE OIL-SOYBEAN OIL-EGG PHOSPHOLIPID 20 % INTRAVENOUS,1.23,0.8,0.18,1.23,40
NDC,0338954006,FAT EMULSION-OLIVE OIL-SOYBEAN OIL-EGG PHOSPHOLIPID 20 % INTRAVENOUS,0.69,0.45,0.1,0.69,40
NDC,0338954007,FAT EMULSION-OLIVE OIL-SOYBEAN OIL-EGG PHOSPHOLIPID 20 % INTRAVENOUS,0.3,0.2,0.04,0.3,40
NDC,0338954301,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,51
NDC,0338954302,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,51
NDC,0338954303,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338954304,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338954305,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338954306,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0338954924,CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,0.78,0.51,0.12,0.78,40
NDC,0338955524,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,1.05,0.68,0.16,1.05,40
NDC,0338955712,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,0.72,0.47,0.11,0.72,40
NDC,0338956001,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 2 ML TOPICAL SYRINGE,207.68,134.99,30.9,207.68,51
NDC,0338963224,ZOSYN 2.25 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.11,0.72,0.17,8.86,51
NDC,0338963624,ZOSYN 3.375 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.47,0.96,0.22,8.86,51
NDC,0338963812,ZOSYN 4.5 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.93,0.6,0.14,8.86,51
NDC,0338964012,VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV,2.7,1.76,0.4,2.7,40
NDC,0338964101,ARTISS 2.5 UNIT TO 6.5 UNIT/ML(10ML) TOPICAL SYRINGE,220.66,143.43,48.77,422.08,57
NDC,0362055705,MARCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION CARTRIDGE,4.56,2.96,0.68,4.56,40
NDC,0362075305,CARBOCAINE 30 MG/ML (3 %) INJECTION DENTAL CARTRIDGE,2.13,1.38,0.32,2.13,40
NDC,0362089805,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.84,0.55,0.12,0.84,40
NDC,0362901150,VIVACAINE 0.5 %-1:200000 INJECTION CARTRIDGE,2.01,1.31,0.3,2.01,40
NDC,0363016406,ORAL RELIEF SORE THROAT SPRAY 1.4 % AEROSOL,0.06,0.04,0.01,0.06,40
NDC,0363064526,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,40
NDC,0378001401,METHOTREXATE SODIUM 2.5 MG TABLET,12.48,8.11,0.27,15.18,51
NDC,0378002305,DILTIAZEM 30 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,0378005301,CIMETIDINE 200 MG TABLET,3.1,2.02,0.46,3.1,40
NDC,0378007801,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,0378008101,CAPTOPRIL 25 MG-HYDROCHLOROTHIAZIDE 15 MG TABLET,5.7,3.71,0.85,5.7,40
NDC,0378015601,PROBENECID 500 MG TABLET,2.3,1.5,0.34,2.3,40
NDC,0378018101,ALLOPURINOL 300 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,0378021101,AMITRIPTYLINE-CHLORDIAZEPOXIDE 12.5 MG-5 MG TABLET,3.06,1.99,0.46,3.06,40
NDC,0378021301,CHLORTHALIDONE 50 MG TABLET,2.98,1.94,0.44,2.98,40
NDC,0378021401,HALOPERIDOL 2 MG TABLET,1.26,0.82,0.19,1.26,40
NDC,0378021801,ATENOLOL 25 MG TABLET,1.64,1.07,0.24,1.64,40
NDC,0378022101,TIMOLOL 10 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,0378022201,CHLORTHALIDONE 25 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,0378023101,ATENOLOL 50 MG TABLET,1.7,1.11,0.25,1.7,40
NDC,0378023205,FUROSEMIDE 80 MG TABLET,0.94,0.61,0.14,0.94,40
NDC,0378025701,HALOPERIDOL 1 MG TABLET,0.92,0.6,0.14,0.92,40
NDC,0378033001,PERPHENAZINE-AMITRIPTYLINE 2 MG-10 MG TABLET,3.08,2.0,0.46,3.08,40
NDC,0378035101,HALOPERIDOL 0.5 MG TABLET,0.66,0.43,0.1,0.66,40
NDC,0378044201,PERPHENAZINE-AMITRIPTYLINE 2 MG-25 MG TABLET,3.92,2.55,0.58,3.92,40
NDC,0378057401,PERPHENAZINE-AMITRIPTYLINE 4 MG-25 MG TABLET,4.26,2.77,0.63,4.26,40
NDC,0378057701,AMILORIDE 5 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.32,1.51,0.35,2.32,40
NDC,0378061101,METHYLDOPA 250 MG TABLET,0.84,0.55,0.12,0.84,40
NDC,0378061401,THIORIDAZINE 25 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,0378061601,THIORIDAZINE 50 MG TABLET,2.1,1.37,0.31,2.1,40
NDC,0378061801,THIORIDAZINE 100 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,0378075701,ATENOLOL 100 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,0378082501,CLOZAPINE 25 MG TABLET,2.64,1.72,0.39,2.64,40
NDC,0378086001,CLOZAPINE 100 MG TABLET,6.84,4.45,1.02,6.84,40
NDC,0378087116,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,66.24,43.06,9.86,66.24,40
NDC,0378087216,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,111.54,72.5,16.6,111.54,40
NDC,0378087316,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,154.72,100.57,23.02,154.72,40
NDC,0378102077,NICARDIPINE 20 MG CAPSULE,4.46,2.9,0.66,4.46,40
NDC,0378104901,DOXEPIN 10 MG CAPSULE,1.26,0.82,0.19,1.26,40
NDC,0378110101,PRAZOSIN 1 MG CAPSULE,1.8,1.17,0.27,1.8,40
NDC,0378113401,KETOROLAC 10 MG TABLET,4.54,2.95,0.68,4.54,40
NDC,0378119001,GUANFACINE 2 MG TABLET,2.36,1.53,0.35,2.36,40
NDC,0378143077,NICARDIPINE 30 MG CAPSULE,6.38,4.15,0.95,6.38,40
NDC,0378145401,ESTRADIOL 1 MG TABLET,0.76,0.49,0.11,0.76,40
NDC,0378181777,LEVOTHYROXINE 175 MCG TABLET,1.62,1.05,0.24,1.62,40
NDC,0378204501,TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASE,4.46,2.9,0.36,8.86,51
NDC,0378204601,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.36,8.92,51
NDC,0378204701,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.36,44.6,51
NDC,0378206301,ATENOLOL 50 MG-CHLORTHALIDONE 25 MG TABLET,3.76,2.44,0.56,3.76,40
NDC,0378210001,LOPERAMIDE 2 MG CAPSULE,2.1,1.37,0.31,2.1,40
NDC,0378210005,LOPERAMIDE 2 MG CAPSULE,2.1,1.37,0.31,2.1,40
NDC,0378215001,MECLOFENAMATE 50 MG CAPSULE,8.34,5.42,1.24,8.34,40
NDC,0378240101,TRIFLUOPERAZINE 1 MG TABLET,1.76,1.14,0.26,1.76,40
NDC,0378240201,TRIFLUOPERAZINE 2 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,0378240501,TRIFLUOPERAZINE 5 MG TABLET,3.24,2.11,0.48,3.24,40
NDC,0378241001,TRIFLUOPERAZINE 10 MG TABLET,4.9,3.19,0.73,4.9,40
NDC,0378306577,FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET,3.82,2.48,0.57,3.82,40
NDC,0378312501,DOXEPIN 25 MG CAPSULE,1.64,1.07,0.24,1.64,40
NDC,0378320501,PRAZOSIN 5 MG CAPSULE,4.36,2.83,0.65,4.36,40
NDC,0378322493,CANDESARTAN 4 MG TABLET,6.12,3.98,0.91,6.12,40
NDC,0378322593,CANDESARTAN 8 MG TABLET,6.12,3.98,0.91,6.12,40
NDC,0378323177,CANDESARTAN 16 MG TABLET,6.12,3.98,0.91,6.12,40
NDC,0378323277,CANDESARTAN 32 MG TABLET,8.34,5.42,1.24,8.34,40
NDC,0378326694,ETOPOSIDE 50 MG CAPSULE,207.72,135.02,2.17,327.06,59
NDC,0378334999,ESTRADIOL 0.025 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378335016,ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378335099,ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378335199,ESTRADIOL 0.075 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378335299,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378336099,ESTRADIOL 0.0375 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378336199,ESTRADIOL 0.06 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,6.91,46.42,40
NDC,0378363501,CETIRIZINE 5 MG TABLET,4.98,3.24,0.74,4.98,40
NDC,0378363701,CETIRIZINE 10 MG TABLET,4.98,3.24,0.74,4.98,40
NDC,0378395305,ATORVASTATIN 80 MG TABLET,11.54,7.5,1.72,11.54,40
NDC,0378404277,LOSARTAN 50 MG TABLET,4.84,3.15,0.72,4.84,40
NDC,0378405091,NEVIRAPINE 200 MG TABLET,21.66,14.08,3.22,21.66,40
NDC,0378412201,ALBUTEROL SULFATE ER 4 MG TABLETEXTENDED RELEASE12 HR,3.56,2.31,0.53,3.56,40
NDC,0378425001,DOXEPIN 50 MG CAPSULE,2.36,1.53,0.35,2.36,40
NDC,0378427193,AMBRISENTAN 10 MG TABLET,698.2,453.83,103.89,698.2,40
NDC,0378456077,POTASSIUM CHLORIDE ER 8 MEQ TABLETEXTENDED RELEASE,1.08,0.7,0.16,1.08,40
NDC,0378464126,ESTRADIOL 0.075 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,22.7,14.76,3.38,22.7,40
NDC,0378464426,ESTRADIOL 0.025 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,22.66,14.73,3.37,22.66,40
NDC,0378537501,DOXEPIN 75 MG CAPSULE,3.62,2.35,0.54,3.62,40
NDC,0378563159,SUMATRIPTAN 50 MG TABLET,50.28,32.68,7.48,50.28,40
NDC,0378563259,SUMATRIPTAN 100 MG TABLET,50.28,32.68,7.48,50.28,40
NDC,0378606001,DILTIAZEM ER 60 MG CAPSULEEXTENDED RELEASE 12 HR,6.34,4.12,0.94,6.34,40
NDC,0378609001,DILTIAZEM ER 90 MG CAPSULEEXTENDED RELEASE 12 HR,7.26,4.72,1.08,7.26,40
NDC,0378612001,DILTIAZEM ER 120 MG CAPSULEEXTENDED RELEASE 12 HR,9.46,6.15,1.41,9.46,40
NDC,0378617201,METOLAZONE 2.5 MG TABLET,5.16,3.35,0.77,5.16,40
NDC,0378617301,METOLAZONE 5 MG TABLET,5.86,3.81,0.87,5.86,40
NDC,0378638001,VERAPAMIL ER 180 MG 24 HR CAPSULEEXTENDED RELEASE,4.06,2.64,0.6,4.06,40
NDC,0378668877,PANTOPRAZOLE 20 MG TABLETDELAYED RELEASE,10.54,6.85,1.57,10.54,40
NDC,0378668910,PANTOPRAZOLE 40 MG TABLETDELAYED RELEASE,10.54,6.85,1.57,10.54,40
NDC,0378696093,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,2.17,649.23,57
NDC,0378696112,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,2.17,1572.9,57
NDC,0378698188,LANSOPRAZOLE 15 MG DELAYED RELEASEDISINTEGRATING TABLET,31.54,20.5,4.69,31.54,40
NDC,0378698789,SODIUM CHLORIDE 0.9 % FOR NEBULIZATION,0.12,0.08,0.02,0.12,40
NDC,0378699789,SODIUM CHLORIDE 3 % FOR NEBULIZATION,0.12,0.08,0.02,0.12,40
NDC,0378699889,SODIUM CHLORIDE 10 % FOR NEBULIZATION,0.12,0.08,0.02,0.12,40
NDC,0378715501,BUDESONIDE DR - ER 3 MG CAPSULEDELAYEDEXTENDED RELEASE,37.7,24.51,5.61,37.7,40
NDC,0378729353,NORGESTIMATE-ETHINYL ESTRADIOL 0.18MG/0.215MG/0.25MG-0.035MG(28)TABLET,2.8,1.82,0.42,2.8,40
NDC,0378730653,ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL 1 MG-50 MCG TABLET,2.14,1.39,0.32,2.14,40
NDC,0378730753,ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL 1 MG-35 MCG TABLET,2.14,1.39,0.32,2.14,40
NDC,0378730785,ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL 1 MG-35 MCG TABLET,2.14,1.39,0.32,2.14,40
NDC,0378802093,FLUVASTATIN 20 MG CAPSULE,10.02,6.51,1.49,10.02,40
NDC,0378802193,FLUVASTATIN 40 MG CAPSULE,10.02,6.51,1.49,10.02,40
NDC,0378803093,LANSOPRAZOLE 30 MG CAPSULEDELAYED RELEASE,11.8,7.67,1.76,11.8,40
NDC,0378808515,TRETINOIN 0.01 % TOPICAL GEL,13.5,8.78,2.01,13.5,40
NDC,0378808615,TRETINOIN 0.025 % TOPICAL GEL,13.62,8.85,2.03,13.62,40
NDC,0378876793,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,18.46,12.0,2.17,47.96,48
NDC,0378908001,ENTACAPONE 200 MG TABLET,7.92,5.15,1.18,7.92,40
NDC,0378910216,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,3.72,2.42,0.55,3.72,40
NDC,0378910293,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,3.72,2.42,0.55,3.72,40
NDC,0378910493,NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,3.8,2.47,0.57,3.8,40
NDC,0378911293,NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,4.34,2.82,0.65,4.34,40
NDC,0378911616,NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH,4.8,3.12,0.71,4.8,40
NDC,0378911693,NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH,4.8,3.12,0.71,4.8,40
NDC,0378911998,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,40.6,26.39,6.04,40.6,40
NDC,0378912198,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,28.84,18.75,4.29,28.84,40
NDC,0378912398,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,80.42,52.27,11.97,80.42,40
NDC,0378912498,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,106.72,69.37,15.88,106.72,40
NDC,0386000102,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.72,0.47,0.11,0.72,40
NDC,0386000103,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.8,0.52,0.12,0.8,40
NDC,0386000104,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.86,0.56,0.13,0.86,40
NDC,0386000111,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.7,0.46,0.1,0.7,40
NDC,0386000802,PAIN EASE MIST SPRAY TOPICAL,0.74,0.48,0.11,0.74,40
NDC,0386000803,PAIN EASE MEDIUM STREAM SPRAY TOPICAL,0.72,0.47,0.11,0.72,40
NDC,0386000804,PAIN EASE MEDIUM STREAM SPRAY TOPICAL,1.08,0.7,0.16,1.08,40
NDC,0395004912,ALUM AMMONIUM (BULK) POWDER,0.12,0.08,0.02,0.12,40
NDC,0395009416,FLAVOR SWEET-SF ORAL LIQUID,0.08,0.05,0.01,0.08,40
NDC,0395024392,BENZOIN COMPOUND 10 %-2 %-8 %-4 % TOPICAL TINCTURE,0.36,0.23,0.05,0.36,40
NDC,0395024792,BENZOIN (BULK) TOPICAL TINCTURE,0.42,0.27,0.06,0.42,40
NDC,0395051592,CASTOR OIL 100 % ORAL,0.2,0.13,0.03,0.2,40
NDC,0395080716,EPSOM SALT 100 % CRYSTALS,0.01,0.01,0.01,0.01,40
NDC,0395100392,GENTIAN VIOLET 1 % TOPICAL SOLUTION,0.28,0.18,0.04,0.28,40
NDC,0395100592,GENTIAN VIOLET 2 % TOPICAL SOLUTION,0.54,0.35,0.08,0.54,40
NDC,0395103116,GLYCERIN 99.5 % TOPICAL SOLUTION,0.15,0.1,0.02,0.15,40
NDC,0395104916,GREEN SOAP TOPICAL TINCTURE,0.06,0.04,0.01,0.06,40
NDC,0395124928,ISOPROPYL ALCOHOL 70 % SOLUTION,0.02,0.01,0.01,0.02,40
NDC,0395166792,METHYL SALICYLATE TOPICAL LIQUID,0.32,0.21,0.05,0.32,40
NDC,0395194991,CLOVE OIL (BULK),0.91,0.59,0.14,0.91,40
NDC,0395199794,OLIVE OIL,0.2,0.13,0.03,0.2,40
NDC,0395201591,PEPPERMINT OIL,1.8,1.17,0.27,1.8,40
NDC,0395206394,SWEET OIL,0.12,0.08,0.02,0.12,40
NDC,0395224391,PEPPERMINT SPIRIT ORAL,0.85,0.55,0.13,0.85,40
NDC,0395232598,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.04,0.03,0.01,0.04,40
NDC,0395266116,SIMPLE SYRUP,0.1,0.07,0.01,0.1,40
NDC,0395266216,CHERRY FLAVOR (BULK) ORAL SYRUP,0.1,0.07,0.01,0.1,40
NDC,0395268594,SODIUM BICARBONATE (BULK) POWDER,0.07,0.05,0.01,0.07,40
NDC,0395392016,SYRPALTA VEHICLE ORAL SYRUP,0.13,0.08,0.02,0.13,40
NDC,0404001835,BENZOCAINE 20% TOPICAL SPRAY,1.48,0.96,0.22,1.48,39
NDC,0404040047,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.44,0.29,0.07,0.44,40
NDC,0404651205,LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100000 INJECTION CARTRIDGE,1.29,0.84,0.19,1.29,40
NDC,0406012301,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,1.38,0.9,0.21,1.38,40
NDC,0406012362,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,2.22,1.44,0.33,2.22,40
NDC,0406012462,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,2.46,1.6,0.37,2.46,40
NDC,0406012562,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,3.36,2.18,0.5,3.36,40
NDC,0406030412,BISMUTH SUBGALLATE (BULK) POWDER,0.42,0.27,0.06,0.42,40
NDC,0406048301,ACETAMINOPHEN 300 MG-CODEINE 15 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,0406048462,ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET,2.54,1.65,0.38,2.54,40
NDC,0406051262,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,3.8,2.47,0.57,3.8,40
NDC,0406052201,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,5.44,3.54,0.81,5.44,40
NDC,0406052362,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,9.88,6.42,1.47,9.88,40
NDC,0406052710,METHADOSE 10 MG/ML ORAL CONCENTRATE,0.17,0.11,0.03,0.17,40
NDC,0406055201,OXYCODONE 5 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,0406055262,OXYCODONE 5 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,0406113052,FENTANYL CITRATE (BULK) 100 % POWDER,4999.98,3249.99,744.0,4999.98,40
NDC,0406114201,METHYLPHENIDATE 5 MG TABLET,1.46,0.95,0.22,1.46,40
NDC,0406114401,METHYLPHENIDATE 10 MG TABLET,2.08,1.35,0.31,2.08,40
NDC,0406114601,METHYLPHENIDATE 20 MG TABLET,3.0,1.95,0.45,3.0,40
NDC,0406117003,NALTREXONE 50 MG TABLET,11.04,7.18,1.64,11.04,40
NDC,0406123601,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,0406147301,METHYLPHENIDATE ER 20 MG TABLETEXTENDED RELEASE,15.5,10.08,2.31,15.5,40
NDC,0406152153,MORPHINE (BULK) 100 % POWDER,36.9,23.99,5.49,36.9,40
NDC,0406154832,CODEINE PHOSPHATE (BULK) 100 % POWDER,24.75,16.09,3.68,24.75,40
NDC,0406182001,METHYLPHENIDATE CD 20 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,16.84,10.95,2.51,16.84,40
NDC,0406222401,LEVORPHANOL TARTRATE 2 MG TABLET,106.8,69.42,15.89,106.8,40
NDC,0406322257,HYDROMORPHONE (BULK) 100 % POWDER,498.75,324.19,74.21,498.75,40
NDC,0406324301,HYDROMORPHONE 2 MG TABLET,1.24,0.81,0.18,1.24,40
NDC,0406324401,HYDROMORPHONE 4 MG TABLET,1.78,1.16,0.26,1.78,40
NDC,0406324901,HYDROMORPHONE 8 MG TABLET,3.58,2.33,0.53,3.58,40
NDC,0406511101,LISDEXAMFETAMINE 10 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406511201,LISDEXAMFETAMINE 20 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406511301,LISDEXAMFETAMINE 30 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406511401,LISDEXAMFETAMINE 40 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406511501,LISDEXAMFETAMINE 50 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406511601,LISDEXAMFETAMINE 60 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406511701,LISDEXAMFETAMINE 70 MG CAPSULE,23.08,15.0,3.43,23.08,40
NDC,0406575562,METHADONE 5 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,0406800312,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,1.8,1.17,0.27,1.8,40
NDC,0406800330,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,1.13,0.73,0.17,1.13,40
NDC,0406831501,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,3.36,2.18,0.5,3.36,40
NDC,0406831562,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,4.08,2.65,0.61,4.08,40
NDC,0406833001,MORPHINE ER 30 MG TABLETEXTENDED RELEASE,6.34,4.12,0.94,6.34,40
NDC,0406833062,MORPHINE ER 30 MG TABLETEXTENDED RELEASE,7.36,4.78,1.1,7.36,40
NDC,0406838001,MORPHINE ER 60 MG TABLETEXTENDED RELEASE,12.42,8.07,1.85,12.42,40
NDC,0406838062,MORPHINE ER 60 MG TABLETEXTENDED RELEASE,11.6,7.54,1.73,11.6,40
NDC,0406839001,MORPHINE ER 100 MG TABLETEXTENDED RELEASE,18.4,11.96,2.74,18.4,40
NDC,0406839062,MORPHINE ER 100 MG TABLETEXTENDED RELEASE,18.18,11.82,2.71,18.18,40
NDC,0406851562,OXYCODONE 15 MG TABLET,5.16,3.35,0.77,5.16,40
NDC,0406853001,OXYCODONE 30 MG TABLET,7.18,4.67,1.07,7.18,40
NDC,0406880601,CLOMIPRAMINE 25 MG CAPSULE,22.48,14.61,3.35,22.48,40
NDC,0406880801,CLOMIPRAMINE 75 MG CAPSULE,22.48,14.61,3.35,22.48,40
NDC,0406888501,DEXTROAMPHETAMINE-AMPHETAMINE 15 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0406889101,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0406889201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0406889301,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0406895101,DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0406895201,DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0406895301,DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0406895401,DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0406895501,DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0406895801,DEXTROAMPHETAMINE SULFATE 5 MG TABLET,5.8,3.77,0.86,5.8,40
NDC,0406896001,DEXTROAMPHETAMINE SULFATE ER 5 MG CAPSULEEXTENDED RELEASE,8.1,5.27,1.21,8.1,40
NDC,0406896101,DEXTROAMPHETAMINE SULFATE ER 10 MG CAPSULEEXTENDED RELEASE,10.12,6.58,1.51,10.12,40
NDC,0406896201,DEXTROAMPHETAMINE SULFATE ER 15 MG CAPSULEEXTENDED RELEASE,13.08,8.5,1.95,13.08,40
NDC,0406901276,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,40.6,26.39,6.04,40.6,40
NDC,0406902576,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,28.84,18.75,4.29,28.84,40
NDC,0406905076,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,52.72,34.27,7.84,52.72,40
NDC,0406907576,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,80.42,52.27,11.97,80.42,40
NDC,0406911276,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,40.6,26.39,6.04,40.6,40
NDC,0406912576,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,28.84,18.75,4.29,28.84,40
NDC,0406915076,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,52.72,34.27,7.84,52.72,40
NDC,0406917576,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,80.42,52.27,11.97,80.42,40
NDC,0406991501,RESTORIL 7.5 MG CAPSULE,74.74,48.58,11.12,74.74,40
NDC,0406996001,TEMAZEPAM 7.5 MG CAPSULE,19.88,12.92,2.96,19.88,40
NDC,0407069020,OMNISCAN 10 MMOL/20 ML (287 MG/ML) INTRAVENOUS SOLUTION,17.34,11.27,0.01,22.96,49
NDC,0407141110,OMNIPAQUE 180 MG IODINE/ML INTRATHECAL SOLUTION,17.34,11.27,0.01,22.96,49
NDC,0407141210,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,18.84,12.25,0.01,22.96,49
NDC,0407141220,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,9.96,6.47,0.01,22.96,49
NDC,0407141230,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,0.97,0.63,0.01,22.96,49
NDC,0407141233,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,2.79,1.81,0.01,22.96,49
NDC,0407141238,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,0.8,0.52,0.01,22.96,49
NDC,0407141310,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,17.4,11.31,0.01,22.96,49
NDC,0407141359,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,5.13,3.33,0.01,22.96,49
NDC,0407141361,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.42,2.22,0.01,22.96,49
NDC,0407141363,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.36,2.18,0.01,22.96,49
NDC,0407141365,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.27,2.13,0.01,22.96,49
NDC,0407141372,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.06,1.99,0.01,22.96,49
NDC,0407141386,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.33,2.16,0.01,22.96,49
NDC,0407141403,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.33,2.16,0.01,22.96,49
NDC,0407141448,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,2.88,1.87,0.01,22.96,49
NDC,0407141472,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.09,2.01,0.01,22.96,49
NDC,0407141476,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.12,2.03,0.01,22.96,49
NDC,0407141484,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.63,2.36,0.01,22.96,49
NDC,0407141489,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.01,22.96,49
NDC,0407141491,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.01,22.96,49
NDC,0407141493,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.45,2.24,0.01,22.96,49
NDC,0407141509,OMNIPAQUE 9 MG IODINE/ML ORAL SOLUTION,0.02,0.01,0.01,47.96,51
NDC,0407141612,OMNIPAQUE 12  MG IODINE/ML ORAL SOLUTION,0.03,0.02,0.01,47.96,51
NDC,0407222216,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.99,2.59,0.01,22.96,49
NDC,0407222217,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.9,2.54,0.01,22.96,49
NDC,0407222219,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.78,2.46,0.01,22.96,49
NDC,0407222316,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,5.19,3.37,0.01,22.96,49
NDC,0407222317,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.32,2.81,0.01,22.96,49
NDC,0407222319,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.99,2.59,0.01,22.96,49
NDC,0407222321,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.69,2.4,0.01,22.96,49
NDC,0407270703,OPTISON 0.22 MG/ML INTRAVENOUS SUSPENSION,154.44,100.39,2.17,154.44,51
NDC,0407294301,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.01,22.96,49
NDC,0407294302,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.01,22.96,49
NDC,0407294305,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.01,22.96,49
NDC,0407294312,CLARISCAN 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.8,12.87,0.01,22.96,49
NDC,0409000125,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,2.13,1.38,0.25,8.86,51
NDC,0409000710,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,0409012525,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,1.05,0.68,0.16,8.86,51
NDC,0409014710,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,0409015201,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,0.12,40
NDC,0409015224,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,0.12,40
NDC,0409018101,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,8.28,5.38,1.23,47.96,51
NDC,0409018125,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,2.36,1.53,0.35,47.96,51
NDC,0409018225,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,2.6,1.69,0.39,47.96,51
NDC,0409018301,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,8.52,5.54,1.27,47.96,51
NDC,0409018325,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,4.24,2.76,0.63,47.96,51
NDC,0409018501,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,53.36,34.68,2.17,53.36,51
NDC,0409018601,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,243.76,158.44,2.17,243.76,51
NDC,0409020102,DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,167.48,108.86,2.17,327.06,65
NDC,0409020110,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.24,98.31,1.16,327.06,51
NDC,0409020120,DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.04,98.18,1.16,327.06,51
NDC,0409021201,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.58,1.68,0.38,8.86,51
NDC,0409021202,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.04,1.33,0.3,8.86,51
NDC,0409021210,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.58,1.68,0.38,8.86,51
NDC,0409021211,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.04,1.33,0.3,8.86,51
NDC,0409080101,NIPENT 10 MG INTRAVENOUS SOLUTION,14661.92,9530.25,2.17,14661.92,65
NDC,0409083011,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,241.02,156.66,2.17,241.02,51
NDC,0409104501,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,99.0,64.35,0.62,2642.72,65
NDC,0409110502,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,4.62,3.0,0.69,4.62,40
NDC,0409110522,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,4.62,3.0,0.69,4.62,40
NDC,0409110901,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.07,3.3,0.75,5.07,40
NDC,0409110911,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.07,3.3,0.75,5.07,40
NDC,0409111201,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,189.68,123.29,0.89,500.04,65
NDC,0409114102,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.63,0.41,0.09,0.63,40
NDC,0409114402,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,29.1,18.92,4.33,29.1,40
NDC,0409114405,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,52.89,34.38,7.87,52.89,40
NDC,0409114410,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,52.89,34.38,7.87,52.89,40
NDC,0409115901,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.84,0.55,0.02,8.86,51
NDC,0409115902,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.3,0.2,0.02,8.86,51
NDC,0409116001,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.27,0.18,0.02,8.86,51
NDC,0409116201,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.99,0.64,0.02,8.86,51
NDC,0409116202,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.33,0.21,0.02,8.86,51
NDC,0409116218,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.99,0.64,0.02,8.86,51
NDC,0409116301,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,0.21,0.14,0.02,8.86,51
NDC,0409116501,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,1.05,0.68,0.02,8.86,51
NDC,0409116502,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,0.57,0.37,0.02,8.86,51
NDC,0409117630,DEMEROL (PF) 25 MG/ML INJECTION SYRINGE,79.2,51.48,2.17,79.2,51
NDC,0409117830,DEMEROL (PF) 50 MG/ML INJECTION SYRINGE,100.8,65.52,2.17,100.8,51
NDC,0409117903,DEMEROL (PF) 75 MG/ML INJECTION SYRINGE,23.04,14.98,2.17,23.04,51
NDC,0409117930,DEMEROL (PF) 75 MG/ML INJECTION SYRINGE,23.04,14.98,2.17,23.04,51
NDC,0409118130,DEMEROL 50 MG/ML INJECTION SOLUTION,78.66,51.13,2.17,78.66,51
NDC,0409120703,GENTAMICIN 40 MG/ML INJECTION SOLUTION,6.51,4.23,0.97,8.86,51
NDC,0409120901,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,4.68,3.04,0.02,8.86,51
NDC,0409120910,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,4.68,3.04,0.02,8.86,51
NDC,0409121501,NALOXONE 0.4 MG/ML INJECTION SOLUTION,57.0,37.05,0.12,57.0,51
NDC,0409121521,NALOXONE 0.4 MG/ML INJECTION SOLUTION,57.0,37.05,0.12,57.0,51
NDC,0409121901,NALOXONE 0.4 MG/ML INJECTION SOLUTION,42.75,27.79,0.12,47.96,51
NDC,0409127303,DIAZEPAM 5 MG/ML INJECTION SYRINGE,72.0,46.8,2.17,72.0,51
NDC,0409127332,DIAZEPAM 5 MG/ML INJECTION SYRINGE,72.0,46.8,2.17,72.0,51
NDC,0409128303,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,39.6,25.74,0.09,39.6,57
NDC,0409128331,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,39.6,25.74,0.09,39.6,57
NDC,0409128337,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,43.2,28.08,0.09,43.2,57
NDC,0409130431,HYDROMORPHONE 4 MG/ML INJECTION SYRINGE,54.0,35.1,0.09,54.0,57
NDC,0409131203,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.09,57.6,57
NDC,0409131230,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.09,57.6,57
NDC,0409131632,HEPARIN PORCINE (PF) 5000 UNIT/0.5 ML INJECTION SYRINGE,29.76,19.34,0.32,29.76,51
NDC,0409131901,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,782.04,508.33,0.04,782.04,51
NDC,0409132305,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,5.25,3.41,0.02,8.86,51
NDC,0409140101,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,126.12,81.98,2.17,126.12,51
NDC,0409140105,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,126.12,81.98,2.17,126.12,51
NDC,0409146301,NALBUPHINE 10 MG/ML INJECTION SOLUTION,22.29,14.49,2.17,22.29,51
NDC,0409146349,NALBUPHINE 10 MG/ML INJECTION SOLUTION,12.9,8.39,1.92,12.9,51
NDC,0409146371,NALBUPHINE 10 MG/ML INJECTION SOLUTION,22.29,14.49,2.17,22.29,51
NDC,0409146401,NALBUPHINE 10 MG/ML INJECTION SOLUTION,19.77,12.85,2.17,19.77,51
NDC,0409146461,NALBUPHINE 10 MG/ML INJECTION SOLUTION,19.77,12.85,2.17,19.77,51
NDC,0409146501,NALBUPHINE 20 MG/ML INJECTION SOLUTION,38.64,25.12,2.17,38.64,51
NDC,0409146701,NALBUPHINE 20 MG/ML INJECTION SOLUTION,29.37,19.09,2.17,29.37,51
NDC,0409155554,HEXTEND 6 % INTRAVENOUS SOLUTION,4.38,2.85,0.65,4.38,40
NDC,0409155930,MARCAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.6,0.39,0.02,8.86,51
NDC,0409156010,MARCAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,1.86,1.21,0.02,8.86,51
NDC,0409158210,MARCAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,1.89,1.23,0.02,8.86,51
NDC,0409159304,THAM 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,2.82,1.83,0.42,2.82,40
NDC,0409162301,BUTORPHANOL 1 MG/ML INJECTION SOLUTION,60.84,39.55,2.17,60.84,51
NDC,0409162601,BUTORPHANOL 2 MG/ML INJECTION SOLUTION,74.43,48.38,2.17,74.43,51
NDC,0409163010,ATROPINE 0.1 MG/ML INJECTION SYRINGE,3.69,2.4,0.18,8.86,51
NDC,0409163110,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,4.53,2.94,0.05,8.86,51
NDC,0409163802,PRECEDEX 100 MCG/ML INTRAVENOUS SOLUTION,10.8,7.02,1.61,10.8,40
NDC,0409166020,PRECEDEX 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLUTION,4.77,3.1,0.71,4.77,40
NDC,0409166050,PRECEDEX 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLUTION,2.01,1.31,0.3,2.01,40
NDC,0409174610,MARCAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,2.88,1.87,0.43,2.88,40
NDC,0409174630,MARCAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,1.53,0.99,0.23,1.53,40
NDC,0409174910,MARCAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,2.97,1.93,0.44,2.97,40
NDC,0409174929,MARCAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,1.65,1.07,0.25,1.65,40
NDC,0409175250,MARCAINE-EPINEPHRINE 0.25 %-1:200000 INJECTION SOLUTION,1.47,0.96,0.22,1.47,40
NDC,0409175550,MARCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,1.56,1.01,0.23,1.56,40
NDC,0409176105,MARCAINE SPINAL (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,14.19,9.22,2.11,14.19,40
NDC,0409176110,MARCAINE SPINAL (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,14.19,9.22,2.11,14.19,40
NDC,0409176118,MARCAINE SPINAL (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,14.19,9.22,2.11,14.19,40
NDC,0409177510,DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,8.16,5.3,1.21,8.16,40
NDC,0409177805,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,1.05,0.68,0.16,8.86,51
NDC,0409178269,NALOXONE 0.4 MG/ML INJECTION SYRINGE,241.2,156.78,0.12,241.2,51
NDC,0409180501,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,115.2,74.88,0.09,115.2,57
NDC,0409188602,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,2.79,1.81,0.07,8.86,51
NDC,0409188622,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,2.79,1.81,0.07,8.86,51
NDC,0409189001,MORPHINE 2 MG/ML INTRAVENOUS SYRINGE,36.0,23.4,2.17,36.0,51
NDC,0409189023,MORPHINE 2 MG/ML INTRAVENOUS SYRINGE,20.55,13.36,2.17,20.55,51
NDC,0409189101,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,32.4,21.06,2.17,32.4,51
NDC,0409189323,MORPHINE 10 MG/ML INTRAVENOUS SYRINGE,100.8,65.52,2.17,100.8,51
NDC,0409189620,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,15.66,10.18,2.17,15.66,51
NDC,0409190201,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,147.54,95.9,2.17,1020.7,65
NDC,0409196602,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.27,0.18,0.04,0.27,40
NDC,0409196607,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.27,0.18,0.04,0.27,40
NDC,0409196612,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.75,0.49,0.11,0.75,40
NDC,0409198503,LORAZEPAM 2 MG/ML INJECTION SYRINGE,57.6,37.44,2.17,57.6,51
NDC,0409198530,LORAZEPAM 2 MG/ML INJECTION SYRINGE,57.6,37.44,2.17,57.6,51
NDC,0409201105,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,0.99,0.64,0.07,8.86,51
NDC,0409201125,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,0.99,0.64,0.07,8.86,51
NDC,0409201232,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SYRINGE,115.2,74.88,2.17,115.2,51
NDC,0409205105,KETAMINE 100 MG/ML INJECTION SOLUTION,6.0,3.9,0.89,6.0,40
NDC,0409205310,KETAMINE 50 MG/ML INJECTION SOLUTION,1.32,0.86,0.2,1.32,40
NDC,0409206605,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,1.98,1.29,0.02,8.86,51
NDC,0409216877,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.8,1.17,0.27,8.86,51
NDC,0409218801,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,89.61,58.25,0.62,2642.72,65
NDC,0409222212,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0409226754,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.93,0.6,0.14,8.86,51
NDC,0409230024,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,8.86,51
NDC,0409230504,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.15,8.86,51
NDC,0409230505,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.15,8.86,51
NDC,0409230550,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.63,0.41,0.09,8.86,51
NDC,0409230801,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,5.01,3.26,0.25,8.86,51
NDC,0409230802,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,2.43,1.58,0.25,8.86,51
NDC,0409230849,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,3.39,2.2,0.25,8.86,51
NDC,0409230869,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,3.39,2.2,0.25,8.86,51
NDC,0409233725,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,146.61,95.3,2.17,146.61,51
NDC,0409233924,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,14.4,9.36,0.62,14.4,51
NDC,0409233934,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,14.4,9.36,0.62,14.4,51
NDC,0409234488,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,0.93,0.6,0.14,16.85,51
NDC,0409234632,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.05,16.85,51
NDC,0409234732,DOBUTAMINE 500 MG/250 ML (2000 MCG/ML) IN 5 % DEXTROSE IV,0.57,0.37,0.08,16.85,51
NDC,0409258501,CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,9.84,6.4,1.46,9.84,51
NDC,0409258705,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.81,0.53,0.12,8.86,51
NDC,0409259603,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,5.1,3.32,0.25,8.86,51
NDC,0409259605,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.7,1.76,0.25,8.86,51
NDC,0409263401,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,281.01,182.66,0.09,281.01,57
NDC,0409263405,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,16.35,10.63,0.09,16.35,57
NDC,0409263450,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,17.73,11.52,0.09,17.73,57
NDC,0409268901,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,19.38,12.6,2.17,19.38,51
NDC,0409268921,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,19.38,12.6,2.17,19.38,51
NDC,0409272001,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,6.69,4.35,0.32,8.86,51
NDC,0409272002,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.18,8.86,51
NDC,0409272003,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,0.93,0.6,0.14,8.86,51
NDC,0409272031,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.18,8.86,51
NDC,0409272101,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,11.85,7.7,0.32,11.85,51
NDC,0409272130,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,11.85,7.7,0.32,11.85,51
NDC,0409272301,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,7.62,4.95,0.32,8.86,51
NDC,0409272302,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,4.2,2.73,0.32,8.86,51
NDC,0409272330,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,7.62,4.95,0.32,8.86,51
NDC,0409298703,AMPICILLIN-SULBACTAM 3 GRAM INTRAVENOUS SOLUTION,33.24,21.61,2.17,33.24,51
NDC,0409317701,LIDOCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0409317802,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.86,1.21,0.02,8.86,51
NDC,0409317803,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.93,0.6,0.02,8.86,51
NDC,0409317817,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.86,1.21,0.02,8.86,51
NDC,0409317818,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.93,0.6,0.02,8.86,51
NDC,0409318101,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,2.22,1.44,0.02,8.86,51
NDC,0409318202,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.75,0.49,0.02,8.86,51
NDC,0409318203,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.75,0.49,0.02,8.86,51
NDC,0409318221,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.75,0.49,0.02,8.86,51
NDC,0409318301,LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,0409318910,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,2.67,1.74,0.4,2.67,40
NDC,0409321312,DIAZEPAM 5 MG/ML INJECTION SOLUTION,20.85,13.55,2.17,20.85,51
NDC,0409329425,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.51,0.12,0.78,40
NDC,0409329451,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.81,0.53,0.12,0.81,40
NDC,0409329461,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.81,0.53,0.12,0.81,40
NDC,0409329905,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.87,0.57,0.13,0.87,40
NDC,0409329906,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0409329926,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0409330703,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,2.43,1.58,0.36,2.43,40
NDC,0409330803,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,2.55,1.66,0.38,2.55,40
NDC,0409333024,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0409336510,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,72.75,47.29,0.09,72.75,57
NDC,0409337504,LEVOPHED 1 MG/ML INTRAVENOUS SOLUTION,20.22,13.14,3.01,20.22,40
NDC,0409338221,SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION,70.35,45.73,10.47,70.35,40
NDC,0409338513,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,37.65,24.47,1.94,37.65,51
NDC,0409341411,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,2.25,1.46,0.33,8.86,51
NDC,0409343524,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.81,0.53,0.12,8.86,51
NDC,0409351501,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,87.66,56.98,0.05,87.66,51
NDC,0409357801,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,5.37,3.49,0.8,8.86,51
NDC,0409357811,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,5.37,3.49,0.8,8.86,51
NDC,0409361301,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,6.15,4.0,0.92,6.15,40
NDC,0409372432,DOBUTAMINE 1000 MG/250 ML(4000 MCG/ML) IN 5 % DEXTROSE IV,0.42,0.27,0.06,16.85,51
NDC,0409379301,KETOROLAC 15 MG/ML INJECTION SOLUTION,10.83,7.04,0.31,10.83,65
NDC,0409379501,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,23.52,15.29,0.31,23.52,65
NDC,0409379519,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,23.52,15.29,0.31,23.52,65
NDC,0409379601,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.88,3.82,0.31,8.86,65
NDC,0409379619,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.88,3.82,0.31,8.86,65
NDC,0409381201,MARCAINE-EPINEPHRINE 0.25 %-1:200000 INJECTION SOLUTION,0.69,0.45,0.1,0.69,40
NDC,0409381411,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,8.37,5.44,1.25,47.96,51
NDC,0409381412,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,8.37,5.44,1.25,47.96,51
NDC,0409381512,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,16.77,10.9,2.17,47.96,51
NDC,0409397701,WATER FOR INJECTION BACTERIOSTATIC INJECTION SOLUTION,0.93,0.6,0.14,0.93,40
NDC,0409397703,WATER FOR INJECTION BACTERIOSTATIC INJECTION SOLUTION,0.93,0.6,0.14,0.93,40
NDC,0409403101,MANNITOL 25 % INTRAVENOUS SOLUTION,0.66,0.43,0.1,8.86,51
NDC,0409409101,MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,13.89,9.03,2.07,13.89,40
NDC,0409409201,COPPER CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,11.43,7.43,1.7,11.43,40
NDC,0409409301,CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,7.38,4.8,1.1,7.38,40
NDC,0409426401,HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE,108.0,70.2,0.09,108.0,57
NDC,0409427501,LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,0.3,0.2,0.04,0.3,40
NDC,0409427601,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.57,0.37,0.02,8.86,51
NDC,0409427602,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.21,0.14,0.02,8.86,51
NDC,0409427616,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.57,0.37,0.02,8.86,51
NDC,0409427617,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.21,0.14,0.03,0.21,40
NDC,0409427701,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.72,0.47,0.02,8.86,51
NDC,0409427702,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.27,0.18,0.02,8.86,51
NDC,0409427717,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.27,0.18,0.02,8.86,51
NDC,0409427801,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.3,0.2,0.02,8.86,51
NDC,0409427902,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,0.39,0.25,0.02,8.86,51
NDC,0409427916,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,0.36,0.23,0.02,8.86,51
NDC,0409428201,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.48,2.26,0.02,8.86,51
NDC,0409428202,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.61,1.7,0.02,8.86,51
NDC,0409428212,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.61,1.7,0.02,8.86,51
NDC,0409428301,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,3.18,2.07,0.47,3.18,40
NDC,0409428311,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,3.18,2.07,0.47,3.18,40
NDC,0409428325,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,3.18,2.07,0.47,3.18,40
NDC,0409433201,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,0.05,29.37,51
NDC,0409433211,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,2.17,29.37,51
NDC,0409434673,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,1.95,1.27,0.29,47.96,51
NDC,0409435003,DILTIAZEM 100 MG INTRAVENOUS SOLUTION,41.07,26.7,0.05,41.07,51
NDC,0409435013,DILTIAZEM 100 MG INTRAVENOUS SOLUTION,41.07,26.7,0.05,41.07,51
NDC,0409469924,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.12,8.86,51
NDC,0409469933,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.12,8.86,51
NDC,0409471302,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.11,0.72,0.02,8.86,51
NDC,0409471332,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,2.1,1.37,0.02,8.86,51
NDC,0409475503,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,2.31,1.5,0.16,8.86,51
NDC,0409475518,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,2.1,1.37,0.16,8.86,51
NDC,0409475901,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,1.29,0.84,0.16,8.86,51
NDC,0409477601,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION,1.65,1.07,0.25,1.65,40
NDC,0409477610,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION,1.65,1.07,0.25,1.65,40
NDC,0409477702,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.06,0.04,0.01,8.86,51
NDC,0409488723,WATER FOR INJECTION STERILE 100 % INJECTION SOLUTION,0.36,0.23,0.05,0.36,40
NDC,0409488750,WATER FOR INJECTION STERILE 100 % INJECTION SOLUTION,0.63,0.41,0.09,0.63,40
NDC,0409488802,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0409488803,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.06,0.42,40
NDC,0409488810,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.33,0.21,0.05,0.33,40
NDC,0409488820,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.06,0.42,40
NDC,0409488850,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.27,0.18,0.04,0.27,40
NDC,0409508216,TAZICEF 1 GRAM SOLUTION FOR INJECTION,15.36,9.98,2.17,15.36,51
NDC,0409508411,TAZICEF 2 GRAM SOLUTION FOR INJECTION,34.38,22.35,2.17,34.38,51
NDC,0409508611,TAZICEF 6 GRAM SOLUTION FOR INJECTION,110.04,71.53,2.17,110.04,51
NDC,0409555502,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,5.58,3.63,0.83,5.58,40
NDC,0409581610,STERILE EMPTY 10ML VIAL,1.9,1.24,0.28,1.9,40
NDC,0409582001,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,3.18,2.07,0.47,8.86,51
NDC,0409592101,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,7.92,5.15,1.18,18.53,51
NDC,0409592116,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,7.92,5.15,1.18,18.53,51
NDC,0409592201,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,2.55,1.66,0.38,18.53,51
NDC,0409592216,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,2.55,1.66,0.38,18.53,51
NDC,0409610202,FUROSEMIDE 10 MG/ML INJ,7.53,4.89,0.04,8.86,51
NDC,0409610204,FUROSEMIDE 10 MG/ML INJ,2.64,1.72,0.04,8.86,51
NDC,0409610210,FUROSEMIDE 10 MG/ML INJ,2.1,1.37,0.04,8.86,51
NDC,0409610218,FUROSEMIDE 10 MG/ML INJ,2.64,1.72,0.04,8.86,51
NDC,0409610225,FUROSEMIDE 10 MG/ML INJ,6.06,3.94,0.04,8.86,51
NDC,0409610226,FUROSEMIDE 10 MG/ML INJ,2.64,1.72,0.04,8.86,51
NDC,0409610227,FUROSEMIDE 10 MG/ML INJ,1.8,1.17,0.04,8.86,51
NDC,0409610235,FUROSEMIDE 10 MG/ML INJ,6.15,4.0,0.04,8.86,51
NDC,0409647644,ERYTHROCIN 500 MG INTRAVENOUS SOLUTION,304.32,197.81,2.17,304.32,51
NDC,0409648201,ERYTHROCIN 500 MG INTRAVENOUS SOLUTION,711.12,462.23,2.17,711.12,51
NDC,0409650901,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,324.93,211.2,2.17,324.93,51
NDC,0409650949,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,71.97,46.78,0.04,71.97,51
NDC,0409653101,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,24.06,15.64,0.18,24.06,51
NDC,0409653102,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,35.4,23.01,0.18,35.4,51
NDC,0409653112,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,35.4,23.01,0.18,35.4,51
NDC,0409653321,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,58.62,38.1,2.17,58.62,51
NDC,0409653401,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,19.53,12.69,0.04,19.53,51
NDC,0409653501,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,30.18,19.62,2.17,30.18,51
NDC,0409655701,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,30.54,19.85,0.05,30.54,51
NDC,0409662514,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,0.72,0.47,0.11,0.72,40
NDC,0409662530,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,0.66,0.43,0.1,0.66,40
NDC,0409662535,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,0.66,0.43,0.1,0.66,40
NDC,0409662902,QUELICIN 20 MG/ML INJECTION SOLUTION,6.99,4.54,1.04,8.86,51
NDC,0409663501,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,3.57,2.32,0.21,8.86,51
NDC,0409664802,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,0.42,0.27,0.06,0.42,40
NDC,0409664816,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,0.42,0.27,0.06,0.42,40
NDC,0409665106,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,1.38,0.9,0.21,8.86,51
NDC,0409665305,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.9,0.59,0.13,8.86,51
NDC,0409665318,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.9,0.59,0.13,8.86,51
NDC,0409666075,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.75,0.49,0.11,8.86,51
NDC,0409669502,AMIDATE 2 MG/ML INTRAVENOUS SOLUTION,1.17,0.76,0.17,1.17,40
NDC,0409672723,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0409672923,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,8.86,51
NDC,0409672924,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,1.17,0.76,0.17,8.86,51
NDC,0409673013,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.54,0.35,0.08,8.86,51
NDC,0409703710,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,2.58,1.68,0.38,2.58,40
NDC,0409710002,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,0.09,40
NDC,0409710004,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,0.09,40
NDC,0409710066,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,0.3,40
NDC,0409710067,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,0.15,40
NDC,0409710068,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,0.3,40
NDC,0409710069,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,0.15,40
NDC,0409710102,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,0.09,40
NDC,0409710166,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.33,0.21,0.05,0.33,40
NDC,0409710167,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.15,0.1,0.02,0.15,40
NDC,0409724803,HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.45,0.29,0.07,0.45,40
NDC,0409729501,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,3.54,2.3,0.53,3.54,40
NDC,0409729925,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.57,0.37,0.08,0.57,40
NDC,0409729945,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.57,0.37,0.08,0.57,40
NDC,0409729973,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,2.25,1.46,0.33,2.25,40
NDC,0409729983,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,2.25,1.46,0.33,2.25,40
NDC,0409733201,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,5.49,3.57,0.82,8.86,51
NDC,0409733220,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,4.5,2.93,0.67,8.86,51
NDC,0409733410,CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,62.34,40.52,0.82,62.34,51
NDC,0409733503,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,10.41,6.77,0.82,10.41,51
NDC,0409733604,CEFTRIAXONE 2 GRAM INTRAVENOUS SOLUTION,28.71,18.66,0.82,28.71,51
NDC,0409733701,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,2.73,1.77,0.41,8.86,51
NDC,0409733801,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,3.48,2.26,0.52,8.86,51
NDC,0409733811,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,3.48,2.26,0.52,8.86,51
NDC,0409738501,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,0.24,0.16,0.04,18.53,51
NDC,0409739172,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,9.99,6.49,1.49,9.99,40
NDC,0409741803,LMD (DEXTRAN 40) 10 % IN 5 % DEXTROSE INTRAVENOUS SOLUTION,2.28,1.48,0.34,142.17,51
NDC,0409741903,LMD (DEXTRAN 40) 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,2.37,1.54,0.35,142.17,51
NDC,0409751716,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,1.56,1.01,0.23,1.56,40
NDC,0409762003,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0409762049,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0409762059,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,0409765030,HEPARIN (PORCINE) 25000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN,0.24,0.16,0.04,8.86,51
NDC,0409781022,DOPAMINE 800 MG/250 ML (3200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.33,0.21,0.05,8.86,51
NDC,0409796905,PLEGISOL 16 MEQ/L (POTASSIUM) PERFUSION SOLUTION,0.3,0.2,0.04,0.3,40
NDC,0409818301,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.96,0.62,0.14,0.96,40
NDC,0409818311,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.96,0.62,0.14,0.96,40
NDC,0409904201,BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,2.88,1.87,0.43,2.88,40
NDC,0409904217,BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,1.53,0.99,0.23,1.53,40
NDC,0409904501,BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,2.97,1.93,0.44,2.97,40
NDC,0409904517,BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,1.65,1.07,0.25,1.65,40
NDC,0409909417,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.66,2.38,0.54,8.86,51
NDC,0409909418,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,2.46,1.6,0.37,8.86,51
NDC,0409909422,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,7.53,4.89,1.12,8.86,51
NDC,0409909425,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,2.46,1.6,0.37,8.86,51
NDC,0409909428,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.66,2.38,0.54,8.86,51
NDC,0409909431,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,1.89,1.23,0.28,8.86,51
NDC,0409909461,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.36,2.18,0.5,8.86,51
NDC,0409910420,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,2.82,1.83,0.42,8.86,51
NDC,0409913705,LIDOCAINE (PF) 50 MG/5 ML (1 %) INTRAVENOUS SYRINGE,10.8,7.02,0.02,10.8,51
NDC,0409915701,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.17,47.96,51
NDC,0409915731,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.17,47.96,51
NDC,0409915750,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.17,47.96,51
NDC,0409915801,VITAMIN K1 10 MG/ML INJECTION SOLUTION,176.28,114.58,2.17,176.28,51
NDC,0409955805,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,2.67,1.74,0.4,2.67,40
NDC,0409955849,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,1.32,0.86,0.2,1.32,40
NDC,0409956610,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.93,14.25,1.55,21.93,51
NDC,0409973510,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,36.18,23.52,1.55,36.18,51
NDC,0414200007,FLORASTOR 250 MG CAPSULE,1.98,1.29,0.29,1.98,40
NDC,0430375414,ESTRACE 0.01% (0.1 MG/GRAM) VAGINAL CREAM,19.48,12.66,2.9,19.48,40
NDC,0436067216,DAKIN'S SOLUTION 0.125 %,0.08,0.05,0.01,0.08,40
NDC,0436093616,DAKIN'S SOLUTION 0.25 %,0.08,0.05,0.01,0.08,40
NDC,0436094616,DAKIN'S SOLUTION 0.5 %,0.08,0.05,0.01,0.08,40
NDC,0456040010,TEFLARO 400 MG INTRAVENOUS SOLUTION,926.85,602.45,2.17,926.85,65
NDC,0456045801,ARMOUR THYROID 30 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,0456045901,ARMOUR THYROID 60 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,0456046001,ARMOUR THYROID 90 MG TABLET,4.22,2.74,0.63,4.22,40
NDC,0456046101,ARMOUR THYROID 120 MG TABLET,4.94,3.21,0.74,4.94,40
NDC,0456060010,TEFLARO 600 MG INTRAVENOUS SOLUTION,926.85,602.45,2.17,926.85,65
NDC,0456111030,VIIBRYD 10 MG TABLET,29.18,18.97,4.34,29.18,40
NDC,0456112030,VIIBRYD 20 MG TABLET,29.18,18.97,4.34,29.18,40
NDC,0456114030,VIIBRYD 40 MG TABLET,29.18,18.97,4.34,29.18,40
NDC,0456155060,SAVELLA 50 MG TABLET,20.48,13.31,3.05,20.48,40
NDC,0456201001,LEXAPRO 10 MG TABLET,36.9,23.99,5.49,36.9,40
NDC,0456202001,LEXAPRO 20 MG TABLET,38.5,25.03,5.73,38.5,40
NDC,0456224030,FETZIMA 40 MG CAPSULEEXTENDED RELEASE,42.12,27.38,6.27,42.12,40
NDC,0456240560,SAPHRIS 5 MG SUBLINGUAL TABLET,50.44,32.79,7.51,50.44,40
NDC,0456241060,SAPHRIS 10 MG SUBLINGUAL TABLET,50.44,32.79,7.51,50.44,40
NDC,0456270001,AVYCAZ 2.5 GRAM INTRAVENOUS SOLUTION,1495.32,971.96,2.17,1495.32,65
NDC,0456270010,AVYCAZ 2.5 GRAM INTRAVENOUS SOLUTION,1495.32,971.96,2.17,1495.32,65
NDC,0456340733,NAMENDA XR 7 MG CAPSULE SPRINKLEEXTENDED RELEASE,37.18,24.17,5.53,37.18,40
NDC,0469012599,XTANDI 40 MG CAPSULE,298.12,193.78,44.36,298.12,40
NDC,0469052002,CRESEMBA 186 MG CAPSULE,277.8,180.57,41.34,277.8,40
NDC,0469060773,PROGRAF 0.5 MG CAPSULE,8.88,5.77,0.36,8.88,51
NDC,0469061773,PROGRAF 1 MG CAPSULE,17.76,11.54,0.36,17.76,51
NDC,0469062599,XTANDI 40 MG TABLET,245.52,159.59,36.53,245.52,40
NDC,0469067773,ASTAGRAF XL 1 MG CAPSULEEXTENDED RELEASE,13.86,9.01,1.05,13.86,51
NDC,0469072560,XTANDI 80 MG TABLET,573.3,372.65,85.31,573.3,40
NDC,0469142590,XOSPATA 40 MG TABLET,772.78,502.31,114.99,772.78,40
NDC,0469260190,MYRBETRIQ 25 MG TABLETEXTENDED RELEASE,36.82,23.93,5.48,36.82,40
NDC,0469260290,MYRBETRIQ 50 MG TABLETEXTENDED RELEASE,36.82,23.93,5.48,36.82,40
NDC,0469301601,PROGRAF 5 MG/ML INTRAVENOUS SOLUTION,918.09,596.76,2.17,918.09,65
NDC,0469305130,AMBISOME 50 MG INTRAVENOUS SUSPENSION,1145.91,744.84,2.17,1145.91,65
NDC,0469342510,VYLOY 100 MG INTRAVENOUS SOLUTION,7680.0,4992.0,2.17,7680.0,59
NDC,0469442530,VYLOY 300 MG INTRAVENOUS SOLUTION,23040.0,14976.0,2.17,23040.0,59
NDC,0469650189,LEXISCAN 0.4 MG/5 ML INTRAVENOUS SYRINGE,185.58,120.63,2.17,185.58,51
NDC,0472001304,GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,1.63,1.06,0.24,1.63,40
NDC,0472008216,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,2.35,1.53,0.35,2.35,40
NDC,0472016615,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.34,1.52,0.35,2.34,40
NDC,0472037915,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,5.16,3.35,0.77,5.16,40
NDC,0472037945,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,3.7,2.41,0.55,3.7,40
NDC,0472038015,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,5.54,3.6,0.82,5.54,40
NDC,0472038045,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,3.7,2.41,0.55,3.7,40
NDC,0472038115,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,6.72,4.37,1.0,6.72,40
NDC,0472038215,BETAMETHASONE AUGMENTED 0.05 % TOPICAL OINTMENT,8.46,5.5,1.26,8.46,40
NDC,0472038245,BETAMETHASONE AUGMENTED 0.05 % TOPICAL OINTMENT,5.68,3.69,0.85,5.68,40
NDC,0472103016,HYDROMET 5 MG-1.5 MG/5 ML ORAL SOLUTION,0.48,0.31,0.07,0.48,40
NDC,0472173803,MICONAZOLE-3 200 MG VAGINAL SUPPOSITORY,38.2,24.83,5.68,38.2,40
NDC,0480372056,PYRIMETHAMINE 25 MG TABLET,1710.0,1111.5,254.45,1710.0,40
NDC,0480706356,PERAMPANEL 4 MG TABLET,93.26,60.62,13.88,93.26,40
NDC,0485015130,UROGESIC-BLUE 81.6 MG-40.8 MG-0.12 MG TABLET,13.48,8.76,2.01,13.48,40
NDC,0486111101,K-PHOS ORIGINAL 500 MG SOLUBLE TABLET,1.22,0.79,0.18,1.22,40
NDC,0486112501,K-PHOS-NEUTRAL 250 MG TABLET,1.7,1.11,0.25,1.7,40
NDC,0487020101,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.48,0.96,0.22,1.48,40
NDC,0487020160,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.4,0.91,0.21,1.4,40
NDC,0487278401,ASTHMANEFRIN REFILL 2.25 % SOLUTION FOR NEBULIZATION,5.0,3.25,0.74,5.0,40
NDC,0487590199,S2 RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,5.0,3.25,0.74,5.0,40
NDC,0487900330,SODIUM CHLORIDE 3 % FOR NEBULIZATION,0.4,0.26,0.06,0.4,40
NDC,0487900730,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.4,0.26,0.06,0.4,40
NDC,0487930103,SODIUM CHLORIDE 0.9 % FOR NEBULIZATION,0.2,0.13,0.03,0.2,40
NDC,0487930133,SODIUM CHLORIDE 0.9 % FOR NEBULIZATION,0.24,0.16,0.04,0.24,40
NDC,0487950101,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.08,0.54,40
NDC,0487950103,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.08,0.54,40
NDC,0487950125,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.08,0.54,40
NDC,0487950160,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.08,0.54,40
NDC,0487960101,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,9.48,6.16,1.41,9.48,40
NDC,0487980101,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,0.28,0.18,0.04,0.28,40
NDC,0487980125,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,1.06,0.69,0.16,1.06,40
NDC,0487980160,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,1.06,0.69,0.16,1.06,40
NDC,0487990130,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,1.8,1.17,0.27,1.8,40
NDC,0487990425,ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,1.1,0.72,0.16,1.1,40
NDC,0496051304,DETACHOL ADHESIVE REMOVER LIQUID,0.22,0.14,0.03,0.22,40
NDC,0496051306,DETACHOL ADHESIVE REMOVER LIQUID,0.3,0.2,0.04,0.3,40
NDC,0496052306,MASTISOL LIQUID ADHESIVE,1.14,0.74,0.17,1.14,40
NDC,0496074804,PRAX 1 % LOTION,0.34,0.22,0.05,0.34,40
NDC,0496088205,LMX 4 4 % TOPICAL CREAM,3.36,2.18,0.5,3.36,40
NDC,0496088206,LMX 4 4 % TOPICAL CREAM,3.36,2.18,0.5,3.36,40
NDC,0496088207,LMX 4 PLUS 4 % TOPICAL KIT,96.14,62.49,14.31,96.14,40
NDC,0496088215,LMX 4 4 % TOPICAL CREAM,3.9,2.54,0.58,3.9,40
NDC,0496088230,LMX 4 4 % TOPICAL CREAM,3.6,2.34,0.54,3.6,40
NDC,0496088330,LMX 5 5 % TOPICAL CREAM,4.32,2.81,0.64,4.32,40
NDC,0501373005,NEOSPORIN (NEO-BAC-POLYM) 3.5 MG-400 UNIT-5000 UNIT/GRAM TOP OINTMENT,0.54,0.35,0.08,0.54,40
NDC,0517003125,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,25.17,16.36,1.14,25.17,51
NDC,0517013001,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.84,8.35,1.14,12.84,51
NDC,0517013005,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.84,8.35,1.14,12.84,51
NDC,0517030110,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,22.5,14.63,4.97,29.03,65
NDC,0517031010,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,3.06,1.99,0.68,29.03,65
NDC,0517037271,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,20.16,13.1,4.46,29.03,65
NDC,0517037370,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,49.17,31.96,8.53,49.17,65
NDC,0517037405,PROVAYBLUE 5 MG/ML INTRAVENOUS SOLUTION,84.39,54.85,8.53,84.39,65
NDC,0517037510,INDIGO CARMINE 8 MG/ML (0.8 %) INJECTION SOLUTION,5.19,3.37,1.15,27.55,59
NDC,0517038105,PROVAYBLUE 5 MG/ML INTRAVENOUS SOLUTION,84.39,54.85,8.53,84.39,65
NDC,0517042001,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,100.14,65.09,2.17,100.14,51
NDC,0517065001,INJECTAFER 50 MG IRON/ML INTRAVENOUS SOLUTION,371.1,241.22,1.1,667.03,65
NDC,0517071001,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,4155.87,2701.32,2.17,4155.87,65
NDC,0517072001,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,39.63,25.76,2.17,39.63,51
NDC,0517073001,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,15.12,9.83,2.17,47.96,51
NDC,0517073101,CLONIDINE (PF) 5000 MCG/10 ML EPIDURAL SOLUTION,63.0,40.95,2.17,63.0,51
NDC,0517073510,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,11.07,7.2,0.12,130.36,51
NDC,0517074001,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,112.62,73.2,2.17,112.62,51
NDC,0517074020,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,112.62,73.2,2.17,112.62,51
NDC,0517086610,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,28.17,18.31,2.17,162.7,51
NDC,0517095501,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,142.17,92.41,1.44,142.17,51
NDC,0517100125,ATROPINE 1 MG/ML INJECTION SOLUTION,61.05,39.68,0.23,61.05,51
NDC,0517100425,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,40.44,26.29,0.23,40.44,51
NDC,0517101025,ATROPINE 1 MG/ML INJECTION SOLUTION,45.21,29.39,0.23,45.21,51
NDC,0517182001,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,576.0,374.4,2.17,576.0,51
NDC,0517190525,DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,2.37,1.54,0.35,8.86,51
NDC,0517198001,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,70.2,45.63,2.17,70.2,51
NDC,0517210225,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,11.52,7.49,1.71,11.52,40
NDC,0517231005,VENOFER 200 MG IRON/10 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
NDC,0517232510,VENOFER 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
NDC,0517234001,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
NDC,0517234010,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
NDC,0517234025,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.43,47.96,51
NDC,0517250201,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,70.44,45.79,10.48,70.44,40
NDC,0517250210,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,70.44,45.79,10.48,70.44,40
NDC,0517300525,STERILE WATER 100 % FOR INJECTION,2.07,1.35,0.31,2.07,40
NDC,0517400225,PAPAVERINE 30 MG/ML INJECTION SOLUTION,74.55,48.46,2.17,102.6,51
NDC,0517420125,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,110.04,71.53,2.17,110.04,51
NDC,0517430001,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,7867.04,5113.58,2.17,7867.04,65
NDC,0517460125,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,46.8,30.42,0.51,46.8,57
NDC,0517460225,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,41.4,26.91,0.51,41.4,57
NDC,0517460525,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,31.68,20.59,0.51,31.68,57
NDC,0517462025,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,23.01,14.96,0.51,23.01,57
NDC,0517481001,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,5.61,3.65,0.83,5.61,40
NDC,0517481025,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,5.61,3.65,0.83,5.61,40
NDC,0517560125,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,121.35,78.88,2.17,121.35,51
NDC,0517560225,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,83.55,54.31,2.17,83.55,51
NDC,0517610125,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,11.04,7.18,1.64,11.04,40
NDC,0517620225,MULTITRACE-4 NEONATAL 0.85 MCG-0.1 MG-25 MCG-1.5 MG/ML INTRAVENOUS,20.85,13.55,3.1,20.85,40
NDC,0517651025,SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,6.39,4.15,0.95,6.39,40
NDC,0517671010,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,7.29,4.74,0.05,8.86,51
NDC,0517730525,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,13.98,9.09,2.08,13.98,40
NDC,0517731525,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,9.9,6.44,1.47,9.9,40
NDC,0517750401,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,8.53,5.54,1.27,8.53,40
NDC,0517750425,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,8.53,5.54,1.27,8.53,40
NDC,0517760401,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,11.3,7.35,1.68,11.3,40
NDC,0517760425,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,11.3,7.35,1.68,11.3,40
NDC,0517800525,ZINC SULFATE 5 MG/ML INTRAVENOUS SOLUTION,55.26,35.92,8.22,55.26,40
NDC,0517890510,METHYLDOPATE 250 MG/5 ML INTRAVENOUS SOLUTION,28.8,18.72,2.17,184.43,51
NDC,0517912025,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,1.86,1.21,0.28,47.96,51
NDC,0517930525,TRALEMENT 3 MG-0.3 MG-55 MCG-60 MCG/ML INTRAVENOUS SOLUTION,101.49,65.97,15.1,101.49,40
NDC,0517970225,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,19.14,12.44,2.17,29.09,51
NDC,0525096690,FOLTX 2 MG-1.13 MG-25 MG TABLET,5.2,3.38,0.77,5.2,40
NDC,0525110290,DEPLIN (ALGAL OIL) 15 MG-90.314 MG CAPSULE,16.62,10.8,2.47,16.62,40
NDC,0525113990,DEPLIN (ALGAL OIL) 7.5 MG-90.314 MG CAPSULE,16.62,10.8,2.47,16.62,40
NDC,0527123101,PRIMIDONE 250 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,0527130101,PRIMIDONE 50 MG TABLET,1.0,0.65,0.15,1.0,40
NDC,0527131101,TERBUTALINE 5 MG TABLET,13.3,8.65,1.98,13.3,40
NDC,0527131801,TERBUTALINE 2.5 MG TABLET,10.88,7.07,1.62,10.88,40
NDC,0527132601,URSODIOL 300 MG CAPSULE,14.7,9.56,2.19,14.7,40
NDC,0527136701,PROBENECID 500 MG TABLET,7.46,4.85,1.11,7.46,40
NDC,0527136801,DANAZOL 100 MG CAPSULE,10.88,7.07,1.62,10.88,40
NDC,0527136901,DANAZOL 200 MG CAPSULE,18.14,11.79,2.7,18.14,40
NDC,0527139201,DANAZOL 50 MG CAPSULE,7.26,4.72,1.08,7.26,40
NDC,0527139401,LOXAPINE SUCCINATE 5 MG CAPSULE,1.98,1.29,0.29,1.98,40
NDC,0527139501,LOXAPINE SUCCINATE 10 MG CAPSULE,2.54,1.65,0.38,2.54,40
NDC,0527139601,LOXAPINE SUCCINATE 25 MG CAPSULE,3.86,2.51,0.57,3.86,40
NDC,0527139701,LOXAPINE SUCCINATE 50 MG CAPSULE,5.14,3.34,0.76,5.14,40
NDC,0527163201,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG CAPSULE,0.82,0.53,0.12,0.82,40
NDC,0527169501,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.38,2.2,0.5,3.38,40
NDC,0527178801,FLUPHENAZINE 1 MG TABLET,8.78,5.71,1.31,8.78,40
NDC,0527178901,FLUPHENAZINE 2.5 MG TABLET,13.6,8.84,2.02,13.6,40
NDC,0527179001,FLUPHENAZINE 5 MG TABLET,18.4,11.96,2.74,18.4,40
NDC,0527179101,FLUPHENAZINE 10 MG TABLET,23.2,15.08,3.45,23.2,40
NDC,0527193206,CLARITHROMYCIN 500 MG TABLET,12.04,7.83,1.79,12.04,40
NDC,0527213335,POSACONAZOLE 100 MG TABLETDELAYED RELEASE,148.02,96.21,22.03,148.02,40
NDC,0527258037,FLUVASTATIN ER 80 MG TABLETEXTENDED RELEASE 24 HR,17.52,11.39,2.61,17.52,40
NDC,0527410737,MEXILETINE 150 MG CAPSULE,5.08,3.3,0.76,5.08,40
NDC,0527411637,PROPRANOLOL ER 60 MG CAPSULE24 HREXTENDED RELEASE,4.12,2.68,0.61,4.12,40
NDC,0527411837,PROPRANOLOL ER 120 MG CAPSULE24 HREXTENDED RELEASE,5.96,3.87,0.89,5.96,40
NDC,0527457937,METHYLPHENIDATE CD 10 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,11.54,7.5,1.72,11.54,40
NDC,0527458037,METHYLPHENIDATE CD 20 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,11.54,7.5,1.72,11.54,40
NDC,0527458137,METHYLPHENIDATE CD 30 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,11.54,7.5,1.72,11.54,40
NDC,0527466537,LISDEXAMFETAMINE 50 MG CAPSULE,26.56,17.26,3.95,26.56,40
NDC,0527600480,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,2.58,1.68,0.38,2.58,40
NDC,0527810637,DEXMETHYLPHENIDATE ER 5 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,16.26,10.57,2.42,16.26,40
NDC,0527810737,DEXMETHYLPHENIDATE ER 10 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,18.96,12.32,2.82,18.96,40
NDC,0527810837,DEXMETHYLPHENIDATE ER 15 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,15.42,10.02,2.29,15.42,40
NDC,0527810937,DEXMETHYLPHENIDATE ER 20 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,19.5,12.68,2.9,19.5,40
NDC,0536009185,ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,0.05,0.03,0.01,0.05,40
NDC,0536104610,SODIUM BICARBONATE 325 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,0536105556,ACNE MEDICATION 5 % TOPICAL GEL,0.2,0.13,0.03,0.2,40
NDC,0536105656,ACNE MEDICATION 10 % TOPICAL GEL,0.22,0.14,0.03,0.22,40
NDC,0536110688,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.61,4.12,40
NDC,0536110788,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.61,4.12,40
NDC,0536110945,UREA 20 % TOPICAL CREAM,0.2,0.13,0.03,0.2,40
NDC,0536114397,WHITE PETROLATUM 42 % TOPICAL OINTMENT,0.14,0.09,0.02,0.14,40
NDC,0536114398,WHITE PETROLATUM 42 % TOPICAL OINTMENT,0.06,0.04,0.01,0.06,40
NDC,0536118612,HEMORRHOIDAL (PHENYLEPH-COCOA) 0.25 %-88.44 % RECTAL SUPPOSITORY,0.58,0.38,0.09,0.58,40
NDC,0536121195,DIBUCAINE 1 % TOPICAL OINTMENT,0.42,0.27,0.06,0.42,40
NDC,0536122858,PHENASEPTIC 1.4 % MUCOSAL SPRAY,0.04,0.03,0.01,0.04,40
NDC,0536123441,ASPIRIN 81 MG TABLETDELAYED RELEASE,0.06,0.04,0.01,0.06,40
NDC,0536124801,STIMULANT LAXATIVE PLUS 8.6 MG-50 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0536125391,SODIUM CHLORIDE 5 % EYE OINTMENT,7.04,4.58,1.05,7.04,40
NDC,0536125494,SODIUM CHLORIDE 5 % EYE DROPS,0.7,0.46,0.1,0.7,40
NDC,0536126511,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.2,0.13,0.03,0.2,40
NDC,0536126526,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.12,0.08,0.02,0.12,40
NDC,0536126595,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.18,0.12,0.03,0.18,40
NDC,0536127180,FIRST AID ANTISEPTIC (POVIDONE-IODINE) 10 % TOPICAL OINTMENT,0.16,0.1,0.02,0.16,40
NDC,0536128636,STOMACH RELIEF 262 MG/15 ML ORAL SUSPENSION,0.05,0.03,0.01,0.05,40
NDC,0536128806,HEMORRHOIDAL(PHENYLEPH-MIN OIL-PETROLAT)0.25 %-14 %-74.9 % RECTAL OINT,0.1,0.07,0.01,0.1,40
NDC,0536129434,DICLOFENAC 1 % TOPICAL GEL,0.42,0.27,0.06,0.42,40
NDC,0536130375,INFANTS SIMETHICONE 40 MG/0.6 ML ORAL DROPSSUSPENSION,0.23,0.15,0.03,0.23,40
NDC,0536131108,CHEST CONGESTION RELIEF 400 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,0536131385,CHEST CONGESTION RELIEF DM 10 MG-100 MG/5 ML ORAL SYRUP,0.03,0.02,0.01,0.03,40
NDC,0536131543,TOLNAFTATE 1 % TOPICAL CREAM,0.24,0.16,0.04,0.24,40
NDC,0536131625,ZINC OXIDE 20 % TOPICAL OINTMENT,0.12,0.08,0.02,0.12,40
NDC,0536131628,ZINC OXIDE 20 % TOPICAL OINTMENT,0.16,0.1,0.02,0.16,40
NDC,0536132601,PAIN RELIEVER PLUS 250 MG-250 MG-65 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0536132710,ACETAMINOPHEN 325 MG TABLET,0.02,0.01,0.01,0.02,40
NDC,0536133632,CALCIUM ACETATE 667 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,0536134957,MUSCLE RUB 15 %-10 % TOPICAL CREAM,0.1,0.07,0.01,0.1,40
NDC,0536136206,NICOTINE (POLACRILEX) 2 MG GUM,0.76,0.49,0.11,0.76,40
NDC,0536136223,NICOTINE (POLACRILEX) 2 MG GUM,0.5,0.33,0.07,0.5,40
NDC,0536137575,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.36,0.23,0.05,0.36,40
NDC,0536137801,VITAMIN B COMPLEX CAPSULE,0.14,0.09,0.02,0.14,40
NDC,0536140795,HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM,0.12,0.08,0.02,0.12,40
NDC,0536140894,POLYVINYL ALCOHOL 1.4 % EYE DROPS,0.86,0.56,0.13,0.86,40
NDC,0536143097,MUCUS-CHEST CONGESTION 100 MG/5 ML ORAL LIQUID,0.08,0.05,0.01,0.08,40
NDC,0536143607,COENZYME Q10 30 MG CAPSULE,0.5,0.33,0.07,0.5,40
NDC,0536199553,ANTI-DANDRUFF 1 % SHAMPOO,0.04,0.03,0.01,0.04,40
NDC,0536252525,CAPSAICIN 0.025 % TOPICAL CREAM,0.28,0.18,0.04,0.28,40
NDC,0536302906,NICOTINE (POLACRILEX) 2 MG GUM,0.76,0.49,0.11,0.76,40
NDC,0536302923,NICOTINE (POLACRILEX) 2 MG GUM,0.5,0.33,0.07,0.5,40
NDC,0536302934,NICOTINE (POLACRILEX) 2 MG GUM,1.08,0.7,0.16,1.08,40
NDC,0536303023,NICOTINE (POLACRILEX) 4 MG GUM,0.68,0.44,0.1,0.68,40
NDC,0536344308,CEROVITE JR 18 MG IRON-10 MCG CHEWABLE TABLET,0.14,0.09,0.02,0.14,40
NDC,0536406301,CLASSIC PRENATAL 28 MG IRON-800 MCG TABLET,0.12,0.08,0.02,0.12,40
NDC,0536408501,PRENATAL 28 MG IRON-800 MCG TABLET,0.12,0.08,0.02,0.12,40
NDC,0536440601,VITAMIN B-6 25 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0536478701,VITAMINS B COMPLEX CAPSULE,0.14,0.09,0.02,0.14,40
NDC,0536479901,VITAMIN E 268 MG (400 UNIT) CAPSULE,0.16,0.1,0.02,0.16,40
NDC,0536589453,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.78,3.11,0.71,4.78,40
NDC,0536589588,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.61,4.12,40
NDC,0536589688,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.61,4.12,40
NDC,0548540000,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,90.0,58.5,1.08,90.0,51
NDC,0548570100,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,90.0,58.5,1.08,90.0,51
NDC,0548585000,GLUCAGON EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1008.0,655.2,2.17,1008.0,65
NDC,0548590000,CORTROSYN 0.25 MG SOLUTION FOR INJECTION,383.7,249.41,2.17,383.7,51
NDC,0548909010,AMPHADASE 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,2.17,200.88,51
NDC,0555003302,CHLORDIAZEPOXIDE 10 MG CAPSULE,0.8,0.52,0.12,0.8,40
NDC,0555015802,CHLORDIAZEPOXIDE 5 MG CAPSULE,0.7,0.46,0.1,0.7,40
NDC,0555017178,MEFLOQUINE 250 MG TABLET,21.18,13.77,3.15,21.18,40
NDC,0555021110,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.79,5.3,40
NDC,0555030202,HYDROXYZINE PAMOATE 50 MG CAPSULE,1.22,0.79,0.18,1.22,40
NDC,0555032302,HYDROXYZINE PAMOATE 25 MG CAPSULE,1.14,0.74,0.17,1.14,40
NDC,0555057202,METHOTREXATE SODIUM 2.5 MG TABLET,7.12,4.63,0.27,15.18,51
NDC,0555060602,MEGESTROL 20 MG TABLET,2.08,1.35,0.31,2.08,40
NDC,0555060702,MEGESTROL 40 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0555063302,DANAZOL 50 MG CAPSULE,7.26,4.72,1.08,7.26,40
NDC,0555063402,DANAZOL 100 MG CAPSULE,10.88,7.07,1.62,10.88,40
NDC,0555063509,DANAZOL 200 MG CAPSULE,20.58,13.38,3.06,20.58,40
NDC,0555077902,MEDROXYPROGESTERONE 10 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,0555087202,MEDROXYPROGESTERONE 2.5 MG TABLET,0.62,0.4,0.09,0.62,40
NDC,0555087302,MEDROXYPROGESTERONE 5 MG TABLET,0.94,0.61,0.14,0.94,40
NDC,0555088202,HYDROXYUREA 500 MG CAPSULE,2.94,1.91,0.44,2.94,40
NDC,0555088602,ESTRADIOL 1 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,0555095202,DEXTROAMPHETAMINE SULFATE 5 MG TABLET,5.8,3.77,0.86,5.8,40
NDC,0555095302,DEXTROAMPHETAMINE SULFATE 10 MG TABLET,6.3,4.1,0.94,6.3,40
NDC,0555097102,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0555097202,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0555097302,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0555097402,DEXTROAMPHETAMINE-AMPHETAMINE 30 MG TABLET,3.42,2.22,0.51,3.42,40
NDC,0555100901,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,66.32,43.11,9.87,66.32,40
NDC,0555101001,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,111.66,72.58,16.62,111.66,40
NDC,0555901058,NORTREL 1/35 (28) 1 MG-35 MCG TABLET,2.1,1.37,0.31,2.1,40
NDC,0555901658,SPRINTEC (28) 0.25 MG-0.035 MG TABLET,2.3,1.5,0.34,2.3,40
NDC,0555904358,APRI 0.15 MG-0.03 MG TABLET,2.18,1.42,0.32,2.18,40
NDC,0555912366,JOLESSA 0.15 MG-30 MCG (91) TABLETS3 MONTH DOSE PACK,3.54,2.3,0.53,3.54,40
NDC,0562780500,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,2.17,442.8,51
NDC,0562780501,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,2.17,442.8,51
NDC,0562780505,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,2.17,442.8,51
NDC,0562780525,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,2.17,442.8,51
NDC,0573017920,ADVIL JUNIOR STRENGTH 100 MG CHEWABLE TABLET,0.6,0.39,0.09,0.6,40
NDC,0573019120,INFANT'S ADVIL 50 MG/1.25 ML ORAL DROPSSUSPENSION,1.23,0.8,0.18,1.23,40
NDC,0573021341,ANBESOL (BENZOCAINE) 10 % ORAL MUCOSAL LIQUID,1.4,0.91,0.21,1.4,40
NDC,0573022567,ANBESOL (BENZOCAINE) MAXIMUM STRENGTH 20 % MUCOSAL GEL,1.58,1.03,0.24,1.58,40
NDC,0573266024,ALAVERT D-12 ALLERGY-SINUS 5 MG-120 MG TABLETEXTENDED RELEASE,1.42,0.92,0.21,1.42,40
NDC,0573287193,PREPARATION H 0.25 %-14 %-74.9 % OINTMENT,0.86,0.56,0.13,0.86,40
NDC,0573288320,PREPARATION H(PHENYLEPHCOCOA BUTTR) 0.25 %-88.44 % RECTAL SUPPOSITORY,1.18,0.77,0.18,1.18,40
NDC,0573445174,CENTRUM 18 MG-400 MCG TABLET,0.22,0.14,0.03,0.22,40
NDC,0574006716,ISOPROPYL ALCOHOL 70 % SOLUTION,0.01,0.01,0.01,0.01,40
NDC,0574006915,GLUTOSE-15 40 % ORAL GEL,0.22,0.14,0.03,0.22,40
NDC,0574006930,GLUTOSE-15 40 % ORAL GEL,0.22,0.14,0.03,0.22,40
NDC,0574007030,GLUTOSE-15 40 % ORAL GEL,0.22,0.14,0.03,0.22,40
NDC,0574010601,BROMOCRIPTINE 2.5 MG TABLET,7.52,4.89,1.12,7.52,40
NDC,0574010770,CLOTRIMAZOLE 10 MG TROCHE,3.22,2.09,0.48,3.22,40
NDC,0574010777,CLOTRIMAZOLE 10 MG TROCHE,2.86,1.86,0.43,2.86,40
NDC,0574011501,FLAVOXATE 100 MG TABLET,2.92,1.9,0.43,2.92,40
NDC,0574014560,TROSPIUM 20 MG TABLET,1.9,1.24,0.28,1.9,40
NDC,0574015004,MIDAZOLAM 2 MG/ML ORAL SYRUP,1.04,0.68,0.15,1.04,40
NDC,0574029201,AMILORIDE 5 MG TABLET,0.54,0.35,0.08,0.54,40
NDC,0574030216,ORA-SWEET SF ORAL LIQUID,0.13,0.08,0.02,0.13,40
NDC,0574030316,ORA-PLUS ORAL SUSPENSION,0.13,0.08,0.02,0.13,40
NDC,0574030416,ORA-SWEET ORAL SYRUP,0.13,0.08,0.02,0.13,40
NDC,0574031116,ORA-BLEND ORAL SUSPENSION,0.13,0.08,0.02,0.13,40
NDC,0574031216,ORA-BLEND SF ORAL SUSPENSION,0.13,0.08,0.02,0.13,40
NDC,0574050801,FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET,0.12,0.08,0.02,0.12,40
NDC,0574050811,FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET,0.22,0.14,0.03,0.22,40
NDC,0574052074,ACTIDOSE/SORBITOL 25 GRAM/120 ML ORAL SUSPENSION,0.35,0.23,0.05,0.35,40
NDC,0574052174,ACTIDOSE-AQUA 25 GRAM/120 ML ORAL SUSPENSION,0.35,0.23,0.05,0.35,40
NDC,0574060115,PODOCON 25 % TOPICAL LIQUID,20.43,13.28,3.04,20.43,40
NDC,0574060811,FERROUS SULFATE 324 MG (65 MG IRON) TABLETDELAYED RELEASE,0.22,0.14,0.03,0.22,40
NDC,0574061105,PODOFILOX 0.5 % TOPICAL SOLUTION,61.8,40.17,9.2,61.8,40
NDC,0574079101,METHAZOLAMIDE 50 MG TABLET,11.04,7.18,1.64,11.04,40
NDC,0574200815,NYSTOP 100000 UNIT/GRAM TOPICAL POWDER,3.66,2.38,0.54,3.66,40
NDC,0574200830,NYSTOP 100000 UNIT/GRAM TOPICAL POWDER,3.58,2.33,0.53,3.58,40
NDC,0574204230,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,1.2,0.78,0.18,1.2,40
NDC,0574206130,CICLOPIROX 0.77 % TOPICAL GEL,5.38,3.5,0.8,5.38,40
NDC,0574220145,TRETINOIN 0.1 % TOPICAL CREAM,10.94,7.11,1.63,10.94,40
NDC,0574220545,TRETINOIN 0.05 % TOPICAL CREAM,9.4,6.11,1.4,9.4,40
NDC,0574222545,TRETINOIN 0.025 % TOPICAL CREAM,8.46,5.5,1.26,8.46,40
NDC,0574402135,POLYCIN 500 UNIT-10000 UNIT/GRAM EYE OINTMENT,14.92,9.7,2.22,14.92,40
NDC,0574402235,BACITRACIN 500 UNIT/GRAM EYE OINTMENT,74.1,48.17,11.03,74.1,40
NDC,0574402435,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,10.26,6.67,1.53,10.26,40
NDC,0574402450,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,17.4,11.31,2.59,17.4,40
NDC,0574403105,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,36.5,23.73,5.43,36.5,40
NDC,0574403110,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,36.5,23.73,5.43,36.5,40
NDC,0574403125,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,36.42,23.67,5.42,36.42,40
NDC,0574416035,NEOMYCIN 3.5 MG/G-POLYMYXIN B 10000 UNIT/G-DEXAMETH 0.1 % EYE OINT,8.66,5.63,1.29,8.66,40
NDC,0574419035,SULFACETAMIDE SODIUM 10 % EYE OINTMENT,37.64,24.47,5.6,37.64,40
NDC,0574703412,ASPIRIN 300 MG RECTAL SUPPOSITORY,2.92,1.9,0.43,2.92,40
NDC,0574704012,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,66.9,43.49,9.95,66.9,40
NDC,0574704512,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,55.04,35.78,8.19,55.04,40
NDC,0574705012,BISACODYL 10 MG RECTAL SUPPOSITORY,0.84,0.55,0.12,0.84,40
NDC,0574705050,BISACODYL 10 MG RECTAL SUPPOSITORY,0.64,0.42,0.1,0.64,40
NDC,0574709012,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,28.86,18.76,4.29,28.86,40
NDC,0574711212,MORPHINE 10 MG RECTAL SUPPOSITORY,18.75,12.19,2.79,18.75,40
NDC,0574711412,MORPHINE 20 MG RECTAL SUPPOSITORY,22.5,14.63,3.35,22.5,40
NDC,0574722406,HYDROMORPHONE 3 MG RECTAL SUPPOSITORY,24.54,15.95,3.65,24.54,40
NDC,0574722612,COMPRO 25 MG RECTAL SUPPOSITORY,25.16,16.35,3.74,25.16,40
NDC,0574985510,BUDESONIDE DR - ER 3 MG CAPSULEDELAYEDEXTENDED RELEASE,2.38,1.55,0.35,2.38,40
NDC,0575620030,PROGLYCEM 50 MG/ML ORAL SUSPENSION,48.65,31.62,7.24,48.65,40
NDC,0591034301,VERAPAMIL 80 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,0591034501,VERAPAMIL 120 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,0591036901,LOXAPINE SUCCINATE 5 MG CAPSULE,1.98,1.29,0.29,1.98,40
NDC,0591037001,LOXAPINE SUCCINATE 10 MG CAPSULE,2.54,1.65,0.38,2.54,40
NDC,0591037101,LOXAPINE SUCCINATE 25 MG CAPSULE,3.86,2.51,0.57,3.86,40
NDC,0591039501,PENTAZOCINE 50 MG-NALOXONE 0.5 MG TABLET,4.94,3.21,0.74,4.94,40
NDC,0591040401,VERAPAMIL 40 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,0591042401,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,0591044401,GUANFACINE 1 MG TABLET,1.74,1.13,0.26,1.74,40
NDC,0591045301,GUANFACINE 2 MG TABLET,2.36,1.53,0.35,2.36,40
NDC,0591046001,GLIPIZIDE 5 MG TABLET,0.76,0.49,0.11,0.76,40
NDC,0591046101,GLIPIZIDE 10 MG TABLET,1.2,0.78,0.18,1.2,40
NDC,0591046110,GLIPIZIDE 10 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,0591079401,DICYCLOMINE 10 MG CAPSULE,1.08,0.7,0.16,1.08,40
NDC,0591079501,DICYCLOMINE 20 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,0591231215,ALVIMOPAN 12 MG CAPSULE,414.6,269.49,61.69,414.6,40
NDC,0591247319,TAMOXIFEN 20 MG TABLET,7.58,4.93,1.13,7.58,40
NDC,0591252001,CHLORZOXAZONE 500 MG TABLET,2.16,1.4,0.32,2.16,40
NDC,0591257920,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,28.43,18.48,4.23,28.43,40
NDC,0591268201,POTASSIUM CITRATE ER 5 MEQ (540 MG) TABLETEXTENDED RELEASE,3.48,2.26,0.52,3.48,40
NDC,0591288830,HYDROXOCOBALAMIN 1000 MCG/ML INTRAMUSCULAR SOLUTION,3.84,2.5,0.01,8.86,57
NDC,0591292754,LEVALBUTEROL HFA 45 MCG/ACTUATION AEROSOL INHALER,9.82,6.38,1.46,9.82,40
NDC,0591312879,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,11.64,7.57,1.28,11.64,51
NDC,0591315901,URSODIOL 300 MG CAPSULE,14.7,9.56,2.19,14.7,40
NDC,0591321730,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,6.0,3.9,0.89,6.0,40
NDC,0591336901,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.38,2.2,0.5,3.38,40
NDC,0591351004,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,154.72,100.57,23.02,154.72,40
NDC,0591352430,TESTOSTERONE 50 MG/5 GRAM (1 %) TRANSDERMAL GEL,7.76,5.04,1.15,7.76,40
NDC,0591352530,LIDOCAINE 5 % TOPICAL PATCH,18.72,12.17,2.79,18.72,40
NDC,0591354060,BUPROPION HCL SR 100 MG TABLET12 HR SUSTAINED-RELEASE,3.38,2.2,0.5,3.38,40
NDC,0591354125,BUPROPION HCL SR 150 MG TABLET12 HR SUSTAINED-RELEASE,3.76,2.44,0.56,3.76,40
NDC,0591354160,BUPROPION HCL SR 150 MG TABLET12 HR SUSTAINED-RELEASE,3.88,2.52,0.58,3.88,40
NDC,0591367001,NABUMETONE 500 MG TABLET,2.6,1.69,0.39,2.6,40
NDC,0591372030,TRANEXAMIC ACID 650 MG TABLET,10.44,6.79,1.55,10.44,40
NDC,0591387544,MEMANTINE 10 MG TABLET,12.2,7.93,1.82,12.2,40
NDC,0591401201,VALPROIC ACID 250 MG CAPSULE,1.58,1.03,0.24,1.58,40
NDC,0591410101,PERPHENAZINE 2 MG TABLET,3.5,2.28,0.52,3.5,40
NDC,0591410401,PERPHENAZINE 16 MG TABLET,7.8,5.07,1.16,7.8,40
NDC,0591530701,PROMETHAZINE 25 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,0591533501,TRIHEXYPHENIDYL 2 MG TABLET,0.36,0.23,0.05,0.36,40
NDC,0591533701,TRIHEXYPHENIDYL 5 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,0591534701,PROBENECID 500 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,0591544205,PREDNISONE 10 MG TABLET,0.48,0.31,0.02,8.86,51
NDC,0591544305,PREDNISONE 20 MG TABLET,0.52,0.34,0.02,8.86,51
NDC,0591554301,ALLOPURINOL 100 MG TABLET,0.96,0.62,0.14,0.96,40
NDC,0591554401,ALLOPURINOL 300 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,0591554405,ALLOPURINOL 300 MG TABLET,1.76,1.14,0.26,1.76,40
NDC,0591555701,PROPRANOLOL 80 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,0591559001,TRANYLCYPROMINE 10 MG TABLET,7.2,4.68,1.07,7.2,40
NDC,0591564201,MINOXIDIL 2.5 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,0591564301,MINOXIDIL 10 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,0591566001,SULINDAC 200 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,0591569401,MINOCYCLINE 50 MG CAPSULE,3.4,2.21,0.51,3.4,40
NDC,0591569550,MINOCYCLINE 100 MG CAPSULE,6.8,4.42,1.01,6.8,40
NDC,0591571301,AMOXAPINE 25 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,0591571501,AMOXAPINE 100 MG TABLET,4.32,2.81,0.64,4.32,40
NDC,0592800099,NASOGEL 0.9 % NASAL GEL,0.56,0.36,0.08,0.56,40
NDC,0597000302,APTIVUS 250 MG CAPSULE,42.76,27.79,6.36,42.76,40
NDC,0597002402,COMBIVENT RESPIMAT 20 MCG-100 MCG/ACTUATION SOLUTION FOR INHALATION,311.48,202.46,46.35,311.48,40
NDC,0597007575,SPIRIVA WITH HANDIHALER 18 MCG AND INHALATION CAPSULES,29.2,18.98,4.34,29.2,40
NDC,0597008717,ATROVENT HFA 17 MCG/ACTUATION AEROSOL INHALER,57.08,37.1,8.49,57.08,40
NDC,0597010051,SPIRIVA RESPIMAT 2.5 MCG/ACTUATION SOLUTION FOR INHALATION,45.0,29.25,2.17,47.96,51
NDC,0597010061,SPIRIVA RESPIMAT 2.5 MCG/ACTUATION SOLUTION FOR INHALATION,316.44,205.69,2.17,316.44,51
NDC,0597010860,PRADAXA 110 MG CAPSULE,7.94,5.16,1.18,7.94,40
NDC,0597013730,GILOTRIF 30 MG TABLET,962.2,625.43,143.18,962.2,40
NDC,0597013830,GILOTRIF 40 MG TABLET,962.2,625.43,143.18,962.2,40
NDC,0597014130,GILOTRIF 20 MG TABLET,962.2,625.43,143.18,962.2,40
NDC,0597015230,JARDIANCE 10 MG TABLET,28.0,18.2,4.17,28.0,40
NDC,0597015237,JARDIANCE 10 MG TABLET,28.0,18.2,4.17,28.0,40
NDC,0597015290,JARDIANCE 10 MG TABLET,28.0,18.2,4.17,28.0,40
NDC,0597015330,JARDIANCE 25 MG TABLET,28.0,18.2,4.17,28.0,40
NDC,0597015337,JARDIANCE 25 MG TABLET,28.0,18.2,4.17,28.0,40
NDC,0597015390,JARDIANCE 25 MG TABLET,28.0,18.2,4.17,28.0,40
NDC,0597015570,STIOLTO RESPIMAT 2.5 MCG-2.5 MCG/ACTUATION SOLUTION FOR INHALATION,45.0,29.25,6.7,45.0,40
NDC,0597019705,PRAXBIND 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,187.35,121.78,27.88,187.35,51
NDC,0597035556,PRADAXA 75 MG CAPSULE,7.94,5.16,1.18,7.94,40
NDC,0597036082,PRADAXA 150 MG CAPSULE,7.94,5.16,1.18,7.94,40
NDC,0597925786,HERNEXEOS 60 MG TABLET,866.68,563.34,128.96,866.68,40
NDC,0600053772,CERAVE TOPICAL CREAM,0.08,0.05,0.01,0.08,40
NDC,0603020922,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.18,0.12,0.03,0.18,40
NDC,0603116158,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,0.75,0.49,0.11,0.75,40
NDC,0603154258,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,2.03,1.32,0.3,2.03,40
NDC,0603243321,BENZTROPINE 0.5 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,0603243421,BENZTROPINE 1 MG TABLET,0.82,0.53,0.12,0.82,40
NDC,0603243521,BENZTROPINE 2 MG TABLET,1.04,0.68,0.15,1.04,40
NDC,0603459315,METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK,2.86,1.86,0.25,8.86,51
NDC,0603506121,PERPHENAZINE 4 MG TABLET,3.18,2.07,0.47,3.18,40
NDC,0603516621,PHENOBARBITAL 32.4 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,0603516721,PHENOBARBITAL 64.8 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,0603516821,PHENOBARBITAL 97.2 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,0603533521,PREDNISONE 1 MG TABLET,0.5,0.33,0.02,8.86,51
NDC,0603533621,PREDNISONE 2.5 MG TABLET,0.34,0.22,0.02,8.86,51
NDC,0603548221,PROPRANOLOL 10 MG TABLET,0.82,0.53,0.12,0.82,40
NDC,0603548321,PROPRANOLOL 20 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,0603548421,PROPRANOLOL 40 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,06132210002,BENZOCAINE 20% TOPICAL SPRAY,0.56,0.36,0.08,0.56,39
NDC,0641036721,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.16,3.35,0.2,8.86,51
NDC,0641036725,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.16,3.35,0.2,8.86,51
NDC,0641037621,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.63,8.86,51
NDC,0641037625,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.63,8.86,51
NDC,0641047625,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,72.0,46.8,2.17,72.0,51
NDC,0641047725,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,165.6,107.64,2.17,165.6,51
NDC,0641049325,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,2.49,1.62,0.37,8.86,51
NDC,0641092825,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.66,4.33,0.99,8.86,51
NDC,0641094835,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.3,4.1,0.94,8.86,51
NDC,0641095521,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.3,4.1,0.94,8.86,51
NDC,0641095525,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.3,4.1,0.94,8.86,51
NDC,0641139735,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,104.01,67.61,2.17,104.01,51
NDC,0641139835,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,59.58,38.73,2.17,69.49,51
NDC,0641141035,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,9.9,6.44,1.47,20.11,51
NDC,0641149531,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.66,4.33,0.99,8.86,51
NDC,0641149535,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.66,4.33,0.99,8.86,51
NDC,0641149631,PROMETHAZINE 50 MG/ML INJECTION SOLUTION,9.33,6.06,1.39,9.33,51
NDC,0641149635,PROMETHAZINE 50 MG/ML INJECTION SOLUTION,9.33,6.06,1.39,9.33,51
NDC,0641234141,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,3.87,2.52,0.09,8.86,57
NDC,0641255541,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,1.44,0.94,0.21,8.86,51
NDC,0641256944,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,7.14,4.64,1.06,14.97,51
NDC,0641600125,ATIVAN 2 MG/ML INJECTION SOLUTION,8.64,5.62,1.29,8.86,51
NDC,0641600710,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,1.17,0.76,0.17,47.96,57
NDC,0641600810,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,2.73,1.77,0.41,47.96,57
NDC,0641601310,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,2.46,1.6,0.05,8.86,51
NDC,0641601410,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,2.25,1.46,0.05,8.86,51
NDC,0641601501,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.32,0.86,0.05,8.86,51
NDC,0641601510,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.32,0.86,0.05,8.86,51
NDC,0641601801,DOPRAM 20 MG/ML INTRAVENOUS SOLUTION,9.57,6.22,1.42,9.57,40
NDC,0641601910,DURAMORPH (PF) 1 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,47.96,51
NDC,0641602010,DURAMORPH (PF) 0.5 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,47.96,51
NDC,0641602725,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.81,2.48,0.57,8.86,51
NDC,0641602901,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,1.98,1.29,0.29,8.86,51
NDC,0641603901,INFUMORPH P/F 10 MG/ML INJECTION SOLUTION,37.44,24.34,2.17,47.96,51
NDC,0641604001,INFUMORPH P/F 25 MG/ML INJECTION SOLUTION,63.66,41.38,2.17,63.66,51
NDC,0641604225,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,5.7,3.71,0.31,8.86,65
NDC,0641604425,LORAZEPAM 2 MG/ML INJECTION SOLUTION,8.64,5.62,1.29,8.86,51
NDC,0641604525,LORAZEPAM 4 MG/ML INJECTION SOLUTION,12.3,8.0,1.83,12.3,51
NDC,0641604610,LORAZEPAM 2 MG/ML INJECTION SOLUTION,4.62,3.0,0.69,8.86,51
NDC,0641604710,LORAZEPAM 4 MG/ML INJECTION SOLUTION,6.3,4.1,0.94,8.86,51
NDC,0641604825,LORAZEPAM 2 MG/ML INJECTION SOLUTION,4.65,3.02,0.69,8.86,51
NDC,0641605010,LORAZEPAM 2 MG/ML INJECTION SOLUTION,3.84,2.5,0.57,8.86,51
NDC,0641605201,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,9.12,5.93,1.36,15.87,51
NDC,0641605225,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,9.12,5.93,1.36,15.87,51
NDC,0641605301,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,9.51,6.18,1.42,15.87,51
NDC,0641605325,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,9.51,6.18,1.42,15.87,51
NDC,0641605401,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,15.87,51
NDC,0641605425,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,10.44,6.79,1.55,15.87,51
NDC,0641605610,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.78,0.51,0.12,8.86,51
NDC,0641605725,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,1.17,0.76,0.17,8.86,51
NDC,0641605910,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.15,8.86,51
NDC,0641606010,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.49,1.62,0.25,8.86,51
NDC,0641606101,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,4.32,2.81,0.25,8.86,51
NDC,0641606125,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,4.32,2.81,0.25,8.86,51
NDC,0641606325,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.25,1.46,0.25,8.86,51
NDC,0641607901,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,1.41,0.92,0.16,8.86,51
NDC,0641608025,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,1.08,0.7,0.16,8.86,51
NDC,0641611610,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,15.12,9.83,2.17,15.12,51
NDC,0641611701,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,14.4,9.36,2.14,14.4,51
NDC,0641611710,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,14.4,9.36,2.14,14.4,51
NDC,0641611801,AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,142.56,92.66,2.17,142.56,51
NDC,0641612525,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.34,10.44,51
NDC,0641612625,MORPHINE 8 MG/ML INTRAVENOUS SOLUTION,10.17,6.61,1.51,10.44,51
NDC,0641612701,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,9.18,5.97,1.37,10.44,51
NDC,0641612725,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,9.18,5.97,1.37,10.44,51
NDC,0641613525,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,13.05,8.48,1.94,13.05,51
NDC,0641613801,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,2.1,1.37,0.31,8.86,51
NDC,0641613825,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,2.1,1.37,0.31,8.86,51
NDC,0641613901,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,1.17,0.76,0.17,8.86,51
NDC,0641614201,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.4,9.36,0.02,14.4,51
NDC,0641614225,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.4,9.36,0.02,14.4,51
NDC,0641614501,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,3.48,2.26,0.2,8.86,51
NDC,0641614910,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,3.24,2.11,0.48,8.86,51
NDC,0641615001,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.43,8.86,51
NDC,0641615010,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.43,8.86,51
NDC,0641615125,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,10.8,7.02,0.09,10.8,57
NDC,0641616710,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,14.4,9.36,1.1,14.4,51
NDC,0641616910,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,13.44,8.74,0.09,13.44,57
NDC,0641617310,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,43.62,28.35,2.17,47.96,51
NDC,0641617401,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,16.2,10.53,1.17,16.2,51
NDC,0641617410,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,16.2,10.53,1.17,16.2,51
NDC,0641618210,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,28.08,18.25,2.17,31.9,51
NDC,0641622925,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,3.03,1.97,0.02,8.86,51
NDC,0641623610,EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,8.88,5.77,1.32,8.88,40
NDC,0641624410,DIAZEPAM 5 MG/ML INJECTION SYRINGE,44.31,28.8,2.17,44.31,51
NDC,0641624725,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,7.02,4.56,1.04,8.86,51
NDC,0641921810,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.44,0.94,0.05,8.86,51
NDC,0641921901,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,0.84,0.55,0.05,8.86,51
NDC,0641921910,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,0.84,0.55,0.05,8.86,51
NDC,0699310002,BENZOCAINE 20% TOPICAL SPRAY,1.16,0.75,0.17,1.16,39
NDC,0703024101,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,29.13,18.93,1.32,29.13,51
NDC,0703024301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,29.55,19.21,1.32,29.55,51
NDC,0703024501,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,22.08,14.35,1.32,22.08,51
NDC,0703067601,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,544.35,353.83,2.17,667.03,65
NDC,0703068601,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,1088.7,707.66,2.17,1088.7,65
NDC,0703367501,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.32,2.81,0.64,15.18,51
NDC,0703367801,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.0,2.6,0.6,15.18,51
NDC,0703400401,ROMIDEPSIN 5 MG/ML INTRAVENOUS SOLUTION,7292.92,4740.4,2.17,7292.92,65
NDC,0703424601,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,5.04,3.28,0.75,8.28,43
NDC,0703440211,VINCASAR PFS 1 MG/ML INTRAVENOUS SOLUTION,72.24,46.96,2.17,72.24,51
NDC,0703441211,VINCASAR PFS 2 MG/2 ML INTRAVENOUS SOLUTION,72.24,46.96,2.17,72.24,51
NDC,0703450201,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,6.03,3.92,0.9,8.86,51
NDC,0703450204,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,6.03,3.92,0.9,8.86,51
NDC,0703574711,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.92,1.25,0.29,15.18,51
NDC,0703950303,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.53,2.94,0.07,47.96,51
NDC,0703951403,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.53,2.94,0.07,47.96,51
NDC,0703952601,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.53,2.94,0.07,47.96,51
NDC,0713013206,PROMETHEGAN 50 MG RECTAL SUPPOSITORY,71.54,46.5,10.65,71.54,40
NDC,0713013212,PROMETHEGAN 50 MG RECTAL SUPPOSITORY,71.54,46.5,10.65,71.54,40
NDC,0713013512,PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,24.52,15.94,3.65,24.52,40
NDC,0713016612,MIGERGOT 2 MG-100 MG RECTAL SUPPOSITORY,541.76,352.14,80.61,541.76,40
NDC,0713022415,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,4.52,2.94,0.67,4.52,40
NDC,0713026831,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.24,0.16,0.04,0.24,40
NDC,0713028031,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.24,0.16,0.04,0.24,40
NDC,0713050306,ANUCORT-HC 25 MG SUPPOSITORY,45.3,29.45,6.74,45.3,40
NDC,0713050324,ANUCORT-HC 25 MG SUPPOSITORY,43.02,27.96,6.4,43.02,40
NDC,0713052612,PROMETHEGAN 25 MG RECTAL SUPPOSITORY,35.42,23.02,5.27,35.42,40
NDC,0713053606,PROMETHEGAN 12.5 MG RECTAL SUPPOSITORY,35.42,23.02,5.27,35.42,40
NDC,0713053612,PROMETHEGAN 12.5 MG RECTAL SUPPOSITORY,35.42,23.02,5.27,35.42,40
NDC,0713062231,TRIPLE ANTIBIOTIC PLUS 3.5 MG-500 UNIT-10000 UNIT/GRAM TOP OINTMENT,0.3,0.2,0.04,0.3,40
NDC,0713063337,METRONIDAZOLE 0.75 % TOPICAL CREAM,24.44,15.89,3.64,24.44,40
NDC,0713063415,MOMETASONE 0.1 % TOPICAL CREAM,3.88,2.52,0.58,3.88,40
NDC,0713063515,MOMETASONE 0.1 % TOPICAL OINTMENT,3.46,2.25,0.51,3.46,40
NDC,0713065615,CLOBETASOL 0.05 % TOPICAL OINTMENT,20.72,13.47,3.08,20.72,40
NDC,0713065631,CLOBETASOL 0.05 % TOPICAL OINTMENT,17.32,11.26,2.58,17.32,40
NDC,0713067815,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,2.34,1.52,0.35,2.34,40
NDC,0713067831,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,1.76,1.14,0.26,1.76,40
NDC,0713068215,GENTAMICIN 0.1 % TOPICAL OINTMENT,6.58,4.28,0.98,6.58,40
NDC,0713068231,GENTAMICIN 0.1 % TOPICAL OINTMENT,6.58,4.28,0.98,6.58,40
NDC,0713068315,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,0.98,6.58,40
NDC,0713068331,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,0.98,6.58,40
NDC,0713068615,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.34,1.52,0.35,2.34,40
NDC,0713068631,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,1.76,1.14,0.26,1.76,40
NDC,0713070915,FLUOCINOLONE 0.025 % TOPICAL CREAM,5.98,3.89,0.89,5.98,40
NDC,0713070960,FLUOCINOLONE 0.025 % TOPICAL CREAM,5.98,3.89,0.89,5.98,40
NDC,0761043310,VITAMIN A PALMITATE 3000 MCG (10000 UNIT) CAPSULE,0.06,0.04,0.01,0.06,40
NDC,0766145020,NICODERM CQ 21 MG/24 HR DAILY TRANSDERMAL PATCH,7.2,4.68,1.07,7.2,40
NDC,0781107701,ALPRAZOLAM 0.5 MG TABLET,1.74,1.13,0.26,1.74,40
NDC,0781148601,AMITRIPTYLINE 10 MG TABLET,0.36,0.23,0.05,0.36,40
NDC,0781148801,AMITRIPTYLINE 50 MG TABLET,1.42,0.92,0.21,1.42,40
NDC,0781163501,ISOSORBIDE DINITRATE 5 MG TABLET,1.98,1.29,0.29,1.98,40
NDC,0781187431,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,11.84,7.7,1.76,11.84,40
NDC,0781194339,AMOXICILLIN-POTASSIUM CLAVULANATE 1000 MG-62.5 MG TABLETEXT.REL 12HR,16.86,10.96,2.51,16.86,40
NDC,0781196160,CLARITHROMYCIN 250 MG TABLET,12.04,7.83,1.79,12.04,40
NDC,0781196260,CLARITHROMYCIN 500 MG TABLET,12.04,7.83,1.79,12.04,40
NDC,0781202001,AMOXICILLIN 250 MG CAPSULE,0.5,0.33,0.07,0.5,40
NDC,0781206701,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,7.94,5.16,0.27,8.86,51
NDC,0781222801,THIOTHIXENE 5 MG CAPSULE,0.92,0.6,0.14,0.92,40
NDC,0781227001,BUTALBITAL-ASPIRIN-CAFFEINE 50 MG-325 MG-40 MG CAPSULE,2.74,1.78,0.41,2.74,40
NDC,0781232368,APREPITANT 125 MG CAPSULE,636.78,413.91,2.17,636.78,51
NDC,0781233501,DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,1.82,12.26,40
NDC,0781261301,AMOXICILLIN 500 MG CAPSULE,0.86,0.56,0.13,0.86,40
NDC,0781261305,AMOXICILLIN 500 MG CAPSULE,0.76,0.49,0.11,0.76,40
NDC,0781261460,RIVASTIGMINE 1.5 MG CAPSULE,8.48,5.51,1.26,8.48,40
NDC,0781304072,REGONOL 5 MG/ML INJECTION SOLUTION,57.6,37.44,8.57,57.6,40
NDC,0781304095,REGONOL 5 MG/ML INJECTION SOLUTION,57.6,37.44,8.57,57.6,40
NDC,0781305670,ISONIAZID 100 MG/ML INJECTION SOLUTION,105.63,68.66,0.3,105.63,59
NDC,0781305972,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,11.22,7.29,1.67,20.11,51
NDC,0781305995,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,11.22,7.29,1.67,20.11,51
NDC,0781311395,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,55.38,36.0,1.94,55.38,51
NDC,0781315606,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,1.32,0.86,0.09,8.86,51
NDC,0781315895,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,3411.81,2217.68,0.28,3411.81,51
NDC,0781315972,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,124.5,80.93,1.44,124.5,51
NDC,0781320695,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,44.49,28.92,0.82,44.49,51
NDC,0781320795,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,80.64,52.42,0.82,80.64,51
NDC,0781320895,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,138.0,89.7,0.82,138.0,51
NDC,0781320995,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,274.23,178.25,0.82,274.23,51
NDC,0781321046,CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,1345.29,874.44,0.82,1345.29,51
NDC,0781323394,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1648.12,1071.28,0.58,1648.12,65
NDC,0781323434,GLATOPA 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,2.17,649.23,57
NDC,0781323471,GLATOPA 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,2.17,649.23,57
NDC,0781324494,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,3296.24,2142.56,0.58,3296.24,65
NDC,0781325071,GLATOPA 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,2.17,1572.9,57
NDC,0781325089,GLATOPA 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,2.17,1572.9,57
NDC,0781325594,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,6592.52,4285.14,0.58,6592.52,65
NDC,0781328891,CLINDAMYCIN 300 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.6,0.39,0.09,47.96,51
NDC,0781340295,AMPICILLIN 250 MG SOLUTION FOR INJECTION,12.57,8.17,1.05,12.57,51
NDC,0781340495,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,25.92,16.85,1.05,25.92,51
NDC,0781340795,AMPICILLIN 500 MG SOLUTION FOR INJECTION,13.23,8.6,1.05,13.23,51
NDC,0781340895,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,50.25,32.66,1.05,50.25,51
NDC,0781340995,AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,323.31,210.15,1.05,323.31,51
NDC,0781341392,AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,104.25,67.76,1.05,104.25,51
NDC,0781344095,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,288.72,187.67,2.17,288.72,51
NDC,0781345196,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,22.5,14.63,1.48,22.5,51
NDC,0781346595,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,345.63,224.66,1.44,345.63,51
NDC,0781400332,LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,2673.0,1737.45,2.17,2673.0,43
NDC,0781506101,AMOXICILLIN 875 MG TABLET,1.74,1.13,0.26,1.74,40
NDC,0781506120,AMOXICILLIN 875 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,0781517501,MYCOPHENOLATE MOFETIL 500 MG TABLET,15.88,10.32,0.27,15.88,51
NDC,0781528364,CETIRIZINE 5 MG CHEWABLE TABLET,10.72,6.97,1.6,10.72,40
NDC,0781528464,CETIRIZINE 10 MG CHEWABLE TABLET,10.72,6.97,1.6,10.72,40
NDC,0781551501,GRISEOFULVIN MICROSIZE 500 MG TABLET,18.7,12.16,2.78,18.7,40
NDC,0781557801,ENTACAPONE 200 MG TABLET,7.9,5.14,1.18,7.9,40
NDC,0781562501,CARBIDOPA 18.75 MG-LEVODOPA 75 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,0781563701,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,0781564101,CARBIDOPA 31.25 MG-LEVODOPA 125 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,0781565401,CARBIDOPA 37.5 MG-LEVODOPA 150 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,0781566901,CARBIDOPA 50 MG-LEVODOPA 200 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,0781600078,DIFLUPREDNATE 0.05 % EYE DROPS,88.56,57.56,13.18,88.56,40
NDC,0781602246,CLARITHROMYCIN 125 MG/5 ML ORAL SUSPENSION,3.75,2.44,0.56,3.75,40
NDC,0781602346,CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,5.45,3.54,0.81,5.45,40
NDC,0781602352,CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,5.9,3.84,0.88,5.9,40
NDC,0781613595,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,47.64,30.97,1.39,47.64,51
NDC,0781613954,AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,1.65,1.07,0.25,1.65,40
NDC,0781613957,AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,1.73,1.12,0.26,1.73,40
NDC,0781615395,PENICILLIN G SODIUM 5 MILLION UNIT SOLUTION FOR INJECTION,172.8,112.32,2.17,172.8,57
NDC,0781618667,CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPSSUSPENSION,74.72,48.57,11.12,74.72,40
NDC,0781620693,BIMATOPROST 0.03 % DROPS WITH APPLICATOR EYELASH BASE,96.44,62.69,14.35,96.44,40
NDC,0781712983,ESTRADIOL 0.025 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,27.18,17.67,4.04,27.18,40
NDC,0781713593,MOXIFLOXACIN 0.5 % EYE DROPS,116.22,75.54,17.29,116.22,40
NDC,0781714483,ESTRADIOL 0.05 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,27.18,17.67,4.04,27.18,40
NDC,0781716783,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,27.22,17.69,4.05,27.22,40
NDC,0781729685,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,13.42,8.72,2.0,13.42,40
NDC,0781730431,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.03,33.8,40
NDC,0781730458,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.03,33.8,40
NDC,0781730931,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.03,33.8,40
NDC,0781730958,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.03,33.8,40
NDC,0781731331,RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.03,33.8,40
NDC,0781802801,TRIFLUOPERAZINE 1 MG TABLET,1.76,1.14,0.26,1.76,40
NDC,0781803401,TRIFLUOPERAZINE 5 MG TABLET,3.24,2.11,0.48,3.24,40
NDC,0781940495,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,25.92,16.85,1.05,25.92,51
NDC,0781940880,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,50.25,32.66,1.05,50.25,51
NDC,0781940895,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,50.25,32.66,1.05,50.25,51
NDC,0799000102,CALMOSEPTINE 0.44 %-20.6 % TOPICAL OINTMENT,0.14,0.09,0.02,0.14,40
NDC,0799000104,CALMOSEPTINE 0.44 %-20.6 % TOPICAL OINTMENT,0.1,0.07,0.01,0.1,40
NDC,0799000105,CALMOSEPTINE 0.44 %-20.6 % TOPICAL OINTMENT IN PACKET,0.28,0.18,0.04,0.28,40
NDC,0832022500,MORPHINE ER 10 MG CAPSULEEXTENDED RELEASE PELLETS,9.46,6.15,1.41,9.46,40
NDC,0832022600,MORPHINE ER 20 MG CAPSULEEXTENDED RELEASE PELLETS,10.46,6.8,1.56,10.46,40
NDC,0832022700,MORPHINE ER 30 MG CAPSULEEXTENDED RELEASE PELLETS,11.38,7.4,1.69,11.38,40
NDC,0832022800,MORPHINE ER 50 MG CAPSULEEXTENDED RELEASE PELLETS,19.0,12.35,2.83,19.0,40
NDC,0832028500,BEXAROTENE 75 MG CAPSULE,536.7,348.86,79.86,536.7,40
NDC,0832051000,BETHANECHOL CHLORIDE 5 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,0832051100,BETHANECHOL CHLORIDE 10 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,0832051101,BETHANECHOL CHLORIDE 10 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,0832051189,BETHANECHOL CHLORIDE 10 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,0832051200,BETHANECHOL CHLORIDE 25 MG TABLET,5.34,3.47,0.79,5.34,40
NDC,0832051201,BETHANECHOL CHLORIDE 25 MG TABLET,5.34,3.47,0.79,5.34,40
NDC,0832058011,CLOBAZAM 10 MG TABLET,36.62,23.8,5.45,36.62,40
NDC,0832058111,CLOBAZAM 20 MG TABLET,73.22,47.59,10.9,73.22,40
NDC,0832059530,EXEMESTANE 25 MG TABLET,40.46,26.3,6.02,40.46,40
NDC,0832074260,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,2.98,20.0,40
NDC,0832107130,TOPIRAMATE XR 25 MG CAPSULE SPRINKLEEXTENDED RELEASE 24 HR,19.86,12.91,2.96,19.86,40
NDC,0832112035,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,5.5,3.58,0.82,5.5,40
NDC,0832601700,CHLORPROMAZINE 10 MG TABLET,8.4,5.46,1.25,8.4,40
NDC,0832601800,CHLORPROMAZINE 25 MG TABLET,15.28,9.93,2.27,15.28,40
NDC,0832603212,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,2.45,1.59,0.36,2.45,40
NDC,0869060243,EPSOM SALT 100 % CRYSTALS,0.01,0.01,0.01,0.01,40
NDC,0869068638,CITROMA ORAL SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0869420610,MINERAL OIL ORAL,0.03,0.02,0.01,0.03,40
NDC,0884629730,PHENOL EZ 89 % TOPICAL SWAB,10.92,7.1,1.62,10.92,40
NDC,0904001259,ALLERGY (CHLORPHENIRAMINE) 4 MG TABLET,0.02,0.01,0.01,0.02,40
NDC,0904001261,ALLERGY (CHLORPHENIRAMINE) 4 MG TABLET,0.18,0.12,0.03,0.18,40
NDC,0904027746,VITAMIN E (DL ACETATE) 450 MG (1000 UNIT) CAPSULE,0.3,0.2,0.04,0.3,40
NDC,0904027760,VITAMIN E (DL ACETATE) 450 MG (1000 UNIT) CAPSULE,0.28,0.18,0.04,0.28,40
NDC,0904052360,VITAMIN C 500 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0904052361,VITAMIN C 500 MG TABLET,0.1,0.07,0.01,0.1,40
NDC,0904052372,VITAMIN C 500 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0904053061,TAB-A-VITE 400 MCG TABLET,0.1,0.07,0.01,0.1,40
NDC,0904053961,THERA 400 MCG TABLET,0.12,0.08,0.02,0.12,40
NDC,0904078816,MILK OF MAGNESIA 400 MG/5 ML ORAL SUSPENSION,0.03,0.02,0.01,0.03,40
NDC,0904110309,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.04,0.03,0.01,0.04,40
NDC,0904188361,OYSTER SHELL CALCIUM-500  500 MG (AS CARBONATE 1250 MG) TABLET,0.1,0.07,0.01,0.1,40
NDC,0904198760,MAPAP (ACETAMINOPHEN) 500 MG CAPSULE,0.08,0.05,0.01,0.08,40
NDC,0904201559,TRI-BUFFERED ASPIRIN 325 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0904205112,DRIMINATE 50 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,0904205159,DRIMINATE 50 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,0904208560,VITAMIN A 3000 MCG (10000 UNIT) CAPSULE,0.1,0.07,0.01,0.1,40
NDC,0904227260,NIACIN 500 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,0904250091,FIBER (CALCIUM POLYCARBOPHIL) 625 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,0904253321,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,0.02,0.01,0.01,0.02,40
NDC,0904385461,CARBAMAZEPINE 100 MG CHEWABLE TABLET,1.22,0.79,0.18,1.22,40
NDC,0904386575,DEEP SEA NASAL 0.65 % SPRAY AEROSOL,0.06,0.04,0.01,0.06,40
NDC,0904404073,ASPIRIN 81 MG CHEWABLE TABLET,0.06,0.04,0.01,0.06,40
NDC,0904429909,THERA-DERM LOTION,0.02,0.01,0.01,0.02,40
NDC,0904505359,SUDOGEST 30 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,0904515460,GUAIFENESIN 200 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,0904522452,DAIRY-AID 3000 UNIT TABLET,0.18,0.12,0.03,0.18,40
NDC,0904530016,LUBRISOFT LOTION,0.02,0.01,0.01,0.02,40
NDC,0904530661,DIPHENHYDRAMINE 25 MG CAPSULE,0.08,0.05,0.01,0.08,40
NDC,0904530909,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,0904530920,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,0904531346,PRENATAL VITAMIN 27 MG IRON-0.8 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,0904535431,BANOPHEN ANTI-ITCH 2 %-0.1 % TOPICAL CREAM,0.16,0.1,0.02,0.16,40
NDC,0904539561,FERREX 150 MG IRON CAPSULE,0.3,0.2,0.04,0.3,40
NDC,0904544861,PENTOXIFYLLINE ER 400 MG TABLETEXTENDED RELEASE,0.74,0.48,0.11,0.74,40
NDC,0904546080,OYSTER SHELL CALCIUM-VITAMIN D3 500 MG-5 MCG (200 UNIT) TABLET,0.04,0.03,0.01,0.04,40
NDC,0904552261,DOXAZOSIN 1 MG TABLET,2.04,1.33,0.3,2.04,40
NDC,0904552461,DOXAZOSIN 4 MG TABLET,2.06,1.34,0.31,2.06,40
NDC,0904552952,HEARTBURN RELIEF (FAMOTIDINE) 10 MG TABLET,0.18,0.12,0.03,0.18,40
NDC,0904552987,HEARTBURN RELIEF (FAMOTIDINE) 10 MG TABLET,0.2,0.13,0.03,0.2,40
NDC,0904555159,BANOPHEN 25 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,0904557720,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,0904567661,PAROXETINE 10 MG TABLET,1.92,1.25,0.29,1.92,40
NDC,0904567761,PAROXETINE 20 MG TABLET,0.6,0.39,0.09,0.6,40
NDC,0904572514,MINTOX MAXIMUM STRENGTH 400 MG-400 MG-40 MG/5 ML ORAL SUSPENSION,0.03,0.02,0.01,0.03,40
NDC,0904573182,WHITE PETROLATUM TOPICAL JELLY,0.02,0.01,0.01,0.02,40
NDC,0904579146,CHILDREN'S MAPAP 80 MG CHEWABLE TABLET,0.16,0.1,0.02,0.16,40
NDC,0904582360,VITAMIN D3 10 MCG (400 UNIT) TABLET,0.04,0.03,0.01,0.04,40
NDC,0904585361,IBUPROFEN 400 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,0904589161,PRAVASTATIN 10 MG TABLET,0.94,0.61,0.14,0.94,40
NDC,0904592161,DIGOXIN 125 MCG (0.125 MG) TABLET,3.24,2.11,0.48,3.24,40
NDC,0904592261,DIGOXIN 250 MCG (0.25 MG) TABLET,3.24,2.11,0.48,3.24,40
NDC,0904595961,CLINDAMYCIN HCL 150 MG CAPSULE,0.8,0.52,0.12,0.8,40
NDC,0904598426,AMMONIUM LACTATE 12 % LOTION,0.04,0.03,0.01,0.04,40
NDC,0904598463,AMMONIUM LACTATE 12 % LOTION,0.04,0.03,0.01,0.04,40
NDC,0904608261,ZOLPIDEM 5 MG TABLET,0.2,0.13,0.03,0.2,40
NDC,0904608461,CITALOPRAM 10 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,0904608561,CITALOPRAM 20 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,0904617261,CARBAMAZEPINE 200 MG TABLET,2.16,1.4,0.32,2.16,40
NDC,0904625549,SORE THROAT (BENZOCAINE WITH MENTHOL) 15 MG-3.6 MG LOZENGES,0.38,0.25,0.06,0.38,40
NDC,0904626908,ZIPRASIDONE 20 MG CAPSULE,11.58,7.53,1.72,11.58,40
NDC,0904630521,SORE THROAT (PHENOL) 1.4 % AEROSOL SPRAY,0.04,0.03,0.01,0.04,40
NDC,0904632261,METOPROLOL SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,2.1,1.37,0.31,2.1,40
NDC,0904633724,SUDOGEST 30 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,0904635161,LEVOFLOXACIN 250 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,0904635261,LEVOFLOXACIN 500 MG TABLET,0.58,0.38,0.09,0.58,40
NDC,0904635361,LEVOFLOXACIN 750 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,0904636961,AMLODIPINE 2.5 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,0904637361,ROPINIROLE 0.25 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,0904637461,ROPINIROLE 1 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,0904640761,BISACODYL 5 MG TABLETDELAYED RELEASE,0.06,0.04,0.01,0.06,40
NDC,0904641292,CALCIUM ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.04,0.03,0.01,0.04,40
NDC,0904641861,TIZANIDINE 4 MG TABLET,1.26,0.82,0.19,1.26,40
NDC,0904642661,ESCITALOPRAM 10 MG TABLET,0.36,0.23,0.05,0.36,40
NDC,0904642761,ESCITALOPRAM 20 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,0904643604,TEMAZEPAM 7.5 MG CAPSULE,8.4,5.46,1.25,8.4,40
NDC,0904645061,ISOSORBIDE MONONITRATE ER 60 MG TABLETEXTENDED RELEASE 24 HR,1.0,0.65,0.15,1.0,40
NDC,0904646707,CLOPIDOGREL 300 MG TABLET,31.88,20.72,4.74,31.88,40
NDC,0904647761,DONEPEZIL 5 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,0904657561,PHENOBARBITAL 32.4 MG TABLET,0.92,0.6,0.14,0.92,40
NDC,0904659961,PERPHENAZINE 2 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,0904663861,QUETIAPINE 25 MG TABLET,0.7,0.46,0.1,0.7,40
NDC,0904663961,QUETIAPINE 50 MG TABLET,1.12,0.73,0.17,1.12,40
NDC,0904664524,CHILDREN'S MAPAP 160 MG CHEWABLE TABLET,0.2,0.13,0.03,0.2,40
NDC,0904672040,ACETAMINOPHEN 500 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,0904672852,SUDOGEST 60 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,0904673061,ACETAMINOPHEN 500 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,0904673080,ACETAMINOPHEN 500 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,0904673461,MEMANTINE 7 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,6.22,4.04,0.93,6.22,40
NDC,0904674860,BISACODYL 5 MG TABLETDELAYED RELEASE,0.04,0.03,0.01,0.04,40
NDC,0904675180,ASPIRIN 81 MG TABLETDELAYED RELEASE,0.02,0.01,0.01,0.02,40
NDC,0904675415,SUDOGEST 12-HOUR 120 MG TABLETEXTENDED RELEASE,0.94,0.61,0.14,0.94,40
NDC,0904676520,CHILDREN'S CETIRIZINE 1 MG/ML ORAL SOLUTION,0.13,0.08,0.02,0.13,40
NDC,0904677361,ACETAMINOPHEN 325 MG TABLET,0.12,0.08,0.02,0.12,40
NDC,0904679480,ASPIRIN 81 MG CHEWABLE TABLET,0.02,0.01,0.01,0.02,40
NDC,0904679761,LISINOPRIL 5 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,0904680861,MONTELUKAST 10 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,0904683620,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.1,0.07,0.01,0.1,40
NDC,0904686861,TRAZODONE 50 MG TABLET,0.3,0.2,0.04,0.3,40
NDC,0904690706,PSEUDOEPHEDRINE 60 MG TABLET,0.18,0.12,0.03,0.18,40
NDC,0904693181,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,3.1,2.02,0.46,3.1,40
NDC,0904699061,PSEUDOEPHEDRINE 30 MG TABLET,0.1,0.07,0.01,0.1,40
NDC,0904701416,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,0904701420,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID,0.05,0.03,0.01,0.05,40
NDC,0904702367,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.26,0.17,0.04,0.26,40
NDC,0904702761,OXYBUTYNIN CHLORIDE 5 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,0904705699,ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULEEXT.RELEASE 12 HR MULTIPHASE,25.34,16.47,3.77,25.34,40
NDC,0904710761,RIVASTIGMINE 1.5 MG CAPSULE,7.88,5.12,1.17,7.88,40
NDC,0904714110,METHOTREXATE SODIUM 2.5 MG TABLET,7.16,4.65,0.27,15.18,51
NDC,0904714504,DRONABINOL 5 MG CAPSULE,41.26,26.82,6.14,41.26,40
NDC,0904715661,METRONIDAZOLE 250 MG TABLET,0.96,0.62,0.14,0.96,40
NDC,0904717207,EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,4.68,3.04,0.7,4.68,40
NDC,0904717761,FUROSEMIDE 20 MG TABLET,0.18,0.12,0.03,0.18,40
NDC,0904717861,FUROSEMIDE 40 MG TABLET,0.18,0.12,0.03,0.18,40
NDC,0904718361,DOCUSATE SODIUM 100 MG CAPSULE,0.12,0.08,0.02,0.12,40
NDC,0904719106,THIAMINE HCL (VITAMIN B1) 100 MG TABLET,0.36,0.23,0.05,0.36,40
NDC,0904719260,FEXOFENADINE 60 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,0904723661,MEGESTROL 40 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,0904724361,CIPROFLOXACIN 500 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,0904725261,SENNA LAX 8.6 MG TABLET,0.1,0.07,0.01,0.1,40
NDC,0904726261,OXCARBAZEPINE 150 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,0904726361,OXCARBAZEPINE 300 MG TABLET,2.02,1.31,0.3,2.02,40
NDC,0904728060,DOCUSATE SODIUM 100 MG CAPSULE,0.04,0.03,0.01,0.04,40
NDC,0904731970,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,0.65,0.42,0.1,0.65,40
NDC,0904734661,FLUOXETINE 20 MG CAPSULE,0.22,0.14,0.03,0.22,40
NDC,0904748660,FEXOFENADINE 180 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,0904750852,DAIRY RELIEF 3000 UNIT TABLET,0.18,0.12,0.03,0.18,40
NDC,0904750930,ASPIRIN 81 MG CHEWABLE TABLET,0.18,0.12,0.03,0.18,40
NDC,0904754012,LUBRIFRESH PM 83 %-15 % EYE OINTMENT,4.14,2.69,0.62,4.14,40
NDC,0904759160,FEROSUL 325 MG (65 MG IRON) TABLET,0.04,0.03,0.01,0.04,40
NDC,0904759161,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.08,0.05,0.01,0.08,40
NDC,0904772512,ANTI-DIARRHEAL (LOPERAMIDE) 2 MG TABLET,0.36,0.23,0.05,0.36,40
NDC,0904772524,ANTI-DIARRHEAL (LOPERAMIDE) 2 MG TABLET,0.3,0.2,0.04,0.3,40
NDC,0904772714,ACID GONE ANTACID 95 MG-358 MG/15 ML ORAL SUSPENSION,0.05,0.03,0.01,0.05,40
NDC,0904773445,MICONAZOLE-7  2 % VAGINAL CREAM,0.34,0.22,0.05,0.34,40
NDC,0904773518,PROSIGHT 5000 UNIT-60 MG-30 UNIT TABLET,0.08,0.05,0.01,0.08,40
NDC,0904773552,PROSIGHT 5000 UNIT-60 MG-30 UNIT TABLET,0.08,0.05,0.01,0.08,40
NDC,0904775127,MINERIN CREME TOPICAL,0.02,0.01,0.01,0.02,40
NDC,0941040901,DIANEAL LOW CALCIUM WITH 1.5% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,0941040905,DIANEAL LOW CALCIUM WITH 1.5% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941040906,DIANEAL LOW CALCIUM WITH 1.5% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941041106,DIANEAL PD-2 WITH 1.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941041301,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941041305,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.18,0.12,0.03,0.18,40
NDC,0941041306,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.12,0.08,0.02,0.12,40
NDC,0941041505,DIANEAL PD-2 WITH 4.25% DEXTROSE CALCIUM 3.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.15,0.1,0.02,0.15,40
NDC,0941041506,DIANEAL PD-2 WITH 4.25% DEXTROSE CALCIUM 3.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941042452,DIANEAL WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941042453,DIANEAL WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941042652,ULTRABAG/DIANEAL PD-2/1.5% DEXTROS CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941042653,DIANEAL PD-2 WITH 1.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941042752,ULTRABAG/DIANEAL PD-2 WITH 2.5% DEXTROSE CA 3.5 MEQ/L-MAG 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941042952,ULTRABAG/DIANEAL PD-2 WITH 4.25 % DEXTROSE CA 3.5 MEQ/L-MAG 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941043052,ULTRABAG/DIANEAL DEXTROSE 2.5 %-LOW CALCIUM 2.5 MEQ-LOW MAG 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941043053,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941043352,DIANEAL WITH 4.25 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.09,0.06,0.01,0.09,40
NDC,0941043353,DIANEAL WITH 4.25 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941045701,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,0941045702,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941045708,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941045901,DIANEAL LOW CALCIUM WITH 4.25% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5MEQ/L,0.03,0.02,0.01,0.03,40
NDC,0941045908,DIANEAL LOW CALCIUM WITH 4.25% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5MEQ/L,0.06,0.04,0.01,0.06,40
NDC,0941067906,EXTRANEAL 7.5 % WITH CALCIUM 3.5 MEQ/L-LOW MAGNESIUM 0.5 MEQ/L,0.21,0.14,0.03,0.21,40
NDC,0941067952,EXTRANEAL 7.5 % WITH CALCIUM 3.5 MEQ/L-LOW MAGNESIUM 0.5 MEQ/L,0.27,0.18,0.04,0.27,40
NDC,0941069606,DIANEAL LOW CALCIUM WITH 4.25% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5MEQ/L,0.03,0.02,0.01,0.03,40
NDC,0941069806,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,0942064104,ACD-A 2.45-2.2 GRAM-730 MG/100 ML SOLUTION,0.01,0.01,0.01,0.01,40
NDC,0942950410,SODIUM CITRATE 4 GRAM/100 ML (4 %) SOLUTION,0.02,0.01,0.01,0.02,40
NDC,0942950510,SODIUM CITRATE 4 GRAM/100 ML (4 %) SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0944049301,FLEXBUMIN 25 % INTRAVENOUS SOLUTION,4.17,2.71,0.92,192.16,59
NDC,0944049302,FLEXBUMIN 25 % INTRAVENOUS SOLUTION,4.17,2.71,0.92,192.16,59
NDC,0944049505,FLEXBUMIN 5 % INTRAVENOUS SOLUTION,0.84,0.55,0.19,315.24,65
NDC,0944251002,HYQVIA 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
NDC,0944251102,HYQVIA 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
NDC,0944251202,HYQVIA 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
NDC,0944251302,HYQVIA 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
NDC,0944251402,HYQVIA 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,2.17,3257.22,65
NDC,0944265603,GAMMAGARD S-D (IGA < 1 MCG/ML) 5 GRAM INTRAVENOUS SOLUTION,4097.16,2663.15,2.17,4097.16,65
NDC,0944265804,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM INTRAVENOUS SOLUTION,8194.32,5326.31,2.17,8194.32,65
NDC,0944270002,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270003,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270004,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270005,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270006,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270007,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270012,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944270013,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,2.17,3257.22,65
NDC,0944281401,ARALAST NP 500 MG INTRAVENOUS SOLUTION,2.34,1.52,0.52,2642.72,65
NDC,0944284310,RECOMBINATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
NDC,0944284410,RECOMBINATE 1500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.05,7.05,43
NDC,0944305102,ADVATE 250 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
NDC,0944305202,ADVATE 500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
NDC,0944305302,ADVATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
NDC,0944305402,ADVATE 1500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.55,4417.71,65
NDC,0944417910,CEPROTIN (GREEN BAR) 1000 UNIT INTRAVENOUS SOLUTION,5.4,3.51,1.19,3257.22,65
NDC,0944500101,OBIZUR 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,10.62,6.9,2.17,4417.71,65
NDC,0944755102,VONVENDI 650 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.58,4417.71,65
NDC,0944755302,VONVENDI 1300 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.58,4417.71,65
NDC,0951110308,PYRIDOXAL-5-PHOSPHATE 33.8 MG CAPSULE,0.54,0.35,0.08,0.54,40
NDC,0955102001,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,523.2,340.08,1.16,523.2,51
NDC,0955102104,DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,522.0,339.3,1.16,522.0,51
NDC,0990613822,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0990613903,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0990614322,ACETIC ACID 0.25 % IRRIGATION SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0990707426,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.18,0.12,0.03,8.86,51
NDC,0990710709,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,8.86,51
NDC,0990711109,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,0.06,0.04,0.01,8.86,51
NDC,0990711609,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
NDC,0990713809,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0990717117,AMINOSYN II 15 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,40
NDC,0990771502,MANNITOL 20 % INTRAVENOUS SOLUTION,0.33,0.21,0.05,47.96,51
NDC,0990771512,MANNITOL 20 % INTRAVENOUS SOLUTION,0.33,0.21,0.05,47.96,51
NDC,0990771513,MANNITOL 20 % INTRAVENOUS SOLUTION,0.15,0.1,0.02,47.96,51
NDC,0990790209,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,0990791819,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,40
NDC,0990792202,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,0.09,43
NDC,0990792203,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990792209,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990792261,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,43
NDC,0990792320,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,1.35,0.88,0.2,8.86,51
NDC,0990792323,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,43
NDC,0990792337,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,0990792409,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990792909,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990793002,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.09,0.06,0.01,47.96,48
NDC,0990793003,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,47.96,48
NDC,0990793519,DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,40
NDC,0990793619,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,40
NDC,0990794109,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990795303,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990797205,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0990798302,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,8.86,51
NDC,0990798303,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990798309,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,0990798355,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,0990798361,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,0990798420,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.54,0.35,0.08,8.86,51
NDC,0990798423,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.15,0.1,0.02,8.86,51
NDC,0990798436,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.24,0.16,0.04,0.24,43
NDC,0990798437,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,0990799009,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,0995803131,"""MEDIHONEY (CALCIUM ALGINATE-HONEY) 2"""" X 2"""" BANDAGE""",11.42,7.42,1.7,11.42,40
NDC,0995803361,MEDIHONEY (HONEY) 100 % TOPICAL PASTE,0.78,0.51,0.12,0.78,40
NDC,0995803470,MEDIHONEY (HONEY) 80 % TOPICAL GEL,0.78,0.51,0.12,0.78,40
NDC,0995803471,MEDIHONEY (HONEY) 80 % TOPICAL GEL,0.78,0.51,0.12,0.78,40
NDC,0998001530,AZO URINARY PAIN RELIEF 95 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,0998001615,ALCAINE 0.5 % EYE DROPS,4.72,3.07,0.7,4.72,40
NDC,0998030305,ISOPTO ATROPINE 1 % EYE DROPS,17.62,11.45,2.62,17.62,40
NDC,0998035515,MYDRIACYL 1 % EYE DROPS,17.84,11.6,2.65,17.84,40
NDC,0998101009,MICROFIBRILLAR COLLAGEN HEMOSTAT 70 MM X 35 MM SHEETS,696.0,452.4,103.56,696.0,40
NDC,1000670012,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,1000670020,NIACIN ER 250 MG CAPSULEEXTENDED RELEASE,0.22,0.14,0.03,0.22,40
NDC,1000670038,OYSTER SHELL CALCIUM-VITAMIN D3 500 MG-5 MCG (200 UNIT) TABLET,0.12,0.08,0.02,0.12,40
NDC,1000673013,SLOW RELEASE IRON 140 MG (45 MG IRON) TABLETEXTENDED RELEASE,0.34,0.22,0.05,0.34,40
NDC,1001905561,BREVIBLOC 2500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,1.86,1.21,0.28,47.96,51
NDC,1001907587,BREVIBLOC 2000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,18.15,11.8,0.37,47.96,51
NDC,1001907901,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,2808.0,1825.2,2.17,3257.22,65
NDC,1001911501,BREVIBLOC 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,7.68,4.99,1.14,7.68,40
NDC,1001955303,TRANSDERM-SCOP 1 MG OVER 3 DAYS TRANSDERMAL PATCH,51.12,33.23,7.61,51.12,40
NDC,1001992501,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,176.36,114.63,2.17,176.36,43
NDC,1001992602,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,516.2,335.53,2.17,516.2,43
NDC,1001992616,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,516.2,335.53,2.17,516.2,43
NDC,1001995301,MESNA 100 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.34,9.0,43
NDC,1001995362,MESNA 100 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.34,9.0,43
NDC,1001995501,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1758.0,1142.7,2.17,1758.0,59
NDC,1001995601,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,2253.52,1464.79,2.17,2253.52,59
NDC,1001995701,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,7032.0,4570.8,2.17,7032.0,59
NDC,1004259001,SUSVIMO IMPLANT AND INSERTION TOOL INTRAVITREAL,3000.0,1950.0,446.4,3000.0,39
NDC,1011900252,EYE WASH (BORIC ACID) EYE WASH SOLUTION,0.06,0.04,0.01,0.06,40
NDC,1011902219,SOOTHE LUBRICANT 0.6 %-0.6 % EYE DROPS IN A DROPPERETTE,0.62,0.4,0.09,0.62,40
NDC,1011902239,SOOTHE NIGHT TIME LUBRICANT 80 %-20 % EYE OINTMENT,5.04,3.28,0.75,5.04,40
NDC,1011903048,RENU DISINFECTING SOLUTION,0.06,0.04,0.01,0.06,40
NDC,1011903582,BIO TRUE SOLUTION,0.08,0.05,0.01,0.08,40
NDC,1011905610,BOSTON CONDITIONING SOLUTION,0.18,0.12,0.03,0.18,40
NDC,1011905611,BOSTON SIMPLUS SOLUTION,0.2,0.13,0.03,0.2,40
NDC,1012216002,ELFABRIO 2 MG/ML INTRAVENOUS SOLUTION,1626.21,1057.04,2.17,3257.22,65
NDC,1012218002,LAMZEDE 10 MG INTRAVENOUS SOLUTION,16274.4,10578.36,2.17,16617.81,65
NDC,1012231301,CARDENE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,1.83,1.19,0.27,1.83,40
NDC,1012231310,CARDENE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,1.83,1.19,0.27,1.83,40
NDC,1012251001,CUROSURF 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,1507.95,980.17,224.38,1507.95,40
NDC,1012251003,CUROSURF 240 MG/3 ML INTRATRACHEAL SUSPENSION,1486.74,966.38,221.23,1486.74,40
NDC,1012261010,CLEVIPREX 25 MG/50 ML INTRAVENOUS EMULSION,6.54,4.25,1.45,130.36,59
NDC,1012261110,CLEVIPREX 50 MG/100 ML INTRAVENOUS EMULSION,6.54,4.25,1.45,130.36,59
NDC,1012262001,KENGREAL 50 MG INTRAVENOUS SOLUTION,3780.93,2457.6,2.17,3780.93,65
NDC,1012262010,KENGREAL 50 MG INTRAVENOUS SOLUTION,3780.93,2457.6,2.17,3780.93,65
NDC,1013518001,FOLIC ACID 400 MCG TABLET,0.04,0.03,0.01,0.04,40
NDC,1013540401,SALSALATE 750 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,1013562101,PHENAZOPYRIDINE 200 MG TABLET,5.84,3.8,0.87,5.84,40
NDC,1013567191,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,2.68,1.74,0.4,2.68,40
NDC,1014706881,METHYLPHENIDATE ER 27 MG TABLETEXTENDED RELEASE 24 HR,19.16,12.45,2.85,19.16,40
NDC,1014708913,GALANTAMINE ER 8 MG 24 HR CAPSULEEXTENDED RELEASE,12.2,7.93,1.82,12.2,40
NDC,1014709225,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,177.66,115.48,2.17,177.66,51
NDC,1014717003,ITRACONAZOLE 100 MG CAPSULE,17.82,11.58,2.65,17.82,40
NDC,1015799512,BLISTEX MEDICATED 0.6 %-0.5 %-1.1 %-0.5 % TOPICAL OINTMENT,0.44,0.29,0.07,0.44,40
NDC,1022302013,CETACAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,21.62,14.05,3.22,21.62,40
NDC,1022302014,CETACAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,39.7,25.81,5.91,39.7,40
NDC,1036179301,E-Z-GAS II 2.21 GRAM-1.53 GRAM/4 GRAM ORAL EFFERVESCENT GRANULES PACK,5.68,3.69,0.85,5.68,40
NDC,1037036511,TOPIRAMATE XR 25 MG CAPSULEEXTENDED RELEASE 24 HR,26.56,17.26,3.95,26.56,40
NDC,1037036701,TOPIRAMATE XR 100 MG CAPSULEEXTENDED RELEASE 24 HR,68.54,44.55,10.2,68.54,40
NDC,1037082905,DILTIAZEM SR 120 MG 24 HR CAP,2.28,1.48,0.34,2.28,40
NDC,1037083005,DILTIAZEM SR 180 MG 24 HR CAP,2.74,1.78,0.41,2.74,40
NDC,1037083009,DILTIAZEM SR 180 MG 24 HR CAP,2.9,1.89,0.43,2.9,40
NDC,1037083105,DILTIAZEM SR 240 MG 24 HR CAP,3.9,2.54,0.58,3.9,40
NDC,1043201702,DELTA D3 10 MCG (400 UNIT) TABLET,0.1,0.07,0.01,0.1,40
NDC,1045471010,MYOBLOC 2500 UNIT/0.5 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,2.17,2286.3,65
NDC,1045471110,MYOBLOC 5000 UNIT/ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,2.17,2286.3,65
NDC,1045471210,MYOBLOC 10000 UNIT/2 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,2.17,2286.3,65
NDC,1048101118,LUGOLS 5 %-10 % TOPICAL SOLUTION,2.74,1.78,0.41,2.74,40
NDC,1048101128,MONSEL'S 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLUTION APPLICATOR,3.64,2.37,0.54,3.64,40
NDC,1048110511,SILVER NITRATE 10 % TOPICAL SOLUTION,4.5,2.93,0.67,4.5,40
NDC,1048130081,TRI-CHLOR 80 % TOPICAL SOLUTION,10.34,6.72,1.54,10.34,40
NDC,1051103001,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,64.8,42.12,9.64,2964.23,51
NDC,1051130012,CYSVIEW 100 MG INTRAVESICAL SOLUTION,97.2,63.18,14.46,2964.23,51
NDC,1057210001,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,0.03,0.02,0.01,0.03,40
NDC,1057230201,PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,0.03,0.02,0.01,0.03,40
NDC,1059900301,SINUVA 1350 MCG SINUS IMPLANT,3538.44,2299.99,2.17,3538.44,65
NDC,1063120601,RIOMET 500 MG/5 ML ORAL SOLUTION,4.23,2.75,0.63,4.23,40
NDC,1063120602,RIOMET 500 MG/5 ML ORAL SOLUTION,4.23,2.75,0.63,4.23,40
NDC,1063140701,PROCTOSOL HC 2.5 % TOPICAL CREAM PERINEAL APPLICATOR,5.92,3.85,0.88,5.92,40
NDC,1070201101,HYDROXYZINE HCL 25 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,1070201301,BETAXOLOL 10 MG TABLET,2.48,1.61,0.37,2.48,40
NDC,1070201601,INDOMETHACIN ER 75 MG CAPSULEEXTENDED RELEASE,6.08,3.95,0.9,6.08,40
NDC,1070203615,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,1.8,1.17,0.27,1.8,40
NDC,1070205503,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG TABLET,2.98,1.94,0.44,2.98,40
NDC,1070207606,METHYLPHENIDATE ER 20 MG TABLETEXTENDED RELEASE,15.5,10.08,2.31,15.5,40
NDC,1081938852,POVIDONE-IODINE 10 % TOPICAL SWAB,0.32,0.21,0.05,0.32,40
NDC,1085808107,SITZMARKS 24 MARKERS CAPSULE,239.76,155.84,35.68,239.76,40
NDC,1093914533,CALDYPHEN 1 %-8 % LOTION,0.04,0.03,0.01,0.04,40
NDC,1093914833,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,0.02,0.01,0.01,0.02,40
NDC,1093920444,ATHLETE'S FOOT (TERBINAFINE) 1 % TOPICAL CREAM,0.56,0.36,0.08,0.56,40
NDC,1093938033,MICONAZOLE NITRATE 2 % VAGINAL CREAM,0.4,0.26,0.06,0.4,40
NDC,1108603701,DRITHOCREME HP 1 % TOPICAL,16.8,10.92,2.5,16.8,40
NDC,1150900367,VAGISIL 5 %-2 % TOPICAL CREAM,0.22,0.14,0.03,0.22,40
NDC,1152309191,LOTRIMIN AF 2 % TOPICAL POWDER,0.12,0.08,0.02,0.12,40
NDC,1152311673,AFRIN (OXYMETAZOLINE) 0.05 % NASAL SPRAY,0.7,0.46,0.1,0.7,40
NDC,1152311676,AFRIN (OXYMETAZOLINE) 0.05 % NASAL SPRAY,0.98,0.64,0.15,0.98,40
NDC,1152343252,CORICIDIN HBP COLD AND FLU 2 MG-325 MG TABLET,0.76,0.49,0.11,0.76,40
NDC,1152371623,CLARITIN-D 12 HOUR 5 MG-120 MG TABLETEXTENDED RELEASE,2.22,1.44,0.33,2.22,40
NDC,1152371631,CLARITIN 5 MG/5 ML ORAL SOLUTION,0.23,0.15,0.03,0.23,40
NDC,1152802001,COVARYX H.S. 0.625 MG-1.25 MG TABLET,7.2,4.68,1.07,7.2,40
NDC,1153416501,FOLIC ACID 1 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,1153416644,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,0.42,0.27,0.06,0.42,40
NDC,1167346162,IBUPROFEN 100 MG CHEWABLE TABLET,0.38,0.25,0.06,0.38,40
NDC,1170102214,ATRAC-TAIN (WITH AHA) 10 %-4 % TOPICAL CREAM,0.16,0.1,0.02,0.16,40
NDC,1170102223,ATRAC-TAIN (WITH AHA) 10 %-4 % TOPICAL CREAM,0.26,0.17,0.04,0.26,40
NDC,1170103816,MICRO-GUARD 2 % TOPICAL POWDER,0.2,0.13,0.03,0.2,40
NDC,1170104514,BAZA ANTIFUNGAL 2 % TOPICAL CREAM,0.18,0.12,0.03,0.18,40
NDC,1170104523,BAZA ANTIFUNGAL 2 % TOPICAL CREAM,0.26,0.17,0.04,0.26,40
NDC,1170105033,CRITIC-AID 20 %-51 % TOPICAL PASTE,0.24,0.16,0.04,0.24,40
NDC,1170106633,CRITIC-AID CLEAR 71.5 % TOPICAL OINTMENT,0.28,0.18,0.04,0.28,40
NDC,1170106723,CRITIC-AID CLEAR AF (MICONAZOLE) 2 % TOPICAL OINTMENT,0.28,0.18,0.04,0.28,40
NDC,1170462001,DUODOTE 600 MG/2 ML-2.1 MG/0.7 ML INTRAMUSCULAR PEN INJECTOR,56.46,36.7,8.4,56.46,40
NDC,1174302235,SUCROSE ORAL SOLUTION 24%,0.75,0.49,0.11,0.75,39
NDC,1174302237,SUCROSE ORAL SOLUTION 24%,1.53,0.99,0.23,1.53,39
NDC,1184507365,BIOTIN 800 MCG TABLET,0.16,0.1,0.02,0.16,40
NDC,1184514922,FISH OIL 360 MG-1200 MG CAPSULE,0.32,0.21,0.05,0.32,40
NDC,1184577901,PHYTONADIONE (VITAMIN K1) 100 MCG TABLET,0.1,0.07,0.01,0.1,40
NDC,1198017405,PRED MILD 0.12 % EYE DROPSSUSPENSION,77.0,50.05,11.46,77.0,40
NDC,1198018005,PRED FORTE 1 % EYE DROPSSUSPENSION,77.0,50.05,11.46,77.0,40
NDC,1198018010,PRED FORTE 1 % EYE DROPSSUSPENSION,77.0,50.05,11.46,77.0,40
NDC,1198021105,FML LIQUIFILM 0.1 % EYE DROPSSUSPENSION,80.84,52.55,12.03,80.84,40
NDC,1198022805,FML FORTE 0.25 % EYE DROPSSUSPENSION,80.84,52.55,12.03,80.84,40
NDC,1198077905,OCUFLOX 0.3 % EYE DROPS,59.54,38.7,8.86,59.54,40
NDC,1199400602,NEUROLITE 0.9 MG INTRAVENOUS SOLUTION,3766.0,2447.9,0.01,3766.0,60
NDC,1199401116,DEFINITY 1.1 MG/ML INTRAVENOUS SUSPENSION,675.0,438.75,2.17,675.0,51
NDC,1199412711,XENON XE-133  370 MBQ (10 MCI) GAS FOR INHALATION,460.0,299.0,0.01,557.75,45
NDC,1216510001,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,0.48,0.31,0.07,0.48,40
NDC,1216520003,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,1.0,0.65,0.15,1.0,40
NDC,1249601001,SUBLOCADE 100 MG/0.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,15854.61,10305.5,2.17,15854.61,65
NDC,1249601201,PERSERIS 120 MG SUBCUTANEOUS EXTENDED RELEASE SUSPENSION SYRINGE,10435.83,6783.29,2.17,10435.83,65
NDC,1249603001,SUBLOCADE 300 MG/1.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,5284.86,3435.16,2.17,5920.84,65
NDC,1249612021,SUBOXONE 2 MG-0.5 MG SUBLINGUAL FILM,12.02,7.81,1.79,47.96,48
NDC,1249612023,SUBOXONE 2 MG-0.5 MG SUBLINGUAL FILM,12.02,7.81,1.79,47.96,48
NDC,1249612043,SUBOXONE 4 MG-1 MG SUBLINGUAL FILM,21.56,14.01,3.21,21.56,40
NDC,1249612081,SUBOXONE 8 MG-2 MG SUBLINGUAL FILM,21.56,14.01,2.17,47.96,48
NDC,1249612083,SUBOXONE 8 MG-2 MG SUBLINGUAL FILM,21.56,14.01,2.17,47.96,48
NDC,1254717162,BENADRYL ITCH STOPPING 1 %-0.1 % TOPICAL CREAM,0.3,0.2,0.04,0.3,40
NDC,1284310239,BAYER ASPIRIN 325 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,1287000011,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,1.82,1.18,0.27,1.82,40
NDC,1287000012,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,1.68,1.09,0.25,1.68,40
NDC,1298002000,ILEX SKIN PROTECTANT TOPICAL PASTE,0.94,0.61,0.14,0.94,40
NDC,1310700130,MIRTAZAPINE 7.5 MG TABLET,5.26,3.42,0.78,5.26,40
NDC,1310700334,MIRTAZAPINE 30 MG TABLET,5.54,3.6,0.82,5.54,40
NDC,1310701401,GLYCOPYRROLATE 1 MG TABLET,2.62,1.7,0.39,2.62,40
NDC,1310703105,MIRTAZAPINE 15 MG TABLET,5.4,3.51,0.8,5.4,40
NDC,1331015307,QUALAQUIN 324 MG CAPSULE,15.72,10.22,2.34,15.72,40
NDC,1351710030,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,30.98,20.14,4.61,30.98,40
NDC,1353331801,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,279.94,2642.72,65
NDC,1353331803,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,279.94,2642.72,65
NDC,1353331805,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,279.94,2642.72,65
NDC,1353333504,GAMASTAN 15 %-18 % RANGE INTRAMUSCULAR SOLUTION,187.26,121.72,2.17,187.26,65
NDC,1353333512,GAMASTAN 15 %-18 % RANGE INTRAMUSCULAR SOLUTION,171.15,111.25,2.17,171.15,65
NDC,1353360250,THROMBATE III 500 (+/-) UNIT INTRAVENOUS SOLUTION,16.53,10.74,2.17,4417.71,65
NDC,1353360612,THROMBATE III 500 (+/-) UNIT INTRAVENOUS SOLUTION,16.53,10.74,2.17,4417.71,65
NDC,1353363102,HYPERRHO 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,307.11,199.62,2.17,307.11,51
NDC,1353363402,HYPERTET (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2360.37,1534.24,2.17,2360.37,65
NDC,1353363601,HYPERHEP B 220 UNIT/ML INTRAMUSCULAR SOLUTION,618.45,401.99,136.68,1287.79,65
NDC,1353363603,HYPERHEP B NEONATAL 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,655.92,426.35,137.82,1287.79,65
NDC,1353363605,HYPERHEP B 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,593.46,385.75,131.15,1287.79,65
NDC,1353370501,PROLASTIN-C 1000  MG (+/-)/20 ML INTRAVENOUS SOLUTION,2.22,1.44,0.49,2642.72,65
NDC,1353370511,PROLASTIN-C 1000  MG (+/-)/20 ML INTRAVENOUS SOLUTION,2.22,1.44,0.49,2642.72,65
NDC,1353380012,GAMUNEX-C 1 GRAM/10 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
NDC,1353380015,GAMUNEX-C 2.5 GRAM/25 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
NDC,1353380020,GAMUNEX-C 5 GRAM/50 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
NDC,1353380024,GAMUNEX-C 20 GRAM/200 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
NDC,1353380040,GAMUNEX-C 40 GRAM/400 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
NDC,1353380071,GAMUNEX-C 10 GRAM/100 ML (10 %) INJECTION SOLUTION,55.14,35.84,2.17,2642.72,65
NDC,1366800901,CITALOPRAM 10 MG TABLET,5.16,3.35,0.77,5.16,40
NDC,1366800905,CITALOPRAM 10 MG TABLET,4.92,3.2,0.73,4.92,40
NDC,1366801001,CITALOPRAM 20 MG TABLET,5.38,3.5,0.8,5.38,40
NDC,1366801005,CITALOPRAM 20 MG TABLET,5.12,3.33,0.76,5.12,40
NDC,1366801101,CITALOPRAM 40 MG TABLET,5.56,3.61,0.83,5.56,40
NDC,1366808830,OLANZAPINE 10 MG DISINTEGRATING TABLET,41.34,26.87,6.15,41.34,40
NDC,1366808930,OLANZAPINE 15 MG DISINTEGRATING TABLET,60.66,39.43,9.03,60.66,40
NDC,1366809190,PRAMIPEXOLE 0.125 MG TABLET,5.9,3.84,0.88,5.9,40
NDC,1366809290,PRAMIPEXOLE 0.25 MG TABLET,5.9,3.84,0.88,5.9,40
NDC,1366809390,PRAMIPEXOLE 0.5 MG TABLET,5.9,3.84,0.88,5.9,40
NDC,1366809490,PRAMIPEXOLE 1 MG TABLET,5.9,3.84,0.88,5.9,40
NDC,1366809590,PRAMIPEXOLE 1.5 MG TABLET,5.9,3.84,0.88,5.9,40
NDC,1366810290,DONEPEZIL 5 MG TABLET,15.58,10.13,2.32,15.58,40
NDC,1366810390,DONEPEZIL 10 MG TABLET,15.58,10.13,2.32,15.58,40
NDC,1366813201,FELODIPINE ER 2.5 MG TABLETEXTENDED RELEASE 24 HR,3.02,1.96,0.45,3.02,40
NDC,1366813301,FELODIPINE ER 5 MG TABLETEXTENDED RELEASE 24 HR,3.02,1.96,0.45,3.02,40
NDC,1366813401,FELODIPINE ER 10 MG TABLETEXTENDED RELEASE 24 HR,5.44,3.54,0.81,5.44,40
NDC,1366845301,ANAGRELIDE 0.5 MG CAPSULE,22.32,14.51,3.32,22.32,40
NDC,1366846201,ANAGRELIDE 1 MG CAPSULE,48.14,31.29,7.16,48.14,40
NDC,1366858630,ERYTHROMYCIN 250 MG TABLETDELAYED RELEASE,16.78,10.91,2.5,16.78,40
NDC,1366858730,ERYTHROMYCIN 333 MG TABLETDELAYED RELEASE,21.12,13.73,3.14,21.12,40
NDC,1366859181,APREPITANT 40 MG CAPSULE,219.88,142.92,32.72,219.88,40
NDC,1381100710,TRINATAL RX 1 60 MG IRON-1 MG TABLET,0.64,0.42,0.1,0.64,40
NDC,1381170110,HYDROMORPHONE ER 8 MG TABLETEXTENDED RELEASE 24 HR,18.48,12.01,2.75,18.48,40
NDC,1381170210,HYDROMORPHONE ER 12 MG TABLETEXTENDED RELEASE 24 HR,27.62,17.95,4.11,27.62,40
NDC,1381170610,METHYLPHENIDATE ER 18 MG TABLETEXTENDED RELEASE 24 HR,18.68,12.14,2.78,18.68,40
NDC,1381170710,METHYLPHENIDATE ER 27 MG TABLETEXTENDED RELEASE 24 HR,19.16,12.45,2.85,19.16,40
NDC,1381170810,METHYLPHENIDATE ER 36 MG TABLETEXTENDED RELEASE 24 HR,19.76,12.84,2.94,19.76,40
NDC,1392550401,DAPSONE 25 MG TABLET,4.4,2.86,0.65,4.4,40
NDC,1392552201,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,361.0,234.65,53.72,361.0,40
NDC,1424720335,SUCROSE ORAL SOLUTION 24%,0.63,0.41,0.09,0.63,39
NDC,1453781775,ANTICOAGULANT CITRATE DEXTROSE(ACD) SOLN A 2.45-2.2 GRAM-800 MG/100 ML,0.03,0.02,0.01,0.03,40
NDC,1453796775,ANTICOAGULANT CITRATE DEXTROSE(ACD) SOLN A 2.45-2.2 GRAM-800 MG/100 ML,0.03,0.02,0.01,0.03,40
NDC,1453967306,DIFLUNISAL 500 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,1465425314,Q-GEL MEGA 100 MG-150 UNIT CAPSULE,1.24,0.81,0.18,1.24,40
NDC,1478910205,TIROFIBAN 12.5 MG/250 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,2.31,1.5,0.34,327.06,51
NDC,1478911605,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,720.0,468.0,2.17,720.0,51
NDC,1478911905,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,48.6,31.59,8.53,48.6,65
NDC,1478912105,PAPAVERINE 30 MG/ML INJECTION SOLUTION,67.5,43.88,2.17,102.6,51
NDC,1478912705,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,63.0,40.95,2.17,70.13,51
NDC,1478912805,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,158.4,102.96,2.17,158.4,51
NDC,1478925110,EMERPHED 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,27.0,17.55,4.02,27.0,40
NDC,1505400431,ONIVYDE 4.3 MG/ML INTRAVENOUS DISPERSION,1465.44,952.54,2.17,4487.68,65
NDC,1505405001,DYSPORT 500 UNIT INTRAMUSCULAR SOLUTION,3169.8,2060.37,2.17,3169.8,65
NDC,1505405306,DYSPORT 300 UNIT INTRAMUSCULAR SOLUTION,1902.6,1236.69,2.17,1902.6,65
NDC,1505410604,SOMATULINE DEPOT 60 MG/0.2 ML SUBCUTANEOUS SYRINGE,113976.0,74084.4,2.17,113976.0,65
NDC,1505410904,SOMATULINE DEPOT 90 MG/0.3 ML SUBCUTANEOUS SYRINGE,101184.0,65769.6,2.17,101184.0,65
NDC,1505411204,SOMATULINE DEPOT 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,71596.8,46537.92,2.17,71596.8,65
NDC,1558401011,ATRIPLA 600 MG-200 MG-300 MG TABLET,239.58,155.73,35.65,239.58,40
NDC,1571889305,RETAINE PM 80 %-20 % EYE OINTMENT,6.38,4.15,0.95,6.38,40
NDC,1611051815,ALTABAX 1 % TOPICAL OINTMENT,57.78,37.56,8.6,57.78,40
NDC,1611091530,TAZORAC 0.05 % TOPICAL CREAM,40.3,26.2,6.0,40.3,40
NDC,1625253901,ISRADIPINE 2.5 MG CAPSULE,3.8,2.47,0.57,3.8,40
NDC,1647734003,UREA 40 % TOPICAL CREAM,3.78,2.46,0.56,3.78,40
NDC,1647773801,HYOSCYAMINE ER 0.375 MG TABLETEXTENDED RELEASE12 HR,3.2,2.08,0.48,3.2,40
NDC,1650002322,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.28,0.83,0.19,1.28,40
NDC,1650002324,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.6,1.04,0.24,1.6,40
NDC,1657112848,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.08,0.05,0.01,0.08,40
NDC,1657120310,DICLOFENAC SODIUM 25 MG TABLETDELAYED RELEASE,2.84,1.85,0.42,2.84,40
NDC,1657141250,CIPROFLOXACIN 500 MG TABLET,9.86,6.41,1.47,9.86,40
NDC,1657141305,CIPROFLOXACIN 750 MG TABLET,10.9,7.09,1.62,10.9,40
NDC,1657165906,SELEGILINE 5 MG CAPSULE,4.6,2.99,0.68,4.6,40
NDC,1657166101,MECLIZINE 25 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,1657166901,PHENOBARBITAL 100 MG TABLET,1.48,0.96,0.22,1.48,40
NDC,1657167101,PHENOBARBITAL 16.2 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,1657167516,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,0.3,0.2,0.04,0.3,40
NDC,1657168901,CARBIDOPA 12.5 MG-LEVODOPA 50 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,1657172348,SULFAMYLON 85 MG/G TOPICAL CREAM,2.64,1.72,0.39,2.64,40
NDC,1657172360,SULFAMYLON 85 MG/G TOPICAL CREAM,3.06,1.99,0.46,3.06,40
NDC,1657173806,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,2.98,20.0,40
NDC,1657175809,NATEGLINIDE 60 MG TABLET,3.32,2.16,0.49,3.32,40
NDC,1657177301,GLIMEPIRIDE 1 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,1657185601,PENTOXIFYLLINE ER 400 MG TABLETEXTENDED RELEASE,2.28,1.48,0.34,2.28,40
NDC,1671423401,PENICILLIN V POTASSIUM 250 MG TABLET,1.64,1.07,0.24,1.64,40
NDC,1671439001,CEFADROXIL 500 MG/5 ML ORAL SUSPENSION,2.1,1.37,0.31,2.1,40
NDC,1672902310,BICALUTAMIDE 50 MG TABLET,36.7,23.86,5.46,36.7,40
NDC,1672907212,CAPECITABINE 150 MG TABLET,23.48,15.26,0.03,23.48,65
NDC,1672909001,FINASTERIDE 5 MG TABLET,6.26,4.07,0.93,6.26,40
NDC,1672909512,QUETIAPINE ER 200 MG TABLETEXTENDED RELEASE 24 HR,35.06,22.79,5.22,35.06,40
NDC,1672909612,QUETIAPINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,45.96,29.87,6.84,45.96,40
NDC,1672909712,QUETIAPINE ER 400 MG TABLETEXTENDED RELEASE 24 HR,54.02,35.11,8.04,54.02,40
NDC,1672910811,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2831.28,1840.33,2.17,2831.28,65
NDC,1672911431,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,9.08,5.9,1.35,15.18,51
NDC,1672911505,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,1089.84,708.4,2.17,1089.84,65
NDC,1672911638,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,5662.56,3680.66,2.17,5662.56,65
NDC,1672913212,QUETIAPINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,17.74,11.53,2.64,17.74,40
NDC,1672915131,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,1433.0,931.45,2.17,1433.0,43
NDC,1672917501,AMITRIPTYLINE 100 MG TABLET,5.08,3.3,0.76,5.08,40
NDC,1672918401,HYDROCHLOROTHIAZIDE 50 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,1672918929,MYCOPHENOLATE SODIUM 360 MG TABLETDELAYED RELEASE,18.28,11.88,0.57,18.28,51
NDC,1672921101,DOXAZOSIN 1 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,1672921301,DOXAZOSIN 4 MG TABLET,2.84,1.85,0.42,2.84,40
NDC,1672924331,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,519.24,337.51,2.17,519.24,43
NDC,1672924711,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2831.28,1840.33,2.17,2831.28,65
NDC,1672924838,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,5662.56,3680.66,2.17,5662.56,65
NDC,1672926003,EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION,56.34,36.62,2.17,327.06,59
NDC,1672926763,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,1460.6,949.39,1.16,1460.6,51
NDC,1672926764,DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,1.16,1460.6,51
NDC,1672926765,DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,1.16,1460.6,51
NDC,1672927210,PRASUGREL HCL 5 MG TABLET,33.02,21.46,4.91,33.02,40
NDC,1672927603,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,6.36,4.13,0.95,15.18,51
NDC,1672927668,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,6.36,4.13,0.95,15.18,51
NDC,1672927735,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.12,2.68,0.61,15.18,51
NDC,1672929212,DALFAMPRIDINE ER 10 MG TABLETEXTENDED RELEASE12 HR,96.9,62.99,14.42,96.9,40
NDC,1672941604,DIMETHYL FUMARATE 120 MG CAPSULEDELAYED RELEASE,296.94,193.01,44.18,296.94,40
NDC,1683787230,PEPCID AC 10 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,1686424001,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.6,1.04,0.24,1.6,40
NDC,1686468001,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.14,0.09,0.02,0.14,40
NDC,1686468002,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.2,0.13,0.03,0.2,40
NDC,1686468003,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.16,0.1,0.02,0.16,40
NDC,1715602101,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,5030.0,3269.5,0.01,5030.0,60
NDC,1715602205,CERETEC 0.5 MG INTRAVENOUS SOLUTION,3128.0,2033.2,0.01,3128.0,60
NDC,1715602630,MYOVIEW KIT 1.38 MG INTRAVENOUS SOLUTION,62.0,40.3,0.01,339.38,45
NDC,1715625108,INDIUM IN-111 DTPA 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4518.0,2936.7,0.01,4518.0,60
NDC,1719100738,EXACTA-MIX EVA CONTAINER 500 ML,7.01,4.56,1.04,7.01,39
NDC,1719100739,EXACTA-MIX EVA CONTAINER 1000 ML,7.49,4.87,1.11,7.49,39
NDC,1719100741,EXACTA-MIX EVA CONTAINER 3000 ML,17.4,11.31,2.59,17.4,39
NDC,1719101100,STERL FLUID TRANSFER TUBE SET,30.36,19.73,4.52,30.36,39
NDC,1723890011,BIOGLO 1 MG EYE STRIPS,0.52,0.34,0.08,0.52,40
NDC,1723890030,BIOGLO 1 MG EYE STRIPS,0.42,0.27,0.06,0.42,40
NDC,1727007400,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,17.42,11.32,2.59,17.42,40
NDC,1727170105,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,8.86,51
NDC,1727170107,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,1743398763,ENEMEEZ 283 MG/5 ML ENEMA,1.56,1.01,0.23,1.56,40
NDC,1747825310,AK-FLUOR 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,51.84,33.7,7.71,51.84,39
NDC,1747870102,IC GREEN 25 MG SOLUTION FOR INJECTION,410.16,266.6,61.03,410.16,40
NDC,1777210130,TROKENDI XR 25 MG CAPSULEEXTENDED RELEASE,31.28,20.33,4.65,31.28,40
NDC,1777210201,TROKENDI XR 50 MG CAPSULE EXTENDED RELEASE,36.26,23.57,5.4,36.26,40
NDC,1777212101,OXTELLAR XR 150 MG TABLETEXTENDED RELEASE,22.98,14.94,3.42,22.98,40
NDC,1777212201,OXTELLAR XR 300 MG TABLETEXTENDED RELEASE,31.92,20.75,4.75,31.92,40
NDC,1777212301,OXTELLAR XR 600 MG TABLETEXTENDED RELEASE,58.42,37.97,8.69,58.42,40
NDC,1777213130,QELBREE 100 MG CAPSULEEXTENDED RELEASE,32.02,20.81,4.76,32.02,40
NDC,1777213230,QELBREE 150 MG CAPSULEEXTENDED RELEASE,32.02,20.81,4.76,32.02,40
NDC,1777213330,QELBREE 200 MG CAPSULEEXTENDED RELEASE,32.02,20.81,4.76,32.02,40
NDC,1802983017,Q-CARE RX Q4 0.12 % KIT,71.08,46.2,10.58,71.08,40
NDC,1865711704,HYLENEX 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,0.64,200.88,51
NDC,1990301021,INFANTS' MYLICON 40 MG/0.6 ML ORAL DROPSSUSPENSION,0.88,0.57,0.13,0.88,40
NDC,2055500100,ASCORBIC ACID (VITAMIN C) 250 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,2055502500,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.22,0.14,0.03,0.22,40
NDC,2055503300,CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1000 UNIT) TABLET,0.12,0.08,0.02,0.12,40
NDC,2158601102,CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION,35.1,22.82,2.17,35.1,51
NDC,2158601202,CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,70.32,45.71,2.17,70.32,51
NDC,2181200975,AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION,1.02,0.66,0.15,1.02,40
NDC,2192200407,DESONIDE 0.05 % TOPICAL OINTMENT,10.7,6.96,1.59,10.7,40
NDC,2192201604,CLOBETASOL 0.05 % TOPICAL CREAM,0.8,0.52,0.12,0.8,40
NDC,2192201605,CLOBETASOL 0.05 % TOPICAL CREAM,0.8,0.52,0.12,0.8,40
NDC,2192201607,CLOBETASOL 0.05 % TOPICAL CREAM,0.8,0.52,0.12,0.8,40
NDC,2192201952,TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,5.76,3.74,0.86,5.76,40
NDC,2192202107,PERMETHRIN 5 % TOPICAL CREAM,3.94,2.56,0.59,3.94,40
NDC,2192202705,CLINDAMYCIN 1 % TOPICAL GEL,6.92,4.5,1.03,6.92,40
NDC,2192202707,CLINDAMYCIN 1 % TOPICAL GEL,6.22,4.04,0.93,6.22,40
NDC,2192203923,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,0.68,0.44,0.1,0.68,40
NDC,2192206122,CLOBETASOL 0.05 % SCALP SOLUTION,8.26,5.37,1.23,8.26,40
NDC,2192206304,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.74,0.48,0.11,0.74,40
NDC,2192206315,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.34,0.22,0.05,0.34,40
NDC,2192206330,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.18,0.12,0.03,0.18,40
NDC,2315501701,TETRACYCLINE 250 MG CAPSULE,15.76,10.24,2.35,15.76,40
NDC,2315505101,NYSTATIN 500000 UNIT TABLET,2.84,1.85,0.42,2.84,40
NDC,2315507001,METHIMAZOLE 5 MG TABLET,0.88,0.57,0.13,0.88,40
NDC,2315510301,METFORMIN 850 MG TABLET,2.4,1.56,0.36,2.4,40
NDC,2315510601,HYDROXYZINE HCL 25 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,2315511401,PROPRANOLOL 80 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,2315514801,ACARBOSE 50 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,2315519101,BUPROPION HCL 75 MG TABLET,1.58,1.03,0.24,1.58,40
NDC,2315519201,BUPROPION HCL 100 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,2315526141,BICNU 100 MG INTRAVENOUS SOLUTION,18867.76,12264.04,2.17,18867.76,65
NDC,2315528801,ACETAZOLAMIDE 250 MG TABLET,5.76,3.74,0.86,5.76,40
NDC,2315529041,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,13.5,8.78,1.1,13.5,51
NDC,2315529442,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,16.2,10.53,2.17,16.2,51
NDC,2315547341,FUROSEMIDE 10 MG/ML INJ,4.92,3.2,0.04,8.86,51
NDC,2315550101,HYDROXYZINE HCL 25 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,2315553006,TROSPIUM 20 MG TABLET,5.68,3.69,0.85,5.68,40
NDC,2315553825,DOXERCALCIFEROL 0.5 MCG CAPSULE,15.82,10.28,2.35,15.82,40
NDC,2315560141,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.28,1.48,0.25,8.86,51
NDC,2315560601,GLYCOPYRROLATE 1 MG TABLET,2.62,1.7,0.39,2.62,40
NDC,2315574603,RASAGILINE 0.5 MG TABLET,6.88,4.47,1.02,6.88,40
NDC,2315582373,CABERGOLINE 0.5 MG TABLET,73.32,47.66,1.95,73.32,48
NDC,2315585878,VANCOMYCIN 125 MG CAPSULE,62.62,40.7,9.32,62.62,40
NDC,2315586301,GRISEOFULVIN ULTRAMICROSIZE 125 MG TABLET,9.98,6.49,1.49,9.98,40
NDC,2359450550,MILLIPRED 5 MG TABLET,33.74,21.93,5.02,33.74,40
NDC,2373160535,ACD-A SOLUTION,1.32,0.86,0.2,1.32,40
NDC,2420110024,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.39,0.25,0.06,8.86,51
NDC,2420120105,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,138.6,90.09,20.62,138.6,40
NDC,2420802401,INSTA-GLUCOSE (WITH DEXTRIN) 24 GRAM/31 GRAM ORAL GEL,0.4,0.26,0.06,0.4,40
NDC,2420804040,XIPERE (PF) 40 MG/ML SUPRACHOROIDAL SUSPENSION,6600.0,4290.0,2.17,6600.0,65
NDC,2420827615,MURO 128 2 % EYE DROPS,2.3,1.5,0.34,2.3,40
NDC,2420827715,MURO 128 5 % EYE DROPS,2.42,1.57,0.36,2.42,40
NDC,2420829005,TOBRAMYCIN 0.3 % EYE DROPS,5.64,3.67,0.84,5.64,40
NDC,2420829505,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,52.34,34.02,7.79,52.34,40
NDC,2420829525,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,52.2,33.93,7.77,52.2,40
NDC,2420831510,POLYMYXIN B SULFATE 10000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS,2.68,1.74,0.4,2.68,40
NDC,2420831705,SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,7.5,4.88,1.12,7.5,40
NDC,2420834205,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY,98.5,64.03,14.66,98.5,40
NDC,2420834425,FLUNISOLIDE 25 MCG (0.025 %) NASAL SPRAY,5.5,3.58,0.82,5.5,40
NDC,2420835305,ALREX 0.2 % EYE DROPSSUSPENSION,145.7,94.71,21.68,145.7,40
NDC,2420838555,MURO 128 5 % EYE OINTMENT,10.38,6.75,1.54,10.38,40
NDC,2420838556,MURO 128 5 % EYE OINTMENT,8.0,5.2,1.19,8.0,40
NDC,2420838760,OCUVITE WITH LUTEIN 300 MCG-200 MG-27 MG-2 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,2420838762,OCUVITE WITH LUTEIN 300 MCG-200 MG-27 MG-2 MG TABLET,0.22,0.14,0.03,0.22,40
NDC,2420839915,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,6.08,3.95,0.9,6.08,40
NDC,2420841005,OFLOXACIN 0.3 % EAR DROPS,61.72,40.12,9.18,61.72,40
NDC,2420841105,BRIMONIDINE 0.2 % EYE DROPS,7.26,4.72,1.08,7.26,40
NDC,2420841110,BRIMONIDINE 0.2 % EYE DROPS,6.82,4.43,1.01,6.82,40
NDC,2420841115,BRIMONIDINE 0.2 % EYE DROPS,7.3,4.75,1.09,7.3,40
NDC,2420841601,RETISERT 0.59 MG INTRAVITREAL IMPLANT,45660.0,29679.0,2.17,45660.0,65
NDC,2420843262,PRESERVISION AREDS 2148 MCG-113 MG-45 MG-17.4 MG TABLET,0.26,0.17,0.04,0.26,40
NDC,2420844605,BESIVANCE 0.6 % EYE DROPSSUSPENSION,110.42,71.77,16.43,110.42,40
NDC,2420848510,DORZOLAMIDE 2 % EYE DROPS,9.18,5.97,1.37,9.18,40
NDC,2420850505,LEVOBUNOLOL 0.5 % EYE DROPS,9.68,6.29,1.44,9.68,40
NDC,2420850912,MAGONATE (MAGNESIUM CARB) 54 MG/5 ML ORAL LIQUID,0.08,0.05,0.01,0.08,40
NDC,2420853535,ZIRGAN 0.15 % EYE GEL,229.02,148.86,34.08,229.02,40
NDC,2420853920,MIOCHOL-E 1 % (10 MG/ML) INTRAOCULAR KIT,313.36,203.68,46.63,313.36,40
NDC,2420855555,BACITRACIN-POLYMYXIN B 500 UNIT-10000 UNIT/GRAM EYE OINTMENT,16.38,10.65,2.44,16.38,40
NDC,2420858060,GENTAMICIN 0.3 % EYE DROPS,17.14,11.14,2.55,17.14,40
NDC,2420858564,TROPICAMIDE 1 % EYE DROPS,5.0,3.25,0.74,5.0,40
NDC,2420859064,TROPICAMIDE 0.5 % EYE DROPS,3.34,2.17,0.5,3.34,40
NDC,2420863110,NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10000 UNIT/ML-1 % EAR SOLUTION,20.14,13.09,3.0,20.14,40
NDC,2420863562,NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10000 UNIT/ML-1 % EAR DROPSSUSP,20.14,13.09,3.0,20.14,40
NDC,2420867004,SULFACETAMIDE SODIUM 10 % EYE DROPS,8.14,5.29,1.21,8.14,40
NDC,2420872002,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,25.88,16.82,3.85,25.88,40
NDC,2420873006,PROPARACAINE 0.5 % EYE DROPS,5.62,3.65,0.84,5.62,40
NDC,2420873501,CYCLOPENTOLATE 1 % EYE DROPS,16.34,10.62,2.43,16.34,40
NDC,2420873506,CYCLOPENTOLATE 1 % EYE DROPS,5.1,3.32,0.76,5.1,40
NDC,2420878055,NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10000 UNIT/GRAM EYE OINT,32.54,21.15,4.84,32.54,40
NDC,2420878555,NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10000 UNIT/G-1 % EYE OINTMENT,37.18,24.17,5.53,37.18,40
NDC,2420879062,NEOMYCIN 1.75 MG-POLYMYXIN 10000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS,12.38,8.05,1.84,12.38,40
NDC,2420879535,NEOMYCIN 3.5 MG/G-POLYMYXIN B 10000 UNIT/G-DEXAMETH 0.1 % EYE OINT,11.34,7.37,1.69,11.34,40
NDC,2420883060,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10000 UNIT/ML-0.1% EYE DROPS,7.94,5.16,1.18,7.94,40
NDC,2420891019,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,24.84,16.15,3.7,24.84,40
NDC,2420891055,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,10.86,7.06,1.62,10.86,40
NDC,2427505251,GALLIUM GA-68 GOZETOTIDE 18.5 MBQ TO 185 MBQ/ML (0.5-5 MCI/ML) IV SOLN,16335.0,10617.75,0.01,16335.0,60
NDC,2433805008,GLIADEL WAFER 7.7 MG IMPLANT,23443.16,15238.05,3488.34,23443.16,40
NDC,2433810203,ERYTHROMYCIN 250 MG TABLET,27.86,18.11,4.15,27.86,40
NDC,2433810603,ERYTHROCIN (AS STEARATE) 250 MG TABLET,26.26,17.07,3.91,26.26,40
NDC,2433812203,ERY-TAB 250 MG TABLETDELAYED RELEASE,20.48,13.31,3.05,20.48,40
NDC,2433813013,ERYPED 400 MG/5 ML ORAL SUSPENSION,19.85,12.9,2.95,19.85,40
NDC,2433815401,DANZITEN 71 MG TABLET,386.26,251.07,41.42,386.26,51
NDC,2433815501,DANZITEN 95 MG TABLET,386.26,251.07,41.42,386.26,51
NDC,2433853025,SOTYLIZE 5 MG/ML ORAL SOLUTION,7.28,4.73,1.08,7.28,40
NDC,2433853048,SOTYLIZE 5 MG/ML ORAL SOLUTION,7.28,4.73,1.08,7.28,40
NDC,2435770105,ANECREAM 4 % TOPICAL,1.68,1.09,0.25,1.68,40
NDC,2435770106,ANECREAM 4 % TOPICAL,1.68,1.09,0.25,1.68,40
NDC,2435770130,ANECREAM 4 % TOPICAL,2.0,1.3,0.3,2.0,40
NDC,2435770230,ANECREAM5 5 % TOPICAL,2.96,1.92,0.44,2.96,40
NDC,2438500346,GENTIAN VIOLET 1 % TOPICAL SOLUTION,0.18,0.12,0.03,0.18,40
NDC,2438500934,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,2438502465,PINK BISMUTH 262 MG CHEWABLE TABLET,0.46,0.3,0.07,0.46,40
NDC,2438506003,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,0.38,0.25,0.06,0.38,40
NDC,2438507282,CALDYPHEN 1 %-8 % LOTION,0.08,0.05,0.01,0.08,40
NDC,2438511878,GAS RELIEF 80 (SIMETHICONE) 80 MG CHEWABLE TABLET,0.2,0.13,0.03,0.2,40
NDC,2438514976,DAIRY RELIEF 3000 UNIT TABLET,0.2,0.13,0.03,0.2,40
NDC,2438521003,ANTI-ITCH (DIPHENHYDRAMINE) WITH ZINC 2 %-0.1 % TOPICAL CREAM,0.34,0.22,0.05,0.34,40
NDC,2438527603,HYDROCORTISONE 1 % TOPICAL OINTMENT,0.28,0.18,0.04,0.28,40
NDC,2438537926,DIPHEDRYL 12.5 MG/5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,40
NDC,2438541396,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,0.06,0.04,0.01,0.06,40
NDC,2438544164,SLEEP AID (DOXYLAMINE) 25 MG TABLET,0.68,0.44,0.1,0.68,40
NDC,2438546843,STOOL SOFTENER 50 MG/5 ML ORAL LIQUID,0.05,0.03,0.01,0.05,40
NDC,2438547847,ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.08,0.05,0.01,0.08,40
NDC,2438548547,ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.08,0.05,0.01,0.08,40
NDC,2438552403,TERBINAFINE HCL 1 % TOPICAL CREAM,0.78,0.51,0.12,0.78,40
NDC,2438552405,TERBINAFINE HCL 1 % TOPICAL CREAM,1.1,0.72,0.16,1.1,40
NDC,2438559029,MICONAZOLE-7  2 % VAGINAL CREAM,0.52,0.34,0.08,0.52,40
NDC,2438590534,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,2438593191,CINNAMON OIL,0.58,0.38,0.09,0.58,40
NDC,2438593291,PEPPERMINT SPIRIT ORAL,0.63,0.41,0.09,0.63,40
NDC,2438599875,ALL DAY ALLERGY (CETIRIZINE) 10 MG TABLET,0.68,0.44,0.1,0.68,40
NDC,2447091710,ERGOTAMINE 1 MG-CAFFEINE 100 MG TABLET,27.76,18.04,4.13,27.76,40
NDC,2447807401,QUILLICHEW ER 20 MG CHEWABLE TABLET EXTENDED RELEASE,29.82,19.38,4.44,29.82,40
NDC,2451005010,NUCYNTA 50 MG TABLET,29.22,18.99,4.35,29.22,40
NDC,2451005860,NUCYNTA ER 50 MG TABLETEXTENDED RELEASE,30.58,19.88,4.55,30.58,40
NDC,2451007510,NUCYNTA 75 MG TABLET,34.14,22.19,5.08,34.14,40
NDC,2451010010,NUCYNTA 100 MG TABLET,45.5,29.58,6.77,45.5,40
NDC,2457110206,PRISMASOL BGK K (2 MEQ/L)-MG(1MEQ/L) HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457110306,PRISMASOL BGK K 2 MEQ-CA 3.5 MEQ-MG 1 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457110506,PRISMASOL BGK K (4 MEQ/L)-CA (2.5)-MG (1.5) HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457110806,PRISMASOL BGK CA 2.5 MEQ-MG 1.5 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457111106,PRISMASOL B22GK K 4 MEQ/L-MG 1.5 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457111306,PRISMASOL BK MG 1.2 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457111406,PRISMASOL BGK K 4 MEQ-MG 1.2 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2457111705,PHOXILLUM B22K K 4 MEQ-MG 1.5 MEQ-PO4 1 MMOL/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,40
NDC,2497900407,DONEPEZIL 23 MG TABLET,17.44,11.34,2.6,17.44,40
NDC,2497904113,MEGESTROL 625 MG/5 ML (125 MG/ML) ORAL SUSPENSION,14.73,9.57,2.19,14.73,40
NDC,2497920101,DICYCLOMINE 10 MG CAPSULE,1.08,0.7,0.16,1.08,40
NDC,2502100102,LATANOPROST 0.005 % EYE DROPS,7.2,4.68,1.07,7.2,40
NDC,2502111502,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,6.15,4.0,0.92,6.15,40
NDC,2502111506,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,3.27,2.13,0.49,3.27,40
NDC,2502111810,CEFUROXIME SODIUM 750 MG SOLUTION FOR INJECTION,11.01,7.16,1.64,11.01,51
NDC,2502113283,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.27,0.18,0.04,8.86,51
NDC,2502113610,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,14.4,9.36,1.05,14.4,51
NDC,2502113910,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,34.2,22.23,0.11,34.2,51
NDC,2502115120,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,18.72,12.17,2.17,18.72,51
NDC,2502115899,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,356.37,231.64,2.17,356.37,51
NDC,2502116224,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,32.4,21.06,1.01,32.4,51
NDC,2502116268,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,32.4,21.06,1.01,32.4,51
NDC,2502117302,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,13.95,9.07,1.1,13.95,51
NDC,2502117304,AMIKACIN 1000 MG/4 ML INJECTION SOLUTION,12.87,8.37,1.1,12.87,51
NDC,2502117415,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,62.1,40.37,0.09,62.1,51
NDC,2502117916,DAPTOMYCIN 350 MG INTRAVENOUS SOLUTION,86.22,56.04,0.04,86.22,57
NDC,2502118010,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,16.74,10.88,2.17,16.74,51
NDC,2502118487,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.24,0.16,0.04,8.86,51
NDC,2502119287,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,8.86,51
NDC,2502120110,MESNA 100 MG/ML INTRAVENOUS SOLUTION,7.2,4.68,1.07,7.2,43
NDC,2502120401,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,120.0,78.0,2.17,120.0,43
NDC,2502120405,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,86.4,56.16,2.17,86.4,43
NDC,2502120751,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,6.4,4.16,0.95,7.57,43
NDC,2502121599,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,1.4,0.91,0.21,15.18,51
NDC,2502122320,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,4.4,2.86,0.65,15.18,51
NDC,2502122610,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,180.96,117.62,2.17,500.04,57
NDC,2502123002,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,41.2,26.78,2.17,41.2,43
NDC,2502123550,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,238.32,154.91,2.17,238.32,51
NDC,2502124202,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,522.0,339.3,2.17,522.0,49
NDC,2502124410,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,336.0,218.4,2.17,940.91,51
NDC,2502124602,THIOTEPA 15 MG SOLUTION FOR INJECTION,960.0,624.0,2.17,960.0,59
NDC,2502125350,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,2.68,1.74,0.4,15.18,51
NDC,2502125351,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.92,1.25,0.29,15.18,51
NDC,2502126210,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,192.0,124.8,2.17,940.91,51
NDC,2502130167,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,28.8,18.72,0.69,47.96,51
NDC,2502130168,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,23.4,15.21,0.69,47.96,51
NDC,2502130566,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,114.06,74.14,2.17,137.85,51
NDC,2502131002,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,234.0,152.1,34.82,234.0,40
NDC,2502131382,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,0.33,0.21,0.05,8.86,51
NDC,2502131720,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.54,0.35,0.08,8.86,51
NDC,2502131910,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.41,0.92,0.05,8.86,51
NDC,2502132210,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,33.12,21.53,2.17,1020.7,65
NDC,2502132302,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,810.0,526.5,2.17,1020.7,65
NDC,2502140102,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,18.72,12.17,2.17,18.72,51
NDC,2502140304,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,6.84,4.45,0.32,8.86,51
NDC,2502140401,HEPARIN (PORCINE) 20000 UNIT/ML INJECTION SOLUTION,36.0,23.4,0.32,36.0,51
NDC,2502145101,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,16.2,10.53,1.17,16.2,51
NDC,2502146001,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,152.16,98.9,2.17,184.43,57
NDC,2502147174,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,84.0,54.6,2.17,500.04,65
NDC,2502148101,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.63,8.86,51
NDC,2502150002,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,17.91,11.64,2.17,17.91,51
NDC,2502160103,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,24.0,15.6,2.17,24.0,51
NDC,2502165102,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,21.6,14.04,2.17,31.9,51
NDC,2502165905,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.76,3.74,0.86,5.76,40
NDC,2502167182,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.09,8.86,51
NDC,2502167187,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.09,8.86,51
NDC,2502167210,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.76,3.74,0.86,5.76,40
NDC,2502167376,GLYDO 2 % MUCOSAL JELLY IN APPLICATOR,2.38,1.55,0.35,2.38,40
NDC,2502167377,GLYDO 2 % MUCOSAL JELLY IN APPLICATOR,1.38,0.9,0.21,1.38,40
NDC,2502167620,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,217.8,141.57,2.17,217.8,59
NDC,2502167650,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,151.2,98.28,2.17,151.2,59
NDC,2502167820,BACLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,21.24,13.81,2.17,667.03,65
NDC,2502167920,BACLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,85.14,55.34,2.17,667.03,65
NDC,2502168171,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,158.4,102.96,2.17,158.4,51
NDC,2502168220,KETAMINE 10 MG/ML INJECTION SOLUTION,4.38,2.85,0.65,4.38,40
NDC,2502170001,KETOROLAC 15 MG/ML INJECTION SOLUTION,13.47,8.76,0.31,13.47,65
NDC,2502170102,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.7,3.71,0.31,8.86,65
NDC,2502170582,ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.45,0.29,0.07,8.86,51
NDC,2502170587,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.04,8.86,51
NDC,2502179002,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,9.54,6.2,1.42,9.54,51
NDC,2502179120,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,11.79,7.66,1.75,47.96,51
NDC,2502179810,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,7.2,4.68,1.34,47.96,59
NDC,2502180166,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,129.6,84.24,2.17,129.6,51
NDC,2502181230,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,6.0,3.9,0.66,8.86,51
NDC,2502181310,LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,31.68,20.59,2.17,31.68,43
NDC,2502181430,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,72.0,46.8,2.17,72.0,43
NDC,2502181530,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,72.0,46.8,2.17,72.0,43
NDC,2502181630,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,252.0,163.8,2.17,252.0,43
NDC,2502182273,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,300.0,195.0,2.17,300.0,51
NDC,2502182667,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,0.93,0.6,0.14,47.96,51
NDC,2502182682,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,6.48,4.21,0.96,47.96,51
NDC,2502182761,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,300.0,195.0,2.17,300.0,51
NDC,2502183082,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,12.6,8.19,1.87,47.96,51
NDC,2520800104,AGGRASTAT CONCENTRATE 250 MCG/ML INTRAVENOUS,14.07,9.15,2.09,327.06,51
NDC,2520800201,AGGRASTAT 5 MG/100 ML (50 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,3.3,2.15,0.49,327.06,51
NDC,2520800202,AGGRASTAT 12.5 MG/250 ML (50 MCG/ML) IN ISO-OSMOTIC SODIUM CHLORIDE IV,3.45,2.24,0.51,327.06,51
NDC,2520800203,AGGRASTAT 5 MG/100 ML (50 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,3.3,2.15,0.49,327.06,51
NDC,2568200101,SOLIRIS 300 MG/30 ML INTRAVENOUS SOLUTION,782.76,508.79,2.17,16617.81,59
NDC,2568202501,ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION,10712.6,6963.19,2.17,16617.81,65
NDC,2568202801,ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION,10712.6,6963.19,2.17,16617.81,65
NDC,2724101531,MONTELUKAST 4 MG ORAL GRANULES IN PACKET,14.95,9.72,2.22,14.95,40
NDC,2724104011,ELETRIPTAN 40 MG TABLET,122.92,79.9,18.29,122.92,40
NDC,2724106203,VORICONAZOLE 50 MG TABLET,39.76,25.84,5.92,39.76,40
NDC,2724111203,TADALAFIL 5 MG TABLET,24.62,16.0,3.66,24.62,40
NDC,2724111603,FENOFIBRATE 54 MG TABLET,1.58,1.03,0.24,1.58,40
NDC,2724113909,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,6.83,4.44,1.02,6.83,40
NDC,2724115704,OXYBUTYNIN CHLORIDE ER 15 MG TABLETEXTENDED RELEASE 24 HR,6.74,4.38,1.0,6.74,40
NDC,2724116201,CAPTOPRIL 50 MG TABLET,5.8,3.77,0.86,5.8,40
NDC,2724116301,CAPTOPRIL 100 MG TABLET,7.62,4.95,1.13,7.62,40
NDC,2724117456,VARENICLINE TARTRATE 1 MG TABLET,18.56,12.06,2.76,18.56,40
NDC,2724124949,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,8.85,5.75,1.32,8.85,40
NDC,2724130501,OXCARBAZEPINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,28.6,18.59,4.26,28.6,40
NDC,2780800201,RISPERIDONE 1 MG/ML ORAL SOLUTION,13.98,9.09,2.08,13.98,40
NDC,2780803301,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,0.6,0.39,0.09,0.6,40
NDC,2780805102,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,0.25,0.16,0.04,0.25,40
NDC,2780805801,METHYLPHENIDATE 5 MG/5 ML ORAL SOLUTION,2.25,1.46,0.33,2.25,40
NDC,2780809201,DEXMETHYLPHENIDATE 5 MG TABLET,1.94,1.26,0.29,1.94,40
NDC,2780822201,PALIPERIDONE ER 1.5 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,9.11,61.2,40
NDC,2780822301,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,9.11,61.2,40
NDC,2930012501,MELOXICAM 15 MG TABLET,9.7,6.31,1.44,9.7,40
NDC,2930012901,HYDROCHLOROTHIAZIDE 50 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,2930016815,TIZANIDINE 2 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,2930016910,TIZANIDINE 4 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,2930016915,TIZANIDINE 4 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,2930018701,BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,7.16,4.65,1.07,7.16,40
NDC,2930018801,BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,7.16,4.65,1.07,7.16,40
NDC,2930018901,BISOPROLOL 10 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,7.16,4.65,1.07,7.16,40
NDC,2930024016,TOLTERODINE 2 MG TABLET,6.8,4.42,1.01,6.8,40
NDC,2930030816,QUETIAPINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,17.74,11.53,2.64,17.74,40
NDC,2930034901,ALLOPURINOL 100 MG TABLET,0.96,0.62,0.14,0.96,40
NDC,2930035001,ALLOPURINOL 300 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,2930042201,AMITRIPTYLINE 75 MG TABLET,3.82,2.48,0.57,3.82,40
NDC,2930042301,AMITRIPTYLINE 100 MG TABLET,5.08,3.3,0.76,5.08,40
NDC,2930042801,ZONISAMIDE 25 MG CAPSULE,1.1,0.72,0.16,1.1,40
NDC,2930042901,ZONISAMIDE 50 MG CAPSULE,2.2,1.43,0.33,2.2,40
NDC,3023789006,PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION,901.47,585.96,199.22,161177.59,65
NDC,3124800199,DRAMAMINE 50 MG TABLET,0.82,0.53,0.12,0.82,40
NDC,3138289805,LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100000 INJECTION CARTRIDGE,1.98,1.29,0.29,1.98,40
NDC,3160401160,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.18,0.12,0.03,0.18,40
NDC,3160402718,CYANOCOBALAMIN (VITAMIN B-12) 2500 MCG TABLET,0.38,0.25,0.06,0.38,40
NDC,3160402727,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 400 MCG TABLET,0.16,0.1,0.02,0.16,40
NDC,3172200760,ZAFIRLUKAST 10 MG TABLET,8.2,5.33,1.22,8.2,40
NDC,3172200860,ZAFIRLUKAST 20 MG TABLET,8.2,5.33,1.22,8.2,40
NDC,3172201490,DROXIDOPA 100 MG CAPSULE,73.56,47.81,10.95,73.56,40
NDC,3172202015,ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,10.2,6.63,1.52,10.2,40
NDC,3172203523,AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,33.68,21.89,5.01,33.68,40
NDC,3172205030,EPLERENONE 50 MG TABLET,8.68,5.64,1.29,8.68,40
NDC,3172206701,BUPROPION HCL SR 150 MG TABLET12 HR SUSTAINED-RELEASE,3.86,2.51,0.57,3.86,40
NDC,3172206801,BUPROPION HCL SR 200 MG TABLET12 HR SUSTAINED-RELEASE,6.76,4.39,1.01,6.76,40
NDC,3172212101,HYDROMORPHONE ER 16 MG TABLETEXTENDED RELEASE 24 HR,36.82,23.93,5.48,36.82,40
NDC,3172212901,POTASSIUM CITRATE ER 5 MEQ (540 MG) TABLETEXTENDED RELEASE,3.5,2.28,0.52,3.5,40
NDC,3172213130,DUTASTERIDE 0.5 MG CAPSULE,12.1,7.87,1.8,12.1,40
NDC,3172213190,DUTASTERIDE 0.5 MG CAPSULE,12.1,7.87,1.8,12.1,40
NDC,3172213747,GLYCERIN 99.5 % TOPICAL SOLUTION,0.05,0.03,0.01,0.05,40
NDC,3172224030,LAMOTRIGINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,28.08,18.25,4.18,28.08,40
NDC,3172230032,ELTROMBOPAG 12.5 MG POWDER PACKET FOR ORAL SUSPENSION,563.44,366.24,83.84,563.44,40
NDC,3172230132,ELTROMBOPAG OLAMINE 25 MG ORAL POWDER PACKET,563.46,366.25,83.84,563.46,40
NDC,3172250430,EFAVIRENZ 600 MG TABLET,74.52,48.44,11.09,74.52,40
NDC,3172250660,LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,31.06,20.19,4.62,31.06,40
NDC,3172250960,ZIDOVUDINE 300 MG TABLET,12.04,7.83,1.79,12.04,40
NDC,3172251210,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,3172252101,HYDRALAZINE 50 MG TABLET,1.12,0.73,0.17,1.12,40
NDC,3172252201,HYDRALAZINE 100 MG TABLET,2.02,1.31,0.3,2.02,40
NDC,3172252630,FINASTERIDE 1 MG TABLET,5.42,3.52,0.81,5.42,40
NDC,3172253001,TORSEMIDE 10 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,3172253301,METHOCARBAMOL 500 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,3172253401,METHOCARBAMOL 750 MG TABLET,1.46,0.95,0.22,1.46,40
NDC,3172254401,LITHIUM CARBONATE 150 MG CAPSULE,0.28,0.18,0.04,0.28,40
NDC,3172255612,LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,18.44,11.99,2.74,18.44,40
NDC,3172255760,ABACAVIR 300 MG TABLET,20.1,13.07,2.99,20.1,40
NDC,3172256224,ABACAVIR 20 MG/ML ORAL SOLUTION,1.63,1.06,0.24,1.63,40
NDC,3172256424,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,1.23,0.8,0.18,1.23,40
NDC,3172256560,INDOMETHACIN ER 75 MG CAPSULEEXTENDED RELEASE,6.0,3.9,0.89,6.0,40
NDC,3172257230,ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULEDELAYED RELEASE,17.04,11.08,2.54,17.04,40
NDC,3172257390,ESOMEPRAZOLE MAGNESIUM 40 MG CAPSULEDELAYED RELEASE,17.04,11.08,2.54,17.04,40
NDC,3172257447,LEVETIRACETAM 100 MG/ML ORAL SOLUTION,1.63,1.06,0.24,1.63,40
NDC,3172258060,MARAVIROC 300 MG TABLET,58.78,38.21,8.75,58.78,40
NDC,3172259812,RUFINAMIDE 200 MG TABLET,28.5,18.53,4.24,28.5,40
NDC,3172259912,RUFINAMIDE 400 MG TABLET,57.02,37.06,8.48,57.02,40
NDC,3172262921,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,18.78,12.21,2.79,18.78,40
NDC,3172268147,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,2.35,1.53,0.35,2.35,40
NDC,3172270090,LOSARTAN 25 MG TABLET,3.34,2.17,0.5,3.34,40
NDC,3172270110,LOSARTAN 50 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,3172271030,SILDENAFIL 50 MG TABLET,132.92,86.4,19.78,132.92,40
NDC,3172272730,MONTELUKAST 4 MG CHEWABLE TABLET,11.32,7.36,1.68,11.32,40
NDC,3172272790,MONTELUKAST 4 MG CHEWABLE TABLET,11.32,7.36,1.68,11.32,40
NDC,3172275260,LAMIVUDINE 100 MG TABLET,32.22,20.94,4.79,32.22,40
NDC,3172281360,LACOSAMIDE 100 MG TABLET,35.94,23.36,5.35,35.94,40
NDC,3172282111,TETRABENAZINE 12.5 MG TABLET,157.62,102.45,23.45,157.62,40
NDC,3172283430,ENTECAVIR 1 MG TABLET,88.86,57.76,13.22,88.86,40
NDC,3172284130,ELTROMBOPAG OLAMINE 12.5 MG TABLET,563.44,366.24,83.84,563.44,40
NDC,3172284230,ELTROMBOPAG OLAMINE 25 MG TABLET,563.44,366.24,83.84,563.44,40
NDC,3172284330,ELTROMBOPAG OLAMINE 50 MG TABLET,1019.64,662.77,151.72,1019.64,40
NDC,3172284430,ELTROMBOPAG OLAMINE 75 MG TABLET,1529.46,994.15,227.58,1529.46,40
NDC,3172286803,TOLVAPTAN 15 MG TABLET,1123.5,730.28,167.18,1123.5,40
NDC,3172292901,OXYMORPHONE 5 MG TABLET,7.14,4.64,1.06,7.14,40
NDC,3172293747,SIMPLE SYRUP,0.1,0.07,0.01,0.1,40
NDC,3172293847,CHERRY FLAVOR (BULK) ORAL LIQUID,0.1,0.07,0.01,0.1,40
NDC,3172295901,SOSWEET SYRUP VEHICLE,0.13,0.08,0.02,0.13,40
NDC,3290910510,VARIBAR THIN LIQUID 81 % (W/W) ORAL POWDER,0.05,0.03,0.01,0.05,40
NDC,3290911500,VARIBAR NECTAR 40 % (W/V) 30 % (W/W) ORAL SUSPENSION,0.07,0.05,0.01,0.07,40
NDC,3290911600,VARIBAR NECTAR 40 % (W/V) 30 % (W/W) ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,3290912107,VARIBAR THIN HONEY 40 % (W/V) 29 % (W/W) (1500 CPS) ORAL SUSPENSION,0.26,0.17,0.04,0.26,40
NDC,3290912522,VARIBAR PUDDING 40 % (W/V) 30% (W/W) ORAL PASTE,0.3,0.2,0.04,0.3,40
NDC,3290916755,LIQUID POLIBAR PLUS 105 % (W/V) 58 % (W/W) ORAL SUSPENSION,0.03,0.02,0.01,0.03,40
NDC,3290918601,LIQUID E-Z PAQUE 60 % (W/V) ORAL SUSPENSION,0.02,0.01,0.01,0.02,40
NDC,3290918702,LIQUID E-Z PAQUE 60 % (W/V) ORAL SUSPENSION,0.02,0.01,0.01,0.02,40
NDC,3290971103,READI-CAT 2   2 % (W/V) ORAL SUSPENSION,0.01,0.01,0.01,0.01,40
NDC,3290972403,READI-CAT 2   2 % (W/V) ORAL SUSPENSION,0.01,0.01,0.01,0.01,40
NDC,3290974103,READI-CAT 2   2 % (W/V) ORAL SUSPENSION,0.01,0.01,0.01,0.01,40
NDC,3290975003,E-Z-PAQUE 96 % (W/W) ORAL POWDER FOR SUSPENSION,0.03,0.02,0.01,0.03,40
NDC,3290977001,E-Z-PASTE 60 % ORAL CREAM,0.14,0.09,0.02,0.14,40
NDC,3290992703,NEULUMEX 0.1 % (W/V) 0.1 % (W/W) ORAL SUSPENSION,0.02,0.01,0.01,0.02,40
NDC,3334202407,FAMCICLOVIR 125 MG TABLET,11.62,7.55,1.73,11.62,40
NDC,3334205507,PIOGLITAZONE 30 MG TABLET,21.42,13.92,3.19,21.42,40
NDC,3334205510,PIOGLITAZONE 30 MG TABLET,21.42,13.92,3.19,21.42,40
NDC,3334206107,DONEPEZIL 23 MG TABLET,22.72,14.77,3.38,22.72,40
NDC,3334206110,DONEPEZIL 23 MG TABLET,22.72,14.77,3.38,22.72,40
NDC,3334206707,OLANZAPINE 2.5 MG TABLET,20.84,13.55,3.1,20.84,40
NDC,3334206807,OLANZAPINE 5 MG TABLET,24.58,15.98,3.66,24.58,40
NDC,3334206907,OLANZAPINE 7.5 MG TABLET,29.9,19.44,4.45,29.9,40
NDC,3334207007,OLANZAPINE 10 MG TABLET,37.06,24.09,5.51,37.06,40
NDC,3334209109,RIVASTIGMINE 4.5 MG CAPSULE,8.06,5.24,1.2,8.06,40
NDC,3334211407,CANDESARTAN 4 MG TABLET,6.12,3.98,0.91,6.12,40
NDC,3334223807,NEVIRAPINE ER 400 MG TABLETEXTENDED RELEASE 24 HR,39.66,25.78,5.9,39.66,40
NDC,3334227407,FEBUXOSTAT 40 MG TABLET,23.74,15.43,3.53,23.74,40
NDC,3334227809,TADALAFIL 20 MG TABLET (PULMONARY HYPERTENSION),152.3,99.0,22.66,152.3,40
NDC,3334230409,LACOSAMIDE 150 MG TABLET,35.6,23.14,5.3,35.6,40
NDC,3334232186,CLOBETASOL 0.05 % SCALP SOLUTION,8.26,5.37,1.23,8.26,40
NDC,3334232915,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.74,0.48,0.11,0.74,40
NDC,3334232980,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.32,0.21,0.05,0.32,40
NDC,3334240530,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.27,15.24,40
NDC,3334240550,LIDOCAINE 5 % TOPICAL OINTMENT,15.22,9.89,2.26,15.22,40
NDC,3504600322,MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,0.16,0.1,0.02,0.16,40
NDC,3504606732,MELATONIN ORAL LIQUID 3.5 MG/2 ML ADS,0.23,0.15,0.03,0.23,40
NDC,3557343330,KETOCONAZOLE 200 MG TABLET,7.58,4.93,1.13,7.58,40
NDC,3557347302,PHENOXYBENZAMINE 10 MG CAPSULE,258.9,168.29,38.52,258.9,40
NDC,3566401053,"""ZINC OXIDE 4"""" X 10 YARD BANDAGE""",27.42,17.82,4.08,27.42,40
NDC,3600001225,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,1.62,1.05,0.16,8.86,51
NDC,3600003310,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,0.72,0.47,0.11,8.86,51
NDC,3600024201,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.58,1.68,0.38,8.86,51
NDC,3600028225,FUROSEMIDE 10 MG/ML INJ,1.23,0.8,0.04,8.86,51
NDC,3600028325,FUROSEMIDE 10 MG/ML INJ,0.99,0.64,0.04,8.86,51
NDC,3600028425,FUROSEMIDE 10 MG/ML INJ,0.57,0.37,0.04,8.86,51
NDC,3600032010,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,3.81,2.48,0.57,8.86,51
NDC,3600032201,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.39,0.25,0.06,8.86,51
NDC,3600032202,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.39,0.25,0.06,8.86,51
NDC,3600036401,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,18.0,11.7,2.17,119.02,51
NDC,3600037240,ACETAMINOPHEN 650 MG/65 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.04,8.86,51
NDC,3676542001,MAGTAB 84 MG TABLETEXTENDED RELEASE,0.84,0.55,0.12,0.84,40
NDC,3700001804,PEPTO-BISMOL 262 MG CHEWABLE TABLET,0.34,0.22,0.05,0.34,40
NDC,3700002404,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.88,0.57,0.13,0.88,40
NDC,3700002410,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.88,0.57,0.13,0.88,40
NDC,3700002444,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.98,0.64,0.15,0.98,40
NDC,3700003201,PEPTO-BISMOL 262 MG/15 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,3700047709,PEPTO-BISMOL 262 MG CHEWABLE TABLET,0.34,0.22,0.05,0.34,40
NDC,3700047710,PEPTO-BISMOL 262 MG CHEWABLE TABLET,0.32,0.21,0.05,0.32,40
NDC,3700074108,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.88,0.57,0.13,0.88,40
NDC,3780303812,CLONIDINE HCL (BULK) POWDER,516.0,335.4,76.78,516.0,40
NDC,3780320310,BACLOFEN (BULK) 100 % POWDER,49.45,32.14,7.36,49.45,40
NDC,3780322310,BUPIVACAINE (BULK) 100 % POWDER,55.01,35.76,8.19,55.01,40
NDC,3839650663,DEX4 GLUCOSE 4 GRAM CHEWABLE TABLET,0.38,0.25,0.06,0.38,40
NDC,3839654164,GLUCOSE 4 GRAM CHEWABLE TABLET,0.26,0.17,0.04,0.26,40
NDC,3848586335,THERMOTABS 287 MG-180 MG-15 MG TABLET,0.18,0.12,0.03,0.18,40
NDC,3874309001,AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION,1.02,0.66,0.15,1.02,40
NDC,3877900635,BENZOCAINE (BULK) POWDER,2.19,1.42,0.33,2.19,40
NDC,3877900715,DEXAMETHASONE SOD PHOS (BULK) 100 % POWDER,119.82,77.88,17.83,119.82,40
NDC,3877900728,DEXTROSE (BULK) POWDER,0.34,0.22,0.05,0.34,40
NDC,3877900825,LIDOCAINE HCL (BULK) 100 % POWDER,4.28,2.78,0.64,4.28,40
NDC,3877901653,TESTOSTERONE PROPIONATE (BULK) POWDER,205.2,133.38,30.53,205.2,40
NDC,3877903883,BACLOFEN (BULK) 100 % POWDER,35.63,23.16,5.3,35.63,40
NDC,3877905101,PROPYLENE GLYCOL (BULK) 99.5 % (NOT LESS THAN USP) LIQUID,0.48,0.31,0.07,0.48,40
NDC,3877905215,MENTHOL (BULK) CRYSTALS,2.28,1.48,0.34,2.28,40
NDC,3877905244,BUPIVACAINE (BULK) 100 % POWDER,91.2,59.28,13.57,91.2,40
NDC,3877905518,SODIUM BENZOATE (BULK) POWDER,0.45,0.29,0.07,0.45,40
NDC,3877905611,CLONIDINE HCL (BULK) POWDER,413.26,268.62,61.49,413.26,40
NDC,3877906255,FLEXIBLE COLLODION (BULK) LIQUID,3.43,2.23,0.51,3.43,40
NDC,3877906408,SODIUM BICARBONATE (BULK) POWDER,0.26,0.17,0.04,0.26,40
NDC,3877906409,SODIUM BICARBONATE (BULK) POWDER,0.26,0.17,0.04,0.26,40
NDC,3877907233,COCAINE (BULK) 100 % CRYSTALS,793.61,515.85,118.09,793.61,40
NDC,3877907236,COCAINE (BULK) 100 % CRYSTALS,2380.83,1547.54,354.27,2380.83,40
NDC,3877907311,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,298.98,2009.25,40
NDC,3877907313,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,298.98,2009.25,40
NDC,3877907314,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,298.98,2009.25,40
NDC,3877907316,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,298.98,2009.25,40
NDC,3877908843,PYRIMETHAMINE (BULK) POWDER,17.43,11.33,2.59,17.43,40
NDC,3877910408,BETAINE (BULK) 100 % POWDER,1.5,0.98,0.22,1.5,40
NDC,3877910464,BISMUTH SUBGALLATE (BULK) POWDER,11.04,7.18,1.64,11.04,40
NDC,3877910465,BISMUTH SUBGALLATE (BULK) POWDER,5.52,3.59,0.82,5.52,40
NDC,3877912168,COTTONSEED OIL (BULK),0.16,0.1,0.02,0.16,40
NDC,3877912845,FERRIC SUBSULFATE (BULK) 20 TO 22 GRAM/100 ML SOLUTION,1.8,1.17,0.27,1.8,39
NDC,3877912848,FERRIC SUBSULFATE (BULK) 20 TO 22 GRAM/100 ML SOLUTION,1.8,1.17,0.27,1.8,39
NDC,3877917563,FENTANYL CITRATE (BULK) 100 % POWDER,17296.08,11242.45,2573.66,17296.08,40
NDC,3877917791,SIMPLE SYRUP,1.43,0.93,0.21,1.43,40
NDC,3877919385,PHENOL (BULK) 89 % LIQUID,1.01,0.66,0.15,1.01,40
NDC,3877919388,PHENOL (BULK) 89 % LIQUID,1.01,0.66,0.15,1.01,40
NDC,3877920040,BIOTIN (BULK) 100 % POWDER,149.62,97.25,22.26,149.62,40
NDC,3877922985,HYDROGEL,0.63,0.41,0.09,0.63,40
NDC,3877923498,ORA-BLEND SF ORAL SUSPENSION,0.25,0.16,0.04,0.25,40
NDC,3877925118,ORAL SYRUP ORAL LIQUID,0.33,0.21,0.05,0.33,40
NDC,3877925128,ORAL MIX ORAL SUSPENSION,0.33,0.21,0.05,0.33,40
NDC,3877925495,SODIUM PHENYLBUTYRATE (BULK) 100 % POWDER,71.21,46.29,10.6,71.21,40
NDC,3877926008,ORAL MIX SF ORAL SUSPENSION,0.33,0.21,0.05,0.33,40
NDC,3877927909,MIDAZOLAM (BULK) 100 % POWDER,108.0,70.2,16.07,108.0,40
NDC,3877928979,L-ASPARTIC ACID POWDER,3.36,2.18,0.5,3.36,40
NDC,3877928988,L-GLUTAMIC ACID POWDER,2.4,1.56,0.36,2.4,40
NDC,3877932093,BACLOFEN (BULK) 100 % POWDER,35.63,23.16,5.3,35.63,40
NDC,3877977721,EMPTY VIAL,4.44,2.89,0.66,4.44,40
NDC,3877997104,LUER LOCK SYRINGE 30 ML,10.26,6.67,1.53,10.26,39
NDC,3932805110,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,1.78,1.16,0.26,1.78,40
NDC,3932806250,HYSEPT 0.5 % SOLUTION,0.08,0.05,0.01,0.08,40
NDC,3932806325,HYSEPT 0.25 % SOLUTION,0.08,0.05,0.01,0.08,40
NDC,3932806412,H-CHLOR 12  0.125 % SOLUTION,0.08,0.05,0.01,0.08,40
NDC,3932810610,PRENATAL VITAMINS WITH CALCIUM NO.72-IRON 27 MG-FOLIC ACID 1 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,3932835760,CALCIDOL 200 MCG/ML (8000 UNIT/ML) ORAL DROPS,4.15,2.7,0.62,4.15,40
NDC,3982203105,NEOMYCIN 500 MG TABLET,3.26,2.12,0.49,3.26,40
NDC,3982203502,LINCOMYCIN 300 MG/ML INJECTION SOLUTION,45.24,29.41,6.73,45.24,40
NDC,3982204121,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,288.0,187.2,2.17,288.0,51
NDC,3982204126,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,270.0,175.5,2.17,270.0,51
NDC,3982207061,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,29.25,19.01,2.17,64.43,51
NDC,3982207062,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,270.0,175.5,2.17,270.0,51
NDC,3982210001,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,2.16,1.4,0.05,47.96,51
NDC,3982210302,IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,594.0,386.1,2.17,594.0,51
NDC,3982210555,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,180.0,117.0,2.17,180.0,51
NDC,3982212011,NEOMYCIN 40 MG-POLYMYXIN B 200000 UNIT/ML GU IRRIGATION SOLUTION,39.33,25.56,5.85,39.33,40
NDC,3982212201,NEOMYCIN 40 MG-POLYMYXIN B 200000 UNIT/ML GU IRRIGATION SOLUTION,25.5,16.58,3.79,25.5,40
NDC,3982220001,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,9.0,5.85,1.34,47.96,51
NDC,3982221002,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,2655.0,1725.75,2.17,2655.0,65
NDC,3982230502,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,337.5,219.38,0.43,337.5,51
NDC,4002851230,SODIUM FLUORIDE F-18 10-200 MCI/ML (370-7400 MBQ/ML) INTRAVENOUS SOLN,500.0,325.0,0.01,563.32,45
NDC,4009310196,SELENIUM 200 MCG TABLET,0.12,0.08,0.02,0.12,40
NDC,4056511182,BENZOIN TOPICAL TINCTURE,0.72,0.47,0.11,0.72,40
NDC,4056512249,IODOSORB 0.9 % TOPICAL GEL,5.14,3.34,0.76,5.14,40
NDC,4056512251,IODOFLEX 0.9 % TOPICAL PADS,38.52,25.04,5.73,38.52,40
NDC,4056512253,IODOFLEX 0.9 % TOPICAL PADS,78.08,50.75,11.62,78.08,40
NDC,4056512256,IODOSORB 0.9 % TOPICAL GEL,5.76,3.74,0.86,5.76,40
NDC,4098527086,ARGININE HCL (L-ARGININE) 1000 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,4110007299,CORRECTOL 5 MG TABLET,0.22,0.14,0.03,0.22,40
NDC,4110008882,SOLARCAINE 20 %-0.13 % TOPICAL SPRAY,0.12,0.08,0.02,0.12,40
NDC,4110081122,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.12,0.08,0.02,0.12,40
NDC,4110081124,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.08,0.05,0.01,0.08,40
NDC,4110082076,MIRALAX 17 GRAM/DOSE ORAL POWDER,0.18,0.12,0.03,0.18,40
NDC,4116700609,UNISOM (DOXYLAMINE) 25 MG TABLET,0.82,0.53,0.12,0.82,40
NDC,4116700623,UNISOM (DOXYLAMINE) 25 MG TABLET,0.64,0.42,0.1,0.64,40
NDC,4116700881,ICY HOT 30 %-10 % TOPICAL CREAM,0.3,0.2,0.04,0.3,40
NDC,4116700883,ICY HOT 30 %-10 % TOPICAL CREAM,0.26,0.17,0.04,0.26,40
NDC,4116705723,ASPERCREME 10 % TOPICAL,0.24,0.16,0.04,0.24,40
NDC,4116705847,ASPERCREME (LIDOCAINE) 4 % TOPICAL PATCH,5.26,3.42,0.78,5.26,40
NDC,4116706003,ARTHRITIS HOT PAIN RELIEF 15 %-10 % TOPICAL CREAM,0.08,0.05,0.01,0.08,40
NDC,4116741312,ALLEGRA ALLERGY 60 MG TABLET,2.34,1.52,0.35,2.34,40
NDC,4116741314,ALLEGRA ALLERGY 60 MG TABLET,1.64,1.07,0.24,1.64,40
NDC,4116742444,CHILDREN'S ALLEGRA ALLERGY 30 MG/5 ML ORAL SUSPENSION,0.33,0.21,0.05,0.33,40
NDC,4116743102,ALLEGRA-D 12 HOUR 60 MG-120 MG TABLETEXTENDED RELEASE,3.74,2.43,0.56,3.74,40
NDC,4138821020,BLISTEX MEDICATED 0.6 %-0.5 %-1.1 %-0.5 % TOPICAL OINTMENT,0.44,0.29,0.07,0.44,40
NDC,4167936513,MCT OIL 7.7 KCAL/ML ORAL,0.2,0.13,0.03,0.2,40
NDC,4202310401,APLISOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,454.17,295.21,67.58,454.17,40
NDC,4202310501,BREVITAL 500 MG SOLUTION FOR INJECTION,401.52,260.99,59.75,401.52,40
NDC,4202311001,DELESTROGEN 10 MG/ML INTRAMUSCULAR OIL,95.58,62.13,14.22,95.58,40
NDC,4202311101,DELESTROGEN 20 MG/ML INTRAMUSCULAR OIL,134.7,87.56,2.17,134.7,51
NDC,4202311510,KETALAR 100 MG/ML INJECTION SOLUTION,9.6,6.24,1.43,9.6,40
NDC,4202311602,PITOCIN 10 UNIT/ML INJECTION SOLUTION,5.04,3.28,0.75,8.86,51
NDC,4202311625,PITOCIN 10 UNIT/ML INJECTION SOLUTION,12.96,8.42,1.93,12.96,51
NDC,4202311925,TIGAN 100 MG/ML INTRAMUSCULAR SOLUTION,118.95,77.32,2.17,118.95,51
NDC,4202312306,DANTRIUM 20 MG INTRAVENOUS SOLUTION,319.11,207.42,47.48,319.11,40
NDC,4202312401,DANTRIUM 25 MG CAPSULE,2.56,1.66,0.38,2.56,40
NDC,4202314625,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,9.75,6.34,1.45,9.75,40
NDC,4202315701,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,13680.0,8892.0,2.17,13680.0,59
NDC,4202315901,ADRENALIN 1 MG/ML (1 ML) INJECTION SOLUTION,29.52,19.19,2.17,29.52,51
NDC,4202315925,ADRENALIN 1 MG/ML (1 ML) INJECTION SOLUTION,29.52,19.19,2.17,29.52,51
NDC,4202316401,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,46.44,30.19,0.94,47.96,51
NDC,4202316410,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,46.44,30.19,0.94,47.96,51
NDC,4202316425,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,35.7,23.21,0.94,47.96,51
NDC,4202316801,ADRENALIN 1 MG/ML INJECTION SOLUTION,11.76,7.64,1.75,11.76,51
NDC,4202317901,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,65.36,42.48,2.17,65.36,51
NDC,4202317905,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,49.02,31.86,2.17,49.02,51
NDC,4202318201,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,734.4,477.36,0.6,734.4,65
NDC,4202319501,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,114.36,74.33,17.02,114.36,40
NDC,4202320501,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,1440.0,936.0,2.17,2642.72,57
NDC,4202321625,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,104.55,67.96,15.56,104.55,40
NDC,4202322101,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,144.0,93.6,2.17,144.0,51
NDC,4202322110,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,144.0,93.6,2.17,144.0,51
NDC,4202322910,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,269.28,175.03,0.39,269.28,51
NDC,4202323010,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,538.56,350.06,0.39,538.56,51
NDC,4202323710,VASOSTRICT 0.2 UNIT/ML INTRAVENOUS SOLUTION,1.23,0.8,0.18,47.96,51
NDC,4202331510,ADRENALIN IN 0.9 % SODIUM CHLORIDE 4 MG/250 ML (16 MCG/ML) IV SOLUTION,0.57,0.37,0.08,8.86,51
NDC,4203710475,GLY-OXIDE 10 % MUCOSAL SOLUTION,1.25,0.81,0.19,1.25,40
NDC,4203710476,GLY-OXIDE 10 % MUCOSAL SOLUTION,0.55,0.36,0.08,0.55,40
NDC,4203710478,DEBROX 6.5 % EAR DROPS,1.18,0.77,0.18,1.18,40
NDC,4219232701,NP THYROID 15 MG TABLET,1.78,1.16,0.26,1.78,40
NDC,4219232901,NP THYROID 30 MG TABLET,2.1,1.37,0.31,2.1,40
NDC,4219233001,NP THYROID 60 MG TABLET,2.32,1.51,0.35,2.32,40
NDC,4219233801,HYOSCYAMINE 0.125 MG DISINTEGRATING TABLET,1.7,1.11,0.25,1.7,40
NDC,4219233901,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,1.7,1.11,0.25,1.7,40
NDC,4219234001,HYOSCYAMINE SULFATE 0.125 MG TABLET,1.7,1.11,0.25,1.7,40
NDC,4219260816,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,2.08,1.35,0.31,2.08,40
NDC,4219260840,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,3.0,1.95,0.45,3.0,40
NDC,4219260845,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLUTION,3.6,2.34,0.54,3.6,40
NDC,4219555014,CIPROFLOXACIN 0.2 % EAR DROPS IN A DROPPERETTE,24.32,15.81,3.62,24.32,40
NDC,4222708101,CINRYZE 500 UNIT (5 ML) INTRAVENOUS SOLUTION,11513.49,7483.77,2.17,11513.49,65
NDC,4222708301,CINRYZE 500 UNIT (5 ML) INTRAVENOUS SOLUTION,11513.49,7483.77,2.17,11513.49,65
NDC,4229200120,METRONIDAZOLE 500 MG TABLET,1.66,1.08,0.25,1.66,40
NDC,4229203820,LEVOTHYROXINE 88 MCG TABLET,1.22,0.79,0.18,1.22,40
NDC,4229203920,LEVOTHYROXINE 112 MCG TABLET,1.42,0.92,0.21,1.42,40
NDC,4236752125,BELRAPZO 25 MG/ML INTRAVENOUS SOLUTION,3120.0,2028.0,2.17,3257.22,65
NDC,4236754032,RYANODEX 250 MG INTRAVENOUS SUSPENSION,9943.08,6463.0,1479.53,9943.08,40
NDC,4238592499,PIRFENIDONE 267 MG TABLET,88.24,57.36,13.13,88.24,40
NDC,4238592690,PIRFENIDONE 801 MG TABLET,264.72,172.07,39.39,264.72,40
NDC,4238801114,COMETRIQ 140 MG/DAY (80 MG X 1-20 MG X 3) CAPSULES,415.28,269.93,61.79,415.28,40
NDC,4238801214,COMETRIQ 100 MG/DAY (80 MG X 1-20 MG X 1) CAPSULES,830.54,539.85,123.58,830.54,40
NDC,4238801314,COMETRIQ 60 MG/DAY (20 MG X 3/DAY) CAPSULES,553.7,359.91,82.39,553.7,40
NDC,4238802326,CABOMETYX 60 MG TABLET,2104.1,1367.67,313.09,2104.1,40
NDC,4238802426,CABOMETYX 20 MG TABLET,2104.1,1367.67,313.09,2104.1,40
NDC,4238802526,CABOMETYX 40 MG TABLET,2104.1,1367.67,313.09,2104.1,40
NDC,4249445120,VANCOMYCIN 250 MG CAPSULE,115.44,75.04,17.18,115.44,40
NDC,4251500201,IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,2124.57,1380.97,13.37,2124.57,51
NDC,4257113252,CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,3.25,2.11,0.48,3.25,40
NDC,4257113725,KETOROLAC 0.5 % EYE DROPS,42.4,27.56,6.31,42.4,40
NDC,4257117601,PIROXICAM 10 MG CAPSULE,5.22,3.39,0.78,5.22,40
NDC,4257117701,PIROXICAM 20 MG CAPSULE,8.98,5.84,1.34,8.98,40
NDC,4257124301,ACETAZOLAMIDE ER 500 MG CAPSULEEXTENDED RELEASE,8.58,5.58,1.28,8.58,40
NDC,4257125101,CLINDAMYCIN HCL 150 MG CAPSULE,2.38,1.55,0.35,2.38,40
NDC,4257125201,CLINDAMYCIN HCL 300 MG CAPSULE,7.44,4.84,1.11,7.44,40
NDC,4257133201,METHENAMINE HIPPURATE 1 GRAM TABLET,4.18,2.72,0.62,4.18,40
NDC,4257138519,TRIAMCINOLONE ACETONIDE 0.1 % LOTION,3.0,1.95,0.45,3.0,40
NDC,4274776101,POTELIGEO 4 MG/ML INTRAVENOUS SOLUTION,4591.08,2984.2,2.17,7011.25,65
NDC,4279400308,ADEFOVIR 10 MG TABLET,75.8,49.27,11.28,75.8,40
NDC,4279400402,PROTRIPTYLINE 5 MG TABLET,12.0,7.8,1.79,12.0,40
NDC,4279401208,GRISEOFULVIN MICROSIZE 500 MG TABLET,23.34,15.17,3.47,23.34,40
NDC,4279401610,ASENAPINE 5 MG SUBLINGUAL TABLET,9.0,5.85,1.34,9.0,40
NDC,4279401710,ASENAPINE 10 MG SUBLINGUAL TABLET,9.0,5.85,1.34,9.0,40
NDC,4279401812,LIOTHYRONINE 5 MCG TABLET,1.7,1.11,0.25,1.7,40
NDC,4279401912,LIOTHYRONINE 25 MCG TABLET,2.2,1.43,0.33,2.2,40
NDC,4279402012,LIOTHYRONINE 50 MCG TABLET,3.3,2.15,0.49,3.3,40
NDC,4279911901,BUMETANIDE 0.5 MG TABLET,4.8,3.12,0.71,4.8,40
NDC,4279912001,BUMETANIDE 1 MG TABLET,5.34,3.47,0.79,5.34,40
NDC,4279912101,BUMETANIDE 2 MG TABLET,5.88,3.82,0.87,5.88,40
NDC,4279912301,CARBIDOPA 25 MG TABLET,21.0,13.65,3.12,21.0,40
NDC,4279920801,TINIDAZOLE 500 MG TABLET,20.3,13.2,3.02,20.3,40
NDC,4279921701,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,15.7,10.21,2.34,15.7,40
NDC,4279980601,IVERMECTIN 3 MG TABLET,9.94,6.46,1.48,9.94,40
NDC,4279981501,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,0.78,0.51,0.12,0.78,40
NDC,4279992030,BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,14.74,9.58,2.19,14.74,40
NDC,4280601801,SULINDAC 150 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,4280605030,MEPERIDINE 50 MG TABLET,94.78,61.61,14.1,94.78,40
NDC,4280605801,FLAVOXATE 100 MG TABLET,4.32,2.81,0.64,4.32,40
NDC,4280608701,ESTRADIOL 0.5 MG TABLET,1.1,0.72,0.16,1.1,40
NDC,4280614448,DEMECLOCYCLINE 300 MG TABLET,68.28,44.38,10.16,68.28,40
NDC,4280626060,GEMFIBROZIL 600 MG TABLET,4.86,3.16,0.72,4.86,40
NDC,4280626695,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,8.38,5.45,1.25,8.38,40
NDC,4280627095,CHOLESTYRAMINE LIGHT 4 GRAM POWDER FOR SUSPENSION IN A PACKET,8.38,5.45,1.25,8.38,40
NDC,4280651230,QUINIDINE SULFATE 300 MG TABLET,31.8,20.67,4.73,31.8,40
NDC,4280651330,QUINIDINE SULFATE 200 MG TABLET,30.18,19.62,4.49,30.18,40
NDC,4280654930,DUTASTERIDE 0.5 MG CAPSULE,12.1,7.87,1.8,12.1,40
NDC,4280655212,OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,4.14,2.69,0.62,4.14,40
NDC,4280671401,BENZONATATE 100 MG CAPSULE,5.0,3.25,0.74,5.0,40
NDC,4280671405,BENZONATATE 100 MG CAPSULE,4.54,2.95,0.68,4.54,40
NDC,4280675760,SULFADIAZINE 500 MG TABLET,40.08,26.05,5.96,40.08,40
NDC,4285800210,OXYCODONE 10 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,4285805501,DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULEEXTEND RELEASE,1.44,0.94,0.21,1.44,40
NDC,4285813401,FENOFIBRATE MICRONIZED 134 MG CAPSULE,0.38,0.25,0.06,0.38,40
NDC,4285830125,HYDROMORPHONE 2 MG TABLET,0.4,0.26,0.06,0.4,40
NDC,4285849340,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,193.28,125.63,28.76,193.28,40
NDC,4285850203,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,1.92,1.25,0.29,1.92,40
NDC,4285858640,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,278.82,181.23,41.49,278.82,40
NDC,4285870303,PAROXETINE ER 12.5 MG TABLETEXTENDED RELEASE 24 HR,1.6,1.04,0.24,1.6,40
NDC,4285870503,PAROXETINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,1.72,1.12,0.26,1.72,40
NDC,4285875040,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,128.86,83.76,19.17,128.86,40
NDC,4285883940,BUPRENORPHINE 20 MCG/HOUR WEEKLY TRANSDERMAL PATCH,342.18,222.42,50.92,342.18,40
NDC,4285886706,DRONABINOL 2.5 MG CAPSULE,4.94,3.21,0.74,4.94,40
NDC,4293770310,SALSALATE 500 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,4306600801,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.59,1.03,0.05,47.96,51
NDC,4306600810,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.59,1.03,0.05,47.96,51
NDC,4306600910,CARDENE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,0.9,0.59,0.13,0.9,40
NDC,4306601610,CARDENE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,1.44,0.94,0.21,1.44,40
NDC,4306601910,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,1.26,0.82,0.09,8.86,51
NDC,4306602310,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.96,0.62,0.09,8.86,51
NDC,4306615010,NEXTERONE 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLUTION,1.26,0.82,0.19,47.96,51
NDC,4306636020,NEXTERONE 360 MG/200 ML (1.8 MG/ML) INTRAVENOUS SOLUTION,0.84,0.55,0.12,47.96,51
NDC,4306810102,FANAPT 1 MG TABLET,73.7,47.91,10.97,73.7,40
NDC,4306810202,FANAPT 2 MG TABLET,73.7,47.91,10.97,73.7,40
NDC,4306810402,FANAPT 4 MG TABLET,73.7,47.91,10.97,73.7,40
NDC,4306810602,FANAPT 6 MG TABLET,90.68,58.94,13.49,90.68,40
NDC,4306810802,FANAPT 8 MG TABLET,90.68,58.94,13.49,90.68,40
NDC,4306811002,FANAPT 10 MG TABLET,145.22,94.39,21.61,145.22,40
NDC,4306811202,FANAPT 12 MG TABLET,145.22,94.39,21.61,145.22,40
NDC,4329256000,VITAMIN B-2  100 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,4329256336,CHOLECALCIFEROL (VITAMIN D3) 1250 MCG (50000 UNIT) CAPSULE,0.12,0.08,0.02,0.12,40
NDC,4337632230,FINTEPLA 2.2 MG/ML ORAL SOLUTION,99.03,64.37,14.74,99.03,40
NDC,4338648024,ORPHENADRINE CITRATE ER 100 MG TABLETEXTENDED RELEASE,4.62,3.0,0.69,4.62,40
NDC,4352800305,HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1121.4,728.91,7.93,1121.4,51
NDC,4354727410,ROPINIROLE 5 MG TABLET,5.0,3.25,0.74,5.0,40
NDC,4354727509,DONEPEZIL 5 MG TABLET,17.32,11.26,2.58,17.32,40
NDC,4354734250,RISPERIDONE 2 MG TABLET,15.2,9.88,2.26,15.2,40
NDC,4354739910,CYCLOBENZAPRINE 5 MG TABLET,3.28,2.13,0.49,3.28,40
NDC,4354752403,NEBIVOLOL 2.5 MG TABLET,9.48,6.16,1.41,9.48,40
NDC,4354752509,NEBIVOLOL 5 MG TABLET,9.48,6.16,1.41,9.48,40
NDC,4354754510,ENALAPRIL MALEATE 2.5 MG TABLET,2.92,1.9,0.43,2.92,40
NDC,4354754610,ENALAPRIL MALEATE 5 MG TABLET,3.7,2.41,0.55,3.7,40
NDC,4354754710,ENALAPRIL MALEATE 10 MG TABLET,3.88,2.52,0.58,3.88,40
NDC,4354754810,ENALAPRIL MALEATE 20 MG TABLET,5.54,3.6,0.82,5.54,40
NDC,4354768810,CIPROFLOXACIN 250 MG TABLET,8.88,5.77,1.32,8.88,40
NDC,4359801252,AUGMENTIN 125 MG-31.25 MG/5 ML ORAL SUSPENSION,16.68,10.84,2.48,16.68,40
NDC,4359812925,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,27.36,17.78,0.3,27.36,57
NDC,4359816605,OLANZAPINE 10 MG TABLET,39.84,25.9,5.93,39.84,40
NDC,4359821025,SSD 1 % TOPICAL CREAM,0.72,0.47,0.11,0.72,40
NDC,4359821040,SSD 1 % TOPICAL CREAM,0.32,0.21,0.05,0.32,40
NDC,4359821055,SSD 1 % TOPICAL CREAM,0.6,0.39,0.09,0.6,40
NDC,4359834837,DECITABINE 50 MG INTRAVENOUS SOLUTION,2304.0,1497.6,1.16,2304.0,51
NDC,4359839467,TETRABENAZINE 12.5 MG TABLET,151.18,98.27,22.5,151.18,40
NDC,4359843901,METHYLPHENIDATE ER 27 MG TABLETEXTENDED RELEASE 24 HR,19.96,12.97,2.97,19.96,40
NDC,4359844674,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.26,2.77,0.63,4.26,40
NDC,4359844828,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,3.84,2.5,0.57,3.84,40
NDC,4359850930,ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULEDELAYED RELEASE,18.04,11.73,2.68,18.04,40
NDC,4359858201,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.6,11.44,2.17,47.96,48
NDC,4359858230,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.6,11.44,2.17,47.96,48
NDC,4359867611,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,8.07,5.25,1.2,8.86,51
NDC,4382520001,TERLIVAZ 0.85 MG INTRAVENOUS SOLUTION,3556.8,2311.92,41.42,3556.8,51
NDC,4382560641,RECOTHROM 5000 UNIT TOPICAL SOLUTION,206.4,134.16,30.71,206.4,40
NDC,4390018215,BOOST VHC 0.09 GRAM-2.25 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,4390022510,RESOURCE THICKENUP ORAL POWDER,0.05,0.03,0.01,0.05,40
NDC,4390028300,GLUTASOLVE 15 GRAM ORAL POWDER PACKET,4.54,2.95,0.68,4.54,40
NDC,4390035988,ARGINAID 4.5 GRAM-156 MG/9.2 GRAM ORAL POWDER PACKET,2.76,1.79,0.41,2.76,40
NDC,4390097647,NUTRISOURCE FIBER PACKET,1.14,0.74,0.17,1.14,40
NDC,4397530610,FENOFIBRATE MICRONIZED 200 MG CAPSULE,1.58,1.03,0.24,1.58,40
NDC,4397544410,FENOFIBRATE MICRONIZED 67 MG CAPSULE,0.54,0.35,0.08,0.54,40
NDC,4408700443,REBIF (WITH ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRINGE,6592.98,4285.44,2.17,6592.98,51
NDC,4408735351,BAVENCIO 20 MG/ML INTRAVENOUS SOLUTION,1005.12,653.33,2.17,4417.71,65
NDC,4420630001,RHOPHYLAC 1500 UNIT (300 MCG)/2 ML INJECTION SYRINGE,318.54,207.05,2.17,318.54,51
NDC,4420630010,RHOPHYLAC 1500 UNIT (300 MCG)/2 ML INJECTION SYRINGE,289.56,188.21,2.17,289.56,51
NDC,4420631050,ALBURX (HUMAN) 5 % INTRAVENOUS SOLUTION,1.29,0.84,0.29,315.24,65
NDC,4420643605,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,2.17,2642.72,65
NDC,4420643710,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,2.17,2642.72,65
NDC,4420643820,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,2.17,2642.72,65
NDC,4420643940,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,2.17,2642.72,65
NDC,4422930760,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.18,0.12,0.03,0.18,40
NDC,4452361701,UREA 40 % TOPICAL CREAM,7.3,4.75,1.09,7.3,40
NDC,4456721110,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,54.0,35.1,2.17,54.0,51
NDC,4456723525,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,16.2,10.53,2.17,16.2,51
NDC,4456723610,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,36.0,23.4,2.17,36.0,51
NDC,4456724625,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,71.82,46.68,2.17,71.82,51
NDC,4456740206,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,118.44,76.99,1.62,118.44,57
NDC,4456741024,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,8.86,51
NDC,4456760104,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,45.57,29.62,6.78,45.57,40
NDC,4456761110,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.96,0.62,0.14,8.86,51
NDC,4456762001,CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE ISO-OSM IV SOLUTION,1.41,0.92,0.16,8.86,51
NDC,4456762101,CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,1.41,0.92,0.21,1.41,40
NDC,4456762124,CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,1.41,0.92,0.21,1.41,40
NDC,4456762201,CALCIUM GLUCONATE 1 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,0.45,0.29,0.07,0.45,40
NDC,4456762224,CALCIUM GLUCONATE 1 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,0.45,0.29,0.07,0.45,40
NDC,4456770625,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,5.76,3.74,0.86,8.86,51
NDC,4456781110,ESMOLOL 2500 MG/250 ML (10 MG/ML) IN STERILE WATER INTRAVENOUS SOLN,1.71,1.11,0.25,47.96,51
NDC,4467710202,LANOLIN (HPA) 100 % TOPICAL CREAM,1.42,0.92,0.21,1.42,40
NDC,4556700301,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,200.0,130.0,0.01,1615.51,45
NDC,4556700601,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,118.0,76.7,0.01,119.02,45
NDC,4556706551,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,568.0,369.2,0.01,1651.69,45
NDC,4562908901,FOTIVDA 0.89 MG CAPSULE,3633.82,2361.98,540.71,3633.82,40
NDC,4562913401,FOTIVDA 1.34 MG CAPSULE,3633.82,2361.98,540.71,3633.82,40
NDC,4580200402,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.5,0.33,0.07,0.5,40
NDC,4580200403,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.78,0.51,0.12,0.78,40
NDC,4580201402,HYDROCORTISONE 2.5 % TOPICAL OINTMENT,0.5,0.33,0.07,0.5,40
NDC,4580202146,BETAMETHASONE DIPROPIONATE 0.05 % LOTION,1.5,0.98,0.22,1.5,40
NDC,4580204064,SELENIUM SULFIDE 2.5 % LOTION,0.34,0.22,0.05,0.34,40
NDC,4580204501,TRIAMCINOLONE ACETONIDE 0.147 MG/GRAM TOPICAL AEROSOL,7.78,5.06,1.16,7.78,40
NDC,4580204635,GENTAMICIN 0.1 % TOPICAL OINTMENT,6.58,4.28,0.98,6.58,40
NDC,4580204811,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,1.76,1.14,0.26,1.76,40
NDC,4580204835,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.34,1.52,0.35,2.34,40
NDC,4580204935,TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,1.34,0.87,0.2,1.34,40
NDC,4580205435,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,0.82,0.53,0.12,0.82,40
NDC,4580205436,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,0.26,0.17,0.04,0.26,40
NDC,4580205535,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.74,0.48,0.11,0.74,40
NDC,4580205536,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.32,0.21,0.05,0.32,40
NDC,4580205611,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,0.98,6.58,40
NDC,4580205635,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,0.98,6.58,40
NDC,4580206001,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.52,0.34,0.08,0.52,40
NDC,4580206070,BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,0.46,0.3,0.07,0.46,40
NDC,4580206335,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.6,0.39,0.09,0.6,40
NDC,4580206336,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.26,0.17,0.04,0.26,40
NDC,4580206435,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.52,0.34,0.08,0.52,40
NDC,4580206436,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.24,0.16,0.04,0.24,40
NDC,4580206535,TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,1.34,0.87,0.2,1.34,40
NDC,4580209851,MESALAMINE 4 GRAM/60 ML ENEMA,0.82,0.53,0.12,0.82,40
NDC,4580210752,PSEUDOEPHEDRINE ER 120 MG TABLETEXTENDED RELEASE,0.76,0.49,0.11,0.76,40
NDC,4580210901,TRIAMCINOLONE ACETONIDE 55 MCG NASAL SPRAY AEROSOL,2.0,1.3,0.3,2.0,40
NDC,4580211214,MUPIROCIN 2 % TOPICAL OINTMENT,0.98,0.64,0.15,0.98,40
NDC,4580211222,MUPIROCIN 2 % TOPICAL OINTMENT,1.02,0.66,0.15,1.02,40
NDC,4580211937,MOMETASONE 0.1 % TOPICAL OINTMENT,3.24,2.11,0.48,3.24,40
NDC,4580211942,MOMETASONE 0.1 % TOPICAL OINTMENT,1.98,1.29,0.29,1.98,40
NDC,4580212801,CLINDAMYCIN 1 % LOTION,3.84,2.5,0.57,3.84,40
NDC,4580213811,CICLOPIROX 0.77 % TOPICAL CREAM,3.76,2.44,0.56,3.76,40
NDC,4580213835,CICLOPIROX 0.77 % TOPICAL CREAM,4.22,2.74,0.63,4.22,40
NDC,4580214301,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.6,0.39,0.09,0.6,40
NDC,4580214303,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.44,0.29,0.07,0.44,40
NDC,4580214370,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT TOPICAL OINTMENT PACKET,0.56,0.36,0.08,0.56,40
NDC,4580218816,HEMORRHOIDAL(PHENYLEPH-MIN OIL-PETROLAT)0.25 %-14 %-74.9 % RECTAL OINT,0.18,0.12,0.03,0.18,40
NDC,4580220126,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,4580221001,NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL,91.62,59.55,13.63,91.62,40
NDC,4580221696,BENZOYL PEROXIDE 5 % TOPICAL GEL,0.68,0.44,0.1,0.68,40
NDC,4580224414,NYSTATIN-TRIAMCINOLONE 100000 UNIT/GRAM-0.1 % TOPICAL OINTMENT,2.5,1.63,0.37,2.5,40
NDC,4580226337,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SWAB,1.68,1.09,0.25,1.68,40
NDC,4580226937,PERMETHRIN 5 % TOPICAL CREAM,3.96,2.57,0.59,3.96,40
NDC,4580227603,HYDROCORTISONE 1 % TOPICAL OINTMENT,0.28,0.18,0.04,0.28,40
NDC,4580235803,ITCH RELIEF 2 %-0.1 % TOPICAL CREAM,0.28,0.18,0.04,0.28,40
NDC,4580236853,IMIQUIMOD 5 % TOPICAL CREAM PACKET,36.8,23.92,5.48,36.8,40
NDC,4580236862,IMIQUIMOD 5 % TOPICAL CREAM PACKET,5.0,3.25,0.74,5.0,40
NDC,4580239000,TACROLIMUS 0.03 % TOPICAL OINTMENT,5.6,3.64,0.83,5.6,40
NDC,4580239504,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,0.08,0.05,0.01,0.08,40
NDC,4580241059,NASAL SPRAY (OXYMETAZOLINE) 0.05 %,0.16,0.1,0.02,0.16,40
NDC,4580242335,DESONIDE 0.05 % TOPICAL OINTMENT,3.1,2.02,0.46,3.1,40
NDC,4580242337,DESONIDE 0.05 % TOPICAL OINTMENT,3.1,2.02,0.46,3.1,40
NDC,4580243321,DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,0.23,0.15,0.03,0.23,40
NDC,4580243411,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.36,0.23,0.05,0.36,40
NDC,4580243803,HYDROCORTISONE 1 % TOPICAL CREAM,0.28,0.18,0.04,0.28,40
NDC,4580246564,KETOCONAZOLE 2 % SHAMPOO,0.5,0.33,0.07,0.5,40
NDC,4580246611,ECONAZOLE NITRATE 1 % TOPICAL CREAM,4.0,2.6,0.6,4.0,40
NDC,4580246635,ECONAZOLE NITRATE 1 % TOPICAL CREAM,4.0,2.6,0.6,4.0,40
NDC,4580246653,ECONAZOLE NITRATE 1 % TOPICAL CREAM,2.82,1.83,0.42,2.82,40
NDC,4580247265,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % (4G) RECTAL CREAM,4.52,2.94,0.67,4.52,40
NDC,4580249535,DESOXIMETASONE 0.25 % TOPICAL CREAM,7.78,5.06,1.16,7.78,40
NDC,4580249537,DESOXIMETASONE 0.25 % TOPICAL CREAM,6.64,4.32,0.99,6.64,40
NDC,4580249614,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,2.4,1.56,0.36,2.4,40
NDC,4580249696,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,2.0,1.3,0.3,2.0,40
NDC,4580250584,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,4.22,2.74,0.63,4.22,40
NDC,4580252555,AMMONIUM LACTATE 12 % LOTION,0.16,0.1,0.02,0.16,40
NDC,4580256201,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,1.94,1.26,0.29,1.94,40
NDC,4580262626,CETIRIZINE 1 MG/ML ORAL SOLUTION,0.75,0.49,0.11,0.75,40
NDC,4580265078,LORATADINE 10 MG TABLET,0.6,0.39,0.09,0.6,40
NDC,4580265087,LORATADINE 10 MG TABLET,0.6,0.39,0.09,0.6,40
NDC,4580270000,TACROLIMUS 0.1 % TOPICAL OINTMENT,8.0,5.2,1.19,8.0,40
NDC,4580270001,TACROLIMUS 0.1 % TOPICAL OINTMENT,8.0,5.2,1.19,8.0,40
NDC,4580273000,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.68,0.44,0.1,0.68,40
NDC,4580273030,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,1.34,0.87,0.2,1.34,40
NDC,4580273032,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.68,0.44,0.1,0.68,40
NDC,4580273033,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.5,0.33,0.07,0.5,40
NDC,4580273200,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,0.74,0.48,0.11,0.74,40
NDC,4580273230,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,0.74,0.48,0.11,0.74,40
NDC,4580273233,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,0.48,0.31,0.07,0.48,40
NDC,4580286802,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,0.08,0.05,0.01,0.08,40
NDC,4580286803,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,0.1,0.07,0.01,0.1,40
NDC,4580288014,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,3.36,2.18,0.5,3.36,40
NDC,4580288094,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,2.36,1.53,0.35,2.36,40
NDC,4580291987,CETIRIZINE 10 MG TABLET,0.2,0.13,0.03,0.2,40
NDC,4580293716,HYDROCORTISONE 2.5 % LOTION,1.82,1.18,0.27,1.82,40
NDC,4580293726,HYDROCORTISONE 2.5 % LOTION,1.3,0.85,0.19,1.3,40
NDC,4580295243,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.02,0.15,40
NDC,4580297426,CETIRIZINE 1 MG/ML ORAL SOLUTION,0.23,0.15,0.03,0.23,40
NDC,4596314290,BUPROPION XL 300 MG 24 HR TAB,12.6,8.19,1.87,12.6,40
NDC,4596334102,DESIPRAMINE 10 MG TABLET,2.36,1.53,0.35,2.36,40
NDC,4596334202,DESIPRAMINE 25 MG TABLET,2.84,1.85,0.42,2.84,40
NDC,4596343864,ENULOSE 10 GRAM/15 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,40
NDC,4596355611,GABAPENTIN 300 MG CAPSULE,2.66,1.73,0.4,2.66,40
NDC,4596355750,GABAPENTIN 400 MG CAPSULE,3.2,2.08,0.48,3.2,40
NDC,4601701816,VIVARIN 200 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,4612210006,NATURAL FIBER LAXATIVE 0.52 GRAM CAPSULE,0.2,0.13,0.03,0.2,40
NDC,4612210846,LICE TREATMENT 1 % TOPICAL LIQUID,0.36,0.23,0.05,0.36,40
NDC,4612216510,NASAL SPRAY (OXYMETAZOLINE) 0.05 %,0.42,0.27,0.06,0.42,40
NDC,4612216660,PSEUDOEPHEDRINE ER 120 MG TABLETEXTENDED RELEASE,1.12,0.73,0.17,1.12,40
NDC,4612221126,CHILDREN'S PAIN AND FEVER RELIEF 160 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.02,0.15,40
NDC,4612222163,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.36,0.23,0.05,0.36,40
NDC,4612222263,GLYCERIN (CHILD) RECTAL SUPPOSITORY,0.36,0.23,0.05,0.36,40
NDC,4612226530,SORE THROAT (PHENOL) 1.4 % AEROSOL SPRAY,0.06,0.04,0.01,0.06,40
NDC,4612233443,HYDROGEN PEROXIDE 3 % SOLUTION,0.02,0.01,0.01,0.02,40
NDC,4612239465,ACID REDUCER (FAMOTIDINE) 10 MG TABLET,0.62,0.4,0.09,0.62,40
NDC,4612239516,MINERAL OIL ORAL,0.05,0.03,0.01,0.05,40
NDC,4612241403,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.52,0.34,0.08,0.52,40
NDC,4612241405,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.74,0.48,0.11,0.74,40
NDC,4612242326,LORATADINE 5 MG/5 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,40
NDC,4612243140,ANTACID-ANTIGAS 400 MG-400 MG-40 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,4612243340,ANTACID REGULAR STRENGTH 200 MG-200 MG-20 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,4612244062,ALLERGY RELIEF (DIPHENHYDRAMINE) 25 MG CAPSULE,0.42,0.27,0.06,0.42,40
NDC,4612244427,MICONAZORB AF 2 % TOPICAL POWDER,0.24,0.16,0.04,0.24,40
NDC,4612245773,ALERTNESS AID 200 MG TABLET,0.62,0.4,0.09,0.62,40
NDC,4612252413,CALLUS REMOVERS 40 % TOPICAL PATCH,0.56,0.36,0.08,0.56,40
NDC,4612253653,MOTION SICKNESS RELIEF 50 MG TABLET,1.14,0.74,0.17,1.14,40
NDC,4612254426,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,40
NDC,4612255705,EAR WAX REMOVAL DROPS 6.5 %,1.02,0.66,0.15,1.02,40
NDC,4612257310,ANTI-ITCH (MENTHOL-CAMPHOR) 0.5 %-0.5 % LOTION,0.1,0.07,0.01,0.1,40
NDC,4612259602,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.1,0.07,0.01,0.1,40
NDC,4612267264,OLOPATADINE 0.1 % EYE DROPS,5.28,3.43,0.79,5.28,40
NDC,4612267746,HEMORRHOIDAL(PHENYLEPH-MIN OIL-PETROLAT)0.25 %-14 %-74.9 % RECTAL OINT,0.42,0.27,0.06,0.42,40
NDC,4612270165,PINK BISMUTH 262 MG CHEWABLE TABLET,0.46,0.3,0.07,0.46,40
NDC,4612271427,WHITE PETROLATUM TOPICAL JELLY,0.04,0.03,0.01,0.04,40
NDC,4612272626,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,0.1,0.07,0.01,0.1,40
NDC,4612274038,MAGNESIUM CITRATE ORAL SOLUTION,0.03,0.02,0.01,0.03,40
NDC,4612275051,MUCUS RELIEF ER 600 MG TABLET EXTENDED RELEASE,1.3,0.85,0.19,1.3,40
NDC,4612275252,DICLOFENAC 1 % TOPICAL GEL,0.3,0.2,0.04,0.3,40
NDC,4612277966,FEXOFENADINE 180 MG TABLET,0.82,0.53,0.12,0.82,40
NDC,4612278929,MICONAZORB AF 2 % TOPICAL POWDER,0.24,0.16,0.04,0.24,40
NDC,4616321295,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4628700601,SPS (WITH SORBITOL) 15 GRAM-20 GRAM/60 ML ORAL SUSPENSION,1.4,0.91,0.21,1.4,40
NDC,4628700604,SPS (WITH SORBITOL) 30 GRAM-40 GRAM/120 ML ENEMA,2.42,1.57,0.36,2.42,40
NDC,4628700660,SPS (WITH SORBITOL) 15 GRAM-20 GRAM/60 ML ORAL SUSPENSION,1.3,0.85,0.19,1.3,40
NDC,4628700901,ISONIAZID 50 MG/5 ML ORAL SOLUTION,2.48,1.61,0.37,2.48,40
NDC,4628701401,ORACIT 490 MG-640 MG/5 ML ORAL SOLUTION,0.3,0.2,0.04,0.3,40
NDC,4628701430,ORACIT 490 MG-640 MG/5 ML ORAL SOLUTION,0.63,0.41,0.09,0.63,40
NDC,4628702001,CAROSPIR 25 MG/5 ML ORAL SUSPENSION,10.98,7.14,1.63,10.98,40
NDC,4628702004,CAROSPIR 25 MG/5 ML ORAL SUSPENSION,11.0,7.15,1.64,11.0,40
NDC,4628704515,TADLIQ 20 MG/5 ML (4 MG/ML) ORAL SUSPENSION,41.0,26.65,6.1,41.0,40
NDC,4628750001,SORBITOL 70 % SOLUTION,0.08,0.05,0.01,0.08,40
NDC,4628750030,SORBITOL 70 % SOLUTION,0.35,0.23,0.05,0.35,40
NDC,4628750816,PETROLATUM TOPICAL OINTMENT,0.26,0.17,0.04,0.26,40
NDC,4641422221,AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,0.32,0.21,0.05,0.32,40
NDC,4678316001,XEOMIN 100 UNIT INTRAMUSCULAR SOLUTION,1735.2,1127.88,2.17,1735.2,65
NDC,4678316101,XEOMIN 50 UNIT INTRAMUSCULAR SOLUTION,1839.6,1195.74,2.17,1839.6,65
NDC,4733500388,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.42,4.82,1.1,7.42,40
NDC,4733500488,CARBIDOPA 31.25 MG-LEVODOPA 125 MG-ENTACAPONE 200 MG TABLET,7.42,4.82,1.1,7.42,40
NDC,4733500588,CARBIDOPA 37.5 MG-LEVODOPA 150 MG-ENTACAPONE 200 MG TABLET,7.42,4.82,1.1,7.42,40
NDC,4733517795,ILUMYA 100 MG/ML SUBCUTANEOUS SYRINGE,64661.19,42029.77,2.17,64661.19,65
NDC,4733518688,CARBIDOPA 10 MG-LEVODOPA 100 MG DISINTEGRATING TABLET,1.86,1.21,0.28,1.86,40
NDC,4733518788,CARBIDOPA 25 MG-LEVODOPA 100 MG DISINTEGRATING TABLET,2.76,1.79,0.41,2.76,40
NDC,4733518888,CARBIDOPA 25 MG-LEVODOPA 250 MG DISINTEGRATING TABLET,3.5,2.28,0.52,3.5,40
NDC,4733530383,ODOMZO 200 MG CAPSULE,1143.02,742.96,170.08,1143.02,40
NDC,4733574483,PALIPERIDONE ER 1.5 MG TABLETEXTENDED RELEASE 24 HR,61.12,39.73,9.09,61.12,40
NDC,4733578891,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),98.5,64.03,14.66,98.5,40
NDC,4742620101,CINVANTI 130 MG/18 ML (7.2 MG/ML) INTRAVENOUS EMULSION,92.73,60.27,1.71,184.43,65
NDC,4778135703,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.58,11.43,2.17,47.96,48
NDC,4778147013,OSELTAMIVIR 75 MG CAPSULE,30.92,20.1,4.6,30.92,40
NDC,4778160730,DISULFIRAM 250 MG TABLET,8.08,5.25,1.2,8.08,40
NDC,4778310101,KALBITOR 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,20543.67,13353.39,2.17,20543.67,65
NDC,4843311201,PRENATAL 28 MG IRON-800 MCG TABLET,0.52,0.34,0.08,0.52,40
NDC,4843320230,MINERAL OIL ORAL,0.2,0.13,0.03,0.2,40
NDC,4843323015,STRONG IODINE 5 % ORAL SOLUTION,7.98,5.19,1.19,7.98,40
NDC,4858200155,BIOTENE MOISTURIZING MOUTH MUCOSAL SPRAY,0.44,0.29,0.07,0.44,40
NDC,4858251201,BIOTENE ORALBALANCE (GLYCERIN) MUCOSAL GEL,0.46,0.3,0.07,0.46,40
NDC,4858280220,BIOTENE DRY MOUTH ORAL RINSE MOUTHWASH,0.08,0.05,0.01,0.08,40
NDC,4878311208,MONSEL'S 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLUTION APPLICATOR,5.35,3.48,0.8,5.35,40
NDC,4881510011,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,210.0,136.5,0.01,239.94,45
NDC,4898500155,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.26,2.77,0.63,4.26,40
NDC,4902213112,THERAPEUTIC MOISTURIZING TOPICAL CREAM,0.06,0.04,0.01,0.06,40
NDC,4910036374,CULTURELLE 15 BILLION CELL SPRINKLE CAPSULE,1.64,1.07,0.24,1.64,40
NDC,4910036404,CULTURELLE 15 BILLION CELL SPRINKLE CAPSULE,1.64,1.07,0.24,1.64,40
NDC,4910040007,CULTURELLE 10 BILLION CELL CAPSULE,3.08,2.0,0.46,3.08,40
NDC,4910040009,CULTURELLE DIGESTIVE HEALTH 10 BILLION CELL-200 MG SPRINKLE CAPSULE,1.5,0.98,0.22,1.5,40
NDC,4910040021,CULTURELLE DIGESTIVE HEALTH 10 BILLION CELL-200 MG SPRINKLE CAPSULE,1.4,0.91,0.21,1.4,40
NDC,4923020692,DELFLEX-LC WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4923020695,DELFLEX-LC WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4923020923,DELFLEX-LC WITH 2.5 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,40
NDC,4923020992,DELFLEX WITH 2.5 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4923020995,DELFLEX WITH 2.5 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4923021223,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4923021292,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4923021295,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,40
NDC,4928112565,FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,406.53,264.24,7.93,406.53,51
NDC,4928119020,IMOGAM RABIES-HT (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,1629.24,1059.01,352.44,2642.72,65
NDC,4928121510,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,319.77,207.85,7.93,319.77,51
NDC,4928121515,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,319.77,207.85,7.93,319.77,51
NDC,4928121588,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,319.74,207.83,7.93,319.74,51
NDC,4928122510,TETANUSDIPHTHERIA TOXOID PED (PF) 5 LF UNIT-25 LF UNIT/0.5 ML IM SUSP,442.89,287.88,7.93,442.89,51
NDC,4928124858,IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION,1561.71,1015.11,13.37,1561.71,65
NDC,4928125051,IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION,1561.71,1015.11,13.37,1561.71,65
NDC,4928128610,DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP,210.75,136.99,7.93,210.75,51
NDC,4928128658,DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP,210.75,136.99,7.93,210.75,51
NDC,4928129110,DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,141.48,91.96,7.93,141.48,51
NDC,4928140010,ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP,351.57,228.52,7.93,351.57,51
NDC,4928140020,ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE,351.57,228.52,7.93,351.57,51
NDC,4928140058,ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP,351.57,228.52,7.93,351.57,51
NDC,4928140089,ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE,351.57,228.52,7.93,351.57,51
NDC,4928142550,FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE,149.4,97.11,7.93,149.4,51
NDC,4928151105,PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT,467.67,303.99,7.93,467.67,51
NDC,4928154503,ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,47.37,30.79,7.05,47.37,51
NDC,4928154758,ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,47.37,30.79,7.05,47.37,51
NDC,4928156210,QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,443.34,288.17,7.93,443.34,51
NDC,4928157415,BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE,2142.21,1392.44,318.76,2142.21,51
NDC,4928157488,BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE,2142.21,1392.44,318.76,2142.21,51
NDC,4928157500,BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,4284.42,2784.87,637.52,4284.42,51
NDC,4928157515,BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,4284.45,2784.89,637.53,4284.45,51
NDC,4928159005,MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1269.78,825.36,13.37,1269.78,51
NDC,4928159058,MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1269.78,825.36,13.37,1269.78,51
NDC,4928172510,FLUBLOK 2025-2026 (PF) 135 MCG (45 MCG X 3)/0.5 ML IM SYRINGE,615.45,400.04,91.58,615.45,43
NDC,4928175221,TUBERSOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,454.17,295.21,67.58,454.17,40
NDC,4928175222,TUBERSOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,353.94,230.06,52.67,353.94,40
NDC,4928175278,TUBERSOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,454.17,295.21,67.58,454.17,40
NDC,4928179020,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,802.41,521.57,7.93,802.41,51
NDC,4928179051,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1163.52,756.29,7.93,1163.52,51
NDC,4928186010,IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION,338.85,220.25,7.93,338.85,51
NDC,4940108801,BENLYSTA 200 MG/ML SUBCUTANEOUS AUTO-INJECTOR,6164.88,4007.17,2.17,6164.88,65
NDC,4940110101,BENLYSTA 120 MG INTRAVENOUS SOLUTION,3169.92,2060.45,2.17,3169.92,65
NDC,4940110201,BENLYSTA 400 MG INTRAVENOUS SOLUTION,10565.6,6867.64,2.17,10565.6,65
NDC,4941105030,AMICAR 500 MG TABLET,48.86,31.76,7.27,48.86,40
NDC,4941105208,AMICAR 250 MG/ML (25 %) ORAL SOLUTION,35.45,23.04,5.27,35.45,40
NDC,4945211551,BISMUTH SUBGALLATE (BULK) POWDER,6.48,4.21,0.96,6.48,40
NDC,4945211552,BISMUTH SUBGALLATE (BULK) POWDER,4.16,2.7,0.62,4.16,40
NDC,4945213132,BUPIVACAINE (BULK) 100 % POWDER,188.38,122.45,28.03,188.38,40
NDC,4945263031,ROPIVACAINE HCL (BULK) 100 % POWDER,30.42,19.77,4.53,30.42,40
NDC,4947100105,PRE-PEN 0.25 ML INTRADERMAL INJECTION SOLUTION,2557.44,1662.34,380.55,2557.44,40
NDC,4948322110,NITRO-TIME 2.5 MG CAPSULEEXTENDED RELEASE,1.38,0.9,0.21,1.38,40
NDC,4948322210,NITRO-TIME 6.5 MG CAPSULEEXTENDED RELEASE,1.62,1.05,0.24,1.62,40
NDC,4948368703,PARICALCITOL 1 MCG CAPSULE,16.0,10.4,2.38,16.0,40
NDC,4950210102,EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,540.0,351.0,1.63,540.0,51
NDC,4950210202,EPINEPHRINE 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,540.0,351.0,1.63,540.0,51
NDC,4950245093,CIMDUO 300 MG-300 MG TABLET,99.54,64.7,14.81,99.54,40
NDC,4950250001,EPIPEN 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
NDC,4950250002,EPIPEN 2-PAK 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
NDC,4950250101,EPIPEN JR 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
NDC,4950250102,EPIPEN JR 2-PAK 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,1.63,1095.51,51
NDC,4950290001,EMSAM 6 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,28.15,189.18,40
NDC,4950290030,EMSAM 6 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,28.15,189.18,40
NDC,4950290130,EMSAM 9 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,28.15,189.18,40
NDC,4950290201,EMSAM 12 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,28.15,189.18,40
NDC,4950290230,EMSAM 12 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,28.15,189.18,40
NDC,4959153251,CYTOGAM 50 MG/ML INTRAVENOUS SOLUTION,130.29,84.69,2.17,5357.33,65
NDC,4970221301,RETROVIR 10 MG/ML INTRAVENOUS SOLUTION,5.25,3.41,1.16,47.96,59
NDC,4970221326,RETROVIR 10 MG/ML INTRAVENOUS SOLUTION,5.25,3.41,1.16,47.96,59
NDC,4970222248,ZIAGEN 20 MG/ML ORAL SOLUTION,1.83,1.19,0.27,1.83,40
NDC,4970222318,SELZENTRY 150 MG TABLET,65.32,42.46,9.72,65.32,40
NDC,4970222418,SELZENTRY 300 MG TABLET,65.32,42.46,9.72,65.32,40
NDC,4970222813,TIVICAY 50 MG TABLET,191.6,124.54,28.51,191.6,40
NDC,4970223113,TRIUMEQ 600 MG-50 MG-300 MG TABLET,321.14,208.74,47.79,321.14,40
NDC,4970224015,CABENUVA 600 MG/3 ML-900 MG/3 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,2.17,4487.68,65
NDC,4970224213,JULUCA 50 MG-25 MG TABLET,300.98,195.64,44.79,300.98,40
NDC,4970224613,DOVATO 50 MG-300 MG TABLET,260.04,169.03,38.69,260.04,40
NDC,4970225018,RUKOBIA 600 MG TABLETEXTENDED RELEASE,386.06,250.94,57.45,386.06,40
NDC,4970225315,CABENUVA 400 MG/2 ML-600 MG/2 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,2.17,4487.68,65
NDC,4970225537,TIVICAY PD 5 MG TABLET FOR ORAL SUSPENSION,19.16,12.45,2.85,19.16,40
NDC,4970226423,APRETUDE 600 MG/3 ML (200 MG/ML) IM SUSPENSION EXTENDED RELEASE,5074.8,3298.62,2.17,5074.8,65
NDC,4970228063,APRETUDE 600 MG/3 ML (200 MG/ML) IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,2.17,4279.77,65
NDC,4973011330,NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH,4.12,2.68,0.61,4.12,40
NDC,4988402201,ISOSORBIDE DINITRATE 20 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,4988406501,GLYCOPYRROLATE 1 MG TABLET,2.62,1.7,0.39,2.62,40
NDC,4988411074,ALPRAZOLAM 0.25 MG DISINTEGRATING TABLET,3.04,1.98,0.45,3.04,40
NDC,4988411701,AMILORIDE 5 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,4988415676,VARENICLINE TARTRATE 1 MG TABLET,17.58,11.43,2.62,17.58,40
NDC,4988416111,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,64.08,41.65,9.54,64.08,40
NDC,4988421255,RISPERIDONE 0.25 MG DISINTEGRATING TABLET,8.96,5.82,1.33,8.96,40
NDC,4988423183,PRAZIQUANTEL 600 MG TABLET,179.36,116.58,26.69,179.36,40
NDC,4988425601,MINOXIDIL 2.5 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,4988425701,MINOXIDIL 10 MG TABLET,3.38,2.2,0.5,3.38,40
NDC,4988430702,CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,2.6,1.69,0.39,2.6,40
NDC,4988430802,CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,2.6,1.69,0.39,2.6,40
NDC,4988430902,CLONAZEPAM 1 MG DISINTEGRATING TABLET,2.96,1.92,0.44,2.96,40
NDC,4988431002,CLONAZEPAM 2 MG DISINTEGRATING TABLET,4.1,2.67,0.61,4.1,40
NDC,4988431555,RISPERIDONE 1 MG DISINTEGRATING TABLET,11.5,7.48,1.71,11.5,40
NDC,4988434701,PIMOZIDE 1 MG TABLET,3.66,2.38,0.54,3.66,40
NDC,4988434801,PIMOZIDE 2 MG TABLET,4.88,3.17,0.73,4.88,40
NDC,4988436401,DANTROLENE 100 MG CAPSULE,3.9,2.54,0.58,3.9,40
NDC,4988446565,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,6.74,4.38,1.0,6.74,40
NDC,4988448454,LAMOTRIGINE 25 MG DISINTEGRATING TABLET,17.76,11.54,2.64,17.76,40
NDC,4988448611,LAMOTRIGINE 100 MG DISINTEGRATING TABLET,20.28,13.18,3.02,20.28,40
NDC,4988455601,ISOSORBIDE DINITRATE 40 MG TABLET,41.08,26.7,6.11,41.08,40
NDC,4988456111,LAMOTRIGINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,13.1,8.52,1.95,13.1,40
NDC,4988456211,LAMOTRIGINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,26.18,17.02,3.9,26.18,40
NDC,4988456311,LAMOTRIGINE ER 100 MG TABLETEXTENDED RELEASE 24 HR,28.06,18.24,4.18,28.06,40
NDC,4988456411,LAMOTRIGINE ER 200 MG TABLETEXTENDED RELEASE 24 HR,29.92,19.45,4.45,29.92,40
NDC,4988460411,LAMOTRIGINE ER 250 MG TABLETEXTENDED RELEASE 24 HR,40.8,26.52,6.07,40.8,40
NDC,4988460511,LAMOTRIGINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,44.88,29.17,6.68,44.88,40
NDC,4988472401,HYDROXYUREA 500 MG CAPSULE,2.56,1.66,0.38,2.56,40
NDC,4988476854,TOLVAPTAN 15 MG TABLET,1123.56,730.31,167.19,1123.56,40
NDC,4988493666,QUESTRAN 4 GRAM ORAL POWDER,0.49,0.32,0.07,0.49,40
NDC,5000472500,DEFLUX 50 MG-15 MG/ML (1) SYRINGE,11438.85,7435.25,1702.1,11438.85,41
NDC,5001442850,ISOPROPYL ALCOHOL 70 % SOLUTION,0.64,0.42,0.1,0.64,40
NDC,5001695711,GEL-ONE 30 MG/3 ML INTRA-ARTICULAR SYRINGE,1380.0,897.0,2.17,1564.4,65
NDC,5002443203,ANBESOL (BENZOCAINE) MAXIMUM STRENGTH 20 % MUCOSAL GEL,1.26,0.82,0.19,1.26,40
NDC,5009002951,KENALOG 10 MG/ML SUSPENSION FOR INJECTION,8.7,5.66,1.29,8.86,51
NDC,5009018680,AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION,5.83,3.79,0.87,5.83,40
NDC,5009067050,HADLIMA 40 MG/0.8 ML SUBCUTANEOUS SYRINGE,2335.5,1518.08,347.52,2335.5,40
NDC,5009067060,HADLIMA PUSHTOUCH 40 MG/0.8 ML SUBCUTANEOUS AUTO-INJECTOR,2335.53,1518.09,347.53,2335.53,40
NDC,5010211101,ECONTRA EZ 1.5 MG TABLET,73.12,47.53,10.88,73.12,40
NDC,5010211112,ECONTRA EZ 1.5 MG TABLET,73.12,47.53,10.88,73.12,40
NDC,5011132703,HYDRALAZINE 25 MG TABLET,1.0,0.65,0.15,1.0,40
NDC,5011132801,HYDRALAZINE 50 MG TABLET,1.12,0.73,0.17,1.12,40
NDC,5011132803,HYDRALAZINE 50 MG TABLET,1.1,0.72,0.16,1.1,40
NDC,5011133402,METRONIDAZOLE 500 MG TABLET,1.38,0.9,0.21,1.38,40
NDC,5011139701,HYDRALAZINE 100 MG TABLET,2.02,1.31,0.3,2.02,40
NDC,5011139803,HYDRALAZINE 10 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,5011145601,OXYBUTYNIN CHLORIDE 5 MG TABLET,1.52,0.99,0.23,1.52,40
NDC,5011164701,FLUOXETINE 10 MG CAPSULE,5.2,3.38,0.77,5.2,40
NDC,5011164803,FLUOXETINE 20 MG CAPSULE,5.24,3.41,0.78,5.24,40
NDC,5011191701,TORSEMIDE 20 MG TABLET,1.64,1.07,0.24,1.64,40
NDC,5019014123,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.38,0.25,0.06,0.38,40
NDC,5019014263,NEBUSAL 3 % SOLUTION FOR NEBULIZATION,0.38,0.25,0.06,0.38,40
NDC,5019074060,PULMOSAL 7 % SOLUTION FOR NEBULIZATION,0.4,0.26,0.06,0.4,40
NDC,5020124001,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET,0.82,0.53,0.12,0.82,40
NDC,5022234602,ADBRY 150 MG/ML SUBCUTANEOUS SYRINGE,3662.43,2380.58,41.42,3662.43,51
NDC,5022814601,HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE,0.86,0.56,0.13,0.86,40
NDC,5022845701,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,5022846501,NABUMETONE 500 MG TABLET,2.48,1.61,0.37,2.48,40
NDC,5022846601,NABUMETONE 750 MG TABLET,2.92,1.9,0.43,2.92,40
NDC,5022848201,DILTIAZEM 60 MG TABLET,3.14,2.04,0.47,3.14,40
NDC,5022848301,DILTIAZEM 90 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,5022848401,DILTIAZEM 120 MG TABLET,5.76,3.74,0.86,5.76,40
NDC,5024201403,TNKASE 25 MG INTRAVENOUS SOLUTION,30766.26,19998.07,2.17,30766.26,65
NDC,5024204062,XOLAIR 150 MG SUBCUTANEOUS SOLUTION,7069.24,4595.01,2.17,7069.24,65
NDC,5024204164,CATHFLO ACTIVASE 2 MG INTRA-CATHETER SOLUTION,666.6,433.29,2.17,666.6,65
NDC,5024204413,ACTIVASE 50 MG INTRAVENOUS SOLUTION,15840.66,10296.43,2.17,15840.66,65
NDC,5024205121,RITUXAN 10 MG/ML CONCENTRATEINTRAVENOUS,450.96,293.12,2.17,4487.68,65
NDC,5024205306,RITUXAN 10 MG/ML CONCENTRATEINTRAVENOUS,450.96,293.12,2.17,4487.68,65
NDC,5024206001,AVASTIN 25 MG/ML INTRAVENOUS SOLUTION,956.32,621.61,2.17,3257.22,65
NDC,5024206101,AVASTIN 25 MG/ML INTRAVENOUS SOLUTION,956.32,621.61,2.17,3257.22,65
NDC,5024207001,GAZYVA 1000 MG/40 ML INTRAVENOUS SOLUTION,1080.04,702.03,2.17,4417.71,65
NDC,5024207501,NUTROPIN AQ NUSPIN 5 MG/2 ML (2.5 MG/ML) SUBCUTANEOUS PEN INJECTOR,1131.6,735.54,2.17,1131.6,57
NDC,5024207701,HERCEPTIN HYLECTA 600 MG-10000 UNIT/5 ML SUBCUTANEOUS SOLUTION,4488.24,2917.36,2.17,4488.24,65
NDC,5024207812,SUSVIMO 10 MG/0.1 ML INTRAVITREAL SOLUTION,288000.0,187200.0,2.17,288000.0,65
NDC,5024207855,SUSVIMO (INITIAL FILL) 10 MG/0.1 ML INTRAVITREAL IMPLANT SOLUTION,288000.0,187200.0,2.17,288000.0,65
NDC,5024207908,ITOVEBI 9 MG TABLET,1960.02,1274.01,291.65,1960.02,40
NDC,5024208001,DARVOCET-N 50 50 MG-325 MG TAB,140400.0,91260.0,2.17,140400.0,65
NDC,5024208003,LUCENTIS 0.5 MG/0.05 ML INTRAVITREAL SYRINGE,140400.0,91260.0,2.17,140400.0,65
NDC,5024208203,LUCENTIS 0.3 MG/0.05 ML INTRAVITREAL SYRINGE,84240.0,54756.0,2.17,84240.0,65
NDC,5024208408,ITOVEBI 3 MG TABLET,980.02,637.01,145.83,980.02,40
NDC,5024208527,ACTIVASE 100 MG INTRAVENOUS SOLUTION,31681.29,20592.84,2.17,31681.29,65
NDC,5024208701,KADCYLA 160 MG INTRAVENOUS SOLUTION,30640.32,19916.21,2.17,30640.32,65
NDC,5024208801,KADCYLA 100 MG INTRAVENOUS SOLUTION,19150.24,12447.66,2.17,19150.24,65
NDC,5024209002,ZELBORAF 240 MG TABLET,126.32,82.11,18.8,126.32,40
NDC,5024209130,ROZLYTREK 100 MG CAPSULE,561.2,364.78,83.51,561.2,40
NDC,5024209490,ROZLYTREK 200 MG CAPSULE,561.2,364.78,83.51,561.2,40
NDC,5024209601,VABYSMO 6 MG/0.05 ML INTRAVITREAL SOLUTION,168976.08,109834.45,2.17,168976.08,65
NDC,5024209606,VABYSMO 6 MG/0.05 ML INTRAVITREAL SYRINGE,168976.08,109834.45,2.17,168976.08,65
NDC,5024210039,PULMOZYME 1 MG/ML SOLUTION FOR INHALATION,128.42,83.47,19.11,128.42,40
NDC,5024210040,PULMOZYME 1 MG/ML SOLUTION FOR INHALATION,128.42,83.47,19.11,128.42,40
NDC,5024210301,POLIVY 30 MG INTRAVENOUS SOLUTION,19143.2,12443.08,2.17,19143.2,65
NDC,5024210501,POLIVY 140 MG INTRAVENOUS SOLUTION,89334.76,58067.59,2.17,89334.76,65
NDC,5024210801,RITUXAN HYCELA 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2698.08,1753.75,2.17,4487.68,65
NDC,5024210901,RITUXAN HYCELA 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2019.24,1312.51,2.17,4487.68,65
NDC,5024212047,TNKASE 50 MG INTRAVENOUS SOLUTION,29870.13,19415.58,2.17,29870.13,65
NDC,5024212501,COLUMVI 1 MG/ML INTRAVENOUS SOLUTION,5203.8,3382.47,2.17,8424.39,65
NDC,5024212701,COLUMVI 1 MG/ML INTRAVENOUS SOLUTION,5203.84,3382.5,2.17,8424.39,65
NDC,5024213001,ALECENSA 150 MG CAPSULE,194.66,126.53,28.97,194.66,40
NDC,5024213201,HERCEPTIN 150 MG INTRAVENOUS SOLUTION,7480.4,4862.26,2.17,7480.4,65
NDC,5024213501,ACTEMRA 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,2.17,1287.79,65
NDC,5024213601,ACTEMRA 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,2.17,1287.79,65
NDC,5024213701,ACTEMRA 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,2.17,1287.79,65
NDC,5024213801,ACTEMRA 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,6265.64,4072.67,2.17,6265.64,65
NDC,5024214001,ERIVEDGE 150 MG CAPSULE,1180.24,767.16,175.62,1180.24,40
NDC,5024214201,LUNSUMIO 1 MG/ML INTRAVENOUS SOLUTION,2996.44,1947.69,2.17,16617.81,65
NDC,5024214501,PERJETA 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,2338.44,1519.99,2.17,4487.68,65
NDC,5024215001,OCREVUS 30 MG/ML INTRAVENOUS SOLUTION,7430.76,4829.99,2.17,16617.81,65
NDC,5024215901,LUNSUMIO 1 MG/ML INTRAVENOUS SOLUTION,2996.4,1947.66,2.17,16617.81,65
NDC,5024217601,TNKASE 50 MG INTRAVENOUS SOLUTION,29870.13,19415.58,2.17,29870.13,65
NDC,5024221401,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,2.17,5301.93,65
NDC,5024221403,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,2.17,5301.93,65
NDC,5024221455,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,2.17,5301.93,65
NDC,5024221501,XOLAIR 150 MG/ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,2.17,5301.93,65
NDC,5024221503,XOLAIR 150 MG/ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,2.17,5301.93,65
NDC,5024221555,XOLAIR 150 MG/ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,2.17,5301.93,65
NDC,5024222701,XOLAIR 300 MG/2 ML SUBCUTANEOUS SYRINGE,5301.96,3446.27,2.17,5301.96,65
NDC,5024222755,XOLAIR 300 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,5301.96,3446.27,2.17,5301.96,65
NDC,5024224501,PHESGO 1200 MG-600 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,4453.28,2894.63,2.17,4487.68,65
NDC,5024226001,PHESGO 600 MG-600 MG-20000 UNIT/10 ML SUBCUTANEOUS SOLUTION,4453.12,2894.53,2.17,4487.68,65
NDC,5024255401,OCREVUS ZUNOVO 920 MG-23000 UNIT/23 ML SUBCUTANEOUS SOLUTION,6461.52,4199.99,2.17,16617.81,59
NDC,5024271701,COTELLIC 20 MG TABLET,310.64,201.92,46.22,310.64,40
NDC,5024291701,TECENTRIQ 1200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,2.17,7011.25,65
NDC,5024291801,TECENTRIQ 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,2.17,7011.25,65
NDC,5024292001,HEMLIBRA 30 MG/ML SUBCUTANEOUS SOLUTION,13057.68,8487.49,2.17,16617.81,65
NDC,5024292101,HEMLIBRA 60 MG/0.4 ML SUBCUTANEOUS SOLUTION,65288.34,42437.42,2.17,65288.34,65
NDC,5024292301,HEMLIBRA 150 MG/ML SUBCUTANEOUS SOLUTION,65288.37,42437.44,2.17,65288.37,65
NDC,5026803715,AMITRIPTYLINE 10 MG TABLET,1.0,0.65,0.15,1.0,40
NDC,5026803815,AMITRIPTYLINE 25 MG TABLET,1.0,0.65,0.15,1.0,40
NDC,5026803915,AMITRIPTYLINE 50 MG TABLET,1.3,0.85,0.19,1.3,40
NDC,5026804315,ARTIFICIAL TEARS(DEXTRAN-HYPROMEL-GLYCERN) 0.1 %-0.3 %-0.2 % EYE DROPS,1.06,0.69,0.16,1.06,40
NDC,5026805011,ACEBUTOLOL 200 MG CAPSULE,3.56,2.31,0.53,3.56,40
NDC,5026805015,ACEBUTOLOL 200 MG CAPSULE,3.56,2.31,0.53,3.56,40
NDC,5026805415,ACETAZOLAMIDE 250 MG TABLET,8.38,5.45,1.25,8.38,40
NDC,5026806115,ACYCLOVIR 400 MG TABLET,7.5,4.88,1.12,7.5,40
NDC,5026806915,AMANTADINE HCL 100 MG CAPSULE,6.96,4.52,1.04,6.96,40
NDC,5026808612,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,20.65,13.42,3.07,20.65,40
NDC,5026808712,ARIPIPRAZOLE 2 MG TABLET,61.18,39.77,9.1,61.18,40
NDC,5026808815,ARIPIPRAZOLE 5 MG TABLET,59.86,38.91,8.91,59.86,40
NDC,5026808915,ARIPIPRAZOLE 10 MG TABLET,59.86,38.91,8.91,59.86,40
NDC,5026809012,ARIPIPRAZOLE 15 MG TABLET,61.22,39.79,9.11,61.22,40
NDC,5026810213,BALSALAZIDE 750 MG CAPSULE,5.28,3.43,0.79,5.28,40
NDC,5026810515,BACLOFEN 5 MG TABLET,5.44,3.54,0.81,5.44,40
NDC,5026812815,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,5.74,3.73,0.85,5.74,40
NDC,5026813015,BUMETANIDE 0.5 MG TABLET,3.04,1.98,0.45,3.04,40
NDC,5026813111,BUMETANIDE 1 MG TABLET,3.0,1.95,0.45,3.0,40
NDC,5026813115,BUMETANIDE 1 MG TABLET,3.0,1.95,0.45,3.0,40
NDC,5026813515,BUSPIRONE 15 MG TABLET,1.38,0.9,0.21,1.38,40
NDC,5026814415,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,9.5,6.18,1.41,47.96,48
NDC,5026814515,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,16.92,11.0,2.17,47.96,48
NDC,5026814911,CALCIUM 500 MG (AS CALCIUM CARBONATE 1250 MG) CHEWABLE TABLET,0.54,0.35,0.08,0.54,40
NDC,5026815115,CEPHALEXIN 250 MG CAPSULE,1.36,0.88,0.2,1.36,40
NDC,5026816815,CELECOXIB 100 MG CAPSULE,8.74,5.68,1.3,8.74,40
NDC,5026817415,CLONAZEPAM 1 MG TABLET,1.42,0.92,0.21,1.42,40
NDC,5026817815,CLARITHROMYCIN 250 MG TABLET,11.68,7.59,1.74,11.68,40
NDC,5026818412,CLOPIDOGREL 300 MG TABLET,38.54,25.05,5.73,38.54,40
NDC,5026818715,COLCHICINE 0.6 MG TABLET,14.4,9.36,2.14,14.4,40
NDC,5026819015,CYCLOBENZAPRINE 5 MG TABLET,2.46,1.6,0.37,2.46,40
NDC,5026819115,CYCLOBENZAPRINE 10 MG TABLET,0.42,0.27,0.06,0.42,40
NDC,5026825915,DIVALPROEX ER 250 MG TABLETEXTENDED RELEASE 24 HR,1.24,0.81,0.18,1.24,40
NDC,5026826013,DIVALPROEX ER 500 MG TABLETEXTENDED RELEASE 24 HR,3.3,2.15,0.49,3.3,40
NDC,5026827715,DOXYCYCLINE HYCLATE 50 MG CAPSULE,5.56,3.61,0.83,5.56,40
NDC,5026827811,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.0,5.2,1.19,8.0,40
NDC,5026827815,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.0,5.2,1.19,8.0,40
NDC,5026829715,ERGOCALCIFEROL (VITAMIN D2) 1250 MCG (50000 UNIT) CAPSULE,3.84,2.5,0.57,3.84,40
NDC,5026829812,EZETIMIBE 10 MG TABLET,24.78,16.11,3.69,24.78,40
NDC,5026829915,FAMOTIDINE 20 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,5026830415,FAMOTIDINE 40 MG TABLET,6.54,4.25,0.97,6.54,40
NDC,5026831211,FENOFIBRATE 54 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,5026831215,FENOFIBRATE 54 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,5026831311,FENOFIBRATE 160 MG TABLET,10.26,6.67,1.53,10.26,40
NDC,5026831315,FENOFIBRATE 160 MG TABLET,10.26,6.67,1.53,10.26,40
NDC,5026831415,FINASTERIDE 5 MG TABLET,6.26,4.07,0.93,6.26,40
NDC,5026833015,FLUDROCORTISONE 0.1 MG TABLET,3.2,2.08,0.48,3.2,40
NDC,5026833715,FLUCONAZOLE 100 MG TABLET,19.06,12.39,2.84,19.06,40
NDC,5026833915,FLUCONAZOLE 200 MG TABLET,32.62,21.2,4.85,32.62,40
NDC,5026834615,FOLIC ACID 400 MCG TABLET,0.56,0.36,0.08,0.56,40
NDC,5026837515,GLUCOSAMINE SULFATE 500 MG CAPSULE,0.92,0.6,0.14,0.92,40
NDC,5026839850,HYDROXYZINE PAMOATE 25 MG CAPSULE,1.14,0.74,0.17,1.14,40
NDC,5026843015,INDOMETHACIN 25 MG CAPSULE,0.86,0.56,0.13,0.86,40
NDC,5026843115,INDOMETHACIN 50 MG CAPSULE,1.32,0.86,0.2,1.32,40
NDC,5026844215,IRBESARTAN 300 MG TABLET,7.4,4.81,1.1,7.4,40
NDC,5026844715,ISOSORBIDE DINITRATE 5 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,5026845012,ITRACONAZOLE 100 MG CAPSULE,11.32,7.36,1.68,11.32,40
NDC,5026847615,LETROZOLE 2.5 MG TABLET,36.1,23.47,5.37,36.1,40
NDC,5026848215,LOPERAMIDE 2 MG CAPSULE,1.98,1.29,0.29,1.98,40
NDC,5026850615,LOSARTAN 100 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,5026852215,MECLIZINE 12.5 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,5026852415,MELATONIN 3 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,5026852511,MELOXICAM 7.5 MG TABLET,6.2,4.03,0.92,6.2,40
NDC,5026852515,MELOXICAM 7.5 MG TABLET,6.2,4.03,0.92,6.2,40
NDC,5026854915,METHENAMINE HIPPURATE 1 GRAM TABLET,6.84,4.45,1.02,6.84,40
NDC,5026855015,METFORMIN ER 500 MG TABLETEXTENDED RELEASE 24 HR,1.24,0.81,0.18,1.24,40
NDC,5026855115,METFORMIN ER 750 MG TABLETEXTENDED RELEASE 24 HR,2.42,1.57,0.36,2.42,40
NDC,5026855311,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,5026855313,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,5026855615,MONTELUKAST 10 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,5026856815,MUPIROCIN 2 % TOPICAL OINTMENT,10.26,6.67,1.53,10.26,40
NDC,5026857411,MONTELUKAST 5 MG CHEWABLE TABLET,8.22,5.34,1.22,8.22,40
NDC,5026857415,MONTELUKAST 5 MG CHEWABLE TABLET,8.22,5.34,1.22,8.22,40
NDC,5026858215,NIACIN 100 MG TABLET,0.9,0.59,0.13,0.9,40
NDC,5026858413,NIACIN ER 500 MG TABLETEXTENDED RELEASE 24 HR,11.48,7.46,1.71,11.48,40
NDC,5026858515,PANTOPRAZOLE 20 MG TABLETDELAYED RELEASE,7.98,5.19,1.19,7.98,40
NDC,5026858713,MEMANTINE 5 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,5026859411,NAPROXEN 250 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,5026859415,NAPROXEN 250 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,5026859515,NAPROXEN 375 MG TABLET,1.98,1.29,0.29,1.98,40
NDC,5026859715,NIFEDIPINE ER 30 MG TABLETEXTENDED RELEASE 24 HR,2.62,1.7,0.39,2.62,40
NDC,5026859915,NIFEDIPINE ER 90 MG TABLETEXTENDED RELEASE 24 HR,4.98,3.24,0.74,4.98,40
NDC,5026861513,OLANZAPINE 5 MG DISINTEGRATING TABLET,27.94,18.16,4.16,27.94,40
NDC,5026862115,ONDANSETRON HCL 4 MG TABLET,1.48,0.96,0.22,1.48,40
NDC,5026862315,NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,8.84,5.75,1.32,8.84,40
NDC,5026862415,NITROFURANTOIN MACROCRYSTAL 100 MG CAPSULE,6.9,4.49,1.03,6.9,40
NDC,5026863915,PANTOPRAZOLE 40 MG TABLETDELAYED RELEASE,8.06,5.24,1.2,8.06,40
NDC,5026864515,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,5.42,3.52,0.81,5.42,40
NDC,5026865212,PILOCARPINE 5 MG TABLET,6.76,4.39,1.01,6.76,40
NDC,5026867113,POTASSIUM CHLORIDE ER 10 MEQ CAPSULEEXTENDED RELEASE,8.0,5.2,1.19,8.0,40
NDC,5026868415,PROCHLORPERAZINE MALEATE 5 MG TABLET,3.22,2.09,0.48,3.22,40
NDC,5026868515,PROCHLORPERAZINE MALEATE 10 MG TABLET,3.54,2.3,0.53,3.54,40
NDC,5026871015,ROSUVASTATIN 20 MG TABLET,2.96,1.92,0.44,2.96,40
NDC,5026871115,ROSUVASTATIN 40 MG TABLET,3.18,2.07,0.47,3.18,40
NDC,5026872215,RANOLAZINE ER 500 MG TABLETEXTENDED RELEASE12 HR,3.78,2.46,0.56,3.78,40
NDC,5026872815,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,1.32,0.86,0.2,1.32,40
NDC,5026874015,TAMSULOSIN 0.4 MG CAPSULE,0.96,0.62,0.14,0.96,40
NDC,5026874215,ROPINIROLE 0.5 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,5026874415,ROPINIROLE 2 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,5026874514,SUCRALFATE 100 MG/ML ORAL SUSPENSION,2.15,1.4,0.32,2.15,40
NDC,5026875415,TORSEMIDE 5 MG TABLET,1.26,0.82,0.19,1.26,40
NDC,5026875515,TORSEMIDE 10 MG TABLET,1.42,0.92,0.21,1.42,40
NDC,5026875715,TORSEMIDE 100 MG TABLET,5.78,3.76,0.86,5.78,40
NDC,5026875812,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,11.32,7.36,1.68,11.32,40
NDC,5026876212,TEMOZOLOMIDE 100 MG CAPSULE,152.84,99.35,0.58,152.84,51
NDC,5026878712,VALGANCICLOVIR 450 MG TABLET,298.86,194.26,44.47,298.86,40
NDC,5026878815,VALACYCLOVIR 500 MG TABLET,11.94,7.76,1.78,11.94,40
NDC,5026880312,VORICONAZOLE 200 MG TABLET,47.4,30.81,7.05,47.4,40
NDC,5026885115,VITAMIN B-1 (MONONITRATE) 100 MG TABLET,0.62,0.4,0.09,0.62,40
NDC,5026885215,VITAMIN B-12  100 MCG TABLET,0.62,0.4,0.09,0.62,40
NDC,5026885415,VITAMIN B-12 500 MCG TABLET,0.64,0.42,0.1,0.64,40
NDC,5026885511,VITAMIN B-12  1000 MCG TABLET,0.72,0.47,0.11,0.72,40
NDC,5026885515,VITAMIN B-12  1000 MCG TABLET,0.72,0.47,0.11,0.72,40
NDC,5026885811,VITAMIN B-6 50 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,5026885815,VITAMIN B-6 50 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,5026885915,VITAMIN B-6 100 MG TABLET,0.58,0.38,0.09,0.58,40
NDC,5026886011,VITAMIN C 250 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,5026886015,VITAMIN C 250 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,5026886315,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,0.56,0.36,0.08,0.56,40
NDC,5026886611,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) TABLET,0.66,0.43,0.1,0.66,40
NDC,5026886615,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) TABLET,0.66,0.43,0.1,0.66,40
NDC,5026886815,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) CAPSULE,0.76,0.49,0.11,0.76,40
NDC,5028932501,A.E.R. WITCH HAZEL 12.5 %-50 % TOPICAL PADS,0.18,0.12,0.03,0.18,40
NDC,5038308710,GUAIATUSSIN AC 10 MG-100 MG/5 ML ORAL LIQUID,0.2,0.13,0.03,0.2,40
NDC,5038308712,GUAIATUSSIN AC 10 MG-100 MG/5 ML ORAL LIQUID,0.16,0.1,0.02,0.16,40
NDC,5041917103,STIVARGA 40 MG TABLET,681.24,442.81,101.37,681.24,40
NDC,5041925001,ADEMPAS 0.5 MG TABLET,376.28,244.58,55.99,376.28,40
NDC,5041925101,ADEMPAS 1 MG TABLET,376.28,244.58,55.99,376.28,40
NDC,5041925201,ADEMPAS 1.5 MG TABLET,376.28,244.58,55.99,376.28,40
NDC,5041925301,ADEMPAS 2 MG TABLET,376.28,244.58,55.99,376.28,40
NDC,5041925401,ADEMPAS 2.5 MG TABLET,376.28,244.58,55.99,376.28,40
NDC,5041925491,ADEMPAS 2.5 MG TABLET,376.28,244.58,55.99,376.28,40
NDC,5041932005,EOVIST 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,51.12,33.23,0.01,51.12,49
NDC,5041934405,ULTRAVIST 300 MG IODINE/ML INJECTION SOLUTION,1.5,0.98,0.01,22.96,49
NDC,5041939001,VITRAKVI 25 MG CAPSULE,540.58,351.38,80.44,540.58,40
NDC,5041939101,VITRAKVI 100 MG CAPSULE,1621.78,1054.16,241.32,1621.78,40
NDC,5041939201,VITRAKVI 20 MG/ML ORAL SOLUTION,540.58,351.38,80.44,540.58,40
NDC,5041942201,SKYLA 14 MCG/24 HR (UP TO 3 YEARS) 13.5 MG INTRAUTERINE DEVICE,2427.32,1577.76,2.17,2635.36,51
NDC,5041942301,MIRENA 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2915.12,1894.83,2.17,3164.98,51
NDC,5041942401,KYLEENA 17.5 MCG/24 HR (UP TO 5 YEARS) 19.5 MG INTRAUTERINE DEVICE,2915.12,1894.83,2.17,3164.98,51
NDC,5041945104,CLIMARA 0.05 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,6.81,45.78,40
NDC,5041945204,CLIMARA 0.1 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,6.81,45.78,40
NDC,5041945404,CLIMARA 0.025 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,6.81,45.78,40
NDC,5041945604,CLIMARA 0.0375 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,6.81,45.78,40
NDC,5041952435,BETASERON 0.3 MG SUBCUTANEOUS KIT,2558.01,1662.71,2.17,2558.01,51
NDC,5041954001,KERENDIA 10 MG TABLET,54.94,35.71,8.18,54.94,40
NDC,5041954101,KERENDIA 20 MG TABLET,54.94,35.71,8.18,54.94,40
NDC,5041954106,KERENDIA 20 MG TABLET,57.24,37.21,8.52,57.24,40
NDC,5041954201,KERENDIA 40 MG TABLET,54.94,35.71,8.18,54.94,40
NDC,5041954206,KERENDIA 40 MG TABLET,54.94,35.71,8.18,54.94,40
NDC,5041974701,BILTRICIDE 600 MG TABLET,199.3,129.55,29.66,199.3,40
NDC,5041975101,LAMPIT 120 MG TABLET,7.2,4.68,1.07,7.2,40
NDC,5041977301,CIPRO 500 MG/5 ML ORAL SUSPENSION,4.58,2.98,0.68,4.58,40
NDC,5041977701,CIPRO 250 MG/5 ML ORAL SUSPENSION,3.93,2.55,0.58,3.93,40
NDC,5041986251,PRECOSE 100 MG TABLET,2.9,1.89,0.43,2.9,40
NDC,5045802800,SPRAVATO 28 MG NASAL SPRAY,1001.04,650.68,148.95,1001.04,51
NDC,5045802802,SPRAVATO 56 MG (28 MG X 2) NASAL SPRAY,1001.04,650.68,148.95,1001.04,51
NDC,5045802803,SPRAVATO 84 MG (28 MG X 3) NASAL SPRAY,1001.04,650.68,148.95,1001.04,51
NDC,5045809801,ELMIRON 100 MG CAPSULE,28.74,18.68,4.28,28.74,40
NDC,5045814030,INVOKANA 100 MG TABLET,47.88,31.12,7.12,47.88,40
NDC,5045814130,INVOKANA 300 MG TABLET,47.88,31.12,7.12,47.88,40
NDC,5045829001,SPORANOX 100 MG CAPSULE,68.9,44.79,10.25,68.9,40
NDC,5045829004,SPORANOX 100 MG CAPSULE,68.9,44.79,10.25,68.9,40
NDC,5045830001,RISPERDAL 1 MG TABLET,11.76,7.64,1.75,11.76,40
NDC,5045830206,RISPERDAL 0.5 MG TABLET,11.06,7.19,1.65,11.06,40
NDC,5045830503,RISPERDAL 1 MG/ML ORAL SOLUTION,16.43,10.68,2.44,16.43,40
NDC,5045830611,RISPERDAL CONSTA 25 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,2323.05,1509.98,2.17,2323.05,65
NDC,5045830711,RISPERDAL CONSTA 37.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,3484.68,2265.04,2.17,3484.68,65
NDC,5045830811,RISPERDAL CONSTA 50 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,4646.4,3020.16,2.17,4646.4,65
NDC,5045830901,RISPERDAL CONSTA 12.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,1161.66,755.08,2.17,1161.66,65
NDC,5045832001,RISPERDAL 2 MG TABLET,19.66,12.78,2.93,19.66,40
NDC,5045832006,RISPERDAL 2 MG TABLET,19.66,12.78,2.93,19.66,40
NDC,5045835001,RISPERDAL 4 MG TABLET,31.0,20.15,4.61,31.0,40
NDC,5045855001,INVEGA 3 MG TABLETEXTENDED RELEASE,30.02,19.51,4.47,30.02,40
NDC,5045855101,INVEGA 6 MG TABLETEXTENDED RELEASE,30.02,19.51,4.47,30.02,40
NDC,5045855201,INVEGA 9 MG TABLETEXTENDED RELEASE,45.02,29.26,6.7,45.02,40
NDC,5045856001,INVEGA SUSTENNA 39 MG/0.25 ML INTRAMUSCULAR SYRINGE,8565.27,5567.43,2.17,8565.27,65
NDC,5045856101,INVEGA SUSTENNA 78 MG/0.5 ML INTRAMUSCULAR SYRINGE,8565.69,5567.7,2.17,8565.69,65
NDC,5045856201,INVEGA SUSTENNA 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8565.84,5567.8,2.17,8565.84,65
NDC,5045856301,INVEGA SUSTENNA 156 MG/ML INTRAMUSCULAR SYRINGE,8566.17,5568.01,2.17,8566.17,65
NDC,5045856401,INVEGA SUSTENNA 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,8565.96,5567.87,2.17,8565.96,65
NDC,5045857701,XARELTO 2.5 MG TABLET,23.92,15.55,3.56,23.92,40
NDC,5045857710,XARELTO 2.5 MG TABLET,23.92,15.55,3.56,23.92,40
NDC,5045857760,XARELTO 2.5 MG TABLET,23.92,15.55,3.56,23.92,40
NDC,5045857801,XARELTO 15 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045857810,XARELTO 15 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045857830,XARELTO 15 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045857890,XARELTO 15 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045857901,XARELTO 20 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045857910,XARELTO 20 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045857930,XARELTO 20 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045858001,XARELTO 10 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045858010,XARELTO 10 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045858030,XARELTO 10 MG TABLET,47.84,31.1,7.12,47.84,40
NDC,5045858601,CONCERTA 36 MG TABLETEXTENDED RELEASE,32.74,21.28,4.87,32.74,40
NDC,5045858701,CONCERTA 54 MG TABLETEXTENDED RELEASE,35.62,23.15,5.3,35.62,40
NDC,5045860701,INVEGA TRINZA 410 MG/1.32 ML INTRAMUSCULAR SYRINGE,14600.88,9490.57,2.17,14600.88,65
NDC,5045860801,INVEGA TRINZA 546 MG/1.75 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,2.17,14684.85,65
NDC,5045860901,INVEGA TRINZA 819 MG/2.63 ML INTRAMUSCULAR SYRINGE,14656.59,9526.78,2.17,14656.59,65
NDC,5045861101,INVEGA HAFYERA 1092 MG/3.5 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,2.17,14684.85,65
NDC,5045861201,INVEGA HAFYERA 1560 MG/5 ML INTRAMUSCULAR SYRINGE,15418.74,10022.18,2.17,15418.74,65
NDC,5045863965,TOPAMAX 25 MG TABLET,16.04,10.43,2.39,16.04,40
NDC,5045864065,TOPAMAX 50 MG TABLET,32.02,20.81,4.76,32.02,40
NDC,5045864165,TOPAMAX 100 MG TABLET,43.72,28.42,6.51,43.72,40
NDC,5045864265,TOPAMAX 200 MG TABLET,51.18,33.27,7.62,51.18,40
NDC,5045864565,TOPAMAX 25 MG SPRINKLE CAPSULE,18.34,11.92,2.73,18.34,40
NDC,5045864765,TOPAMAX 15 MG SPRINKLE CAPSULE,15.18,9.87,2.26,15.18,40
NDC,5045883002,NUCYNTA 75 MG TABLET,21.54,14.0,3.21,21.54,40
NDC,5045884002,NUCYNTA 100 MG TABLET,28.72,18.67,4.27,28.72,40
NDC,5047400148,KEPPRA 100 MG/ML ORAL SOLUTION,5.85,3.8,0.87,5.85,40
NDC,5047400263,KEPPRA 500 MG/5 ML INTRAVENOUS SOLUTION,49.11,31.92,0.07,49.11,51
NDC,5047437066,BRIVIACT 10 MG TABLET,58.92,38.3,8.77,58.92,40
NDC,5047447066,BRIVIACT 25 MG TABLET,58.92,38.3,8.77,58.92,40
NDC,5047457009,BRIVIACT 50 MG TABLET,58.92,38.3,8.77,58.92,40
NDC,5047457066,BRIVIACT 50 MG TABLET,58.92,38.3,8.77,58.92,40
NDC,5047459440,KEPPRA 250 MG TABLET,19.88,12.92,2.96,19.88,40
NDC,5047459540,KEPPRA 500 MG TABLET,24.28,15.78,3.61,24.28,40
NDC,5047459640,KEPPRA 750 MG TABLET,32.9,21.39,4.9,32.9,40
NDC,5047465165,HEALON GV PRO 18 MG/ML INTRAOCULAR SYRINGE,638.22,414.84,94.97,638.22,40
NDC,5047470062,CIMZIA POWDER FOR RECON 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,28797.28,18718.23,2.17,28797.28,65
NDC,5047471079,CIMZIA 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYRINGE KIT,21597.96,14038.67,2.17,21597.96,65
NDC,5047477009,BRIVIACT 100 MG TABLET,58.92,38.3,8.77,58.92,40
NDC,5047477066,BRIVIACT 100 MG TABLET,58.92,38.3,8.77,58.92,40
NDC,5047478184,BIMZELX AUTOINJECTOR 160 MG/ML SUBCUTANEOUS AUTO-INJECTOR,28522.41,18539.57,4244.13,28522.41,43
NDC,5047478284,BIMZELX AUTOINJECTOR 320 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,38029.84,24719.4,41.42,38029.84,51
NDC,5047480103,NEUPRO 1 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,10.29,69.12,40
NDC,5047480203,NEUPRO 2 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,10.29,69.12,40
NDC,5047480303,NEUPRO 3 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,10.29,69.12,40
NDC,5047480403,NEUPRO 4 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,10.29,69.12,40
NDC,5047480503,NEUPRO 6 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,57.0,37.05,8.48,57.0,40
NDC,5047480603,NEUPRO 8 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,10.29,69.12,40
NDC,5047487015,BRIVIACT 10 MG/ML ORAL SOLUTION,8.84,5.75,1.32,8.84,40
NDC,5047497075,BRIVIACT 50 MG/5 ML INTRAVENOUS SOLUTION,45.45,29.54,6.76,47.96,51
NDC,5047498079,RYSTIGGO 140 MG/ML SUBCUTANEOUS SOLUTION,11163.96,7256.57,2.17,11163.96,65
NDC,5048401030,SANTYL 250 UNIT/GRAM TOPICAL OINTMENT,26.66,17.33,3.97,26.66,40
NDC,5058022651,BENADRYL ALLERGY 25 MG TABLET,0.5,0.33,0.07,0.5,40
NDC,5058045711,TYLENOL EXTRA STRENGTH 500 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,5058053408,BENADRYL ALLERGY 12.5 MG/5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,40
NDC,5058053501,BENADRYL ALLERGY 12.5 MG/5 ML ORAL LIQUID,0.15,0.1,0.02,0.15,40
NDC,5058053504,BENADRYL ALLERGY 12.5 MG/5 ML ORAL LIQUID,0.15,0.1,0.02,0.15,40
NDC,5058057902,CHILDREN'S TYLENOL 160 MG/5 ML ORAL SUSPENSION,0.13,0.08,0.02,0.13,40
NDC,5063201001,RABAVERT (PF) 2.5 UNIT IM SUSPENSION,1564.59,1016.98,13.37,1564.59,65
NDC,5063201301,RABAVERT (PF) 2.5 UNIT IM SUSPENSION,1564.59,1016.98,13.37,1564.59,65
NDC,5063201602,VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE,70.38,45.75,7.93,194.04,51
NDC,5063311012,CROFAB 1 GRAM SOLUTION FOR INJECTION,11512.8,7483.32,2.17,11512.8,65
NDC,5063312011,DIGIFAB 40 MG INTRAVENOUS SOLUTION,17906.4,11639.16,2.17,17906.4,65
NDC,5063321011,VORAXAZE 1000 UNIT INTRAVENOUS SOLUTION,155638.8,101165.22,448.69,155638.8,59
NDC,5063331011,CYANOKIT 5 GRAM INTRAVENOUS SOLUTION,3772.8,2452.32,2.17,3772.8,65
NDC,5063332010,EDETATE CALCIUM DISODIUM 50 MG/ML INTRAVENOUS SOLUTION,126.0,81.9,2.17,18396.77,65
NDC,5074211201,DESIPRAMINE 10 MG TABLET,3.34,2.17,0.5,3.34,40
NDC,5074211301,DESIPRAMINE 25 MG TABLET,4.02,2.61,0.6,4.02,40
NDC,5074211401,DESIPRAMINE 50 MG TABLET,7.56,4.91,1.12,7.56,40
NDC,5074211808,CABERGOLINE 0.5 MG TABLET,73.32,47.66,1.95,73.32,48
NDC,5074214201,METHENAMINE HIPPURATE 1 GRAM TABLET,4.18,2.72,0.62,4.18,40
NDC,5074215230,MODAFINIL 100 MG TABLET,44.14,28.69,6.57,44.14,40
NDC,5074223830,QUININE 324 MG CAPSULE,14.66,9.53,2.18,14.66,40
NDC,5074223901,MEXILETINE 150 MG CAPSULE,5.08,3.3,0.76,5.08,40
NDC,5074224001,MEXILETINE 200 MG CAPSULE,6.06,3.94,0.9,6.06,40
NDC,5074224101,MEXILETINE 250 MG CAPSULE,7.0,4.55,1.04,7.0,40
NDC,5074226101,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,4.58,2.98,0.68,4.58,40
NDC,5074226750,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.79,5.3,40
NDC,5074227901,DICLOFENAC POTASSIUM 50 MG TABLET,5.5,3.58,0.82,5.5,40
NDC,5074235001,METOLAZONE 5 MG TABLET,5.86,3.81,0.87,5.86,40
NDC,5074236360,IVABRADINE 7.5 MG TABLET,21.98,14.29,3.27,21.98,40
NDC,5074236530,BUPRENORPHINE 12 MG-NALOXONE 3 MG SUBLINGUAL FILM,36.86,23.96,2.17,47.96,51
NDC,5074237304,BUPRENORPHINE 7.5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,233.08,151.5,34.68,233.08,40
NDC,5074239730,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,9.82,6.38,1.46,47.96,48
NDC,5074250510,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,45.94,29.86,6.84,45.94,40
NDC,5074251501,NITRO-DUR 0.3 MG/HR TRANSDERMAL 24 HOUR PATCH,127.18,82.67,18.92,127.18,40
NDC,5074251530,NITRO-DUR 0.3 MG/HR TRANSDERMAL 24 HOUR PATCH,127.18,82.67,18.92,127.18,40
NDC,5074251830,NITRO-DUR 0.8 MG/HR TRANSDERMAL 24 HOUR PATCH,137.94,89.66,20.53,137.94,40
NDC,5074252005,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,527.4,342.81,0.69,527.4,65
NDC,5074263860,QUETIAPINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,45.96,29.87,6.84,45.96,40
NDC,5074266701,PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG TABLET,18.66,12.13,2.78,18.66,40
NDC,5088100560,JAKAFI 5 MG TABLET,704.0,457.6,104.76,704.0,40
NDC,5088100603,ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION,3538.32,2299.91,2.17,7011.25,65
NDC,5088101060,JAKAFI 10 MG TABLET,704.0,457.6,104.76,704.0,40
NDC,5088101303,MONJUVI 200 MG INTRAVENOUS SOLUTION,6700.16,4355.1,2.17,6700.16,65
NDC,5088101560,JAKAFI 15 MG TABLET,704.0,457.6,104.76,704.0,40
NDC,5088102060,JAKAFI 20 MG TABLET,704.0,457.6,104.76,704.0,40
NDC,5088102311,NIKTIMVO 50 MG/ML INTRAVENOUS SOLUTION,94500.0,61425.0,2.17,94500.0,59
NDC,5088102560,JAKAFI 25 MG TABLET,704.0,457.6,104.76,704.0,40
NDC,5088102601,PEMAZYRE 4.5 MG TABLET,3477.6,2260.44,517.47,3477.6,40
NDC,5088102701,PEMAZYRE 9 MG TABLET,3477.6,2260.44,517.47,3477.6,40
NDC,5088102801,PEMAZYRE 13.5 MG TABLET,3477.6,2260.44,517.47,3477.6,40
NDC,5088103412,NIKTIMVO 50 MG/ML INTRAVENOUS SOLUTION,94500.0,61425.0,2.17,94500.0,59
NDC,5092407920,ACCU-CHEK SAFE-T-PRO PLUS 23 GAUGE,0.56,0.36,0.08,0.56,39
NDC,5107902320,METOLAZONE 2.5 MG TABLET,6.58,4.28,0.98,6.58,40
NDC,5107902420,METOLAZONE 5 MG TABLET,7.46,4.85,1.11,7.46,40
NDC,5107902820,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.36,44.6,51
NDC,5107905820,CHLORTHALIDONE 25 MG TABLET,4.6,2.99,0.68,4.6,40
NDC,5107908320,ISONIAZID 300 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,5107908620,MIRTAZAPINE 15 MG TABLET,5.44,3.54,0.81,5.44,40
NDC,5107908720,MIRTAZAPINE 30 MG TABLET,5.6,3.64,0.83,5.6,40
NDC,5107908820,MIRTAZAPINE 45 MG TABLET,5.7,3.71,0.85,5.7,40
NDC,5107910320,SPIRONOLACTONE 25 MG TABLET,0.86,0.56,0.13,0.86,40
NDC,5107910903,BUPROPION XL 300 MG 24 HR TAB,12.6,8.19,1.87,12.6,40
NDC,5107911820,DICYCLOMINE 10 MG CAPSULE,1.2,0.78,0.18,1.2,40
NDC,5107912108,LANSOPRAZOLE 30 MG CAPSULEDELAYED RELEASE,11.32,7.36,1.68,11.32,40
NDC,5107913020,CHLORPROMAZINE 50 MG TABLET,27.66,17.98,4.12,27.66,40
NDC,5107913320,AMITRIPTYLINE 50 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,5107914120,CHLORDIAZEPOXIDE 25 MG CAPSULE,1.34,0.87,0.2,1.34,40
NDC,5107914720,AMITRIPTYLINE 75 MG TABLET,3.82,2.48,0.57,3.82,40
NDC,5107916403,VORICONAZOLE 50 MG TABLET,18.76,12.19,2.79,18.76,40
NDC,5107916901,METOPROLOL SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,2.34,1.52,0.35,2.34,40
NDC,5107916920,METOPROLOL SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,2.34,1.52,0.35,2.34,40
NDC,5107917020,METOPROLOL SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,2.34,1.52,0.35,2.34,40
NDC,5107917101,METOPROLOL SUCCINATE ER 100 MG TABLETEXTENDED RELEASE 24 HR,3.52,2.29,0.52,3.52,40
NDC,5107917103,METOPROLOL SUCCINATE ER 100 MG TABLETEXTENDED RELEASE 24 HR,3.52,2.29,0.52,3.52,40
NDC,5107918220,CIPROFLOXACIN 500 MG TABLET,10.2,6.63,1.52,10.2,40
NDC,5107920001,METHYLDOPA 250 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,5107920020,METHYLDOPA 250 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,5107920120,METHYLDOPA 500 MG TABLET,1.34,0.87,0.2,1.34,40
NDC,5107920406,ABACAVIR 300 MG TABLET,20.08,13.05,2.99,20.08,40
NDC,5107920520,ALLOPURINOL 100 MG TABLET,0.76,0.49,0.11,0.76,40
NDC,5107920620,ALLOPURINOL 300 MG TABLET,1.52,0.99,0.23,1.52,40
NDC,5107920820,ATORVASTATIN 10 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,5107920901,ATORVASTATIN 20 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,5107920920,ATORVASTATIN 20 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,5107921001,ATORVASTATIN 40 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,5107921020,ATORVASTATIN 40 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,5107921101,ATORVASTATIN 80 MG TABLET,3.84,2.5,0.57,3.84,40
NDC,5107921103,ATORVASTATIN 80 MG TABLET,3.84,2.5,0.57,3.84,40
NDC,5107924620,LORATADINE 10 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,5107925501,METOPROLOL TARTRATE 25 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,5107925520,METOPROLOL TARTRATE 25 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,5107928401,DIAZEPAM 2 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,5107928420,DIAZEPAM 2 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,5107928501,DIAZEPAM 5 MG TABLET,0.64,0.42,0.1,0.64,40
NDC,5107928520,DIAZEPAM 5 MG TABLET,0.64,0.42,0.1,0.64,40
NDC,5107928620,DIAZEPAM 10 MG TABLET,0.86,0.56,0.13,0.86,40
NDC,5107930120,CLONIDINE HCL 0.3 MG TABLET,0.96,0.62,0.14,0.96,40
NDC,5107934820,NITROFURANTOIN MONOHYDRATE & MACROCRYSTAL 100 MG ORAL CAP,10.2,6.63,1.52,10.2,40
NDC,5107937401,CHLORDIAZEPOXIDE 5 MG CAPSULE,1.62,1.05,0.24,1.62,40
NDC,5107937420,CHLORDIAZEPOXIDE 5 MG CAPSULE,1.62,1.05,0.24,1.62,40
NDC,5107937520,CHLORDIAZEPOXIDE 10 MG CAPSULE,1.24,0.81,0.18,1.24,40
NDC,5107941721,LORAZEPAM 0.5 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,5107941820,TEMAZEPAM 15 MG CAPSULE,1.42,0.92,0.21,1.42,40
NDC,5107941920,TEMAZEPAM 30 MG CAPSULE,1.66,1.08,0.25,1.66,40
NDC,5107943601,DOXEPIN 10 MG CAPSULE,1.28,0.83,0.19,1.28,40
NDC,5107943620,DOXEPIN 10 MG CAPSULE,1.28,0.83,0.19,1.28,40
NDC,5107943701,DOXEPIN 25 MG CAPSULE,1.68,1.09,0.25,1.68,40
NDC,5107943720,DOXEPIN 25 MG CAPSULE,1.68,1.09,0.25,1.68,40
NDC,5107943801,DOXEPIN 50 MG CAPSULE,2.34,1.52,0.35,2.34,40
NDC,5107943820,DOXEPIN 50 MG CAPSULE,2.34,1.52,0.35,2.34,40
NDC,5107944020,LEVOTHYROXINE 50 MCG TABLET,1.08,0.7,0.16,1.08,40
NDC,5107944120,LEVOTHYROXINE 75 MCG TABLET,1.2,0.78,0.18,1.2,40
NDC,5107944220,LEVOTHYROXINE 100 MCG TABLET,1.22,0.79,0.18,1.22,40
NDC,5107944320,LEVOTHYROXINE 125 MCG TABLET,1.44,0.94,0.21,1.44,40
NDC,5107944420,LEVOTHYROXINE 25 MCG TABLET,0.96,0.62,0.14,0.96,40
NDC,5107944520,LEVOTHYROXINE 150 MCG TABLET,1.48,0.96,0.22,1.48,40
NDC,5107945120,AMLODIPINE 5 MG TABLET,3.46,2.25,0.51,3.46,40
NDC,5107945320,MIDODRINE 5 MG TABLET,5.42,3.52,0.81,5.42,40
NDC,5107945420,SIMVASTATIN 10 MG TABLET,5.58,3.63,0.83,5.58,40
NDC,5107945520,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,5107945801,PRAVASTATIN 20 MG TABLET,6.54,4.25,0.97,6.54,40
NDC,5107945820,PRAVASTATIN 20 MG TABLET,6.54,4.25,0.97,6.54,40
NDC,5107946620,DICLOFENAC SODIUM 50 MG TABLETDELAYED RELEASE,2.94,1.91,0.44,2.94,40
NDC,5107948020,VENLAFAXINE 37.5 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,5107948520,FLUPHENAZINE 1 MG TABLET,1.16,0.75,0.17,1.16,40
NDC,5107951620,CHLORPROMAZINE 100 MG TABLET,44.48,28.91,6.62,44.48,40
NDC,5107951820,CHLORPROMAZINE 10 MG TABLET,13.26,8.62,1.97,13.26,40
NDC,5107951920,CHLORPROMAZINE 25 MG TABLET,19.12,12.43,2.85,19.12,40
NDC,5107956320,AMITRIPTYLINE 100 MG TABLET,5.08,3.3,0.76,5.08,40
NDC,5107956520,THIORIDAZINE 10 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,5107956601,THIORIDAZINE 25 MG TABLET,1.52,0.99,0.23,1.52,40
NDC,5107956620,THIORIDAZINE 25 MG TABLET,1.52,0.99,0.23,1.52,40
NDC,5107956720,THIORIDAZINE 50 MG TABLET,1.9,1.24,0.28,1.9,40
NDC,5107957220,TRIFLUOPERAZINE 1 MG TABLET,2.68,1.74,0.4,2.68,40
NDC,5107957320,TRIFLUOPERAZINE 2 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,5107957420,TRIFLUOPERAZINE 5 MG TABLET,5.1,3.32,0.76,5.1,40
NDC,5107957520,TRIFLUOPERAZINE 10 MG TABLET,6.16,4.0,0.92,6.16,40
NDC,5107958020,THIORIDAZINE 100 MG TABLET,2.18,1.42,0.32,2.18,40
NDC,5107958101,LEUCOVORIN CALCIUM 5 MG TABLET,6.5,4.23,0.97,6.5,40
NDC,5107958106,LEUCOVORIN CALCIUM 5 MG TABLET,6.5,4.23,0.97,6.5,40
NDC,5107959701,CETIRIZINE 10 MG TABLET,4.98,3.24,0.74,4.98,40
NDC,5107959720,CETIRIZINE 10 MG TABLET,4.98,3.24,0.74,4.98,40
NDC,5107963020,PRAZOSIN 1 MG CAPSULE,3.62,2.35,0.54,3.62,40
NDC,5107963120,PRAZOSIN 2 MG CAPSULE,5.04,3.28,0.75,5.04,40
NDC,5107963220,PRAZOSIN 5 MG CAPSULE,8.62,5.6,1.28,8.62,40
NDC,5107964420,CYCLOBENZAPRINE 10 MG TABLET,1.94,1.26,0.29,1.94,40
NDC,5107965101,DOXEPIN 100 MG CAPSULE,4.0,2.6,0.6,4.0,40
NDC,5107965120,DOXEPIN 100 MG CAPSULE,4.0,2.6,0.6,4.0,40
NDC,5107967005,METHOTREXATE SODIUM 2.5 MG TABLET,12.48,8.11,0.27,15.18,51
NDC,5107968401,ATENOLOL 50 MG TABLET,1.78,1.16,0.26,1.78,40
NDC,5107968420,ATENOLOL 50 MG TABLET,1.78,1.16,0.26,1.78,40
NDC,5107968520,ATENOLOL 100 MG TABLET,2.98,1.94,0.44,2.98,40
NDC,5107969001,LOPERAMIDE 2 MG CAPSULE,1.76,1.14,0.26,1.76,40
NDC,5107969020,LOPERAMIDE 2 MG CAPSULE,1.76,1.14,0.26,1.76,40
NDC,5107972320,OXYBUTYNIN CHLORIDE ER 10 MG TABLETEXTENDED RELEASE 24 HR,6.58,4.28,0.98,6.58,40
NDC,5107972420,ZOLPIDEM 5 MG TABLET,9.24,6.01,1.37,9.24,40
NDC,5107972501,ZOLPIDEM 10 MG TABLET,9.24,6.01,1.37,9.24,40
NDC,5107973320,HALOPERIDOL 0.5 MG TABLET,0.7,0.46,0.1,0.7,40
NDC,5107973420,HALOPERIDOL 1 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,5107973520,HALOPERIDOL 2 MG TABLET,1.34,0.87,0.2,1.34,40
NDC,5107974520,DILTIAZEM 30 MG TABLET,0.9,0.59,0.13,0.9,40
NDC,5107974720,DILTIAZEM 90 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,5107975301,SUCRALFATE 1 GRAM TABLET,0.76,0.49,0.11,0.76,40
NDC,5107975320,SUCRALFATE 1 GRAM TABLET,0.76,0.49,0.11,0.76,40
NDC,5107975901,ATENOLOL 25 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,5107975920,ATENOLOL 25 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,5107977120,CARVEDILOL 3.125 MG TABLET,4.26,2.77,0.63,4.26,40
NDC,5107978220,PRAVASTATIN 40 MG TABLET,9.54,6.2,1.42,9.54,40
NDC,5107978820,ALPRAZOLAM 0.25 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,5107978920,ALPRAZOLAM 0.5 MG TABLET,1.52,0.99,0.23,1.52,40
NDC,5107979020,ALPRAZOLAM 1 MG TABLET,2.02,1.31,0.3,2.02,40
NDC,5107980120,METOPROLOL TARTRATE 50 MG TABLET,1.14,0.74,0.17,1.14,40
NDC,5107980220,METOPROLOL TARTRATE 100 MG TABLET,1.66,1.08,0.25,1.66,40
NDC,5107981020,GLIPIZIDE 5 MG TABLET,0.76,0.49,0.11,0.76,40
NDC,5107981220,NADOLOL 20 MG TABLET,12.38,8.05,1.84,12.38,40
NDC,5107981720,TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASE,4.46,2.9,0.36,8.86,51
NDC,5107981820,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.36,8.92,51
NDC,5107985203,GALANTAMINE 4 MG TABLET,8.44,5.49,1.26,8.44,40
NDC,5107985303,GALANTAMINE 8 MG TABLET,8.44,5.49,1.26,8.44,40
NDC,5107987020,CARBAMAZEPINE 100 MG CHEWABLE TABLET,1.32,0.86,0.2,1.32,40
NDC,5107988121,CLONAZEPAM 0.5 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,5107988220,CLONAZEPAM 1 MG TABLET,1.82,1.18,0.27,1.82,40
NDC,5107988320,CLONAZEPAM 2 MG TABLET,2.48,1.61,0.37,2.48,40
NDC,5107988601,METOCLOPRAMIDE 5 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,5107988620,METOCLOPRAMIDE 5 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,5107990120,LOXAPINE SUCCINATE 10 MG CAPSULE,2.54,1.65,0.38,2.54,40
NDC,5107990220,LOXAPINE SUCCINATE 25 MG CAPSULE,3.86,2.51,0.57,3.86,40
NDC,5107990320,LOXAPINE SUCCINATE 50 MG CAPSULE,5.14,3.34,0.76,5.14,40
NDC,5107991720,VERAPAMIL ER 120 MG 24 HR CAPSULEEXTENDED RELEASE,10.74,6.98,1.6,10.74,40
NDC,5107992120,CLOZAPINE 25 MG TABLET,2.64,1.72,0.39,2.64,40
NDC,5107992220,CLOZAPINE 100 MG TABLET,6.86,4.46,1.02,6.86,40
NDC,5107992320,CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLETEXTENDED RELEASE,3.48,2.26,0.52,3.48,40
NDC,5107992401,DILTIAZEM ER 60 MG CAPSULEEXTENDED RELEASE 12 HR,7.94,5.16,1.18,7.94,40
NDC,5107992420,DILTIAZEM ER 60 MG CAPSULEEXTENDED RELEASE 12 HR,7.94,5.16,1.18,7.94,40
NDC,5107992520,DILTIAZEM ER 90 MG CAPSULEEXTENDED RELEASE 12 HR,9.34,6.07,1.39,9.34,40
NDC,5107992620,DILTIAZEM ER 120 MG CAPSULEEXTENDED RELEASE 12 HR,13.04,8.48,1.94,13.04,40
NDC,5107992820,LABETALOL 100 MG TABLET,0.96,0.62,0.14,0.96,40
NDC,5107992920,LABETALOL 200 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,5107993720,TERAZOSIN 2 MG CAPSULE,3.22,2.09,0.48,3.22,40
NDC,5107994320,BUPROPION HCL 75 MG TABLET,3.1,2.02,0.46,3.1,40
NDC,5107995820,DOXAZOSIN 2 MG TABLET,7.52,4.89,1.12,7.52,40
NDC,5107995920,DOXAZOSIN 4 MG TABLET,7.9,5.14,1.18,7.9,40
NDC,5107996620,FAMOTIDINE 20 MG TABLET,3.48,2.26,0.52,3.48,40
NDC,5107997820,CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLETEXTENDED RELEASE,1.86,1.21,0.28,1.86,40
NDC,5107997920,SPIRONOLACTONE 50 MG TABLET,1.76,1.14,0.26,1.76,40
NDC,5107998501,BUSPIRONE 5 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,5107998520,BUSPIRONE 5 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,5107998601,BUSPIRONE 10 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,5107998620,BUSPIRONE 10 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,5107999120,TRAMADOL 50 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,5107999220,FLUVOXAMINE 50 MG TABLET,5.14,3.34,0.76,5.14,40
NDC,5107999320,FLUVOXAMINE 100 MG TABLET,5.28,3.43,0.79,5.28,40
NDC,5107999820,TIZANIDINE 4 MG TABLET,5.1,3.32,0.76,5.1,40
NDC,5114400160,TUKYSA 50 MG TABLET,270.44,175.79,40.24,270.44,40
NDC,5114400260,TUKYSA 150 MG TABLET,543.8,353.47,80.92,543.8,40
NDC,5114400301,TIVDAK 40 MG INTRAVENOUS SOLUTION,35523.84,23090.5,2.17,35523.84,65
NDC,5114402001,PADCEV 20 MG INTRAVENOUS SOLUTION,13483.2,8764.08,2.17,13483.2,65
NDC,5114403001,PADCEV 30 MG INTRAVENOUS SOLUTION,20224.8,13146.12,2.17,20224.8,65
NDC,5114405001,ADCETRIS 50 MG INTRAVENOUS SOLUTION,63216.76,41090.89,2.17,63216.76,65
NDC,5116729009,CASGEVY 4X10EXP6 TO 13X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,10560000.0,6864000.0,0.02,10560000.0,62
NDC,5128504001,ZIAC 10 MG-6.25 MG TABLET,21.62,14.05,3.22,21.62,40
NDC,5128504702,ZIAC 2.5 MG-6.25 MG TABLET,21.62,14.05,3.22,21.62,40
NDC,5128505002,ZIAC 5 MG-6.25 MG TABLET,21.62,14.05,3.22,21.62,40
NDC,5128536601,TREXALL 5 MG TABLET,55.36,35.98,8.24,55.36,40
NDC,5129362701,PHENOBARBITAL 64.8 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,5129362801,PHENOBARBITAL 97.2 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,5129369201,PHENOBARBITAL 30 MG TABLET,0.84,0.55,0.12,0.84,40
NDC,5129380401,SALSALATE 750 MG TABLET,5.5,3.58,0.82,5.5,40
NDC,5129381001,PHENAZOPYRIDINE 100 MG TABLET,5.4,3.51,0.8,5.4,40
NDC,5129383197,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,0.95,0.62,0.14,0.95,40
NDC,5140785330,ERYTHROMYCIN 250 MG TABLETDELAYED RELEASE,11.84,7.7,1.76,11.84,40
NDC,5140900700,NEW SKIN (BENZETHONIUM) 0.2 % TOPICAL FILM-FORMING LIQUID,0.7,0.46,0.1,0.7,40
NDC,5140900722,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.18,0.12,0.03,0.18,40
NDC,5152504311,FELBAMATE 600 MG TABLET,11.84,7.7,1.76,11.84,40
NDC,5155200516,ACETIC ACID (BULK) 3 % LIQUID,0.33,0.21,0.05,0.33,40
NDC,5155200556,ACETIC ACID (BULK) 5 % LIQUID,0.14,0.09,0.02,0.14,40
NDC,5155200715,POTASSIUM HYDROXIDE (BULK) 10 % SOLUTION,0.13,0.08,0.02,0.13,40
NDC,5155201174,FLEXIBLE COLLODION (BULK) LIQUID,1.6,1.04,0.24,1.6,40
NDC,5155201183,PHENOL (BULK) 89 % LIQUID,0.72,0.47,0.11,0.72,40
NDC,5155201944,STRONG IODINE 5 %-10 % TOPICAL SOLUTION,0.86,0.56,0.13,0.86,40
NDC,5155202025,BISMUTH SUBGALLATE (BULK) POWDER,1.19,0.77,0.18,1.19,40
NDC,5155202056,FORMALDEHYDE (BULK) 37 % SOLUTION,0.32,0.21,0.05,0.32,40
NDC,5155203573,FERRIC SUBSULFATE (BULK) 20 TO 22 GRAM/100 ML SOLUTION,1.14,0.74,0.17,1.14,39
NDC,5155204486,SODIUM BISULFITE (BULK) 100 % POWDER,0.14,0.09,0.02,0.14,40
NDC,5155208434,D-XYLOSE (BULK) POWDER,6.46,4.2,0.96,6.46,40
NDC,5155208979,ETHYL ALCOHOL (BULK) 95 % LIQUID,0.2,0.13,0.03,0.2,40
NDC,5155210795,SYRSPEND SF LIQUID ORAL SUSPENSION,0.33,0.21,0.05,0.33,40
NDC,5155213235,POVIDONE (BULK) K-30 POWDER,4.44,2.89,0.66,4.44,40
NDC,5164573108,CALCIUM 600 + D(3) 600 MG-5 MCG (200 UNIT) TABLET,0.1,0.07,0.01,0.1,40
NDC,5164582601,OYSTER SHELL + D3 250 MG-3.125 MCG (125 UNIT) TABLET,0.06,0.04,0.01,0.06,40
NDC,5164582899,CALCIUM 500 + D 500 MG-5 MCG (200 UNIT) TABLET,0.2,0.13,0.03,0.2,40
NDC,5164583701,PRENATAL 28 MG IRON-800 MCG TABLET,0.12,0.08,0.02,0.12,40
NDC,5164591401,VITAMIN B-12  1000 MCG TABLET,0.12,0.08,0.02,0.12,40
NDC,5166072415,ALLERGY RELIEF AND NASAL DECONGESTANT 10 MG-240 MG TABLETEXTENDED REL,1.14,0.74,0.17,1.14,40
NDC,5167212581,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.54,17.1,40
NDC,5167212582,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.54,17.1,40
NDC,5167212583,CLOBETASOL 0.05 % TOPICAL CREAM,15.3,9.95,2.28,15.3,40
NDC,5167212603,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,4.98,3.24,0.74,4.98,40
NDC,5167212611,DESOXIMETASONE 0.05 % TOPICAL GEL,12.26,7.97,1.82,12.26,40
NDC,5167212621,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,14.16,9.2,2.11,14.16,40
NDC,5167212623,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,11.76,7.64,1.75,11.76,40
NDC,5167212631,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,14.92,9.7,2.22,14.92,40
NDC,5167212632,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,10.64,6.92,1.58,10.64,40
NDC,5167212641,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.4,9.44,40
NDC,5167212642,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.4,9.44,40
NDC,5167212643,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.4,9.44,40
NDC,5167212675,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,32.24,20.96,4.8,32.24,40
NDC,5167212701,DESOXIMETASONE 0.25 % TOPICAL CREAM,13.5,8.78,2.01,13.5,40
NDC,5167212703,DESOXIMETASONE 0.25 % TOPICAL CREAM,12.9,8.39,1.92,12.9,40
NDC,5167212713,DESOXIMETASONE 0.05 % TOPICAL CREAM,12.24,7.96,1.82,12.24,40
NDC,5167212721,NYSTATIN-TRIAMCINOLONE 100000 UNIT/GRAM-0.1 % TOPICAL OINTMENT,14.92,9.7,2.22,14.92,40
NDC,5167212751,CLOTRIMAZOLE 1 % TOPICAL CREAM,2.66,1.73,0.4,2.66,40
NDC,5167212752,CLOTRIMAZOLE 1 % TOPICAL CREAM,2.32,1.51,0.35,2.32,40
NDC,5167212791,FLUOCINONIDE 0.05 % TOPICAL GEL,7.94,5.16,1.18,7.94,40
NDC,5167212792,FLUOCINONIDE 0.05 % TOPICAL GEL,7.94,5.16,1.18,7.94,40
NDC,5167212793,FLUOCINONIDE 0.05 % TOPICAL GEL,7.94,5.16,1.18,7.94,40
NDC,5167212801,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.59,10.7,40
NDC,5167212803,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.59,10.7,40
NDC,5167212822,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.56,0.36,0.08,0.56,40
NDC,5167212891,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,2.34,1.52,0.35,2.34,40
NDC,5167212892,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,1.76,1.14,0.26,1.76,40
NDC,5167212901,HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,11.94,7.76,1.78,11.94,40
NDC,5167212906,HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,8.02,5.21,1.19,8.02,40
NDC,5167212981,KETOCONAZOLE 2 % TOPICAL CREAM,17.52,11.39,2.61,17.52,40
NDC,5167212982,KETOCONAZOLE 2 % TOPICAL CREAM,13.9,9.04,2.07,13.9,40
NDC,5167212983,KETOCONAZOLE 2 % TOPICAL CREAM,9.24,6.01,1.37,9.24,40
NDC,5167213014,AMMONIUM LACTATE 12 % TOPICAL CREAM,0.32,0.21,0.05,0.32,40
NDC,5167213020,TERCONAZOLE 0.8 % VAGINAL CREAM,4.1,2.67,0.61,4.1,40
NDC,5167213031,ECONAZOLE NITRATE 1 % TOPICAL CREAM,14.5,9.43,2.16,14.5,40
NDC,5167213032,ECONAZOLE NITRATE 1 % TOPICAL CREAM,14.5,9.43,2.16,14.5,40
NDC,5167213083,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % LOTION,11.18,7.27,1.66,11.18,40
NDC,5167213091,BETAMETHASONE AUGMENTED 0.05 % TOPICAL GEL,8.2,5.33,1.22,8.2,40
NDC,5167213093,BETAMETHASONE AUGMENTED 0.05 % TOPICAL GEL,5.46,3.55,0.81,5.46,40
NDC,5167213101,BETAMETHASONE AUGMENTED 0.05 % TOPICAL CREAM,5.06,3.29,0.75,5.06,40
NDC,5167213355,ORALONE 0.1 % DENTAL PASTE,35.82,23.28,5.33,35.82,40
NDC,5167213654,FLUOCINOLONE 0.01 % TOPICAL SOLUTION,6.26,4.07,0.93,6.26,40
NDC,5167213701,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,32.68,21.24,4.86,32.68,40
NDC,5167213702,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,22.16,14.4,3.3,22.16,40
NDC,5167213858,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.2,0.13,0.03,0.2,40
NDC,5167213859,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.02,0.15,40
NDC,5167213861,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,0.9,6.08,40
NDC,5167220011,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.7,0.46,0.1,0.7,40
NDC,5167220012,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.48,0.31,0.07,0.48,40
NDC,5167220036,CLOTRIMAZOLE 1 % VAGINAL CREAM,0.36,0.23,0.05,0.36,40
NDC,5167220102,HYDROCORTISONE 0.5 % TOPICAL CREAM,0.38,0.25,0.06,0.38,40
NDC,5167220202,TOLNAFTATE 1 % TOPICAL CREAM,0.58,0.38,0.09,0.58,40
NDC,5167220356,MICONAZOLE NITRATE 2 % VAGINAL CREAM,0.5,0.33,0.07,0.5,40
NDC,5167220371,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,9.02,5.86,1.34,9.02,40
NDC,5167220442,DOUBLE ANTIBIOTIC (BACITRCN ZN) 500 UNIT-10000 UNIT/GRAM TOP OINTMENT,0.46,0.3,0.07,0.46,40
NDC,5167220752,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,0.5,0.33,0.07,0.5,40
NDC,5167220801,TERBINAFINE HCL 1 % TOPICAL CREAM,1.08,0.7,0.16,1.08,40
NDC,5167220802,TERBINAFINE HCL 1 % TOPICAL CREAM,0.8,0.52,0.12,0.8,40
NDC,5167221142,FEVERALL 80 MG RECTAL SUPPOSITORY,1.6,1.04,0.24,1.6,40
NDC,5167221152,FEVERALL 120 MG RECTAL SUPPOSITORY,2.24,1.46,0.33,2.24,40
NDC,5167221162,FEVERALL 325 MG RECTAL SUPPOSITORY,1.6,1.04,0.24,1.6,40
NDC,5167230032,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.68,0.44,0.1,0.68,40
NDC,5167230071,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,45.16,29.35,6.72,45.16,40
NDC,5167230083,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.27,15.24,40
NDC,5167240015,NORTRIPTYLINE 10 MG CAPSULE,0.26,0.17,0.04,0.26,40
NDC,5167240025,NORTRIPTYLINE 25 MG CAPSULE,0.36,0.23,0.05,0.36,40
NDC,5167240035,NORTRIPTYLINE 50 MG CAPSULE,0.42,0.27,0.06,0.42,40
NDC,5167240041,NORTRIPTYLINE 75 MG CAPSULE,8.44,5.49,1.26,8.44,40
NDC,5167240051,CARBAMAZEPINE 200 MG TABLET,3.2,2.08,0.48,3.2,40
NDC,5167240052,CARBAMAZEPINE 200 MG TABLET,3.16,2.05,0.47,3.16,40
NDC,5167240116,CLOMIPRAMINE 25 MG CAPSULE,22.48,14.61,3.35,22.48,40
NDC,5167240161,ETODOLAC 200 MG CAPSULE,2.88,1.87,0.43,2.88,40
NDC,5167240171,ETODOLAC 300 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,5167240221,ACETAZOLAMIDE 125 MG TABLET,4.36,2.83,0.65,4.36,40
NDC,5167240231,ACETAZOLAMIDE 250 MG TABLET,5.76,3.74,0.86,5.76,40
NDC,5167240261,KETOCONAZOLE 200 MG TABLET,6.32,4.11,0.94,6.32,40
NDC,5167240266,KETOCONAZOLE 200 MG TABLET,6.32,4.11,0.94,6.32,40
NDC,5167240412,CARBAMAZEPINE 100 MG CHEWABLE TABLET,1.32,0.86,0.2,1.32,40
NDC,5167240461,ENALAPRIL 10 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,5167240479,CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,0.5,0.33,0.07,0.5,40
NDC,5167240481,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,4.1,2.67,0.61,4.1,40
NDC,5167240556,AMIODARONE 100 MG TABLET,14.86,9.66,2.21,14.86,40
NDC,5167240621,FLUOROURACIL 2 % TOPICAL SOLUTION,15.12,9.83,2.25,15.12,40
NDC,5167240794,DESONIDE 0.05 % LOTION,10.04,6.53,1.49,10.04,40
NDC,5167240913,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,12.0,7.8,1.79,12.0,40
NDC,5167241166,METRONIDAZOLE 0.75 % TOPICAL GEL,14.2,9.23,2.11,14.2,40
NDC,5167241186,FLUOROURACIL 5 % TOPICAL CREAM,19.24,12.51,2.86,19.24,40
NDC,5167241231,CARBAMAZEPINE ER 100 MG TABLETEXTENDED RELEASE12 HR,2.28,1.48,0.34,2.28,40
NDC,5167241461,PHENYTOIN 50 MG CHEWABLE TABLET,1.06,0.69,0.16,1.06,40
NDC,5167241543,CALCIPOTRIENE 0.005 % TOPICAL OINTMENT,12.06,7.84,1.79,12.06,40
NDC,5167242153,METRONIDAZOLE 1 % TOPICAL GEL,9.24,6.01,1.37,9.24,40
NDC,5167252961,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,35.42,23.02,5.27,35.42,40
NDC,5167252971,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,35.42,23.02,5.27,35.42,40
NDC,5175410073,ELCYS 50 MG/ML INTRAVENOUS SOLUTION,37.29,24.24,5.55,37.29,40
NDC,5175420014,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.96,0.62,0.14,0.96,40
NDC,5175450114,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,3.3,2.15,0.49,3.3,40
NDC,5175450124,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,2.67,1.74,0.4,2.67,40
NDC,5175920410,AJOVY SYRINGE 225 MG/1.5 ML SUBCUTANEOUS,1812.36,1178.03,2.17,1812.36,51
NDC,5175920813,EPYSQLI 300 MG/30 ML INTRAVENOUS SOLUTION,730.56,474.86,31.67,2642.72,59
NDC,5175930510,UZEDY 50 MG/0.14 ML SUBCUT EXT REL SUSPENSION SYRINGE,33768.0,21949.2,2.17,33768.0,65
NDC,5175941010,UZEDY 75 MG/0.21 ML SUBCUT EXT REL SUSPENSION SYRINGE,33769.71,21950.31,2.17,33769.71,65
NDC,5175952010,UZEDY 100 MG/0.28 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.87,21951.72,2.17,33771.87,65
NDC,5175963010,UZEDY 125 MG/0.35 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,2.17,33771.09,65
NDC,5175970813,SELARSDI 130 MG/26 ML INTRAVENOUS SOLUTION,193.86,126.01,42.84,7011.25,59
NDC,5175974010,UZEDY 150 MG/0.42 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,2.17,33770.58,65
NDC,5175985010,UZEDY 200 MG/0.56 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,2.17,33770.58,65
NDC,5175996010,UZEDY 250 MG/0.7 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,2.17,33771.09,65
NDC,5180100101,EFFER-K 25 MEQ EFFERVESCENT TABLET,0.82,0.53,0.12,0.82,40
NDC,5180100701,EFFER-K 25 MEQ EFFERVESCENT TABLET,0.94,0.61,0.14,0.94,40
NDC,5180100730,EFFER-K 25 MEQ EFFERVESCENT TABLET,0.94,0.61,0.14,0.94,40
NDC,5180100940,GLOSTRIPS 1 MG FOR THE EYE,0.3,0.2,0.04,0.3,40
NDC,5180101301,EFFER-K 10 MEQ EFFERVESCENT TABLET,1.0,0.65,0.15,1.0,40
NDC,5180101330,EFFER-K 10 MEQ EFFERVESCENT TABLET,1.14,0.74,0.17,1.14,40
NDC,5186200560,DOFETILIDE 500 MCG CAPSULE,17.1,11.12,2.54,17.1,40
NDC,5186202560,DOFETILIDE 250 MCG CAPSULE,17.1,11.12,2.54,17.1,40
NDC,5186224030,AMIODARONE 100 MG TABLET,14.86,9.66,2.21,14.86,40
NDC,5186233201,ESTRADIOL 0.5 MG TABLET,1.1,0.72,0.16,1.1,40
NDC,5186233301,ESTRADIOL 1 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,5186245847,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.41,8.86,51
NDC,5186246047,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.64,11.0,51
NDC,5186246260,TOLSURA 65 MG ORAL SOLID DISPERSION CAPSULE,94.52,61.44,14.06,94.52,40
NDC,5186256406,LOW-OGESTREL (28) 0.3 MG-30 MCG TABLET,2.18,1.42,0.32,2.18,40
NDC,5186268201,SOLTAMOX 20 MG/10 ML ORAL SOLUTION,13.85,9.0,2.06,13.85,40
NDC,5192711650,CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,0.6,0.39,0.09,0.6,40
NDC,5192713130,COTTONSEED OIL (BULK),0.17,0.11,0.03,0.17,40
NDC,5192732270,PCCA-PLUS BASE ORAL SUSPENSION,1.7,1.11,0.25,1.7,40
NDC,5199100298,METHADONE 10 MG/ML INJECTION SOLUTION,76.95,50.02,2.17,76.95,51
NDC,5199100633,DESVENLAFAXINE SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,22.94,14.91,3.41,22.94,40
NDC,5199107401,ASCOMP WITH CODEINE 30 MG-50 MG-325 MG-40 MG CAPSULE,5.48,3.56,0.82,5.48,40
NDC,5199108290,FOLBEE PLUS 5 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,5199108490,FOLBEE 2.5 MG-25 MG-1 MG TABLET,1.38,0.9,0.21,1.38,40
NDC,5199114417,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,71.13,46.23,2.17,71.13,51
NDC,5199119811,FERREX 150 FORTE 150 MG-25 MCG-1 MG CAPSULE,0.56,0.36,0.08,0.56,40
NDC,5199120311,FERREX 150 MG IRON CAPSULE,0.56,0.36,0.08,0.56,40
NDC,5199120399,FERREX 150 MG IRON CAPSULE,0.56,0.36,0.08,0.56,40
NDC,5199125201,FOLPLEX 2.2 MG-25 MG-0.5 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,5199129401,OXCARBAZEPINE 600 MG TABLET,9.66,6.28,1.44,9.66,40
NDC,5199131133,DESVENLAFAXINE SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,22.94,14.91,3.41,22.94,40
NDC,5199131233,DESVENLAFAXINE SUCCINATE ER 100 MG TABLETEXTENDED RELEASE 24 HR,22.94,14.91,3.41,22.94,40
NDC,5199135860,ASENAPINE 5 MG SUBLINGUAL TABLET,43.22,28.09,6.43,43.22,40
NDC,5199138490,FOLBIC 2.5 MG-25 MG-2 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,5199152601,TERBINAFINE HCL 250 MG TABLET,26.16,17.0,3.89,26.16,40
NDC,5199154390,MULTIGEN 70 MG-150 MG-10 MCG-2 MG-75MG TABLET,2.5,1.63,0.37,2.5,40
NDC,5199161690,FOLBIC RF 2 MG-1.13 MG-25 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,5199170390,FERREX 150 PLUS 150 MG-50 MG-50 MG CAPSULE,2.54,1.65,0.38,2.54,40
NDC,5199173520,GRANISETRON HCL 1 MG TABLET,118.1,76.77,17.57,118.1,40
NDC,5199173532,GRANISETRON HCL 1 MG TABLET,118.12,76.78,17.58,118.12,40
NDC,5201508001,DIFICID 200 MG TABLET,624.6,405.99,92.94,624.6,40
NDC,5224401006,EDEX 10 MCG INTRACAVERNOSAL KIT,1952.34,1269.02,290.51,1952.34,40
NDC,5224402002,EDEX 20 MCG INTRACAVERNOSAL KIT,840.63,546.41,1.01,840.63,51
NDC,5224402006,EDEX 20 MCG INTRACAVERNOSAL KIT,2521.77,1639.15,1.01,2521.77,51
NDC,5224410010,THEO-24 100 MG CAPSULEEXTENDED RELEASE,9.28,6.03,1.38,9.28,40
NDC,5224420010,THEO-24 200 MG CAPSULEEXTENDED RELEASE,13.8,8.97,2.05,13.8,40
NDC,5224430010,THEO-24 300 MG CAPSULEEXTENDED RELEASE,16.96,11.02,2.52,16.96,40
NDC,5226801201,SUPREP BOWEL PREP KIT 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLUTION,1.0,0.65,0.15,1.0,40
NDC,5226810001,GOLYTELY ORAL SOLUTION,0.03,0.02,0.01,0.03,40
NDC,5226820001,SUTAB 1.479-0.188-0.225 GRAM TABLET,16.88,10.97,2.51,16.88,40
NDC,5237602102,PAROEX ORAL RINSE 0.12 % MOUTHWASH,0.05,0.03,0.01,0.05,40
NDC,5238001262,POVIDONE-IODINE 10 % TOPICAL OINTMENT,0.3,0.2,0.04,0.3,40
NDC,5238012724,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,0.12,0.08,0.02,0.12,40
NDC,5238012727,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,0.04,0.03,0.01,0.04,40
NDC,5238012728,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,0.08,0.05,0.01,0.08,40
NDC,5238019054,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,40
NDC,5238019056,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,40
NDC,5238019057,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,40
NDC,5238019059,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,40
NDC,5253618003,ERYTHROMYCIN 250 MG TABLETDELAYED RELEASE,16.78,10.91,2.5,16.78,40
NDC,5253650001,DEXTROAMPHETAMINE SULFATE 5 MG TABLET,5.82,3.78,0.87,5.82,40
NDC,5253660011,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,18.15,11.8,2.7,18.15,40
NDC,52579160005,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1190.0,773.5,0.01,1190.0,45
NDC,5260900015,ALKERAN 2 MG TABLET,27.16,17.65,2.17,27.74,43
NDC,5265220011,XATMEP 2.5 MG/ML ORAL SOLUTION,64.38,41.85,9.58,64.38,40
NDC,5265220016,XATMEP 2.5 MG/ML ORAL SOLUTION,67.65,43.97,10.07,67.65,40
NDC,5265230011,QBRELIS 1 MG/ML ORAL SOLUTION,14.08,9.15,2.1,14.08,40
NDC,5265240011,EPANED 1 MG/ML ORAL SOLUTION,13.98,9.09,2.08,13.98,40
NDC,5265250011,KATERZIA 1 MG/ML ORAL SUSPENSION,13.18,8.57,1.96,13.18,40
NDC,5265260011,FLEQSUVY 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,18.7,12.16,2.78,18.7,40
NDC,5265280011,ZONISADE 100 MG/5 ML ORAL SUSPENSION,8.65,5.62,1.29,8.65,40
NDC,5270915013,GRASTEK 2800 BAU SUBLINGUAL TABLET,29.46,19.15,4.38,29.46,40
NDC,5270916013,RAGWITEK 12 AMB A 1 UNIT SUBLINGUAL TABLET,29.46,19.15,4.38,29.46,40
NDC,5280048816,LUBRIDERM DAILY MOISTURE LOTION,0.04,0.03,0.01,0.04,40
NDC,5280048826,LUBRIDERM DAILY MOISTURE LOTION,0.04,0.03,0.01,0.04,40
NDC,5281711710,PRIMIDONE 125 MG TABLET,3.96,2.57,0.59,3.96,40
NDC,5281727130,BISOPROLOL FUMARATE 10 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,5281736410,TRIAMTERENE 50 MG CAPSULE,23.88,15.52,3.55,23.88,40
NDC,5281761004,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,156.56,101.76,23.3,156.56,40
NDC,5281761104,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,263.6,171.34,39.22,263.6,40
NDC,5281781154,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.14,0.09,0.02,0.14,40
NDC,5281781615,ACETIC ACID 2 % EAR SOLUTION,6.4,4.16,0.95,6.4,40
NDC,5281781701,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % RECTAL CREAM,10.48,6.81,1.56,10.48,40
NDC,5293700340,VASCEPA 0.5 GRAM CAPSULE,4.14,2.69,0.62,4.14,40
NDC,5319136201,CHOLECALCIFEROL (VITAMIN D3) 1250 MCG (50000 UNIT) CAPSULE,0.36,0.23,0.05,0.36,40
NDC,53276101001,AVITENE TOPICAL POWDER IN PACKET,289.2,187.98,43.03,289.2,40
NDC,53276101002,AVITENE FLOUR TOPICAL POWDER,456.0,296.4,67.85,456.0,40
NDC,53276101009,AVITENE 70 MM X 35 MM TOPICAL SHEETS,456.0,296.4,67.85,456.0,40
NDC,53276101015,ENDO AVITENE 10 MM TOPICAL SHEETS,480.0,312.0,71.42,480.0,40
NDC,53276101026,ENDO AVITENE 5 MM TOPICAL SHEETS,288.0,187.2,42.85,288.0,40
NDC,53276105003,ULTRAFOAM 8 CM X 6.25 CM X 1 CM SPONGE,132.0,85.8,19.64,132.0,40
NDC,53276105004,ULTRAFOAM 8 CM X 12.5 CM X 1 CM SPONGE,192.0,124.8,28.57,192.0,40
NDC,5332906801,PETROLEUM JELLY TOPICAL,0.64,0.42,0.1,0.64,40
NDC,5332941059,MEDIPLAST CORN-CALLUS-WART REMOVER 40 % TOPICAL PATCH,2.4,1.56,0.36,2.4,40
NDC,5332977144,SENSI-CARE PROTECTIVE BARRIER 15 %-49 % TOPICAL OINTMENT,0.12,0.08,0.02,0.12,40
NDC,5332977414,MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,0.22,0.14,0.03,0.22,40
NDC,5332994675,POVIDONE-IODINE 10 % TOPICAL SWAB,0.42,0.27,0.06,0.42,40
NDC,5343608430,VELTASSA 8.4 GRAM ORAL POWDER PACKET,85.2,55.38,12.68,85.2,40
NDC,5346200315,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.03,0.02,0.01,0.03,40
NDC,5346270520,CHLORHEXIDINE GLUCONATE 2 % TOWELETTE,3.28,2.13,0.49,3.28,40
NDC,5348914101,QUINIDINE GLUCONATE ER 324 MG TABLETEXTENDED RELEASE,18.12,11.78,2.7,18.12,40
NDC,5348914801,THIORIDAZINE 10 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,5348917601,ALBUTEROL SULFATE 2 MG TABLET,11.76,7.64,1.75,11.76,40
NDC,5348933001,IMIPRAMINE 10 MG TABLET,0.86,0.56,0.13,0.86,40
NDC,5348937001,FELODIPINE ER 10 MG TABLETEXTENDED RELEASE 24 HR,5.44,3.54,0.81,5.44,40
NDC,5348937601,TRIMETHOBENZAMIDE 300 MG CAPSULE,3.28,2.13,0.49,3.28,40
NDC,5348938601,MINOXIDIL 2.5 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,5348938701,MINOXIDIL 10 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,5348947801,SULINDAC 150 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,5348947901,SULINDAC 200 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,5348955101,PROPAFENONE 150 MG TABLET,3.28,2.13,0.49,3.28,40
NDC,5374627101,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,5374627205,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,2.3,1.5,0.34,2.3,40
NDC,5402385876,Q-GEL MEGA 100 MG-150 UNIT CAPSULE,1.24,0.81,0.18,1.24,40
NDC,5402392937,LIQ-10 100 MG/5 ML ORAL SYRUP,0.65,0.42,0.1,0.65,40
NDC,5402399617,ACTIVE Q 100 MG/5 ML ORAL SUSPENSION,1.15,0.75,0.17,1.15,40
NDC,5409206301,AGRYLIN 0.5 MG CAPSULE,19.84,12.9,2.95,19.84,40
NDC,5409217112,CARBATROL 100 MG CAPSULE EXTENDED RELEASE,4.26,2.77,0.63,4.26,40
NDC,5409218981,PENTASA 250 MG CAPSULECONTROLLED RELEASE,7.28,4.73,1.08,7.28,40
NDC,5409225290,FOSRENOL 500 MG CHEWABLE TABLET,28.82,18.73,4.29,28.82,40
NDC,5409225490,FOSRENOL 1000 MG CHEWABLE TABLET,28.82,18.73,4.29,28.82,40
NDC,5409238901,ADDERALL XR 25 MG CAPSULEEXTENDED RELEASE,17.1,11.12,2.54,17.1,40
NDC,5409239101,ADDERALL XR 30 MG CAPSULEEXTENDED RELEASE,17.1,11.12,2.54,17.1,40
NDC,5409247612,LIALDA 1.2 GRAM TABLETDELAYED RELEASE,22.46,14.6,3.34,22.46,40
NDC,5409251702,INTUNIV ER 3 MG TABLETEXTENDED RELEASE,23.32,15.16,3.47,23.32,40
NDC,5409251902,INTUNIV ER 4 MG TABLETEXTENDED RELEASE,23.32,15.16,3.47,23.32,40
NDC,5409270001,ELAPRASE 6 MG/3 ML INTRAVENOUS SOLUTION,3875.88,2519.32,2.17,13108.79,65
NDC,5409270104,VPRIV 400 UNIT INTRAVENOUS SOLUTION,5418.03,3521.72,2.17,7011.25,65
NDC,5409270202,FIRAZYR 30 MG/3 ML SUBCUTANEOUS SYRINGE,13377.0,8695.05,2.17,13377.0,57
NDC,5409270203,FIRAZYR 30 MG/3 ML SUBCUTANEOUS SYRINGE,13377.0,8695.05,2.17,13377.0,57
NDC,5428810301,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,52.5,34.13,1.98,52.5,51
NDC,5428810310,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,52.5,34.13,1.98,52.5,51
NDC,5428810515,ABLYSINOL 99 % INTRA-ARTERIAL SOLUTION,599.7,389.81,89.24,599.7,40
NDC,5428811105,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,388.5,252.53,2.17,388.5,51
NDC,5428812001,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,28.5,18.53,1.98,28.5,51
NDC,5428812701,TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,163.89,106.53,24.39,163.89,40
NDC,5428812710,TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,163.89,106.53,24.39,163.89,40
NDC,5428816401,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,12.4,8.06,1.85,12.4,43
NDC,5428816501,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,8.72,5.67,1.3,8.72,43
NDC,5428816601,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.44,4.84,1.11,8.28,43
NDC,5428816701,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,6.03,3.92,0.9,8.28,43
NDC,5429530815,UREA 40 % TOPICAL CREAM,7.3,4.75,1.09,7.3,40
NDC,5429530824,UREA 40 % TOPICAL CREAM,3.78,2.46,0.56,3.78,40
NDC,5429530825,UREA 40 % TOPICAL CREAM,1.74,1.13,0.26,1.74,40
NDC,5448205401,MATULANE 50 MG CAPSULE,424.18,275.72,63.12,424.18,40
NDC,5448214407,CARNITOR 330 MG TABLET,3.1,2.02,0.46,3.1,40
NDC,5448214701,CARNITOR 200 MG/ML INTRAVENOUS SOLUTION,27.99,18.19,2.17,58.28,51
NDC,54629085401,MAGNESIUM (OXIDE/AA CHELATE) 300 MG CAPSULE,0.2,0.13,0.03,0.2,40
NDC,54629409760,ACETYLCYSTEINE 600 MG CAPSULE,0.24,0.16,0.04,0.24,40
NDC,5464356461,INFUVITE PEDIATRIC 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLUTION,17.31,11.25,2.58,17.31,40
NDC,5464356491,INFUVITE ADULT 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION,96.3,62.6,14.33,96.3,40
NDC,5464356502,INFUVITE ADULT 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION,5.13,3.33,0.76,5.13,40
NDC,5473898001,GUAIFENESIN 200 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,5475800628,SWEET CHEEKS 1.2 GRAM/3 ML (40 %) ORAL GEL IN SYRINGE (ORAL USE ONLY),2.6,1.69,0.39,2.6,40
NDC,5476609306,RIDAURA 3 MG CAPSULE,62.64,40.72,9.32,62.64,40
NDC,5482800101,NEURACEQ 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,6200.0,4030.0,0.01,6200.0,60
NDC,5483800180,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL ELIXIR,0.1,0.07,0.01,0.1,40
NDC,5483850115,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,6.68,4.34,0.99,6.68,40
NDC,5483850140,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,1.13,0.73,0.17,1.13,40
NDC,5483850280,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,1.4,0.91,0.21,1.4,40
NDC,5483850615,HYOSYNE 0.125 MG/ML ORAL DROPS,6.68,4.34,0.99,6.68,40
NDC,5483851080,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,0.28,0.18,0.04,0.28,40
NDC,5483851240,DOXEPIN 10 MG/ML ORAL CONCENTRATE,5.23,3.4,0.78,5.23,40
NDC,5487900101,ETHAMBUTOL 100 MG TABLET,0.92,0.6,0.14,0.92,40
NDC,5499500701,CAMPHO-PHENIQUE 10.8 %-4.7 % TOPICAL SOLUTION,0.3,0.2,0.04,0.3,40
NDC,5511112506,CIPROFLOXACIN 100 MG TABLET,30.44,19.79,4.53,30.44,40
NDC,5511117001,OXAPROZIN 600 MG TABLET,7.32,4.76,1.09,7.32,40
NDC,5511117915,TIZANIDINE 2 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,5511128130,LEVOFLOXACIN 750 MG TABLET,50.16,32.6,7.46,50.16,40
NDC,5511129109,SUMATRIPTAN 25 MG TABLET,54.1,35.17,8.05,54.1,40
NDC,5511132001,GLIMEPIRIDE 1 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,5511132101,GLIMEPIRIDE 2 MG TABLET,1.3,0.85,0.19,1.3,40
NDC,5511135460,RIVASTIGMINE 4.5 MG CAPSULE,8.48,5.51,1.26,8.48,40
NDC,5511164101,MEPROBAMATE 400 MG TABLET,16.5,10.73,2.46,16.5,40
NDC,5511168405,IBU 800 MG TABLET,0.62,0.4,0.09,0.62,40
NDC,5511168852,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,30.12,19.58,2.17,47.96,51
NDC,5511176260,VALGANCICLOVIR 450 MG TABLET,128.8,83.72,19.17,128.8,40
NDC,5513513201,TRODELVY 180 MG INTRAVENOUS SOLUTION,12304.8,7998.12,2.17,12304.8,65
NDC,5515011310,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,24.63,16.01,1.05,24.63,51
NDC,5515011420,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,47.76,31.04,1.05,47.76,51
NDC,5515011620,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,23.22,15.09,2.17,23.22,51
NDC,5515011720,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,43.8,28.47,2.17,43.8,51
NDC,5515011930,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,10.8,7.02,1.61,10.8,51
NDC,5515012030,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,19.8,12.87,1.94,19.8,51
NDC,5515012215,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,43.5,28.28,0.11,43.5,51
NDC,5515012715,OXACILLIN 1 GRAM SOLUTION FOR INJECTION,43.5,28.28,1.01,43.5,51
NDC,5515015411,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,4.8,3.12,0.11,8.86,51
NDC,5515016102,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.62,3.0,0.02,8.86,51
NDC,5515016402,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,6.75,4.39,0.02,8.86,51
NDC,5515016505,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.16,1.4,0.02,8.86,51
NDC,5515016613,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,55.2,35.88,8.21,55.2,40
NDC,5515016910,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,1.08,0.7,0.02,8.86,51
NDC,5515017301,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,79.2,51.48,2.17,348.15,51
NDC,5515017305,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,79.2,51.48,2.17,348.15,51
NDC,5515019183,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,500.01,325.01,2.17,500.01,51
NDC,5515019410,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,2.64,1.72,0.39,2.64,40
NDC,5515019699,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,2.16,1.4,0.09,8.86,51
NDC,5515019720,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,1.02,0.66,0.09,8.86,51
NDC,5515021899,EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,5.4,3.51,1.19,327.06,59
NDC,5515022110,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.43,2.88,40
NDC,5515022310,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,3.6,2.34,0.54,14.98,51
NDC,5515023410,POLYMYXIN B SULFATE 500000 UNIT SOLUTION FOR INJECTION,52.5,34.13,7.81,52.5,40
NDC,5515023510,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,19.8,12.87,2.95,19.8,40
NDC,5515025110,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.96,0.62,0.02,8.86,51
NDC,5515025410,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,1.38,0.9,0.02,8.86,51
NDC,5515025520,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.75,0.49,0.02,8.86,51
NDC,5515026705,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,108.0,70.2,2.17,108.0,51
NDC,5515029901,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,234.0,152.1,0.63,234.0,65
NDC,5515031825,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,104.01,67.61,2.17,104.01,51
NDC,5515031925,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,59.58,38.73,2.17,69.49,51
NDC,5515033001,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,252.0,163.8,1.08,252.0,51
NDC,5515033701,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,201.6,131.04,2.17,940.91,51
NDC,5515034510,NALOXONE 1 MG/ML INJECTION SYRINGE,56.7,36.86,0.12,56.7,51
NDC,5515035401,IRINOTECAN 300 MG/15 ML INTRAVENOUS SOLUTION,32.0,20.8,2.17,32.0,43
NDC,5529213801,SIGNIFOR LAR 60 MG IM SUSPENSION,78332.04,50915.83,2.17,78332.04,65
NDC,5529214301,SIGNIFOR LAR 60 MG IM SUSPENSION,78332.04,50915.83,2.17,78332.04,65
NDC,5529220111,CHEMET 100 MG CAPSULE,52.88,34.37,7.87,52.88,40
NDC,5529270255,PANHEMATIN 350 MG INTRAVENOUS SOLUTION,41137.77,26739.55,2.17,41137.77,65
NDC,5551300204,ARANESP 25 MCG/ML (IN POLYSORBATE) INJECTION,696.6,452.79,2.17,696.6,65
NDC,5551300304,ARANESP 40 MCG/ML (IN POLYSORBATE) INJECTION,1114.56,724.46,2.17,1114.56,65
NDC,5551300404,ARANESP 60 MCG/ML (IN POLYSORBATE) INJECTION,1671.84,1086.7,2.17,1671.84,65
NDC,5551300504,ARANESP 100 MCG/ML (IN POLYSORBATE) INJECTION,2786.4,1811.16,2.17,2786.4,65
NDC,5551300601,ARANESP 200 MCG/ML (IN POLYSORBATE) INJECTION,5572.8,3622.32,2.17,5572.8,65
NDC,5551302101,ARANESP 40 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,2786.4,1811.16,2.17,2786.4,65
NDC,5551302104,ARANESP 40 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,2786.4,1811.16,2.17,2786.4,65
NDC,5551302301,ARANESP 60 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.17,5572.8,65
NDC,5551302304,ARANESP 60 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.17,5572.8,65
NDC,5551302501,ARANESP 100 MCG/0.5 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.17,5572.8,65
NDC,5551302504,ARANESP 100 MCG/0.5 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.17,5572.8,65
NDC,5551302701,ARANESP 150 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
NDC,5551302704,ARANESP 150 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
NDC,5551302801,ARANESP 200 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
NDC,5551303201,ARANESP 500 MCG/ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
NDC,5551305701,ARANESP 25 MCG/0.42 ML (IN POLYSORBATE) INJECTION SYRINGE,1658.58,1078.08,2.17,1658.58,65
NDC,5551305704,ARANESP 25 MCG/0.42 ML (IN POLYSORBATE) INJECTION SYRINGE,1658.58,1078.08,2.17,1658.58,65
NDC,5551305901,IMDELLTRA 1 MG INTRAVENOUS SOLUTION,7200.0,4680.0,2.17,7200.0,65
NDC,5551307330,SENSIPAR 30 MG TABLET,64.54,41.95,9.6,64.54,40
NDC,5551307701,IMDELLTRA 10 MG INTRAVENOUS SOLUTION,72000.0,46800.0,2.17,72000.0,65
NDC,5551307801,IMLYGIC 10EXP6 (1 MILLION) PFU/ML SUSPENSION FOR INJECTION,335.36,217.98,2.17,4417.71,65
NDC,5551307901,IMLYGIC 10EXP8 (100 MILLION) PFU/ML SUSPENSION FOR INJECTION,33531.8,21795.67,2.17,33531.8,65
NDC,5551311101,ARANESP 300 MCG/0.6 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.17,13932.0,65
NDC,5551311201,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRINGE,8234.7,5352.56,2.17,8234.7,65
NDC,5551312301,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS PEN INJECTOR,8811.84,5727.7,2.17,8811.84,65
NDC,5551312601,EPOGEN 2000 UNIT/ML INJECTION SOLUTION,119.37,77.59,2.17,184.43,65
NDC,5551312610,EPOGEN 2000 UNIT/ML INJECTION SOLUTION,119.37,77.59,2.17,184.43,65
NDC,5551313201,KANJINTI 420 MG INTRAVENOUS SOLUTION,18279.28,11881.53,2.17,18279.28,65
NDC,5551313760,OTEZLA 30 MG TABLET,212.94,138.41,31.69,212.94,40
NDC,5551314101,KANJINTI 150 MG INTRAVENOUS SOLUTION,6528.32,4243.41,2.17,6528.32,65
NDC,5551314401,EPOGEN 10000 UNIT/ML INJECTION SOLUTION,596.88,387.97,2.17,596.88,65
NDC,5551314410,EPOGEN 10000 UNIT/ML INJECTION SOLUTION,596.88,387.97,2.17,596.88,65
NDC,5551314801,EPOGEN 4000 UNIT/ML INJECTION SOLUTION,238.74,155.18,2.17,238.74,65
NDC,5551314810,EPOGEN 4000 UNIT/ML INJECTION SOLUTION,238.74,155.18,2.17,238.74,65
NDC,5551315001,BLINCYTO 35 MCG INTRAVENOUS SOLUTION,26672.48,17337.11,2.17,26672.48,65
NDC,5551316001,BLINCYTO 35 MCG INTRAVENOUS KIT,26672.48,17337.11,2.17,26672.48,65
NDC,5551318001,BKEMV 300 MG/30 ML INTRAVENOUS SOLUTION,939.32,610.56,42.34,2642.72,59
NDC,5551319001,NEULASTA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,38507.94,25030.16,2.17,38507.94,65
NDC,5551319201,NEULASTA ONPRO 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,38507.94,25030.16,2.17,38507.94,65
NDC,5551320601,MVASI 25 MG/ML INTRAVENOUS SOLUTION,837.28,544.23,2.17,1287.79,65
NDC,5551320701,MVASI 25 MG/ML INTRAVENOUS SOLUTION,837.28,544.23,2.17,1287.79,65
NDC,5551320901,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.45,1554.44,0.99,2391.45,65
NDC,5551320910,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.42,1554.42,0.99,2391.42,65
NDC,5551320991,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.45,1554.44,0.99,2391.45,65
NDC,5551322101,NPLATE 250 MCG SUBCUTANEOUS SOLUTION,9910.86,6442.06,2.17,9910.86,65
NDC,5551322201,NPLATE 500 MCG SUBCUTANEOUS SOLUTION,19821.66,12884.08,2.17,19821.66,65
NDC,5551322301,NPLATE 125 MCG SUBCUTANEOUS SOLUTION,4955.52,3221.09,2.17,4955.52,65
NDC,5551322401,RIABNI 10 MG/ML INTRAVENOUS SOLUTION,258.06,167.74,2.17,3257.22,65
NDC,5551326701,EPOGEN 3000 UNIT/ML INJECTION SOLUTION,179.07,116.4,2.17,184.43,65
NDC,5551326710,EPOGEN 3000 UNIT/ML INJECTION SOLUTION,179.07,116.4,2.17,184.43,65
NDC,5551328301,EPOGEN 20000 UNIT/2 ML INJECTION SOLUTION,596.88,387.97,2.17,596.88,65
NDC,5551332601,RIABNI 10 MG/ML INTRAVENOUS SOLUTION,258.06,167.74,2.17,3257.22,65
NDC,5551347801,EPOGEN 20000 UNIT/ML INJECTION SOLUTION,1193.76,775.94,2.17,1193.76,65
NDC,5551347810,EPOGEN 20000 UNIT/ML INJECTION SOLUTION,1193.76,775.94,2.17,1193.76,65
NDC,5551353001,NEUPOGEN 300 MCG/ML INJECTION SOLUTION,1133.4,736.71,0.99,1133.4,65
NDC,5551353010,NEUPOGEN 300 MCG/ML INJECTION SOLUTION,1133.4,736.71,0.99,1133.4,65
NDC,5551354601,NEUPOGEN 480 MCG/1.6 ML INJECTION SOLUTION,1128.0,733.2,0.99,1128.0,65
NDC,5551354610,NEUPOGEN 480 MCG/1.6 ML INJECTION SOLUTION,1128.0,733.2,0.99,1128.0,65
NDC,5551367001,AVSOLA 100 MG INTRAVENOUS SOLUTION,2400.0,1560.0,2.17,2400.0,65
NDC,5551371001,PROLIA 60 MG/ML SUBCUTANEOUS SYRINGE,6751.56,4388.51,2.17,6751.56,65
NDC,5551371021,PROLIA 60 MG/ML SUBCUTANEOUS SYRINGE,6751.56,4388.51,2.17,6751.56,65
NDC,5551373001,XGEVA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7305.33,4748.46,2.17,7305.33,65
NDC,5551373021,XGEVA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7305.33,4748.46,2.17,7305.33,65
NDC,5551380060,CORLANOR 5 MG TABLET,25.04,16.28,3.73,25.04,40
NDC,5551381328,CORLANOR 5 MG/5 ML ORAL SOLUTION,6.25,4.06,0.93,6.25,40
NDC,5551388002,EVENITY 210 MG/2.34 ML (105 MG/1.17 ML X 2) SUBCUTANEOUS SYRINGE,4044.48,2628.91,2.17,4044.48,65
NDC,5551392401,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.64,1561.72,0.99,2402.64,65
NDC,5551392410,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.67,1561.74,0.99,2402.67,65
NDC,5551392491,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.64,1561.72,0.99,2402.64,65
NDC,5551395401,VECTIBIX 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,2.17,4487.68,65
NDC,5551395601,VECTIBIX 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,2.17,4487.68,65
NDC,5551399802,EVENITY 210 MG/2.34 ML (105 MG/1.17 ML X 2) SUBCUTANEOUS SYRINGE,4044.48,2628.91,2.17,4044.48,65
NDC,5556610501,ADSTILADRIN 3X10EXP11 VP/ML INTRAVESICAL SUSPENSION,73080.0,47502.0,2.17,190420.49,65
NDC,5556615021,NOVAREL 5000 UNIT INTRAMUSCULAR SOLUTION,607.65,394.97,2.17,607.65,51
NDC,5556628001,CERVIDIL 10 MG VAGINAL INSERTCONTROLLED RELEASE,1320.44,858.29,196.48,1320.44,40
NDC,5556641001,EUFLEXXA 10 MG/ML (MW 2.4-3.6 MILLION) INTRA-ARTICULAR SYRINGE,649.14,421.94,2.17,649.14,65
NDC,5556665003,ENDOMETRIN 100 MG VAGINAL INSERT,35.38,23.0,5.26,35.38,40
NDC,5556683031,FIRMAGON KIT WITH DILUENT SYRINGE 80 MG SUBCUTANEOUS SOLUTION,1758.42,1142.97,2.17,1758.42,65
NDC,5556684031,FIRMAGON KIT WITH DILUENT SYRINGE 120 MG SUBCUTANEOUS SOLUTION,3658.04,2377.73,2.17,3658.04,65
NDC,5556698000,REBYOTA 150 ML ENEMA,148.36,96.43,2.17,4417.71,65
NDC,5556698002,REBYOTA 150 ML ENEMA,148.36,96.43,2.17,4417.71,65
NDC,5579200710,ELLIOTTS B (PF) 73 MG-19 MG-8 MG-3 MG/10 ML INTRATHECAL SOLUTION,37.8,24.57,2.17,47.96,51
NDC,56151146001,TRUE METRIX GLUCOSE TEST STRIP,1.24,0.81,0.18,1.24,40
NDC,56151161211,TRUEPLUS GLUCOSE 4 GRAM CHEWABLE TABLET,0.4,0.26,0.06,0.4,40
NDC,56151162501,TRUEPLUS GLUCOSE 15 GRAM/32 ML ORAL GEL PACKET,0.33,0.21,0.05,0.33,40
NDC,5618412105,LITTLE NOSES 0.125 % NASAL DROPS,0.74,0.48,0.11,0.74,40
NDC,5707400177,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.6,1.04,0.24,1.6,40
NDC,5723700201,HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE,0.86,0.56,0.13,0.86,40
NDC,5723700330,FLUCONAZOLE 50 MG TABLET,11.2,7.28,1.67,11.2,40
NDC,5723700511,FLUCONAZOLE 150 MG TABLET,27.86,18.11,4.15,27.86,40
NDC,5723701106,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,4.72,3.07,0.7,4.72,40
NDC,5723701206,MIRTAZAPINE 30 MG DISINTEGRATING TABLET,4.86,3.16,0.72,4.86,40
NDC,5723704001,PENICILLIN V POTASSIUM 250 MG TABLET,1.7,1.11,0.25,1.7,40
NDC,5723704101,PENICILLIN V POTASSIUM 500 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,5723705160,GALANTAMINE 12 MG TABLET,6.36,4.13,0.95,6.36,40
NDC,5723707530,ONDANSETRON HCL 4 MG TABLET,49.56,32.21,7.37,49.56,40
NDC,5723707630,ONDANSETRON HCL 8 MG TABLET,78.66,51.13,11.7,78.66,40
NDC,5723707710,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.56,28.96,6.63,44.56,40
NDC,5723707730,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.58,28.98,6.63,44.58,40
NDC,5723708763,RIZATRIPTAN 5 MG TABLET,63.26,41.12,9.41,63.26,40
NDC,5723710101,METOPROLOL TARTRATE 50 MG TABLET,1.12,0.73,0.17,1.12,40
NDC,5723710199,METOPROLOL TARTRATE 50 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,5723710201,METOPROLOL TARTRATE 100 MG TABLET,1.6,1.04,0.24,1.6,40
NDC,5723710299,METOPROLOL TARTRATE 100 MG TABLET,1.52,0.99,0.23,1.52,40
NDC,5723711490,ALFUZOSIN ER 10 MG TABLETEXTENDED RELEASE 24 HR,8.42,5.47,1.25,8.42,40
NDC,5723714935,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,2.58,1.68,0.38,2.58,40
NDC,5723715630,MOXIFLOXACIN 400 MG TABLET,54.4,35.36,8.09,54.4,40
NDC,5723718190,PRAMIPEXOLE 0.25 MG TABLET,5.9,3.84,0.88,5.9,40
NDC,5723722190,PIOGLITAZONE 45 MG TABLET,23.22,15.09,3.46,23.22,40
NDC,5723722501,RAMIPRIL 10 MG CAPSULE,4.44,2.89,0.66,4.44,40
NDC,5723727424,LAMIVUDINE 10 MG/ML ORAL SOLUTION,1.25,0.81,0.19,1.25,40
NDC,5723732552,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.64,0.42,0.1,0.64,40
NDC,5766447758,METOPROLOL TARTRATE 50 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,5766449918,MIRTAZAPINE 15 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,5766450083,MIRTAZAPINE 30 MG TABLET,0.9,0.59,0.13,0.9,40
NDC,5766450389,TIZANIDINE 4 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,5766464888,CHLORTHALIDONE 25 MG TABLET,0.58,0.38,0.09,0.58,40
NDC,5766465588,PINDOLOL 5 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,5777005500,OCUCOAT 2 % INTRAOCULAR SYRINGE,226.8,147.42,33.75,226.8,40
NDC,5777005501,HYPROMELLOSE 2 % INTRAOCULAR SYRINGE,189.0,122.85,28.12,189.0,40
NDC,5778239726,CROMOLYN 5.2 MG/SPRAY (4 %) NASAL SPRAY,1.0,0.65,0.15,1.0,40
NDC,5782645502,CITRIC ACID-SOD CITPHOS-DEXTROSE 0.327 GRAM-2.63 GRAM/100 ML SOLUTION,0.12,0.08,0.02,0.12,40
NDC,5784413001,ADDERALL 30 MG TABLET,28.16,18.3,4.19,28.16,40
NDC,5789403001,REMICADE 100 MG INTRAVENOUS SOLUTION,4204.14,2732.69,2.17,4204.14,65
NDC,5789405060,AKEEGA 50 MG-500 MG TABLET,765.0,497.25,113.83,765.0,40
NDC,5789405427,STELARA 130 MG/26 ML INTRAVENOUS SOLUTION,293.49,190.77,2.17,4487.68,65
NDC,5789406002,STELARA 45 MG/0.5 ML SUBCUTANEOUS SOLUTION,104945.34,68214.47,2.17,104945.34,57
NDC,5789406003,STELARA 45 MG/0.5 ML SUBCUTANEOUS SYRINGE,104945.34,68214.47,2.17,104945.34,57
NDC,5789406103,STELARA 90 MG/ML SUBCUTANEOUS SYRINGE,104945.25,68214.41,2.17,104945.25,57
NDC,5789407001,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS SYRINGE,45692.85,29700.35,2.17,45692.85,65
NDC,5789407002,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,45692.85,29700.35,41.42,45692.85,51
NDC,5789407101,SIMPONI 100 MG/ML SUBCUTANEOUS SYRINGE,26273.4,17077.71,2.17,26273.4,65
NDC,5789408060,LAZCLUZE 80 MG TABLET,727.92,473.15,108.31,727.92,40
NDC,5789410060,AKEEGA 100 MG-500 MG TABLET,765.0,497.25,113.83,765.0,40
NDC,5789411101,CARVYKTI 0.5X 10EXP6 TO 1X 10EXP8 CELL INTRAVENOUS SUSPENSION,2665490.12,1732568.58,0.02,2665490.12,64
NDC,5789411102,CARVYKTI 0.5X 10EXP6 TO 1X 10EXP8 CELL INTRAVENOUS SUSPENSION,2665490.12,1732568.58,0.02,2665490.12,64
NDC,5789416001,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,1710.0,1111.5,2.17,1710.0,65
NDC,5789424030,LAZCLUZE 240 MG TABLET,1455.84,946.3,216.63,1455.84,40
NDC,5789435001,SIMPONI ARIA 12.5 MG/ML INTRAVENOUS SOLUTION,1799.28,1169.53,2.17,2642.72,65
NDC,5789444901,TECVAYLI 10 MG/ML SUBCUTANEOUS SOLUTION,3277.64,2130.47,2.17,4487.68,65
NDC,5789445001,TECVAYLI 90 MG/ML SUBCUTANEOUS SOLUTION,29498.96,19174.32,2.17,29498.96,65
NDC,5789446901,TALVEY 2 MG/ML SUBCUTANEOUS SOLUTION,2772.72,1802.27,2.17,4417.71,65
NDC,5789447001,TALVEY 40 MG/ML SUBCUTANEOUS SOLUTION,55454.56,36045.46,2.17,55454.56,65
NDC,5789450101,RYBREVANT 50 MG/ML INTRAVENOUS SOLUTION,2610.28,1696.68,2.17,4417.71,65
NDC,5789450301,DARZALEX FASPRO 1800 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,2537.25,1649.21,2.17,4487.68,65
NDC,5789450505,DARZALEX 20 MG/ML INTRAVENOUS SOLUTION,744.6,483.99,2.17,4487.68,65
NDC,5789450520,DARZALEX 20 MG/ML INTRAVENOUS SOLUTION,744.6,483.99,2.17,4487.68,65
NDC,5789464001,TREMFYA 100 MG/ML SUBCUTANEOUS SYRINGE,52439.19,34085.47,2.17,52439.19,65
NDC,5789464011,TREMFYA ONE-PRESS 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,52439.19,34085.47,2.17,52439.19,65
NDC,5789465002,TREMFYA 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,2621.97,1704.28,2.17,7011.25,65
NDC,5789480101,IMAAVY 185 MG/ML INTRAVENOUS SOLUTION,6912.0,4492.8,2.17,7011.25,59
NDC,5789614314,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT TOPICAL OINTMENT PACKET,0.18,0.12,0.03,0.18,40
NDC,5789641501,GERI-KOT 8.6 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,5789646208,SENNA 8.8 MG/5 ML ORAL SYRUP,0.13,0.08,0.02,0.13,40
NDC,5789666116,GERI-TUSSIN DM 10 MG-100 MG/5 ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,5789670916,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,0.03,0.02,0.01,0.03,40
NDC,5789690110,ASPIRIN 325 MG TABLET,0.02,0.01,0.01,0.02,40
NDC,5789692101,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.04,0.03,0.01,0.04,40
NDC,5789692110,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.02,0.01,0.01,0.02,40
NDC,5796200712,IMBRUVICA 70 MG/ML ORAL SUSPENSION,177.4,115.31,26.4,177.4,40
NDC,5796201428,IMBRUVICA 140 MG TABLET,849.42,552.12,126.39,849.42,40
NDC,5796207028,IMBRUVICA 70 MG CAPSULE,849.6,552.24,126.42,849.6,40
NDC,5796214012,IMBRUVICA 140 MG CAPSULE,283.2,184.08,42.14,283.2,40
NDC,5796228028,IMBRUVICA 280 MG TABLET,849.46,552.15,126.4,849.46,40
NDC,5796242028,IMBRUVICA 420 MG TABLET,849.54,552.2,126.41,849.54,40
NDC,5815111088,DILANTIN EXTENDED 100 MG CAPSULE,4.82,3.13,0.72,4.82,40
NDC,5816081052,INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE,204.72,133.07,7.93,204.72,51
NDC,5816081152,PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,773.7,502.91,7.93,773.7,51
NDC,5816081252,KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,447.93,291.15,7.93,447.93,51
NDC,5816081552,TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE,504.36,327.83,13.37,504.36,51
NDC,5816081912,SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT,775.83,504.29,13.37,775.83,51
NDC,5816082043,ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,211.38,137.4,7.93,211.38,51
NDC,5816082052,ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,211.38,137.4,7.93,211.38,51
NDC,5816082111,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SUSPENSION,267.66,173.98,13.37,346.93,51
NDC,5816082152,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,267.66,173.98,7.93,267.66,51
NDC,5816082311,SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT,844.89,549.18,13.37,844.89,51
NDC,5816082552,HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE,284.61,185.0,7.93,284.61,51
NDC,5816082652,HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE,319.74,207.83,7.93,319.74,51
NDC,5816082801,SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION,775.83,504.29,13.37,775.83,51
NDC,5816082803,SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION,844.89,549.18,13.37,844.89,51
NDC,5816084252,BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE,344.82,224.13,7.93,344.82,51
NDC,5816095509,MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS),633.45,411.74,13.37,633.45,51
NDC,5816097602,BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1804.02,1172.61,13.37,1804.02,51
NDC,5816097620,BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1804.02,1172.61,13.37,1804.02,51
NDC,5818130405,GLEOSTINE 10 MG CAPSULE,291.58,189.53,43.39,291.58,40
NDC,5818130415,GLEOSTINE 40 MG CAPSULE,1166.28,758.08,173.54,1166.28,40
NDC,5818130425,GLEOSTINE 100 MG CAPSULE,3219.5,2092.68,479.06,3219.5,40
NDC,5823207213,DESITIN 40 % TOPICAL PASTE,0.1,0.07,0.01,0.1,40
NDC,5828420801,BRIXADI WEEKLY 8 MG/0.16 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,9607.5,6244.88,2.17,9607.5,65
NDC,5828421601,BRIXADI WEEKLY 16 MG/0.32 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,4803.75,3122.44,2.17,4803.75,65
NDC,5828422401,BRIXADI WEEKLY 24 MG/0.48 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,3202.5,2081.63,2.17,3202.5,65
NDC,5828422801,BRIXADI MONTHLY 128 MG/0.36 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,17079.99,11101.99,2.17,17079.99,65
NDC,5828423201,BRIXADI WEEKLY 32 MG/0.64 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,2401.89,1561.23,2.17,2401.89,65
NDC,5828426401,BRIXADI MONTHLY 64 MG/0.18 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,34160.01,22204.01,2.17,34160.01,65
NDC,5828429601,BRIXADI MONTHLY 96 MG/0.27 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,22773.33,14802.66,2.17,22773.33,65
NDC,5839463403,BENEFIX 500 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
NDC,5839463503,BENEFIX 1000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
NDC,5839463603,BENEFIX 2000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
NDC,5839463703,BENEFIX 3000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.42,4417.71,65
NDC,5840601001,ENBREL 25 MG/0.5 ML (0.5 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,2.17,7341.84,57
NDC,5840602104,ENBREL 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,2.17,7341.84,57
NDC,5840603204,ENBREL SURECLICK 50 MG/ML (1 ML) SUBCUTANEOUS PEN INJECTOR,7341.84,4772.2,2.17,7341.84,57
NDC,5840604401,ENBREL MINI 50 MG/ML (1 ML) SUBCUTANEOUS CARTRIDGE,7341.84,4772.2,2.17,7341.84,57
NDC,5840605504,ENBREL 25 MG/0.5 ML SUBCUTANEOUS SOLUTION,7341.84,4772.2,2.17,7341.84,57
NDC,5846800302,THYROGEN 0.9 MG INTRAMUSCULAR SOLUTION,6613.77,4298.95,2.17,6613.77,65
NDC,5846800401,FABRAZYME 35 MG INTRAVENOUS SOLUTION,38699.0,25154.35,2.17,38699.0,65
NDC,5846800411,FABRAZYME 5 MG INTRAVENOUS SOLUTION,5527.48,3592.86,2.17,7011.25,65
NDC,5846800501,XENPOZYME 20 MG INTRAVENOUS SOLUTION,28092.66,18260.23,2.17,28092.66,65
NDC,5846800701,ALDURAZYME 2.9 MG/5 ML INTRAVENOUS SOLUTION,833.7,541.91,2.17,7011.25,65
NDC,5846800801,THYMOGLOBULIN 25 MG INTRAVENOUS SOLUTION,4130.85,2685.05,2.17,4130.85,65
NDC,5846800901,SYNVISC 16 MG/2 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,2.17,821.76,65
NDC,5846800903,SYNVISC-ONE 48 MG/6 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,2.17,821.76,65
NDC,5846801311,RENVELA 2.4 GRAM ORAL POWDER PACKET,42.84,27.85,6.37,42.84,40
NDC,5846801312,RENVELA 2.4 GRAM ORAL POWDER PACKET,42.84,27.85,6.37,42.84,40
NDC,5846801322,RENVELA 0.8 GRAM ORAL POWDER PACKET,42.84,27.85,6.37,42.84,40
NDC,5846801601,LUMIZYME 50 MG INTRAVENOUS SOLUTION,3647.64,2370.97,2.17,16617.81,65
NDC,5846802001,LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION,118976.96,77335.02,2.17,118976.96,65
NDC,5846802251,CABLIVI 11 MG INJECTION KIT,32092.38,20860.05,2.17,32092.38,59
NDC,5846804261,NEXVIAZYME 100 MG INTRAVENOUS SOLUTION,7295.25,4741.91,2.17,16617.81,65
NDC,5846846631,CEREZYME 400 UNIT INTRAVENOUS SOLUTION,6305.28,4098.43,2.17,7011.25,65
NDC,5846878203,CAPRELSA 100 MG TABLET,724.06,470.64,107.74,724.06,40
NDC,5846878403,CAPRELSA 300 MG TABLET,1448.1,941.27,215.48,1448.1,40
NDC,5865731016,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.23,0.15,0.03,0.23,40
NDC,5865731116,POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,0.38,0.25,0.06,0.38,40
NDC,5865731216,POTASSIUM CITRATE-CITRIC ACID 1100 MG-334 MG/5 ML ORAL SOLUTION,0.4,0.26,0.06,0.4,40
NDC,5865732250,FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,0.7,0.46,0.1,0.7,40
NDC,5865752816,M-DRYL 12.5 MG/5 ML ORAL LIQUID,0.1,0.07,0.01,0.1,40
NDC,5865760250,LABETALOL 100 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,5865767601,CIPROFLOXACIN 500 MG TABLET,9.9,6.44,1.47,9.9,40
NDC,5879000330,THERATEARS 1 % GEL IN A DROPPERETTE,1.04,0.68,0.15,1.04,40
NDC,5891450156,CANASA 1000 MG RECTAL SUPPOSITORY,92.94,60.41,13.83,92.94,40
NDC,5898001205,DOUBLE ANTIBIOTIC (BACITRCN ZN) 500 UNIT-10000 UNIT/GRAM TOP OINTMENT,0.62,0.4,0.09,0.62,40
NDC,5898040912,GLYCERIN (CHILD) RECTAL SUPPOSITORY,1.68,1.09,0.25,1.68,40
NDC,5898040925,GLYCERIN (CHILD) RECTAL SUPPOSITORY,1.22,0.79,0.18,1.22,40
NDC,5898041012,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.4,0.26,0.06,0.4,40
NDC,5898041025,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.3,0.2,0.04,0.3,40
NDC,5898060530,UREA 10 % TOPICAL CREAM,0.22,0.14,0.03,0.22,40
NDC,5898060880,UREA 10 % LOTION,0.08,0.05,0.01,0.08,40
NDC,5898082010,CASTELLANI PAINT 1.5 % TOPICAL LIQUID,2.18,1.42,0.32,2.18,40
NDC,5898096012,SONAFINE TOPICAL EMULSION,1.22,0.79,0.18,1.22,40
NDC,5898096031,SONAFINE TOPICAL EMULSION,1.0,0.65,0.15,1.0,40
NDC,5901141020,OXYCONTIN 10 MG TABLETCRUSH RESISTANTEXTENDED RELEASE,15.14,9.84,2.25,15.14,40
NDC,5901141510,OXYCONTIN 15 MG TABLETCRUSH RESISTANTEXTENDED RELEASE,21.72,14.12,3.23,21.72,40
NDC,5901141520,OXYCONTIN 15 MG TABLETEXTENDED RELEASE,22.28,14.48,3.32,22.28,40
NDC,5901142010,OXYCONTIN 20 MG TABLETCRUSH RESISTANTEXTENDED RELEASE,27.52,17.89,4.09,27.52,40
NDC,5901142020,OXYCONTIN 20 MG TABLETEXTENDED RELEASE,28.22,18.34,4.2,28.22,40
NDC,5901144010,OXYCONTIN 40 MG TABLETEXTENDED RELEASE,47.12,30.63,7.01,47.12,40
NDC,5901144020,OXYCONTIN 40 MG TABLETEXTENDED RELEASE,48.32,31.41,7.19,48.32,40
NDC,5901148020,OXYCONTIN 80 MG TABLETEXTENDED RELEASE,84.34,54.82,12.55,84.34,40
NDC,5901175104,BUTRANS 10 MCG/HOUR TRANSDERMAL PATCH,184.9,120.19,27.51,184.9,40
NDC,5901642019,MAGTAB 84 MG TABLETEXTENDED RELEASE,0.84,0.55,0.12,0.84,40
NDC,5913723101,GLEOLAN 30 MG/ML ORAL SOLUTION,9588.0,6232.2,1426.69,9588.0,40
NDC,5914800613,ABILIFY 2 MG TABLET,46.7,30.36,6.95,46.7,40
NDC,5914800713,ABILIFY 5 MG TABLET,46.7,30.36,6.95,46.7,40
NDC,5914800813,ABILIFY 10 MG TABLET,46.7,30.36,6.95,46.7,40
NDC,5914801870,ABILIFY MAINTENA 300 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,7842.0,5097.3,2.17,7842.0,65
NDC,5914801970,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,2.17,10455.99,65
NDC,5914801971,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,2.17,10455.99,65
NDC,5914802050,SAMSCA 15 MG TABLET,1248.48,811.51,185.77,1248.48,40
NDC,5914802150,SAMSCA 30 MG TABLET,1295.14,841.84,192.72,1295.14,40
NDC,5914803513,REXULTI 0.25 MG TABLET,121.26,78.82,18.04,121.26,40
NDC,5914803613,REXULTI 0.5 MG TABLET,121.26,78.82,18.04,121.26,40
NDC,5914803713,REXULTI 1 MG TABLET,121.26,78.82,18.04,121.26,40
NDC,5914803813,REXULTI 2 MG TABLET,121.26,78.82,18.04,121.26,40
NDC,5914803913,REXULTI 3 MG TABLET,121.26,78.82,18.04,121.26,40
NDC,5914804013,REXULTI 4 MG TABLET,121.26,78.82,18.04,121.26,40
NDC,5914804580,ABILIFY MAINTENA 300 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,7842.0,5097.3,2.17,7842.0,65
NDC,5914807280,ABILIFY MAINTENA 400 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,10455.99,6796.39,2.17,10455.99,65
NDC,5914811480,ABILIFY ASIMTUFII 960 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,6534.99,4247.74,2.17,6534.99,65
NDC,5914823212,ABILIFY MAINTENA 300 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,7842.0,5097.3,2.17,7842.0,65
NDC,5914824512,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,2.17,10455.99,65
NDC,5921200201,DYRENIUM 50 MG CAPSULE,35.62,23.15,5.3,35.62,40
NDC,5921200301,DYRENIUM 100 MG CAPSULE,35.62,23.15,5.3,35.62,40
NDC,5921242304,DONNATAL 16.2 MG-0.1037 MG-0.0194 MG/5 ML ORAL ELIXIR,13.05,8.48,1.94,13.05,40
NDC,5921270112,ORAPRED ODT 15 MG DISINTEGRATING TABLET,74.4,48.36,11.07,74.4,40
NDC,5931030240,QVAR REDIHALER 40 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,49.58,32.23,7.38,49.58,40
NDC,5931030480,QVAR REDIHALER 80 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,66.4,43.16,9.88,66.4,40
NDC,5931061031,CINQAIR 10 MG/ML INTRAVENOUS SOLUTION,408.96,265.82,2.17,2642.72,65
NDC,5931610212,BIOFREEZE (MENTHOL) 4 % TOPICAL GEL,0.2,0.13,0.03,0.2,40
NDC,5931611520,BIOFREEZE (MENTHOL) 5 % TOPICAL GEL,0.18,0.12,0.03,0.18,40
NDC,5931620510,BIOFREEZE (MENTHOL) 4 % TOPICAL GEL,0.22,0.14,0.03,0.22,40
NDC,5933877501,FERAHEME 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,252.78,164.31,0.34,369.35,65
NDC,5936551291,PARAGARD T380A (SINGLE HAND) 380 SQUARE MM INTRAUTERINE DEVICE,2732.0,1775.8,2.17,2968.56,51
NDC,5938502160,BELBUCA 75 MCG BUCCAL FILM,18.06,11.74,2.69,18.06,40
NDC,5938502260,BELBUCA 150 MCG BUCCAL FILM,18.06,11.74,2.69,18.06,40
NDC,5938502360,BELBUCA 300 MCG BUCCAL FILM,28.36,18.43,4.22,28.36,40
NDC,5938502460,BELBUCA 450 MCG BUCCAL FILM,38.54,25.05,5.73,38.54,40
NDC,5939003613,12 HOUR NASAL RELIEF SPRAY 0.05 %,0.48,0.31,0.07,0.48,40
NDC,5939017535,EYE WASH STERILE SOLUTION,0.09,0.06,0.01,0.09,40
NDC,5939020505,FLUORESCEIN 0.25 %-PROPARACAINE 0.5 % EYE DROPS,4.02,2.61,0.6,4.02,40
NDC,5939021805,ALTAFLUOR BENOX 0.25 %-0.4 % EYE DROPS,18.0,11.7,2.68,18.0,40
NDC,5941710210,VYVANSE 20 MG CAPSULE,31.02,20.16,4.62,31.02,40
NDC,5941710310,VYVANSE 30 MG CAPSULE,31.02,20.16,4.62,31.02,40
NDC,5941710510,VYVANSE 50 MG CAPSULE,31.02,20.16,4.62,31.02,40
NDC,5941710710,VYVANSE 70 MG CAPSULE,31.02,20.16,4.62,31.02,40
NDC,5952803312,CALPHRON 667 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,5952844561,NEPHRON FA 66 MG IRON-1000 MCG TABLET,1.24,0.81,0.18,1.24,40
NDC,5957220514,THALOMID 50 MG CAPSULE,410.16,266.6,61.03,410.16,40
NDC,5957221015,THALOMID 100 MG CAPSULE,665.78,432.76,99.07,665.78,40
NDC,5957240228,REVLIMID 2.5 MG CAPSULE,2139.72,1390.82,318.39,2139.72,40
NDC,5957240528,REVLIMID 5 MG CAPSULE,2139.72,1390.82,318.39,2139.72,40
NDC,5957241028,REVLIMID 10 MG CAPSULE,2139.72,1390.82,318.39,2139.72,40
NDC,5957241521,REVLIMID 15 MG CAPSULE,2139.72,1390.82,318.39,2139.72,40
NDC,5957242021,REVLIMID 20 MG CAPSULE,2139.72,1390.82,318.39,2139.72,40
NDC,5957242521,REVLIMID 25 MG CAPSULE,2139.72,1390.82,318.39,2139.72,40
NDC,5957250121,POMALYST 1 MG CAPSULE,2739.54,1780.7,407.64,2739.54,40
NDC,5957250221,POMALYST 2 MG CAPSULE,2739.54,1780.7,407.64,2739.54,40
NDC,5957250321,POMALYST 3 MG CAPSULE,2739.54,1780.7,407.64,2739.54,40
NDC,5957250421,POMALYST 4 MG CAPSULE,2739.54,1780.7,407.64,2739.54,40
NDC,5957251501,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,52239.52,33955.69,0.02,1653372.9,64
NDC,5957251502,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,10447.92,6791.15,0.02,1653372.9,64
NDC,5957251503,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,5223.96,3395.57,0.02,1653372.9,64
NDC,5957270530,IDHIFA 50 MG TABLET,2882.74,1873.78,428.95,2882.74,40
NDC,5957271030,IDHIFA 100 MG TABLET,2882.74,1873.78,428.95,2882.74,40
NDC,5957271101,REBLOZYL 25 MG SUBCUTANEOUS SOLUTION,19743.08,12833.0,2.17,19743.08,65
NDC,5957272012,INREBIC 100 MG CAPSULE,552.0,358.8,82.14,552.0,40
NDC,5957273007,ONUREG 200 MG TABLET,4496.24,2922.56,669.04,4496.24,40
NDC,5957274007,ONUREG 300 MG TABLET,4496.24,2922.56,669.04,4496.24,40
NDC,5957277501,REBLOZYL 75 MG SUBCUTANEOUS SOLUTION,59228.96,38498.82,2.17,59228.96,65
NDC,5957298401,ISTODAX 10 MG/2 ML INTRAVENOUS SOLUTION,15353.52,9979.79,2.17,15353.52,65
NDC,5958413801,CANDIN FDA STANDARD ALLERGEN PREP INTRADERMAL,1155.0,750.75,171.86,1155.0,40
NDC,5962722205,AVONEX 30 MCG/0.5 ML INTRAMUSCULAR SYRINGE KIT,7774.02,5053.11,2.17,7774.02,57
NDC,5963026601,FETROJA 1 GRAM INTRAVENOUS SOLUTION,838.23,544.85,2.17,838.23,65
NDC,5963026610,FETROJA 1 GRAM INTRAVENOUS SOLUTION,838.23,544.85,2.17,838.23,65
NDC,5965101990,NIACIN ER 750 MG TABLETEXTENDED RELEASE 24 HR,12.08,7.85,1.8,12.08,40
NDC,5965102655,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,2.13,1.38,0.32,2.13,40
NDC,5965114601,CARBIDOPA 25 MG TABLET,43.7,28.41,6.5,43.7,40
NDC,5965115201,PROGESTERONE MICRONIZED 100 MG CAPSULE,4.2,2.73,0.62,4.2,40
NDC,5965115301,PROGESTERONE MICRONIZED 200 MG CAPSULE,8.0,5.2,1.19,8.0,40
NDC,5965120508,CAPECITABINE 500 MG TABLET,78.24,50.86,0.03,78.24,65
NDC,5965124090,IMATINIB 100 MG TABLET,202.26,131.47,30.1,202.26,40
NDC,5965125101,NADOLOL 40 MG TABLET,7.92,5.15,1.18,7.92,40
NDC,5965127860,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,2.98,20.0,40
NDC,5965129960,TAMOXIFEN 10 MG TABLET,3.78,2.46,0.56,3.78,40
NDC,5965133101,FLUCYTOSINE 250 MG CAPSULE,164.14,106.69,24.42,164.14,40
NDC,5965133201,FLUCYTOSINE 500 MG CAPSULE,317.62,206.45,47.26,317.62,40
NDC,5965140112,CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,12.99,8.44,1.93,12.99,40
NDC,5965140430,MEMANTINE 7 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.56,19.86,4.55,30.56,40
NDC,5965140530,MEMANTINE 14 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.56,19.86,4.55,30.56,40
NDC,5965142011,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,131.09,85.21,19.51,131.09,40
NDC,5965145601,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.42,0.92,0.21,1.42,40
NDC,5965149530,AMBRISENTAN 10 MG TABLET,681.18,442.77,101.36,681.18,40
NDC,5965153901,ISOSORBIDE MONONITRATE ER 30 MG TABLETEXTENDED RELEASE 24 HR,6.7,4.36,1.0,6.7,40
NDC,5965156360,RUFINAMIDE 40 MG/ML ORAL SUSPENSION,10.3,6.7,1.53,10.3,40
NDC,5965158901,NADOLOL 20 MG TABLET,6.78,4.41,1.01,6.78,40
NDC,5965162108,MYCOPHENOLATE SODIUM 180 MG TABLETDELAYED RELEASE,9.14,5.94,0.57,9.14,51
NDC,5965172001,DICYCLOMINE 20 MG TABLET,1.16,0.75,0.17,1.16,40
NDC,5965187350,CIPROFLOXACIN 750 MG TABLET,11.26,7.32,1.68,11.26,40
NDC,5967627801,EDURANT 25 MG TABLET,118.66,77.13,17.66,118.66,40
NDC,5967630201,PROCRIT 2000 UNIT/ML INJECTION SOLUTION,192.45,125.09,2.17,192.45,65
NDC,5967630301,PROCRIT 3000 UNIT/ML INJECTION SOLUTION,288.66,187.63,2.17,288.66,65
NDC,5967630400,PROCRIT 4000 UNIT/ML INJECTION SOLUTION,384.84,250.15,2.17,384.84,65
NDC,5967630401,PROCRIT 4000 UNIT/ML INJECTION SOLUTION,384.84,250.15,2.17,384.84,65
NDC,5967631001,PROCRIT 10000 UNIT/ML INJECTION SOLUTION,962.1,625.37,2.17,962.1,65
NDC,5967631204,PROCRIT 20000 UNIT/2 ML INJECTION SOLUTION,962.1,625.37,2.17,962.1,65
NDC,5967632000,PROCRIT 20000 UNIT/ML INJECTION SOLUTION,1924.2,1250.73,2.17,1924.2,65
NDC,5967632004,PROCRIT 20000 UNIT/ML INJECTION SOLUTION,1924.2,1250.73,2.17,1924.2,65
NDC,5967634000,PROCRIT 40000 UNIT/ML INJECTION SOLUTION,3848.4,2501.46,2.17,3848.4,65
NDC,5967634001,PROCRIT 40000 UNIT/ML INJECTION SOLUTION,3848.4,2501.46,2.17,3848.4,65
NDC,5967636001,ORTHOVISC 30 MG/2 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,2.17,860.4,65
NDC,5967656201,PREZISTA 600 MG TABLET,86.32,56.11,12.84,86.32,40
NDC,5967656630,PREZISTA 800 MG TABLET,172.66,112.23,25.69,172.66,40
NDC,5967657001,INTELENCE 100 MG TABLET,29.96,19.47,4.46,29.96,40
NDC,5967657101,INTELENCE 200 MG TABLET,59.92,38.95,8.92,59.92,40
NDC,5967657530,PREZCOBIX 800 MG-150 MG TABLET,197.34,128.27,29.36,197.34,40
NDC,5967660012,ERLEADA 60 MG TABLET,306.0,198.9,45.53,306.0,40
NDC,5967660430,ERLEADA 240 MG TABLET,1224.04,795.63,182.14,1224.04,40
NDC,5967661001,YONDELIS 1 MG INTRAVENOUS SOLUTION,17708.84,11510.75,2.17,17708.84,65
NDC,5967680030,SYMTUZA 800 MG-150 MG-200 MG-10 MG TABLET,377.36,245.28,56.15,377.36,40
NDC,5967682001,MONOVISC 88 MG/4 ML INTRA-ARTICULAR SYRINGE,1350.0,877.5,2.17,1673.19,65
NDC,5974600314,METHYLPREDNISOLONE 16 MG TABLET,6.22,4.04,0.25,8.86,51
NDC,5974601032,RISPERIDONE 0.5 MG DISINTEGRATING TABLET,9.84,6.4,1.46,9.84,40
NDC,5974602022,RISPERIDONE 1 MG DISINTEGRATING TABLET,11.0,7.15,1.64,11.0,40
NDC,5974603022,RISPERIDONE 2 MG DISINTEGRATING TABLET,17.9,11.64,2.66,17.9,40
NDC,5974611306,PROCHLORPERAZINE MALEATE 5 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,5974611506,PROCHLORPERAZINE MALEATE 10 MG TABLET,1.78,1.16,0.26,1.78,40
NDC,5974612106,MECLIZINE 25 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,5974617710,CYCLOBENZAPRINE 10 MG TABLET,2.2,1.43,0.33,2.2,40
NDC,5974638306,TERAZOSIN 1 MG CAPSULE,3.22,2.09,0.48,3.22,40
NDC,5974638506,TERAZOSIN 5 MG CAPSULE,3.22,2.09,0.48,3.22,40
NDC,5976200382,DOFETILIDE 250 MCG CAPSULE,10.0,6.5,1.49,10.0,40
NDC,5976200392,DOFETILIDE 500 MCG CAPSULE,10.0,6.5,1.49,10.0,40
NDC,5976200401,TRIFLURIDINE 1 % EYE DROPS,41.36,26.88,6.15,41.36,40
NDC,5976200551,MEDROXYPROGESTERONE 2.5 MG TABLET,0.62,0.4,0.09,0.62,40
NDC,5976200581,MEDROXYPROGESTERONE 5 MG TABLET,0.94,0.61,0.14,0.94,40
NDC,5976200671,SERTRALINE 20 MG/ML ORAL CONCENTRATE,2.8,1.82,0.42,2.8,40
NDC,5976200731,HYDROCORTISONE 5 MG TABLET,0.68,0.44,0.1,0.68,40
NDC,5976200751,HYDROCORTISONE 20 MG TABLET,2.18,1.42,0.32,2.18,40
NDC,5976201045,SULFASALAZINE 500 MG TABLETDELAYED RELEASE,0.76,0.49,0.11,0.76,40
NDC,5976201046,SULFASALAZINE 500 MG TABLETDELAYED RELEASE,0.72,0.47,0.11,0.72,40
NDC,5976201191,PHENELZINE 15 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,5976201315,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.6,0.39,0.09,0.6,40
NDC,5976201316,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.6,0.39,0.09,0.6,40
NDC,5976201318,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.64,0.42,0.1,0.64,40
NDC,5976201401,PIROXICAM 10 MG CAPSULE,1.48,0.96,0.22,1.48,40
NDC,5976201552,ATORVASTATIN 10 MG TABLET,0.5,0.33,0.07,0.5,40
NDC,5976201561,ATORVASTATIN 20 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,5976201562,ATORVASTATIN 20 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,5976201571,ATORVASTATIN 40 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,5976201581,ATORVASTATIN 80 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,5976203332,LATANOPROST 0.005 % EYE DROPS,76.22,49.54,11.34,76.22,40
NDC,5976204891,NITROGLYCERIN 0.6 MG SUBLINGUAL TABLET,0.94,0.61,0.14,0.94,40
NDC,5976205312,PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,0.4,0.26,0.06,0.4,40
NDC,5976210011,SIROLIMUS 0.5 MG TABLET,16.94,11.01,1.73,16.94,51
NDC,5976210021,SIROLIMUS 1 MG TABLET,33.9,22.04,1.73,33.9,51
NDC,5976210031,SIROLIMUS 2 MG TABLET,67.8,44.07,1.73,67.8,51
NDC,5976210611,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,5976210612,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,5976213501,RIFABUTIN 150 MG CAPSULE,34.98,22.74,5.21,34.98,40
NDC,5976215171,CELECOXIB 200 MG CAPSULE,2.46,1.6,0.37,2.46,40
NDC,5976215761,PREGABALIN 20 MG/ML ORAL SOLUTION,3.38,2.2,0.5,3.38,40
NDC,5976220126,ASENAPINE 5 MG SUBLINGUAL TABLET,14.42,9.37,2.15,14.42,40
NDC,5976222502,ETHOSUXIMIDE 250 MG CAPSULE,2.88,1.87,0.43,2.88,40
NDC,5976230511,AZITHROMYCIN 1 GRAM ORAL PACKET,58.26,37.87,8.67,58.26,40
NDC,5976230512,AZITHROMYCIN 1 GRAM ORAL PACKET,58.26,37.87,8.67,58.26,40
NDC,5976230602,AZITHROMYCIN 250 MG TABLET,5.1,3.32,0.76,5.1,40
NDC,5976230603,AZITHROMYCIN 250 MG TABLET,8.16,5.3,1.21,8.16,40
NDC,5976231101,AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION,4.0,2.6,0.6,4.0,40
NDC,5976231201,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,4.0,2.6,0.6,4.0,40
NDC,5976231401,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,2.0,1.3,0.3,2.0,40
NDC,5976233041,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,0.94,0.61,0.14,0.94,40
NDC,5976233043,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,2.06,1.34,0.31,2.06,40
NDC,5976237191,ALPRAZOLAM 0.25 MG TABLET,1.24,0.81,0.18,1.24,40
NDC,5976237201,ALPRAZOLAM 0.5 MG TABLET,1.48,0.96,0.22,1.48,40
NDC,5976237431,CLINDAMYCIN 1 % TOPICAL GEL,5.76,3.74,0.86,5.76,40
NDC,5976237441,CLINDAMYCIN 1 % LOTION,4.0,2.6,0.6,4.0,40
NDC,5976249003,SERTRALINE 50 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,5976249005,SERTRALINE 50 MG TABLET,0.24,0.16,0.04,0.24,40
NDC,5976249103,SERTRALINE 100 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,5976249211,NITROGLYCERIN 0.3 MG SUBLINGUAL TABLET,0.94,0.61,0.14,0.94,40
NDC,5976250005,SULFASALAZINE 500 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,5976250071,MISOPROSTOL 100 MCG TABLET,1.64,1.07,0.24,1.64,40
NDC,5976250091,CLINDAMYCIN 2 % VAGINAL CREAM,5.44,3.54,0.81,5.44,40
NDC,5976250291,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,2.48,1.61,0.37,2.48,40
NDC,5976250301,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,8.98,5.84,1.34,8.98,40
NDC,5976250507,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,0.8,0.52,0.12,0.8,40
NDC,5976700401,PERTZYE 4000 UNIT-14375 UNIT-15125 UNIT CAPSULEDELAYED RELEASE,4.52,2.94,0.67,4.52,40
NDC,5976701601,PERTZYE 16000 UNIT-57500 UNIT-60500 UNIT CAPSULEDELAYED RELEASE,13.42,8.72,2.0,13.42,40
NDC,5976702401,PERTZYE 24000-86250-90750 UNIT CAPSULEDELAYED RELEASE,20.14,13.09,3.0,20.14,40
NDC,5992360110,PAMIDRONATE 30 MG INTRAVENOUS SOLUTION,67.65,43.97,2.17,67.65,51
NDC,5992360310,PAMIDRONATE 90 MG INTRAVENOUS SOLUTION,202.92,131.9,2.17,202.92,51
NDC,5992372010,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,2.79,1.81,0.02,8.86,51
NDC,6021916771,CHLORDIAZEPOXIDE-CLIDINIUM 5 MG-2.5 MG CAPSULE,79.5,51.68,11.83,79.5,40
NDC,6021917226,ETRAVIRINE 200 MG TABLET,53.64,34.87,7.98,53.64,40
NDC,6021917482,ATROPINE 1 % EYE DROPS,47.86,31.11,7.12,47.86,40
NDC,6021917493,ATROPINE 1 % EYE DROPS,23.36,15.18,3.48,23.36,40
NDC,6021917508,ATROPINE 1 % EYE DROPS,22.0,14.3,3.27,22.0,40
NDC,6021920561,DEXAMETHASONE 2 MG TABLET,1.2,0.78,0.02,8.86,51
NDC,6021939551,FOSFOMYCIN 3 G ORAL PACK,200.8,130.52,29.88,200.8,40
NDC,6025800216,CYTRA-3 550 MG-500 MG-334 MG/5 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,6025800601,PHOS-NAK 280 MG-160 MG-250 MG ORAL POWDER PACKET,1.63,1.06,0.24,1.63,40
NDC,6025816001,RENA-VITE 0.8 MG TABLET,0.28,0.18,0.04,0.28,40
NDC,6025816201,RENAL CAPS 1 MG CAPSULE,1.34,0.87,0.2,1.34,40
NDC,6025817101,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.3,0.2,0.04,0.3,40
NDC,6025818601,POLY-IRON 150 FORTE 150 MG-25 MCG-1 MG CAPSULE,0.52,0.34,0.08,0.52,40
NDC,6026731110,SODIUM NITRITE 30 MG/ML INTRAVENOUS SOLUTION,36.0,23.4,5.36,36.0,40
NDC,6026770550,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,7.2,4.68,0.88,4417.71,59
NDC,6026781200,NITHIODOTE 300 MG/10 ML-12.5 GRAM/50 ML INTRAVENOUS SOLUTION,11.76,7.64,2.16,184.43,65
NDC,6043206500,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,2.15,1.4,0.32,2.15,40
NDC,6043206575,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,2.15,1.4,0.32,2.15,40
NDC,6050500166,DILT-XR 240 MG CAPSULE EXTENDED RELEASE,2.86,1.86,0.43,2.86,40
NDC,6050500391,ETODOLAC 200 MG CAPSULE,2.88,1.87,0.43,2.88,40
NDC,6050500401,ETODOLAC 300 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6050500411,ETODOLAC 400 MG TABLET,2.92,1.9,0.43,2.92,40
NDC,6050500551,SELEGILINE 5 MG CAPSULE,4.6,2.99,0.68,4.6,40
NDC,6050500652,OMEPRAZOLE 20 MG CAPSULEDELAYED RELEASE,8.3,5.4,1.24,8.3,40
NDC,6050500800,SOTALOL 80 MG TABLET,5.12,3.33,0.76,5.12,40
NDC,6050500930,DOXAZOSIN 1 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,6050501011,PAROXETINE 40 MG TABLET,5.94,3.86,0.88,5.94,40
NDC,6050501330,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),8.84,5.75,0.94,8.86,51
NDC,6050501340,CYCLOSPORINE 100 MG ORAL CAP (SANDIMMUNE),35.32,22.96,2.17,35.32,51
NDC,6050501410,GLIPIZIDE 5 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,6050501412,GLIPIZIDE 5 MG TABLET,0.7,0.46,0.1,0.7,40
NDC,6050501420,GLIPIZIDE 10 MG TABLET,1.34,0.87,0.2,1.34,40
NDC,6050501590,SOTALOL 120 MG TABLET,6.84,4.45,1.02,6.84,40
NDC,6050501651,FLUVOXAMINE 50 MG TABLET,5.14,3.34,0.76,5.14,40
NDC,6050504025,PAXIL 10 MG/5 ML ORAL SUSPENSION,5.33,3.46,0.79,5.33,40
NDC,6050507495,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,7.83,5.09,1.17,8.86,51
NDC,6050508150,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),98.5,64.03,14.66,98.5,40
NDC,6050508291,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAYSUSPENSION,10.66,6.93,1.59,10.66,40
NDC,6050508301,MOMETASONE 50 MCG/ACTUATION NASAL SPRAY,30.14,19.59,4.48,30.14,40
NDC,6050513211,MIDODRINE 5 MG TABLET,4.86,3.16,0.72,4.86,40
NDC,6050525799,ATORVASTATIN 20 MG TABLET,11.54,7.5,1.72,11.54,40
NDC,6050526561,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,6050526565,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,6050526571,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.22,1.44,0.33,2.22,40
NDC,6050532506,LAMIVUDINE 100 MG TABLET,32.22,20.94,4.79,32.22,40
NDC,6050532773,OLANZAPINE 15 MG DISINTEGRATING TABLET,61.86,40.21,9.2,61.86,40
NDC,6050534383,SELEGILINE 5 MG TABLET,4.2,2.73,0.62,4.2,40
NDC,6050547733,VILAZODONE 20 MG TABLET,22.7,14.76,3.38,22.7,40
NDC,6050561511,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,44.46,28.9,0.82,44.46,51
NDC,6050561514,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,47.82,31.08,0.82,47.82,51
NDC,6050570620,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,4.58,2.98,0.68,4.58,40
NDC,6050570630,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,5.14,3.34,0.76,5.14,40
NDC,6068710001,URSODIOL 300 MG CAPSULE,15.28,9.93,2.27,15.28,40
NDC,6068710411,KETOROLAC 10 MG TABLET,14.62,9.5,2.18,14.62,40
NDC,6068710421,KETOROLAC 10 MG TABLET,14.62,9.5,2.18,14.62,40
NDC,6068710511,MEDROXYPROGESTERONE 10 MG TABLET,3.36,2.18,0.5,3.36,40
NDC,6068710521,MEDROXYPROGESTERONE 10 MG TABLET,3.36,2.18,0.5,3.36,40
NDC,6068711211,ANASTROZOLE 1 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,6068711221,ANASTROZOLE 1 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,6068711301,CLONIDINE HCL 0.1 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,6068711311,CLONIDINE HCL 0.1 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,6068712201,PREDNISONE 5 MG TABLET,0.4,0.26,0.02,8.86,51
NDC,6068712401,CLONIDINE HCL 0.2 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,6068714311,METFORMIN 850 MG TABLET,2.4,1.56,0.36,2.4,40
NDC,6068714501,PREDNISONE 20 MG TABLET,0.48,0.31,0.02,8.86,51
NDC,6068714994,CAPECITABINE 500 MG TABLET,30.0,19.5,0.03,30.0,65
NDC,6068715201,CEPHALEXIN 250 MG CAPSULE,1.42,0.92,0.21,1.42,40
NDC,6068715501,METFORMIN 500 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,6068715511,METFORMIN 500 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,6068716101,HALOPERIDOL 5 MG TABLET,2.18,1.42,0.32,2.18,40
NDC,6068716201,METFORMIN 1000 MG TABLET,3.04,1.98,0.45,3.04,40
NDC,6068716211,METFORMIN 1000 MG TABLET,3.04,1.98,0.45,3.04,40
NDC,6068716301,CEPHALEXIN 500 MG CAPSULE,2.7,1.76,0.4,2.7,40
NDC,6068716801,ARIPIPRAZOLE 5 MG TABLET,1.16,0.75,0.17,1.16,40
NDC,6068717901,ARIPIPRAZOLE 10 MG TABLET,1.5,0.98,0.22,1.5,40
NDC,6068718811,ENTACAPONE 200 MG TABLET,9.88,6.42,1.47,9.88,40
NDC,6068718821,ENTACAPONE 200 MG TABLET,9.88,6.42,1.47,9.88,40
NDC,6068719121,ARIPIPRAZOLE 15 MG TABLET,4.44,2.89,0.66,4.44,40
NDC,6068719501,DILTIAZEM SR 120 MG 24 HR CAP,1.94,1.26,0.29,1.94,40
NDC,6068719511,DILTIAZEM SR 120 MG 24 HR CAP,1.94,1.26,0.29,1.94,40
NDC,6068719901,MELOXICAM 15 MG TABLET,9.56,6.21,1.42,9.56,40
NDC,6068719911,MELOXICAM 15 MG TABLET,9.56,6.21,1.42,9.56,40
NDC,6068720221,ARIPIPRAZOLE 20 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,6068720601,DILTIAZEM SR 180 MG 24 HR CAP,1.94,1.26,0.29,1.94,40
NDC,6068721001,SIMVASTATIN 40 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,6068721501,PROPRANOLOL ER 60 MG CAPSULE24 HREXTENDED RELEASE,4.36,2.83,0.65,4.36,40
NDC,6068721625,ENTECAVIR 0.5 MG TABLET,44.58,28.98,6.63,44.58,40
NDC,6068721701,DILTIAZEM SR 240 MG 24 HR CAP,1.6,1.04,0.24,1.6,40
NDC,6068722401,GEMFIBROZIL 600 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6068722411,GEMFIBROZIL 600 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6068722794,LEUCOVORIN CALCIUM 25 MG TABLET,25.7,16.71,3.82,25.7,40
NDC,6068722801,DILTIAZEM SR 300 MG 24 HR CAP,5.36,3.48,0.8,5.36,40
NDC,6068722901,LOPERAMIDE 2 MG CAPSULE,2.04,1.33,0.3,2.04,40
NDC,6068723001,ZONISAMIDE 100 MG CAPSULE,1.8,1.17,0.27,1.8,40
NDC,6068723011,ZONISAMIDE 100 MG CAPSULE,1.8,1.17,0.27,1.8,40
NDC,6068723101,SERTRALINE 25 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,6068723111,SERTRALINE 25 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,6068723401,ROSUVASTATIN 5 MG TABLET,14.28,9.28,2.12,14.28,40
NDC,6068724201,SERTRALINE 50 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,6068724501,ROSUVASTATIN 10 MG TABLET,14.28,9.28,2.12,14.28,40
NDC,6068725301,SERTRALINE 100 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,6068727294,CEFUROXIME AXETIL 250 MG TABLET,8.26,5.37,1.23,8.26,40
NDC,6068727566,PHENYTOIN 100 MG/4 ML ORAL SUSPENSION,5.03,3.27,0.75,5.03,40
NDC,6068728394,CEFUROXIME AXETIL 500 MG TABLET,11.0,7.15,1.64,11.0,40
NDC,6068729925,ITRACONAZOLE 100 MG CAPSULE,8.0,5.2,1.19,8.0,40
NDC,6068729995,ITRACONAZOLE 100 MG CAPSULE,8.0,5.2,1.19,8.0,40
NDC,6068730301,DONEPEZIL 10 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,6068730411,CAPTOPRIL 12.5 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,6068730421,CAPTOPRIL 12.5 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,6068731521,CAPTOPRIL 25 MG TABLET,3.7,2.41,0.55,3.7,40
NDC,6068731911,TOLTERODINE ER 2 MG CAPSULEEXTENDED RELEASE 24 HR,24.1,15.67,3.59,24.1,40
NDC,6068731921,TOLTERODINE ER 2 MG CAPSULEEXTENDED RELEASE 24 HR,24.1,15.67,3.59,24.1,40
NDC,6068732501,LISINOPRIL 10 MG TABLET,0.3,0.2,0.04,0.3,40
NDC,6068732625,ATOMOXETINE 40 MG CAPSULE,15.18,9.87,2.26,15.18,40
NDC,6068732701,QUETIAPINE 25 MG TABLET,7.56,4.91,1.12,7.56,40
NDC,6068732711,QUETIAPINE 25 MG TABLET,7.56,4.91,1.12,7.56,40
NDC,6068732831,SEVELAMER CARBONATE 800 MG TABLET,13.08,8.5,1.95,13.08,40
NDC,6068733021,TOLTERODINE ER 4 MG CAPSULEEXTENDED RELEASE 24 HR,24.1,15.67,3.59,24.1,40
NDC,6068733301,LISINOPRIL 20 MG TABLET,0.3,0.2,0.04,0.3,40
NDC,6068733311,LISINOPRIL 20 MG TABLET,0.3,0.2,0.04,0.3,40
NDC,6068733611,MINOCYCLINE 100 MG CAPSULE,2.64,1.72,0.39,2.64,40
NDC,6068733665,MINOCYCLINE 100 MG CAPSULE,2.64,1.72,0.39,2.64,40
NDC,6068733801,QUETIAPINE 50 MG TABLET,12.4,8.06,1.85,12.4,40
NDC,6068733811,QUETIAPINE 50 MG TABLET,12.4,8.06,1.85,12.4,40
NDC,6068734501,CALCITRIOL 0.25 MCG CAPSULE,1.92,1.25,0.29,1.92,40
NDC,6068734901,QUETIAPINE 100 MG TABLET,12.96,8.42,1.93,12.96,40
NDC,6068734911,QUETIAPINE 100 MG TABLET,12.96,8.42,1.93,12.96,40
NDC,6068735101,BUPROPION HCL 100 MG TABLET,3.58,2.33,0.53,3.58,40
NDC,6068736001,QUETIAPINE 200 MG TABLET,24.44,15.89,3.64,24.44,40
NDC,6068736011,QUETIAPINE 200 MG TABLET,24.44,15.89,3.64,24.44,40
NDC,6068736901,DICYCLOMINE 10 MG CAPSULE,1.32,0.86,0.2,1.32,40
NDC,6068737101,QUETIAPINE 300 MG TABLET,32.04,20.83,4.77,32.04,40
NDC,6068737701,ALPRAZOLAM 0.25 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,6068738194,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,161.7,105.11,24.06,161.7,40
NDC,6068738201,QUETIAPINE 400 MG TABLET,37.66,24.48,5.6,37.66,40
NDC,6068738801,ALPRAZOLAM 0.5 MG TABLET,0.88,0.57,0.13,0.88,40
NDC,6068739101,PIOGLITAZONE 15 MG TABLET,2.52,1.64,0.37,2.52,40
NDC,6068740401,CLOZAPINE 25 MG TABLET,2.66,1.73,0.4,2.66,40
NDC,6068740411,CLOZAPINE 25 MG TABLET,2.66,1.73,0.4,2.66,40
NDC,6068740583,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,0.52,0.34,0.08,0.52,40
NDC,6068740677,OXYCODONE 5 MG/5 ML ORAL SOLUTION,2.13,1.38,0.32,2.13,40
NDC,6068741511,CLOZAPINE 100 MG TABLET,6.92,4.5,1.03,6.92,40
NDC,6068741771,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,0.83,0.54,0.12,0.83,40
NDC,6068741901,CHLORPROMAZINE 10 MG TABLET,10.28,6.68,1.53,10.28,40
NDC,6068741911,CHLORPROMAZINE 10 MG TABLET,10.28,6.68,1.53,10.28,40
NDC,6068742025,RITONAVIR 100 MG TABLET,22.5,14.63,3.35,22.5,40
NDC,6068742321,CLOBAZAM 10 MG TABLET,6.24,4.06,0.93,6.24,40
NDC,6068742601,CLOZAPINE 200 MG TABLET,13.08,8.5,1.95,13.08,40
NDC,6068743201,TRAZODONE 150 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,6068743701,AMIODARONE 200 MG TABLET,1.22,0.79,0.18,1.22,40
NDC,6068743801,MYCOPHENOLATE MOFETIL 500 MG TABLET,3.12,2.03,0.27,8.86,51
NDC,6068743901,LABETALOL 100 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,6068743911,LABETALOL 100 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,6068744301,TRAZODONE 50 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,6068744311,TRAZODONE 50 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,6068744601,IBUPROFEN 400 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,6068745121,EPLERENONE 25 MG TABLET,10.0,6.5,1.49,10.0,40
NDC,6068745401,TRAZODONE 100 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,6068745411,TRAZODONE 100 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,6068745701,IBUPROFEN 600 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,6068746101,LABETALOL 300 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,6068746501,SPIRONOLACTONE 25 MG TABLET,0.46,0.3,0.07,0.46,40
NDC,6068746601,POTASSIUM CHLORIDE ER 10 MEQ TABLETEXTENDED RELEASE,1.22,0.79,0.18,1.22,40
NDC,6068746611,POTASSIUM CHLORIDE ER 10 MEQ TABLETEXTENDED RELEASE,1.22,0.79,0.18,1.22,40
NDC,6068746801,IBUPROFEN 800 MG TABLET,0.86,0.56,0.13,0.86,40
NDC,6068747301,PREGABALIN 25 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068747601,SPIRONOLACTONE 50 MG TABLET,1.1,0.72,0.16,1.1,40
NDC,6068748401,PREGABALIN 50 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068748411,PREGABALIN 50 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068748701,SPIRONOLACTONE 100 MG TABLET,1.76,1.14,0.26,1.76,40
NDC,6068748801,AMLODIPINE 5 MG TABLET,0.38,0.25,0.06,0.38,40
NDC,6068749211,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,8.4,5.46,1.25,8.4,40
NDC,6068749221,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,8.4,5.46,1.25,8.4,40
NDC,6068749501,PREGABALIN 75 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068749511,PREGABALIN 75 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068749601,AMLODIPINE 10 MG TABLET,0.38,0.25,0.06,0.38,40
NDC,6068749611,AMLODIPINE 10 MG TABLET,0.38,0.25,0.06,0.38,40
NDC,6068750601,PREGABALIN 100 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068750701,GABAPENTIN 600 MG TABLET,4.84,3.15,0.72,4.84,40
NDC,6068750711,GABAPENTIN 600 MG TABLET,4.84,3.15,0.72,4.84,40
NDC,6068751701,PREGABALIN 150 MG CAPSULE,3.24,2.11,0.48,3.24,40
NDC,6068751801,GABAPENTIN 800 MG TABLET,5.82,3.78,0.87,5.82,40
NDC,6068751811,GABAPENTIN 800 MG TABLET,5.82,3.78,0.87,5.82,40
NDC,6068752321,POSACONAZOLE 100 MG TABLETDELAYED RELEASE,113.2,73.58,16.84,113.2,40
NDC,6068752483,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.2,7.28,1.67,11.2,40
NDC,6068752601,METRONIDAZOLE 250 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,6068752711,URSODIOL 250 MG TABLET,8.4,5.46,1.25,8.4,40
NDC,6068752721,URSODIOL 250 MG TABLET,8.4,5.46,1.25,8.4,40
NDC,6068753436,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,17.15,11.15,2.55,17.15,40
NDC,6068755001,METRONIDAZOLE 500 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,6068755801,CYCLOBENZAPRINE 10 MG TABLET,0.42,0.27,0.06,0.42,40
NDC,6068755901,METHOCARBAMOL 500 MG TABLET,0.6,0.39,0.09,0.6,40
NDC,6068756021,REPAGLINIDE 1 MG TABLET,7.1,4.62,1.06,7.1,40
NDC,6068756711,ATOMOXETINE 25 MG CAPSULE,8.8,5.72,1.31,8.8,40
NDC,6068756801,METHOCARBAMOL 750 MG TABLET,0.74,0.48,0.11,0.74,40
NDC,6068757001,PRAMIPEXOLE 0.25 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,6068757011,PRAMIPEXOLE 0.25 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,6068757521,RIFAMPIN 150 MG CAPSULE,7.64,4.97,1.14,7.64,40
NDC,6068757701,ROPINIROLE 0.25 MG TABLET,1.32,0.86,0.2,1.32,40
NDC,6068757811,ACETAZOLAMIDE ER 500 MG CAPSULEEXTENDED RELEASE,11.42,7.42,1.7,11.42,40
NDC,6068757821,ACETAZOLAMIDE ER 500 MG CAPSULEEXTENDED RELEASE,11.42,7.42,1.7,11.42,40
NDC,6068758001,GABAPENTIN 100 MG CAPSULE,1.16,0.75,0.17,1.16,40
NDC,6068758121,PRAMIPEXOLE 0.5 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,6068758201,HYDROCORTISONE 10 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,6068758321,CARBAMAZEPINE ER 200 MG TABLETEXTENDED RELEASE12 HR,8.08,5.25,1.2,8.08,40
NDC,6068758421,MIRTAZAPINE 7.5 MG TABLET,6.84,4.45,1.02,6.84,40
NDC,6068758601,RIFAMPIN 300 MG CAPSULE,4.46,2.9,0.66,4.46,40
NDC,6068758701,PROPRANOLOL 10 MG TABLET,0.6,0.39,0.09,0.6,40
NDC,6068759001,HYDROMORPHONE 4 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068759101,GABAPENTIN 300 MG CAPSULE,2.76,1.79,0.41,2.76,40
NDC,6068759221,PRAMIPEXOLE 1 MG TABLET,2.66,1.73,0.4,2.66,40
NDC,6068759301,HYDROCHLOROTHIAZIDE 25 MG TABLET,0.5,0.33,0.07,0.5,40
NDC,6068759421,CARBAMAZEPINE ER 400 MG TABLETEXTENDED RELEASE12 HR,13.94,9.06,2.07,13.94,40
NDC,6068759501,FAMOTIDINE 20 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,6068759511,FAMOTIDINE 20 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,6068759801,PROPRANOLOL 20 MG TABLET,1.1,0.72,0.16,1.1,40
NDC,6068760211,GABAPENTIN 400 MG CAPSULE,2.44,1.59,0.36,2.44,40
NDC,6068760601,DICLOFENAC SODIUM 50 MG TABLETDELAYED RELEASE,1.26,0.82,0.19,1.26,40
NDC,6068760721,DESVENLAFAXINE SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,5.14,3.34,0.76,5.14,40
NDC,6068760901,PROPRANOLOL 40 MG TABLET,1.34,0.87,0.2,1.34,40
NDC,6068761221,VALSARTAN 40 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,6068761821,FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET,3.82,2.48,0.57,3.82,40
NDC,6068762001,METOCLOPRAMIDE 5 MG TABLET,1.38,0.9,0.21,1.38,40
NDC,6068762201,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.38,0.25,0.06,0.38,40
NDC,6068762211,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.38,0.25,0.06,0.38,40
NDC,6068762301,VALSARTAN 80 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,6068762401,METOLAZONE 2.5 MG TABLET,6.6,4.29,0.98,6.6,40
NDC,6068762665,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,6.1,3.97,0.91,47.96,48
NDC,6068763101,METOCLOPRAMIDE 10 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068763111,METOCLOPRAMIDE 10 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068763401,VALSARTAN 160 MG TABLET,2.9,1.89,0.43,2.9,40
NDC,6068763411,VALSARTAN 160 MG TABLET,2.9,1.89,0.43,2.9,40
NDC,6068764111,NEBIVOLOL 5 MG TABLET,7.02,4.56,1.04,7.02,40
NDC,6068765621,LISINOPRIL 2.5 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,6068765701,LEVETIRACETAM 500 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068765711,LEVETIRACETAM 500 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068765801,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,1.62,1.05,0.24,1.62,40
NDC,6068765811,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,1.62,1.05,0.24,1.62,40
NDC,6068766001,PROMETHAZINE 12.5 MG TABLET,1.24,0.81,0.18,1.24,40
NDC,6068766101,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,1.64,1.07,0.24,1.64,40
NDC,6068766401,HYDROXYZINE HCL 10 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,6068766801,LEVETIRACETAM 1000 MG TABLET,3.36,2.18,0.5,3.36,40
NDC,6068766901,METHIMAZOLE 5 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068766911,METHIMAZOLE 5 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6068767140,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,1.61,1.05,0.24,1.61,40
NDC,6068767167,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,1.61,1.05,0.24,1.61,40
NDC,6068767311,NATEGLINIDE 60 MG TABLET,5.28,3.43,0.79,5.28,40
NDC,6068767321,NATEGLINIDE 60 MG TABLET,5.28,3.43,0.79,5.28,40
NDC,6068767501,HYDROXYZINE HCL 25 MG TABLET,0.8,0.52,0.12,0.8,40
NDC,6068767657,LACOSAMIDE 50 MG TABLET,4.72,3.07,0.7,4.72,40
NDC,6068767701,ALLOPURINOL 100 MG TABLET,1.0,0.65,0.15,1.0,40
NDC,6068767711,ALLOPURINOL 100 MG TABLET,1.0,0.65,0.15,1.0,40
NDC,6068767801,LISINOPRIL 40 MG TABLET,1.22,0.79,0.18,1.22,40
NDC,6068768001,METHIMAZOLE 10 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,6068768101,FOLIC ACID 1 MG TABLET,0.42,0.27,0.06,0.42,40
NDC,6068768111,FOLIC ACID 1 MG TABLET,0.42,0.27,0.06,0.42,40
NDC,6068768421,NATEGLINIDE 120 MG TABLET,6.94,4.51,1.03,6.94,40
NDC,6068768711,LACOSAMIDE 100 MG TABLET,7.38,4.8,1.1,7.38,40
NDC,6068768757,LACOSAMIDE 100 MG TABLET,7.38,4.8,1.1,7.38,40
NDC,6068768801,ALLOPURINOL 300 MG TABLET,1.88,1.22,0.28,1.88,40
NDC,6068768811,ALLOPURINOL 300 MG TABLET,1.88,1.22,0.28,1.88,40
NDC,6068769101,DEMECLOCYCLINE 150 MG TABLET,21.26,13.82,3.16,21.26,40
NDC,6068769301,LAMOTRIGINE 150 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,6068769411,METHENAMINE HIPPURATE 1 GRAM TABLET,5.92,3.85,0.88,5.92,40
NDC,6068769421,METHENAMINE HIPPURATE 1 GRAM TABLET,5.92,3.85,0.88,5.92,40
NDC,6068769857,LACOSAMIDE 200 MG TABLET,7.8,5.07,1.16,7.8,40
NDC,6068769921,CEFDINIR 300 MG CAPSULE,8.1,5.27,1.21,8.1,40
NDC,6068770001,BETHANECHOL CHLORIDE 25 MG TABLET,3.56,2.31,0.53,3.56,40
NDC,6068770011,BETHANECHOL CHLORIDE 25 MG TABLET,3.56,2.31,0.53,3.56,40
NDC,6068770701,HYDROXYZINE PAMOATE 50 MG CAPSULE,1.02,0.66,0.15,1.02,40
NDC,6068771521,COLESTIPOL 1 GRAM TABLET,10.02,6.51,1.49,10.02,40
NDC,6068771701,DILTIAZEM 30 MG TABLET,1.06,0.69,0.16,1.06,40
NDC,6068771801,DEXAMETHASONE 4 MG TABLET,2.42,1.57,0.36,2.42,40
NDC,6068772121,DESMOPRESSIN 0.1 MG TABLET,5.26,3.42,0.78,5.26,40
NDC,6068773001,MECLIZINE 25 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,6068773501,MISOPROSTOL 100 MCG TABLET,4.96,3.22,0.74,4.96,40
NDC,6068774201,AZITHROMYCIN 250 MG TABLET,8.44,5.49,1.26,8.44,40
NDC,6068774601,MISOPROSTOL 200 MCG TABLET,5.46,3.55,0.81,5.46,40
NDC,6068774721,LURASIDONE 20 MG TABLET,10.22,6.64,1.52,10.22,40
NDC,6068775021,TRANEXAMIC ACID 650 MG TABLET,10.3,6.7,1.53,10.3,40
NDC,6068775321,AZITHROMYCIN 500 MG TABLET,13.74,8.93,2.04,13.74,40
NDC,6068775586,DIAZEPAM 5 MG/5 ML (1 MG/ML 5 ML) ORAL SOLUTION,2.35,1.53,0.35,2.35,40
NDC,6068775821,LURASIDONE 40 MG TABLET,10.26,6.67,1.53,10.26,40
NDC,6068777301,DEXAMETHASONE 2 MG TABLET,1.72,1.12,0.02,8.86,51
NDC,6068778021,LURASIDONE 80 MG TABLET,10.56,6.86,1.57,10.56,40
NDC,6068778194,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,9.3,6.05,1.38,9.3,40
NDC,6068778201,BUPROPION XL 150 MG TAB,4.44,2.89,0.66,4.44,40
NDC,6068778701,AMOXICILLIN 500 MG CAPSULE,2.7,1.76,0.4,2.7,40
NDC,6068778821,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,2.8,1.82,0.42,2.8,40
NDC,6068778901,PYRAZINAMIDE 500 MG TABLET,13.94,9.06,2.07,13.94,40
NDC,6068779021,ABIRATERONE 250 MG TABLET,12.0,7.8,1.79,12.0,40
NDC,6068779201,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.56,2.31,0.53,3.56,40
NDC,6068779211,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.56,2.31,0.53,3.56,40
NDC,6068779501,TRAMADOL 50 MG TABLET,0.36,0.23,0.05,0.36,40
NDC,6068780301,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.8,2.47,0.57,3.8,40
NDC,6068780701,CHLORDIAZEPOXIDE 25 MG CAPSULE,1.6,1.04,0.24,1.6,40
NDC,6068781394,METHYLERGONOVINE 0.2 MG TABLET,132.0,85.8,19.64,132.0,40
NDC,6068782201,HYDRALAZINE 25 MG TABLET,0.5,0.33,0.07,0.5,40
NDC,6068783301,HYDRALAZINE 50 MG TABLET,0.88,0.57,0.13,0.88,40
NDC,6068784201,LORAZEPAM 2 MG TABLET,2.16,1.4,0.32,2.16,40
NDC,6068785401,PREDNISONE 50 MG TABLET,1.08,0.7,0.02,8.86,51
NDC,6068790301,PREDNISONE 5 MG TABLET,0.54,0.35,0.02,8.86,51
NDC,6075811905,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,21.12,13.73,3.14,21.12,40
NDC,6075877305,KETOROLAC 0.4 % EYE DROPS,32.06,20.84,4.77,32.06,40
NDC,6075880105,TIMOLOL MALEATE 0.5 % EYE DROPS,2.62,1.7,0.39,2.62,40
NDC,6075888005,FLUOROMETHOLONE 0.1 % EYE DROPSSUSPENSION,37.18,24.17,5.53,37.18,40
NDC,6075888010,FLUOROMETHOLONE 0.1 % EYE DROPSSUSPENSION,37.16,24.15,5.53,37.16,40
NDC,6079311501,CYTOMEL 5 MCG TABLET,0.98,0.64,0.15,0.98,40
NDC,6079311601,CYTOMEL 25 MCG TABLET,1.34,0.87,0.2,1.34,40
NDC,6079311701,CYTOMEL 50 MCG TABLET,2.26,1.47,0.34,2.26,40
NDC,6079320505,THROMBIN-JMI 5000 UNIT NASAL SPRAY SYRINGE,212.32,138.01,31.59,212.32,40
NDC,6079321505,THROMBIN-JMI 5000 UNIT TOPICAL SOLUTION,272.82,177.33,40.6,272.82,40
NDC,6079321720,THROMBIN-JMI 20000 UNIT TOPICAL SOLUTION,717.26,466.22,106.73,717.26,40
NDC,6079321721,THROMBIN-JMI 20000 UNIT TOPICAL SPRAY,820.92,533.6,122.15,820.92,40
NDC,6079321722,THROMBIN-JMI 20000 UNIT TOPICAL SPRAY SYRINGE,820.92,533.6,122.15,820.92,40
NDC,6079360002,BICILLIN C-R 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,437.61,284.45,2.17,437.61,65
NDC,6079360010,BICILLIN C-R 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,437.61,284.45,2.17,437.61,65
NDC,6079370010,BICILLIN L-A 600000 UNIT/ML INTRAMUSCULAR SYRINGE,843.78,548.46,2.17,843.78,65
NDC,6079370110,BICILLIN L-A 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,730.68,474.94,2.17,730.68,65
NDC,6079370204,BICILLIN L-A 2400000 UNIT/4 ML INTRAMUSCULAR SYRINGE,748.65,486.62,2.17,748.65,65
NDC,6079370210,BICILLIN L-A 2400000 UNIT/4 ML INTRAMUSCULAR SYRINGE,748.65,486.62,2.17,748.65,65
NDC,6079370505,THROMBIN-JMI 5000 UNIT TOPICAL SPRAY SYRINGE,202.24,131.46,30.09,202.24,40
NDC,6079385701,LEVOXYL 137 MCG TABLET,2.88,1.87,0.43,2.88,40
NDC,6079385801,LEVOXYL 150 MCG TABLET,2.94,1.91,0.44,2.94,40
NDC,6079386001,LEVOXYL 200 MCG TABLET,3.38,2.2,0.5,3.38,40
NDC,6084680401,UNITHROID 88 MCG TABLET,10.54,6.85,1.57,10.54,40
NDC,6084680801,UNITHROID 137 MCG TABLET,10.62,6.9,1.58,10.62,40
NDC,6092328410,EXONDYS-51  50 MG/ML INTRAVENOUS SOLUTION,2880.0,1872.0,2.17,13108.79,59
NDC,6097714101,PROTOPAM CHLORIDE 1 GRAM SOLUTION FOR INJECTION,312.12,202.88,2.17,312.12,51
NDC,6097714127,PROTOPAM CHLORIDE 1 GRAM SOLUTION FOR INJECTION,312.12,202.88,2.17,312.12,51
NDC,6101056013,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.22,0.14,0.03,0.22,40
NDC,6116810104,KYBELLA 10 MG/ML SUBCUTANEOUS SOLUTION,2160.0,1404.0,2.17,2160.0,51
NDC,6126922063,CLOTRIMAZOLE 1 % VAGINAL CREAM,0.22,0.14,0.03,0.22,40
NDC,6126932560,FOLTABS 800 0.8 MG-10 MG-115 MCG TABLET,1.0,0.65,0.15,1.0,40
NDC,6126941020,ETOPOPHOS 100 MG INTRAVENOUS SOLUTION,817.68,531.49,1.85,817.68,51
NDC,6126991060,IRON CHEWS 15 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,6131401425,DICLOFENAC 0.1 % EYE DROPS,35.82,23.28,5.33,35.82,40
NDC,6131401601,PROPARACAINE 0.5 % EYE DROPS,5.86,3.81,0.87,5.86,40
NDC,6131401910,DORZOLAMIDE 2 % EYE DROPS,13.36,8.68,1.99,13.36,40
NDC,6131404475,TRIFLURIDINE 1 % EYE DROPS,65.34,42.47,9.72,65.34,40
NDC,6131412605,KETOROLAC 0.5 % EYE DROPS,42.2,27.43,6.28,42.2,40
NDC,6131412610,KETOROLAC 0.5 % EYE DROPS,42.0,27.3,6.25,42.0,40
NDC,6131414305,BRIMONIDINE 0.2 % EYE DROPS,13.06,8.49,1.94,13.06,40
NDC,6131414405,BRIMONIDINE 0.15 % EYE DROPS,76.68,49.84,11.41,76.68,40
NDC,6131420315,PILOCARPINE 1 % EYE DROPS,13.14,8.54,1.96,13.14,40
NDC,6131420415,PILOCARPINE 2 % EYE DROPS,13.44,8.74,2.0,13.44,40
NDC,6131420615,PILOCARPINE 4 % EYE DROPS,14.1,9.17,2.1,14.1,40
NDC,6131422405,TIMOLOL MALEATE 0.25 % EYE GEL FORMING SOLUTION,79.3,51.55,11.8,79.3,40
NDC,6131422505,TIMOLOL MALEATE 0.5 % EYE GEL FORMING SOLUTION,86.9,56.49,12.93,86.9,40
NDC,6131422605,TIMOLOL MALEATE 0.25 % EYE DROPS,6.0,3.9,0.89,6.0,40
NDC,6131422610,TIMOLOL MALEATE 0.25 % EYE DROPS,5.56,3.61,0.83,5.56,40
NDC,6131422705,TIMOLOL MALEATE 0.5 % EYE DROPS,6.8,4.42,1.01,6.8,40
NDC,6131422710,TIMOLOL MALEATE 0.5 % EYE DROPS,6.48,4.21,0.96,6.48,40
NDC,6131422894,WYOST 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6793.95,4416.07,28.23,6793.95,59
NDC,6131423710,CROMOLYN 4 % EYE DROPS,7.44,4.84,1.11,7.44,40
NDC,6131423805,CARTEOLOL 1 % EYE DROPS,8.52,5.54,1.27,8.52,40
NDC,6131424063,JUBBONTI 60 MG/ML SUBCUTANEOUS SYRINGE,5774.88,3753.67,28.23,5774.88,59
NDC,6131424501,BETAXOLOL 0.5 % EYE DROPS,26.5,17.23,3.94,26.5,40
NDC,6131431801,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.38,1284.0,0.34,1975.38,65
NDC,6131431805,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,65
NDC,6131431810,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,65
NDC,6131432601,ZARXIO 480 MCG/0.8 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,65
NDC,6131432605,ZARXIO 480 MCG/0.8 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,65
NDC,6131435401,TROPICAMIDE 0.5 % EYE DROPS,3.56,2.31,0.53,3.56,40
NDC,6131435501,TROPICAMIDE 1 % EYE DROPS,9.34,6.07,1.39,9.34,40
NDC,6131439601,CYCLOPENTOLATE 1 % EYE DROPS,16.8,10.92,2.5,16.8,40
NDC,6131439603,CYCLOPENTOLATE 1 % EYE DROPS,5.4,3.51,0.8,5.4,40
NDC,6131454701,LATANOPROST 0.005 % EYE DROPS,76.0,49.4,11.31,76.0,40
NDC,6131462810,POLYMYXIN B SULFATE 10000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS,3.48,2.26,0.52,3.48,40
NDC,6131463006,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10000 UNIT/ML-0.1% EYE DROPS,17.6,11.44,2.62,17.6,40
NDC,6131463136,NEOMYCIN 3.5 MG/G-POLYMYXIN B 10000 UNIT/G-DEXAMETH 0.1 % EYE OINT,25.14,16.34,3.74,25.14,40
NDC,6131463305,GENTAMICIN 0.3 % EYE DROPS,8.68,5.64,1.29,8.68,40
NDC,6131463705,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,22.12,14.38,3.29,22.12,40
NDC,6131463710,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,22.1,14.37,3.29,22.1,40
NDC,6131463715,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,21.28,13.83,3.17,21.28,40
NDC,6131464175,NEOMYCIN 3.5 MG-POLYMYXIN 10000 UNIT-HYDROCORT 10 MG/ML EYE DROPSUSP,49.9,32.44,7.43,49.9,40
NDC,6131464305,TOBRAMYCIN 0.3 % EYE DROPS,13.6,8.84,2.02,13.6,40
NDC,6131464511,NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10000 UNIT/ML-1 % EAR DROPSSUSP,20.98,13.64,3.12,20.98,40
NDC,6131464705,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,58.18,37.82,8.66,58.18,40
NDC,6131464725,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,58.04,37.73,8.64,58.04,40
NDC,6131465494,PYZCHIVA 130 MG/26 ML INTRAVENOUS SOLUTION,152.31,99.0,8.26,4487.68,59
NDC,6131465605,CIPROFLOXACIN 0.3 % EYE DROPS,18.92,12.3,2.82,18.92,40
NDC,6131465610,CIPROFLOXACIN 0.3 % EYE DROPS,18.88,12.27,2.81,18.88,40
NDC,6131465625,CIPROFLOXACIN 0.3 % EYE DROPS,20.02,13.01,2.98,20.02,40
NDC,6131466505,APRACLONIDINE 0.5 % EYE DROPS,34.7,22.56,5.16,34.7,40
NDC,6131466510,APRACLONIDINE 0.5 % EYE DROPS,34.46,22.4,5.13,34.46,40
NDC,6136418103,RAPIVAB (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,57.0,37.05,1.67,2642.72,65
NDC,6144211505,GLIMEPIRIDE 1 MG TABLET,1.94,1.26,0.29,1.94,40
NDC,6147010141,AMERIGEL TOPICAL,1.34,0.87,0.2,1.34,40
NDC,6157007201,MENEST 0.3 MG TABLET,4.54,2.95,0.68,4.54,40
NDC,6157007301,MENEST 0.625 MG TABLET,6.44,4.19,0.96,6.44,40
NDC,6157007401,MENEST 1.25 MG TABLET,9.0,5.85,1.34,9.0,40
NDC,6157011001,ALTACE 1.25 MG CAPSULE,12.92,8.4,1.92,12.92,40
NDC,6157011101,ALTACE 2.5 MG CAPSULE,15.26,9.92,2.27,15.26,40
NDC,6157013120,SILVADENE 1 % TOPICAL CREAM,1.1,0.72,0.16,1.1,40
NDC,6157013125,SILVADENE 1 % TOPICAL CREAM,0.74,0.48,0.11,0.74,40
NDC,6157013140,SILVADENE 1 % TOPICAL CREAM,0.3,0.2,0.04,0.3,40
NDC,6157013155,SILVADENE 1 % TOPICAL CREAM,0.62,0.4,0.09,0.62,40
NDC,6170330346,CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,2.8,1.82,0.42,15.18,51
NDC,6170330436,CYTARABINE 20 MG/ML INJECTION SOLUTION,3.2,2.08,0.48,15.18,51
NDC,6170330538,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,6.32,4.11,0.94,15.18,51
NDC,6170330906,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,89.48,58.16,2.17,89.48,51
NDC,6170330916,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,45.44,29.54,2.17,45.44,51
NDC,6170330925,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,26.48,17.21,2.17,26.48,51
NDC,6170330926,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,28.48,18.51,2.17,28.48,51
NDC,6170331922,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,4.88,3.17,0.73,15.18,51
NDC,6170332322,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,449.36,292.08,2.17,449.36,43
NDC,6170332418,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,5.19,3.37,0.77,47.96,51
NDC,6170332518,PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,16.35,10.63,2.17,47.96,51
NDC,6170332618,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,13.5,8.78,2.01,47.96,51
NDC,6170333218,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,181.65,118.07,2.17,181.65,43
NDC,6170333918,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,12.88,8.37,1.92,12.88,43
NDC,6170333922,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.44,4.84,1.11,8.28,43
NDC,6170333950,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,5.04,3.28,0.75,8.28,43
NDC,6170333956,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,3.54,2.3,0.53,8.28,43
NDC,6170334222,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,8.12,5.28,0.18,8.12,43
NDC,6170334250,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,6.84,4.45,0.18,6.84,43
NDC,6170334318,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,82.84,53.85,2.17,500.04,65
NDC,6170334365,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,82.84,53.85,2.17,500.04,65
NDC,6170334366,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,85.72,55.72,2.17,500.04,65
NDC,6170334909,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,21.08,13.7,2.17,21.08,43
NDC,6170334916,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,34.24,22.26,2.17,34.24,43
NDC,6170334936,IRINOTECAN 500 MG/25 ML INTRAVENOUS SOLUTION,32.0,20.8,2.17,32.0,43
NDC,6170335010,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,12.72,8.27,1.89,15.18,51
NDC,6170335038,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,17.44,11.34,2.17,17.44,51
NDC,6170336318,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,23.04,14.98,0.09,47.96,51
NDC,6170336322,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,23.04,14.98,0.09,47.96,51
NDC,6170340841,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.64,3.02,0.69,15.18,51
NDC,6175500501,EYLEA 2 MG/0.05 ML INTRAVITREAL SYRINGE,139847.76,90901.04,2.17,139847.76,65
NDC,6175500502,EYLEA 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,139847.76,90901.04,2.17,139847.76,65
NDC,6175500801,LIBTAYO 50 MG/ML INTRAVENOUS SOLUTION,7772.32,5052.01,2.17,7772.32,65
NDC,6175502001,PRALUENT PEN 75 MG/ML SUBCUTANEOUS PEN INJECTOR,938.82,610.23,139.7,938.82,40
NDC,6175502101,PRALUENT PEN 150 MG/ML SUBCUTANEOUS PEN INJECTOR,938.82,610.23,139.7,938.82,40
NDC,6175505001,EYLEA HD 8 MG/0.07 ML INTRAVITREAL SOLUTION FOR INJECTION,140454.0,91295.1,2.17,140454.0,65
NDC,6175505401,LYNOZYFIC 2 MG/ML INTRAVENOUS SOLUTION,902.4,586.56,96.82,7011.25,59
NDC,6175505601,LYNOZYFIC 20 MG/ML INTRAVENOUS SOLUTION,9024.0,5865.6,96.82,9024.0,59
NDC,6177259081,AMVISC 12 MG/ML INTRAOCULAR SYRINGE,567.0,368.55,84.37,567.0,40
NDC,6177260081,AMVISC PLUS 16 MG/ML INTRAOCULAR SYRINGE,684.0,444.6,101.78,684.0,40
NDC,6178706204,DIABETIC TUSSIN DM 10 MG-100 MG/5 ML ORAL LIQUID,0.18,0.12,0.03,0.18,40
NDC,6187411511,VRAYLAR 1.5 MG CAPSULE,121.52,78.99,18.08,121.52,40
NDC,6187411520,VRAYLAR 1.5 MG CAPSULE,121.52,78.99,18.08,121.52,40
NDC,6187413020,VRAYLAR 3 MG CAPSULE,121.52,78.99,18.08,121.52,40
NDC,6187413030,VRAYLAR 3 MG CAPSULE,121.52,78.99,18.08,121.52,40
NDC,6187414530,VRAYLAR 4.5 MG CAPSULE,121.52,78.99,18.08,121.52,40
NDC,6187416030,VRAYLAR 6 MG CAPSULE,121.52,78.99,18.08,121.52,40
NDC,6191979525,CIPROFLOXACIN 0.3 % EYE DROPS,26.6,17.29,3.96,26.6,40
NDC,6192418808,DERMASARRA ANTI-ITCH (MENTHOL-CAMPHOR) 0.5 %-0.5 % LOTION,0.06,0.04,0.01,0.06,40
NDC,6195300043,FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION,19.05,12.38,2.83,19.05,40
NDC,6195300044,FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION,19.05,12.38,2.83,19.05,40
NDC,6195300045,FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION,19.05,12.38,2.83,19.05,40
NDC,6195300053,FLEBOGAMMA DIF 10 % INTRAVENOUS SOLUTION,38.13,24.78,2.17,2642.72,62
NDC,6195804011,VIREAD 300 MG TABLET,100.28,65.18,14.92,100.28,40
NDC,6195806011,EMTRIVA 200 MG CAPSULE,42.92,27.9,6.39,42.92,40
NDC,6195806021,EMTRIVA 10 MG/ML ORAL SOLUTION,2.23,1.45,0.33,2.23,40
NDC,6195807011,TRUVADA 200 MG-300 MG TABLET,147.38,95.8,21.93,147.38,40
NDC,6195808015,LETAIRIS 5 MG TABLET,1099.7,714.81,163.64,1099.7,40
NDC,6195808021,LETAIRIS 10 MG TABLET,1099.72,714.82,163.64,1099.72,40
NDC,6195809011,CAYSTON 75 MG/ML SOLUTION FOR NEBULIZATION,362.56,235.66,53.95,362.56,40
NDC,6195811011,COMPLERA 200 MG-25 MG-300 MG TABLET,306.96,199.52,45.68,306.96,40
NDC,6195812011,STRIBILD 150 MG-150 MG-200 MG-300 MG TABLET,353.82,229.98,52.65,353.82,40
NDC,6195814011,TYBOST 150 MG TABLET,25.18,16.37,3.75,25.18,40
NDC,6195815011,SOVALDI 400 MG TABLET,2400.0,1560.0,357.12,2400.0,40
NDC,6195817011,ZYDELIG 100 MG TABLET,584.92,380.2,87.04,584.92,40
NDC,6195817021,ZYDELIG 150 MG TABLET,584.92,380.2,87.04,584.92,40
NDC,6195818011,HARVONI 90 MG-400 MG TABLET,2700.0,1755.0,401.76,2700.0,40
NDC,6195819011,GENVOYA 150 MG-150 MG-200 MG-10 MG TABLET,337.28,219.23,50.19,337.28,40
NDC,6195820021,DESCOVY 200 MG-25 MG TABLET,176.18,114.52,26.22,176.18,40
NDC,6195820022,DESCOVY 200 MG-25 MG TABLET,176.18,114.52,26.22,176.18,40
NDC,6195821011,ODEFSEY 200 MG-25 MG-25 MG TABLET,306.96,199.52,45.68,306.96,40
NDC,6195823011,VEMLIDY 25 MG TABLET,122.14,79.39,18.17,122.14,40
NDC,6195825011,BIKTARVY 50 MG-200 MG-25 MG TABLET,337.28,219.23,50.19,337.28,40
NDC,6195825013,BIKTARVY 50 MG-200 MG-25 MG TABLET,337.28,219.23,50.19,337.28,40
NDC,6195825051,BIKTARVY 30 MG-120 MG-15 MG TABLET,337.28,219.23,50.19,337.28,40
NDC,6195829012,VEKLURY 100 MG INTRAVENOUS POWDER FOR SOLUTION,2342.58,1522.68,2.17,2342.58,65
NDC,6195829022,REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),93.6,60.84,2.17,667.03,65
NDC,6195830011,SUNLENCA 300 MG TABLET,1950.0,1267.5,290.16,1950.0,40
NDC,6195830021,SUNLENCA 309 MG/ML SUBCUTANEOUS SOLUTION,23400.0,15210.0,2.17,23400.0,65
NDC,6195834011,YEZTUGO 300 MG TABLET,1410.9,917.09,2.17,1846.11,59
NDC,6195834021,YEZTUGO 309 MG/ML SUBCUTANEOUS SOLUTION,16930.8,11005.02,2.17,16930.8,59
NDC,6203210036,OBAGI NU-DERM BLENDER 4 % TOPICAL CREAM,1.92,1.25,0.29,1.92,40
NDC,6203210136,OBAGI NU-DERM CLEAR 4 % TOPICAL CREAM,2.0,1.3,0.3,2.0,40
NDC,6203210536,OBAGI-C THERAPY NIGHT 4 % TOPICAL CREAM,1.98,1.29,0.29,1.98,40
NDC,6203210610,OBAGI-C CLARIFYING SERUM 4 %-10 % TOPICAL,4.36,2.83,0.65,4.36,40
NDC,6206412202,TROGARZO 200 MG/1.33 ML (150 MG/ML) INTRAVENOUS SOLUTION,4126.47,2682.21,2.17,4417.71,65
NDC,6210333302,BOUDREAUXS BUTT PASTE 16 % TOPICAL OINTMENT,0.2,0.13,0.03,0.2,40
NDC,6210333304,BOUDREAUXS BUTT PASTE 16 % TOPICAL OINTMENT,0.16,0.1,0.02,0.16,40
NDC,6210333306,BOUDREAUXS BUTT PASTE 16 % TOPICAL OINTMENT,0.1,0.07,0.01,0.1,40
NDC,6213532190,METHYLDOPA 250 MG TABLET,18.0,11.7,2.68,18.0,40
NDC,6213534053,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,1.58,1.03,0.24,1.58,40
NDC,6213543690,SUCRALFATE 1 GRAM TABLET,9.6,6.24,1.43,9.6,40
NDC,6213575047,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,3.18,2.07,0.47,3.18,40
NDC,6213577330,TRIMETHOBENZAMIDE 300 MG CAPSULE,43.2,28.08,6.43,43.2,40
NDC,6213596031,SULFASALAZINE 500 MG TABLET,4.8,3.12,0.71,4.8,40
NDC,6214455105,IMPROVUE (PF) 1.7 % EYE DROPS WITH APPLICATOR,40.02,26.01,5.95,40.02,40
NDC,6217526137,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,4.62,3.0,0.69,4.62,40
NDC,6217532046,NIACIN ER 500 MG TABLETEXTENDED RELEASE 24 HR,10.44,6.79,1.55,10.44,40
NDC,6217532246,NIACIN ER 1000 MG TABLETEXTENDED RELEASE 24 HR,18.46,12.0,2.75,18.46,40
NDC,6217547032,PAROXETINE ER 12.5 MG TABLETEXTENDED RELEASE 24 HR,11.16,7.25,1.66,11.16,40
NDC,6217561743,PANTOPRAZOLE 40 MG TABLETDELAYED RELEASE,8.12,5.28,1.21,8.12,40
NDC,6232733343,STERITALC 3 GRAM INTRAPLEURAL AEROSOL POWDER,421.2,273.78,62.67,421.2,43
NDC,6232744404,STERITALC 4 GRAM INTRAPLEURAL SUSPENSION,469.2,304.98,69.82,469.2,40
NDC,6232744444,STERITALC 4 GRAM INTRAPLEURAL SUSPENSION,469.2,304.98,69.82,469.2,40
NDC,6233202531,THEOPHYLLINE ER 300 MG TABLETEXTENDED RELEASE12 HR,8.6,5.59,1.28,8.6,40
NDC,6233202631,THEOPHYLLINE ER 450 MG TABLETEXTENDED RELEASE12 HR,12.1,7.87,1.8,12.1,40
NDC,6233203031,ROPINIROLE 0.25 MG TABLET,5.0,3.25,0.74,5.0,40
NDC,6233203231,ROPINIROLE 1 MG TABLET,5.0,3.25,0.74,5.0,40
NDC,6233203431,ROPINIROLE 3 MG TABLET,5.0,3.25,0.74,5.0,40
NDC,6233203531,ROPINIROLE 4 MG TABLET,5.0,3.25,0.74,5.0,40
NDC,6233203631,ROPINIROLE 5 MG TABLET,5.0,3.25,0.74,5.0,40
NDC,6233206460,RIVASTIGMINE 3 MG CAPSULE,9.32,6.06,1.39,9.32,40
NDC,6233209531,LAMOTRIGINE 5 MG ORAL CHEWABLE,6.1,3.97,0.91,6.1,40
NDC,6233209631,LAMOTRIGINE 25 MG ORAL CHEWABLE,6.4,4.16,0.95,6.4,40
NDC,6233209730,ARIPIPRAZOLE 2 MG TABLET,64.0,41.6,9.52,64.0,40
NDC,6233209831,ARIPIPRAZOLE 5 MG TABLET,64.16,41.7,9.55,64.16,40
NDC,6233210230,ARIPIPRAZOLE 30 MG TABLET,90.0,58.5,13.39,90.0,40
NDC,6233210330,ARIPIPRAZOLE 10 MG DISINTEGRATING TABLET,83.78,54.46,12.47,83.78,40
NDC,6233210430,ARIPIPRAZOLE 15 MG DISINTEGRATING TABLET,83.78,54.46,12.47,83.78,40
NDC,6233214060,CELECOXIB 50 MG CAPSULE,4.32,2.81,0.64,4.32,40
NDC,6233214231,CELECOXIB 200 MG CAPSULE,15.14,9.84,2.25,15.14,40
NDC,6233219130,FEBUXOSTAT 80 MG TABLET,24.76,16.09,3.68,24.76,40
NDC,6233223430,VILAZODONE 40 MG TABLET,16.8,10.92,2.5,16.8,40
NDC,6233249630,LURASIDONE 60 MG TABLET,75.66,49.18,11.26,75.66,40
NDC,6233254505,TIMOLOL MALEATE 0.25 % EYE GEL FORMING SOLUTION,97.12,63.13,14.45,97.12,40
NDC,6233254605,TIMOLOL MALEATE 0.5 % EYE GEL FORMING SOLUTION,106.44,69.19,15.84,106.44,40
NDC,6233255660,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,22.94,14.91,3.41,22.94,40
NDC,6233255760,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,22.94,14.91,3.41,22.94,40
NDC,6233255860,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,22.94,14.91,3.41,22.94,40
NDC,6233258231,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,1.82,1.18,0.27,1.82,40
NDC,6233260330,BISOPROLOL FUMARATE 5 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,6233260331,BISOPROLOL FUMARATE 5 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,6233261831,CYCLOPHOSPHAMIDE 25 MG CAPSULE,17.96,11.67,1.81,17.96,43
NDC,6233261931,CYCLOPHOSPHAMIDE 50 MG CAPSULE,32.98,21.44,1.81,32.98,43
NDC,6233274130,ACITRETIN 10 MG CAPSULE,62.4,40.56,9.29,62.4,40
NDC,6233279031,FLUPHENAZINE 5 MG TABLET,18.4,11.96,2.74,18.4,40
NDC,6237263015,INFANTS' MYLICON 40 MG/0.6 ML ORAL DROPSSUSPENSION,0.88,0.57,0.13,0.88,40
NDC,6248400155,XROMI 100 MG/ML ORAL SOLUTION,15.4,10.01,2.29,15.4,40
NDC,6248400202,PURIXAN 20 MG/ML ORAL SUSPENSION,40.95,26.62,6.09,40.95,40
NDC,6253000011,URE-NA 15 GRAM ORAL POWDER PACKET,10.88,7.07,1.62,10.88,40
NDC,6254140510,PANCREAZE 21000 UNIT-54700 UNIT-83900 UNIT CAPSULEDELAYED RELEASE,16.84,10.95,2.51,16.84,40
NDC,6255913807,HYDROCORTISONE 100 MG/60 ML ENEMA,0.86,0.56,0.13,0.86,40
NDC,6255915304,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,9.41,6.12,1.4,9.41,40
NDC,6255915801,FLUVOXAMINE 25 MG TABLET,4.6,2.99,0.68,4.6,40
NDC,6255915901,FLUVOXAMINE 50 MG TABLET,5.14,3.34,0.76,5.14,40
NDC,6255916001,FLUVOXAMINE 100 MG TABLET,5.26,3.42,0.78,5.26,40
NDC,6255917331,NILUTAMIDE 150 MG TABLET,450.48,292.81,67.03,450.48,40
NDC,6255923001,PROPAFENONE 150 MG TABLET,3.28,2.13,0.49,3.28,40
NDC,6255923101,PROPAFENONE 225 MG TABLET,4.66,3.03,0.69,4.66,40
NDC,6255924001,METHAZOLAMIDE 25 MG TABLET,10.22,6.64,1.52,10.22,40
NDC,6255924101,METHAZOLAMIDE 50 MG TABLET,20.44,13.29,3.04,20.44,40
NDC,6255925101,ETODOLAC 300 MG CAPSULE,3.1,2.02,0.46,3.1,40
NDC,6255927530,NEBIVOLOL 2.5 MG TABLET,11.36,7.38,1.69,11.36,40
NDC,6255927730,NEBIVOLOL 10 MG TABLET,11.36,7.38,1.69,11.36,40
NDC,6255927890,NEBIVOLOL 20 MG TABLET,11.36,7.38,1.69,11.36,40
NDC,6255928860,FLUOCINOLONE 0.01 % TOPICAL CREAM,4.46,2.9,0.66,4.46,40
NDC,6255935601,KIONEX (WITH SORBITOL) 15 GRAM-20 GRAM/60 ML ORAL SUSPENSION,1.3,0.85,0.19,1.3,40
NDC,6255939050,VANCOMYCIN 125 MG CAPSULE,62.62,40.7,9.32,62.62,40
NDC,6255943130,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,5.54,3.6,0.82,5.54,40
NDC,6255949001,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,6255963001,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,10.13,6.58,1.51,10.13,40
NDC,6255973101,FELBAMATE 600 MG TABLET,11.96,7.77,1.78,11.96,40
NDC,6255999212,FLUCONAZOLE 150 MG TABLET,27.96,18.17,4.16,27.96,40
NDC,6258426501,METOPROLOL TARTRATE 25 MG TABLET,0.22,0.14,0.03,0.22,40
NDC,6258426511,METOPROLOL TARTRATE 25 MG TABLET,0.22,0.14,0.03,0.22,40
NDC,6258426601,METOPROLOL TARTRATE 50 MG TABLET,0.26,0.17,0.04,0.26,40
NDC,6258426611,METOPROLOL TARTRATE 50 MG TABLET,0.26,0.17,0.04,0.26,40
NDC,6258426701,METOPROLOL TARTRATE 100 MG TABLET,0.68,0.44,0.1,0.68,40
NDC,6258481211,OXAZEPAM 10 MG CAPSULE,5.72,3.72,0.85,5.72,40
NDC,6258481311,OXAZEPAM 15 MG CAPSULE,6.3,4.1,0.94,6.3,40
NDC,6258498401,WARFARIN 2 MG TABLET,1.24,0.81,0.18,1.24,40
NDC,6258499401,WARFARIN 5 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,6275622483,TIAGABINE 4 MG TABLET,15.24,9.91,2.27,15.24,40
NDC,6275625802,ZONISAMIDE 25 MG CAPSULE,0.5,0.33,0.07,0.5,40
NDC,6275625902,ZONISAMIDE 50 MG CAPSULE,0.7,0.46,0.1,0.7,40
NDC,6275652188,SUMATRIPTAN 50 MG TABLET,4.04,2.63,0.6,4.04,40
NDC,6275652926,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,92.64,60.22,2.17,184.43,57
NDC,6275652940,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,285.2,185.38,2.17,285.2,57
NDC,6275653886,RILUZOLE 50 MG TABLET,3.16,2.05,0.47,3.16,40
NDC,6285621201,LEQEMBI 100 MG/ML INTRAVENOUS SOLUTION,474.9,308.69,1.33,720.96,65
NDC,6285621501,LEQEMBI 100 MG/ML INTRAVENOUS SOLUTION,474.93,308.7,1.33,720.96,65
NDC,6285638901,HALAVEN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3384.0,2199.6,2.17,3384.0,65
NDC,6285670405,LENVIMA 4 MG CAPSULE,1998.64,1299.12,297.4,1998.64,40
NDC,6285671030,LENVIMA 10 MG/DAY (10 MG X 1) CAPSULE,1998.64,1299.12,297.4,1998.64,40
NDC,6285671230,LENVIMA 12 MG/DAY (4 MG X 3) CAPSULE,666.22,433.04,99.13,666.22,40
NDC,6285671405,LENVIMA 14 MG/DAY(10 MG X 1-4 MG X 1) CAPSULE,999.32,649.56,148.7,999.32,40
NDC,6285671805,LENVIMA 18 MG/DAY (10 MG X 1 AND 4 MG X 2) CAPSULE,666.22,433.04,99.13,666.22,40
NDC,6285672430,LENVIMA 24 MG PER DAY (10 MG X 2 AND 4 MG X 1) CAPSULE,666.22,433.04,99.13,666.22,40
NDC,6293515350,FENSOLVI 45 MG SUBCUTANEOUS SYRINGE,103734.78,67427.61,2.17,103734.78,65
NDC,6293522305,ELIGARD 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,4878.24,3170.86,2.17,4878.24,65
NDC,6293522710,ELIGARD 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,4878.24,3170.86,2.17,4878.24,65
NDC,6293530330,ELIGARD 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,6504.33,4227.81,2.17,6504.33,65
NDC,6293530640,ELIGARD 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,6504.33,4227.81,2.17,6504.33,65
NDC,6293545345,ELIGARD 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,9756.48,6341.71,2.17,9756.48,65
NDC,6293546150,ELIGARD 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,9756.48,6341.71,2.17,9756.48,65
NDC,6293575375,ELIGARD 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,2168.12,1409.28,2.17,2168.12,65
NDC,6293575680,ELIGARD 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,2168.12,1409.28,2.17,2168.12,65
NDC,6299112035,PAPAVERINE (BULK) POWDER,83.0,53.95,12.35,83.0,40
NDC,6299113721,SODIUM CHLORIDE (BULK) GRANULES,0.19,0.12,0.03,0.19,40
NDC,6299114222,CLONIDINE HCL (BULK) POWDER,435.0,282.75,64.73,435.0,40
NDC,6299116483,BISMUTH SUBGALLATE (BULK) POWDER,3.6,2.34,0.54,3.6,40
NDC,6299117082,TETRACAINE (BULK) 100 % WAX,28.5,18.53,4.24,28.5,40
NDC,6299128121,PILOCARPINE NITRATE (BULK) POWDER,61.47,39.96,9.15,61.47,40
NDC,6299128632,EPINEPHRINE BITARTRATE (BULK) POWDER,97.5,63.38,14.51,97.5,40
NDC,6299130821,FORMALDEHYDE (BULK) 37 % SOLUTION,0.32,0.21,0.05,0.32,40
NDC,6300477311,ACTHAR H.P. 80 UNIT/ML INJECTION GEL,21514.5,13984.43,2.17,21514.5,59
NDC,6300487101,ACTHAR 80 UNIT/ML INJECTION GEL,32618.88,21202.27,2.17,32618.88,59
NDC,6301001030,VIRACEPT 250 MG TABLET,9.72,6.32,1.45,9.72,40
NDC,6302004901,VELCADE 3.5 MG SOLUTION FOR INJECTION,7694.4,5001.36,2.17,7694.4,51
NDC,6302009030,ALUNBRIG 90 MG TABLET,1663.44,1081.24,247.52,1663.44,40
NDC,6302011330,ALUNBRIG 30 MG TABLET,554.72,360.57,82.54,554.72,40
NDC,6302018030,ALUNBRIG 180 MG TABLET,1663.44,1081.24,247.52,1663.44,40
NDC,6302021021,FRUZAQLA 1 MG CAPSULE,752.92,489.4,112.03,752.92,40
NDC,6302022521,FRUZAQLA 5 MG CAPSULE,3011.08,1957.2,448.05,3011.08,40
NDC,6302023002,NINLARO 2.3 MG CAPSULE,10852.0,7053.8,1614.78,10852.0,40
NDC,6302039002,NINLARO 3 MG CAPSULE,10852.0,7053.8,1614.78,10852.0,40
NDC,6302040002,NINLARO 4 MG CAPSULE,10852.0,7053.8,1614.78,10852.0,40
NDC,6302053330,ICLUSIG 30 MG TABLET,1865.6,1212.64,277.6,1865.6,40
NDC,6302053430,ICLUSIG 45 MG TABLET,1865.6,1212.64,277.6,1865.6,40
NDC,6302053530,ICLUSIG 15 MG TABLET,1865.6,1212.64,277.6,1865.6,40
NDC,6302053630,ICLUSIG 10 MG TABLET,1865.6,1212.64,277.6,1865.6,40
NDC,6304420301,IFEREX 150 150 MG IRON CAPSULE,0.66,0.43,0.1,0.66,40
NDC,6304440420,AMMONIUM LACTATE 12 % TOPICAL CREAM,0.4,0.26,0.06,0.4,40
NDC,6304462201,RENO CAPS 1 MG CAPSULE,1.32,0.86,0.2,1.32,40
NDC,6304463510,TRICON 110 MG-0.5 MG CAPSULE,0.78,0.51,0.12,0.78,40
NDC,6309010030,NUPLAZID 10 MG TABLET,409.6,266.24,60.95,409.6,40
NDC,6309034030,NUPLAZID 34 MG CAPSULE,409.6,266.24,60.95,409.6,40
NDC,6325610030,SCLEROSOL INTRAPLEURAL 4 GRAM AEROSOL POWDER,8.4,5.46,1.25,8.4,40
NDC,6325620005,STERILE TALC 5 GRAM INTRAPLEURAL SUSPENSION,298.5,194.03,44.42,298.5,40
NDC,6326125021,LYMPHAZURIN 1 % SUBCUTANEOUS SOLUTION,452.91,294.39,8.53,452.91,65
NDC,6330419130,DESVENLAFAXINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,11.14,7.24,1.66,11.14,40
NDC,6330469301,CLINDAMYCIN HCL 300 MG CAPSULE,1.04,0.68,0.15,1.04,40
NDC,6332300105,EMPTY STERILIZED VIAL,3.1,2.02,0.46,3.1,39
NDC,6332300110,EMPTY STERILIZED VIAL,1.36,0.88,0.2,1.36,40
NDC,6332301002,GENTAMICIN 40 MG/ML INJECTION SOLUTION,7.32,4.76,1.09,8.86,51
NDC,6332301003,GENTAMICIN 40 MG/ML INJECTION SOLUTION,5.25,3.41,0.78,8.86,51
NDC,6332301020,GENTAMICIN 40 MG/ML INJECTION SOLUTION,5.25,3.41,0.78,8.86,51
NDC,6332301115,CHLORAMPHENICOL SODIUM SUCCINATE 1 GRAM INTRAVENOUS SOLUTION,175.14,113.84,2.17,175.14,59
NDC,6332301203,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,10.8,7.02,1.61,10.8,51
NDC,6332301207,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,5.4,3.51,0.8,8.86,51
NDC,6332301210,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,3.69,2.4,0.55,8.86,51
NDC,6332301211,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,10.8,7.02,1.61,10.8,51
NDC,6332301230,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,6.48,4.21,0.96,8.86,51
NDC,6332301302,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,17.91,11.64,2.17,17.91,51
NDC,6332301309,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,9.18,5.97,1.37,9.18,51
NDC,6332302425,MANNITOL 25 % INTRAVENOUS SOLUTION,0.45,0.29,0.07,8.86,51
NDC,6332302605,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,1.83,1.19,0.27,1.83,40
NDC,6332303011,CHORIONIC GONADOTROPIN HUMAN 10000 UNIT IM POWDER FOR SOLUTION,1124.1,730.67,2.17,1124.1,51
NDC,6332304400,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.24,7.96,1.14,12.24,51
NDC,6332304401,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.24,7.96,1.14,12.24,51
NDC,6332306401,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,3.57,2.32,0.53,8.86,51
NDC,6332306402,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,2.85,1.85,0.42,8.86,51
NDC,6332306403,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,3.57,2.32,0.53,8.86,51
NDC,6332306410,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,0.63,0.41,0.09,8.86,51
NDC,6332306411,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.02,0.66,0.15,8.86,51
NDC,6332306421,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,2.16,1.4,0.32,8.86,51
NDC,6332306423,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,2.16,1.4,0.32,8.86,51
NDC,6332308303,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,16.95,11.02,2.52,16.95,40
NDC,6332308305,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,16.95,11.02,2.52,16.95,40
NDC,6332308605,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,10.65,6.92,1.58,10.65,40
NDC,6332308650,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,4.83,3.14,0.72,4.83,40
NDC,6332309020,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.93,0.6,0.14,8.86,51
NDC,6332309040,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.51,0.12,8.86,51
NDC,6332309330,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.93,0.6,0.14,8.86,51
NDC,6332309561,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.63,0.41,0.09,8.86,51
NDC,6332310213,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,57.6,37.44,2.17,57.6,51
NDC,6332310351,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.29,15.18,51
NDC,6332310364,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.29,15.18,51
NDC,6332310365,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.29,15.18,51
NDC,6332310406,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,11.96,7.77,1.78,15.18,51
NDC,6332310425,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,11.96,7.77,1.78,15.18,51
NDC,6332310450,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,11.96,7.77,1.78,15.18,51
NDC,6332310601,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.33,0.21,0.05,8.86,51
NDC,6332310605,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.93,0.6,0.14,8.86,51
NDC,6332310610,MAGNESIUM SULFATE 40 GRAM/1000 ML (4 %) IN WATER INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332310705,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.6,0.39,0.09,8.86,51
NDC,6332310801,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.33,0.21,0.05,8.86,51
NDC,6332311310,PENTAM 300 MG SOLUTION FOR INJECTION,600.81,390.53,0.43,600.81,51
NDC,6332311700,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.64,1.07,0.24,15.18,51
NDC,6332311710,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.64,1.07,0.24,15.18,51
NDC,6332311719,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.32,0.86,0.2,15.18,51
NDC,6332311720,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,1.64,1.07,0.24,15.18,51
NDC,6332311751,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,1.4,0.91,0.21,15.18,51
NDC,6332311759,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,0.88,0.57,0.13,15.18,51
NDC,6332311761,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,1.4,0.91,0.21,15.18,51
NDC,6332312250,METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION,305.28,198.43,2.17,305.28,51
NDC,6332312302,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,10.8,7.02,1.61,15.18,51
NDC,6332312310,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,16.12,10.48,2.17,16.12,51
NDC,6332312553,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,235.2,152.88,2.17,235.2,51
NDC,6332312710,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,59.48,38.66,2.17,59.48,43
NDC,6332312820,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,57.6,37.44,2.17,57.6,43
NDC,6332313002,DOXY-100 100 MG INTRAVENOUS SOLUTION,94.8,61.62,0.18,94.8,51
NDC,6332313011,DOXY-100 100 MG INTRAVENOUS SOLUTION,94.8,61.62,0.18,94.8,51
NDC,6332313013,DOXY-100 100 MG INTRAVENOUS SOLUTION,62.37,40.54,0.18,62.37,51
NDC,6332313210,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,195.68,127.19,2.17,500.04,65
NDC,6332313610,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,158.96,103.32,2.17,158.96,43
NDC,6332313720,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,351.52,228.49,2.17,351.52,43
NDC,6332314010,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,208.8,135.72,2.17,500.04,65
NDC,6332314210,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,278.64,181.12,2.17,278.64,43
NDC,6332314212,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,290.24,188.66,2.17,290.24,43
NDC,6332314397,ADDAMEL N 5.33 MCG-0.34 MG-0.54 MG/ML INTRAVENOUS SOLUTION,5.76,3.74,0.86,5.76,40
NDC,6332316101,KETOROLAC 15 MG/ML INJECTION SOLUTION,13.5,8.78,0.31,13.5,65
NDC,6332316112,KETOROLAC 15 MG/ML INJECTION SOLUTION,2.52,1.64,0.31,8.86,65
NDC,6332316201,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,20.52,13.34,0.31,20.52,65
NDC,6332316202,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,14.76,9.59,0.31,14.76,65
NDC,6332316212,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,2.52,1.64,0.31,8.86,65
NDC,6332316214,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,1.62,1.05,0.31,8.86,65
NDC,6332316501,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,10.38,6.75,0.2,10.38,51
NDC,6332316505,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,4.98,3.24,0.2,8.86,51
NDC,6332316530,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,5.58,3.63,0.2,8.86,51
NDC,6332317245,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.56,4.91,1.12,8.28,43
NDC,6332317301,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,9.75,6.34,1.45,9.75,51
NDC,6332317302,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,9.75,6.34,1.45,9.75,51
NDC,6332318001,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,78.24,50.86,2.17,78.24,51
NDC,6332318410,FOLIC ACID 5 MG/ML INJECTION SOLUTION,23.01,14.96,0.09,23.01,51
NDC,6332318510,STERILE WATER 100 % FOR INJECTION,1.8,1.17,0.27,1.8,40
NDC,6332318520,STERILE WATER 100 % FOR INJECTION,1.17,0.76,0.17,1.17,40
NDC,6332318550,STERILE WATER 100 % FOR INJECTION,0.6,0.39,0.09,0.6,40
NDC,6332318600,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.06,0.42,40
NDC,6332318601,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.06,0.42,40
NDC,6332318602,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,1.92,1.25,0.29,1.92,40
NDC,6332318610,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.06,0.42,40
NDC,6332318620,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.33,0.21,0.05,0.33,40
NDC,6332319202,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,652.52,424.14,2.17,652.52,49
NDC,6332319302,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,38.4,24.96,2.17,38.4,43
NDC,6332319420,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,41.34,26.87,2.17,327.06,51
NDC,6332320102,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,5.1,3.32,0.02,8.86,51
NDC,6332320110,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.96,0.62,0.02,8.86,51
NDC,6332320202,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,5.34,3.47,0.02,8.86,51
NDC,6332320500,OMEGAVEN 10 % INTRAVENOUS EMULSION,3.78,2.46,0.56,3.78,40
NDC,6332320805,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,2.7,1.76,0.02,8.86,51
NDC,6332322905,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,11.16,7.25,1.66,11.16,51
NDC,6332322915,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,8.04,5.23,1.2,8.86,51
NDC,6332322930,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,6.69,4.35,1.0,8.86,51
NDC,6332322935,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,4.74,3.08,0.71,8.86,51
NDC,6332323861,CEFAZOLIN 10 GRAM INTRAVENOUS SOLUTION,45.15,29.35,1.48,45.15,51
NDC,6332324120,GLYCOPHOS 1 MMOL/ML INTRAVENOUS SOLUTION,2.34,1.52,0.35,2.34,40
NDC,6332325402,MURI-LUBE OIL,11.83,7.69,1.76,11.83,40
NDC,6332325410,MURI-LUBE OIL,2.73,1.77,0.41,2.73,40
NDC,6332325503,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,21.9,14.24,0.3,21.9,57
NDC,6332325803,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,41.94,27.26,0.3,41.94,57
NDC,6332326037,POLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,1.35,0.88,0.2,8.86,51
NDC,6332326110,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,10.77,7.0,1.28,10.77,51
NDC,6332326530,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG INTRAVENOUS SOLUTION,123.18,80.07,0.3,123.18,57
NDC,6332326910,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.16,8.86,51
NDC,6332326922,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.16,8.86,51
NDC,6332326929,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.16,8.86,51
NDC,6332326937,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,0.42,0.27,0.06,8.86,51
NDC,6332326950,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.16,8.86,51
NDC,6332326957,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.14,0.74,0.16,8.86,51
NDC,6332326965,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.16,8.86,51
NDC,6332326967,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.14,0.74,0.16,8.86,51
NDC,6332327205,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,111.57,72.52,2.17,111.57,51
NDC,6332327301,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,352.8,229.32,2.17,352.8,51
NDC,6332327602,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,23.73,15.42,0.32,23.73,51
NDC,6332327810,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,25.8,16.77,2.17,25.8,43
NDC,6332328110,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,69.15,44.95,2.17,69.15,57
NDC,6332328260,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,1.41,0.92,0.21,1.41,40
NDC,6332328357,POLOCAINE 1 % (10 MG/ML) INJECTION SOLUTION,1.14,0.74,0.17,8.86,51
NDC,6332328420,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,57.24,37.21,2.17,57.24,51
NDC,6332328503,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328507,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328510,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328513,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328520,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328523,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328561,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.09,8.86,51
NDC,6332328564,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.47,0.96,0.09,8.86,51
NDC,6332328565,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.47,0.96,0.09,8.86,51
NDC,6332328567,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,0.75,0.49,0.09,8.86,51
NDC,6332328600,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.19,1.42,0.09,8.86,51
NDC,6332328605,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.61,1.7,0.09,8.86,51
NDC,6332328623,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.61,1.7,0.09,8.86,51
NDC,6332328695,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.6,0.39,0.09,8.86,51
NDC,6332328720,NAROPIN (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,3.39,2.2,0.09,8.86,51
NDC,6332328721,NAROPIN (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,3.39,2.2,0.09,8.86,51
NDC,6332328803,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.09,8.86,51
NDC,6332328810,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.09,8.86,51
NDC,6332328811,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.09,8.86,51
NDC,6332328821,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.09,8.86,51
NDC,6332328827,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.74,1.13,0.09,8.86,51
NDC,6332328829,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.35,0.88,0.09,8.86,51
NDC,6332329337,POLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,1.8,1.17,0.27,8.86,51
NDC,6332329427,POLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.33,8.86,51
NDC,6332329657,POLOCAINE 2 % INJECTION SOLUTION,1.17,0.76,0.17,8.86,51
NDC,6332330351,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,300.6,195.39,2.17,300.6,51
NDC,6332330355,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,708.75,460.69,2.17,708.75,51
NDC,6332330502,TOBRAMYCIN 10 MG/ML INJECTION SOLUTION,23.01,14.96,2.17,23.01,51
NDC,6332330602,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,6.09,3.96,0.91,8.86,51
NDC,6332330630,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.64,1.72,0.39,8.86,51
NDC,6332330751,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,3.78,2.46,0.56,8.86,51
NDC,6332331461,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,765.0,497.25,2.17,765.0,51
NDC,6332331510,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,350.16,227.6,2.17,350.16,51
NDC,6332332110,POLYMYXIN B SULFATE 500000 UNIT SOLUTION FOR INJECTION,41.01,26.66,6.1,41.01,40
NDC,6332332225,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,107.94,70.16,2.17,107.94,51
NDC,6332332293,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,40.38,26.25,2.17,47.96,51
NDC,6332332620,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,20.88,13.57,1.55,20.88,51
NDC,6332332710,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,53.61,34.85,0.11,53.61,51
NDC,6332332820,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,104.01,67.61,0.11,104.01,51
NDC,6332334020,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,35.64,23.17,1.55,35.64,51
NDC,6332334101,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,22.98,14.94,2.17,22.98,51
NDC,6332334125,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,22.98,14.94,2.17,22.98,51
NDC,6332334225,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,50.25,32.66,2.17,50.25,51
NDC,6332334925,IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,61.53,39.99,2.17,61.53,51
NDC,6332335120,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,550.8,358.02,0.27,550.8,51
NDC,6332335601,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION,1213.2,788.58,2.17,1213.2,51
NDC,6332336001,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,3.6,2.34,0.05,8.86,51
NDC,6332336003,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,1.95,1.27,0.05,8.86,51
NDC,6332336019,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,3.6,2.34,0.05,8.86,51
NDC,6332336059,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,1.95,1.27,0.05,8.86,51
NDC,6332336061,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,1.95,1.27,0.05,8.86,51
NDC,6332336501,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,18.21,11.84,1.17,18.21,51
NDC,6332336601,DIMENHYDRINATE 50 MG/ML INJECTION SOLUTION,47.31,30.75,1.64,47.31,51
NDC,6332336820,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,14.01,9.11,2.08,14.01,51
NDC,6332336920,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,27.75,18.04,2.17,27.75,51
NDC,6332337601,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,35.79,23.26,0.88,35.79,50
NDC,6332337701,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,178.89,116.28,1.17,178.89,51
NDC,6332337805,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,71.55,46.51,1.17,71.55,51
NDC,6332337905,OCTREOTIDE ACETATE 1000 MCG/ML INJECTION SOLUTION,357.75,232.54,1.17,357.75,51
NDC,6332338510,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,87.18,56.67,0.52,87.18,51
NDC,6332338620,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,174.39,113.35,0.52,174.39,51
NDC,6332338910,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,21.24,13.81,1.05,21.24,51
NDC,6332339306,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,100.77,65.5,2.17,100.77,51
NDC,6332339810,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,26.76,17.39,2.17,26.76,51
NDC,6332339812,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,89.85,58.4,2.17,89.85,51
NDC,6332340005,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,2.97,1.93,0.07,8.86,51
NDC,6332340120,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,129.9,84.44,19.33,129.9,40
NDC,6332340201,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,205.92,133.85,2.17,205.92,51
NDC,6332340220,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,205.92,133.85,2.17,205.92,51
NDC,6332340230,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,185.22,120.39,2.17,185.22,51
NDC,6332340302,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,9.84,6.4,1.34,47.96,59
NDC,6332340510,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,7.2,4.68,1.07,47.96,51
NDC,6332340603,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,44.18,28.72,6.57,44.18,40
NDC,6332341605,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,10.08,6.55,1.5,10.08,40
NDC,6332341710,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,6.63,4.31,0.99,6.63,40
NDC,6332341820,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,30.0,19.5,4.46,30.0,40
NDC,6332342410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,28.05,18.23,4.17,28.05,40
NDC,6332343441,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.36,0.23,0.05,8.86,51
NDC,6332345101,MORPHINE 10 MG/ML INJECTION SOLUTION,10.98,7.14,1.63,12.05,51
NDC,6332345201,MORPHINE 2 MG/ML INJECTION SOLUTION,10.32,6.71,1.54,12.05,51
NDC,6332345401,MORPHINE 4 MG/ML INJECTION SOLUTION,10.32,6.71,1.54,12.05,51
NDC,6332345801,MORPHINE 8 MG/ML INJECTION SOLUTION,10.59,6.88,1.58,10.59,51
NDC,6332346037,SENSORCAINE-MPF/EPINEPHRINE 0.75 %-1:200000 INJECTION SOLUTION,1.77,1.15,0.26,1.77,40
NDC,6332346217,SENSORCAINE-MPF/EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,2.82,1.83,0.42,2.82,40
NDC,6332346237,SENSORCAINE-MPF/EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,1.56,1.01,0.23,1.56,40
NDC,6332346357,SENSORCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,1.5,0.98,0.22,1.5,40
NDC,6332346617,SENSORCAINE-MPF 0.5 % (5 MG/ML) INJECTION SOLUTION,2.07,1.35,0.02,8.86,51
NDC,6332346757,SENSORCAINE 0.5 % (5 MG/ML) INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,6332346901,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,101.1,65.72,2.17,101.1,51
NDC,6332347101,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,185.34,120.47,2.17,185.34,51
NDC,6332347401,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,21.57,14.02,1.3,21.57,51
NDC,6332347410,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,20.7,13.46,1.3,20.7,51
NDC,6332347537,NESACAINE 10 MG/ML (1 %) INJECTION SOLUTION,2.16,1.4,0.06,47.96,51
NDC,6332347637,NESACAINE 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.06,47.96,51
NDC,6332347701,NESACAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.38,2.85,0.06,47.96,51
NDC,6332347727,NESACAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.38,2.85,0.06,47.96,51
NDC,6332347827,NESACAINE-MPF 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.06,47.96,51
NDC,6332348157,XYLOCAINE WITH EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,0.66,0.43,0.1,0.66,40
NDC,6332348217,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,1.44,0.94,0.02,8.86,51
NDC,6332348227,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,6332348257,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,0.93,0.6,0.02,8.86,51
NDC,6332348303,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,6332348327,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.02,8.86,51
NDC,6332348357,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,0.75,0.49,0.02,8.86,51
NDC,6332348457,XYLOCAINE 5 MG/ML (0.5 %) INJECTION SOLUTION,0.39,0.25,0.06,0.39,40
NDC,6332348527,XYLOCAINE 10 MG/ML (1 %) INJECTION SOLUTION,0.6,0.39,0.02,8.86,51
NDC,6332348557,XYLOCAINE 10 MG/ML (1 %) INJECTION SOLUTION,0.42,0.27,0.02,8.86,51
NDC,6332348617,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,1.23,0.8,0.02,8.86,51
NDC,6332348627,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,0.6,0.39,0.02,8.86,51
NDC,6332348657,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,0.51,0.33,0.02,8.86,51
NDC,6332348701,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,3.99,2.59,0.02,8.86,51
NDC,6332348717,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,3.99,2.59,0.02,8.86,51
NDC,6332348731,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,1.23,0.8,0.02,8.86,51
NDC,6332348737,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,1.86,1.21,0.02,8.86,51
NDC,6332348817,XYLOCAINE-MPF/EPINEPHRINE 1.5 %-1:200000 INJECTION SOLUTION,3.93,2.55,0.02,8.86,51
NDC,6332348837,XYLOCAINE-MPF/EPINEPHRINE 1.5 %-1:200000 INJECTION SOLUTION,2.13,1.38,0.02,8.86,51
NDC,6332348917,XYLOCAINE-MPF/EPINEPHRINE 2 %-1:200000 INJECTION SOLUTION,4.23,2.75,0.02,8.86,51
NDC,6332348927,XYLOCAINE-MPF/EPINEPHRINE 2 %-1:200000 INJECTION SOLUTION,4.23,2.75,0.02,8.86,51
NDC,6332349157,XYLOCAINE-MPF 5 MG/ML (0.5 %) INJECTION SOLUTION,1.05,0.68,0.02,8.86,51
NDC,6332349204,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,4.02,2.61,0.02,8.86,51
NDC,6332349227,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,4.02,2.61,0.02,8.86,51
NDC,6332349257,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,2.82,1.83,0.02,8.86,51
NDC,6332349297,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,2.13,1.38,0.02,8.86,51
NDC,6332349391,XYLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,2.16,1.4,0.32,2.16,40
NDC,6332349397,XYLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,2.4,1.56,0.36,2.4,40
NDC,6332349401,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,4.83,3.14,0.09,184.43,51
NDC,6332349405,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,4.83,3.14,0.09,184.43,51
NDC,6332349507,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.58,1.68,0.02,8.86,51
NDC,6332349527,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.59,2.98,0.02,8.86,51
NDC,6332349697,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.49,1.62,0.02,8.86,51
NDC,6332350601,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,27.0,17.55,0.2,27.0,51
NDC,6332350720,MEROPENEM 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.68,10.8,51
NDC,6332350830,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,21.24,13.81,0.68,21.24,51
NDC,6332351610,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.58,3.63,0.2,8.86,51
NDC,6332351977,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,8.86,51
NDC,6332352603,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,465.12,302.33,0.6,465.12,65
NDC,6332353075,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332353190,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,71.55,46.51,0.94,71.55,51
NDC,6332353784,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,107.31,69.75,0.94,107.31,51
NDC,6332354011,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,2.61,1.7,0.32,8.86,51
NDC,6332354209,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,31.32,20.36,0.32,31.32,51
NDC,6332354213,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,31.32,20.36,0.32,31.32,51
NDC,6332354214,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,18.48,12.01,0.32,18.48,51
NDC,6332354401,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION,5.79,3.76,0.04,8.86,51
NDC,6332354411,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION,1.2,0.78,0.04,8.86,51
NDC,6332355993,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,33.24,21.61,0.94,33.24,51
NDC,6332356497,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,33.12,21.53,0.94,33.12,51
NDC,6332356621,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,32.22,20.94,0.94,32.22,51
NDC,6332356999,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,54.24,35.26,0.94,54.24,51
NDC,6332357270,CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,704.32,457.81,2.17,1287.79,65
NDC,6332358020,ATROPINE 0.4 MG/ML INJECTION SOLUTION,13.74,8.93,0.23,13.74,51
NDC,6332358282,GLUCAGON (HCL) EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1007.28,654.73,2.17,1007.28,65
NDC,6332358499,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,33.3,21.65,0.94,33.3,51
NDC,6332358696,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,33.54,21.8,0.94,33.54,51
NDC,6332358921,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,50.25,32.66,0.94,50.25,51
NDC,6332358994,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,50.25,32.66,0.94,50.25,51
NDC,6332359303,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,797.94,518.66,2.17,797.94,65
NDC,6332359403,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,540.0,351.0,2.17,540.0,65
NDC,6332359613,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,909.66,591.28,2.17,909.66,65
NDC,6332359710,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,53.13,34.53,2.17,53.13,51
NDC,6332359930,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,148.32,96.41,2.17,148.32,51
NDC,6332360401,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,41.34,26.87,2.17,41.34,51
NDC,6332360584,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,71.58,46.53,0.94,71.58,51
NDC,6332360701,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,71.58,46.53,0.94,71.58,51
NDC,6332360788,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,71.58,46.53,0.94,71.58,51
NDC,6332361400,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,61.35,39.88,2.17,61.35,51
NDC,6332361401,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,61.35,39.88,2.17,61.35,51
NDC,6332361421,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,45.0,29.25,2.17,45.0,51
NDC,6332361455,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,45.0,29.25,2.17,45.0,51
NDC,6332361603,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.4,1.56,0.36,47.96,51
NDC,6332361609,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.19,1.42,0.33,47.96,51
NDC,6332361710,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.91,1.89,0.43,8.86,51
NDC,6332361720,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,3.06,1.99,0.46,8.86,51
NDC,6332361750,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,1.44,0.94,0.21,8.86,51
NDC,6332362376,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332362410,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332362474,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,6332362601,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,40
NDC,6332362603,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,40
NDC,6332363110,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,7.92,5.15,1.18,9.48,43
NDC,6332363150,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,7.77,5.05,1.16,9.48,43
NDC,6332364220,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.62,1.05,0.24,8.86,51
NDC,6332364250,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.68,1.09,0.25,1.68,40
NDC,6332364810,LEVOTHYROXINE 500 MCG INTRAVENOUS POWDER FOR SOLUTION,1900.47,1235.31,2.17,1900.47,51
NDC,6332364907,LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,433.29,281.64,2.17,433.29,51
NDC,6332364916,LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,317.82,206.58,2.17,317.82,51
NDC,6332365102,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,19.71,12.81,0.69,47.96,51
NDC,6332365130,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.28,15.13,0.69,47.96,51
NDC,6332365210,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,6.48,4.21,0.96,6.48,40
NDC,6332365599,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,49.92,32.45,0.94,49.92,51
NDC,6332365820,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,1071.72,696.62,2.17,1071.72,51
NDC,6332365827,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,175.29,113.94,2.17,175.29,51
NDC,6332365903,INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,1904.19,1237.72,283.34,1904.19,40
NDC,6332366401,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,10.83,7.04,1.26,10.83,51
NDC,6332366416,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,2.94,1.91,0.44,8.86,51
NDC,6332366501,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,70.92,46.1,2.17,70.92,51
NDC,6332368810,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,8.86,51
NDC,6332369210,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,5.18,3.37,0.77,5.18,40
NDC,6332369310,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,5.18,3.37,0.77,5.18,40
NDC,6332371100,LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,310.29,201.69,2.17,310.29,43
NDC,6332372303,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,231.51,150.48,34.45,231.51,40
NDC,6332373101,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,21.57,14.02,2.12,21.57,51
NDC,6332373310,MESNA 100 MG/ML INTRAVENOUS SOLUTION,31.84,20.7,2.17,31.84,43
NDC,6332373311,MESNA 100 MG/ML INTRAVENOUS SOLUTION,23.88,15.52,2.17,23.88,43
NDC,6332373410,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,12.69,8.25,1.89,47.96,51
NDC,6332373510,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,38.01,24.71,2.17,47.96,51
NDC,6332373809,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.62,1.05,0.02,47.96,51
NDC,6332373820,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.62,1.05,0.02,47.96,51
NDC,6332373912,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1.62,1.05,0.02,47.96,51
NDC,6332375101,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,11.52,7.49,0.02,11.52,51
NDC,6332376020,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,5513.28,3583.63,2.17,5513.28,65
NDC,6332376210,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,652.96,424.42,2.17,652.96,43
NDC,6332377139,AZACITIDINE 100 MG SOLUTION FOR INJECTION,432.04,280.83,0.62,432.04,51
NDC,6332380811,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,7.95,5.17,1.18,8.86,51
NDC,6332381100,OXACILLIN 10 GRAM SOLUTION FOR INJECTION,420.48,273.31,1.01,420.48,51
NDC,6332381220,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,84.09,54.66,1.01,84.09,51
NDC,6332381320,OXACILLIN 1 GRAM SOLUTION FOR INJECTION,42.06,27.34,1.01,42.06,51
NDC,6332382000,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.87,0.57,0.13,0.87,40
NDC,6332382004,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.42,0.27,0.06,0.42,40
NDC,6332382010,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.24,0.16,0.04,0.24,40
NDC,6332382050,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.27,0.18,0.04,0.27,40
NDC,6332382074,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.42,0.27,0.06,0.42,40
NDC,6332385074,MOXIFLOXACIN 400 MG/250 ML-SODIUM ACETSUL-WATER INTRAVENOUS PIGGYBACK,0.66,0.43,0.1,14.07,51
NDC,6332385150,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,12.24,7.96,0.09,12.24,57
NDC,6332385225,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,15.54,10.1,0.09,15.54,57
NDC,6332385410,HYDROMORPHONE (PF) 4 MG/ML INJECTION SOLUTION,16.14,10.49,0.09,16.14,57
NDC,6332387074,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332387310,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332387374,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6332387715,NEBUPENT 300 MG SOLUTION FOR INHALATION,400.54,260.35,59.6,400.54,40
NDC,6332388330,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,6.4,4.16,0.95,7.57,43
NDC,6332388510,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,63.87,41.52,2.17,130.36,65
NDC,6332388514,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,53.94,35.06,2.17,130.36,65
NDC,6332388656,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,9.9,6.44,1.47,9.9,40
NDC,6332389010,LEVOTHYROXINE 40 MCG/ML INTRAVENOUS SOLUTION,159.63,103.76,2.17,159.63,65
NDC,6332391513,HEPARIN (PORCINE) 20000 UNIT/ML INJECTION SOLUTION,60.33,39.21,0.32,60.33,51
NDC,6332392430,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.54,0.35,0.08,0.54,40
NDC,6332392688,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,15209.52,9886.19,2.17,15209.52,65
NDC,6332396010,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,561.6,365.04,2.17,561.6,51
NDC,6332396502,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.48,0.31,0.07,8.86,51
NDC,6332396503,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.84,0.55,0.12,8.86,51
NDC,6332396510,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.84,0.55,0.12,8.86,51
NDC,6332396520,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.48,0.31,0.07,8.86,51
NDC,6332396600,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,10.8,7.02,1.61,47.96,51
NDC,6332396730,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.48,0.31,0.07,8.86,51
NDC,6336124310,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,1172.58,762.18,7.93,1172.58,51
NDC,6336124315,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1172.58,762.18,7.93,1172.58,51
NDC,6340220430,APTIOM 400 MG TABLET,107.76,70.04,16.03,107.76,40
NDC,6340220660,APTIOM 600 MG TABLET,107.76,70.04,16.03,107.76,40
NDC,6340230230,LATUDA 20 MG TABLET,113.5,73.78,16.89,113.5,40
NDC,6340230430,LATUDA 40 MG TABLET,113.5,73.78,16.89,113.5,40
NDC,6340230830,LATUDA 80 MG TABLET,113.5,73.78,16.89,113.5,40
NDC,6340231230,LATUDA 120 MG TABLET,169.42,110.12,25.21,169.42,40
NDC,6340291101,BROVANA 15 MCG/2 ML SOLUTION FOR NEBULIZATION,22.52,14.64,3.35,22.52,40
NDC,6340291130,BROVANA 15 MCG/2 ML SOLUTION FOR NEBULIZATION,22.52,14.64,3.35,22.52,40
NDC,6345910310,TRUXIMA 10 MG/ML INTRAVENOUS SOLUTION,405.88,263.82,2.17,3257.22,65
NDC,6345910450,TRUXIMA 10 MG/ML INTRAVENOUS SOLUTION,405.88,263.82,2.17,3257.22,65
NDC,6345930343,HERZUMA 150 MG INTRAVENOUS SOLUTION,5235.6,3403.14,2.17,5235.6,65
NDC,6345930547,HERZUMA 420 MG INTRAVENOUS SOLUTION,14659.68,9528.79,2.17,14659.68,65
NDC,6345934804,BENDEKA 25 MG/ML INTRAVENOUS SOLUTION,2968.56,1929.56,2.17,3257.22,65
NDC,6345939008,TREANDA 25 MG INTRAVENOUS POWDER FOR SOLUTION,3566.16,2318.0,2.04,3566.16,65
NDC,6345939120,TREANDA 100 MG INTRAVENOUS POWDER FOR SOLUTION,14264.64,9272.02,2.04,14264.64,65
NDC,6345941230,GABITRIL 12 MG TABLET,36.96,24.02,5.5,36.96,40
NDC,6345950230,ACTIQ 200 MCG LOZENGE ON A HANDLE,209.72,136.32,31.21,209.72,40
NDC,6345950630,ACTIQ 600 MCG LOZENGE ON A HANDLE,325.32,211.46,48.41,325.32,40
NDC,6345954128,FENTORA 100 MCG BUCCAL TABLET EFFERVESCENT,188.76,122.69,28.09,188.76,40
NDC,6345954228,FENTORA 200 MCG BUCCAL TABLET EFFERVESCENT,238.48,155.01,35.49,238.48,40
NDC,6345954428,FENTORA 400 MCG BUCCAL TABLET EFFERVESCENT,346.04,224.93,51.49,346.04,40
NDC,6345991011,GRANIX 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1798.98,1169.34,0.24,1798.98,65
NDC,6345991015,GRANIX 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1799.01,1169.36,0.24,1799.01,65
NDC,6345991211,GRANIX 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1799.49,1169.67,0.24,1799.49,65
NDC,6362987811,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.14,0.09,0.02,0.14,40
NDC,6371301972,SURGIFOAM 12 MM-7 MM SPONGE,13.48,8.76,2.01,13.48,40
NDC,6371301974,SURGIFOAM 100 SPONGE,65.8,42.77,9.79,65.8,40
NDC,6371301975,SURGIFOAM 100 CM SPONGE,65.8,42.77,9.79,65.8,40
NDC,63736003001,NIX CREME RINSE 1 % TOPICAL LIQUID,0.34,0.22,0.05,0.34,40
NDC,6373602403,NIX CREME RINSE 1 % TOPICAL LIQUID,0.34,0.22,0.05,0.34,40
NDC,6373612002,NIX CREME RINSE 1 % TOPICAL LIQUID,0.52,0.34,0.08,0.52,40
NDC,6373612003,NIX CREME RINSE 1 % TOPICAL LIQUID,0.42,0.27,0.06,0.42,40
NDC,6373633942,DERMAREST ECZEMA (HYDROCORTISONE) 1 % LOTION,0.18,0.12,0.03,0.18,40
NDC,6373637882,AMERICAINE 20 % TOPICAL AEROSOL,0.24,0.16,0.04,0.24,40
NDC,6373644101,1-DAY 6.5 % VAGINAL OINTMENT,9.62,6.25,1.43,9.62,40
NDC,6373644860,MONISTAT 3 200 MG-2 % (9 GRAM) VAGINAL KIT,50.58,32.88,7.53,50.58,40
NDC,6373921202,ASPIRIN 81 MG TABLETDELAYED RELEASE,0.12,0.08,0.02,0.12,40
NDC,6373925701,ACETAZOLAMIDE 250 MG TABLET,8.64,5.62,1.29,8.64,40
NDC,6373957010,SIMVASTATIN 5 MG TABLET,0.5,0.33,0.07,0.5,40
NDC,6380710001,SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,0.15,0.1,0.02,0.15,40
NDC,6380750055,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,2.1,1.37,0.04,8.86,51
NDC,6382400815,MUCINEX 600 MG TABLET EXTENDED RELEASE,1.02,0.66,0.15,1.02,40
NDC,6382400850,MUCINEX 600 MG TABLET EXTENDED RELEASE,0.9,0.59,0.13,0.9,40
NDC,6382405632,MUCINEX DM 30 MG-600 MG TABLETEXTENDED RELEASE 12 HR,1.54,1.0,0.23,1.54,40
NDC,6382405634,MUCINEX DM 30 MG-600 MG TABLETEXTENDED RELEASE 12 HR,1.34,0.87,0.2,1.34,40
NDC,6382405640,MUCINEX DM 30 MG-600 MG TABLETEXTENDED RELEASE 12 HR,1.88,1.22,0.28,1.88,40
NDC,6382405718,MUCINEX D 60 MG-600 MG TABLETEXTENDED RELEASE,1.7,1.11,0.25,1.7,40
NDC,6382417563,DELSYM 12 HOUR 30 MG/5 ML ORAL SUSPENSIONEXTENDED RELEASE,0.33,0.21,0.05,0.33,40
NDC,6382417565,DELSYM 12 HOUR 30 MG/5 ML ORAL SUSPENSIONEXTENDED RELEASE,0.25,0.16,0.04,0.25,40
NDC,6382471316,CEPACOL SORE THROAT (BENZOCAINE-MENTHOL) 15 MG-3.6 MG LOZENGES,0.36,0.23,0.05,0.36,40
NDC,6382471516,CEPACOL SORE THROAT (BENZOCAINE-MENTHOL) 15 MG-3.6 MG LOZENGES,0.36,0.23,0.05,0.36,40
NDC,6382473216,CEPACOL SORE THROAT (BENZOCAINE-MENTHOL) 15 MG-2.6 MG LOZENGES,0.36,0.23,0.05,0.36,40
NDC,6383338602,KCENTRA 500 UNIT (400-620 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,3257.22,65
NDC,6383338702,KCENTRA 1000 UNIT (800-1240 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,3257.22,65
NDC,6383361502,HUMATE-P 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.36,4487.68,65
NDC,6383361602,HUMATE-P 500 UNIT-1200 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.36,4487.68,65
NDC,6383361702,HUMATE-P 1000 UNIT-2400 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.36,4487.68,65
NDC,6383382502,BERINERT 500 UNIT (10 ML) INTRAVENOUS KIT,15992.88,10395.37,2.17,15992.88,65
NDC,6383389151,RIASTAP 1 GRAM (900 MG-1300 MG) INTRAVENOUS SOLUTION,5.46,3.55,1.21,4417.71,65
NDC,6406721601,UVADEX 20 MCG/ML INJECTION SOLUTION,302.88,196.87,45.07,302.88,40
NDC,6419342402,FEIBA NF 700 UNIT-1300 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.15,4417.71,65
NDC,6419342502,FEIBA NF 1750 UNIT-3250 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.15,4417.71,65
NDC,6419342602,FEIBA NF 350 UNIT-650 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.15,4417.71,65
NDC,6420877531,COAGADEX 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,40.98,26.64,2.17,16617.81,65
NDC,6425311130,NORMAL SALINE FLUSH 0.9 % INJECTION SYRINGE,1.11,0.72,0.17,1.11,40
NDC,6425322235,HEPARIN PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.42,0.27,0.04,8.86,51
NDC,6425333330,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.24,0.16,0.04,8.86,51
NDC,6425333333,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.81,0.53,0.04,8.86,51
NDC,6425333335,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.48,0.31,0.04,8.86,51
NDC,6425344425,HEPARIN PORCINE (PF) 1 UNIT/ML INTRAVENOUS SYRINGE,0.72,0.47,0.11,0.72,40
NDC,6428110000,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,218.4,141.96,2.17,218.4,51
NDC,6428110006,PROVOCHOLINE 100 MG SOLUTION FOR INHALATION,218.4,141.96,2.17,218.4,51
NDC,6428111006,PROVOCHOLINE 0 TO 48 MG/3 ML SOLUTION FOR NEBULIZATION,18.0,11.7,2.17,47.96,51
NDC,6438016001,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,1.5,0.98,0.22,1.5,40
NDC,6438017202,OLANZAPINE 5 MG DISINTEGRATING TABLET,28.54,18.55,4.25,28.54,40
NDC,6438017302,OLANZAPINE 10 MG DISINTEGRATING TABLET,41.94,27.26,6.24,41.94,40
NDC,6438018401,PROPAFENONE ER 225 MG CAPSULEEXTENDED RELEASE 12 HR,15.78,10.26,2.35,15.78,40
NDC,6438018601,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,2.98,20.0,40
NDC,6438071003,LAMIVUDINE 150 MG TABLET,14.3,9.3,2.13,14.3,40
NDC,6438072406,CALCITRIOL 0.5 MCG CAPSULE,3.86,2.51,0.57,3.86,40
NDC,6438074206,BUSPIRONE 10 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,6438075806,ACARBOSE 25 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,6438075906,ACARBOSE 50 MG TABLET,1.94,1.26,0.29,1.94,40
NDC,6438078206,PREDNISONE 1 MG TABLET,0.5,0.33,0.02,8.86,51
NDC,6438078932,LIDOCAINE 5 % TOPICAL OINTMENT,17.88,11.62,2.66,17.88,40
NDC,6438078933,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.27,15.24,40
NDC,6438087806,ETHOSUXIMIDE 250 MG CAPSULE,5.58,3.63,0.83,5.58,40
NDC,6438091906,URSODIOL 500 MG TABLET,9.5,6.18,1.41,9.5,40
NDC,6440600801,TYSABRI 300 MG/15 ML INTRAVENOUS SOLUTION,2131.02,1385.16,2.17,4417.71,65
NDC,6440601901,BYOOVIZ 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,83800.8,54470.52,60.21,83800.8,65
NDC,6440602201,TOFIDENCE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,720.96,65
NDC,6440602301,TOFIDENCE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,720.96,65
NDC,6440602401,TOFIDENCE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,720.96,65
NDC,6440605801,SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION,105335.25,68467.91,2.17,105335.25,65
NDC,6440610901,QALSODY 100 MG/15 ML (6.7 MG/ML) INTRATHECAL SOLUTION,3623.19,2355.07,2.17,13108.79,65
NDC,6467969902,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,87.0,56.55,1.01,87.0,51
NDC,6476408060,AMITIZA 8 MCG CAPSULE,14.84,9.65,2.21,14.84,40
NDC,6476413001,ADZYNMA 500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,2.17,105.08,65
NDC,6476414005,ADZYNMA 500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,2.17,105.08,65
NDC,6476414505,ADZYNMA 1500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,2.17,105.08,65
NDC,6476415104,ACTOS 15 MG TABLET,31.08,20.2,4.62,31.08,40
NDC,6476430020,ENTYVIO 300 MG INTRAVENOUS SOLUTION,36391.32,23654.36,2.17,36391.32,65
NDC,6476430114,ACTOS 30 MG TABLET,47.5,30.88,7.07,47.5,40
NDC,6476445124,ACTOS 45 MG TABLET,51.52,33.49,7.67,51.52,40
NDC,6476454311,PREVACID SOLUTAB 15 MG DELAYED RELEASEDISINTEGRATING TABLET,33.2,21.58,4.94,33.2,40
NDC,6476454411,PREVACID SOLUTAB 30 MG DELAYED RELEASEDISINTEGRATING TABLET,33.2,21.58,4.94,33.2,40
NDC,6476472030,TRINTELLIX 5 MG TABLET,43.18,28.07,6.43,43.18,40
NDC,6476473030,TRINTELLIX 10 MG TABLET,43.18,28.07,6.43,43.18,40
NDC,6476475030,TRINTELLIX 20 MG TABLET,43.18,28.07,6.43,43.18,40
NDC,6476480028,LIVTENCITY 200 MG TABLET,549.58,357.23,81.78,549.58,40
NDC,6476480530,ROZEREM 8 MG TABLET,31.12,20.23,4.63,31.12,40
NDC,6476491830,ULORIC 40 MG TABLET,26.4,17.16,3.93,26.4,40
NDC,6484207279,INQOVI 35 MG-100 MG TABLET,4163.94,2706.56,619.59,4163.94,40
NDC,6484210201,LONSURF 20 MG-8.19 MG TABLET,697.72,453.52,103.82,697.72,40
NDC,6484210251,LONSURF 15 MG-6.14 MG TABLET,523.3,340.15,77.87,523.3,40
NDC,6485091101,ISRADIPINE 5 MG CAPSULE,8.3,5.4,1.24,8.3,40
NDC,6487500101,MIFEPREX 200 MG TABLET,103.2,67.08,15.36,103.2,40
NDC,6489666101,RYTARY 23.75 MG-95 MG CAPSULEEXTENDED RELEASE,9.98,6.49,1.49,9.98,40
NDC,6489666201,RYTARY 36.25 MG-145 MG CAPSULEEXTENDED RELEASE,9.98,6.49,1.49,9.98,40
NDC,6489666301,RYTARY 48.75 MG-195 MG CAPSULEEXTENDED RELEASE,9.98,6.49,1.49,9.98,40
NDC,6489666401,RYTARY 61.25 MG-245 MG CAPSULEEXTENDED RELEASE,12.54,8.15,1.87,12.54,40
NDC,6489669501,OXYMORPHONE ER 5 MG TABLETEXTENDED RELEASE12 HR,12.66,8.23,1.88,12.66,40
NDC,6489696716,CREXONT 35 MG-140 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.63,10.96,40
NDC,6489696816,CREXONT 52.5 MG-210 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.63,10.96,40
NDC,6489696916,CREXONT 70 MG-280 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.63,10.96,40
NDC,6489697016,CREXONT 87.5 MG-350 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.63,10.96,40
NDC,6495034245,HYCODAN 5 MG-1.5 MG/5 ML (5 ML) ORAL SOLUTION,5.85,3.8,0.87,5.85,40
NDC,6495034316,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,1.25,0.81,0.19,1.25,40
NDC,6495037147,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,40
NDC,6495037416,ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ORAL SOLUTION,0.99,0.64,0.15,0.99,40
NDC,6498010401,PHOSPHA NEUTRAL 250 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,6498013301,DIPYRIDAMOLE 25 MG TABLET,2.84,1.85,0.42,2.84,40
NDC,6498013401,DIPYRIDAMOLE 50 MG TABLET,4.58,2.98,0.68,4.58,40
NDC,6498013501,DIPYRIDAMOLE 75 MG TABLET,6.12,3.98,0.91,6.12,40
NDC,6498014612,FLORANEX 100 MILLION CELL ORAL GRANULES IN PACKET,4.06,2.64,0.6,4.06,40
NDC,6498017750,CHLOROQUINE 250 MG TABLET,18.38,11.95,2.73,18.38,40
NDC,6498017802,CHLOROQUINE 500 MG TABLET,47.7,31.01,7.1,47.7,40
NDC,6498020612,ZILEUTON ER 600 MG TABLETEXTENDED RELEASE 12HR MPHASE,64.44,41.89,9.59,64.44,40
NDC,6498022003,PYRIDOSTIGMINE BROMIDE ER 180 MG TABLETEXTENDED RELEASE,49.62,32.25,7.38,49.62,40
NDC,6498029001,PERPHENAZINE 2 MG TABLET,3.5,2.28,0.52,3.5,40
NDC,6498030130,PROCTOZONE-HC 2.5 % TOPICAL CREAM PERINEAL APPLICATOR,5.82,3.78,0.87,5.82,40
NDC,6498030401,CHLORTHALIDONE 50 MG TABLET,2.98,1.94,0.44,2.98,40
NDC,6498032005,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,32.24,20.96,4.8,32.24,40
NDC,6498032212,RISAMINE 0.44 %-20.6 % TOPICAL OINTMENT,0.08,0.05,0.01,0.08,40
NDC,6498033901,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.3,0.2,0.04,0.3,40
NDC,6498034003,ALENDRONATE 10 MG TABLET,5.86,3.81,0.87,5.86,40
NDC,6498034214,ALENDRONATE 70 MG TABLET,40.96,26.62,6.09,40.96,40
NDC,6498037503,ATOMOXETINE 25 MG CAPSULE,28.46,18.5,4.23,28.46,40
NDC,6498037603,ATOMOXETINE 40 MG CAPSULE,30.94,20.11,4.6,30.94,40
NDC,6498037703,ATOMOXETINE 60 MG CAPSULE,30.94,20.11,4.6,30.94,40
NDC,6498037903,ATOMOXETINE 100 MG CAPSULE,33.38,21.7,4.97,33.38,40
NDC,6498040524,ABACAVIR 20 MG/ML ORAL SOLUTION,1.63,1.06,0.24,1.63,40
NDC,6498040906,SERTRALINE 20 MG/ML ORAL CONCENTRATE,2.8,1.82,0.42,2.8,40
NDC,6498042712,TINIDAZOLE 500 MG TABLET,16.92,11.0,2.52,16.92,40
NDC,6498050312,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,0.98,0.64,0.15,0.98,40
NDC,6498050448,CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,0.35,0.23,0.05,0.35,40
NDC,6498050924,DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR,0.68,0.44,0.1,0.68,40
NDC,6498051301,TIMOLOL MALEATE 0.25 % EYE DROPS,5.56,3.61,0.83,5.56,40
NDC,6498051305,TIMOLOL MALEATE 0.25 % EYE DROPS,6.0,3.9,0.89,6.0,40
NDC,6498051401,TIMOLOL MALEATE 0.5 % EYE DROPS,6.48,4.21,0.96,6.48,40
NDC,6498051415,TIMOLOL MALEATE 0.5 % EYE DROPS,6.5,4.23,0.97,6.5,40
NDC,6498051501,OFLOXACIN 0.3 % EYE DROPS,27.14,17.64,4.04,27.14,40
NDC,6498051505,OFLOXACIN 0.3 % EYE DROPS,28.14,18.29,4.19,28.14,40
NDC,6498052660,NITAZOXANIDE 500 MG TABLET,330.42,214.77,49.17,330.42,40
NDC,6498058851,EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,4676.13,3039.48,2.17,18396.77,65
NDC,6498059324,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,36.53,23.74,5.44,36.53,40
NDC,6504450521,ALLERGENIC EXTRACT-CANDIDA ALBICANS 1:10 INJECTION SOLUTION,92.7,60.26,13.79,92.7,43
NDC,6504499981,POSITIVE SKIN TEST CONTROL-HISTAMINE 10 MG/ML INTRADERMAL SOLUTION,197.88,128.62,29.44,197.88,40
NDC,6516208774,ITRACONAZOLE 10 MG/ML ORAL SOLUTION,6.13,3.98,0.91,6.13,40
NDC,6516218810,NAPROXEN 250 MG TABLET,1.54,1.0,0.23,1.54,40
NDC,6516228003,PALIPERIDONE ER 1.5 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,9.11,61.2,40
NDC,6516228103,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,9.11,61.2,40
NDC,6516228203,PALIPERIDONE ER 6 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,9.11,61.2,40
NDC,6516228303,PALIPERIDONE ER 9 MG TABLETEXTENDED RELEASE 24 HR,91.78,59.66,13.66,91.78,40
NDC,6516246410,IBUPROFEN 400 MG TABLET,0.78,0.51,0.12,0.78,40
NDC,6516247505,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.79,5.3,40
NDC,6516251210,SALSALATE 500 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,6516251310,SALSALATE 750 MG TABLET,5.6,3.64,0.83,5.6,40
NDC,6516255410,DEMECLOCYCLINE 150 MG TABLET,18.8,12.22,2.8,18.8,40
NDC,6516255548,DEMECLOCYCLINE 300 MG TABLET,34.14,22.19,5.08,34.14,40
NDC,6516257410,BETHANECHOL CHLORIDE 50 MG TABLET,6.86,4.46,1.02,6.86,40
NDC,6516259606,ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULEEXT.RELEASE 12 HR MULTIPHASE,16.72,10.87,2.49,16.72,40
NDC,6516264978,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,2.73,1.77,0.41,2.73,40
NDC,6516267384,RISPERIDONE 1 MG/ML ORAL SOLUTION,12.7,8.26,1.89,12.7,40
NDC,6516267684,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,9.7,6.31,1.44,9.7,40
NDC,6516268110,PHENAZOPYRIDINE 100 MG TABLET,5.4,3.51,0.8,5.4,40
NDC,6516268210,PHENAZOPYRIDINE 200 MG TABLET,8.0,5.2,1.19,8.0,40
NDC,6516269179,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,12.0,7.8,1.79,12.0,40
NDC,6516269388,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,16.4,10.66,2.44,16.4,40
NDC,6516273509,FELBAMATE 600 MG TABLET,11.96,7.77,1.78,11.96,40
NDC,6516274934,RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.03,33.8,40
NDC,6516276110,WARFARIN 1 MG TABLET,1.16,0.75,0.17,1.16,40
NDC,6516276210,WARFARIN 2 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,6516276310,WARFARIN 2.5 MG TABLET,1.26,0.82,0.19,1.26,40
NDC,6516276410,WARFARIN 3 MG TABLET,1.32,0.86,0.2,1.32,40
NDC,6516276510,WARFARIN 4 MG TABLET,1.32,0.86,0.2,1.32,40
NDC,6516276610,WARFARIN 5 MG TABLET,1.34,0.87,0.2,1.34,40
NDC,6516276710,WARFARIN 6 MG TABLET,1.84,1.2,0.27,1.84,40
NDC,6516276810,WARFARIN 7.5 MG TABLET,1.92,1.25,0.29,1.92,40
NDC,6516276910,WARFARIN 10 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,6516278303,MEMANTINE 14 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,4.54,30.52,40
NDC,6516278403,MEMANTINE 21 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,4.54,30.52,40
NDC,6516278503,MEMANTINE 28 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,4.54,30.52,40
NDC,6516278509,MEMANTINE 28 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,4.54,30.52,40
NDC,6516280114,TEMOZOLOMIDE 5 MG CAPSULE,28.92,18.8,0.32,28.92,50
NDC,6516280151,TEMOZOLOMIDE 5 MG CAPSULE,28.58,18.58,0.32,28.58,50
NDC,6516280214,TEMOZOLOMIDE 20 MG CAPSULE,115.1,74.82,0.32,115.1,50
NDC,6516280251,TEMOZOLOMIDE 20 MG CAPSULE,115.12,74.83,0.32,115.12,50
NDC,6516280551,TEMOZOLOMIDE 180 MG CAPSULE,1035.94,673.36,0.58,1035.94,51
NDC,6516289703,ARIPIPRAZOLE 5 MG TABLET,64.16,41.7,9.55,64.16,40
NDC,6516291446,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,56.54,36.75,8.41,56.54,40
NDC,6516291838,LIDOCAINE 5 % TOPICAL OINTMENT,16.94,11.01,2.52,16.94,40
NDC,6516291853,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.27,15.24,40
NDC,6517427030,DRAXIMAGE MAA 2.5 MG INTRAVENOUS SOLUTION,1092.0,709.8,0.01,1092.0,45
NDC,6517428801,DRAXIMAGE DTPA 20 MG INTRAVENOUS SOLUTION,426.0,276.9,0.01,426.0,45
NDC,6517446105,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE,180.0,117.0,0.01,203.07,45
NDC,6517466030,DRAXIMAGE MDP-25 25 MG INTRAVENOUS SOLUTION,56.0,36.4,0.01,127.26,45
NDC,6517488025,HICON 250 MCI/0.25 ML ORAL KIT,675.95,439.37,100.58,675.95,39
NDC,6519740010,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.16,0.1,0.02,0.16,40
NDC,6519740101,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.1,0.07,0.01,0.1,40
NDC,6521905229,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,17.28,11.23,2.57,17.28,40
NDC,6521905429,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,11.52,7.49,1.71,11.52,40
NDC,6521911810,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,8.86,51
NDC,6521912012,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6404.4,4162.86,2.17,6404.4,65
NDC,6521914404,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,6521914410,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,6521915075,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,6521915175,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,40
NDC,6521925600,PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,528.36,343.43,1.94,528.36,51
NDC,6521929510,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,72.0,46.8,2.17,184.43,57
NDC,6521938302,IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.27,2.13,0.01,22.96,49
NDC,6521945830,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,43
NDC,6521947030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,8.86,51
NDC,6521947410,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.86,51
NDC,6521953110,INTRALIPID 20 % INTRAVENOUS EMULSION,1.14,0.74,0.17,1.14,40
NDC,6521953325,INTRALIPID 20 % INTRAVENOUS EMULSION,0.69,0.45,0.1,0.69,40
NDC,6521953550,INTRALIPID 20 % INTRAVENOUS EMULSION,0.3,0.2,0.04,0.3,40
NDC,6521955001,PRALATREXATE 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,23913.44,15543.74,2.17,23913.44,65
NDC,6521955202,PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION,23913.44,15543.74,2.17,23913.44,65
NDC,6521959004,TYENNE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,65
NDC,6521959210,TYENNE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,65
NDC,6521959420,TYENNE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,65
NDC,6521959810,TYENNE 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,4072.68,2647.24,4.19,4072.68,65
NDC,6521962210,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,5.52,3.59,0.11,8.86,51
NDC,6521962420,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,5.16,3.35,0.11,8.86,51
NDC,6521966801,CONEXXENCE 60 MG/ML SUBCUTANEOUS SYRINGE,6549.0,4256.85,28.72,6549.0,59
NDC,6521967001,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7086.18,4606.02,28.72,7086.18,59
NDC,6521967201,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SYRINGE,7086.18,4606.02,41.42,7086.18,51
NDC,6521982805,OTULFI 130 MG/26 ML INTRAVENOUS SOLUTION,233.4,151.71,32.95,4487.68,59
NDC,6525013309,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,91.2,59.28,1.32,91.2,65
NDC,6525026609,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,56.7,36.86,1.32,56.7,65
NDC,6525026620,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,75.36,48.98,1.32,75.36,65
NDC,6559740601,ENHERTU 100 MG INTRAVENOUS SOLUTION,14815.04,9629.78,2.17,14815.04,65
NDC,6559740720,TURALIO 125 MG CAPSULE,494.32,321.31,73.55,494.32,40
NDC,6559750428,VANFLYTA 17.7 MG TABLET,1402.24,911.46,208.65,1402.24,40
NDC,6559751128,VANFLYTA 26.5 MG TABLET,1402.24,911.46,208.65,1402.24,40
NDC,6559780101,DATROWAY 100 MG INTRAVENOUS SOLUTION,23477.12,15260.13,2.17,23477.12,59
NDC,6564920175,MOVIPREP 100 GRAM-7.5 GRAM-2.691 GRAM ORAL POWDER PACKET,377.65,245.47,56.19,377.65,40
NDC,6564930103,XIFAXAN 200 MG TABLET,28.56,18.56,4.25,28.56,40
NDC,6564930302,XIFAXAN 550 MG TABLET,146.84,95.45,21.85,146.84,40
NDC,6564930303,XIFAXAN 550 MG TABLET,146.84,95.45,21.85,146.84,40
NDC,6564931112,DIURIL 250 MG/5 ML ORAL SUSPENSION,0.95,0.62,0.14,0.95,40
NDC,6564940130,ANUSOL-HC 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,14.22,9.24,2.12,14.22,40
NDC,6564955102,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,1120.5,728.33,2.17,1120.5,51
NDC,6564955103,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,1120.5,728.33,2.17,1120.5,51
NDC,6564955107,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,1120.5,728.33,2.17,1120.5,51
NDC,6564955204,RELISTOR 8 MG/0.4 ML SUBCUTANEOUS SYRINGE,1680.75,1092.49,2.17,1680.75,51
NDC,6570212810,COAGUCHEK XS STRIPS,16.0,10.4,2.38,16.0,39
NDC,6575730001,VIVITROL 380 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,6085.23,3955.4,2.17,6085.23,65
NDC,6575740103,ARISTADA 441 MG/1.6 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.17,3579.75,65
NDC,6575740203,ARISTADA 662 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3582.48,2328.61,2.17,3582.48,65
NDC,6575740303,ARISTADA 882 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.17,3579.75,65
NDC,6575740403,ARISTADA 1064 MG/3.9 ML SUSPENSION EXTEND.REL. IM SYRINGE,3543.33,2303.16,2.17,3543.33,65
NDC,6575750003,ARISTADA INITIO 675 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3652.83,2374.34,2.17,3652.83,65
NDC,6585715030,FLUDEOXYGLUCOSE F-18 20 MCI TO 500 MCI/ML INTRAVENOUS SOLUTION,250.0,162.5,0.01,897.82,45
NDC,6586201105,SERTRALINE 25 MG TABLET,5.7,3.71,0.85,5.7,40
NDC,6586201130,SERTRALINE 25 MG TABLET,5.7,3.71,0.85,5.7,40
NDC,6586201330,SERTRALINE 100 MG TABLET,5.7,3.71,0.85,5.7,40
NDC,6586201501,AMOXICILLIN 875 MG TABLET,1.74,1.13,0.26,1.74,40
NDC,6586202106,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,4.72,3.07,0.7,4.72,40
NDC,6586202206,MIRTAZAPINE 30 MG DISINTEGRATING TABLET,4.86,3.16,0.72,4.86,40
NDC,6586202460,ZIDOVUDINE 300 MG TABLET,12.04,7.83,1.79,12.04,40
NDC,6586202801,GLYBURIDE 1.25 MG TABLET,0.56,0.36,0.08,0.56,40
NDC,6586203001,GLYBURIDE 5 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,6586204824,ZIDOVUDINE 10 MG/ML ORAL SYRUP,0.6,0.39,0.09,0.6,40
NDC,6586204930,EFAVIRENZ 600 MG TABLET,74.52,48.44,11.09,74.52,40
NDC,6586205724,NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,1.98,1.29,0.29,1.98,40
NDC,6586207150,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,40
NDC,6586207360,ABACAVIR 300 MG TABLET,20.1,13.07,2.99,20.1,40
NDC,6586207601,CIPROFLOXACIN 250 MG TABLET,9.16,5.95,1.36,9.16,40
NDC,6586207930,TERBINAFINE HCL 250 MG TABLET,25.58,16.63,3.81,25.58,40
NDC,6586210701,ZIDOVUDINE 100 MG CAPSULE,4.04,2.63,0.6,4.04,40
NDC,6586214636,SUMATRIPTAN 25 MG TABLET,54.1,35.17,8.05,54.1,40
NDC,6586214736,SUMATRIPTAN 50 MG TABLET,50.28,32.68,7.48,50.28,40
NDC,6586214836,SUMATRIPTAN 100 MG TABLET,50.28,32.68,7.48,50.28,40
NDC,6586216001,ZOLPIDEM 10 MG TABLET,10.28,6.68,1.53,10.28,40
NDC,6586220768,RIBAVIRIN 200 MG TABLET,16.54,10.75,2.46,16.54,40
NDC,6586221150,MINOCYCLINE 100 MG CAPSULE,6.8,4.42,1.01,6.8,40
NDC,6586221801,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,2.03,1.32,0.3,2.03,40
NDC,6586221860,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,2.13,1.38,0.32,2.13,40
NDC,6586229084,RIBAVIRIN 200 MG CAPSULE,19.06,12.39,2.84,19.06,40
NDC,6586239010,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.58,28.98,6.63,44.58,40
NDC,6586242001,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,2.3,1.5,0.34,2.3,40
NDC,6586244890,VALACYCLOVIR 500 MG TABLET,14.14,9.19,2.1,14.14,40
NDC,6586245860,GALANTAMINE 4 MG TABLET,6.36,4.13,0.95,6.36,40
NDC,6586245960,GALANTAMINE 8 MG TABLET,6.36,4.13,0.95,6.36,40
NDC,6586246060,GALANTAMINE 12 MG TABLET,6.36,4.13,0.95,6.36,40
NDC,6586247401,RAMIPRIL 1.25 MG CAPSULE,3.06,1.99,0.46,3.06,40
NDC,6586247501,RAMIPRIL 2.5 MG CAPSULE,3.62,2.35,0.54,3.62,40
NDC,6586247601,RAMIPRIL 5 MG CAPSULE,3.8,2.47,0.57,3.8,40
NDC,6586247701,RAMIPRIL 10 MG CAPSULE,4.44,2.89,0.66,4.44,40
NDC,6586249647,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,1.15,0.75,0.17,1.15,40
NDC,6586250220,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,7.58,4.93,1.13,7.58,40
NDC,6586250320,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,10.14,6.59,1.51,10.14,40
NDC,6586252730,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,8.32,5.41,1.24,8.32,40
NDC,6586252790,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,8.32,5.41,1.24,8.32,40
NDC,6586252830,VENLAFAXINE ER 75 MG CAPSULEEXTENDED RELEASE 24 HR,9.34,6.07,1.39,9.34,40
NDC,6586253350,AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSION,0.93,0.6,0.14,0.93,40
NDC,6586253401,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.73,1.12,0.26,1.73,40
NDC,6586253450,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.75,1.14,0.26,1.75,40
NDC,6586253475,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.55,1.01,0.23,1.55,40
NDC,6586253650,LEVOFLOXACIN 250 MG TABLET,33.62,21.85,5.0,33.62,40
NDC,6586253750,LEVOFLOXACIN 500 MG TABLET,38.54,25.05,5.73,38.54,40
NDC,6586253820,LEVOFLOXACIN 750 MG TABLET,72.16,46.9,10.74,72.16,40
NDC,6586257290,VALSARTAN 160 MG TABLET,10.0,6.5,1.49,10.0,40
NDC,6586259601,CLINDAMYCIN PEDIATRIC 75 MG/5 ML ORAL SOLUTION,1.55,1.01,0.23,1.55,40
NDC,6586259602,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,1.55,1.01,0.23,1.55,40
NDC,6586264169,AZITHROMYCIN 250 MG TABLET,15.56,10.11,2.32,15.56,40
NDC,6586264290,AZITHROMYCIN 500 MG TABLET,31.14,20.24,4.63,31.14,40
NDC,6586265401,ENTACAPONE 200 MG TABLET,9.08,5.9,1.35,9.08,40
NDC,6586266630,ARIPIPRAZOLE 30 MG TABLET,90.82,59.03,13.51,90.82,40
NDC,6586267001,REPAGLINIDE 0.5 MG TABLET,6.66,4.33,0.99,6.66,40
NDC,6586267201,REPAGLINIDE 2 MG TABLET,7.32,4.76,1.09,7.32,40
NDC,6586267801,ALPRAZOLAM 1 MG TABLET,2.32,1.51,0.35,2.32,40
NDC,6586268730,RITONAVIR 100 MG TABLET,18.52,12.04,2.76,18.52,40
NDC,6586270060,CEFUROXIME AXETIL 500 MG TABLET,16.0,10.4,2.38,16.0,40
NDC,6586270260,ZIPRASIDONE 20 MG CAPSULE,17.92,11.65,2.67,17.92,40
NDC,6586270360,ZIPRASIDONE 40 MG CAPSULE,17.92,11.65,2.67,17.92,40
NDC,6586270655,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,40
NDC,6586270680,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.01,0.1,40
NDC,6586271160,ATAZANAVIR 150 MG CAPSULE,55.6,36.14,8.27,55.6,40
NDC,6586271260,ATAZANAVIR 200 MG CAPSULE,55.6,36.14,8.27,55.6,40
NDC,6586273205,AMIODARONE 200 MG TABLET,6.76,4.39,1.01,6.76,40
NDC,6586273260,AMIODARONE 200 MG TABLET,6.76,4.39,1.01,6.76,40
NDC,6586276590,PREGABALIN 300 MG CAPSULE,16.86,10.96,2.51,16.86,40
NDC,6586276990,FENOFIBRATE NANOCRYSTALLIZED 145 MG TABLET,11.46,7.45,1.71,11.46,40
NDC,6586278201,METHENAMINE HIPPURATE 1 GRAM TABLET,4.18,2.72,0.62,4.18,40
NDC,6586282930,PRASUGREL HCL 5 MG TABLET,33.02,21.46,4.91,33.02,40
NDC,6586283030,PRASUGREL HCL 10 MG TABLET,33.02,21.46,4.91,33.02,40
NDC,6586284401,CLOZAPINE 25 MG TABLET,2.64,1.72,0.39,2.64,40
NDC,6586284601,CLOZAPINE 100 MG TABLET,6.86,4.46,1.02,6.86,40
NDC,6586292127,SEVELAMER CARBONATE 800 MG TABLET,12.2,7.93,1.82,12.2,40
NDC,6586292730,FINASTERIDE 1 MG TABLET,5.42,3.52,0.81,5.42,40
NDC,6586292790,FINASTERIDE 1 MG TABLET,4.88,3.17,0.73,4.88,40
NDC,6586293008,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,36.58,23.78,5.44,36.58,40
NDC,6586293090,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,36.58,23.78,5.44,36.58,40
NDC,6586293108,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,36.58,23.78,5.44,36.58,40
NDC,6586293190,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,36.58,23.78,5.44,36.58,40
NDC,6586298601,POTASSIUM CHLORIDE ER 8 MEQ TABLETEXTENDED RELEASE,1.08,0.7,0.16,1.08,40
NDC,6597610024,ARESTIN 1 MG DENTAL CARTRIDGE,99.15,64.45,14.75,99.15,40
NDC,6601911210,FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE,61.06,39.69,7.93,62.69,51
NDC,6621510103,TRACLEER 62.5 MG TABLET,536.56,348.76,79.84,536.56,40
NDC,6621510206,TRACLEER 125 MG TABLET,536.56,348.76,79.84,536.56,40
NDC,6621540201,VELETRI 1.5 MG INTRAVENOUS SOLUTION,198.93,129.3,2.17,198.93,43
NDC,6621540301,VELETRI 0.5 MG INTRAVENOUS SOLUTION,99.48,64.66,2.17,99.48,43
NDC,6621550115,OPSUMIT 10 MG TABLET,1036.4,673.66,154.22,1036.4,40
NDC,6621550130,OPSUMIT 10 MG TABLET,1036.4,673.66,154.22,1036.4,40
NDC,6621560206,UPTRAVI 200 MCG TABLET,613.94,399.06,91.35,613.94,40
NDC,6621560806,UPTRAVI 800 MCG TABLET,954.76,620.59,142.07,954.76,40
NDC,6621561606,UPTRAVI 1600 MCG TABLET,954.76,620.59,142.07,954.76,40
NDC,6622016010,VAPRISOL IN 5 % DEXTROSE 20 MG/100 ML INTRAVENOUS SOLUTION,33.42,21.72,2.17,667.03,51
NDC,6622071930,KRISTALOSE 10 GRAM ORAL PACKET,24.48,15.91,3.64,24.48,40
NDC,6622072930,KRISTALOSE 20 GRAM ORAL PACKET,31.73,20.62,4.72,31.73,40
NDC,6628871001,VANCOMYCIN 100 GRAM SOLUTION FOR INJECTION,1440.0,936.0,0.05,1440.0,51
NDC,6629800456,COPPER CITRATE 2 MG CAPSULE,0.18,0.12,0.03,0.18,40
NDC,6630201401,UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION,20095.64,13062.17,2.17,20095.64,43
NDC,6630210101,REMODULIN 1 MG/ML INJECTION SOLUTION,229.2,148.98,2.17,667.03,65
NDC,6630210201,REMODULIN 2.5 MG/ML INJECTION SOLUTION,573.0,372.45,2.17,667.03,65
NDC,6630210501,REMODULIN 5 MG/ML INJECTION SOLUTION,1146.0,744.9,2.17,1146.0,65
NDC,6630211001,REMODULIN 10 MG/ML INJECTION SOLUTION,2291.97,1489.78,2.17,2291.97,65
NDC,6630220603,TYVASO 1.74 MG/2.9 ML (0.6 MG/ML) SOLUTION FOR NEBULIZATION,692.98,450.44,103.12,692.98,40
NDC,6630230002,ORENITRAM 0.125 MG TABLETEXTENDED RELEASE,18.34,11.92,2.73,18.34,40
NDC,6630230201,ORENITRAM 0.25 MG TABLETEXTENDED RELEASE,36.66,23.83,5.46,36.66,40
NDC,6630231001,ORENITRAM 1 MG TABLETEXTENDED RELEASE,146.66,95.33,21.82,146.66,40
NDC,6630231002,ORENITRAM 1 MG TABLETEXTENDED RELEASE,146.66,95.33,21.82,146.66,40
NDC,6630232501,ORENITRAM 2.5 MG TABLETEXTENDED RELEASE,366.66,238.33,54.56,366.66,40
NDC,6630246760,ADCIRCA 20 MG TABLET,166.8,108.42,24.82,166.8,40
NDC,6630261601,TYVASO DPI 16 MCG CARTRIDGE WITH INHALER,542.42,352.57,80.71,542.42,40
NDC,6630263201,TYVASO DPI 32 MCG CARTRIDGE WITH INHALER,224.0,145.6,33.33,224.0,40
NDC,6630264801,TYVASO DPI 48 MCG CARTRIDGE WITH INHALER,224.0,145.6,33.33,224.0,40
NDC,6630266401,TYVASO DPI 64 MCG CARTRIDGE WITH INHALER,542.42,352.57,80.71,542.42,40
NDC,6630271604,TYVASO DPI 16 MCG CARTRIDGE WITH INHALER,542.76,352.79,80.76,542.76,40
NDC,6630273204,TYVASO DPI 32 MCG CARTRIDGE WITH INHALER,542.76,352.79,80.76,542.76,40
NDC,6630274804,TYVASO DPI 48 MCG CARTRIDGE WITH INHALER,542.76,352.79,80.76,542.76,43
NDC,6630276404,TYVASO DPI 64 MCG CARTRIDGE WITH INHALER,542.76,352.79,80.76,542.76,40
NDC,6631217616,XYLOCAINE DENTAL WITH EPINEPHRINE 2 %-1:100000 INJECTION CARTRIDGE,1.8,1.17,0.27,1.8,40
NDC,6655300101,ASPIRIN 325 MG TABLET,0.12,0.08,0.02,0.12,40
NDC,6655300201,CHILDREN'S ASPIRIN 81 MG CHEWABLE TABLET,0.12,0.08,0.02,0.12,40
NDC,6655300401,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.14,0.09,0.02,0.14,40
NDC,6665820490,ORFADIN 4 MG/ML ORAL SUSPENSION,356.38,231.65,53.03,356.38,40
NDC,6665823407,KINERET 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,1211.28,787.33,180.24,1211.28,40
NDC,6665850101,GAMIFANT 5 MG/ML INTRAVENOUS SOLUTION,6679.8,4341.87,2.17,16617.81,65
NDC,6665850501,GAMIFANT 5 MG/ML INTRAVENOUS SOLUTION,6679.8,4341.87,2.17,16617.81,65
NDC,6668920308,INSTA-CHAR-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,0.43,0.28,0.06,0.43,40
NDC,6668930708,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,22.65,14.72,0.43,22.65,51
NDC,6668932702,DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,6.2,4.03,0.92,6.2,40
NDC,6668934702,SIROLIMUS 1 MG/ML ORAL SOLUTION,87.5,56.88,1.73,87.5,51
NDC,6668940316,OXYCODONE 5 MG/5 ML ORAL SOLUTION,0.44,0.29,0.07,0.44,40
NDC,6668940610,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,15.9,10.34,2.37,15.9,40
NDC,6668973505,ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,5.2,3.38,0.77,5.2,40
NDC,6673394823,ERBITUX 100 MG/50 ML INTRAVENOUS SOLUTION,80.32,52.21,2.17,3257.22,65
NDC,6673395823,ERBITUX 200 MG/100 ML INTRAVENOUS SOLUTION,80.32,52.21,2.17,3257.22,65
NDC,6675808570,AZOPT 1 % EYE DROPSSUSPENSION,88.22,57.34,13.13,88.22,40
NDC,6675808770,CIPRO HC 0.2 %-1 % EAR DROPSSUSPENSION,87.48,56.86,13.02,87.48,40
NDC,6679415101,GABLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,345.0,224.25,2.17,345.0,51
NDC,6679415501,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SYRINGE,49.8,32.37,2.17,667.03,65
NDC,6679415502,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,46.35,30.13,2.17,667.03,65
NDC,6679415601,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SYRINGE,99.63,64.76,2.17,667.03,65
NDC,6679415602,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SOLUTION,92.73,60.27,2.17,667.03,65
NDC,6679415701,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SYRINGE,199.44,129.64,2.17,667.03,65
NDC,6679415702,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,185.43,120.53,2.17,667.03,65
NDC,6679416202,MITIGO (PF) 25 MG/ML INJECTION SOLUTION,69.45,45.14,2.17,69.45,51
NDC,6679423042,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,9.45,6.14,1.41,9.45,40
NDC,6686920490,LIVALO 2 MG TABLET,25.58,16.63,3.81,25.58,40
NDC,6688700301,XIAFLEX 0.9 MG SOLUTION FOR INJECTION,26586.84,17281.45,2.17,26586.84,65
NDC,6688700401,TESTOPEL 75 MG IMPLANT PELLET,259.64,168.77,2.17,720.96,59
NDC,6688700410,TESTOPEL 75 MG IMPLANT PELLET,259.64,168.77,2.17,720.96,59
NDC,6697710003,REGENECARE WITH ALOE 2 % TOPICAL GEL,0.4,0.26,0.06,0.4,40
NDC,6697710005,REGENECARE WITH ALOE 2 % TOPICAL GEL,0.48,0.31,0.07,0.48,40
NDC,6699301968,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,6.94,4.51,1.03,6.94,40
NDC,6699306027,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.82,9.63,2.21,14.82,40
NDC,6699307896,FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,44.0,28.6,6.55,44.0,40
NDC,6699307996,FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,52.02,33.81,7.74,52.02,40
NDC,6699313597,FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,14.58,9.48,2.17,14.58,40
NDC,6699314130,ALISKIREN 150 MG TABLET,15.62,10.15,2.32,15.62,40
NDC,6699337083,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.55,190.81,1.08,293.55,51
NDC,6699340732,CARBAMAZEPINE ER 100 MG CAPSULEEXTENDED RELEASE MPHASE12HR,3.92,2.55,0.58,3.92,40
NDC,6699345630,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,44.26,28.77,6.59,44.26,40
NDC,6699345730,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,44.26,28.77,6.59,44.26,40
NDC,6699358497,FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,11.92,7.75,1.77,11.92,40
NDC,6699358597,FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,14.82,9.63,2.21,14.82,40
NDC,6699358697,FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,19.48,12.66,2.9,19.48,40
NDC,6699387778,CALCIPOTRIENE 0.005 % TOPICAL CREAM,13.5,8.78,2.01,13.5,40
NDC,6699396245,METRONIDAZOLE 0.75 % TOPICAL GEL,14.2,9.23,2.11,14.2,40
NDC,6706600501,CHIRHOSTIM 16 MCG INTRAVENOUS SOLUTION,2379.6,1546.74,2.17,2379.6,65
NDC,6710835659,MESNEX 400 MG TABLET,188.62,122.6,28.07,188.62,40
NDC,6715710150,ASCOR 500 MG/ML INTRAVENOUS SOLUTION,16.56,10.76,2.46,16.56,40
NDC,6715710151,ASCOR 500 MG/ML INTRAVENOUS SOLUTION,19.26,12.52,2.87,19.26,40
NDC,6717211131,PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,0.08,0.05,0.01,0.08,40
NDC,6725346110,GLYBURIDE MICRONIZED 3 MG TABLET,1.2,0.78,0.18,1.2,40
NDC,6725365110,PROPYLTHIOURACIL 50 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,6730810106,LEVULAN 20 % TOPICAL SOLUTION,943.72,613.42,2.17,1154.88,65
NDC,6738611101,SABRIL 500 MG TABLET,461.3,299.85,68.64,461.3,40
NDC,6738613051,VYEPTI 100 MG/ML INTRAVENOUS SOLUTION,6984.24,4539.76,2.17,6984.24,65
NDC,6738621165,SABRIL 500 MG ORAL POWDER PACKET,576.63,374.81,85.8,576.63,40
NDC,6738631401,ONFI 10 MG TABLET,75.14,48.84,11.18,75.14,40
NDC,6738682219,NORTHERA 300 MG CAPSULE,307.02,199.56,45.68,307.02,40
NDC,6740583008,BENZOYL PEROXIDE 10 % TOPICAL CLEANSER,0.12,0.08,0.02,0.12,40
NDC,6745711850,ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,6.51,4.23,0.97,6.51,40
NDC,6745713450,MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,1.14,0.74,0.17,1.14,40
NDC,6745714630,B COMPLEX 100 100 MG-2 MG-100 MG-2MG-2MG/ML INJECTABLE SOLUTION,22.17,14.41,3.3,22.17,40
NDC,6745715318,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,3.45,2.24,0.51,47.96,51
NDC,6745716200,SOTRADECOL 1 % (10 MG/ML) INTRAVENOUS SOLUTION,140.64,91.42,20.93,140.64,40
NDC,6745716202,SOTRADECOL 1 % (10 MG/ML) INTRAVENOUS SOLUTION,140.64,91.42,20.93,140.64,40
NDC,6745716302,SOTRADECOL 3 % (30 MG/ML) INTRAVENOUS SOLUTION,140.64,91.42,20.93,140.64,40
NDC,6745717750,RIMSO-50  50 % INTRAVESICAL SOLUTION,52.53,34.14,2.17,2219.67,65
NDC,6745718210,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,2.64,1.72,0.39,2.64,40
NDC,6745719602,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,15.99,10.39,2.17,15.99,51
NDC,6745721005,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,711.87,462.72,2.17,1676.17,65
NDC,6745721102,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,2464.32,1601.81,2.17,2464.32,65
NDC,6745721810,DURACLON (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,11.28,7.33,1.68,47.96,51
NDC,6745722005,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,874.23,568.25,8.53,874.23,65
NDC,6745722702,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,317.43,206.33,2.17,317.43,51
NDC,6745725510,LEVETIRACETAM 500 MG/100 ML IN SODIUM CHLORIDE (ISO-OSM) IV PIGGYBACK,1.08,0.7,0.07,8.86,51
NDC,6745726500,LEVETIRACETAM 1000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,1.8,1.17,0.07,8.86,51
NDC,6745726510,LEVETIRACETAM 1000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,1.8,1.17,0.07,8.86,51
NDC,6745726610,LEVETIRACETAM 1500 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,2.67,1.74,0.07,8.86,51
NDC,6745732325,MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.66,0.43,0.1,19.72,51
NDC,6745734001,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,57.75,37.54,0.04,57.75,51
NDC,6745734105,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,320.16,208.1,2.17,320.16,51
NDC,6745734910,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,46.11,29.97,2.17,46.11,51
NDC,6745738499,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,0.81,0.53,0.12,8.86,51
NDC,6745738599,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.29,0.84,0.19,8.86,51
NDC,6745739054,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,424.8,276.12,2.17,424.8,51
NDC,6745741013,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,79.2,51.48,2.17,79.2,51
NDC,6745742010,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,1.44,0.94,0.2,8.86,51
NDC,6745742130,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,1.26,0.82,0.19,1.26,40
NDC,6745742200,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,1.41,0.92,0.21,1.41,40
NDC,6745742254,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,1.41,0.92,0.2,8.86,51
NDC,6745742300,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,2.97,1.93,0.44,2.97,40
NDC,6745742312,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,2.97,1.93,0.2,8.86,51
NDC,6745742612,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,4.32,2.81,0.64,8.86,51
NDC,6745742800,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.61,1.7,0.39,8.86,51
NDC,6745742830,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.61,1.7,0.39,8.86,51
NDC,6745743010,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,9.72,6.32,1.45,47.96,51
NDC,6745743322,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1.59,1.03,0.02,47.96,51
NDC,6745743650,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,1262.56,820.66,2.17,1262.56,43
NDC,6745743710,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,60.03,39.02,0.18,60.03,51
NDC,6745743810,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,20.52,13.34,3.05,20.52,40
NDC,6745744610,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,33.69,21.9,2.17,47.96,51
NDC,6745745010,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,168.0,109.2,2.17,500.04,65
NDC,6745745500,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,4.56,2.96,0.68,15.18,51
NDC,6745745552,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,4.56,2.96,0.68,15.18,51
NDC,6745745720,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.59,1.03,0.02,47.96,51
NDC,6745747322,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,3.57,2.32,0.53,8.86,51
NDC,6745752433,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,505.2,328.38,2.17,505.2,51
NDC,6745756420,BACLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,139.17,90.46,2.17,667.03,65
NDC,6745757300,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,3.63,2.36,0.54,3.63,40
NDC,6745757305,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,3.63,2.36,0.54,3.63,40
NDC,6745758210,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,327.9,213.14,1.44,327.9,51
NDC,6745758300,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,964.59,626.98,1.44,964.59,51
NDC,6745758304,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,964.59,626.98,1.44,964.59,51
NDC,6745758400,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,643.05,417.98,1.44,643.05,51
NDC,6745758406,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,643.05,417.98,1.44,643.05,51
NDC,6745758508,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,482.28,313.48,1.44,482.28,51
NDC,6745760305,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,6.84,4.45,0.32,8.86,51
NDC,6745760399,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,6.84,4.45,0.32,8.86,51
NDC,6745761610,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,7.32,4.76,1.09,47.96,51
NDC,6745761730,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,7.32,4.76,1.09,47.96,51
NDC,6745762910,EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION,56.25,36.56,2.17,327.06,59
NDC,6745778108,DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,1.16,1460.6,51
NDC,6745782399,VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION,72.36,47.03,0.18,72.36,51
NDC,6745782499,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.18,86.82,51
NDC,6745783306,FULPHILA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,12525.0,8141.25,2.17,12525.0,65
NDC,6745785404,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,0.69,47.96,51
NDC,6745785500,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,11.25,7.31,0.69,47.96,51
NDC,6745785502,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,11.25,7.31,0.69,47.96,51
NDC,6745785620,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.4,15.21,0.69,47.96,51
NDC,6745785730,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.52,15.29,0.69,47.96,51
NDC,6745788701,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.25,190.61,1.08,293.25,51
NDC,6745788799,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.55,190.81,1.08,293.55,51
NDC,6745792650,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,842.46,547.6,2.17,842.46,65
NDC,6754611112,ALINIA 500 MG TABLET,323.12,210.03,48.08,323.12,40
NDC,6754621221,ALINIA 100 MG/5 ML ORAL SUSPENSION,26.1,16.97,3.88,26.1,40
NDC,6761811128,COLACE CLEAR 50 MG CAPSULE,0.62,0.4,0.09,0.62,40
NDC,6761815001,BETADINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,40
NDC,6761815004,BETADINE 10 % TOPICAL SOLUTION,0.04,0.03,0.01,0.04,40
NDC,6761815017,BETADINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,40
NDC,6761820016,BETASEPT SURGICAL SCRUB 4 % TOPICAL LIQUID,0.06,0.04,0.01,0.06,40
NDC,6761830050,SENOKOT 8.6 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,6768419012,LIPIODOL 480 MG IODINE/ML OIL FOR INJECTION,440.64,286.42,41.42,440.64,51
NDC,6768420005,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,20.28,13.18,0.01,22.96,49
NDC,6768420006,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.92,12.95,0.01,22.96,49
NDC,6768420007,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.56,12.71,0.01,22.96,49
NDC,6768420010,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,19.08,12.4,0.01,22.96,49
NDC,6768420011,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,11.88,7.72,0.01,22.96,49
NDC,6768420012,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,10.08,6.55,0.01,22.96,49
NDC,6768420013,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,10.08,6.55,0.01,22.96,49
NDC,6768430013,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,10.8,7.02,0.01,22.96,49
NDC,6768442301,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,0.01,39.75,49
NDC,6768442302,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,0.01,39.75,49
NDC,6768442312,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,0.01,39.75,49
NDC,6768442322,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,0.01,39.75,49
NDC,6777725101,AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION,0.96,0.62,0.14,0.96,40
NDC,6785014005,ASCLERA 0.5 % (10 MG/2 ML) INTRAVENOUS SOLUTION,35.46,23.05,5.28,35.46,40
NDC,6785014105,ASCLERA 1 % (20 MG/2 ML) INTRAVENOUS SOLUTION,40.68,26.44,6.05,40.68,40
NDC,6787147906,ETHAMOLIN 5 % INTRAVENOUS SOLUTION,951.48,618.46,2.17,1531.87,65
NDC,6787712405,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.84,0.55,0.12,0.84,40
NDC,6787712420,SILVER SULFADIAZINE 1 % TOPICAL CREAM,2.9,1.89,0.43,2.9,40
NDC,6787712425,SILVER SULFADIAZINE 1 % TOPICAL CREAM,1.08,0.7,0.16,1.08,40
NDC,6787712450,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.84,0.55,0.12,0.84,40
NDC,6787721520,CEFUROXIME AXETIL 250 MG TABLET,11.32,7.36,1.68,11.32,40
NDC,6787721660,CEFUROXIME AXETIL 500 MG TABLET,22.2,14.43,3.3,22.2,40
NDC,6787723022,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,22.65,14.72,0.43,22.65,51
NDC,6787724601,QUETIAPINE 200 MG TABLET,25.9,16.84,3.85,25.9,40
NDC,6787725001,QUETIAPINE 100 MG TABLET,13.72,8.92,2.04,13.72,40
NDC,6787725145,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.14,0.09,0.02,0.14,40
NDC,6787725180,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.36,0.23,0.05,0.36,40
NDC,6787726030,RASAGILINE 1 MG TABLET,49.96,32.47,7.43,49.96,40
NDC,6787726218,RIZATRIPTAN 10 MG TABLET,66.62,43.3,9.91,66.62,40
NDC,6787727590,LANSOPRAZOLE 30 MG CAPSULEDELAYED RELEASE,11.7,7.61,1.74,11.7,40
NDC,6787728660,RILUZOLE 50 MG TABLET,73.88,48.02,10.99,73.88,40
NDC,6787732005,IBUPROFEN 600 MG TABLET,1.04,0.68,0.15,1.04,40
NDC,6787741690,VALSARTAN 80 MG TABLET,9.22,5.99,1.37,9.22,40
NDC,6787741890,VALSARTAN 320 MG TABLET,12.56,8.16,1.87,12.56,40
NDC,6787741933,LINEZOLID 600 MG TABLET,367.32,238.76,54.66,367.32,40
NDC,6787741984,LINEZOLID 600 MG TABLET,367.32,238.76,54.66,367.32,40
NDC,6787745430,ITRACONAZOLE 100 MG CAPSULE,48.3,31.4,7.19,48.3,40
NDC,6787752790,SOLIFENACIN 5 MG TABLET,26.22,17.04,3.9,26.22,40
NDC,6787752890,SOLIFENACIN 10 MG TABLET,26.22,17.04,3.9,26.22,40
NDC,6787754588,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,0.58,0.38,0.09,0.58,40
NDC,6787754798,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,2.13,1.38,0.32,2.13,40
NDC,6787754898,CEFDINIR 250 MG/5 ML ORAL SUSPENSION,4.15,2.7,0.62,4.15,40
NDC,6787755130,DEFERASIROX 500 MG DISPERSIBLE TABLET,344.58,223.98,51.27,344.58,40
NDC,6787756110,METFORMIN 500 MG TABLET,1.42,0.92,0.21,1.42,40
NDC,6787758433,CEFIXIME 400 MG CAPSULE,47.06,30.59,7.0,47.06,40
NDC,6787763633,TOLVAPTAN 30 MG TABLET,1092.1,709.87,162.5,1092.1,40
NDC,6787771831,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,20.08,13.05,2.1,20.08,43
NDC,6787771931,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,40.14,26.09,2.1,40.14,43
NDC,6787772131,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG TABLET,80.12,52.08,11.92,80.12,40
NDC,6787773295,LACOSAMIDE 10 MG/ML ORAL SOLUTION,3.32,2.16,0.49,3.32,40
NDC,6787773360,LACOSAMIDE 50 MG TABLET,22.74,14.78,3.38,22.74,40
NDC,6787774701,SIROLIMUS 1 MG TABLET,33.9,22.04,1.73,33.9,51
NDC,6787783347,TOPIRAMATE 25 MG/ML ORAL SOLUTION,4.4,2.86,0.65,4.4,40
NDC,6787788271,RIVAROXABAN 1 MG/ML ORAL SUSPENSION,10.2,6.63,1.52,10.2,40
NDC,6791903001,ZERBAXA 1.5 GRAM INTRAVENOUS SOLUTION,627.69,408.0,2.17,627.69,65
NDC,6791904002,SIVEXTRO 200 MG INTRAVENOUS SOLUTION,1333.74,866.93,1.81,1333.74,65
NDC,6791904105,SIVEXTRO 200 MG TABLET,1116.2,725.53,166.09,1116.2,40
NDC,6797900101,VALSTAR 40 MG/ML INTRAVESICAL SOLUTION,1776.24,1154.56,2.17,4487.68,65
NDC,6797900201,SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT,180653.82,117424.98,2.17,180653.82,65
NDC,6797951143,AVEED 750 MG/3 ML (250MG/ML) INTRAMUSCULAR SOLUTION,2607.6,1694.94,1.95,2607.6,65
NDC,6800111306,LEVETIRACETAM ER 500 MG TABLETEXTENDED RELEASE 24 HR,8.9,5.79,1.32,8.9,40
NDC,6800111406,LEVETIRACETAM ER 750 MG TABLETEXTENDED RELEASE 24 HR,13.36,8.68,1.99,13.36,40
NDC,6800115100,CARVEDILOL 12.5 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115103,CARVEDILOL 12.5 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115200,CARVEDILOL 25 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115203,CARVEDILOL 25 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115300,CARVEDILOL 3.125 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115303,CARVEDILOL 3.125 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115403,CARVEDILOL 6.25 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,6800115600,VENLAFAXINE 100 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6800115700,VENLAFAXINE 25 MG TABLET,3.88,2.52,0.58,3.88,40
NDC,6800115800,VENLAFAXINE 37.5 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,6800115900,VENLAFAXINE 50 MG TABLET,4.12,2.68,0.61,4.12,40
NDC,6800116000,VENLAFAXINE 75 MG TABLET,4.38,2.85,0.65,4.38,40
NDC,6800116100,PROMETHAZINE 12.5 MG TABLET,0.98,0.64,0.15,0.98,40
NDC,6800116200,PROMETHAZINE 25 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,6800118000,QUETIAPINE 50 MG TABLET,13.14,8.54,1.96,13.14,40
NDC,6800118100,QUETIAPINE 400 MG TABLET,39.88,25.92,5.93,39.88,40
NDC,6800118200,QUETIAPINE 200 MG TABLET,25.88,16.82,3.85,25.88,40
NDC,6800118300,QUETIAPINE 300 MG TABLET,33.92,22.05,5.05,33.92,40
NDC,6800118400,QUETIAPINE 100 MG TABLET,13.72,8.92,2.04,13.72,40
NDC,6800118500,QUETIAPINE 25 MG TABLET,8.0,5.2,1.19,8.0,40
NDC,6800123700,CLONIDINE HCL 0.1 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,6800123703,CLONIDINE HCL 0.1 MG TABLET,0.5,0.33,0.07,0.5,40
NDC,6800123800,CLONIDINE HCL 0.2 MG TABLET,0.76,0.49,0.11,0.76,40
NDC,6800123900,CLONIDINE HCL 0.3 MG TABLET,1.04,0.68,0.15,1.04,40
NDC,6800124200,ZONISAMIDE 25 MG CAPSULE,1.1,0.72,0.16,1.1,40
NDC,6800124400,ZONISAMIDE 100 MG CAPSULE,4.38,2.85,0.65,4.38,40
NDC,6800124604,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.58,28.98,6.63,44.58,40
NDC,6800124616,ONDANSETRON 4 MG DISINTEGRATING TABLET,46.22,30.04,6.88,46.22,40
NDC,6800124617,ONDANSETRON 4 MG DISINTEGRATING TABLET,46.22,30.04,6.88,46.22,40
NDC,6800124716,ONDANSETRON 8 MG DISINTEGRATING TABLET,77.0,50.05,11.46,77.0,40
NDC,6800124717,ONDANSETRON 8 MG DISINTEGRATING TABLET,77.0,50.05,11.46,77.0,40
NDC,6800125104,FLUCONAZOLE 50 MG TABLET,11.2,7.28,1.67,11.2,40
NDC,6800125204,FLUCONAZOLE 100 MG TABLET,17.6,11.44,2.62,17.6,40
NDC,6800127900,DICLOFENAC SODIUM 25 MG TABLETDELAYED RELEASE,2.84,1.85,0.42,2.84,40
NDC,6800128100,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,3.54,2.3,0.53,3.54,40
NDC,6800130900,BUPROPION HCL 100 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,6800131400,LOVASTATIN 10 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,6800131500,LOVASTATIN 20 MG TABLET,4.74,3.08,0.71,4.74,40
NDC,6800131600,LOVASTATIN 40 MG TABLET,8.54,5.55,1.27,8.54,40
NDC,6800132500,DESMOPRESSIN 0.1 MG TABLET,10.58,6.88,1.57,10.58,40
NDC,6800132800,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.22,1.44,0.33,2.22,40
NDC,6800133200,LISINOPRIL 2.5 MG TABLET,1.3,0.85,0.19,1.3,40
NDC,6800133300,LISINOPRIL 5 MG TABLET,1.94,1.26,0.29,1.94,40
NDC,6800133400,LISINOPRIL 10 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,6800133500,LISINOPRIL 20 MG TABLET,2.16,1.4,0.32,2.16,40
NDC,6800133600,LISINOPRIL 30 MG TABLET,3.02,1.96,0.45,3.02,40
NDC,6800136206,CEFDINIR 300 MG CAPSULE,10.22,6.64,1.52,10.22,40
NDC,6800136500,METRONIDAZOLE 500 MG TABLET,1.46,0.95,0.22,1.46,40
NDC,6800137500,ISOSORBIDE DINITRATE 20 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,6800137800,URSODIOL 500 MG TABLET,9.5,6.18,1.41,9.5,40
NDC,6800138100,LABETALOL 100 MG TABLET,1.02,0.66,0.15,1.02,40
NDC,6800138300,LABETALOL 300 MG TABLET,1.94,1.26,0.29,1.94,40
NDC,6800139700,FAMOTIDINE 20 MG TABLET,4.84,3.15,0.72,4.84,40
NDC,6800139708,FAMOTIDINE 20 MG TABLET,4.84,3.15,0.72,4.84,40
NDC,6800139900,FLUOXETINE 10 MG CAPSULE,5.2,3.38,0.77,5.2,40
NDC,6800140303,LEVETIRACETAM 500 MG TABLET,7.02,4.56,1.04,7.02,40
NDC,6800140307,LEVETIRACETAM 500 MG TABLET,7.02,4.56,1.04,7.02,40
NDC,6800142800,RAMIPRIL 1.25 MG CAPSULE,2.9,1.89,0.43,2.9,40
NDC,6800142900,RAMIPRIL 2.5 MG CAPSULE,3.62,2.35,0.54,3.62,40
NDC,6800143000,RAMIPRIL 5 MG CAPSULE,3.8,2.47,0.57,3.8,40
NDC,6800143100,RAMIPRIL 10 MG CAPSULE,4.44,2.89,0.66,4.44,40
NDC,6800143616,CETIRIZINE 10 MG TABLET,4.98,3.24,0.74,4.98,40
NDC,6800143900,FEXOFENADINE 60 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,6800144000,FEXOFENADINE 180 MG TABLET,0.64,0.42,0.1,0.64,40
NDC,6800145106,ZIPRASIDONE 40 MG CAPSULE,17.92,11.65,2.67,17.92,40
NDC,6800145206,ZIPRASIDONE 60 MG CAPSULE,21.76,14.14,3.24,21.76,40
NDC,6800145306,ZIPRASIDONE 80 MG CAPSULE,21.76,14.14,3.24,21.76,40
NDC,6800147745,BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,0.46,0.3,0.07,0.46,40
NDC,6800147746,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.5,0.33,0.07,0.5,40
NDC,6800147747,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.24,0.16,0.04,0.24,40
NDC,6800147748,BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,0.46,0.3,0.07,0.46,40
NDC,6800148145,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.2,0.13,0.03,0.2,40
NDC,6800148147,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.2,0.13,0.03,0.2,40
NDC,6800148148,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.28,0.18,0.04,0.28,40
NDC,6800148345,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.54,0.35,0.08,0.54,40
NDC,6800148346,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.76,0.49,0.11,0.76,40
NDC,6800148600,LISINOPRIL 40 MG TABLET,3.14,2.04,0.47,3.14,40
NDC,6800149404,FAMOTIDINE 10 MG TABLET,0.24,0.16,0.04,0.24,40
NDC,6800150555,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,0.08,0.05,0.01,0.08,40
NDC,6800158500,GLIMEPIRIDE 2 MG TABLET,1.3,0.85,0.19,1.3,40
NDC,6800158600,GLIMEPIRIDE 4 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,6800159100,ESCITALOPRAM 5 MG TABLET,8.28,5.38,1.23,8.28,40
NDC,6800161200,DICLOFENAC ER 100 MG TABLETEXTENDED RELEASE 24 HR,5.6,3.64,0.83,5.6,40
NDC,6807128704,ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID,0.1,0.07,0.01,0.1,40
NDC,6808402121,ABACAVIR 300 MG TABLET,20.08,13.05,2.99,20.08,40
NDC,6808402701,WARFARIN 2.5 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,6808402711,WARFARIN 2.5 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,6808404401,PAROXETINE 10 MG TABLET,5.34,3.47,0.79,5.34,40
NDC,6808404411,PAROXETINE 10 MG TABLET,5.34,3.47,0.79,5.34,40
NDC,6808404501,PAROXETINE 20 MG TABLET,5.58,3.63,0.83,5.58,40
NDC,6808404511,PAROXETINE 20 MG TABLET,5.58,3.63,0.83,5.58,40
NDC,6808404601,PAROXETINE 30 MG TABLET,5.56,3.61,0.83,5.56,40
NDC,6808404611,PAROXETINE 30 MG TABLET,5.56,3.61,0.83,5.56,40
NDC,6808404701,PAROXETINE 40 MG TABLET,6.06,3.94,0.9,6.06,40
NDC,6808407521,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,60.64,39.42,9.02,60.64,40
NDC,6808408201,ISOSORBIDE DINITRATE 10 MG TABLET,2.5,1.63,0.37,2.5,40
NDC,6808408211,ISOSORBIDE DINITRATE 10 MG TABLET,2.5,1.63,0.37,2.5,40
NDC,6808409701,ATORVASTATIN 10 MG TABLET,1.26,0.82,0.19,1.26,40
NDC,6808409801,ATORVASTATIN 20 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,6808409811,ATORVASTATIN 20 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,6808409901,ATORVASTATIN 40 MG TABLET,1.72,1.12,0.26,1.72,40
NDC,6808410309,ZIPRASIDONE 20 MG CAPSULE,16.94,11.01,2.52,16.94,40
NDC,6808410311,ZIPRASIDONE 20 MG CAPSULE,16.94,11.01,2.52,16.94,40
NDC,6808410409,ZIPRASIDONE 40 MG CAPSULE,16.94,11.01,2.52,16.94,40
NDC,6808410609,ZIPRASIDONE 80 MG CAPSULE,20.54,13.35,3.06,20.54,40
NDC,6808411901,MIRTAZAPINE 15 MG TABLET,2.1,1.37,0.31,2.1,40
NDC,6808412001,MIRTAZAPINE 30 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,6808412011,MIRTAZAPINE 30 MG TABLET,2.58,1.68,0.38,2.58,40
NDC,6808414901,METHYLPREDNISOLONE 4 MG TABLET,4.3,2.8,0.25,8.86,51
NDC,6808415501,PROMETHAZINE 25 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,6808415511,PROMETHAZINE 25 MG TABLET,1.08,0.7,0.16,1.08,40
NDC,6808415701,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,3.68,2.39,0.55,3.68,40
NDC,6808418401,OXYCODONE 15 MG TABLET,3.74,2.43,0.56,3.74,40
NDC,6808418501,OXYCODONE 30 MG TABLET,7.12,4.63,1.06,7.12,40
NDC,6808420201,PRIMIDONE 50 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,6808420211,PRIMIDONE 50 MG TABLET,1.96,1.27,0.29,1.96,40
NDC,6808420301,PRIMIDONE 250 MG TABLET,2.1,1.37,0.31,2.1,40
NDC,6808420311,PRIMIDONE 250 MG TABLET,2.1,1.37,0.31,2.1,40
NDC,6808420401,MINOXIDIL 2.5 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,6808420411,MINOXIDIL 2.5 MG TABLET,3.4,2.21,0.51,3.4,40
NDC,6808420501,MINOXIDIL 10 MG TABLET,4.24,2.76,0.63,4.24,40
NDC,6808421401,BENZONATATE 100 MG CAPSULE,1.46,0.95,0.22,1.46,40
NDC,6808422001,ONDANSETRON HCL 4 MG TABLET,1.8,1.17,0.27,1.8,40
NDC,6808422101,ONDANSETRON HCL 8 MG TABLET,2.3,1.5,0.34,2.3,40
NDC,6808422901,AZATHIOPRINE 50 MG TABLET,1.7,1.11,0.11,8.86,51
NDC,6808424301,CLINDAMYCIN HCL 150 MG CAPSULE,1.26,0.82,0.19,1.26,40
NDC,6808424401,CLINDAMYCIN HCL 300 MG CAPSULE,2.6,1.69,0.39,2.6,40
NDC,6808424801,LORATADINE 10 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,6808424811,LORATADINE 10 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,6808424901,HALOPERIDOL 10 MG TABLET,3.8,2.47,0.57,3.8,40
NDC,6808426901,HYDROXYCHLOROQUINE 200 MG TABLET,8.78,5.71,1.31,8.78,40
NDC,6808427001,RISPERIDONE 0.25 MG TABLET,7.78,5.06,1.16,7.78,40
NDC,6808427101,RISPERIDONE 0.5 MG TABLET,8.54,5.55,1.27,8.54,40
NDC,6808427111,RISPERIDONE 0.5 MG TABLET,8.54,5.55,1.27,8.54,40
NDC,6808427201,RISPERIDONE 1 MG TABLET,9.08,5.9,1.35,9.08,40
NDC,6808427301,RISPERIDONE 2 MG TABLET,15.18,9.87,2.26,15.18,40
NDC,6808427401,RISPERIDONE 3 MG TABLET,17.82,11.58,2.65,17.82,40
NDC,6808428001,ETHAMBUTOL 400 MG TABLET,3.26,2.12,0.49,3.26,40
NDC,6808428401,HYDROXYUREA 500 MG CAPSULE,2.2,1.43,0.33,2.2,40
NDC,6808428801,FLUDROCORTISONE 0.1 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,6808429121,NALTREXONE 50 MG TABLET,8.62,5.6,1.28,8.62,40
NDC,6808429901,TAMSULOSIN 0.4 MG CAPSULE,8.42,5.47,1.25,8.42,40
NDC,6808430011,DANTROLENE 25 MG CAPSULE,3.88,2.52,0.58,3.88,40
NDC,6808430021,DANTROLENE 25 MG CAPSULE,3.88,2.52,0.58,3.88,40
NDC,6808430921,VALACYCLOVIR 1 GRAM TABLET,12.4,8.06,1.85,12.4,40
NDC,6808431301,DIVALPROEX 125 MG CAPSULEDELAYED RELEASE SPRINKLE,2.84,1.85,0.42,2.84,40
NDC,6808431801,LAMOTRIGINE 25 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,6808431811,LAMOTRIGINE 25 MG TABLET,0.44,0.29,0.07,0.44,40
NDC,6808431901,LAMOTRIGINE 100 MG TABLET,0.46,0.3,0.07,0.46,40
NDC,6808434201,TOPIRAMATE 25 MG TABLET,4.2,2.73,0.62,4.2,40
NDC,6808434211,TOPIRAMATE 25 MG TABLET,4.2,2.73,0.62,4.2,40
NDC,6808434401,TOPIRAMATE 100 MG TABLET,12.4,8.06,1.85,12.4,40
NDC,6808434411,TOPIRAMATE 100 MG TABLET,12.4,8.06,1.85,12.4,40
NDC,6808434521,TOPIRAMATE 200 MG TABLET,2.24,1.46,0.33,2.24,40
NDC,6808434601,LOSARTAN 25 MG TABLET,3.36,2.18,0.5,3.36,40
NDC,6808434611,LOSARTAN 25 MG TABLET,3.36,2.18,0.5,3.36,40
NDC,6808434701,LOSARTAN 50 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,6808434711,LOSARTAN 50 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,6808437101,AMIODARONE 200 MG TABLET,1.22,0.79,0.18,1.22,40
NDC,6808438101,BENZTROPINE 0.5 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,6808438801,BENZTROPINE 1 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,6808438901,BENZTROPINE 2 MG TABLET,1.34,0.87,0.2,1.34,40
NDC,6808440301,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,3.68,2.39,0.55,3.68,40
NDC,6808445001,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.36,8.92,51
NDC,6808445101,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.36,44.6,51
NDC,6808448001,OXYBUTYNIN CHLORIDE ER 5 MG TABLETEXTENDED RELEASE 24 HR,6.02,3.91,0.9,6.02,40
NDC,6808449401,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,3.32,2.16,0.49,3.32,40
NDC,6808451101,SIMVASTATIN 10 MG TABLET,5.58,3.63,0.83,5.58,40
NDC,6808451201,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,6808452501,OLANZAPINE 2.5 MG TABLET,22.34,14.52,3.32,22.34,40
NDC,6808452901,OLANZAPINE 20 MG TABLET,81.26,52.82,12.09,81.26,40
NDC,6808453901,TORSEMIDE 20 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,6808453911,TORSEMIDE 20 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,6808454921,TEMAZEPAM 7.5 MG CAPSULE,16.7,10.86,2.48,16.7,40
NDC,6808457201,MUCINEX 600 MG TABLET EXTENDED RELEASE,2.0,1.3,0.3,2.0,40
NDC,6808457211,MUCINEX 600 MG TABLET EXTENDED RELEASE,2.0,1.3,0.3,2.0,40
NDC,6808459701,NIFEDIPINE ER 30 MG TABLETEXTENDED RELEASE 24 HR,3.58,2.33,0.53,3.58,40
NDC,6808459801,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,5.94,3.86,0.88,5.94,40
NDC,6808459811,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,5.94,3.86,0.88,5.94,40
NDC,6808460201,PERPHENAZINE 4 MG TABLET,4.2,2.73,0.62,4.2,40
NDC,6808460211,PERPHENAZINE 4 MG TABLET,4.2,2.73,0.62,4.2,40
NDC,6808460701,PERPHENAZINE 8 MG TABLET,5.06,3.29,0.75,5.06,40
NDC,6808460801,TRAZODONE 150 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,6808460811,TRAZODONE 150 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,6808461021,OXYBUTYNIN CHLORIDE ER 10 MG TABLETEXTENDED RELEASE 24 HR,6.58,4.28,0.98,6.58,40
NDC,6808461701,ESCITALOPRAM 10 MG TABLET,8.64,5.62,1.29,8.64,40
NDC,6808461711,ESCITALOPRAM 10 MG TABLET,8.64,5.62,1.29,8.64,40
NDC,6808461801,ESCITALOPRAM 20 MG TABLET,9.2,5.98,1.37,9.2,40
NDC,6808461811,ESCITALOPRAM 20 MG TABLET,9.2,5.98,1.37,9.2,40
NDC,6808462121,MODAFINIL 100 MG TABLET,52.76,34.29,7.85,52.76,40
NDC,6808464001,LITHIUM CARBONATE ER 300 MG TABLETEXTENDED RELEASE,1.0,0.65,0.15,1.0,40
NDC,6808464011,LITHIUM CARBONATE ER 300 MG TABLETEXTENDED RELEASE,1.0,0.65,0.15,1.0,40
NDC,6808464301,PANTOPRAZOLE 20 MG TABLETDELAYED RELEASE,7.6,4.94,1.13,7.6,40
NDC,6808464501,TIZANIDINE 4 MG TABLET,3.02,1.96,0.45,3.02,40
NDC,6808465401,SOTALOL 80 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6808465411,SOTALOL 80 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6808465501,LITHIUM CARBONATE ER 450 MG TABLETEXTENDED RELEASE,1.52,0.99,0.23,1.52,40
NDC,6808465801,IBUPROFEN 400 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,6808469701,BUPROPION HCL SR 100 MG TABLET12 HR SUSTAINED-RELEASE,3.32,2.16,0.49,3.32,40
NDC,6808469801,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,7.48,4.86,1.11,7.48,40
NDC,6808469811,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,7.48,4.86,1.11,7.48,40
NDC,6808470411,BETHANECHOL CHLORIDE 25 MG TABLET,3.56,2.31,0.53,3.56,40
NDC,6808470901,VENLAFAXINE ER 75 MG CAPSULEEXTENDED RELEASE 24 HR,8.4,5.46,1.25,8.4,40
NDC,6808471301,VENLAFAXINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,9.14,5.94,1.36,9.14,40
NDC,6808471311,VENLAFAXINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,9.14,5.94,1.36,9.14,40
NDC,6808472121,MODAFINIL 200 MG TABLET,70.78,46.01,10.53,70.78,40
NDC,6808472265,MOXIFLOXACIN 400 MG TABLET,53.82,34.98,8.01,53.82,40
NDC,6808472301,OLANZAPINE 5 MG TABLET,21.78,14.16,3.24,21.78,40
NDC,6808472921,GALANTAMINE 4 MG TABLET,9.58,6.23,1.43,9.58,40
NDC,6808473501,FLUCONAZOLE 200 MG TABLET,88.0,57.2,13.09,88.0,40
NDC,6808473511,FLUCONAZOLE 200 MG TABLET,88.0,57.2,13.09,88.0,40
NDC,6808474001,OLANZAPINE 10 MG TABLET,40.64,26.42,6.05,40.64,40
NDC,6808475225,CLOPIDOGREL 300 MG TABLET,53.26,34.62,7.93,53.26,40
NDC,6808476425,PHOSPHA NEUTRAL 250 MG TABLET,3.2,2.08,0.48,3.2,40
NDC,6808477525,TIZANIDINE 2 MG TABLET,3.5,2.28,0.52,3.5,40
NDC,6808477595,TIZANIDINE 2 MG TABLET,3.5,2.28,0.52,3.5,40
NDC,6808478825,GLIMEPIRIDE 1 MG TABLET,2.02,1.31,0.3,2.02,40
NDC,6808479025,CLOMIPRAMINE 25 MG CAPSULE,22.36,14.53,3.33,22.36,40
NDC,6808480521,METHYLPHENIDATE 5 MG TABLET,5.62,3.65,0.84,5.62,40
NDC,6808481825,CLOMIPRAMINE 50 MG CAPSULE,32.94,21.41,4.9,32.94,40
NDC,6808482321,METHYLPHENIDATE 10 MG TABLET,3.98,2.59,0.59,3.98,40
NDC,6808484311,CARVEDILOL 3.125 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,6808484401,VENLAFAXINE 37.5 MG TABLET,4.0,2.6,0.6,4.0,40
NDC,6808485032,POTASSIUM CITRATE ER 10 MEQ (1080 MG) TABLETEXTENDED RELEASE,5.78,3.76,0.86,5.78,40
NDC,6808485033,POTASSIUM CITRATE ER 10 MEQ (1080 MG) TABLETEXTENDED RELEASE,5.78,3.76,0.86,5.78,40
NDC,6808485401,CARVEDILOL 6.25 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,6808485411,CARVEDILOL 6.25 MG TABLET,3.9,2.54,0.58,3.9,40
NDC,6808485601,VENLAFAXINE 75 MG TABLET,4.38,2.85,0.65,4.38,40
NDC,6808485901,LEVETIRACETAM 250 MG TABLET,1.2,0.78,0.18,1.2,40
NDC,6808485911,LEVETIRACETAM 250 MG TABLET,1.2,0.78,0.18,1.2,40
NDC,6808487925,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),11.5,7.48,0.94,11.5,51
NDC,6808487995,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),11.5,7.48,0.94,11.5,51
NDC,6808488201,LEVETIRACETAM 750 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,6808488211,LEVETIRACETAM 750 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,6808489625,VENLAFAXINE 25 MG TABLET,4.14,2.69,0.62,4.14,40
NDC,6808491595,SIROLIMUS 1 MG TABLET,34.1,22.17,1.73,34.1,51
NDC,6808492125,CYCLOSPORINE 100 MG ORAL CAP (SANDIMMUNE),39.72,25.82,2.17,39.72,51
NDC,6808493025,HYDROCORTISONE 20 MG TABLET,4.16,2.7,0.62,4.16,40
NDC,6808496425,PROPYLTHIOURACIL 50 MG TABLET,6.72,4.37,1.0,6.72,40
NDC,6808496495,PROPYLTHIOURACIL 50 MG TABLET,6.72,4.37,1.0,6.72,40
NDC,6808498832,ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,1.76,1.14,0.26,1.76,40
NDC,6808499601,PRAZOSIN 1 MG CAPSULE,3.58,2.33,0.53,3.58,40
NDC,6808499701,PRAZOSIN 2 MG CAPSULE,4.98,3.24,0.74,4.98,40
NDC,6809400159,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.83,0.54,0.12,0.83,40
NDC,6809400162,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.83,0.54,0.12,0.83,40
NDC,6809400459,CETIRIZINE 5 MG/5 ML ORAL SOLUTION,1.43,0.93,0.21,1.43,40
NDC,6809400462,CETIRIZINE 5 MG/5 ML ORAL SOLUTION,1.73,1.12,0.26,1.73,40
NDC,6809401861,DIPHENHYDRAMINE 25 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,6809402959,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.88,0.57,0.13,0.88,40
NDC,6809402962,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,1.05,0.68,0.16,1.05,40
NDC,6809403062,ACETAMINOPHEN 650 MG/20.3 ML ORAL SUSPENSION,0.28,0.18,0.04,0.28,40
NDC,6809403162,METHADONE 5 MG/5 ML ORAL SOLUTION,0.72,0.47,0.11,0.72,40
NDC,6809403758,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,1.13,0.73,0.17,1.13,40
NDC,6809404558,MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY),8.88,5.77,1.32,8.88,40
NDC,6809405059,OSELTAMIVIR 75 MG CAPSULE,6.72,4.37,1.0,6.72,40
NDC,6809406162,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,0.93,0.6,0.14,0.93,40
NDC,6809407458,CLOBAZAM 10 MG/4 ML ORAL SYRINGE (ORAL USE),4.05,2.63,0.6,4.05,40
NDC,6809411061,MELATONIN 3 MG TABLET,0.54,0.35,0.08,0.54,40
NDC,6809411361,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.48,0.31,0.07,0.48,40
NDC,6809412962,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.63,0.41,0.09,0.63,40
NDC,6809433061,ACETAMINOPHEN 325 MG/10.15 ML ORAL SUSPENSION,0.38,0.25,0.06,0.38,40
NDC,6809449459,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.48,0.31,0.07,0.48,40
NDC,6809449461,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.55,0.36,0.08,0.55,40
NDC,6809450359,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.4,0.26,0.06,0.4,40
NDC,6809475659,FUROSEMIDE 40 MG/4 ML ORAL SOLUTION,1.55,1.01,0.23,1.55,40
NDC,6809475662,FUROSEMIDE 40 MG/4 ML ORAL SOLUTION,1.55,1.01,0.23,1.55,40
NDC,6809476262,MIDAZOLAM 2 MG/ML ORAL SYRUP,6.33,4.11,0.94,6.33,40
NDC,6809476459,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,3.68,2.39,0.55,3.68,40
NDC,6809476462,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,3.68,2.39,0.55,3.68,40
NDC,6809486762,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,1.23,0.8,0.18,1.23,40
NDC,6813420116,NAPROXEN 125 MG/5 ML ORAL SUSPENSION,3.53,2.29,0.53,3.53,40
NDC,6813502001,NAGLAZYME 5 MG/5 ML INTRAVENOUS SOLUTION,1790.64,1163.92,2.17,13108.79,59
NDC,6817600010,DEKAS PLUS LIQUID 500 MCG/ML ORAL,1.35,0.88,0.2,1.35,40
NDC,6817600015,DEKAS PLUS (FOLIC ACID) 200 MCG-1000 MCG-10 MG CHEWABLE TABLET,1.22,0.79,0.18,1.22,40
NDC,6818012101,CEPHALEXIN 250 MG CAPSULE,1.38,0.9,0.21,1.38,40
NDC,6818012201,CEPHALEXIN 500 MG CAPSULE,2.76,1.79,0.41,2.76,40
NDC,6818012202,CEPHALEXIN 500 MG CAPSULE,2.46,1.6,0.37,2.46,40
NDC,6818015001,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,8.85,5.75,1.32,8.85,40
NDC,6818028001,ETHAMBUTOL 100 MG TABLET,1.18,0.77,0.18,1.18,40
NDC,6818028101,ETHAMBUTOL 400 MG TABLET,3.58,2.33,0.53,3.58,40
NDC,6818029006,ESLICARBAZEPINE 200 MG TABLET,96.98,63.04,14.43,96.98,40
NDC,6818040501,CEFIXIME 100 MG/5 ML ORAL SUSPENSION,11.13,7.23,1.66,11.13,40
NDC,6818042201,MOXIFLOXACIN 0.5 % EYE DROPS,111.56,72.51,16.6,111.56,40
NDC,6818046403,SIMVASTATIN 40 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,6818046406,SIMVASTATIN 40 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,6818046509,SIMVASTATIN 80 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,6818047902,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.46,9.84,40
NDC,6818051202,LISINOPRIL 2.5 MG TABLET,1.28,0.83,0.19,1.28,40
NDC,6818051303,LISINOPRIL 5 MG TABLET,1.9,1.24,0.28,1.9,40
NDC,6818065701,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,0.95,0.62,0.14,0.95,40
NDC,6818067511,OSELTAMIVIR 30 MG CAPSULE,28.36,18.43,4.22,28.36,40
NDC,6818067711,OSELTAMIVIR 75 MG CAPSULE,30.92,20.1,4.6,30.92,40
NDC,6818070909,RIVAROXABAN 2.5 MG TABLET,20.5,13.33,3.05,20.5,40
NDC,6818086306,AZITHROMYCIN 600 MG TABLET,37.36,24.28,5.56,37.36,40
NDC,6818094902,DESOXIMETASONE 0.05 % TOPICAL CREAM,12.24,7.96,1.82,12.24,40
NDC,6818095001,DESOXIMETASONE 0.25 % TOPICAL CREAM,7.78,5.06,1.16,7.78,40
NDC,6818095403,HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,7.24,4.71,1.08,7.24,40
NDC,6818096301,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,17.42,11.32,2.59,17.42,40
NDC,6822920102,ALOCANE EMERGENCY BURN 4 % TOPICAL GEL,0.36,0.23,0.05,0.36,40
NDC,6838200106,PAROXETINE 40 MG TABLET,5.76,3.74,0.86,5.76,40
NDC,6838200301,AZATHIOPRINE 50 MG TABLET,4.22,2.74,0.11,8.86,51
NDC,6838200414,TOPIRAMATE 15 MG SPRINKLE CAPSULE,4.84,3.15,0.72,4.84,40
NDC,6838200514,TOPIRAMATE 25 MG SPRINKLE CAPSULE,5.84,3.8,0.87,5.84,40
NDC,6838200601,LAMOTRIGINE 25 MG TABLET,9.1,5.92,1.35,9.1,40
NDC,6838200610,LAMOTRIGINE 25 MG TABLET,9.1,5.92,1.35,9.1,40
NDC,6838200810,LAMOTRIGINE 100 MG TABLET,10.38,6.75,1.54,10.38,40
NDC,6838201014,LAMOTRIGINE 200 MG TABLET,12.4,8.06,1.85,12.4,40
NDC,6838203416,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,8.32,5.41,1.24,8.32,40
NDC,6838203516,VENLAFAXINE ER 75 MG CAPSULEEXTENDED RELEASE 24 HR,9.34,6.07,1.39,9.34,40
NDC,6838203616,VENLAFAXINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,10.16,6.6,1.51,10.16,40
NDC,6838204201,PROMETHAZINE 50 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,6838205001,MELOXICAM 7.5 MG TABLET,6.34,4.12,0.94,6.34,40
NDC,6838205101,MELOXICAM 15 MG TABLET,9.7,6.31,1.44,9.7,40
NDC,6838205105,MELOXICAM 15 MG TABLET,9.7,6.31,1.44,9.7,40
NDC,6838207901,HALOPERIDOL 5 MG TABLET,2.04,1.33,0.3,2.04,40
NDC,6838208001,HALOPERIDOL 10 MG TABLET,2.88,1.87,0.43,2.88,40
NDC,6838209605,HYDROXYCHLOROQUINE 200 MG TABLET,8.14,5.29,1.21,8.14,40
NDC,6838209706,PAROXETINE 10 MG TABLET,5.24,3.41,0.78,5.24,40
NDC,6838209716,PAROXETINE 10 MG TABLET,5.22,3.39,0.78,5.22,40
NDC,6838209801,PAROXETINE 20 MG TABLET,5.46,3.55,0.81,5.46,40
NDC,6838209805,PAROXETINE 20 MG TABLET,5.46,3.55,0.81,5.46,40
NDC,6838209806,PAROXETINE 20 MG TABLET,5.46,3.55,0.81,5.46,40
NDC,6838209906,PAROXETINE 30 MG TABLET,5.64,3.67,0.84,5.64,40
NDC,6838209916,PAROXETINE 30 MG TABLET,5.62,3.65,0.84,5.62,40
NDC,6838210101,VENLAFAXINE 100 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6838210601,DIVALPROEX 125 MG CAPSULEDELAYED RELEASE SPRINKLE,2.24,1.46,0.33,2.24,40
NDC,6838211214,RISPERIDONE 0.25 MG TABLET,7.8,5.07,1.16,7.8,40
NDC,6838211314,RISPERIDONE 0.5 MG TABLET,8.56,5.56,1.27,8.56,40
NDC,6838211414,RISPERIDONE 1 MG TABLET,9.1,5.92,1.35,9.1,40
NDC,6838211514,RISPERIDONE 2 MG TABLET,15.22,9.89,2.26,15.22,40
NDC,6838211614,RISPERIDONE 3 MG TABLET,17.86,11.61,2.66,17.86,40
NDC,6838212105,AMLODIPINE 2.5 MG TABLET,3.46,2.25,0.51,3.46,40
NDC,6838212205,AMLODIPINE 5 MG TABLET,3.46,2.25,0.51,3.46,40
NDC,6838212305,AMLODIPINE 10 MG TABLET,4.74,3.08,0.71,4.74,40
NDC,6838213201,TAMSULOSIN 0.4 MG CAPSULE,8.42,5.47,1.25,8.42,40
NDC,6838213610,LOSARTAN 50 MG TABLET,4.52,2.94,0.67,4.52,40
NDC,6838213805,TOPIRAMATE 25 MG TABLET,5.12,3.33,0.76,5.12,40
NDC,6838213814,TOPIRAMATE 25 MG TABLET,5.12,3.33,0.76,5.12,40
NDC,6838214005,TOPIRAMATE 100 MG TABLET,13.92,9.05,2.07,13.92,40
NDC,6838214014,TOPIRAMATE 100 MG TABLET,13.92,9.05,2.07,13.92,40
NDC,6838220401,GABAPENTIN 600 MG TABLET,5.06,3.29,0.75,5.06,40
NDC,6838222705,AMIODARONE 200 MG TABLET,6.46,4.2,0.96,6.46,40
NDC,6838231818,MINOCYCLINE 100 MG CAPSULE,6.8,4.42,1.01,6.8,40
NDC,6838237001,NYSTATIN 100000 UNIT/GRAM TOPICAL POWDER,3.74,2.43,0.56,3.74,40
NDC,6838237002,NYSTATIN 100000 UNIT/GRAM TOPICAL POWDER,3.34,2.17,0.5,3.34,40
NDC,6838237003,NYSTATIN 100000 UNIT/GRAM TOPICAL POWDER,3.2,2.08,0.48,3.2,40
NDC,6838238306,EXEMESTANE 25 MG TABLET,40.46,26.3,6.02,40.46,40
NDC,6838244614,BOSENTAN 62.5 MG TABLET,418.28,271.88,62.24,418.28,40
NDC,6838244714,BOSENTAN 125 MG TABLET,418.28,271.88,62.24,418.28,40
NDC,6838250010,OMEPRAZOLE 40 MG CAPSULEDELAYED RELEASE,14.8,9.62,2.2,14.8,40
NDC,6838253601,POTASSIUM CITRATE ER 5 MEQ (540 MG) TABLETEXTENDED RELEASE,3.5,2.28,0.52,3.5,40
NDC,6838256928,ACAMPROSATE 333 MG TABLETDELAYED RELEASE,3.52,2.29,0.52,3.52,40
NDC,6838262301,BUSPIRONE 7.5 MG TABLET,3.16,2.05,0.47,3.16,40
NDC,6838262483,ROFLUMILAST 250 MCG TABLET,31.12,20.23,4.63,31.12,40
NDC,6838265906,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,2.56,1.66,0.38,2.56,40
NDC,6838270718,DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,4.74,3.08,0.71,4.74,40
NDC,6838272001,BUDESONIDE DR - ER 3 MG CAPSULEDELAYEDEXTENDED RELEASE,49.72,32.32,7.4,49.72,40
NDC,6838275805,METFORMIN 500 MG TABLET,1.4,0.91,0.21,1.4,40
NDC,6838275901,METFORMIN 850 MG TABLET,2.4,1.56,0.36,2.4,40
NDC,6838277177,LANSOPRAZOLE 15 MG DELAYED RELEASEDISINTEGRATING TABLET,31.54,20.5,4.69,31.54,40
NDC,6838278301,DOXAZOSIN 1 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,6838278401,DOXAZOSIN 2 MG TABLET,2.7,1.76,0.4,2.7,40
NDC,6838278501,DOXAZOSIN 4 MG TABLET,2.84,1.85,0.42,2.84,40
NDC,6838279901,LABETALOL 200 MG TABLET,2.28,1.48,0.34,2.28,40
NDC,6838280505,TRAZODONE 50 MG TABLET,1.68,1.09,0.25,1.68,40
NDC,6838280601,TRAZODONE 100 MG TABLET,2.78,1.81,0.41,2.78,40
NDC,6838285701,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.22,1.44,0.33,2.22,40
NDC,6838291406,ERLOTINIB 100 MG TABLET,567.88,369.12,84.5,567.88,40
NDC,6838291506,ERLOTINIB 150 MG TABLET,642.3,417.5,95.57,642.3,40
NDC,6838291711,METHYLPREDNISOLONE 8 MG TABLET,4.02,2.61,0.25,8.86,50
NDC,6838297906,LAMOTRIGINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,13.1,8.52,1.95,13.1,40
NDC,6838298006,LAMOTRIGINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,26.18,17.02,3.9,26.18,40
NDC,6838298106,LAMOTRIGINE ER 100 MG TABLETEXTENDED RELEASE 24 HR,28.06,18.24,4.18,28.06,40
NDC,6840311006,BABYBIG 100 MG INTRAVENOUS SOLUTION,51570.0,33520.5,7673.62,51570.0,40
NDC,6841879396,DIACOMIT 250 MG CAPSULE,91.92,59.75,13.68,91.92,40
NDC,6841879406,DIACOMIT 500 MG CAPSULE,183.82,119.48,27.35,183.82,40
NDC,6841879416,DIACOMIT 250 MG ORAL POWDER PACKET,91.92,59.75,13.68,91.92,40
NDC,6841879426,DIACOMIT 500 MG ORAL POWDER PACKET,183.82,119.48,27.35,183.82,40
NDC,6845510690,STOMAHESIVE PASTE,0.32,0.21,0.05,0.32,40
NDC,6845510763,"""UNNA-FLEX ELASTIC UNNA BOOT 3"""" X 10 YARD BANDAGE""",24.44,15.89,3.64,24.44,40
NDC,6845510764,"""UNNA-FLEX ELASTIC UNNA BOOT 4"""" X 10 YARD BANDAGE""",27.42,17.82,4.08,27.42,40
NDC,6846212801,ZONISAMIDE 25 MG CAPSULE,1.1,0.72,0.16,1.1,40
NDC,6846212901,ZONISAMIDE 50 MG CAPSULE,2.2,1.43,0.33,2.2,40
NDC,6846213001,ZONISAMIDE 100 MG CAPSULE,4.4,2.86,0.65,4.4,40
NDC,6846215713,ONDANSETRON 4 MG DISINTEGRATING TABLET,46.22,30.04,6.88,46.22,40
NDC,6846215813,ONDANSETRON 8 MG DISINTEGRATING TABLET,77.0,50.05,11.46,77.0,40
NDC,6846218022,MUPIROCIN 2 % TOPICAL OINTMENT,3.88,2.52,0.58,3.88,40
NDC,6846218801,NAPROXEN 250 MG TABLET,1.56,1.01,0.23,1.56,40
NDC,6846218901,NAPROXEN 375 MG TABLET,2.12,1.38,0.32,2.12,40
NDC,6846219001,NAPROXEN 500 MG TABLET,2.6,1.69,0.39,2.6,40
NDC,6846219590,PRAVASTATIN 10 MG TABLET,6.44,4.19,0.96,6.44,40
NDC,6846222401,LITHIUM CARBONATE ER 450 MG TABLETEXTENDED RELEASE,1.0,0.65,0.15,1.0,40
NDC,6846223301,FELODIPINE ER 2.5 MG TABLETEXTENDED RELEASE 24 HR,3.16,2.05,0.47,3.16,40
NDC,6846225301,ROPINIROLE 0.25 MG TABLET,5.02,3.26,0.75,5.02,40
NDC,6846225501,ROPINIROLE 1 MG TABLET,5.02,3.26,0.75,5.02,40
NDC,6846225601,ROPINIROLE 2 MG TABLET,5.02,3.26,0.75,5.02,40
NDC,6846225801,ROPINIROLE 4 MG TABLET,5.2,3.38,0.77,5.2,40
NDC,6846225901,ROPINIROLE 5 MG TABLET,5.2,3.38,0.77,5.2,40
NDC,6846226001,VERAPAMIL ER (SR) 240 MG TABLETEXTENDED RELEASE,3.28,2.13,0.49,3.28,40
NDC,6846230450,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.79,5.3,40
NDC,6846240444,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.3,9.3,2.13,14.3,40
NDC,6846240467,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.3,9.3,2.13,14.3,40
NDC,6846240601,INDOMETHACIN 25 MG CAPSULE,0.8,0.52,0.12,0.8,40
NDC,6846243518,ACAMPROSATE 333 MG TABLETDELAYED RELEASE,3.52,2.29,0.52,3.52,40
NDC,6846250165,CALCIPOTRIENE 0.005 % TOPICAL CREAM,20.3,13.2,3.02,20.3,40
NDC,6846263925,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,2.06,1.34,0.31,2.06,40
NDC,6846263945,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,2.06,1.34,0.31,2.06,40
NDC,6846272101,THEOPHYLLINE ER 300 MG TABLETEXTENDED RELEASE12 HR,8.6,5.59,1.28,8.6,40
NDC,6851646171,ALPHANATE 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,5.1,3.32,1.13,4487.68,65
NDC,6851646182,ALPHANATE 1000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.13,4487.68,65
NDC,6851646192,ALPHANATE 1500 (600 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.13,4487.68,65
NDC,6851652141,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.69,0.45,0.15,315.24,65
NDC,6851652142,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.69,0.45,0.15,315.24,65
NDC,6851652145,ALBUTEIN 5 % INTRAVENOUS SOLUTION,2.37,1.54,0.52,192.16,59
NDC,6851652149,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.66,0.43,0.15,315.24,65
NDC,6851652160,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.74,192.16,59
NDC,6851652161,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.74,192.16,59
NDC,6851652162,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.74,192.16,59
NDC,6851652165,ALBUTEIN 25 % INTRAVENOUS SOLUTION,5.01,3.26,1.11,192.16,65
NDC,6851652169,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.74,192.16,59
NDC,6851652192,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.69,0.45,0.15,315.24,65
NDC,6854614256,AZILECT 0.5 MG TABLET,100.08,65.05,14.89,100.08,40
NDC,6854622956,AZILECT 1 MG TABLET,100.08,65.05,14.89,100.08,40
NDC,6854631730,COPAXONE 20 MG/ML SUBCUTANEOUS SYRINGE,853.68,554.89,2.17,853.68,57
NDC,6854632512,COPAXONE 40 MG/ML SUBCUTANEOUS SYRINGE,1837.08,1194.1,2.17,1837.08,57
NDC,6854700501,GIAPREZA 0.5 MG/ML INTRAVENOUS SOLUTION,1890.0,1228.5,41.42,1890.0,51
NDC,6854711110,XACDURO 1 GRAM-1 GRAM (0.5 GRAM X 2) INTRAVENOUS SOLUTION,630.0,409.5,41.42,630.0,51
NDC,6854721120,SULBACTAM SODIUM 1 GRAM INTRAVENOUS SOLUTION,630.0,409.5,93.74,630.0,40
NDC,6854731130,DURLOBACTAM 0.5 GRAM INTRAVENOUS SOLUTION,630.0,409.5,93.74,630.0,40
NDC,6854750102,GIAPREZA 2.5 MG/ML INTRAVENOUS SOLUTION,6836.4,4443.66,41.42,6836.4,51
NDC,6858500575,MAG 64 64 MG TABLETDELAYED RELEASE,0.28,0.18,0.04,0.28,40
NDC,6861118001,YUTIQ 0.18 MG INTRAVITREAL IMPLANT,22244.0,14458.6,2.17,22244.0,65
NDC,6861119002,ILUVIEN 0.19 MG INTRAVITREAL IMPLANT,22092.0,14359.8,2.17,22092.0,65
NDC,6868200610,DILTIAZEM 30 MG TABLET,2.0,1.3,0.3,2.0,40
NDC,6868200710,DILTIAZEM 60 MG TABLET,3.14,2.04,0.47,3.14,40
NDC,6868201110,ETHACRYNIC ACID 25 MG TABLET,47.9,31.14,7.13,47.9,40
NDC,6868210910,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,4.44,2.89,0.66,4.44,40
NDC,6868211001,PIMECROLIMUS 1 % TOPICAL CREAM,20.3,13.2,3.02,20.3,40
NDC,6868299398,DILTIAZEM SR 120 MG 24 HR CAP,1.86,1.21,0.28,1.86,40
NDC,6872771201,ZEPZELCA 4 MG INTRAVENOUS SOLUTION,39600.0,25740.0,2.17,39600.0,65
NDC,6872774502,VYXEOS 44 MG-100 MG INTRAVENOUS SOLUTION,52704.0,34257.6,2.17,52704.0,65
NDC,6872780002,DEFITELIO 80 MG/ML INTRAVENOUS SOLUTION,1720.8,1118.52,256.06,1720.8,40
NDC,6872790003,RYLAZE 10 MG/0.5 ML INTRAMUSCULAR SOLUTION,50976.0,33134.4,2.17,50976.0,65
NDC,6872795002,ZIIHERA 300 MG INTRAVENOUS SOLUTION,17064.0,11091.6,2.17,17064.0,59
NDC,6880361210,VISIONBLUE 0.06 % INTRAOCULAR SYRINGE,623.73,405.42,92.81,623.73,40
NDC,6880372225,TISSUEBLUE 0.025 % INTRAOCULAR SYRINGE,1208.73,785.67,179.86,1208.73,40
NDC,6881713450,ABRAXANE 100 MG INTRAVENOUS SUSPENSION,7584.28,4929.78,2.17,7584.28,65
NDC,6887501031,GATTEX ONE-VIAL 5 MG SUBCUTANEOUS KIT,6472.56,4207.16,963.12,6472.56,40
NDC,6896855523,DAYTRANA 10 MG/9 HR DAILY PATCH,14.44,9.39,2.15,14.44,40
NDC,6896855543,DAYTRANA 20 MG/9 HR DAILY PATCH,14.44,9.39,2.15,14.44,40
NDC,6898285001,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,6898285002,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,6898285003,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,6898285004,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,6898285005,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,2.17,2642.72,65
NDC,6899230101,ENVARSUS XR 1 MG TABLETEXTENDED RELEASE,17.14,11.14,2.17,47.96,51
NDC,6899230103,ENVARSUS XR 1 MG TABLETEXTENDED RELEASE,17.14,11.14,2.17,47.96,51
NDC,6899230401,ENVARSUS XR 4 MG TABLETEXTENDED RELEASE,68.58,44.58,2.17,68.58,51
NDC,6899230403,ENVARSUS XR 4 MG TABLETEXTENDED RELEASE,68.58,44.58,2.17,68.58,51
NDC,6899230751,ENVARSUS XR 0.75 MG TABLETEXTENDED RELEASE,12.86,8.36,1.91,47.96,51
NDC,6899230753,ENVARSUS XR 0.75 MG TABLETEXTENDED RELEASE,12.86,8.36,1.91,47.96,51
NDC,6905130001,IMPAVIDO 50 MG CAPSULE,1427.14,927.64,212.36,1427.14,40
NDC,6909722316,ALENDRONATE 35 MG TABLET,40.98,26.64,6.1,40.98,40
NDC,6909730102,EFAVIRENZ 600 MG TABLET,71.54,46.5,10.65,71.54,40
NDC,6909731602,EXEMESTANE 25 MG TABLET,26.06,16.94,3.88,26.06,40
NDC,6909731987,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.08,7.2,1.65,11.08,40
NDC,6909732187,BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,23.08,15.0,3.43,23.08,40
NDC,6909736202,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,93.0,60.45,13.84,93.0,40
NDC,6909741002,CINACALCET 30 MG TABLET,61.32,39.86,9.12,61.32,40
NDC,6909741102,CINACALCET 60 MG TABLET,122.62,79.7,18.25,122.62,40
NDC,6909743105,DARIFENACIN ER 7.5 MG TABLETEXTENDED RELEASE 24 HR,22.12,14.38,3.29,22.12,40
NDC,6909743205,DARIFENACIN ER 15 MG TABLETEXTENDED RELEASE 24 HR,22.12,14.38,3.29,22.12,40
NDC,6909764202,EMTRICITABINE 200 MG CAPSULE,38.62,25.1,5.75,38.62,40
NDC,6909770896,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,153.96,100.07,2.17,153.96,51
NDC,6909770996,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,43.2,28.08,2.17,47.96,51
NDC,6909780232,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,69.3,45.05,0.05,69.3,51
NDC,6909782103,GEMFIBROZIL 600 MG TABLET,4.86,3.16,0.72,4.86,40
NDC,6909782112,GEMFIBROZIL 600 MG TABLET,4.64,3.02,0.69,4.64,40
NDC,6909782502,RALOXIFENE 60 MG TABLET,14.26,9.27,2.12,14.26,40
NDC,6909786107,ZONISAMIDE 100 MG CAPSULE,4.38,2.85,0.65,4.38,40
NDC,6909787067,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,64027.14,41617.64,2.17,64027.14,65
NDC,6923030001,ALLERGY RELIEF (FEXOFENADINE) 180 MG TABLET,0.64,0.42,0.1,0.64,40
NDC,6923811201,OXAPROZIN 600 MG TABLET,15.46,10.05,2.3,15.46,40
NDC,6923811709,DOXEPIN 25 MG CAPSULE,1.64,1.07,0.24,1.64,40
NDC,6923811739,DOXEPIN 100 MG CAPSULE,3.94,2.56,0.59,3.94,40
NDC,6923812651,OSELTAMIVIR 45 MG CAPSULE,28.36,18.43,4.22,28.36,40
NDC,6923813196,DIMETHYL FUMARATE 240 MG CAPSULEDELAYED RELEASE,297.6,193.44,44.28,297.6,40
NDC,6923813421,ETODOLAC 400 MG TABLET,2.94,1.91,0.44,2.94,40
NDC,6923814592,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,2.03,1.32,0.3,2.03,40
NDC,6923815324,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.54,17.1,40
NDC,6923815943,SIROLIMUS 1 MG/ML ORAL SOLUTION,78.95,51.32,1.73,78.95,51
NDC,6923816171,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,21.48,13.96,3.2,21.48,40
NDC,6923816173,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,21.48,13.96,3.2,21.48,40
NDC,6923816781,FLUPHENAZINE 1 MG TABLET,8.78,5.71,1.31,8.78,40
NDC,6923816791,FLUPHENAZINE 2.5 MG TABLET,13.6,8.84,2.02,13.6,40
NDC,6923818301,LEVOTHYROXINE 25 MCG TABLET,0.88,0.57,0.13,0.88,40
NDC,6923818311,LEVOTHYROXINE 50 MCG TABLET,1.0,0.65,0.15,1.0,40
NDC,6923818321,LEVOTHYROXINE 75 MCG TABLET,1.1,0.72,0.16,1.1,40
NDC,6923818331,LEVOTHYROXINE 88 MCG TABLET,1.12,0.73,0.17,1.12,40
NDC,6923818341,LEVOTHYROXINE 100 MCG TABLET,1.12,0.73,0.17,1.12,40
NDC,6923818351,LEVOTHYROXINE 112 MCG TABLET,1.3,0.85,0.19,1.3,40
NDC,6923818361,LEVOTHYROXINE 125 MCG TABLET,1.32,0.86,0.2,1.32,40
NDC,6923818371,LEVOTHYROXINE 137 MCG TABLET,1.34,0.87,0.2,1.34,40
NDC,6923818381,LEVOTHYROXINE 150 MCG TABLET,1.36,0.88,0.2,1.36,40
NDC,6923818391,LEVOTHYROXINE 175 MCG TABLET,1.62,1.05,0.24,1.62,40
NDC,6923818397,LEVOTHYROXINE 175 MCG TABLET,1.62,1.05,0.24,1.62,40
NDC,6923818401,LEVOTHYROXINE 200 MCG TABLET,1.62,1.05,0.24,1.62,40
NDC,6923818411,LEVOTHYROXINE 300 MCG TABLET,2.18,1.42,0.32,2.18,40
NDC,6923821417,ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,10.2,6.63,1.52,10.2,40
NDC,6929272225,FLURBIPROFEN 0.03 % EYE DROPS,34.56,22.46,5.14,34.56,40
NDC,6931511601,FUROSEMIDE 20 MG TABLET,0.28,0.18,0.04,0.28,40
NDC,6931511610,FUROSEMIDE 20 MG TABLET,0.28,0.18,0.04,0.28,40
NDC,6931511701,FUROSEMIDE 40 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,6931511710,FUROSEMIDE 40 MG TABLET,0.32,0.21,0.05,0.32,40
NDC,6931512701,FOLIC ACID 1 MG TABLET,0.72,0.47,0.11,0.72,40
NDC,6931512710,FOLIC ACID 1 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,6931513301,IMIPRAMINE 10 MG TABLET,0.86,0.56,0.13,0.86,40
NDC,6931513401,IMIPRAMINE 25 MG TABLET,1.44,0.94,0.21,1.44,40
NDC,6931513501,IMIPRAMINE 50 MG TABLET,2.64,1.72,0.39,2.64,40
NDC,6931515501,HYDROCHLOROTHIAZIDE 12.5 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,6931518403,LEUCOVORIN CALCIUM 5 MG TABLET,4.1,2.67,0.61,4.1,40
NDC,6931518624,LEUCOVORIN CALCIUM 15 MG TABLET,23.56,15.31,3.51,23.56,40
NDC,6931518725,LEUCOVORIN CALCIUM 25 MG TABLET,48.0,31.2,7.14,48.0,40
NDC,6931521101,NIFEDIPINE 10 MG CAPSULE,2.14,1.39,0.32,2.14,40
NDC,6931521201,NIFEDIPINE 20 MG CAPSULE,4.6,2.99,0.68,4.6,40
NDC,6931530130,RECTASMOOTHE 5 % TOPICAL CREAM,1.28,0.83,0.19,1.28,40
NDC,6931530802,CIPROFLOXACIN 0.3 % EYE DROPS,10.08,6.55,1.5,10.08,40
NDC,6931530805,CIPROFLOXACIN 0.3 % EYE DROPS,6.72,4.37,1.0,6.72,40
NDC,6933913634,DIAZEPAM 5 MG/ML INJECTION SYRINGE,44.31,28.8,2.17,44.31,51
NDC,6933913819,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.35,0.23,0.05,0.35,40
NDC,6933915105,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.28,0.83,0.19,1.28,40
NDC,6933915117,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.28,0.83,0.19,1.28,40
NDC,6933915119,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.23,0.8,0.18,1.23,40
NDC,6933915217,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,0.73,0.47,0.11,0.73,40
NDC,6933916317,LUBIPROSTONE 24 MCG CAPSULE,31.5,20.48,4.69,31.5,40
NDC,6934410101,INDOCIN 25 MG/5 ML ORAL SUSPENSION,27.28,17.73,4.06,27.28,40
NDC,6936719430,CLOPIDOGREL 300 MG TABLET,55.68,36.19,8.29,55.68,40
NDC,6936722001,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.34,0.22,0.05,0.34,40
NDC,6936728302,ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8000 UNIT/ML) ORAL DROPS,4.18,2.72,0.62,4.18,40
NDC,6936731401,WESCAPS 1 MG CAPSULE,1.34,0.87,0.2,1.34,40
NDC,6944801926,IMULDOSA 130 MG/26 ML INTRAVENOUS SOLUTION,205.44,133.54,30.57,4487.68,51
NDC,6944802563,UDENYCA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,25050.0,16282.5,2.17,25050.0,65
NDC,6945211721,TETRABENAZINE 12.5 MG TABLET,157.46,102.35,23.43,157.46,40
NDC,6945211821,TETRABENAZINE 25 MG TABLET,314.9,204.69,46.86,314.9,40
NDC,6945215020,VALPROIC ACID 250 MG CAPSULE,1.68,1.09,0.25,1.68,40
NDC,6945215773,RIZATRIPTAN 10 MG DISINTEGRATING TABLET,66.48,43.21,9.89,66.48,40
NDC,6945215825,COLESEVELAM 625 MG TABLET,7.48,4.86,1.11,7.48,40
NDC,6945215913,DEFERASIROX 125 MG DISPERSIBLE TABLET,86.14,55.99,12.82,86.14,40
NDC,6945220920,NIMODIPINE 30 MG CAPSULE,36.82,23.93,5.48,36.82,40
NDC,6948972130,EXELDERM 1 % TOPICAL SOLUTION,38.44,24.99,5.72,38.44,40
NDC,6954735302,NARCAN 4 MG/ACTUATION NASAL SPRAY,150.0,97.5,22.32,150.0,40
NDC,6954762702,NARCAN 4 MG/ACTUATION NASAL SPRAY,53.98,35.09,8.03,53.98,40
NDC,6958411110,CARISOPRODOL 350 MG TABLET,1.2,0.78,0.18,1.2,40
NDC,6961627230,FYCOMPA 2 MG TABLET,49.68,32.29,7.39,49.68,40
NDC,6961627430,FYCOMPA 4 MG TABLET,98.16,63.8,14.61,98.16,40
NDC,6961627630,FYCOMPA 6 MG TABLET,98.16,63.8,14.61,98.16,40
NDC,6961628230,FYCOMPA 12 MG TABLET,98.16,63.8,14.61,98.16,40
NDC,6961629038,FYCOMPA 0.5 MG/ML ORAL SUSPENSION,8.39,5.45,1.25,8.39,40
NDC,6961800858,MULTI-VITE 9 MG IRON/15 ML ORAL LIQUID,0.05,0.03,0.01,0.05,40
NDC,6961801501,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.04,0.03,0.01,0.04,40
NDC,6961801854,LIQUID C 500 MG/5 ML ORAL,0.15,0.1,0.02,0.15,40
NDC,6961801959,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,0.18,0.12,0.03,0.18,40
NDC,6961806782,CALPROTECT 0.44 %-20.6 % TOPICAL OINTMENT,0.1,0.07,0.01,0.1,40
NDC,6961806958,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,0.1,0.07,0.01,0.1,40
NDC,6961807059,FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,0.15,0.1,0.02,0.15,40
NDC,6968011210,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,16.2,10.53,1.14,16.2,51
NDC,6968012035,LIDOCAINE 5 % TOPICAL OINTMENT,1.48,0.96,0.22,1.48,40
NDC,6968013160,PROPAFENONE ER 325 MG CAPSULEEXTENDED RELEASE 12 HR,3.4,2.21,0.51,3.4,40
NDC,6968013260,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,3.4,2.21,0.51,3.4,40
NDC,6972411210,SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,1186.56,771.26,2.17,1186.56,65
NDC,6980042031,NABI-HB GREATER THAN 1560 UNIT/5 ML INTRAMUSCULAR SOLUTION,569.07,369.9,125.76,1287.79,65
NDC,6991810101,DESMOPRESSIN 0.1 MG TABLET,10.58,6.88,1.57,10.58,40
NDC,6991820101,DESMOPRESSIN 0.2 MG TABLET,15.24,9.91,2.27,15.24,40
NDC,6991873110,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,450.0,292.5,66.96,450.0,40
NDC,6991873510,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,100.8,65.52,15.0,100.8,40
NDC,6991889901,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,182.4,118.56,2.17,184.43,57
NDC,6991889910,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,182.4,118.56,2.17,184.43,57
NDC,6991889911,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,152.4,99.06,2.17,184.43,57
NDC,6991890110,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,189.6,123.24,2.17,189.6,57
NDC,6993200101,AXUMIN 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,9888.0,6427.2,0.01,9888.0,60
NDC,6993200201,POSLUMA 296 MBQ/ML TO 5846 MBQ/ML INTRAVENOUS SOLUTION,9836.0,6393.4,102.79,9836.0,62
NDC,6994506401,DETECTNET 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,7700.0,5005.0,0.01,7700.0,60
NDC,6994506820,ULTRATAG RBC INTRAVENOUS SOLUTION,350.0,227.5,0.01,350.0,45
NDC,6994509120,TECHNESCAN HDP 3.15 MG INTRAVENOUS SOLUTION,82.0,53.3,0.01,119.02,45
NDC,6994516605,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3150.0,2047.5,0.01,4111.32,60
NDC,6996800603,POLYSPORIN 500 UNIT-10000 UNIT/GRAM TOPICAL OINTMENT,0.7,0.46,0.1,0.7,40
NDC,6996800609,POLYSPORIN 500 UNIT-10000 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.52,0.34,0.08,0.52,40
NDC,6996800614,ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,0.12,0.08,0.02,0.12,40
NDC,7001000601,DEXMETHYLPHENIDATE ER 15 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,20.46,13.3,3.04,20.46,40
NDC,7001001201,METHYLPHENIDATE LA 10 MG BIPHASIC 50-50 CAPSULEEXTENDED RELEASE,24.66,16.03,3.67,24.66,40
NDC,7001001301,METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULEEXTENDED RELEASE,25.96,16.87,3.86,25.96,40
NDC,7001004201,METHYLPHENIDATE ER 10 MG TABLETEXTENDED RELEASE,16.0,10.4,2.38,16.0,40
NDC,7001004301,METHYLPHENIDATE ER 20 MG TABLETEXTENDED RELEASE,16.5,10.73,2.46,16.5,40
NDC,7001013901,NAPROXEN 500 MG TABLET,2.3,1.5,0.34,2.3,40
NDC,7001014901,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.38,2.2,0.5,3.38,40
NDC,7002019101,IXEMPRA 15 MG INTRAVENOUS SOLUTION,9669.88,6285.42,2.17,9669.88,65
NDC,7002019111,IXEMPRA 45 MG INTRAVENOUS SOLUTION,29009.68,18856.29,2.17,29009.68,65
NDC,7006900501,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.81,8.33,1.14,12.81,51
NDC,7006900510,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,13.35,8.68,1.14,13.35,51
NDC,7006902125,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,18.87,12.27,0.2,18.87,51
NDC,7006903003,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,93.75,60.94,2.17,93.75,51
NDC,7006905101,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,5.0,3.25,0.74,5.0,40
NDC,7006912101,TROPICAMIDE 1 % EYE DROPS,4.76,3.09,0.71,4.76,40
NDC,7006913101,TOBRAMYCIN 0.3 % EYE DROPS,2.5,1.63,0.37,2.5,40
NDC,7006917201,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,5.85,3.8,0.87,8.86,51
NDC,7006918101,PILOCARPINE 1 % EYE DROPS,12.36,8.03,1.84,12.36,40
NDC,7006919101,PILOCARPINE 2 % EYE DROPS,12.64,8.22,1.88,12.64,40
NDC,7006920101,PILOCARPINE 4 % EYE DROPS,13.26,8.62,1.97,13.26,40
NDC,7006923101,BRIMONIDINE 0.2 % EYE DROPS,5.0,3.25,0.74,5.0,40
NDC,7006923201,BRIMONIDINE 0.2 % EYE DROPS,1.68,1.09,0.25,1.68,40
NDC,7006923301,BRIMONIDINE 0.2 % EYE DROPS,1.5,0.98,0.22,1.5,40
NDC,7006936210,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.56,2.96,0.07,47.96,51
NDC,7006936301,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.56,2.96,0.07,47.96,51
NDC,7006938301,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,145.5,94.58,2.17,145.5,51
NDC,7006942101,LATANOPROST 0.005 % EYE DROPS,76.0,49.4,11.31,76.0,40
NDC,7006950625,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,9.75,6.34,1.45,9.75,40
NDC,7006959601,TETRACAINE 0.5 % EYE DROPS,14.4,9.36,2.14,14.4,40
NDC,7006967210,NALBUPHINE 20 MG/ML INJECTION SOLUTION,40.26,26.17,2.17,40.26,51
NDC,7006981001,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,28.23,18.35,4.2,28.23,40
NDC,7007440707,ENSURE PLUS 0.05 GRAM-1.5 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,7007440729,TWOCAL HN 0.08 GRAM-2 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,7007450241,GLUCERNA 1 CAL 0.04 GRAM-1 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,7007450775,PROMOTE 0.06 GRAM-1 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,40
NDC,7007456974,SIMILAC ADVANCE ORAL CONCENTRATE,0.05,0.03,0.01,0.05,40
NDC,7007457536,SIMILAC SENSITIVE FUSS AND GAS 2.1-5.4-11.1 GRAM/100 KCAL ORAL CONC,0.03,0.02,0.01,0.03,40
NDC,7007460850,SIMILAC PM ORAL POWDER,0.1,0.07,0.01,0.1,40
NDC,70092100736,DILTIAZEM 125 MG/125 ML (1 MG/ML) IN DEXTROSE 5 % IV,0.84,0.55,0.12,0.84,40
NDC,70092103417,NOREPINEPHRINE BITARTRATE 4 MG/250 ML (16 MCG/ML) IN DEXTROSE 5 % IV,0.36,0.23,0.05,47.96,51
NDC,70092103817,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN DEXTROSE 5 % IV,0.72,0.47,0.11,0.72,40
NDC,70092104646,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,2.28,1.48,0.34,2.28,40
NDC,70092107124,OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML INTRAVENOUS SOLUTION,0.21,0.14,0.03,0.21,40
NDC,70092109436,FENTANYL (PF) 20 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,8.86,51
NDC,70092111944,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,5.64,3.67,0.84,47.96,51
NDC,70092113036,MORPHINE 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.75,0.49,0.11,0.75,40
NDC,70092113343,MORPHINE (PF) 2 MG/2 ML(1 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,13.74,8.93,2.04,13.74,40
NDC,70092114843,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,15.3,9.95,2.28,15.3,40
NDC,70092116037,FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.1 %-NACL INJECTION SOLUTION,0.6,0.39,0.09,0.6,40
NDC,70092117546,BUFFERED LIDOCAINE 0.9 % (10 ML) INJECTION SYRINGE,2.91,1.89,0.43,2.91,40
NDC,70092121650,HEPARIN (PORCINE)(PF) 50 UNIT/50 ML (1 UNIT/ML) IN 0.9% NACL IV SYRING,1.92,1.25,0.29,1.92,40
NDC,70092131046,METHOHEXITAL 100 MG/10 ML (10 MG/ML) IN STERILE WATER (PF)  IV SYRINGE,14.73,9.57,2.19,14.73,40
NDC,70092138036,MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.57,0.37,0.08,10.44,51
NDC,70092140043,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,30.75,19.99,4.58,30.75,40
NDC,70092143350,ROPIV 2.46-EPI 0.005-CLONID 0.0008-KETOROL 0.3 MG/ML PERIARTICULR SYRG,4.77,3.1,0.71,4.77,40
NDC,70092144343,BUFFERED LIDOCAINE 0.9 % (1 ML) INJECTION SYRINGE,25.98,16.89,3.87,25.98,40
NDC,70092151246,EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,1.56,1.01,0.23,1.56,40
NDC,70092157536,DILTIAZEM 125 MG/125 ML (1 MG/ML) IN DEXTROSE 5 % IV,0.48,0.31,0.07,0.48,40
NDC,70092158643,LIDOCAINE 15 MG/3 ML(0.5%)-EPINEPH 1:100000-SOD CHL INJECTION SYRINGE,11.37,7.39,1.69,11.37,40
NDC,70092161144,L.E.T. (LIDOCAINE-EPINEPHRINE-TETRACAINE) 4 %-0.05 %-0.5 % TOPICAL GEL,12.92,8.4,1.92,12.92,40
NDC,70092161243,L.E.T. (LIDOCAINE-EPINEPHRINE-TETRACAINE) 4 %-0.05 %-0.5 % TOPICAL GEL,25.64,16.67,3.82,25.64,40
NDC,70092161746,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,3.36,2.18,0.5,3.36,40
NDC,70092165517,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN DEXTROSE 5 % IV,0.78,0.51,0.12,0.78,40
NDC,70092168846,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,3.36,2.18,0.5,3.36,40
NDC,70092169244,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,15.3,9.95,2.28,15.3,40
NDC,70092911944,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,7.65,4.97,1.14,47.96,51
NDC,70092926937,FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.0625 %-NACL INJECTION SOLUTION,0.51,0.33,0.08,0.51,40
NDC,70092933807,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.36,0.23,0.05,0.36,40
NDC,70092940043,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,39.36,25.58,5.86,39.36,40
NDC,7010042402,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,764.07,496.65,113.69,764.07,40
NDC,7010082502,IC GREEN 25 MG SOLUTION FOR INJECTION,1029.0,668.85,153.12,1029.0,40
NDC,7011410101,UDENYCA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,25050.0,16282.5,2.17,25050.0,65
NDC,7011413001,UDENYCA ONBODY 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,25050.0,16282.5,2.17,25050.0,65
NDC,7011434001,LOQTORZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,7805.8,5073.77,2.17,7805.8,65
NDC,7011444101,CIMERLI 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,97920.0,63648.0,83.34,97920.0,65
NDC,7012110491,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,1.32,30.6,51
NDC,7012110492,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,1.32,30.6,51
NDC,7012110495,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,1.32,30.6,51
NDC,7012111681,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,31.2,20.28,1.32,31.2,51
NDC,7012111691,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,23.31,15.15,1.32,23.31,51
NDC,7012114822,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,3600.0,2340.0,2.17,3600.0,65
NDC,7012115731,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,34.71,22.56,0.12,34.71,57
NDC,7012115741,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,58.74,38.18,0.12,58.74,57
NDC,7012115787,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.58,9.48,0.02,14.58,51
NDC,7012115791,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.28,9.28,0.02,14.28,51
NDC,7012116271,FYLNETRA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15000.0,9750.0,127.22,15000.0,65
NDC,7012116311,TEPADINA 100 MG SOLUTION FOR INJECTION,8640.0,5616.0,2.17,8640.0,59
NDC,7012116515,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,1.32,30.6,51
NDC,7012116807,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1148.37,746.44,2.17,1148.37,59
NDC,7012116942,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,3171.0,2061.15,2.17,4417.71,65
NDC,7012117434,NELARABINE 5 MG/ML INTRAVENOUS SOLUTION,63.44,41.24,2.17,4417.71,65
NDC,7012117541,ALYMSYS 25 MG/ML INTRAVENOUS SOLUTION,646.74,420.38,33.01,1287.79,65
NDC,7012117551,ALYMSYS 25 MG/ML INTRAVENOUS SOLUTION,646.74,420.38,33.01,1287.79,65
NDC,7012125011,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,42.54,27.65,2.17,667.03,65
NDC,7012125031,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,65
NDC,7012125042,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,1701.24,1105.81,2.17,1701.24,65
NDC,7012125052,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,65
NDC,7012126311,FOCINVEZ 150 MG/50 ML (3 MG/ML) INTRAVENOUS SOLUTION,33.93,22.05,2.17,47.96,65
NDC,7012710010,EPIDIOLEX 100 MG/ML ORAL SOLUTION,30.78,20.01,4.58,30.78,40
NDC,7012710060,EPIDIOLEX 100 MG/ML ORAL SOLUTION,30.78,20.01,4.58,30.78,40
NDC,7019902611,AQUASOL A 50000 UNIT/ML INTRAMUSCULAR SOLUTION,1293.75,840.94,192.51,1293.75,40
NDC,7025501002,MEKTOVI 15 MG TABLET,227.2,147.68,33.81,227.2,40
NDC,7025502501,BRAFTOVI 75 MG CAPSULE,231.58,150.53,34.46,231.58,40
NDC,7025756001,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,42.54,27.65,2.17,667.03,65
NDC,7025756002,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,1701.24,1105.81,2.17,1701.24,65
NDC,7025756102,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,65
NDC,7025756255,LIORESAL 50 MCG/ML INTRATHECAL SOLUTION,118.68,77.14,2.17,118.68,51
NDC,7025756301,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,65
NDC,7025756302,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,65
NDC,7025756320,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,2.17,667.03,65
NDC,7037010801,INGREZZA 80 MG CAPSULE,704.64,458.02,104.85,704.64,40
NDC,7037020401,INGREZZA 40 MG CAPSULE,644.0,418.6,95.83,644.0,40
NDC,7038220401,DEXTENZA 0.4 MG INTRACANALICULAR INSERT,1536.0,998.4,2.17,1536.0,65
NDC,7038220410,DEXTENZA 0.4 MG INTRACANALICULAR INSERT,1536.0,998.4,2.17,1536.0,65
NDC,7043602780,EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,14.07,9.15,2.17,327.06,59
NDC,7043603901,GUANFACINE ER 1 MG TABLETEXTENDED RELEASE 24 HR,20.98,13.64,3.12,20.98,40
NDC,7043604001,GUANFACINE ER 2 MG TABLETEXTENDED RELEASE 24 HR,20.98,13.64,3.12,20.98,40
NDC,7043615541,PROMETHAZINE-DM 6.25 MG-15 MG/5 ML ORAL SYRUP,0.23,0.15,0.03,0.23,40
NDC,7043619082,ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,125.64,81.67,0.43,125.64,51
NDC,7043622748,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,9.28,6.03,1.38,9.28,40
NDC,7043623039,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,35.18,22.87,5.23,35.18,40
NDC,7043724018,NERLYNX 40 MG TABLET,316.0,205.4,47.02,316.0,40
NDC,7046000401,VAXCHORA VACCINE 4X10EXP8 TO 2X10EXP9 CF UNIT ORAL SUSPENSION,8.25,5.36,1.23,8.25,40
NDC,7050520260,NITISINONE 2 MG CAPSULE,100.0,65.0,14.88,100.0,40
NDC,7051021712,RADICAVA 30 MG/100 ML INTRAVENOUS SOLUTION,23.37,15.19,2.17,720.96,65
NDC,7051526310,LANOXIN PEDIATRIC 100 MCG/ML (0.1 MG/ML) INJECTION SOLUTION,515.61,335.15,2.17,515.61,51
NDC,7053900101,TYMLOS 80 MCG/DOSE (3120 MCG/1.56 ML) SUBCUTANEOUS PEN INJECTOR,6523.89,4240.53,970.75,6523.89,40
NDC,7059402304,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,100.8,65.52,2.17,100.8,51
NDC,7062110110,AMELUZ 10 % TOPICAL GEL,457.2,297.18,1.72,457.2,65
NDC,7070031527,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.55,190.81,1.08,293.55,51
NDC,7071010102,OSELTAMIVIR 75 MG CAPSULE,30.92,20.1,4.6,30.92,40
NDC,7071010141,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,133.98,87.09,19.94,133.98,40
NDC,7071010471,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,3.94,26.46,40
NDC,7071010473,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,3.94,26.46,40
NDC,7071010611,ALBUTEROL SULFATE 2 MG TABLET,11.76,7.64,1.75,11.76,40
NDC,7071011101,CYPROHEPTADINE 4 MG TABLET,2.14,1.39,0.32,2.14,40
NDC,7071011271,URSODIOL 250 MG TABLET,5.36,3.48,0.8,5.36,40
NDC,7071011281,URSODIOL 500 MG TABLET,9.5,6.18,1.41,9.5,40
NDC,7071011583,LEFLUNOMIDE 20 MG TABLET,32.82,21.33,4.88,32.82,40
NDC,7071011793,AMBRISENTAN 5 MG TABLET,665.6,432.64,99.04,665.6,40
NDC,7071012855,BACLOFEN 10 MG TABLET,4.52,2.94,0.67,4.52,40
NDC,7071012861,BACLOFEN 20 MG TABLET,10.26,6.67,1.53,10.26,40
NDC,7071013027,MESALAMINE 1000 MG RECTAL SUPPOSITORY,76.4,49.66,11.37,76.4,40
NDC,7071013653,EMTRICITABINE 133 MG-TENOFOVIR DISOPROXIL FUMARATE 200 MG TABLET,140.02,91.01,20.83,140.02,40
NDC,7071013663,EMTRICITABINE 167 MG-TENOFOVIR DISOPROXIL FUMARATE 250 MG TABLET,140.02,91.01,20.83,140.02,40
NDC,7071014781,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,3600.0,2340.0,2.17,3600.0,65
NDC,7071017416,DASATINIB 20 MG TABLET,384.7,250.06,57.24,384.7,40
NDC,7071017426,DASATINIB 50 MG TABLET,769.4,500.11,114.49,769.4,40
NDC,7071017436,DASATINIB 70 MG TABLET,769.4,500.11,114.49,769.4,40
NDC,7071018527,INDOMETHACIN 50 MG RECTAL SUPPOSITORY,825.14,536.34,122.78,825.14,40
NDC,7072072010,PRIALT 100 MCG/ML INTRATHECAL SOLUTION,4520.82,2938.53,2.17,4520.82,65
NDC,7072072210,PRIALT 100 MCG/ML INTRATHECAL SOLUTION,4290.51,2788.83,2.17,4290.51,65
NDC,7072072310,PRIALT 25 MCG/ML INTRATHECAL SOLUTION,1072.62,697.2,2.17,2642.72,65
NDC,7072095036,ZOLADEX 3.6 MG SUBCUTANEOUS IMPLANT,5659.28,3678.53,2.17,5659.28,65
NDC,7072095130,ZOLADEX 10.8 MG SUBCUTANEOUS IMPLANT,15421.96,10024.27,2.17,15421.96,65
NDC,7074812906,LEFLUNOMIDE 10 MG TABLET,32.84,21.35,4.89,32.84,40
NDC,7074817530,ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION,20.26,13.17,3.01,20.26,40
NDC,7075621590,FENOFIBRATE 160 MG TABLET,4.76,3.09,0.71,4.76,40
NDC,7075640411,NITROFURANTOIN MONOHYDRATE & MACROCRYSTAL 100 MG ORAL CAP,8.16,5.3,1.21,8.16,40
NDC,7075660915,OFLOXACIN 0.3 % EAR DROPS,62.94,40.91,9.37,62.94,40
NDC,7075661430,PHENYLEPHRINE 10 % EYE DROPS,20.0,13.0,2.98,20.0,40
NDC,7075662925,PHENYLEPHRINE 2.5 % EYE DROPS,40.64,26.42,6.05,40.64,40
NDC,7075664935,PHENYLEPHRINE 2.5 % EYE DROPS,15.0,9.75,2.23,15.0,40
NDC,7075680630,LANSOPRAZOLE 15 MG CAPSULEDELAYED RELEASE,9.44,6.14,1.4,9.44,40
NDC,7083915030,TEKTURNA 150 MG TABLET,27.62,17.95,4.11,27.62,40
NDC,7083930030,TEKTURNA 300 MG TABLET,34.86,22.66,5.19,34.86,40
NDC,7083936204,COCAINE 4 % NASAL SOLUTION,193.8,125.97,2.17,193.8,51
NDC,7084212001,VABOMERE 2 GRAM INTRAVENOUS SOLUTION,825.03,536.27,2.09,825.03,65
NDC,7084212006,VABOMERE 2 GRAM INTRAVENOUS SOLUTION,825.03,536.27,2.09,825.03,65
NDC,7084216010,MINOCIN 100 MG INTRAVENOUS SOLUTION,958.53,623.04,2.17,958.53,65
NDC,7084222501,KIMYRSA 1200 MG INTRAVENOUS SOLUTION,20173.38,13112.7,2.17,20173.38,65
NDC,7084224001,REZZAYO 200 MG INTRAVENOUS SOLUTION,7673.16,4987.55,2.17,7673.16,65
NDC,7086020005,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,9.6,6.24,0.18,9.6,43
NDC,7086021051,ZOLEDRONIC ACID 4 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1.71,1.11,0.25,47.96,51
NDC,7086021461,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,960.0,624.0,2.17,1287.79,65
NDC,7086080101,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,6.48,4.21,0.96,8.86,51
NDC,7095401510,THIOTHIXENE 2 MG CAPSULE,3.14,2.04,0.47,3.14,40
NDC,7095401610,THIOTHIXENE 5 MG CAPSULE,4.76,3.09,0.71,4.76,40
NDC,7095401710,THIOTHIXENE 10 MG CAPSULE,6.72,4.37,1.0,6.72,40
NDC,7095402110,PRAZOSIN 5 MG CAPSULE,4.36,2.83,0.65,4.36,40
NDC,7095404110,RIFABUTIN 150 MG CAPSULE,34.98,22.74,5.21,34.98,40
NDC,7095405110,FELBAMATE 600 MG/5 ML ORAL SUSPENSION,6.78,4.41,1.01,6.78,40
NDC,7095413520,DAPSONE 25 MG TABLET,4.4,2.86,0.65,4.4,40
NDC,7095413610,DAPSONE 100 MG TABLET,6.04,3.93,0.9,6.04,40
NDC,7095413620,DAPSONE 100 MG TABLET,5.4,3.51,0.8,5.4,40
NDC,7095414010,LEVOCARNITINE 100 MG/ML ORAL SOLUTION,0.98,0.64,0.15,0.98,40
NDC,7095414810,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,7.08,4.6,1.05,7.08,40
NDC,7095415110,NAPROXEN 125 MG/5 ML ORAL SUSPENSION,5.98,3.89,0.89,5.98,40
NDC,7095415720,CLORAZEPATE DIPOTASSIUM 15 MG TABLET,10.9,7.09,1.62,10.9,40
NDC,7095415850,CLORAZEPATE DIPOTASSIUM 7.5 MG TABLET,10.04,6.53,1.49,10.04,40
NDC,7095415950,CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET,8.06,5.24,1.2,8.06,40
NDC,7095431910,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,3.95,2.57,0.59,3.95,40
NDC,7095440110,DEXAMETHASONE 1.5 MG TABLET,0.96,0.62,0.02,8.86,51
NDC,7095440310,DEXAMETHASONE 4 MG TABLET,2.38,1.55,0.35,2.38,40
NDC,7095451810,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,2.58,1.68,0.38,2.58,40
NDC,7095454110,TRIMETHOPRIM 100 MG TABLET,4.66,3.03,0.69,4.66,40
NDC,7095456510,ESTRADIOL 1 MG TABLET,1.36,0.88,0.2,1.36,40
NDC,7095456610,ESTRADIOL 2 MG TABLET,1.88,1.22,0.28,1.88,40
NDC,7095497820,BROMOCRIPTINE 2.5 MG TABLET,7.52,4.89,1.12,7.52,40
NDC,7110480101,ELOCTATE 250 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480201,ELOCTATE 500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480301,ELOCTATE 750 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480401,ELOCTATE 1000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480501,ELOCTATE 1500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480601,ELOCTATE 2000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480701,ELOCTATE 3000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480801,ELOCTATE 4000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110480901,ELOCTATE 5000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110481001,ELOCTATE 6000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,2.17,4417.71,65
NDC,7110491101,ALPROLIX 500 UNIT INTRAVENOUS SOLUTION,14.55,9.46,2.17,4417.71,65
NDC,7110492201,ALPROLIX 1000 UNIT INTRAVENOUS SOLUTION,14.55,9.46,2.17,4417.71,65
NDC,7110498101,ALTUVIIIO 1000 (+/-) UNIT INTRAVENOUS SOLUTION,20.49,13.32,2.17,4487.68,65
NDC,7126665191,PHENOL 6 % INJECTION SOLUTION,26.79,17.41,3.99,26.79,40
NDC,7126666703,GENTAMICIN 960 MCG/3 ML IN 4 % SODIUM CITRATE INTRA-CATHETER SYRINGE,5.76,3.74,0.86,5.76,40
NDC,7126680201,AMINOPROTECT 25 MG-25 MG/ML INTRAVENOUS SOLUTION,0.63,0.41,0.09,0.63,40
NDC,7128500091,CARDIOPLEGIA REPERFUSATE 4:1  15 MEQ/500 ML (POTASSIUM) PERFUSION SOLN,1.02,0.66,0.15,1.02,40
NDC,7128501011,CARDIOPLEGIA INDUCTION 4:1  36 MEQ/500 ML(POTASSIUM)PERFUSION SOLUTION,0.72,0.47,0.11,0.72,39
NDC,7128501041,CARDIOPLEGIA MAINTENANCE 4:1  36 MEQ/L (POTASSIUM) PERFUSION SOLUTION,0.48,0.31,0.07,0.48,40
NDC,7128502021,CARDIOPLEGIA DEL NIDO FORMULA 26 MEQ/1052.8 ML (POTASSIUM) PERFUSION,0.18,0.12,0.03,0.18,40
NDC,7128560581,PHENYLEPHRINE 10 MG/250 ML(40 MCG/ML)IN 0.9 % SOD.CHLORIDE INTRAVENOUS,0.15,0.1,0.02,0.15,40
NDC,7128560731,VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,40
NDC,7128560751,VANCOMYCIN 1.5 GRAM/250 ML IN DEXTROSE 5% INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,40
NDC,7128570181,EPINEPHRINE HCL 4 MG/250 ML (16 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.24,0.16,0.04,0.24,40
NDC,7128570231,HEPARIN (PORCINE) 5000 UNIT/500 ML(10 UNIT/ML) IN 0.9 % NACL IV SOLN,0.09,0.06,0.01,0.09,40
NDC,7128580862,TROMETHAMINE 1.8 GRAM/50 ML (0.3 MOLAR) IN STERILE WATER IV SYRINGE,5.79,3.76,0.86,5.79,40
NDC,7128590001,VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV,9.54,6.2,1.42,9.54,40
NDC,7128711901,YESCARTA INTRAVENOUS SUSPENSION,2417184.0,1571169.6,0.02,2417184.0,64
NDC,7128721901,TECARTUS 2X10EXP6 TO 2X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,0.02,2217600.0,64
NDC,7128722001,TECARTUS 1X10EXP6 TO 1X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,0.02,2217600.0,64
NDC,7128801911,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,378.0,245.7,2.17,378.0,51
NDC,7128802730,VORICONAZOLE 200 MG INTRAVENOUS POWDER FOR SOLUTION,126.0,81.9,1.34,126.0,51
NDC,7128811728,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,4.0,2.6,0.6,47.96,51
NDC,7128811754,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,4.08,2.65,0.61,47.96,51
NDC,7128816610,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,144.0,93.6,2.17,2642.72,65
NDC,7128816750,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,720.0,468.0,2.17,2642.72,65
NDC,7128840905,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,6.48,4.21,0.62,8.86,51
NDC,7128842711,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,252.0,163.8,0.28,252.0,51
NDC,7128870105,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,3.42,2.22,0.51,3.42,40
NDC,7128870210,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,3.39,2.2,0.5,3.39,40
NDC,7128870211,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,3.39,2.2,0.5,3.39,40
NDC,7128880321,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,261.0,169.65,0.66,667.03,51
NDC,7128880651,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,3.6,2.34,0.54,47.96,51
NDC,7132180230,VITAMIN E (DL ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS,3.38,2.2,0.5,3.38,40
NDC,7132180320,CALCIUM ACETATE 667 MG TABLET,0.3,0.2,0.04,0.3,40
NDC,7133200101,TAVALISSE 100 MG TABLET,614.0,399.1,91.36,614.0,40
NDC,7133200201,TAVALISSE 150 MG TABLET,614.0,399.1,91.36,614.0,40
NDC,7133610001,ONPATTRO 2 MG/ML INTRAVENOUS SOLUTION,7045.2,4579.38,2.17,13108.79,65
NDC,7133610011,GIVLAARI 189 MG/ML SUBCUTANEOUS SOLUTION,158018.4,102711.96,2.17,158018.4,65
NDC,7133610031,AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,859327.2,558562.68,2.17,859327.2,65
NDC,7134907006,YCANTH 0.7 % TOPICAL SOLUTION APPLICATOR,1725.6,1121.64,256.77,1725.6,51
NDC,7139001111,BYFAVO 20 MG INTRAVENOUS SOLUTION,157.74,102.53,2.17,157.74,51
NDC,7139900396,ONELAX DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,0.08,0.05,0.01,0.08,40
NDC,7139901224,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,0.08,0.05,0.01,0.08,40
NDC,7139901606,CHILDREN'S PAIN RELIEF 160 MG/5 ML ORAL ELIXIR,0.03,0.02,0.01,0.03,40
NDC,7139905001,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,3.28,2.13,0.49,3.28,40
NDC,7139910271,DIPHENHYDRAMINE 25 MG CAPSULE,0.26,0.17,0.04,0.26,40
NDC,7139982452,SENNA LAXATIVE 8.6 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,7144909042,LIDOCAINE 1 %-PHENYLEPHRINE 1.5 % IN STERILE WATER INTRAOCULAR SOLN,101.52,65.99,15.11,101.52,40
NDC,7144909190,BEVACIZUMAB 2.75 MG/0.11 ML INTRAVITREAL SYRINGE,2814.54,1829.45,418.8,2814.54,40
NDC,7144909199,BEVACIZUMAB 2.25 MG/0.09 ML INTRAVITREAL SYRINGE,1045.44,679.54,155.56,1045.44,40
NDC,7144909245,CYCLOPENTOLATE 1 %-TROPICAM 1 %-PHENYLEPHRINE 2.5 % IN WATER EYE DROPS,115.2,74.88,17.14,115.2,40
NDC,7144909246,CYCLOPENTOLATE 1 %-TROPICAM 1 %-PHENYLEPHRINE 2.5 % IN WATER EYE DROPS,35.04,22.78,5.21,35.04,40
NDC,7144909742,MOXIFLOXACIN (PF) 5 MG/ML IN SODIUM CHLORIDEISO-OSM INTRAOCULAR SOLN,68.04,44.23,10.12,68.04,40
NDC,7146923101,GLEOLAN 30 MG/ML ORAL SOLUTION,55.78,36.26,8.3,55.78,40
NDC,7165606620,LIKMEZ 500 MG/5 ML ORAL SUSPENSION,8.18,5.32,1.22,8.18,40
NDC,7165606675,LIKMEZ 500 MG/5 ML ORAL SUSPENSION,8.18,5.32,1.22,8.18,40
NDC,7169902530,XCOPRI 25 MG TABLET,100.16,65.1,14.9,100.16,40
NDC,7169905030,XCOPRI 50 MG TABLET,100.16,65.1,14.9,100.16,40
NDC,7169910030,XCOPRI 100 MG TABLET,100.16,65.1,14.9,100.16,40
NDC,7169915030,XCOPRI 150 MG TABLET,100.16,65.1,14.9,100.16,40
NDC,7169920030,XCOPRI 200 MG TABLET,100.16,65.1,14.9,100.16,40
NDC,7171500102,NUZYRA 100 MG INTRAVENOUS SOLUTION,1770.78,1151.01,2.17,1770.78,65
NDC,7174011230,SSKI 1 GRAM/ML ORAL SOLUTION,47.6,30.94,7.08,47.6,40
NDC,7177010560,SIKLOS 100 MG TABLET,15.44,10.04,2.3,15.44,40
NDC,7177305012,XERAVA 50 MG INTRAVENOUS SOLUTION,262.5,170.63,1.29,262.5,59
NDC,7177610005,FLAREX 0.1 % EYE DROPSSUSPENSION,60.02,39.01,8.93,60.02,40
NDC,7177912502,COPIKTRA 25 MG CAPSULE,774.62,503.5,115.26,774.62,40
NDC,7183710002,BIZENGRI 375 MG/18.75 ML (20 MG/ML) INTRAVENOUS SOLUTION,3067.36,1993.78,2.17,4417.71,59
NDC,7183758435,LEUKINE 250 MCG SOLUTION FOR INJECTION,1132.65,736.22,2.17,1132.65,65
NDC,7188110145,PALFORZIA (LEVEL  1) 3 MG (1 MG X 3) SPRINKLE CAPSULE,31.16,20.25,4.64,31.16,40
NDC,7188110290,PALFORZIA (LEVEL  2) 6 MG (1 MG X 6) SPRINKLE CAPSULE,15.58,10.13,2.32,15.58,40
NDC,7188110345,PALFORZIA (LEVEL  3) 12 MG (1 MG X 2 10 MG X 1) SPRINKLE CAPSULE,31.16,20.25,4.64,31.16,40
NDC,7188110415,PALFORZIA (LEVEL  4) 20 MG SPRINKLE CAPSULE,93.48,60.76,13.91,93.48,40
NDC,7188110530,PALFORZIA (LEVEL  5) 40 MG (20 MG X 2) SPRINKLE CAPSULE,46.74,30.38,6.95,46.74,40
NDC,7188110660,PALFORZIA (LEVEL  6) 80 MG (20 MG X 4) SPRINKLE CAPSULE,23.38,15.2,3.48,23.38,40
NDC,7188110730,PALFORZIA (LEVEL  7) 120 MG (20 MG X 1 100 MG X1) SPRINKLE CAPSULE,46.74,30.38,6.95,46.74,40
NDC,7188110860,PALFORZIA (LEVEL  8) 160 MG (20 MG X 3 100 MG X1) SPRINKLE CAPSULE,23.38,15.2,3.48,23.38,40
NDC,7188110930,PALFORZIA (LEVEL  9) 200 MG (100 MG X 2) SPRINKLE CAPSULE,46.74,30.38,6.95,46.74,40
NDC,7188111060,PALFORZIA (LEVEL 10) 240 MG(20 MG X 2 100 MG X 2) SPRINKLE CAPSULE,23.38,15.2,3.48,23.38,40
NDC,7188111115,PALFORZIA (LEVEL 11 UP-DOSE) 300 MG ORAL POWDER PACKET,93.48,60.76,13.91,93.48,40
NDC,7188111130,PALFORZIA (LEVEL 11 MAINTENANCE) 300 MG ORAL POWDER PACKET,93.48,60.76,13.91,93.48,40
NDC,7188111313,PALFORZIA INITIAL(4-17YRS) 0.5 MG/1 MG/1.5 MG/3 MG/6 MG SPRNK CAPSULE,7.28,4.73,1.08,7.28,40
NDC,7189412002,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412103,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412203,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412303,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412404,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412504,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412604,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412705,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412805,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189412905,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413006,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413106,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413206,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413307,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413407,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413507,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413608,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413708,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413808,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189413909,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189414009,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7189414109,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,0.02,7670115.76,65
NDC,7190420001,POMBILITI 105 MG INTRAVENOUS SOLUTION,7052.4,4584.06,2.17,13108.79,65
NDC,7190430001,OPFOLDA 65 MG CAPSULE,85.2,55.38,2.17,130.36,51
NDC,7192117820,ABIRATERONE 250 MG TABLET,4.5,2.93,0.67,4.5,40
NDC,7192130856,VARENICLINE TARTRATE 0.5 MG TABLET,18.56,12.06,2.76,18.56,40
NDC,7193002890,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,2.44,1.59,0.36,2.44,40
NDC,7206014240,CAPLYTA 42 MG CAPSULE,136.8,88.92,20.36,136.8,40
NDC,7206411030,AYVAKIT 100 MG TABLET,3266.96,2123.52,486.12,3266.96,40
NDC,7206412030,AYVAKIT 200 MG TABLET,3266.96,2123.52,486.12,3266.96,40
NDC,7206412530,AYVAKIT 25 MG TABLET,3266.96,2123.52,486.12,3266.96,40
NDC,7206413030,AYVAKIT 300 MG TABLET,3266.96,2123.52,486.12,3266.96,40
NDC,7206415030,AYVAKIT 50 MG TABLET,3266.96,2123.52,486.12,3266.96,40
NDC,7207803300,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,10.8,7.02,0.69,47.96,51
NDC,7207803302,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,10.8,7.02,0.69,47.96,51
NDC,7207803401,ULTIVA 1 MG INTRAVENOUS SOLUTION,242.49,157.62,36.08,242.49,40
NDC,7207803502,ULTIVA 2 MG INTRAVENOUS SOLUTION,484.98,315.24,72.17,484.98,40
NDC,7207803605,ULTIVA 5 MG INTRAVENOUS SOLUTION,1031.88,670.72,153.54,1031.88,40
NDC,7207806699,VANCOMYCIN 2 GRAM INTRAVENOUS SOLUTION,154.08,100.15,0.18,154.08,51
NDC,7207808106,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,112.53,73.14,1.62,112.53,57
NDC,7214000021,EUCERIN TOPICAL CREAM,0.1,0.07,0.01,0.1,40
NDC,7214000022,EUCERIN TOPICAL CREAM,0.22,0.14,0.03,0.22,40
NDC,7214001945,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.2,0.13,0.03,0.2,40
NDC,7214003147,AQUAPHOR ORIGINAL 41 % TOPICAL OINTMENT,0.12,0.08,0.02,0.12,40
NDC,7214003868,EUCERIN TOPICAL CREAM,0.3,0.2,0.04,0.3,40
NDC,7214011047,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.86,0.56,0.13,0.86,40
NDC,7214045231,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.34,0.22,0.05,0.34,40
NDC,7214063377,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.3,0.2,0.04,0.3,40
NDC,7214063608,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.14,0.09,0.02,0.14,40
NDC,7218701013,ORSERDU 86 MG TABLET,660.92,429.6,98.34,660.92,40
NDC,7218701023,ORSERDU 345 MG TABLET,1982.74,1288.78,295.03,1982.74,40
NDC,7218704011,ELZONRIS 1000 MCG/ML INTRAVENOUS SOLUTION,162031.92,105320.75,2.17,162031.92,65
NDC,7219601011,CARDIOPLEGIC SOLN 30 (INDUCT 4:1) 36 MEQ/500 ML (POTASSIUM) PERFUSION,0.72,0.47,0.11,0.72,39
NDC,7219601041,CARDIOPLEGIC SOLN NO.26(MAINT 4:1) 36 MEQ/L (POTASSIUM) FOR PERFUSION,0.48,0.31,0.07,0.48,40
NDC,7219604181,AMINO ACID 2.5 % PED-D10-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,0.57,0.37,0.08,0.57,40
NDC,7219660751,VANCOMYCIN 1.5 GRAM/250 ML IN DEXTROSE 5% INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,40
NDC,7220502390,ATORVASTATIN 20 MG TABLET,10.98,7.14,1.63,10.98,40
NDC,7220503960,DOFETILIDE 125 MCG CAPSULE,19.48,12.66,2.9,19.48,40
NDC,7220505108,ALBENDAZOLE 200 MG TABLET,457.82,297.58,68.12,457.82,40
NDC,7220508430,TIAGABINE 2 MG TABLET,15.88,10.32,2.36,15.88,40
NDC,7220508530,TIAGABINE 4 MG TABLET,15.88,10.32,2.36,15.88,40
NDC,7220509191,DOXEPIN 75 MG CAPSULE,3.62,2.35,0.54,3.62,40
NDC,7220520030,ROFLUMILAST 500 MCG TABLET,24.76,16.09,3.68,24.76,40
NDC,7220526030,VILAZODONE 10 MG TABLET,20.6,13.39,3.07,20.6,40
NDC,7220526130,VILAZODONE 20 MG TABLET,20.6,13.39,3.07,20.6,40
NDC,7223710103,XPOVIO 60 MG TWICE WEEKLY (120 MG/WEEK) (20 MG X 6) TABLET,3472.2,2256.93,516.66,3472.2,40
NDC,7223710202,XPOVIO 80 MG/WEEK (40 MG X 2) TABLET,10416.6,6770.79,1549.99,10416.6,40
NDC,7223710206,XPOVIO 40 MG TWICE WEEK (40 MG X 2) TABLET,10416.6,6770.79,1549.99,10416.6,40
NDC,7223710305,XPOVIO 100 MG/WEEK (50 MG X 2) TABLET,10416.6,6770.79,1549.99,10416.6,40
NDC,7223710401,XPOVIO 60 MG/WEEK (60 MG X 1) TABLET,20833.2,13541.58,3099.98,20833.2,40
NDC,7224101303,RIVASTIGMINE 4.5 MG CAPSULE,0.4,0.26,0.06,0.4,40
NDC,7224101403,RIVASTIGMINE 6 MG CAPSULE,0.4,0.26,0.06,0.4,40
NDC,7224103122,PAROXETINE ER 37.5 MG TABLETEXTENDED RELEASE 24 HR,1.26,0.82,0.19,1.26,40
NDC,7226611825,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,6.3,4.1,0.31,8.86,65
NDC,7226616010,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,118.05,76.73,2.17,118.05,51
NDC,7226616201,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,6.0,3.9,0.09,47.96,51
NDC,7226625110,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,35.82,23.28,2.12,35.82,51
NDC,7231900602,SELEGILINE 5 MG TABLET,4.2,2.73,0.62,4.2,40
NDC,7242611803,NEXLETOL 180 MG TABLET,34.62,22.5,5.15,34.62,40
NDC,7248511310,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,50.4,32.76,7.5,50.4,40
NDC,7248520290,IMATINIB 100 MG TABLET,202.0,131.3,30.06,202.0,40
NDC,7248521730,ERLOTINIB 25 MG TABLET,206.76,134.39,30.77,206.76,40
NDC,7248550725,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,11.16,7.25,1.66,11.16,40
NDC,7248561110,LIDOCAINE HCL 2 % MUCOSAL JELLY,1.34,0.87,0.2,1.34,40
NDC,7248562513,CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPSSUSPENSION,41.02,26.66,6.1,41.02,40
NDC,7249310303,JELMYTO 40 MG X 2 INTRA-PYELOCALYCEAL KIT,122136.0,79388.4,2.17,122136.0,65
NDC,7251139301,REPATHA SURECLICK 140 MG/ML SUBCUTANEOUS PEN INJECTOR,1030.86,670.06,153.39,1030.86,40
NDC,7251175001,REPATHA SYRINGE 140 MG/ML SUBCUTANEOUS SYRINGE,1030.86,670.06,153.39,1030.86,40
NDC,7251177001,REPATHA PUSHTRONEX 420 MG/3.5 ML SUBCUTANEOUS WEARABLE INJECTOR,638.19,414.82,94.96,638.19,40
NDC,7251292801,QUTENZA 8 % TOPICAL KIT,2180.26,1417.17,2.17,2180.26,65
NDC,7251292901,QUTENZA 8 % TOPICAL KIT,4360.48,2834.31,2.17,4360.48,65
NDC,7251293001,QUTENZA 8 % TOPICAL KIT,8721.0,5668.65,2.17,8721.0,65
NDC,7251603150,METOPROLOL SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,2.52,1.64,0.37,2.52,40
NDC,7257805601,FELBAMATE 400 MG TABLET,5.58,3.63,0.83,5.58,40
NDC,7257808601,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.59,10.7,40
NDC,7257808602,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.59,10.7,40
NDC,7257808901,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.24,1.46,0.33,2.24,40
NDC,7257808904,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,1.78,1.16,0.26,1.78,40
NDC,7257809501,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,14.16,9.2,2.11,14.16,40
NDC,7257809818,LEVOFLOXACIN 250 MG TABLET,33.62,21.85,5.0,33.62,40
NDC,7257809918,LEVOFLOXACIN 500 MG TABLET,38.54,25.05,5.73,38.54,40
NDC,7257817301,THEOPHYLLINE ER 300 MG TABLETEXTENDED RELEASE12 HR,8.6,5.59,1.28,8.6,40
NDC,7257901102,BRUKINSA 80 MG CAPSULE,314.88,204.67,46.85,314.88,40
NDC,7260601101,VEGZELMA 25 MG/ML INTRAVENOUS SOLUTION,812.88,528.37,38.15,1287.79,65
NDC,7260601201,VEGZELMA 25 MG/ML INTRAVENOUS SOLUTION,812.88,528.37,38.15,1287.79,65
NDC,7260602901,STEQEYMA 130 MG/26 ML INTRAVENOUS SOLUTION,42.06,27.34,6.26,4487.68,51
NDC,7260603701,STOBOCLO 60 MG/ML SUBCUTANEOUS SYRINGE,6413.97,4169.08,28.13,6413.97,59
NDC,7260603801,OSENVELT 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6940.05,4511.03,28.13,6940.05,59
NDC,7260710000,TAZVERIK 200 MG TABLET,207.76,135.04,30.91,207.76,40
NDC,7261176101,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.04,10.8,51
NDC,7261176110,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.04,10.8,51
NDC,7261178502,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,4643.61,3018.35,2.17,4643.61,65
NDC,7261830002,NURTEC ODT 75 MG DISINTEGRATING TABLET,322.58,209.68,48.0,322.58,40
NDC,7262627011,SOFOSBUVIR 400 MG-VELPATASVIR 100 MG TABLET,685.72,445.72,102.04,685.72,40
NDC,7262722021,TESTOSTERONE 100 MG IMPLANT PELLET,174.0,113.1,25.89,174.0,40
NDC,7264733104,METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK,3.3,2.15,0.25,8.86,51
NDC,7269451501,ASPARLAS 750 UNIT/ML INTRAVENOUS SOLUTION,21428.67,13928.64,2.17,21428.67,59
NDC,7269461760,TIBSOVO 250 MG TABLET,1415.14,919.84,210.57,1415.14,40
NDC,7269472840,VORANIGO 40 MG TABLET,3293.24,2140.61,490.03,3293.24,40
NDC,7269487910,VORANIGO 10 MG TABLET,1646.62,1070.3,245.02,1646.62,40
NDC,7269495401,ONCASPAR 750 UNIT/ML INJECTION SOLUTION,26386.12,17150.98,2.17,84209.09,65
NDC,7288808401,ISOSORBIDE DINITRATE 30 MG TABLET,2.62,1.7,0.39,2.62,40
NDC,7288811201,MIDODRINE 2.5 MG TABLET,3.04,1.98,0.45,3.04,40
NDC,7288811401,MIDODRINE 10 MG TABLET,17.48,11.36,2.6,17.48,40
NDC,7288815401,CLONAZEPAM 2 MG TABLET,2.36,1.53,0.35,2.36,40
NDC,7288817246,LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,1.63,1.06,0.24,1.63,40
NDC,7289300201,BELEODAQ 500 MG INTRAVENOUS SOLUTION,12327.52,8012.89,2.17,12327.52,65
NDC,7289300704,ZEVALIN (Y-90) 3.2 MG/2 ML INTRAVENOUS KIT,148248.86,96361.76,14774.74,168348.38,65
NDC,7290385301,ELAHERE 5 MG/ML INTRAVENOUS SOLUTION,1627.76,1058.04,2.17,13108.79,65
NDC,7296011201,DAXXIFY 100 UNIT INTRAMUSCULAR SOLUTION,1512.0,982.8,2.17,1512.0,65
NDC,7297412001,ORGOVYX 120 MG TABLET,227.62,147.95,33.87,227.62,40
NDC,7304220101,DANYELZA 4 MG/ML INTRAVENOUS SOLUTION,12511.64,8132.57,2.17,13108.79,65
NDC,7309042001,SYLVANT 100 MG INTRAVENOUS SOLUTION,7882.64,5123.72,2.17,7882.64,65
NDC,7309042101,SYLVANT 400 MG INTRAVENOUS SOLUTION,31530.64,20494.92,2.17,31530.64,65
NDC,73090800002,SALIVA SUBSTITUTE COMBO NO.2,1.0,0.65,0.15,1.0,40
NDC,7315015006,BRIUMVI 25 MG/ML INTRAVENOUS SOLUTION,6666.0,4332.9,2.17,13108.79,65
NDC,7315390001,BREYANZI 1.5X TO 70X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,2678006.0,1740703.9,0.02,2678006.0,64
NDC,7317710102,KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLORISO-OSMOTIC IV SYRINGE,4.77,3.1,0.71,4.77,40
NDC,7317710201,FENTANYL (PF) 20 MCG/2 ML (10 MCG/ML) IN 0.9 % SOD CHLORIDE IV SYRINGE,10.77,7.0,1.6,10.77,40
NDC,7317710401,HYDROMORPHONE (PF) 0.4 MG/2 ML (0.2 MG/ML) IN NACL ISO-OSM IV SYRINGE,11.4,7.41,1.7,11.4,40
NDC,7317710405,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN NACL ISO-OSM IV PCA SYR,1.02,0.66,0.15,1.02,40
NDC,7317710505,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,1.11,0.72,0.17,10.44,51
NDC,7317710605,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN SOD CHLORISO-OSM IV SYRINGE,1.5,0.98,0.22,8.86,51
NDC,7317710803,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,2.25,1.46,0.33,2.25,40
NDC,7317712119,L.E.T. (LIDOCAINE-EPINEPHRINE BIT-TETRACAINE) 4 %-0.09 %-0.5 % TOP GEL,8.82,5.73,1.31,8.82,40
NDC,7317712302,DEXMEDETOMIDINE 20 MCG/5 ML (4 MCG/ML) IN 0.9 % SODIUM CHLR IV SYRINGE,8.61,5.6,1.28,8.61,40
NDC,7317714633,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,6.0,3.9,0.89,6.0,40
NDC,7317714902,METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,14.4,9.36,2.14,14.4,40
NDC,7317715527,KETAMINE (PF) 5 MG/ML IN SODIUM CHLORIDE ISO-OSMOTIC IV SOLUTION,1.05,0.68,0.16,1.05,40
NDC,7317715602,KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLORISO-OSMOTIC IV SYRINGE,4.77,3.1,0.71,47.96,51
NDC,7317716333,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,6.0,3.9,0.89,6.0,40
NDC,7320710130,QINLOCK 50 MG TABLET,1243.2,808.08,184.99,1243.2,40
NDC,7320730240,ROMVIMZA 14 MG CAPSULE,8308.8,5400.72,1236.35,8308.8,40
NDC,7320730340,ROMVIMZA 20 MG CAPSULE,8308.8,5400.72,1236.35,8308.8,40
NDC,7320730440,ROMVIMZA 30 MG CAPSULE,8308.8,5400.72,1236.35,8308.8,40
NDC,7330245601,ELLA 30 MG TABLET,93.0,60.45,13.84,93.0,40
NDC,7337201161,SCENESSE 16 MG SUBCUTANEOUS IMPLANT,120982.0,78638.3,2.17,120982.0,65
NDC,7344180004,OMISIRGE INTRAVENOUS SUSPENSION,3330720.0,2164968.0,41.42,3330720.0,47
NDC,7347530415,VYVGART 20 MG/ML INTRAVENOUS SOLUTION,1136.55,738.76,2.17,7011.25,65
NDC,7347531023,VYVGART HYTRULO 1008 MG-11200 UNIT/5.6 ML SUBCUTANEOUS SOLUTION,10549.44,6857.14,2.17,10549.44,65
NDC,7353650001,BESREMI 500 MCG/ML SUBCUTANEOUS SYRINGE,33084.0,21504.6,41.42,33084.0,51
NDC,7355411111,LYFGENIA 1.7 X TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,14880000.0,9672000.0,0.02,14880000.0,62
NDC,7355431111,ZYNTEGLO 2 X 10EXP6 TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,13440000.0,8736000.0,0.02,13440000.0,62
NDC,7355550000,REVUFORJ 25 MG TABLET,830.0,539.5,41.42,830.0,51
NDC,7355550100,REVUFORJ 110 MG TABLET,1639.26,1065.52,41.42,1639.26,51
NDC,7355550200,REVUFORJ 160 MG TABLET,1639.26,1065.52,41.42,1639.26,51
NDC,7355616801,TAVNEOS 10 MG CAPSULE,238.42,154.97,35.48,238.42,40
NDC,7355616802,TAVNEOS 10 MG CAPSULE,238.38,154.95,35.47,238.38,40
NDC,7356210410,VIOKACE 10440 UNIT-39150 UNIT-39150 UNIT TABLET,10.44,6.79,1.55,10.44,40
NDC,7356211201,ZENPEP 20000 UNIT-63000 UNIT-84000 UNIT CAPSULEDELAYED RELEASE,20.6,13.39,3.07,20.6,40
NDC,7356211501,ZENPEP 5000 UNIT-17000 UNIT-24000 UNIT CAPSULEDELAYED RELEASE,5.32,3.46,0.79,5.32,40
NDC,7356220810,VIOKACE 20880 UNIT-78300 UNIT-78300 UNIT TABLET,20.6,13.39,3.07,20.6,40
NDC,7359493101,MONOFERRIC 100 MG IRON/ML INTRAVENOUS SOLUTION,1314.78,854.61,2.17,1314.78,65
NDC,7360602001,SYFOVRE (PF) 15 MG/0.1 ML INTRAVITREAL SOLUTION,84470.04,54905.53,2.17,84470.04,65
NDC,7360602002,SYFOVRE (PF) 15 MG/0.1 ML INTRAVITREAL SOLUTION,84470.04,54905.53,2.17,84470.04,65
NDC,7360701111,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,16135.5,10488.08,2.17,16135.5,65
NDC,7364811303,RYONCIL 6.68 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,931200.0,605280.0,0.02,931200.0,59
NDC,7377600111,AMTAGVI 7.5 X 10EXP9 TO 72 X 10EXP9 CELL INTRAVENOUS SUSPENSION,2940384.0,1911249.6,41.42,2940384.0,47
NDC,7430000070,DESITIN 40 % TOPICAL PASTE,0.18,0.12,0.03,0.18,40
NDC,7430000300,DESITIN DAILY DEFENSE 13 % TOPICAL CREAM,0.16,0.1,0.02,0.16,40
NDC,7430000301,DESITIN DAILY DEFENSE 13 % TOPICAL CREAM,0.12,0.08,0.02,0.12,40
NDC,7430000421,RID COMPLETE LICE ELIMINATION KIT 0.5 % SPRAY,0.08,0.05,0.01,0.08,40
NDC,7431200640,VITAMIN B-2  100 MG TABLET,0.12,0.08,0.02,0.12,40
NDC,7431202832,MELATONIN 1 MG TABLET,0.06,0.04,0.01,0.06,40
NDC,7452702202,MARGENZA 25 MG/ML INTRAVENOUS SOLUTION,1034.73,672.57,2.17,4487.68,65
NDC,7467659041,TRELSTAR 11.25 MG IM SUSPENSION,10362.0,6735.3,2.17,10362.0,65
NDC,7467659061,TRELSTAR 22.5 MG IM SUSPENSION,20724.0,13470.6,2.17,20724.0,65
NDC,7583360102,HEPZATO (62 MM CATHETER) 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,2.17,181536.0,65
NDC,7583380001,HEPZATO 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,2.17,181536.0,65
NDC,7583415801,VERAPAMIL ER (SR) 180 MG TABLETEXTENDED RELEASE,2.88,1.87,0.43,2.88,40
NDC,7583415901,VERAPAMIL ER (SR) 240 MG TABLETEXTENDED RELEASE,3.28,2.13,0.49,3.28,40
NDC,7583417001,ZINC OXIDE 20 % TOPICAL OINTMENT,0.46,0.3,0.07,0.46,40
NDC,7583424230,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,3.94,26.46,40
NDC,7583428008,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,6.45,4.19,0.96,6.45,40
NDC,7583428030,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,33.48,21.76,4.98,33.48,40
NDC,7583432001,VERAPAMIL ER (SR) 120 MG TABLETEXTENDED RELEASE,2.14,1.39,0.32,2.14,40
NDC,7598705801,KRYSTEXXA 8 MG/50 ML INTRAVENOUS SOLUTION,2213.49,1438.77,2.17,13108.79,65
NDC,7598706008,BUPHENYL 500 MG TABLET,65.42,42.52,9.73,65.42,40
NDC,7598707009,BUPHENYL 0.94 GRAM/GRAM ORAL POWDER,61.48,39.96,9.15,61.48,40
NDC,7598708010,KRYSTEXXA 8 MG/ML INTRAVENOUS SOLUTION,110674.77,71938.6,2.17,110674.77,65
NDC,7598711111,ACTIMMUNE 100 MCG (2 MILLION UNIT)/0.5 ML SUBCUTANEOUS SOLUTION,40606.35,26394.13,2.17,40606.35,51
NDC,7598713015,TEPEZZA 500 MG INTRAVENOUS SOLUTION,64868.22,42164.34,2.17,64868.22,65
NDC,7598715003,UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION,16829.82,10939.38,2.17,16829.82,65
NDC,7601490210,BLOXIVERZ 0.5 MG/ML INTRAVENOUS SOLUTION,27.45,17.84,1.5,27.45,51
NDC,7604500120,MIDAZOLAM (PF) 2 MG/2 ML (1 MG/ML) INJECTION SYRINGE,5.64,3.67,0.25,8.86,51
NDC,7604500411,MORPHINE 2 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,51
NDC,7604500510,MORPHINE 4 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,51
NDC,7604500511,MORPHINE 4 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,51
NDC,7604500610,MORPHINE 5 MG/ML INJECTION SYRINGE,10.32,6.71,1.54,12.05,51
NDC,7604500906,DILAUDID (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,29.88,19.42,0.09,29.88,57
NDC,7604500911,DILAUDID (PF) 1 MG/ML INJECTION SYRINGE,14.94,9.71,0.09,14.94,57
NDC,7604500996,DILAUDID (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,29.88,19.42,0.09,29.88,57
NDC,7604510210,DIPHENHYDRAMINE 50 MG/ML INJECTION SYRINGE,9.36,6.08,1.26,9.36,51
NDC,7604510910,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SYRINGE,20.82,13.53,0.2,20.82,51
NDC,7607510101,KYPROLIS 60 MG INTRAVENOUS SOLUTION,16978.52,11036.04,2.17,16978.52,65
NDC,7607510201,KYPROLIS 30 MG INTRAVENOUS SOLUTION,8489.28,5518.03,2.17,8489.28,65
NDC,7607510301,KYPROLIS 10 MG INTRAVENOUS SOLUTION,2829.76,1839.34,2.17,2829.76,65
NDC,7612815575,PHOTOFRIN 75 MG INTRAVENOUS SOLUTION,111950.4,72767.76,2.17,111950.4,65
NDC,7620402160,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.42,0.27,0.06,0.42,40
NDC,7620402260,SODIUM CHLORIDE 3 % FOR NEBULIZATION,0.42,0.27,0.06,0.42,40
NDC,7620420001,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.94,0.61,0.14,0.94,40
NDC,7620420030,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.88,0.57,0.13,0.88,40
NDC,7620460030,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.46,0.95,0.22,1.46,40
NDC,7620460060,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.46,0.95,0.22,1.46,40
NDC,7620470001,LEVALBUTEROL 0.31 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.2,1.34,40
NDC,7620470011,LEVALBUTEROL 0.31 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.2,1.34,40
NDC,7620480001,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.2,1.34,40
NDC,7620480011,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.2,1.34,40
NDC,7620490001,LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.2,1.34,40
NDC,7629700122,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.15,0.1,0.02,0.15,43
NDC,7629943004,NITROMIST 400 MCG/SPRAY TRANSLINGUAL AEROSOL,176.86,114.96,26.32,176.86,40
NDC,7631001750,ETHYOL 500 MG INTRAVENOUS SOLUTION,3857.07,2507.1,2.17,3857.07,51
NDC,7631002401,FOSCAVIR 24 MG/ML INTRAVENOUS SOLUTION,4.95,3.22,0.74,184.43,57
NDC,7631002425,FOSCAVIR 24 MG/ML INTRAVENOUS SOLUTION,6.9,4.49,1.03,184.43,57
NDC,7632912401,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,178.05,115.73,2.17,178.05,51
NDC,7632930115,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,2.88,1.87,0.43,2.88,40
NDC,7632930135,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,1.7,1.11,0.25,1.7,40
NDC,7632930155,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,1.22,0.79,0.18,1.22,40
NDC,7632933181,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,4.95,3.22,0.74,8.86,51
NDC,7632933401,ATROPINE 0.1 MG/ML INJECTION SYRINGE,3.75,2.44,0.18,8.86,51
NDC,7632933521,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,1.41,0.92,0.21,1.41,40
NDC,7632933691,NALOXONE 1 MG/ML INJECTION SYRINGE,59.4,38.61,0.12,59.4,51
NDC,7632933901,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,6.45,4.19,0.02,8.86,51
NDC,7632963005,LIDOCAINE HCL 4 % LARYNGOTRACHEAL SOLUTION,18.12,11.78,2.7,18.12,40
NDC,7632990600,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,27.0,17.55,0.82,27.0,51
NDC,7633608060,LYSODREN 500 MG TABLET,46.7,30.36,6.95,46.7,40
NDC,7633645518,METOPIRONE 250 MG CAPSULE,154.6,100.49,23.0,154.6,40
NDC,7638510001,METHSCOPOLAMINE 2.5 MG TABLET,5.58,3.63,0.83,5.58,40
NDC,7638510201,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,3.6,2.34,0.54,3.6,40
NDC,7638511501,SOTALOL 120 MG TABLET,6.84,4.45,1.02,6.84,40
NDC,7638513101,PINDOLOL 5 MG TABLET,4.28,2.78,0.64,4.28,40
NDC,7638513201,PINDOLOL 10 MG TABLET,5.34,3.47,0.79,5.34,40
NDC,7733312050,FIBER LAXATIVE (CALCIUM POLYCARBOPHIL) 625 MG TABLET,1.38,0.9,0.21,1.38,40
NDC,7733351625,MELATONIN 3 MG TABLET,0.52,0.34,0.08,0.52,40
NDC,7733371510,PRENATAL VITAMIN 27 MG IRON-0.8 MG TABLET,0.42,0.27,0.06,0.42,40
NDC,7733381210,SIMETHICONE 80 MG CHEWABLE TABLET,0.48,0.31,0.07,0.48,40
NDC,7733383110,SODIUM BICARBONATE 650 MG TABLET,0.4,0.26,0.06,0.4,40
NDC,7733383510,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.58,0.38,0.09,0.58,40
NDC,7733384410,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.58,0.38,0.09,0.58,40
NDC,7733386110,THERA-VITE MAX-M 9 MG IRON-400 MCG TABLET,0.52,0.34,0.08,0.52,40
NDC,7733386125,THERA-VITE MAX-M 9 MG IRON-400 MCG TABLET,0.52,0.34,0.08,0.52,40
NDC,7733394010,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,7733394025,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.34,0.22,0.05,0.34,40
NDC,7733394825,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,0.46,0.3,0.07,0.46,40
NDC,7733395110,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.52,0.34,0.08,0.52,40
NDC,7733395125,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.52,0.34,0.08,0.52,40
NDC,7733398310,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.46,0.3,0.07,0.46,40
NDC,7733398325,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.46,0.3,0.07,0.46,40
NDC,7779002215,VISTA GONIO 2.5 % EYE DROPS,4.92,3.2,0.73,4.92,40
NDC,7811201103,CHLORASEPTIC THROAT SPRAY 1.4 % AEROSOL,0.1,0.07,0.01,0.1,40
NDC,7811201106,CHLORASEPTIC SORE THROAT 6 MG-10 MG LOZENGES,0.46,0.3,0.07,0.46,40
NDC,7811201266,CHLORASEPTIC SORE THROAT 6 MG-10 MG LOZENGES,0.46,0.3,0.07,0.46,40
NDC,7811210189,CHLORASEPTIC WARMING SORE THROAT 15 MG LOZENGES,0.46,0.3,0.07,0.46,40
NDC,7811210256,CHLORASEPTIC THROAT SPRAY 1.4 % AEROSOL,0.1,0.07,0.01,0.1,40
NDC,7820611402,ASMANEX TWISTHALER 220 MCG/ACTUATION(60 DOSES) BREATH ACTIVATED INHALR,282.96,183.92,42.1,282.96,40
NDC,7820611403,ASMANEX TWISTHALER 220 MCG/ACTUATION(14 DOSES) BREATH ACTIVATED INHALR,93.12,60.53,13.86,93.12,40
NDC,7820611404,ASMANEX TWISTHALER 220 MCG/ACTUATION(30 DOSES) BREATH ACTIVATED INHALR,241.12,156.73,35.88,241.12,40
NDC,7820611501,ASMANEX TWISTHALER 110 MCG/ACTUATION(30 DOSES) BREATH ACTIVATED INHALR,223.3,145.15,33.23,223.3,40
NDC,7820612601,DULERA 200 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,9.41,63.26,40
NDC,7820612602,DULERA 200 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,9.41,63.26,40
NDC,7820612701,DULERA 100 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,9.41,63.26,40
NDC,7820612702,DULERA 100 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,9.41,63.26,40
NDC,7820614501,NEXPLANON 68 MG SUBDERMAL IMPLANT,3060.86,1989.56,2.17,3163.59,51
NDC,7820614701,ONTRUZANT 150 MG INTRAVENOUS SOLUTION,6358.36,4132.93,2.17,6358.36,65
NDC,7820614801,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,2.17,17803.4,65
NDC,7820614899,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,2.17,17803.4,65
NDC,7820616201,RENFLEXIS 100 MG INTRAVENOUS SOLUTION,2712.21,1762.94,2.17,2712.21,65
NDC,7820616299,RENFLEXIS 100 MG INTRAVENOUS SOLUTION,2712.21,1762.94,2.17,2712.21,65
NDC,7820619301,BILDYOS 60 MG/ML SUBCUTANEOUS SYRINGE,3038.4,1974.96,41.42,3038.4,51
NDC,7820619501,BILPREVDA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,3574.59,2323.48,41.42,3574.59,51
NDC,7861320130,SYNDROS 5 MG/ML ORAL SOLUTION,291.72,189.62,43.41,291.72,40
NDC,7867000367,REVONTO 20 MG INTRAVENOUS SOLUTION,252.0,163.8,37.5,252.0,40
NDC,7867015001,IWILFIN 192 MG TABLET,243.84,158.5,36.28,243.84,40
NDC,7980220030,REZUROCK 200 MG TABLET,1523.48,990.26,226.69,1523.48,40
NDC,7995211001,ZYNLONTA 10 MG INTRAVENOUS SOLUTION,104507.16,67929.65,2.17,104507.16,65
NDC,8019629660,SILVASORB TOPICAL GELEXTENDED RELEASE,1.18,0.77,0.18,1.18,40
NDC,8021513548,MULTI-AD TRANSFER SET,10.6,6.89,1.58,10.6,40
NDC,8044640101,KIMMTRAK 100 MCG/0.5 ML INTRAVENOUS SOLUTION,201504.0,130977.6,2.17,201504.0,65
NDC,8065183055,PROVISC 10 MG/ML INTRAOCULAR SYRINGE,1223.4,795.21,182.04,1223.4,40
NDC,8065183085,PROVISC 10 MG/ML INTRAOCULAR SYRINGE,1039.17,675.46,154.63,1039.17,40
NDC,8065183135,DUOVISC VISCO ELASTIC 3 %-4 %(0.35 ML) 1 %(0.4 ML) INTRAOCULAR SYRINGE,1250.55,812.86,186.08,1250.55,40
NDC,8065183150,DUOVISC VISCO ELASTIC 3 %-4 %(0.5 ML) 1 %(0.55 ML) INTRAOCULAR SYRINGE,944.94,614.21,2.17,944.94,51
NDC,8065183710,DISCOVISC 40 MG-17 MG/ML INTRAOCULAR SYRINGE,1189.44,773.14,176.99,1189.44,40
NDC,8065183905,VISCOAT 4 %-3 % (40 MG-30 MG/ML) INTRAOCULAR SYRINGE,1427.55,927.91,212.42,1427.55,40
NDC,8065183975,VISCOAT 4 %-3 % (40 MG-30 MG/ML) INTRAOCULAR SYRINGE,1250.55,812.86,186.08,1250.55,40
NDC,8068101900,NIACINAMIDE 500 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,8068102500,PYRIDOXINE (VITAMIN B6) 100 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,8068104100,MELATONIN 1 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,8068104900,CHILDREN'S MULTIVITAMIN CHEWABLE TABLET,0.06,0.04,0.01,0.06,40
NDC,8068105200,EYE MULTIVITAMIN 2148 MCG-113 MG-45 MG-17.4 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,8068105700,NIACIN 100 MG TABLET,0.04,0.03,0.01,0.04,40
NDC,8068107100,CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET,0.04,0.03,0.01,0.04,40
NDC,8068107400,FOLIC ACID 800 MCG TABLET,0.04,0.03,0.01,0.04,40
NDC,8068108500,MELATONIN 3 MG TABLET,0.14,0.09,0.02,0.14,40
NDC,8068110000,GLUCOSE 3.75 GRAM CHEWABLE TABLET,0.56,0.36,0.08,0.56,40
NDC,8068111701,GLUCOSAMINE-CHONDROITIN 500 MG-400 MG CAPSULE,0.4,0.26,0.06,0.4,40
NDC,8068112600,B-COMPLEX WITH VITAMIN C TABLET,0.06,0.04,0.01,0.06,40
NDC,8068112900,ASCORBIC ACID (VITAMIN C) 250 MG CHEWABLE TABLET,0.06,0.04,0.01,0.06,40
NDC,8068113100,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) CAPSULE,0.08,0.05,0.01,0.08,40
NDC,8068113400,VITAMIN E (DL ACETATE) 45 MG (100 UNIT) CAPSULE,0.04,0.03,0.01,0.04,40
NDC,8068113500,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.06,0.04,0.01,0.06,40
NDC,8068114000,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.08,0.05,0.01,0.08,40
NDC,8068116900,CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1000 UNIT) TABLET,0.04,0.03,0.01,0.04,40
NDC,8072525001,HUMATIN 250 MG CAPSULE,291.74,189.63,43.41,291.74,40
NDC,8072561025,LEUKERAN 2 MG TABLET,1386.16,901.0,206.26,1386.16,40
NDC,8072562025,MYLERAN 2 MG TABLET,720.86,468.56,2.17,720.86,65
NDC,8072563025,TABLOID 40 MG TABLET,1297.52,843.39,193.07,1297.52,40
NDC,8073981218,KRAZATI 200 MG TABLET,301.24,195.81,44.82,301.24,40
NDC,8077711380,SPIKEVAX 2025-26 (6M-11Y) (PF) 25 MCG/0.25 ML INTRAMUSCULAR SYRINGE,1857.6,1207.44,7.93,1857.6,51
NDC,8080200055,MONOJECT DISPOSABLE SYRINGE 20 ML,0.94,0.61,0.14,0.94,39
NDC,8080431302,"""XEROFORM PETROLATUM OVERWRAP 1"""" X 8"""" BANDAGE""",1.8,1.17,0.27,1.8,40
NDC,8080431605,"""XEROFORM PETROLATUM OVERWRAP 5"""" X 9"""" BANDAGE""",3.8,2.47,0.57,3.8,40
NDC,8080432000,"""XEROFORM PETROLATUM DRESSING 4"""" X 3 YARD""",14.9,9.69,2.22,14.9,40
NDC,8080433301,"""XEROFORM PETROLATUM DRESSING 1"""" X 8""""""",1.86,1.21,0.28,1.86,40
NDC,8080433501,"""XEROFORM PETROLATUM DRESSING 4"""" X 4""""""",2.64,1.72,0.39,2.64,40
NDC,8083023292,TRANEXAMIC ACID 1000 MG/100 ML(10 MG/ML)IN SOD CHLORISO IV PIGGYBACK,0.75,0.49,0.11,0.75,40
NDC,8083023293,TRANEXAMIC ACID 1000 MG/100 ML(10 MG/ML)IN SOD CHLORISO IV PIGGYBACK,0.75,0.49,0.11,0.75,40
NDC,8103300230,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,40
NDC,8103300240,ACETAMINOPHEN 325 MG/10.15 ML ORAL SOLUTION,0.33,0.21,0.05,0.33,40
NDC,8105213810,CYTALUX 3.2 MG/1.6 ML INTRAVENOUS SOLUTION,9562.5,6215.63,0.01,9562.5,49
NDC,8128431505,BLUDIGO 8 MG/ML (0.8 %) INTRAVENOUS SOLUTION,288.0,187.2,2.17,288.0,59
NDC,8129838901,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3084.0,2004.6,2.17,3084.0,65
NDC,8129886603,AK-FLUOR 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,51.84,33.7,7.71,51.84,39
NDC,8137003640,AVEENO SOOTHING BATH PACKET,1.6,1.04,0.24,1.6,40
NDC,8148180301,ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION,322200.0,209430.0,2.17,322200.0,65
NDC,8164392701,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,17474.92,11358.7,2.17,17474.92,57
NDC,8166520301,SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,360.0,234.0,53.57,360.0,40
NDC,8186410130,OJJAARA 200 MG TABLET,2372.82,1542.33,353.08,2372.82,40
NDC,8186410230,OJJAARA 150 MG TABLET,2372.82,1542.33,353.08,2372.82,40
NDC,8186410330,OJJAARA 100 MG TABLET,2372.82,1542.33,353.08,2372.82,40
NDC,8196003103,PEMGARDA (EUA) 125 MG/ML INTRAVENOUS SOLUTION,635.01,412.76,138.43,15274.29,51
NDC,8196420501,AMOXICILLIN 500 MG CAPSULE,0.9,0.59,0.13,0.9,40
NDC,8196804530,AUVELITY 45 MG-105 MG TABLET EXTENDED RELEASE,49.92,32.45,7.43,49.92,40
NDC,8212427181,ILEX SKIN PROTECTANT TOPICAL PASTE,0.24,0.16,0.04,0.24,40
NDC,8213009005,IODOFLEX 0.9 % TOPICAL PADS,16.24,10.56,2.42,16.24,40
NDC,8226029910,LOTEPREDNOL ETABONATE 0.5 % EYE DROPSSUSPENSION,102.58,66.68,15.26,102.58,40
NDC,8234704055,DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL 12 HOUR PATCH,24.5,15.93,3.65,24.5,40
NDC,82415501300,ZINC OXIDE-METHYL SALICYLATE-EUCALYPTOL-CLOVE OIL OINTMENT,0.08,0.05,0.01,0.08,40
NDC,8244805018,OGSIVEO 50 MG TABLET,417.6,271.44,62.14,417.6,40
NDC,8244810014,OGSIVEO 100 MG TABLET,1327.98,863.19,41.42,1327.98,48
NDC,8244813042,GOMEKLI 1 MG CAPSULE,534.6,347.49,41.42,534.6,51
NDC,8244813442,GOMEKLI 1 MG TABLET FOR ORAL SUSPENSION,534.6,347.49,79.55,534.6,40
NDC,8244815014,OGSIVEO 150 MG TABLET,1327.98,863.19,41.42,1327.98,48
NDC,8244826042,GOMEKLI 2 MG CAPSULE,1069.2,694.98,41.42,1069.2,51
NDC,8262588011,MOVANTIK 12.5 MG TABLET,34.92,22.7,5.2,34.92,40
NDC,8262588021,MOVANTIK 25 MG TABLET,34.92,22.7,5.2,34.92,40
NDC,8262588023,MOVANTIK 25 MG TABLET,34.92,22.7,5.2,34.92,40
NDC,8266720001,IOPIDINE 1 % EYE DROPS IN A DROPPERETTE,66.54,43.25,9.9,66.54,40
NDC,8266760005,MAXIDEX 0.1 % EYE DROPSSUSPENSION,33.12,21.53,4.93,33.12,40
NDC,8266780001,TRIESENCE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,2606.4,1694.16,2.17,2606.4,59
NDC,8270500201,EPKINLY 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,8405.0,5463.25,2.17,8405.0,65
NDC,8270501001,EPKINLY 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,100859.76,65558.84,2.17,100859.76,65
NDC,8273707301,APHEXDA 62 MG SUBCUTANEOUS SOLUTION,21240.0,13806.0,2.17,21240.0,65
NDC,8282900201,IZERVAY (PF) 2 MG/0.1 ML INTRAVITREAL SOLUTION,75600.0,49140.0,2.17,75600.0,65
NDC,8290094010,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.18,0.12,0.03,0.18,40
NDC,8290301032,BD SYRINGE SLIP TIP NON-STERILE 20 ML,1.02,0.66,0.15,1.02,39
NDC,8290301604,BD SLIP TIP SYRINGE 10 ML,0.36,0.23,0.05,0.36,39
NDC,8290302831,B-D SLIP TIP SYRINGE 20 ML,1.54,1.0,0.23,1.54,39
NDC,8290302832,LUER-LOK TIP 30 ML SYRINGE,1.44,0.94,0.21,1.44,39
NDC,8290302995,BD LUER-LOK SYRINGE 10 ML,0.2,0.13,0.03,0.2,39
NDC,8290305196,"""BD REGULAR BEVEL NEEDLES 18 GAUGE X 1 1/2""""""",0.32,0.21,0.05,0.32,39
NDC,8290305201,"""BD FILTER NEEDLE 5-MIRCON NOKOR POINT 18 GAUGE X 1 1/2""""""",0.62,0.4,0.09,0.62,40
NDC,8290305211,"""FILTER NEEDLES 18 GAUGE X 1 1/2""""""",0.72,0.47,0.11,0.72,40
NDC,8290305617,BD LUER-LOK BULK SYRINGE 20 ML,1.0,0.65,0.15,1.0,39
NDC,8290305618,SYRINGE (DISPOSABLE) 30 ML,0.14,0.09,0.02,0.14,39
NDC,8290305620,"""BD TUBERCULIN SYRINGE 1/2 ML 27 X 1/2""""""",0.48,0.31,0.07,0.48,39
NDC,8290306413,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.84,0.55,0.04,8.86,51
NDC,8290306414,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.48,0.31,0.04,8.86,51
NDC,8290306424,HEPARIN LOCK FLUSH (PORCINE) (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.51,0.33,0.04,8.86,51
NDC,8290306544,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.54,0.35,0.08,0.54,40
NDC,8290306545,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.33,0.21,0.05,0.33,40
NDC,8290306546,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.18,0.12,0.03,0.18,40
NDC,8290306547,NORMAL SALINE FLUSH 0.9 % INJECTION SYRINGE,0.18,0.12,0.03,0.18,40
NDC,8290306553,NORMAL SALINE FLUSH 0.9 % INJECTION SYRINGE,0.45,0.29,0.07,0.45,40
NDC,8290308341,SYRINGE LUER TIP CAP,0.14,0.09,0.02,0.14,39
NDC,8290309605,BD SYRINGE LUER-LOK STERILE 10 ML,0.88,0.57,0.13,0.88,39
NDC,8290309644,"""BD LUER-LOK SYRINGE 10 ML 20 X 1""""""",0.66,0.43,0.1,0.66,39
NDC,8290309680,BD SYRINGE LUER-LOK STERILE 50 ML,2.28,1.48,0.34,2.28,39
NDC,8295911101,RYTELO 188 MG INTRAVENOUS SOLUTION,49966.0,32477.9,2.17,49966.0,65
NDC,8295911201,RYTELO 47 MG INTRAVENOUS SOLUTION,12491.52,8119.49,2.17,12491.52,65
NDC,8304741004,AUCATZYL INTRAVENOUS SUSPENSION,2520000.0,1638000.0,8866.62,2520000.0,47
NDC,8309000310,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.56,1.01,0.02,8.86,51
NDC,8310702204,PRAMOSONE 1 %-1 % LOTION,8.24,5.36,1.23,8.24,40
NDC,8320500012,TECELRA 2.68X 10EXP9 TO 10X 10EXP9 CELL INTRAVENOUS SUSPENSION,3489600.0,2268240.0,0.02,3489600.0,58
NDC,8325700111,OGIVRI 150 MG INTRAVENOUS SOLUTION,4514.44,2934.39,2.17,4514.44,65
NDC,8325700412,OGIVRI 420 MG INTRAVENOUS SOLUTION,12600.24,8190.16,2.17,12600.24,65
NDC,8325700541,FULPHILA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,12525.0,8141.25,2.17,12525.0,65
NDC,8325702541,YESINTEK 90 MG/ML SUBCUTANEOUS SYRINGE,10799.94,7019.96,24.68,10799.94,59
NDC,8325702611,YESINTEK 130 MG/26 ML INTRAVENOUS SOLUTION,55.38,36.0,12.24,4487.68,59
NDC,8345701210,OSPOMYV 60 MG/ML SUBCUTANEOUS SYRINGE,3510.0,2281.5,522.29,3510.0,40
NDC,8349020760,HYPER-SAL 7 % SOLUTION FOR NEBULIZATION,0.46,0.3,0.07,0.46,40
NDC,8349030760,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.18,0.12,0.03,0.18,40
NDC,8385110030,FLUORESCEIN 1 MG EYE STRIPS,0.48,0.31,0.07,0.48,40
NDC,8438311001,LENTOCILIN S  1.2 MILLION UNIT IM SUSPENSION,52.38,34.05,7.79,52.38,40
NDC,8452100686,VASELINE WHITE PETROLEUM TOPICAL OINTMENT IN PACKET,0.12,0.08,0.02,0.12,40
NDC,8452701492,"""XEROFORM PETROLATUM DRESSING 1"""" X 8""""""",1.86,1.21,0.28,1.86,40
NDC,8461206601,WEZLANA 130 MG/26 ML INTRAVENOUS SOLUTION,27.69,18.0,6.12,4487.68,59
NDC,8541203196,BAG EMPTY VIAFLEX 250 ML,7.76,5.04,1.15,7.76,39
NDC,8541229561,BAG EMPTY INTRAVIA 500 ML,3.9,2.54,0.58,3.9,39
NDC,8541229578,BAG EMPTY INTRAVIA 250 ML,3.84,2.5,0.57,3.84,39
NDC,8541246162,EMPTY CONTAINER BOTTLE,10.75,6.99,1.6,10.75,40
NDC,8544508321,SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE,856.47,556.71,127.44,856.47,40
NDC,8544636971,HEALON PRO 10 MG/ML INTRAOCULAR SYRINGE,654.54,425.45,97.4,654.54,40
NDC,8544636981,HEALON PRO 10 MG/ML INTRAOCULAR SYRINGE,588.72,382.67,87.6,588.72,40
NDC,8765176030,AZO BORIC ACID 600 MG VAGINAL SUPPOSITORY,1.38,0.9,0.21,1.38,40
NDC,8770140065,GLYCERIN 99.5 % TOPICAL SOLUTION,0.13,0.08,0.02,0.13,40
NDC,8770140073,GENTIAN VIOLET 1 % TOPICAL SOLUTION,0.18,0.12,0.03,0.18,40
NDC,8770140729,VITAMIN B-1 100 MG TABLET,0.1,0.07,0.01,0.1,40
NDC,8770140730,VITAMIN B-6 100 MG TABLET,0.1,0.07,0.01,0.1,40
NDC,8770140731,CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET,0.1,0.07,0.01,0.1,40
NDC,8770140734,BIOTIN 5 MG CAPSULE,0.18,0.12,0.03,0.18,40
NDC,8770140752,VITAMIN D3 125 MCG (5000 UNIT) TABLET,0.18,0.12,0.03,0.18,40
NDC,8770140753,VITAMIN E (DL ACETATE) 90 MG (200 UNIT) CAPSULE,0.2,0.13,0.03,0.2,40
NDC,8770140754,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.2,0.13,0.03,0.2,40
NDC,8770140813,MELATONIN 3 MG TABLET,0.08,0.05,0.01,0.08,40
NDC,8770140816,COENZYME Q10 100 MG CAPSULE,0.94,0.61,0.14,0.94,40
NDC,8770142510,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.36,0.23,0.05,0.36,40
NDC,8884430100,WHITE PETROLEUM JELLY TOPICAL,0.1,0.07,0.01,0.1,40
NDC,8884433605,"""XEROFORM PETROLATUM DRESSING 5"""" X 9""""""",2.76,1.79,0.41,2.76,40
NDC,88888000066,NITROGLYCERIN INTRACORONARY 0.2 MG/ML,2.88,1.87,0.43,8.86,51
NDC,89122049663,HYMOVIS 24 MG/3 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,2.17,860.4,65
NDC,89122072412,HYALGAN 10 MG/ML INTRA-ARTICULAR SOLUTION,342.0,222.3,2.17,342.0,51
NDC,89122072420,HYALGAN 10 MG/ML INTRA-ARTICULAR SYRINGE,342.0,222.3,2.17,342.0,51
NDC,8913020201,DUROLANE 60 MG/3 ML INTRA-ARTICULAR SYRINGE,1338.0,869.7,2.17,1338.0,65
NDC,8913031111,GELSYN-3  16.8 MG/2 ML INTRA-ARTICULAR SYRINGE,698.4,453.96,0.67,698.4,59
NDC,8913044441,SUPARTZ FX 10 MG/ML INTRA-ARTICULAR SYRINGE,341.58,222.03,2.17,341.58,51
NDC,9697400002,MG-PLUS-PROTEIN 133 MG TABLET,0.16,0.1,0.02,0.16,40
NDC,9866900201,OASIS MOISTURIZING MOUTH 35 % MUCOSAL SPRAY,0.48,0.31,0.07,0.48,40
NDC,9999003590,SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,0.15,0.1,0.02,0.15,40
NDC,9999103016,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,0.48,0.31,0.07,0.48,40
NDC,9999317763,DEXAMETHASONE ORAL LIQUID 0.5 MG/5 ML ADS,0.13,0.08,0.02,0.13,40
NDC,9999545209,SENNOSIDES ORAL LIQUID 8.8 MG/5 ML ADS,0.13,0.08,0.02,0.13,40
NDC,9999568216,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,1.28,0.83,0.19,1.28,40
NDC,99998020218,MIDAZOLAM 2 MG/ML ORAL SYRUP,1.73,1.12,0.26,1.73,40
NDC,9999998266,ACETYLCHOLINE 10% SOLUTION - CCHS COMPOUNDING,0.5,0.33,0.07,0.5,40